THE OFFICIAL PATIENT’S SOURCEBOOK
on
LU NFECTION J AMES N. P ARKER , M.D. AND P HILIP M. P ARKER , P H .D., E DITORS
ii
ICON Health Publications ICON Group International, Inc. 4370 La Jolla Village Drive, 4th Floor San Diego, CA 92122 USA Copyright Ó2002 by ICON Group International, Inc. Copyright Ó2002 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: Tiffany LaRochelle 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 as a substitute for consultation with your physician. All matters regarding your health require medical supervision. 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, in close consultation with a qualified physician. The reader is advised to always check product information (package inserts) for changes and new information regarding dose and contraindications before taking 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., 1960The Official Patient’s Sourcebook on Flu Infection: A Revised and Updated Directory for the Internet Age/James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary and index. ISBN: 0-597-83448-2 1. Flu Infection-Popular works. I. Title.
iii
Disclaimer This publication is not intended to be used for the diagnosis or treatment of a health problem or as a substitute for consultation with licensed medical professionals. 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, or the authors are not responsible for the content of any Web pages nor publications referenced in this publication.
Copyright Notice If a physician wishes to copy limited passages from this sourcebook for patient use, this right is automatically granted without written permission from ICON Group International, Inc. (ICON Group). However, all of ICON Group publications are copyrighted. 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 sourcebook.
iv
Dedication To the healthcare professionals dedicating their time and efforts to the study of flu infection.
Acknowledgements The collective knowledge generated from academic and applied research summarized in various references has been critical in the creation of this sourcebook which is best viewed as a comprehensive compilation and collection of information prepared by various official agencies which directly or indirectly are dedicated to flu infection. All of the Official Patient’s Sourcebooks 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 sourcebook. 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 LaRochelle for her excellent editorial support.
v
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 the Official Patient’s Sourcebook series published 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 the Official Patient’s Sourcebook series published by ICON Health Publications.
vi
About ICON Health Publications In addition to flu infection, Official Patient’s Sourcebooks are available for the following related topics: ·
The Official Patient's Sourcebook on Common Cold
·
The Official Patient's Sourcebook on Pneumonia
·
The Official Patient's Sourcebook on Primary Immunodeficiency
·
The Official Patient's Sourcebook on Sinusitis
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
Contents vii
Table of Contents INTRODUCTION...................................................................................... 1
Overview............................................................................................................... 1 Organization......................................................................................................... 3 Scope ..................................................................................................................... 3 Moving Forward................................................................................................... 4
PART I: THE ESSENTIALS ................................................. 7 CHAPTER 1. THE ESSENTIALS ON FLU INFECTION: GUIDELINES ......... 9
Overview............................................................................................................... 9 What Is the Flu? ................................................................................................. 10 When and Where Do People Usually Get the Flu?............................................ 11 Is the Flu an Important Disease? ....................................................................... 11 How is the Flu Transmitted?.............................................................................. 11 What are Flu Symptoms? ................................................................................... 12 How Does a Doctor Diagnose the Flu? .............................................................. 12 How Can I Keep from Getting the Flu? ............................................................. 13 Medicine for Prevention ..................................................................................... 14 Flu Treatments ................................................................................................... 15 Medicine for Treatment ...................................................................................... 16 What are Possible Complications from the Flu? ................................................ 16 Flu Complications Affecting Children ............................................................... 17 Are There Different Types of Flu Viruses? ........................................................ 17 Flu Pandemics in the 20th Century ................................................................... 17 Research .............................................................................................................. 18 Where Can I Get More Information about the Flu?........................................... 19 More Guideline Sources ..................................................................................... 19 Vocabulary Builder............................................................................................. 25
CHAPTER 2. SEEKING GUIDANCE ....................................................... 33
Overview............................................................................................................. 33 Associations and Flu Infection ........................................................................... 33 Finding Associations .......................................................................................... 34 Finding Doctors.................................................................................................. 36 Finding Specialists.............................................................................................. 37 Selecting Your Doctor ........................................................................................ 37 Working with Your Doctor ................................................................................ 38 Broader Health-Related Resources ..................................................................... 39
CHAPTER 3. CLINICAL TRIALS AND FLU INFECTION.......................... 41
Overview............................................................................................................. 41 Recent Trials on Flu Infection ............................................................................ 44 Benefits and Risks............................................................................................... 49 Keeping Current on Clinical Trials.................................................................... 52
viii Contents
General References.............................................................................................. 53 Vocabulary Builder............................................................................................. 54
PART II: ADDITIONAL RESOURCES AND ADVANCED MATERIAL.................................................. 57 CHAPTER 4. STUDIES ON FLU INFECTION ........................................... 59
Overview............................................................................................................. 59 The Combined Health Information Database ..................................................... 59 Federally-Funded Research on Flu Infection...................................................... 65 E-Journals: PubMed Central .............................................................................. 67 The National Library of Medicine: PubMed ...................................................... 73 Vocabulary Builder............................................................................................. 74
CHAPTER 5. PATENTS ON FLU INFECTION.......................................... 81
Overview............................................................................................................. 81 Patents on Flu Infection ..................................................................................... 82 Patent Applications on Flu Infection ................................................................. 83 Keeping Current ................................................................................................. 85 Vocabulary Builder............................................................................................. 86
CHAPTER 6. BOOKS ON FLU INFECTION ............................................. 89
Overview............................................................................................................. 89 Book Summaries: Federal Agencies .................................................................... 89 Book Summaries: Online Booksellers ................................................................. 90 The National Library of Medicine Book Index ................................................... 92 Chapters on Flu Infection ................................................................................... 95 Directories........................................................................................................... 96 General Home References ................................................................................... 97 Vocabulary Builder............................................................................................. 98
CHAPTER 7. MULTIMEDIA ON FLU INFECTION................................. 101
Overview........................................................................................................... 101 Video Recordings .............................................................................................. 101 Bibliography: Multimedia on Flu Infection...................................................... 102 Vocabulary Builder........................................................................................... 103
CHAPTER 8. PERIODICALS AND NEWS ON FLU INFECTION.............. 105
Overview........................................................................................................... 105 News Services & Press Releases ....................................................................... 105 Newsletter Articles ........................................................................................... 114 Academic Periodicals covering Flu Infection ................................................... 115
CHAPTER 9. PHYSICIAN GUIDELINES AND DATABASES ................... 119
Overview........................................................................................................... 119 NIH Guidelines................................................................................................. 119 NIH Databases.................................................................................................. 120 Other Commercial Databases ........................................................................... 125 The Genome Project and Flu Infection ............................................................. 126
Contents
ix
Specialized References....................................................................................... 130 Vocabulary Builder........................................................................................... 131
CHAPTER 10. DISSERTATIONS ON FLU INFECTION ........................... 133
Overview........................................................................................................... 133 Dissertations on Flu Infection .......................................................................... 133 Keeping Current ............................................................................................... 134 Vocabulary Builder........................................................................................... 134
PART III. APPENDICES .................................................. 137 APPENDIX A. RESEARCHING YOUR MEDICATIONS.......................... 139
Overview........................................................................................................... 139 Your Medications: The Basics .......................................................................... 140 Learning More about Your Medications .......................................................... 141 Commercial Databases...................................................................................... 166 Contraindications and Interactions (Hidden Dangers) ................................... 172 A Final Warning .............................................................................................. 173 General References............................................................................................ 173 Vocabulary Builder........................................................................................... 174
APPENDIX B. RESEARCHING ALTERNATIVE MEDICINE ................... 181
Overview........................................................................................................... 181 What Is CAM? ................................................................................................. 181 What Are the Domains of Alternative Medicine?............................................ 182 Can Alternatives Affect My Treatment? ......................................................... 185 Finding CAM References on Flu Infection ...................................................... 186 Additional Web Resources................................................................................ 196 General References............................................................................................ 269 Vocabulary Builder........................................................................................... 269
APPENDIX C. RESEARCHING NUTRITION ......................................... 279
Overview........................................................................................................... 279 Food and Nutrition: General Principles........................................................... 280 Finding Studies on Flu Infection...................................................................... 284 Federal Resources on Nutrition........................................................................ 287 Additional Web Resources................................................................................ 287 Vocabulary Builder........................................................................................... 313
APPENDIX D. FINDING MEDICAL LIBRARIES.................................... 315
Overview........................................................................................................... 315 Preparation ....................................................................................................... 315 Finding a Local Medical Library ...................................................................... 316 Medical Libraries Open to the Public............................................................... 316
APPENDIX E. YOUR RIGHTS AND INSURANCE ................................. 323
Overview........................................................................................................... 323 Your Rights as a Patient................................................................................... 323 Patient Responsibilities .................................................................................... 327
x
Contents
Choosing an Insurance Plan............................................................................. 328 Medicare and Medicaid .................................................................................... 330 NORD’s Medication Assistance Programs ..................................................... 333 Additional Resources ........................................................................................ 334 Vocabulary Builder........................................................................................... 335
ONLINE GLOSSARIES.................................................... 337 Online Dictionary Directories.......................................................................... 345
FLU INFECTION GLOSSARY........................................ 347 General Dictionaries and Glossaries ................................................................ 383
INDEX................................................................................... 385
Introduction
1
INTRODUCTION Overview Dr. C. Everett Koop, former U.S. Surgeon General, once said, “The best prescription is knowledge.”1 The Agency for Healthcare Research and Quality (AHRQ) of the National Institutes of Health (NIH) echoes this view and recommends that every patient incorporate education into the treatment process. According to the AHRQ: Finding out more about your condition is a good place to start. By contacting groups that support your condition, visiting your local library, and searching on the Internet, you can find good information to help guide your treatment decisions. Some information may be hard to find—especially if you don’t know where to look.2 As the AHRQ mentions, finding the right information is not an obvious task. Though many physicians and public officials had thought that the emergence of the Internet would do much to assist patients in obtaining reliable information, 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.3
Quotation from http://www.drkoop.com. The Agency for Healthcare Research and Quality (AHRQ): http://www.ahcpr.gov/consumer/diaginfo.htm. 3 From the NIH, National Cancer Institute (NCI): http://cancertrials.nci.nih.gov/beyond/evaluating.html. 1 2
2
Flu Infection
Since the late 1990s, physicians have seen a general increase in patient Internet usage rates. Patients frequently enter their doctor’s offices with printed Web pages of home remedies in the guise of latest medical research. This scenario is so common that doctors often spend more time dispelling misleading information than guiding patients through sound therapies. The Official Patient’s Sourcebook on Flu Infection has been created for patients who have decided to make education and research an integral part of the treatment process. The pages that follow will tell you where and how to look for information covering virtually all topics related to flu infection, from the essentials to the most advanced areas of research. The title of this book includes the word “official.” This reflects the fact that the sourcebook draws from public, academic, government, and peerreviewed research. Selected readings from various agencies are reproduced to give you some of the latest official information available to date on flu infection. Given patients’ increasing sophistication in using the Internet, abundant references to reliable Internet-based resources are provided throughout this sourcebook. Where possible, guidance is provided on how to obtain free-ofcharge, primary research results as well as more detailed information via the Internet. E-book and electronic versions of this sourcebook are fully interactive with each of the Internet sites mentioned (clicking on a hyperlink automatically opens your browser to the site indicated). Hard copy users of this sourcebook can type cited Web addresses directly into their browsers to obtain access to the corresponding sites. Since we are working with ICON Health Publications, hard copy Sourcebooks are frequently updated and printed on demand to ensure that the information provided is current. In addition to extensive references accessible via the Internet, every chapter presents a “Vocabulary Builder.” Many health guides offer glossaries of technical or uncommon terms in an appendix. In editing this sourcebook, we have decided to place a smaller glossary within each chapter that covers terms used in that chapter. Given the technical nature of some chapters, you may need to revisit many sections. Building one’s vocabulary of medical terms in such a gradual manner has been shown to improve the learning process. We must emphasize that no sourcebook on flu infection should affirm that a specific diagnostic procedure or treatment discussed in a research study, patent, or doctoral dissertation is “correct” or your best option. This sourcebook is no exception. Each patient is unique. Deciding on appropriate
Introduction
3
options is always up to the patient in consultation with their physician and healthcare providers.
Organization This sourcebook is organized into three parts. Part I explores basic techniques to researching flu infection (e.g. finding guidelines on diagnosis, treatments, and prognosis), followed by a number of topics, including information on how to get in touch with organizations, associations, or other patient networks dedicated to flu infection. It also gives you sources of information that can help you find a doctor in your local area specializing in treating flu infection. Collectively, the material presented in Part I is a complete primer on basic research topics for patients with flu infection. Part II moves on to advanced research dedicated to flu infection. Part II is intended for those willing to invest many hours of hard work and study. It is here that we direct you to the latest scientific and applied research on flu infection. When possible, contact names, links via the Internet, and summaries are provided. It is in Part II where the vocabulary process becomes important as authors publishing advanced research frequently use highly specialized language. In general, every attempt is made to recommend “free-to-use” options. Part III provides appendices of useful background reading for all patients with flu infection or related disorders. The appendices are dedicated to more pragmatic issues faced by many patients with flu infection. Accessing materials via medical libraries may be the only option for some readers, so a guide is provided for finding local medical libraries which are open to the public. Part III, therefore, focuses on advice that goes beyond the biological and scientific issues facing patients with flu infection.
Scope While this sourcebook covers flu infection, your doctor, research publications, and specialists may refer to your condition using a variety of terms. Therefore, you should understand that flu infection is often considered a synonym or a condition closely related to the following: ·
Acute Catarrhal Fever
·
Asian Flu
·
Asian Flu Type a
4
Flu Infection
·
Asian Flu Type B
·
Flu
·
Grip
·
Influenza a
·
Influenza B
In addition to synonyms and related conditions, physicians may refer to flu infection using certain coding systems. The International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) is the most commonly used system of classification for the world’s illnesses. Your physician may use this coding system as an administrative or tracking tool. The following classification is commonly used for flu infection:4 ·
487 influenza
·
487.1 influenza
·
487.1 influenza w/ upper respiratory symptoms
For the purposes of this sourcebook, we have attempted to be as inclusive as possible, looking for official information for all of the synonyms relevant to flu infection. You may find it useful to refer to synonyms when accessing databases or interacting with healthcare professionals and medical librarians.
Moving Forward Since the 1980s, the world has seen a proliferation of healthcare guides covering most illnesses. Some are written by patients or their family members. These generally take a layperson’s approach to understanding and coping with an illness or disorder. They can be uplifting, encouraging, and highly supportive. Other guides are authored by physicians or other healthcare providers who have a more clinical outlook. Each of these two styles of guide has its purpose and can be quite useful. As editors, we have chosen a third route. We have chosen to expose you to as many sources of official and peer-reviewed information as practical, for the purpose of educating you about basic and advanced knowledge as 4 This list is based on the official version of the World Health Organization’s 9th Revision, International Classification of Diseases (ICD-9). According to the National Technical Information Service, “ICD-9CM extensions, interpretations, modifications, addenda, or errata other than those approved by the U.S. Public Health Service and the Health Care Financing Administration are not to be considered official and should not be utilized. Continuous maintenance of the ICD-9-CM is the responsibility of the federal government.”
Introduction
5
recognized by medical science today. You can think of this sourcebook as your personal Internet age reference librarian. Why “Internet age”? All too often, patients diagnosed with flu infection will log on to the Internet, type words into a search engine, and receive several Web site listings which are mostly irrelevant or redundant. These patients are left to wonder where the relevant information is, and how to obtain it. Since only the smallest fraction of information dealing with flu infection is even indexed in search engines, a non-systematic approach often leads to frustration and disappointment. With this sourcebook, we hope to direct you to the information you need that you would not likely find using popular Web directories. Beyond Web listings, in many cases we will reproduce brief summaries or abstracts of available reference materials. These abstracts often contain distilled information on topics of discussion. While we focus on the more scientific aspects of flu infection, there is, of course, the emotional side to consider. Later in the sourcebook, we provide a chapter dedicated to helping you find peer groups and associations that can provide additional support beyond research produced by medical science. We hope that the choices we have made give you the most options available in moving forward. In this way, we wish you the best in your efforts to incorporate this educational approach into your treatment plan. The Editors
7
PART I: THE ESSENTIALS
ABOUT PART I Part I has been edited to give you access to what we feel are “the essentials” on flu infection. The essentials of a disease typically include the definition or description of the disease, a discussion of who it affects, the signs or symptoms associated with the disease, tests or diagnostic procedures that might be specific to the disease, and treatments for the disease. Your doctor or healthcare provider may have already explained the essentials of flu infection to you or even given you a pamphlet or brochure describing flu infection. Now you are searching for more in-depth information. As editors, we have decided, nevertheless, to include a discussion on where to find essential information that can complement what your doctor has already told you. In this section we recommend a process, not a particular Web site or reference book. The process ensures that, as you search the Web, you gain background information in such a way as to maximize your understanding.
Guidelines
9
CHAPTER 1. THE ESSENTIALS ON FLU INFECTION: GUIDELINES Overview Official agencies, as well as federally-funded institutions supported by national grants, frequently publish a variety of guidelines on flu infection. 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. The great advantage of guidelines over other sources is that they are often written with the patient in mind. Since new guidelines on flu infection 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.
The National Institutes of Health (NIH)5 The National Institutes of Health (NIH) is the first place to search for relatively current patient guidelines and fact sheets on flu infection. Originally founded in 1887, the NIH is one of the world’s foremost medical research centers and the federal focal point for medical research in the United States. At any given time, the NIH supports some 35,000 research grants at universities, medical schools, and other research and training institutions, both nationally and internationally. The rosters of those who have conducted research or who have received NIH support over the years include the world’s most illustrious scientists and physicians. Among them are 97 scientists who have won the Nobel Prize for achievement in medicine.
5
Adapted from the NIH: http://www.nih.gov/about/NIHoverview.html.
10 Flu Infection
There is no guarantee that any one Institute will have a guideline on a specific disease, though the National Institutes of Health collectively publish over 600 guidelines for both common and rare diseases. The best way to access NIH guidelines is via the Internet. Although the NIH is organized into many different Institutes and Offices, the following is a list of key Web sites where you are most likely to find NIH clinical guidelines and publications dealing with flu infection and associated conditions: ·
Office of the Director (OD); guidelines consolidated across agencies available at http://www.nih.gov/health/consumer/conkey.htm
·
National Library of Medicine (NLM); extensive encyclopedia (A.D.A.M., Inc.) with guidelines available at http://www.nlm.nih.gov/medlineplus/healthtopics.html
·
National Institute of Allergy and Infectious Diseases (NIAID); guidelines available at http://www.niaid.nih.gov/publications/
·
Centers for Disease Control and Prevention: various fact sheets on infectious diseases at http://www.cdc.gov/health/diseases.htm
Among the above, the National Institute of Allergy and Infectious Diseases (NIAID) is particularly noteworthy. The mission of the NIAID is to provide support for scientists conducting research aimed at developing better ways to diagnose, treat, and prevent the many infectious, immunologic and allergic diseases that afflict people worldwide.6 The NIAID is composed of four extramural divisions: the Division of AIDS; the Division of Allergy, Immunology and Transplantation; the Division of Microbiology and Infectious Diseases; and the Division of Extramural Activities. In addition, NIAID scientists conduct intramural research in laboratories located in Bethesda, Rockville and Frederick, Maryland, and in Hamilton, Montana. The following patient guideline was recently published by the NIAID on flu infection.
What Is the Flu?7 Influenza, or the flu, is a respiratory infection caused by a variety of flu viruses. The most familiar aspect of the flu is the way it can “knock you off your feet” as it sweeps through entire communities. This paragraph has been adapted from the NIAID: http://www.niaid.nih.gov/facts/overview.htm. “Adapted” signifies that a passage has been reproduced exactly or slightly edited for this book. 7 Adapted from The National Institute of Allergy and Infectious Diseases (NIAID): http://www.niaid.nih.gov/factsheets/flu.htm. 6
Guidelines 11
The flu differs in several ways from the common cold, a respiratory infection also caused by viruses. For example, people with colds rarely get fevers or headaches or suffer from the extreme exhaustion that flu viruses cause. The U.S. Centers for Disease Control and Prevention (CDC) estimates that 35 to 50 million Americans come down with the flu during each flu season, which typically lasts from November to March. Children are two to three times more likely than adults to get sick with the flu, and children frequently spread the virus to others. Although most people recover from the illness, CDC estimates that in the United States more than 100,000 people are hospitalized and more than 20,000 people die from the flu and its complications every year.
When and Where Do People Usually Get the Flu? Flu outbreaks usually begin suddenly and occur mainly in the late fall and winter. The disease spreads through communities creating an epidemic. During the epidemic, the number of cases peaks in about three weeks and subsides after another three or four weeks. Half of the population of a community may be affected. Because schools are an excellent place for flu viruses to attack and spread, families with school-age children have more infections than other families, with an average of one-third of the family members infected each year.
Is the Flu an Important Disease? Besides the rapid start of the outbreaks and the large numbers of people affected, the flu is an important disease because it can cause serious complications. Most people who get the flu get better within a week (although they may have a lingering cough and tire easily for a while longer). For elderly people, newborn babies, and people with certain chronic illnesses, however, the flu and its complications can be life threatening.
How is the Flu Transmitted? You can get the flu if someone around you who has the flu coughs or sneezes. You can get the flu simply by touching a surface like a telephone or doorknob that has been contaminated by a touch from someone who has the flu. The viruses can pass through the air and can enter your body through
12 Flu Infection
your nose or mouth. If you’ve touched a contaminated surface, they can pass from your hand to your nose or mouth. You are at greatest risk of getting infected in highly populated areas, such as in crowded living conditions and in schools.
What are Flu Symptoms? If you get infected by the flu virus, you will usually feel symptoms one to four days later. You can spread the flu to others before your symptoms start and for another three to four days after your symptoms appear. The symptoms start very quickly and are ·
Headache
·
Chills
·
Dry cough
·
Body aches
·
Fever
·
Stuffy nose
·
Sore throat
Typically, the fever begins to decline on the second or third day of the illness. The flu almost never causes symptoms in the stomach and intestines. The illness that some people often call “stomach flu” is not influenza.
How Does a Doctor Diagnose the Flu? Usually, doctors or other health care workers diagnose the flu on the basis of whether flu is epidemic in the community and whether the patient’s complaints fit the current pattern of symptoms. Doctors rarely use laboratory tests to identify the virus during an epidemic. Health officials, however, monitor certain U.S. health clinics and do laboratory tests to determine which type of flu virus is responsible for the epidemic.
Guidelines 13
How Can I Keep from Getting the Flu? Flu Vaccine The main way to keep from getting the flu is to get a yearly flu vaccine. You can get the vaccine at your doctor’s office or a local clinic, and in many communities at workplaces, supermarkets, and drugstores. You must get the vaccine every year because it changes. Scientists make a different vaccine every year because the strains of flu viruses change from year to year. Nine to 10 months before the flu season begins, they prepare a new vaccine made from inactivated (killed) flu viruses. Because the viruses are killed, they cannot cause infections. The vaccine preparation is based on the strains of the flu viruses that are in circulation at the time. It includes those A and B viruses (see section below on types of flu viruses) expected to circulate the following winter. Sometimes, an unpredicted new strain may appear after the vaccine has been made and distributed to doctors and clinics. Because of this, even if you do get the flu vaccine, you still may get infected. If you do get infected, however, the disease usually is milder because the vaccine still will give you some protection. Your immune system takes time to respond to the flu vaccine. Therefore, you should get vaccinated six to eight weeks before flu season begins to prevent getting infected or reduce the severity of flu if you do get it. The vaccine itself cannot cause the flu, but you could become exposed to the virus by someone else and get infected soon after you are vaccinated.
Are There Possible Side Effects from the Flu Vaccine? You should be aware that the flu vaccine can cause side effects. The most common side effect in children and adults is soreness at the site of the vaccination. Other side effects, especially in children who previously have not been exposed to the flu virus, include fever, tiredness, and sore muscles. These side effects may begin 6 to 12 hours after vaccination and may last for up to two days. Viruses for producing the vaccine are grown in chicken eggs and then killed with a chemical so that they can no longer cause an infection. The flu vaccine may contain some egg protein, which can cause an allergic reaction. Therefore, if you are allergic to eggs or have ever had a serious allergic
14 Flu Infection
reaction to the flu vaccine, CDC recommends that you consult with your doctor before getting vaccinated.
Who Should Get the Flu Vaccine? If you are in any of the following groups or live in a household with someone who is, CDC recommends that you get the flu vaccine. ·
You are 50 years of age or older.
·
You have chronic diseases of your heart, lungs, or kidneys.
·
You have diabetes.
·
Your immune system does not function properly.
·
You have a severe form of anemia.
·
You will be more than three months pregnant during the flu season.
·
You live in a nursing home or other chronic-care housing facility.
The vaccine can be administered to children as young as six months old. Children should get the flu vaccine if they are taking long-term aspirin treatment as they may be at risk of developing Reye’s syndrome following a flu infection (see section on complications in children). They should also get the flu vaccine if they live in a household with someone in the above groups. Health care workers and volunteers should get the flu vaccine if they work with patients in any of the above groups.
Medicine for Prevention Although the flu vaccine is the best way to prevent getting the flu, three antiviral medicines also are available by prescription that will help prevent flu infection: ·
Tamiflu® (oseltamivir)
·
Flumadine® (rimantadine)
·
Symmetrel® (amantadine)
The Food and Drug Administration (FDA) has approved Tamiflu® for use in adults and adolescents 13 years and older. Rimantadine and amantadine
Guidelines 15
have been approved for use by adults and children who are 1 year of age and older. Rimantadine and amantadine have unpleasant side effects. Your doctor can help you decide which medicine is best for you. ·
These medicines help prevent the flu if you take them for at least two weeks during the outbreak of flu in your community.
·
You may use these medicines if you are in close contact with family members or others who have the flu.
·
You may use them if you are in close contact with people who have been vaccinated but whom you want to give added protection from getting the flu.
·
You may use either medicine immediately following flu vaccination during a flu epidemic to protect you during the two- to four-week period before antibodies (proteins from your immune system that protect you from the flu virus) develop or when a flu epidemic is caused by virus strains other than those covered by the vaccine.
You should discuss the flu vaccine and the medicines with your doctor before the flu season begins.
Flu Treatments Many people treat their flu infections by simply: ·
Resting in bed
·
Drinking plenty of fluids
·
Taking over-the-counter medicine such as aspirin or acetaminophen (Tylenol®, for example)
You should not give aspirin to children and adolescents who have the flu. You should not take antibiotics to treat the flu because they do not work on viruses. Antibiotics only work against some infections caused by bacteria.
16 Flu Infection
Medicine for Treatment If you do get the flu and want to take medicine to treat it, your doctor may prescribe one of four available antiviral medicines: ·
Tamiflu® (oseltamivir) helps adults 18 years and older and Relenza® (zanamivir) helps adults and children 7 years and older who have an uncomplicated flu infection and who have had symptoms for no more than two days. FDA recently approved Tamiflu® for use in children 1 year of age and older who have had symptoms for no more than two days. Both treat influenza type A and type B infections.
·
Flumadine® (rimantadine) helps adults who have influenza type A virus infections. It has no effect on influenza type B virus infections.
·
Symmetrel® (amantadine) can be taken by adults and children who are 1 year of age and older to prevent and treat type A or type B influenza virus infections. Amantadine, however, is more likely to cause side effects such as lightheadedness and inability to sleep more often than is rimantadine.
To work well, you must take these medicines within 48 hours after the flu begins. They reduce the length or time fever and other symptoms last and allow you to return to your daily routine quicker.
What are Possible Complications from the Flu? You can have flu complications if you get a bacterial infection, which causes pneumonia in your weakened lungs. Pneumonia also can be caused by the flu virus itself. Symptoms of complications will usually appear after you start feeling better. After a brief period of improvement, you may suddenly get: ·
High fever
·
Shaking chills
·
Chest pain with each breath
·
Coughing that produces thick, yellow-greenish-colored mucus
Pneumonia can be a very serious and sometimes life-threatening condition. If you have any of these symptoms, you should contact your doctor immediately so that you can get the appropriate treatment.
Guidelines 17
Flu Complications Affecting Children Reye’s syndrome, a condition that affects the nerves, sometimes develops in children and adolescents who are recovering from the flu. Reye’s syndrome begins with nausea and vomiting, but the progressive mental changes (such as confusion or delirium) cause the greatest concern. The syndrome often begins in young people after they take aspirin to get rid of fever or pain. Although very few children develop Reye’s syndrome, you should consult a doctor before giving aspirin or products that contain aspirin to children. Acetaminophen does not seem to be associated with Reye’s syndrome. Other complications of the flu that affect children are ·
Convulsions caused by fever
·
Croup
·
Ear infections, such as otitis media
Newborn babies recently out of intensive care units are particularly vulnerable to suffering from flu complications.
Are There Different Types of Flu Viruses? The first flu virus was identified in the 1930’s. Since then, scientists have classified flu viruses into types A, B, and C. Type A is the most common and usually causes the most serious epidemics. Type B outbreaks also can cause epidemics, but the disease it produces generally is milder than that caused by type A. Type C viruses, on the other hand, never have been connected with a large epidemic.
Flu Pandemics in the 20th Century If a flu virus emerges that is either new or that has not circulated in many years, and if it is able to spread easily from person to person, it could quickly travel around the world and cause serious illness and death for millions of people. This is called a flu pandemic.
18 Flu Infection
The 1918 Spanish flu pandemic is the catastrophe against which all modern pandemics are measured. More than 20 million people were killed worldwide; 500,000 died in the United States alone. This virus was especially quick to kill. So far, the world has not seen a virus that severe again. In 1957 and 1968, the Asian flu and Hong Kong flu, respectively, invaded the United States. Although hundreds of thousands of people in the United States died, the death toll for each pandemic was not as high as that for the Spanish flu . In 1976, the United States experienced a swine flu scare. When a new flu virus was first identified at Fort Dix, New Jersey, it was labeled the “killer flu,” and health experts were afraid that it would infect people around the world. In fact, swine flu never left the Fort Dix area. Research on the virus later showed that if it had spread, it would probably have been much less deadly than the Spanish flu. In 1997, another “near miss” pandemic occurred when 18 people in Hong Kong became ill from a new flu virus. Six of the infected people subsequently died. Usually, flu viruses move first from chickens to pigs, and then from pigs to humans. This virus was different because it moved directly from chickens to people. The avian flu never became a pandemic, however, because it didn’t easily spread from person to person. In addition, public health authorities ordered the slaughter of all live chickens in Hong Kong.
Research Although flu epidemics pop up in the fall and winter seasons in communities throughout the world every year, including the United States, there has not been a pandemic since 1968. Scientists are worried that a new flu virus will emerge in the 21st century and cause a severe pandemic again. For this reason, research institutions and health departments around the world are cooperating to track flu outbreaks in humans and animals, and to determine what types and strains of flu viruses are the causes. To prevent another flu pandemic and reduce the numbers of flu epidemics, the National Institute of Allergy and Infectious Diseases (NIAID) supports research to find out how influenza viruses work, and to develop better vaccines to prevent and treat influenza virus infections.
Guidelines 19
For more information on NIAID influenza research, see “Focus on the Flu” at www.niaid.nih.gov/spotlight/flu00/default.htm.
Where Can I Get More Information about the Flu? For more information, contact: National Institute on Aging Information Center 1-800-222-2225 http://www.nih.gov/nia Centers for Disease Control and Prevention (CDC) National Immunization Information Program 1-800-232-2522 http://www.cdc.gov/nip Food and Drug Administration (FDA) HFI-40 Rockville, MD 20857 1-888-INFO-FDA (1-888-463-6332) http://www.fda.gov
More Guideline Sources The guideline above on flu infection is only one example of the kind of material that you can find online and free of charge. The remainder of this chapter will direct you to other sources which either publish or can help you find additional guidelines on topics related to flu infection. Many of the guidelines listed below address topics that may be of particular relevance to your specific situation or of special interest to only some patients with flu infection. 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.
Topic Pages: MEDLINEplus For patients wishing to go beyond guidelines published by specific Institutes of the NIH, the National Library of Medicine has created a vast and patientoriented healthcare information portal called MEDLINEplus. Within this
20 Flu Infection
Internet-based system are “health topic pages.” You can think of a health topic page as a guide to patient guides. To access this system, log on to http://www.nlm.nih.gov/medlineplus/healthtopics.html. If you do not find topics of interest when browsing health topic pages, then you can choose to use the advanced search utility of MEDLINEplus at http://www.nlm.nih.gov/medlineplus/advancedsearch.html. This utility is similar to the NIH Search Utility, with the exception that it only includes material 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 flu infection and related conditions. One of the advantages of CHID over other sources is that it 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: ·
Immunizations: Not Just Kids' Stuff Source: St. Paul, MN: Immunization Action Coalition. 1997. 1 p. Contact: Available from Hepatitis B Coalition. 1573 Selby Avenue, Suite 229, St. Paul, MN 55104. (612) 647-9009. Fax (612) 647-9131. Price: $1.00. Summary: This reproducible brochure reviews some communicable diseases and the immunizations available to prevent them. The brochure reminds adult readers that getting immunized is a lifelong, life-protecting job. The brochure briefly describes each disease and then notes the vaccines and the recommendations for each. Included are: hepatitis B, MMR (measles, mumps, rubella), polio, Td (tetanus, diphtheria), varicella (chicken pox), hepatitis A, influenza vaccine (flu shot), and pneumococcal vaccine. The last page of the brochure features a blank immunization record and encourages readers to keep tract of their own immunization history. The brochure is illustrated with humorous line drawings.
Guidelines 21
·
What You Should Know About Infectious Diseases: A Guide for Hemodialysis Patients and Their Families Source: New York, NY: National Kidney Foundation. 1996. 13 p. Contact: Available from National Kidney Foundation. 30 East 33rd Street, New York, NY 10016. (800) 622-9010. Price: Single copy free. Summary: This booklet reviews information about infectious diseases that is relevant to hemodialysis patients and their families. Written in nontechnical language, the booklet discusses hepatitis B, hepatitis C, human immunodeficiency virus (HIV), other infectious diseases (flu, pneumonia, and tuberculosis), vaccinations, and preventing infection of the hemodialysis access site. For each infectious disease, the author describes the symptoms, the transmission, treatment options, and preventive measures. 1 table.
The National Guideline Clearinghouse™ The National Guideline Clearinghouse™ offers hundreds of evidence-based clinical practice guidelines published in the United States and other countries. You can search their site located at http://www.guideline.gov by using the keyword “flu infection” or synonyms. The following was recently posted: ·
Immunization and the prevention of influenza and pneumococcal disease in people with diabetes. Source: American Diabetes Association.; 1999 October (republished 2002 Jan); 3 pages http://www.guideline.gov/FRAMESETS/guideline_fs.asp?guideline=00 2368&sSearch_string=flu
Healthfinder™ Healthfinder™ is an additional source sponsored by the U.S. Department of Health and Human Services which offers links to hundreds of other sites that contain healthcare information. This Web site is located at http://www.healthfinder.gov. Again, keyword searches can be used to find guidelines. The following was recently found in this database:
22 Flu Infection
·
100% Immunization Campaign: Immunization for Seniors Summary: The goal of 100% Immunization Campaign is to promote immunization of older adults with pneumococcal and influenza vaccines. Source: American Society of Consultant Pharmacists http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&R ecordID=5170
·
Age Page - Shots for Safety Summary: This fact sheet recommends immunization against influenza, pneumococcal diseases, tetanus, and diphtheria. A vaccine schedule and additional resources are included. Source: National Institute on Aging, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&R ecordID=451
·
Age Page - What To Do About the Flu Summary: Flu - short for influenza - is usually a mild disease in healthy children, young adults, and middle-age people. However, flu can be life threatening in older people. Source: National Institute on Aging, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&R ecordID=42
·
Fight Flu and Pneumonia Summary: This publication describes the flu, explains which groups of people should get the flu shot and why, directs people on when to get the shot, and informs people on Medicare where they can go to get flu Source: Centers for Medicare and Medicaid Services (CMS), formerly the Health Care Financing Administration http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&R ecordID=3187
Guidelines 23
·
Flu Summary: This NIAID fact sheet provides information on the flu: its prevention, transmission, symptoms, diagnosis, and treatment. Source: National Institute of Allergy and Infectious Diseases, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&R ecordID=6371
·
Flu News Summary: This page features media reports, a flu bulletin, information about the vaccine supply, CDC's flu watcher, and background information on the flu. Source: National Immunization Program, Centers for Disease Control and Prevention http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&R ecordID=6322
·
Flu Season 2001-02 Summary: This page from the CDC's National Immunization Program provides information and updates about the flu and flu vaccines. Source: National Immunization Program, Centers for Disease Control and Prevention http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&R ecordID=6321
·
Guidelines for the Prevention and Treatment of Influenza and the Common Cold Summary: This online booklet describes the causes and symptoms of cold and flu infections, and offers specific recommendations regarding prevention, complications, and treatment. Source: American Lung Association http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&R ecordID=5034
24 Flu Infection
·
Influenza and Colds Fact Sheets and Brochures Summary: This web site presents fact sheets and brochures about influenza (flu) and the common cold as well as related news reports, alerts and advisories. Source: National Institute of Allergy and Infectious Diseases, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&R ecordID=235 The NIH Search Utility
After browsing the references listed at the beginning of this chapter, you may want to explore the NIH Search Utility. This allows you to search for documents on over 100 selected Web sites that comprise the NIH-WEBSPACE. 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 flu infection. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html.
Additional Web Sources A number of Web sites that often link to government sites are available to the public. 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
·
drkoop.comÒ: http://www.drkoop.com/conditions/ency/index.html
·
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/
Guidelines 25
·
Yahoo.com: http://dir.yahoo.com/Health/Diseases_and_Conditions/
·
WebMDÒHealth: http://my.webmd.com/health_topics
Vocabulary Builder The material in this chapter may have contained a number of unfamiliar words. The following Vocabulary Builder introduces you to terms used in this chapter that have not been covered in the previous chapter: Abdominal: Pertaining to the abdomen. [EU] Acetaminophen: Analgesic antipyretic derivative of acetanilide. It has weak anti-inflammatory properties and is used as a common analgesic, but may cause liver, blood cell, and kidney damage. [NIH] Alopecia: Baldness; absence of the hair from skin areas where it normally is present. [EU] Amantadine: An antiviral that is used in the prophylactic or symptomatic treatment of influenza A. It is also used as an antiparkinsonian agent, to treat extrapyramidal reactions, and for postherpetic neuralgia. The mechanisms of its effects in movement disorders are not well understood but probably reflect an increase in synthesis and release of dopamine, with perhaps some inhibition of dopamine uptake. [NIH] Anal: Pertaining to the anus. [EU] Anemia: A reduction in the number of circulating erythrocytes or in the quantity of hemoglobin. [NIH] Anorexia: Lack or loss of the appetite for food. [EU] Antibiotic: A chemical substance produced by a microorganism which has the capacity, in dilute solutions, to inhibit the growth of or to kill other microorganisms. Antibiotics that are sufficiently nontoxic to the host are used as chemotherapeutic agents in the treatment of infectious diseases of man, animals and plants. [EU] Antiviral: Destroying viruses or suppressing their replication. [EU] 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] Campylobacter: A genus of bacteria found in the reproductive organs, intestinal tract, and oral cavity of animals and man. Some species are pathogenic. [NIH] Cholesterol: The principal sterol of all higher animals, distributed in body
26 Flu Infection
tissues, especially the brain and spinal cord, and in animal fats and oils. [NIH] Chronic: Persisting over a long period of time. [EU] Cirrhosis: Liver disease characterized pathologically by loss of the normal microscopic lobular architecture, with fibrosis and nodular regeneration. The term is sometimes used to refer to chronic interstitial inflammation of any organ. [EU] Confusion: Disturbed orientation in regard to time, place, or person, sometimes accompanied by disordered consciousness. [EU] Contamination: The soiling or pollution by inferior material, as by the introduction of organisms into a wound, or sewage into a stream. [EU] Convulsion: A violent involuntary contraction or series of contractions of the voluntary muscles. [EU] Croup: A condition characterized by resonant barking cough, hoarseness and persistant stridor and caused by allergy, foreign body, infection, or neoplasm. It occurs chiefly in infants and children. [NIH] Cyclospora: A genus of coccidian parasites in the family eimeriidae. Cyclospora cayetanensis is pathogenic in humans, probably transmitted via the fecal-oral route, and causes nausea and diarrhea. [NIH] Cytotoxic: Pertaining to or exhibiting cytotoxicity. [EU] Dehydration: The condition that results from excessive loss of body water. Called also anhydration, deaquation and hypohydration. [EU] Dermatology: A medical specialty concerned with the skin, its structure, functions, diseases, and treatment. [NIH] Diarrhea: Passage of excessively liquid or excessively frequent stools. [NIH] Diphtheria: A localized infection of mucous membranes or skin caused by toxigenic strains of corynebacterium diphtheriae. It is characterized by the presence of a pseudomembrane at the site of infection. Diphtheria toxin, produced by C. diphtheriae, can cause myocarditis, polyneuritis, and other systemic toxic effects. [NIH] Disinfection: Rendering pathogens harmless through the use of heat, antiseptics, antibacterial agents, etc. [NIH] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Epidemic: Occurring suddenly in numbers clearly in excess of normal expectancy; said especially of infectious diseases but applied also to any disease, injury, or other health-related event occurring in such outbreaks. [EU] Fatigue: The state of weariness following a period of exertion, mental or physical, characterized by a decreased capacity for work and reduced efficiency to respond to stimuli. [NIH]
Guidelines 27
Feces: The excrement discharged from the intestines, consisting of bacteria, cells exfoliated from the intestines, secretions, chiefly of the liver, and a small amount of food residue. [EU] Fungus: A general term used to denote a group of eukaryotic protists, including mushrooms, yeasts, rusts, moulds, smuts, etc., which are characterized by the absence of chlorophyll and by the presence of a rigid cell wall composed of chitin, mannans, and sometimes cellulose. They are usually of simple morphological form or show some reversible cellular specialization, such as the formation of pseudoparenchymatous tissue in the fruiting body of a mushroom. The dimorphic fungi grow, according to environmental conditions, as moulds or yeasts. [EU] Gonorrhea: Acute infectious disease characterized by primary invasion of the urogenital tract. The etiologic agent, neisseria gonorrhoeae, was isolated by Neisser in 1879. [NIH] Haemophilus: A genus of pasteurellaceae that consists of several species occurring in animals and humans. Its organisms are described as gramnegative, facultatively anaerobic, coccobacillus or rod-shaped, and nonmotile. [NIH] Handwashing: The act of cleansing the hands with water or other liquid, with or without the inclusion of soap or other detergent, for the purpose of removing soil or microorganisms. [NIH] Hepatitis: Inflammation of the liver. [EU] Herpes: Any inflammatory skin disease caused by a herpesvirus and characterized by the formation of clusters of small vesicles. When used alone, the term may refer to herpes simplex or to herpes zoster. [EU] Immunity: The condition of being immune; the protection against infectious disease conferred either by the immune response generated by immunization or previous infection or by other nonimmunologic factors (innate i.). [EU] Immunization: The induction of immunity. [EU] Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Influenza: An acute viral infection involving the respiratory tract. It is marked by inflammation of the nasal mucosa, the pharynx, and conjunctiva, and by headache and severe, often generalized, myalgia. [NIH] Interferons: Proteins secreted by vertebrate cells in response to a wide variety of inducers. They confer resistance against many different viruses, inhibit proliferation of normal and malignant cells, impede multiplication of
28 Flu Infection
intracellular parasites, enhance macrophage and granulocyte phagocytosis, augment natural killer cell activity, and show several other immunomodulatory functions. [NIH] Intestinal: Pertaining to the intestine. [EU] Intestines: The section of the alimentary canal from the stomach to the anus. It includes the large intestine and small intestine. [NIH] Intravenous: Within a vein or veins. [EU] Jaundice: A clinical manifestation of hyperbilirubinemia, consisting of deposition of bile pigments in the skin, resulting in a yellowish staining of the skin and mucous membranes. [NIH] Lupus: A form of cutaneous tuberculosis. It is seen predominantly in women and typically involves the nasal, buccal, and conjunctival mucosa. [NIH]
Mental: Pertaining to the mind; psychic. 2. (L. mentum chin) pertaining to the chin. [EU] Microbiology: The study of microorganisms such as fungi, bacteria, algae, archaea, and viruses. [NIH] Mononucleosis: The presence of an abnormally large number of mononuclear leucocytes (monocytes) in the blood. The term is often used alone to refer to infectious mononucleosis. [EU] Mucus: The free slime of the mucous membranes, composed of secretion of the glands, along with various inorganic salts, desquamated cells, and leucocytes. [EU] Nausea: An unpleasant sensation, vaguely referred to the epigastrium and abdomen, and often culminating in vomiting. [EU] Occult: Obscure; concealed from observation, difficult to understand. [EU] Oral: Pertaining to the mouth, taken through or applied in the mouth, as an oral medication or an oral thermometer. [EU] Otitis: Inflammation of the ear, which may be marked by pain, fever, abnormalities of hearing, hearing loss, tinnitus, and vertigo. [EU] Pathogen: Any disease-producing microorganism. [EU] Plasmids: Any extrachromosomal hereditary determinant. Plasmids are self-replicating circular molecules of DNA that are found in a variety of bacterial, archaeal, fungal, algal, and plant species. [NIH] Pneumonia: Inflammation of the lungs with consolidation. [EU] Poisoning: A condition or physical state produced by the ingestion, injection or inhalation of, or exposure to a deleterious agent. [NIH] Progressive:
Advancing; going forward; going from bad to worse;
Guidelines 29
increasing in scope or severity. [EU] Prophylaxis: The prevention of disease; preventive treatment. [EU] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH]
Ribavirin: 1-beta-D-Ribofuranosyl-1H-1,2,4-triazole-3-carboxamide. A nucleoside antimetabolite antiviral agent that blocks nucleic acid synthesis and is used against both RNA and DNA viruses. [NIH] Rimantadine: An RNA synthesis inhibitor that is used as an antiviral agent in the prophylaxis and treatment of influenza. [NIH] Rubella: An acute, usually benign, infectious disease caused by a togavirus and most often affecting children and nonimmune young adults, in which the virus enters the respiratory tract via droplet nuclei and spreads to the lymphatic system. It is characterized by a slight cold, sore throat, and fever, followed by enlargement of the postauricular, suboccipital, and cervical lymph nodes, and the appearances of a fine pink rash that begins on the head and spreads to become generalized. Called also German measles, roetln, röteln, and three-day measles, and rubeola in French and Spanish. [EU] Salmonella: A genus of gram-negative, facultatively anaerobic, rod-shaped bacteria that utilizes citrate as a sole carbon source. It is pathogenic for humans, causing enteric fevers, gastroenteritis, and bacteremia. Food poisoning is the most common clinical manifestation. Organisms within this genus are separated on the basis of antigenic characteristics, sugar fermentation patterns, and bacteriophage susceptibility. [NIH] Sanitation: The development and establishment of environmental conditions favorable to the health of the public. [NIH] Sclerosis: A induration, or hardening; especially hardening of a part from inflammation and in diseases of the interstitial substance. The term is used chiefly for such a hardening of the nervous system due to hyperplasia of the connective tissue or to designate hardening of the blood vessels. [EU] 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] Semen: The thick, yellowish-white, viscid fluid secretion of male reproductive organs discharged upon ejaculation. In addition to reproductive organ secretions, it contains spermatozoa and their nutrient plasma. [NIH] Serum: The clear portion of any body fluid; the clear fluid moistening serous membranes. 2. blood serum; the clear liquid that separates from blood
30 Flu Infection
on clotting. 3. immune serum; blood serum from an immunized animal used for passive immunization; an antiserum; antitoxin, or antivenin. [EU] Sigmoidoscopy: Endoscopic examination, therapy or surgery of the sigmoid flexure. [NIH] Sterilization: 1. the complete destruction or elimination of all living microorganisms, accomplished by physical methods (dry or moist heat), chemical agents (ethylene oxide, formaldehyde, alcohol), radiation (ultraviolet, cathode), or mechanical methods (filtration). 2. any procedure by which an individual is made incapable of reproduction, as by castration, vasectomy, or salpingectomy. [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] Syphilis: A contagious venereal disease caused by the spirochete treponema pallidum. [NIH] Systemic: Pertaining to or affecting the body as a whole. [EU] Tetanus: A disease caused by tetanospasmin, a powerful protein toxin produced by clostridium tetani. Tetanus usually occurs after an acute injury, such as a puncture wound or laceration. Generalized tetanus, the most common form, is characterized by tetanic muscular contractions and hyperreflexia. Localized tetanus presents itself as a mild condition with manifestations restricted to muscles near the wound. It may progress to the generalized form. [NIH] Toxin: A poison; frequently used to refer specifically to a protein produced by some higher plants, certain animals, and pathogenic bacteria, which is highly toxic for other living organisms. Such substances are differentiated from the simple chemical poisons and the vegetable alkaloids by their high molecular weight and antigenicity. [EU] Transfusion: The introduction of whole blood or blood component directly into the blood stream. [EU] Transplantation: The grafting of tissues taken from the patient's own body or from another. [EU] Tuberculosis: Any of the infectious diseases of man and other animals caused by species of mycobacterium. [NIH] Urinalysis: Examination of urine by chemical, physical, or microscopic means. Routine urinalysis usually includes performing chemical screening tests, determining specific gravity, observing any unusual color or odor, screening for bacteriuria, and examining the sediment microscopically. [NIH] Urinary: Pertaining to the urine; containing or secreting urine. [EU]
Guidelines 31
Vaccination: The introduction of vaccine into the body for the purpose of inducing immunity. Coined originally to apply to the injection of smallpox vaccine, the term has come to mean any immunizing procedure in which vaccine is injected. [EU] Vaccine: A suspension of attenuated or killed microorganisms (bacteria, viruses, or rickettsiae), administered for the prevention, amelioration or treatment of infectious diseases. [EU] Vaginal: 1. of the nature of a sheath; ensheathing. 2. pertaining to the vagina. 3. pertaining to the tunica vaginalis testis. [EU] Varicella: Chicken pox. [EU] Vibrio: A genus of vibrionaceae, made up of short, slightly curved, motile, gram-negative rods. Various species produce cholera and other gastrointestinal disorders as well as abortion in sheep and cattle. [NIH] Viruses: Minute infectious agents whose genomes are composed of DNA or RNA, but not both. They are characterized by a lack of independent metabolism and the inability to replicate outside living host cells. [NIH]
Seeking Guidance 33
CHAPTER 2. SEEKING GUIDANCE Overview Some patients are comforted by the knowledge that a number of organizations dedicate their resources to helping people with flu infection. These associations can become invaluable sources of information and advice. Many associations offer aftercare support, financial assistance, and other important services. Furthermore, healthcare research has shown that support groups often help people to better cope with their conditions.8 In addition to support groups, your physician can be a valuable source of guidance and support. Therefore, finding a physician that can work with your unique situation is a very important aspect of your care. In this chapter, we direct you to resources that can help you find patient organizations and medical specialists. We begin by describing how to find associations and peer groups that can help you better understand and cope with flu infection. The chapter ends with a discussion on how to find a doctor that is right for you.
Associations and Flu Infection As mentioned by the Agency for Healthcare Research and Quality, sometimes the emotional side of an illness can be as taxing as the physical side.9 You may have fears or feel overwhelmed by your situation. Everyone has different ways of dealing with disease or physical injury. Your attitude, your expectations, and how well you cope with your condition can all Churches, synagogues, and other houses of worship might also have groups that can offer you the social support you need. 9 This section has been adapted from http://www.ahcpr.gov/consumer/diaginf5.htm. 8
34 Flu Infection
influence your well-being. This is true for both minor conditions and serious illnesses. For example, a study on female breast cancer survivors revealed that women who participated in support groups lived longer and experienced better quality of life when compared with women who did not participate. In the support group, women learned coping skills and had the opportunity to share their feelings with other women in the same situation.
Finding Associations There are a number of directories that list additional medical associations that you may find useful. While not all of these directories will provide different information than what is listed above, by consulting all of them, you will have nearly exhausted all sources for patient associations.
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 flu infection. 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. DIRLINE A comprehensive source of information on associations is the DIRLINE database maintained by the National Library of Medicine. The database comprises some 10,000 records of organizations, research centers, and government institutes and associations which primarily focus on health and biomedicine. DIRLINE is available via the Internet at the following Web site: http://dirline.nlm.nih.gov/. Simply type in “flu infection” (or a synonym) or the name of a topic, and the site will list information contained in the database on all relevant organizations.
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 “flu
Seeking Guidance 35
infection”. 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.” By making these selections and typing in “flu infection” (or synonyms) into the “For these words:” box, you will only receive results on organizations dealing with flu infection. You should check back periodically with this database since it is updated every 3 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 specific diseases. You can access this database at the following Web site: http://www.rarediseases.org/cgi-bin/nord/searchpage. Select the option called “Organizational Database (ODB)” and type “flu infection” (or a synonym) in the search box.
Online Support Groups In addition to support groups, commercial Internet service providers offer forums and chat rooms for people with different illnesses and conditions. WebMDÒ, for example, offers such a service at their Web site: http://boards.webmd.com/roundtable. These online self-help communities can help you connect with a network of people whose concerns are similar to yours. Online support groups are places where people can talk informally. If you read about a novel approach, consult with your doctor or other healthcare providers, as the treatments or discoveries you hear about may not be scientifically proven to be safe and effective.
36 Flu Infection
Finding Doctors One of the most important aspects of your treatment will be the relationship between you and your doctor or specialist. All patients with flu infection must go through the process of selecting a physician. While this process will vary from person to person, the Agency for Healthcare Research and Quality makes a number of suggestions, including the following:10 ·
If you are in a managed care plan, check the plan’s list of doctors first.
·
Ask doctors or other health professionals who work with doctors, such as hospital nurses, for referrals.
·
Call a hospital’s doctor referral service, but keep in mind that these services usually refer you to doctors on staff at that particular hospital. The services do not have information on the quality of care that these doctors provide.
·
Some local medical societies offer lists of member doctors. Again, these lists do not have information on the quality of care that these doctors provide.
Additional steps you can take to locate doctors include the following: ·
Check with the associations listed earlier in this chapter.
·
Information on doctors in some states is available on the Internet at http://www.docboard.org. This Web site is run by “Administrators in Medicine,” a group of state medical board directors.
·
The American Board of Medical Specialties can tell you if your doctor is board certified. “Certified” means that the doctor has completed a training program in a specialty and has passed an exam, or “board,” to assess his or her knowledge, skills, and experience to provide quality patient care in that specialty. Primary care doctors may also be certified as specialists. The AMBS Web site is located at http://www.abms.org/newsearch.asp.11 You can also contact the ABMS by phone at 1-866-ASK-ABMS.
·
You can call the American Medical Association (AMA) at 800-665-2882 for information on training, specialties, and board certification for many licensed doctors in the United States. This information also can be found in “Physician Select” at the AMA’s Web site: http://www.amaassn.org/aps/amahg.htm.
This section is adapted from the AHRQ: www.ahrq.gov/consumer/qntascii/qntdr.htm. While board certification is a good measure of a doctor’s knowledge, it is possible to receive quality care from doctors who are not board certified. 10 11
Seeking Guidance 37
Finding Specialists The American Academy of Allergy, Asthma, and Immunology (AAAAI) maintains a Physician Referral System on its Web site (http://www.aaaai.org/). The Referral System contains contact information for the organization’s 6,000 members, all medical professionals specializing in the treatment of allergies, asthma, or infectious diseases. To use this free service, go to the search form located at http://www.aaaai.org/scripts/find-adoc/main.asp and select the search criteria you would like to use by clicking on the circle to the left of the option. Then type in the information you are looking for such as the physician’s location, zip code, name, or specialty. Click the “Search” button. If your query returns information about particular physicians, click on the physician’s name for more information. If the previous sources did not meet your needs, you may want to log on to the Web site of the National Organization for Rare Disorders (NORD) at http://www.rarediseases.org/. NORD maintains a database of doctors with expertise in various rare diseases. The Metabolic Information Network (MIN), 800-945-2188, also maintains a database of physicians with expertise in various metabolic diseases.
Selecting Your Doctor12 When you have compiled a list of prospective doctors, call each of their offices. First, ask if the doctor accepts your health insurance plan and if he or she is taking new patients. If the doctor is not covered by your plan, ask yourself if you are prepared to pay the extra costs. The next step is to schedule a visit with your chosen physician. During the first visit you will have the opportunity to evaluate your doctor and to find out if you feel comfortable with him or her. Ask yourself, did the doctor: ·
Give me a chance to ask questions about flu infection?
·
Really listen to my questions?
·
Answer in terms I understood?
·
Show respect for me?
·
Ask me questions?
·
Make me feel comfortable?
·
Address the health problem(s) I came with?
12 This
section has been adapted from the AHRQ: www.ahrq.gov/consumer/qntascii/qntdr.htm.
38 Flu Infection
·
Ask me my preferences about different kinds of treatments for flu infection?
·
Spend enough time with me?
Trust your instincts when deciding if the doctor is right for you. But remember, it might take time for the relationship to develop. It takes more than one visit for you and your doctor to get to know each other.
Working with Your Doctor13 Research has shown that patients who have good relationships with their doctors tend to be more satisfied with their care and have better results. Here are some tips to help you and your doctor become partners: ·
You know important things about your symptoms and your health history. Tell your doctor what you think he or she needs to know.
·
It is important to tell your doctor personal information, even if it makes you feel embarrassed or uncomfortable.
·
Bring a “health history” list with you (and keep it up to date).
·
Always bring any medications you are currently taking with you to the appointment, or you can bring a list of your medications including dosage and frequency information. Talk about any allergies or reactions you have had to your medications.
·
Tell your doctor about any natural or alternative medicines you are taking.
·
Bring other medical information, such as x-ray films, test results, and medical records.
·
Ask questions. If you don’t, your doctor will assume that you understood everything that was said.
·
Write down your questions before your visit. List the most important ones first to make sure that they are addressed.
·
Consider bringing a friend with you to the appointment to help you ask questions. This person can also help you understand and/or remember the answers.
·
Ask your doctor to draw pictures if you think that this would help you understand.
This section has been adapted from the AHRQ: www.ahrq.gov/consumer/qntascii/qntdr.htm.
13
Seeking Guidance 39
·
Take notes. Some doctors do not mind if you bring a tape recorder to help you remember things, but always ask first.
·
Let your doctor know if you need more time. If there is not time that day, perhaps you can speak to a nurse or physician assistant on staff or schedule a telephone appointment.
·
Take information home. Ask for written instructions. Your doctor may also have brochures and audio and videotapes that can help you.
·
After leaving the doctor’s office, take responsibility for your care. If you have questions, call. If your symptoms get worse or if you have problems with your medication, call. If you had tests and do not hear from your doctor, call for your test results. If your doctor recommended that you have certain tests, schedule an appointment to get them done. If your doctor said you should see an additional specialist, make an appointment.
By following these steps, you will enhance the relationship you will have with your physician.
Broader Health-Related Resources In addition to the references above, the NIH has set up guidance Web sites that can help patients find healthcare professionals. These include:14 ·
Caregivers: http://www.nlm.nih.gov/medlineplus/caregivers.html
·
Choosing a Doctor or Healthcare Service: http://www.nlm.nih.gov/medlineplus/choosingadoctororhealthcareserv ice.html
·
Hospitals and Health Facilities: http://www.nlm.nih.gov/medlineplus/healthfacilities.html
You can access this information at: http://www.nlm.nih.gov/medlineplus/healthsystem.html.
14
Clinical Trials 41
CHAPTER 3. CLINICAL TRIALS AND FLU INFECTION Overview Very few medical conditions have a single treatment. The basic treatment guidelines that your physician has discussed with you, or those that you have found using the techniques discussed in Chapter 1, may provide you with all that you will require. For some patients, current treatments can be enhanced with new or innovative techniques currently under investigation. In this chapter, we will describe how clinical trials work and show you how to keep informed of trials concerning flu infection.
What Is a Clinical Trial?15 Clinical trials involve the participation of people in medical research. Most medical research begins with studies in test tubes and on animals. Treatments that show promise in these early studies may then be tried with people. The only sure way to find out whether a new treatment is safe, effective, and better than other treatments for flu infection is to try it on patients in a clinical trial.
The discussion in this chapter has been adapted from the NIH and the NEI: www.nei.nih.gov/netrials/ctivr.htm.
15
42 Flu Infection
What Kinds of Clinical Trials Are There? Clinical trials are carried out in three phases: ·
Phase I. Researchers first conduct Phase I trials with small numbers of patients and healthy volunteers. If the new treatment is a medication, researchers also try to determine how much of it can be given safely.
·
Phase II. Researchers conduct Phase II trials in small numbers of patients to find out the effect of a new treatment on flu infection.
·
Phase III. Finally, researchers conduct Phase III trials to find out how new treatments for flu infection compare with standard treatments already being used. Phase III trials also help to determine if new treatments have any side effects. These trials--which may involve hundreds, perhaps thousands, of people--can also compare new treatments with no treatment. How Is a Clinical Trial Conducted?
Various organizations support clinical trials at medical centers, hospitals, universities, and doctors’ offices across the United States. The “principal investigator” is the researcher in charge of the study at each facility participating in the clinical trial. Most clinical trial researchers are medical doctors, academic researchers, and specialists. The “clinic coordinator” knows all about how the study works and makes all the arrangements for your visits. All doctors and researchers who take part in the study on flu infection carefully follow a detailed treatment plan called a protocol. This plan fully explains how the doctors will treat you in the study. The “protocol” ensures that all patients are treated in the same way, no matter where they receive care. Clinical trials are controlled. This means that researchers compare the effects of the new treatment with those of the standard treatment. In some cases, when no standard treatment exists, the new treatment is compared with no treatment. Patients who receive the new treatment are in the treatment group. Patients who receive a standard treatment or no treatment are in the “control” group. In some clinical trials, patients in the treatment group get a new medication while those in the control group get a placebo. A placebo is a harmless substance, a “dummy” pill, that has no effect on flu infection. In other clinical trials, where a new surgery or device (not a medicine) is being tested, patients in the control group may receive a “sham treatment.” This
Clinical Trials 43
treatment, like a placebo, has no effect on flu infection and does not harm patients. Researchers assign patients “randomly” to the treatment or control group. This is like flipping a coin to decide which patients are in each group. If you choose to participate in a clinical trial, you will not know which group you will be appointed to. The chance of any patient getting the new treatment is about 50 percent. You cannot request to receive the new treatment instead of the placebo or sham treatment. Often, you will not know until the study is over whether you have been in the treatment group or the control group. This is called a “masked” study. In some trials, neither doctors nor patients know who is getting which treatment. This is called a “double masked” study. These types of trials help to ensure that the perceptions of the patients or doctors will not affect the study results. Natural History Studies Unlike clinical trials in which patient volunteers may receive new treatments, natural history studies provide important information to researchers on how flu infection develops over time. A natural history study follows patient volunteers to see how factors such as age, sex, race, or family history might make some people more or less at risk for flu infection. A natural history study may also tell researchers if diet, lifestyle, or occupation affects how a disease or disorder develops and progresses. Results from these studies provide information that helps answer questions such as: How fast will a disease or disorder usually progress? How bad will the condition become? Will treatment be needed? What Is Expected of Patients in a Clinical Trial? Not everyone can take part in a clinical trial for a specific disease or disorder. Each study enrolls patients with certain features or eligibility criteria. These criteria may include the type and stage of disease or disorder, as well as, the age and previous treatment history of the patient. You or your doctor can contact the sponsoring organization to find out more about specific clinical trials and their eligibility criteria. If you are interested in joining a clinical trial, your doctor must contact one of the trial’s investigators and provide details about your diagnosis and medical history. If you participate in a clinical trial, you may be required to have a number of medical tests. You may also need to take medications and/or undergo
44 Flu Infection
surgery. Depending upon the treatment and the examination procedure, you may be required to receive inpatient hospital care. Or, you may have to return to the medical facility for follow-up examinations. These exams help find out how well the treatment is working. Follow-up studies can take months or years. However, the success of the clinical trial often depends on learning what happens to patients over a long period of time. Only patients who continue to return for follow-up examinations can provide this important long-term information.
Recent Trials on Flu Infection The National Institutes of Health and other organizations sponsor trials on various diseases and disorders. Because funding for research goes to the medical areas that show promising research opportunities, it is not possible for the NIH or others to sponsor clinical trials for every disease and disorder at all times. The following lists recent trials dedicated to flu infection.16 If the trial listed by the NIH is still recruiting, you may be eligible. If it is no longer recruiting or has been completed, then you can contact the sponsors to learn more about the study and, if published, the results. Further information on the trial is available at the Web site indicated. Please note that some trials may no longer be recruiting patients or are otherwise closed. Before contacting sponsors of a clinical trial, consult with your physician who can help you determine if you might benefit from participation. ·
A Pilot Study of Autologous T-Cell Transplantation with Vaccine Driven Expansion of Anti-Tumor Effectors After Cytoreductive Therapy in Metastatic Pediatric Sarcomas Condition(s): Ewing's Sarcoma; Rhabdomyosarcoma Study Status: This study is currently recruiting patients. Sponsor(s): National Cancer Institute (NCI) Purpose - Excerpt: This is a single arm study. The tumor specimen is analyzed for the presence of a fusion protein which corresponds to available peptides. Patients undergo T cell harvest 10 days after an initial priming peptide-pulsed antigen presenting cell (APC) vaccine is performed. Fresh APCs are utilized for initial priming vaccination. All subsequent vaccinations will use cryopreserved APCs. Minimum number of APCs administered per vaccination is 100,000/kg and maximum is 100,000,000/kg. Patients undergo cytoreductive therapy for the treatment of their particular malignancy. This therapy usually consists of multiagent chemotherapy in the context of a separate protocol. Following
16
These are listed at www.ClinicalTrials.gov.
Clinical Trials 45
chemotherapy, infusion of harvested T cells followed by infusion of peptide-pulsed APC vaccinations occurs every 6 weeks for a total of 3 post-priming vaccinations. Influenza vaccine is administered by intramuscular injection concurrent to peptide-pulsed APC vaccines. IL-2 is administered as a continuous IV infusion for 4 days/week for 3 successive weeks starting on the same day as T cell /peptide-pulsed infusions. Phase(s): Phase II Study Type: Interventional Contact(s): Maryland; National Cancer Institute (NCI), 9000 Rockville Pike Bethesda, Maryland, 20892, United States; Recruiting; Patient Recruitment and Public Liaison Office 1-800-411-1222
[email protected]; TTY 1-866-411-1010 Web Site: http://clinicaltrials.gov/ct/gui/show/NCT00001566;jsessionid=B400C2 5056732992D05081F431460639 ·
A Pilot Study of Tumor-Specific Peptide Vaccination and IL-2 with or without Autologous T Cell Transplantation in Recurrent Pediatric Sarcomas Condition(s): Ewing's Sarcoma; Rhabdomyosarcoma Study Status: This study is currently recruiting patients. Sponsor(s): National Cancer Institute (NCI) Purpose - Excerpt: Arm A: Peripheral blood apheresis by harvesting chemotherapy-naive T cells and populations enriched for professional APCs. T cells and APCs are separated from the apheresis product using countercurrent centrifugal elutriation and a monocyte rich fraction is collected. Autologous T cell transplantation during immunotherapy. Arm B: Cell harvesting is performed as soon as possible. Both Arm A and B: Patients receive intravenous infusion of irradiated peptide-pulsed antigen presenting cell vaccination (APC) products as well as intramuscular injection of influenza vaccine on the same day. Recombinant human IL-2 is administered within 4 hours of the peptide pulsed vaccine by continuous intravenous infusion for 4 days per week for 3 successive weeks. Primary toxic effect of this therapy is expected to be related to the IL-2 therapy. Patients with Grade 2 neurologic or cardiac or any Grade 3 or 4 toxic effects will discontinued IL-2 therapy. If toxic effect is not resolved in 72-hours, the patient may remain on study but will not receive any further IL-2. Phase(s): Phase II
46 Flu Infection
Study Type: Interventional Contact(s): Maryland; National Cancer Institute (NCI), 9000 Rockville Pike Bethesda, Maryland, 20892, United States; Recruiting; Patient Recruitment and Public Liaison Office 1-800-411-1222
[email protected]; TTY 1-866-411-1010 Web Site: http://clinicaltrials.gov/ct/gui/show/NCT00001564;jsessionid=B400C2 5056732992D05081F431460639 ·
A Study to Monitor Patients with Primary or Early HIV Infection Condition(s): HIV Infections Study Status: This study is currently recruiting patients. Sponsor(s): National Institute of Allergy and Infectious Diseases (NIAID) Purpose - Excerpt: The purpose of this study is to monitor patients who recently have been infected with HIV in order to learn how their immune systems respond to HIV infection and to study how the virus acts in their bodies. Primary HIV infection occurs within 20 days to 8 weeks following exposure to HIV. The symptoms of primary HIV infection are usually fever, tiredness, headache, or muscle aches. However, symptoms vary greatly from person to person, and some people might not experience any symptoms at all. Because these symptoms also resemble the cold or the flu, it is difficult to identify patients with primary HIV infection. Information gathered from this study will help doctors decide what kind of treatment is best to give patients who recently have been infected. Study Type: Observational Contact(s): California; UCSD, San Diego, California, 92103, United States; Recruiting; Susan Little 619-543-8080
[email protected]. Study chairs or principal investigators: Susan Little, Principal Investigator; Diane Havlir, Principal Investigator Web Site: http://clinicaltrials.gov/ct/gui/show/NCT00000911;jsessionid=B400C2 5056732992D05081F431460639
·
Influenza Vaccine in HIV Infection: Immune Response and Effect on Viral Load Condition(s): HIV Infection Study Status: This study is currently recruiting patients. Sponsor(s): National Institute of Allergy and Infectious Diseases (NIAID)
Clinical Trials 47
Purpose - Excerpt: This 2-part study will examine 1) the immune response to influenza (flu) vaccine in HIV-infected patients, and 2) the effect of flu vaccine on HIV viral loads. Earlier studies have shown that people with HIV infection do not respond as well to flu vaccine as healthy subjects; that is, they don't make as many antibodies in response to the vaccine. Also, studies done before the use of HAART (highly active antiretroviral treatment) have shown that HIV levels increase for a period of time after flu vaccination. One small study showed a small brief increase in HIV even in patients taking HAART. The current trial will examine whether the flu vaccine does, in fact, cause an elevation in viral load and whether this increase is harmful or indicates a better response to the vaccine. HIV-infected patients and healthy normal volunteers between 18 and 60 years of age may be eligible for part1of this study. (Healthy volunteers will serve as control subjects to make sure the flu vaccine stimulates production of enough antibody to protect against the flu). Part 2 will include only HIV-infected patients with fewer than 50 copies per milliliter of HIV. Patients in both parts of the study must have been receiving HAART (consisting of at least two nucleoside reverse transcriptase inhibitors plus a non-nucleoside reverse transcriptase inhibitor or a protease inhibitor) for at least 3 months before enrollment in the study. Candidates will be screened with a medical history and blood tests, including HLA testing (a genetic test of immune system markers). Women who are able to have children will have a pregnancy test. Pregnant women are excluded from the study. Participants will undergo the following procedures: - Part 1 - Immune Response to Flu Vaccine In the first of two visits, participants will have blood drawn for flu antibody levels before vaccination and, in HIV-infected patients, measures of T cell count and viral load. They will then receive the flu vaccine. Blood will be drawn at a second visit 28 days later for the same tests. - Part 2 - Effect of Flu Vaccine on Viral Levels Participants will be randomly assigned to receive the flu vaccine either at the beginning of their enrollment in the study (immediate) or 3 weeks after enrollment (deferred). Those in the immediate group receive the flu vaccine on the first day (day 0) and have blood drawn on days 0, 3, 7, 10, 14, 17, 21, 24, 28, 31, 35, 38 and 42. Those in the deferred group are vaccinated on day 21 and have blood drawn on days 0, 3, 7, 10, 14, 17, 21, 24, 28, 31, 35, 38, 42 and 49. The blood is tested for viral load, CD4 cell counts and antibody levels. Study Type: Observational Contact(s): Maryland; National Institute of Allergy and Infectious Diseases (NIAID), 9000 Rockville Pike Bethesda, Maryland, 20892, United
48 Flu Infection
States; Recruiting; Patient Recruitment and Public Liaison Office 1-800411-1222
[email protected]; TTY 1-866-411-1010 Web Site: http://clinicaltrials.gov/ct/gui/show/NCT00025922;jsessionid=B400C2 5056732992D05081F431460639 ·
Half-Dose Flu Vaccine Study in Healthy Adults Condition(s): Influenza Study Status: This study is no longer recruiting patients. Sponsor(s): National Institute of Allergy and Infectious Diseases (NIAID) Purpose - Excerpt: It appears likely that there will be a delay and possibly a reduction in the amount of influenza vaccine available for the 2000-2001 influenza season. One possible way of increasing the availability of influenza vaccine for this year is to use a half-dose in healthy adults. The objective of this study is to determine if the immune system responds to a half-dose the same way it responds to a whole dose. This study will use the currently approved inactivated influenza vaccine in healthy adults ages 18 to 49 years old. If the immune response to the half-dose is not significantly different than the immune response generated to the whole dose, this could be a strategy to extend the amount of vaccine that could be available in this age group. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/gui/show/NCT00006146;jsessionid=B400C2 5056732992D05081F431460639
·
Study of a Flu Vaccine in Children. Condition(s): Influenza Study Status: This study is no longer recruiting patients. Sponsor(s): National Institute of Allergy and Infectious Diseases (NIAID); Aviron Purpose - Excerpt: This study tests the safety and effectiveness of a flu vaccine in school children. School children are usually the first members of a community to come down with the flu, and they often give the flu to their younger siblings, parents, and grandparents. It is hoped that giving
Clinical Trials 49
school children a flu vaccine can help prevent the spread of the flu to other members of the community. Phase(s): Phase III Study Type: Interventional Contact(s): Texas; Pedro A. Piedra, M.D., Houston, Texas, 77030, United States Web Site: http://clinicaltrials.gov/ct/gui/show/NCT00001127;jsessionid=B400C2 5056732992D05081F431460639
Benefits and Risks17 What Are the Benefits of Participating in a Clinical Trial? If you are interested in a clinical trial, it is important to realize that your participation can bring many benefits to you and society at large: ·
A new treatment could be more effective than the current treatment for flu infection. Although only half of the participants in a clinical trial receive the experimental treatment, if the new treatment is proved to be more effective and safer than the current treatment, then those patients who did not receive the new treatment during the clinical trial may be among the first to benefit from it when the study is over.
·
If the treatment is effective, then it may improve health or prevent diseases or disorders.
·
Clinical trial patients receive the highest quality of medical care. Experts watch them closely during the study and may continue to follow them after the study is over.
·
People who take part in trials contribute to scientific discoveries that may help other people with flu infection. In cases where certain diseases or disorders run in families, your participation may lead to better care or prevention for your family members.
This section has been adapted from ClinicalTrials.gov, a service of the National Institutes of Health: http://www.clinicaltrials.gov/ct/gui/c/a1r/info/whatis?JServSessionIdzone_ct=9jmun6f291. 17
50 Flu Infection
The Informed Consent Once you agree to take part in a clinical trial, you will be asked to sign an “informed consent.” This document explains a clinical trial’s risks and benefits, the researcher’s expectations of you, and your rights as a patient. What Are the Risks? Clinical trials may involve risks as well as benefits. Whether or not a new treatment will work cannot be known ahead of time. There is always a chance that a new treatment may not work better than a standard treatment. There is also the possibility that it may be harmful. The treatment you receive may cause side effects that are serious enough to require medical attention. How Is Patient Safety Protected? Clinical trials can raise fears of the unknown. Understanding the safeguards that protect patients can ease some of these fears. Before a clinical trial begins, researchers must get approval from their hospital’s Institutional Review Board (IRB), an advisory group that makes sure a clinical trial is designed to protect patient safety. During a clinical trial, doctors will closely watch you to see if the treatment is working and if you are experiencing any side effects. All the results are carefully recorded and reviewed. In many cases, experts from the Data and Safety Monitoring Committee carefully monitor each clinical trial and can recommend that a study be stopped at any time. You will only be asked to take part in a clinical trial as a volunteer giving informed consent.
What Are a Patient’s Rights in a Clinical Trial? If you are eligible for a clinical trial, you will be given information to help you decide whether or not you want to participate. As a patient, you have the right to: ·
Information on all known risks and benefits of the treatments in the study.
·
Know how the researchers plan to carry out the study, for how long, and where.
·
Know what is expected of you.
Clinical Trials 51
·
Know any costs involved for you or your insurance provider.
·
Know before any of your medical or personal information is shared with other researchers involved in the clinical trial.
·
Talk openly with doctors and ask any questions.
After you join a clinical trial, you have the right to: ·
Leave the study at any time. Participation is strictly voluntary. However, you should not enroll if you do not plan to complete the study.
·
Receive any new information about the new treatment.
·
Continue to ask questions and get answers.
·
Maintain your privacy. Your name will not appear in any reports based on the study.
·
Know whether you participated in the treatment group or the control group (once the study has been completed).
What about Costs? In some clinical trials, the research facility pays for treatment costs and other associated expenses. You or your insurance provider may have to pay for costs that are considered standard care. These things may include inpatient hospital care, laboratory and other tests, and medical procedures. You also may need to pay for travel between your home and the clinic. You should find out about costs before committing to participation in the trial. If you have health insurance, find out exactly what it will cover. If you don’t have health insurance, or if your insurance company will not cover your costs, talk to the clinic staff about other options for covering the cost of your care. What Should You Ask before Deciding to Join a Clinical Trial? Questions you should ask when thinking about joining a clinical trial include the following: ·
What is the purpose of the clinical trial?
·
What are the standard treatments for flu infection? Why do researchers think the new treatment may be better? What is likely to happen to me with or without the new treatment?
52 Flu Infection
·
What tests and treatments will I need? Will I need surgery? Medication? Hospitalization?
·
How long will the treatment last? How often will I have to come back for follow-up exams?
·
What are the treatment’s possible benefits to my condition? What are the short- and long-term risks? What are the possible side effects?
·
Will the treatment be uncomfortable? Will it make me feel sick? If so, for how long?
·
How will my health be monitored?
·
Where will I need to go for the clinical trial? How will I get there?
·
How much will it cost to be in the study? What costs are covered by the study? How much will my health insurance cover?
·
Will I be able to see my own doctor? Who will be in charge of my care?
·
Will taking part in the study affect my daily life? Do I have time to participate?
·
How do I feel about taking part in a clinical trial? Are there family members or friends who may benefit from my contributions to new medical knowledge?
Keeping Current on Clinical Trials Various government agencies maintain databases on trials. The U.S. National Institutes of Health, through the National Library of Medicine, has developed ClinicalTrials.gov to provide patients, family members, and physicians with current information about clinical research across the broadest number of diseases and conditions. The site was launched in February 2000 and currently contains approximately 5,700 clinical studies in over 59,000 locations worldwide, with most studies being conducted in the United States. ClinicalTrials.gov receives about 2 million hits per month and hosts approximately 5,400 visitors daily. To access this database, simply go to their Web site (www.clinicaltrials.gov) and search by “flu infection” (or synonyms). While ClinicalTrials.gov is the most comprehensive listing of NIH-supported clinical trials available, not all trials are in the database. The database is updated regularly, so clinical trials are continually being added. The
Clinical Trials 53
following is a list of specialty databases affiliated with the National Institutes of Health that offer additional information on trials: ·
For clinical studies at the Warren Grant Magnuson Clinical Center located in Bethesda, Maryland, visit their Web site: http://clinicalstudies.info.nih.gov/
·
For clinical studies conducted at the Bayview Campus in Baltimore, Maryland, visit their Web site: http://www.jhbmc.jhu.edu/studies/index.html
·
For trials on infectious, immune, and allergic diseases, visit the site of the National Institute of Allergy and Infectious Diseases: http://www.niaid.nih.gov/clintrials/
General References The following references describe clinical trials and experimental medical research. They have been selected to ensure that they are likely to be available from your local or online bookseller or university medical library. These references are usually written for healthcare professionals, so you may consider consulting with a librarian or bookseller who might recommend a particular reference. The following includes some of the most readily available references (sorted alphabetically by title; hyperlinks provide rankings, information and reviews at Amazon.com): ·
A Guide to Patient Recruitment : Today’s Best Practices & Proven Strategies by Diana L. Anderson; Paperback - 350 pages (2001), CenterWatch, Inc.; ISBN: 1930624115; http://www.amazon.com/exec/obidos/ASIN/1930624115/icongroupinterna
·
A Step-By-Step Guide to Clinical Trials by Marilyn Mulay, R.N., M.S., OCN; Spiral-bound - 143 pages Spiral edition (2001), Jones & Bartlett Pub; ISBN: 0763715697; http://www.amazon.com/exec/obidos/ASIN/0763715697/icongroupinterna
·
The CenterWatch Directory of Drugs in Clinical Trials by CenterWatch; Paperback - 656 pages (2000), CenterWatch, Inc.; ISBN: 0967302935; http://www.amazon.com/exec/obidos/ASIN/0967302935/icongroupinterna
·
The Complete Guide to Informed Consent in Clinical Trials by Terry Hartnett (Editor); Paperback - 164 pages (2000), PharmSource Information Services, Inc.; ISBN: 0970153309; http://www.amazon.com/exec/obidos/ASIN/0970153309/icongroupinterna
54 Flu Infection
·
Dictionary for Clinical Trials by Simon Day; Paperback - 228 pages (1999), John Wiley & Sons; ISBN: 0471985961; http://www.amazon.com/exec/obidos/ASIN/0471985961/icongroupinterna
·
Extending Medicare Reimbursement in Clinical Trials by Institute of Medicine Staff (Editor), et al; Paperback 1st edition (2000), National Academy Press; ISBN: 0309068886; http://www.amazon.com/exec/obidos/ASIN/0309068886/icongroupinterna
·
Handbook of Clinical Trials by Marcus Flather (Editor); Paperback (2001), Remedica Pub Ltd; ISBN: 1901346293; http://www.amazon.com/exec/obidos/ASIN/1901346293/icongroupinterna
Vocabulary Builder The following vocabulary builder gives definitions of words used in this chapter that have not been defined in previous chapters: 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] 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]
Antibody: An immunoglobulin molecule that has a specific amino acid sequence by virtue of which it interacts only with the antigen that induced its synthesis in cells of the lymphoid series (especially plasma cells), or with antigen closely related to it. Antibodies are classified according to their ode of action as agglutinins, bacteriolysins, haemolysins, opsonins, precipitins, etc. [EU] Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized Tlymphocytes, 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] Biopsy: The removal and examination, usually microscopic, of tissue from the living body, performed to establish precise diagnosis. [EU]
Clinical Trials 55
Cardiac: Pertaining to the heart. [EU] Chemotherapy: The treatment of disease by means of chemicals that have a specific toxic effect upon the disease - producing microorganisms or that selectively destroy cancerous tissue. [EU] Enzyme: A protein molecule that catalyses chemical reactions of other substances without itself being destroyed or altered upon completion of the reactions. Enzymes are classified according to the recommendations of the Nomenclature Committee of the International Union of Biochemistry. Each enzyme is assigned a recommended name and an Enzyme Commission (EC) number. They are divided into six main groups; oxidoreductases, transferases, hydrolases, lyases, isomerases, and ligases. [EU] Hydrocortisone: The main glucocorticoid secreted by the adrenal cortex. Its synthetic counterpart is used, either as an injection or topically, in the treatment of inflammation, allergy, collagen diseases, asthma, adrenocortical deficiency, shock, and some neoplastic conditions. [NIH] Immunotherapy: Manipulation of the host's immune system in treatment of disease. It includes both active and passive immunization as well as immunosuppressive therapy to prevent graft rejection. [NIH] Infusion: The therapeutic introduction of a fluid other than blood, as saline solution, solution, into a vein. [EU] Intramuscular: Within the substance of a muscle. [EU] Necrosis: The sum of the morphological changes indicative of cell death and caused by the progressive degradative action of enzymes; it may affect groups of cells or part of a structure or an organ. [EU] Piedra: Either of two diseases resulting from fungal infection of the hair shafts. Black piedra occurs mainly in and on the hairs of the scalp and is caused by Piedraia hortae; white piedra occurs in and on the hairs of the scalp, beard, moustache and genital areas and is caused by Trichosporon beigelii. [NIH] Prednisolone: A glucocorticoid with the general properties of the corticosteroids. It is the drug of choice for all conditions in which routine systemic corticosteroid therapy is indicated, except adrenal deficiency states. [NIH]
Prednisone: A synthetic anti-inflammatory glucocorticoid derived from cortisone. It is biologically inert and converted to prednisolone in the liver. [NIH]
Protease: Proteinase (= any enzyme that catalyses the splitting of interior peptide bonds in a protein). [EU] Recombinant: 1. a cell or an individual with a new combination of genes not found together in either parent; usually applied to linked genes. [EU]
56 Flu Infection
Remission: A diminution or abatement of the symptoms of a disease; also the period during which such diminution occurs. [EU] Sarcoma: A tumour made up of a substance like the embryonic connective tissue; tissue composed of closely packed cells embedded in a fibrillar or homogeneous substance. Sarcomas are often highly malignant. [EU]
57
PART II: ADDITIONAL RESOURCES AND ADVANCED MATERIAL
ABOUT PART II In Part II, we introduce you to additional resources and advanced research on flu infection. All too often, patients who conduct their own research are overwhelmed by the difficulty in finding and organizing information. The purpose of the following chapters is to provide you an organized and structured format to help you find additional information resources on flu infection. In Part II, as in Part I, our objective is not to interpret the latest advances on flu infection or render an opinion. Rather, our goal is to give you access to original research and to increase your awareness of sources you may not have already considered. In this way, you will come across the advanced materials often referred to in pamphlets, books, or other general works. Once again, some of this material is technical in nature, so consultation with a professional familiar with flu infection is suggested.
Studies 59
CHAPTER 4. STUDIES ON FLU INFECTION Overview Every year, academic studies are published on flu infection or related conditions. Broadly speaking, there are two types of studies. The first are peer reviewed. Generally, the content of these studies has been reviewed by scientists or physicians. Peer-reviewed studies are typically published in scientific journals and are usually available at medical libraries. The second type of studies is non-peer reviewed. These works include summary articles that do not use or report scientific results. These often appear in the popular press, newsletters, or similar periodicals. In this chapter, we will show you how to locate peer-reviewed references and studies on flu infection. We will begin by discussing research that has been summarized and is free to view by the public via the Internet. We then show you how to generate a bibliography on flu infection and teach you how to keep current on new studies as they are published or undertaken by the scientific community.
The Combined Health Information Database The Combined Health Information Database summarizes studies across numerous federal agencies. To limit your investigation to research studies and flu infection, 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
60 Flu Infection
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 in “flu infection” (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 a sample of what you can expect from this type of search: ·
Flu Shots, Mammograms, and Alzheimer's Disease: Ethics of Preventive Medicine and Dementia Source: Alzheimer Disease and Associated Disorders. 8(1): 8-14. Spring 1994. Summary: The author describes the ethics of preventive medical care for patients with dementia, focusing on the decision-making process. The main ethical and clinical factors discussed are: (1) the goals of patient care; (2) the patient's clinical state and prognosis; (3) advantages and disadvantages of preventive measures; and (4) consideration of whether one would treat a condition if it was not prevented. The author argues that periodic care-planning conferences with the patient, family, and clinician (or health care team) provide the best opportunity for optimal decision making and allow for explicit discussion of changes in caregiving goals and treatment plans as the patient's clinical condition progresses. 18 references.
·
Diarrhea and Intestinal Flu Source: Metro Wash By-Pass. p. 7. December 1992. Contact: Available from United Ostomy Association. Metropolitan Washington Chapter, Washington Hospital Center, East Building, Room 3102, 110 Irving Street, N.W., Washington, DC 20010. (202) 877-6019. Summary: This brief newsletter article describes the symptoms of diarrhea and intestinal flu. The author defines diarrhea, discusses the various causes of diarrhea, and describes the symptoms and treatment of intestinal flu. The author also briefly discusses dehydration and its prevention and treatment. The editor mentions the problem of diarrhea in people with ostomies.
·
Why Your Yearly Flu Shot Matters Source: Diabetes Forecast. 54(2): 85-86. February 2001.
Studies 61
Contact: Available from American Diabetes Association. 1701 North Beauregard Street, Alexandria, VA 22311. (800) 232-3472. Website: www.diabetes.org. Summary: This article explains why people who have diabetes can benefit from getting a yearly flu shot. Influenza is a viral disease that causes fever, cough, chills, headache, sore throat, and muscle pain. Types of flu virus are A, B, and C. Each type has many strains, and the virus strains change from year to year. Once people have had a particular strain, they usually remain resistant to it for the remainder of their life; however, they are still susceptible to other strains. There is no cure for the flu, and new drugs that can treat the flu reduce symptoms by only a day or two. Therefore, the flu shot is the best bet for staying healthy during the flu season. Each year, health authorities examine patterns of flu around the world and make a guess about which types and strains are most likely to hit the following winter. The flu vaccine is then developed to act against those strains. If health authorities have guessed correctly, people who get the flu vaccine either do not catch the flu or get a mild case. However, if they have guessed incorrectly, people who have received the vaccine may get the flu. Side effects from the flu vaccine are minor, and people cannot get the flu from receiving a flu shot. The American Diabetes Association recommends that everyone who has diabetes who is at least 6 months old, except for people who are allergic to eggs, should get a flu shot in the fall. ·
Fending Off the Flu and Other Preventable Diseases Source: Diabetes Self-Management. 16(6): 82-83. November-December 1999. Contact: Available from R.A. Rapaport Publishing, Inc. 150 West 22nd Street, New York, NY 10011. (800) 234-0923. Summary: This article presents guidelines for receiving various types of vaccinations. Many deaths occur in the United States from vaccine preventable deaths. The article identifies the people who should and should not receive influenza; pneumonia; hepatitis A and B; tetanus and diphtheria; measles, mumps, and rubella; and chicken pox vaccinations. In addition, the article explains when and how often these vaccinations should be received.
·
Fighting Colds and Flu Source: Diabetes Self-Management. 15(1): 47-48, 50-52. January-February 1998.
62 Flu Infection
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 caring for colds and the flu. In a section on guidelines for coping, the author addresses diabetes medicines, blood glucose monitoring, testing for ketones, eating, dehydration, fevers, resting, and prescription and nonprescription drugs. Other topics include prevention, planning ahead, and when to call a doctor. The article warns that diabetic ketoacidosis and hyperosmolar hyperglycemic nonketotic syndrome may result if blood glucose is allowed to rise unchecked. Symptoms of high ketones include stomach pain, nausea, vomiting, chest pain, rapid shallow breathing, and difficulty staying awake or alert. The author notes that people should continue taking insulin or oral drugs even if they cannot eat. The article includes a form to be filled out and used as a sick day plan. (AA-M). ·
Guarding Against the Flu Source: Diabetes Forecast. 44(10): 74, 76-77. October 1991. Summary: This article for people with diabetes discusses the problems encountered in dealing with influenza viruses or the flu. The author focuses on the different kinds of influenza viruses and the vaccine that can protect against influenza. The author also explains why influenza poses a specific threat to people with diabetes. A final section describes the flu shot itself and possible side effects from the vaccine.
·
Nonprescription Drugs for Colds and Flu Source: Diabetes Self-Management. 6(6): 7-8, 10. November-December 1989. Summary: This article helps the patient with diabetes to select an appropriate nonprescription drug to ease cold and flu symptoms. Some over-the-counter products warn patients with diabetes that adrenalinelike decongestants can elevate blood glucose levels. Usually, the increase is not significant enough to cause long-term problems; however, it is suggested, people with diabetes discuss use of nonprescription drugs with their physicians. The stress of being infected by a virus alone will raise blood glucose levels and patients who are sick or stressed should test their blood glucose levels at least 4 times per day. There are many medications that can be purchased without a prescription. It is important to read the label and ingredients of all non prescription drugs. A listing is provided of sugar-free cough and cold medicines by brand names, and another table analyzes the ingredients and possible side effects of aspirin,
Studies 63
antihistamines, decongestants, cough suppressants, expectorants, caffeine, alcohol, gargles, throat sprays, and lozenges. Some helpful hints on interpreting chemical ingredients are offered along with precautions. ·
Consumer Attitudes Towards Computer-assisted Self-care of the Common Cold Source: Patient Education and Counseling. 23(1):55-62, April 1994. Summary: Researchers compared the attitudes and knowledge of 260 young adult computer users and 194 young adult college students dichotomized according to their perceived effectiveness of computerassisted self-care for colds and flu. Recruited from a large public midwest university, participants (1) completed a knowledge questionnaire on colds and flu, (2) used a computer program designed to enhance self-care for colds and the flu, and (3) then completed a second questionnaire. The second questionnaire elicited information on (1) their attitudes toward using a computer for self-care for colds and flu and (2) the perceived importance of physician interactions, physician expertise, and patientphysician interaction. The first questionnaire contained 27 true/false/donot-know questions and the second questionnaire contained 27 attitude questions on a 4-point Likert scale. Researchers classified participants as users of computer-assisted self-care if they agreed that computergenerated information on diagnosis and treatment options for a cold or related illness would allow people to be more responsible for their health, and that computer-generated information on diagnosis and treatment for a cold or related illness would make the respondents themselves more responsible for managing their own health. Researchers analyzed user and nonusers according to their perceived importance of physician expertise, time spent with the physician, and the quality of the interpersonal interaction between patients and physicians. Compared with users, nonusers preferred personal contact with their physicians and felt that computerized health assessments would be limited in vocabulary and range of current medical information. Nonusers were more likely to agree that people could not be trusted to do an accurate computerized health assessment and that the average person was too computer illiterate to use computers for self-care. 2 tables, 27 references.
·
Factors Associated with Utilization of the Swine Flu Vaccination Program Among Senior Citizens Source: Medical Care. 17(2):191-200, February 1979. Summary: The health belief model was tested in the context of the swine flue vaccination program for senior citizens. Analysis was based on 232 responses to a questionnaire mailed to a simple random sample of 500
64 Flu Infection
senior citizens in Tompkins County, New York. Social and psychological variables identified by the model as important in determining utilization of preventive health services were (1) perceived susceptibility and severity of disease, (2) perceived efficacy and danger associated with the preventive action, and (3) general health motivations. Differences of means between users and nonusers for these variables were computed and compared with the results of a more sophisticated analytic technique, logit analysis, for use with dichotomous dependent variables. Results reveal that the health belief model accounts for 34 percent of the variance in use of the vaccine by senior citizens. Perceived susceptibility to the disease and amount of danger associated with receiving the swine flu immunization were found to be the most important determinants of utilization. 21 references. ·
Flu: More Than Just a Nuisance Source: Diabetes Self-Management. 17(6): 87-89, 91-92. NovemberDecember 2000. Contact: Available from R.A. Rapaport Publishing, Inc. 150 West 22nd Street, New York, NY 10011. (800) 234-0923. Website: www.diabetes-selfmgmt.com. Summary: This article provides an overview of influenza, focusing on what the flu is, why it can be a problem for people who have diabetes, and how people can avoid getting this potentially life threatening infection. Influenza is a respiratory infection caused by the influenza virus. The main strains of the influenza virus are A, B, and C. The A and B strains tend to make people the sickest and cause flu epidemics, but infection with a C virus usually causes only mild respiratory symptoms. The flu, which is highly contagious, is usually spread from person to person when an infected person sneezes or coughs, releasing the virus into the air. The virus is then inhaled by other people, who may become infected. The flu can also be spread by contact with objects that have been contaminated with the virus. Onset of the flu usually occurs within 24 to 48 hours after a person has been infected. Symptoms include high fever, chills, fatigue, muscle or joint aches, runny nose, dry cough, and headache that worsens in bright light. Higher than normal blood glucose levels can impair the body's ability to fight off infection, so a person who has diabetes and high blood glucose is more susceptible to getting the flu. In addition, the stress hormones that are released when a person has the flu tend to raise blood sugar. Monitoring more frequently and using supplemental insulin may be needed to assist with blood glucose control. The most effective way to avoid getting the flu is to get an annual flu vaccine and to have a healthy lifestyle. The article identifies people who
Studies 65
should and should not get a flu shot each year and addresses the issue of getting a pneumonia vaccine. In addition, the article offers suggestions for developing sick day guidelines, describes antiviral drugs that have been approved to prevent influenza A and treat people who get the flu, and explains how to differentiate between a cold and the flu. 1 table.
Federally-Funded Research on Flu Infection The U.S. Government supports a variety of research studies relating to flu infection and associated conditions. These studies are tracked by the Office of Extramural Research at the National Institutes of Health.18 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. Visit the CRISP Web site at http://commons.cit.nih.gov/crisp3/CRISP.Generate_Ticket. You can perform targeted searches by various criteria including geography, date, as well as topics related to flu infection and related conditions. 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 flu infection and related conditions. In some cases, therefore, it may be difficult to understand how some basic or fundamental research could eventually translate into medical practice. The following sample is typical of the type of information found when searching the CRISP database for flu infection: ·
Project Title: A Longitudinal Study of Influenza Vaccine Decisions Principal Investigator & Institution: Chapman, Gretchen B.; Assistant Professor; Psychology; Rutgers the St Univ of Nj New Brunswick New Jersey New Brunswick New Brunswick, Nj 08903 Timing: Fiscal Year 2001; Project Start 1-MAR-2001; Project End 1-AUG2004 Summary: Understanding how people make decisions about preventive health behavior is crucial to the design of effective interventions to promote such behavior. This proposal explores decision making about
18 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).
66 Flu Infection
influenza vaccination, an important preventive health behavior because it both saves money and prevents the considerable morbidity and mortality caused by the flu. Unlike most previous studies of flu shot acceptance, the current study will use a longitudinal design over three flu seasons, allow us to address research questions previously not considered. It will also assess vaccination decisions among two previously understudied groups: healthcare workers and healthy adults in a workplace setting. These two groups are important because the flu shot has considerable health-related and economic benefits for them, and they afford a sensitive examination of decision making factors that drive vaccine acceptance, since they have easy access to free vaccination against influenza and are aware of its availability. Using a utility theory framework, the proposed study will address three Specific Aims. (1) First, we extend previous research showing that prior vaccine acceptance is one of the best predictors of present vaccine acceptance by using a longitudinal design to test two possible explanations for this association. One is that people make an explicit decision each year as to whether to obtain the vaccine, but, because costs and benefits of the vaccine remain constant from year to year, decisions are consistent across time. An alternative explanation is that vaccination is driven by habit, not explicit decisions. (2) Our second aim concerns reasons for the strong predictive relationship, found in previous studies, between perceived effectiveness of the influenza vaccine and vaccine acceptance. We will extend previous research by examining the origins of such effectiveness beliefs. (3) Third, because the benefits of vaccination are both belayed and uncertain, we will examine the psychological role of time and risk in decisions about vaccine acceptance. We will test whether vaccine acceptance is related to individual time preferences (the extent to which future health outcomes are valued relative to certain ones). In addition, vaccination decisions may be influenced by perceptions of the risk of influenza, and intentions to vaccinate sometimes may not be activated on because of inaccurate forecasting of future preferences. The results of this study will extend the understanding of predictors of influenza vaccine acceptance and will prove valuable in the development of intervention strategies to boost vaccine acceptance rates. Website: http://commons.cit.nih.gov/crisp3/CRISP.Generate_Ticket ·
Project Title: Microcarrier Culture System for Human Influenza Vaccine Principal Investigator & Institution: Hillegas, William J.; Solohill Engineering, Inc. 4220 Varsity Dr Ann Arbor, Mi 48108 Timing: Fiscal Year 2001; Project Start 1-SEP-2001; Project End 8-FEB-2002
Studies 67
Summary: (Provided by Applicant): The goal of the research herein proposed is to develop a microcarrier - bioreactor - cell culture-based protocol that enables the rapid, efficient, low cost production of human influenza vaccine. Currently, virtually all human influenza virus vaccine is produced in embryonated eggs. The Federal government and the World Health Organization are actively seeking alternative cell culture approaches to flu vaccine production since there are several problems with the egg-derived vaccines. A cell culture-based protocol, with its potential to rapidly achieve large scale, would be invaluable in the case of an influenza pandemic. A new microcarrier substrate (Hillex), developed by SoloHill (under grant CA74595) has been shown to support attachment and growth of a variety of low adhesive cells in sera-free media and shows promise for this application. To achieve this research goal, the following two specific aims will be performed. Specific Aim I. To demonstrate feasibility for growing two different cell types (Vero and MDCK) on Hillex microcarriers and identify critical cell culture variables that will provide high cell yields on this substrate under serum-free conditions. Specific Aim II. To demonstrate influenza virus production on Vero and MDCK cells maintained on Hillex microcarriers (others have demonstrated that either Vero or MDCK cells can feasibly be used to propagate human influenza virus) under optimized bioreactor-type conditions. Proposed Commercial Application: Not Available Website: http://commons.cit.nih.gov/crisp3/CRISP.Generate_Ticket
E-Journals: PubMed Central19 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).20 Access to this growing archive of e-journals is free and unrestricted.21 To search, go to http://www.pubmedcentral.nih.gov/index.html#search, and type “flu infection” (or synonyms) into the search box. This search gives you access to
Adapted from the National Library of Medicine: http://www.pubmedcentral.nih.gov/about/intro.html. 20 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. 21 The value of PubMed Central, in addition to its role as an archive, lies 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. 19
68 Flu Infection
full-text articles. The following is a sample of items found for flu infection in the PubMed Central database: ·
A Potential Peptide Vaccine Against Two Different Strains of Influenza Virus Isolated at Intervals of about 10 Years by H Naruse, K Ogasawara, R Kaneda, S Hatakeyama, T Itoh, H Kida, T Miyazaki, RA Good, and K Onoe; 1994 September 27 http://www.pubmedcentral.nih.gov/articlerender.fcgi?rendertype=abst ract&artid=44858
·
A Simple Restriction Fragment Length Polymorphism-Based Strategy That Can Distinguish the Internal Genes of Human H1N1, H3N2, and H5N1 Influenza A Viruses by Lynn A. Cooper and Kanta Subbarao; 2000 July http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=86974&ren dertype=external
·
An Influenza A Virus Containing Influenza B Virus 5' and 3' Noncoding Regions on the Neuraminidase Gene is Attenuated in Mice by T Muster, EK Subbarao, M Enami, BR Murphy, and P Palese; 1991 June 15 http://www.pubmedcentral.nih.gov/articlerender.fcgi?rendertype=abst ract&artid=51835
·
Application of a Fluorogenic PCR Assay for Typing and Subtyping of Influenza Viruses in Respiratory Samples by B. Schweiger, I. Zadow, R. Heckler, H. Timm, and G. Pauli; 2000 April http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=86487&ren dertype=external
·
Avian-to-human transmission of H9N2 subtype influenza A viruses: Relationship between H9N2 and H5N1 human isolates by Y. P. Lin, M. Shaw, V. Gregory, K. Cameron, W. Lim, A. Klimov, K. Subbarao, Y. Guan, S. Krauss, K. Shortridge, R. Webster, N. Cox, and A. Hay; 2000 August 15 http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=16920
·
Characteristics of virus-specific CD8 + T cells in the liver during the control and resolution phases of influenza pneumonia by Gabrielle T. Belz, John D. Altman, and Peter C. Doherty; 1998 November 10 http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=24906
·
Characterization of the 1918 "Spanish" influenza virus neuraminidase gene by Ann H. Reid, Thomas G. Fanning, Thomas A. Janczewski, and Jeffery K. Taubenberger; 2000 June 6 http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=18739
Studies 69
·
Combined PCR-Heteroduplex Mobility Assay for Detection and Differentiation of Influenza A Viruses from Different Animal Species by Joanna S. Ellis and Maria C. Zambon; 2001 November http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=88493&ren dertype=external
·
Commentary: Influenza virus hemagglutinin cleavage into HA1, HA2: No laughing matter by Jeffery K. Taubenberger; 1998 August 18 http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=33880
·
Commentary:1918 Spanish influenza: The secrets remain elusive by Robert G. Webster; 1999 February 16 http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=33548
·
Commentary:Amiloride-sensitive sodium channels contribute to the woes of the flu by William B. Guggino and Sandra E. Guggino; 2000 August 29 http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=34034
·
Comparative study of nasopharyngeal aspirate and nasal swab specimens for detection of influenza by Terho Heikkinen, Aimo A Salmi, and Olli Ruuskanen; 2001 January 20 http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=26590
·
Comparison of a New Neuraminidase Detection Assay with an Enzyme Immunoassay, Immunofluorescence, and Culture for Rapid Detection of Influenza A and B Viruses in Nasal Wash Specimens by Daniel E. Noyola, Bruce Clark, Frederick T. O'Donnell, Robert L. Atmar, Jewel Greer, and Gail J. Demmler; 2000 March http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=86363&ren dertype=external
·
Comparison of Four Clinical Specimen Types for Detection of Influenza A and B Viruses by Optical Immunoassay (FLU OIA Test) and Cell Culture Methods by Kristi A. Covalciuc, Kenneth H. Webb, and Curtis A. Carlson; 1999 December http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=85858&ren dertype=external
·
Controversy:Mass influenza vaccination in Ontario: a sensible move by Richard E. Schabas; 2001 January 9 http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=80630&ren dertype=external
·
Controversy:Mass influenza vaccination in Ontario: Is it worthwhile? by Vittorio Demicheli; 2001 January 9 http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=80631&ren dertype=external
70 Flu Infection
·
Detection of Antibody to Avian Influenza A (H5N1) Virus in Human Serum by Using a Combination of Serologic Assays by Thomas Rowe, Robert A. Abernathy, Jean Hu-Primmer, William W. Thompson, Xiuhua Lu, Wilina Lim, Keiji Fukuda, Nancy J. Cox, and Jacqueline M. Katz; 1999 April http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=88628&ren dertype=external
·
Detection of Influenza A Viruses from Different Species by PCR Amplification of Conserved Sequences in the Matrix Gene by Ron A. M. Fouchier, Theo M. Bestebroer, Sander Herfst, Liane Van Der Kemp, Guus F. Rimmelzwaan, and Albert D. M. E. Osterhaus; 2000 November http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=87547&ren dertype=external
·
Evaluation of a Rapid Optical Immunoassay for Influenza Viruses (FLU OIA Test) in Comparison with Cell Culture and Reverse Transcription-PCR by Guy Boivin, Isabelle Hardy, and Andrew Kress; 2001 February http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=87806&ren dertype=external
·
Excess winter mortality: influenza or cold stress? Observational study by G C Donaldson and W R Keatinge; 2002 January 12 http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=64505
·
Flu vaccination in Alberta long-term care facilities by Paddy Quail; 2001 November 13 http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=81609&ren dertype=external
·
FLU: A negative regulator of chlorophyll biosynthesis in Arabidopsis thaliana by Rasa Meskauskiene, Mena Nater, David Goslings, Felix Kessler, Roel op den Camp, and Klaus Apel; 2001 October 23 http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=60138
·
From the Cover:Sequence of the 1918 pandemic influenza virus nonstructural gene (NS) segment and characterization of recombinant viruses bearing the 1918 NS genes by Christopher F. Basler, Ann H. Reid, Jody K. Dybing, Thomas A. Janczewski, Thomas G. Fanning, Hongyong Zheng, Mirella Salvatore, Michael L. Perdue, David E. Swayne, Adolfo Garcia-Sastre, Peter Palese, and Jeffery K. Taubenberger; 2001 February 27 http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=30210
Studies 71
·
Genetic Characterization of an H1N2 Influenza Virus Isolated from a Pig In Indiana by Alexander I. Karasin, Christopher W. Olsen, and Gary A. Anderson; 2000 June http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=86843&ren dertype=external
·
Genotypic Stability of Cold-Adapted Influenza Virus Vaccine in an Efficacy Clinical Trial by Tai-An Cha, Kevin Kao, Jackie Zhao, Patricia E. Fast, Paul M. Mendelman, and Ann Arvin; 2000 February http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=86217&ren dertype=external
·
Haemophilus influenzae Pill are Composite Structures Assembled via the HifB Chaperone by JWS Geme, JS Pinker, GP Krasan, J Heuser, E Bullitt, AL Smith, and SJ Hultgren; 1996 October 15 http://www.pubmedcentral.nih.gov/articlerender.fcgi?rendertype=abst ract&artid=38158
·
Heterogeneity of Influenza B Virus Strains in One Epidemic Season Differentiated by Monoclonal Antibodies and Nucleotide Sequences by Naoko Nakagawa, Ritsuko Kubota, Akiko Maeda, Toshimasa Nakagawa, and Yoshinobu Okuno; 2000 September http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=87409&ren dertype=external
·
Impact of Sample Type on Rapid Detection of Influenza Virus A by Cytospin-Enhanced Immunofluorescence and Membrane EnzymeLinked Immunosorbent Assay by Marie L. Landry, Sandra Cohen, and David Ferguson; 2000 January http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=88742&ren dertype=external
·
Influenza vaccination in Alberta long-term care facilities by Margaret L. Russell; 2001 May 15 http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=81068
·
Innate and acquired humoral immunities to influenza virus are mediated by distinct arms of the immune system by Nicole Baumgarth, Ometa C. Herman, Gina C. Jager, Lorena Brown, Leonard A. Herzenberg, and Leonore A. Herzenberg; 1999 March 2 http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=26769
·
Isolation of Amantadine-Resistant Influenza A Viruses (H3N2) from Patients following Administration of Amantadine in Japan by Jun Iwahashi, Katsuro Tsuji, Tetsuya Ishibashi, Junboku Kajiwara, Yoshihiro Imamura, Ryoichi Mori, Koyu Hara, Takahito Kashiwagi, Yasushi Ohtsu,
72 Flu Infection
Nobuyuki Hamada, Hisao Maeda, Michiko Toyoda, and Tetsuya Toyoda; 2001 April http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=87992&ren dertype=external ·
Mink Lung Cells and Mixed Mink Lung and A549 Cells for Rapid Detection of Influenza Virus and Other Respiratory Viruses by Yung T. Huang and Brian M. Turchek; 2000 January http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=88739&ren dertype=external
·
Molecular characterization of H9N2 influenza viruses: Were they the donors of the "internal" genes of H5N1 viruses in Hong Kong? by Yi Guan, Kennedy F. Shortridge, Scott Krauss, and Robert G. Webster; 1999 August 3 http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=17788
·
Origin and evolution of the 1918 "Spanish" influenza virus hemagglutinin gene by Ann H. Reid, Thomas G. Fanning, Johan V. Hultin, and Jeffery K. Taubenberger; 1999 February 16 http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=15547
·
Paramedics face dismissal for refusing flu shots by Brad Mackay; 2002 March 19 http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=99478&ren dertype=external
·
Prevention of influenza and pneumococcal pneumonia in Canadian long-term care facilities: How are we doing? by Colin G. Stevenson, Margaret A. McArthur, Monika Naus, Erika Abraham, and Allison J. McGeer; 2001 May 15 http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=81067
·
Rapid virological surveillance of community influenza infection in general practice by William F Carman, Lesley A Wallace, Jacqueline Walker, Sheena McIntyre, Ahilya Noone, Peter Christie, James Millar, and James D Douglas; 2000 September 23 http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=27488
·
Regulation of a nuclear export signal by an adjacent inhibitory sequence: The effector domain of the influenza virus NS1 protein by Yongzhong Li, Yoshihiko Yamakita, and Robert M. Krug; 1998 April 28 http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=20179
Studies 73
·
Regulation of eukaryotic protein synthesis: Selective influenza viral mRNA translation is mediated by the cellular RNA-binding protein GRSF-1 by Young Woo Park, Jeffrey Wilusz, and Michael G. Katze; 1999 June 8 http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=21977
·
Sequence of an Influenza Virus Hemagglutinin Determined Directly from a Clinical Sample by A Rajakumar, EM Swierkosz, and IT Schulze; 1990 June 1 http://www.pubmedcentral.nih.gov/articlerender.fcgi?rendertype=abst ract&artid=54066
·
Simultaneous Detection and Typing of Influenza Viruses A and B by a Nested Reverse Transcription-PCR: Comparison to Virus Isolation and Antigen Detection by Immunofluorescence and Optical Immunoassay (FLU OIA) by Bjorn Herrmann, Christine Larsson, and Benita Wirgart Zweygberg; 2001 January http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=87692&ren dertype=external
·
Simultaneous Detection of Influenza Viruses A and B Using Real-Time Quantitative PCR by L. J. R. van Elden, M. Nijhuis, P. Schipper, R. Schuurman, and A. M. van Loon; 2001 January http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=87701&ren dertype=external
·
Variable efficacy of repeated annual influenza vaccination by Derek J. Smith, Stephanie Forrest, David H. Ackley, and Alan S. Perelson; 1999 November 23 http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=24180
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. 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 the public.22 If the publisher has a Web site that offers full text of its journals, PubMed will provide links to that site, as well 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.
22
74 Flu Infection
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 flu infection, simply go to the PubMed Web site at www.ncbi.nlm.nih.gov/pubmed. Type “flu infection” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for “flu infection” (hyperlinks lead to article summaries): ·
The effect of garlic extract, applied as such or in association with NaF, on experimental influenza in mice. Author(s): Esanu V, Prahoveanu E. Source: Virologie. 1983 January-March; 34(1): 11-7. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db= PubMed&list_uids=6304996&dopt=Abstract
·
Vitamin E supplementation increases T helper 1 cytokine production in old mice infected with influenza virus. Author(s): Han SN, Wu D, Ha WK, Beharka A, Smith DE, Bender BS, Meydani SN. Source: Immunology. 2000 August; 100(4): 487-93. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db= PubMed&list_uids=10929076&dopt=Abstract
Vocabulary Builder Acylation: The addition of an organic acid radical into a molecule. [NIH] Antidepressant: An agent that stimulates the mood of a depressed patient, including tricyclic antidepressants and monoamine oxidase inhibitors. [EU] Antifungal: Destructive to fungi, or suppressing their reproduction or growth; effective against fungal infections. [EU] Antigens: Substances that are recognized by the immune system and induce an immune reaction. [NIH] Antihistamine: A drug that counteracts the action of histamine. The antihistamines are of two types. The conventional ones, as those used in allergies, block the H1 histamine receptors, whereas the others block the H2 receptors. Called also antihistaminic. [EU] Antimicrobial: Killing microorganisms, or suppressing their multiplication or growth. [EU]
Studies 75
Antioxidant: One of many widely used synthetic or natural substances added to a product to prevent or delay its deterioration by action of oxygen in the air. Rubber, paints, vegetable oils, and prepared foods commonly contain antioxidants. [EU] Aqueous: Watery; prepared with water. [EU] Arabidopsis: A genus of flowering plants found in north temperate regions. The species A. thaliana is used for experiments in classical plant genetics as well as molecular genetic studies in plant physiology, biochemistry, and development. [NIH] Assay: Determination of the amount of a particular constituent of a mixture, or of the biological or pharmacological potency of a drug. [EU] Babesiosis: A group of tick-borne diseases of mammals including zoonoses in humans. They are caused by protozoans of the genus babesia, which parasitize erythrocytes, producing hemolysis. In the U.S., the organism's natural host is mice and transmission is by the deer tick ixodes scapularis. [NIH]
Benzocaine: A surface anesthetic that acts by preventing transmission of impulses along nerve fibers and at nerve endings. [NIH] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biosynthesis: The building up of a chemical compound in the physiologic processes of a living organism. [EU] Carbohydrate: An aldehyde or ketone derivative of a polyhydric alcohol, particularly of the pentahydric and hexahydric alcohols. They are so named because the hydrogen and oxygen are usually in the proportion to form water, (CH2O)n. The most important carbohydrates are the starches, sugars, celluloses, and gums. They are classified into mono-, di-, tri-, poly- and heterosaccharides. [EU] Chimera: An individual that contains cell populations derived from different zygotes. [NIH] Chlorophyll: Porphyrin derivatives containing magnesium that act to convert light energy in photosynthetic organisms. [NIH] Cognition: Intellectual or mental process whereby an organism becomes aware of or obtains knowledge. [NIH] Colorectal: Pertaining to or affecting the colon and rectum. [EU] Cortex: The outer layer of an organ or other body structure, as distinguished from the internal substance. [EU] Cortical: Pertaining to or of the nature of a cortex or bark. [EU] Cytokines: Non-antibody proteins secreted by inflammatory leukocytes and
76 Flu Infection
some non-leukocytic cells, that act as intercellular mediators. They differ from classical hormones in that they are produced by a number of tissue or cell types rather than by specialized glands. They generally act locally in a paracrine or autocrine rather than endocrine manner. [NIH] Decongestant: An agent that reduces congestion or swelling. [EU] Dementia: An acquired organic mental disorder with loss of intellectual abilities of sufficient severity to interfere with social or occupational functioning. The dysfunction is multifaceted and involves memory, behavior, personality, judgment, attention, spatial relations, language, abstract thought, and other executive functions. The intellectual decline is usually progressive, and initially spares the level of consciousness. [NIH] Dendritic: 1. branched like a tree. 2. pertaining to or possessing dendrites. [EU]
Echinacea: A genus of perennial herbs used topically and internally. It contains echinacoside, glycosides, inulin, isobutyl amides, resin, and sesquiterpenes. [NIH] Echoviruses: A group of enteroviruses isolated from man and originally thought not to be associated with disease, whence the name Enteric Cytopathic Human Orphan; however, several serotypes have been found to cause meningitis, diarrhea, and respiratory disease. [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] Encephalitis: Inflammation of the brain. [EU] Endocytosis: Cellular uptake of extracellular materials within membranelimited vacuoles or microvesicles. Endosomes play a central role in endocytosis. [NIH] Endosomes: Cytoplasmic vesicles formed when coated vesicles shed their clathrin coat. Endosomes internalize macromolecules bound by receptors on the cell surface. [NIH] Enterovirus: A genus of the family picornaviridae whose members preferentially inhabit the intestinal tract of a variety of hosts. The genus contains many species. Newly described members of human enteroviruses are assigned continuous numbers with the species designated "human enterovirus". [NIH] Eosinophils: Granular leukocytes with a nucleus that usually has two lobes connected by a slender thread of chromatin, and cytoplasm containing coarse, round granules that are uniform in size and stainable by eosin. [NIH] Epithelium: The covering of internal and external surfaces of the body, including the lining of vessels and other small cavities. It consists of cells
Studies 77
joined by small amounts of cementing substances. Epithelium is classified into types on the basis of the number of layers deep and the shape of the superficial cells. [EU] Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH] Escherichia: A genus of gram-negative, facultatively anaerobic, rod-shaped bacteria whose organisms occur in the lower part of the intestine of warmblooded animals. The species are either nonpathogenic or opportunistic pathogens. [NIH] Exocytosis: Cellular release of material within membrane-limited vesicles by fusion of the vesicles with the cell membrane. [NIH] Expectorant: 1. promoting the ejection, by spitting, of mucus or other fluids from the lungs and trachea. 2. an agent that promotes the ejection of mucus or exudate from the lungs, bronchi, and trachea; sometimes extended to all remedies that quiet cough (antitussives). [EU] Fluconazole: Triazole antifungal agent that is used to treat oropharyngeal candidiasis and cryptococcal meningitis in AIDS. [NIH] Fluorescence: The property of emitting radiation while being irradiated. The radiation emitted is usually of longer wavelength than that incident or absorbed, e.g., a substance can be irradiated with invisible radiation and emit visible light. X-ray fluorescence is used in diagnosis. [NIH] Fluoxetine: The first highly specific serotonin uptake inhibitor. It is used as an antidepressant and often has a more acceptable side-effects profile than traditional antidepressants. [NIH] Glucose: D-glucose, a monosaccharide (hexose), C6H12O6, also known as dextrose (q.v.), found in certain foodstuffs, especially fruits, and in the normal blood of all animals. It is the end product of carbohydrate metabolism and is the chief source of energy for living organisms, its utilization being controlled by insulin. Excess glucose is converted to glycogen and stored in the liver and muscles for use as needed and, beyond that, is converted to fat and stored as adipose tissue. Glucose appears in the urine in diabetes mellitus. [EU] Glycine: A non-essential amino acid. It is found primarily in gelatin and silk fibroin and used therapeutically as a nutrient. It is also a fast inhibitory neurotransmitter. [NIH] Granule: A small pill made from sucrose. [EU] Haematological: Relating to haematology, that is that branch of medical science which treats of the morphology of the blood and blood-forming tissues. [EU]
78 Flu Infection
Hexylresorcinol: A substituted dihydroxybenzene that is used topically as an antiseptic for the treatment of minor skin infections. [NIH] Hormonal: Pertaining to or of the nature of a hormone. [EU] Hormones: Chemical substances having a specific regulatory effect on the activity of a certain organ or organs. The term was originally applied to substances secreted by various endocrine glands and transported in the bloodstream to the target organs. It is sometimes extended to include those substances that are not produced by the endocrine glands but that have similar effects. [NIH] Humoral: Of, relating to, proceeding from, or involving a bodily humour now often used of endocrine factors as opposed to neural or somatic. [EU] Hybridization: The genetic process of crossbreeding to produce a hybrid. Hybrid nucleic acids can be formed by nucleic acid hybridization of DNA and RNA molecules. Protein hybridization allows for hybrid proteins to be formed from polypeptide chains. [NIH] Immunoassay: Immunochemical assay or detection of a substance by serologic or immunologic methods. Usually the substance being studied serves as antigen both in antibody production and in measurement of antibody by the test substance. [NIH] 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] Insulin: A protein hormone secreted by beta cells of the pancreas. Insulin plays a major role in the regulation of glucose metabolism, generally promoting the cellular utilization of glucose. It is also an important regulator of protein and lipid metabolism. Insulin is used as a drug to control insulindependent diabetes mellitus. [NIH] Itraconazole: An antifungal agent that has been used in the treatment of histoplasmosis, blastomycosis, cryptococcal meningitis, and aspergillosis. [NIH]
Ketoacidosis: Acidosis accompanied by the accumulation of ketone bodies (ketosis) in the body tissues and fluids, as in diabetic acidosis. [EU] Kinetic: Pertaining to or producing motion. [EU] Lethal: Deadly, fatal. [EU] Lipid: Any of a heterogeneous group of flats and fatlike substances characterized by being water-insoluble and being extractable by nonpolar (or fat) solvents such as alcohol, ether, chloroform, benzene, etc. All contain as a major constituent aliphatic hydrocarbons. The lipids, which are easily stored in the body, serve as a source of fuel, are an important constituent of cell
Studies 79
structure, and serve other biological functions. Lipids may be considered to include fatty acids, neutral fats, waxes, and steroids. Compound lipids comprise the glycolipids, lipoproteins, and phospholipids. [EU] Liposome: A spherical particle in an aqueous medium, formed by a lipid bilayer enclosing an aqueous compartment. [EU] Localization: 1. the determination of the site or place of any process or lesion. 2. restriction to a circumscribed or limited area. 3. prelocalization. [EU] Mediator: An object or substance by which something is mediated, such as (1) a structure of the nervous system that transmits impulses eliciting a specific response; (2) a chemical substance (transmitter substance) that induces activity in an excitable tissue, such as nerve or muscle; or (3) a substance released from cells as the result of the interaction of antigen with antibody or by the action of antigen with a sensitized lymphocyte. [EU] Membrane: A thin layer of tissue which covers a surface, lines a cavity or divides a space or organ. [EU] Meningitis: Inflammation of the meninges. When it affects the dura mater, the disease is termed pachymeningitis; when the arachnoid and pia mater are involved, it is called leptomeningitis, or meningitis proper. [EU] Menthol: An alcohol produced from mint oils or prepared synthetically. [NIH]
Microscopy: The application of microscope magnification to the study of materials that cannot be properly seen by the unaided eye. [NIH] Mobility: Capability of movement, of being moved, or of flowing freely. [EU] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Myocarditis: Inflammation of the myocardium; inflammation of the muscular walls of the heart. [EU] Neutrophil: Having an affinity for neutral dyes. [EU] Nucleocapsid: A protein-nucleic acid complex which forms part or all of a virion. It consists of a capsid plus enclosed nucleic acid. Depending on the virus, the nucleocapsid may correspond to a naked core or be surrounded by a membranous envelope. [NIH] Parasitic: Pertaining to, of the nature of, or caused by a parasite. [EU] Particle: A tiny mass of material. [EU] Phenylpropanolamine: A sympathomimetic that acts mainly by causing release of norepinephrine but also has direct agonist activity at some adrenergic receptors. It is most commonly used as a nasal vasoconstrictor and an appetite depressant. [NIH] Psychiatry:
The medical science that deals with the origin, diagnosis,
80 Flu Infection
prevention, and treatment of mental disorders. [NIH] Psychology: The science dealing with the study of mental processes and behavior in man and animals. [NIH] Psychosomatic: Pertaining to the mind-body relationship; having bodily symptoms of psychic, emotional, or mental origin; called also psychophysiologic. [EU] Pulmonary: Pertaining to the lungs. [EU] Pyelonephritis: Inflammation of the kidney and its pelvis, beginning in the interstitium and rapidly extending to involve the tubules, glomeruli, and blood vessels; due to bacterial infection. [EU] Receptor: 1. a molecular structure within a cell or on the surface characterized by (1) selective binding of a specific substance and (2) a specific physiologic effect that accompanies the binding, e.g., cell-surface receptors for peptide hormones, neurotransmitters, antigens, complement fragments, and immunoglobulins and cytoplasmic receptors for steroid hormones. 2. a sensory nerve terminal that responds to stimuli of various kinds. [EU] Reconstitution: 1. a type of regeneration in which a new organ forms by the rearrangement of tissues rather than from new formation at an injured surface. 2. the restoration to original form of a substance previously altered for preservation and storage, as the restoration to a liquid state of blood serum or plasma that has been dried and stored. [EU] Recurrence: The return of a sign, symptom, or disease after a remission. [NIH] Sneezing: Sudden, forceful, involuntary expulsion of air from the nose and mouth caused by irritation to the mucous membranes of the upper respiratory tract. [NIH] Substrate: A substance upon which an enzyme acts. [EU] Topical: Pertaining to a particular surface area, as a topical anti-infective applied to a certain area of the skin and affecting only the area to which it is applied. [EU] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Virulence: The degree of pathogenicity within a group or species of microorganisms or viruses as indicated by case fatality rates and/or the ability of the organism to invade the tissues of the host. [NIH] Vitreous: Glasslike or hyaline; often used alone to designate the vitreous body of the eye (corpus vitreum). [EU]
Patents 81
CHAPTER 5. PATENTS ON FLU INFECTION Overview You can learn about innovations relating to flu infection by reading recent patents and patent applications. Patents can be physical innovations (e.g. chemicals, pharmaceuticals, medical equipment) or processes (e.g. treatments or diagnostic procedures). The United States Patent and Trademark Office defines a patent as a grant of a property right to the inventor, issued by the Patent and Trademark Office.23 Patents, therefore, are intellectual property. For the United States, the term of a new patent is 20 years from the date when the patent application was filed. If the inventor wishes to receive economic benefits, it is likely that the invention will become commercially available to patients with flu infection within 20 years of the initial filing. It is important to understand, therefore, that an inventor’s patent does not indicate that a product or service is or will be commercially available to patients with flu infection. The patent implies only that the inventor has “the right to exclude others from making, using, offering for sale, or selling” the invention in the United States. While this relates to U.S. patents, similar rules govern foreign patents. In this chapter, we show you how to locate information on patents and their inventors. If you find a patent that is particularly interesting to you, contact the inventor or the assignee for further information.
23Adapted
from The U. S. Patent and Trademark Office: http://www.uspto.gov/web/offices/pac/doc/general/whatis.htm.
82 Flu Infection
Patents on Flu Infection By performing a patent search focusing on flu infection, you can obtain information such as the title of the invention, the names of the inventor(s), the assignee(s) or the company that owns or controls the patent, a short abstract that summarizes the patent, and a few excerpts from the description of the patent. The abstract of a patent tends to be more technical in nature, while the description is often written for the public. Full patent descriptions contain much more information than is presented here (e.g. claims, references, figures, diagrams, etc.). We will tell you how to obtain this information later in the chapter. The following is an example of the type of information that you can expect to obtain from a patent search on flu infection: ·
Ayurvedic composition for the prophylaxis and treatment of AIDS, flu, TB and other immuno-deficiencies and the process for preparing the same Inventor(s): Rohatgi; Surendra (16/78 Civil Lines, Kanpur, IN) Assignee(s): none reported Patent Number: 5,529,778 Date filed: September 13, 1994 Abstract: An ayurvedic composition for prophylaxis and treatment of AIDS, flu, TB, and other immuno-deficiency conditions, and for liver diseases such as hepatitis and sclerosis, includes prescribed doses of extracts or isolates of two multi-component drugs in selected proportions. The first multi-component drug, LIVZON, consists of Phyllanthus niruri (292-310 mg.), Tinospora cordifolia (190-210 mg.), Phyllanthus emblica (90-110 mg.), Terminalia belerica (90-110 mg.), and Terminalia chebula (290-310 mg.); and the second multi-component drug, IMMINEX, consists of Holarrhena antidysenterica (40-60 mg.), Picrorhiza kurrooa (40-60 mg.), and Swertia chirata (15-35 mg.). The beneficial composition may be administered in the form of aqueous extracts, hard gelatin capsules, or mixed with syrup. The process of making the composition requires the basic ingredients to be cleaned, washed, dried and separated from all extraneous matter, after which they are powdered and extracts obtained therefrom with distilled water. The extracted material may be concentrated, granulated and dried at low temperature before the various ingredients are mixed in their selected proportions to form the necessary pharmaceutical dosage. Hard gelatin capsules or a syrup are other optional forms for dispensing the composition to patients.
Patents 83
Excerpt(s): This invention relates to ayurvedic composition for the prophylaxis and treatment of AIDS, FLU, TB as also viral, bacterial and parasitical diseases and other immunodeficiency conditions and the process for preparing the same. Web site: http://www.delphion.com/details?pn=US05529778__
Patent Applications on Flu Infection As of December 2000, U.S. patent applications are open to public viewing.24 Applications are patent requests which have yet to be granted (the process to achieve a patent can take several years). The following patent applications have been filed since December 2000 relating to flu infection: ·
Process for the topical treatment of rhinitis, conjunctivitis cold, and cold-like and flu symptoms Inventor(s): Crespo, Maria Del Carmen Diez ; (Madrid, ES), Szelenyi, Istvan ; (Schwaig, DE), Muckenschnabel, Reinhard ; (Frankfurt, DE), Mainardi, Roberto ; (Sau Paulo, BR) Correspondence: Gabriel P. Katona L.L.P.; 708 Third Avenue; 14 Floor`; New York; NY; 10017; US Patent Application Number: 20020037297 Date filed: December 14, 2000 Abstract: A pharmaceutical composition of topically effective amounts of (i) a non-sedating antihistamine or a pharmaceutically acceptable salt thereof, together with (ii) an .alpha.-adrenergic agonist or a pharmaceutically acceptable salt thereof, and a process for the treatment of or prophylaxis against allergic rhinitis, vasomotoric rhinitis, conjunctivitis, cold, cold-like and/or flu symptoms, by topically administering the composition to mucous tissues of a patient in need therefor. Excerpt(s): The present invention relates generally to novel pharmaceutical compositions for the topical treatment of rhinitis, conjunctivitis cold, and cold-like and flu symptoms. ... Antihistamines are generally used in the symptomatic treatment of these disorders. They are effective in reducing itching, sneezing and watery secretion. Based on the ICAM-1(rhinovirus binding site) down-regulating effect of azelastine, it may be particularly useful in the treatment of common cold/flu. Antihistamines are, in general, less effective in the reduction of nasal
24
This has been a common practice outside the United States prior to December 2000.
84 Flu Infection
congestion (blockage). To achieve a further reduction of nasal congestion and ocular oedema, .alpha.-adrenergic agonists are often used either alone or in combination with antihistamines. ... As disclosed in WO 94/08551, with regard to allergic diseases and the common cold, either topical or oral .alpha.-adrenergic agonists are used. Oral decongestants (e.g. pseudoephedrine, phenylephrine, phenylpropanolamine as disclosed in, for example, WO 92/04021, WO 92/04022, WO 94/08550, WO 94/14449 and WO 95/23591) carry the risk of inducing systemic adverse effects such as tachycardia, increased blood pressure, and CNS stimulation (e.g. insomnia). Topical .alpha.-adrenergic agonists such as epinephrine, fenoxazoline, indanazoline, naphazoline, oxedrine, oxymetazoline, phenylephrine, tefazoline, tetryzoline, tramazoline, tymazoline, xylometazoline are used as local decongestants in patients with allergic or vasomotor rhinitis, conjunctivitis or with upper respiratory infections (e.g. common cold, flu). .alpha.-adrenergic drugs probably decrease resistance to airflow by decreasing the volume of the nasal mucosa. This may occur by activation of .alpha.-adrenergic receptors in venous capacitance vessels in nasal tissues. Topical decongestants are particularly useful because of their more selective site of action. Although their topical administration is associated with few systemic adversed effects, prolonged use may result in rebound congestion and worsening of symptoms. Therefore, the use of formulations containing a nasal vasoconstrictor compound is not recommended longer than 7-10 days. In addition, the recommended daily dosage should not be exceeded. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html ·
Herbal formulation for stimulating the immune system to prevent colds and the flu and method of using same Inventor(s): Shaner, Edward O. ; (Ocean City, MD) Correspondence: Lowe Hauptman Gilman & Berner, LLP; 1700 Diagonal Road, Suite 310; Alexandria; VA; 22314; US Patent Application Number: 20010018077 Date filed: December 19, 2000 Abstract: A herbal formulation that is orally administered and which affects colds or the flu in a human subject comprises beta glucans, olive leaf extract, echinacea, goldenseal, una de gato, pao d'arco, elderberry dried berries and cayenne pepper. The formulation can also include zinc lozenges if symptoms of a sore throat are present in the subject.
Patents 85
Excerpt(s): The present invention relates generally to a method of and/or formula for reducing the effects of colds and the flu and, more particularly, to a combination of herbs for reducing the effects of colds and the flu. ... The most powerful and versatile biological defense system in humans is the immune system. It is the system humans depend upon to protect against winter colds and the flu. Cold and flu viruses are predators that enter the cells that line the nose and throat, proliferate, and inflame the host cell. The immune defense system consists of specialized cells called lymphocytes which have the unique ability to recognize, evaluate, and destroy foreign invaders. With advancing age, the immune system declines in effectiveness. ... There are hundreds of common colds and flu viruses. No vaccine exists that provides a common defense. Persons with weakened immune systems are highly susceptible. Herbs with known viricidal properties are echinacea by itself and in combination with goldenseal, una de gato (also known as Cat's Claw) by itself, pao d'arco by itself, elderberry dried berries by themselves, olive leaf extract by itself, beta glucans by themselves, cayenne pepper by itself, vitamin C, garlic perles and beta carotene. In addition, zinc lozenges (zinc gluconate) are a known sore throat suppression agent. Single herbs that exhibit viricidal properties are relatively ineffective against viruses which cause colds and the flu. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
Keeping Current In order to stay informed about patents and patent applications dealing with flu infection, you can access the U.S. Patent Office archive via the Internet at no cost to you. This archive is available at the following Web address: http://www.uspto.gov/main/patents.htm. Under “Services,” click on “Search Patents.” You will see two broad options: (1) Patent Grants, and (2) Patent Applications. To see a list of granted patents, perform the following steps: Under “Patent Grants,” click “Quick Search.” Then, type “flu infection” (or synonyms) into the “Term 1” box. After clicking on the search button, scroll down to see the various patents which have been granted to date on flu infection. You can also use this procedure to view pending patent applications concerning flu infection. Simply go back to the following Web address: http://www.uspto.gov/main/patents.htm. Under “Services,” click on “Search Patents.” Select “Quick Search” under “Patent Applications.” Then proceed with the steps listed above.
86 Flu Infection
Vocabulary Builder 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] 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] Capsules: Hard or soft soluble containers used for the oral administration of medicine. [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]
Congestion: Excessive or abnormal accumulation of blood in a part. [EU] Conjunctivitis: Inflammation of the conjunctiva, generally consisting of conjunctival hyperaemia associated with a discharge. [EU] 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] Gelatin: A product formed from skin, white connective tissue, or bone collagen. It is used as a protein food adjuvant, plasma substitute, hemostatic, suspending agent in pharmaceutical preparations, and in the manufacturing of capsules and suppositories. [NIH] Glucans: Polysaccharides composed of repeating glucose units. They can consist of branched or unbranched chains in any linkages. [NIH] Insomnia: Inability to sleep; abnormal wakefulness. [EU] Naphazoline: An adrenergic vasoconstrictor agent used as a decongestant. [NIH]
Ocular: 1. of, pertaining to, or affecting the eye. 2. eyepiece. [EU] Oedema: The presence of abnormally large amounts of fluid in the intercellular tissue spaces of the body; usually applied to demonstrable accumulation of excessive fluid in the subcutaneous tissues. Edema may be localized, due to venous or lymphatic obstruction or to increased vascular permeability, or it may be systemic due to heart failure or renal disease. Collections of edema fluid are designated according to the site, e.g. ascites
Patents 87
(peritoneal cavity), hydrothorax (pleural cavity), and hydropericardium (pericardial sac). Massive generalized edema is called anasarca. [EU] Phenylephrine: An alpha-adrenergic agonist used as a mydriatic, nasal decongestant, and cardiotonic agent. [NIH] Rhinitis: Inflammation of the mucous membrane of the nose. [EU] Symptomatic: 1. pertaining to or of the nature of a symptom. 2. indicative (of a particular disease or disorder). 3. exhibiting the symptoms of a particular disease but having a different cause. 4. directed at the allying of symptoms, as symptomatic treatment. [EU] Tachycardia: Excessive rapidity in the action of the heart; the term is usually applied to a heart rate above 100 per minute and may be qualified as atrial, junctional (nodal), or ventricular, and as paroxysmal. [EU]
Books 89
CHAPTER 6. BOOKS ON FLU INFECTION Overview This chapter provides bibliographic book references relating to flu infection. You have many options to locate books on flu infection. The simplest method is to go to your local bookseller and inquire about titles that they have in stock or can special order for you. Some patients, however, feel uncomfortable approaching their local booksellers and prefer online sources (e.g. www.amazon.com and www.bn.com). In addition to online booksellers, excellent sources for book titles on flu infection include the Combined Health Information Database and the National Library of Medicine. Once you have found a title that interests you, visit your local public or medical library to see if it is 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 to 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 “flu infection” (or synonyms) into the “For these words:” box. You will only receive results on books. You should check back periodically with this database which is updated every 3 months. The following is a typical result when searching for books on flu infection: ·
Herbal Medicinals: A Clinician's Guide Source: New York, NY: Pharmaceutical Products Press. 1998. 383 p.
90 Flu Infection
Contact: Available from Haworth Herbal Press. 10 Alice Street, Binghamton, NY 13904-1580. (800) HAWORTH. Fax (800) 895-0582. Email:
[email protected]. Website: www.haworthpressinc.com. Price: $39.95 plus shipping and handling. ISBN: 0789004666. Summary: This book provides information on herbal medicines and nutraceuticals and how they interact with conventional medicines so that clinicians will be aware of issues associated with the concomitant use of herbal and conventional medicines. Topics include the renal implications of herbal remedies; hepatic effects of herbal remedies; and herbal medicines for colds and flu, gastrointestinal problems, rheumatoid arthritis and osteoarthritis, diabetes, hypertension, dyslipidemia and atherosclerosis, asthma, anxiety and depression, substance abuse, cancer, dermatologic conditions, and gynecological and obstetric problems. In addition, chapters discuss specific toxicological considerations of selected herbal products and consider the use of herbs from a legal and regulatory perspective. Most chapters use a case based format to provide information on the pharmacology of a particular herb, potential and known interactions, adverse herbal side effects, and effects of the disease state that may affect medication efficacy. 46 tables. Numerous references.
Book Summaries: Online Booksellers Commercial Internet-based booksellers, such as Amazon.com and Barnes & Noble.com, offer summaries which have been supplied by each title’s publisher. Some summaries also include customer reviews. Your local bookseller may have access to in-house and commercial databases that index all published books (e.g. Books in PrintÒ). The following have been recently listed with online booksellers as relating to flu infection (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): ·
Dechema: Corrosion Handbook: Corrosive Agents and Their Interaction Wit Materials/ Acetates, Aluminum Chloride, Chlorine and Chlorinated Water, Flu by Dieter Behrens (Editor) (1987); ISBN: 3527266526; http://www.amazon.com/exec/obidos/ASIN/3527266526/icongroupin terna
·
77 Ways to Beat Colds and Flu (A People's Medical Society Book) by Charles B. Inlander, et al (1994); ISBN: 0802774474; http://www.amazon.com/exec/obidos/ASIN/0802774474/icongroupin terna
Books 91
·
The Ultimate Cause and Preventive Cure for the Common Cold: How to Prevent Yourself from Catching the Common Cold or the Flu by Lloyd R. Stark, Robin R. Stark (Illustrator) (1994); ISBN: 0963912305; http://www.amazon.com/exec/obidos/ASIN/0963912305/icongroupin terna
·
Jane Brody's Cold and Flu Fighter by Jane E. Brody (1995); ISBN: 0393039137; http://www.amazon.com/exec/obidos/ASIN/0393039137/icongroupin terna
·
Echinacea: How to Grow, Harvest, & Use This Amazing Flower to Fight Colds, Flu, & Infection by Boosting Your Immune System by Bryce Finley, Richard Walker (1996); ISBN: 1896245005; http://www.amazon.com/exec/obidos/ASIN/1896245005/icongroupin terna
·
Colds and Flu and You: Building Optimum Immunity (Healthy Healing Library) by Linda R. Page, et al (1997); ISBN: 1884334474; http://www.amazon.com/exec/obidos/ASIN/1884334474/icongroupin terna
·
Methods to Defend the Natural Cold & Flu by C. M. Hawkes (1998); ISBN: 1580540163; http://www.amazon.com/exec/obidos/ASIN/1580540163/icongroupin terna
·
Natural Cold and Flu Defense: Using Echinacea, Zinc, Vitamin C and Other Supplements by C. W. Hawken, Remi Cooper (1998); ISBN: 1885670907; http://www.amazon.com/exec/obidos/ASIN/1885670907/icongroupin terna
·
The Flu Epidemic (The American Adventure) by Joann A. Grote (1998); ISBN: 1577484517; http://www.amazon.com/exec/obidos/ASIN/1577484517/icongroupin terna
·
Growing Herbs for Cold and Flu Relief (Storey Country Wisdom Bulletin, A-219) by Dorie Byers (1999); ISBN: 1580172660; http://www.amazon.com/exec/obidos/ASIN/1580172660/icongroupin terna
·
Flu Therapy: A Natural and Herbal Approach (Storey Country Wisdom Bulletin, A-266) by Elizabeth Wotton (2000); ISBN: 1580173489; http://www.amazon.com/exec/obidos/ASIN/1580173489/icongroupin terna
92 Flu Infection
·
Devil's Flu: The World's Deadliest Influenza Epidemic and the Scientific Hunt for the Virus That Caused It by Pete Davies (2000); ISBN: 0805066225; http://www.amazon.com/exec/obidos/ASIN/0805066225/icongroupin terna
·
Colds, Flu, and Other Common Ailments: Basic Consumer Health Information About Common Ailments and Injuries, Including Colds and More (Health referen by Chad T. Kimball (Editor) (2001); ISBN: 078080435X; http://www.amazon.com/exec/obidos/ASIN/078080435X/icongroupi nterna
·
Drive Thru Flu Shots by Ruth Carrico (2002); ISBN: 187926045X; http://www.amazon.com/exec/obidos/ASIN/187926045X/icongroupi nterna
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 “flu infection” (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:25 ·
America's forgotten pandemic: the influenza of 1918. Author: A.W. Crosby; Year: 1990; New York, New York/Cambridge, England, Cambridge University Press, 1990
·
Colds, flu, and other common ailments sourcebook: basic consumer health information about common ailments and injuries: including colds, coughs, the flu, sinus problems, headaches, fever, nausea and
In addition to LOCATORPlus, in collaboration with authors and publishers, the National Center for Biotechnology Information (NCBI) is 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.
25
Books 93
vomiting, menstrual cramps, diarrhea, constipation hem. ; Year: 2001; Detroit, MI: Omnigraphics, c2001; ISBN: 078080435X (alk. paper) http://www.amazon.com/exec/obidos/ASIN/078080435X/icongroupi nterna ·
Devil's flu: the world's deadliest influenza epidemic and the scientific hunt for the virus that caused it. Author: Pete Davies; Year: 2000; New York: Henry Holt and Co., 2000; ISBN: 0805066225 http://www.amazon.com/exec/obidos/ASIN/0805066225/icongroupin terna
·
Disease and the politics of community: Norwood and the great flu epidemic of 1918. Author: by Patricia J. Fanning; Year: 1995; 1995
·
Farewell to colds & 'flu. Author: Powell, Eric F. W. (Eric Frederick William), 1899-; Year: 1939; London, Daniel [1939]
·
Flu: the story of the great influenza pandemic of 1918 and the search for the virus that caused it. Author: Gina Kolata; Year: 1999; New York: Farrar, Straus and Giroux, 1999; ISBN: 0374157065 (alk. paper) http://www.amazon.com/exec/obidos/ASIN/0374157065/icongroupin terna
·
Flu vaccine: steps are needed to better prepare for possible future shortages: testimony before the Special Committee on Aging, U.S. Senate. Author: Janet Heinrich; Year: 2001; Washington, DC: U.S. General Accounting Office, 2001
·
Flu vaccine: supply problems heighten need to ensure access for highrisk people: report to congressional requesters. Author: United States General Accounting Office; Year: 2001; Washington, D.C.: The Office, [2001]
·
Influenza and other viruses. Author: by Judy Monroe; Year: 2001; Mankato, Minn.: LifeMatters, c2001; ISBN: 0736810250 http://www.amazon.com/exec/obidos/ASIN/0736810250/icongroupin terna
·
Pure politics and impure science: the swine flu affair. Author: Arthur M. Silverstein; Year: 1981; Baltimore: Johns Hopkins University Press, c1981; ISBN: 0801826322 http://www.amazon.com/exec/obidos/ASIN/0801826322/icongroupin terna
·
Review and evaluation of the swine flu immunization program: hearing before the Subcommittee on Health and the Environment of the Committee on Interstate and Foreign Commerce, House of Representatives, Ninety-fifth Congress, first session, on the experie. Author: United States. Congress. House. Committee on Interstate and
94 Flu Infection
Foreign Commerce. Subcommittee on Health and the Environment; Year: 1977; Washington: U. S. Govt. Print. Off., 1977 ·
Review of The swine flu affair: decision-making on a slippery disease. Author: David Allen; Year: 1979; [Manchester, Lancashire]: Health Services Management Unit, Dept. of Social Administration, University of Manchester, 1979
·
Silent enemy: Canada and the deadly flu of 1918. Author: Eileen Pettigrew; Year: 1983; Saskatoon, Sask.: Western Producer Prairie Books, c1983; ISBN: 0888331045 http://www.amazon.com/exec/obidos/ASIN/0888331045/icongroupin terna
·
Suspension of the swine flu immunization program, 1976: hearing before the Subcommittee on Health of the Committee on Labor and Public Welfare, United States Senate, Ninety-fourth Congress, second session ... December 17, 1976. Author: United States. Congress. Senate. Committee on Labor and Public Welfare. Subcommittee on Health; Year: 1977; Washington: U.S. G.P.O., 1977
·
Swine flu affair: decision-making on a slippery disease. Author: Richard E. Neustadt, Harvey V. Fineberg; Year: 1978; [Washington]: U. S. Dept. of Health, Education, and Welfare: for sale by the Supt. of Docs., U. S. Govt. Print. Off., 1978
·
Vaccine guide: risks and benefits for children and adults. Author: by Randall Neustaedter; Year: 2002; Berkeley, Calif.: North Atlantic Books, c2002; ISBN: 1556434235 (pbk.) http://www.amazon.com/exec/obidos/ASIN/1556434235/icongroupin terna
·
Viruses, colds, and flu. Author: Irwin, Michael Henry Knox; Year: 1966; New York, Public Affairs Committee, 1966]
·
Vitamin C, the common cold, and the flu. Author: Linus Pauling; Year: 1976; San Francisco: Freeman, c1976; ISBN: 0716703610 http://www.amazon.com/exec/obidos/ASIN/0716703610/icongroupin terna
·
What to do about the flu. Author: Pascal James Imperato; Year: 1976; New York: Dutton, c1976; ISBN: 052523263X http://www.amazon.com/exec/obidos/ASIN/052523263X/icongroupi nterna
·
When does a cohort's mortality differ from what we might expect? Author: J. Wilmoth, J. Vallin, G. Caselli; Year: 1988; 1988
Books 95
Chapters on Flu Infection Frequently, flu infection will be discussed within a book, perhaps within a specific chapter. In order to find chapters that are specifically dealing with flu infection, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and flu infection using the “Detailed Search” option. Go directly 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.” By making these selections and typing in “flu infection” (or synonyms) into the “For these words:” box, you will only receive results on chapters in books. The following is a typical result when searching for book chapters on flu infection: ·
Reye's Syndrome Source: in Gilbert, P. A-Z Reference Book of Syndromes and Inherited Disorders. 2nd ed. London, England: Chapman and Hall. 1996. p. 251253. Contact: Available from Singular Publishing Group, Inc. 401 West 'A' Street, Suite 325, San Diego, CA 92101-7904. (800) 521-8545 or (619) 2386777. Fax (800) 774-8398 or (619) 238-6789. E-mail:
[email protected]. Website: www.singpub.com. Price: $42.95 plus shipping and handling. ISBN: 0412641208. Summary: This chapter on Reye's syndrome is from a practical reference book that describes the inherited disorders and syndromes of both children and adults. Reye's syndrome follows an acute viral infection, such as an upper respiratory tract infection, chickenpox, flu, or a diarrheal illness. The use of aspirin to control fever and pain in young children with an infection has been suggested to be an added causative factor in Reye's syndrome. Recent research has suggested that some children who develop Reye's syndrome have an underlying genetically determined metabolic defect. The syndrome features an acute illness and a chronic phase. Severe learning disability can occur in children who survive the acute illness. Any problem with movement, speech, or cognitive function will need specialized help from the appropriate therapists. The chapter includes alternative names for the condition, incidence, history, causation, characteristics, management implications, prognosis, and self-help groups. The book is published in England and lists English support groups and organizations.
96 Flu Infection
Directories In addition to the references and resources discussed earlier in this chapter, a number of directories relating to flu infection have been published that consolidate information across various sources. These too might be useful in gaining access to additional guidance on flu infection. The Combined Health Information Database lists the following, which you may wish to consult in your local medical library:26 ·
A guide to primary health care: Where to turn for programs in Allegheny County Source: Pittsburgh, PA: Jewish Healthcare Foundation. [1996?]. 63 pp. Contact: Available from Jewish Healthcare Foundation, Center City Tower, 650 Smithfield Street, Suite 2330, Pittsburgh, PA 15222. Telephone: (412) 594-2550 / fax: (412) 232-6240 / e-mail:
[email protected]. Summary: This directory provides a listing of primary health centers in Allegheny County and is designed for families in that region that need help in finding such care and who may be financially challenged. Each center lists its location, hours, services, eligibilities, and fees. Health areas covered in this directory include: 1) AIDS, 2) caregivers, 3) dental care, 4) diseases/disorders, 5) eye and ear care, 6) home health/hospice care, 7) hospitals/health care centers/community clinics, 8) immunizations/flu shots, 9) infants/children, 10) medical equipment, 11) mental health/drugs and alcohol, 12) screenings, 13) senior health care, 14) sexually transmitted diseases, 15) medical transportation, and 16) women's health care.
·
Product Guide Source: SCD. Special Care in Dentistry. 19(6): 281-285. NovemberDecember 1999. Contact: Available from Special Care Dentistry. 211 East Chicago Avenue, Chicago, IL 60611. (312) 440-2660. Fax (312) 440-2824.
You will need to limit your search to “Directories” and flu infection using the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find directories, use the drop boxes at the bottom of the search page where “You may refine your search by”. For publication date, select “All Years”, select language and the format option “Directory”. By making these selections and typing in “flu infection” (or synonyms) into the “For these words:” box, you will only receive results on directories dealing with flu infection. You should check back periodically with this database as it is updated every three months. 26
Books 97
Summary: This article offers a compilation of dental products and manufacturers of those products designed for special needs patients. The guide provides practitioners with a useful resource for those special patients with functional limitations or a disability, who may need unconventional dental aids to maintain their oral health. The guide lists home aids, including desensitizing dentifrices, fluoride mouth rinses (over the counter), grip aids, floss aids, oral irrigating devices, electric toothbrushes, manual toothbrushes, saliva substitutes and oral moisturizers, denture care products, and other home aids. Also listed are dental materials; medications, including sedatives, miscellaneous, fluoride supplements, topical fluoride gels, fluoride mouthrinses, and fluoride varnish; stabilizers and mouth props; video training for caregivers; portable dental equipment; and information resources, including the National Oral Health Information Clearinghouse. For each category, the guide lists products, the manufacturer or distributor, and the telephone number where readers can obtain the items (most are toll free telephone lines).
General Home References In addition to references for flu infection, you may want a general home medical guide that spans all aspects of home healthcare. The following list is a recent sample of such guides (sorted alphabetically by title; hyperlinks provide rankings, information, and reviews at Amazon.com): · Epidemic! The World of Infectious Disease by Rob Desalle (Editor), Paperback – 246 pages, 1st edition (September 1999), New Press; ISBN: 1565845463; http://www.amazon.com/exec/obidos/ASIN/1565845463/icongroupinterna · Handbook of Diseases; Paperback -- 986 pages, 2nd edition (January 15, 2000), Springhouse Pub Co; ISBN: 0874349796; http://www.amazon.com/exec/obidos/ASIN/0874349796/icongroupinterna · Infectious Disease Secrets by Robert H. Gates (Editor); Paperback – 400 pages, 1st edition (January 15, 1998), Hanley & Belfus; ISBN: 1560532661; http://www.amazon.com/exec/obidos/ASIN/1560532661/icongroupinterna · Invisible Enemies: Stories of Infectious Disease by Jeanette Farrell; Hardcover – 224 pages (April 1998), Farrar, Straus & Giroux (Juv); ISBN: 0374336377; http://www.amazon.com/exec/obidos/ASIN/0374336377/icongroupinterna · Maneater: And Other True Stories of a Life in Infectious Disease by Pamela Nagami; Hardcover – 287 pages, 1st edition (November 2001), St.
98 Flu Infection
Martin’s Press; ISBN: 1580632092; http://www.amazon.com/exec/obidos/ASIN/1580632092/icongroupinterna
Vocabulary Builder Abortion: 1. the premature expulsion from the uterus of the products of conception - of the embryo, or of a nonviable fetus. The four classic symptoms, usually present in each type of abortion, are uterine contractions, uterine haemorrhage, softening and dilatation of the cervix, and presentation or expulsion of all or part of the products of conception. 2. premature stoppage of a natural or a pathological process. [EU] Aluminum: A metallic element that has the atomic number 13, atomic symbol Al, and atomic weight 26.98. [NIH] Anxiety: The unpleasant emotional state consisting of psychophysiological responses to anticipation of unreal or imagined danger, ostensibly resulting from unrecognized intrapsychic conflict. Physiological concomitants include increased heart rate, altered respiration rate, sweating, trembling, weakness, and fatigue; psychological concomitants include feelings of impending danger, powerlessness, apprehension, and tension. [EU] Appendicitis: Acute inflammation of the vermiform appendix. [NIH] Benign: Not malignant; not recurrent; favourable for recovery. [EU] Bronchitis: Inflammation of one or more bronchi. [EU] Chlorine: A greenish-yellow, diatomic gas that is a member of the halogen family of elements. It has the atomic symbol Cl, atomic number 17, and atomic weight 70.906. It is a powerful irritant that can cause fatal pulmonary edema. Chlorine is used in manufacturing, as a reagent in synthetic chemistry, for water purification, and in the production of chlorinated lime, which is used in fabric bleaching. [NIH] Colic: Paroxysms of pain. This condition usually occurs in the abdominal region but may occur in other body regions as well. [NIH] Colitis: Inflammation of the colon. [EU] Concomitant: Accompanying; accessory; joined with another. [EU] Constipation: Infrequent or difficult evacuation of the faeces. [EU] Cutaneous: Pertaining to the skin; dermal; dermic. [EU] Dentifrices: Any preparations used for cleansing teeth; they usually contain an abrasive, detergent, binder and flavoring agent and may exist in the form of liquid, paste or powder; may also contain medicaments and caries preventives. [NIH]
Books 99
Diverticulitis: Inflammation of a diverticulum, especially inflammation related to colonic diverticula, which may undergo perforation with abscess formation. Sometimes called left-sided or L-sides appendicitis. [EU] Dizziness: An imprecise term which may refer to a sense of spatial disorientation, motion of the environment, or lightheadedness. [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] Flatulence: The presence of excessive amounts of air or gases in the stomach or intestine, leading to distention of the organs. [EU] Gastritis: Inflammation of the stomach. [EU] Gastroenteritis: An acute inflammation of the lining of the stomach and intestines, characterized by anorexia, nausea, diarrhoea, abdominal pain, and weakness, which has various causes, including food poisoning due to infection with such organisms as Escherichia coli, Staphylococcus aureus, and Salmonella species; consumption of irritating food or drink; or psychological factors such as anger, stress, and fear. Called also enterogastritis. [EU] Gastrointestinal: Pertaining to or communicating with the stomach and intestine, as a gastrointestinal fistula. [EU] Gels: Colloids with a solid continuous phase and liquid as the dispersed phase; gels may be unstable when, due to temperature or other cause, the solid phase liquifies; the resulting colloid is called a sol. [NIH] Gluten: The protein of wheat and other grains which gives to the dough its tough elastic character. [EU] Heartburn: Substernal pain or burning sensation, usually associated with regurgitation of gastric juice into the esophagus. [NIH] Hemorrhoids: Varicosities of the hemorrhoidal venous plexuses. [NIH] Hepatic: Pertaining to the liver. [EU] Hernia: (he protrusion of a loop or knuckle of an organ or tissue through an abnormal opening. [EU] Hiccup: A spasm of the diaphragm that causes a sudden inhalation followed by rapid closure of the glottis which produces a sound. [NIH] Hypertension: Persistently high arterial blood pressure. Various criteria for its threshold have been suggested, ranging from 140 mm. Hg systolic and 90 mm. Hg diastolic to as high as 200 mm. Hg systolic and 110 mm. Hg diastolic. Hypertension may have no known cause (essential or idiopathic h.) or be associated with other primary diseases (secondary h.). [EU] Incontinence: Inability to control excretory functions, as defecation (faecal i.) or urination (urinary i.). [EU]
100 Flu Infection
Melanoma: A tumour arising from the melanocytic system of the skin and other organs. When used alone the term refers to malignant melanoma. [EU] Menstruation: The cyclic, physiologic discharge through the vagina of blood and mucosal tissues from the nonpregnant uterus; it is under hormonal control and normally recurs, usually at approximately four-week intervals, in the absence of pregnancy during the reproductive period (puberty through menopause) of the female of the human and a few species of primates. It is the culmination of the menstrual cycle. [EU] Osteoarthritis: Noninflammatory degenerative joint disease occurring chiefly in older persons, characterized by degeneration of the articular cartilage, hypertrophy of bone at the margins, and changes in the synovial membrane. It is accompanied by pain and stiffness, particularly after prolonged activity. [EU] Peptic: Pertaining to pepsin or to digestion; related to the action of gastric juices. [EU] Psychotherapy: A generic term for the treatment of mental illness or emotional disturbances primarily by verbal or nonverbal communication. [NIH]
Rehydration: The restoration of water or of fluid content to a body or to substance which has become dehydrated. [EU] Rheumatoid: Resembling rheumatism. [EU] 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] Sedative: 1. allaying activity and excitement. 2. an agent that allays excitement. [EU] Sunburn: An injury to the skin causing erythema, tenderness, and sometimes blistering and resulting from excessive exposure to the sun. The reaction is produced by the ultraviolet radiation in sunlight. [NIH] Triage: The sorting out and classification of patients or casualties to determine priority of need and proper place of treatment. [NIH] Ulcer: A local defect, or excavation, of the surface of an organ or tissue; which is produced by the sloughing of inflammatory necrotic tissue. [EU] Vaginitis: Inflammation of the vagina characterized by pain and a purulent discharge. [NIH]
Multimedia 101
CHAPTER 7. MULTIMEDIA ON FLU INFECTION Overview Information on flu infection can come in a variety of formats. Among multimedia sources, video productions, slides, audiotapes, and computer databases are often available. In this chapter, we show you how to keep current on multimedia sources of information on flu infection. 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. If you see an interesting item, visit your local medical library to check on the availability of the title.
Video Recordings Most diseases do not have a video dedicated to them. If they do, they are often rather technical in nature. An excellent source of multimedia information on flu infection is the Combined Health Information Database. You will need to limit your search to “video recording” and “flu infection” using the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find video productions, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Videorecording (videotape, videocassette, etc.).” By making these selections and typing “flu infection” (or synonyms) into the “For these words:” box, you will only receive results on video productions. The following is a typical result when searching for video recordings on flu infection:
102 Flu Infection
·
Preventing Communicable Diseases: Colds, Flu, AIDS, STDs (Condom Version) Contact: AIMS Multimedia, 9710 DeSoto Ave, Chatsworth, CA, 913114409, (818) 773-4300, http://www.aims-multimedia.com. Summary: This video, for adolescents, provides information on preventing communicable and sexually transmitted diseases (STDs). It explains how bacteria and germs enter the human body and how the immune system has the ability to fight germs and bacteria. It states that a person's immune system works best if they do not abuse substances and if they take good physical care of themselves. It provides proper sanitation and hygiene tips and examines the causes, transmission, and prevention of colds and the flu; it provides information on STDs and how they are transmitted; it describes how to use condoms properly to help prevent STDs; and it discusses the human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS), its transmission and prevention. The video stresses that sexual abstinence is the best way to prevent the transmission of STDs such as HIV.
Bibliography: Multimedia on Flu Infection 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 flu infection (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 flu infection. For more information, follow the hyperlink indicated: ·
Asian flu. Source: Johns Hopkins University; WJZ TV ABC production; Year: 1990; Format: Videorecording; [Baltimore, Md.: The University, 1990]
·
Bioterrorism for healthcare : essential disaster planning. Source: Medfilms Inc; Year: 2002; Format: Videorecording; Tucson, AZ: Medfilms, c2002
·
Body story. Infiltration by influenza B. Source: a presentation of Films for the Humanities & Sciences; a Wall to Wall Television Ltd production for Discovery Channel, Channel Four, and ITEL; Year: 1999; Format: Videorecording; Princeton, N.J.: Films for the Humanities & Sciences, c1999
Multimedia 103
·
Case presentation : children with flu-like illness to the emergency room. Source: the University of Texas Medical School at Houston; produced by UT/TV, Houston; Year: 1991; Format: Videorecording; [Houston, Tex.: UT/TV], c1991
·
Cold & flu. Source: Films for the Humanities & Sciences; produced for Discovery Health Channel by Big Rock Productions; Year: 2002; Format: Videorecording; Princeton, N.J.: Films for the Humanities & Sciences, c2002
·
Influenza. Source: a film by Bruno Carrière; [presented by] Films for the Humanities & Sciences; NFB ONF, a coproduction of the National Film Board of Canada, Les Films d'lci, and France 2; Year: 1998; Format: Videorecording; Princeton, N.J.: Films for the Humanities & Sciences, c1998
·
Prospects for control of influenza. Source: William C. Marine; Year: 1971; Format: Videorecording; [Atlanta: Emory Univ., 1971?]
·
Standing in the safety zone : Baltimore remembers the 1918 flu epidemic. Source: [presented by] the Health Care Financing Administration; Year: 1998; Format: Videorecording; [Baltimore, Md.?]: The Administration, 1998
·
Viruses : the mysterious enemy. Source: Human Relations Media; Year: 1982; Format: Videorecording; Pleasantville, N.Y.: Human Relations Media, c1982
Vocabulary Builder Infiltration: The diffusion or accumulation in a tissue or cells of substances not normal to it or in amounts of the normal. Also, the material so accumulated. [EU] Manifest: Being the part or aspect of a phenomenon that is directly observable : concretely expressed in behaviour. [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] Sweat: The fluid excreted by the sweat glands. It consists of water containing sodium chloride, phosphate, urea, ammonia, and other waste products. [NIH]
Periodicals and News 105
CHAPTER 8. PERIODICALS AND NEWS ON FLU INFECTION Overview Keeping up on the news relating to flu infection can be challenging. Subscribing to targeted periodicals can be an effective way to stay abreast of recent developments on flu infection. Periodicals include newsletters, magazines, and academic journals. In this chapter, we suggest a number of news sources and present various periodicals that cover flu infection beyond and including those which are published by patient associations mentioned earlier. We will first focus on news services, and then on periodicals. News services, press releases, and newsletters generally use more accessible language, so if you do chose to subscribe to one of the more technical periodicals, make sure that it uses language you can easily follow.
News Services & Press Releases Well before articles show up in newsletters or the popular press, they may appear in the form of a press release or a public relations announcement. One of the simplest ways of tracking press releases on flu infection is to search the news wires. News wires are used by professional journalists, and have existed since the invention of the telegraph. Today, there are several major “wires” that are used by companies, universities, and other organizations to announce new medical breakthroughs. 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.
106 Flu Infection
PR Newswire Perhaps the broadest of the wires is PR Newswire Association, Inc. To access this archive, simply go to http://www.prnewswire.com. Below the search box, select the option “The last 30 days.” In the search box, type “flu infection” or synonyms. The search results are shown by order of relevance. When reading these press releases, do not forget that the sponsor of the release may be a company or organization that is trying to sell a particular product or therapy. Their views, therefore, may be biased. The following is typical of press releases that can be found on PR Newswire: Reuters The Reuters’ Medical News database can be very useful in exploring news archives relating to flu infection. While some of the listed articles are free to view, others can be purchased for a nominal fee. To access this archive, go to http://www.reutershealth.com/frame2/arch.html and search by “flu infection” (or synonyms). The following was recently listed in this archive for flu infection: ·
Los Angeles hospitals ill-prepared for flu season Source: Reuters Health eLine Date: July 12, 2002 http://www.reuters.gov/archive/2002/07/12/eline/links/20020712elin 029.html
·
ID Biomedical reports positive phase I data for nasal flu vaccine Source: Reuters Industry Breifing Date: July 08, 2002 http://www.reuters.gov/archive/2002/07/08/business/links/20020708 drgd006.html
·
Phase III results find peramivir ineffective against influenza Source: Reuters Medical News Date: June 25, 2002 http://www.reuters.gov/archive/2002/06/25/professional/links/20020 625drgd007.html
·
BioCryst stock tumbles on revelation phase III flu drug is ineffective Source: Reuters Industry Breifing Date: June 25, 2002 http://www.reuters.gov/archive/2002/06/25/business/links/20020625 drgd005.html
Periodicals and News 107
·
Research provides clues to 1997 'bird flu' outbreak Source: Reuters Health eLine Date: June 18, 2002 http://www.reuters.gov/archive/2002/06/18/eline/links/20020618elin 012.html
·
Genetic reassortment of "bird flu" viruses could result in human outbreak Source: Reuters Medical News Date: June 18, 2002 http://www.reuters.gov/archive/2002/06/18/professional/links/20020 618epid003.html
·
Cases of influenza still occurring in US Source: Reuters Medical News Date: June 14, 2002 http://www.reuters.gov/archive/2002/06/14/professional/links/20020 614publ004.html
·
Cases of flu still occurring, US agency reports Source: Reuters Health eLine Date: June 13, 2002 http://www.reuters.gov/archive/2002/06/13/eline/links/20020613elin 027.html
·
Tamiflu radio ad overstates flu drug's effect: FDA Source: Reuters Health eLine Date: June 10, 2002 http://www.reuters.gov/archive/2002/06/10/eline/links/20020610elin 031.html
·
FDA takes issue with Roche Tamiflu ad Source: Reuters Industry Breifing Date: June 10, 2002 http://www.reuters.gov/archive/2002/06/10/business/links/20020610 rglt003.html
·
Theratechnologies says phase II peptide boosts immune response to flu vaccine Source: Reuters Industry Breifing Date: June 06, 2002 http://www.reuters.gov/archive/2002/06/06/business/links/20020606 drgd006.html
108 Flu Infection
·
Swiss Biotech drops flu spray; shares fall Source: Reuters Industry Breifing Date: June 06, 2002 http://www.reuters.gov/archive/2002/06/06/business/links/20020606 inds001.html
·
MedImmume to create flu vaccine using Crucell technology Source: Reuters Industry Breifing Date: May 29, 2002 http://www.reuters.gov/archive/2002/05/29/business/links/20020529 inds006.html
·
Study offers clues on flu drug's effects Source: Reuters Health eLine Date: May 28, 2002 http://www.reuters.gov/archive/2002/05/28/eline/links/20020528elin 024.html
·
Recent Hong Kong avian flu virus different from deadly 1997 strain Source: Reuters Medical News Date: May 24, 2002 http://www.reuters.gov/archive/2002/05/24/professional/links/20020 524publ001.html
·
New HK bird flu virus different from 1997 strain Source: Reuters Health eLine Date: May 24, 2002 http://www.reuters.gov/archive/2002/05/24/eline/links/20020524elin 018.html
·
Flu, flesh-eating bug make lethal team Source: Reuters Health eLine Date: May 21, 2002 http://www.reuters.gov/archive/2002/05/21/eline/links/20020521elin 025.html
·
Flu vaccine now recommended for infants Source: Reuters Health eLine Date: May 06, 2002 http://www.reuters.gov/archive/2002/05/06/eline/links/20020506elin 017.html
·
British scientists hope to exhume 1918 flu victim Source: Reuters Health eLine Date: May 06, 2002 http://www.reuters.gov/archive/2002/05/06/eline/links/20020506elin 033.html
Periodicals and News 109
·
Gene cluster technique may help predict future influenza A strains Source: Reuters Medical News Date: April 22, 2002 http://www.reuters.gov/archive/2002/04/22/professional/links/20020 422publ002.html
·
Flu vaccination lowers mortality risk in CHD patients Source: Reuters Medical News Date: April 17, 2002 http://www.reuters.gov/archive/2002/04/17/professional/links/20020 417clin014.html
·
Flu shot may extend heart patients' survival Source: Reuters Health eLine Date: April 17, 2002 http://www.reuters.gov/archive/2002/04/17/eline/links/20020417elin 042.html
·
Resistance mutations occur in subset of HIV patients after flu vaccination Source: Reuters Medical News Date: March 26, 2002 http://www.reuters.gov/archive/2002/03/26/professional/links/20020 326clin012.html
·
BioCryst completes enrollment of phase III flu drug Source: Reuters Industry Breifing Date: March 25, 2002 http://www.reuters.gov/archive/2002/03/25/business/links/20020325 drgd003.html
·
One dose of experimental drug fights flu in mice Source: Reuters Health eLine Date: March 21, 2002 http://www.reuters.gov/archive/2002/03/21/eline/links/20020321elin 023.html
·
US health advisers include Australia strain in flu vaccine Source: Reuters Industry Breifing Date: March 07, 2002 http://www.reuters.gov/archive/2002/03/07/business/links/20020307 publ005.html
110 Flu Infection
·
US flu advisers put Australia strain in vaccine Source: Reuters Health eLine Date: March 06, 2002 http://www.reuters.gov/archive/2002/03/06/eline/links/20020306elin 033.html
·
China to tighten grip on antibiotics in foods Source: Reuters Health eLine Date: March 06, 2002 http://www.reuters.gov/archive/2002/03/06/eline/links/20020306elin 021.html
·
Hong Kong kills more chickens to curb flu virus Source: Reuters Health eLine Date: March 05, 2002 http://www.reuters.gov/archive/2002/03/05/eline/links/20020305elin 017.html
·
Influenza vaccine encouraged for infants 6 to 23 months Source: Reuters Industry Breifing Date: February 21, 2002 http://www.reuters.gov/archive/2002/02/21/business/links/20020221 publ002.html
·
Flu vaccine encouraged for kids 6 to 23 months Source: Reuters Health eLine Date: February 21, 2002 http://www.reuters.gov/archive/2002/02/21/eline/links/20020221elin 043.html
·
Hong Kong kills more chickens in flu outbreak Source: Reuters Health eLine Date: February 20, 2002 http://www.reuters.gov/archive/2002/02/20/eline/links/20020220elin 021.html
·
African Americans less likely to get flu vaccine Source: Reuters Health eLine Date: February 19, 2002 http://www.reuters.gov/archive/2002/02/19/eline/links/20020219elin 004.html
·
Bird flu outbreak highlights Asia food safety risk Source: Reuters Health eLine Date: February 07, 2002 http://www.reuters.gov/archive/2002/02/07/eline/links/20020207elin 022.html
Periodicals and News 111
·
Hong Kong slaughters more chickens to halt spread of avian influenza Source: Reuters Medical News Date: February 06, 2002 http://www.reuters.gov/archive/2002/02/06/professional/links/20020 206publ002.html
·
Bird flu virus mutating fast in Hong Kong outbreak Source: Reuters Health eLine Date: February 06, 2002 http://www.reuters.gov/archive/2002/02/06/eline/links/20020206elin 026.html
·
Hong Kong kills 67,000 chickens to curb bird flu Source: Reuters Health eLine Date: February 04, 2002 http://www.reuters.gov/archive/2002/02/04/eline/links/20020204elin 034.html
·
HK kills 67,000 chickens to contain bird flu Source: Reuters Medical News Date: February 04, 2002 http://www.reuters.gov/archive/2002/02/04/professional/links/20020 204publ001.html
·
US officials watching Canadian flu strain Source: Reuters Industry Breifing Date: January 31, 2002 http://www.reuters.gov/archive/2002/01/31/business/links/20020131 publ004.html
·
Officials watching Canadian flu strain Source: Reuters Health eLine Date: January 31, 2002 http://www.reuters.gov/archive/2002/01/31/eline/links/20020131elin 023.html
·
Mild flu season may gain strength: CDC Source: Reuters Health eLine Date: January 31, 2002 http://www.reuters.gov/archive/2002/01/31/eline/links/20020131elin 032.html
·
Influenza vaccination linked to lower stroke risk Source: Reuters Industry Breifing Date: January 31, 2002 http://www.reuters.gov/archive/2002/01/31/business/links/20020131 epid003.html
112 Flu Infection
·
Flu vaccination linked to lower stroke risk Source: Reuters Health eLine Date: January 31, 2002 http://www.reuters.gov/archive/2002/01/31/eline/links/20020131elin 002.html
·
Roche claims Tamiflu production problems were exaggerated by media Source: Reuters Industry Breifing Date: January 16, 2002 http://www.reuters.gov/archive/2002/01/16/business/links/20020116 inds004.html
·
Stuffy nose? How to tell if it's a cold or flu Source: Reuters Health eLine Date: January 14, 2002 http://www.reuters.gov/archive/2002/01/14/eline/links/20020114elin 005.html
·
Cold weather, not flu, ups death risk in winter Source: Reuters Health eLine Date: January 11, 2002 http://www.reuters.gov/archive/2002/01/11/eline/links/20020111elin 002.html
·
Aviron responds to FDA FluMist letter Source: Reuters Industry Breifing Date: January 08, 2002 http://www.reuters.gov/archive/2002/01/08/business/links/20020108 rglt010.html
·
BioCryst resumes enrollment of phase III flu drug study Source: Reuters Industry Breifing Date: January 03, 2002 http://www.reuters.gov/archive/2002/01/03/business/links/20020103 inds008.html
·
Universal flu vaccination costs less than treatment Source: Reuters Industry Breifing Date: December 31, 2001 http://www.reuters.gov/archive/2001/12/31/business/links/20011231 econ001.html
Periodicals and News 113
·
More aggressive flu and pneumococcal immunization recommended in US Source: Reuters Industry Breifing Date: December 10, 2001 http://www.reuters.gov/archive/2001/12/10/business/links/20011210 prof003.html
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 http://www.nlm.nih.gov/medlineplus/newsbydate.html. Often, news items are indexed by MEDLINEplus within their 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.
Internet Wire Internet Wire is more focused on technology than the other wires. To access this site, go to http://www.internetwire.com and use the “Search Archive” option. Type in “flu infection” (or synonyms). As this service is oriented to technology, you may wish to search for press releases covering diagnostic procedures or tests that you may have read about.
Search Engines Free-to-view news can also be found in the news section of your favorite search engines (see the health news page at Yahoo: http://dir.yahoo.com/Health/News_and_Media/, or use this Web site’s general news search page http://news.yahoo.com/. Type in “flu infection” (or synonyms). If you know the name of a company that is relevant to flu infection, you can go to any stock trading Web site (such as
114 Flu Infection
www.etrade.com) and search for the company name there. News items across various news sources are reported on indicated hyperlinks.
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 “flu infection” (or synonyms).
Newsletter Articles If you choose not to subscribe to a newsletter, you can nevertheless find references to newsletter articles. We recommend that you use the Combined Health Information Database, while limiting 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.” By making these selections, and typing in “flu infection” (or synonyms) into the “For these words:” box, you will only receive results on newsletter articles. You should check back periodically with this database as it is updated every 3 months. The following is a typical result when searching for newsletter articles on flu infection: ·
Running Into Cold Season Source: Running and Fitnews. (18)11:3. November 2000. Contact: The American Running Association. 4405 East West Hwy., Number 405, Bethesda, MD 20814, 800/776-2732, www.americanrunning.org. Summary: A review in Medicine and Science in Sports and Exercise confirmed what has been commonly believed about exercise and resistance to colds and the flu. The combined effects of small, adverse changes in immune function can result in a lower immune response for runners and other athletes who train intensely for a long period of time. For runners who train less intensely, the immune system is either unaffected or moderately enhanced. The article recommends avoiding overtraining and advises that adequate rest and recovery is required for good health, resistance to infection, and optimum performance.
Periodicals and News 115
·
Tips From a Physical Therapist Source: UAB Center for Aging Alzheimer Family Program. [Newsletter] p. 3-4. April 1991. Contact: Available from University of Alabama at Birmingham Center for Aging Alzheimer Family Program. Community Health Services Building, 933 South Nineteenth Street, Birmingham, AL 35294. (205) 934-2178. Price: Donation of $15.00 for subscription requested. Summary: This newsletter article provides tips for caregivers from two physical therapists. Providing care for a patient with Alzheimer's disease can be very demanding physically. Patients may develop difficulty in coordinating body movements that can cause problems with their ability to walk and move. If a patient has difficulty walking, put a wide canvas belt around the waist. Walk beside the patient, keeping a firm grip on the belt. If the patient falls, don't panic. If the patient is hurt or too big to handle, call 911 or an ambulance for help. If the fall does not appear to be serious, move a chair over close to the patient and encourage the patient to put one arm up on the chair, then move one leg up with the knees bent. Caregivers are advised always to remain calm and never try to rush the patient.
Academic Periodicals covering Flu Infection Academic periodicals can be a highly technical yet valuable source of information on flu infection. We have compiled the following list of periodicals known to publish articles relating to flu infection and which are currently indexed within the National Library of Medicine’s PubMed database (follow hyperlinks to view more information, summaries, etc., for each). In addition to these sources, to keep current on articles written on flu infection published by any of the periodicals listed below, you can simply follow the hyperlink indicated or go to the following Web site: www.ncbi.nlm.nih.gov/pubmed. Type the periodical’s name into the search box to find the latest studies published. If you want complete details about the historical contents of a periodical, you can also visit 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.” The following is a sample of periodicals which publish articles on flu infection:
116 Flu Infection
·
Antiviral Research. (Antiviral Res) http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi?field=0®exp=An tiviral+Research&dispmax=20&dispstart=0
·
British Journal of Clinical Pharmacology. (Br J Clin Pharmacol) http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi?field=0®exp=Bri tish+Journal+of+Clinical+Pharmacology&dispmax=20&dispstart=0
·
British Journal of Haematology. (Br J Haematol) http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi?field=0®exp=Bri tish+Journal+of+Haematology&dispmax=20&dispstart=0
·
Chemical & Pharmaceutical Bulletin. (Chem Pharm Bull (Tokyo)) http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi?field=0®exp=Ch emical+&+Pharmaceutical+Bulletin&dispmax=20&dispstart=0
·
European Journal of Pharmacology. (Eur J Pharmacol) http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi?field=0®exp=Eu ropean+Journal+of+Pharmacology&dispmax=20&dispstart=0
·
Forschende Komplementarmedizin. (Forsch Komplementarmed) http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi?field=0®exp=Fo rschende+Komplementarmedizin&dispmax=20&dispstart=0
·
Immunopharmacology and Immunotoxicology. (Immunopharmacol Immunotoxicol) http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi?field=0®exp=Im munopharmacology+and+Immunotoxicology&dispmax=20&dispstart=0
·
International Journal of Immunopharmacology. (Int J Immunopharmacol) http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi?field=0®exp=Int ernational+Journal+of+Immunopharmacology&dispmax=20&dispstart= 0
·
Journal of Alternative and Complementary Medicine (New York, N. . . (J Altern Complement Med) http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi?field=0®exp=Jo urnal+of+Alternative+and+Complementary+Medicine+(New+York,+N. +.+&dispmax=20&dispstart=0
Periodicals and News 117
·
Journal of Psychosomatic Research. (J Psychosom Res) http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi?field=0®exp=Jo urnal+of+Psychosomatic+Research&dispmax=20&dispstart=0
·
Mediators of Inflammation. (Mediators Inflamm) http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi?field=0®exp=M ediators+of+Inflammation&dispmax=20&dispstart=0
·
Pharmacology, Biochemistry, and Behavior. (Pharmacol Biochem Behav) http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi?field=0®exp=Ph armacology,+Biochemistry,+and+Behavior&dispmax=20&dispstart=0
·
Phytotherapy Research : Ptr. (Phytother Res) http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi?field=0®exp=Ph ytotherapy+Research+:+Ptr&dispmax=20&dispstart=0
·
Planta Medica. (Planta Med) http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi?field=0®exp=Pl anta+Medica&dispmax=20&dispstart=0
·
Revue D'epidemiologie Et De Sante Publique. (Rev Epidemiol Sante Publique) http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi?field=0®exp=Re vue+D'epidemiologie+Et+De+Sante+Publique&dispmax=20&dispstart=0
·
Social Science & Medicine (1982). (Soc Sci Med) http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi?field=0®exp=So cial+Science+&+Medicine+(1982)&dispmax=20&dispstart=0
·
The Journal of Infectious Diseases. (J Infect Dis) http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi?field=0®exp=Th e+Journal+of+Infectious+Diseases&dispmax=20&dispstart=0
·
The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences. (J Gerontol A Biol Sci Med Sci) http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi?field=0®exp=Th e+Journals+of+Gerontology.+Series+A,+Biological+Sciences+and+Medic al+Sciences&dispmax=20&dispstart=0
118 Flu Infection
·
The Lancet Infectious Diseases. (Lancet Infect Dis) http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi?field=0®exp=Th e+Lancet+Infectious+Diseases&dispmax=20&dispstart=0
Physician Guidelines and Databases 119
CHAPTER 9. PHYSICIAN GUIDELINES AND DATABASES Overview Doctors and medical researchers rely on a number of information sources to help patients with their conditions. Many will subscribe to journals or newsletters published by their professional associations or refer to specialized textbooks or clinical guides published for the medical profession. In this chapter, we focus on databases and Internet-based guidelines created or written for this professional audience.
NIH Guidelines For the more common diseases, The National Institutes of Health publish guidelines that are frequently consulted by physicians. Publications are typically written by one or more of the various NIH Institutes. For physician guidelines, commonly referred to as “clinical” or “professional” guidelines, you can visit the following Institutes: ·
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 Institute of Allergy and Infectious Diseases (NIAID); guidelines available at http://www.niaid.nih.gov/publications/
120 Flu Infection
·
Centers for Disease Control and Prevention; various fact sheets on infectious diseases available at http://www.cdc.gov/health/diseases.htm
NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.27 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:28 ·
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
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). 28 See http://www.nlm.nih.gov/databases/databases.html. 27
Physician Guidelines and Databases 121
·
Cancer Information: Access to caner-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
·
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
While all of the above references may be of interest to physicians who study and treat flu infection, the following are particularly noteworthy.
The Combined Health Information Database A comprehensive source of information on clinical guidelines written for professionals is the Combined Health Information Database. You will need to limit your search to “Brochure/Pamphlet,” “Fact Sheet,” or “Information Package” and flu infection using the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find associations, use the drop boxes at the bottom of the search page where “You may refine your search by.” For the publication date, select “All Years,” select your preferred language, and the format option “Fact Sheet.” By making these selections and typing “flu infection” (or synonyms) into the
122 Flu Infection
“For these words:” box above, you will only receive results on fact sheets dealing with flu infection. The following is a sample result: ·
Infectious Disease Guidelines From the Georgia High School Association: Guidelines for the Prevention of Serious Infectious Diseases in High School Athletics Contact: Georgia High School Association, Georgia Department of Human Resources, 878 Peachtree St Ste 109, Atlanta, GA, 30309, (404) 894-5304. Summary: This policy statement presents guidelines adopted by the Georgia High School Association in an effort to prevent the transmission of infectious diseases during high school athletic events. The precautions discussed primarily address bloodborne pathogens such as HIV infection and the Hepatitis B virus, and also contain common-sense methods for preventing the spread of less serious contagions such as colds and flu. The guidelines focus on contact sports but are applicable to all athletics. Definitions and transmission methods of Hepatitis and HIV are presented, concentrating on the possible risk of transmission during exposure of open wounds or mucous membranes to contaminated blood. Athletes and coaches are advised about the proper handling of situations in which blood may be present, including: 1) covering open wounds before competition; 2) self-treating wounds whenever possible; 3) wearing protective gloves when giving first aid or wiping off another's blood; 4) stopping play and cleaning and decontaminating surfaces in case of bleeding; 5) using a disinfectant; 6) not sharing towels, cups or water bottles; 7) using disposable towels and discarding these in sealed plastic bags; and 8) washing soiled linen and uniforms in hot, soapy water with bleach.
·
AIDS - Related Disseminated Histoplasmosis Contact: US Department of Health and Human Services, Public Health Service, National Institutes of Health, National Institute of Allergy and Infectious Diseases, 31 Center Dr MSC 2520, Bethesda, MD, 20892-2520, (301) 496-5717, http://www.niaid.nih.gov. Summary: This report studies histoplasmosis in patients with Human immunodeficiency virus (HIV) infection or Acquired immunodeficiency syndrome (AIDS). A fungal disease which may disseminate to many organs, histoplasmosis may be present in the body for a long time. The infection is common in certain regions, such as the Midwest and the Caribbean, where residents inhale or ingest spores of the fungus Historians Capsulate. The disease begins as an acute illness akin to pneumonia or influenza, and may spread to the meninges, heart, and
Physician Guidelines and Databases 123
adrenal glands. Persons with AIDS (PWA's) usually respond to the standard treatment with intravenous amphotericin B, but in 80-90 percent of patients, it recurs within a year without maintenance therapy. However, side effects may include high fever, shaking chills, headache, nausea, loss of appetite, muscle and joint pain, suppression of bloodforming cells, depletion of potassium, and abnormal kidney function. Ketoconzale and Itraconazole are being considered as possible alternative drugs. The National Institute of Allergy and Infectious Diseases (NIAID) is presently conducting three clinical trials of these drugs.
The NLM Gateway29 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.30 One target audience for the Gateway is the Internet user who is new to NLM’s online resources and does not know what information is available or how best to search for it. This audience may include physicians and other healthcare providers, researchers, librarians, students, and, increasingly, patients, their families, and the public.31 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “flu infection” (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.
Adapted from NLM: http://gateway.nlm.nih.gov/gw/Cmd?Overview.x. The NLM Gateway is currently being developed by the Lister Hill National Center for Biomedical Communications (LHNCBC) at the National Library of Medicine (NLM) of the National Institutes of Health (NIH). 31 Other users may find the Gateway useful for an overall search of NLM’s information resources. Some searchers may locate what they need immediately, while others will utilize the Gateway as an adjunct tool to other NLM search services such as PubMed® and MEDLINEplus®. The Gateway connects users with multiple NLM retrieval systems while also providing a search interface for its own collections. These collections include various types of information that do not logically belong in PubMed, LOCATORplus, or other established NLM retrieval systems (e.g., meeting announcements and pre-1966 journal citations). The Gateway will provide access to the information found in an increasing number of NLM retrieval systems in several phases. 29 30
124 Flu Infection
Results Summary Category Items Found Journal Articles 345044 Books / Periodicals / Audio Visual 2564 Consumer Health 293 Meeting Abstracts 3093 Other Collections 100 Total 351094
HSTAT32 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.33 HSTAT’s audience includes healthcare providers, health service researchers, policy makers, insurance companies, consumers, and the information professionals who serve these groups. HSTAT provides access to a wide variety of publications, including clinical practice guidelines, quick-reference 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.34 Simply search by “flu infection” (or synonyms) at the following Web site: http://text.nlm.nih.gov. Coffee Break: Tutorials for Biologists35 Some patients may wish to have access to 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. To this end, we Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. The HSTAT URL is http://hstat.nlm.nih.gov/. 34 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. 35 Adapted from http://www.ncbi.nlm.nih.gov/Coffeebreak/Archive/FAQ.html. 32 33
Physician Guidelines and Databases 125
recommend “Coffee Break,” 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.36 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.37 This site has new articles every few weeks, so it can be considered an online magazine of sorts, and intended for general background information. You can access the Coffee Break Web site at 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 a few 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/.
·
Image Engine: Multimedia electronic medical record system that integrates a wide range of digitized clinical images with textual data stored in the University of Pittsburgh Medical Center’s MARS electronic medical record system; see the following Web site: http://www.cml.upmc.edu/cml/imageengine/imageEngine.html.
·
Medical World Search: Searches full text from thousands of selected medical sites on the Internet; see http://www.mwsearch.com/.
·
MedWeaver: Prototype system that allows users to search differential diagnoses for any list of signs and symptoms, to search medical literature, and to explore relevant Web sites; see http://www.med.virginia.edu/~wmd4n/medweaver.html.
·
Metaphrase: Middleware component intended for use by both caregivers and medical records personnel. It converts the informal language generally used by caregivers into terms from formal, controlled vocabularies; see http://www.lexical.com/Metaphrase.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. 37 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. 36
126 Flu Infection
The Genome Project and Flu Infection With all the discussion in the press about the Human Genome Project, it is only natural that physicians, researchers, and patients want to know about how human genes relate to flu infection. In the following section, we will discuss databases and references used by physicians and scientists who work in this area.
Online Mendelian Inheritance in Man (OMIM) The Online Mendelian Inheritance in Man (OMIM) database is a catalog of human genes and genetic disorders authored and edited by Dr. Victor A. McKusick and his colleagues at Johns Hopkins and elsewhere. OMIM was developed for the World Wide Web by the National Center for Biotechnology Information (NCBI).38 The database contains textual information, pictures, and reference information. It also contains copious links to NCBI’s Entrez database of MEDLINE articles and sequence information. Go to http://www.ncbi.nlm.nih.gov/Omim/searchomim.html to search the database. Type “flu infection” (or synonyms) in the search box, and click “Submit Search.” If too many results appear, you can narrow the search by adding the word “clinical.” Each report will have additional links to related research and databases. By following these links, especially the link titled “Database Links,” you will be exposed to numerous specialized databases that are largely used by the scientific community. These databases are overly technical and seldom used by the general public, but offer an abundance of information. The following is an example of the results you can obtain from the OMIM for flu infection: ·
Arrhythmogenic Right Ventricular Dysplasia, Familial, 1; Arvd1 Web site: http://www.ncbi.nlm.nih.gov/htbinpost/Omim/dispmim?107970
·
Blu Gene Web site: http://www.ncbi.nlm.nih.gov/htbinpost/Omim/dispmim?607070
Adapted from http://www.ncbi.nlm.nih.gov/. Established in 1988 as a national resource for molecular biology information, NCBI creates public databases, conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information--all for the better understanding of molecular processes affecting human health and disease.
38
Physician Guidelines and Databases 127
·
Interferon, Alpha-2 Web site: http://www.ncbi.nlm.nih.gov/htbinpost/Omim/dispmim?147562
·
Interferon, Gamma Web site: http://www.ncbi.nlm.nih.gov/htbinpost/Omim/dispmim?147570
·
Malignant Hyperthermia Susceptibility 1 Web site: http://www.ncbi.nlm.nih.gov/htbinpost/Omim/dispmim?145600
·
Melanoma, Cutaneous Malignant Web site: http://www.ncbi.nlm.nih.gov/htbinpost/Omim/dispmim?155600
Genes and Disease (NCBI - Map) The Genes and Disease database is produced by the National Center for Biotechnology Information of the National Library of Medicine at the National Institutes of Health. This Web site categorizes each disorder by the system of the body associated with it. Go to http://www.ncbi.nlm.nih.gov/disease/, and browse the system pages to have a full view of important conditions linked to human genes. Since this site is regularly updated, you may wish to re-visit it from time to time. The following systems and associated disorders are addressed: ·
Immune System: Fights invaders. Examples: Asthma, autoimmune polyglandular syndrome, Crohn’s disease, DiGeorge syndrome, familial Mediterranean fever, immunodeficiency with Hyper-IgM, severe combined immunodeficiency. Web site: http://www.ncbi.nlm.nih.gov/disease/Immune.html
·
Nervous System: Mind and body. Examples: Alzheimer disease, Amyotrophic lateral sclerosis, Angelman syndrome, Charcot-Marie-Tooth disease, epilepsy, essential tremor, Fragile X syndrome, Friedreich’s ataxia, Huntington disease, NiemannPick disease, Parkinson disease, Prader-Willi syndrome, Rett syndrome, Spinocerebellar atrophy, Williams syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Brain.html
·
Signals: Cellular messages. Examples: Ataxia telangiectasia, Baldness, Cockayne syndrome, Glaucoma, SRY: sex determination, Tuberous sclerosis, Waardenburg syndrome, Werner syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Signals.html
128 Flu Infection
·
Transporters: Pumps and channels. Examples: Cystic Fibrosis, deafness, diastrophic dysplasia, Hemophilia A, long-QT syndrome, Menkes syndrome, Pendred syndrome, polycystic kidney disease, sickle cell anemia, Wilson’s disease, Zellweger syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Transporters.html Entrez
Entrez is a search and retrieval system that integrates several linked databases at the National Center for Biotechnology Information (NCBI). These databases include nucleotide sequences, protein sequences, macromolecular structures, whole genomes, and MEDLINE through PubMed. Entrez provides access to the following databases: ·
PubMed: Biomedical literature (PubMed), Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed
·
Nucleotide Sequence Database (Genbank): Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Nucleotide
·
Protein Sequence Database: Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Protein
·
Structure: Three-dimensional macromolecular structures, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Structure
·
Genome: Complete genome assemblies, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Genome
·
PopSet: Population study data sets, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Popset
·
OMIM: Online Mendelian Inheritance in Man, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=OMIM
·
Taxonomy: Organisms in GenBank, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Taxonomy
·
Books: Online books, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=books
·
ProbeSet: Gene Expression Omnibus (GEO), Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=geo
·
3D Domains: Domains from Entrez Structure, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=geo
Physician Guidelines and Databases 129
·
NCBI’s Protein Sequence Information Survey Results: Web site: http://www.ncbi.nlm.nih.gov/About/proteinsurvey/
To access the Entrez system at the National Center for Biotechnology Information, go to http://www.ncbi.nlm.nih.gov/entrez, and then select the database that you would like to search. The databases available are listed in the drop box next to “Search.” In the box next to “for,” enter “flu infection” (or synonyms) and click “Go.” Jablonski’s Multiple Congenital Anomaly/Mental Retardation (MCA/MR) Syndromes Database39 This online resource can be quite useful. It has been developed to facilitate the identification and differentiation of syndromic entities. Special attention is given to the type of information that is usually limited or completely omitted in existing reference sources due to space limitations of the printed form. At http://www.nlm.nih.gov/mesh/jablonski/syndrome_toc/toc_a.html you can also search across syndromes using an alphabetical index. You can also search at http://www.nlm.nih.gov/mesh/jablonski/syndrome_db.html. The Genome Database40 Established at Johns Hopkins University in Baltimore, Maryland in 1990, the Genome Database (GDB) is the official central repository for genomic mapping data resulting from the Human Genome Initiative. In the spring of 1999, the Bioinformatics Supercomputing Centre (BiSC) at the Hospital for Sick Children in Toronto, Ontario assumed the management of GDB. The Human Genome Initiative is a worldwide research effort focusing on structural analysis of human DNA to determine the location and sequence of the estimated 100,000 human genes. In support of this project, GDB stores and curates data generated by researchers worldwide who are engaged in the mapping effort of the Human Genome Project (HGP). GDB’s mission is to provide scientists with an encyclopedia of the human genome which is continually revised and updated to reflect the current state of scientific knowledge. Although GDB has historically focused on gene mapping, its Adapted from the National Library of Medicine: http://www.nlm.nih.gov/mesh/jablonski/about_syndrome.html. 40 Adapted from the Genome Database: http://gdbwww.gdb.org/gdb/aboutGDB.html#mission. 39
130 Flu Infection
focus will broaden as the Genome Project moves from mapping to sequence, and finally, to functional analysis. To access the GDB, simply go to the following hyperlink: http://www.gdb.org/. Search “All Biological Data” by “Keyword.” Type “flu infection” (or synonyms) into the search box, and review the results. If more than one word is used in the search box, then separate each one with the word “and” or “or” (using “or” might be useful when using synonyms). This database is extremely technical as it was created for specialists. The articles are the results which are the most accessible to non-professionals and often listed under the heading “Citations.” The contact names are also accessible to non-professionals.
Specialized References The following books are specialized references written for professionals interested in flu infection (sorted alphabetically by title, hyperlinks provide rankings, information, and reviews at Amazon.com): ·
2003 Pocket Book of Infectious Disease Therapy by John G. Bartlett; 12th edition (June 15, 2003), Lippincott, Williams & Wilkins Publishers; ISBN: 0781738962; http://www.amazon.com/exec/obidos/ASIN/0781738962/icongroupinterna
·
Immunology and Evolution of Infectious Disease by Steven A. Frank; Paperback – 352 pages (August 2002), Princeton University Press; ISBN: 0691095957; http://www.amazon.com/exec/obidos/ASIN/0691095957/icongroupinterna
·
Infectious Disease Epidemiology: Theory and Practice by Kenrad E. Nelson, et al; Hardcover – 600 pages (May 2000), Aspen Publishers, Inc.; ISBN: 083421766X; http://www.amazon.com/exec/obidos/ASIN/083421766X/icongroupinterna
·
Infectious Disease Pearls (The Pearls Series) by Steven A. Sahn (Editor), et al; Paperback – 250 pages (November 1998), Hanley & Belfus; ISBN: 1560532033; http://www.amazon.com/exec/obidos/ASIN/1560532033/icongroupinterna
·
Manual of Clinical Problems in Infectious Disease by Nelson M. Gantz, et al; Spiral-bound -- 523 pages, 4th edition (May 15, 1999), Lippincott Williams & Wilkins Publishers; ISBN: 0781719100; http://www.amazon.com/exec/obidos/ASIN/0781719100/icongroupinterna
·
Mims’ Pathogenesis of Infectious Disease by Cedric A. Mims, et al; Paperback -- 474 pages, 5th edition (January 15, 2001), Academic Press;
Physician Guidelines and Databases 131
ISBN: 0124982654; http://www.amazon.com/exec/obidos/ASIN/0124982654/icongroupinterna ·
A Practical Approach to Infectious Diseases by Richard E. Reese, M.D. (Editor), Robert F. Betts, M.D. (Editor); Paperback, 4th edition (September 1996), Little Brown & Co.; ISBN: 0316737216; http://www.amazon.com/exec/obidos/ASIN/0316737216/icongroupinterna
Vocabulary Builder Arrhythmogenic: Producing or promoting arrhythmia. [EU] Disinfectant: An agent that disinfects; applied particularly to agents used on inanimate objects. [EU] Dysplasia: Abnormality of development; in pathology, alteration in size, shape, and organization of adult cells. [EU] Homicide: The killing of one person by another. [NIH] Hyperthermia: Abnormally high body temperature, especially that induced for therapeutic purposes. [EU] Malignant: Tending to become progressively worse and to result in death. Having the properties of anaplasia, invasion, and metastasis; said of tumours. [EU] Potassium: An element that is in the alkali group of metals. It has an atomic symbol K, atomic number 19, and atomic weight 39.10. It is the chief cation in the intracellular fluid of muscle and other cells. Potassium ion is a strong electrolyte and it plays a significant role in the regulation of fluid volume and maintenance of the water-electrolyte balance. [NIH] Prenatal: Existing or occurring before birth, with reference to the fetus. [EU] Spores: The reproductive elements of lower organisms, such as protozoa, fungi, and cryptogamic plants. [NIH] Ventricular: Pertaining to a ventricle. [EU]
Dissertations 133
CHAPTER 10. DISSERTATIONS ON FLU INFECTION Overview University researchers are active in studying almost all known diseases. The result of research is often published in the form of Doctoral or Master’s dissertations. You should understand, therefore, that applied diagnostic procedures and/or therapies can take many years to develop after the thesis that proposed the new technique or approach was written. In this chapter, we will give you a bibliography on recent dissertations relating to flu infection. You can read about these in more detail using the Internet or your local medical library. We will also provide you with information on how to use the Internet to stay current on dissertations.
Dissertations on Flu Infection ProQuest Digital Dissertations is the largest archive of academic dissertations available. From this archive, we have compiled the following list covering dissertations devoted to flu infection. You will see that the information provided includes the dissertation’s title, its author, and the author’s institution. To read more about the following, simply use the Internet address indicated. The following covers recent dissertations dealing with flu infection: ·
'black October': the Impact of the Spanish Influenza Epidemic of 1918 on South Africa by Phillips, Howard, Phd from University of Cape Town (south Africa), 1984 http://wwwlib.umi.com/dissertations/fullcit/f2278981
134 Flu Infection
·
Disease and the Politics of Community: Norwood and the Great Flu Epidemic of 1918 (massachusetts) by Fanning, Patricia J., Phd from Boston College, 1995, 252 pages http://wwwlib.umi.com/dissertations/fullcit/9610866
·
Dominant Gating Governing Transient Gaba(a) Receptor Activity: Flunitrazepam Modulation of Activation and Desensitization Kinetics by Burkat, Paul Michael; Phd from The University of Rochester, 2001, 159 pages http://wwwlib.umi.com/dissertations/fullcit/3013376
·
Interpretive Sociological Theory and Public Policy-making: the Case of the Swine Flu by Conley, Eugene Dean, Jr., Phd from The George Washington University, 1984, 536 pages http://wwwlib.umi.com/dissertations/fullcit/8410478
·
Paradoxical Trends in Influenza Immunization Rates and Rates of Hospitalization for Pneumonia and Influenza in the Elderly by Hebert, Paul Louis; Phd from University of Minnesota, 2001, 293 pages http://wwwlib.umi.com/dissertations/fullcit/3034608
·
The French Experience of Pandemic Influenza during the Great War by Talbert, Joseph Allen; Phd from The Ohio State University, 2000, 163 pages http://wwwlib.umi.com/dissertations/fullcit/9982989
Keeping Current As previously mentioned, an effective way to stay current on dissertations dedicated to flu infection is to use the database called ProQuest Digital Dissertations via the Internet, located at the following Web address: http://wwwlib.umi.com/dissertations. The site allows you to freely access the last two years of citations and abstracts. Ask your medical librarian if the library has full and unlimited access to this database. From the library, you should be able to do more complete searches than with the limited 2-year access available to the general public.
Vocabulary Builder Desensitization: The prevention or reduction of immediate hypersensitivity reactions by administration of graded doses of allergen; called also hyposensitization and immunotherapy. [EU] Flunitrazepam: Benzodiazepine with pharmacologic actions similar to those
Dissertations 135
of diazepam. The United States Government has banned the importation of this drug. Steps are being taken to reclassify this substance as a Schedule 1 drug with no accepted medical use. [NIH] Gaba: The most common inhibitory neurotransmitter in the central nervous system. [NIH] Kinetics: The study of rate dynamics in chemical or physical systems. [NIH] Paradoxical: Occurring at variance with the normal rule. [EU]
137
PART III. APPENDICES
ABOUT PART III Part III is a collection of appendices on general medical topics which may be of interest to patients with flu infection and related conditions.
Researching Your Medications 139
APPENDIX A. RESEARCHING YOUR MEDICATIONS Overview There are a number of sources available on new or existing medications which could be prescribed to patients with flu infection. While a number of hard copy or CD-Rom resources are available to patients and physicians for research purposes, a more flexible method is to use Internet-based databases. In this chapter, we will begin with a general overview of medications. We will then proceed to outline official recommendations on how you should view your medications. You may also want to research medications that you are currently taking for other conditions as they may interact with medications for flu infection. Research can give you information on the side effects, interactions, and limitations of prescription drugs used in the treatment of flu infection. Broadly speaking, there are two sources of information on approved medications: public sources and private sources. We will emphasize free-to-use public sources.
140 Flu Infection
Your Medications: The Basics41 The Agency for Health Care Research and Quality has published extremely useful guidelines on how you can best participate in the medication aspects of flu infection. Taking medicines is not always as simple as swallowing a pill. It can involve many steps and decisions each day. The AHCRQ recommends that patients with flu infection take part in treatment decisions. Do not be afraid to ask questions and talk about your concerns. By taking a moment to ask questions early, you may avoid problems later. Here are some points to cover each time a new medicine is prescribed: ·
Ask about all parts of your treatment, including diet changes, exercise, and medicines.
·
Ask about the risks and benefits of each medicine or other treatment you might receive.
·
Ask how often you or your doctor will check for side effects from a given medication.
Do not hesitate to ask what is important to you about your medicines. You may want a medicine with the fewest side effects, or the fewest doses to take each day. You may care most about cost, or how the medicine might affect how you live or work. Or, you may want the medicine your doctor believes will work the best. Telling your doctor will help him or her select the best treatment for you. Do not be afraid to “bother” your doctor with your concerns and questions about medications for flu infection. You can also talk to a nurse or a pharmacist. They can help you better understand your treatment plan. Feel free to bring a friend or family member with you when you visit your doctor. Talking over your options with someone you trust can help you make better choices, especially if you are not feeling well. Specifically, ask your doctor the following: ·
The name of the medicine and what it is supposed to do.
·
How and when to take the medicine, how much to take, and for how long.
·
What food, drinks, other medicines, or activities you should avoid while taking the medicine.
·
What side effects the medicine may have, and what to do if they occur.
·
If you can get a refill, and how often.
41
This section is adapted from AHCRQ: http://www.ahcpr.gov/consumer/ncpiebro.htm.
Researching Your Medications 141
·
About any terms or directions you do not understand.
·
What to do if you miss a dose.
·
If there is written information you can take home (most pharmacies have information sheets on your prescription medicines; some even offer large-print or Spanish versions).
Do not forget to tell your doctor about all the medicines you are currently taking (not just those for flu infection). This includes prescription medicines and the medicines that you buy over the counter. Then your doctor can avoid giving you a new medicine that may not work well with the medications you take now. When talking to your doctor, you may wish to prepare a list of medicines you currently take, the reason you take them, and how you take them. Be sure to include the following information for each: ·
Name of medicine
·
Reason taken
·
Dosage
·
Time(s) of day
Also include any over-the-counter medicines, such as: ·
Laxatives
·
Diet pills
·
Vitamins
·
Cold medicine
·
Aspirin or other pain, headache, or fever medicine
·
Cough medicine
·
Allergy relief medicine
·
Antacids
·
Sleeping pills
·
Others (include names)
Learning More about Your Medications Because of historical investments by various organizations and the emergence of the Internet, it has become rather simple to learn about the medications your doctor has recommended for flu infection. One such
142 Flu Infection
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 www.usp.org. The USP currently provides standards for over 3,700 medications. The resulting USP DIÒ Advice for the PatientÒ 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.42 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 Pharmacopoeia (USP). It is important to read the disclaimer by the USP (http://www.nlm.nih.gov/medlineplus/drugdisclaimer.html) before using the information provided. Of course, we as editors cannot be certain as to what medications you are taking. Therefore, we have compiled a list of medications associated with the treatment of flu infection. Once again, due to space limitations, we only list a sample of medications and provide hyperlinks to ample documentation (e.g. typical dosage, side effects, drug-interaction risks, etc.). The following drugs have been mentioned in the Pharmacopeia and other sources as being potentially applicable to flu infection: Allopurinol ·
Systemic - U.S. Brands: Aloprim; Zyloprim http://www.nlm.nih.gov/medlineplus/druginfo/allopurinolsyste mic202021.html
Though cumbersome, the FDA database can be freely browsed at the following site: www.fda.gov/cder/da/da.htm.
42
Researching Your Medications 143
Amantadine ·
Systemic - U.S. Brands: Symmetrel http://www.nlm.nih.gov/medlineplus/druginfo/amantadinesyst emic202024.html
Aminoglycosides ·
Systemic - U.S. Brands: Amikin; Garamycin; G-Mycin; Jenamicin; Kantrex; Nebcin; Netromycin http://www.nlm.nih.gov/medlineplus/druginfo/aminoglycoside ssystemic202027.html
Aminosalicylate Sodium ·
Systemic - U.S. Brands: Tubasal http://www.nlm.nih.gov/medlineplus/druginfo/aminosalicylate sodiumsystemic202028.html
Androgens ·
Systemic - U.S. Brands: Andro L.A. 200; Androderm; AndroGel 1%; Android; Android-F; Andronate 100; Andronate 200; Andropository 200; Andryl 200; Delatest; Delatestryl; Depotest; Depo-Testosterone; Everone 200; Halotestin; ORETON Methyl; TCypionate; Testamone 100; Testaqua; Te http://www.nlm.nih.gov/medlineplus/druginfo/androgenssyste mic202036.html
Androgens and Estrogens ·
Systemic - U.S. Brands: Andrest 90-4; Andro-Estro 90-4; Androgyn L.A.; De-Comberol; Deladumone; Delatestadiol; depAndrogyn; Depo-Testadiol; Depotestogen; Duo-Cyp; Duo-Gen L.A.; DuraDumone 90/4; Duratestin; Estratest; Estratest H.S.; Halodrin; Menoject-L.A.; OB; Premarin with http://www.nlm.nih.gov/medlineplus/druginfo/androgensandes trogenssystemic202037.html
Anesthetics, General ·
Systemic - U.S. Brands: Amidate; Brevital; Diprivan; Ethrane; Fluothane; Forane; Ketalar; Penthrane; Pentothal http://www.nlm.nih.gov/medlineplus/druginfo/anestheticsgene ralsystemic203043.html
144 Flu Infection
Antacids ·
Oral - U.S. Brands: Advanced Formula Di-Gel; Alamag; Alamag Plus; Alenic Alka; Alenic Alka Extra Strength; Alka-Mints; Alkets; Alkets Extra Strength; Almacone; Almacone II; AlternaGEL; AluCap; Aludrox; Alu-Tab; Amitone; Amphojel; Antacid Gelcaps; Antacid Liquid; Antacid L http://www.nlm.nih.gov/medlineplus/druginfo/antacidsoral202 047.html
Antidiabetic Agents, Sulfonylurea ·
Systemic - U.S. Brands: Amaryl; DiaBeta; Diabinese; Dymelor; Glucotrol; Glucotrol XL; Glynase PresTab; Micronase; Orinase; Tolinase http://www.nlm.nih.gov/medlineplus/druginfo/antidiabeticagen tssulfonylurea202742.html
Antifungals, Azole ·
Systemic - U.S. Brands: Diflucan; Nizoral; Sporanox http://www.nlm.nih.gov/medlineplus/druginfo/antifungalsazole systemic202697.html
Antiglaucoma Agents, Cholinergic, Long-Acting ·
Ophthalmic - U.S. Brands: Humorsol; Phospholine Iodide http://www.nlm.nih.gov/medlineplus/druginfo/antiglaucomaag entscholinergicl202059.html
Antihistamines, Decongestants, and Analgesics ·
Systemic - U.S. Brands: Aclophen; Actifed Cold & Sinus; Actifed Cold & Sinus Caplets; Actifed Sinus Nighttime; Actifed Sinus Nighttime Caplets; Alka-Seltzer Plus Allergy Medicine Liqui-Gels; Alka-Seltzer Plus Cold Medicine; Alka-Seltzer Plus Cold Medicine Liqui-Gels; Allerest http://www.nlm.nih.gov/medlineplus/druginfo/antihistaminesd econgestantsand202062.html
Anti-Inflammatory Drugs, Nonsteroidal ·
Ophthalmic - U.S. Brands: Ocufen; Profenal; Voltaren Ophthalmic http://www.nlm.nih.gov/medlineplus/druginfo/antiinflammator ydrugsnonsteroi202647.html
Researching Your Medications 145
·
Systemic - U.S. Brands: Actron; Advil; Advil Caplets; Advil, Children's; Aleve; Anaprox; Anaprox DS; Ansaid; Bayer Select Ibuprofen Pain Relief Formula Caplets; Cataflam; Clinoril; Cotylbutazone; Cramp End; Daypro; Dolgesic; Dolobid; ECNaprosyn; Excedrin IB; Excedrin IB Caple http://www.nlm.nih.gov/medlineplus/druginfo/antiinflammator ydrugsnonsteroi202743.html
Antipyrine and Benzocaine ·
Otic - U.S. Brands: Allergen; Antiben; Auralgan; Aurodex; Auroto; Dolotic; Otocalm http://www.nlm.nih.gov/medlineplus/druginfo/antipyrineandb enzocaineotic202066.html
Asparaginase ·
Systemic - U.S. Brands: Elspar http://www.nlm.nih.gov/medlineplus/druginfo/asparaginasesys temic202072.html
Attapulgite ·
Oral - U.S. Brands: Diar-Aid; Diarrest; Diasorb; Diatrol; Donnagel; Kaopectate; Kaopek; K-Pek; Parepectolin; Rheaban http://www.nlm.nih.gov/medlineplus/druginfo/attapulgiteoral2 02076.html
Azithromycin ·
Systemic - U.S. Brands: Zithromax http://www.nlm.nih.gov/medlineplus/druginfo/azithromycinsys temic202642.html
Aztreonam ·
Systemic - U.S. Brands: Azactam http://www.nlm.nih.gov/medlineplus/druginfo/aztreonamsyste mic202078.html Bacillus Calmette-Guйrin (Bcg) Live for Cancer ·
Mucosal-Local - U.S. Brands: Pacis; TheraCys http://www.nlm.nih.gov/medlineplus/druginfo/bacilluscalmette guirinbcglivef202079.html
146 Flu Infection
Benzodiazepines ·
Systemic - U.S. Brands: Alprazolam Intensol; Ativan; Dalmane; Diastat; Diazepam Intensol; Dizac; Doral; Halcion; Klonopin; Librium; Lorazepam Intensol; Paxipam; ProSom; Restoril; Serax; Tranxene T-Tab; Tranxene-SD; Tranxene-SD Half Strength; Valium; Xanax http://www.nlm.nih.gov/medlineplus/druginfo/benzodiazepine ssystemic202084.html
Benzonatate ·
Systemic - U.S. Brands: Tessalon http://www.nlm.nih.gov/medlineplus/druginfo/benzonatatesyst emic202085.html
Beta-Adrenergic Blocking Agents and Thiazide Diuretics ·
Systemic - U.S. Brands: Corzide 40/5; Corzide 80/5; Inderide; Inderide LA; Lopressor HCT; Tenoretic 100; Tenoretic 50; Timolide 10-25; Ziac http://www.nlm.nih.gov/medlineplus/druginfo/betaadrenergicb lockingagentsan202088.html
Bethanechol ·
Systemic - U.S. Brands: Duvoid; Urabeth; Urecholine http://www.nlm.nih.gov/medlineplus/druginfo/bethanecholsyst emic202090.html
Bismuth Subsalicylate ·
Oral - U.S. Brands: Bismatrol; Pepto-Bismol http://www.nlm.nih.gov/medlineplus/druginfo/bismuthsubsalic ylateoral202092.html
Busulfan ·
Systemic - U.S. Brands: Busulfex; Myleran http://www.nlm.nih.gov/medlineplus/druginfo/busulfansystemi c202101.html
Researching Your Medications 147
Calcium Channel Blocking Agents ·
Systemic - U.S. Brands: Adalat; Adalat CC; Calan; Calan SR; Cardene; Cardizem; Cardizem CD; Cardizem SR; Dilacor-XR; DynaCirc; Isoptin; Isoptin SR; Nimotop; Plendil; Procardia; Procardia XL; Vascor; Verelan http://www.nlm.nih.gov/medlineplus/druginfo/calciumchannel blockingagentssy202107.html
Cephalosporins ·
Systemic - U.S. Brands: Ancef; Ceclor; Ceclor CD; Cedax; Cefadyl; Cefizox; Cefobid; Cefotan; Ceftin; Cefzil; Ceptaz; Claforan; Duricef; Fortaz; Keflex 20; Keftab 20; Kefurox; Kefzol; Mandol; Maxipime; Mefoxin; Monocid; Omnicef; Rocephin; Suprax; Tazicef; Tazidime; Vantin; Velo http://www.nlm.nih.gov/medlineplus/druginfo/cephalosporinss ystemic202119.html
Charcoal, Activated ·
Oral - U.S. Brands: Actidose with Sorbitol; Actidose-Aqua; CharcoAid; CharcoAid 2000; CharcoAid G; Insta-Char in an Aqueous Base; Insta-Char in an Aqueous Base with Cherry Flavor; Insta-Char Pediatric in an Aqueous Base with Cherry Flavor; InstaChar Pediatric with Cherry http://www.nlm.nih.gov/medlineplus/druginfo/charcoalactivate doral202120.html
Chlorambucil ·
Systemic - U.S. Brands: Leukeran http://www.nlm.nih.gov/medlineplus/druginfo/chlorambucilsys temic202124.html
Chloramphenicol ·
Systemic - U.S. Brands: Chloromycetin http://www.nlm.nih.gov/medlineplus/druginfo/chloramphenico lsystemic202127.html
Chlorhexidine ·
Dental - U.S. Brands: Peridex; PerioGard http://www.nlm.nih.gov/medlineplus/druginfo/chlorhexidinede ntal202131.html
148 Flu Infection
Cinoxacin ·
Systemic - U.S. Brands: Cinobac http://www.nlm.nih.gov/medlineplus/druginfo/cinoxacinsystem ic202141.html
Cisapride ·
Systemic - U.S. Brands: Propulsid http://www.nlm.nih.gov/medlineplus/druginfo/cisapridesystem ic202672.html
Cisplatin ·
Systemic - U.S. Brands: Platinol; Platinol-AQ http://www.nlm.nih.gov/medlineplus/druginfo/cisplatinsystemi c202143.html
Clarithromycin ·
Systemic - U.S. Brands: Biaxin http://www.nlm.nih.gov/medlineplus/druginfo/clarithromycins ystemic202667.html
Clindamycin ·
Systemic - U.S. Brands: Cleocin http://www.nlm.nih.gov/medlineplus/druginfo/clindamycinsyst emic202145.html
Coal Tar ·
Topical - U.S. Brands: Alphosyl; Aquatar; Estar; Fototar; Lavatar; Medotar; Psorigel; Taraphilic; Tarbonis http://www.nlm.nih.gov/medlineplus/druginfo/coaltartopical20 2158.html
Corticosteroids ·
Inhalation - U.S. Brands: AeroBid; AeroBid-M; Azmacort; Beclovent; Decadron Respihaler; Pulmicort Respules; Pulmicort Turbuhaler; Vanceril; Vanceril 84 mcg Double Strength http://www.nlm.nih.gov/medlineplus/druginfo/corticosteroidsi nhalation202011.html
Researching Your Medications 149
·
Nasal - U.S. Brands: Beconase; Beconase AQ; Dexacort Turbinaire; Flonase; Nasacort; Nasacort AQ; Nasalide; Nasarel; Nasonex; Rhinocort; Vancenase; Vancenase AQ 84 mcg; Vancenase pockethaler http://www.nlm.nih.gov/medlineplus/druginfo/corticosteroidsn asal202012.html
·
Ophthalmic - U.S. Brands: AK-Dex; AK-Pred; AK-Tate; Baldex; Decadron; Dexair; Dexotic; Econopred; Econopred Plus; Eflone; Flarex; Fluor-Op; FML Forte; FML Liquifilm; FML S.O.P.; HMS Liquifilm; Inflamase Forte; Inflamase Mild; I-Pred; Lite Pred; Maxidex; Ocu-Dex; Ocu-Pred; Ocu-Pr http://www.nlm.nih.gov/medlineplus/druginfo/corticosteroidso phthalmic202013.html
Corticosteroids Low Potency ·
Topical - U.S. Brands: 9-1-1; Aclovate; Acticort 100; Aeroseb-Dex; Aeroseb-HC; Ala-Cort; Ala-Scalp HP; Allercort; Alphaderm; Bactine; Beta-HC; CaldeCORT Anti-Itch; CaldeCORT Light; Carmol-HC; Cetacort; Cloderm; Cortaid; Cort-Dome; Cortef Feminine Itch; Corticaine; Cortifair; http://www.nlm.nih.gov/medlineplus/druginfo/corticosteroidsl owpotencytopic202907.html
Corticosteroids Medium to Very High Potency ·
Topical - U.S. Brands: Alphatrex; Aristocort 20; Aristocort A 20; Betatrex; Beta-Val; Bio-Syn; Cordran; Cordran SP; Cormax; Cutivate; Cyclocort; Delta-Tritex 20; Dermabet; Dermatop; Diprolene; Diprolene AF; Diprosone; Elocon; Florone; Florone E; Fluocet; Fluocin; Fluonid; Flu http://www.nlm.nih.gov/medlineplus/druginfo/corticosteroids mediumtoveryhig202016.html
Cromolyn ·
Oral - U.S. Brands: Gastrocrom http://www.nlm.nih.gov/medlineplus/druginfo/cromolynoral20 2169.html
Cyclophosphamide ·
Systemic - U.S. Brands: Cytoxan; Neosar http://www.nlm.nih.gov/medlineplus/druginfo/cyclophosphami desystemic202174.html
150 Flu Infection
Cytarabine ·
Systemic - U.S. Brands: Cytosar-U http://www.nlm.nih.gov/medlineplus/druginfo/cytarabinesyste mic202177.html
Daunorubicin ·
Systemic - U.S. Brands: Cerubidine http://www.nlm.nih.gov/medlineplus/druginfo/daunorubicinsy stemic202183.html
Daunorubicin, Liposomal ·
Systemic - U.S. Brands: DaunoXome http://www.nlm.nih.gov/medlineplus/druginfo/daunorubicinlip osomalsystemic203539.html
Desflurane ·
Inhalation-Systemic - U.S. Brands: Suprane http://www.nlm.nih.gov/medlineplus/druginfo/desfluraneinhal ationsystemic202685.html
Dextromethorphan ·
Systemic - U.S. Brands: Cough-X; Creo-Terpin; Trocal http://www.nlm.nih.gov/medlineplus/druginfo/dextromethorph ansystemic202187.html
Difenoxin and Atropine ·
Systemic - U.S. Brands: Motofen http://www.nlm.nih.gov/medlineplus/druginfo/difenoxinandatr opinesystemic202193.html
Diphenoxylate and Atropine ·
Systemic - U.S. Brands: Lofene; Logen; Lomocot; Lomotil; Lonox; Vi-Atro http://www.nlm.nih.gov/medlineplus/druginfo/diphenoxylatea ndatropinesystem202200.html
http://www.nlm.nih.gov/medlineplus/druginfo/diphtheriaandtetanustox oidsand202911.html ·
Systemic - U.S. Brands: Tetramune http://www.nlm.nih.gov/medlineplus/druginfo/diphtheriaandte tanustoxoidsand202911.html
Researching Your Medications 151
Dirithromycin ·
Systemic - U.S. Brands: Dynabac http://www.nlm.nih.gov/medlineplus/druginfo/dirithromycinsy stemic202785.html
Diuretics, Thiazide ·
Systemic - U.S. Brands: Aquatensen; Diucardin; Diulo; Diuril; Enduron; Esidrix; Hydro-chlor; Hydro-D; HydroDIURIL; Hydromox; Hygroton; Metahydrin; Microzide; Mykrox; Naqua; Naturetin; Oretic; Renese; Saluron; Thalitone; Trichlorex 10; Zaroxolyn http://www.nlm.nih.gov/medlineplus/druginfo/diureticsthiazid esystemic202208.html
Doxorubicin ·
Systemic - U.S. Brands: Rubex http://www.nlm.nih.gov/medlineplus/druginfo/doxorubicinsyst emic202209.html
Doxorubicin, Liposomal ·
Systemic - U.S. Brands: Doxil http://www.nlm.nih.gov/medlineplus/druginfo/doxorubicinlipo somalsystemic203540.html
Epirubicin ·
Systemic - U.S. Brands: Ellence http://www.nlm.nih.gov/medlineplus/druginfo/epirubicinsyste mic500038.html
Epoprostenol ·
Systemic - U.S. Brands: Flolan http://www.nlm.nih.gov/medlineplus/druginfo/epoprostenolsys temic203429.html
Erythromycin and Sulfisoxazole ·
Systemic - U.S. Brands: Eryzole; Pediazole http://www.nlm.nih.gov/medlineplus/druginfo/erythromycinan dsulfisoxazolesy202224.html
152 Flu Infection
Erythromycins ·
Systemic - U.S. Brands: E.E.S.; E-Base; E-Mycin; ERYC; EryPed; Ery-Tab; Erythro; Erythrocin; Erythrocot; Ilosone; Ilotycin; My-E; PCE; Wintrocin http://www.nlm.nih.gov/medlineplus/druginfo/erythromycinss ystemic202223.html
Estrogens ·
Systemic - U.S. Brands: Alora; Aquest; Climara; Clinagen LA 40; Delestrogen; depGynogen; Depo-Estradiol; Depogen; Dioval 40; Dioval XX; Dura-Estrin; Duragen-20; E-Cypionate; Estinyl; Estrace; Estraderm; Estragyn 5; Estragyn LA 5; Estra-L 40; Estratab; Estro-A; Estro-Cyp; Estro http://www.nlm.nih.gov/medlineplus/druginfo/estrogenssystem ic202226.html
·
Vaginal - U.S. Brands: Estrace; Estring; Ogen; Ortho Dienestrol; Premarin http://www.nlm.nih.gov/medlineplus/druginfo/estrogensvagina l202227.html
Estrogens and Progestins (Ovarian Hormone Therapy) ·
Systemic - U.S. Brands: Activella; Note: http://www.nlm.nih.gov/medlineplus/druginfo/estrogensandpr ogestinsovarianh500070.html
Finasteride ·
Systemic - U.S. Brands: Propecia; Proscar http://www.nlm.nih.gov/medlineplus/druginfo/finasteridesyste mic202649.html
Flucytosine ·
Systemic - U.S. Brands: Ancobon http://www.nlm.nih.gov/medlineplus/druginfo/flucytosinesyste mic202243.html
Fludarabine ·
Systemic - U.S. Brands: Fludara http://www.nlm.nih.gov/medlineplus/druginfo/fludarabinesyst emic202630.html
Researching Your Medications 153
Fludrocortisone ·
Systemic - U.S. Brands: Florinef http://www.nlm.nih.gov/medlineplus/druginfo/fludrocortisones ystemic202244.html
Fluoroquinolones ·
Systemic - U.S. Brands: Avelox; Cipro; Cipro I.V.; Floxin; Floxin I.V.; Levaquin; Maxaquin; Noroxin; Penetrex; Tequin; Zagam http://www.nlm.nih.gov/medlineplus/druginfo/fluoroquinolone ssystemic202656.html
Fluorouracil ·
Systemic - U.S. Brands: Adrucil http://www.nlm.nih.gov/medlineplus/druginfo/fluorouracilsyst emic202245.html
·
Topical - U.S. Brands: Efudex; Fluoroplex http://www.nlm.nih.gov/medlineplus/druginfo/fluorouraciltopi cal202246.html
Fluoxetine ·
Systemic - U.S. Brands: Prozac; Sarafem http://www.nlm.nih.gov/medlineplus/druginfo/fluoxetinesyste mic202247.html
Fluticasone ·
Inhalation-Local - U.S. Brands: Flovent http://www.nlm.nih.gov/medlineplus/druginfo/fluticasoneinhal ationlocal203649.html
·
Nasal - U.S. Brands: Flonase http://www.nlm.nih.gov/medlineplus/druginfo/fluticasonenasal 203588.html
Fluvoxamine ·
Systemic - U.S. Brands: Luvox http://www.nlm.nih.gov/medlineplus/druginfo/fluvoxaminesys temic202919.html
Foscarnet ·
Systemic - U.S. Brands: Foscavir http://www.nlm.nih.gov/medlineplus/druginfo/foscarnetsystem ic202617.html
154 Flu Infection
Ganciclovir ·
Systemic - U.S. Brands: Cytovene; Cytovene-IV http://www.nlm.nih.gov/medlineplus/druginfo/ganciclovirsyste mic202255.html
Gemcitabine ·
Systemic - U.S. Brands: Gemzar http://www.nlm.nih.gov/medlineplus/druginfo/gemcitabinesyst emic203038.html
Hmg-Coa Reductase Inhibitors ·
Systemic - U.S. Brands: Baycol; Lescol; Lipitor; Mevacor; Pravachol; Zocor http://www.nlm.nih.gov/medlineplus/druginfo/hmgcoareductas einhibitorssyste202284.html
Hydroxypropyl Methylcellulose ·
Parenteral-Local - U.S. Brands: Ocucoat http://www.nlm.nih.gov/medlineplus/druginfo/hydroxypropyl methylcellulosepa203682.html
Hydroxyurea ·
Systemic - U.S. Brands: Droxia; Hydrea http://www.nlm.nih.gov/medlineplus/druginfo/hydroxyureasys temic202291.html
Idarubicin ·
Systemic - U.S. Brands: Idamycin http://www.nlm.nih.gov/medlineplus/druginfo/idarubicinsyste mic202611.html
Ifosfamide ·
Systemic - U.S. Brands: IFEX http://www.nlm.nih.gov/medlineplus/druginfo/ifosfamidesyste mic202293.html
Indinavir ·
Systemic - U.S. Brands: Crixivan http://www.nlm.nih.gov/medlineplus/druginfo/indinavirsystem ic203523.html
Researching Your Medications 155
Influenza Virus Vaccine ·
Systemic - U.S. Brands: FluShield; Fluvirin; Fluzone http://www.nlm.nih.gov/medlineplus/druginfo/influenzavirusv accinesystemic202297.html
Insulin ·
Systemic - U.S. Brands: Humulin 50/50; Humulin 70/30; Humulin 70/30 Pen; Humulin L; Humulin N; Humulin N Pen; Humulin R; Humulin R, Regular U-500 (Concentrated); Humulin U; Lente; Lente Iletin II; Novolin 70/30; Novolin 70/30 PenFill; Novolin 70/30 Prefilled; Novolin L; Novoli http://www.nlm.nih.gov/medlineplus/druginfo/insulinsystemic 203298.html
Interferon, Beta-1B ·
Systemic - U.S. Brands: Betaseron http://www.nlm.nih.gov/medlineplus/druginfo/interferonbeta1 bsystemic203538.html
Ipratropium ·
Nasal - U.S. Brands: Atrovent http://www.nlm.nih.gov/medlineplus/druginfo/ipratropiumnas al202713.html
Kaolin and Pectin ·
Oral - U.S. Brands: Kao-Spen; Kapectolin; K-P http://www.nlm.nih.gov/medlineplus/druginfo/kaolinandpectin oral202313.html
Lansoprazole ·
Systemic - U.S. Brands: Prevacid http://www.nlm.nih.gov/medlineplus/druginfo/lansoprazolesys temic202787.html
Latanoprost ·
Ophthalmic - U.S. Brands: Xalatan http://www.nlm.nih.gov/medlineplus/druginfo/latanoprostopht halmic203607.html
156 Flu Infection
Laxatives ·
Oral - U.S. Brands: Afko-Lube; Afko-Lube Lax 40; Agoral Marshmallow; Agoral Raspberry; Alaxin; Alophen; Alphamul; Alramucil Orange; Alramucil Regular; Bilagog; Bilax; Bisac-Evac; Black-Draught; Black-Draught Lax-Senna; Carter's Little Pills; Cholac; Chronulac; Cillium; Cit http://www.nlm.nih.gov/medlineplus/druginfo/laxativesoral202 319.html
Leflunomide ·
Systemic - U.S. Brands: Arava http://www.nlm.nih.gov/medlineplus/druginfo/leflunomidesyst emic203680.html
Leucovorin ·
Systemic - U.S. Brands: Wellcovorin http://www.nlm.nih.gov/medlineplus/druginfo/leucovorinsyste mic202321.html
Lincomycin ·
Systemic - U.S. Brands: Lincocin; Lincorex http://www.nlm.nih.gov/medlineplus/druginfo/lincomycinsyste mic202328.html
Lindane ·
Topical - U.S. Brands: Bio-Well; GBH; G-well; Kildane; Kwell; Kwildane; Scabene; Thionex http://www.nlm.nih.gov/medlineplus/druginfo/lindanetopical2 02329.html
Linezolid ·
Systemic - U.S. Brands: Zyvox http://www.nlm.nih.gov/medlineplus/druginfo/linezolidsystemi c500165.html
Lithium ·
Systemic - U.S. Brands: Cibalith-S; Eskalith; Lithane; Lithobid; Lithonate; Lithotabs http://www.nlm.nih.gov/medlineplus/druginfo/lithiumsystemic 202330.html
Researching Your Medications 157
Loperamide ·
Oral - U.S. Brands: Imodium http://www.nlm.nih.gov/medlineplus/druginfo/loperamideoral2 02332.html
Loracarbef ·
Systemic - U.S. Brands: Lorabid http://www.nlm.nih.gov/medlineplus/druginfo/loracarbefsyste mic202680.html
Malathion ·
Topical - U.S. Brands: Ovide http://www.nlm.nih.gov/medlineplus/druginfo/malathiontopica l202336.html
Mechlorethamine ·
Systemic - U.S. Brands: Mustargen http://www.nlm.nih.gov/medlineplus/druginfo/mechlorethamin esystemic202341.html
Mefloquine ·
Systemic - U.S. Brands: Lariam http://www.nlm.nih.gov/medlineplus/druginfo/mefloquinesyste mic202344.html
Melphalan ·
Systemic - U.S. Brands: Alkeran http://www.nlm.nih.gov/medlineplus/druginfo/melphalansyste mic202345.html
Menotropins ·
Systemic - U.S. Brands: Humegon; Pergonal http://www.nlm.nih.gov/medlineplus/druginfo/menotropinssys temic202347.html
Mercaptopurine ·
Systemic - U.S. Brands: Purinethol http://www.nlm.nih.gov/medlineplus/druginfo/mercaptopurine systemic202350.html
158 Flu Infection
Metformin ·
Systemic - U.S. Brands: Glucophage http://www.nlm.nih.gov/medlineplus/druginfo/metforminsyste mic202756.html
Metoclopramide ·
Systemic - U.S. Brands: Octamide; Reglan http://www.nlm.nih.gov/medlineplus/druginfo/metoclopramide systemic202364.html
Metronidazole ·
Systemic - U.S. Brands: Flagyl; Protostat http://www.nlm.nih.gov/medlineplus/druginfo/metronidazoles ystemic202365.html
Mitoxantrone ·
Systemic - U.S. Brands: Novantrone http://www.nlm.nih.gov/medlineplus/druginfo/mitoxantronesy stemic202378.html
Omeprazole ·
Systemic - U.S. Brands: Prilosec http://www.nlm.nih.gov/medlineplus/druginfo/omeprazolesyst emic202423.html Oseltamivir ·
Systemic - U.S. Brands: Tamiflu http://www.nlm.nih.gov/medlineplus/druginfo/oseltamivirsyste mic500062.html
Pantoprazole ·
Systemic - U.S. Brands: Protonix http://www.nlm.nih.gov/medlineplus/druginfo/pantoprazolesys temic500064.html
Pegaspargase ·
Systemic - U.S. Brands: Oncaspar http://www.nlm.nih.gov/medlineplus/druginfo/pegaspargasesy stemic203543.html
Researching Your Medications 159
Penicillins ·
Systemic - U.S. Brands: Amoxil; Bactocill; Beepen-VK; BetapenVK; Bicillin L-A; Cloxapen; Crysticillin 300 A.S.; Dycill; Dynapen; Geocillin; Geopen; Ledercillin VK; Mezlin; Nafcil; Nallpen; Omnipen; Omnipen-N; Pathocil; Pen Vee K; Pentids; Permapen; Pfizerpen; Pfizerpen-AS; Pi http://www.nlm.nih.gov/medlineplus/druginfo/penicillinssyste mic202446.html
Penicillins and Beta-Lactamase Inhibitors ·
Systemic - U.S. Brands: Augmentin; Timentin; Unasyn; Zosyn http://www.nlm.nih.gov/medlineplus/druginfo/penicillinsandbe talactamaseinh202705.html
Phenothiazines ·
Systemic - U.S. Brands: Chlorpromazine Hydrochloride Intensol; Compazine; Compazine Spansule; Mellaril; Mellaril Concentrate; Mellaril-S; Permitil; Permitil Concentrate; Prolixin; Prolixin Concentrate; Prolixin Decanoate; Prolixin Enanthate; Serentil; Serentil Concentrate; Ste http://www.nlm.nih.gov/medlineplus/druginfo/phenothiaziness ystemic202457.html
Podofilox ·
Topical - U.S. Brands: Condylox http://www.nlm.nih.gov/medlineplus/druginfo/podofiloxtopical 203519.html
Podophyllum ·
Topical - U.S. Brands: Podocon-; Podofin http://www.nlm.nih.gov/medlineplus/druginfo/podophyllumto pical202469.html
Polyethylene Glycol and Electrolytes ·
Local - U.S. Brands: Co-Lav; Colovage; Colyte; Colyte-flavored; Go-Evac; GoLYTELY; NuLYTELY; OCL http://www.nlm.nih.gov/medlineplus/druginfo/polyethylenegly colandelectroly202636.html
160 Flu Infection
Praziquantel ·
Systemic - U.S. Brands: Biltricide http://www.nlm.nih.gov/medlineplus/druginfo/praziquantelsys temic202474.html
Probenecid ·
Systemic - U.S. Brands: Benemid; Probalan http://www.nlm.nih.gov/medlineplus/druginfo/probenecidsyste mic202480.html
Probenecid and Colchicine ·
Systemic - U.S. Brands: ColBenemid; Col-Probenecid; Proben-C http://www.nlm.nih.gov/medlineplus/druginfo/probenecidandc olchicinesystemi202481.html
Pyrethrins and Piperonyl Butoxide ·
Topical - U.S. Brands: Barc; Blue; Licetrol; Pyrinyl; Rid; Tisit http://www.nlm.nih.gov/medlineplus/druginfo/pyrethrinsandpi peronylbutoxide202492.html
Pyrithione ·
Topical - U.S. Brands: Sebulon; XSeb; Zincon http://www.nlm.nih.gov/medlineplus/druginfo/pyrithionetopic al202495.html
Quinupristin and Dalfopristin ·
Systemic - U.S. Brands: Synercid http://www.nlm.nih.gov/medlineplus/druginfo/quinupristinand dalfopristinsys500048.html
Rabeprazole ·
Systemic - U.S. Brands: AcipHex http://www.nlm.nih.gov/medlineplus/druginfo/rabeprazolesyst emic500054.html
Rauwolfia Alkaloids and Thiazide Diuretics ·
Systemic - U.S. Brands: Demi-Regroton; Diupres; Diurigen with Reserpine; Diutensen-R; Enduronyl; Enduronyl Forte; Oreticyl; Oreticyl Forte; Rauzide; Regroton http://www.nlm.nih.gov/medlineplus/druginfo/rauwolfiaalkaloi dsandthiazided202504.html
Researching Your Medications 161
Resorcinol ·
Topical - U.S. Brands: RA http://www.nlm.nih.gov/medlineplus/druginfo/resorcinoltopica l202507.html
Resorcinol and Sulfur ·
Topical - U.S. Brands: Sulforcin http://www.nlm.nih.gov/medlineplus/druginfo/resorcinolandsu lfurtopical202508.html
Ribavirin ·
Systemic - U.S. Brands: Virazole http://www.nlm.nih.gov/medlineplus/druginfo/ribavirinsystemi c202509.html
Ribavirin and Interferon Alfa-2B, Recombinant ·
Systemic - U.S. Brands: Rebetron http://www.nlm.nih.gov/medlineplus/druginfo/ribavirinandinte rferonalfa2bre500032.html
Rifabutin ·
Systemic - U.S. Brands: Mycobutin http://www.nlm.nih.gov/medlineplus/druginfo/rifabutinsystemi c202683.html
Rifampin ·
Systemic - U.S. Brands: Rifadin; Rimactane http://www.nlm.nih.gov/medlineplus/druginfo/rifampinsystemi c202511.html
Rimantadine ·
Systemic - U.S. Brands: Flumadine http://www.nlm.nih.gov/medlineplus/druginfo/rimantadinesyst emic202771.html
162 Flu Infection
Salicylic Acid ·
Topical - U.S. Brands: Antinea; Duofilm; Freezone; Gordofilm; Hydrisalic; Keralyt; Lactisol; Mediplast; P&S; Paplex; Salac; Salacid; Saligel; Salonil; Sebucare; Trans-Plantar; Trans-Ver-Sal; Viranol; XSeb http://www.nlm.nih.gov/medlineplus/druginfo/salicylicacidtopi cal202516.html
Salicylic Acid and Sulfur ·
Topical - U.S. Brands: Meted; Sebex http://www.nlm.nih.gov/medlineplus/druginfo/salicylicacidand sulfurtopical202517.html
Salicylic Acid, Sulfur, and Coal Tar ·
Topical - U.S. Brands: Sebutone; Vanseb-T http://www.nlm.nih.gov/medlineplus/druginfo/salicylicacidsulf urandcoaltart202518.html
Selenium Sulfide ·
Topical - U.S. Brands: Glo-Sel; Selsun http://www.nlm.nih.gov/medlineplus/druginfo/seleniumsulfide topical202520.html
Sevoflurane ·
Inhalation-Systemic - U.S. Brands: Ultane http://www.nlm.nih.gov/medlineplus/druginfo/sevofluraneinha lationsystemic202793.html
Sodium Fluoride ·
Systemic - U.S. Brands: Fluoritab; Fluorodex; Flura; Flura-Drops; Flura-Loz; Karidium; Luride; Pediaflor; Pharmaflur; Phos-Flur http://www.nlm.nih.gov/medlineplus/druginfo/sodiumfluoride systemic202527.html
Sparfloxacin ·
Systemic - U.S. Brands: Zagam http://www.nlm.nih.gov/medlineplus/druginfo/sparfloxacinsyst emic203530.html
Researching Your Medications 163
Spectinomycin ·
Systemic - U.S. Brands: Trobicin http://www.nlm.nih.gov/medlineplus/druginfo/spectinomycins ystemic202530.html
Streptozocin ·
Systemic - U.S. Brands: Zanosar http://www.nlm.nih.gov/medlineplus/druginfo/streptozocinsyst emic202532.html
Succimer ·
Systemic - U.S. Brands: Chemet http://www.nlm.nih.gov/medlineplus/druginfo/succimersystem ic202664.html
Sucralfate ·
Oral - U.S. Brands: Carafate http://www.nlm.nih.gov/medlineplus/druginfo/sucralfateoral20 2533.html
Sulfinpyrazone ·
Systemic - U.S. Brands: Anturane http://www.nlm.nih.gov/medlineplus/druginfo/sulfinpyrazones ystemic202538.html
Sulfonamides ·
Systemic - U.S. Brands: Gantanol; Gantrisin; Thiosulfil Forte; Urobak http://www.nlm.nih.gov/medlineplus/druginfo/sulfonamidessy stemic202540.html
Sulfonamides and Trimethoprim ·
Systemic - U.S. Brands: Bactrim; Bactrim DS; Bactrim I.V.; Bactrim Pediatric; Cofatrim Forte; Cotrim; Cotrim DS; Cotrim Pediatric; Septra; Septra DS; Septra Grape Suspension; Septra I.V.; Septra Suspension; Sulfatrim; Sulfatrim Pediatric; Sulfatrim S/S; Sulfatrim Suspension; S http://www.nlm.nih.gov/medlineplus/druginfo/sulfonamidesan dtrimethoprimsys202781.html
164 Flu Infection
Sulfur ·
Topical - U.S. Brands: Finac; Sulpho-Lac http://www.nlm.nih.gov/medlineplus/druginfo/sulfurtopical202 543.html
Talc ·
Intrapleural-Local - U.S. Brands: Sclerosol http://www.nlm.nih.gov/medlineplus/druginfo/talcintrapleurall ocal203587.html
Tetracyclines ·
Systemic - U.S. Brands: Achromycin V; Declomycin; Doryx; Dynacin; Minocin; Monodox; Terramycin; Vibramycin; Vibra-Tabs http://www.nlm.nih.gov/medlineplus/druginfo/tetracyclinessyst emic202552.html
Thioxanthenes ·
Systemic - U.S. Brands: Navane; Taractan; Thiothixene HCl Intensol http://www.nlm.nih.gov/medlineplus/druginfo/thioxanthenessy stemic202564.html
Trifluridine ·
Ophthalmic - U.S. Brands: Viroptic http://www.nlm.nih.gov/medlineplus/druginfo/trifluridineopht halmic202576.html
Trimethoprim ·
Systemic - U.S. Brands: Proloprim; Trimpex http://www.nlm.nih.gov/medlineplus/druginfo/trimethoprimsy stemic202579.html
Urea ·
Intra-Amniotic - U.S. Brands: Ureaphil http://www.nlm.nih.gov/medlineplus/druginfo/ureaintraamniot ic202584.html
Urofollitropin ·
Systemic - U.S. Brands: Fertinex; Metrodin http://www.nlm.nih.gov/medlineplus/druginfo/urofollitropinsy stemic202586.html
Researching Your Medications 165
Valrubicin ·
Mucosal-Local - U.S. Brands: Valstar http://www.nlm.nih.gov/medlineplus/druginfo/valrubicinmuco sallocal203706.html
Vancomycin ·
Oral - U.S. Brands: Vancocin http://www.nlm.nih.gov/medlineplus/druginfo/vancomycinoral 202589.html
·
Systemic - U.S. Brands: Vancocin http://www.nlm.nih.gov/medlineplus/druginfo/vancomycinsyst emic202590.html
Venlafaxine ·
Systemic - U.S. Brands: Effexor http://www.nlm.nih.gov/medlineplus/druginfo/venlafaxinesyst emic202764.html
Vinblastine ·
Systemic - U.S. Brands: Velban http://www.nlm.nih.gov/medlineplus/druginfo/vinblastinesyste mic202593.html
Vincristine ·
Systemic - U.S. Brands: Oncovin; Vincrex http://www.nlm.nih.gov/medlineplus/druginfo/vincristinesyste mic202594.html
Vinorelbine ·
Systemic - U.S. Brands: Navelbine http://www.nlm.nih.gov/medlineplus/druginfo/vinorelbinesyste mic203542.html
Vitamins and Fluoride ·
Systemic - U.S. Brands: Adeflor; Cari-Tab; Mulvidren-F; Poly-ViFlor; Tri-Vi-Flor; Vi-Daylin/F http://www.nlm.nih.gov/medlineplus/druginfo/vitaminsandflu oridesystemic202600.html
166 Flu Infection
Zanamivir ·
Inhalation--Systemic - U.S. Brands: Relenza http://www.nlm.nih.gov/medlineplus/druginfo/zanamivirinhala tionsystemic500004.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. You may be able to access these sources from your local medical library or your doctor’s office.
Reuters Health Drug Database The Reuters Health Drug Database can be searched by keyword at the hyperlink: http://www.reutershealth.com/frame2/drug.html. The following medications are listed in the Reuters’ database as associated with flu infection (including those with contraindications):43 ·
Allopurinol http://www.reutershealth.com/atoz/html/Allopurinol.htm
·
Aspirin http://www.reutershealth.com/atoz/html/Aspirin.htm
·
Aspirin (Acetylsalicylic Acid; ASA) http://www.reutershealth.com/atoz/html/Aspirin_(Acetylsalicylic_Aci d;_ASA).htm
·
Atorvastatin Calcium http://www.reutershealth.com/atoz/html/Atorvastatin_Calcium.htm
·
Balsalazide Disodium http://www.reutershealth.com/atoz/html/Balsalazide_Disodium.htm
·
Bupropion HCl http://www.reutershealth.com/atoz/html/Bupropion_HCl.htm
·
Butalbital Aspirin Caffeine http://www.reutershealth.com/atoz/html/Butalbital_Aspirin_Caffeine. htm
43
Adapted from A to Z Drug Facts by Facts and Comparisons.
Researching Your Medications 167
·
Butalbital Aspirin Caffeine Codeine Phosphate http://www.reutershealth.com/atoz/html/Butalbital_Aspirin_Caffeine _Codeine_Phosphate.htm
·
Captopril http://www.reutershealth.com/atoz/html/Captopril.htm
·
Caspofungin Acetate http://www.reutershealth.com/atoz/html/Caspofungin_Acetate.htm
·
Celecoxib http://www.reutershealth.com/atoz/html/Celecoxib.htm
·
Clofibrate http://www.reutershealth.com/atoz/html/Clofibrate.htm
·
Delavirdine Mesylate http://www.reutershealth.com/atoz/html/Delavirdine_Mesylate.htm
·
Diclofenac Sodium Misoprostol http://www.reutershealth.com/atoz/html/Diclofenac_Sodium_Misopr ostol.htm
·
Didanosine http://www.reutershealth.com/atoz/html/Didanosine.htm
·
Didanosine (ddl; dideoxyinosine) http://www.reutershealth.com/atoz/html/Didanosine_(ddl;_dideoxyin osine).htm
·
Diflunisal http://www.reutershealth.com/atoz/html/Diflunisal.htm
·
Dofetilide http://www.reutershealth.com/atoz/html/Dofetilide.htm
·
Epoprostenol Sodium http://www.reutershealth.com/atoz/html/Epoprostenol_Sodium.htm
·
Estradiol http://www.reutershealth.com/atoz/html/Estradiol.htm
·
Estrogens Conjugated http://www.reutershealth.com/atoz/html/Estrogens_Conjugated.htm
·
Estropipate http://www.reutershealth.com/atoz/html/Estropipate.htm
·
Estropipate (Piperazine Estrone Sulfate) http://www.reutershealth.com/atoz/html/Estropipate_(Piperazine_Est rone_Sulfate).htm
168 Flu Infection
·
Fenofibrate http://www.reutershealth.com/atoz/html/Fenofibrate.htm
·
Fexofenadine HCl http://www.reutershealth.com/atoz/html/Fexofenadine_HCl.htm
·
Fluoxetine HCl http://www.reutershealth.com/atoz/html/Fluoxetine_HCl.htm
·
Fluticasone Propionate http://www.reutershealth.com/atoz/html/Fluticasone_Propionate.htm
·
Fluvoxamine Maleate http://www.reutershealth.com/atoz/html/Fluvoxamine_Maleate.htm
·
Glatiramer Acetate http://www.reutershealth.com/atoz/html/Glatiramer_Acetate.htm
·
Indinavir Sulfate http://www.reutershealth.com/atoz/html/Indinavir_Sulfate.htm
·
Interferon Alfacon-I http://www.reutershealth.com/atoz/html/Interferon_Alfacon-I.htm
·
Interferon Alfa-n3 http://www.reutershealth.com/atoz/html/Interferon_Alfa-n3.htm
·
Interferon beta-1a http://www.reutershealth.com/atoz/html/Interferon_beta-1a.htm
·
Interferon Beta-1b (rIFN-B) http://www.reutershealth.com/atoz/html/Interferon_Beta-1b_(rIFNB).htm
·
Interferon Beta-1b(rIFN-B) http://www.reutershealth.com/atoz/html/Interferon_Beta-1b(rIFNB).htm
·
Interferon Gamma-1b http://www.reutershealth.com/atoz/html/Interferon_Gamma-1b.htm
·
Ipratropium Bromide Albuterol Sulfate http://www.reutershealth.com/atoz/html/Ipratropium_Bromide_Albu terol_Sulfate.htm
·
Lamotrigine http://www.reutershealth.com/atoz/html/Lamotrigine.htm
·
Latanoprost http://www.reutershealth.com/atoz/html/Latanoprost.htm
Researching Your Medications 169
·
Lopinavir Ritonavir http://www.reutershealth.com/atoz/html/Lopinavir_Ritonavir.htm
·
Meloxicam http://www.reutershealth.com/atoz/html/Meloxicam.htm
·
Mesalamine http://www.reutershealth.com/atoz/html/Mesalamine.htm
·
Methyldopa and Methyldopate HCl http://www.reutershealth.com/atoz/html/Methyldopa_and_Methyldo pate_HCl.htm
·
Mirtazapine http://www.reutershealth.com/atoz/html/Mirtazapine.htm
·
Moexipril HCl http://www.reutershealth.com/atoz/html/Moexipril_HCl.htm
·
Muromonab–CD3 http://www.reutershealth.com/atoz/html/Muromonab–CD3.ht m
·
Nateglinide http://www.reutershealth.com/atoz/html/Nateglinide.htm
·
Nefazodone Hydrochloride http://www.reutershealth.com/atoz/html/Nefazodone_Hydrochloride. htm
·
Olanzapine http://www.reutershealth.com/atoz/html/Olanzapine.htm
·
Oseltamivir Phosphate http://www.reutershealth.com/atoz/html/Oseltamivir_Phosphate.htm
·
Oxybutynin Chloride http://www.reutershealth.com/atoz/html/Oxybutynin_Chloride.htm
·
Pantoprazole http://www.reutershealth.com/atoz/html/Pantoprazole.htm
·
Pantoprazole Sodium http://www.reutershealth.com/atoz/html/Pantoprazole_Sodium.htm
·
Peginterferon Alfa-2B http://www.reutershealth.com/atoz/html/Peginterferon_Alfa-2B.htm
·
Pentoxifylline http://www.reutershealth.com/atoz/html/Pentoxifylline.htm
170 Flu Infection
·
Pergolide Mesylate http://www.reutershealth.com/atoz/html/Pergolide_Mesylate.htm
·
Quetiapine Fumarate http://www.reutershealth.com/atoz/html/Quetiapine_Fumarate.htm
·
Raloxifene HCl http://www.reutershealth.com/atoz/html/Raloxifene_HCl.htm
·
Raloxifene Hydrochloride http://www.reutershealth.com/atoz/html/Raloxifene_Hydrochloride.h tm
·
Ramipril http://www.reutershealth.com/atoz/html/Ramipril.htm
·
Risedronate Sodium http://www.reutershealth.com/atoz/html/Risedronate_Sodium.htm
·
Rivastigmine Tartrate http://www.reutershealth.com/atoz/html/Rivastigmine_Tartrate.htm
·
Rofecoxib http://www.reutershealth.com/atoz/html/Rofecoxib.htm
·
Salicylate Combination http://www.reutershealth.com/atoz/html/Salicylate_Combination.htm
·
Sibutramine Hydrochloride http://www.reutershealth.com/atoz/html/Sibutramine_Hydrochloride. htm
·
Sildenafil http://www.reutershealth.com/atoz/html/Sildenafil.htm
·
Sirolimus http://www.reutershealth.com/atoz/html/Sirolimus.htm
·
Tacrolimus http://www.reutershealth.com/atoz/html/Tacrolimus.htm
·
Terazosin http://www.reutershealth.com/atoz/html/Terazosin.htm
·
Tiagabine Hydrochloride http://www.reutershealth.com/atoz/html/Tiagabine_Hydrochloride.ht m
·
Topiramate http://www.reutershealth.com/atoz/html/Topiramate.htm
Researching Your Medications 171
·
Trifluoperazine HCl http://www.reutershealth.com/atoz/html/Trifluoperazine_HCl.htm
·
Unoprostone Isopropyl http://www.reutershealth.com/atoz/html/Unoprostone_Isopropyl.htm
·
Zidovudine http://www.reutershealth.com/atoz/html/Zidovudine.htm
·
Zileuton http://www.reutershealth.com/atoz/html/Zileuton.htm
·
Ziprasidone http://www.reutershealth.com/atoz/html/Ziprasidone.htm
·
Zolpidem Tartrate http://www.reutershealth.com/atoz/html/Zolpidem_Tartrate.htm
·
Zonisamide http://www.reutershealth.com/atoz/html/Zonisamide.htm
Mosby’s GenRx Mosby’s GenRx 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. Information can be obtained at the following hyperlink: http://www.genrx.com/Mosby/PhyGenRx/group.html. Physicians Desk Reference The Physicians Desk Reference database (also available in CD-Rom and book format) is a full-text drug database. The database is searchable by brand name, generic name or by indication. It features multiple drug interactions reports. Information can be obtained at the following hyperlink: http://physician.pdr.net/physician/templates/en/acl/psuser_t.htm.
Other Web Sites A number of additional Web sites discuss drug information. As an example, you may like to look at www.drugs.com which 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. which allows users to
172 Flu Infection
download articles on various drugs and therapeutics for a nominal fee: http://www.medletter.com/.
Contraindications and Interactions (Hidden Dangers) Some of the medications mentioned in the previous discussions can be problematic for patients with flu infection--not because they are used in the treatment process, but because of contraindications, or side effects. Medications with contraindications are those that could react with drugs used to treat flu infection or potentially create deleterious side effects in patients with flu infection. You should ask your physician about any contraindications, especially as these might apply to other medications that you may be taking for common ailments. Drug-drug interactions occur when two or more drugs react with each other. This drug-drug interaction may cause you to experience an unexpected side effect. Drug interactions may make your medications less effective, cause unexpected side effects, or increase the action of a particular drug. Some drug interactions can even be harmful to you. Be sure to read the label every time you use a nonprescription or prescription drug, and take the time to learn about drug interactions. These precautions may be critical to your health. You can reduce the risk of potentially harmful drug interactions and side effects with a little bit of knowledge and common sense. Drug labels contain important information about ingredients, uses, warnings, and directions which you should take the time to read and understand. Labels also include warnings about possible drug interactions. Further, drug labels may change as new information becomes available. This is why it’s especially important to read the label every time you use a medication. When your doctor prescribes a new drug, discuss all over-thecounter and prescription medications, dietary supplements, vitamins, botanicals, minerals and herbals you take as well as the foods you eat. Ask your pharmacist for the package insert for each prescription drug you take. The package insert provides more information about potential drug interactions.
Researching Your Medications 173
A Final Warning At some point, you may hear of alternative medications from friends, relatives, or in the news media. Advertisements may suggest that certain alternative drugs can produce positive results for patients with flu infection. Exercise caution--some of these drugs may have fraudulent claims, and others may actually hurt you. The Food and Drug Administration (FDA) is the official U.S. agency charged with discovering which medications are likely to improve the health of patients with flu infection. The FDA warns patients to watch out for44: ·
Secret formulas (real scientists share what they know)
·
Amazing breakthroughs or miracle cures (real breakthroughs don’t happen very often; when they do, real scientists do not call them amazing or miracles)
·
Quick, painless, or guaranteed cures
·
If it sounds too good to be true, it probably isn’t true.
If you have any questions about any kind of 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, 1888-INFO-FDA (1-888-463-6332), or on the World Wide Web at www.fda.gov.
General References In addition to the resources provided earlier in this chapter, the following general references describe medications (sorted alphabetically by title; hyperlinks provide rankings, information and reviews at Amazon.com): ·
Antimicrobial Pharmacodynamics in Theory and Clinical Practice by C. H. Nightingale (Editor), et al; Hardcover – 416 pages, 1st edition (January 15, 2002), Marcel Dekker; ISBN: 0824705610; http://www.amazon.com/exec/obidos/ASIN/0824705610/icongroupinterna
·
Antimicrobial Therapy and Vaccines by Victor L. Yu (Editor), et al; Hardcover - 1460 pages, 1st edition (January 15, 1999), Lippincott, Williams & Wilkins; ISBN: 068330061X; http://www.amazon.com/exec/obidos/ASIN/068330061X/icongroupinterna
44
This section has been adapted from http://www.fda.gov/opacom/lowlit/medfraud.html.
174 Flu Infection
·
Essentials of Antimicrobial Pharmacology: A Guide to Fundamentals for Practice by Paul H. Axelsen; Paperback – 141 pages, 1st edition (January 15, 2002), Humana Press; ISBN: 0896038424; http://www.amazon.com/exec/obidos/ASIN/0896038424/icongroupinterna
·
Macrolide Antibiotics: Chemistry, Biology, and Practice by Satoshi Omura (Editor); Hardcover – 768 pages, 2nd edition (June 15, 2002), Academic Press; ISBN: 0125264518; http://www.amazon.com/exec/obidos/ASIN/0125264518/icongroupinterna
·
Management of Antimicrobials in Infectious Diseases: Impact of Antibiotic Resistance by Arch G. Mainous, Ph.D. (Editor), et al; Hardcover – 350 pages, 1st edition (January 15, 2001), Humana Press; ISBN: 0896038211; http://www.amazon.com/exec/obidos/ASIN/0896038211/icongroupinterna
·
Vaccines by Stanley A., Md. Plotkin (Editor), et al; Hardcover - 1230 pages, 3rd edition (February 15, 1999), W B Saunders Co.; ISBN: 0721674437; http://www.amazon.com/exec/obidos/ASIN/0721674437/icongroupinterna
Vocabulary Builder The following vocabulary builder gives definitions of words used in this chapter that have not been defined in previous chapters: Albuterol: A racemic mixture with a 1:1 ratio of the r-isomer, levalbuterol, and s-albuterol. It is a short-acting beta2-adrenergic agonist with its main clinical use in asthma. [NIH] Alkaloid: One of a large group of nitrogenous basis substances found in plants. They are usually very bitter and many are pharmacologically active. Examples are atropine, caffeine, coniine, morphine, nicotine, quinine, strychnine. The term is also applied to synthetic substances (artificial a's) which have structures similar to plant alkaloids, such as procaine. [EU] Allergen: A antigenic substance capable of producing immediate-type hypersensitivity (allergy). [EU] Allopurinol: A xanthine oxidase inhibitor that decreases uric acid production. [NIH] Androgens: A class of sex hormones associated with the development and maintenance of the secondary male sex characteristics, sperm induction, and sexual differentiation. In addition to increasing virility and libido, they also increase nitrogen and water retention and stimulate skeletal growth. [NIH] Asparaginase: A hydrolase enzyme that converts L-asparagine and water to
Researching Your Medications 175
L-aspartate and NH3. EC 3.5.1.1. [NIH] Azithromycin: A semi-synthetic macrolide antibiotic structurally related to erythromycin. It has been used in the treatment of Mycobacterium avium intracellulare infections, toxoplasmosis, and cryptosporidiosis. [NIH] Aztreonam: A monocyclic beta-lactam antibiotic originally isolated from Chromobacterium violaceum. It is resistant to beta-lactamases and is used in gram-negative infections, especially of the meninges, bladder, and kidneys. It may cause a superinfection with gram-positive organisms. [NIH] Benzodiazepines: A two-ring heterocyclic compound consisting of a benzene ring fused to a diazepine ring. Permitted is any degree of hydrogenation, any substituents and any H-isomer. [NIH] Bethanechol: A slowly hydrolyzed muscarinic agonist with no nicotinic effects. Bethanechol is generally used to increase smooth muscle tone, as in the GI tract following abdominal surgery or in urinary retention in the absence of obstruction. It may cause hypotension, cardiac rate changes, and bronchial spasms. [NIH] Captopril: A potent and specific inhibitor of peptidyl-dipeptidase A. It blocks the conversion of angiotensin I to angiotensin II, a vasoconstrictor and important regulator of arterial blood pressure. Captopril acts to suppress the renin-angiotensin system and inhibits pressure responses to exogenous angiotensin. [NIH] Chlorhexidine: Disinfectant and topical anti-infective agent used also as mouthwash to prevent oral plaque. [NIH] Chlorpromazine: The prototypical phenothiazine antipsychotic drug. Like the other drugs in this class chlorpromazine's antipsychotic actions are thought to be due to long-term adaptation by the brain to blocking dopamine receptors. Chlorpromazine has several other actions and therapeutic uses, including as an antiemetic and in the treatment of intractable hiccup. [NIH] Cholinergic: Resembling acetylcholine in pharmacological stimulated by or releasing acetylcholine or a related compound. [EU]
action;
Cinoxacin: Synthetic antimicrobial related to oxolinic and nalidixic acids and used in urinary tract infections. [NIH] Cisplatin: An inorganic and water-soluble platinum complex. After undergoing hydrolysis, it reacts with DNA to produce both intra and interstrand crosslinks. These crosslinks appear to impair replication and transcription of DNA. The cytotoxicity of cisplatin correlates with cellular arrest in the G2 phase of the cell cycle. [NIH] Clarithromycin: A semisynthetic macrolide antibiotic derived from erythromycin that is active against a variety of microorganisms. It can inhibit
176 Flu Infection
protein synthesis in bacteria by reversibly binding to the 50S ribosomal subunits. This inhibits the translocation of aminoacyl transfer-RNA and prevents peptide chain elongation. [NIH] Clindamycin: An antibacterial agent that is a semisynthetic analog of lincomycin. [NIH] Codeine: An opioid analgesic related to morphine but with less potent analgesic properties and mild sedative effects. It also acts centrally to suppress cough. [NIH] Cyclophosphamide: Precursor of an alkylating nitrogen mustard antineoplastic and immunosuppressive agent that must be activated in the liver to form the active aldophosphamide. It is used in the treatment of lymphomas, leukemias, etc. Its side effect, alopecia, has been made use of in defleecing sheep. Cyclophosphamide may also cause sterility, birth defects, mutations, and cancer. [NIH] Daunorubicin: Very toxic anthracycline aminoglycoside antibiotic isolated from Streptomyces peucetius and others, used in treatment of leukemias and other neoplasms. [NIH] Didanosine: A dideoxynucleoside compound in which the 3'-hydroxy group on the sugar moiety has been replaced by a hydrogen. This modification prevents the formation of phosphodiester linkages which are needed for the completion of nucleic acid chains. Didanosine is a potent inhibitor of HIV replication, acting as a chain-terminator of viral DNA by binding to reverse transcriptase; ddI is then metabolized to dideoxyadenosine triphosphate, its putative active metabolite. [NIH] Dienestrol: A synthetic, non-steroidal estrogen structurally related to stilbestrol. It is used, usually as the cream, in the treatment of menopausal and postmenopausal symptoms. [NIH] Diflunisal: A salicylate derivative and anti-inflammatory analgesic with actions and side effects similar to those of aspirin. [NIH] Diuretics, Thiazide: Diuretics characterized as analogs of 1,2,4benzothiadiazine-1,1-dioxide. All have a common mechanism of action and differ primarily in the dose required to produce a given effect. They act directly on the kidney to increase the excretion of sodium chloride and water and also increase excretion of potassium ions. [NIH] Doxorubicin: Antineoplastic antibiotic obtained from Streptomyces peucetics. It is a hydroxy derivative of daunorubicin and is used in treatment of both leukemia and solid tumors. [NIH] Epirubicin: An anthracycline antibiotic which is the 4'-epi-isomer of doxorubicin. The compound exerts its antitumor effects by interference with the synthesis and function of DNA. Clinical studies indicate activity in breast
Researching Your Medications 177
cancer, non-Hodgkin's lymphomas, ovarian cancer, soft-tissue sarcomas, pancreatic cancer, gastric cancer, small-cell lung cancer and acute leukemia. It is equal in activity to doxorubicin but exhibits less acute toxicities and less cardiotoxicity. [NIH] Epoprostenol: A prostaglandin that is biosynthesized enzymatically from prostaglandin endoperoxides in human vascular tissue. It is a potent inhibitor of platelet aggregation. The sodium salt has been also used to treat primary pulmonary hypertension. [NIH] Estradiol: The most potent mammalian estrogenic hormone. It is produced in the ovary, placenta, testis, and possibly the adrenal cortex. [NIH] Finasteride: An orally active testosterone 5-alpha-reductase inhibitor. It is used as a surgical alternative for treatment of benign prostatic hyperplasia. [NIH]
Flucytosine: A fluorinated cytosine analog that is used as an antifungal agent. [NIH] Fludrocortisone: activity. [NIH]
A synthetic mineralocorticoid with anti-inflammatory
Fluvoxamine: A selective serotonin reuptake inhibitor. It is effective in the treatment of depression, obsessive-compulsive disorders, anxiety, panic disorders, and alcohol amnestic disorders. [NIH] Foscarnet: An antiviral agent used in the treatment of cytomegalovirus retinitis. Foscarnet also shows activity against human herpesviruses and HIV. [NIH] Ganciclovir: Acyclovir analog that is a potent inhibitor of the Herpesvirus family including cytomegalovirus. Ganciclovir is used to treat complications from AIDS-associated cytomegalovirus infections. [NIH] Hydroxyurea: An antineoplastic agent that inhibits DNA synthesis through the inhibition of ribonucleoside diphosphate reductase. [NIH] Ibuprofen: A nonsteroidal anti-inflammatory agent with analgesic properties used in the therapy of rheumatism and arthritis. [NIH] Idarubicin: An orally administered anthracycline antibiotic. The compound has shown activity against breast cancer, lymphomas and leukemias, together with potential for reduced cardiac toxicity. [NIH] Ifosfamide: Positional isomer of cyclophosphamide which is active as an alkylating agent and an immunosuppressive agent. [NIH] Indinavir: A potent and specific HIV protease inhibitor that appears to have good oral bioavailability. [NIH] Inhalation: The drawing of air or other substances into the lungs. [EU] Ipratropium: A muscarinic antagonist structurally related to atropine but
178 Flu Infection
often considered safer and more effective for inhalation use. It is used for various bronchial disorders, in rhinitis, and as an antiarrhythmic. [NIH] Leucovorin: The active metabolite of folic acid. Leucovorin is used principally as its calcium salt as an antidote to folic acid antagonists which block the conversion of folic acid to folinic acid. [NIH] Lindane: An organochlorine insecticide that has been used as a pediculicide and a scabicide. It has been shown to cause cancer. [NIH] Liquifilm: A thin liquid layer of coating. [EU] Lithium: Lithium. An element in the alkali metals family. It has the atomic symbol Li, atomic number 3, and atomic weight 6.94. Salts of lithium are used in treating manic-depressive disorders. [NIH] Lorazepam: An anti-anxiety agent with few side effects. It also has hypnotic, anticonvulsant, and considerable sedative properties and has been proposed as a preanesthetic agent. [NIH] Malathion: A wide spectrum aliphatic organophosphate insecticide widely used for both domestic and commercial agricultural purposes. [NIH] Mechlorethamine: A vesicant and necrotizing irritant destructive to mucous membranes. It was formerly used as a war gas. The hydrochloride is used as an antineoplastic in Hodgkin's disease and lymphomas. It causes severe gastrointestinal and bone marrow damage. [NIH] Melphalan: An alkylating nitrogen mustard that is used as an antineoplastic in the form of the levo isomer - melphalan, the racemic mixture - merphalan, and the dextro isomer - medphalan; toxic to bone marrow, but little vesicant action; potential carcinogen. [NIH] Menotropins: Extracts from human menopausal urine containing FSH and LH activity. They are used to treat infertility disorders. [NIH] Metoclopramide: A dopamine D2 antagonist that is used as an antiemetic. [NIH]
Mitoxantrone: An anthracenedione-derived antineoplastic agent. [NIH] Ophthalmic: Pertaining to the eye. [EU] Parenteral: Not through the alimentary canal but rather by injection through some other route, as subcutaneous, intramuscular, intraorbital, intracapsular, intraspinal, intrasternal, intravenous, etc. [EU] Pentoxifylline: A methylxanthine derivative that inhibits phosphodiesterase and affects blood rheology. It improves blood flow by increasing erythrocyte and leukocyte flexibility. It also inhibits platelet aggregation. Pentoxifylline modulates immunologic activity by stimulating cytokine production. [NIH] Pharmacodynamics: The study of the biochemical and physiological effects of drugs and the mechanisms of their actions, including the correlation of
Researching Your Medications 179
actions and effects of drugs with their chemical structure; also, such effects on the actions of a particular drug or drugs. [EU] Podophyllum: A genus of poisonous American herbs, family Berberidaceae. The roots yield podophyllotoxins and other pharmacologically important agents. The plant was formerly used as a cholagogue and cathartic. It is different from the European mandrake, mandragora. [NIH] Praziquantel: An anthelmintic used in most schistosome and many cestode infestations. [NIH] Probenecid: The prototypical uricosuric agent. It inhibits the renal excretion of organic anions and reduces tubular reabsorption of urate. Probenecid has also been used to treat patients with renal impairment, and, because it reduces the renal tubular excretion of other drugs, has been used as an adjunct to antibacterial therapy. [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]
Reserpine: An alkaloid found in the roots of Rauwolfia serpentina and R. vomitoria. Reserpine inhibits the uptake of norepinephrine into storage vesicles resulting in depletion of catecholamines and serotonin from central and peripheral axon terminals. It has been used as an antihypertensive and an antipsychotic as well as a research tool, but its adverse effects limit its clinical use. [NIH] Rifabutin: A broad-spectrum antibiotic that is being used as prophylaxis against disseminated Mycobacterium avium complex infection in HIVpositive patients. [NIH] Senna: Preparations of Cassia senna L. and C. angustifolia of the Leguminosae. They contain sennosides, which are anthraquinone type cathartics and are used in many different preparations as laxatives. [NIH] Sirolimus: A macrolide compound obtained from Streptomyces hygroscopicus that acts by selectively blocking the transcriptional activation of cytokines thereby inhibiting cytokine production. It is bioactive only when bound to immunophilins. Sirolimus is a potent immunosuppressant and possesses both antifungal and antineoplastic properties. [NIH] Sodium Fluoride: A source of inorganic fluoride which is used topically to prevent dental caries. [NIH] Sorbitol: A polyhydric alcohol with about half the sweetness of sucrose. Sorbitol occurs naturally and is also produced synthetically from glucose. It was formerly used as a diuretic and may still be used as a laxative and in irrigating solutions for some surgical procedures. It is also used in many manufacturing processes, as a pharmaceutical aid, and in several research applications. [NIH]
180 Flu Infection
Spectinomycin: An antibiotic produced by Streptomyces spectabilis. It is active against gram-negative bacteria and used for the treatment of gonorrhea. [NIH] Streptozocin: An antibiotic that is produced by Stretomyces achromogenes. It is used as an antineoplastic agent and to induce diabetes in experimental animals. [NIH] Succimer: A mercaptodicarboxylic acid used as an antidote to heavy metal poisoning because it forms strong chelates with them. [NIH] Sucralfate: A basic aluminum complex of sulfated sucrose. It is advocated in the therapy of peptic, duodenal, and prepyloric ulcers, gastritis, reflux esophagitis, and other gastrointestinal irritations. It acts primarily at the ulcer site, where it has cytoprotective, pepsinostatic, antacid, and bile acidbinding properties. The drug is only slightly absorbed by the digestive mucosa, which explains the absence of systemic effects and toxicity. [NIH] Sulfinpyrazone: A uricosuric drug that is used to reduce the serum urate levels in gout therapy. It lacks anti-inflammatory, analgesic, and diuretic properties. [NIH] Tacrolimus: A macrolide isolated from the culture broth of a strain of Streptomyces tsukubaensis that has strong immunosuppressive activity in vivo and prevents the activation of T-lymphocytes in response to antigenic or mitogenic stimulation in vitro. [NIH] Tetracycline: An antibiotic originally produced by Streptomyces viridifaciens, but used mostly in synthetic form. It is an inhibitor of aminoacyl-tRNA binding during protein synthesis. [NIH] Thiothixene: A thioxanthine used as an antipsychotic agent. Its effects are similar to the phenothiazine antipsychotics. [NIH] Vancomycin: Antibacterial obtained from Streptomyces orientalis. It is a glycopeptide related to ristocetin that inhibits bacterial cell wall assembly and is toxic to kidneys and the inner ear. [NIH]
Researching Alternative Medicine 181
APPENDIX B. RESEARCHING ALTERNATIVE MEDICINE Overview Complementary and alternative medicine (CAM) is one of the most contentious aspects of modern medical practice. You may have heard of these treatments on the radio or on television. Maybe you have seen articles written about these treatments in magazines, newspapers, or books. Perhaps your friends or doctor have mentioned alternatives. In this chapter, we will begin by giving you a broad perspective on complementary and alternative therapies. Next, we will introduce you to official information sources on CAM relating to flu infection. Finally, at the conclusion of this chapter, we will provide a list of readings on flu infection from various authors. We will begin, however, with the National Center for Complementary and Alternative Medicine’s (NCCAM) overview of complementary and alternative medicine.
What Is CAM?45 Complementary and alternative medicine (CAM) covers a broad range of healing philosophies, approaches, and therapies. Generally, it is defined as those treatments and healthcare practices which are not taught in medical schools, used in hospitals, or reimbursed by medical insurance companies. Many CAM therapies are termed “holistic,” which generally means that the healthcare practitioner considers the whole person, including physical, mental, emotional, and spiritual health. Some of these therapies are also known as “preventive,” which means that the practitioner educates and 45
Adapted from the NCCAM: http://nccam.nih.gov/nccam/fcp/faq/index.html#what-is.
182 Flu Infection
treats the person to prevent health problems from arising, rather than treating symptoms after problems have occurred. People use CAM treatments and therapies in a variety of ways. Therapies are used alone (often referred to as alternative), in combination with other alternative therapies, or in addition to conventional treatment (sometimes referred to as complementary). Complementary and alternative medicine, or “integrative medicine,” includes a broad range of healing philosophies, approaches, and therapies. Some approaches are consistent with physiological principles of Western medicine, while others constitute healing systems with non-Western origins. While some therapies are far outside the realm of accepted Western medical theory and practice, others are becoming established in mainstream medicine. Complementary and alternative therapies are used in an effort to prevent illness, reduce stress, prevent or reduce side effects and symptoms, or control or cure disease. Some commonly used methods of complementary or alternative therapy include mind/body control interventions such as visualization and relaxation, manual healing including acupressure and massage, homeopathy, vitamins or herbal products, and acupuncture.
What Are the Domains of Alternative Medicine?46 The list of CAM practices changes continually. The reason being is that these new practices and therapies are often proved to be safe and effective, and therefore become generally accepted as “mainstream” healthcare practices. Today, CAM practices may be grouped within five major domains: (1) alternative medical systems, (2) mind-body interventions, (3) biologicallybased treatments, (4) manipulative and body-based methods, and (5) energy therapies. The individual systems and treatments comprising these categories are too numerous to list in this sourcebook. Thus, only limited examples are provided within each. Alternative Medical Systems Alternative medical systems involve complete systems of theory and practice that have evolved independent of, and often prior to, conventional biomedical approaches. Many are traditional systems of medicine that are
46
Adapted from the NCCAM: http://nccam.nih.gov/nccam/fcp/classify/index.html.
Researching Alternative Medicine 183
practiced by individual cultures throughout the world, including a number of venerable Asian approaches. Traditional oriental medicine emphasizes the balance or disturbances of qi (pronounced chi) or vital energy in health and disease, respectively. Traditional oriental medicine consists of a group of techniques and methods including acupuncture, herbal medicine, oriental massage, and qi gong (a form of energy therapy). Acupuncture involves stimulating specific anatomic points in the body for therapeutic purposes, usually by puncturing the skin with a thin needle. Ayurveda is India’s traditional system of medicine. Ayurvedic medicine (meaning “science of life”) is a comprehensive system of medicine that places equal emphasis on body, mind, and spirit. Ayurveda strives to restore the innate harmony of the individual. Some of the primary Ayurvedic treatments include diet, exercise, meditation, herbs, massage, exposure to sunlight, and controlled breathing. Other traditional healing systems have been developed by the world’s indigenous populations. These populations include Native American, Aboriginal, African, Middle Eastern, Tibetan, and Central and South American cultures. Homeopathy and naturopathy are also examples of complete alternative medicine systems. Homeopathic medicine is an unconventional Western system that is based on the principle that “like cures like,” i.e., that the same substance that in large doses produces the symptoms of an illness, in very minute doses cures it. Homeopathic health practitioners believe that the more dilute the remedy, the greater its potency. Therefore, they use small doses of specially prepared plant extracts and minerals to stimulate the body’s defense mechanisms and healing processes in order to treat illness. Naturopathic medicine is based on the theory that disease is a manifestation of alterations in the processes by which the body naturally heals itself and emphasizes health restoration rather than disease treatment. Naturopathic physicians employ an array of healing practices, including the following: diet and clinical nutrition, homeopathy, acupuncture, herbal medicine, hydrotherapy (the use of water in a range of temperatures and methods of applications), spinal and soft-tissue manipulation, physical therapies (such as those involving electrical currents, ultrasound, and light), therapeutic counseling, and pharmacology.
184 Flu Infection
Mind-Body Interventions Mind-body interventions employ a variety of techniques designed to facilitate the mind’s capacity to affect bodily function and symptoms. Only a select group of mind-body interventions having well-documented theoretical foundations are considered CAM. For example, patient education and cognitive-behavioral approaches are now considered “mainstream.” On the other hand, complementary and alternative medicine includes meditation, certain uses of hypnosis, dance, music, and art therapy, as well as prayer and mental healing.
Biological-Based Therapies This category of CAM includes natural and biological-based practices, interventions, and products, many of which overlap with conventional medicine’s use of dietary supplements. This category includes herbal, special dietary, orthomolecular, and individual biological therapies. Herbal therapy employs an individual herb or a mixture of herbs for healing purposes. An herb is a plant or plant part that produces and contains chemical substances that act upon the body. Special diet therapies, such as those proposed by Drs. Atkins, Ornish, Pritikin, and Weil, are believed to prevent and/or control illness as well as promote health. Orthomolecular therapies aim to treat disease with varying concentrations of chemicals such as magnesium, melatonin, and mega-doses of vitamins. Biological therapies include, for example, the use of laetrile and shark cartilage to treat cancer and the use of bee pollen to treat autoimmune and inflammatory diseases.
Manipulative and Body-Based Methods This category includes methods that are based on manipulation and/or movement of the body. For example, chiropractors focus on the relationship between structure and function, primarily pertaining to the spine, and how that relationship affects the preservation and restoration of health. Chiropractors use manipulative therapy as an integral treatment tool. In contrast, osteopaths place particular emphasis on the musculoskeletal system and practice osteopathic manipulation. Osteopaths believe that all of the body’s systems work together and that disturbances in one system may have an impact upon function elsewhere in the body. Massage therapists manipulate the soft tissues of the body to normalize those tissues.
Researching Alternative Medicine 185
Energy Therapies Energy therapies focus on energy fields originating within the body (biofields) or those from other sources (electromagnetic fields). Biofield therapies are intended to affect energy fields (the existence of which is not yet experimentally proven) that surround and penetrate the human body. Some forms of energy therapy manipulate biofields by applying pressure and/or manipulating the body by placing the hands in or through these fields. Examples include Qi gong, Reiki and Therapeutic Touch. Qi gong is a component of traditional oriental medicine that combines movement, meditation, and regulation of breathing to enhance the flow of vital energy (qi) in the body, improve blood circulation, and enhance immune function. Reiki, the Japanese word representing Universal Life Energy, is based on the belief that, by channeling spiritual energy through the practitioner, the spirit is healed and, in turn, heals the physical body. Therapeutic Touch is derived from the ancient technique of “laying-on of hands.” It is based on the premises that the therapist’s healing force affects the patient’s recovery and that healing is promoted when the body’s energies are in balance. By passing their hands over the patient, these healers identify energy imbalances. Bioelectromagnetic-based therapies involve the unconventional use of electromagnetic fields to treat illnesses or manage pain. These therapies are often used to treat asthma, cancer, and migraine headaches. Types of electromagnetic fields which are manipulated in these therapies include pulsed fields, magnetic fields, and alternating current or direct current fields.
Can Alternatives Affect My Treatment? A critical issue in pursuing complementary alternatives mentioned thus far is the risk that these might have undesirable interactions with your medical treatment. It becomes all the more important to speak with your doctor who can offer advice on the use of alternatives. Official sources confirm this view. Though written for women, we find that the National Women’s Health Information Center’s advice on pursuing alternative medicine is appropriate for patients of both genders and all ages.47
47
Adapted from http://www.4woman.gov/faq/alternative.htm.
186 Flu Infection
Is It Okay to Want Both Traditional and Alternative Medicine? Should you wish to explore non-traditional types of treatment, be sure to discuss all issues concerning treatments and therapies with your healthcare provider, whether a physician or practitioner of complementary and alternative medicine. Competent healthcare management requires knowledge of both conventional and alternative therapies you are taking for the practitioner to have a complete picture of your treatment plan. The decision to use complementary and alternative treatments is an important one. Consider before selecting an alternative therapy, the safety and effectiveness of the therapy or treatment, the expertise and qualifications of the healthcare practitioner, and the quality of delivery. These topics should be considered when selecting any practitioner or therapy.
Finding CAM References on Flu Infection Having read the previous discussion, you may be wondering which complementary or alternative treatments might be appropriate for flu infection. For the remainder of this chapter, we will direct you to a number of official sources which can assist you in researching studies and publications. Some of these articles are rather technical, so some patience may be required. The Combined Health Information Database For a targeted search, The Combined Health Information Database is a bibliographic database produced by health-related agencies of the Federal Government (mostly from the National Institutes of Health). This database is updated four times a year at the end of January, April, July, and October. Check the titles, summaries, and availability of CAM-related information by using the “Simple Search” option at the following Web site: http://chid.nih.gov/simple/simple.html. In the drop box at the top, select “Complementary and Alternative Medicine.” Then type “flu infection” (or synonyms) in the second search box. We recommend that you select 100 “documents per page” and to check the “whole records” options. The following was extracted using this technique:
Researching Alternative Medicine 187
·
Efficacy of Echinacea Compound Herbal Tea Preparation on the Severity and Duration of Upper Respiratory and Flue Symptoms: A Randomized, Double-Blind Placebo-Controlled Study Source: Journal of Alternative and Complementary Medicine: Research on Paradigm, Practice and Policy. 6(4): 327-334. 2000. Summary: This journal article examines the efficacy of an echinacea compound herbal tea preparation (Echinacea Plus) on the duration and severity of upper respiratory and flu symptoms. A total of 95 patients with early symptoms of cold or flu (runny nose, scratchy throat, fever) were randomly assigned to receive Echinacea Plus tea or placebo for 5 days under double-blind conditions. The dosage of both the herbal tea and placebo was 5 to 6 cups the first day titrating to 1 cup by the fifth day. Each participant completed a questionnaire 14 days after starting the program. The questionnaire asked about the effectiveness of the tea for relieving cold or flu symptoms, the number of days the symptoms lasted, and the number of days it took to notice a difference in the symptoms. There was a significant difference favoring the Echinacea Plus tea on all three measures. The authors conclude that treatment with Echinacea Plus at early onset of cold or flu symptoms may be effective for relieving those symptoms in a shorter period of time than placebo. The article has 2 tables and 32 references. 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 allow patients to search for articles that specifically relate to flu infection and complementary medicine. To search the database, go to the following Web site: www.nlm.nih.gov/nccam/camonpubmed.html. Select “CAM on PubMed.” Enter “flu infection” (or synonyms) into the search box. Click “Go.” The following references provide information on particular aspects of complementary and alternative medicine (CAM) that are related to flu infection: ·
A controlled evaluation of a homoeopathic preparation in the treatment of influenza-like syndromes. Author(s): Ferley JP, Zmirou D, D'Adhemar D, Balducci F.
188 Flu Infection
Source: British Journal of Clinical Pharmacology. 1989 March; 27(3): 32935. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db= PubMed&list_uids=2655683&dopt=Abstract ·
A homeopathic nosode for influenza-like syndromes. Author(s): de Lange de Klerk E. Source: Forschende Komplementarmedizin. 1999 February; 6(1): 31; Discussion 31-2. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db= PubMed&list_uids=10336310&dopt=Abstract
·
A randomized controlled trial of itraconazole versus fluconazole for the prevention of fungal infections in patients with haematological malignancies. U.K. Multicentre Antifungal Prophylaxis Study Group. Author(s): Morgenstern GR, Prentice AG, Prentice HG, Ropner JE, Schey SA, Warnock DW. Source: British Journal of Haematology. 1999 June; 105(4): 901-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db= PubMed&list_uids=10554799&dopt=Abstract
·
A randomized trial in the prevention of influenza-like syndromes by homeopathic management. Author(s): Attena F, Toscano G, Agozzino E, Del Giudice N. Source: Revue D'epidemiologie Et De Sante Publique. 1995; 43(4): 380-2. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db= PubMed&list_uids=7667544&dopt=Abstract
·
A strategic call to utilize Echinacea-garlic in flu-cold seasons. Author(s): Abdullah T. Source: J Natl Med Assoc. 2000 January; 92(1): 48-51. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db= PubMed&list_uids=10800289&dopt=Abstract
·
Administration of isoferulic acid improved the survival rate of lethal influenza virus pneumonia in mice. Author(s): Sakai S, Ochiai H, Mantani N, Kogure T, Shibahara N, Terasawa K.
Researching Alternative Medicine 189
Source: Mediators of Inflammation. 2001 April; 10(2): 93-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db= PubMed&list_uids=11405556&dopt=Abstract ·
Antioxidant properties of rimantadine in influenza virus infected mice and in some model systems. Author(s): Mileva M, Hadjimitova V, Tantcheva L, Traykov T, Galabov AS, Savov V, Ribarov S. Source: Z Naturforsch [c]. 2000 September-October; 55(9-10): 824-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db= PubMed&list_uids=11098838&dopt=Abstract
·
Antipyretic activity of cinnamyl derivatives and related compounds in influenza virus-infected mice. Author(s): Kurokawa M, Kumeda CA, Yamamura J, Kamiyama T, Shiraki K. Source: European Journal of Pharmacology. 1998 May 1; 348(1): 45-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db= PubMed&list_uids=9650830&dopt=Abstract
·
Antipyretic activity of gingyo-san, a traditional medicine, in influenza virus-infected mice. Author(s): Kurokawa M, Yamamura J, Li Z, Sato H, Hitomi N, Tatsumi Y, Shiraki K. Source: Chemical & Pharmaceutical Bulletin. 1998 September; 46(9): 14447. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db= PubMed&list_uids=9775439&dopt=Abstract
·
Antiviral effect of gingyo-san, a traditional Chinese herbal medicine, on influenza A2 virus infection in mice. Author(s): Kobayashi M, Davis SM, Utsunomiya T, Pollard RB, Suzuki F. Source: Am J Chin Med. 1999; 27(1): 53-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db= PubMed&list_uids=10354817&dopt=Abstract
·
Barbara, what's a nice girl like you doing writing an article like this? : the scientific basis of folk remedies for colds and flu. Author(s): Bender BS.
190 Flu Infection
Source: Chest. 2000 October; 118(4): 887-8. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db= PubMed&list_uids=11035648&dopt=Abstract ·
Botanical sources of influenza inhibitors. Author(s): Cochran KW, Nishikawa T, Beneke ES. Source: Antimicrobial Agents Chemother. 1966; 6: 515-20. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db= PubMed&list_uids=5985281&dopt=Abstract
·
Chemotherapy of influenza. Author(s): Esanu V. Source: Virologie. 1982 October-December; 33(4): 283-302. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db= PubMed&list_uids=6761956&dopt=Abstract
·
Combined antiinfluenza virus activity of Flos verbasci infusion and amantadine derivatives. Author(s): Serkedjieva J. Source: Phytotherapy Research : Ptr. 2000 November; 14(7): 571-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db= PubMed&list_uids=11054856&dopt=Abstract
·
Combined effect of selected antiviral substances of natural and synthetic origin. II. Anti-influenza activity of a combination of a polyphenolic complex isolated from Geranium sanguineum L. and rimantadine in vivo. Author(s): Gegova G, Manolova N, Serkedzhieva Iu, Maksimova V, Uzunov S, Dzeguze D, Indulen M. Source: Acta Microbiol Bulg. 1993; 30: 37-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db= PubMed&list_uids=8285131&dopt=Abstract
·
Effect of long-term dietary antioxidant supplementation on influenza virus infection. Author(s): Han SN, Meydani M, Wu D, Bender BS, Smith DE, Vina J, Cao G, Prior RL, Meydani SN.
Researching Alternative Medicine 191
Source: The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences. 2000 October; 55(10): B496-503. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db= PubMed&list_uids=11034223&dopt=Abstract ·
Effects of alprazolam on influenza virus infection in stressed mice. Author(s): Freire-Garabal M, Balboa JL, Fernandez-Rial JC, Nunez MJ, Belmonte A. Source: Pharmacology, Biochemistry, and Behavior. 1993 September; 46(1): 167-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db= PubMed&list_uids=8255908&dopt=Abstract
·
Efficacy and safety of the standardised Ginseng extract G115 for potentiating vaccination against the influenza syndrome and protection against the common cold [corrected] Author(s): Scaglione F, Cattaneo G, Alessandria M, Cogo R. Source: Drugs Exp Clin Res. 1996; 22(2): 65-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db= PubMed&list_uids=8879982&dopt=Abstract
·
Fluorouracil, high-dose folinic acid, low-dose alpha-2b interferon and dipyridamole in the treatment of advanced colorectal cancer. A pilot study. Author(s): Zaniboni A, Marpicati P, Simoncini E, Montini E, Meriggi F, Arcangeli G, Bonera F, Braga M, Ragni F, Marini G. Source: Journal of Chemotherapy (Florence, Italy). 1991 June; 3(3): 180-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db= PubMed&list_uids=1919656&dopt=Abstract
·
Folk flu and viral syndrome: an epidemiological perspective. Author(s): McCombie SC. Source: Social Science & Medicine (1982). 1987; 25(9): 987-93. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db= PubMed&list_uids=3423849&dopt=Abstract
·
Homoeopathic Oscillococcinum for preventing and treating influenza and influenza-like syndromes. Author(s): Vickers AJ, Smith C.
192 Flu Infection
Source: Cochrane Database Syst Rev. 2000; (2): Cd001957. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db= PubMed&list_uids=10796675&dopt=Abstract ·
Human mannan-binding lectin inhibits the infection of influenza A virus without complement. Author(s): Kase T, Suzuki Y, Kawai T, Sakamoto T, Ohtani K, Eda S, Maeda A, Okuno Y, Kurimura T, Wakamiya N. Source: Immunology. 1999 July; 97(3): 385-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db= PubMed&list_uids=10447758&dopt=Abstract
·
In vivo anti-influenza virus activity of kampo (Japanese herbal) medicine "sho-seiryu-to" and its mode of action. Author(s): Nagai T, Yamada H. Source: International Journal of Immunopharmacology. 1994 August; 16(8): 605-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db= PubMed&list_uids=7527377&dopt=Abstract
·
In vivo anti-influenza virus activity of Kampo (Japanese herbal) medicine "Sho-seiryu-to"--effects on aged mice, against subtypes of a viruses and B virus, and therapeutic effect. Author(s): Nagai T, Urata M, Yamada H. Source: Immunopharmacology and Immunotoxicology. 1996 May; 18(2): 193-208. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db= PubMed&list_uids=8771367&dopt=Abstract
·
In vivo anti-influenza virus activity of Kampo (Japanese herbal) medicine "sho-seiryu-to"--stimulation of mucosal immune system and effect on allergic pulmonary inflammation model mice. Author(s): Nagai T, Yamada H. Source: Immunopharmacology and Immunotoxicology. 1998 May; 20(2): 267-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db= PubMed&list_uids=9653672&dopt=Abstract
·
Influenza and its osteopathic management. 1937. Author(s): Ward EA.
Researching Alternative Medicine 193
Source: J Am Osteopath Assoc. 2000 May; 100(5): 325-8. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db= PubMed&list_uids=10850020&dopt=Abstract ·
Inhibition of several strains of influenza virus in vitro and reduction of symptoms by an elderberry extract (Sambucus nigra L.) during an outbreak of influenza B Panama. Author(s): Zakay-Rones Z, Varsano N, Zlotnik M, Manor O, Regev L, Schlesinger M, Mumcuoglu M. Source: Journal of Alternative and Complementary Medicine (New York, N.Y.). 1995 Winter; 1(4): 361-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db= PubMed&list_uids=9395631&dopt=Abstract
·
Inhibitory effect of ferulic acid and isoferulic acid on murine interleukin-8 production in response to influenza virus infections in vitro and in vivo. Author(s): Hirabayashi T, Ochiai H, Sakai S, Nakajima K, Terasawa K. Source: Planta Medica. 1995 June; 61(3): 221-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db= PubMed&list_uids=7617763&dopt=Abstract
·
Mode of action of the anti-influenza virus activity of plant flavonoid, 5,7,4'-trihydroxy-8-methoxyflavone, from the roots of Scutellaria baicalensis. Author(s): Nagai T, Moriguchi R, Suzuki Y, Tomimori T, Yamada H. Source: Antiviral Research. 1995 January; 26(1): 11-25. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db= PubMed&list_uids=7741518&dopt=Abstract
·
Neuraminidase activity of influenza virus-infected cells: localization and properties. Author(s): Orlova TG, Orlova NG. Source: Acta Virol. 1975 April; 19(2): 130-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db= PubMed&list_uids=239558&dopt=Abstract
·
One hundred thousand cases of influenza with a death rate of onefortieth of that officially reported under conventional medical treatment. 1919. Author(s): Smith RK.
194 Flu Infection
Source: J Am Osteopath Assoc. 2000 May; 100(5): 320-3. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db= PubMed&list_uids=10850019&dopt=Abstract ·
Osteopathic success in the treatment of influenza and pneumonia. 1919. Author(s): Riley GW. Source: J Am Osteopath Assoc. 2000 May; 100(5): 315-9. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db= PubMed&list_uids=10850018&dopt=Abstract
·
Patient power. Arming yourself to fight the flu. Author(s): Rountree R. Source: Newsweek. 2000 November 6; 136(19): 88-9. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db= PubMed&list_uids=11185324&dopt=Abstract
·
Plant polyphenolic complex inhibits the reproduction of influenza and herpes simplex viruses. Author(s): Serkedjieva J, Manolova N. Source: Basic Life Sci. 1992; 59: 705-15. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db= PubMed&list_uids=1329716&dopt=Abstract
·
Prophylactic effect of a Beta vulgaris extract on experimental influenza infection in mice. Author(s): Prahoveanu E, Esanu V, Anton G, Frunzulica S. Source: Virologie. 1986 April-June; 37(2): 121-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db= PubMed&list_uids=3727395&dopt=Abstract
·
Psychological treatment for recurrent symptoms of colds and flu in children. Author(s): Hewson-Bower B, Drummond PD. Source: Journal of Psychosomatic Research. 2001 July; 51(1): 369-77. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db= PubMed&list_uids=11448705&dopt=Abstract
·
The antiviral effect of keishi-ni-eppi-ichi-to, a traditional Chinese herbal medicine, on influenza A2(H2N2) virus infection in mice.
Researching Alternative Medicine 195
Author(s): Ball MA, Utsunomiya T, Ikemoto K, Kobayashi M, Pollard RB, Suzuki F. Source: Experientia. 1994 August 15; 50(8): 774-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db= PubMed&list_uids=7520870&dopt=Abstract ·
The effect of an aqueous horse-radish extract, applied as such or in association with caffeine, on experimental influenza in mice. Author(s): Esanu V, Prahoveanu E. Source: Virologie. 1985 April-June; 36(2): 95-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db= PubMed&list_uids=4036004&dopt=Abstract
·
The effect of garlic extract, applied as such or in association with NaF, on experimental influenza in mice. Author(s): Esanu V, Prahoveanu E. Source: Virologie. 1983 January-March; 34(1): 11-7. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db= PubMed&list_uids=6304996&dopt=Abstract
·
The efficacy of echinacea compound herbal tea preparation on the severity and duration of upper respiratory and flu symptoms: a randomized, double-blind placebo-controlled study. Author(s): Lindenmuth GF, Lindenmuth EB. Source: Journal of Alternative and Complementary Medicine (New York, N.Y.). 2000 August; 6(4): 327-34. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db= PubMed&list_uids=10976979&dopt=Abstract
·
Thoracic lymphatic pumping and the efficacy of influenza vaccination in healthy young and elderly populations. Author(s): Breithaupt T, Harris K, Ellis J, Purcell E, Weir J, Clothier M, Boesler D. Source: J Am Osteopath Assoc. 2001 January; 101(1): 21-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db= PubMed&list_uids=11234217&dopt=Abstract
·
Treating colds and flu the Chinese way (1). Author(s): Liu H.
196 Flu Infection
Source: J Okla State Med Assoc. 1984 September; 77(9): 318-23. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db= PubMed&list_uids=6502293&dopt=Abstract ·
Treating colds and flu the Chinese way (2). Author(s): Hong L. Source: J Okla State Med Assoc. 1984 October; 77(10): 361-5. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db= PubMed&list_uids=6502291&dopt=Abstract
·
Vitamin E supplementation decreases lung virus titers in mice infected with influenza. Author(s): Hayek MG, Taylor SF, Bender BS, Han SN, Meydani M, Smith DE, Eghtesada S, Meydani SN. Source: The Journal of Infectious Diseases. 1997 July; 176(1): 273-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db= PubMed&list_uids=9207381&dopt=Abstract
·
Vitamin E supplementation increases T helper 1 cytokine production in old mice infected with influenza virus. Author(s): Han SN, Wu D, Ha WK, Beharka A, Smith DE, Bender BS, Meydani SN. Source: Immunology. 2000 August; 100(4): 487-93. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db= PubMed&list_uids=10929076&dopt=Abstract
·
World War I may have allowed the emergence of "Spanish" influenza. Author(s): Oxford JS, Sefton A, Jackson R, Innes W, Daniels RS, Johnson NP. Source: The Lancet Infectious Diseases. 2002 February; 2(2): 111-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db= PubMed&list_uids=11901642&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/
Researching Alternative Medicine 197
·
AOL: http://search.aol.com/cat.adp?id=169&layer=&from=subcats
·
Chinese Medicine: http://www.newcenturynutrition.com/
·
drkoop.comÒ: http://www.drkoop.com/InteractiveMedicine/IndexC.html
·
Family Village: http://www.familyvillage.wisc.edu/med_altn.htm
·
Google: http://directory.google.com/Top/Health/Alternative/
·
Healthnotes: http://www.thedacare.org/healthnotes/
·
Open Directory Project: http://dmoz.org/Health/Alternative/
·
TPN.com: http://www.tnp.com/
·
Yahoo.com: http://dir.yahoo.com/Health/Alternative_Medicine/
·
WebMDÒHealth: http://my.webmd.com/drugs_and_herbs
·
WellNet: http://www.wellnet.ca/herbsa-c.htm
·
WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,,00.html
The following is a specific Web list relating to flu; 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 Abdominal Wall Inflammation Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Peri tonitiscc.html Acne Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Acn ecc.html
198 Flu Infection
Acne Vulgaris Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Acne_Vulgaris.ht m Age-Related Cognitive Decline Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/ARCD.htm AIDS and HIV Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/HIV andAIDScc.html Alcohol Withdrawal Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Alcohol.htm Alcoholism Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Alc oholismcc.html Allergic Reaction, Anaphylaxis Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Ana phylaxiscc.html Allergic Rhinitis Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Alle rgicRhinitiscc.html
Researching Alternative Medicine 199
Allergies and Sensitivities Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Allergies.htm Allergy, Food Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Foo dAllergycc.html Alzheimer's Disease Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Alz heimersDiseasecc.html Alzheimer's Disease, Non-Alzheimer's Dementia, and Normal AgeRelated Memory Loss Source: Prima Communications, Inc. Hyperlink: http://www.personalhealthzone.com/pg000259.html Amenorrhea Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Amenorrhea.htm Amyloidosis Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Am yloidosiscc.html Anaphylaxis Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Ana phylaxiscc.html
200 Flu Infection
Angina Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Angina.htm Angina Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Ang inacc.html Anorexia Nervosa Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Ano rexiaNervosacc.html Anxiety Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Anxiety.htm Appendicitis Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/App endicitiscc.html Arteries, Hardening of Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Ath erosclerosiscc.html
Researching Alternative Medicine 201
Arteriosclerosis Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Ath erosclerosiscc.html Arthritis, OsteoSource: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Ost eoarthritiscc.html Arthritis, Rheumatoid Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Rhe umatoidArthritiscc.html Ascariasis Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Rou ndwormscc.html Asthma Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Asthma.htm Atherosclerosis Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Atherosclerosis.ht m
202 Flu Infection
Atherosclerosis Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Ath erosclerosiscc.html Atherosclerosis and Heart Disease Prevention Source: Prima Communications, Inc. Hyperlink: http://www.personalhealthzone.com/pg000263.html Attention Deficit Hyperactivity Disorder Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Atte ntionDeficitHyperactivityDisordercc.html Autism Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Autism.htm Back Pain, Low Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Low BackPaincc.html Benign Prostatic Hyperplasia Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/BPH.htm Benign Prostatic Hyperplasia Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Beni gnProstaticHyperplasiacc.html
Researching Alternative Medicine 203
Bipolar Disorder Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Bipolar_Disorder. htm Birth Defects Prevention Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Birth_Defects.htm Blood Sugar, Low Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Hyp oglycemiacc.html Bone Loss Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Ost eoporosiscc.html BPH Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Beni gnProstaticHyperplasiacc.html Brain Cancer Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Can cerBraincc.html
204 Flu Infection
Brain Inflammation, Meningitis Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Me ningitiscc.html Brain Inflammation, Viral Encephalitis Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Enc ephalitisViralcc.html Breast Cancer Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Cancer_Breast.ht m Breast Cancer Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Can cerBreastcc.html Bronchitis Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Bronchitis.htm Bronchitis Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Bro nchitiscc.html
Researching Alternative Medicine 205
Bulimia Nervosa Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Buli miaNervosacc.html Burns Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Burns.htm Burns Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Bur nscc.html Bursitis Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Bursitis.htm Bursitis Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Bur sitiscc.html Cancer Prevention (Reducing the Risk) Source: Prima Communications, Inc. Hyperlink: http://www.personalhealthzone.com/pg000272.html Cancer, Brain Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Can cerBraincc.html
206 Flu Infection
Cancer, Breast Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Can cerBreastcc.html Cancer, Colorectal Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Can cerColorectalcc.html Cancer, Lung Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Can cerLungcc.html Cancer, Prostate Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Can cerProstatecc.html Canker Sores Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Canker_Sores.htm Cardiac Arrhythmia Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Cardiac_Arrhyth mia.htm Cardiovascular Disease Overview Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Cardiovascular_Di sease.htm
Researching Alternative Medicine 207
Carpal Tunnel Syndrome Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Carpal_Tunnel.ht m Carpal Tunnel Syndrome Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Car palTunnelSyndromecc.html Cataracts Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Cat aractscc.html Cellulitis Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Cell ulitiscc.html Chickenpox and Shingles Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Her pesZosterandVaricellaVirusescc.html Cholesterol, High Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Hyp ercholesterolemiacc.html
208 Flu Infection
Chronic Candidiasis Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Chronic_Candidia sis.htm Chronic Fatigue Syndrome Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Chronic_Fatigue_ Syndrome.htm Chronic Fatigue Syndrome Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Chr onicFatigueSyndromecc.html Chronic Obstructive Pulmonary Disease Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/COPD.htm Chronic Obstructive Pulmonary Disease Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Chr onicObstructivePulmonaryDiseasecc.html Cirrhosis Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Cirr hosisoftheLivercc.html Cluster Headache Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Cluster_Headache .htm
Researching Alternative Medicine 209
Cold Sores Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Cold_Sores.htm Cold Sores Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Her pesSimplexViruscc.html Colds and Flus Source: Prima Communications, Inc. Hyperlink: http://www.personalhealthzone.com/pg000282.html Colic Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Colic.htm Colon Cancer Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Cancer_Colon.htm Colorectal Cancer Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Can cerColorectalcc.html Common Cold Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Co mmonColdcc.html
210 Flu Infection
Common Cold/Sore Throat Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Common_Cold.ht m Congestive Heart Failure Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Congestive_Heart. htm Congestive Heart Failure Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Con gestiveHeartFailurecc.html Congestive Heart Failure Source: Prima Communications, Inc. Hyperlink: http://www.personalhealthzone.com/pg000283.html Conjunctivitis Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Con junctivitiscc.html Constipation Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Constipation.htm Constipation Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Con stipationcc.html
Researching Alternative Medicine 211
Constipation Source: Prima Communications, Inc. Hyperlink: http://www.personalhealthzone.com/pg000284.html Coronary Artery Disease Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Ath erosclerosiscc.html Cough Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Cou ghcc.html Crohn's Disease Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Cro hnsDiseasecc.html Cutaneous Drug Reactions Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Cut aneousDrugReactionscc.html Dementia Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/De mentiacc.html Depression Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Depression.htm
212 Flu Infection
Depression Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Dep ressioncc.html Depression (Mild to Moderate) Source: Prima Communications, Inc. Hyperlink: http://www.personalhealthzone.com/pg000280.html Diabetes Source: Prima Communications, Inc. Hyperlink: http://www.personalhealthzone.com/pg000285.html Diabetes Mellitus Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Dia betesMellituscc.html Diarrhea Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Diarrhea.htm Diarrhea Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Diar rheacc.html Diverticular Disease Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Diverticular_Disea se.htm
Researching Alternative Medicine 213
Drug Reactions, Cutaneous Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Cut aneousDrugReactionscc.html Dysmenorrhea Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Dysmenorrhea.ht m Dysmenorrhea Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Dys menorrheacc.html Dysphagia Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Dys phagiacc.html Ear Infection Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Otit isMediacc.html Eating Disorders Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Eating_Disorders. htm
214 Flu Infection
Eating Disorders, Anorexia Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Ano rexiaNervosacc.html Eating Disorders, Bulimia Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Buli miaNervosacc.html Eczema Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Eczema.htm Eczema Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Ecz emacc.html Edema Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Edema.htm Edema Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Ede macc.html
Researching Alternative Medicine 215
Emphysema Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Chr onicObstructivePulmonaryDiseasecc.html Encephalitis, Viral Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Enc ephalitisViralcc.html Endocarditis Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/End ocarditiscc.html Endometriosis Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/End ometriosiscc.html Epilepsy Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Epilepsy.htm Erythema Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Skin DisordersErythemacc.html
216 Flu Infection
Fainting Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Fain tingcc.html Fatigue, Chronic Syndrome Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Chr onicFatigueSyndromecc.html Female Infertility Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Infertility_Female. htm Fever of Unknown Origin Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Fev erofUnknownOrigincc.html Fibromyalgia Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Fibromyalgia.htm Fibromyalgia Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Fibr omyalgiacc.html
Researching Alternative Medicine 217
Flu Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Fluc c.html Food Allergy Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Foo dAllergycc.html Food Poisoning Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Foo dPoisoningcc.html Frostbite Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Fros tbitecc.html Gallbladder Disease Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Gall bladderDiseasecc.html Gallstones Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Gallstones.htm
218 Flu Infection
Gastritis Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Gastritis.htm Gastritis Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Gas tritiscc.html Gastroesophageal Reflux Disease Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/GERD.htm Gastroesophageal reflux disease Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/InteractiveMedicine/ConsLookups/Uses/ gastroesophagealrefluxdisease.html Gastroesophageal Reflux Disease Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Gas troesophagealRefluxDiseasecc.html Genital Herpes Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Genital_Herpes.ht m Gestational Hypertension Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Gestational_Hype rtension.htm
Researching Alternative Medicine 219
Gingivitis Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Gingivitis.htm Glaucoma Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Glaucoma.htm Glaucoma Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Gla ucomacc.html Gout Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Gou tcc.html Guinea Worm Disease Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Rou ndwormscc.html Hay Fever Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Alle rgicRhinitiscc.html
220 Flu Infection
Headache, Migraine Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Hea dacheMigrainecc.html Headache, Tension Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Hea dacheTensioncc.html Heart Attack Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Heart_Attack.htm Heart Failure, Congestive Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Con gestiveHeartFailurecc.html Heart Infection, Endocarditis Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/End ocarditiscc.html Heart Infection, Pericarditis Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Peri carditiscc.html
Researching Alternative Medicine 221
Heartburn Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Gas troesophagealRefluxDiseasecc.html Heat Exhaustion Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Hea tExhaustioncc.html Hemorrhoids Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Hemorrhoids.htm Hemorrhoids Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/He morrhoidscc.html Hepatitis Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Hepatitis.htm Hepatitis, Viral Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Hep atitisViralcc.html Herpes Alternative names: Genital Herpes, Cold Sores Source: Prima Communications, Inc. Hyperlink: http://www.personalhealthzone.com/pg000281.html
222 Flu Infection
Herpes Simplex Virus Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Her pesSimplexViruscc.html Herpes Zoster and Varicella Viruses Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Her pesZosterandVaricellaVirusescc.html High Cholesterol Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Hyp ercholesterolemiacc.html High Cholesterol Source: Prima Communications, Inc. Hyperlink: http://www.personalhealthzone.com/pg000278.html High Triglycerides Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/High_Triglyceride s.htm Histoplasmosis Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Hist oplasmosiscc.html
Researching Alternative Medicine 223
HIV and AIDS Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/HIV andAIDScc.html HIV and AIDS Support Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/HIV_Support.htm Hookworm Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Rou ndwormscc.html Hypercholesterolemia Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Hyp ercholesterolemiacc.html Hypertension Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Hypertension.htm Hypochondriasis Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Hyp ochondriasiscc.html Hypoglycemia Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Hypoglycemia.ht m
224 Flu Infection
Hypoglycemia Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Hyp oglycemiacc.html Hypothermia Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Hyp othermiacc.html Hypothyroidism Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Hypothyroidism.h tm Immune Function Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Immune_Function .htm Indigestion, Heartburn, and Low Stomach Acidity Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Indigestion.htm Infection Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Infection.htm Inflammatory Bowel Disease Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Ulc erativeColitiscc.html
Researching Alternative Medicine 225
Inflammatory Bowel Disease, Crohn's Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Cro hnsDiseasecc.html Influenza Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Influenza.htm Influenza Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Fluc c.html Influenza Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/InteractiveMedicine/ConsLookups/Uses/ influenza.html Insomnia Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Insomnia.htm Insomnia Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Inso mniacc.html Insomnia Source: Prima Communications, Inc. Hyperlink: http://www.personalhealthzone.com/pg000296.html
226 Flu Infection
Insulin Resistance Syndrome Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Insulin_Resistance _Syndrome.htm Intermittent Claudication Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Intermittent_Clau dication.htm Intermittent Claudication Alternative names: Peripheral Vascular Disease Source: Prima Communications, Inc. Hyperlink: http://www.personalhealthzone.com/pg000297.html Irritable Bowel Syndrome Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Irritable_Bowel.ht m Irritable Bowel Syndrome Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Irrit ableBowelSyndromecc.html Kidney Stones Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Kidney_Stones.ht m Kidney Stones Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Uro lithiasiscc.html
Researching Alternative Medicine 227
Laryngitis Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Lar yngitiscc.html Leukemia Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Leu kemiacc.html Leukoplakia Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Leukoplakia.htm Liver Cirrhosis Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Liver_Cirrhosis.ht m Liver Disease Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Cirr hosisoftheLivercc.html Loiasis Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Rou ndwormscc.html
228 Flu Infection
Low Back Pain Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Low BackPaincc.html Low Blood Sugar Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Hyp oglycemiacc.html Lung Cancer Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Can cerLungcc.html Lupus Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Syst emicLupusErythematosuscc.html Lyme Disease Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Ly meDiseasecc.html Lymphatic Filariasis Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Rou ndwormscc.html
Researching Alternative Medicine 229
Ménière's Disease Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Menieres_Disease. htm Macular Degeneration Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Mac ularDegenerationcc.html Male Infertility Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Infertility_Male.ht m Male Infertility Source: Prima Communications, Inc. Hyperlink: http://www.personalhealthzone.com/pg000295.html Measles Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Mea slescc.html Meningitis Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Me ningitiscc.html Menkes' Disease Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Menkes_Disease.h tm
230 Flu Infection
Menopausal Symptoms (Other Than Osteoporosis) Source: Prima Communications, Inc. Hyperlink: http://www.personalhealthzone.com/pg000276.html Menopause Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Menopause.htm Menopause Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Me nopausecc.html Menstrual Pain Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Dys menorrheacc.html Migraine Headache Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Hea dacheMigrainecc.html Miscarriage Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Mis carriagecc.html Morning Sickness Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Morning_Sickness .htm
Researching Alternative Medicine 231
MSG Sensitivity Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/MSG_Sensitivity.h tm Multiple Sclerosis Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Multiple_Sclerosis .htm Multiple Sclerosis Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Mul tipleSclerosiscc.html Mumps Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Mu mpscc.html Nail Disorders Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Nail Disorderscc.html Nausea Source: Prima Communications, Inc. Hyperlink: http://www.personalhealthzone.com/pg000299.html Night Blindness Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Night_Blindness.h tm
232 Flu Infection
Obesity Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Obe sitycc.html Osteoarthritis Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Osteoarthritis.htm Osteoarthritis Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Ost eoarthritiscc.html Osteoarthritis Source: Prima Communications, Inc. Hyperlink: http://www.personalhealthzone.com/pg000264.html Osteoporosis Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Osteoporosis.htm Osteoporosis Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Ost eoporosiscc.html Osteoporosis Source: Prima Communications, Inc. Hyperlink: http://www.personalhealthzone.com/pg000270.html
Researching Alternative Medicine 233
Otitis Media Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Otit isMediacc.html Pain Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Pain.htm Pancreas, Inflammation of Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Pan creatitiscc.html Pancreatic Insufficiency Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Pancreatic_Insuffi ciency.htm Pancreatitis Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Pan creatitiscc.html Parasites Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Parasites.htm Parasitic Infection, Histoplasmosis Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Hist oplasmosiscc.html
234 Flu Infection
Parasitic Infection, Roundworms Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Rou ndwormscc.html Parkinson's Disease Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Parkinsons_Diseas e.htm Parkinson's Disease Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Par kinsonsDiseasecc.html Peptic Ulcer Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Peptic_Ulcer.htm Pericarditis Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Peri carditiscc.html Peripheral Vascular Disease Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Peripheral_Vascul ar_Disease.htm
Researching Alternative Medicine 235
Peritonitis Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Peri tonitiscc.html Pharyngitis Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Pha ryngitiscc.html Phenylketonuria Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Phenylketonuria.h tm Photodermatitis Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Skin DisordersPhotodermatitiscc.html Pink Eye Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Con junctivitiscc.html Pinworm Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Rou ndwormscc.html
236 Flu Infection
PMS Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Pre menstrualSyndromePMScc.html PMS Alternative names: Premenstrual Stress Syndrome Source: Prima Communications, Inc. Hyperlink: http://www.personalhealthzone.com/pg000289.html Post Traumatic Stress Disorder Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Post TraumaticStressDisordercc.html Preeclampsia Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Preeclampsia.htm Preeclampsia Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Pree clampsiacc.html Pregnancy and Postpartum Support Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Pregnancy.htm Premenstrual Syndrome Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/PMS.htm
Researching Alternative Medicine 237
Premenstrual Syndrome Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Pre menstrualSyndromePMScc.html Prostate Cancer Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Cancer_Prostate.h tm Prostate Cancer Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Can cerProstatecc.html Prostate Enlargement Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Beni gnProstaticHyperplasiacc.html Prostate Infection Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Pros tatitiscc.html Prostatitis Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Prostatitis.htm
238 Flu Infection
Prostatitis Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Pros tatitiscc.html Psoriasis Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Psoriasis.htm Psoriasis Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Psor iasiscc.html PTSD Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Post TraumaticStressDisordercc.html Pulmonary Edema Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Pul monaryEdemacc.html Pulmonary Hypertension Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Pri maryPulmonaryHypertensioncc.html
Researching Alternative Medicine 239
Pyloric Stenosis Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Pyl oricStenosiscc.html Radiation Damage Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Rad iationDamagecc.html Raynaud's Disease Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Raynauds_Disease .htm Raynaud's Phenomenon Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Ray naudsPhenomenoncc.html Raynaud's Phenomenon Source: Prima Communications, Inc. Hyperlink: http://www.personalhealthzone.com/pg000302.html Recurrent Ear Infections Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Ear_Infections.ht m Respiratory Infection, Bronchitis Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Bro nchitiscc.html
240 Flu Infection
Respiratory Infection, Cold Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Co mmonColdcc.html Retinopathy Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Retinopathy.htm Rheumatoid Arthritis Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Rheumatoid_Arth ritis.htm Rheumatoid Arthritis Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Rhe umatoidArthritiscc.html Rhinitis, Allergic Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Alle rgicRhinitiscc.html River Blindness Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Rou ndwormscc.html
Researching Alternative Medicine 241
Roseola Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Ros eolacc.html Roundworms Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Rou ndwormscc.html Rubella Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Rub ellacc.html Schizophrenia Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Schizophrenia.ht m Scleroderma Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Scle rodermacc.html Seasonal Affective Disorder Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Seasonal_Affectiv e_Disorder.htm
242 Flu Infection
Seborrheic Dermatitis Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Seborrheic_Derma titis.htm Senile Dementia Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/De mentiacc.html Serum Sickness Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Ser umSicknesscc.html Sexual Dysfunction Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Sex ualDysfunctioncc.html Sexually Transmitted Diseases Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Sex uallyTransmittedDiseasescc.html Shingles and Chickenpox Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Her pesZosterandVaricellaVirusescc.html
Researching Alternative Medicine 243
Shingles and Postherpetic Neuralgia Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Shingles.htm Shock Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Sho ckcc.html Sickle Cell Anemia Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Sickle_Cell_Anem ia.htm Sinus Congestion Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Sinus_Congestion. htm Sinus Infection Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Sin usitiscc.html Sinusitis Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Sinusitis.htm Sinusitis Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Sin usitiscc.html
244 Flu Infection
Skin Disorders, Drug Reactions Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Cut aneousDrugReactionscc.html Skin Disorders, Eczema Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Ecz emacc.html Skin Disorders, Erythema Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Skin DisordersErythemacc.html Skin Disorders, Photodermatitis Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Skin DisordersPhotodermatitiscc.html Skin Infection Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Cell ulitiscc.html Sleeplessness Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Inso mniacc.html
Researching Alternative Medicine 245
Sore Throat Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Pha ryngitiscc.html Spastic Colon Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Irrit ableBowelSyndromecc.html Spontaneous Abortion Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Mis carriagecc.html Sprains and Strains Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Sprains_Strains.ht m STDs Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Sex uallyTransmittedDiseasescc.html Stomach Inflammation Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Gas tritiscc.html
246 Flu Infection
Stress Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Stre sscc.html Stroke Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Stroke.htm Sunburn Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Skin DisordersPhotodermatitiscc.html Swallowing, Difficulty Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Dys phagiacc.html Syncope Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Fain tingcc.html Systemic Lupus Erythematosus Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Syst emicLupusErythematosuscc.html
Researching Alternative Medicine 247
Tardive Dyskinesia Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Tardive_Dyskinesi a.htm Tension Headache Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Tension_Headach e.htm Tension Headache Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Hea dacheTensioncc.html Threadworm Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Rou ndwormscc.html Throat, Sore Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Pha ryngitiscc.html Trichinosis Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Rou ndwormscc.html
248 Flu Infection
Tuberculosis Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Tub erculosiscc.html Ulcerative Colitis Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Ulcerative_Colitis. htm Ulcerative Colitis Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Ulc erativeColitiscc.html Urethral Inflammation Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Uret hritiscc.html Urethritis Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Uret hritiscc.html Urinary Tract Infection Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/UTI.htm
Researching Alternative Medicine 249
Urinary Tract Infection in Women Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Uri naryTractInfectioninWomencc.html UTI Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Uri naryTractInfectioninWomencc.html Varicella and Herpes Zoster Viruses Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Her pesZosterandVaricellaVirusescc.html Varicose Veins Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Vari coseVeinscc.html Varicose Veins Source: Prima Communications, Inc. Hyperlink: http://www.personalhealthzone.com/pg000303.html Vertigo Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Vertigo.htm Visceral Larva Migrans Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Rou ndwormscc.html
250 Flu Infection
Warts Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/War tscc.html Water Retention Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Ede macc.html Weight Loss and Obesity Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Weight_Loss.htm Whipworm Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Rou ndwormscc.html Wound Healing Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Wound_Healing.h tm Wounds Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsConditions/Wo undscc.html
Researching Alternative Medicine 251
Yeast Infection Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Yeast_Infection.ht m ·
Alternative Therapy Acu-diet Alternative names: Dr. Bahr's acu-diet Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/a.html Acupuncture Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Therapy/Acupuncture.htm Acupuncture Alternative names: acupuncture therapy Zhenjiu Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/a.html Aromatherapy Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525, 664,00.html Astrology Alternative names: star-gazing Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/a.html Ayurveda Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525, 672,00.html
252 Flu Infection
Bach flower remedies Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525, 673,00.html Biodynamic psychology Alternative names: Biodynamic therapy Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/b.html Biofeedback Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525, 675,00.html Chinese herbal medicine Alternative names: Zhang Yao Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/c.html Chinese herbalism Alternative names: Chinese herbal system Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/c.html Colon Therapy Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Therapy/Colon_Therapy.ht m Colon therapy Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525, 682,00.html
Researching Alternative Medicine 253
Color therapy Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525, 683,00.html Confluent somatic therapy Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/c.html Cosmic vibrational healing Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/c.html Craniosacral therapy Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525, 685,00.html Cupping Alternative names: cupping method cupping therapy; called the "horn method" in ancient China Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/c.html Curative eurhythmy Alternative names: curative eurythmy therapeutic eurhythmy Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/c.html Dance therapy Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525, 687,00.html
254 Flu Infection
Environmental diagnosis Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/e.html Flower Remedies Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Therapy/Flower_Remedies. htm Gerson Therapy Alternative names: Gerson dietary regime GDR Gerson method Gerson treatment Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/g.html Herbal Medicine Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsModalities/Her balMedicinecm.html Homeopathy Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525, 703,00.html Hypnotherapy Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525, 706,00.html Iridology Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525, 709,00.html
Researching Alternative Medicine 255
Light therapy Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525, 713,00.html Lymphasizing Alternative names: The Art of Lymphatic System Activation The Art of Lymphasizing The Fine Art of Lymphasizing The Science of Lymphasizing Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/l.html Macrobiotics Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525, 714,00.html Magnet therapy Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525, 715,00.html Massage therapy Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525, 716,00.html Mesmerism Alternative names: animal magnetism magnetic healing Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/m.html
256 Flu Infection
Metamorphic technique Alternative names: metamorphosis; originally called "prenatal therapy" Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/m.html Mind&Body Medicine Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsModalities/Min dBodyMedicinecm.html Mind/Body Medicine Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Therapy/Mind_Body_Medi cine.htm Nichiren Buddhism Alternative names: Nichirenism Nichiren Shoshu NS Nichiren Shoshu Buddhism Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/n.html Numerology Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/n.html Nutripathy Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/n.html Nutrition Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsModalities/Nutr itioncm.html
Researching Alternative Medicine 257
Orgone therapy Alternative names: medical orgone therapy medical orgonomy orgonomic medicine orgonomic medicine therapy Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/o.html Osteopathy Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525, 724,00.html Prayer Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525, 728,00.html Psychic Self-Defense Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/p.html Qigong Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525, 729,00.html Rei-so Alternative names: spiritual diagnosis Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/r.html Relaxation Techniques Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsModalities/Rela xationTechniquescm.html
258 Flu Infection
Rolfing Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525, 732,00.html Schuessler biochemic system of medicine Alternative names: biochemic medicine biochemic system of medicine biochemic system of medicines tissue salts therapy Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/s.html Spirituality Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsModalities/Spiri tualitycm.html Tai chi Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525, 737,00.html Temple Beautiful Programs Alternative names: formerly the Temple Beautiful Program Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/t.html Tibetan medicine Alternative names: Amchi Emchi Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/t.html Touch And Breathe Alternative names: TAB TAB approach Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/t.html
Researching Alternative Medicine 259
Traditional Chinese Medicine Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsModalities/Trad itionalChineseMedicinecm.html Traditional Chinese medicine Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525, 10085,00.html UN System Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/u.html Unani Alternative names: Unani medicine Unani system of medicine Unani Tibb Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/u.html Yoga Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsModalities/Yog acm.html Yoga Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525, 746,00.html
260 Flu Infection
·
Chinese Medicine Baizhu Alternative names: Largehead Atractylodes Rhizome; Rhizoma Atractylodis Macrocephalae Source: Chinese Materia Medica Hyperlink: http://www.newcenturynutrition.com/ Banxia Alternative names: Pinellia Tuber; Rhizoma Pinelliae Source: Chinese Materia Medica Hyperlink: http://www.newcenturynutrition.com/ Beishashen Alternative names: Coastal Glehnia Root; Radix Glehniae Source: Chinese Materia Medica Hyperlink: http://www.newcenturynutrition.com/ Bohe Alternative names: Peppermint; Herba Menthae Source: Chinese Materia Medica Hyperlink: http://www.newcenturynutrition.com/ Chaihu Alternative names: Chinese Thorowax Root; Radix Bupleuri Source: Chinese Materia Medica Hyperlink: http://www.newcenturynutrition.com/ Chonglou Alternative names: Paris Root; Rhizoma Paridis Source: Chinese Materia Medica Hyperlink: http://www.newcenturynutrition.com/ Chuanbei Xueli Alternative names: Chuanbei Xueli Concentrated Decoction; Chuanbei Xueli Gao Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China Hyperlink: http://www.newcenturynutrition.com/cgilocal/patent_herbs_db/db.cgi?db=default&Chinese=Chuanbei%20Xu eli&mh=10&sb=---&view_records=View+Records
Researching Alternative Medicine 261
Ciwujia Jingao Alternative names: Manyprickle Acanthopanax Extract; Ciwujia Jingao (Ci Wu Jia Jin Gao)
Extractum Acanthopanacis Senticosi Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China Hyperlink: http://www.newcenturynutrition.com/cgilocal/patent_herbs_db/db.cgi?db=default&Chinese=Ciwujia%20Jing ao&mh=10&sb=---&view_records=View+Records Cuitang Wan Alternative names: Cuitang Pills Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China Hyperlink: http://www.newcenturynutrition.com/cgilocal/patent_herbs_db/db.cgi?db=default&Chinese=Cuitang%20Wa n&mh=10&sb=---&view_records=View+Records Dandouchi Alternative names: Fermented Soybean; Semen Sojae Preparatum Source: Chinese Materia Medica Hyperlink: http://www.newcenturynutrition.com/ Dihuang Alternative names: Digitalis Leaf; Yangdihuangye; Folium Digitalis Source: Chinese Materia Medica Hyperlink: http://www.newcenturynutrition.com/ Erdong Gao Alternative names: Erdong Concentrated Decoction; Erdong Gao (Er Dong Gao) Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China Hyperlink: http://www.newcenturynutrition.com/cgilocal/patent_herbs_db/db.cgi?db=default&Chinese=Erdong%20Gao &mh=10&sb=---&view_records=View+Records Fengmi Alternative names: Honey; Mel Source: Chinese Materia Medica Hyperlink: http://www.newcenturynutrition.com/
262 Flu Infection
Fufang Danshen Pian Alternative names: Compound Saivia Tablets Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China Hyperlink: http://www.newcenturynutrition.com/cgilocal/patent_herbs_db/db.cgi?db=default&Chinese=Fufang%20Dans hen%20Pian&mh=10&sb=---&view_records=View+Records Fuling Alternative names: Indian Bread; Poria Source: Chinese Materia Medica Hyperlink: http://www.newcenturynutrition.com/ Gegen Alternative names: Kudzuvine Root; Radix Puerariae Source: Chinese Materia Medica Hyperlink: http://www.newcenturynutrition.com/ Huodan Wan Alternative names: Huodan Pills Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China Hyperlink: http://www.newcenturynutrition.com/cgilocal/patent_herbs_db/db.cgi?db=default&Chinese=Huodan%20Wa n&mh=10&sb=---&view_records=View+Records Huomaren Alternative names: Hemp Seed; Semen Cannabis Source: Chinese Materia Medica Hyperlink: http://www.newcenturynutrition.com/ Jiang Liujingao Alternative names: Ginger Liquid Extract; Jiang Liujingao
Extractum Zingiberis Liquidum Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China Hyperlink: http://www.newcenturynutrition.com/cgilocal/patent_herbs_db/db.cgi?db=default&Chinese=Jiang%20Liujing ao&mh=10&sb=---&view_records=View+Records
Researching Alternative Medicine 263
Jiangtang Wan Alternative names: Jiantang Pills Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China Hyperlink: http://www.newcenturynutrition.com/cgilocal/patent_herbs_db/db.cgi?db=default&Chinese=Jiangtang%20W an&mh=10&sb=---&view_records=View+Records Jingzhi Guanxin Pian Alternative names: Jingzhi Guanxin Tablets Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China Hyperlink: http://www.newcenturynutrition.com/cgilocal/patent_herbs_db/db.cgi?db=default&Chinese=Jingzhi%20Guan xin%20Pian&mh=10&sb=---&view_records=View+Records Jisheng Shenqi Wan Alternative names: Jisheng Shenqi Pills Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China Hyperlink: http://www.newcenturynutrition.com/cgilocal/patent_herbs_db/db.cgi?db=default&Chinese=Jisheng%20Shen qi%20Wan&mh=10&sb=---&view_records=View+Records Kongxian Wan Alternative names: Kongxian Pills Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China Hyperlink: http://www.newcenturynutrition.com/cgilocal/patent_herbs_db/db.cgi?db=default&Chinese=Kongxian%20W an&mh=10&sb=---&view_records=View+Records Kuxingren Alternative names: Bitter Apricot Seed; Semen Armeniacae Amarum Source: Chinese Materia Medica Hyperlink: http://www.newcenturynutrition.com/ Lugen Alternative names: Reed Rhizome; Rhizoma Phragmitis Source: Chinese Materia Medica Hyperlink: http://www.newcenturynutrition.com/
264 Flu Infection
Maidong Alternative names: Liriope Root Tuber; Shanmaidong; Radix Liriopes Source: Chinese Materia Medica Hyperlink: http://www.newcenturynutrition.com/ Nambaniangan Alternative names: Baphicacanthus Root; Rhizoma et Radix Baphicacanthis Cusae Source: Chinese Materia Medica Hyperlink: http://www.newcenturynutrition.com/ Niubangzi Alternative names: Great Burdock Achene; Fructus Arctii Source: Chinese Materia Medica Hyperlink: http://www.newcenturynutrition.com/ Qianjinzi Alternative names: Caper Euphorbia Seed; Semen Euphorbiae Source: Chinese Materia Medica Hyperlink: http://www.newcenturynutrition.com/ Qianniuzi Alternative names: Pharbitis Seed; Semen Pharbitidis Source: Chinese Materia Medica Hyperlink: http://www.newcenturynutrition.com/ Qingguo Alternative names: Chinese White Olive; Fructus Canarii Source: Chinese Materia Medica Hyperlink: http://www.newcenturynutrition.com/ Qingre Jiedu Koufuye Alternative names: Qingre Jiedu Oral Liquid Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China Hyperlink: http://www.newcenturynutrition.com/cgilocal/patent_herbs_db/db.cgi?db=default&Chinese=Qingre%20Jiedu %20Koufuye&mh=10&sb=---&view_records=View+Records
Researching Alternative Medicine 265
Renshen Alternative names: Ginseng Leaf; Renshenye (Ren Shen Ye); Folium Ginseng Source: Chinese Materia Medica Hyperlink: http://www.newcenturynutrition.com/ Renshenye Alternative names: Ginseng Leaf; Renshenye (Ren Shen Ye); Folium Ginseng Source: Chinese Materia Medica Hyperlink: http://www.newcenturynutrition.com/ Reyanning Keli Alternative names: Reyanning Granules; Reyanning Keli
(Rey Yan Ning Ke Li) Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China Hyperlink: http://www.newcenturynutrition.com/cgilocal/patent_herbs_db/db.cgi?db=default&Chinese=Reyanning%20K eli&mh=10&sb=---&view_records=View+Records Rukuaixiao Pian Alternative names: Rukuaixiao Tablets; Rukuaixiao Pian
(Ru Ku Ai Xiao Pian) Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China Hyperlink: http://www.newcenturynutrition.com/cgilocal/patent_herbs_db/db.cgi?db=default&Chinese=Rukuaixiao%20 Pian&mh=10&sb=---&view_records=View+Records Sangshen Alternative names: Mulberry Fruit; Fructus Mori Source: Chinese Materia Medica Hyperlink: http://www.newcenturynutrition.com/ Shanmaidong Alternative names: Liriope Root Tuber; Radix Liriopes Source: Chinese Materia Medica Hyperlink: http://www.newcenturynutrition.com/
266 Flu Infection
Shanyao Alternative names: Common Yam Rhizome; Rhizoma Dioscoreae Source: Chinese Materia Medica Hyperlink: http://www.newcenturynutrition.com/ Shengmai Yin Alternative names: Shengmai Yin Oral Liquid; Shengmai Yin
(Sheng Mai Yin) Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China Hyperlink: http://www.newcenturynutrition.com/cgilocal/patent_herbs_db/db.cgi?db=default&Chinese=Shengmai%20Yi n&mh=10&sb=---&view_records=View+Records Shi'erwei Yishou San Alternative names: Shi'erwei Yishou Powder; Shi'erwei Yishou San
(Shi’ Erwei Yi Shou San) Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China Hyperlink: http://www.newcenturynutrition.com/cgilocal/patent_herbs_db/db.cgi?db=default&Chinese=Shi%27erwei%2 0Yishou%20San&mh=10&sb=---&view_records=View+Records Shihu Alternative names: Dendrobium; Herba Dendrobii Source: Chinese Materia Medica Hyperlink: http://www.newcenturynutrition.com/ Sini Tang Alternative names: Sini Mixture; Sini Tang
(Si Ni Tang) Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China Hyperlink: http://www.newcenturynutrition.com/cgilocal/patent_herbs_db/db.cgi?db=default&Chinese=Sini%20Tang&m h=10&sb=---&view_records=View+Records Suanzaoren Alternative names: Spine Date Seed; Semen Ziziphi Spinosae Source: Chinese Materia Medica Hyperlink: http://www.newcenturynutrition.com/
Researching Alternative Medicine 267
Suhexiang Alternative names: Storax; Styrax Source: Chinese Materia Medica Hyperlink: http://www.newcenturynutrition.com/ Taizishen Alternative names: Heterophylly Falsestarwort Root; Radix Pseudostellariae Source: Chinese Materia Medica Hyperlink: http://www.newcenturynutrition.com/ Tiandong Alternative names: Cochinchinese Asparagus Root; Radix Asparagi Source: Chinese Materia Medica Hyperlink: http://www.newcenturynutrition.com/ Tianhuafen Alternative names: Snakegourd Root; Radix Trichosanthis Source: Chinese Materia Medica Hyperlink: http://www.newcenturynutrition.com/ Wumei Alternative names: Smoked Plum; Fructus Mume Source: Chinese Materia Medica Hyperlink: http://www.newcenturynutrition.com/ Wuweizi Alternative names: Chinese Magnoliavine Fruit; Fructus Schisandrae Source: Chinese Materia Medica Hyperlink: http://www.newcenturynutrition.com/ Xixin Alternative names: Manchurian Wildginger; Herba Asari Source: Chinese Materia Medica Hyperlink: http://www.newcenturynutrition.com/ Xuanshen Alternative names: Figwort Root; Radix Scrophulariae Source: Chinese Materia Medica Hyperlink: http://www.newcenturynutrition.com/
268 Flu Infection
Yimucao Gao Alternative names: Concentrated Decoction of Motherwort Herb; Yimucao Gao
Extractum Leonuri Inspissatum Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China Hyperlink: http://www.newcenturynutrition.com/cgilocal/patent_herbs_db/db.cgi?db=default&Chinese=Yimucao%20Ga o&mh=10&sb=---&view_records=View+Records Yuganzi Alternative names: Emblic Leafflower Fruit; Fructus Phylianthi Source: Chinese Materia Medica Hyperlink: http://www.newcenturynutrition.com/ Yuzhu Alternative names: Fragrant Solomonseal Rhizome; Rhizoma Polygonati Odorati Source: Chinese Materia Medica Hyperlink: http://www.newcenturynutrition.com/ Zexie Alternative names: Oriental Waterplantain Rhizome; Rhizoma Alismatis Source: Chinese Materia Medica Hyperlink: http://www.newcenturynutrition.com/ Zhimu Alternative names: Common Anemarrhena Rhizome; Rhizoma Anemarrhenae Source: Chinese Materia Medica Hyperlink: http://www.newcenturynutrition.com/ Zhiqiao Alternative names: Orange Fruit; Fructus Aurantii Source: Chinese Materia Medica Hyperlink: http://www.newcenturynutrition.com/ Zishiyin Alternative names: Fluorite; Fluoritum Source: Chinese Materia Medica Hyperlink: http://www.newcenturynutrition.com/
Researching Alternative Medicine 269
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: 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. The following additional references describe, in broad terms, alternative and complementary medicine (sorted alphabetically by title; hyperlinks provide rankings, information, and reviews at Amazon.com): · Antibiotic Crisis, Antibiotic Alternatives by Leon Chaitow; Hardcover – 240 pages (October 1998), Thorsons Publishing; ISBN: 0722537727; http://www.amazon.com/exec/obidos/ASIN/0722537727/icongroupinterna · Natural Alternatives to Antibiotics by John McKenna; Paperback – 176 pages (November 1998), Avery Penguin Putnam; ISBN: 0895298392; http://www.amazon.com/exec/obidos/ASIN/0895298392/icongroupinterna For additional information on complementary and alternative medicine, ask your doctor or write to: National Institutes of Health National Center for Complementary and Alternative Medicine Clearinghouse P. O. Box 8218 Silver Spring, MD 20907-8218
Vocabulary Builder The following vocabulary builder gives definitions of words used in this chapter that have not been defined in previous chapters: Acetylcysteine: The N-acetyl derivative of cysteine. It is used as a mucolytic agent to reduce the viscosity of mucous secretions. It has also been shown to have antiviral effects in patients with HIV due to inhibition of viral stimulation by reactive oxygen intermediates. [NIH] Acidity: L. aciditas) the quality of being acid or sour; containing acid (hydrogen ions). [EU] Acne: An inflammatory disease of the pilosebaceous unit, the specific type
270 Flu Infection
usually being indicated by a modifying term; frequently used alone to designate common acne, or acne vulgaris. [EU] Alanine: A non-essential amino acid that occurs in high levels in its free state in plasma. It is produced from pyruvate by transamination. It is involved in sugar and acid metabolism, increases immunity, and provides energy for muscle tissue, brain, and the central nervous system. [NIH] Amenorrhea: amenia. [EU]
Absence or abnormal stoppage of the menses; called also
Amoxicillin: A broad-spectrum semisynthetic antibiotic similar to ampicillin except that its resistance to gastric acid permits higher serum levels with oral administration. [NIH] Ampicillin: Semi-synthetic derivative of penicillin that functions as an orally active broad-spectrum antibiotic. [NIH] Anaphylaxis: An acute hypersensitivity reaction due to exposure to a previously encountered antigen. The reaction may include rapidly progressing urticaria, respiratory distress, vascular collapse, systemic shock, and death. [NIH] Androstenedione: A steroid with androgenic properties that is produced in the testis, ovary, and adrenal cortex. It is a precursor to testosterone and other androgenic hormones. [NIH] Anthocyanins: Glycosidic pigments in blue, red, and purple flowers and also found as metabolic byproducts in blood and urine. [NIH] Anticonvulsant: An agent that prevents or relieves convulsions. [EU] Arrhythmia: Any variation from the normal rhythm of the heart beat, including sinus arrhythmia, premature beat, heart block, atrial fibrillation, atrial flutter, pulsus alternans, and paroxysmal tachycardia. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Ascariasis: Infection by nematodes of the genus ascaris. Ingestion of infective eggs causes diarrhea and pneumonitis. Its distribution is more prevalent in areas of poor sanitation and where human feces are used for fertilizer. [NIH] Bursitis: Inflammation of a bursa, occasionally accompanied by a calcific deposit in the underlying supraspinatus tendon; the most common site is the subdeltoid bursa. [EU] Candidiasis: Infection with a fungus of the genus Candida. It is usually a superficial infection of the moist cutaneous areas of the body, and is generally caused by C. albicans; it most commonly involves the skin (dermatocandidiasis), oral mucous membranes (thrush, def. 1), respiratory tract (bronchocandidiasis), and vagina (vaginitis). Rarely there is a systemic
Researching Alternative Medicine 271
infection or endocarditis. Called also moniliasis, candidosis, oidiomycosis, and formerly blastodendriosis. [EU] Cannabis: The hemp plant Cannabis sativa. Products prepared from the dried flowering tops of the plant include marijuana, hashish, bhang, and ganja. [NIH] Cardiovascular: Pertaining to the heart and blood vessels. [EU] Cataract: An opacity, partial or complete, of one or both eyes, on or in the lens or capsule, especially an opacity impairing vision or causing blindness. The many kinds of cataract are classified by their morphology (size, shape, location) or etiology (cause and time of occurrence). [EU] Cellulitis: An acute, diffuse, and suppurative inflammation of loose connective tissue, particularly the deep subcutaneous tissues, and sometimes muscle, which is most commonly seen as a result of infection of a wound, ulcer, or other skin lesions. [NIH] Chlorpheniramine: A histamine H1 antagonist used in allergic reactions, hay fever, rhinitis, urticaria, and asthma. It has also been used in veterinary applications. One of the most widely used of the classical antihistaminics, it generally causes less drowsiness and sedation than promethazine. [NIH] Cholecalciferol: An antirachitic oil-soluble vitamin. [NIH] Cimetidine: A histamine congener, it competitively inhibits histamine binding to H2 receptors. Cimetidine has a range of pharmacological actions. It inhibits gastric acid secretion, as well as pepsin and gastrin output. It also blocks the activity of cytochrome P-450. [NIH] Ciprofloxacin: A carboxyfluoroquinoline antimicrobial agent that is effective against a wide range of microorganisms. It has been successfully and safely used in the treatment of resistant respiratory, skin, bone, joint, gastrointestinal, urinary, and genital infections. [NIH] Claudication: Limping or lameness. [EU] Clozapine: A tricylic dibenzodiazepine, classified as an atypical antipsychotic agent. It binds several types of central nervous system receptors, and displays a unique pharmacological profile. Clozapine is a serotonin antagonist, with strong binding to 5-HT 2A/2C receptor subtype. It also displays strong affinity to several dopaminergic receptors, but shows only weak antagonism at the dopamine D2 receptor, a receptor commonly thought to modulate neuroleptic activity. Agranulocytosis is a major adverse effect associated with administration of this agent. [NIH] Coenzyme: An organic nonprotein molecule, frequently a phosphorylated derivative of a water-soluble vitamin, that binds with the protein molecule (apoenzyme) to form the active enzyme (holoenzyme). [EU] Colostrum: The thin, yellow, serous fluid secreted by the mammary glands
272 Flu Infection
during pregnancy and immediately postpartum before lactation begins. It consists of immunologically active substances, white blood cells, water, protein, fat, and carbohydrates. [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] Curative: Tending to overcome disease and promote recovery. [EU] Digitalis: A genus of toxic herbaceous Eurasian plants of the Scrophulaceae which yield cardiotonic glycosides. The most useful are Digitalis lanata and D. purpurea. [NIH] Diltiazem: A benzothiazepine derivative with vasodilating action due to its antagonism of the actions of the calcium ion in membrane functions. It is also teratogenic. [NIH] Diphenhydramine: A histamine H1 antagonist used as an antiemetic, antitussive, for dermatoses and pruritus, for hypersensitivity reactions, as a hypnotic, an antiparkinson, and as an ingredient in common cold preparations. It has some undesired antimuscarinic and sedative effects. [NIH] Doxycycline: A synthetic tetracycline derivative with a range of antimicrobial activity and mode of action similar to that of tetracycline, but more effective against many species. Animal studies suggest that it may cause less tooth staining than other tetracyclines. [NIH] Dysentery: Any of various disorders marked by inflammation of the intestines, especially of the colon, and attended by pain in the abdomen, tenesmus, and frequent stools containing blood and mucus. Causes include chemical irritants, bacteria, protozoa, or parasitic worms. [EU] Dyskinesia: Impairment of the power of voluntary movement, resulting in fragmentary or incomplete movements. [EU] Dysmenorrhea: Painful menstruation. [NIH] Dysphagia: Difficulty in swallowing. [EU] Eczema: A pruritic papulovesicular dermatitis occurring as a reaction to many endogenous and exogenous agents, characterized in the acute stage by erythema, edema associated with a serous exudate between the cells of the epidermis (spongiosis) and an inflammatory infiltrate in the dermis, oozing and vesiculation, and crusting and scaling; and in the more chronic stages by lichenification or thickening or both, signs of excoriations, and hyperpigmentation or hypopigmentation or both. Atopic dermatitis is the most common type of dermatitis. Called also eczematous dermatitis. [EU] Emphysema: A pathological accumulation of air in tissues or organs; applied especially to such a condition of the lungs. [EU]
Researching Alternative Medicine 273
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] Endometriosis: A condition in which tissue more or less perfectly resembling the uterine mucous membrane (the endometrium) and containing typical endometrial granular and stromal elements occurs aberrantly in various locations in the pelvic cavity; called also adenomyosis externa and endometriosis externa. [EU] Equisetum: A genus of plants closely related to ferns. Some species have medicinal use and some are poisonous. [NIH] Erythrina: A genus of leguminous shrubs or trees, mainly tropical, yielding certain alkaloids, lectins, and other useful compounds. [NIH] Eucalyptus: A genus of Australian trees of the Myrtaceae family that yields gums, oils, and resins which are used as flavoring agents, astringents, and aromatics, and formerly to treat diarrhea, asthma, bronchitis, and respiratory tract infections. [NIH] Famotidine: A competitive histamine H2-receptor antagonist. Its main pharmacodynamic effect is the inhibition of gastric secretion. [NIH] Filariasis: Infections with nematodes of the superfamily filarioidea. The presence of living worms in the body is mainly asymptomatic but the death of adult worms leads to granulomatous inflammation and permanent fibrosis. Organisms of the genus Elaeophora infect wild elk and domestic sheep causing ischaemic necrosis of the brain, blindness, and dermatosis of the face. [NIH] Flurbiprofen: An anti-inflammatory analgesic and antipyretic of the phenylalkynoic acid series. It has been shown to reduce bone resorption in periodontal disease by inhibiting carbonic anhydrase. [NIH] Frostbite: Damage to tissues as the result of low environmental temperatures. [NIH] Gingivitis: Inflammation of the gingivae. Gingivitis associated with bony changes is referred to as periodontitis. Called also oulitis and ulitis. [EU] Ginseng: An araliaceous genus of plants that contains a number of pharmacologically active agents used as stimulants, sedatives, and tonics, especially in traditional medicine. [NIH] Glipizide: An oral hypoglycemic agent which is rapidly absorbed and completely metabolized. [NIH] Glutamine: A non-essential amino acid present abundantly throught the
274 Flu Infection
body and is involved in many metabolic processes. It is synthesized from glutamic acid and ammonia. It is the principal carrier of nitrogen in the body and is an important energy source for many cells. [NIH] Glycyrrhiza: A genus of leguminous herbs or shrubs whose roots yield glycyrrhetinic acid and its derivatives, carbenoxolone for example. Licorice toxicity is manifested as hypokalemia, low blood potassium. Licorice is used as flavoring and aromatic in pharmaceuticals and as candy. [NIH] Gout: Hereditary metabolic disorder characterized by recurrent acute arthritis, hyperuricemia and deposition of sodium urate in and around the joints, sometimes with formation of uric acid calculi. [NIH] Hyperplasia: The abnormal multiplication or increase in the number of normal cells in normal arrangement in a tissue. [EU] Hypothermia: A low body temperature, as that due to exposure in cold weather or a state of low temperature of the body induced as a means of decreasing metabolism of tissues and thereby the need for oxygen, as used in various surgical procedures, especially on the heart, or in an excised organ being preserved for transplantation. [EU] 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] Indapamide: A sulfamyl diuretic with about 16x the effect of furosemide. It has also been shown to be an effective antihypertensive agent in the clinic. [NIH]
Infertility: The diminished or absent ability to conceive or produce an offspring while sterility is the complete inability to conceive or produce an offspring. [NIH] Intermittent: Occurring at separated intervals; having periods of cessation of activity. [EU] Ipecac: A syrup made from the dried rhizomes of two different species, Cephaelis ipecacuanha and C. acuminata, belonging to the rubiaciae family. They contain emetine, cephaeline, psychotrine and other isoquinolines. Ipecac syrup is used widely as an emetic acting both locally on the gastric mucosa and centrally on the chemoreceptor trigger zone. [NIH] Isoflavones: 3-Phenylchromones. Isomeric form of flavones in which the benzene group is attached to the 3 position of the benzopyran ring instead of the 2 position. [NIH]
Researching Alternative Medicine 275
Isosorbide: 1,4:3,6-Dianhydro D-glucitol. Chemically inert osmotic diuretic used mainly to treat hydrocephalus; also used in glaucoma. [NIH] Juniper: A slow growing coniferous evergreen tree or shrub, genus Juniperus. The Juniper is cultivated for its berries, which take up to three years to ripen. The resinous, sweetly flavored berries are borne only by the female juniper, and can be found in various stages of ripeness on the same plant. [NIH] Kava: Dried rhizome and roots of Piper methysticum, a shrub native to Oceania and known for its anti-anxiety and sedative properties. Heavy usage results in some adverse effects. It contains alkaloids, lactones, kawain, methysticin, mucilage, starch, and yangonin. Kava is also the name of the pungent beverage prepared from the plant's roots. [NIH] Labetalol: Blocker of both alpha- and beta-adrenergic receptors that is used as an antihypertensive. [NIH] Larva: Wormlike or grublike stage, following the egg in the life cycle of insects, worms, and other metamorphosing animals. [NIH] Laryngitis: Inflammation of the larynx, a condition attended with dryness and soreness of the throat, hoarseness, cough and dysphagia. [EU] Menopause: Cessation of menstruation in the human female, occurring usually around the age of 50. [EU] Methotrexate: An antineoplastic antimetabolite with immunosuppressant properties. It is an inhibitor of dihydrofolate reductase and prevents the formation of tetrahydrofolate, necessary for synthesis of thymidylate, an essential component of DNA. [NIH] Midwifery: The practice of assisting women in childbirth. [NIH] Minocycline: A semisynthetic antibiotic effective against tetracyclineresistant staphylococcus infections. [NIH] Neuralgia: Paroxysmal pain which extends along the course of one or more nerves. Many varieties of neuralgia are distinguished according to the part affected or to the cause, as brachial, facial, occipital, supraorbital, etc., or anaemic, diabetic, gouty, malarial, syphilitic, etc. [EU] Nitrofurantoin: A urinary anti-infective agent effective against most grampositive and gram-negative organisms. Although sulfonamides and antibiotics are usually the agents of choice for urinary tract infections, nitrofurantoin is widely used for prophylaxis and long-term suppression. [NIH]
Nizatidine: A histamine H2 receptor antagonist with low toxicity that inhibits gastric acid secretion. The drug is used for the treatment of duodenal ulcers. [NIH] Ornithine: An amino acid produced in the urea cycle by the splitting off of
276 Flu Infection
urea from arginine. [NIH] Oxazepam: A benzodiazepine used in the treatment of anxiety, alcohol withdrawal, and insomnia. [NIH] Paclitaxel: Antineoplastic agent isolated from the bark of the Pacific yew tree, Taxus brevifolia. Paclitaxel stabilizes microtubules in their polymerized form and thus mimics the action of the proto-oncogene proteins C-MOS. [NIH] Pancreas: A mixed exocrine and endocrine gland situated transversely across the posterior abdominal wall in the epigastric and hypochondriac regions. The endocrine portion is comprised of the islets of langerhans, while the exocrine portion is a compound acinar gland that secretes digestive enzymes. [NIH] Pericarditis: Inflammation of the pericardium. [EU] Pharyngitis: Inflammation of the pharynx. [EU] Phenobarbital: A barbituric acid derivative that acts as a nonselective central nervous system depressant. It promotes binding to inhibitory gaba subtype receptors, and modulates chloride currents through receptor channels. It also inhibits glutamate induced depolarizations. [NIH] Phenylalanine: An aromatic amino acid that is essential in the animal diet. It is a precursor of melanin, dopamine, noradrenalin, and thyroxine. [NIH] Plantago: Three different species of Plantago or plantain, P. psyllium, P. ovata and P. indica. The seeds swell in water and are used as laxatives. [NIH] Preeclampsia: A toxaemia of late pregnancy characterized by hypertension, edema, and proteinuria, when convulsions and coma are associated, it is called eclampsia. [EU] Progesterone: Pregn-4-ene-3,20-dione. The principal progestational hormone of the body, secreted by the corpus luteum, adrenal cortex, and placenta. Its chief function is to prepare the uterus for the reception and development of the fertilized ovum. It acts as an antiovulatory agent when administered on days 5-25 of the menstrual cycle. [NIH] Prostate: A gland in males that surrounds the neck of the bladder and the urethra. It secretes a substance that liquifies coagulated semen. It is situated in the pelvic cavity behind the lower part of the pubic symphysis, above the deep layer of the triangular ligament, and rests upon the rectum. [NIH] Protozoa: A subkingdom consisting of unicellular organisms that are the simplest in the animal kingdom. Most are free living. They range in size from submicroscopic to macroscopic. Protozoa are divided into seven phyla: sarcomastigophora, Labyrinthomorpha, Apicomplexa, Microspora, Ascetospora, Myxozoa, And Ciliophora. [NIH] Psoriasis: A common genetically determined, chronic, inflammatory skin
Researching Alternative Medicine 277
disease characterized by rounded erythematous, dry, scaling patches. The lesions have a predilection for nails, scalp, genitalia, extensor surfaces, and the lumbosacral region. Accelerated epidermopoiesis is considered to be the fundamental pathologic feature in psoriasis. [NIH] Psychic: Pertaining to the psyche or to the mind; mental. [EU] Reflux: A backward or return flow. [EU] Retinopathy: 1. retinitis (= inflammation of the retina). 2. retinosis (= degenerative, noninflammatory condition of the retina). [EU] Schizophrenia: A severe emotional disorder of psychotic depth characteristically marked by a retreat from reality with delusion formation, hallucinations, emotional disharmony, and regressive behavior. [NIH] Sertraline: A selective serotonin uptake inhibitor that is used in the treatment of depression. [NIH] Sotalol: An adrenergic beta-antagonist that is used in the treatment of lifethreatening arrhythmias. [NIH] Spastic: 1. of the nature of or characterized by spasms. 2. hypertonic, so that the muscles are stiff and the movements awkward. 3. a person exhibiting spasticity, such as occurs in spastic paralysis or in cerebral palsy. [EU] Stenosis: Narrowing or stricture of a duct or canal. [EU] Syncope: A temporary suspension of consciousness due to generalized cerebral schemia, a faint or swoon. [EU] Tardive: Marked by lateness, late; said of a disease in which the characteristic lesion is late in appearing. [EU] Taurine: 2-Aminoethanesulfonic acid. A conditionally essential nutrient, important during mammalian development. It is present in milk but is isolated mostly from ox bile and strongly conjugates bile acids. [NIH] Triazolam: A short-acting benzodiazepine used in the treatment of insomnia. Some countries temporarily withdrew triazolam from the market because of concerns about adverse reactions, mostly psychological, associated with higher dose ranges. Its use at lower doses with appropriate care and labeling has been reaffirmed by the FDA and most other countries. [NIH]
Trichinosis: A disease due to infection with trichinella spiralis. It is caused by eating undercooked meat, usually pork. [NIH] Tyrosine: A non-essential amino acid. In animals it is synthesized from phenylalanine. It is also the precursor of epinephrine, thyroid hormones, and melanin. [NIH] Uricosuric: 1. pertaining to, characterized by, or promoting uricosuria (= the excretion of uric acid in the urine). 2. an agent that promotes uricosuria. [EU]
278 Flu Infection
Valerian: Valeriana officinale, an ancient, sedative herb of the large family Valerianaceae. The roots were formerly used to treat hysterias and other neurotic states and are presently used to treat sleep disorders. [NIH] Veins: The vessels carrying blood toward the heart. [NIH] Verapamil: A calcium channel blocker that is a class IV anti-arrhythmia agent. [NIH] Vertigo: An illusion of movement; a sensation as if the external world were revolving around the patient (objective vertigo) or as if he himself were revolving in space (subjective vertigo). The term is sometimes erroneously used to mean any form of dizziness. [EU] Warfarin: An anticoagulant that acts by inhibiting the synthesis of vitamin K-dependent coagulation factors. Warfarin is indicated for the prophylaxis and/or treatment of venous thrombosis and its extension, pulmonary embolism, and atrial fibrillation with embolization. It is also used as an adjunct in the prophylaxis of systemic embolism after myocardial infarction. Warfarin is also used as a rodenticide. [NIH] Warts: Benign epidermal proliferations or tumors; some are viral in origin. [NIH]
Withdrawal: 1. a pathological retreat from interpersonal contact and social involvement, as may occur in schizophrenia, depression, or schizoid avoidant and schizotypal personality disorders. 2. (DSM III-R) a substancespecific organic brain syndrome that follows the cessation of use or reduction in intake of a psychoactive substance that had been regularly used to induce a state of intoxication. [EU]
Researching Nutrition 279
APPENDIX C. RESEARCHING NUTRITION Overview Since the time of Hippocrates, doctors have understood the importance of diet and nutrition to patients’ health and well-being. Since then, they have accumulated an impressive archive of studies and knowledge dedicated to this subject. Based on their experience, doctors and healthcare providers may recommend particular dietary supplements to patients with flu infection. Any dietary recommendation is based on a patient’s age, body mass, gender, lifestyle, eating habits, food preferences, and health condition. It is therefore likely that different patients with flu infection may be given different recommendations. Some recommendations may be directly related to flu infection, while others may be more related to the patient’s general health. These recommendations, themselves, may differ from what official sources recommend for the average person. In this chapter we will begin by briefly reviewing the essentials of diet and nutrition that will broadly frame more detailed discussions of flu infection. We will then show you how to find studies dedicated specifically to nutrition and flu infection.
280 Flu Infection
Food and Nutrition: General Principles What Are Essential Foods? Food is generally viewed by official sources as consisting of six basic elements: (1) fluids, (2) carbohydrates, (3) protein, (4) fats, (5) vitamins, and (6) minerals. Consuming a combination of these elements is considered to be a healthy diet: ·
Fluids are essential to human life as 80-percent of the body is composed of water. Water is lost via urination, sweating, diarrhea, vomiting, diuretics (drugs that increase urination), caffeine, and physical exertion.
·
Carbohydrates are the main source for human energy (thermoregulation) and the bulk of typical diets. They are mostly classified as being either simple or complex. Simple carbohydrates include sugars which are often consumed in the form of cookies, candies, or cakes. Complex carbohydrates consist of starches and dietary fibers. Starches are consumed in the form of pastas, breads, potatoes, rice, and other foods. Soluble fibers can be eaten in the form of certain vegetables, fruits, oats, and legumes. Insoluble fibers include brown rice, whole grains, certain fruits, wheat bran and legumes.
·
Proteins are eaten to build and repair human tissues. Some foods that are high in protein are also high in fat and calories. Food sources for protein include nuts, meat, fish, cheese, and other dairy products.
·
Fats are consumed for both energy and the absorption of certain vitamins. There are many types of fats, with many general publications recommending the intake of unsaturated fats or those low in cholesterol.
Vitamins and minerals are fundamental to human health, growth, and, in some cases, disease prevention. Most are consumed in your diet (exceptions being vitamins K and D which are produced by intestinal bacteria and sunlight on the skin, respectively). Each vitamin and mineral plays a different role in health. The following outlines essential vitamins: ·
Vitamin A is important to the health of your eyes, hair, bones, and skin; sources of vitamin A include foods such as eggs, carrots, and cantaloupe.
·
Vitamin B1, also known as thiamine, is important for your nervous system and energy production; food sources for thiamine include meat, peas, fortified cereals, bread, and whole grains.
·
Vitamin B2, also known as riboflavin, is important for your nervous system and muscles, but is also involved in the release of proteins from
Researching Nutrition 281
nutrients; food sources for riboflavin include dairy products, leafy vegetables, meat, and eggs. ·
Vitamin B3, also known as niacin, is important for healthy skin and helps the body use energy; food sources for niacin include peas, peanuts, fish, and whole grains
·
Vitamin B6, also known as pyridoxine, is important for the regulation of cells in the nervous system and is vital for blood formation; food sources for pyridoxine include bananas, whole grains, meat, and fish.
·
Vitamin B12 is vital for a healthy nervous system and for the growth of red blood cells in bone marrow; food sources for vitamin B12 include yeast, milk, fish, eggs, and meat.
·
Vitamin C allows the body’s immune system to fight various diseases, strengthens body tissue, and improves the body’s use of iron; food sources for vitamin C include a wide variety of fruits and vegetables.
·
Vitamin D helps the body absorb calcium which strengthens bones and teeth; food sources for vitamin D include oily fish and dairy products.
·
Vitamin E can help protect certain organs and tissues from various degenerative diseases; food sources for vitamin E include margarine, vegetables, eggs, and fish.
·
Vitamin K is essential for bone formation and blood clotting; common food sources for vitamin K include leafy green vegetables.
·
Folic Acid maintains healthy cells and blood and, when taken by a pregnant woman, can prevent her fetus from developing neural tube defects; food sources for folic acid include nuts, fortified breads, leafy green vegetables, and whole grains.
It should be noted that one can overdose on certain vitamins which become toxic if consumed in excess (e.g. vitamin A, D, E and K). Like vitamins, minerals are chemicals that are required by the body to remain in good health. Because the human body does not manufacture these chemicals internally, we obtain them from food and other dietary sources. The more important minerals include: ·
Calcium is needed for healthy bones, teeth, and muscles, but also helps the nervous system function; food sources for calcium include dry beans, peas, eggs, and dairy products.
·
Chromium is helpful in regulating sugar levels in blood; food sources for chromium include egg yolks, raw sugar, cheese, nuts, beets, whole grains, and meat.
282 Flu Infection
·
Fluoride is used by the body to help prevent tooth decay and to reinforce bone strength; sources of fluoride include drinking water and certain brands of toothpaste.
·
Iodine helps regulate the body’s use of energy by synthesizing into the hormone thyroxine; food sources include leafy green vegetables, nuts, egg yolks, and red meat.
·
Iron helps maintain muscles and the formation of red blood cells and certain proteins; food sources for iron include meat, dairy products, eggs, and leafy green vegetables.
·
Magnesium is important for the production of DNA, as well as for healthy teeth, bones, muscles, and nerves; food sources for magnesium include dried fruit, dark green vegetables, nuts, and seafood.
·
Phosphorous is used by the body to work with calcium to form bones and teeth; food sources for phosphorous include eggs, meat, cereals, and dairy products.
·
Selenium primarily helps maintain normal heart and liver functions; food sources for selenium include wholegrain cereals, fish, meat, and dairy products.
·
Zinc helps wounds heal, the formation of sperm, and encourage rapid growth and energy; food sources include dried beans, shellfish, eggs, and nuts.
The United States government periodically publishes recommended diets and consumption levels of the various elements of food. Again, your doctor may encourage deviations from the average official recommendation based on your specific condition. To learn more about basic dietary guidelines, visit the Web site: http://www.health.gov/dietaryguidelines/. Based on these guidelines, many foods are required to list the nutrition levels on the food’s packaging. Labeling Requirements are listed at the following site maintained by the Food and Drug Administration: http://www.cfsan.fda.gov/~dms/labcons.html. When interpreting these requirements, the government recommends that consumers become familiar with the following abbreviations before reading FDA literature:48 ·
DVs (Daily Values): A new dietary reference term that will appear on the food label. It is made up of two sets of references, DRVs and RDIs.
·
DRVs (Daily Reference Values): A set of dietary references that applies to fat, saturated fat, cholesterol, carbohydrate, protein, fiber, sodium, and potassium.
48
Adapted from the FDA: http://www.fda.gov/fdac/special/foodlabel/dvs.html.
Researching Nutrition 283
·
RDIs (Reference Daily Intakes): A set of dietary references based on the Recommended Dietary Allowances for essential vitamins and minerals and, in selected groups, protein. The name “RDI” replaces the term “U.S. RDA.”
·
RDAs (Recommended Dietary Allowances): A set of estimated nutrient allowances established by the National Academy of Sciences. It is updated periodically to reflect current scientific knowledge. What Are Dietary Supplements?49
Dietary supplements are widely available through many commercial sources, including health food stores, grocery stores, pharmacies, and by mail. Dietary supplements are provided in many forms including tablets, capsules, powders, gel-tabs, extracts, and liquids. Historically in the United States, the most prevalent type of dietary supplement was a multivitamin/mineral tablet or capsule that was available in pharmacies, either by prescription or “over the counter.” Supplements containing strictly herbal preparations were less widely available. Currently in the United States, a wide array of supplement products are available, including vitamin, mineral, other nutrients, and botanical supplements as well as ingredients and extracts of animal and plant origin. The Office of Dietary Supplements (ODS) of the National Institutes of Health is the official agency of the United States which has the expressed goal of acquiring “new knowledge to help prevent, detect, diagnose, and treat disease and disability, from the rarest genetic disorder to the common cold.”50 According to the ODS, dietary supplements can have an important impact on the prevention and management of disease and on the maintenance of health.51 The ODS notes that considerable research on the effects of dietary supplements has been conducted in Asia and Europe where the use of plant products, in particular, has a long tradition. However, the This discussion has been adapted from the NIH: http://ods.od.nih.gov/whatare/whatare.html. 50 Contact: The Office of 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]. 51 Adapted from http://ods.od.nih.gov/about/about.html. The Dietary Supplement Health and Education Act defines dietary supplements as “a product (other than tobacco) intended to supplement the diet that bears or contains one or more of the following dietary ingredients: a vitamin, mineral, amino acid, herb or other botanical; or a dietary substance for use to supplement the diet by increasing the total dietary intake; or a concentrate, metabolite, constituent, extract, or combination of any ingredient described above; and intended for ingestion in the form of a capsule, powder, softgel, or gelcap, and not represented as a conventional food or as a sole item of a meal or the diet.” 49
284 Flu Infection
overwhelming majority of supplements have not been studied scientifically. To explore the role of dietary supplements in the improvement of health care, the ODS plans, organizes, and supports conferences, workshops, and symposia on scientific topics related to dietary supplements. The ODS often works in conjunction with other NIH Institutes and Centers, other government agencies, professional organizations, and public advocacy groups. To learn more about official information on dietary supplements, visit the ODS site at http://ods.od.nih.gov/whatare/whatare.html. Or contact: The Office of 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]
Finding Studies on Flu Infection The NIH maintains an office dedicated to patient nutrition and diet. 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). 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.52 IBIDS is available to the public free of charge through the ODS Internet page: 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. We recommend that you start with the Consumer Database. While you may not find references for the topics that are of most interest to you, check back periodically as this database is frequently updated. More studies can be 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.
52
Researching Nutrition 285
found by searching the Full IBIDS Database. Healthcare professionals and researchers generally use the third option, which lists peer-reviewed citations. In all cases, we suggest that you take advantage of the “Advanced Search” option that allows you to retrieve up to 100 fully explained references in a comprehensive format. Type “flu infection” (or synonyms) into the search box. To narrow the search, you can also select the “Title” field. The following is a typical result when searching for recently indexed consumer information on flu infection: ·
By the way, doctor. I am 68 years old and healthy. For the past two years, I've gotten a flu shot in October. Nonetheless, both winters I experienced what felt like Influenza. I was thrilled to read about a new flu treatment. If I get the flu again this year, should I try the drug? Source: Robb Nicholson, C Harv-Womens-Health-Watch. 2000 February; 7(6): 7 1070-910X
·
Do the new flu drugs measure up? Source: Barza, M Health-News. 1999 November 20; 5(14): 3 1081-5880
·
Flu treatment. A new member of the armamentarium. Source: Anonymous Harv-Health-Lett. 1999 November; 25(1): 3 10521577
·
Surviving colds and flu. Source: Springen, K. Vegetarian-times (USA). (December 1993). (no. 196) page 82-85. rhinitis ascorbic acid therapeutic diets human nutrition 01648497
The following information is typical of that found when using the “Full IBIDS Database” when searching using “flu infection” (or a synonym): ·
Differential effects of unilateral striatal and nigrostriatal lesions on grip strength, skilled paw reaching and drug-induced rotation in the rat. Author(s): Brain Repair Group, School of Biosciences, Cardiff University, Cardiff, UK. Source: Jeyasingham, R A Baird, A L Meldrum, A Dunnett, S B Brain-ResBull. 2001 July 1; 55(4): 541-8 0361-9230
·
Disarming flu viruses. Author(s): Australian National University, Canberra. Source: Laver, W G Bischofberger, N Webster, R G Sci-Am. 1999 January; 280(1): 78-87 0036-8733
·
Epidemiology and pathogenesis of influenza. Author(s): Enteric and Respiratory Virus Laboratory, London, UK.
[email protected]
286 Flu Infection
Source: Zambon, M C J-Antimicrob-Chemother. 1999 November; 44 Suppl B3-9 0305-7453 ·
Failure of dietary zinc supplementation to improve the antibody response to influenza vaccine. Source: Bracker, M.D. Hollingsworth, J.W. Saltman, P.D. Strause, L.G. Klauber, M.R. Lugo, N.J. Nutr-Res. Elmsford, N.Y. : Pergamon Press. January 1988. volume 8 (1) page 99-104. charts. 0271-5317
·
Muramyl peptides and polyinosinic-polycytodylic acid given to mice prior to influenza virus challenge reduces pulmonary disease and mortality. Author(s): Department of Microbiology and Immunology, Baylor College of Medicine, Houston, Texas 77030. Source: Wyde, P R Six, H R Ambrose, M W Throop, B J J-Biol-ResponseMod. 1990 February; 9(1): 98-102 0732-6580
·
Stachyflin and acetylstachyflin, novel anti-influenza A virus substances, produced by Stachybotrys sp. RF-7260. I. Isolation, structure elucidation and biological activities. Author(s): Shionogi Research Laboratories, Shionogi & Co, Ltd, Osaka, Japan.
[email protected] Source: Minagawa, Kazuyuki Kouzuki, Shuichi Yoshimoto, June Kawamura, Yoshimi Tani, Hiroyoshi Iwata, Tatsuo Terui, Yoshihiro Nakai, Hiroshi Yagi, Shigenori Hattori, Naohiko Fujiwara, Tamio Kamigauchi, Toshiyuki J-Antibiot-(Tokyo). 2002 February; 55(2): 155-64 0021-8820
·
The non-specific stimulation of avian peripheral blood lymphocytes from uninfected chickens by paramyxoviruses and influenza viruses. Author(s): Department of Microbiology and Parasitology, Royal Veterinary College, University of London, Gt. Britain. Source: Russell, P H Vet-Microbiol. 1988 February; 16(2): 181-8 0378-1135
·
Tryptophan-depletion challenge in depressed patients treated with desipramine or fluoxetine: implications for the role of serotonin in the mechanism of antidepressant action. Author(s): Department of Psychiatry, West Haven Department of Veterans Affairs Medical Center, Yale University School of Medicine, New Haven, CT, USA. Source: Delgado, P L Miller, H L Salomon, R M Licinio, J Krystal, J H Moreno, F A Heninger, G R Charney, D S Biol-Psychiatry. 1999 July 15; 46(2): 212-20 0006-3223
Researching Nutrition 287
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
·
The Food and Drug Administration’s Web site for federal food safety information: www.foodsafety.gov
·
The National Action Plan on Overweight and Obesity sponsored by the United States Surgeon General: http://www.surgeongeneral.gov/topics/obesity/
·
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/
·
Center for Nutrition Policy and Promotion sponsored by the United States Department of Agriculture: http://www.usda.gov/cnpp/
·
Food and Nutrition Information Center, National Agricultural Library sponsored by the United States Department of Agriculture: http://www.nal.usda.gov/fnic/
·
Food and Nutrition Service sponsored by the United States Department of Agriculture: http://www.fns.usda.gov/fns/
Additional Web Resources A number of additional Web sites offer encyclopedic information covering food and nutrition. The following is a representative sample: ·
AOL: http://search.aol.com/cat.adp?id=174&layer=&from=subcats
·
Family Village: http://www.familyvillage.wisc.edu/med_nutrition.html
·
Google: http://directory.google.com/Top/Health/Nutrition/
·
Healthnotes: http://www.thedacare.org/healthnotes/
·
Open Directory Project: http://dmoz.org/Health/Nutrition/
288 Flu Infection
·
Yahoo.com: http://dir.yahoo.com/Health/Nutrition/
·
WebMDÒHealth: http://my.webmd.com/nutrition
·
WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,,00.html
The following is a specific Web list relating to flu; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: ·
Vitamins Ascorbic Acid Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsSupplements/Vi taminCAscorbicAcidcs.html Folic Acid Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Supp_Drugix/Folic_Acid.ht m Niacin Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsSupplements/Vi taminB3Niacincs.html Niacin Alternative names: Vitamin B3 (Niacin) Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/InteractiveMedicine/ConsSupplements/In teractions/VitaminB3Niacincs.html
Researching Nutrition 289
Niacin Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525, 892,00.html Pyridoxine Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsSupplements/Vi taminB6Pyridoxinecs.html Pyridoxine Alternative names: Vitamin B6 (Pyridoxine) Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/InteractiveMedicine/ConsSupplements/In teractions/VitaminB6Pyridoxinecs.html Riboflavin Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsSupplements/Vi taminB2Riboflavincs.html Riboflavin (vitamin B Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525, 895,00.html Thiamin (vitamin B Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525, 10060,00.html
290 Flu Infection
Vitamin A Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Supp_Drugix/Vitamin_A.ht m Vitamin A Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Supp/Vitamin_A.htm Vitamin A Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525, 10066,00.html Vitamin B1 Source: Prima Communications, Inc. Hyperlink: http://www.personalhealthzone.com/pg000241.html Vitamin B2 (Riboflavin) Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsSupplements/Vi taminB2Riboflavincs.html Vitamin B3 Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Supp_Drugix/Vitamin_B3.h tm Vitamin B3 Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Supp/Vitamin_B3.htm Vitamin B3 Source: Prima Communications, Inc. Hyperlink: http://www.personalhealthzone.com/pg000188.html
Researching Nutrition 291
Vitamin B3 (Niacin) Alternative names: Niacin Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/InteractiveMedicine/ConsSupplements/In teractions/VitaminB3Niacincs.html Vitamin B3 (Niacin) Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsSupplements/Vi taminB3Niacincs.html Vitamin B6 Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Supp_Drugix/Vitamin_B6.h tm Vitamin B6 Source: Prima Communications, Inc. Hyperlink: http://www.personalhealthzone.com/pg000225.html Vitamin B6 (Pyridoxine) Alternative names: Pyridoxine Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/InteractiveMedicine/ConsSupplements/In teractions/VitaminB6Pyridoxinecs.html Vitamin B6 (Pyridoxine) Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsSupplements/Vi taminB6Pyridoxinecs.html
292 Flu Infection
Vitamin C Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Supp/Vitamin_C.htm Vitamin C Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Supp_Drugix/Vitamin_C.ht m Vitamin C Source: Prima Communications, Inc. Hyperlink: http://www.personalhealthzone.com/pg000098.html Vitamin C Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525, 904,00.html Vitamin C (Ascorbic Acid) Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsSupplements/Vi taminCAscorbicAcidcs.html Vitamin D Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Supp_Drugix/Vitamin_D.ht m Vitamin D Alternative names: Calciferol, Calcitrol, Cholecalciferol, Erocalciferol Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsSupplements/Vi taminDcs.html
Researching Nutrition 293
Vitamin E Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Supp/Vitamin_E.htm Vitamin E Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Supp_Drugix/Vitamin_E.ht m Vitamin E Source: Prima Communications, Inc. Hyperlink: http://www.personalhealthzone.com/pg000092.html Vitamin K Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525, 10068,00.html ·
Minerals Aluminum, Calcium, and Magnesium-Containing Preparations Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsDepletions/Ant acidsAluminumCalciumandMagnesiumContainingPreparationscl.ht ml Angiotensin-Converting Enzyme (ACE) Inhibitors Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsDepletions/Car diovascularMedicationsACEInhibitorscl.html Atorvastatin Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Drug/Atorvastatin.htm
294 Flu Infection
Betaine Hydrochloride Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Supp/Betaine_HCl.htm Betaine Hydrochloride Source: Prima Communications, Inc. Hyperlink: http://www.personalhealthzone.com/pg000106.html Biotin Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsSupplements/Vi taminHBiotincs.html Biotin Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525, 10008,00.html Boron Source: Prima Communications, Inc. Hyperlink: http://www.personalhealthzone.com/pg000114.html Calcium Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Supp/Calcium.htm Calcium Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Supp_Drugix/Calcium.htm Calcium Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsSupplements/C alciumcs.html
Researching Nutrition 295
Calcium Source: Prima Communications, Inc. Hyperlink: http://www.personalhealthzone.com/pg000113.html Calcium Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525, 884,00.html Carnitine (L-Carnitine) Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsSupplements/C arnitineLCarnitinecs.html Chondroitin Alternative names: chondroitin sulfate, sodium chondroitin sulfate Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsSupplements/C hondroitincs.html Chondroitin Source: Prima Communications, Inc. Hyperlink: http://www.personalhealthzone.com/pg000130.html Cisplatin Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Drug/Cisplatin.htm Clorazepate Dipotassium Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Drug/Clorazepate_Dipotass ium.htm
296 Flu Infection
Copper Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsSupplements/C oppercs.html Creatine Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsSupplements/Cr eatinecs.html Creatine Monohydrate Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Supp/Creatine_Monohydra te.htm Fluoxetine Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Drug/Fluoxetine.htm Fluvastatin Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Drug/Fluvastatin.htm Gabapentin Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Drug/Gabapentin.htm HMG-CoA Reductase Inhibitors (Statins) Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsDepletions/Cho lesterolLoweringMedicationsHMGCoAReductaseInhibitorscl.html
Researching Nutrition 297
Iron Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Supp/Iron.htm L-Carnitine Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsSupplements/C arnitineLCarnitinecs.html Magnesium Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Supp/Magnesium.htm Paroxetine Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Drug/Paroxetine.htm Phosphocreatine Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsSupplements/Cr eatinecs.html Potassium Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525, 10086,00.html Quercetin Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsSupplements/Q uercetincs.html
298 Flu Infection
Quercetin Source: Prima Communications, Inc. Hyperlink: http://www.personalhealthzone.com/pg000226.html Retinol Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsSupplements/Vi taminARetinolcs.html Selenium Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsSupplements/Se leniumcs.html Simvastatin Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Drug/Simvastatin.htm Sodium Fluoride Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Drug/Sodium_Fluoride.ht m Stinging Nettle Alternative names: Urtica dioica, Urtica urens, Nettle Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsHerbs/Stinging Nettlech.html Sulfur Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsSupplements/S ulfurcs.html
Researching Nutrition 299
Vanadium Alternative names: Vanadate, Vanadyl Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsSupplements/V anadiumcs.html Vinpocetine Source: Prima Communications, Inc. Hyperlink: http://www.personalhealthzone.com/pg000221.html Vitamin A (Retinol) Alternative names: Retinol Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/InteractiveMedicine/ConsSupplements/In teractions/VitaminARetinolcs.html Vitamin A (Retinol) Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsSupplements/Vi taminARetinolcs.html Vitamin H (Biotin) Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsSupplements/Vi taminHBiotincs.html Zinc Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Supp_Drugix/Zinc.htm
300 Flu Infection
Zinc Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsSupplements/Zi nccs.html ·
Food and Diet Aromatic Rice Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Food_Guide/Aromatic_Rice .htm Artichoke Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Food_Guide/Artichoke.htm Artichokes Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/foods_view/0,1523,28,00. html Asparagus Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Food_Guide/Asparagus.ht m Athletic Performance Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Athletic_Performa nce.htm Avocado Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Food_Guide/Avocado.htm
Researching Nutrition 301
Beets Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Food_Guide/Beets.htm Blood Type Diet Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Diet/Blood_Type_Diet.htm Broccoflower Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Food_Guide/Broccoflower. htm Broccoli Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Food_Guide/Broccoli.htm Brussels Sprouts Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Food_Guide/Brussels_Spro uts.htm Brussels sprouts Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/foods_view/0,1523,12,00. html Burdock Alternative names: Arctium lappa, Arctium minus, Arctium tomentosum Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsHerbs/Burdockc h.html
302 Flu Infection
Burdock Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/foods_view/0,1523,235,0 0.html Butter Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Food_Guide/Butter.htm Cabbage Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Food_Guide/Cabbage.htm Cauliflower Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Food_Guide/Cauliflower.ht m Chicken Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/foods_view/0,1523,86,00. html Chicory Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Food_Guide/Chicory.htm Chocolate Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Food_Guide/Chocolate.htm Chocolate Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/foods_view/0,1523,179,0 0.html
Researching Nutrition 303
Cinnamon Alternative names: Cinnamomum zeylanicum Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Herb/Cinnamon.htm Coffee Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Food_Guide/Coffee.htm Collards Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Food_Guide/Collards.htm Cream Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Food_Guide/Cream.htm Dandelion Greens Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Food_Guide/Dandelion_Gr eens.htm Diabetes Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/Diabetes.htm Fasting Diet Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Diet/Fasting_Diet.htm Ferrous Sulfate Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsSupplements/Ir oncs.html
304 Flu Infection
Fish, lean Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/foods_view/0,1523,93,00. html Flounder Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Food_Guide/Flounder.htm Garlic Alternative names: Allium sativum Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsHerbs/Garlicch. html Garlic Source: Prima Communications, Inc. Hyperlink: http://www.personalhealthzone.com/pg000164.html Garlic Source: The Canadian Internet Directory for Holistic Help, WellNet, Health and Wellness Network; www.wellnet.ca Hyperlink: http://www.wellnet.ca/herbsg-i.htm Garlic Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525, 786,00.html Half-and-Half Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Food_Guide/Half_And_Hal f.htm
Researching Nutrition 305
High Cholesterol Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Concern/High_Cholesterol. htm High-Fiber Diet Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Diet/High_Fiber_Diet.htm Jerusalem Artichoke Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Food_Guide/Jerusalem_Art ichoke.htm Jicama Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Food_Guide/Jicama.htm Johnny Jump-Ups Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Food_Guide/Johnny_Jump _Ups.htm Juices Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Food_Guide/Juices.htm Kale Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Food_Guide/Kale.htm Kohlrabi Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Food_Guide/Kohlrabi.htm
306 Flu Infection
Lavender Flowers Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Food_Guide/Lavender_Flo wers.htm Leeks Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Food_Guide/Leeks.htm Low-Oxalate Diet Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Diet/Low_Oxalate_Diet.ht m Low-Purine Diet Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Diet/Low_Purine_Diet.htm Low-Salt Diet Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Diet/Low_Salt_Diet.htm Mackerel Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/foods_view/0,1523,310,0 0.html Macrobiotic Diet Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Diet/Macrobiotic_Diet.htm Marigolds Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Food_Guide/Marigolds.ht m
Researching Nutrition 307
Milk Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/foods_view/0,1523,95,00. html Millet Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/foods_view/0,1523,72,00. html Mushrooms Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525, 10046,00.html Mustard Greens Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Food_Guide/Mustard_Gree ns.htm Natural Sweeteners Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Food_Guide/Natural_Swee teners.htm Okra Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Food_Guide/Okra.htm Omega-3 Fatty Acids Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsSupplements/O mega3FattyAcidscs.html
308 Flu Infection
Omega-6 Fatty Acids Source: Integrative Medicine Communications; www.onemedicine.com Hyperlink: http://www.drkoop.com/interactivemedicine/ConsSupplements/O mega6FattyAcidscs.html Onions Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Food_Guide/Onions.htm Oyster Mushrooms Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Food_Guide/Oyster_Mushr ooms.htm Oysters Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Food_Guide/Oysters.htm Pansies Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Food_Guide/Pansies.htm Parsnips Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Food_Guide/Parsnips.htm Plums Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/foods_view/0,1523,65,00. html
Researching Nutrition 309
Potatoes Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/foods_view/0,1523,270,0 0.html Quinoa Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/foods_view/0,1523,74,00. html Radishes Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Food_Guide/Radishes.htm Refined Sweeteners Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Food_Guide/Refined_Sweet eners.htm Rhubarb Source: The Canadian Internet Directory for Holistic Help, WellNet, Health and Wellness Network; www.wellnet.ca Hyperlink: http://www.wellnet.ca/herbsp-r.htm Rice Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Food_Guide/Rice.htm Rice, white Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/foods_view/0,1523,75,00. html
310 Flu Infection
Romaine Lettuce Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Food_Guide/Romaine_Lett uce.htm Rose Petals Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Food_Guide/Rose_Petals.ht m Rutabagas Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Food_Guide/Rutabagas.ht m Shiitake Mushrooms Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/foods_view/0,1523,308,0 0.html Snow Peas Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Food_Guide/Snow_Peas.ht m Soy Source: Prima Communications, Inc. Hyperlink: http://www.personalhealthzone.com/pg000185.html Sports Drinks Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Food_Guide/Sports_Drinks .htm
Researching Nutrition 311
Sugar Alcohols Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Food_Guide/Sugar_Alcohol s.htm Summer Squash Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Food_Guide/Summer_Squa sh.htm Sweet Peppers Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Food_Guide/Sweet_Pepper s.htm Sweet Potatoes Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Food_Guide/Sweet_Potatoe s.htm Sweeteners Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Food_Guide/Sweeteners.ht m Tea Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Food_Guide/Tea.htm Texmati Rice Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Food_Guide/Texmati_Rice. htm
312 Flu Infection
Tofu Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Food_Guide/Tofu.htm Tomatoes Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Food_Guide/Tomatoes.htm Turkey Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/foods_view/0,1523,92,00. html Turnips Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Food_Guide/Turnips.htm Violets Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Food_Guide/Violets.htm Water Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Food_Guide/Water.htm Wild rice Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/foods_view/0,1523,178,0 0.html Winter Squash Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Food_Guide/Winter_Squas h.htm
Researching Nutrition 313
Yams Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Food_Guide/Yams.htm Zucchini Source: Healthnotes, Inc.; www.healthnotes.com Hyperlink: http://www.thedacare.org/healthnotes/Food_Guide/Zucchini.htm
Vocabulary Builder The following vocabulary builder defines words used in the references in this chapter that have not been defined in previous chapters: Aromatic: Having a spicy odour. [EU] Boron: Boron. A trace element with the atomic symbol B, atomic number 5, and atomic weight 10.81. Boron-10, an isotope of boron, is used as a neutron absorber in boron neutron capture therapy. [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] Creatine: An amino acid that occurs in vertebrate tissues and in urine. In muscle tissue, creatine generally occurs as phosphocreatine. Creatine is excreted as creatinine in the urine. [NIH] Degenerative: Undergoing degeneration : tending to degenerate; having the character of or involving degeneration; causing or tending to cause degeneration. [EU] Desipramine: A tricyclic dibenzazepine compound that potentiates neurotransmission. Desipramine selectively blocks reuptake of norepinephrine from the neural synapse, and also appears to impair serotonin transport. This compound also possesses minor anticholingeric activity, through its affinity to muscarinic receptors. [NIH] Iodine: A nonmetallic element of the halogen group that is represented by the atomic symbol I, atomic number 53, and atomic weight of 126.90. It is a nutritionally essential element, especially important in thyroid hormone synthesis. In solution, it has anti-infective properties and is used topically. [NIH]
Lesion: Any pathological or traumatic discontinuity of tissue or loss of function of a part. [EU]
314 Flu Infection
Niacin: Water-soluble vitamin of the B complex occurring in various animal and plant tissues. Required by the body for the formation of coenzymes NAD and NADP. Has pellagra-curative, vasodilating, and antilipemic properties. [NIH] Overdose: 1. to administer an excessive dose. 2. an excessive dose. [EU] Paroxetine: A serotonin uptake inhibitor that is effective in the treatment of depression. [NIH] Quercetin: Aglucon of quercetrin, rutin, and other glycosides. It is widely distributed in the plant kingdom, especially in rinds and barks, clover blossoms, and ragweed pollen. [NIH] Riboflavin: Nutritional factor found in milk, eggs, malted barley, liver, kidney, heart, and leafy vegetables. The richest natural source is yeast. It occurs in the free form only in the retina of the eye, in whey, and in urine; its principal forms in tissues and cells are as FMN and FAD. [NIH] Stachybotrys: A mitosporic fungal genus including one species which forms a toxin in moldy hay that may cause a serious illness in horses. [NIH] Thyroxine: An amino acid of the thyroid gland which exerts a stimulating effect on thyroid metabolism. [NIH]
Finding Medical Libraries 315
APPENDIX D. FINDING MEDICAL LIBRARIES Overview At a medical library you can find medical texts and reference books, consumer health publications, specialty newspapers and magazines, as well as medical journals. In this Appendix, we show you how to quickly find a medical library in your area.
Preparation Before going to the library, highlight the references mentioned in this sourcebook that you find interesting. Focus on those items that are not available via the Internet, and ask the reference librarian for help with your search. He or she may know of additional resources that could be helpful to you. Most importantly, 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. NLM’s interlibrary loan services are only available to libraries. If you would like to access NLM medical literature, then visit a library in your area that can request the publications for you.53
53
Adapted from the NLM: http://www.nlm.nih.gov/psd/cas/interlibrary.html.
316 Flu Infection
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 Open to the Public In addition to the NN/LM, the National Library of Medicine (NLM) lists a number of libraries that are generally open to the public and have reference facilities. The following is the NLM’s list plus hyperlinks to each library Web site. These Web pages can provide information on hours of operation and other restrictions. The list below is a small sample of 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):54 ·
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), http://www.asmi.org/LIBRARY.HTM
·
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), http://www.humboldt1.com/~kkhic/index.html
·
California: Community Health Library of Los Gatos (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://www-med.stanford.edu/healthlibrary/
54
Abstracted from http://www.nlm.nih.gov/medlineplus/libraries.html.
Finding Medical Libraries 317
·
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: San José PlaneTree Health Library, http://planetreesanjose.org/
·
California: Sutter Resource Library (Sutter Hospitals Foundation), http://go.sutterhealth.org/comm/resc-library/sac-resources.html
·
California: University of California, Davis. Health Sciences Libraries
·
California: ValleyCare Health Library & Ryan Comer Cancer Resource Center (ValleyCare Health System), http://www.valleycare.com/library.html
·
California: Washington Community Health Resource Library (Washington Community Health Resource Library), http://www.healthlibrary.org/
·
Colorado: William V. Gervasini Memorial Library (Exempla Healthcare), http://www.exempla.org/conslib.htm
·
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/
·
Connecticut: Waterbury Hospital Health Center Library (Waterbury Hospital), http://www.waterburyhospital.com/library/consumer.shtml
·
Delaware: Consumer Health Library (Christiana Care Health System, Eugene du Pont Preventive Medicine & Rehabilitation Institute), http://www.christianacare.org/health_guide/health_guide_pmri_health _info.cfm
·
Delaware: Lewis B. Flinn Library (Delaware Academy of Medicine), http://www.delamed.org/chls.html
·
Georgia: Family Resource Library (Medical College of Georgia), http://cmc.mcg.edu/kids_families/fam_resources/fam_res_lib/frl.htm
·
Georgia: Health Resource Center (Medical Center of Central Georgia), http://www.mccg.org/hrc/hrchome.asp
·
Hawaii: Hawaii Medical Library: Consumer Health Information Service (Hawaii Medical Library), http://hml.org/CHIS/
318 Flu Infection
·
Idaho: DeArmond Consumer Health Library (Kootenai Medical Center), http://www.nicon.org/DeArmond/index.htm
·
Illinois: Health Learning Center of Northwestern Memorial Hospital (Northwestern Memorial Hospital, Health Learning Center), http://www.nmh.org/health_info/hlc.html
·
Illinois: Medical Library (OSF Saint Francis Medical Center), http://www.osfsaintfrancis.org/general/library/
·
Kentucky: Medical Library - Services for Patients, Families, Students & the Public (Central Baptist Hospital), http://www.centralbap.com/education/community/library.htm
·
Kentucky: University of Kentucky - Health Information Library (University of Kentucky, Chandler Medical Center, Health Information Library), http://www.mc.uky.edu/PatientEd/
·
Louisiana: Alton Ochsner Medical Foundation Library (Alton Ochsner Medical Foundation), http://www.ochsner.org/library/
·
Louisiana: Louisiana State University Health Sciences Center Medical Library-Shreveport, http://lib-sh.lsuhsc.edu/
·
Maine: Franklin Memorial Hospital Medical Library (Franklin Memorial Hospital), http://www.fchn.org/fmh/lib.htm
·
Maine: Gerrish-True Health Sciences Library (Central Maine Medical Center), http://www.cmmc.org/library/library.html
·
Maine: Hadley Parrot Health Science Library (Eastern Maine Healthcare), http://www.emh.org/hll/hpl/guide.htm
·
Maine: Maine Medical Center Library (Maine Medical Center), http://www.mmc.org/library/
·
Maine: Parkview Hospital, http://www.parkviewhospital.org/communit.htm#Library
·
Maine: Southern Maine Medical Center Health Sciences Library (Southern Maine Medical Center), http://www.smmc.org/services/service.php3?choice=10
·
Maine: Stephens Memorial Hospital Health Information Library (Western Maine Health), http://www.wmhcc.com/hil_frame.html
·
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), http://www.deerlodge.mb.ca/library/libraryservices.shtml
Finding Medical Libraries 319
·
Maryland: Health Information Center at the Wheaton Regional Library (Montgomery County, Md., 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://medlibwww.bu.edu/library/lib.html
·
Massachusetts: Lowell General Hospital Health Sciences Library (Lowell General Hospital), http://www.lowellgeneral.org/library/HomePageLinks/WWW.htm
·
Massachusetts: Paul E. Woodard Health Sciences Library (New England Baptist Hospital), http://www.nebh.org/health_lib.asp
·
Massachusetts: St. Luke’s Hospital Health Sciences Library (St. Luke’s Hospital), 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), 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), http://www.cancer.med.umich.edu/learn/leares.htm
·
Michigan: Sladen Library & Center for Health Information Resources Consumer Health Information, http://www.sladen.hfhs.org/library/consumer/index.html
·
Montana: Center for Health Information (St. Patrick Hospital and Health Sciences Center), http://www.saintpatrick.org/chi/librarydetail.php3?ID=41
320 Flu Infection
·
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/
·
Nevada: Health Science Library, West Charleston Library (Las Vegas Clark County Library District), http://www.lvccld.org/special_collections/medical/index.htm
·
New Hampshire: Dartmouth Biomedical Libraries (Dartmouth College Library), http://www.dartmouth.edu/~biomed/resources.htmld/conshealth.htmld/
·
New Jersey: Consumer Health Library (Rahway Hospital), http://www.rahwayhospital.com/library.htm
·
New Jersey: Dr. Walter Phillips Health Sciences Library (Englewood Hospital and Medical Center), http://www.englewoodhospital.com/links/index.htm
·
New Jersey: Meland Foundation (Englewood Hospital and Medical Center), 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), http://www.upstate.edu/library/hic/
·
New York: Health Sciences Library (Long Island Jewish Medical Center), 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: Saint Francis Health System Patient/Family Resource Center (Saint Francis Health System), http://www.sfhtulsa.com/patientfamilycenter/default.asp
Finding Medical Libraries 321
·
Oregon: Planetree Health Resource Center (Mid-Columbia Medical Center), http://www.mcmc.net/phrc/
·
Pennsylvania: Community Health Information Library (Milton S. Hershey Medical Center), http://www.hmc.psu.edu/commhealth/
·
Pennsylvania: Community Health Resource Library (Geisinger Medical Center), http://www.geisinger.edu/education/commlib.shtml
·
Pennsylvania: HealthInfo Library (Moses Taylor Hospital), http://www.mth.org/healthwellness.html
·
Pennsylvania: Hopwood Library (University of Pittsburgh, Health Sciences Library System), http://www.hsls.pitt.edu/chi/hhrcinfo.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), http://www.shscares.org/services/lrc/index.asp
·
Pennsylvania: Medical Library (UPMC Health System), http://www.upmc.edu/passavant/library.htm
·
Quebec, Canada: Medical Library (Montreal General Hospital), http://ww2.mcgill.ca/mghlib/
·
South Dakota: Rapid City Regional Hospital - Health Information Center (Rapid City Regional Hospital, Health Information Center), http://www.rcrh.org/education/LibraryResourcesConsumers.htm
·
Texas: Houston HealthWays (Houston Academy of Medicine-Texas Medical Center Library), http://hhw.library.tmc.edu/
·
Texas: Matustik Family Resource Center (Cook Children’s Health Care System), http://www.cookchildrens.com/Matustik_Library.html
·
Washington: Community Health Library (Kittitas Valley Community Hospital), http://www.kvch.com/
·
Washington: Southwest Washington Medical Center Library (Southwest Washington Medical Center), http://www.swmedctr.com/Home/
Your Rights and Insurance 323
APPENDIX E. YOUR RIGHTS AND INSURANCE Overview Any patient with flu infection faces a series of issues related more to the healthcare industry than to the medical condition itself. This appendix covers two important topics in this regard: your rights and responsibilities as a patient, and how to get the most out of your medical insurance plan.
Your Rights as a Patient The President’s Advisory Commission on Consumer Protection and Quality in the Healthcare Industry has created the following summary of your rights as a patient.55 Information Disclosure Consumers have the right to receive accurate, easily understood information. Some consumers require assistance in making informed decisions about health plans, health professionals, and healthcare facilities. Such information includes: ·
Health plans. Covered benefits, cost-sharing, and procedures for resolving complaints, licensure, certification, and accreditation status, comparable measures of quality and consumer satisfaction, provider network composition, the procedures that govern access to specialists and emergency services, and care management information.
55Adapted
from Consumer Bill of Rights and Responsibilities: http://www.hcqualitycommission.gov/press/cbor.html#head1.
324 Flu Infection
·
Health professionals. Education, board certification, and recertification, years of practice, experience performing certain procedures, and comparable measures of quality and consumer satisfaction.
·
Healthcare facilities. Experience in performing certain procedures and services, accreditation status, comparable measures of quality, worker, and consumer satisfaction, and procedures for resolving complaints.
·
Consumer assistance programs. Programs must be carefully structured to promote consumer confidence and to work cooperatively with health plans, providers, payers, and regulators. Desirable characteristics of such programs are sponsorship that ensures accountability to the interests of consumers and stable, adequate funding.
Choice of Providers and Plans Consumers have the right to a choice of healthcare providers that is sufficient to ensure access to appropriate high-quality healthcare. To ensure such choice, the Commission recommends the following: ·
Provider network adequacy. All health plan networks should provide access to sufficient numbers and types of providers to assure that all covered services will be accessible without unreasonable delay -including access to emergency services 24 hours a day and 7 days a week. If a health plan has an insufficient number or type of providers to provide a covered benefit with the appropriate degree of specialization, the plan should ensure that the consumer obtains the benefit outside the network at no greater cost than if the benefit were obtained from participating providers.
·
Women’s health services. Women should be able to choose a qualified provider offered by a plan -- such as gynecologists, certified nurse midwives, and other qualified healthcare providers -- for the provision of covered care necessary to provide routine and preventative women’s healthcare services.
·
Access to specialists. Consumers with complex or serious medical conditions who require frequent specialty care should have direct access to a qualified specialist of their choice within a plan’s network of providers. Authorizations, when required, should be for an adequate number of direct access visits under an approved treatment plan.
·
Transitional care. Consumers who are undergoing a course of treatment for a chronic or disabling condition (or who are in the second or third trimester of a pregnancy) at the time they involuntarily change health
Your Rights and Insurance 325
plans or at a time when a provider is terminated by a plan for other than cause should be able to continue seeing their current specialty providers for up to 90 days (or through completion of postpartum care) to allow for transition of care. ·
Choice of health plans. Public and private group purchasers should, wherever feasible, offer consumers a choice of high-quality health insurance plans.
Access to Emergency Services Consumers have the right to access emergency healthcare services when and where the need arises. Health plans should provide payment when a consumer presents to an emergency department with acute symptoms of sufficient severity--including severe pain--such that a “prudent layperson” could reasonably expect the absence of medical attention to result in placing that consumer’s health in serious jeopardy, serious impairment to bodily functions, or serious dysfunction of any bodily organ or part.
Participation in Treatment Decisions Consumers have the right and responsibility to fully participate in all decisions related to their healthcare. Consumers who are unable to fully participate in treatment decisions have the right to be represented by parents, guardians, family members, or other conservators. Physicians and other health professionals should: ·
Provide patients with sufficient information and opportunity to decide among treatment options consistent with the informed consent process.
·
Discuss all treatment options with a patient in a culturally competent manner, including the option of no treatment at all.
·
Ensure that persons with disabilities have effective communications with members of the health system in making such decisions.
·
Discuss all current treatments a consumer may be undergoing.
·
Discuss all risks, nontreatment.
·
Give patients the opportunity to refuse treatment and to express preferences about future treatment decisions.
benefits,
and
consequences
to
treatment
or
326 Flu Infection
·
Discuss the use of advance directives -- both living wills and durable powers of attorney for healthcare -- with patients and their designated family members.
·
Abide by the decisions made by their patients and/or their designated representatives consistent with the informed consent process.
Health plans, health providers, and healthcare facilities should: ·
Disclose to consumers factors -- such as methods of compensation, ownership of or interest in healthcare facilities, or matters of conscience -that could influence advice or treatment decisions.
·
Assure that provider contracts do not contain any so-called “gag clauses” or other contractual mechanisms that restrict healthcare providers’ ability to communicate with and advise patients about medically necessary treatment options.
·
Be prohibited from penalizing or seeking retribution against healthcare professionals or other health workers for advocating on behalf of their patients.
Respect and Nondiscrimination Consumers have the right to considerate, respectful care from all members of the healthcare industry at all times and under all circumstances. An environment of mutual respect is essential to maintain a quality healthcare system. To assure that right, the Commission recommends the following: ·
Consumers must not be discriminated against in the delivery of healthcare services consistent with the benefits covered in their policy, or as required by law, based on race, ethnicity, national origin, religion, sex, age, mental or physical disability, sexual orientation, genetic information, or source of payment.
·
Consumers eligible for coverage under the terms and conditions of a health plan or program, or as required by law, must not be discriminated against in marketing and enrollment practices based on race, ethnicity, national origin, religion, sex, age, mental or physical disability, sexual orientation, genetic information, or source of payment. Confidentiality of Health Information
Consumers have the right to communicate with healthcare providers in confidence and to have the confidentiality of their individually identifiable
Your Rights and Insurance 327
healthcare information protected. Consumers also have the right to review and copy their own medical records and request amendments to their records. Complaints and Appeals Consumers have the right to a fair and efficient process for resolving differences with their health plans, healthcare providers, and the institutions that serve them, including a rigorous system of internal review and an independent system of external review. A free copy of the Patient’s Bill of Rights is available from the American Hospital Association.56
Patient Responsibilities Treatment is a two-way street between you and your healthcare providers. To underscore the importance of finance in modern healthcare as well as your responsibility for the financial aspects of your care, the President’s Advisory Commission on Consumer Protection and Quality in the Healthcare Industry has proposed that patients understand the following “Consumer Responsibilities.”57 In a healthcare system that protects consumers’ rights, it is reasonable to expect and encourage consumers to assume certain responsibilities. Greater individual involvement by the consumer in his or her care increases the likelihood of achieving the best outcome and helps support a quality-oriented, cost-conscious environment. Such responsibilities include: ·
Take responsibility for maximizing healthy habits such as exercising, not smoking, and eating a healthy diet.
·
Work collaboratively with healthcare providers in developing and carrying out agreed-upon treatment plans.
·
Disclose relevant information and clearly communicate wants and needs.
·
Use your health insurance plan’s internal complaint and appeal processes to address your concerns.
·
Avoid knowingly spreading disease.
To order your free copy of the Patient’s Bill of Rights, telephone 312-422-3000 or visit the American Hospital Association’s Web site: http://www.aha.org. Click on “Resource Center,” go to “Search” at bottom of page, and then type in “Patient’s Bill of Rights.” The Patient’s Bill of Rights is also available from Fax on Demand, at 312-422-2020, document number 471124. 57 Adapted from http://www.hcqualitycommission.gov/press/cbor.html#head1. 56
328 Flu Infection
·
Recognize the reality of risks, the limits of the medical science, and the human fallibility of the healthcare professional.
·
Be aware of a healthcare provider’s obligation to be reasonably efficient and equitable in providing care to other patients and the community.
·
Become knowledgeable about your health plan’s coverage and options (when available) including all covered benefits, limitations, and exclusions, rules regarding use of network providers, coverage and referral rules, appropriate processes to secure additional information, and the process to appeal coverage decisions.
·
Show respect for other patients and health workers.
·
Make a good-faith effort to meet financial obligations.
·
Abide by administrative and operational procedures of health plans, healthcare providers, and Government health benefit programs.
Choosing an Insurance Plan There are a number of official government agencies that help consumers understand their healthcare insurance choices.58 The U.S. Department of Labor, in particular, recommends ten ways to make your health benefits choices work best for you.59 1. Your options are important. There are many different types of health benefit plans. Find out which one your employer offers, then check out the plan, or plans, offered. Your employer’s human resource office, the health plan administrator, or your union can provide information to help you match your needs and preferences with the available plans. The more information you have, the better your healthcare decisions will be. 2. Reviewing the benefits available. Do the plans offered cover preventive care, well-baby care, vision or dental care? Are there deductibles? Answers to these questions can help determine the out-of-pocket expenses you may face. Matching your needs and those of your family members will result in the best possible benefits. Cheapest may not always be best. Your goal is high quality health benefits.
More information about quality across programs is provided at the following AHRQ Web site: http://www.ahrq.gov/consumer/qntascii/qnthplan.htm. 59 Adapted from the Department of Labor: http://www.dol.gov/dol/pwba/public/pubs/health/top10-text.html. 58
Your Rights and Insurance 329
3. Look for quality. The quality of healthcare services varies, but quality can be measured. You should consider the quality of healthcare in deciding among the healthcare plans or options available to you. Not all health plans, doctors, hospitals and other providers give the highest quality care. Fortunately, there is quality information you can use right now to help you compare your healthcare choices. Find out how you can measure quality. Consult the U.S. Department of Health and Human Services publication “Your Guide to Choosing Quality Health Care” on the Internet at www.ahcpr.gov/consumer. 4. Your plan’s summary plan description (SPD) provides a wealth of information. Your health plan administrator can provide you with a copy of your plan’s SPD. It outlines your benefits and your legal rights under the Employee Retirement Income Security Act (ERISA), the federal law that protects your health benefits. It should contain information about the coverage of dependents, what services will require a co-pay, and the circumstances under which your employer can change or terminate a health benefits plan. Save the SPD and all other health plan brochures and documents, along with memos or correspondence from your employer relating to health benefits. 5. Assess your benefit coverage as your family status changes. Marriage, divorce, childbirth or adoption, and the death of a spouse are all life events that may signal a need to change your health benefits. You, your spouse and dependent children may be eligible for a special enrollment period under provisions of the Health Insurance Portability and Accountability Act (HIPAA). Even without life-changing events, the information provided by your employer should tell you how you can change benefits or switch plans, if more than one plan is offered. If your spouse’s employer also offers a health benefits package, consider coordinating both plans for maximum coverage. 6. Changing jobs and other life events can affect your health benefits. Under the Consolidated Omnibus Budget Reconciliation Act (COBRA), you, your covered spouse, and your dependent children may be eligible to purchase extended health coverage under your employer’s plan if you lose your job, change employers, get divorced, or upon occurrence of certain other events. Coverage can range from 18 to 36 months depending on your situation. COBRA applies to most employers with 20 or more workers and requires your plan to notify you of your rights. Most plans require eligible individuals to make their COBRA election within 60 days of the plan’s notice. Be sure to follow up with your plan sponsor if you don’t receive notice, and make sure you respond within the allotted time.
330 Flu Infection
7. HIPAA can also help if you are changing jobs, particularly if you have a medical condition. HIPAA generally limits pre-existing condition exclusions to a maximum of 12 months (18 months for late enrollees). HIPAA also requires this maximum period to be reduced by the length of time you had prior “creditable coverage.” You should receive a certificate documenting your prior creditable coverage from your old plan when coverage ends. 8. Plan for retirement. Before you retire, find out what health benefits, if any, extend to you and your spouse during your retirement years. Consult with your employer’s human resources office, your union, the plan administrator, and check your SPD. Make sure there is no conflicting information among these sources about the benefits you will receive or the circumstances under which they can change or be eliminated. With this information in hand, you can make other important choices, like finding out if you are eligible for Medicare and Medigap insurance coverage. 9. Know how to file an appeal if your health benefits claim is denied. Understand how your plan handles grievances and where to make appeals of the plan’s decisions. Keep records and copies of correspondence. Check your health benefits package and your SPD to determine who is responsible for handling problems with benefit claims. Contact PWBA for customer service assistance if you are unable to obtain a response to your complaint. 10. You can take steps to improve the quality of the healthcare and the health benefits you receive. Look for and use things like Quality Reports and Accreditation Reports whenever you can. Quality reports may contain consumer ratings -- how satisfied consumers are with the doctors in their plan, for instance-- and clinical performance measures -- how well a healthcare organization prevents and treats illness. Accreditation reports provide information on how accredited organizations meet national standards, and often include clinical performance measures. Look for these quality measures whenever possible. Consult “Your Guide to Choosing Quality Health Care” on the Internet at www.ahcpr.gov/consumer.
Medicare and Medicaid Illness strikes both rich and poor families. For low-income families, Medicaid is available to defer the costs of treatment. The Health Care Financing Administration (HCFA) administers Medicare, the nation’s largest health insurance program, which covers 39 million Americans. In the following pages, you will learn the basics about Medicare insurance as well as useful
Your Rights and Insurance 331
contact information on how to find more in-depth information about Medicaid.60
Who is Eligible for Medicare? Generally, you are eligible for Medicare if you or your spouse worked for at least 10 years in Medicare-covered employment and you are 65 years old and a citizen or permanent resident of the United States. You might also qualify for coverage if you are under age 65 but have a disability or EndStage Renal disease (permanent kidney failure requiring dialysis or transplant). Here are some simple guidelines: You can get Part A at age 65 without having to pay premiums if: ·
You are already receiving retirement benefits from Social Security or the Railroad Retirement Board.
·
You are eligible to receive Social Security or Railroad benefits but have not yet filed for them.
·
You or your spouse had Medicare-covered government employment.
If you are under 65, you can get Part A without having to pay premiums if: ·
You have received Social Security or Railroad Retirement Board disability benefit for 24 months.
·
You are a kidney dialysis or kidney transplant patient.
Medicare has two parts: ·
Part A (Hospital Insurance). Most people do not have to pay for Part A.
·
Part B (Medical Insurance). Most people pay monthly for Part B. Part A (Hospital Insurance)
Helps Pay For: Inpatient hospital care, care in critical access hospitals (small facilities that give limited outpatient and inpatient services to people in rural areas) and skilled nursing facilities, hospice care, and some home healthcare.
This section has been adapted from the Official U.S. Site for Medicare Information: http://www.medicare.gov/Basics/Overview.asp.
60
332 Flu Infection
Cost: Most people get Part A automatically when they turn age 65. You do not have to pay a monthly payment called a premium for Part A because you or a spouse paid Medicare taxes while you were working. If you (or your spouse) did not pay Medicare taxes while you were working and you are age 65 or older, you still may be able to buy Part A. If you are not sure you have Part A, look on your red, white, and blue Medicare card. It will show “Hospital Part A” on the lower left corner of the card. You can also call the Social Security Administration toll free at 1-800-772-1213 or call your local Social Security office for more information about buying Part A. If you get benefits from the Railroad Retirement Board, call your local RRB office or 1-800-808-0772. For more information, call your Fiscal Intermediary about Part A bills and services. The phone number for the Fiscal Intermediary office in your area can be obtained from the following Web site: http://www.medicare.gov/Contacts/home.asp. Part B (Medical Insurance) Helps Pay For: Doctors, services, outpatient hospital care, and some other medical services that Part A does not cover, such as the services of physical and occupational therapists, and some home healthcare. Part B helps pay for covered services and supplies when they are medically necessary. Cost: As of 2001, you pay the Medicare Part B premium of $50.00 per month. In some cases this amount may be higher if you did not choose Part B when you first became eligible at age 65. The cost of Part B may go up 10% for each 12-month period that you were eligible for Part B but declined coverage, except in special cases. You will have to pay the extra 10% cost for the rest of your life. Enrolling in Part B is your choice. You can sign up for Part B anytime during a 7-month period that begins 3 months before you turn 65. Visit your local Social Security office, or call the Social Security Administration at 1-800-7721213 to sign up. If you choose to enroll in Part B, the premium is usually taken out of your monthly Social Security, Railroad Retirement, or Civil Service Retirement payment. If you do not receive any of the above payments, Medicare sends you a bill for your part B premium every 3 months. You should receive your Medicare premium bill in the mail by the 10th of the month. If you do not, call the Social Security Administration at 1800-772-1213, or your local Social Security office. If you get benefits from the Railroad Retirement Board, call your local RRB office or 1-800-808-0772. For more information, call your Medicare carrier about bills and services. The
Your Rights and Insurance 333
phone number for the Medicare carrier in your area can be found at the following Web site: http://www.medicare.gov/Contacts/home.asp. You may have choices in how you get your healthcare including the Original Medicare Plan, Medicare Managed Care Plans (like HMOs), and Medicare Private Fee-for-Service Plans.
Medicaid Medicaid is a joint federal and state program that helps pay medical costs for some people with low incomes and limited resources. Medicaid programs vary from state to state. People on Medicaid may also get coverage for nursing home care and outpatient prescription drugs which are not covered by Medicare. You can find more information about Medicaid on the HCFA.gov Web site at http://www.hcfa.gov/medicaid/medicaid.htm. States also have programs that pay some or all of Medicare’s premiums and may also pay Medicare deductibles and coinsurance for certain people who have Medicare and a low income. To qualify, you must have: ·
Part A (Hospital Insurance),
·
Assets, such as bank accounts, stocks, and bonds that are not more than $4,000 for a single person, or $6,000 for a couple, and
·
A monthly income that is below certain limits.
For more information on these programs, look at the Medicare Savings Programs brochure, http://www.medicare.gov/Library/PDFNavigation/PDFInterim.asp?Langua ge=English&Type=Pub&PubID=10126. There are also Prescription Drug Assistance Programs available. Find information on these programs which offer discounts or free medications to individuals in need at http://www.medicare.gov/Prescription/Home.asp.
NORD’s Medication Assistance Programs Finally, the National Organization for Rare Disorders, Inc. (NORD) administers medication programs sponsored by humanitarian-minded pharmaceutical and biotechnology companies to help uninsured or underinsured individuals secure life-saving or life-sustaining drugs.61 NORD Adapted from NORD: http://www.rarediseases.org/cgibin/nord/progserv#patient?id=rPIzL9oD&mv_pc=30.
61
334 Flu Infection
programs ensure that certain vital drugs are available “to those individuals whose income is too high to qualify for Medicaid but too low to pay for their prescribed medications.” The program has standards for fairness, equity, and unbiased eligibility. It currently covers some 14 programs for nine pharmaceutical companies. NORD also offers early access programs for investigational new drugs (IND) under the approved “Treatment INDs” programs of the Food and Drug Administration (FDA). In these programs, a limited number of individuals can receive investigational drugs that have yet to be approved by the FDA. These programs are generally designed for rare diseases or disorders. For more information, visit www.rarediseases.org.
Additional Resources In addition to the references already listed in this chapter, you may need more information on health insurance, hospitals, or the healthcare system in general. The NIH has set up an excellent guidance Web site that addresses these and other issues. Topics include:62 ·
Health Insurance: http://www.nlm.nih.gov/medlineplus/healthinsurance.html
·
Health Statistics: http://www.nlm.nih.gov/medlineplus/healthstatistics.html
·
HMO and Managed Care: http://www.nlm.nih.gov/medlineplus/managedcare.html
·
Hospice Care: http://www.nlm.nih.gov/medlineplus/hospicecare.html
·
Medicaid: http://www.nlm.nih.gov/medlineplus/medicaid.html
·
Medicare: http://www.nlm.nih.gov/medlineplus/medicare.html
·
Nursing Homes and Long-term Care: http://www.nlm.nih.gov/medlineplus/nursinghomes.html
·
Patient’s Rights, Confidentiality, Informed Consent, Ombudsman Programs, Privacy and Patient Issues: http://www.nlm.nih.gov/medlineplus/patientissues.html
·
Veteran’s Health, Persian Gulf War, Gulf War Syndrome, Agent Orange: http://www.nlm.nih.gov/medlineplus/veteranshealth.html
You can access this information at: http://www.nlm.nih.gov/medlineplus/healthsystem.html.
62
Your Rights and Insurance 335
Vocabulary Builder Cobalt: A trace element that is a component of vitamin B12. It has the atomic symbol Co, atomic number 27, and atomic weight 58.93. It is used in nuclear weapons, alloys, and pigments. Deficiency in animals leads to anemia; its excess in humans can lead to erythrocytosis. [NIH] Emesis: Vomiting; an act of vomiting. Also used as a word termination, as in haematemesis. [EU] Fluorescein Angiography: Visualization of a vascular system after intravenous injection of a fluorescein solution. The images may be photographed or televised. It is used especially in studying the retinal and uveal vasculature. [NIH] Hydrochloric Acid: A strong corrosive acid that is commonly used as a laboratory reagent. It is formed by dissolving hydrogen chloride in water. gastric acid is the hydrochloric acid component of gastric juice. [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]
Online Glossaries 337
ONLINE GLOSSARIES The Internet provides access to a number of free-to-use medical dictionaries and glossaries. The National Library of Medicine has compiled the following list of online dictionaries: ·
ADAM Medical Encyclopedia (A.D.A.M., Inc.), comprehensive medical reference: http://www.nlm.nih.gov/medlineplus/encyclopedia.html
·
MedicineNet.com Medical Dictionary (MedicineNet, Inc.): http://www.medterms.com/Script/Main/hp.asp
·
Merriam-Webster Medical Dictionary (Inteli-Health, Inc.): http://www.intelihealth.com/IH/
·
Multilingual Glossary of Technical and Popular Medical Terms in Eight European Languages (European Commission) - Danish, Dutch, English, French, German, Italian, Portuguese, and Spanish: http://allserv.rug.ac.be/~rvdstich/eugloss/welcome.html
·
On-line Medical Dictionary (CancerWEB): http://www.graylab.ac.uk/omd/
·
Technology Glossary (National Library of Medicine) - Health Care Technology: http://www.nlm.nih.gov/nichsr/ta101/ta10108.htm
·
Terms and Definitions (Office of Rare Diseases): http://rarediseases.info.nih.gov/ord/glossary_a-e.html
Beyond these, MEDLINEplus contains a very user-friendly encyclopedia covering every aspect of medicine (licensed from A.D.A.M., Inc.). The ADAM Medical Encyclopedia Web site address is 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). Topics of interest can be researched by using keywords before continuing elsewhere, as these basic definitions and concepts will be useful in more advanced areas of research. You may choose to print various pages specifically relating to flu infection and keep them on file. The NIH, in particular, suggests that patients with flu infection visit the following Web sites in the ADAM Medical Encyclopedia:
338 Flu Infection
·
Basic Guidelines for Flu Flu and holidays Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002091.htm Fluid imbalance Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001187.htm Fluorescein angiography Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003846.htm Fluorescein eye stain Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003845.htm Fluorescent lamps Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002787.htm Fluoride in diet Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002420.htm Fluoride overdose Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002650.htm Flurbiprofen overdose Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002651.htm Fluxes Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002830.htm
·
Signs & Symptoms for Flu Afeeling one cannot get enough air Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003075.htm
Online Glossaries 339
Abdominal pain Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003120.htm Abnormal taste Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003050.htm Agitation Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003212.htm Blue lips and fingernails Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003215.htm Blurred vision Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003029.htm Chest pain Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003079.htm Coma Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003202.htm Confusion Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003205.htm Convulsions Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003200.htm Cough Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003072.htm Coughing
340 Flu Infection
Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003072.htm Coughing up blood Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003073.htm Decreased urine output Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003147.htm Diarrhea Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003126.htm Difficulty breathing Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003075.htm Dizziness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003093.htm Drowsiness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003208.htm Edema Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003103.htm Emesis Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003117.htm Excessive salivation Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003048.htm Fever Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003090.htm
Online Glossaries 341
Headache Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003024.htm Increased salivation Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003048.htm Itching Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003217.htm Itchy Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003217.htm Low blood pressure Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003083.htm Metallic taste Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003050.htm Nausea Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003117.htm Nausea and vomiting Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003117.htm Nausea and/or vomiting Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003117.htm No urine output Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003147.htm
342 Flu Infection
Pain in the throat Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003053.htm Rapid pulse Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003077.htm Rash Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003220.htm Ringing in the ears Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003043.htm Runny nose Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003051.htm Shortness of breath Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003075.htm Sneezing Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003060.htm Stomach pain Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003120.htm Stress Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003211.htm Swelling Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003103.htm
Online Glossaries 343
Thirst Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003085.htm Tight chest Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003079.htm Unsteadiness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003199.htm Vomiting Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003117.htm Vomiting blood Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003118.htm Weakness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003174.htm Weight loss Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003107.htm ·
Diagnostics and Tests for Flu Blood pressure Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003398.htm Gastric lavage Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003882.htm Heart rate Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003399.htm
344 Flu Infection
·
Background Topics for Flu Adolescent test or procedure preparation Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002054.htm Bleeding Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000045.htm Choking Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000047.htm Chronic Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002312.htm Cobalt Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002495.htm Epithelium Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002363.htm Eye - foreign object in Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002084.htm Hydrochloric acid Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002498.htm Incidence Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002387.htm Infant test or procedure preparation Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002055.htm
Online Glossaries 345
Mercury Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002476.htm Preschooler test or procedure preparation Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002057.htm Respiratory Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002290.htm Retina Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002291.htm Schoolage test or procedure preparation Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002058.htm Shock Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000039.htm Toddler test or procedure preparation Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002056.htm Unconscious Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000022.htm
Online Dictionary Directories The following are additional online directories compiled by the National Library of Medicine, including a number of specialized medical dictionaries and glossaries: ·
Medical Dictionaries: Medical & Biological (World Health Organization): http://www.who.int/hlt/virtuallibrary/English/diction.htm#Medical
346 Flu Infection
·
MEL-Michigan Electronic Library List of Online Health and Medical Dictionaries (Michigan Electronic Library): http://mel.lib.mi.us/health/health-dictionaries.html
·
Patient Education: Glossaries (DMOZ Open Directory Project): http://dmoz.org/Health/Education/Patient_Education/Glossaries/
·
Web of Online Dictionaries (Bucknell University): http://www.yourdictionary.com/diction5.html#medicine
Glossary 347
FLU INFECTION GLOSSARY The following is a complete glossary of terms used in this sourcebook. The definitions are derived from official public sources including the National Institutes of Health [NIH] and the European Union [EU]. After this glossary, we list a number of additional hardbound and electronic glossaries and dictionaries that you may wish to consult. Abdominal: Pertaining to the abdomen. [EU] Abortion: 1. the premature expulsion from the uterus of the products of conception - of the embryo, or of a nonviable fetus. The four classic symptoms, usually present in each type of abortion, are uterine contractions, uterine haemorrhage, softening and dilatation of the cervix, and presentation or expulsion of all or part of the products of conception. 2. premature stoppage of a natural or a pathological process. [EU] Acetaminophen: Analgesic antipyretic derivative of acetanilide. It has weak anti-inflammatory properties and is used as a common analgesic, but may cause liver, blood cell, and kidney damage. [NIH] Acetylcysteine: The N-acetyl derivative of cysteine. It is used as a mucolytic agent to reduce the viscosity of mucous secretions. It has also been shown to have antiviral effects in patients with HIV due to inhibition of viral stimulation by reactive oxygen intermediates. [NIH] Acidity: L. aciditas) the quality of being acid or sour; containing acid (hydrogen ions). [EU] Acne: An inflammatory disease of the pilosebaceous unit, the specific type usually being indicated by a modifying term; frequently used alone to designate common acne, or acne vulgaris. [EU] Acylation: The addition of an organic acid radical into a molecule. [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] 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] 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]
348 Flu Infection
Alanine: A non-essential amino acid that occurs in high levels in its free state in plasma. It is produced from pyruvate by transamination. It is involved in sugar and acid metabolism, increases immunity, and provides energy for muscle tissue, brain, and the central nervous system. [NIH] Albuterol: A racemic mixture with a 1:1 ratio of the r-isomer, levalbuterol, and s-albuterol. It is a short-acting beta2-adrenergic agonist with its main clinical use in asthma. [NIH] Alkaloid: One of a large group of nitrogenous basis substances found in plants. They are usually very bitter and many are pharmacologically active. Examples are atropine, caffeine, coniine, morphine, nicotine, quinine, strychnine. The term is also applied to synthetic substances (artificial a's) which have structures similar to plant alkaloids, such as procaine. [EU] Allergen: A antigenic substance capable of producing immediate-type hypersensitivity (allergy). [EU] Allopurinol: A xanthine oxidase inhibitor that decreases uric acid production. [NIH] Alopecia: Baldness; absence of the hair from skin areas where it normally is present. [EU] Aluminum: A metallic element that has the atomic number 13, atomic symbol Al, and atomic weight 26.98. [NIH] Amantadine: An antiviral that is used in the prophylactic or symptomatic treatment of influenza A. It is also used as an antiparkinsonian agent, to treat extrapyramidal reactions, and for postherpetic neuralgia. The mechanisms of its effects in movement disorders are not well understood but probably reflect an increase in synthesis and release of dopamine, with perhaps some inhibition of dopamine uptake. [NIH] Amenorrhea: amenia. [EU]
Absence or abnormal stoppage of the menses; called also
Amoxicillin: A broad-spectrum semisynthetic antibiotic similar to ampicillin except that its resistance to gastric acid permits higher serum levels with oral administration. [NIH] Ampicillin: Semi-synthetic derivative of penicillin that functions as an orally active broad-spectrum antibiotic. [NIH] Anal: Pertaining to the anus. [EU] Anaphylaxis: An acute hypersensitivity reaction due to exposure to a previously encountered antigen. The reaction may include rapidly progressing urticaria, respiratory distress, vascular collapse, systemic shock, and death. [NIH] Androgens: A class of sex hormones associated with the development and
Glossary 349
maintenance of the secondary male sex characteristics, sperm induction, and sexual differentiation. In addition to increasing virility and libido, they also increase nitrogen and water retention and stimulate skeletal growth. [NIH] Androstenedione: A steroid with androgenic properties that is produced in the testis, ovary, and adrenal cortex. It is a precursor to testosterone and other androgenic hormones. [NIH] 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]
Anorexia: Lack or loss of the appetite for food. [EU] Anthocyanins: Glycosidic pigments in blue, red, and purple flowers and also found as metabolic byproducts in blood and urine. [NIH] Antibiotic: A chemical substance produced by a microorganism which has the capacity, in dilute solutions, to inhibit the growth of or to kill other microorganisms. Antibiotics that are sufficiently nontoxic to the host are used as chemotherapeutic agents in the treatment of infectious diseases of man, animals and plants. [EU] Antibody: An immunoglobulin molecule that has a specific amino acid sequence by virtue of which it interacts only with the antigen that induced its synthesis in cells of the lymphoid series (especially plasma cells), or with antigen closely related to it. Antibodies are classified according to their ode of action as agglutinins, bacteriolysins, haemolysins, opsonins, precipitins, etc. [EU] Anticonvulsant: An agent that prevents or relieves convulsions. [EU] Antidepressant: An agent that stimulates the mood of a depressed patient, including tricyclic antidepressants and monoamine oxidase inhibitors. [EU] Antifungal: Destructive to fungi, or suppressing their reproduction or growth; effective against fungal infections. [EU] Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized Tlymphocytes, 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] Antihistamine:
A drug that counteracts the action of histamine. The
350 Flu Infection
antihistamines are of two types. The conventional ones, as those used in allergies, block the H1 histamine receptors, whereas the others block the H2 receptors. Called also antihistaminic. [EU] Antimicrobial: Killing microorganisms, or suppressing their multiplication or growth. [EU] Antioxidant: One of many widely used synthetic or natural substances added to a product to prevent or delay its deterioration by action of oxygen in the air. Rubber, paints, vegetable oils, and prepared foods commonly contain antioxidants. [EU] Antiviral: Destroying viruses or suppressing their replication. [EU] Anxiety: The unpleasant emotional state consisting of psychophysiological responses to anticipation of unreal or imagined danger, ostensibly resulting from unrecognized intrapsychic conflict. Physiological concomitants include increased heart rate, altered respiration rate, sweating, trembling, weakness, and fatigue; psychological concomitants include feelings of impending danger, powerlessness, apprehension, and tension. [EU] Appendicitis: Acute inflammation of the vermiform appendix. [NIH] Aqueous: Watery; prepared with water. [EU] Arabidopsis: A genus of flowering plants found in north temperate regions. The species A. thaliana is used for experiments in classical plant genetics as well as molecular genetic studies in plant physiology, biochemistry, and development. [NIH] Aromatic: Having a spicy odour. [EU] Arrhythmia: Any variation from the normal rhythm of the heart beat, including sinus arrhythmia, premature beat, heart block, atrial fibrillation, atrial flutter, pulsus alternans, and paroxysmal tachycardia. [EU] Arrhythmogenic: Producing or promoting arrhythmia. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Ascariasis: Infection by nematodes of the genus ascaris. Ingestion of infective eggs causes diarrhea and pneumonitis. Its distribution is more prevalent in areas of poor sanitation and where human feces are used for fertilizer. [NIH] Asparaginase: A hydrolase enzyme that converts L-asparagine and water to L-aspartate and NH3. EC 3.5.1.1. [NIH] Assay: Determination of the amount of a particular constituent of a mixture, or of the biological or pharmacological potency of a drug. [EU] Azithromycin: A semi-synthetic macrolide antibiotic structurally related to erythromycin. It has been used in the treatment of Mycobacterium avium intracellulare infections, toxoplasmosis, and cryptosporidiosis. [NIH]
Glossary 351
Aztreonam: A monocyclic beta-lactam antibiotic originally isolated from Chromobacterium violaceum. It is resistant to beta-lactamases and is used in gram-negative infections, especially of the meninges, bladder, and kidneys. It may cause a superinfection with gram-positive organisms. [NIH] Babesiosis: A group of tick-borne diseases of mammals including zoonoses in humans. They are caused by protozoans of the genus babesia, which parasitize erythrocytes, producing hemolysis. In the U.S., the organism's natural host is mice and transmission is by the deer tick ixodes scapularis. [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] Benign: Not malignant; not recurrent; favourable for recovery. [EU] Benzocaine: A surface anesthetic that acts by preventing transmission of impulses along nerve fibers and at nerve endings. [NIH] Benzodiazepines: A two-ring heterocyclic compound consisting of a benzene ring fused to a diazepine ring. Permitted is any degree of hydrogenation, any substituents and any H-isomer. [NIH] Bethanechol: A slowly hydrolyzed muscarinic agonist with no nicotinic effects. Bethanechol is generally used to increase smooth muscle tone, as in the GI tract following abdominal surgery or in urinary retention in the absence of obstruction. It may cause hypotension, cardiac rate changes, and bronchial spasms. [NIH] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biopsy: The removal and examination, usually microscopic, of tissue from the living body, performed to establish precise diagnosis. [EU] Biosynthesis: The building up of a chemical compound in the physiologic processes of a living organism. [EU] Boron: Boron. A trace element with the atomic symbol B, atomic number 5, and atomic weight 10.81. Boron-10, an isotope of boron, is used as a neutron absorber in boron neutron capture therapy. [NIH] Bronchitis: Inflammation of one or more bronchi. [EU] Bursitis: Inflammation of a bursa, occasionally accompanied by a calcific deposit in the underlying supraspinatus tendon; the most common site is the subdeltoid bursa. [EU] Campylobacter: A genus of bacteria found in the reproductive organs, intestinal tract, and oral cavity of animals and man. Some species are pathogenic. [NIH] Candidiasis: Infection with a fungus of the genus Candida. It is usually a
352 Flu Infection
superficial infection of the moist cutaneous areas of the body, and is generally caused by C. albicans; it most commonly involves the skin (dermatocandidiasis), oral mucous membranes (thrush, def. 1), respiratory tract (bronchocandidiasis), and vagina (vaginitis). Rarely there is a systemic infection or endocarditis. Called also moniliasis, candidosis, oidiomycosis, and formerly blastodendriosis. [EU] Cannabis: The hemp plant Cannabis sativa. Products prepared from the dried flowering tops of the plant include marijuana, hashish, bhang, and ganja. [NIH] Capsules: Hard or soft soluble containers used for the oral administration of medicine. [NIH] Captopril: A potent and specific inhibitor of peptidyl-dipeptidase A. It blocks the conversion of angiotensin I to angiotensin II, a vasoconstrictor and important regulator of arterial blood pressure. Captopril acts to suppress the renin-angiotensin system and inhibits pressure responses to exogenous angiotensin. [NIH] Carbohydrate: An aldehyde or ketone derivative of a polyhydric alcohol, particularly of the pentahydric and hexahydric alcohols. They are so named because the hydrogen and oxygen are usually in the proportion to form water, (CH2O)n. The most important carbohydrates are the starches, sugars, celluloses, and gums. They are classified into mono-, di-, tri-, poly- and heterosaccharides. [EU] Cardiac: Pertaining to the heart. [EU] Cardiovascular: Pertaining to the heart and blood vessels. [EU] 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]
Cataract: An opacity, partial or complete, of one or both eyes, on or in the lens or capsule, especially an opacity impairing vision or causing blindness. The many kinds of cataract are classified by their morphology (size, shape, location) or etiology (cause and time of occurrence). [EU] Cellulitis: An acute, diffuse, and suppurative inflammation of loose connective tissue, particularly the deep subcutaneous tissues, and sometimes muscle, which is most commonly seen as a result of infection of a wound, ulcer, or other skin lesions. [NIH]
Glossary 353
Chemotherapy: The treatment of disease by means of chemicals that have a specific toxic effect upon the disease - producing microorganisms or that selectively destroy cancerous tissue. [EU] Chimera: An individual that contains cell populations derived from different zygotes. [NIH] Chlorhexidine: Disinfectant and topical anti-infective agent used also as mouthwash to prevent oral plaque. [NIH] Chlorine: A greenish-yellow, diatomic gas that is a member of the halogen family of elements. It has the atomic symbol Cl, atomic number 17, and atomic weight 70.906. It is a powerful irritant that can cause fatal pulmonary edema. Chlorine is used in manufacturing, as a reagent in synthetic chemistry, for water purification, and in the production of chlorinated lime, which is used in fabric bleaching. [NIH] Chlorophyll: Porphyrin derivatives containing magnesium that act to convert light energy in photosynthetic organisms. [NIH] Chlorpheniramine: A histamine H1 antagonist used in allergic reactions, hay fever, rhinitis, urticaria, and asthma. It has also been used in veterinary applications. One of the most widely used of the classical antihistaminics, it generally causes less drowsiness and sedation than promethazine. [NIH] Chlorpromazine: The prototypical phenothiazine antipsychotic drug. Like the other drugs in this class chlorpromazine's antipsychotic actions are thought to be due to long-term adaptation by the brain to blocking dopamine receptors. Chlorpromazine has several other actions and therapeutic uses, including as an antiemetic and in the treatment of intractable hiccup. [NIH] Cholecalciferol: An antirachitic oil-soluble vitamin. [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] Cholinergic: Resembling acetylcholine in pharmacological stimulated by or releasing acetylcholine or a related compound. [EU]
action;
Chronic: Persisting over a long period of time. [EU] Cimetidine: A histamine congener, it competitively inhibits histamine binding to H2 receptors. Cimetidine has a range of pharmacological actions. It inhibits gastric acid secretion, as well as pepsin and gastrin output. It also blocks the activity of cytochrome P-450. [NIH] Cinoxacin: Synthetic antimicrobial related to oxolinic and nalidixic acids and used in urinary tract infections. [NIH] Ciprofloxacin: A carboxyfluoroquinoline antimicrobial agent that is effective against a wide range of microorganisms. It has been successfully
354 Flu Infection
and safely used in the treatment of resistant respiratory, skin, bone, joint, gastrointestinal, urinary, and genital infections. [NIH] Cirrhosis: Liver disease characterized pathologically by loss of the normal microscopic lobular architecture, with fibrosis and nodular regeneration. The term is sometimes used to refer to chronic interstitial inflammation of any organ. [EU] Cisplatin: An inorganic and water-soluble platinum complex. After undergoing hydrolysis, it reacts with DNA to produce both intra and interstrand crosslinks. These crosslinks appear to impair replication and transcription of DNA. The cytotoxicity of cisplatin correlates with cellular arrest in the G2 phase of the cell cycle. [NIH] Clarithromycin: A semisynthetic macrolide antibiotic derived from erythromycin that is active against a variety of microorganisms. It can inhibit protein synthesis in bacteria by reversibly binding to the 50S ribosomal subunits. This inhibits the translocation of aminoacyl transfer-RNA and prevents peptide chain elongation. [NIH] Claudication: Limping or lameness. [EU] Clindamycin: An antibacterial agent that is a semisynthetic analog of lincomycin. [NIH] Clozapine: A tricylic dibenzodiazepine, classified as an atypical antipsychotic agent. It binds several types of central nervous system receptors, and displays a unique pharmacological profile. Clozapine is a serotonin antagonist, with strong binding to 5-HT 2A/2C receptor subtype. It also displays strong affinity to several dopaminergic receptors, but shows only weak antagonism at the dopamine D2 receptor, a receptor commonly thought to modulate neuroleptic activity. Agranulocytosis is a major adverse effect associated with administration of this agent. [NIH] Cobalt: A trace element that is a component of vitamin B12. It has the atomic symbol Co, atomic number 27, and atomic weight 58.93. It is used in nuclear weapons, alloys, and pigments. Deficiency in animals leads to anemia; its excess in humans can lead to erythrocytosis. [NIH] Codeine: An opioid analgesic related to morphine but with less potent analgesic properties and mild sedative effects. It also acts centrally to suppress cough. [NIH] Coenzyme: An organic nonprotein molecule, frequently a phosphorylated derivative of a water-soluble vitamin, that binds with the protein molecule (apoenzyme) to form the active enzyme (holoenzyme). [EU] Cognition: Intellectual or mental process whereby an organism becomes aware of or obtains knowledge. [NIH] Colic: Paroxysms of pain. This condition usually occurs in the abdominal
Glossary 355
region but may occur in other body regions as well. [NIH] Colitis: Inflammation of the colon. [EU] Colorectal: Pertaining to or affecting the colon and rectum. [EU] Colostrum: The thin, yellow, serous fluid secreted by the mammary glands during pregnancy and immediately postpartum before lactation begins. It consists of immunologically active substances, white blood cells, water, protein, fat, and carbohydrates. [NIH] Concomitant: Accompanying; accessory; joined with another. [EU] Condoms: A sheath that is worn over the penis during sexual behavior in order to prevent pregnancy or spread of sexually transmitted disease. [NIH] Confusion: Disturbed orientation in regard to time, place, or person, sometimes accompanied by disordered consciousness. [EU] Congestion: Excessive or abnormal accumulation of blood in a part. [EU] Conjunctivitis: Inflammation of the conjunctiva, generally consisting of conjunctival hyperaemia associated with a discharge. [EU] Constipation: Infrequent or difficult evacuation of the faeces. [EU] Contamination: The soiling or pollution by inferior material, as by the introduction of organisms into a wound, or sewage into a stream. [EU] Convulsion: A violent involuntary contraction or series of contractions of the voluntary muscles. [EU] 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] Cortex: The outer layer of an organ or other body structure, as distinguished from the internal substance. [EU] Cortical: Pertaining to or of the nature of a cortex or bark. [EU] Creatine: An amino acid that occurs in vertebrate tissues and in urine. In muscle tissue, creatine generally occurs as phosphocreatine. Creatine is excreted as creatinine in the urine. [NIH] Croup: A condition characterized by resonant barking cough, hoarseness and persistant stridor and caused by allergy, foreign body, infection, or neoplasm. It occurs chiefly in infants and children. [NIH] Curative: Tending to overcome disease and promote recovery. [EU] Cutaneous: Pertaining to the skin; dermal; dermic. [EU] Cyclophosphamide: Precursor of an alkylating nitrogen mustard antineoplastic and immunosuppressive agent that must be activated in the liver to form the active aldophosphamide. It is used in the treatment of lymphomas, leukemias, etc. Its side effect, alopecia, has been made use of in
356 Flu Infection
defleecing sheep. Cyclophosphamide may also cause sterility, birth defects, mutations, and cancer. [NIH] Cyclospora: A genus of coccidian parasites in the family eimeriidae. Cyclospora cayetanensis is pathogenic in humans, probably transmitted via the fecal-oral route, and causes nausea and diarrhea. [NIH] Cytokines: Non-antibody proteins secreted by inflammatory leukocytes and some non-leukocytic cells, that act as intercellular mediators. They differ from classical hormones in that they are produced by a number of tissue or cell types rather than by specialized glands. They generally act locally in a paracrine or autocrine rather than endocrine manner. [NIH] Cytotoxic: Pertaining to or exhibiting cytotoxicity. [EU] Daunorubicin: Very toxic anthracycline aminoglycoside antibiotic isolated from Streptomyces peucetius and others, used in treatment of leukemias and other neoplasms. [NIH] Decongestant: An agent that reduces congestion or swelling. [EU] Degenerative: Undergoing degeneration : tending to degenerate; having the character of or involving degeneration; causing or tending to cause degeneration. [EU] Dehydration: The condition that results from excessive loss of body water. Called also anhydration, deaquation and hypohydration. [EU] Dementia: An acquired organic mental disorder with loss of intellectual abilities of sufficient severity to interfere with social or occupational functioning. The dysfunction is multifaceted and involves memory, behavior, personality, judgment, attention, spatial relations, language, abstract thought, and other executive functions. The intellectual decline is usually progressive, and initially spares the level of consciousness. [NIH] Dendritic: 1. branched like a tree. 2. pertaining to or possessing dendrites. [EU]
Dentifrices: Any preparations used for cleansing teeth; they usually contain an abrasive, detergent, binder and flavoring agent and may exist in the form of liquid, paste or powder; may also contain medicaments and caries preventives. [NIH] Dermatology: A medical specialty concerned with the skin, its structure, functions, diseases, and treatment. [NIH] Desensitization: The prevention or reduction of immediate hypersensitivity reactions by administration of graded doses of allergen; called also hyposensitization and immunotherapy. [EU] Desipramine: A tricyclic dibenzazepine compound that potentiates neurotransmission. Desipramine selectively blocks reuptake of norepinephrine from the neural synapse, and also appears to impair
Glossary 357
serotonin transport. This compound also possesses minor anticholingeric activity, through its affinity to muscarinic receptors. [NIH] Diarrhea: Passage of excessively liquid or excessively frequent stools. [NIH] Didanosine: A dideoxynucleoside compound in which the 3'-hydroxy group on the sugar moiety has been replaced by a hydrogen. This modification prevents the formation of phosphodiester linkages which are needed for the completion of nucleic acid chains. Didanosine is a potent inhibitor of HIV replication, acting as a chain-terminator of viral DNA by binding to reverse transcriptase; ddI is then metabolized to dideoxyadenosine triphosphate, its putative active metabolite. [NIH] Dienestrol: A synthetic, non-steroidal estrogen structurally related to stilbestrol. It is used, usually as the cream, in the treatment of menopausal and postmenopausal symptoms. [NIH] Diflunisal: A salicylate derivative and anti-inflammatory analgesic with actions and side effects similar to those of ASPIRIN. [NIH] Digitalis: A genus of toxic herbaceous Eurasian plants of the Scrophulaceae which yield cardiotonic glycosides. The most useful are Digitalis lanata and D. purpurea. [NIH] Diltiazem: A benzothiazepine derivative with vasodilating action due to its antagonism of the actions of the calcium ion in membrane functions. It is also teratogenic. [NIH] Diphenhydramine: A histamine H1 antagonist used as an antiemetic, antitussive, for dermatoses and pruritus, for hypersensitivity reactions, as a hypnotic, an antiparkinson, and as an ingredient in common cold preparations. It has some undesired antimuscarinic and sedative effects. [NIH] Diphtheria: A localized infection of mucous membranes or skin caused by toxigenic strains of corynebacterium diphtheriae. It is characterized by the presence of a pseudomembrane at the site of infection. Diphtheria toxin, produced by C. diphtheriae, can cause myocarditis, polyneuritis, and other systemic toxic effects. [NIH] Disinfectant: An agent that disinfects; applied particularly to agents used on inanimate objects. [EU] Disinfection: Rendering pathogens harmless through the use of heat, antiseptics, antibacterial agents, etc. [NIH] Diuretics, Thiazide: Diuretics characterized as analogs of 1,2,4benzothiadiazine-1,1-dioxide. All have a common mechanism of action and differ primarily in the dose required to produce a given effect. They act directly on the kidney to increase the excretion of sodium chloride and water and also increase excretion of potassium ions. [NIH] Diverticulitis:
Inflammation of a diverticulum, especially inflammation
358 Flu Infection
related to colonic diverticula, which may undergo perforation with abscess formation. Sometimes called left-sided or L-sides appendicitis. [EU] Dizziness: An imprecise term which may refer to a sense of spatial disorientation, motion of the environment, or lightheadedness. [NIH] Doxorubicin: Antineoplastic antibiotic obtained from Streptomyces peucetics. It is a hydroxy derivative of daunorubicin and is used in treatment of both leukemia and solid tumors. [NIH] Doxycycline: A synthetic tetracycline derivative with a range of antimicrobial activity and mode of action similar to that of tetracycline, but more effective against many species. Animal studies suggest that it may cause less tooth staining than other tetracyclines. [NIH] Dysentery: Any of various disorders marked by inflammation of the intestines, especially of the colon, and attended by pain in the abdomen, tenesmus, and frequent stools containing blood and mucus. Causes include chemical irritants, bacteria, protozoa, or parasitic worms. [EU] Dyskinesia: Impairment of the power of voluntary movement, resulting in fragmentary or incomplete movements. [EU] Dysmenorrhea: Painful menstruation. [NIH] Dysphagia: Difficulty in swallowing. [EU] Dysplasia: Abnormality of development; in pathology, alteration in size, shape, and organization of adult cells. [EU] Earache: Pain in the ear. [NIH] Echinacea: A genus of perennial herbs used topically and internally. It contains echinacoside, glycosides, inulin, isobutyl amides, resin, and sesquiterpenes. [NIH] Echoviruses: A group of enteroviruses isolated from man and originally thought not to be associated with disease, whence the name Enteric Cytopathic Human Orphan; however, several serotypes have been found to cause meningitis, diarrhea, and respiratory disease. [NIH] Eczema: A pruritic papulovesicular dermatitis occurring as a reaction to many endogenous and exogenous agents, characterized in the acute stage by erythema, edema associated with a serous exudate between the cells of the epidermis (spongiosis) and an inflammatory infiltrate in the dermis, oozing and vesiculation, and crusting and scaling; and in the more chronic stages by lichenification or thickening or both, signs of excoriations, and hyperpigmentation or hypopigmentation or both. Atopic dermatitis is the most common type of dermatitis. Called also eczematous dermatitis. [EU] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU]
Glossary 359
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] Emesis: Vomiting; an act of vomiting. Also used as a word termination, as in haematemesis. [EU] Emphysema: A pathological accumulation of air in tissues or organs; applied especially to such a condition of the lungs. [EU] Encephalitis: Inflammation of the brain. [EU] Endocarditis: Exudative and proliferative inflammatory alterations of the endocardium, characterized by the presence of vegetations on the surface of the endocardium or in the endocardium itself, and most commonly involving a heart valve, but sometimes affecting the inner lining of the cardiac chambers or the endocardium elsewhere. It may occur as a primary disorder or as a complication of or in association with another disease. [EU] Endocytosis: Cellular uptake of extracellular materials within membranelimited vacuoles or microvesicles. Endosomes play a central role in endocytosis. [NIH] Endometriosis: A condition in which tissue more or less perfectly resembling the uterine mucous membrane (the endometrium) and containing typical endometrial granular and stromal elements occurs aberrantly in various locations in the pelvic cavity; called also adenomyosis externa and endometriosis externa. [EU] Endosomes: Cytoplasmic vesicles formed when coated vesicles shed their clathrin coat. Endosomes internalize macromolecules bound by receptors on the cell surface. [NIH] Enterovirus: A genus of the family picornaviridae whose members preferentially inhabit the intestinal tract of a variety of hosts. The genus contains many species. Newly described members of human enteroviruses are assigned continuous numbers with the species designated "human enterovirus". [NIH] Enzyme: A protein molecule that catalyses chemical reactions of other substances without itself being destroyed or altered upon completion of the reactions. Enzymes are classified according to the recommendations of the Nomenclature Committee of the International Union of Biochemistry. Each enzyme is assigned a recommended name and an Enzyme Commission (EC) number. They are divided into six main groups; oxidoreductases, transferases, hydrolases, lyases, isomerases, and ligases. [EU] Eosinophils: Granular leukocytes with a nucleus that usually has two lobes connected by a slender thread of chromatin, and cytoplasm containing coarse, round granules that are uniform in size and stainable by eosin. [NIH]
360 Flu Infection
Epidemic: Occurring suddenly in numbers clearly in excess of normal expectancy; said especially of infectious diseases but applied also to any disease, injury, or other health-related event occurring in such outbreaks. [EU] 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] Epirubicin: An anthracycline antibiotic which is the 4'-epi-isomer of doxorubicin. The compound exerts its antitumor effects by interference with the synthesis and function of DNA. Clinical studies indicate activity in breast cancer, non-Hodgkin's lymphomas, ovarian cancer, soft-tissue sarcomas, pancreatic cancer, gastric cancer, small-cell lung cancer and acute leukemia. It is equal in activity to doxorubicin but exhibits less acute toxicities and less cardiotoxicity. [NIH] Epithelium: The covering of internal and external surfaces of the body, including the lining of vessels and other small cavities. It consists of cells joined by small amounts of cementing substances. Epithelium is classified into types on the basis of the number of layers deep and the shape of the superficial cells. [EU] Epoprostenol: A prostaglandin that is biosynthesized enzymatically from prostaglandin endoperoxides in human vascular tissue. It is a potent inhibitor of platelet aggregation. The sodium salt has been also used to treat primary pulmonary hypertension. [NIH] Equisetum: A genus of plants closely related to ferns. Some species have medicinal use and some are poisonous. [NIH] Erythrina: A genus of leguminous shrubs or trees, mainly tropical, yielding certain alkaloids, lectins, and other useful compounds. [NIH] Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH] Escherichia: A genus of gram-negative, facultatively anaerobic, rod-shaped bacteria whose organisms occur in the lower part of the intestine of warmblooded animals. The species are either nonpathogenic or opportunistic pathogens. [NIH] Estradiol: The most potent mammalian estrogenic hormone. It is produced in the ovary, placenta, testis, and possibly the adrenal cortex. [NIH] Eucalyptus: A genus of Australian trees of the Myrtaceae family that yields gums, oils, and resins which are used as flavoring agents, astringents, and aromatics, and formerly to treat diarrhea, asthma, bronchitis, and respiratory
Glossary 361
tract infections. [NIH] Exocytosis: Cellular release of material within membrane-limited vesicles by fusion of the vesicles with the cell membrane. [NIH] Expectorant: 1. promoting the ejection, by spitting, of mucus or other fluids from the lungs and trachea. 2. an agent that promotes the ejection of mucus or exudate from the lungs, bronchi, and trachea; sometimes extended to all remedies that quiet cough (antitussives). [EU] Famotidine: A competitive histamine H2-receptor antagonist. Its main pharmacodynamic effect is the inhibition of gastric secretion. [NIH] Fatigue: The state of weariness following a period of exertion, mental or physical, characterized by a decreased capacity for work and reduced efficiency to respond to stimuli. [NIH] Feces: The excrement discharged from the intestines, consisting of bacteria, cells exfoliated from the intestines, secretions, chiefly of the liver, and a small amount of food residue. [EU] Filariasis: Infections with nematodes of the superfamily filarioidea. The presence of living worms in the body is mainly asymptomatic but the death of adult worms leads to granulomatous inflammation and permanent fibrosis. Organisms of the genus Elaeophora infect wild elk and domestic sheep causing ischaemic necrosis of the brain, blindness, and dermatosis of the face. [NIH] Finasteride: An orally active testosterone 5-alpha-reductase inhibitor. It is used as a surgical alternative for treatment of benign prostatic hyperplasia. [NIH]
Firearms: Small-arms weapons, including handguns, pistols, revolvers, rifles, shotguns, etc. [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] Flatulence: The presence of excessive amounts of air or gases in the stomach or intestine, leading to distention of the organs. [EU] Flounder: Common name for two families of fish belonging to the order Pleuronectiformes and described as left-eye flounders and right-eye flounders. The latter is more commonly used in research. [NIH] Fluconazole: Triazole antifungal agent that is used to treat oropharyngeal candidiasis and cryptococcal meningitis in AIDS. [NIH] Flucytosine: A fluorinated cytosine analog that is used as an antifungal agent. [NIH] Fludrocortisone: activity. [NIH]
A synthetic mineralocorticoid with anti-inflammatory
362 Flu Infection
Flunitrazepam: Benzodiazepine with pharmacologic actions similar to those of diazepam. The United States Government has banned the importation of this drug. Steps are being taken to reclassify this substance as a Schedule 1 drug with no accepted medical use. [NIH] Fluorescein Angiography: Visualization of a vascular system after intravenous injection of a fluorescein solution. The images may be photographed or televised. It is used especially in studying the retinal and uveal vasculature. [NIH] Fluorescence: The property of emitting radiation while being irradiated. The radiation emitted is usually of longer wavelength than that incident or absorbed, e.g., a substance can be irradiated with invisible radiation and emit visible light. X-ray fluorescence is used in diagnosis. [NIH] Fluoxetine: The first highly specific serotonin uptake inhibitor. It is used as an antidepressant and often has a more acceptable side-effects profile than traditional antidepressants. [NIH] Flurbiprofen: An anti-inflammatory analgesic and antipyretic of the phenylalkynoic acid series. It has been shown to reduce bone resorption in periodontal disease by inhibiting carbonic anhydrase. [NIH] Fluvoxamine: A selective serotonin reuptake inhibitor. It is effective in the treatment of depression, obsessive-compulsive disorders, anxiety, panic disorders, and alcohol amnestic disorders. [NIH] Foscarnet: An antiviral agent used in the treatment of cytomegalovirus retinitis. Foscarnet also shows activity against human herpesviruses and HIV. [NIH] Frostbite: Damage to tissues as the result of low environmental temperatures. [NIH] Fungus: A general term used to denote a group of eukaryotic protists, including mushrooms, yeasts, rusts, moulds, smuts, etc., which are characterized by the absence of chlorophyll and by the presence of a rigid cell wall composed of chitin, mannans, and sometimes cellulose. They are usually of simple morphological form or show some reversible cellular specialization, such as the formation of pseudoparenchymatous tissue in the fruiting body of a mushroom. The dimorphic fungi grow, according to environmental conditions, as moulds or yeasts. [EU] GABA: The most common inhibitory neurotransmitter in the central nervous system. [NIH] Ganciclovir: Acyclovir analog that is a potent inhibitor of the Herpesvirus family including cytomegalovirus. Ganciclovir is used to treat complications from AIDS-associated cytomegalovirus infections. [NIH] Gastritis: Inflammation of the stomach. [EU]
Glossary 363
Gastroenteritis: An acute inflammation of the lining of the stomach and intestines, characterized by anorexia, nausea, diarrhoea, abdominal pain, and weakness, which has various causes, including food poisoning due to infection with such organisms as Escherichia coli, Staphylococcus aureus, and Salmonella species; consumption of irritating food or drink; or psychological factors such as anger, stress, and fear. Called also enterogastritis. [EU] Gastrointestinal: Pertaining to or communicating with the stomach and intestine, as a gastrointestinal fistula. [EU] Gelatin: A product formed from skin, white connective tissue, or bone collagen. It is used as a protein food adjuvant, plasma substitute, hemostatic, suspending agent in pharmaceutical preparations, and in the manufacturing of capsules and suppositories. [NIH] Gels: Colloids with a solid continuous phase and liquid as the dispersed phase; gels may be unstable when, due to temperature or other cause, the solid phase liquifies; the resulting colloid is called a sol. [NIH] Gingivitis: Inflammation of the gingivae. Gingivitis associated with bony changes is referred to as periodontitis. Called also oulitis and ulitis. [EU] Ginseng: An araliaceous genus of plants that contains a number of pharmacologically active agents used as stimulants, sedatives, and tonics, especially in traditional medicine. [NIH] Glipizide: An oral hypoglycemic agent which is rapidly absorbed and completely metabolized. [NIH] Glucans: Polysaccharides composed of repeating glucose units. They can consist of branched or unbranched chains in any linkages. [NIH] Glucose: D-glucose, a monosaccharide (hexose), C6H12O6, also known as dextrose (q.v.), found in certain foodstuffs, especially fruits, and in the normal blood of all animals. It is the end product of carbohydrate metabolism and is the chief source of energy for living organisms, its utilization being controlled by insulin. Excess glucose is converted to glycogen and stored in the liver and muscles for use as needed and, beyond that, is converted to fat and stored as adipose tissue. Glucose appears in the urine in diabetes mellitus. [EU] Glutamine: A non-essential amino acid present abundantly throught the body and is involved in many metabolic processes. It is synthesized from glutamic acid and ammonia. It is the principal carrier of nitrogen in the body and is an important energy source for many cells. [NIH] Gluten: The protein of wheat and other grains which gives to the dough its tough elastic character. [EU] Glycine: A non-essential amino acid. It is found primarily in gelatin and silk
364 Flu Infection
fibroin and used therapeutically as a nutrient. It is also a fast inhibitory neurotransmitter. [NIH] Glycyrrhiza: A genus of leguminous herbs or shrubs whose roots yield glycyrrhetinic acid and its derivatives, carbenoxolone for example. Licorice toxicity is manifested as hypokalemia, low blood potassium. Licorice is used as flavoring and aromatic in pharmaceuticals and as candy. [NIH] Gonorrhea: Acute infectious disease characterized by primary invasion of the urogenital tract. The etiologic agent, neisseria gonorrhoeae, was isolated by Neisser in 1879. [NIH] Gout: Hereditary metabolic disorder characterized by recurrent acute arthritis, hyperuricemia and deposition of sodium urate in and around the joints, sometimes with formation of uric acid calculi. [NIH] Granule: A small pill made from sucrose. [EU] Haematological: Relating to haematology, that is that branch of medical science which treats of the morphology of the blood and blood-forming tissues. [EU] Haemophilus: A genus of pasteurellaceae that consists of several species occurring in animals and humans. Its organisms are described as gramnegative, facultatively anaerobic, coccobacillus or rod-shaped, and nonmotile. [NIH] Handwashing: The act of cleansing the hands with water or other liquid, with or without the inclusion of soap or other detergent, for the purpose of removing soil or microorganisms. [NIH] Heartburn: Substernal pain or burning sensation, usually associated with regurgitation of gastric juice into the esophagus. [NIH] Hemorrhoids: Varicosities of the hemorrhoidal venous plexuses. [NIH] Hepatic: Pertaining to the liver. [EU] Hepatitis: Inflammation of the liver. [EU] Hernia: (he protrusion of a loop or knuckle of an organ or tissue through an abnormal opening. [EU] Herpes: Any inflammatory skin disease caused by a herpesvirus and characterized by the formation of clusters of small vesicles. When used alone, the term may refer to herpes simplex or to herpes zoster. [EU] Hexylresorcinol: A substituted dihydroxybenzene that is used topically as an antiseptic for the treatment of minor skin infections. [NIH] Hiccup: A spasm of the diaphragm that causes a sudden inhalation followed by rapid closure of the glottis which produces a sound. [NIH] Homicide: The killing of one person by another. [NIH]
Glossary 365
Hormonal: Pertaining to or of the nature of a hormone. [EU] Hormones: Chemical substances having a specific regulatory effect on the activity of a certain organ or organs. The term was originally applied to substances secreted by various endocrine glands and transported in the bloodstream to the target organs. It is sometimes extended to include those substances that are not produced by the endocrine glands but that have similar effects. [NIH] Humoral: Of, relating to, proceeding from, or involving a bodily humour now often used of endocrine factors as opposed to neural or somatic. [EU] Hybridization: The genetic process of crossbreeding to produce a hybrid. Hybrid nucleic acids can be formed by nucleic acid hybridization of DNA and RNA molecules. Protein hybridization allows for hybrid proteins to be formed from polypeptide chains. [NIH] Hydrochloric Acid: A strong corrosive acid that is commonly used as a laboratory reagent. It is formed by dissolving hydrogen chloride in water. gastric acid is the hydrochloric acid component of gastric juice. [NIH] Hydrocortisone: The main glucocorticoid secreted by the adrenal cortex. Its synthetic counterpart is used, either as an injection or topically, in the treatment of inflammation, allergy, collagen diseases, asthma, adrenocortical deficiency, shock, and some neoplastic conditions. [NIH] Hydroxyurea: An antineoplastic agent that inhibits DNA synthesis through the inhibition of ribonucleoside diphosphate reductase. [NIH] Hyperplasia: The abnormal multiplication or increase in the number of normal cells in normal arrangement in a tissue. [EU] Hypertension: Persistently high arterial blood pressure. Various criteria for its threshold have been suggested, ranging from 140 mm. Hg systolic and 90 mm. Hg diastolic to as high as 200 mm. Hg systolic and 110 mm. Hg diastolic. Hypertension may have no known cause (essential or idiopathic h.) or be associated with other primary diseases (secondary h.). [EU] Hyperthermia: Abnormally high body temperature, especially that induced for therapeutic purposes. [EU] Hypothermia: A low body temperature, as that due to exposure in cold weather or a state of low temperature of the body induced as a means of decreasing metabolism of tissues and thereby the need for oxygen, as used in various surgical procedures, especially on the heart, or in an excised organ being preserved for transplantation. [EU] 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
366 Flu Infection
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] Ibuprofen: A nonsteroidal anti-inflammatory agent with analgesic properties used in the therapy of rheumatism and arthritis. [NIH] Idarubicin: An orally administered anthracycline antibiotic. The compound has shown activity against breast cancer, lymphomas and leukemias, together with potential for reduced cardiac toxicity. [NIH] Ifosfamide: Positional isomer of cyclophosphamide which is active as an alkylating agent and an immunosuppressive agent. [NIH] Immunity: The condition of being immune; the protection against infectious disease conferred either by the immune response generated by immunization or previous infection or by other nonimmunologic factors (innate i.). [EU] Immunization: The induction of immunity. [EU] Immunoassay: Immunochemical assay or detection of a substance by serologic or immunologic methods. Usually the substance being studied serves as antigen both in antibody production and in measurement of antibody by the test substance. [NIH] Immunotherapy: Manipulation of the host's immune system in treatment of disease. It includes both active and passive immunization as well as immunosuppressive therapy to prevent graft rejection. [NIH] Incontinence: Inability to control excretory functions, as defecation (faecal i.) or urination (urinary i.). [EU] Indapamide: A sulfamyl diuretic with about 16x the effect of furosemide. It has also been shown to be an effective antihypertensive agent in the clinic. [NIH]
Indinavir: A potent and specific HIV protease inhibitor that appears to have good oral bioavailability. [NIH] 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] Infertility: The diminished or absent ability to conceive or produce an offspring while sterility is the complete inability to conceive or produce an offspring. [NIH] Infiltration: The diffusion or accumulation in a tissue or cells of substances not normal to it or in amounts of the normal. Also, the material so accumulated. [EU]
Glossary 367
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] Influenza: An acute viral infection involving the respiratory tract. It is marked by inflammation of the nasal mucosa, the pharynx, and conjunctiva, and by headache and severe, often generalized, myalgia. [NIH] Infusion: The therapeutic introduction of a fluid other than blood, as saline solution, solution, into a vein. [EU] Inhalation: The drawing of air or other substances into the lungs. [EU] Insomnia: Inability to sleep; abnormal wakefulness. [EU] Insulin: A protein hormone secreted by beta cells of the pancreas. Insulin plays a major role in the regulation of glucose metabolism, generally promoting the cellular utilization of glucose. It is also an important regulator of protein and lipid metabolism. Insulin is used as a drug to control insulindependent diabetes mellitus. [NIH] Interferons: Proteins secreted by vertebrate cells in response to a wide variety of inducers. They confer resistance against many different viruses, inhibit proliferation of normal and malignant cells, impede multiplication of intracellular parasites, enhance macrophage and granulocyte phagocytosis, augment natural killer cell activity, and show several other immunomodulatory functions. [NIH] Intermittent: Occurring at separated intervals; having periods of cessation of activity. [EU] Intestinal: Pertaining to the intestine. [EU] Intestines: The section of the alimentary canal from the stomach to the anus. It includes the large intestine and small intestine. [NIH] Intramuscular: Within the substance of a muscle. [EU] Intravenous: Within a vein or veins. [EU] Iodine: A nonmetallic element of the halogen group that is represented by the atomic symbol I, atomic number 53, and atomic weight of 126.90. It is a nutritionally essential element, especially important in thyroid hormone synthesis. In solution, it has anti-infective properties and is used topically. [NIH]
Ipecac: A syrup made from the dried rhizomes of two different species, Cephaelis ipecacuanha and C. acuminata, belonging to the rubiaciae family. They contain emetine, cephaeline, psychotrine and other isoquinolines. Ipecac syrup is used widely as an emetic acting both locally on the gastric mucosa and centrally on the chemoreceptor trigger zone. [NIH] Ipratropium: A muscarinic antagonist structurally related to atropine but
368 Flu Infection
often considered safer and more effective for inhalation use. It is used for various bronchial disorders, in rhinitis, and as an antiarrhythmic. [NIH] Isoflavones: 3-Phenylchromones. Isomeric form of flavones in which the benzene group is attached to the 3 position of the benzopyran ring instead of the 2 position. [NIH] Isosorbide: 1,4:3,6-Dianhydro D-glucitol. Chemically inert osmotic diuretic used mainly to treat hydrocephalus; also used in glaucoma. [NIH] Itraconazole: An antifungal agent that has been used in the treatment of histoplasmosis, blastomycosis, cryptococcal meningitis, and aspergillosis. [NIH]
Jaundice: A clinical manifestation of hyperbilirubinemia, consisting of deposition of bile pigments in the skin, resulting in a yellowish staining of the skin and mucous membranes. [NIH] Juniper: A slow growing coniferous evergreen tree or shrub, genus Juniperus. The Juniper is cultivated for its berries, which take up to three years to ripen. The resinous, sweetly flavored berries are borne only by the female juniper, and can be found in various stages of ripeness on the same plant. [NIH] Kava: Dried rhizome and roots of Piper methysticum, a shrub native to Oceania and known for its anti-anxiety and sedative properties. Heavy usage results in some adverse effects. It contains alkaloids, lactones, kawain, methysticin, mucilage, starch, and yangonin. Kava is also the name of the pungent beverage prepared from the plant's roots. [NIH] Ketoacidosis: Acidosis accompanied by the accumulation of ketone bodies (ketosis) in the body tissues and fluids, as in diabetic acidosis. [EU] Kinetic: Pertaining to or producing motion. [EU] Labetalol: Blocker of both alpha- and beta-adrenergic receptors that is used as an antihypertensive. [NIH] Larva: Wormlike or grublike stage, following the egg in the life cycle of insects, worms, and other metamorphosing animals. [NIH] Laryngitis: Inflammation of the larynx, a condition attended with dryness and soreness of the throat, hoarseness, cough and dysphagia. [EU] Lesion: Any pathological or traumatic discontinuity of tissue or loss of function of a part. [EU] Lethal: Deadly, fatal. [EU] Leucovorin: The active metabolite of folic acid. Leucovorin is used principally as its calcium salt as an antidote to folic acid antagonists which block the conversion of folic acid to folinic acid. [NIH] Lindane: An organochlorine insecticide that has been used as a pediculicide
Glossary 369
and a scabicide. It has been shown to cause cancer. [NIH] Lipid: Any of a heterogeneous group of flats and fatlike substances characterized by being water-insoluble and being extractable by nonpolar (or fat) solvents such as alcohol, ether, chloroform, benzene, etc. All contain as a major constituent aliphatic hydrocarbons. The lipids, which are easily stored in the body, serve as a source of fuel, are an important constituent of cell structure, and serve other biological functions. Lipids may be considered to include fatty acids, neutral fats, waxes, and steroids. Compound lipids comprise the glycolipids, lipoproteins, and phospholipids. [EU] Liposome: A spherical particle in an aqueous medium, formed by a lipid bilayer enclosing an aqueous compartment. [EU] Liquifilm: A thin liquid layer of coating. [EU] Lithium: Lithium. An element in the alkali metals family. It has the atomic symbol Li, atomic number 3, and atomic weight 6.94. Salts of lithium are used in treating manic-depressive disorders. [NIH] Localization: 1. the determination of the site or place of any process or lesion. 2. restriction to a circumscribed or limited area. 3. prelocalization. [EU] Lorazepam: An anti-anxiety agent with few side effects. It also has hypnotic, anticonvulsant, and considerable sedative properties and has been proposed as a preanesthetic agent. [NIH] Lupus: A form of cutaneous tuberculosis. It is seen predominantly in women and typically involves the nasal, buccal, and conjunctival mucosa. [NIH]
Malathion: A wide spectrum aliphatic organophosphate insecticide widely used for both domestic and commercial agricultural purposes. [NIH] Malignant: Tending to become progressively worse and to result in death. Having the properties of anaplasia, invasion, and metastasis; said of tumours. [EU] Manifest: Being the part or aspect of a phenomenon that is directly observable : concretely expressed in behaviour. [EU] Mechlorethamine: A vesicant and necrotizing irritant destructive to mucous membranes. It was formerly used as a war gas. The hydrochloride is used as an antineoplastic in Hodgkin's disease and lymphomas. It causes severe gastrointestinal and bone marrow damage. [NIH] Mediator: An object or substance by which something is mediated, such as (1) a structure of the nervous system that transmits impulses eliciting a specific response; (2) a chemical substance (transmitter substance) that induces activity in an excitable tissue, such as nerve or muscle; or (3) a substance released from cells as the result of the interaction of antigen with antibody or by the action of antigen with a sensitized lymphocyte. [EU]
370 Flu Infection
Melanoma: A tumour arising from the melanocytic system of the skin and other organs. When used alone the term refers to malignant melanoma. [EU] Melphalan: An alkylating nitrogen mustard that is used as an antineoplastic in the form of the levo isomer - melphalan, the racemic mixture - merphalan, and the dextro isomer - medphalan; toxic to bone marrow, but little vesicant action; potential carcinogen. [NIH] Membrane: A thin layer of tissue which covers a surface, lines a cavity or divides a space or organ. [EU] Meningitis: Inflammation of the meninges. When it affects the dura mater, the disease is termed pachymeningitis; when the arachnoid and pia mater are involved, it is called leptomeningitis, or meningitis proper. [EU] Menopause: Cessation of menstruation in the human female, occurring usually around the age of 50. [EU] Menotropins: Extracts from human menopausal urine containing FSH and LH activity. They are used to treat infertility disorders. [NIH] Menstruation: The cyclic, physiologic discharge through the vagina of blood and mucosal tissues from the nonpregnant uterus; it is under hormonal control and normally recurs, usually at approximately four-week intervals, in the absence of pregnancy during the reproductive period (puberty through menopause) of the female of the human and a few species of primates. It is the culmination of the menstrual cycle. [EU] Mental: Pertaining to the mind; psychic. 2. (L. mentum chin) pertaining to the chin. [EU] Menthol: An alcohol produced from mint oils or prepared synthetically. [NIH]
Methotrexate: An antineoplastic antimetabolite with immunosuppressant properties. It is an inhibitor of dihydrofolate reductase and prevents the formation of tetrahydrofolate, necessary for synthesis of thymidylate, an essential component of DNA. [NIH] Metoclopramide: A dopamine D2 antagonist that is used as an antiemetic. [NIH]
Microbiology: The study of microorganisms such as fungi, bacteria, algae, archaea, and viruses. [NIH] Microscopy: The application of microscope magnification to the study of materials that cannot be properly seen by the unaided eye. [NIH] Minocycline: A semisynthetic antibiotic effective against tetracyclineresistant staphylococcus infections. [NIH] Mitoxantrone: An anthracenedione-derived antineoplastic agent. [NIH] Mobility: Capability of movement, of being moved, or of flowing freely. [EU]
Glossary 371
Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Mononucleosis: The presence of an abnormally large number of mononuclear leucocytes (monocytes) in the blood. The term is often used alone to refer to infectious mononucleosis. [EU] Mucus: The free slime of the mucous membranes, composed of secretion of the glands, along with various inorganic salts, desquamated cells, and leucocytes. [EU] Myocarditis: Inflammation of the myocardium; inflammation of the muscular walls of the heart. [EU] Naphazoline: An adrenergic vasoconstrictor agent used as a decongestant. [NIH]
Nausea: An unpleasant sensation, vaguely referred to the epigastrium and abdomen, and often culminating in vomiting. [EU] Necrosis: The sum of the morphological changes indicative of cell death and caused by the progressive degradative action of enzymes; it may affect groups of cells or part of a structure or an organ. [EU] Neuralgia: Paroxysmal pain which extends along the course of one or more nerves. Many varieties of neuralgia are distinguished according to the part affected or to the cause, as brachial, facial, occipital, supraorbital, etc., or anaemic, diabetic, gouty, malarial, syphilitic, etc. [EU] Neutrophil: Having an affinity for neutral dyes. [EU] Niacin: Water-soluble vitamin of the B complex occurring in various animal and plant tissues. Required by the body for the formation of coenzymes NAD and NADP. Has pellagra-curative, vasodilating, and antilipemic properties. [NIH] Nitrofurantoin: A urinary anti-infective agent effective against most grampositive and gram-negative organisms. Although sulfonamides and antibiotics are usually the agents of choice for urinary tract infections, nitrofurantoin is widely used for prophylaxis and long-term suppression. [NIH]
Nizatidine: A histamine H2 receptor antagonist with low toxicity that inhibits gastric acid secretion. The drug is used for the treatment of duodenal ulcers. [NIH] Nucleocapsid: A protein-nucleic acid complex which forms part or all of a virion. It consists of a capsid plus enclosed nucleic acid. Depending on the virus, the nucleocapsid may correspond to a naked core or be surrounded by a membranous envelope. [NIH] Occult: Obscure; concealed from observation, difficult to understand. [EU] Ocular: 1. of, pertaining to, or affecting the eye. 2. eyepiece. [EU]
372 Flu Infection
Oedema: The presence of abnormally large amounts of fluid in the intercellular tissue spaces of the body; usually applied to demonstrable accumulation of excessive fluid in the subcutaneous tissues. Edema may be localized, due to venous or lymphatic obstruction or to increased vascular permeability, or it may be systemic due to heart failure or renal disease. Collections of edema fluid are designated according to the site, e.g. ascites (peritoneal cavity), hydrothorax (pleural cavity), and hydropericardium (pericardial sac). Massive generalized edema is called anasarca. [EU] Ophthalmic: Pertaining to the eye. [EU] Oral: Pertaining to the mouth, taken through or applied in the mouth, as an oral medication or an oral thermometer. [EU] Ornithine: An amino acid produced in the urea cycle by the splitting off of urea from arginine. [NIH] Osteoarthritis: Noninflammatory degenerative joint disease occurring chiefly in older persons, characterized by degeneration of the articular cartilage, hypertrophy of bone at the margins, and changes in the synovial membrane. It is accompanied by pain and stiffness, particularly after prolonged activity. [EU] Otitis: Inflammation of the ear, which may be marked by pain, fever, abnormalities of hearing, hearing loss, tinnitus, and vertigo. [EU] Overdose: 1. to administer an excessive dose. 2. an excessive dose. [EU] Oxazepam: A benzodiazepine used in the treatment of anxiety, alcohol withdrawal, and insomnia. [NIH] Paclitaxel: Antineoplastic agent isolated from the bark of the Pacific yew tree, Taxus brevifolia. Paclitaxel stabilizes microtubules in their polymerized form and thus mimics the action of the proto-oncogene proteins C-MOS. [NIH] Pancreas: A mixed exocrine and endocrine gland situated transversely across the posterior abdominal wall in the epigastric and hypochondriac regions. The endocrine portion is comprised of the islets of langerhans, while the exocrine portion is a compound acinar gland that secretes digestive enzymes. [NIH] Panic: A state of extreme acute, intense anxiety and unreasoning fear accompanied by disorganization of personality function. [NIH] Paradoxical: Occurring at variance with the normal rule. [EU] Parasitic: Pertaining to, of the nature of, or caused by a parasite. [EU] Parenteral: Not through the alimentary canal but rather by injection through some other route, as subcutaneous, intramuscular, intraorbital, intracapsular, intraspinal, intrasternal, intravenous, etc. [EU] Paroxetine: A serotonin uptake inhibitor that is effective in the treatment of
Glossary 373
depression. [NIH] Particle: A tiny mass of material. [EU] Pathogen: Any disease-producing microorganism. [EU] Pentoxifylline: A methylxanthine derivative that inhibits phosphodiesterase and affects blood rheology. It improves blood flow by increasing erythrocyte and leukocyte flexibility. It also inhibits platelet aggregation. Pentoxifylline modulates immunologic activity by stimulating cytokine production. [NIH] Peptic: Pertaining to pepsin or to digestion; related to the action of gastric juices. [EU] Pericarditis: Inflammation of the pericardium. [EU] Pharmacodynamics: The study of the biochemical and physiological effects of drugs and the mechanisms of their actions, including the correlation of actions and effects of drugs with their chemical structure; also, such effects on the actions of a particular drug or drugs. [EU] Pharyngitis: Inflammation of the pharynx. [EU] Phenobarbital: A barbituric acid derivative that acts as a nonselective central nervous system depressant. It promotes binding to inhibitory gaba subtype receptors, and modulates chloride currents through receptor channels. It also inhibits glutamate induced depolarizations. [NIH] Phenylalanine: An aromatic amino acid that is essential in the animal diet. It is a precursor of melanin, dopamine, noradrenalin, and thyroxine. [NIH] Phenylephrine: An alpha-adrenergic agonist used as a mydriatic, nasal decongestant, and cardiotonic agent. [NIH] Phenylpropanolamine: A sympathomimetic that acts mainly by causing release of norepinephrine but also has direct agonist activity at some adrenergic receptors. It is most commonly used as a nasal vasoconstrictor and an appetite depressant. [NIH] Piedra: Either of two diseases resulting from fungal infection of the hair shafts. Black piedra occurs mainly in and on the hairs of the scalp and is caused by Piedraia hortae; white piedra occurs in and on the hairs of the scalp, beard, moustache and genital areas and is caused by Trichosporon beigelii. [NIH] Plantago: Three different species of Plantago or plantain, P. psyllium, P. ovata and P. indica. The seeds swell in water and are used as laxatives. [NIH] Plasmids: Any extrachromosomal hereditary determinant. Plasmids are self-replicating circular molecules of DNA that are found in a variety of bacterial, archaeal, fungal, algal, and plant species. [NIH] Pneumonia: Inflammation of the lungs with consolidation. [EU] Podophyllum: A genus of poisonous American herbs, family Berberidaceae.
374 Flu Infection
The roots yield podophyllotoxins and other pharmacologically important agents. The plant was formerly used as a cholagogue and cathartic. It is different from the European mandrake, mandragora. [NIH] Poisoning: A condition or physical state produced by the ingestion, injection or inhalation of, or exposure to a deleterious agent. [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] Praziquantel: An anthelmintic used in most schistosome and many cestode infestations. [NIH] Prednisolone: A glucocorticoid with the general properties of the corticosteroids. It is the drug of choice for all conditions in which routine systemic corticosteroid therapy is indicated, except adrenal deficiency states. [NIH]
Prednisone: A synthetic anti-inflammatory glucocorticoid derived from cortisone. It is biologically inert and converted to prednisolone in the liver. [NIH]
Preeclampsia: A toxaemia of late pregnancy characterized by hypertension, edema, and proteinuria, when convulsions and coma are associated, it is called eclampsia. [EU] 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] Probenecid: The prototypical uricosuric agent. It inhibits the renal excretion of organic anions and reduces tubular reabsorption of urate. Probenecid has also been used to treat patients with renal impairment, and, because it reduces the renal tubular excretion of other drugs, has been used as an adjunct to antibacterial therapy. [NIH] Progesterone: Pregn-4-ene-3,20-dione. The principal progestational hormone of the body, secreted by the corpus luteum, adrenal cortex, and placenta. Its chief function is to prepare the uterus for the reception and development of the fertilized ovum. It acts as an antiovulatory agent when administered on days 5-25 of the menstrual cycle. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Prophylaxis: The prevention of disease; preventive treatment. [EU] Prostate: A gland in males that surrounds the neck of the Bladder and the
Glossary 375
urethra. It secretes a substance that liquifies coagulated semen. It is situated in the pelvic cavity behind the lower part of the pubic symphysis, above the deep layer of the triangular ligament, and rests upon the rectum. [NIH] Protease: Proteinase (= any enzyme that catalyses the splitting of interior peptide bonds in a protein). [EU] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH]
Protozoa: A subkingdom consisting of unicellular organisms that are the simplest in the animal kingdom. Most are free living. They range in size from submicroscopic to macroscopic. Protozoa are divided into seven phyla: Sarcomastigophora, Labyrinthomorpha, Apicomplexa, Microspora, Ascetospora, Myxozoa, and Ciliophora. [NIH] Psoriasis: A common genetically determined, chronic, inflammatory skin disease characterized by rounded erythematous, dry, scaling patches. The lesions have a predilection for nails, scalp, genitalia, extensor surfaces, and the lumbosacral region. Accelerated epidermopoiesis is considered to be the fundamental pathologic feature in psoriasis. [NIH] 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] Psychology: The science dealing with the study of mental processes and behavior in man and animals. [NIH] Psychosomatic: Pertaining to the mind-body relationship; having bodily symptoms of psychic, emotional, or mental origin; called also psychophysiologic. [EU] Psychotherapy: A generic term for the treatment of mental illness or emotional disturbances primarily by verbal or nonverbal communication. [NIH]
Pulmonary: Pertaining to the lungs. [EU] Pyelonephritis: Inflammation of the kidney and its pelvis, beginning in the interstitium and rapidly extending to involve the tubules, glomeruli, and blood vessels; due to bacterial infection. [EU] Quercetin: Aglucon of quercetrin, rutin, and other glycosides. It is widely distributed in the plant kingdom, especially in rinds and barks, clover blossoms, and ragweed pollen. [NIH] Ramipril: A long-acting angiotensin-converting enzyme inhibitor. It is a prodrug that is transformed in the liver to its active metabolite ramiprilat. [NIH]
Receptor:
1. a molecular structure within a cell or on the surface
376 Flu Infection
characterized by (1) selective binding of a specific substance and (2) a specific physiologic effect that accompanies the binding, e.g., cell-surface receptors for peptide hormones, neurotransmitters, antigens, complement fragments, and immunoglobulins and cytoplasmic receptors for steroid hormones. 2. a sensory nerve terminal that responds to stimuli of various kinds. [EU] Recombinant: 1. a cell or an individual with a new combination of genes not found together in either parent; usually applied to linked genes. [EU] Reconstitution: 1. a type of regeneration in which a new organ forms by the rearrangement of tissues rather than from new formation at an injured surface. 2. the restoration to original form of a substance previously altered for preservation and storage, as the restoration to a liquid state of blood serum or plasma that has been dried and stored. [EU] Recurrence: The return of a sign, symptom, or disease after a remission. [NIH] Reflux: A backward or return flow. [EU] Rehydration: The restoration of water or of fluid content to a body or to substance which has become dehydrated. [EU] Remission: A diminution or abatement of the symptoms of a disease; also the period during which such diminution occurs. [EU] Reserpine: An alkaloid found in the roots of Rauwolfia serpentina and R. vomitoria. Reserpine inhibits the uptake of norepinephrine into storage vesicles resulting in depletion of catecholamines and serotonin from central and peripheral axon terminals. It has been used as an antihypertensive and an antipsychotic as well as a research tool, but its adverse effects limit its clinical use. [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] Retinopathy: 1. retinitis (= inflammation of the retina). 2. retinosis (= degenerative, noninflammatory condition of the retina). [EU] Rheumatoid: Resembling rheumatism. [EU] Rhinitis: Inflammation of the mucous membrane of the nose. [EU] Ribavirin: 1-beta-D-Ribofuranosyl-1H-1,2,4-triazole-3-carboxamide. A nucleoside antimetabolite antiviral agent that blocks nucleic acid synthesis and is used against both RNA and DNA viruses. [NIH] Riboflavin: Nutritional factor found in milk, eggs, malted barley, liver, kidney, heart, and leafy vegetables. The richest natural source is yeast. It
Glossary 377
occurs in the free form only in the retina of the eye, in whey, and in urine; its principal forms in tissues and cells are as FMN and FAD. [NIH] Rifabutin: A broad-spectrum antibiotic that is being used as prophylaxis against disseminated Mycobacterium avium complex infection in HIVpositive patients. [NIH] Rimantadine: An RNA synthesis inhibitor that is used as an antiviral agent in the prophylaxis and treatment of influenza. [NIH] Rubella: An acute, usually benign, infectious disease caused by a togavirus and most often affecting children and nonimmune young adults, in which the virus enters the respiratory tract via droplet nuclei and spreads to the lymphatic system. It is characterized by a slight cold, sore throat, and fever, followed by enlargement of the postauricular, suboccipital, and cervical lymph nodes, and the appearances of a fine pink rash that begins on the head and spreads to become generalized. Called also German measles, roetln, röteln, and three-day measles, and rubeola in French and Spanish. [EU] 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] Salmonella: A genus of gram-negative, facultatively anaerobic, rod-shaped bacteria that utilizes citrate as a sole carbon source. It is pathogenic for humans, causing enteric fevers, gastroenteritis, and bacteremia. Food poisoning is the most common clinical manifestation. Organisms within this genus are separated on the basis of antigenic characteristics, sugar fermentation patterns, and bacteriophage susceptibility. [NIH] Sanitation: The development and establishment of environmental conditions favorable to the health of the public. [NIH] Sarcoma: A tumour made up of a substance like the embryonic connective tissue; tissue composed of closely packed cells embedded in a fibrillar or homogeneous substance. Sarcomas are often highly malignant. [EU] Schizophrenia: A severe emotional disorder of psychotic depth characteristically marked by a retreat from reality with delusion formation, hallucinations, emotional disharmony, and regressive behavior. [NIH] Sclerosis: A induration, or hardening; especially hardening of a part from inflammation and in diseases of the interstitial substance. The term is used chiefly for such a hardening of the nervous system due to hyperplasia of the connective tissue or to designate hardening of the blood vessels. [EU] 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] Sedative:
1. allaying activity and excitement. 2. an agent that allays
378 Flu Infection
excitement. [EU] Semen: The thick, yellowish-white, viscid fluid secretion of male reproductive organs discharged upon ejaculation. In addition to reproductive organ secretions, it contains spermatozoa and their nutrient plasma. [NIH] Senna: Preparations of Cassia senna L. and C. angustifolia of the Leguminosae. They contain sennosides, which are anthraquinone type cathartics and are used in many different preparations as laxatives. [NIH] Sertraline: A selective serotonin uptake inhibitor that is used in the treatment of depression. [NIH] Serum: The clear portion of any body fluid; the clear fluid moistening serous membranes. 2. blood serum; the clear liquid that separates from blood on clotting. 3. immune serum; blood serum from an immunized animal used for passive immunization; an antiserum; antitoxin, or antivenin. [EU] Sigmoidoscopy: Endoscopic examination, therapy or surgery of the sigmoid flexure. [NIH] Sirolimus: A macrolide compound obtained from Streptomyces hygroscopicus that acts by selectively blocking the transcriptional activation of cytokines thereby inhibiting cytokine production. It is bioactive only when bound to immunophilins. Sirolimus is a potent immunosuppressant and possesses both antifungal and antineoplastic properties. [NIH] Sneezing: Sudden, forceful, involuntary expulsion of air from the nose and mouth caused by irritation to the mucous membranes of the upper respiratory tract. [NIH] Sodium Fluoride: A source of inorganic fluoride which is used topically to prevent dental caries. [NIH] Sorbitol: A polyhydric alcohol with about half the sweetness of sucrose. Sorbitol occurs naturally and is also produced synthetically from glucose. It was formerly used as a diuretic and may still be used as a laxative and in irrigating solutions for some surgical procedures. It is also used in many manufacturing processes, as a pharmaceutical aid, and in several research applications. [NIH] Sotalol: An adrenergic beta-antagonist that is used in the treatment of lifethreatening arrhythmias. [NIH] Spastic: 1. of the nature of or characterized by spasms. 2. hypertonic, so that the muscles are stiff and the movements awkward. 3. a person exhibiting spasticity, such as occurs in spastic paralysis or in cerebral palsy. [EU] Spectinomycin: An antibiotic produced by Streptomyces spectabilis. It is active against gram-negative bacteria and used for the treatment of gonorrhea. [NIH]
Glossary 379
Spores: The reproductive elements of lower organisms, such as protozoa, fungi, and cryptogamic plants. [NIH] Stachybotrys: A mitosporic fungal genus including one species which forms a toxin in moldy hay that may cause a serious illness in horses. [NIH] Stenosis: Narrowing or stricture of a duct or canal. [EU] Sterilization: 1. the complete destruction or elimination of all living microorganisms, accomplished by physical methods (dry or moist heat), chemical agents (ethylene oxide, formaldehyde, alcohol), radiation (ultraviolet, cathode), or mechanical methods (filtration). 2. any procedure by which an individual is made incapable of reproduction, as by castration, vasectomy, or salpingectomy. [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] Streptozocin: An antibiotic that is produced by Stretomyces achromogenes. It is used as an antineoplastic agent and to induce diabetes in experimental animals. [NIH] Substrate: A substance upon which an enzyme acts. [EU] Succimer: A mercaptodicarboxylic acid used as an antidote to heavy metal poisoning because it forms strong chelates with them. [NIH] Sucralfate: A basic aluminum complex of sulfated sucrose. It is advocated in the therapy of peptic, duodenal, and prepyloric ulcers, gastritis, reflux esophagitis, and other gastrointestinal irritations. It acts primarily at the ulcer site, where it has cytoprotective, pepsinostatic, antacid, and bile acidbinding properties. The drug is only slightly absorbed by the digestive mucosa, which explains the absence of systemic effects and toxicity. [NIH] Sulfinpyrazone: A uricosuric drug that is used to reduce the serum urate levels in gout therapy. It lacks anti-inflammatory, analgesic, and diuretic properties. [NIH] Sunburn: An injury to the skin causing erythema, tenderness, and sometimes blistering and resulting from excessive exposure to the sun. The reaction is produced by the ultraviolet radiation in sunlight. [NIH] Sweat: The fluid excreted by the sweat glands. It consists of water containing sodium chloride, phosphate, urea, ammonia, and other waste products. [NIH] Symptomatic: 1. pertaining to or of the nature of a symptom. 2. indicative (of a particular disease or disorder). 3. exhibiting the symptoms of a particular disease but having a different cause. 4. directed at the allying of symptoms, as symptomatic treatment. [EU]
380 Flu Infection
Syncope: A temporary suspension of consciousness due to generalized cerebral schemia, a faint or swoon. [EU] Syphilis: A contagious venereal disease caused by the spirochete treponema pallidum. [NIH] Systemic: Pertaining to or affecting the body as a whole. [EU] Tachycardia: Excessive rapidity in the action of the heart; the term is usually applied to a heart rate above 100 per minute and may be qualified as atrial, junctional (nodal), or ventricular, and as paroxysmal. [EU] Tacrolimus: A macrolide isolated from the culture broth of a strain of Streptomyces tsukubaensis that has strong immunosuppressive activity in vivo and prevents the activation of T-lymphocytes in response to antigenic or mitogenic stimulation in vitro. [NIH] Tardive: Marked by lateness, late; said of a disease in which the characteristic lesion is late in appearing. [EU] Taurine: 2-Aminoethanesulfonic acid. A conditionally essential nutrient, important during mammalian development. It is present in milk but is isolated mostly from ox bile and strongly conjugates bile acids. [NIH] Tetanus: A disease caused by tetanospasmin, a powerful protein toxin produced by clostridium tetani. Tetanus usually occurs after an acute injury, such as a puncture wound or laceration. Generalized tetanus, the most common form, is characterized by tetanic muscular contractions and hyperreflexia. Localized tetanus presents itself as a mild condition with manifestations restricted to muscles near the wound. It may progress to the generalized form. [NIH] Tetracycline: An antibiotic originally produced by Streptomyces viridifaciens, but used mostly in synthetic form. It is an inhibitor of aminoacyl-tRNA binding during protein synthesis. [NIH] Thermoregulation: Heat regulation. [EU] Thiothixene: A thioxanthine used as an antipsychotic agent. Its effects are similar to the phenothiazine antipsychotics. [NIH] Thyroxine: An amino acid of the thyroid gland which exerts a stimulating effect on thyroid metabolism. [NIH] Topical: Pertaining to a particular surface area, as a topical anti-infective applied to a certain area of the skin and affecting only the area to which it is applied. [EU] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxin: A poison; frequently used to refer specifically to a protein produced by some higher plants, certain animals, and pathogenic bacteria, which is
Glossary 381
highly toxic for other living organisms. Such substances are differentiated from the simple chemical poisons and the vegetable alkaloids by their high molecular weight and antigenicity. [EU] Transfusion: The introduction of whole blood or blood component directly into the blood stream. [EU] Transplantation: The grafting of tissues taken from the patient's own body or from another. [EU] Triage: The sorting out and classification of patients or casualties to determine priority of need and proper place of treatment. [NIH] Triazolam: A short-acting benzodiazepine used in the treatment of insomnia. Some countries temporarily withdrew triazolam from the market because of concerns about adverse reactions, mostly psychological, associated with higher dose ranges. Its use at lower doses with appropriate care and labeling has been reaffirmed by the FDA and most other countries. [NIH]
Trichinosis: A disease due to infection with trichinella spiralis. It is caused by eating undercooked meat, usually pork. [NIH] Tuberculosis: Any of the infectious diseases of man and other animals caused by species of mycobacterium. [NIH] Tyrosine: A non-essential amino acid. In animals it is synthesized from phenylalanine. It is also the precursor of epinephrine, thyroid hormones, and melanin. [NIH] Ulcer: A local defect, or excavation, of the surface of an organ or tissue; which is produced by the sloughing of inflammatory necrotic tissue. [EU] Uricosuric: 1. pertaining to, characterized by, or promoting uricosuria (= the excretion of uric acid in the urine). 2. an agent that promotes uricosuria. [EU] Urinalysis: Examination of urine by chemical, physical, or microscopic means. Routine urinalysis usually includes performing chemical screening tests, determining specific gravity, observing any unusual color or odor, screening for bacteriuria, and examining the sediment microscopically. [NIH] Urinary: Pertaining to the urine; containing or secreting urine. [EU] Vaccination: The introduction of vaccine into the body for the purpose of inducing immunity. Coined originally to apply to the injection of smallpox vaccine, the term has come to mean any immunizing procedure in which vaccine is injected. [EU] Vaccine: A suspension of attenuated or killed microorganisms (bacteria, viruses, or rickettsiae), administered for the prevention, amelioration or treatment of infectious diseases. [EU] Vaginal: 1. of the nature of a sheath; ensheathing. 2. pertaining to the vagina. 3. pertaining to the tunica vaginalis testis. [EU]
382 Flu Infection
Vaginitis: Inflammation of the vagina characterized by pain and a purulent discharge. [NIH] Valerian: Valeriana officinale, an ancient, sedative herb of the large family Valerianaceae. The roots were formerly used to treat hysterias and other neurotic states and are presently used to treat sleep disorders. [NIH] Vancomycin: Antibacterial obtained from Streptomyces orientalis. It is a glycopeptide related to ristocetin that inhibits bacterial cell wall assembly and is toxic to kidneys and the inner ear. [NIH] Varicella: Chicken pox. [EU] Veins: The vessels carrying blood toward the heart. [NIH] Ventricular: Pertaining to a ventricle. [EU] Verapamil: A calcium channel blocker that is a class IV anti-arrhythmia agent. [NIH] Vertigo: An illusion of movement; a sensation as if the external world were revolving around the patient (objective vertigo) or as if he himself were revolving in space (subjective vertigo). The term is sometimes erroneously used to mean any form of dizziness. [EU] Veterinarians: Individuals with a degree in veterinary medicine that provides them with training and qualifications to treat diseases and injuries of animals. [NIH] Vibrio: A genus of vibrionaceae, made up of short, slightly curved, motile, gram-negative rods. Various species produce cholera and other gastrointestinal disorders as well as abortion in sheep and cattle. [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] Viruses: Minute infectious agents whose genomes are composed of DNA or RNA, but not both. They are characterized by a lack of independent metabolism and the inability to replicate outside living host cells. [NIH] Vitreous: Glasslike or hyaline; often used alone to designate the vitreous body of the eye (corpus vitreum). [EU] Warfarin: An anticoagulant that acts by inhibiting the synthesis of vitamin K-dependent coagulation factors. Warfarin is indicated for the prophylaxis and/or treatment of venous thrombosis and its extension, pulmonary embolism, and atrial fibrillation with embolization. It is also used as an adjunct in the prophylaxis of systemic embolism after myocardial infarction. Warfarin is also used as a rodenticide. [NIH] Warts: Benign epidermal proliferations or tumors; some are viral in origin. [NIH]
Glossary 383
Withdrawal: 1. a pathological retreat from interpersonal contact and social involvement, as may occur in schizophrenia, depression, or schizoid avoidant and schizotypal personality disorders. 2. (DSM III-R) a substancespecific organic brain syndrome that follows the cessation of use or reduction in intake of a psychoactive substance that had been regularly used to induce a state of intoxication. [EU]
General Dictionaries and Glossaries While the above glossary is essentially complete, the dictionaries listed here cover virtually all aspects of medicine, from basic words and phrases to more advanced terms (sorted alphabetically by title; hyperlinks provide rankings, information and reviews at Amazon.com): ·
Dictionary of Medical Acronymns & Abbreviations by Stanley Jablonski (Editor), Paperback, 4th edition (2001), Lippincott Williams & Wilkins Publishers, ISBN: 1560534605, http://www.amazon.com/exec/obidos/ASIN/1560534605/icongroupinterna
·
Dictionary of Medical Terms : For the Nonmedical Person (Dictionary of Medical Terms for the Nonmedical Person, Ed 4) by Mikel A. Rothenberg, M.D, et al, Paperback - 544 pages, 4th edition (2000), Barrons Educational Series, ISBN: 0764112015, http://www.amazon.com/exec/obidos/ASIN/0764112015/icongroupinterna
·
A Dictionary of the History of Medicine by A. Sebastian, CD-Rom edition (2001), CRC Press-Parthenon Publishers, ISBN: 185070368X, http://www.amazon.com/exec/obidos/ASIN/185070368X/icongroupinterna
·
Dorland’s Illustrated Medical Dictionary (Standard Version) by Dorland, et al, Hardcover - 2088 pages, 29th edition (2000), W B Saunders Co, ISBN: 0721662544, http://www.amazon.com/exec/obidos/ASIN/0721662544/icongroupinterna
·
Dorland’s Electronic Medical Dictionary by Dorland, et al, Software, 29th Book & CD-Rom edition (2000), Harcourt Health Sciences, ISBN: 0721694934, http://www.amazon.com/exec/obidos/ASIN/0721694934/icongroupinterna
·
Dorland’s Pocket Medical Dictionary (Dorland’s Pocket Medical Dictionary, 26th Ed) Hardcover - 912 pages, 26th edition (2001), W B Saunders Co, ISBN: 0721682812, http://www.amazon.com/exec/obidos/ASIN/0721682812/icongroupinterna /103-4193558-7304618
384 Flu Infection
·
Melloni’s Illustrated Medical Dictionary (Melloni’s Illustrated Medical Dictionary, 4th Ed) by Melloni, Hardcover, 4th edition (2001), CRC PressParthenon Publishers, ISBN: 85070094X, http://www.amazon.com/exec/obidos/ASIN/85070094X/icongroupinterna
·
Stedman’s Electronic Medical Dictionary Version 5.0 (CD-ROM for Windows and Macintosh, Individual) by Stedmans, CD-ROM edition (2000), Lippincott Williams & Wilkins Publishers, ISBN: 0781726328, http://www.amazon.com/exec/obidos/ASIN/0781726328/icongroupinterna
·
Stedman’s Medical Dictionary by Thomas Lathrop Stedman, Hardcover 2098 pages, 27th edition (2000), Lippincott, Williams & Wilkins, ISBN: 068340007X, http://www.amazon.com/exec/obidos/ASIN/068340007X/icongroupinterna
·
Tabers Cyclopedic Medical Dictionary (Thumb Index) by Donald Venes (Editor), et al, Hardcover - 2439 pages, 19th edition (2001), F A Davis Co, ISBN: 0803606540, http://www.amazon.com/exec/obidos/ASIN/0803606540/icongroupinterna
Index 385
INDEX A Abdominal.......98, 99, 175, 276, 351, 354, 363, 372 Abortion ...........................31, 98, 347, 382 Acetaminophen......................................15 Acne ............................................270, 347 Adenosine......................................54, 347 Adrenergic ....79, 83, 84, 86, 87, 174, 275, 277, 348, 360, 368, 371, 373, 378 Agonist......79, 83, 87, 174, 175, 348, 351, 373 Albuterol ......................................174, 348 Alkaloid ........................................179, 376 Allergen .......................................134, 356 Alopecia.......................................176, 355 Aluminum.....................................180, 379 Amantadine .......................14, 15, 16, 190 Anal .......................................................64 Anemia ..........................14, 128, 335, 354 Anorexia ........................................99, 363 Antibiotic .....175, 176, 177, 179, 180, 270, 275, 348, 350, 351, 354, 356, 358, 360, 366, 370, 377, 378, 379, 380 Antibody .......47, 54, 75, 78, 79, 286, 349, 356, 366, 369 Anticonvulsant .............................178, 369 Antidepressant.......................77, 286, 362 Antifungal...... 77, 78, 177, 179, 361, 368, 378 Antigen ....... 44, 45, 54, 78, 79, 270, 348, 349, 366, 369 Antihistamine .........................................83 Antioxidant...........................................190 Antiviral ....... 14, 16, 25, 29, 65, 177, 190, 194, 269, 347, 348, 362, 376, 377 Anxiety....... 90, 177, 178, 275, 276, 362, 368, 369, 372 Appendicitis ...................................99, 358 Aqueous ..........................79, 82, 195, 369 Aromatic ......................274, 276, 364, 373 Arrhythmia ...........131, 270, 278, 350, 382 Arteries ........................................272, 355 Assay.............................................78, 366 B Bacteria .....15, 25, 27, 28, 29, 30, 31, 54, 77, 102, 176, 180, 272, 280, 349, 351, 354, 358, 360, 361, 370, 377, 378, 380 Benign ...........................29, 177, 361, 377 Biochemical .................................178, 373 Biosynthesis ..........................................70 Boron ...........................................313, 351
Bronchitis .................................... 273, 360 C Candidiasis ................................... 77, 361 Capsules ......................... 82, 86, 283, 363 Carbohydrate ........................ 77, 282, 363 Cardiac... 45, 86, 175, 177, 273, 351, 359, 360, 366 Carotene ............................................... 85 Cataract ...................................... 271, 352 Chemotherapy ................................ 44, 45 Chlorophyll .............................. 27, 70, 362 Chlorpromazine .......................... 175, 353 Cholesterol.................................. 280, 282 Chronic....... 11, 14, 26, 95, 272, 276, 324, 354, 358, 375 Cisplatin ...................................... 175, 354 Colorectal............................................ 191 Concomitant.......................................... 90 Condoms............................................. 102 Confusion.............................................. 17 Congestion.............................. 76, 84, 356 Constipation .......................................... 93 Cortex ...... 55, 75, 99, 177, 276, 355, 360, 361, 365, 374 Creatine ...................................... 313, 355 Curative............................... 253, 314, 371 Cutaneous..................... 28, 270, 352, 369 Cytokines .................................... 179, 378 D Decongestant.................. 86, 87, 371, 373 Degenerative ...... 100, 277, 281, 372, 376 Dehydration..................................... 60, 62 Dementia............................................... 60 Dentifrices ............................................. 97 Desipramine........................................ 286 Diarrhea ..... 26, 60, 76, 93, 270, 273, 280, 350, 356, 358, 360 Diphtheria.................................. 20, 22, 61 Disinfectant ......................................... 122 Dizziness..................................... 278, 382 Doxorubicin ................................. 176, 360 Dysphagia ................................... 275, 368 Dysplasia ............................................ 128 E Echinacea ....................... 84, 85, 187, 195 Electrolyte ................................... 131, 374 Endocarditis ................................ 271, 352 Endocytosis................................... 76, 359 Endometriosis ............................. 273, 359 Enterovirus.................................... 76, 359
386 Flu Infection
Enzyme...55, 80, 174, 179, 271, 350, 354, 359, 375, 379 Epidemic................11, 12, 15, 17, 93, 103 Epidemiological ...................................191 Epinephrine .............................84, 86, 347 Erythrocytes.......25, 75, 77, 349, 351, 360 F Fatigue.....................................64, 98, 350 Feces ...........................................270, 350 Fluconazole .........................................188 Fluorescence .................................77, 362 Fluoxetine ............................................286 Fungus.................................122, 270, 351 G Gastritis .......................................180, 379 Gastroenteritis ...............................29, 377 Gastrointestinal...31, 86, 90, 99, 178, 180, 271, 354, 360, 363, 369, 379, 382 Gelatin .....................................77, 82, 363 Gels .........................................97, 99, 363 Glucans ...........................................84, 85 Glucose ....... 62, 64, 77, 78, 86, 179, 363, 367, 378 Gonorrhea ...................................180, 378 Gout .............................................180, 379 H Haematological....................................188 Hepatic ..................................................90 Hepatitis...............................20, 21, 61, 82 Herpes ...................................27, 194, 364 Hiccup..........................................175, 353 Hormonal .....................................100, 370 Hormones ....... 64, 76, 80, 174, 270, 348, 349, 356, 376 Humoral .................................................71 Hydrochloric Acid.........................335, 365 Hyperplasia....................29, 177, 361, 377 Hypertension .........90, 177, 276, 360, 374 Hypothyroidism............................274, 366 I Immunity ..........................27, 31, 366, 381 Immunization ....20, 22, 27, 30, 55, 64, 93, 94, 113, 366, 378 Immunotherapy......................45, 134, 356 Induction ........................27, 174, 349, 366 Infertility .......................................178, 370 Inflammation .....26, 27, 29, 55, 79, 98, 99, 192, 271, 272, 273, 277, 350, 352, 354, 357, 358, 361, 363, 365, 367, 371, 376 Infusion ..........................................45, 190 Inhalation .........28, 99, 178, 364, 368, 374 Insomnia ................84, 276, 277, 372, 381 Insulin ..................62, 64, 77, 78, 363, 367 Intestinal .....25, 60, 76, 86, 280, 351, 352, 359 Intestines ...12, 27, 99, 272, 358, 361, 363
Intramuscular ........................ 45, 178, 372 Intravenous ... 45, 123, 178, 335, 362, 372 Itraconazole ........................................ 188 J Juniper ........................................ 275, 368 K Ketoacidosis ......................................... 62 L Lesion ........................... 79, 277, 369, 380 Lethal .......................................... 108, 188 Lipid ................................ 78, 79, 367, 369 Lithium ........................................ 178, 369 Localization ......................................... 193 M Malignant ...... 27, 56, 98, 100, 351, 367, 370, 377 Melanoma ................................... 100, 370 Membrane....... 76, 77, 87, 100, 272, 273, 335, 357, 359, 361, 372, 376 Meningitis... 76, 77, 78, 79, 358, 361, 368, 370 Menopause ................................. 100, 370 Menstruation ............... 272, 275, 358, 370 Mental .... 17, 26, 75, 76, 80, 96, 100, 181, 184, 274, 277, 326, 354, 356, 361, 366, 375 Molecular ...... 30, 75, 80, 120, 125, 126, 350, 375, 381 Mononucleosis .............................. 28, 371 Mucus ..................... 16, 77, 272, 358, 361 Myocarditis.................................... 26, 357 N Naphazoline .......................................... 84 Necrosis ...................................... 273, 361 Neuralgia....................... 25, 275, 348, 371 Niacin .................................................. 281 Nitrofurantoin .............................. 275, 371 Nucleocapsid ................................ 79, 371 O Ocular ................................................... 84 Oedema ................................................ 84 Oral .. 25, 26, 28, 62, 84, 86, 97, 175, 177, 270, 273, 348, 351, 352, 353, 356, 363, 366, 372 Osteoarthritis ........................................ 90 Otitis...................................................... 17 Overdose .................................... 281, 338 P Pancreas....................................... 78, 367 Panic ................................... 115, 177, 362 Parasitic ...................................... 272, 358 Particle .......................................... 79, 369 Peptic .......................................... 180, 379 Phenylephrine ....................................... 84 Phenylpropanolamine ........................... 84
Index 387
Pneumonia .....16, 21, 61, 65, 68, 72, 122, 188, 194 Poisoning.........29, 99, 180, 363, 377, 379 Potassium....123, 176, 274, 282, 357, 364 Prenatal ...............................................256 Progressive................17, 55, 76, 356, 371 Prophylaxis .......29, 82, 83, 179, 275, 278, 371, 377, 382 Protease ................................47, 177, 366 Proteins ......15, 54, 75, 78, 280, 282, 349, 356, 365 Protozoa ......................131, 272, 358, 379 Psoriasis ......................................277, 375 Psychic ............................28, 80, 370, 375 Psychology ..........................................252 Pulmonary ....98, 177, 192, 278, 286, 353, 360, 382 R Receptor .......54, 271, 273, 275, 276, 349, 354, 361, 371, 373 Recombinant .........................................70 Reflux ..................................180, 218, 379 Remission......................................80, 376 Retina ..........................277, 314, 376, 377 Rheumatoid ...........................................90 Rhinitis ...........83, 178, 271, 285, 353, 368 Riboflavin.............................................280 Rimantadine ....................14, 16, 189, 190 Rubella ............................................20, 61 S Saliva .....................................................97 Sanitation.............................102, 270, 350 Schizophrenia..............................278, 383 Sclerosis ........................................82, 127 Secretion ..28, 29, 83, 271, 273, 274, 275, 353, 361, 366, 371, 377, 378 Sedative......176, 178, 272, 275, 278, 354, 357, 368, 369, 382 Semen .........................................276, 375 Senna ..........................................179, 378
Serum ...... 29, 67, 80, 180, 270, 348, 376, 378, 379 Sneezing ............................................... 83 Spastic ........................................ 277, 378 Spores................................................. 122 Substrate............................................... 67 Symptomatic ............. 25, 83, 87, 348, 379 Systemic .... 26, 55, 84, 86, 180, 270, 278, 348, 352, 357, 360, 372, 374, 379, 382 T Tachycardia .......................... 84, 270, 350 Tetanus ....................... 20, 22, 30, 61, 380 Tetracycline................. 272, 275, 358, 370 Thermoregulation................................ 280 Thyroxine ............................................ 282 Topical .............. 80, 83, 97, 175, 353, 380 Toxicity....... 177, 180, 274, 275, 364, 366, 371, 379 Toxin ............................. 30, 314, 379, 380 Transplantation ..................... 45, 274, 365 Triazolam .................................... 277, 381 Tuberculosis............................ 21, 28, 369 U Ulcer............................ 180, 271, 352, 379 Uricosuric .................... 179, 180, 374, 379 Urinalysis ...................................... 30, 381 Urinary ...... 99, 175, 271, 275, 351, 353, 354, 366, 371 V Vaccination .... 13, 15, 44, 45, 47, 63, 66, 69, 70, 71, 73, 109, 111, 112, 191, 195 Vaginitis ...................................... 270, 352 Vancomycin ........................................ 165 Varicella ................................................ 20 Veins ............................................. 28, 367 Ventricular..................................... 87, 380 Vertigo........................... 28, 278, 372, 382 Virulence ....................................... 80, 380 Vitreous......................................... 80, 382 W Withdrawal .................................. 276, 372
388 Flu Infection
Index 389
390 Flu Infection
