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

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

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

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

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

Publisher, Health Care: Philip Parker, Ph.D. Editor(s): James Parker, M.D., Philip Parker, Ph.D. Publisher's note: The ideas, procedures, and suggestions contained in this book are not intended for the diagnosis or treatment of a health problem. As new medical or scientific information becomes available from academic and clinical research, recommended treatments and drug therapies may undergo changes. The authors, editors, and publisher have attempted to make the information in this book up to date and accurate in accord with accepted standards at the time of publication. The authors, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of this book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised to always check product information (package inserts) for changes and new information regarding dosage and contraindications before prescribing any drug or pharmacological product. Caution is especially urged when using new or infrequently ordered drugs, herbal remedies, vitamins and supplements, alternative therapies, complementary therapies and medicines, and integrative medical treatments. Cataloging-in-Publication Data Parker, James N., 1961Parker, Philip M., 1960Urine Protein: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References / James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary, and index. ISBN: 0-597-84672-3 1. Urine Protein-Popular works. I. Title.

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

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

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Acknowledgements The collective knowledge generated from academic and applied research summarized in various references has been critical in the creation of this book which is best viewed as a comprehensive compilation and collection of information prepared by various official agencies which produce publications on urine protein. Books in this series draw from various agencies and institutions associated with the United States Department of Health and Human Services, and in particular, the Office of the Secretary of Health and Human Services (OS), the Administration for Children and Families (ACF), the Administration on Aging (AOA), the Agency for Healthcare Research and Quality (AHRQ), the Agency for Toxic Substances and Disease Registry (ATSDR), the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), the Healthcare Financing Administration (HCFA), the Health Resources and Services Administration (HRSA), the Indian Health Service (IHS), the institutions of the National Institutes of Health (NIH), the Program Support Center (PSC), and the Substance Abuse and Mental Health Services Administration (SAMHSA). In addition to these sources, information gathered from the National Library of Medicine, the United States Patent Office, the European Union, and their related organizations has been invaluable in the creation of this book. Some of the work represented was financially supported by the Research and Development Committee at INSEAD. This support is gratefully acknowledged. Finally, special thanks are owed to Tiffany Freeman for her excellent editorial support.

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About the Editors James N. Parker, M.D. Dr. James N. Parker received his Bachelor of Science degree in Psychobiology from the University of California, Riverside and his M.D. from the University of California, San Diego. In addition to authoring numerous research publications, he has lectured at various academic institutions. Dr. Parker is the medical editor for health books by ICON Health Publications. Philip M. Parker, Ph.D. Philip M. Parker is the Eli Lilly Chair Professor of Innovation, Business and Society at INSEAD (Fontainebleau, France and Singapore). Dr. Parker has also been Professor at the University of California, San Diego and has taught courses at Harvard University, the Hong Kong University of Science and Technology, the Massachusetts Institute of Technology, Stanford University, and UCLA. Dr. Parker is the associate editor for ICON Health Publications.

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About ICON Health Publications To discover more about ICON Health Publications, simply check with your preferred online booksellers, including Barnes&Noble.com and Amazon.com which currently carry all of our titles. Or, feel free to contact us directly for bulk purchases or institutional discounts: ICON Group International, Inc. 4370 La Jolla Village Drive, Fourth Floor San Diego, CA 92122 USA Fax: 858-546-4341 Web site: www.icongrouponline.com/health

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Table of Contents FORWARD .......................................................................................................................................... 1 CHAPTER 1. STUDIES ON URINE PROTEIN ........................................................................................ 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Urine Protein ................................................................................ 4 The National Library of Medicine: PubMed .................................................................................. 8 CHAPTER 2. BOOKS ON URINE PROTEIN......................................................................................... 17 Overview...................................................................................................................................... 17 Book Summaries: Online Booksellers........................................................................................... 17 Chapters on Urine Protein........................................................................................................... 17 CHAPTER 3. PERIODICALS AND NEWS ON URINE PROTEIN ........................................................... 19 Overview...................................................................................................................................... 19 News Services and Press Releases................................................................................................ 19 Academic Periodicals covering Urine Protein ............................................................................. 21 APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 25 Overview...................................................................................................................................... 25 NIH Guidelines............................................................................................................................ 25 NIH Databases............................................................................................................................. 27 Other Commercial Databases....................................................................................................... 29 APPENDIX B. PATIENT RESOURCES ................................................................................................. 31 Overview...................................................................................................................................... 31 Patient Guideline Sources............................................................................................................ 31 Finding Associations.................................................................................................................... 43 APPENDIX C. FINDING MEDICAL LIBRARIES .................................................................................. 45 Overview...................................................................................................................................... 45 Preparation................................................................................................................................... 45 Finding a Local Medical Library.................................................................................................. 45 Medical Libraries in the U.S. and Canada ................................................................................... 45 ONLINE GLOSSARIES.................................................................................................................. 51 Online Dictionary Directories ..................................................................................................... 51 URINE PROTEIN DICTIONARY................................................................................................. 53 INDEX ................................................................................................................................................ 81

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FORWARD In March 2001, the National Institutes of Health issued the following warning: "The number of Web sites offering health-related resources grows every day. Many sites provide valuable information, while others may have information that is unreliable or misleading."1 Furthermore, because of the rapid increase in Internet-based information, many hours can be wasted searching, selecting, and printing. Since only the smallest fraction of information dealing with urine protein is indexed in search engines, such as www.google.com or others, a non-systematic approach to Internet research can be not only time consuming, but also incomplete. This book was created for medical professionals, students, and members of the general public who want to know as much as possible about urine protein, using the most advanced research tools available and spending the least amount of time doing so. In addition to offering a structured and comprehensive bibliography, the pages that follow will tell you where and how to find reliable information covering virtually all topics related to urine protein, from the essentials to the most advanced areas of research. Public, academic, government, and peer-reviewed research studies are emphasized. Various abstracts are reproduced to give you some of the latest official information available to date on urine protein. Abundant guidance is given on how to obtain free-of-charge primary research results via the Internet. While this book focuses on the field of medicine, when some sources provide access to non-medical information relating to urine protein, these are noted in the text. E-book and electronic versions of this book are fully interactive with each of the Internet sites mentioned (clicking on a hyperlink automatically opens your browser to the site indicated). If you are using the hard copy version of this book, you can access a cited Web site by typing the provided Web address directly into your Internet browser. You may find it useful to refer to synonyms or related terms when accessing these Internet databases. NOTE: At the time of publication, the Web addresses were functional. However, some links may fail due to URL address changes, which is a common occurrence on the Internet. For readers unfamiliar with the Internet, detailed instructions are offered on how to access electronic resources. For readers unfamiliar with medical terminology, a comprehensive glossary is provided. For readers without access to Internet resources, a directory of medical libraries, that have or can locate references cited here, is given. We hope these resources will prove useful to the widest possible audience seeking information on urine protein. The Editors

1

From the NIH, National Cancer Institute (NCI): http://www.cancer.gov/cancerinfo/ten-things-to-know.

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CHAPTER 1. STUDIES ON URINE PROTEIN Overview In this chapter, we will show you how to locate peer-reviewed references and studies on urine protein.

The Combined Health Information Database The Combined Health Information Database summarizes studies across numerous federal agencies. To limit your investigation to research studies and urine protein, you will need to use the advanced search options. First, go to http://chid.nih.gov/index.html. From there, select the “Detailed Search” option (or go directly to that page with the following hyperlink: http://chid.nih.gov/detail/detail.html). The trick in extracting studies is found in the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Journal Article.” At the top of the search form, select the number of records you would like to see (we recommend 100) and check the box to display “whole records.” We recommend that you type “urine protein” (or synonyms) into the “For these words:” box. Consider using the option “anywhere in record” to make your search as broad as possible. If you want to limit the search to only a particular field, such as the title of the journal, then select this option in the “Search in these fields” drop box. The following is what you can expect from this type of search: •

Blood Pressure and Urine Protein Levels with the Least Risk for Worsening Kidney Disease Source: Annals of Internal Medicine. 139(4): I-36. August 2003. Summary: Chronic kidney disease can cause a gradual and progressive loss of function in both kidneys. Most patients with chronic kidney disease have high blood pressure (hypertension) and high levels of protein in their urine (proteinuria). Doctors use drugs called antihypertensive agents to reduce both blood pressure and protein in urine. This fact sheet helps patients with kidney disease understand the importance of blood pressure and urine protein levels. The fact sheet reviews a recent study undertaken to determine the levels of blood pressure and protein in urine that are associated with the lowest risk for worsening kidney disease. The research found that higher systolic (the top number), but not diastolic (the bottom number), blood pressure was strongly related

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to risk for worsening kidney function. Systolic blood pressure of 110 to 129 millimeters Hg is associated with the least risk for progression of kidney disease in patients with urine protein levels greater than 1.0 gram daily.

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

Project Title: A NOVEL PREDICTOR OF NEPHROLITHIASIS Principal Investigator & Institution: Bergsland, Kristin J.; Litholink Corporation 2250 W Campbell Park Dr Chicago, Il 606123502 Timing: Fiscal Year 2003; Project Start 01-MAY-2003; Project End 31-OCT-2003 Summary: (provided by applicant): The overall scientific and commercial objective of the proposed research is to develop a clinical assay that can predict the recurrence of kidney stones in patients with nephrolithiasis. Since currently available diagnostic tools cannot predict who will develop recurrent kidney stones, those destined to recur would benefit from tests that could identify them in advance. We propose to develop western blotting and ELISA methods to measure various forms of a urine protein that is a known inhibitor of calcium oxalate crystallization. Preliminary studies have shown that measurement of one form of this protein combined with standard stone risk chemistries improves the sensitivity of detection of stone formers compared with stone risk chemistries alone. We will perform the assays on urine from a random sample of 50 stone formers and 50 non-stone formers. We will identify the assay(s) that best discriminate stone formers from non-stone formers, either when used alone or combined with standard stone risk chemistries. In Phase II we will prospectively test whether these measurements can identify kidney stone patients at risk for recurrence. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

2

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

Studies

•

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Project Title: EFFECT OF NAVAJO INTERPRETERS ON DIABETES OUTCOMES Principal Investigator & Institution: Mccabe, Melvina; Associate Professor; Family and Community Medicine; University of New Mexico Albuquerque Controller's Office Albuquerque, Nm 87131 Timing: Fiscal Year 2002; Project Start 30-SEP-2000; Project End 29-SEP-2005 Summary: The state of New Mexico contains a significant portion of the Navajo Nation which is the second largest American Indian (AI) tribe with 2.5 times the rate of diabetes compared to the US general population. The age-adjusted diabetes death rate for AI's is 41.1/100,000 compared to 12.4/100,000 for the US All Races. The proposal will evaluate the effect that formally trained diabetes medical interpreters have on diabetes outcomes and health care utilization patterns compared to usual care interpreters (no formal medical interpreter or diabetes knowledge training). The project is a pre-test/post-test randomized group design. The specific aims of the proposal are: 1. to avoid development of pathology (retinopathy, creatinine, proteinuria, foot pathology) or improve intermediate clinical outcomes (A1C, blood pressure (B/P), low density lipoprotein (LDL), weight). 2. to evaluate participant adherence to selected examinations and laboratory tests for diabetes care (Opthalmology referrals, urine protein, lipid profile, Podiatry referral, immunizations, and diabetes educator referrals). 3. to evaluate the change in diabetes knowledge. 4. to evaluate the change in self-care practices (selfblood glucose monitoring (SBGM), medication adherence, daily activities and physical fitness). 5. to evaluate participant health care utilization patterns (hospitalizations for hypoglycemia, hyperosmotic non-ketotic states including coma, diabetic ketoacidosis, pneumonia, infections of the feet, skin, pyelonephritis; emergency/urgent care visits for medication refills, foot problems, hypoglycemia, urinary tract infections, pyelonephritis). The two research sites are the Indian Health Service (IHS) diabetes clinics located at the Gallup Indian Medical Center (GIMC) in Gallup, New Mexico, and the Northern Navajo Medical Center (NNMC) in Shiprock, New Mexico. Long term objectives of the study are the development and implementation of a Navajo culturebased medical interpreters training program and the expansion of the culture-based medical interpreters training program to other American Indian peoples. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: IN PATHOGENESIS

VITRO

STUDIES

OF

ANCA

GLOMERULONEPHRITIS

Principal Investigator & Institution: Jennette, J. Charles.; Brinkhous Distinguished Professor and Ch; University of North Carolina Chapel Hill Aob 104 Airport Drive Cb#1350 Chapel Hill, Nc 27599 Timing: Fiscal Year 2002 Summary: The proposed research will investigate experimental animal models that elucidate afferent (immunogenic) and efferent (pathogenic) mechanisms of the autoimmune process that cause glomerulonephritis and vasculitis in patients with antineutrophil cytoplasmic autoantibodies (ANCA). The efferent mechanisms will be investigated by testing the hypothesis that ANCA induce disease by synergistic interactions with other pro- inflammatory stimuli. This possibility is supported by clinical observations that suggest that infectious processes prompt the onset and exacerbation of ANCA- disease, and by in vitro experimental observations indicating that neutrophil activation by ANCA requires synergistic neutrophil priming by proinflammatory cytokines. Mice with circulating anti-MPO antibodies will be generated by active immunization with MPO, passive administration of monoclonal murine anti-

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MPO antibodies, and introduction of immunoglobulin transgenes that produce antiMPO antibodies. Mice with circulating anti-MPO, MPO-knockout mice with circulating anti-MPO, and control mice will be challenged with sub-neophritogenic doses of antiGBM, low dose neophritogenic heterologous antigen (horse apoferritin) that induces only mild glomerular inflammation in normal mice, and systemic injection of proinflammatory cytokines. Measuring urine protein, serum creatine, and pathologic changes in renal and other tissues will monitor the onset of renal disease by the synergistic interaction of ANCA with changes in renal and other tissues will monitor the onset of renal disease by the synergistic interaction of ANCA with pro-inflammatory stimuli. Afferent mechanisms of ANCA induction (ANCA immunogenesis) will be studied by testing the hypothesis that certain environmental factors induce the ANCA autoimmune response. This hypothesis is supported by the clinical observation that the development of ANCA and of ANCA-disease can be correlated with environmental exposures, for example silica and certain drugs. BALB/c, C57B6, autoimmune prone mice (MRL/lpr, NOD), and transgenic mice expressing anti-MPO will be exposed to silica or aminoguanidine. Control and exposed mice will be monitored for anti- MPO production and development of ANCA-disease. When models of ANCA immunogenesis and ANCA pathogenesis are established, the underlying mechanisms can be evaluated using experimental tools developed to investigate the immune system and inflammatory mediator systems in mice (measuring mRNA expression and protein levels of inflammatory mediators, evaluating effects of cellular and humoral immune and inflammatory effector depletion, and assessing the effects of targeted gene knock outs (e.g. of chemokines and cytokines, and their receptors. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: AMERICANS

KIDNEY

DISEASE

AND

HYPERTENSION

IN

AFRICAN

Principal Investigator & Institution: Tisher, Charles C.; Professor of Medicine; Medicine; University of Florida Gainesville, Fl 32611 Timing: Fiscal Year 2002; Project Start 15-AUG-1994; Project End 30-JUN-2003 Summary: Clinical and experimental data suggest that adequate control of hypertension can reduce the rate of decline in glomerular filtration rate in patients including African Americans with hypertension-related renal disease. Therefore, the National Institutes of Health is sponsoring a multi-center clinical trail, the African American Study of Kidney Disease and Hypertension, to test the hypothesis that rigorous control of blood pressure in African Americans will retard the progression of renal failure to end-stage in the clinical setting of hypertension-related kidney disease. The specific aims of the study are two-fold: (1) To determine which of three classes of antihypertensive drugs (calcium channel blockers, angiotensin converting enzyme inhibitors, or beta- blockers) is most effective in reducing blood pressure and the rate of decline in kidney function; and (2) To determine the optimum level of blood pressure control [mean arterial pressure (MAP) less than or equal to 92 mmHg versus a MAP between 102 and 107 mmHg] to achieve an effective reduction in the decline in GFR. To be included in the study patients must be African American men and women, age 18-70 years, with hypertension and some degree of reduced renal function. At least one-third of the total study population must be women. The diastolic blood pressure in the sitting position must be 95 mmHg or greater and the measured Initial GFR must be between 25 and 70 ml/min/1.73 sq.m. Major exclusion criteria include a history of accelerated or malignant hypertension within 6 months of entrance into the study, a known history of type I or type II diabetes mellitus, and proteinuria quantified by a 24 hr excretion greater than 2.5 g/24 hr or a

Studies

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urine protein (mg/dL) to creatinine (mg/dL) ratio exceeding 2.5. Patients will be recruited to the study during the initial 24 months. Those randomized to one of the three drug regimens and one of the two levels of blood pressure control will be followed for up to 48 months. Regular monitoring of blood pressure and renal function, the latter through measurement of the GfR, will continue throughout the period of intervention and follow-up. Several "stop" points to ensure patient safety ar built into the study protocol. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: PROTEOMIC AND MRNA PROFILING OF URINE AND URINE SEDIMENT Principal Investigator & Institution: Rovin, Brad H.; Professor; Internal Medicine; Ohio State University 1960 Kenny Road Columbus, Oh 43210 Timing: Fiscal Year 2003; Project Start 01-JUN-2003; Project End 31-MAR-2005 Summary: (provided by applicant): The objective of this project is to validate urine protein and gene expression profiling as tools to derive novel mechanistic and diagnostic information from the urine of patients with glomerulonephritis. Although previous investigations have examined urine to gain insight into the pathogenesis of renal disease, and to identify clinically relevant markers of disease activity, severity, or prognosis, such studies were limited to analysis of a relatively small number of prechosen candidate proteins. It is postulated that by examining the entire urinary proteome during glomerulonephritis, as well as the proteins and genes expressed by leukocytes present in nephritic urine, previously unrecognized patterns of protein expression will emerge. Investigation of these protein networks will lead to new insights into the pathogenesis of glomerular disease. Furthermore, by characterizing patterns of protein expression associated with distinct phases of disease activity, novel prognostic indicators will be identified. These themes will be developed in two Specific Aims. In Aim 1, two-dimensional polyacrylamide gel electrophoresis (2D-PAGE) will be used to map the urine proteins of a well-characterized cohort of patients with SLE nephritis before, during, and after relapse of renal disease. These studies will define how the urinary proteome changes from inactive disease through active SLE. Differentially expressed proteins from these different phases of disease activity will be further identified by mass spectrometry (MS). It is predicted that the protein networks engaged before relapse will reflect mechanisms of disease activation, while proteins expressed in active disease will represent mediators of renal injury, and proteins expressed during treatment will determine therapeutic success or failure. Aim 2 will extend proteomics to the leukocytes present in the urine of patients with active SLE nephritis. Additionally, cDNA microarray analysis will be used to characterize genes expressed by these white blood cells. Urinary gene and protein expression will be compared to that of simultaneously obtained peripheral blood mononuclear cells. It is anticipated that differentially expressed proteins and genes will reflect intra-renal inflammatory events. The results of this project are expected to demonstrate the relevance of urinary proteomic and cDNA microarray analyses by identifying previously unrecognized protein networks active in SLE nephritis that challenge existing paradigms of renal disease pathogenesis. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Urine Protein

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

A new 180 kDa. urine protein marker associated with bladder cancer. Author(s): Zhau HY, Babaian RJ, Hong SJ. Source: The Journal of Urology. 1990 July; 144(1): 47-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2359180

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A prospective comparison of total protein/creatinine ratio versus 24-hour urine protein in women with suspected preeclampsia. Author(s): Durnwald C, Mercer B. Source: American Journal of Obstetrics and Gynecology. 2003 September; 189(3): 848-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14526328

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Acute changes in urine protein excretion may predict chronic ifosfamide nephrotoxicity: a preliminary observation. Author(s): MacLean FR, Skinner R, Hall AG, English M, Pearson AD. Source: Cancer Chemotherapy and Pharmacology. 1998; 41(5): 413-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9523738

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Amino acid utilization and urine protein excretion in children treated with succinylated Acinetobacter glutaminase-asparaginase. Author(s): Kien CL, Holcenberg JS. Source: Cancer Research. 1981 June; 41(6): 2056-62. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7016307

3 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.

Studies

9

•

Aminoglycoside interference with the Dade Behring pyrogallol red-molybdate method for the measurement of total urine protein. Author(s): Koerbin G, Taylor L, Dutton J, Marshall K, Low P, Potter JM. Source: Clinical Chemistry. 2001 December; 47(12): 2183-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11719492

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An algorithmic approach using kappa/lambda ratios to improve the diagnostic accuracy of urine protein electrophoresis and to reduce the volume required for immunoelectrophoresis. Author(s): Levinson SS. Source: Clinica Chimica Acta; International Journal of Clinical Chemistry. 1997 June 27; 262(1-2): 121-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9204214

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Analysis of human urine protein biomarkers via biomolecular interaction analysis mass spectrometry. Author(s): Nedelkov D, Nelson RW. Source: American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation. 2001 September; 38(3): 481-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11532678

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Are the positive interferences in the benzethonium chloride method for urine protein real? Author(s): Beilby K, O'Leary B. Source: Annals of Clinical Biochemistry. 1990 January; 27 ( Pt 1): 88-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2310164

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Assessment of renal function during pregnancy using a random urine protein to creatinine ratio and Cockcroft-Gault formula. Author(s): Quadri KH, Bernardini J, Greenberg A, Laifer S, Syed A, Holley JL. Source: American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation. 1994 September; 24(3): 416-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8079966

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Changes in the urine protein profile following intravesical doxorubicin. Author(s): Yu H, Glashan R, Robinson MR, Richards B, Fryszman A, Daponte D, Cooper EH. Source: The Journal of Urology. 1982 August; 128(2): 272-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7109089

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Urine Protein

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Clinical associations of an increased transthyretin band in routine serum and urine protein electrophoresis. Author(s): Tormey WP, O'Brien PA. Source: Annals of Clinical Biochemistry. 1993 November; 30 ( Pt 6): 550-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8304723

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Comparative urine protein phenotyping using mass spectrometric immunoassay. Author(s): Kiernan UA, Tubbs KA, Nedelkov D, Niederkofler EE, McConnell E, Nelson RW. Source: Journal of Proteome Research. 2003 March-April; 2(2): 191-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12716133

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Comparing ambulatory spot urine protein/creatinine ratios and 24-h urine protein measurements in normal pregnancies. Author(s): Haas DM, Sabi F, McNamara M, Rivera-Alsina M. Source: J Matern Fetal Neonatal Med. 2003 October;14(4):233-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14738168

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Comparison between spot urine and overnight urine in the estimation of 24-hour excretion of urine protein, sodium and kallikrein. Author(s): Tsai TJ, Chen YM, Hsieh BS, Chen WY. Source: J Formos Med Assoc. 1991 August; 90(8): 755-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1683368

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Correlation of 4- and 24-hour urine protein in women with initially diagnosed hypertensive disorders in pregnancy. Author(s): Wongkitisophon K, Phupong V, Yamasmit W, Pansin P, Tannirandorn Y, Charoenvidhya D. Source: J Med Assoc Thai. 2003 June; 86(6): 529-34. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12924801

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Cost-benefit analysis and prediction of 24-hour proteinuria from the spot urine protein-creatinine ratio. Author(s): Chitalia VC, Kothari J, Wells EJ, Livesey JH, Robson RA, Searle M, Lynn KL. Source: Clinical Nephrology. 2001 June; 55(6): 436-47. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11434354

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Cross sectional longitudinal study of spot morning urine protein:creatinine ratio, 24 hour urine protein excretion rate, glomerular filtration rate, and end stage renal failure in chronic renal disease in patients without diabetes. Author(s): Ruggenenti P, Gaspari F, Perna A, Remuzzi G. Source: Bmj (Clinical Research Ed.). 1998 February 14; 316(7130): 504-9. Erratum In: Bmj 1998 November 28; 317(7171): 1491. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9501711

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Decrease of urine protein after treatment with probucol in patients with mild glomerulonephritis and arteriolosclerosis. Author(s): Ogawa M, Ueda S, Anzai N, Ito K, Ohto M, Akikusa B. Source: Nephron. 1995; 70(3): 376-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7477633

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Development and evaluation of a urine protein expert system. Author(s): Ivandic M, Hofmann W, Guder WG. Source: Clinical Chemistry. 1996 August; 42(8 Pt 1): 1214-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8697580

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Drug interference with urine protein determination. Author(s): Yosselson-Superstine S, Sinai Y. Source: J Clin Chem Clin Biochem. 1986 January; 24(1): 103-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3701266

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Effect of dipyridamole with or without aspirin on urine protein excretion in patients with membranous glomerulonephritis. Author(s): De La Cruz JP, Camara S, Frutos MA, Sanchez De La Cuesta F. Source: European Journal of Clinical Pharmacology. 1992; 43(3): 307-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1425898

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Effect of plasma replacement therapy on determinations of urine protein concentration. Author(s): Pena C, Martinez-Bru C, Homs R, Planella T, Cortes M. Source: Clinical Chemistry. 1998 February; 44(2): 359-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9474044

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Evaluation of pediatric nephropathies by a computerized Urine Protein Expert System (UPES). Author(s): Lun A, Ivandic M, Priem F, Filler G, Kirschstein M, Ehrich JH, Guder WG. Source: Pediatric Nephrology (Berlin, Germany). 1999 November; 13(9): 900-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10603145

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From a urinalysis strategy to an evaluated urine protein expert system. Author(s): Ivandic M, Ogurol Y, Hofmann W, Guder WG. Source: Methods of Information in Medicine. 2000 March; 39(1): 93-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10786078

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High dose brain CT with ioxaglate and diatrizoate adverse reactions and effects on urine protein tests. Author(s): Raininko R, Laivola J, Irjala K. Source: European Journal of Radiology. 1988 February; 8(1): 44-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3281838

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Increased urinary excretion of urine protein 1 induced by L-arginine monohydrochloride. Author(s): Itoh Y, Muto S, Okutani R, Ishii S, Asano Y, Kawai T. Source: Nephron. 1992; 62(4): 467-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1284435

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Low molecular weight urine protein investigated by gel filtration. Author(s): Harrison JF, Northam BE. Source: Clinica Chimica Acta; International Journal of Clinical Chemistry. 1966 November; 14(5): 679-88. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5972419

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Measurement of beta 2-microglobulin, retinol-binding protein, alpha 1-microglobulin and urine protein 1 in healthy children using enzyme-linked immunosorbent assay. Author(s): Tomlinson PA, Dalton RN, Turner C, Chantler C. Source: Clinica Chimica Acta; International Journal of Clinical Chemistry. 1990 November 30; 192(2): 99-106. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1705872

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Multiple narrow bands in urine protein electrophoresis. Author(s): Roach BM, Meinke JS, Sridhar N, Vladutiu AO. Source: Clinical Chemistry. 1999 May; 45(5): 716-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10222367

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Partial characterization of urine protein with insulin-like activity. Author(s): Guevera LB, Meek JC, Bolinger RE. Source: Proceedings of the Society for Experimental Biology and Medicine. Society for Experimental Biology and Medicine (New York, N. Y.). 1967 August-September; 125(4): 1049-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6042401

Studies

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Positive and negative interference in the benzethonium chloride method for urine protein. Author(s): Crofton PM. Source: Annals of Clinical Biochemistry. 1989 January; 26 ( Pt 1): 104-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2735743

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Prediction of 24-hour protein excretion in pregnancy with a single voided urine protein-to-creatinine ratio. Author(s): Neithardt AB, Dooley SL, Borensztajn J. Source: American Journal of Obstetrics and Gynecology. 2002 May; 186(5): 883-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12015502

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Predictor of transplanted kidney deterioration following pregnancy--daily urine protein loss or serum creatinine concentration? Author(s): Kozlowska-Boszko B, Durlik M, Kuczynska-Sicinska J, Lao M. Source: Ann Transplant. 1996; 1(4): 30-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9869902

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Purification and partial amino acid sequence of human urine protein 1. Evidence for homology with rabbit uteroglobin. Author(s): Jackson PJ, Turner R, Keen JN, Brooksbank RA, Cooper EH. Source: Journal of Chromatography. 1988 October 28; 452: 359-67. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3243851

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Quantification of proteinuria by urine protein/creatinine ratio. Author(s): Shastri NJ, Shendurnikar N, Nayak U, Kotecha PV. Source: Indian Pediatrics. 1994 March; 31(3): 334-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7896373

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Quantitation of 24-hour urine protein excretion in kidney transplant patients by the use of protein to creatinine ratio. Author(s): Rodrigo E, Pinera C, Ruiz JC, Fernandez-Fresnedo G, Escallada R, Herraez I, Cotorruelo JG, Zubimendi JA, de Francisco AL, Sanz de Castro S, Arias M. Source: Transplantation Proceedings. 2003 March; 35(2): 702. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12644101

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Relationship between single voided urine protein/creatinine ratio and 24-hour urine protein excretion rate among children and adolescents in Taiwan. Author(s): Chang JB, Chen YH, Chu NF. Source: Zhonghua Yi Xue Za Zhi (Taipei). 2000 November; 63(11): 828-32. Erratum In: Zhonghua Yi Xue Za Zhi (Taipei) 2001 January; 64(1): 69. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11155760

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Renal biopsy for 24-h urine protein excretion of 1.5 g/day. Author(s): Barratt TM. Source: Pediatric Nephrology (Berlin, Germany). 1989 October; 3(4): 405. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2642108

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Screening urine protein abnormalities by a novel test paper. Author(s): Shiba K, Kanamori K, Sugiura K. Source: Clinica Chimica Acta; International Journal of Clinical Chemistry. 1995 August 31; 240(1): 83-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8582062

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Serum and urine protein differences in patients with malignant melanoma. Author(s): Tomecki KJ, Montague PM, Hearing VJ Jr. Source: Journal of the National Cancer Institute. 1980 January; 64(1): 29-32. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6928045

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Single voided urine protein/creatinine ratio. Author(s): Perazella MA. Source: Mayo Clinic Proceedings. 1995 March; 70(3): 308-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7861823

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The characterisation of urine protein by gel filtration. Author(s): Davis JS, Flynn FV, Platt HS. Source: Clinica Chimica Acta; International Journal of Clinical Chemistry. 1968 September; 21(3): 357-76. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5725196

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The urine protein to creatinine ratio (P/C) as a predictor of 24-hour urine protein excretion in renal transplant patients. Author(s): Torng S, Rigatto C, Rush DN, Nickerson P, Jeffery JR. Source: Transplantation. 2001 October 27; 72(8): 1453-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11685120

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The urine protein to creatinine ratio as a predictor of 24-hour urine protein excretion in type 1 diabetic patients with nephropathy. The Collaborative Study Group. Author(s): Rodby RA, Rohde RD, Sharon Z, Pohl MA, Bain RP, Lewis EJ. Source: American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation. 1995 December; 26(6): 904-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7503064

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The use of urine protein 1 as an indicator of renal tubular function in type I (insulindependent) diabetes. Author(s): Ayatse JO, Wright JW. Source: Acta Med Hung. 1994; 50(1-2): 99-107. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7638047

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Total blood and urine protein of urolithiasis patients with renal calculi of different chemical composition. Author(s): Bilobrov VM, Mironov OL, Minasjants EZ. Source: Urologia Internationalis. 1993; 51(3): 142-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8249224

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Urine protein 1: a sex-dependent marker of tubular or glomerular dysfunction. Author(s): Bernard AM, Lauwerys RR, Noel A, Vandeleene B, Lambert A. Source: Clinical Chemistry. 1989 October; 35(10): 2141-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2791288

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Urine protein analysis by capillary electrophoresis. Author(s): Friedberg MA, Shihabi ZK. Source: Electrophoresis. 1997 September; 18(10): 1836-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9372277

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Urine protein analysis by gel electrophoresis and laser densitometry after chemotherapy in pediatric cancer patients. Author(s): Mertens R, Granzen B, Vogt K, Melzer H, Mann H. Source: Pediatric Hematology and Oncology. 2000 July-August; 17(5): 365-74. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10914046

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Urine protein dipstick measurements. A screen for a standard, 24-hour urine collection. Author(s): Jazayeri A, Chez RA, Porter KB, Jazayeri M, Spellacy WN. Source: J Reprod Med. 1998 August; 43(8): 687-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9749420

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Urine protein electrophoresis and immunofixation electrophoresis supplement one another in characterizing proteinuria. Author(s): Levinson SS. Source: Ann Clin Lab Sci. 2000 January; 30(1): 79-84. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10678588

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Urine protein electrophoresis of renal transplant recipients using room temperature precipitation technique. Author(s): Mukhtar A. Source: Indian J Pathol Microbiol. 1999 October; 42(4): 447-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11127376

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Urine protein electrophoresis without sample concentration: an evaluation of two methods. Author(s): Trewick AL, Luxton F, Patel S, Heys AD. Source: Annals of Clinical Biochemistry. 1993 May; 30 ( Pt 3): 321-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8517617

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Urine protein excretion after Hymenoptera sting. Author(s): Elming H, Solling K. Source: Scandinavian Journal of Urology and Nephrology. 1994 March; 28(1): 13-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8009186

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Urine protein excretion and swimming events. Author(s): Poortmans JR, Engels MF, Sellier M, Leclercq R. Source: Medicine and Science in Sports and Exercise. 1991 July; 23(7): 831-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1921676

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Urine protein excretion in acute pancreatitis. Author(s): Meier PB, Levitt MD. Source: The Journal of Laboratory and Clinical Medicine. 1986 December; 108(6): 628-34. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2431086

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Urine protein selectivity in human renal allografts. Author(s): Braun WE, Merrill JP. Source: Transplantation. 1968 November; 6(8): 867-78. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4880325

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CHAPTER 2. BOOKS ON URINE PROTEIN Overview This chapter provides bibliographic book references relating to urine protein. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on urine protein include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.

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

Urine Protein Electrophoresis and Immunofixation: Illustrated Interpretations by Didier Le Carrer; ISBN: 2884670033; http://www.amazon.com/exec/obidos/ASIN/2884670033/icongroupinterna

Chapters on Urine Protein In order to find chapters that specifically relate to urine protein, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and urine protein using the “Detailed Search” option. Go to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find book chapters, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Book Chapter.” Type “urine protein” (or

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synonyms) into the “For these words:” box. The following is a typical result when searching for book chapters on urine protein: •

Outpatient Approach to Proteinuria Source: in Mandal, A.K. and Nahman, N.S., Jr., eds. Kidney Disease in Primary Care. Baltimore, MD: Williams and Wilkins. 1998. p. 122-132. Contact: Available from Williams and Wilkins. 351 West Camden Street, Baltimore, MD 21201-2436. (800) 638-0672 or (410) 528-4223. Fax (800) 447-8438 or (410) 528-8550. E-mail: [email protected]. PRICE: $39.95. ISBN: 0683300571. Summary: This chapter on the outpatient approach to proteinuria (protein in the urine) is from a textbook that provides primary care physicians with practical approaches to common clinical problems of kidney diseases. The author first provides background information about proteinuria as a marker of primary renal disease. The author then discusses the causes of proteinuria, including glomerular proteinuria versus tubular proteinuria, proteinuria caused by drugs, and proteinuria associated with systemic diseases; signs and symptoms; diagnostic considerations, including the dipstick test, microscopic analysis of the urine, characterizing proteinuria, persistent orthostatic proteinuria, nonorthostatic or constant proteinuria, overflow proteinuria, urine protein immunoelectrophoresis (UPIEP), quantifying proteinuria, and additional testing; and treatment options, including nonspecific therapy, specific therapy, and complications of nephrotic syndrome. The workup and diagnosis of proteinuria can be initiated as an outpatient. This evaluation should rapidly identify patients with persistent, nonorthostatic proteinuria and provide the physician with an idea of whether the proteinuria is glomerular or tubular in origin. In many cases, renal biopsy will be necessary to definitively identify the cause of glomerular proteinuria and to direct specific therapy. The chapter concludes with a discussion of the indications for referring a patient to a specialist and with the answers to a list of questions commonly asked by patients diagnosed with proteinuria. 3 figures. 3 tables. 5 references.

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CHAPTER 3. PERIODICALS AND NEWS ON URINE PROTEIN Overview In this chapter, we suggest a number of news sources and present various periodicals that cover urine protein.

News Services and Press Releases One of the simplest ways of tracking press releases on urine protein is to search the news wires. In the following sample of sources, we will briefly describe how to access each service. These services only post recent news intended for public viewing. PR Newswire To access the PR Newswire archive, simply go to http://www.prnewswire.com/. Select your country. Type “urine protein” (or synonyms) into the search box. You will automatically receive information on relevant news releases posted within the last 30 days. The search results are shown by order of relevance. Reuters Health The Reuters’ Medical News and Health eLine databases can be very useful in exploring news archives relating to urine protein. While some of the listed articles are free to view, others are available for purchase for a nominal fee. To access this archive, go to http://www.reutershealth.com/en/index.html and search by “urine protein” (or synonyms). The following was recently listed in this archive for urine protein: •

Urine protein dipstick results taken over 24 hours identify patients requiring 24-hour collection Source: Reuters Medical News Date: September 22, 1998

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Urine Protein

Urine Protein Test Predicts Heart Disease Source: Reuters Health eLine Date: August 21, 1996 The NIH

Within MEDLINEplus, the NIH has made an agreement with the New York Times Syndicate, the AP News Service, and Reuters to deliver news that can be browsed by the public. Search news releases at http://www.nlm.nih.gov/medlineplus/alphanews_a.html. MEDLINEplus allows you to browse across an alphabetical index. Or you can search by date at the following Web page: http://www.nlm.nih.gov/medlineplus/newsbydate.html. Often, news items are indexed by MEDLINEplus within its search engine. Business Wire Business Wire is similar to PR Newswire. To access this archive, simply go to http://www.businesswire.com/. You can scan the news by industry category or company name. Market Wire Market Wire is more focused on technology than the other wires. To browse the latest press releases by topic, such as alternative medicine, biotechnology, fitness, healthcare, legal, nutrition, and pharmaceuticals, access Market Wire’s Medical/Health channel at http://www.marketwire.com/mw/release_index?channel=MedicalHealth. Or simply go to Market Wire’s home page at http://www.marketwire.com/mw/home, type “urine protein” (or synonyms) into the search box, and click on “Search News.” As this service is technology oriented, you may wish to use it when searching for press releases covering diagnostic procedures or tests. Search Engines Medical news is also available in the news sections of commercial Internet search engines. See the health news page at Yahoo (http://dir.yahoo.com/Health/News_and_Media/), or you can use this Web site’s general news search page at http://news.yahoo.com/. Type in “urine protein” (or synonyms). If you know the name of a company that is relevant to urine protein, you can go to any stock trading Web site (such as http://www.etrade.com/) and search for the company name there. News items across various news sources are reported on indicated hyperlinks. Google offers a similar service at http://news.google.com/. BBC Covering news from a more European perspective, the British Broadcasting Corporation (BBC) allows the public free access to their news archive located at http://www.bbc.co.uk/. Search by “urine protein” (or synonyms).

Periodicals and News

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Academic Periodicals covering Urine Protein Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to urine protein. In addition to these sources, you can search for articles covering urine protein that have been published by any of the periodicals listed in previous chapters. To find the latest studies published, go to http://www.ncbi.nlm.nih.gov/pubmed, type the name of the periodical into the search box, and click “Go.” If you want complete details about the historical contents of a journal, you can also visit the following Web site: http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi. Here, type in the name of the journal or its abbreviation, and you will receive an index of published articles. At http://locatorplus.gov/, you can retrieve more indexing information on medical periodicals (e.g. the name of the publisher). Select the button “Search LOCATORplus.” Then type in the name of the journal and select the advanced search option “Journal Title Search.”

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APPENDICES

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APPENDIX A. PHYSICIAN RESOURCES Overview In this chapter, we focus on databases and Internet-based guidelines and information resources created or written for a professional audience.

NIH Guidelines Commonly referred to as “clinical” or “professional” guidelines, the National Institutes of Health publish physician guidelines for the most common diseases. Publications are available at the following by relevant Institute4: •

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

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

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

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

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

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

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

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

4

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Physician Resources

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NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.5 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:6 •

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

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

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

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

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

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

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

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

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

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

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

5

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

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Urine Protein

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

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

The NLM Gateway7 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.8 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “urine protein” (or synonyms) into the search box and click “Search.” The results will be presented in a tabular form, indicating the number of references in each database category. Results Summary Category Journal Articles Books / Periodicals / Audio Visual Consumer Health Meeting Abstracts Other Collections Total

Items Found 53199 89 956 108 1316 55668

HSTAT9 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.10 These documents include clinical practice guidelines, quickreference guides for clinicians, consumer health brochures, evidence reports and technology assessments from the Agency for Healthcare Research and Quality (AHRQ), as well as AHRQ’s Put Prevention Into Practice.11 Simply search by “urine protein” (or synonyms) at the following Web site: http://text.nlm.nih.gov.

7

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

8

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). 9 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 10 11

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

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

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Coffee Break: Tutorials for Biologists12 Coffee Break is a general healthcare site that takes a scientific view of the news and covers recent breakthroughs in biology that may one day assist physicians in developing treatments. Here you will find a collection of short reports on recent biological discoveries. Each report incorporates interactive tutorials that demonstrate how bioinformatics tools are used as a part of the research process. Currently, all Coffee Breaks are written by NCBI staff.13 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.14 This site has new articles every few weeks, so it can be considered an online magazine of sorts. It is intended for general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/.

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

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

•

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

12 Adapted 13

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

The figure that accompanies each article is frequently supplied by an expert external to NCBI, in which case the source of the figure is cited. The result is an interactive tutorial that tells a biological story. 14 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process.

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APPENDIX B. PATIENT RESOURCES Overview Official agencies, as well as federally funded institutions supported by national grants, frequently publish a variety of guidelines written with the patient in mind. These are typically called “Fact Sheets” or “Guidelines.” They can take the form of a brochure, information kit, pamphlet, or flyer. Often they are only a few pages in length. Since new guidelines on urine protein can appear at any moment and be published by a number of sources, the best approach to finding guidelines is to systematically scan the Internet-based services that post them.

Patient Guideline Sources The remainder of this chapter directs you to sources which either publish or can help you find additional guidelines on topics related to urine protein. Due to space limitations, these sources are listed in a concise manner. Do not hesitate to consult the following sources by either using the Internet hyperlink provided, or, in cases where the contact information is provided, contacting the publisher or author directly. The National Institutes of Health The NIH gateway to patients is located at http://health.nih.gov/. From this site, you can search across various sources and institutes, a number of which are summarized below. Topic Pages: MEDLINEplus The National Library of Medicine has created a vast and patient-oriented healthcare information portal called MEDLINEplus. Within this Internet-based system are “health topic pages” which list links to available materials relevant to urine protein. To access this system, log on to http://www.nlm.nih.gov/medlineplus/healthtopics.html. From there you can either search using the alphabetical index or browse by broad topic areas. Recently, MEDLINEplus listed the following when searched for “urine protein”:

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Bladder Diseases http://www.nlm.nih.gov/medlineplus/bladderdiseases.html Diabetic Kidney Problems http://www.nlm.nih.gov/medlineplus/diabetickidneyproblems.html Kidney Diseases http://www.nlm.nih.gov/medlineplus/kidneydiseases.html Laboratory Tests http://www.nlm.nih.gov/medlineplus/laboratorytests.html Liver Diseases http://www.nlm.nih.gov/medlineplus/liverdiseases.html Urinary Tract Infections http://www.nlm.nih.gov/medlineplus/urinarytractinfections.html You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the search box and click “Search.” This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system (mostly patient-oriented information). It also has the disadvantage of generating unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search. The Combined Health Information Database (CHID) CHID Online is a reference tool that maintains a database directory of thousands of journal articles and patient education guidelines on urine protein. CHID offers summaries that describe the guidelines available, including contact information and pricing. CHID’s general Web site is http://chid.nih.gov/. To search this database, go to http://chid.nih.gov/detail/detail.html. In particular, you can use the advanced search options to look up pamphlets, reports, brochures, and information kits. The following was recently posted in this archive: •

Nutrition for Children With Chronic Kidney Disease: A Guide for Parents Source: New York, NY: National Kidney Foundation, Inc. 2002. 6 p. Contact: Available from National Kidney Foundation, Inc. Medical Department, 30 East 33rd Street, New York, NY 10016. (800) 622-9010. Fax: (212) 689-9261. E-mail: [email protected]. Website: www.kidney.org. PRICE: Single copy free; Full-text available online at no charge. Summary: This fact sheet helps parents of children with chronic kidney disease understand the role of appropriate diet in helping to keep their children healthy. The guidelines are intended for children who have reduced kidney function caused by chronic kidney disease, have kidney failure and are receiving hemodialysis or peritoneal dialysis, or have received a kidney transplant. Topics include a rationale for good nutrition in children with kidney disease; general guidelines regarding caloric intake, protein, phosphorus, potassium, sodium, fluids, and vitamins and minerals; how to monitor a child's nutrition; how to encourage a child to eat healthy foods; growth and development; the use of supplements; and understanding the child's lab values (diagnostic and monitoring tests), including serum albumin, serum bicarbonate, blood

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pressure, blood urea nitrogen (BUN), body weight, fluid weight gain, calcium, serum creatinine, glomerular filtration rate (GFR), hemoglobin and hematocrit, phosphorus, potassium, urine protein, and TSAT and serum ferritin. The fact sheet offers a blank form for tracking the child's lab values. 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 this site located at http://www.guideline.gov/ by using the keyword “urine protein” (or synonyms). The following was recently posted: •

2001 USPHS/IDSA guidelines for the prevention of opportunistic infections in persons infected with human immunodeficiency virus Source: Centers for Disease Control and Prevention - Federal Government Agency [U.S.]; 1999 August (updated 2001 November 28); 64 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3080&nbr=2306&a mp;string=urine+AND+protein

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2002 national guideline for the management of lymphogranuloma venereum Source: Association for Genitourinary Medicine - Medical Specialty Society; 1999 August (revised 2002); Various pagings http://www.guideline.gov/summary/summary.aspx?doc_id=3039&nbr=2265&a mp;string=urine+AND+protein

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2002 national guideline on the management of non-gonococcal urethritis Source: Association for Genitourinary Medicine - Medical Specialty Society; 1999 August (revised 2002); Various pagings http://www.guideline.gov/summary/summary.aspx?doc_id=3030&nbr=2256&a mp;string=urine+AND+protein

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2002 national guideline on the management of sexually acquired reactive arthritis Source: Association for Genitourinary Medicine - Medical Specialty Society; 1999 August (revised 2002); Various pagings http://www.guideline.gov/summary/summary.aspx?doc_id=3045&nbr=2271&a mp;string=urine+AND+protein

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A practice guideline on Wilson disease Source: American Association for the Study of Liver Diseases - Private Nonprofit Research Organization; 2003 June; 18 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3865&nbr=3075&a mp;string=urine+AND+protein

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Urine Protein

ACC/AHA 2002 guideline update for the management of patients with unstable angina and non-ST-segment elevation myocardial infarction. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Source: American College of Cardiology Foundation - Medical Specialty Society; 2000 (revised online 2002 Mar); 95 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3190&nbr=2416&a mp;string=urine+AND+protein

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Altered mental states Source: American Health Care Association - Professional Association; 1998 (reviewed 2003); 20 pages http://www.guideline.gov/summary/summary.aspx?doc_id=1804&nbr=1030&a mp;string=urine+AND+protein

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American Association of Clinical Endocrinologists medical guidelines for clinical practice for the prevention and treatment of postmenopausal osteoporosis: 2001 edition, with selected updates for 2003 Source: American Association of Clinical Endocrinologists - Medical Specialty Society; 1996 Mar-April (updated 2003 Nov-Dec); 21 pages http://www.guideline.gov/summary/summary.aspx?doc_id=4157&nbr=3185&a mp;string=urine+AND+protein

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American Gastroenterological Association medical position statement: guidelines for the evaluation and management of chronic diarrhea Source: American Gastroenterological Association - Medical Specialty Society; 1998 November 8 (reviewed 2001); 3 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3065&nbr=2291&a mp;string=urine+AND+protein

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American Gastroenterological Association medical position statement: short bowel syndrome and intestinal transplantation Source: American Gastroenterological Association - Medical Specialty Society; 2003 April; 6 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3795&nbr=3021&a mp;string=urine+AND+protein

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American Society of Clinical Oncology clinical practice guidelines: the role of bisphosphonates in multiple myeloma Source: American Society of Clinical Oncology - Medical Specialty Society; 2002 September 1; 19 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3367&nbr=2593&a mp;string=urine+AND+protein

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Appropriate patient preparation for renal replacement therapy Source: Renal Physicians Association - Medical Specialty Society; 2002 October; 78 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3591&nbr=2817&a mp;string=urine+AND+protein

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ASHP therapeutic guidelines for nonsurgical antimicrobial prophylaxis Source: American Society of Health-System Pharmacists - Professional Association; 1999 June 15; 50 pages http://www.guideline.gov/summary/summary.aspx?doc_id=1959&nbr=1185&a mp;string=urine+AND+protein

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Cardiovascular disease in women: a guide to risk factor screening, prevention and management Source: Brigham and Women's Hospital (Boston) - Hospital/Medical Center; 2002; 15 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3487&nbr=2713&a mp;string=urine+AND+protein

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Care of the neonate requiring parenteral nutrition Source: National Association of Neonatal Nurses - Professional Association; 1999; 34 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2144&nbr=1370&a mp;string=urine+AND+protein

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Chemotherapy and biotherapy: guidelines and recommendations for practice Source: Oncology Nursing Society - Professional Association; 2001; 226 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3209&nbr=2435&a mp;string=urine+AND+protein

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Urine Protein

Clinical policy: critical issues in the initial evaluation and management of patients presenting to the emergency department in early pregnancy Source: American College of Emergency Physicians - Medical Specialty Society; 2003 January; 11 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3693&nbr=2919&a mp;string=urine+AND+protein

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Clinical practice guidelines for nutrition in chronic renal failure Source: National Kidney Foundation - Disease Specific Society; 2000 June; 121 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2545&nbr=1771&a mp;string=urine+AND+protein

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Clinical practice parameters for hemodynamic support of pediatric and neonatal patients in septic shock Source: American College of Critical Care Medicine - Professional Association; 2002 June; 14 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3433&nbr=2659&a mp;string=urine+AND+albumin

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Diagnosis and management of hypertension in the primary care setting Source: Department of Defense - Federal Government Agency [U.S.]; 1999 May; Various pagings http://www.guideline.gov/summary/summary.aspx?doc_id=2579&nbr=1805&a mp;string=urine+AND+protein

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Diagnosis and treatment of adult degenerative joint disease (DJD) of the knee Source: Institute for Clinical Systems Improvement - Private Nonprofit Organization; 1996 June (revised 2002 May); 42 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3355&nbr=2581&a mp;string=urine+AND+protein

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Disease modifying therapies in multiple sclerosis: report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology and the MS Council for Clinical Practice Guidelines Source: American Academy of Neurology - Medical Specialty Society; 2002 January 22; 10 pages http://www.guideline.gov/summary/summary.aspx?doc_id=4099&nbr=3144&a mp;string=urine+AND+protein

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Evaluation of asymptomatic microscopic hematuria in adults: the American Urological Association best practice policy. Parts I and II Source: American Urological Association, Inc. - Medical Specialty Society; 2001 April; 12 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2920&nbr=2146&a mp;string=urine+AND+protein

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Gestational diabetes mellitus Source: American Diabetes Association - Professional Association; 1986 (revised 2000; republished 2004 Jan); 3 pages http://www.guideline.gov/summary/summary.aspx?doc_id=4692&nbr=3426&a mp;string=urine+AND+protein

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Glomerulonephritis Source: National Committee on Renal Care (Singapore); 2001 October; 132 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2971&nbr=2197&a mp;string=urine+AND+protein

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Guideline for prevention and management of pressure ulcers Source: Wound, Ostomy, and Continence Nurses Society - Professional Association; 2003; 52 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3860&nbr=3071&a mp;string=urine+AND+protein

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Guidelines and recommendations for laboratory analysis in the diagnosis and management of diabetes mellitus Source: National Academy of Clinical Biochemistry - Professional Association; 2002; 37 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3521&nbr=2747&a mp;string=urine+AND+protein

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Guidelines for preventing opportunistic infections among hematopoietic stem cell transplant recipients Source: American Society for Blood and Marrow Transplantation - Professional Association; 2000 October 20; 126 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2573&nbr=1799&a mp;string=urine+AND+protein

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Urine Protein

Guidelines for the management of leg ulcers in Ireland Source: Smith and Nephew, Ltd. - Private For Profit Organization; 2002; 44 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3616&nbr=2842&a mp;string=urine+AND+protein

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HIV infection: detection, counseling, and referral. Sexually transmitted diseases treatment guidelines 2002 Source: Centers for Disease Control and Prevention - Federal Government Agency [U.S.]; 1993 (revised 2002 May 10); 5 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3232&nbr=2458&a mp;string=urine+AND+protein

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Hypertension diagnosis and treatment Source: Institute for Clinical Systems Improvement - Private Nonprofit Organization; 1995 June (revised 2003 Apr); 47 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3759&nbr=2985&a mp;string=urine+AND+protein

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K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification Source: National Kidney Foundation - Disease Specific Society; 2002 February; 246 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3192&nbr=2418&a mp;string=urine+AND+protein

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Laboratory support for the diagnosis and monitoring of thyroid disease Source: National Academy of Clinical Biochemistry - Professional Association; 2002; 125 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3522&nbr=2748&a mp;string=urine+AND+protein

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Low back pain or sciatica in the primary care setting Source: Department of Defense - Federal Government Agency [U.S.]; 1999 May; Various pagings http://www.guideline.gov/summary/summary.aspx?doc_id=2578&nbr=1804&a mp;string=urine+AND+protein

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Management of chronic kidney disease and pre-ESRD in the primary care setting Source: Department of Defense - Federal Government Agency [U.S.]; 2000 November; Various pagings http://www.guideline.gov/summary/summary.aspx?doc_id=3099&nbr=2325&a mp;string=urine+AND+protein

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Management of diabetes in correctional institutions Source: American Diabetes Association - Professional Association; 1989 (revised 2000; republished 2003 Jan); 2 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3585&nbr=2811&a mp;string=urine+AND+albumin

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Management of diabetes. A national clinical guideline Source: Scottish Intercollegiate Guidelines Network - National Government Agency [Non-U.S.]; 2001 November; 50 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3078&nbr=2304&a mp;string=urine+AND+protein

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Management of type 2 diabetes mellitus Source: Institute for Clinical Systems Improvement - Private Nonprofit Organization; 1996 March (revised 2002 Sep); 77 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3499&nbr=2725&a mp;string=urine+AND+protein

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Massachusetts guidelines for adult diabetes care Source: Massachusetts Department of Public Health, Bureau of Family and Community Health, Diabetes Control Program - State/Local Government Agency [U.S.]; 1999 June (revised 2001 Jun); Various pagings http://www.guideline.gov/summary/summary.aspx?doc_id=3429&nbr=2655&a mp;string=urine+AND+protein

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Mealtime difficulties for older persons: assessment and management Source: The John A. Hartford Foundation Institute for Geriatric Nursing - Academic Institution; 2003; 23 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3506&nbr=2732&a mp;string=urine+AND+albumin

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Multiple myeloma (MM) Source: Finnish Medical Society Duodecim - Professional Association; 2001 December 27; Various pagings http://www.guideline.gov/summary/summary.aspx?doc_id=3394&nbr=2620&a mp;string=urine+AND+protein

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Urine Protein

National High Blood Pressure Education Program: Working Group report on high blood pressure in pregnancy Source: National Heart, Lung, and Blood Institute (U.S.) - Federal Government Agency [U.S.]; 1990 (revised 2000 Jul); 39 pages http://www.guideline.gov/summary/summary.aspx?doc_id=1478&nbr=704&am p;string=urine+AND+protein

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NKF-K/DOQI clinical practice guidelines for peritoneal dialysis adequacy: update 2000 Source: National Kidney Foundation - Disease Specific Society; 1997 (updated 2000); 72 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2782&nbr=2008&a mp;string=urine+AND+protein

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Nutrition principles and recommendations in diabetes Source: American Diabetes Association - Professional Association; 2001 October (republished 2004 Jan); 11 pages http://www.guideline.gov/summary/summary.aspx?doc_id=4680&nbr=3414&a mp;string=urine+AND+protein

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Osteoporosis Source: Singapore Ministry of Health - National Government Agency [Non-U.S.]; 2002 February; 63 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3435&nbr=2661&a mp;string=urine+AND+protein

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Pelvic inflammatory disease. Sexually transmitted diseases treatment guidelines 2002 Source: Centers for Disease Control and Prevention - Federal Government Agency [U.S.]; 1993 (revised 2002 May 10); 5 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3238&nbr=2464&a mp;string=urine+AND+protein

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Practice guidelines for the management of patients with histoplasmosis Source: Infectious Diseases Society of America - Medical Specialty Society; 2000 April; 8 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2668&nbr=1894&a mp;string=urine+AND+protein

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Practice management guidelines for nutritional support of the trauma patient Source: Eastern Association for the Surgery of Trauma - Professional Association; 2001; 112 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2961&nbr=2187&a mp;string=urine+AND+albumin

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Preconception care of women with diabetes Source: American Diabetes Association - Professional Association; 1995 (revised 2000; republished 2004 Jan); 3 pages http://www.guideline.gov/summary/summary.aspx?doc_id=4689&nbr=3423&a mp;string=urine+AND+protein

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Primary care guidelines for the management of core aspects of diabetes care Source: New Zealand Guidelines Group - Private Nonprofit Organization; 2000 June; 19 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3110&nbr=2336&a mp;string=urine+AND+protein

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Recommendations for healthcare system and self-management interventions to reduce morbidity and mortality from diabetes

education

Source: Centers for Disease Control and Prevention - Federal Government Agency [U.S.]; 2002 May; 5 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3178&nbr=2404&a mp;string=urine+AND+protein •

Recommendations for using smallpox vaccine in a pre-event smallpox vaccination program. Supplemental recommendations of the Advisory Committee on Immunization Practices (ACIP) and the Healthcare Infection Control Practices Advisory Committee (HICPAC). Source: Centers for Disease Control and Prevention - Federal Government Agency [U.S.]; 2003 February 26; 17 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3623&nbr=2849&a mp;string=urine+AND+protein

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Screening test to detect Source: Centers for Disease Control and Prevention - Federal Government Agency [U.S.]; 2002 October; 38 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3483&nbr=2709&a mp;string=urine+AND+protein

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Specialty referral guidelines for cardiovascular evaluation and management Source: American Healthways, Inc - Public For Profit Organization; 2002; 26 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3168&nbr=2394&a mp;string=urine+AND+protein

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Specialty referral guidelines for people with diabetes Source: American Healthways, Inc - Public For Profit Organization; 1998 (revised 1999); 22 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2005&nbr=1231&a mp;string=urine+AND+protein

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Systemic lupus erythematosus (SLE) Source: Finnish Medical Society Duodecim - Professional Association; 2001 April 30; Various pagings http://www.guideline.gov/summary/summary.aspx?doc_id=3390&nbr=2616&a mp;string=urine+AND+protein

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Tests of glycemia in diabetes Source: American Diabetes Association - Professional Association; 1996 November (revised 2000; republished 2004 Jan); 3 pages http://www.guideline.gov/summary/summary.aspx?doc_id=4693&nbr=3427&a mp;string=urine+AND+protein

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The management of diabetes mellitus in the primary care setting Source: Department of Defense - Federal Government Agency [U.S.]; 1999 December; 147 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2583&nbr=1809&a mp;string=urine+AND+protein

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Type 2 diabetes practice guidelines Source: International Diabetes Center - Private Nonprofit Organization; 2000 (revised 2003); 2 pages http://www.guideline.gov/summary/summary.aspx?doc_id=4159&nbr=3187&a mp;string=urine+AND+protein The NIH Search Utility

The NIH search utility allows you to search for documents on over 100 selected Web sites that comprise the NIH-WEB-SPACE. Each of these servers is “crawled” and indexed on an ongoing basis. Your search will produce a list of various documents, all of which will relate in some way to urine protein. The drawbacks of this approach are that the information is not

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organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html. Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •

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

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

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

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

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

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

•

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

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

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Simply type in “urine protein” (or a synonym), and you will receive information on all relevant organizations listed in the database. Health Hotlines directs you to toll-free numbers to over 300 organizations. You can access this database directly at http://www.sis.nlm.nih.gov/hotlines/. On this page, you are given the option to search by keyword or by browsing the subject list. When you have received your search results, click on the name of the organization for its description and contact information. The Combined Health Information Database Another comprehensive source of information on healthcare associations is the Combined Health Information Database. Using the “Detailed Search” option, you will need to limit your search to “Organizations” and “urine protein”. Type the following hyperlink into your Web browser: http://chid.nih.gov/detail/detail.html. To find associations, use the drop boxes at the bottom of the search page where “You may refine your search by.” For publication date, select “All Years.” Then, select your preferred language and the format option “Organization Resource Sheet.” Type “urine protein” (or synonyms) into the “For these words:” box. You should check back periodically with this database since it is updated every three months. The National Organization for Rare Disorders, Inc. The National Organization for Rare Disorders, Inc. has prepared a Web site that provides, at no charge, lists of associations organized by health topic. You can access this database at the following Web site: http://www.rarediseases.org/search/orgsearch.html. Type “urine protein” (or a synonym) into the search box, and click “Submit Query.”

45

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

Preparation Your local public library and medical libraries have interlibrary loan programs with the National Library of Medicine (NLM), one of the largest medical collections in the world. According to the NLM, most of the literature in the general and historical collections of the National Library of Medicine is available on interlibrary loan to any library. If you would like to access NLM medical literature, then visit a library in your area that can request the publications for you.15

Finding a Local Medical Library The quickest method to locate medical libraries is to use the Internet-based directory published by the National Network of Libraries of Medicine (NN/LM). This network includes 4626 members and affiliates that provide many services to librarians, health professionals, and the public. To find a library in your area, simply visit http://nnlm.gov/members/adv.html or call 1-800-338-7657.

Medical Libraries in the U.S. and Canada In addition to the NN/LM, the National Library of Medicine (NLM) lists a number of libraries with reference facilities that are open to the public. The following is the NLM’s list and includes hyperlinks to each library’s Web site. These Web pages can provide information on hours of operation and other restrictions. The list below is a small sample of

15

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

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Urine Protein

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)16: •

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

•

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

•

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

•

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

•

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

•

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

•

California: Gateway Health Library (Sutter Gould Medical Foundation)

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

16

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

Finding Medical Libraries

47

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

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•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

Finding Medical Libraries

49

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

50

Urine Protein

•

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

•

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

•

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

•

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

51

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

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

•

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

•

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

•

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

•

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

•

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

•

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

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

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

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

•

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

•

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

•

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

53

URINE PROTEIN DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Abdominal: Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs. [NIH] Acidosis: A pathologic condition resulting from accumulation of acid or depletion of the alkaline reserve (bicarbonate content) in the blood and body tissues, and characterized by an increase in hydrogen ion concentration. [EU] 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] Adrenergic beta-Antagonists: Drugs that bind to but do not activate beta-adrenergic receptors thereby blocking the actions of beta-adrenergic agonists. Adrenergic betaantagonists are used for treatment of hypertension, cardiac arrythmias, angina pectoris, glaucoma, migraine headaches, and anxiety. [NIH] Afferent: Concerned with the transmission of neural impulse toward the central part of the nervous system. [NIH] Affinity: 1. Inherent likeness or relationship. 2. A special attraction for a specific element, organ, or structure. 3. Chemical affinity; the force that binds atoms in molecules; the tendency of substances to combine by chemical reaction. 4. The strength of noncovalent chemical binding between two substances as measured by the dissociation constant of the complex. 5. In immunology, a thermodynamic expression of the strength of interaction between a single antigen-binding site and a single antigenic determinant (and thus of the stereochemical compatibility between them), most accurately applied to interactions among simple, uniform antigenic determinants such as haptens. Expressed as the association constant (K litres mole -1), which, owing to the heterogeneity of affinities in a population of antibody molecules of a given specificity, actually represents an average value (mean intrinsic association constant). 6. The reciprocal of the dissociation constant. [EU] Agarose: A polysaccharide complex, free of nitrogen and prepared from agar-agar which is produced by certain seaweeds (red algae). It dissolves in warm water to form a viscid solution. [NIH] Age of Onset: The age or period of life at which a disease or the initial symptoms or manifestations of a disease appear in an individual. [NIH] Age-Adjusted: Summary measures of rates of morbidity or mortality in a population using statistical procedures to remove the effect of age differences in populations that are being compared. Age is probably the most important and the most common variable in determining the risk of morbidity and mortality. [NIH] Albumin: 1. Any protein that is soluble in water and moderately concentrated salt solutions and is coagulable by heat. 2. Serum albumin; the major plasma protein (approximately 60 per cent of the total), which is responsible for much of the plasma colloidal osmotic pressure

54

Urine Protein

and serves as a transport protein carrying large organic anions, such as fatty acids, bilirubin, and many drugs, and also carrying certain hormones, such as cortisol and thyroxine, when their specific binding globulins are saturated. Albumin is synthesized in the liver. Low serum levels occur in protein malnutrition, active inflammation and serious hepatic and renal disease. [EU] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alimentary: Pertaining to food or nutritive material, or to the organs of digestion. [EU] Alkaline: Having the reactions of an alkali. [EU] Allografts: A graft of tissue obtained from the body of another animal of the same species but with genotype differing from that of the recipient; tissue graft from a donor of one genotype to a host of another genotype with host and donor being members of the same species. [NIH] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Amino Acid Sequence: The order of amino acids as they occur in a polypeptide chain. This is referred to as the primary structure of proteins. It is of fundamental importance in determining protein conformation. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Ammonia: A colorless alkaline gas. It is formed in the body during decomposition of organic materials during a large number of metabolically important reactions. [NIH] Anaesthesia: Loss of feeling or sensation. Although the term is used for loss of tactile sensibility, or of any of the other senses, it is applied especially to loss of the sensation of pain, as it is induced to permit performance of surgery or other painful procedures. [EU] Anal: Having to do with the anus, which is the posterior opening of the large bowel. [NIH] Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] Anemia: A reduction in the number of circulating erythrocytes or in the quantity of hemoglobin. [NIH] Angina: Chest pain that originates in the heart. [NIH] Angiography: Radiography of blood vessels after injection of a contrast medium. [NIH] Angiotensin converting enzyme inhibitor: A drug used to decrease pressure inside blood vessels. [NIH] Angiotensin-Converting Enzyme Inhibitors: A class of drugs whose main indications are the treatment of hypertension and heart failure. They exert their hemodynamic effect mainly by inhibiting the renin-angiotensin system. They also modulate sympathetic nervous system activity and increase prostaglandin synthesis. They cause mainly vasodilation and mild natriuresis without affecting heart rate and contractility. [NIH] Animal model: An animal with a disease either the same as or like a disease in humans.

Dictionary 55

Animal models are used to study the development and progression of diseases and to test new treatments before they are given to humans. Animals with transplanted human cancers or other tissues are called xenograft models. [NIH] Anions: Negatively charged atoms, radicals or groups of atoms which travel to the anode or positive pole during electrolysis. [NIH] Antibiotic: A drug used to treat infections caused by bacteria and other microorganisms. [NIH]

Antibodies: Immunoglobulin molecules having a specific amino acid sequence by virtue of which they interact only with the antigen that induced their synthesis in cells of the lymphoid series (especially plasma cells), or with an antigen closely related to it. [NIH] Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Anticoagulant: A drug that helps prevent blood clots from forming. Also called a blood thinner. [NIH] Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Antihypertensive: An agent that reduces high blood pressure. [EU] Antihypertensive Agents: Drugs used in the treatment of acute or chronic hypertension regardless of pharmacological mechanism. Among the antihypertensive agents are diuretics (especially diuretics, thiazide), adrenergic beta-antagonists, adrenergic alpha-antagonists, angiotensin-converting enzyme inhibitors, calcium channel blockers, ganglionic blockers, and vasodilator agents. [NIH] Anti-infective: An agent that so acts. [EU] Anti-inflammatory: Having to do with reducing inflammation. [NIH] Anti-Inflammatory Agents: Substances that reduce or suppress inflammation. [NIH] Antimicrobial: Killing microorganisms, or suppressing their multiplication or growth. [EU] Anuria: Inability to form or excrete urine. [NIH] Apolipoproteins: The protein components of lipoproteins which remain after the lipids to which the proteins are bound have been removed. They play an important role in lipid transport and metabolism. [NIH] Arginine: An essential amino acid that is physiologically active in the L-form. [NIH] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Arteriolar: Pertaining to or resembling arterioles. [EU] Arterioles: The smallest divisions of the arteries located between the muscular arteries and the capillaries. [NIH] Arteriolosclerosis: Sclerosis and thickening of the walls of the smaller arteries (arterioles).

56

Urine Protein

Hyaline arteriolosclerosis, in which there is homogeneous pink hyaline thickening of the arteriolar walls, is associated with benign nephrosclerosis. Hyperplastic arteriolosclerosis, in which there is a concentric thickening with progressive narrowing of the lumina may be associated with malignant hypertension, nephrosclerosis, and scleroderma. [EU] Asparaginase: A hydrolase enzyme that converts L-asparagine and water to L-aspartate and NH3. EC 3.5.1.1. [NIH] Aspartate: A synthetic amino acid. [NIH] Aspirin: A drug that reduces pain, fever, inflammation, and blood clotting. Aspirin belongs to the family of drugs called nonsteroidal anti-inflammatory agents. It is also being studied in cancer prevention. [NIH] Assay: Determination of the amount of a particular constituent of a mixture, or of the biological or pharmacological potency of a drug. [EU] Asymptomatic: Having no signs or symptoms of disease. [NIH] Autoantibodies: Antibodies that react with self-antigens (autoantigens) of the organism that produced them. [NIH] Autoantigens: Endogenous tissue constituents that have the ability to interact with autoantibodies and cause an immune response. [NIH] Autodigestion: Autolysis; a condition found in disease of the stomach: the stomach wall is digested by the gastric juice. [NIH] Autoimmune disease: A condition in which the body recognizes its own tissues as foreign and directs an immune response against them. [NIH] Back Pain: Acute or chronic pain located in the posterior regions of the trunk, including the thoracic, lumbar, sacral, or adjacent regions. [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] Bacteriuria: The presence of bacteria in the urine with or without consequent urinary tract infection. Since bacteriuria is a clinical entity, the term does not preclude the use of urine/microbiology for technical discussions on the isolation and segregation of bacteria in the urine. [NIH] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU] Basophils: Granular leukocytes characterized by a relatively pale-staining, lobate nucleus and cytoplasm containing coarse dark-staining granules of variable size and stainable by basic dyes. [NIH] Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]

Benzethonium: Bactericidal cationic quaternary ammonium surfactant used as a topical anti-infective agent. It is an ingredient in medicaments, deodorants, mouthwashes, etc., and is used to disinfect apparatus, etc., in the food processing and pharmaceutical industries, in surgery, and also as a preservative. The compound is toxic orally as a result of neuromuscular blockade. [NIH] Beta 2-Microglobulin: An 11 kDa protein associated with the outer membrane of many cells including lymphocytes. It is the small subunit of the MHC class I molecule. Association with

Dictionary 57

beta 2-microglobulin is generally required for the transport of class I heavy chains from the endoplasmic reticulum to the cell surface. Beta 2-microglobulin is present in small amounts in serum, csf, and urine of normal people, and to a much greater degree in the urine and plasma of patients with tubular proteinemia, renal failure, or kidney transplants. [NIH] Bile: An emulsifying agent produced in the liver and secreted into the duodenum. Its composition includes bile acids and salts, cholesterol, and electrolytes. It aids digestion of fats in the duodenum. [NIH] Biliary: Having to do with the liver, bile ducts, and/or gallbladder. [NIH] Biliary Tract: The gallbladder and its ducts. [NIH] Bilirubin: A bile pigment that is a degradation product of heme. [NIH] Biomarkers: Substances sometimes found in an increased amount in the blood, other body fluids, or tissues and that may suggest the presence of some types of cancer. Biomarkers include CA 125 (ovarian cancer), CA 15-3 (breast cancer), CEA (ovarian, lung, breast, pancreas, and GI tract cancers), and PSA (prostate cancer). Also called tumor markers. [NIH] Biomolecular: A scientific field at the interface between advanced computing and biotechnology. [NIH] Biopsy: Removal and pathologic examination of specimens in the form of small pieces of tissue from the living body. [NIH] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Bladder: The organ that stores urine. [NIH] Blood Cell Count: A count of the number of leukocytes and erythrocytes per unit volume in a sample of venous blood. A complete blood count (CBC) also includes measurement of the hemoglobin, hematocrit, and erythrocyte indices. [NIH] Blood Coagulation: The process of the interaction of blood coagulation factors that results in an insoluble fibrin clot. [NIH] Blood Glucose: Glucose in blood. [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber. Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Blood urea: A waste product in the blood that comes from the breakdown of food protein. The kidneys filter blood to remove urea. As kidney function decreases, the BUN level increases. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Body Fluids: Liquid components of living organisms. [NIH] Bone Marrow: The soft tissue filling the cavities of bones. Bone marrow exists in two types, yellow and red. Yellow marrow is found in the large cavities of large bones and consists mostly of fat cells and a few primitive blood cells. Red marrow is a hematopoietic tissue and is the site of production of erythrocytes and granular leukocytes. Bone marrow is made up of a framework of connective tissue containing branching fibers with the frame being filled

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with marrow cells. [NIH] Bowel: The long tube-shaped organ in the abdomen that completes the process of digestion. There is both a small and a large bowel. Also called the intestine. [NIH] Branch: Most commonly used for branches of nerves, but applied also to other structures. [NIH]

Breakdown: A physical, metal, or nervous collapse. [NIH] Buccal: Pertaining to or directed toward the cheek. In dental anatomy, used to refer to the buccal surface of a tooth. [EU] Calcium: A basic element found in nearly all organized tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. [NIH] Calcium channel blocker: A drug used to relax the blood vessel and heart muscle, causing pressure inside blood vessels to drop. It also can regulate heart rhythm. [NIH] Calcium Channel Blockers: A class of drugs that act by selective inhibition of calcium influx through cell membranes or on the release and binding of calcium in intracellular pools. Since they are inducers of vascular and other smooth muscle relaxation, they are used in the drug therapy of hypertension and cerebrovascular spasms, as myocardial protective agents, and in the relaxation of uterine spasms. [NIH] Calcium Oxalate: The calcium salt of oxalic acid, occurring in the urine as crystals and in certain calculi. [NIH] Calculi: An abnormal concretion occurring mostly in the urinary and biliary tracts, usually composed of mineral salts. Also called stones. [NIH] Caloric intake: Refers to the number of calories (energy content) consumed. [NIH] Capillary: Any one of the minute vessels that connect the arterioles and venules, forming a network in nearly all parts of the body. Their walls act as semipermeable membranes for the interchange of various substances, including fluids, between the blood and tissue fluid; called also vas capillare. [EU] Capsules: Hard or soft soluble containers used for the oral administration of medicine. [NIH] Cardiovascular: Having to do with the heart and blood vessels. [NIH] Cauda Equina: The lower part of the spinal cord consisting of the lumbar, sacral, and coccygeal nerve roots. [NIH] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Cell membrane: Cell membrane = plasma membrane. The structure enveloping a cell, enclosing the cytoplasm, and forming a selective permeability barrier; it consists of lipids, proteins, and some carbohydrates, the lipids thought to form a bilayer in which integral proteins are embedded to varying degrees. [EU] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Centrifugation: A method of separating organelles or large molecules that relies upon differential sedimentation through a preformed density gradient under the influence of a gravitational field generated in a centrifuge. [NIH] Cerebrovascular: Pertaining to the blood vessels of the cerebrum, or brain. [EU]

Dictionary 59

Character: In current usage, approximately equivalent to personality. The sum of the relatively fixed personality traits and habitual modes of response of an individual. [NIH] Chemokines: Class of pro-inflammatory cytokines that have the ability to attract and activate leukocytes. They can be divided into at least three structural branches: C (chemokines, C), CC (chemokines, CC), and CXC (chemokines, CXC), according to variations in a shared cysteine motif. [NIH] Chemotactic Factors: Chemical substances that attract or repel cells or organisms. The concept denotes especially those factors released as a result of tissue injury, invasion, or immunologic activity, that attract leukocytes, macrophages, or other cells to the site of infection or insult. [NIH] Chemotherapy: Treatment with anticancer drugs. [NIH] Chin: The anatomical frontal portion of the mandible, also known as the mentum, that contains the line of fusion of the two separate halves of the mandible (symphysis menti). This line of fusion divides inferiorly to enclose a triangular area called the mental protuberance. On each side, inferior to the second premolar tooth, is the mental foramen for the passage of blood vessels and a nerve. [NIH] 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] Cholesterol Esters: Fatty acid esters of cholesterol which constitute about two-thirds of the cholesterol in the plasma. The accumulation of cholesterol esters in the arterial intima is a characteristic feature of atherosclerosis. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Chronic renal: Slow and progressive loss of kidney function over several years, often resulting in end-stage renal disease. People with end-stage renal disease need dialysis or transplantation to replace the work of the kidneys. [NIH] Chylomicrons: A class of lipoproteins that carry dietary cholesterol and triglycerides from the small intestines to the tissues. [NIH] Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] Cloning: The production of a number of genetically identical individuals; in genetic engineering, a process for the efficient replication of a great number of identical DNA molecules. [NIH] Cofactor: A substance, microorganism or environmental factor that activates or enhances the action of another entity such as a disease-causing agent. [NIH] Colloidal: Of the nature of a colloid. [EU] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Concentric: Having a common center of curvature or symmetry. [NIH] Concretion: Minute, hard, yellow masses found in the palpebral conjunctivae of elderly people or following chronic conjunctivitis, composed of the products of cellular degeneration retained in the depressions and tubular recesses in the conjunctiva. [NIH] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or

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treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Convulsions: A general term referring to sudden and often violent motor activity of cerebral or brainstem origin. Convulsions may also occur in the absence of an electrical cerebral discharge (e.g., in response to hypotension). [NIH] Coordination: Muscular or motor regulation or the harmonious cooperation of muscles or groups of muscles, in a complex action or series of actions. [NIH] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Cortisol: A steroid hormone secreted by the adrenal cortex as part of the body's response to stress. [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]

Creatinine: A compound that is excreted from the body in urine. Creatinine levels are measured to monitor kidney function. [NIH] Crystallization: The formation of crystals; conversion to a crystalline form. [EU] CSF: Cerebrospinal fluid. The fluid flowing around the brain and spinal cord. CSF is produced in the ventricles of the brain. [NIH] Cutaneous: Having to do with the skin. [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] Cysteine: A thiol-containing non-essential amino acid that is oxidized to form cystine. [NIH] Cytokines: Non-antibody proteins secreted by inflammatory leukocytes and some nonleukocytic 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] Databases, Bibliographic: Extensive collections, reputedly complete, of references and citations to books, articles, publications, etc., generally on a single subject or specialized subject area. Databases can operate through automated files, libraries, or computer disks. The concept should be differentiated from factual databases which is used for collections of data and facts apart from bibliographic references to them. [NIH] Daunorubicin: Very toxic anthracycline aminoglycoside antibiotic isolated from Streptomyces peucetius and others, used in treatment of leukemias and other neoplasms. [NIH]

Deamination: The removal of an amino group (NH2) from a chemical compound. [NIH] Degenerative: Undergoing degeneration : tending to degenerate; having the character of or involving degeneration; causing or tending to cause degeneration. [EU] Density: The logarithm to the base 10 of the opacity of an exposed and processed film. [NIH] Developing Countries: Countries in the process of change directed toward economic growth, that is, an increase in production, per capita consumption, and income. The process

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of economic growth involves better utilization of natural and human resources, which results in a change in the social, political, and economic structures. [NIH] Diabetes Mellitus: A heterogeneous group of disorders that share glucose intolerance in common. [NIH] Diabetic Ketoacidosis: Complication of diabetes resulting from severe insulin deficiency coupled with an absolute or relative increase in glucagon concentration. The metabolic acidosis is caused by the breakdown of adipose stores and resulting increased levels of free fatty acids. Glucagon accelerates the oxidation of the free fatty acids producing excess ketone bodies (ketosis). [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Dialyzer: A part of the hemodialysis machine. (See hemodialysis under dialysis.) The dialyzer has two sections separated by a membrane. One section holds dialysate. The other holds the patient's blood. [NIH] Diarrhea: Passage of excessively liquid or excessively frequent stools. [NIH] Diastole: Period of relaxation of the heart, especially the ventricles. [NIH] Diastolic: Of or pertaining to the diastole. [EU] Diastolic blood pressure: The minimum pressure that remains within the artery when the heart is at rest. [NIH] Diatrizoate: A commonly used x-ray contrast medium. As Diatrizoate meglumine and as Diatrizoate sodium, it is used for gastrointestinal studies, angiography, and urography. [NIH] Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Dipyridamole: A drug that prevents blood cell clumping and enhances the effectiveness of fluorouracil and other chemotherapeutic agents. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Diuretics, Thiazide: Diuretics characterized as analogs of 1,2,4-benzothiadiazine-1,1dioxide. 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] Eclampsia: Onset of convulsions or coma in a previously diagnosed pre-eclamptic patient. [NIH]

Edema: Excessive amount of watery fluid accumulated in the intercellular spaces, most commonly present in subcutaneous tissue. [NIH] Effector: It is often an enzyme that converts an inactive precursor molecule into an active second messenger. [NIH] Efferent: Nerve fibers which conduct impulses from the central nervous system to muscles and glands. [NIH] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Electrophoresis: An electrochemical process in which macromolecules or colloidal particles with a net electric charge migrate in a solution under the influence of an electric current. [NIH]

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Embolus: Bit of foreign matter which enters the blood stream at one point and is carried until it is lodged or impacted in an artery and obstructs it. It may be a blood clot, an air bubble, fat or other tissue, or clumps of bacteria. [NIH] Embryo: The prenatal stage of mammalian development characterized by rapid morphological changes and the differentiation of basic structures. [NIH] End-stage renal: Total chronic kidney failure. When the kidneys fail, the body retains fluid and harmful wastes build up. A person with ESRD needs treatment to replace the work of the failed kidneys. [NIH] Environmental Exposure: The exposure to potentially harmful chemical, physical, or biological agents in the environment or to environmental factors that may include ionizing radiation, pathogenic organisms, or toxic chemicals. [NIH] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]

Enzymatic: Phase where enzyme cuts the precursor protein. [NIH] Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Enzyme Inhibitors: Compounds or agents that combine with an enzyme in such a manner as to prevent the normal substrate-enzyme combination and the catalytic reaction. [NIH] Enzyme-Linked Immunosorbent Assay: An immunoassay utilizing an antibody labeled with an enzyme marker such as horseradish peroxidase. While either the enzyme or the antibody is bound to an immunosorbent substrate, they both retain their biologic activity; the change in enzyme activity as a result of the enzyme-antibody-antigen reaction is proportional to the concentration of the antigen and can be measured spectrophotometrically or with the naked eye. Many variations of the method have been developed. [NIH] 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] Excrete: To get rid of waste from the body. [NIH] Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] Extracellular: Outside a cell or cells. [EU] Extremity: A limb; an arm or leg (membrum); sometimes applied specifically to a hand or foot. [EU] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fat: Total lipids including phospholipids. [NIH] Fatty acids: A major component of fats that are used by the body for energy and tissue development. [NIH] Ferritin: An iron-containing protein complex that is formed by a combination of ferric iron with the protein apoferritin. [NIH] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH] Filtration: The passage of a liquid through a filter, accomplished by gravity, pressure, or vacuum (suction). [EU] Fluid Therapy: Therapy whose basic objective is to restore the volume and composition of

Dictionary 63

the body fluids to normal with respect to water-electrolyte balance. Fluids may be administered intravenously, orally, by intermittent gavage, or by hypodermoclysis. [NIH] Fluorouracil: A pyrimidine analog that acts as an antineoplastic antimetabolite and also has immunosuppressant. It interferes with DNA synthesis by blocking the thymidylate synthetase conversion of deoxyuridylic acid to thymidylic acid. [NIH] Fold: A plication or doubling of various parts of the body. [NIH] Forearm: The part between the elbow and the wrist. [NIH] Ganglionic Blockers: Agents having as their major action the interruption of neural transmission at nicotinic receptors on postganglionic autonomic neurons. Because their actions are so broad, including blocking of sympathetic and parasympathetic systems, their therapeutic use has been largely supplanted by more specific drugs. They may still be used in the control of blood pressure in patients with acute dissecting aortic aneurysm and for the induction of hypotension in surgery. [NIH] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body through the rectum (flatus) or the mouth (burp). [NIH] Gastrointestinal: Refers to the stomach and intestines. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]

Gene Expression: The phenotypic manifestation of a gene or genes by the processes of gene action. [NIH] Gene Expression Profiling: The determination of the pattern of genes expressed i.e., transcribed, under specific circumstances or in a specific cell. [NIH] Genotype: The genetic constitution of the individual; the characterization of the genes. [NIH] Gland: An organ that produces and releases one or more substances for use in the body. Some glands produce fluids that affect tissues or organs. Others produce hormones or participate in blood production. [NIH] Glomerular: Pertaining to or of the nature of a glomerulus, especially a renal glomerulus. [EU]

Glomerular Filtration Rate: The volume of water filtered out of plasma through glomerular capillary walls into Bowman's capsules per unit of time. It is considered to be equivalent to inulin clearance. [NIH] Glomeruli: Plural of glomerulus. [NIH] Glomerulonephritis: Glomerular disease characterized by an inflammatory reaction, with leukocyte infiltration and cellular proliferation of the glomeruli, or that appears to be the result of immune glomerular injury. [NIH] Glomerulus: A tiny set of looping blood vessels in the nephron where blood is filtered in the kidney. [NIH] Glucose: D-Glucose. A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. [NIH] Glucose Intolerance: A pathological state in which the fasting plasma glucose level is less than 140 mg per deciliter and the 30-, 60-, or 90-minute plasma glucose concentration following a glucose tolerance test exceeds 200 mg per deciliter. This condition is seen frequently in diabetes mellitus but also occurs with other diseases. [NIH] Governing Board: The group in which legal authority is vested for the control of health-

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related institutions and organizations. [NIH] Graft: Healthy skin, bone, or other tissue taken from one part of the body and used to replace diseased or injured tissue removed from another part of the body. [NIH] Granulocytes: Leukocytes with abundant granules in the cytoplasm. They are divided into three groups: neutrophils, eosinophils, and basophils. [NIH] Granuloma: A relatively small nodular inflammatory lesion containing grouped mononuclear phagocytes, caused by infectious and noninfectious agents. [NIH] Granuloma Inguinale: Anogenital ulcers caused by Calymmatobacterium granulomatis as distinguished from lymphogranuloma inguinale (see lymphogranuloma venereum) caused by Chlamydia trachomatis. Diagnosis is made by demonstration of typical intracellular Donovan bodies in crushed-tissue smears. [NIH] Growth: The progressive development of a living being or part of an organism from its earliest stage to maturity. [NIH] Hematocrit: Measurement of the volume of packed red cells in a blood specimen by centrifugation. The procedure is performed using a tube with graduated markings or with automated blood cell counters. It is used as an indicator of erythrocyte status in disease. For example, anemia shows a low hematocrit, polycythemia, high values. [NIH] Hematuria: Presence of blood in the urine. [NIH] Hemodialysis: The use of a machine to clean wastes from the blood after the kidneys have failed. The blood travels through tubes to a dialyzer, which removes wastes and extra fluid. The cleaned blood then flows through another set of tubes back into the body. [NIH] Hemoglobin: One of the fractions of glycosylated hemoglobin A1c. Glycosylated hemoglobin is formed when linkages of glucose and related monosaccharides bind to hemoglobin A and its concentration represents the average blood glucose level over the previous several weeks. HbA1c levels are used as a measure of long-term control of plasma glucose (normal, 4 to 6 percent). In controlled diabetes mellitus, the concentration of glycosylated hemoglobin A is within the normal range, but in uncontrolled cases the level may be 3 to 4 times the normal conentration. Generally, complications are substantially lower among patients with Hb levels of 7 percent or less than in patients with HbA1c levels of 9 percent or more. [NIH] Hemoglobin A: Normal adult human hemoglobin. The globin moiety consists of two alpha and two beta chains. [NIH] Hepatic: Refers to the liver. [NIH] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Homogeneous: Consisting of or composed of similar elements or ingredients; of a uniform quality throughout. [EU] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] Horseradish Peroxidase: An enzyme isolated from horseradish which is able to act as an antigen. It is frequently used as a histochemical tracer for light and electron microscopy. Its antigenicity has permitted its use as a combined antigen and marker in experimental immunology. [NIH] Host: Any animal that receives a transplanted graft. [NIH] Humoral: Of, relating to, proceeding from, or involving a bodily humour - now often used

Dictionary 65

of endocrine factors as opposed to neural or somatic. [EU] Humour: 1. A normal functioning fluid or semifluid of the body (as the blood, lymph or bile) especially of vertebrates. 2. A secretion that is itself an excitant of activity (as certain hormones). [EU] Hydrophobic: Not readily absorbing water, or being adversely affected by water, as a hydrophobic colloid. [EU] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Hypoglycemia: Abnormally low blood sugar [NIH] Id: The part of the personality structure which harbors the unconscious instinctive desires and strivings of the individual. [NIH] Ifosfamide: Positional isomer of cyclophosphamide which is active as an alkylating agent and an immunosuppressive agent. [NIH] Immune response: The activity of the immune system against foreign substances (antigens). [NIH]

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

effects

of

foreign

Immunization: Deliberate stimulation of the host's immune response. Active immunization involves administration of antigens or immunologic adjuvants. Passive immunization involves administration of immune sera or lymphocytes or their extracts (e.g., transfer factor, immune RNA) or transplantation of immunocompetent cell producing tissue (thymus or bone marrow). [NIH] 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] Immunodeficiency: The decreased ability of the body to fight infection and disease. [NIH] Immunodiffusion: Technique involving the diffusion of antigen or antibody through a semisolid medium, usually agar or agarose gel, with the result being a precipitin reaction. [NIH]

Immunoelectrophoresis: A technique that combines protein electrophoresis and double immunodiffusion. In this procedure proteins are first separated by gel electrophoresis (usually agarose), then made visible by immunodiffusion of specific antibodies. A distinct elliptical precipitin arc results for each protein detectable by the antisera. [NIH] Immunogenic: Producing immunity; evoking an immune response. [EU] Immunoglobulin: A protein that acts as an antibody. [NIH] Immunologic: The ability of the antibody-forming system to recall a previous experience with an antigen and to respond to a second exposure with the prompt production of large amounts of antibody. [NIH] Immunosuppressive: Describes the ability to lower immune system responses. [NIH] In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH]

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In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Indicative: That indicates; that points out more or less exactly; that reveals fairly clearly. [EU] Induction: The act or process of inducing or causing to occur, especially the production of a specific morphogenetic effect in the developing embryo through the influence of evocators or organizers, or the production of anaesthesia or unconsciousness by use of appropriate agents. [EU] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]

Infiltration: The diffusion or accumulation in a tissue or cells of substances not normal to it or in amounts of the normal. Also, the material so accumulated. [EU] Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Inguinal: Pertaining to the inguen, or groin. [EU] Insight: The capacity to understand one's own motives, to be aware of one's own psychodynamics, to appreciate the meaning of symbolic behavior. [NIH] Insulator: Material covering the metal conductor of the lead. It is usually polyurethane or silicone. [NIH] Insulin: A protein hormone secreted by beta cells of the pancreas. Insulin plays a major role in the regulation of glucose metabolism, generally promoting the cellular utilization of glucose. It is also an important regulator of protein and lipid metabolism. Insulin is used as a drug to control insulin-dependent diabetes mellitus. [NIH] Insulin-dependent diabetes mellitus: A disease characterized by high levels of blood glucose resulting from defects in insulin secretion, insulin action, or both. Autoimmune, genetic, and environmental factors are involved in the development of type I diabetes. [NIH] Insulin-like: Muscular growth factor. [NIH] Intermittent: Occurring at separated intervals; having periods of cessation of activity. [EU] Interstitial: Pertaining to or situated between parts or in the interspaces of a tissue. [EU] Intervertebral: Situated between two contiguous vertebrae. [EU] Intervertebral Disk Displacement: An intervertebral disk in which the nucleus pulposus has protruded through surrounding fibrocartilage. This occurs most frequently in the lower lumbar region. [NIH] Intestinal: Having to do with the intestines. [NIH] Intestine: A long, tube-shaped organ in the abdomen that completes the process of digestion. There is both a large intestine and a small intestine. Also called the bowel. [NIH] Intracellular: Inside a cell. [NIH]

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Intramuscular: IM. Within or into muscle. [NIH] Intravenous: IV. Into a vein. [NIH] Intravesical: Within the bladder. [NIH] Inulin: A starch found in the tubers and roots of many plants. Since it is hydrolyzable to fructose, it is classified as a fructosan. It has been used in physiologic investigation for determination of the rate of glomerular function. [NIH] Ionizing: Radiation comprising charged particles, e. g. electrons, protons, alpha-particles, etc., having sufficient kinetic energy to produce ionization by collision. [NIH] Joint: The point of contact between elements of an animal skeleton with the parts that surround and support it. [NIH] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Ketone Bodies: Chemicals that the body makes when there is not enough insulin in the blood and it must break down fat for its energy. Ketone bodies can poison and even kill body cells. When the body does not have the help of insulin, the ketones build up in the blood and then "spill" over into the urine so that the body can get rid of them. The body can also rid itself of one type of ketone, called acetone, through the lungs. This gives the breath a fruity odor. Ketones that build up in the body for a long time lead to serious illness and coma. [NIH] Ketosis: A condition of having ketone bodies build up in body tissues and fluids. The signs of ketosis are nausea, vomiting, and stomach pain. Ketosis can lead to ketoacidosis. [NIH] Kidney Disease: Any one of several chronic conditions that are caused by damage to the cells of the kidney. People who have had diabetes for a long time may have kidney damage. Also called nephropathy. [NIH] Kidney Failure: The inability of a kidney to excrete metabolites at normal plasma levels under conditions of normal loading, or the inability to retain electrolytes under conditions of normal intake. In the acute form (kidney failure, acute), it is marked by uremia and usually by oliguria or anuria, with hyperkalemia and pulmonary edema. The chronic form (kidney failure, chronic) is irreversible and requires hemodialysis. [NIH] Kidney Failure, Acute: A clinical syndrome characterized by a sudden decrease in glomerular filtration rate, often to values of less than 1 to 2 ml per minute. It is usually associated with oliguria (urine volumes of less than 400 ml per day) and is always associated with biochemical consequences of the reduction in glomerular filtration rate such as a rise in blood urea nitrogen (BUN) and serum creatinine concentrations. [NIH] Kidney Failure, Chronic: An irreversible and usually progressive reduction in renal function in which both kidneys have been damaged by a variety of diseases to the extent that they are unable to adequately remove the metabolic products from the blood and regulate the body's electrolyte composition and acid-base balance. Chronic kidney failure requires hemodialysis or surgery, usually kidney transplantation. [NIH] Kidney stone: A stone that develops from crystals that form in urine and build up on the inner surfaces of the kidney, in the renal pelvis, or in the ureters. [NIH] Leg Ulcer: Ulceration of the skin and underlying structures of the lower extremity. About 90% of the cases are due to venous insufficiency (varicose ulcer), 5% to arterial disease, and the remaining 5% to other causes. [NIH] Leukemia: Cancer of blood-forming tissue. [NIH] Leukocytes: White blood cells. These include granular leukocytes (basophils, eosinophils,

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and neutrophils) as well as non-granular leukocytes (lymphocytes and monocytes). [NIH] Library Services: Services offered to the library user. They include reference and circulation. [NIH]

Linkages: The tendency of two or more genes in the same chromosome to remain together from one generation to the next more frequently than expected according to the law of independent assortment. [NIH] Lipid: Fat. [NIH] Lipoprotein: Any of the lipid-protein complexes in which lipids are transported in the blood; lipoprotein particles consist of a spherical hydrophobic core of triglycerides or cholesterol esters surrounded by an amphipathic monolayer of phospholipids, cholesterol, and apolipoproteins; the four principal classes are high-density, low-density, and very-lowdensity lipoproteins and chylomicrons. [EU] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Longitudinal study: Also referred to as a "cohort study" or "prospective study"; the analytic method of epidemiologic study in which subsets of a defined population can be identified who are, have been, or in the future may be exposed or not exposed, or exposed in different degrees, to a factor or factors hypothesized to influence the probability of occurrence of a given disease or other outcome. The main feature of this type of study is to observe large numbers of subjects over an extended time, with comparisons of incidence rates in groups that differ in exposure levels. [NIH] Low-density lipoprotein: Lipoprotein that contains most of the cholesterol in the blood. LDL carries cholesterol to the tissues of the body, including the arteries. A high level of LDL increases the risk of heart disease. LDL typically contains 60 to 70 percent of the total serum cholesterol and both are directly correlated with CHD risk. [NIH] Lumbar: Pertaining to the loins, the part of the back between the thorax and the pelvis. [EU] Lupus: A form of cutaneous tuberculosis. It is seen predominantly in women and typically involves the nasal, buccal, and conjunctival mucosa. [NIH] Lymph: The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. [NIH] Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. [NIH] Lymphocyte: A white blood cell. Lymphocytes have a number of roles in the immune system, including the production of antibodies and other substances that fight infection and diseases. [NIH] Lymphogranuloma Venereum: Subacute inflammation of the inguinal lymph glands caused by certain immunotypes of Chlamydia trachomatis. It is a sexually transmitted disease in the U.S. but is more widespread in developing countries. It is distinguished from granuloma venereum (granuloma inguinale), which is caused by Calymmatobacterium granulomatis. [NIH]

Lymphoid: Referring to lymphocytes, a type of white blood cell. Also refers to tissue in which lymphocytes develop. [NIH] Malabsorption: Impaired intestinal absorption of nutrients. [EU] Malabsorption syndrome: A group of symptoms such as gas, bloating, abdominal pain, and diarrhea resulting from the body's inability to properly absorb nutrients. [NIH]

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Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malignant tumor: A tumor capable of metastasizing. [NIH] Malnutrition: A condition caused by not eating enough food or not eating a balanced diet. [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] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Meglumine: 1-Deoxy-1-(methylamino)-D-glucitol. A derivative of sorbitol in which the hydroxyl group in position 1 is replaced by a methylamino group. Often used in conjunction with iodinated organic compounds as contrast medium. [NIH] Melanocytes: Epidermal dendritic pigment cells which control long-term morphological color changes by alteration in their number or in the amount of pigment they produce and store in the pigment containing organelles called melanosomes. Melanophores are larger cells which do not exist in mammals. [NIH] Melanoma: A form of skin cancer that arises in melanocytes, the cells that produce pigment. Melanoma usually begins in a mole. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Menopause: Permanent cessation of menstruation. [NIH] Mental: Pertaining to the mind; psychic. 2. (L. mentum chin) pertaining to the chin. [EU] MI: Myocardial infarction. Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Microorganism: An organism that can be seen only through a microscope. Microorganisms include bacteria, protozoa, algae, and fungi. Although viruses are not considered living organisms, they are sometimes classified as microorganisms. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] Monitor: An apparatus which automatically records such physiological signs as respiration, pulse, and blood pressure in an anesthetized patient or one undergoing surgical or other procedures. [NIH] Monoclonal: An antibody produced by culturing a single type of cell. It therefore consists of a single species of immunoglobulin molecules. [NIH] Monocytes: Large, phagocytic mononuclear leukocytes produced in the vertebrate bone marrow and released into the blood; contain a large, oval or somewhat indented nucleus surrounded by voluminous cytoplasm and numerous organelles. [NIH] Mononuclear: A cell with one nucleus. [NIH] Mucosa: A mucous membrane, or tunica mucosa. [EU]

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Multiple Myeloma: A malignant tumor of plasma cells usually arising in the bone marrow; characterized by diffuse involvement of the skeletal system, hyperglobulinemia, Bence-Jones proteinuria, and anemia. [NIH] Multiple sclerosis: A disorder of the central nervous system marked by weakness, numbness, a loss of muscle coordination, and problems with vision, speech, and bladder control. Multiple sclerosis is thought to be an autoimmune disease in which the body's immune system destroys myelin. Myelin is a substance that contains both protein and fat (lipid) and serves as a nerve insulator and helps in the transmission of nerve signals. [NIH] Myelin: The fatty substance that covers and protects nerves. [NIH] Myeloma: Cancer that arises in plasma cells, a type of white blood cell. [NIH] Myocardial infarction: Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Necrosis: A pathological process caused by the progressive degradative action of enzymes that is generally associated with severe cellular trauma. It is characterized by mitochondrial swelling, nuclear flocculation, uncontrolled cell lysis, and ultimately cell death. [NIH] Need: A state of tension or dissatisfaction felt by an individual that impels him to action toward a goal he believes will satisfy the impulse. [NIH] Neonatal: Pertaining to the first four weeks after birth. [EU] Nephritis: Inflammation of the kidney; a focal or diffuse proliferative or destructive process which may involve the glomerulus, tubule, or interstitial renal tissue. [EU] Nephrolithiasis: Kidney stones. [NIH] Nephropathy: Disease of the kidneys. [EU] Nephrosis: Descriptive histopathologic term for renal disease without an inflammatory component. [NIH] Nephrotic: Pertaining to, resembling, or caused by nephrosis. [EU] Nephrotic Syndrome: Clinical association of heavy proteinuria, hypoalbuminemia, and generalized edema. [NIH] Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Networks: Pertaining to a nerve or to the nerves, a meshlike structure of interlocking fibers or strands. [NIH] Neural: 1. Pertaining to a nerve or to the nerves. 2. Situated in the region of the spinal axis, as the neutral arch. [EU] Neuromuscular: Pertaining to muscles and nerves. [EU] Neuropathy: A problem in any part of the nervous system except the brain and spinal cord. Neuropathies can be caused by infection, toxic substances, or disease. [NIH] Neutrophil: A type of white blood cell. [NIH] Neutrophil Activation: The process in which the neutrophil is stimulated by diverse substances, resulting in degranulation and/or generation of reactive oxygen products, and culminating in the destruction of invading pathogens. The stimulatory substances, including

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opsonized particles, immune complexes, and chemotactic factors, bind to specific cellsurface receptors on the neutrophil. [NIH] Nitrogen: An element with the atomic symbol N, atomic number 7, and atomic weight 14. Nitrogen exists as a diatomic gas and makes up about 78% of the earth's atmosphere by volume. It is a constituent of proteins and nucleic acids and found in all living cells. [NIH] Nucleic acid: Either of two types of macromolecule (DNA or RNA) formed by polymerization of nucleotides. Nucleic acids are found in all living cells and contain the information (genetic code) for the transfer of genetic information from one generation to the next. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nutritional Support: The administration of nutrients for assimilation and utilization by a patient by means other than normal eating. It does not include fluid therapy which normalizes body fluids to restore water-electrolyte balance. [NIH] Oliguria: Clinical manifestation of the urinary system consisting of a decrease in the amount of urine secreted. [NIH] Opacity: Degree of density (area most dense taken for reading). [NIH] Opportunistic Infections: An infection caused by an organism which becomes pathogenic under certain conditions, e.g., during immunosuppression. [NIH] Orthostatic: Pertaining to or caused by standing erect. [EU] Osmotic: Pertaining to or of the nature of osmosis (= the passage of pure solvent from a solution of lesser to one of greater solute concentration when the two solutions are separated by a membrane which selectively prevents the passage of solute molecules, but is permeable to the solvent). [EU] Osteoporosis: Reduction of bone mass without alteration in the composition of bone, leading to fractures. Primary osteoporosis can be of two major types: postmenopausal osteoporosis and age-related (or senile) osteoporosis. [NIH] Outpatient: A patient who is not an inmate of a hospital but receives diagnosis or treatment in a clinic or dispensary connected with the hospital. [NIH] Oxalate: A chemical that combines with calcium in urine to form the most common type of kidney stone (calcium oxalate stone). [NIH] Oxalic Acid: A strong dicarboxylic acid occurring in many plants and vegetables. It is produced in the body by metabolism of glyoxylic acid or ascorbic acid. It is not metabolized but excreted in the urine. It is used as an analytical reagent and general reducing agent. [NIH] Oxidation: The act of oxidizing or state of being oxidized. Chemically it consists in the increase of positive charges on an atom or the loss of negative charges. Most biological oxidations are accomplished by the removal of a pair of hydrogen atoms (dehydrogenation) from a molecule. Such oxidations must be accompanied by reduction of an acceptor molecule. Univalent o. indicates loss of one electron; divalent o., the loss of two electrons. [EU]

Pancreas: A mixed exocrine and endocrine gland situated transversely across the posterior abdominal wall in the epigastric and hypochondriac regions. The endocrine portion is comprised of the Islets of Langerhans, while the exocrine portion is a compound acinar gland that secretes digestive enzymes. [NIH] Pancreatic: Having to do with the pancreas. [NIH] Pancreatitis: Acute or chronic inflammation of the pancreas, which may be asymptomatic or

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symptomatic, and which is due to autodigestion of a pancreatic tissue by its own enzymes. It is caused most often by alcoholism or biliary tract disease; less commonly it may be associated with hyperlipaemia, hyperparathyroidism, abdominal trauma (accidental or operative injury), vasculitis, or uraemia. [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] Parenteral Nutrition: The administering of nutrients for assimilation and utilization by a patient who cannot maintain adequate nutrition by enteral feeding alone. Nutrients are administered by a route other than the alimentary canal (e.g., intravenously, subcutaneously). [NIH] Pathogenesis: The cellular events and reactions that occur in the development of disease. [NIH]

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

Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Peripheral blood: Blood circulating throughout the body. [NIH] Peritoneal: Having to do with the peritoneum (the tissue that lines the abdominal wall and covers most of the organs in the abdomen). [NIH] Peritoneal Cavity: The space enclosed by the peritoneum. It is divided into two portions, the greater sac and the lesser sac or omental bursa, which lies behind the stomach. The two sacs are connected by the foramen of Winslow, or epiploic foramen. [NIH] Peritoneal Dialysis: Dialysis fluid being introduced into and removed from the peritoneal cavity as either a continuous or an intermittent procedure. [NIH] Peritoneum: Endothelial lining of the abdominal cavity, the parietal peritoneum covering the inside of the abdominal wall and the visceral peritoneum covering the bowel, the mesentery, and certain of the organs. The portion that covers the bowel becomes the serosal layer of the bowel wall. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Phospholipids: Lipids containing one or more phosphate groups, particularly those derived from either glycerol (phosphoglycerides; glycerophospholipids) or sphingosine (sphingolipids). They are polar lipids that are of great importance for the structure and function of cell membranes and are the most abundant of membrane lipids, although not stored in large amounts in the system. [NIH] Phosphorus: A non-metallic element that is found in the blood, muscles, nevers, bones, and teeth, and is a component of adenosine triphosphate (ATP; the primary energy source for the body's cells.) [NIH] Physical Fitness: A state of well-being in which performance is optimal, often as a result of physical conditioning which may be prescribed for disease therapy. [NIH] Pigment: A substance that gives color to tissue. Pigments are responsible for the color of skin, eyes, and hair. [NIH] Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized

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regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Plasma cells: A type of white blood cell that produces antibodies. [NIH] Plasma protein: One of the hundreds of different proteins present in blood plasma, including carrier proteins ( such albumin, transferrin, and haptoglobin), fibrinogen and other coagulation factors, complement components, immunoglobulins, enzyme inhibitors, precursors of substances such as angiotension and bradykinin, and many other types of proteins. [EU] Pneumonia: Inflammation of the lungs. [NIH] Polypeptide: A peptide which on hydrolysis yields more than two amino acids; called tripeptides, tetrapeptides, etc. according to the number of amino acids contained. [EU] Polysaccharide: A type of carbohydrate. It contains sugar molecules that are linked together chemically. [NIH] Posterior: Situated in back of, or in the back part of, or affecting the back or dorsal surface of the body. In lower animals, it refers to the caudal end of the body. [EU] Postmenopausal: Refers to the time after menopause. Menopause is the time in a woman's life when menstrual periods stop permanently; also called "change of life." [NIH] Potassium: An element that is in the alkali group of metals. It has an atomic symbol K, atomic number 19, and atomic weight 39.10. It is the chief cation in the intracellular fluid of muscle and other cells. Potassium ion is a strong electrolyte and it plays a significant role in the regulation of fluid volume and maintenance of the water-electrolyte balance. [NIH] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Precipitation: The act or process of precipitating. [EU] Precursor: Something that precedes. In biological processes, a substance from which another, usually more active or mature substance is formed. In clinical medicine, a sign or symptom that heralds another. [EU] 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] Progression: Increase in the size of a tumor or spread of cancer in the body. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Prone: Having the front portion of the body downwards. [NIH] Prophylaxis: An attempt to prevent disease. [NIH] Proportional: Being in proportion : corresponding in size, degree, or intensity, having the

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same or a constant ratio; of, relating to, or used in determining proportions. [EU] Prospective study: An epidemiologic study in which a group of individuals (a cohort), all free of a particular disease and varying in their exposure to a possible risk factor, is followed over a specific amount of time to determine the incidence rates of the disease in the exposed and unexposed groups. [NIH] 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] Protective Agents: Synthetic or natural substances which are given to prevent a disease or disorder or are used in the process of treating a disease or injury due to a poisonous agent. [NIH]

Protein C: A vitamin-K dependent zymogen present in the blood, which, upon activation by thrombin and thrombomodulin exerts anticoagulant properties by inactivating factors Va and VIIIa at the rate-limiting steps of thrombin formation. [NIH] Protein Conformation: The characteristic 3-dimensional shape of a protein, including the secondary, supersecondary (motifs), tertiary (domains) and quaternary structure of the peptide chain. Quaternary protein structure describes the conformation assumed by multimeric proteins (aggregates of more than one polypeptide chain). [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] Proteinuria: The presence of protein in the urine, indicating that the kidneys are not working properly. [NIH] Proteome: The protein complement of an organism coded for by its genome. [NIH] Protocol: The detailed plan for a clinical trial that states the trial's rationale, purpose, drug or vaccine dosages, length of study, routes of administration, who may participate, and other aspects of trial design. [NIH] Psychic: Pertaining to the psyche or to the mind; mental. [EU] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Pulmonary: Relating to the lungs. [NIH] Pulmonary Artery: The short wide vessel arising from the conus arteriosus of the right ventricle and conveying unaerated blood to the lungs. [NIH] Pulmonary Edema: An accumulation of an excessive amount of watery fluid in the lungs, may be caused by acute exposure to dangerous concentrations of irritant gasses. [NIH] Pulse: The rhythmical expansion and contraction of an artery produced by waves of pressure caused by the ejection of blood from the left ventricle of the heart as it contracts. [NIH]

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] Quaternary: 1. Fourth in order. 2. Containing four elements or groups. [EU] Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the

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waves/rays themselves; a stream of electromagnetic particles (electrons, neutrons, protons, alpha particles) or a mixture of these. The most common source is the sun. [NIH] Radiculopathy: Disease involving a spinal nerve root (see spinal nerve roots) which may result from compression related to intervertebral disk displacement; spinal cord injuries; spinal diseases; and other conditions. Clinical manifestations include radicular pain, weakness, and sensory loss referable to structures innervated by the involved nerve root. [NIH]

Randomized: Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments. [NIH] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Recur: To occur again. Recurrence is the return of cancer, at the same site as the original (primary) tumor or in another location, after the tumor had disappeared. [NIH] Recurrence: The return of a sign, symptom, or disease after a remission. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Relapse: The return of signs and symptoms of cancer after a period of improvement. [NIH] Remission: A decrease in or disappearance of signs and symptoms of cancer. In partial remission, some, but not all, signs and symptoms of cancer have disappeared. In complete remission, all signs and symptoms of cancer have disappeared, although there still may be cancer in the body. [NIH] Renal failure: Progressive renal insufficiency and uremia, due to irreversible and progressive renal glomerular tubular or interstitial disease. [NIH] Renal pelvis: The area at the center of the kidney. Urine collects here and is funneled into the ureter, the tube that connects the kidney to the bladder. [NIH] Renal Replacement Therapy: Procedures which temporarily or permanently remedy insufficient cleansing of body fluids by the kidneys. [NIH] Renal tubular: A defect in the kidneys that hinders their normal excretion of acids. Failure to excrete acids can lead to weak bones, kidney stones, and poor growth in children. [NIH] Resection: Removal of tissue or part or all of an organ by surgery. [NIH] Respiration: The act of breathing with the lungs, consisting of inspiration, or the taking into the lungs of the ambient air, and of expiration, or the expelling of the modified air which contains more carbon dioxide than the air taken in (Blakiston's Gould Medical Dictionary, 4th ed.). This does not include tissue respiration (= oxygen consumption) or cell respiration (= cell respiration). [NIH] 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] Retinoids: Derivatives of vitamin A. Used clinically in the treatment of severe cystic acne, psoriasis, and other disorders of keratinization. Their possible use in the prophylaxis and treatment of cancer is being actively explored. [NIH] Retinol: Vitamin A. It is essential for proper vision and healthy skin and mucous membranes. Retinol is being studied for cancer prevention; it belongs to the family of drugs called retinoids. [NIH] Retinopathy: 1. Retinitis (= inflammation of the retina). 2. Retinosis (= degenerative, noninflammatory condition of the retina). [EU]

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Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Sciatica: A condition characterized by pain radiating from the back into the buttock and posterior/lateral aspects of the leg. Sciatica may be a manifestation of sciatic neuropathy; radiculopathy (involving the L4, L5, S1 or S2 spinal nerve roots; often associated with intervertebral disk displacement); or lesions of the cauda equina. [NIH] Scleroderma: A chronic disorder marked by hardening and thickening of the skin. Scleroderma can be localized or it can affect the entire body (systemic). [NIH] Sclerosis: A pathological process consisting of hardening or fibrosis of an anatomical structure, often a vessel or a nerve. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Sediment: A precipitate, especially one that is formed spontaneously. [EU] Senile: Relating or belonging to old age; characteristic of old age; resulting from infirmity of old age. [NIH] Septic: Produced by or due to decomposition by microorganisms; putrefactive. [EU] Serologic: Analysis of a person's serum, especially specific immune or lytic serums. [NIH] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] Serum Albumin: A major plasma protein that serves in maintaining the plasma colloidal osmotic pressure and transporting large organic anions. [NIH] Shock: The general bodily disturbance following a severe injury; an emotional or moral upset occasioned by some disturbing or unexpected experience; disruption of the circulation, which can upset all body functions: sometimes referred to as circulatory shock. [NIH]

Short Bowel Syndrome: A malabsorption syndrome resulting from extensive operative resection of small bowel. [NIH] Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Signs and Symptoms: Clinical manifestations that can be either objective when observed by a physician, or subjective when perceived by the patient. [NIH] Skeletal: Having to do with the skeleton (boney part of the body). [NIH] Skeleton: The framework that supports the soft tissues of vertebrate animals and protects many of their internal organs. The skeletons of vertebrates are made of bone and/or cartilage. [NIH] Smallpox: A generalized virus infection with a vesicular rash. [NIH] Smooth muscle: Muscle that performs automatic tasks, such as constricting blood vessels. [NIH]

Sodium: An element that is a member of the alkali group of metals. It has the atomic symbol Na, atomic number 11, and atomic weight 23. With a valence of 1, it has a strong affinity for oxygen and other nonmetallic elements. Sodium provides the chief cation of the extracellular body fluids. Its salts are the most widely used in medicine. (From Dorland, 27th ed) Physiologically the sodium ion plays a major role in blood pressure regulation, maintenance of fluid volume, and electrolyte balance. [NIH] Solid tumor: Cancer of body tissues other than blood, bone marrow, or the lymphatic system. [NIH]

Dictionary 77

Somatic: 1. Pertaining to or characteristic of the soma or body. 2. Pertaining to the body wall in contrast to the viscera. [EU] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Spinal Nerve Roots: The paired bundles of nerve fibers entering and leaving the spinal cord at each segment. The dorsal and ventral nerve roots join to form the mixed segmental spinal nerves. The dorsal roots are generally afferent, formed by the central projections of the spinal (dorsal root) ganglia sensory cells, and the ventral roots efferent, comprising the axons of spinal motor and autonomic preganglionic neurons. There are, however, some exceptions to this afferent/efferent rule. [NIH] Subacute: Somewhat acute; between acute and chronic. [EU] Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU] Subcutaneous: Beneath the skin. [NIH] Substrate: A substance upon which an enzyme acts. [EU] Suction: The removal of secretions, gas or fluid from hollow or tubular organs or cavities by means of a tube and a device that acts on negative pressure. [NIH] Surfactant: A fat-containing protein in the respiratory passages which reduces the surface tension of pulmonary fluids and contributes to the elastic properties of pulmonary tissue. [NIH]

Symptomatic: Having to do with symptoms, which are signs of a condition or disease. [NIH] Synergistic: Acting together; enhancing the effect of another force or agent. [EU] Systemic: Affecting the entire body. [NIH] Systemic disease: Disease that affects the whole body. [NIH] Systolic: Indicating the maximum arterial pressure during contraction of the left ventricle of the heart. [EU] Thoracic: Having to do with the chest. [NIH] Threshold: For a specified sensory modality (e. g. light, sound, vibration), the lowest level (absolute threshold) or smallest difference (difference threshold, difference limen) or intensity of the stimulus discernible in prescribed conditions of stimulation. [NIH] Thrombin: An enzyme formed from prothrombin that converts fibrinogen to fibrin. (Dorland, 27th ed) EC 3.4.21.5. [NIH] Thrombomodulin: A cell surface glycoprotein of endothelial cells that binds thrombin and serves as a cofactor in the activation of protein C and its regulation of blood coagulation. [NIH]

Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] Thrombus: An aggregation of blood factors, primarily platelets and fibrin with entrapment of cellular elements, frequently causing vascular obstruction at the point of its formation. Some authorities thus differentiate thrombus formation from simple coagulation or clot formation. [EU]

78

Urine Protein

Thymus: An organ that is part of the lymphatic system, in which T lymphocytes grow and multiply. The thymus is in the chest behind the breastbone. [NIH] Thyroid: A gland located near the windpipe (trachea) that produces thyroid hormone, which helps regulate growth and metabolism. [NIH] Thyroxine: An amino acid of the thyroid gland which exerts a stimulating effect on thyroid metabolism. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Topical: On the surface of the body. [NIH] Torsion: A twisting or rotation of a bodily part or member on its axis. [NIH] Toxaemia: 1. The condition resulting from the spread of bacterial products (toxins) by the bloodstream. 2. A condition resulting from metabolic disturbances, e.g. toxaemia of pregnancy. [EU] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxins: Specific, characterizable, poisonous chemicals, often proteins, with specific biological properties, including immunogenicity, produced by microbes, higher plants, or animals. [NIH] Trachea: The cartilaginous and membranous tube descending from the larynx and branching into the right and left main bronchi. [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Transfer Factor: Factor derived from leukocyte lysates of immune donors which can transfer both local and systemic cellular immunity to nonimmune recipients. [NIH] Transgenes: Genes that are introduced into an organism using gene transfer techniques. [NIH]

Transmitter: A chemical substance which effects the passage of nerve impulses from one cell to the other at the synapse. [NIH] Transplantation: Transference of a tissue or organ, alive or dead, within an individual, between individuals of the same species, or between individuals of different species. [NIH] Trauma: Any injury, wound, or shock, must frequently physical or structural shock, producing a disturbance. [NIH] Tuberculosis: Any of the infectious diseases of man and other animals caused by species of Mycobacterium. [NIH] Tumor marker: A substance sometimes found in an increased amount in the blood, other body fluids, or tissues and which may mean that a certain type of cancer is in the body. Examples of tumor markers include CA 125 (ovarian cancer), CA 15-3 (breast cancer), CEA (ovarian, lung, breast, pancreas, and gastrointestinal tract cancers), and PSA (prostate cancer). Also called biomarker. [NIH] Type 2 diabetes: Usually characterized by a gradual onset with minimal or no symptoms of metabolic disturbance and no requirement for exogenous insulin. The peak age of onset is 50 to 60 years. Obesity and possibly a genetic factor are usually present. [NIH]

Dictionary 79

Ulcer: A localized necrotic lesion of the skin or a mucous surface. [NIH] Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [NIH] Uraemia: 1. An excess in the blood of urea, creatinine, and other nitrogenous end products of protein and amino acids metabolism; more correctly referred to as azotemia. 2. In current usage the entire constellation of signs and symptoms of chronic renal failure, including nausea, vomiting anorexia, a metallic taste in the mouth, a uraemic odour of the breath, pruritus, uraemic frost on the skin, neuromuscular disorders, pain and twitching in the muscles, hypertension, edema, mental confusion, and acid-base and electrolyte imbalances. [EU]

Urea: A compound (CO(NH2)2), formed in the liver from ammonia produced by the deamination of amino acids. It is the principal end product of protein catabolism and constitutes about one half of the total urinary solids. [NIH] Uremia: The illness associated with the buildup of urea in the blood because the kidneys are not working effectively. Symptoms include nausea, vomiting, loss of appetite, weakness, and mental confusion. [NIH] Ureters: Tubes that carry urine from the kidneys to the bladder. [NIH] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]

Urethritis: Inflammation of the urethra. [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: Having to do with urine or the organs of the body that produce and get rid of urine. [NIH] Urinary tract: The organs of the body that produce and discharge urine. These include the kidneys, ureters, bladder, and urethra. [NIH] Urinary tract infection: An illness caused by harmful bacteria growing in the urinary tract. [NIH]

Urine: Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra. [NIH] Urography: Radiography of any part of the urinary tract. [NIH] Urolithiasis: Stones in the urinary system. [NIH] Uteroglobin: A protein fraction of pregnant uterine fluid which can induce and regulate blastocystic development. Blastokinin is thought to be similar or identical to uteroglobin. Presence in uterine fluid regulated by progesterone. [NIH] Vaccination: Administration of vaccines to stimulate the host's immune response. This includes any preparation intended for active immunological prophylaxis. [NIH] Vaccine: A substance or group of substances meant to cause the immune system to respond to a tumor or to microorganisms, such as bacteria or viruses. [NIH] Varicose: The common ulcer in the lower third of the leg or near the ankle. [NIH] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vasculitis: Inflammation of a blood vessel. [NIH] Vasodilator: An agent that widens blood vessels. [NIH]

80

Urine Protein

Venous: Of or pertaining to the veins. [EU] Ventricle: One of the two pumping chambers of the heart. The right ventricle receives oxygen-poor blood from the right atrium and pumps it to the lungs through the pulmonary artery. The left ventricle receives oxygen-rich blood from the left atrium and pumps it to the body through the aorta. [NIH] Venules: The minute vessels that collect blood from the capillary plexuses and join together to form veins. [NIH] Vesicular: 1. Composed of or relating to small, saclike bodies. 2. Pertaining to or made up of vesicles on the skin. [EU] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Virus: Submicroscopic organism that causes infectious disease. In cancer therapy, some viruses may be made into vaccines that help the body build an immune response to, and kill, tumor cells. [NIH] Vitro: Descriptive of an event or enzyme reaction under experimental investigation occurring outside a living organism. Parts of an organism or microorganism are used together with artificial substrates and/or conditions. [NIH] Weight Gain: Increase in body weight over existing weight. [NIH] White blood cell: A type of cell in the immune system that helps the body fight infection and disease. White blood cells include lymphocytes, granulocytes, macrophages, and others. [NIH]

Windpipe: A rigid tube, 10 cm long, extending from the cricoid cartilage to the upper border of the fifth thoracic vertebra. [NIH] Xenograft: The cells of one species transplanted to another species. [NIH] X-ray: High-energy radiation used in low doses to diagnose diseases and in high doses to treat cancer. [NIH] Zymogen: Inactive form of an enzyme which can then be converted to the active form, usually by excision of a polypeptide, e. g. trypsinogen is the zymogen of trypsin. [NIH]

81

INDEX A Abdominal, 53, 68, 71, 72 Acidosis, 53, 61 Adenosine, 53, 72 Adrenergic, 53, 55 Adrenergic beta-Antagonists, 53, 55 Afferent, 5, 53, 77 Affinity, 53, 76 Agarose, 53, 65 Age of Onset, 53, 78 Age-Adjusted, 5, 53 Albumin, 32, 36, 39, 41, 53, 73 Algorithms, 54, 57 Alimentary, 54, 72 Alkaline, 53, 54, 58 Allografts, 16, 54 Alternative medicine, 20, 54 Amino Acid Sequence, 13, 54, 55 Amino Acids, 54, 72, 73, 74, 79 Ammonia, 54, 79 Anaesthesia, 54, 66 Anal, 54, 68 Anatomical, 54, 59, 76 Anemia, 54, 64, 70 Angina, 34, 53, 54 Angiography, 54, 61 Angiotensin converting enzyme inhibitor, 6, 54 Angiotensin-Converting Enzyme Inhibitors, 54, 55 Animal model, 5, 54 Anions, 54, 55, 76 Antibiotic, 55, 60, 61 Antibodies, 5, 55, 56, 65, 68, 73 Antibody, 53, 55, 60, 62, 65, 66, 69 Anticoagulant, 55, 74 Antigen, 6, 53, 55, 62, 64, 65, 66, 69 Antihypertensive, 3, 6, 55 Antihypertensive Agents, 3, 55 Anti-infective, 55, 56 Anti-inflammatory, 55, 56 Anti-Inflammatory Agents, 55, 56 Antimicrobial, 35, 55 Anuria, 55, 67 Apolipoproteins, 55, 68 Arginine, 12, 55 Arterial, 6, 55, 59, 65, 67, 74, 77 Arteries, 55, 57, 60, 68, 69, 70

Arteriolar, 55, 56 Arterioles, 55, 57, 58 Arteriolosclerosis, 11, 55 Asparaginase, 8, 56 Aspartate, 56 Aspirin, 11, 56 Assay, 4, 56, 65 Asymptomatic, 37, 56, 71 Autoantibodies, 5, 56 Autoantigens, 56 Autodigestion, 56, 72 Autoimmune disease, 56, 70 B Back Pain, 38, 56 Bacteria, 55, 56, 62, 69, 79 Bacteriuria, 56, 79 Base, 56, 60, 67, 79 Basophils, 56, 64, 67 Benign, 56 Benzethonium, 9, 13, 56 Beta 2-Microglobulin, 12, 56 Bile, 57, 65, 68 Biliary, 57, 58, 72 Biliary Tract, 57, 58, 72 Bilirubin, 54, 57 Biomarkers, 9, 57 Biomolecular, 9, 57 Biopsy, 14, 18, 57 Biotechnology, 8, 20, 27, 57 Bladder, 8, 32, 57, 67, 70, 74, 75, 79 Blood Cell Count, 57, 64 Blood Coagulation, 57, 58, 77 Blood Glucose, 5, 57, 64, 66 Blood pressure, 3, 5, 6, 33, 40, 55, 57, 63, 65, 69, 76 Blood urea, 33, 57, 67 Blood vessel, 54, 57, 58, 59, 63, 74, 76, 77, 79 Body Fluids, 57, 63, 71, 75, 76, 78 Bone Marrow, 57, 65, 68, 69, 70, 76 Bowel, 34, 54, 58, 66, 72, 76 Branch, 49, 58, 72, 77 Breakdown, 57, 58, 61, 63 Buccal, 58, 68 C Calcium, 4, 6, 33, 55, 58, 71 Calcium channel blocker, 6, 55, 58 Calcium Channel Blockers, 6, 55, 58

82

Urine protein

Calcium Oxalate, 4, 58, 71 Calculi, 15, 58 Caloric intake, 32, 58 Capillary, 15, 58, 63, 80 Capsules, 58, 63 Cardiovascular, 35, 42, 58 Cauda Equina, 58, 76 Cell, 37, 56, 57, 58, 60, 61, 62, 63, 65, 66, 69, 70, 71, 72, 73, 75, 77, 78, 80 Cell membrane, 58, 72 Central Nervous System, 58, 61, 70 Centrifugation, 58, 64 Cerebrovascular, 58 Character, 59, 60 Chemokines, 6, 59 Chemotactic Factors, 59, 71 Chemotherapy, 8, 15, 35, 59 Chin, 59, 69 Cholesterol, 57, 59, 68 Cholesterol Esters, 59, 68 Chronic, 3, 8, 11, 32, 34, 36, 38, 55, 56, 59, 62, 66, 67, 71, 76, 77, 79 Chronic renal, 11, 36, 59, 79 Chylomicrons, 59, 68 Clinical trial, 4, 27, 59, 74, 75 Cloning, 57, 59 Cofactor, 59, 74, 77 Colloidal, 53, 59, 61, 76 Computational Biology, 27, 59 Concentric, 56, 59 Concretion, 58, 59 Contraindications, ii, 59 Convulsions, 60, 61, 73 Coordination, 60, 70 Coronary, 60, 69, 70 Coronary Thrombosis, 60, 69, 70 Cortisol, 54, 60 Creatine, 6, 60 Creatinine, 5, 7, 8, 9, 10, 11, 13, 14, 33, 60, 67, 79 Crystallization, 4, 60 CSF, 57, 60 Cutaneous, 60, 68 Cyclophosphamide, 60, 65 Cysteine, 59, 60 Cytokines, 5, 59, 60 D Databases, Bibliographic, 27, 60 Daunorubicin, 60, 61 Deamination, 60, 79 Degenerative, 36, 60, 75 Density, 5, 58, 60, 68, 71

Developing Countries, 60, 68 Diabetes Mellitus, 6, 37, 39, 42, 61, 63, 64 Diabetic Ketoacidosis, 5, 61 Diagnostic procedure, 20, 61 Dialyzer, 61, 64 Diarrhea, 34, 61, 68 Diastole, 61 Diastolic, 3, 6, 61, 65 Diastolic blood pressure, 6, 61 Diatrizoate, 12, 61 Digestion, 54, 57, 58, 61, 66, 68 Dipyridamole, 11, 61 Direct, iii, 18, 61, 75 Diuretics, Thiazide, 55, 61 Doxorubicin, 9, 61 E Eclampsia, 61, 73 Edema, 61, 70, 73, 79 Effector, 6, 61 Efferent, 5, 61, 77 Electrolyte, 61, 63, 67, 71, 73, 76, 79 Electrophoresis, 7, 9, 10, 12, 15, 16, 17, 61, 65 Embolus, 62, 66 Embryo, 62, 66 End-stage renal, 59, 62 Environmental Exposure, 6, 62 Environmental Health, 26, 28, 62 Enzymatic, 58, 62 Enzyme, 6, 12, 56, 61, 62, 64, 73, 77, 80 Enzyme Inhibitors, 6, 62, 73 Enzyme-Linked Immunosorbent Assay, 12, 62 Eosinophils, 62, 64, 67 Excrete, 55, 62, 67, 75 Exogenous, 62, 78 Extracellular, 62, 76 Extremity, 62, 67 F Family Planning, 27, 62 Fat, 57, 62, 67, 68, 70, 77 Fatty acids, 54, 61, 62 Ferritin, 33, 62 Fibrosis, 62, 76 Filtration, 6, 12, 14, 33, 62, 67 Fluid Therapy, 62, 71 Fluorouracil, 61, 63 Fold, 6, 63 Forearm, 57, 63 G Ganglionic Blockers, 55, 63 Gas, 54, 63, 68, 71, 77

83

Gastrointestinal, 61, 63, 78 Gene, 6, 7, 57, 63, 78 Gene Expression, 7, 63 Gene Expression Profiling, 7, 63 Genotype, 54, 63 Gland, 63, 71, 74, 78 Glomerular, 6, 7, 11, 15, 18, 33, 63, 67, 75 Glomerular Filtration Rate, 6, 11, 33, 63, 67 Glomeruli, 63, 74 Glomerulonephritis, 5, 7, 11, 37, 63 Glomerulus, 63, 70 Glucose, 5, 57, 61, 63, 64, 66 Glucose Intolerance, 61, 63 Governing Board, 63, 73 Graft, 54, 64 Granulocytes, 64, 80 Granuloma, 64, 68 Granuloma Inguinale, 64, 68 Growth, 32, 55, 60, 64, 66, 69, 72, 75, 78 H Hematocrit, 33, 57, 64 Hematuria, 37, 64 Hemodialysis, 32, 61, 64, 67 Hemoglobin, 33, 54, 57, 64 Hemoglobin A, 33, 64 Hepatic, 54, 64 Heredity, 63, 64 Homogeneous, 56, 64 Hormone, 60, 64, 66, 73, 78 Horseradish Peroxidase, 62, 64 Host, 54, 64, 65, 79 Humoral, 6, 64 Humour, 64, 65 Hydrophobic, 65, 68 Hypertension, 3, 6, 36, 38, 53, 54, 55, 56, 58, 65, 73, 79 Hypoglycemia, 5, 65 I Id, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 48, 50, 65 Ifosfamide, 8, 65 Immune response, 55, 56, 65, 79, 80 Immune Sera, 65 Immune system, 6, 65, 68, 70, 79, 80 Immunity, 65, 78 Immunization, 5, 41, 65 Immunoassay, 10, 62, 65 Immunodeficiency, 33, 65 Immunodiffusion, 65 Immunoelectrophoresis, 9, 18, 65 Immunogenic, 5, 65

Immunoglobulin, 6, 55, 65, 69 Immunologic, 59, 65 Immunosuppressive, 60, 65 In vitro, 5, 65, 66 In vivo, 65, 66 Indicative, 17, 66, 72, 79 Induction, 6, 63, 66 Infarction, 34, 66 Infection, 38, 41, 59, 65, 66, 68, 70, 71, 74, 76, 77, 80 Infiltration, 63, 66 Inflammation, 6, 54, 55, 56, 62, 66, 68, 70, 71, 73, 74, 75, 79 Inguinal, 66, 68 Insight, 7, 66 Insulator, 66, 70 Insulin, 12, 15, 61, 66, 67, 78 Insulin-dependent diabetes mellitus, 66 Insulin-like, 12, 66 Intermittent, 63, 66, 72 Interstitial, 66, 70, 75 Intervertebral, 66, 75, 76 Intervertebral Disk Displacement, 66, 75, 76 Intestinal, 34, 66, 68 Intestine, 58, 64, 66 Intracellular, 58, 64, 66, 73 Intramuscular, 67, 72 Intravenous, 67, 72 Intravesical, 9, 67 Inulin, 63, 67 Ionizing, 62, 67 J Joint, 36, 67 K Kb, 26, 67 Ketone Bodies, 61, 67 Ketosis, 61, 67 Kidney Disease, 3, 6, 9, 14, 18, 26, 32, 38, 67 Kidney Failure, 32, 62, 67 Kidney Failure, Acute, 67 Kidney Failure, Chronic, 67 Kidney stone, 4, 67, 70, 71, 75 L Leg Ulcer, 38, 67 Leukemia, 61, 67 Leukocytes, 7, 56, 57, 59, 60, 62, 64, 67, 69 Library Services, 48, 68 Linkages, 64, 68 Lipid, 5, 55, 66, 68, 70 Lipoprotein, 5, 68

84

Urine protein

Liver, 32, 33, 53, 54, 57, 60, 64, 68, 79 Localized, 66, 68, 72, 76, 79 Longitudinal study, 11, 68 Low-density lipoprotein, 68 Lumbar, 56, 58, 66, 68 Lupus, 42, 68 Lymph, 65, 68 Lymphatic, 66, 68, 76, 78 Lymphocyte, 55, 68, 69 Lymphogranuloma Venereum, 33, 64, 68 Lymphoid, 55, 68 M Malabsorption, 68, 76 Malabsorption syndrome, 68, 76 Malignant, 6, 14, 56, 69, 70 Malignant tumor, 69, 70 Malnutrition, 54, 69 Mediator, 6, 69 MEDLINE, 27, 69 Meglumine, 61, 69 Melanocytes, 69 Melanoma, 14, 69 Membrane, 56, 58, 61, 69, 71, 72, 75 Menopause, 69, 73 Mental, iv, 4, 26, 28, 34, 59, 69, 74, 79 MI, 51, 69 Microorganism, 59, 69, 80 Molecular, 12, 27, 29, 57, 59, 69 Molecule, 55, 56, 61, 69, 71, 75 Monitor, 6, 32, 60, 69 Monoclonal, 5, 69 Monocytes, 68, 69 Mononuclear, 7, 64, 69 Mucosa, 68, 69 Multiple Myeloma, 35, 70 Multiple sclerosis, 36, 70 Myelin, 70 Myeloma, 35, 39, 70 Myocardial infarction, 34, 60, 69, 70 Myocardium, 69, 70 N Necrosis, 66, 69, 70 Need, 3, 17, 44, 59, 70 Neonatal, 10, 35, 36, 70 Nephritis, 7, 70 Nephrolithiasis, 4, 70 Nephropathy, 14, 67, 70 Nephrosis, 70 Nephrotic, 18, 70 Nephrotic Syndrome, 18, 70 Nerve, 53, 58, 59, 61, 69, 70, 75, 76, 77, 78 Nervous System, 53, 54, 58, 69, 70

Networks, 7, 70 Neural, 53, 63, 65, 70 Neuromuscular, 56, 70, 79 Neuropathy, 70, 76 Neutrophil, 5, 70 Neutrophil Activation, 5, 70 Nitrogen, 33, 53, 60, 67, 71 Nucleic acid, 71 Nucleus, 56, 62, 66, 69, 71 Nutritional Support, 41, 71 O Oliguria, 67, 71 Opacity, 60, 71 Opportunistic Infections, 33, 37, 71 Orthostatic, 18, 71 Osmotic, 53, 71, 76 Osteoporosis, 34, 40, 71 Outpatient, 18, 71 Oxalate, 4, 71 Oxalic Acid, 58, 71 Oxidation, 61, 71 P Pancreas, 53, 57, 66, 71, 78 Pancreatic, 71, 72 Pancreatitis, 16, 71 Parenteral, 35, 72 Parenteral Nutrition, 35, 72 Pathogenesis, 6, 7, 72 Pathologic, 6, 53, 57, 60, 72 Patient Education, 32, 46, 48, 51, 72 Peptide, 72, 73, 74 Peripheral blood, 7, 72 Peritoneal, 32, 40, 72 Peritoneal Cavity, 72 Peritoneal Dialysis, 32, 40, 72 Peritoneum, 72 Pharmacologic, 72, 78 Phospholipids, 62, 68, 72 Phosphorus, 32, 58, 72 Physical Fitness, 5, 72 Pigment, 57, 69, 72 Plants, 63, 67, 71, 72, 78 Plasma, 11, 53, 55, 57, 58, 59, 63, 64, 67, 70, 73, 76 Plasma cells, 55, 70, 73 Plasma protein, 53, 73, 76 Pneumonia, 5, 60, 73 Polypeptide, 54, 73, 74, 80 Polysaccharide, 53, 55, 73 Posterior, 54, 56, 71, 73, 76 Postmenopausal, 34, 71, 73 Potassium, 32, 61, 73

85

Practice Guidelines, 28, 33, 34, 35, 36, 38, 40, 42, 73 Precipitation, 16, 73 Precursor, 60, 61, 62, 73 Preeclampsia, 8, 73 Progesterone, 73, 79 Progression, 4, 6, 55, 73 Progressive, 3, 56, 59, 64, 67, 70, 73, 75 Prone, 6, 73 Prophylaxis, 35, 73, 75, 79 Proportional, 62, 73 Prospective study, 68, 74 Prostate, 57, 74, 78 Protective Agents, 58, 74 Protein C, 4, 11, 31, 54, 55, 62, 68, 74, 79 Protein Conformation, 54, 74 Protein S, 16, 57, 74 Proteins, 7, 54, 55, 58, 60, 65, 69, 71, 72, 73, 74, 76, 78 Proteinuria, 3, 5, 6, 10, 13, 15, 18, 70, 73, 74 Proteome, 7, 10, 74 Protocol, 7, 74 Psychic, 69, 74 Public Policy, 27, 74 Pulmonary, 57, 67, 74, 77, 80 Pulmonary Artery, 57, 74, 80 Pulmonary Edema, 67, 74 Pulse, 69, 74 Pyelonephritis, 5, 74 Q Quaternary, 56, 74 R Radiation, 62, 67, 74, 80 Radiculopathy, 75, 76 Randomized, 5, 7, 75 Receptor, 55, 75 Recur, 4, 75 Recurrence, 4, 75 Refer, 1, 58, 75 Relapse, 7, 75 Remission, 75 Renal failure, 6, 11, 36, 57, 75 Renal pelvis, 67, 75 Renal Replacement Therapy, 35, 75 Renal tubular, 15, 75 Resection, 75, 76 Respiration, 69, 75 Retina, 75 Retinoids, 75 Retinol, 12, 75 Retinopathy, 5, 75 Risk factor, 35, 74, 76

S Sciatica, 38, 76 Scleroderma, 56, 76 Sclerosis, 36, 55, 70, 76 Screening, 14, 35, 41, 59, 76, 79 Sediment, 76, 79 Senile, 71, 76 Septic, 36, 76 Serologic, 65, 76 Serum, 6, 10, 13, 14, 32, 53, 57, 65, 67, 68, 76 Serum Albumin, 32, 76 Shock, 36, 76, 78 Short Bowel Syndrome, 34, 76 Side effect, 60, 76, 78 Signs and Symptoms, 18, 75, 76, 79 Skeletal, 70, 76 Skeleton, 67, 76 Smallpox, 41, 76 Smooth muscle, 58, 76 Sodium, 10, 32, 61, 76 Solid tumor, 61, 76 Somatic, 65, 77 Specialist, 18, 43, 77 Species, 54, 69, 77, 78, 80 Spinal Nerve Roots, 75, 76, 77 Subacute, 66, 68, 77 Subclinical, 66, 77 Subcutaneous, 61, 72, 77 Substrate, 62, 77 Suction, 62, 77 Surfactant, 56, 77 Symptomatic, 72, 77 Synergistic, 5, 77 Systemic, 6, 18, 42, 57, 66, 76, 77, 78 Systemic disease, 18, 77 Systolic, 3, 65, 77 T Thoracic, 56, 77, 80 Threshold, 65, 77 Thrombin, 74, 77 Thrombomodulin, 74, 77 Thrombosis, 74, 77 Thrombus, 60, 66, 77 Thymus, 65, 68, 78 Thyroid, 38, 78 Thyroxine, 54, 78 Tissue, 54, 55, 56, 57, 58, 59, 60, 61, 62, 64, 65, 66, 67, 68, 69, 70, 72, 75, 76, 77, 78 Topical, 56, 78 Torsion, 66, 78 Toxaemia, 73, 78

86

Urine protein

Toxic, iv, 56, 60, 62, 65, 70, 78 Toxicology, 28, 78 Toxins, 55, 66, 78 Trachea, 78 Transfection, 57, 78 Transfer Factor, 65, 78 Transgenes, 6, 78 Transmitter, 69, 78 Transplantation, 13, 14, 16, 34, 37, 59, 65, 67, 78 Trauma, 41, 70, 72, 78 Tuberculosis, 68, 78 Tumor marker, 57, 78 Type 2 diabetes, 39, 42, 78 U Ulcer, 67, 79 Unconscious, 65, 79 Uraemia, 72, 79 Urea, 33, 57, 79 Uremia, 67, 75, 79 Ureters, 67, 79 Urethra, 74, 79 Urethritis, 33, 79 Urinalysis, 12, 79 Urinary, 5, 7, 12, 32, 56, 58, 71, 79 Urinary tract, 5, 56, 79 Urinary tract infection, 5, 56, 79

Urography, 61, 79 Urolithiasis, 15, 79 Uteroglobin, 13, 79 V Vaccination, 41, 79 Vaccine, 41, 74, 79 Varicose, 67, 79 Vascular, 58, 66, 77, 79 Vasculitis, 5, 72, 79 Vasodilator, 55, 79 Venous, 57, 67, 74, 80 Ventricle, 74, 77, 80 Venules, 57, 58, 80 Vesicular, 76, 80 Veterinary Medicine, 27, 80 Virus, 33, 76, 80 Vitro, 5, 80 W Weight Gain, 33, 80 White blood cell, 7, 55, 67, 68, 70, 73, 80 Windpipe, 78, 80 X Xenograft, 55, 80 X-ray, 61, 80 Z Zymogen, 74, 80

87

88

Urine protein

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