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

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

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YEAST

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

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

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ICON Health Publications ICON Group International, Inc. 4370 La Jolla Village Drive, 4th Floor San Diego, CA 92122 USA Copyright 2003 by ICON Group International, Inc. Copyright 2003 by ICON Group International, Inc. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America. Last digit indicates print number: 10 9 8 7 6 4 5 3 2 1

Publisher, Health Care: Philip Parker, Ph.D. Editor(s): James Parker, M.D., Philip Parker, Ph.D. Publisher's note: The ideas, procedures, and suggestions contained in this book are not intended for the diagnosis or treatment of a health problem. As new medical or scientific information becomes available from academic and clinical research, recommended treatments and drug therapies may undergo changes. The authors, editors, and publisher have attempted to make the information in this book up to date and accurate in accord with accepted standards at the time of publication. The authors, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of this book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised to always check product information (package inserts) for changes and new information regarding dosage and contraindications before prescribing any drug or pharmacological product. Caution is especially urged when using new or infrequently ordered drugs, herbal remedies, vitamins and supplements, alternative therapies, complementary therapies and medicines, and integrative medical treatments. Cataloging-in-Publication Data Parker, James N., 1961Parker, Philip M., 1960Yeast Infections: 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: 0-597-83673-6 1. Yeast Infections-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 yeast infections. 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 YEAST INFECTIONS ................................................................................... 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Yeast Infections ............................................................................. 4 E-Journals: PubMed Central ......................................................................................................... 7 The National Library of Medicine: PubMed ................................................................................ 10 CHAPTER 2. NUTRITION AND YEAST INFECTIONS ......................................................................... 27 Overview...................................................................................................................................... 27 Finding Nutrition Studies on Yeast Infections............................................................................ 27 Federal Resources on Nutrition ................................................................................................... 28 Additional Web Resources ........................................................................................................... 29 CHAPTER 3. ALTERNATIVE MEDICINE AND YEAST INFECTIONS ................................................... 31 Overview...................................................................................................................................... 31 National Center for Complementary and Alternative Medicine.................................................. 31 Additional Web Resources ........................................................................................................... 34 General References ....................................................................................................................... 40 CHAPTER 4. CLINICAL TRIALS AND YEAST INFECTIONS ................................................................ 41 Overview...................................................................................................................................... 41 Recent Trials on Yeast Infections................................................................................................. 41 Keeping Current on Clinical Trials ............................................................................................. 54 CHAPTER 5. PATENTS ON YEAST INFECTIONS ................................................................................ 57 Overview...................................................................................................................................... 57 Patents on Yeast Infections.......................................................................................................... 57 Patent Applications on Yeast Infections ...................................................................................... 76 Keeping Current .......................................................................................................................... 79 CHAPTER 6. BOOKS ON YEAST INFECTIONS.................................................................................... 81 Overview...................................................................................................................................... 81 Book Summaries: Federal Agencies.............................................................................................. 81 Book Summaries: Online Booksellers........................................................................................... 82 Chapters on Yeast Infections........................................................................................................ 83 CHAPTER 7. MULTIMEDIA ON YEAST INFECTIONS ......................................................................... 87 Overview...................................................................................................................................... 87 Bibliography: Multimedia on Yeast Infections ............................................................................ 87 CHAPTER 8. PERIODICALS AND NEWS ON YEAST INFECTIONS ...................................................... 89 Overview...................................................................................................................................... 89 News Services and Press Releases................................................................................................ 89 Newsletter Articles ...................................................................................................................... 91 Academic Periodicals covering Yeast Infections .......................................................................... 92 CHAPTER 9. RESEARCHING MEDICATIONS .................................................................................... 95 Overview...................................................................................................................................... 95 U.S. Pharmacopeia....................................................................................................................... 95 Commercial Databases ................................................................................................................. 96 Researching Orphan Drugs ......................................................................................................... 97 APPENDIX A. PHYSICIAN RESOURCES .......................................................................................... 101 Overview.................................................................................................................................... 101 NIH Guidelines.......................................................................................................................... 101 NIH Databases........................................................................................................................... 103 Other Commercial Databases..................................................................................................... 106 APPENDIX B. PATIENT RESOURCES ............................................................................................... 107 Overview.................................................................................................................................... 107

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Patient Guideline Sources.......................................................................................................... 107 Associations and Yeast Infections .............................................................................................. 114 Finding Associations.................................................................................................................. 114 APPENDIX C. FINDING MEDICAL LIBRARIES ................................................................................ 117 Overview.................................................................................................................................... 117 Preparation................................................................................................................................. 117 Finding a Local Medical Library................................................................................................ 117 Medical Libraries in the U.S. and Canada ................................................................................. 117 ONLINE GLOSSARIES................................................................................................................ 123 Online Dictionary Directories ................................................................................................... 123 YEAST INFECTIONS DICTIONARY........................................................................................ 125 INDEX .............................................................................................................................................. 161

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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 yeast infections 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 yeast infections, 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 yeast infections, 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 yeast infections. 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 yeast infections, 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 yeast infections. 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 YEAST INFECTIONS Overview In this chapter, we will show you how to locate peer-reviewed references and studies on yeast infections.

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

Questions and Answers About Yeast Infections Source: WORLD; December 1993. Contact: Women Organized to Respond to Life - Threatening Diseases, Box 11535, Oakland, CA, 94611, (510) 986-0340, http://www.womenhiv.org. Summary: This article presents facts about yeast infections in a question-and-answer format. According to the author, more than 13 million yeast infections are diagnosed annually, and are particularly problematic for HIV-positive women. The article considers the following issues: what a yeast infection is, including a discussion of the infection-causing Candida Albicans fungus; the symptoms of an infection; whether or not the yeast problems may be sexually transmitted; and the role of antibiotics in causing yeast infections.

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All About Yeast Infections Source: Diabetes Self-Management. 8(6): 22, 24-25. November/December 1991. Summary: This article reviews the causes, treatment, and prevention of yeast infections and explains why women with diabetes are especially prone to this condition. Topics include the role of antibiotics, pregnancy, HIV infection, poorly controlled diabetes, recognizing candidiasis, when to see a health care provider, treating yeast infections, and other causes of vaginitis. A final section lists suggestions for preventing yeast infections.

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Chronic Mucocutaneous Candidiasis Source: Journal of the American Academy of Physician Assistants. JAAPA. 15(4): 6768,70. April 2002. Summary: This journal article uses a case study to provide health professionals with information on chronic mucocutaneous candidiasis (CMC). The case involved a 30 year old woman who presented to an infectious disease clinic for evaluation of chronic oral yeast infections. The woman reported a history of yeast infections since birth. Intermittent treatment with oral ketoconazole beginning at age 9 initially controlled the infections, but they always recurred. Oral fluconazole had no effect on her symptoms. The patient's current medications included an oral contraceptive, norethindrom-ethinyl estradiol; rabeprazole; and itraconazole. Physical examination revealed a generally healthy appearing woman with inflammation of the vermilion border of the lips and marked angular cheilitis. Thrush and leukoplakia were found in the oral cavity. There was no evidence of skin rashes or nail changes. Laboratory test results were within normal limits. A fungal culture grew Candida albicans sensitive to amphotericin B but resistant to fluconazole, itraconazole, ketoconazole, and 5-flucytosine. The article discusses protective immunity to Candida and comments on the diagnosis and treatment of chronic mucocutaneous candidiasis (CMC). Diagnostic evaluation of patients with suspected CMC involves identifying Candida with culture and sensitivities and performing a complete blood count with differential, a human immunodeficiency virus antibody test, and serum immunoglobulin G, A, M, and E tests. Endocrine function tests are important to eliminate coexisting disease and establish a baseline for future tests. Current therapy for CMC involves long term use of antifungal agents such as ketoconazole, itraconazole, fluconazole, and amphotericin B. Treatment should be guided by in vitro susceptibility testing. All antifungal therapies do not address the underlying immune defect of CMC, so relapse usually occurs after treatment ends. Treatment with transfer factor focuses on correcting the actual immune defect. Thus, treatment with both antifungals and transfer factor may provide a more definitive treatment for CMC. 2 figures and 12 references.

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

Project Title: ACTG 323/MSG40--USE OF FLUCONAZOLE AS CHRONIC SUPR THERAPY VS EPISODIC THERAPY Principal Investigator & Institution: Reichman, Richard C. Professor; University of Rochester Orpa - Rc Box 270140 Rochester, NY 14627 Timing: Fiscal Year 2001 Summary: The main purpose of the study is to determine whether it is better to give subjects fluconazole to prevent thrush from coming back or to wait and treat each episode of thrush. Also the effect of each strategy on the development of thrush in other places such as esophagus and vagina; conditions that put HIV-infected persons at risk for yeast infections; what happens to those who do not respond to treatment; and the effect each strategy will have on the quality of subjects' lives. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

•

Project Title: C CANDIDIASIS

ALBICANS

GLUCOAMYLOSE

(GCAL)

IN

MUCOSAL

Principal Investigator & Institution: Dixon, Freddie M.; University of the District of Columbia 4200 Connecticut Ave Nw Washington, DC 20008 Timing: Fiscal Year 2001 Summary: Candida albicans is a commensal yeast which causes infections on the mucosal surfaces of the oral, vaginal and gastrointestinal tracts of humans. Candidiasis can also become invasive, causing systemic infections. Candida infections are particularly prevalent in the AIDS or immunocompromised cancer and transplant patients, and patients using long-term antibacterial antibiotics. Adherence of C. albicans to host cells is a complex process which involves factors such as the type of candida adhesins, nutritional influences, pH, and the type of host cell ligands. Most observations of adherence in Candida involve in vitro studies using either acrylics or human cells. In vivo studies are now possible in which single gene deleted strains can be evaluated for virulence functions. Previous studies have found that C. albicans was more adherent to human esophageal cell lines (HET1-A), human buccal epithelial cells (HEBEC), and a murine alveolar macrophage cell line (MH-S) when grown on media containing 500 mMD-galactose than when grown on 500 mMD- glucose. Additionally, an SDS-PAGE extracted cell wall 190KD mannoprotein (MP 190) was more likely expressed when C. albicans were grown in 500 mMD-glucose than in 500 mMD-glucose The gene encoding this mannoprotein has been identified as a glucoamylse (GCA1) which encodes a protein containing 946 amino acids. It's expression is greater in cells grown in galactose, starch, cellobiose and sucrose, but is minimally expressed in glucose. Expression in a rat model of oral candidiasis also was observed using RT-PCR, indicating that GCA1 is

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associated with disease development. The specific aims of the proposal are to: 1. Construct strains of C. albicans deleted in GCA1 (construction of the deltagca1). 2 (a). Examine the role of GCA1 in vitro. and (b). Examine the role of GCA1 in vivo (virulence studies). 3. Characterization of Gca1p enzymatically (glucoamylase assays). Our broad objective is to determine the function and role of GCA1 in the growth, morphogenesis, adherence, and virulence of the organism. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: EVOLVING FUNGAL CELL SURFACES: CHARACTERIZATION BY AFM Principal Investigator & Institution: Bonetti, Sandra J. Professor; University of Southern Colorado 2200 Bonforte Blvd Pueblo, CO 81001 Timing: Fiscal Year 2002; Project Start 25-AUG-1981; Project End 30-JUN-2006 Summary: (provided by applicant): The fungal cell wall serves as an osmoprotectant, a determinant of fungal cell shape, and more importantly as a defense against attack by immune system cells. Fungal and yeast infections caused by Aspergillus and Candida spp. are common nocosomial infections in immunocompromised patients, including individuals with AIDS, cancer, and who have undergone organ transplantation. The invasiveness of the infection often leads to mortality among these patients. In order to design effective antifungal agents, knowledge of fungal cell wall structure and remodeling processes is imperative. In this subproject, titled Evolving Fungal Cell Surfaces: Characterization by Atomic Force Microscopy, the structure of Penicillium cell walls and wall remodeling processes will be investigated using a promising new instrument, the atomic force microscope (AFM). Penicillium will be used in these investigations as it serves as a good model for Aspergillus and Candida spp., as they are related organisms. ln this subproject, we propose to examine the effect of endogenous glycohydrolases, acid phosphatases, and cell wall biosynthesis inhibitors, on cell wall structure. Our subproject research goals are to: (1) identify the effect of extracellular hydrolases (cellulases, galactofuranosidases, and acid phosphatases) on Penicillium fellutanum cell walls with structural changes in mycelial glycopeptides and polysaccharides; (2) identify the effect of cell wall biosynthesis inhibitors on Penicillium fellutanum cell walls with structural changes in mycelial glycopeptides and polysaccharides; and (3) adapt and establish a procedure for the examination of fungal cell surfaces and structures using atomic force microscopy. In order to support these research goals, we have requested funding for 25% effort for both the principal investigator and the co-investigator, a full-time technician, accompanying summer salaries for faculty, travel, a 6 micron AFM scanner head, a Tektronix printer for image printing, and other project costs. Results from our investigations are expected to yield a minimum of 4 publications, 10 presentations, and one non-SCORE grant in the four year period of support. The activities in this proposal are aimed at developing new AFM techniques for the study of biological and evolving surfaces and will contribute to the knowledge of cell wall structure and remodeling. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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E-Journals: PubMed Central3 PubMed Central (PMC) is a digital archive of life sciences journal literature developed and managed by the National Center for Biotechnology Information (NCBI) at the U.S. National Library of Medicine (NLM).4 Access to this growing archive of e-journals is free and unrestricted.5 To search, go to http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Pmc, and type “yeast infections” (or synonyms) into the search box. This search gives you access to full-text articles. The following is a sample of items found for yeast infections in the PubMed Central database: •

Antifungal Activity of LY303366, a Novel Echinocandin B, in Experimental Disseminated Candidiasis in Rabbits. by Petraitiene R, Petraitis V, Groll AH, Candelario M, Sein T, Bell A, Lyman CA, McMillian CL, Bacher J, Walsh TJ. 1999 Sep; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=89438

•

Carriage Frequency, Intensity of Carriage, and Strains of Oral Yeast Species Vary in the Progression to Oral Candidiasis in Human Immunodeficiency Virus-Positive Individuals. by Vargas KG, Joly S. 2002 Feb; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=153371

•

Characterization and Quantitation of the Pharmacodynamics of Fluconazole in a Neutropenic Murine Disseminated Candidiasis Infection Model. by Andes D, van Ogtrop M. 1999 Sep; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=89432

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Distinct Patterns of Gene Expression Associated with Development of Fluconazole Resistance in Serial Candida albicans Isolates from Human Immunodeficiency VirusInfected Patients with Oropharyngeal Candidiasis. by Lopez-Ribot JL, McAtee RK, Lee LN, Kirkpatrick WR, White TC, Sanglard D, Patterson TF. 1998 Nov; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=105968

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Effects of Amphetamine on Development of Oral Candidiasis in Rats. by FreireGarabal M, Nunez MJ, Balboa J, Rodriguez-Cobo A, Lopez-Paz JM, Rey-Mendez M, Suarez-Quintanilla JA, Millan JC, Mayan JM. 1999 Jul; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=95721

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Effects of Psychological Stress and Alprazolam on Development of Oral Candidiasis in Rats. by Nunez MJ, Balboa J, Riveiro P, Linares D, Mana P, Rey-Mendez M, Rodriguez-Cobos A, Suarez-Quintanilla JA, Garcia-Vallejo LA, Freire-Garabal M. 2002 Jul; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=120028

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

With PubMed Central, NCBI is taking the lead in preservation and maintenance of open access to electronic literature, just as NLM has done for decades with printed biomedical literature. PubMed Central aims to become a world-class library of the digital age. 5 The value of PubMed Central, in addition to its role as an archive, lies in the availability of data from diverse sources stored in a common format in a single repository. Many journals already have online publishing operations, and there is a growing tendency to publish material online only, to the exclusion of print.

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Efficacy of FK463, a New Lipopeptide Antifungal Agent, in Mouse Models of Disseminated Candidiasis and Aspergillosis. by Ikeda F, Wakai Y, Matsumoto S, Maki K, Watabe E, Tawara S, Goto T, Watanabe Y, Matsumoto F, Kuwahara S. 2000 Mar; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=89735

•

Elevated Phenotypic Switching and Drug Resistance of Candida albicans from Human Immunodeficiency Virus-Positive Individuals prior to First Thrush Episode. by Vargas K, Messer SA, Pfaller M, Lockhart SR, Stapleton JT, Hellstein J, Soll DR. 2000 Oct; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=87443

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Evaluation of the Oricult-N Dipslide for Laboratory Diagnosis of Vaginal Candidiasis. by Carlson P, Richardson M, Paavonen J. 2000 Mar; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=86339

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Immunohistochemical Evaluation of T Cells in Oral Lesions from Human Immunodeficiency Virus-Positive Persons with Oropharyngeal Candidiasis. by Myers TA, Leigh JE, Arribas AR, Hager S, Clark R, Lilly E, Fidel, Jr. PL. 2003 Feb; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=145388

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Immunopathogenesis of recurrent vulvovaginal candidiasis. by Fidel PL Jr, Sobel JD. 1996 Jul; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=172897

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Improved Immunodiagnosis of Human Candidiasis by an Enzyme-Linked Immunosorbent Assay Using a Candida albicans 52-Kilodalton Metallopeptidase. by El Moudni B, Rodier MH, Daniault G, Jacquemin JL. 1998 Nov; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=96209

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In Vitro Antifungal Activity of KP-103, a Novel Triazole Derivative, and Its Therapeutic Efficacy against Experimental Plantar Tinea Pedis and Cutaneous Candidiasis in Guinea Pigs. by Tatsumi Y, Yokoo M, Arika T, Yamaguchi H. 2001 May; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=90494

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In Vivo Analysis of Secreted Aspartyl Proteinase Expression in Human Oral Candidiasis. by Naglik JR, Newport G, White TC, Fernandes-Naglik LL, Greenspan JS, Greenspan D, Sweet SP, Challacombe SJ, Agabian N. 1999 May; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=115994

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Low Levels of Antigenic Variability in Fluconazole-Susceptible and -Resistant Candida albicans Isolates from Human Immunodeficiency Virus-Infected Patients with Oropharyngeal Candidiasis. by Lopez-Ribot JL, McAtee RK, Kirkpatrick WR, La Valle R, Patterson TF. 1999 Sep; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=95751

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PCR Fingerprinting of Candida albicans Associated with Chronic Hyperplastic Candidosis and Other Oral Conditions. by Bartie KL, Williams DW, Wilson MJ, Potts AJ, Lewis MA. 2001 Nov; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=88488

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Primary Role for CD4 + T Lymphocytes in Recovery from Oropharyngeal Candidiasis. by Farah CS, Elahi S, Drysdale K, Pang G, Gotjamanos T, Seymour GJ, Clancy RL, Ashman RB. 2002 Feb; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=127699

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Quantification of Candida albicans Actin mRNA by the LightCycler System as a Means of Assessing Viability in a Model of Cutaneous Candidiasis. by Okeke CN, Tsuboi R, Ogawa H. 2001 Oct; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=88377

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Quantitation of Candida albicans Ergosterol Content Improves the Correlation between In Vitro Antifungal Susceptibility Test Results and In Vivo Outcome after Fluconazole Treatment in a Murine Model of Invasive Candidiasis. by ArthingtonSkaggs BA, Warnock DW, Morrison CJ. 2000 Aug; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=90017

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Replacement of Candida albicans with C. dubliniensis in Human Immunodeficiency Virus-Infected Patients with Oropharyngeal Candidiasis Treated with Fluconazole. by Martinez M, Lopez-Ribot JL, Kirkpatrick WR, Coco BJ, Bachmann SP, Patterson TF. 2002 Sep; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=130753

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Response to fluconazole by 23 patients with human immunodeficiency virus infection and oral candidiasis: pharmacological and mycological factors. by Lacassin F, Damond F, Chochillon C, Longuet P, Lebras J, Vilde JL, Leport C. 1996 Aug; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=163452

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Roles of the Candida albicans Mitogen-Activated Protein Kinase Homolog, Cek1p, in Hyphal Development and Systemic Candidiasis. by Csank C, Schroppel K, Leberer E, Harcus D, Mohamed O, Meloche S, Thomas DY, Whiteway M. 1998 Jun; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=108260

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Serum Is More Suitable than Whole Blood for Diagnosis of Systemic Candidiasis by Nested PCR. by Bougnoux ME, Dupont C, Mateo J, Saulnier P, Faivre V, Payen D, Nicolas-Chanoine MH. 1999 Apr; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=88626

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Simple and Rapid Detection of Candida albicans DNA in Serum by PCR for Diagnosis of Invasive Candidiasis. by Wahyuningsih R, Freisleben HJ, Sonntag HG, Schnitzler P. 2000 Aug; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=87175

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Synergism of Voriconazole and Terbinafine against Candida albicans Isolates from Human Immunodeficiency Virus-Infected Patients with Oropharyngeal Candidiasis. by Weig M, Muller FM. 2001 Mar; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=90406

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Trends in Antifungal Use and Epidemiology of Nosocomial Yeast Infections in a University Hospital. by Berrouane YF, Herwaldt LA, Pfaller MA. 1999 Mar; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=84452

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Virulence of a Phosphoribosylaminoimidazole Carboxylase-Deficient Candida albicans Strain in an Immunosuppressed Murine Model of Systemic Candidiasis. by Donovan M, Schumuke JJ, Fonzi WA, Bonar SL, Gheesling-Mullis K, Jacob GS, Davisson VJ, Dotson SB. 2001 Apr; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=98190

The National Library of Medicine: PubMed One of the quickest and most comprehensive ways to find academic studies in both English and other languages is to use PubMed, maintained by the National Library of Medicine.6 The advantage of PubMed over previously mentioned sources is that it covers a greater number of domestic and foreign references. It is also free to use. If the publisher has a Web site that offers full text of its journals, PubMed will provide links to that site, as well as to sites offering other related data. User registration, a subscription fee, or some other type of fee may be required to access the full text of articles in some journals. To generate your own bibliography of studies dealing with yeast infections, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “yeast infections” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for yeast infections (hyperlinks lead to article summaries): •

A cause for conversion of laparoscopic splenectomy: splenic candidiasis. Author(s): Vecchio R, Cacciola E, di Martino M, Cacciola RR, MacFadyen BV. Source: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A. 2002 December; 12(6): 441-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12590726&dopt=Abstract

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A comparative study of once versus twice daily treatment of superficial dermatophyte and yeast infections with tioconazole (1%) cream. Author(s): Kashin P, Phyfferoen MC, Gibbs DL. Source: J Int Med Res. 1985; 13(2): 88-95. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3888731&dopt=Abstract

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PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM) at the National Institutes of Health (NIH). The PubMed database was developed in conjunction with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text journal articles at Web sites of participating publishers. Publishers that participate in PubMed supply NLM with their citations electronically prior to or at the time of publication.

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A comparison of the specificity and sensitivity of two Candida antigen assay systems for the diagnosis of deep candidiasis in patients with hematologic diseases. Author(s): Misaki H, Iwasaki H, Ueda T. Source: Medical Science Monitor : International Medical Journal of Experimental and Clinical Research. 2003 February; 9(2): Mt1-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12601299&dopt=Abstract

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A novel missense mutation of AIRE gene in a patient with autoimmune polyendocrinopathy, candidiasis and ectodermal dystrophy (APECED), accompanied with progressive muscular atrophy: case report and review of the literature in Japan. Author(s): Sato K, Nakajima K, Imamura H, Deguchi T, Horinouchi S, Yamazaki K, Yamada E, Kanaji Y, Takano K. Source: Endocr J. 2002 December; 49(6): 625-33. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12625412&dopt=Abstract

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A systematic review of the management of oral candidiasis associated with HIV/AIDS. Author(s): Albougy HA, Naidoo S. Source: Sadj. 2002 December; 57(11): 457-66. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12674866&dopt=Abstract

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A.B.C's periodontics: “Y” is for yeast infections. Author(s): Swenson HM. Source: J Indiana Dent Assoc. 1987 September-October; 66(5): 21-2. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3479543&dopt=Abstract

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ABC of dermatology. Fungal and yeast infections. Author(s): Buxton PK. Source: British Medical Journal (Clinical Research Ed.). 1988 February 6; 296(6619): 4202. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3125928&dopt=Abstract

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Antifungal therapy of yeast infections. Author(s): Hay RJ. Source: Journal of the American Academy of Dermatology. 1994 September; 31(3 Pt 2): S6-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8077509&dopt=Abstract

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Association between chronic disseminated candidiasis in adult acute leukemia and common IL4 promoter haplotypes. Author(s): Choi EH, Foster CB, Taylor JG, Erichsen HC, Chen RA, Walsh TJ, Anttila VJ, Ruutu T, Palotie A, Chanock SJ. Source: The Journal of Infectious Diseases. 2003 April 1; 187(7): 1153-6. Epub 2003 March 19. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12660931&dopt=Abstract

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Autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy syndrome: time to review diagnostic criteria? Author(s): Buzi F, Badolato R, Mazza C, Giliani S, Notarangelo LD, Radetti G, Plebani A, Notarangelo LD. Source: The Journal of Clinical Endocrinology and Metabolism. 2003 July; 88(7): 3146-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12843157&dopt=Abstract

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Caspofungin in the treatment of oropharyngeal candidiasis. Author(s): Garbino J, Lew D, Hirschel B, Rohner P. Source: Int J Clin Pract. 2003 March; 57(2): 143-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12661800&dopt=Abstract

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Caspofungin versus amphotericin B for invasive candidiasis. Author(s): Brown AL, Greig JR. Source: The New England Journal of Medicine. 2003 March 27; 348(13): 1287-8; Author Reply 1287-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12660396&dopt=Abstract

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Changes in the spectrum and risk factors for invasive candidiasis in liver transplant recipients: prospective, multicenter, case-controlled study. Author(s): Husain S, Tollemar J, Dominguez EA, Baumgarten K, Humar A, Paterson DL, Wagener MM, Kusne S, Singh N. Source: Transplantation. 2003 June 27; 75(12): 2023-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12829905&dopt=Abstract

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Childhood oral candidiasis (oral thrush). Author(s): Janniger CK, Kihiczak TC. Source: Cutis; Cutaneous Medicine for the Practitioner. 1994 January; 53(1): 30-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8119075&dopt=Abstract

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Chronic hyperplastic candidosis/candidiasis (candidal leukoplakia). Author(s): Sitheeque MA, Samaranayake LP. Source: Critical Reviews in Oral Biology and Medicine : an Official Publication of the American Association of Oral Biologists. 2003; 14(4): 253-67. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12907694&dopt=Abstract

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Classification and clinical manifestations of oral yeast infections. Author(s): Holmstrup P, Axell T. Source: Acta Odontologica Scandinavica. 1990 February; 48(1): 57-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2181811&dopt=Abstract

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Clinical-mycologic diagnosis of oral yeast infections. Author(s): Olsen I, Stenderup A. Source: Acta Odontologica Scandinavica. 1990 February; 48(1): 11-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2181806&dopt=Abstract

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Clotrimazole for vaginal yeast infections. Author(s): Blake GJ. Source: Nursing. 1992 October; 22(10): 98. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1436804&dopt=Abstract

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Comparison of caspofungin and amphotericin B for invasive candidiasis. Author(s): Mora-Duarte J, Betts R, Rotstein C, Colombo AL, Thompson-Moya L, Smietana J, Lupinacci R, Sable C, Kartsonis N, Perfect J; Caspofungin Invasive Candidiasis Study Group. Source: The New England Journal of Medicine. 2002 December 19; 347(25): 2020-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12490683&dopt=Abstract

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Comparison of fluconazole and nystatin oral suspensions for treatment of oral candidiasis in infants. Author(s): Goins RA, Ascher D, Waecker N, Arnold J, Moorefield E. Source: The Pediatric Infectious Disease Journal. 2002 December; 21(12): 1165-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12506950&dopt=Abstract

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Contour-clamped homogeneous electric field gel electrophoresis as a powerful epidemiologic tool in yeast infections. Author(s): Pittet D, Monod M, Filthuth I, Frenk E, Suter PM, Auckenthaler R. Source: The American Journal of Medicine. 1991 September 16; 91(3B): 256S-263S. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1928173&dopt=Abstract

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Deeply invasive candidiasis. Author(s): Ostrosky-Zeichner L, Rex JH, Bennett J, Kullberg BJ. Source: Infectious Disease Clinics of North America. 2002 December; 16(4): 821-35. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12512183&dopt=Abstract

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Diagnosis and management of candidiasis vaginitis. Author(s): Hainsworth T. Source: Nurs Times. 2002 December 3-9; 98(49): 30-2. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12514963&dopt=Abstract

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Disseminated candidiasis and hepatic malarial infection in mannose-binding-lectinA-deficient mice. Author(s): Lee SJ, Gonzalez-Aseguinolaza G, Nussenzweig MC. Source: Molecular and Cellular Biology. 2002 December; 22(23): 8199-203. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12417723&dopt=Abstract

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Disseminated candidiasis following prednisolone therapy in systemic lupus erythematosus. Author(s): Tanaka H, Suzuki K, Nakahata T, Tateyama T, Sugimoto K, Ito E, Waga S. Source: Pediatrics International : Official Journal of the Japan Pediatric Society. 2002 December; 44(6): 702-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12421277&dopt=Abstract

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Disseminated candidiasis in a patient with acute myelogenous leukemia. Author(s): Grabowski R, Dugan E. Source: Cutis; Cutaneous Medicine for the Practitioner. 2003 June; 71(6): 466-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12839257&dopt=Abstract

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Echinocandins--an advance in the primary treatment of invasive candidiasis. Author(s): Walsh TJ. Source: The New England Journal of Medicine. 2002 December 19; 347(25): 2070-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12490691&dopt=Abstract

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Ecology of yeast and epidemiology of yeast infections. Author(s): Stenderup A. Source: Acta Derm Venereol Suppl (Stockh). 1986; 121: 27-37. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3459343&dopt=Abstract

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Efficacy of alcohol-based and alcohol-free melaleuca oral solution for the treatment of fluconazole-refractory oropharyngeal candidiasis in patients with AIDS. Author(s): Vazquez JA, Zawawi AA. Source: Hiv Clinical Trials. 2002 September-October; 3(5): 379-85. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12407487&dopt=Abstract

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Etiology, pathogenesis, therapy, and prophylaxis of oral yeast infections. Author(s): Budtz-Jorgensen E. Source: Acta Odontologica Scandinavica. 1990 February; 48(1): 61-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2181812&dopt=Abstract

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Factors associated with vaginal yeast infections in HIV-positive women. Author(s): Williams AB, Andrews S, Tashima K, Mezger J, Yu C. Source: The Journal of the Association of Nurses in Aids Care : Janac. 1998 SeptemberOctober; 9(5): 47-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9742480&dopt=Abstract

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Factors predisposing to oral yeast infections. Author(s): Oksala E. Source: Acta Odontologica Scandinavica. 1990 February; 48(1): 71-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2181813&dopt=Abstract

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First characterization of Candida albicans by random amplified polymorphic DNA method in Nicaragua and comparison of the diagnosis methods for vaginal candidiasis in Nicaraguan women. Author(s): Darce Bello M, Gonzalez A, Barnabe C, Larrouy G. Source: Memorias Do Instituto Oswaldo Cruz. 2002 October; 97(7): 985-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12471425&dopt=Abstract

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Fluconazole to prevent yeast infections in bone marrow transplantation patients: a randomized trial of high versus reduced dose, and determination of the value of maintenance therapy. Author(s): MacMillan ML, Goodman JL, DeFor TE, Weisdorf DJ. Source: The American Journal of Medicine. 2002 April 1; 112(5): 369-79. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11904111&dopt=Abstract

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Fungal and yeast infections of the central nervous system. A clinical review. Author(s): Salaki JS, Louria DB, Chmel H. Source: Medicine; Analytical Reviews of General Medicine, Neurology, Psychiatry, Dermatology, and Pediatrics. 1984 March; 63(2): 108-32. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6366452&dopt=Abstract

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Gamma-interferon treatment for resistant oropharyngeal candidiasis in an HIVpositive patient. Author(s): Bodasing N, Seaton RA, Shankland GS, Pithie A. Source: The Journal of Antimicrobial Chemotherapy. 2002 November; 50(5): 765-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12407143&dopt=Abstract

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Genetic relatedness of Candida strains isolated from women with vaginal candidiasis in Malaysia. Author(s): Chong PP, Lee YL, Tan BC, Ng KP. Source: Journal of Medical Microbiology. 2003 August; 52(Pt 8): 657-66. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12867559&dopt=Abstract

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Genital yeast infections. Author(s): Maclean AB. Source: British Medical Journal. 1977 August 20; 2(6085): 523. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=578123&dopt=Abstract

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Genital yeast infections. Author(s): Oriel JD, Partridge BM, Denny MJ, Coleman JC. Source: British Medical Journal. 1972 December 30; 4(843): 761-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4566994&dopt=Abstract

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'Genotypic shuffling' of sequential clones of Candida albicans in HIV-infected individuals with and without symptomatic oral candidiasis. Author(s): Samaranayake YH, Samaranayake LP, Dassanayake RS, Yau JY, Tsang WK, Cheung BP, Yeung KW. Source: Journal of Medical Microbiology. 2003 April; 52(Pt 4): 349-59. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12676875&dopt=Abstract

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Histopathologic and scanning electron microscope examination of the nail and hair in chronic mucocutaneous candidiasis. Author(s): Liu J, Lei P. Source: Journal of the American Academy of Dermatology. 2003 August; 49(2 Suppl Case Reports): S154-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12894108&dopt=Abstract

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Histopathology, immunology, and serology of oral yeast infections. Diagnosis of oral candidosis. Author(s): Budtz-Jorgensen E. Source: Acta Odontologica Scandinavica. 1990 February; 48(1): 37-43. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2181809&dopt=Abstract

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Immunohistochemical evaluation of T cells in oral lesions from human immunodeficiency virus-positive persons with oropharyngeal candidiasis. Author(s): Myers TA, Leigh JE, Arribas AR, Hager S, Clark R, Lilly E, Fidel PL Jr. Source: Infection and Immunity. 2003 February; 71(2): 956-63. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12540578&dopt=Abstract

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Immunological findings in patients with autoimmune polyendocrinopathycandidiasis-ectodermal dystrophy (APECED) and their family members: are heterozygotes subclinically affected? Author(s): Sediva A, Cihakova D, Lebl J. Source: J Pediatr Endocrinol Metab. 2002 November-December; 15(9): 1491-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12503856&dopt=Abstract

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In vivo pharmacodynamics of a new triazole, ravuconazole, in a murine candidiasis model. Author(s): Andes D, Marchillo K, Stamstad T, Conklin R. Source: Antimicrobial Agents and Chemotherapy. 2003 April; 47(4): 1193-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12654646&dopt=Abstract

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In vivo pharmacodynamics of antifungal drugs in treatment of candidiasis. Author(s): Andes D. Source: Antimicrobial Agents and Chemotherapy. 2003 April; 47(4): 1179-86. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12654644&dopt=Abstract

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Incident and persistent vulvovaginal candidiasis among human immunodeficiency virus-infected women: Risk factors and severity. Author(s): Duerr A, Heilig CM, Meikle SF, Cu-Uvin S, Klein RS, Rompalo A, Sobel JD; HER Study Group. Source: Obstetrics and Gynecology. 2003 March; 101(3): 548-56. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12636961&dopt=Abstract

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Invasive oesophageal candidiasis: current and developing treatment options. Author(s): Vazquez JA. Source: Drugs. 2003; 63(10): 971-89. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12699400&dopt=Abstract

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Invasive yeast infections other than Candida spp. in acute leukaemia. Author(s): Krcmery V, Krupova I, Denning DW. Source: The Journal of Hospital Infection. 1999 March; 41(3): 181-94. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10204120&dopt=Abstract

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Levamisole aids in treatment of refractory oral candidiasis in two patients with thymoma associated with myasthenia gravis: report of two cases. Author(s): Lai WH, Lu SY, Eng HL. Source: Chang Gung Med J. 2002 September; 25(9): 606-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12479622&dopt=Abstract

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Life stress and chronic yeast infections. Author(s): Williams NA, Deffenbacher JL. Source: J Human Stress. 1983 March; 9(1): 26-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6886404&dopt=Abstract

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Longitudinal study of mucosal Candida species colonization and candidiasis among human immunodeficiency virus (HIV)-seropositive and at-risk HIV-seronegative women. Author(s): Ohmit SE, Sobel JD, Schuman P, Duerr A, Mayer K, Rompalo A, Klein RS; HIV Epidemiology Research Study (HERS) Group. Source: The Journal of Infectious Diseases. 2003 July 1; 188(1): 118-27. Epub 2003 June 23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12825180&dopt=Abstract

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Management of genital candidiasis. Review omitted issues on recurrent thrush. Author(s): White DJ, Drake SM. Source: Bmj (Clinical Research Ed.). 1995 September 2; 311(7005): 629. Erratum In: Bmj 1995 October 14; 311(7011): 1028. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7663268&dopt=Abstract

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Management of patients with recurrent vulvovaginal candidiasis. Author(s): Sobel JD. Source: Drugs. 2003; 63(11): 1059-66. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12749733&dopt=Abstract

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Mannan antigen detection in the diagnosis of patients with invasive candidiasis. Author(s): Rao DS, Ghosh A, Singhi S, Chakrabarti A. Source: The Indian Journal of Medical Research. 2002 July; 116: 13-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12514973&dopt=Abstract

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Mucosal candidiasis. Author(s): Vazquez JA, Sobel JD. Source: Infectious Disease Clinics of North America. 2002 December; 16(4): 793-820, V. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12512182&dopt=Abstract

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Multiple patterns of resistance to fluconazole in Candida glabrata isolates from a patient with oropharyngeal candidiasis receiving head and neck radiation. Author(s): Redding SW, Kirkpatrick WR, Saville S, Coco BJ, White W, Fothergill A, Rinaldi M, Eng T, Patterson TF, Lopez-Ribot J. Source: Journal of Clinical Microbiology. 2003 February; 41(2): 619-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12574256&dopt=Abstract

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Neonatal invasive candidiasis: a prospective multicenter study of 118 cases. Author(s): Lopez Sastre JB, Coto Cotallo GD, Fernandez Colomer B; Grupo de Hospitales Castrillo. Source: American Journal of Perinatology. 2003 April; 20(3): 153-63. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12802715&dopt=Abstract

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Nonspecific secretory immunity in HIV-infected patients with oral candidiasis. Author(s): Bard E, Laibe S, Clair S, Biichle S, Millon L, Drobacheff C, Bettinger D, Seilles E, Meillet D. Source: Journal of Acquired Immune Deficiency Syndromes (1999). 2002 November 1; 31(3): 276-84. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12439202&dopt=Abstract

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Opportunistic yeast infections, with special reference to candidiasis. Author(s): Taschdjian CL, Kozinn PJ, Toni EF. Source: Annals of the New York Academy of Sciences. 1970 October 30; 174(2): 606-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5278139&dopt=Abstract

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Oral and maxillofacial pathology case of the month. Candidiasis. Author(s): Simmons ME, Wright JM. Source: Tex Dent J. 2002 November; 119(11): 1138, 1144. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12518686&dopt=Abstract

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Oral candidiasis associated with inhaled corticosteroid use: comparison of fluticasone and beclomethasone. Author(s): Fukushima C, Matsuse H, Tomari S, Obase Y, Miyazaki Y, Shimoda T, Kohno S. Source: Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology. 2003 June; 90(6): 646-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12839324&dopt=Abstract

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Oral candidiasis in head and neck cancer patients receiving radiotherapy with amifostine cytoprotection. Author(s): Nicolatou-Galitis O, Sotiropoulou-Lontou A, Velegraki A, Pissakas G, Kolitsi G, Kyprianou K, Kouloulias V, Papanikolaou I, Yiotakis I, Dardoufas K. Source: Oral Oncology. 2003 June; 39(4): 397-401. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12676261&dopt=Abstract

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Oral candidiasis, switching and antifungal resistance. Author(s): Blignaut E. Source: Sadj. 2000 December; 55(12): 694. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12608245&dopt=Abstract

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Oral versus intra-vaginal imidazole and triazole anti-fungal agents for the treatment of uncomplicated vulvovaginal candidiasis (thrush): a systematic review. Author(s): Watson MC, Grimshaw JM, Bond CM, Mollison J, Ludbrook A. Source: Bjog : an International Journal of Obstetrics and Gynaecology. 2002 January; 109(1): 85-95. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11843377&dopt=Abstract

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Oral versus intra-vaginal imidazole and triazole anti-fungal treatment of uncomplicated vulvovaginal candidiasis (thrush). Author(s): Watson MC, Grimshaw JM, Bond CM, Mollison J, Ludbrook A. Source: Cochrane Database Syst Rev. 2001; (4): Cd002845. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11687165&dopt=Abstract

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Oral versus intra-vaginal imidazole and triazole anti-fungal treatment of uncomplicated vulvovaginal candidiasis (thrush). Author(s): Watson MC, Grimshaw JM, Bond CM, Mollison J, Ludbrook A. Source: Cochrane Database Syst Rev. 2001; (1): Cd002845. Review. Update In: http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11279767&dopt=Abstract

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Oral yeast infections in immunocompromised and seriously diseased patients. Author(s): Heimdahl A, Nord CE. Source: Acta Odontologica Scandinavica. 1990 February; 48(1): 77-84. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2181814&dopt=Abstract

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Oropharyngeal candidiasis caused by non-albicans yeast in patients receiving external beam radiotherapy for head-and-neck cancer. Author(s): Dahiya MC, Redding SW, Dahiya RS, Eng TY, Kirkpatrick WR, Coco BJ, Sadkowski LC, Fothergill AW, Waite A, Rinaldi MG, Patterson TF, Thomas CR. Source: International Journal of Radiation Oncology, Biology, Physics. 2003 September 1; 57(1): 79-83. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12909218&dopt=Abstract

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Overcoming drug-resistant yeast infections. Author(s): Dorrell S. Source: Drug Discovery Today. 2002 March 15; 7(6): 332-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11893534&dopt=Abstract

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Pediatric management problems: yeast infections. Author(s): Kieltyka EG. Source: Pediatric Nursing. 1992 July-August; 18(4): 376-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1518676&dopt=Abstract

Studies 21

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Polyglandular autoimmune syndrome type 1 without chronic mucocutaneous candidiasis in a 16 year-old male. Author(s): Bhansali A, Kotwal N, Suresh V, Murlidharan R, Chattopadhyay A, Mathur K. Source: J Pediatr Endocrinol Metab. 2003 January; 16(1): 103-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12585347&dopt=Abstract

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Preventing and treating vaginal yeast infections. Author(s): Pujol G. Source: Surviv News (Atlanta Ga). 2003 March; : 12. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12772680&dopt=Abstract

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Prevention and treatment of vulvovaginal candidiasis using exogenous Lactobacillus. Author(s): Jeavons HS. Source: Journal of Obstetric, Gynecologic, and Neonatal Nursing : Jognn / Naacog. 2003 May-June; 32(3): 287-96. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12774870&dopt=Abstract

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Real-time antifungal susceptibility screening aids management of invasive yeast infections in immunocompromised patients. Author(s): Hadley S, Martinez JA, McDermott L, Rapino B, Snydman DR. Source: The Journal of Antimicrobial Chemotherapy. 2002 February; 49(2): 415-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11815592&dopt=Abstract

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Relation between recurrent vulvovaginal candidiasis, vaginal concentrations of mannose-binding lectin, and a mannose-binding lectin gene polymorphism in Latvian women. Author(s): Babula O, Lazdane G, Kroica J, Ledger WJ, Witkin SS. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 2003 September 1; 37(5): 733-7. Epub 2003 August 13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12942410&dopt=Abstract

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Relative risk of vaginal candidiasis after use of antibiotics compared with antidepressants in women: postmarketing surveillance data in England. Author(s): Wilton L, Kollarova M, Heeley E, Shakir S. Source: Drug Safety : an International Journal of Medical Toxicology and Drug Experience. 2003; 26(8): 589-97. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12825971&dopt=Abstract

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Resolution of azole-resistant oesophageal candidiasis in an AIDS patient after treatment with caspofungin. Author(s): Smith K, Youle M, Baker B, Ballinger J, Cuthbertson Z, Johnson M. Source: Aids (London, England). 2003 February 14; 17(3): 448-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12556703&dopt=Abstract

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Serologic diagnosis of yeast infections. Author(s): Dolan CT, Stried RP. Source: American Journal of Clinical Pathology. 1973 January; 59(1): 49-55. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4631818&dopt=Abstract

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The protective immune response against vaginal candidiasis: lessons learned from clinical studies and animal models. Author(s): Fidel PL Jr. Source: International Reviews of Immunology. 2002 November-December; 21(6): 515-48. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12650240&dopt=Abstract

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The secreted aspartyl proteinases Sap1 and Sap2 cause tissue damage in an in vitro model of vaginal candidiasis based on reconstituted human vaginal epithelium. Author(s): Schaller M, Bein M, Korting HC, Baur S, Hamm G, Monod M, Beinhauer S, Hube B. Source: Infection and Immunity. 2003 June; 71(6): 3227-34. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12761103&dopt=Abstract

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The successful treatment of oral candidiasis (thrush) in a pediatric patient using itraconazole. Author(s): Crutchfield CE 3rd, Lewis EJ. Source: Pediatric Dermatology. 1997 May-June; 14(3): 246. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9192426&dopt=Abstract

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The syndrome of chronic mucocutaneous candidiasis with selective antibody deficiency. Author(s): Kalfa VC, Roberts RL, Stiehm ER. Source: Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology. 2003 February; 90(2): 259-64. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12602677&dopt=Abstract

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The treatment of fungus and yeast infections of nails by the method of “chemical removal'. Author(s): White MI, Clayton YM. Source: Clinical and Experimental Dermatology. 1982 May; 7(3): 273-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7105479&dopt=Abstract

Studies 23

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Topical treatment for vaginal candidiasis (thrush) in pregnancy. Author(s): Young GL, Jewell D. Source: Cochrane Database Syst Rev. 2001; (4): Cd000225. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11687074&dopt=Abstract

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Treatment of neonatal candidiasis with liposomal amphotericin B(L-AMP-LRC-1): phase II study. Author(s): Kotwani RN, Bodhe PV, Kirodian BG, Mehta KP, Ali US, Kshirsagar NA. Source: Indian Pediatrics. 2003 June; 40(6): 545-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12824664&dopt=Abstract

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Trends in antifungal use and epidemiology of nosocomial yeast infections in a university hospital. Author(s): Berrouane YF, Herwaldt LA, Pfaller MA. Source: Journal of Clinical Microbiology. 1999 March; 37(3): 531-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9986807&dopt=Abstract

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Vaccines for the management of dermatophyte and superficial yeast infections. Author(s): Segal E. Source: Curr Top Med Mycol. 1989; 3: 36-49. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2688920&dopt=Abstract

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Vaginal pH and microflora related to yeast infections and treatment. Author(s): Drake SM, Evans BA, Gerken A. Source: Br J Vener Dis. 1980 April; 56(2): 107-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7388581&dopt=Abstract

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Vaginal yeast infections exacerbated by sugar intake. Author(s): Crook WG. Source: The Nurse Practitioner. 1993 January; 18(1): 8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8419863&dopt=Abstract

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Vaginal yeast infections in diabetic women. Author(s): Peer AK, Hoosen AA, Seedat MA, van den Ende J, Omar MA. Source: South African Medical Journal. Suid-Afrikaanse Tydskrif Vir Geneeskunde. 1993 October; 83(10): 727-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8191325&dopt=Abstract

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Vulvovaginal candidiasis. Author(s): Marrazzo J. Source: Bmj (Clinical Research Ed.). 2003 May 10; 326(7397): 993-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12742894&dopt=Abstract

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What interventions are effective for the prevention and treatment of cutaneous candidiasis? Author(s): Evans EC, Gray M. Source: Journal of Wound, Ostomy, and Continence Nursing : Official Publication of the Wound, Ostomy and Continence Nurses Society / Wocn. 2003 January; 30(1): 11-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12529589&dopt=Abstract

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Yeast infections and breastfeeding. Author(s): Jain E. Source: Can Nurse. 1996 April; 92(4): 5-6. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8785727&dopt=Abstract

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Yeast infections in humans with special emphasis on Malassezia furfur and infections caused by 'rare' yeast species. Author(s): Schmidt A. Source: Contrib Microbiol. 2000; 5: 36-53. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10863664&dopt=Abstract

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Yeast infections of the lower urinary tract. 1. In vitro studies of the tissue phase of Candida albicans. Author(s): Haley LD. Source: Sabouraudia. 1965 June; 4(2): 98-105. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5896108&dopt=Abstract

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Yeast infections on the neonatal unit: one cheer for parenteral nutrition admixture filters. Author(s): Leck AK, Puntis JW. Source: Nutrition (Burbank, Los Angeles County, Calif.). 1998 April; 14(4): 400-1. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9591314&dopt=Abstract

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Yeast infections. Author(s): Hay RJ. Source: Dermatologic Clinics. 1996 January; 14(1): 113-24. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8821164&dopt=Abstract

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Young woman with recurrent yeast infections. Author(s): Becker KL, Walton-Moss BJ. Source: Lippincott's Primary Care Practice. 2000 January-February; 4(1): 125-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11022528&dopt=Abstract

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CHAPTER 2. NUTRITION AND YEAST INFECTIONS Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and yeast infections.

Finding Nutrition Studies on Yeast Infections The National Institutes of Health’s Office of Dietary Supplements (ODS) offers a searchable bibliographic database called the IBIDS (International Bibliographic Information on Dietary Supplements; National Institutes of Health, Building 31, Room 1B29, 31 Center Drive, MSC 2086, Bethesda, Maryland 20892-2086, Tel: 301-435-2920, Fax: 301-480-1845, E-mail: [email protected]). The IBIDS contains over 460,000 scientific citations and summaries about dietary supplements and nutrition as well as references to published international, scientific literature on dietary supplements such as vitamins, minerals, and botanicals.7 The IBIDS includes references and citations to both human and animal research studies. As a service of the ODS, access to the IBIDS database is available free of charge at the following Web address: http://ods.od.nih.gov/databases/ibids.html. After entering the search area, you have three choices: (1) IBIDS Consumer Database, (2) Full IBIDS Database, or (3) Peer Reviewed Citations Only. Now that you have selected a database, click on the “Advanced” tab. An advanced search allows you to retrieve up to 100 fully explained references in a comprehensive format. Type “yeast infections” (or synonyms) into the search box, and click “Go.” To narrow the search, you can also select the “Title” field.

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

28 Yeast Infections

The following is a typical result when searching for recently indexed consumer information on yeast infections: •

A yeast for all reasons or is candidiasis the hidden enemy? Source: Palmer, C.A. Dwyer, J.T. Nutrition-today (USA). (June 1993). volume 28(3) page 24-29. candida mycoses yeasts diet hypersensitivity women therapeutic diets drug therapy 0029-666X Summary: candida mycose levure regime alimentaire reaction allergique femme regime alimentaire therapeutique therapeutique medicamenteuse

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

Nonspecific secretory immunity in HIV-infected patients with oral candidiasis. Author(s): Institut d'Etude et de Transfert de Genes EA3181, Faculte de MedicinePharmacie, Besancon, France. Source: Bard, E Laibe, S Clair, S Biichle, S Millon, L Drobacheff, C Bettinger, D Seilles, E Meillet, D J-Acquir-Immune-Defic-Syndr. 2002 November 1; 31(3): 276-84 1525-4135

Federal Resources on Nutrition In addition to the IBIDS, the United States Department of Health and Human Services (HHS) and the United States Department of Agriculture (USDA) provide many sources of information on general nutrition and health. Recommended resources include: •

healthfinder®, HHS’s gateway to health information, including diet and nutrition: http://www.healthfinder.gov/scripts/SearchContext.asp?topic=238&page=0

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

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

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

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

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

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

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

Nutrition 29

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

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

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

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

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

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

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

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

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

The following is a specific Web list relating to yeast infections; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •

Vitamins Vitamin C Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,904,00.html

•

Minerals Betaine Hydrochloride Source: Healthnotes, Inc. www.healthnotes.com Biotin Source: Integrative Medicine Communications; www.drkoop.com Nystatin Oral Source: Healthnotes, Inc. www.healthnotes.com Nystatin Topical Source: Healthnotes, Inc. www.healthnotes.com Vitamin H (Biotin) Source: Integrative Medicine Communications; www.drkoop.com

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•

Food and Diet Cinnamon Alternative names: Cinnamomum zeylanicum Source: Healthnotes, Inc. www.healthnotes.com Garlic Alternative names: Allium sativum Source: Healthnotes, Inc. www.healthnotes.com Garlic Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,786,00.html Juices Source: Healthnotes, Inc. www.healthnotes.com Kefir Source: Healthnotes, Inc. www.healthnotes.com Lhassi Source: Healthnotes, Inc. www.healthnotes.com Milk Source: Healthnotes, Inc. www.healthnotes.com Nutritional Yeast Source: Integrative Medicine Communications; www.drkoop.com Yogurt Source: Healthnotes, Inc. www.healthnotes.com Yogurt Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/foods_view/0,1523,97,00.html Yogurt Cheese Source: Healthnotes, Inc. www.healthnotes.com

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CHAPTER 3. INFECTIONS

ALTERNATIVE

MEDICINE

AND

YEAST

Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to yeast infections. At the conclusion of this chapter, we will provide additional sources.

National Center for Complementary and Alternative Medicine The National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health (http://nccam.nih.gov/) has created a link to the National Library of Medicine’s databases to facilitate research for articles that specifically relate to yeast infections and complementary medicine. To search the database, go to the following Web site: http://www.nlm.nih.gov/nccam/camonpubmed.html. Select “CAM on PubMed.” Enter “yeast infections” (or synonyms) into the search box. Click “Go.” The following references provide information on particular aspects of complementary and alternative medicine that are related to yeast infections: •

1998 William J. Stickel Bronze Award. Antifungal activity of Melaleuca alternifolia (tea-tree) oil against various pathogenic organisms. Author(s): Concha JM, Moore LS, Holloway WJ. Source: Journal of the American Podiatric Medical Association. 1998 October; 88(10): 489-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9791953&dopt=Abstract

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A case of cutaneous Exophiala spinifera infection. Author(s): Oba M, Suzuki Y, Kawasaki M. Source: Nihon Ishinkin Gakkai Zasshi = Japanese Journal of Medical Mycology. 2000; 41(1): 17-21. Japanese. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10660638&dopt=Abstract

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A new mycological culture medium. Author(s): Sanyal M, Basu N. Source: Bull Calcutta Sch Trop Med. 1968 January; 16(1): 15-6. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5713688&dopt=Abstract

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Activation of human complement system Paracoccidioides brasiliensis and its deposition on the yeast form cell surface. Author(s): Munk ME, Da Silva WD. Source: Journal of Medical and Veterinary Mycology : Bi-Monthly Publication of the International Society for Human and Animal Mycology. 1992; 30(6): 481-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1287168&dopt=Abstract

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An assessment of two Carpobrotus species extracts as potential antimicrobial agents. Author(s): Springfield EP, Amabeoku G, Weitz F, Mabusela W, Johnson Q. Source: Phytomedicine : International Journal of Phytotherapy and Phytopharmacology. 2003; 10(5): 434-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12834010&dopt=Abstract

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An isolate of Arthroderma benhamiae with Trichophyton mentagrophytes var. erinacei anamorph isolated from a four-toed hedgehog (Atelerix albiventris) in Japan. Author(s): Takahashi Y, Haritani K, Sano A, Takizawa K, Fukushima K, Miyaji M, Nishimura K. Source: Nihon Ishinkin Gakkai Zasshi = Japanese Journal of Medical Mycology. 2002; 43(4): 249-55. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12402026&dopt=Abstract

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Antagonistic effect of Lactobacillus acidophilus, Saccharomyces boulardii and Escherichia coli combinations against experimental infections with Shigella flexneri and Salmonella enteritidis subsp. typhimurium in gnotobiotic mice. Author(s): Filho-Lima JV, Vieira EC, Nicoli JR. Source: Journal of Applied Microbiology. 2000 March; 88(3): 365-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10747216&dopt=Abstract

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Anticandidal activity of Santolina chamaecyparissus volatile oil. Author(s): Suresh B, Sriram S, Dhanaraj SA, Elango K, Chinnaswamy K. Source: Journal of Ethnopharmacology. 1997 January; 55(2): 151-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9032628&dopt=Abstract

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Anti-Cryptococcus activity of combination of extracts of Cassia alata and Ocimum sanctum. Author(s): Ranganathan S, Balajee SA.

Alternative Medicine 33

Source: Mycoses. 2000 September; 43(7-8): 299-301. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11036400&dopt=Abstract •

Antifungal activity in human urine and serum after ingestion of garlic (Allium sativum). Author(s): Caporaso N, Smith SM, Eng RH. Source: Antimicrobial Agents and Chemotherapy. 1983 May; 23(5): 700-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6870217&dopt=Abstract

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Effect of commercial ethanol propolis extract on the in vitro growth of Candida albicans collected from HIV-seropositive and HIV-seronegative Brazilian patients with oral candidiasis. Author(s): Martins RS, Pereira ES Jr, Lima SM, Senna MI, Mesquita RA, Santos VR. Source: J Oral Sci. 2002 March; 44(1): 41-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12058869&dopt=Abstract

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Evaluation of two self-care treatments for prevention of vaginal candidiasis in women with HIV. Author(s): Williams AB, Yu C, Tashima K, Burgess J, Danvers K. Source: The Journal of the Association of Nurses in Aids Care : Janac. 2001 July-August; 12(4): 51-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11486720&dopt=Abstract

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In vitro activity of Cinnamomum zeylanicum against azole resistant and sensitive Candida species and a pilot study of cinnamon for oral candidiasis. Author(s): Quale JM, Landman D, Zaman MM, Burney S, Sathe SS. Source: The American Journal of Chinese Medicine. 1996; 24(2): 103-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8874667&dopt=Abstract

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Intestinal candidiasis. A clinical report and comments about this opportunistic pathology. Author(s): Ruiz-Sanchez D, Calderon-Romero L, Sanchez-Vega JT, Tay J. Source: Mycopathologia. 2002; 156(1): 9-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12715941&dopt=Abstract

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Oral fungal colonization and oral candidiasis in renal transplant patients: the relationship to Miswak use. Author(s): Al-Mohaya MA, Darwazeh A, Al-Khudair W. Source: Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics. 2002 April; 93(4): 455-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12029285&dopt=Abstract

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Quantitation of Candida albicans ergosterol content improves the correlation between in vitro antifungal susceptibility test results and in vivo outcome after fluconazole treatment in a murine model of invasive candidiasis. Author(s): Arthington-Skaggs BA, Warnock DW, Morrison CJ. Source: Antimicrobial Agents and Chemotherapy. 2000 August; 44(8): 2081-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10898679&dopt=Abstract

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

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

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

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

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

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

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

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

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

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

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

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

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

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

The following is a specific Web list relating to yeast infections; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •

General Overview Allergies and Sensitivities Source: Healthnotes, Inc. www.healthnotes.com Asthma Source: Integrative Medicine Communications; www.drkoop.com Bone Infection Source: Integrative Medicine Communications; www.drkoop.com

Alternative Medicine 35

Candida/Yeast Hypersensitivity Syndrome Source: Prima Communications, Inc.www.personalhealthzone.com Candidiasis Source: Integrative Medicine Communications; www.drkoop.com Canker Sores Source: Healthnotes, Inc. www.healthnotes.com Chronic Candidiasis Source: Healthnotes, Inc. www.healthnotes.com Diabetes Mellitus Source: Integrative Medicine Communications; www.drkoop.com HIV and AIDS Support Source: Healthnotes, Inc. www.healthnotes.com Hives Source: Healthnotes, Inc. www.healthnotes.com Hypoparathyroidism Source: Integrative Medicine Communications; www.drkoop.com Infection Source: Healthnotes, Inc. www.healthnotes.com Nail Disorders Source: Integrative Medicine Communications; www.drkoop.com Osteomyelitis Source: Integrative Medicine Communications; www.drkoop.com Vaginal Inflammation Source: Integrative Medicine Communications; www.drkoop.com Vaginitis Source: Healthnotes, Inc. www.healthnotes.com Vaginitis Source: Integrative Medicine Communications; www.drkoop.com Vitiligo Source: Healthnotes, Inc. www.healthnotes.com Yeast Infection Source: Healthnotes, Inc. www.healthnotes.com Yeast Infection Source: Integrative Medicine Communications; www.drkoop.com

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Homeopathy Borax Source: Healthnotes, Inc. www.healthnotes.com Calcarea carbonica Source: Healthnotes, Inc. www.healthnotes.com Candida albicans Source: Healthnotes, Inc. www.healthnotes.com Kali bichromicum Source: Healthnotes, Inc. www.healthnotes.com Kreosotum Source: Healthnotes, Inc. www.healthnotes.com Natrum muriaticum Source: Healthnotes, Inc. www.healthnotes.com Pulsatilla Source: Healthnotes, Inc. www.healthnotes.com Sepia Source: Healthnotes, Inc. www.healthnotes.com Sulphur Source: Healthnotes, Inc. www.healthnotes.com

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Herbs and Supplements Acidophilus Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,748,00.html Acidophilus and Other Probiotics Source: Prima Communications, Inc.www.personalhealthzone.com Aminoglycosides Source: Integrative Medicine Communications; www.drkoop.com Amphotericin B Source: Healthnotes, Inc. www.healthnotes.com Antibiotic Combination: Sulfa Drugs Source: Integrative Medicine Communications; www.drkoop.com Antibiotics (General) Source: Prima Communications, Inc.www.personalhealthzone.com

Alternative Medicine 37

Antituberculosis Agents Source: Integrative Medicine Communications; www.drkoop.com Barberry Alternative names: Berberis vulgaris Source: Healthnotes, Inc. www.healthnotes.com Barberry Alternative names: Berberis vulgaris, Berberry Source: Integrative Medicine Communications; www.drkoop.com Berberis vulgaris Source: Integrative Medicine Communications; www.drkoop.com Berberry Source: Integrative Medicine Communications; www.drkoop.com Blue-green Algae Source: Integrative Medicine Communications; www.drkoop.com Boric Acid Source: Healthnotes, Inc. www.healthnotes.com Brewer’s Yeast Source: Healthnotes, Inc. www.healthnotes.com Brewer's Yeast Alternative names: Nutritional Yeast Source: Integrative Medicine Communications; www.drkoop.com Caprylic acid Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10111,00.html Cephalosporins Source: Integrative Medicine Communications; www.drkoop.com Cinnamomum Alternative names: Cinnamon; Cinnamomum zeylanicum Source: Alternative Medicine Foundation, Inc. www.amfoundation.org Digestive Enzymes Source: Healthnotes, Inc. www.healthnotes.com Echinacea Alternative names: Echinacea purpurea, Echinacea angustifolia, Echinacea pallida Source: Healthnotes, Inc. www.healthnotes.com

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Echinacea Alternative names: Echinacea angustifolia, Echinacea pallida, Echinacea purpurea, Purple Coneflower Source: Integrative Medicine Communications; www.drkoop.com Echinacea Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,775,00.html Echinacea angustifolia Alternative names: Echinacea Source: Integrative Medicine Communications; www.drkoop.com Echinacea pallida Alternative names: Echinacea Source: Integrative Medicine Communications; www.drkoop.com Echinacea purpurea Alternative names: Echinacea Source: Integrative Medicine Communications; www.drkoop.com Econazole Source: Healthnotes, Inc. www.healthnotes.com FOS Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10026,00.html Goldenseal Alternative names: Hydrastis canadensis Source: Healthnotes, Inc. www.healthnotes.com Goldenseal Alternative names: Hydrastis canadensis Source: Integrative Medicine Communications; www.drkoop.com Goldenseal Source: Prima Communications, Inc.www.personalhealthzone.com Goldenseal Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,791,00.html Grapefruit seed extract Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,985,00.html

Alternative Medicine 39

Hydrastis canadensis Source: Integrative Medicine Communications; www.drkoop.com Ketoconazole Source: Healthnotes, Inc. www.healthnotes.com L. Acidophilus Source: Integrative Medicine Communications; www.drkoop.com Lactobacillus Acidophilus Source: Integrative Medicine Communications; www.drkoop.com Lapacho Source: Prima Communications, Inc.www.personalhealthzone.com Macrolides Source: Integrative Medicine Communications; www.drkoop.com Oregano/Wild Marjoram Alternative names: Origanum vulgare Source: Healthnotes, Inc. www.healthnotes.com Oregon Grape Alternative names: Berberis aquifolium Source: Healthnotes, Inc. www.healthnotes.com Pau d'arco Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,811,00.html Penicillin Derivatives Source: Integrative Medicine Communications; www.drkoop.com Peppermint Alternative names: Mentha piperita Source: Healthnotes, Inc. www.healthnotes.com Peppermint Source: Prima Communications, Inc.www.personalhealthzone.com Probiotics Source: Healthnotes, Inc. www.healthnotes.com Purple Coneflower Alternative names: Echinacea Source: Integrative Medicine Communications; www.drkoop.com Quinolones Source: Integrative Medicine Communications; www.drkoop.com

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Rosemary Alternative names: Rosmarinus officinalis Source: Healthnotes, Inc. www.healthnotes.com Spirulina Alternative names: Blue-green Algae Source: Integrative Medicine Communications; www.drkoop.com Tea Tree Alternative names: Melaleuca alternifolia Source: Healthnotes, Inc. www.healthnotes.com Terconazole Source: Healthnotes, Inc. www.healthnotes.com Tetracycline Derivatives Source: Integrative Medicine Communications; www.drkoop.com Thyme Alternative names: Thymus vulgaris Source: Healthnotes, Inc. www.healthnotes.com Topical Corticosteroids Source: Healthnotes, Inc. www.healthnotes.com

General References A good place to find general background information on CAM is the National Library of Medicine. It has prepared within the MEDLINEplus system an information topic page dedicated to complementary and alternative medicine. To access this page, go to the MEDLINEplus site at http://www.nlm.nih.gov/medlineplus/alternativemedicine.html. This Web site provides a general overview of various topics and can lead to a number of general sources.

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CHAPTER 4. CLINICAL TRIALS AND YEAST INFECTIONS Overview In this chapter, we will show you how to keep informed of the latest clinical trials concerning yeast infections.

Recent Trials on Yeast Infections The following is a list of recent trials dedicated to yeast infections.8 Further information on a trial is available at the Web site indicated. •

Anidulafungin versus Fluconazole in the Treatment of Candidemia Condition(s): Candida; Candidiasis Study Status: This study is currently recruiting patients. Sponsor(s): National Cancer Institute (NCI) Purpose - Excerpt: Fluconazole is an FDA-approved drug that is widely used to treat fungal infections due to candida. The experimental drug anidulafungin has been found to be active in treating life-threatening fungal infections. The purpose of this study is to determine whether anidulafungin is as effective as fluconazole in treating candidemia, an invasive form of candidiasis. Three hundred patients 16 years of age or older will participate in this study. Participants will be randomly assigned to one of two groups: one-half will receive anidulafungin; the other half will receive fluconazole. They will receive the drug for as few as 10 days or for up to 42 days, depending on the seriousness of the infection. The drug will be given over a four-hour period on the first day, and over two hours on the remaining days. While taking the study medication, participants will be required to give blood samples every week until the end of treatment. At two weeks and six weeks following the end of therapy, participants will return for evaluation. Prior to their participation in this study, patients will undergo the following evaluations: a physical exam, an eye exam, an electrocardiogram, and possibly blood work. Phase(s): Phase III Study Type: Interventional

8

These are listed at www.ClinicalTrials.gov.

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Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00058682 •

The Safety and Efficacy of Anidulafungin versus Comparator in Patients with Candidemia and Invasive Candidiasis Condition(s): Candidiasis Study Status: This study is currently recruiting patients. Sponsor(s): Vicuron Pharmaceuticals Purpose - Excerpt: Anidulafungin is a medicine being developed for treatment of patients with certain kinds of fungal infections. These infections due to yeast (a type of fungus) in the mouth/esophagus, in the blood or in other areas within the body. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00056368

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The Safety and Efficacy of Intravenous Anidulafungin as a Treatment for AzoleRefractory Mucosal Candidiasis (FRMC) Condition(s): Candidiasis Study Status: This study is currently recruiting patients. Sponsor(s): Vicuron Pharmaceuticals Purpose - Excerpt: Anidulafungin is an antifungal agent of the echinocandin class which is highly active in vitro against fluconazole resistant Candida species. The efficacy of anidulafungin has demonstrated in various animal models of fluconazole-resistant mucosal disease; as well as, in Phase 2 Esophageal Candidiasis studies. This study is intended to offer patients with FRMC an alternate therapy with amphotericin B or with other agents whose efficacy and/or safety are inadequate in the treatment of this disease. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00041704

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A Randomized, Prospective, Double-Blind Study Comparing Fluconazole With Placebo for Primary and Secondary Prophylaxis of Mucosal Candidiasis in HIVInfected Women Condition(s): Candidiasis; Candidiasis, esophageal; HIV Infections Study Status: This study is no longer recruiting patients. Sponsor(s): National Institute of Allergy and Infectious Diseases (NIAID); Pfizer Purpose - Excerpt: To compare the efficacy of fluconazole versus placebo for the prevention of Candida esophagitis and vaginal/oropharyngeal candidiasis, including a comparison of the development of clinical resistance. Fluconazole has been shown to be effective in preventing or suppressing candidiasis in HIV-negative women. An

Clinical Trials 43

increasing likelihood of oral and esophageal candidiasis in conjunction with progressive immunosuppression raises the question of the potential role of prophylactic antifungal therapy in high-risk persons. Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000744 •

A Study of Nystatin in the Prevention of Fungal Infections of the Mouth in Patients with AIDS or AIDS-Related Syndromes Condition(s): Candidiasis, Oral; HIV Infections Study Status: This study is no longer recruiting patients. Sponsor(s): Bristol-Myers Squibb Purpose - Excerpt: To determine a safe, effective, and convenient dosing schedule for nystatin pastilles in the prophylaxis of oral candidiasis in patients with AIDS or AIDS related syndromes (group III or IV, CDC classification) Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00002293

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A Study to Assess the Effect of Concomitant Administration of Fluconazole on the Clinical Pharmacokinetics of Methadone Condition(s): Candidiasis; HIV Infections Study Status: This study is no longer recruiting patients. Sponsor(s): National Institute of Allergy and Infectious Diseases (NIAID) Purpose - Excerpt: To evaluate the pharmacokinetics and safety of concomitant administration of methadone and fluconazole. Injection drug users constitute the second largest subset of the U.S. population at risk for HIV infection and AIDS-associated mortality. Narcotic addiction is often treated by use of methadone. Fluconazole has been shown to be highly effective in treating symptomatic mucosal candidiasis, but it is unknown whether fluconazole affects methadone metabolism, which could result in symptoms of methadone withdrawal or overdose in patients taking the drugs in combination. Phase(s): Phase I Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000788

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A Study to Compare the Use of Fluconazole as Continuous Therapy Versus Periodic Therapy in HIV-Positive Patients with Recurrent Thrush Condition(s): Candidiasis, Oral; HIV Infections Study Status: This study is no longer recruiting patients. Sponsor(s): National Institute of Allergy and Infectious Diseases (NIAID)

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Purpose - Excerpt: The purpose of this study is to determine whether it is better to treat patients with fluconazole on a continuous basis to prevent thrush (yeast infection in the mouth) from coming back or to wait and treat each episode of thrush. Fluconazole is one of the most commonly prescribed drugs to treat thrush and other yeast infections. However, the number of patients with fluconazole-resistant thrush is increasing, and it is not known whether continuous or intermittent use of fluconazole leads to greater resistance. Therefore, it is important to determine the most effective treatment strategy. Phase(s): Phase IV Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000951 •

Comparison of Two Treatments to Prevent Invasive Fungal Infections in Patients Who Have Received Liver Transplants. Condition(s): Candidiasis Study Status: This study is no longer recruiting patients. Sponsor(s): National Institute of Allergy and Infectious Diseases (NIAID) Purpose - Excerpt: The purpose of this study is to compare the safety and effectiveness of 2 treatments to prevent invasive fungal infections (IFI), which are infections caused by yeasts and molds that are common in patients with weak immune systems or transplant patients. AmBisome, a new treatment, will be compared to fluconazole, the traditional treatment for fungal infections caused by the yeast Candida. Treatment will only be given to liver transplant patients who are found to be at high risk for IFI. Liver transplant patients who are at low risk for IFI will be monitored but will receive no study medication. IFIs are found mainly in a high risk group of liver transplant patients, and are not common in those with low risk. If IFI preventive therapy is focused on the high risk group, there may be a lesser chance of Candida becoming resistant (able to grow despite the presence of drugs used to kill it). Treating only the high risk group will also save money. Phase(s): Phase IV Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00001107

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Evaluation of Amphotericin B in the Treatment of Biopsy Proven Candida Esophagitis in Immunocompromised Patients Condition(s): Candidiasis, esophageal; HIV Infections Study Status: This study is no longer recruiting patients. Sponsor(s): Bristol-Myers Squibb Purpose - Excerpt: To determine the appropriate duration of amphotericin B therapy for Candida esophagitis. To compare the effectiveness of two different amphotericin B doses in the treatment of biopsy-proven Candida esophagitis. To determine if low-dose amphotericin B is less toxic than standard dose therapy during a limited treatment period. To evaluate pharmacokinetic and pharmacodynamic parameters of the two different dosing regimens.

Clinical Trials 45

Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00002041 •

Nystatin Pastilles for the Prevention of Oral Candidiasis in Patients With AIDS or ARC Condition(s): Candidiasis, Oral; HIV Infections Study Status: This study is no longer recruiting patients. Sponsor(s): Bristol-Myers Squibb Purpose - Excerpt: To determine a safe, effective, and convenient dosing schedule for nystatin pastilles in the prevention of oral candidiasis in patients with AIDS or AIDS related complex (ARC) (group III or IV, CDC classification). Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00002057

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Study of FK463 in the Treatment of Candidemia or Invasive Candidiasis Condition(s): Candidiasis Study Status: This study is no longer recruiting patients. Sponsor(s): Fujisawa Healthcare, Inc. Fujisawa GmbH Purpose - Excerpt: The purpose of the study is to evaluate the safety and efficacy of FK463 in the treatment of patients with confirmed candidemia or invasive candidiasis. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00036179

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A Comparison of Fluconazole and Ketoconazole in the Treatment of Fungal Infections of the Throat in Patients with Weakened Immune Systems Condition(s): Candidiasis, esophageal; HIV Infections Study Status: This study is completed. Sponsor(s): Pfizer Purpose - Excerpt: To compare the safety, tolerance, and effectiveness of fluconazole and ketoconazole in the treatment of candidal esophagitis in immunocompromised patients. Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00002304

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A Comparison of SCH 56592 and Fluconazole in the Treatment of Oropharyngeal Candidiasis (OPC) in HIV-Positive Patients Condition(s): Candidiasis, Oral; HIV Infections

46 Yeast Infections

Study Status: This study is completed. Sponsor(s): Schering-Plough Purpose - Excerpt: The purpose of this study is to compare the safety and effectiveness of SCH 56592 with that of fluconazole in the treatment of OPC (a fungal infection of the throat) in HIV-positive patients. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00002399 •

A Comparison of the Safety and Effectiveness of Fluconazole or Clotrimazole in the Treatment of Fungal Infections of the Mouth and Throat in Patients with AIDS Condition(s): Candidiasis, Oral; HIV Infections Study Status: This study is completed. Sponsor(s): Pfizer Purpose - Excerpt: To compare the efficacy, safety, and tolerance of fluconazole single daily capsule for 14 days versus clotrimazole troche 5 x daily for 14 days in the treatment of oropharyngeal candidiasis in patients with AIDS. Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00002282

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A Randomized, Double-Blind, Placebo Controlled Trial Evaluating the Impact of Nystatin on the Development of Oral Irritation in Patients Receiving High Dose Intravenous Interleukin-2 Condition(s): Candidiasis, Oral; Gastrointestinal Diseases; Stomatitis Study Status: This study is completed. Sponsor(s): National Cancer Institute (NCI) Purpose - Excerpt: In patients who are receiving intravenous high dose Interleukin-2, patients will be randomized into two groups: group one will receive nystatin swish and swallow immediately before initiation of IL-2, and the second group will receive a placebo. The patients in each group will be monitored and evaluated for differences in the rate and severity of development of oral irritation during treatment. They will also be studied for differences between the two groups in the number of doses of IL-2 taken. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00001812

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A Study of Amphotericin B in the Treatment of Fungal Infections of the Mouth in HIV-Infected Patients Who Have Not Had Success with Fluconazole Condition(s): Candidiasis, Oral; HIV Infections Study Status: This study is completed.

Clinical Trials 47

Sponsor(s): National Institute of Allergy and Infectious Diseases (NIAID); Bristol-Myers Squibb Purpose - Excerpt: To assess response and toxicity in patients with fluconazole-resistant oral candidiasis ( thrush ) when given initial induction with amphotericin B oral suspension. Experience with amphotericin B oral suspension for drug-sensitive thrush in HIV-infected patients is limited but encouraging. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00001065 •

A Study of Fluconazole in the Treatment of Fungal Infections of the Throat in Patients with Weakened Immune Systems Condition(s): Candidiasis, esophageal; HIV Infections Study Status: This study is completed. Sponsor(s): Pfizer Purpose - Excerpt: To determine the safety, toleration, and efficacy of fluconazole oral suspension in the treatment of esophageal candidiasis in immunocompromised patients, including those with AIDS. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00002339

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A Study of the Side Effects of L-743,872 in Men with Candidal Esophagitis Condition(s): Candidiasis, esophageal; HIV Infections Study Status: This study is completed. Sponsor(s): Merck Research Laboratories Purpose - Excerpt: The purpose of this study is to see if it is safe to give L-743,872 to men with candidal esophagitis, an AIDS-related yeast infection in the esophagus. Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00005921

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A Study of Treatments for Fungal Infections of the Mouth and Throat in HIVInfected Patients Who Have Had Success with Itraconazole But Not with Fluconazole Condition(s): Candidiasis, Oral; HIV Infections Study Status: This study is completed. Sponsor(s): Janssen Pharmaceutica Purpose - Excerpt: To provide maintenance treatment with itraconazole solution for patients who were clinical responders in the ITR-USA-94 protocol, even if they subsequently relapsed.

48 Yeast Infections

Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00002341 •

An Open Label, Non-Comparative, Multicenter, Phase III Trial of the Efficacy, Safety and Toleration of Voriconazole in the Primary or Secondary Treatment of Invasive Fungal Infections Condition(s): Aspergillosis; Candidiasis; Fungemia; Mycoses Study Status: This study is completed. Sponsor(s): National Cancer Institute (NCI) Purpose - Excerpt: The objective of this study is to evaluate the efficacy, safety and toleration of voriconazole in the primary treatment of systemic or invasive fungal infections due to fungal pathogens for which there is no licensed therapy; and in the secondary treatment of systemic or invasive fungal infections in patients failing or intolerant to treatment with approved systemic antifungal agents. This trial is a Phase II multicenter, open label study investigating the utilization of voriconazole for the treatment of systemic or invasive fungal infections. Enrollment is targeted for 150 patients to be recruited from multiple centers. The patient population will consist of patients with proven, deeply invasive fungal infection for which there is no licensed therapy or if the patient is failing or intolerant to treatment with approved systemic antifungal agents. Voriconazole will be administered initially by a loading dose of 6 mg/kg q12 hours for the first two doses followed by 4 mg/kg q12 hours. Efficacy will be evaluated by clinical, radiological and microbiological response. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00001810

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An Open Study of the Effect of Itraconazole Oral Solution for the Treatment of Fluconazole Refractory Oropharyngeal Candidiasis in HIV-Positive Subjects. Condition(s): Candidiasis, Oral; HIV Infections Study Status: This study is completed. Sponsor(s): Janssen Pharmaceutica Purpose - Excerpt: To assess the efficacy and safety of itraconazole oral solution in HIVseropositive patients with oropharyngeal candidiasis that is refractory to fluconazole. Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00002133

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Comparative Randomized Study of the Efficacy, Safety, and Toleration of Fluconazole Oral Suspension or Nystatin Oral Suspension in the Treatment of Patients With Oropharyngeal Candidiasis in Association With the Acquired Immunodeficiency Syndrome Condition(s): Candidiasis, Oral; HIV Infections

Clinical Trials 49

Study Status: This study is completed. Sponsor(s): Pfizer Purpose - Excerpt: To compare the efficacy, safety, and toleration of fluconazole as a single daily oral suspension for 14 days versus nystatin oral suspension 4 times daily for 14 days in the treatment of oropharyngeal candidiasis in patients with AIDS or HIV infection. Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00002112 •

Comparing the Effectiveness of Fluconazole and a New Medicine (FK463) in Preventing Fungal Infections in Bone Marrow Transplant Patients Condition(s): Aspergillosis; Candidiasis; Fungemia; Mycoses Study Status: This study is completed. Sponsor(s): National Cancer Institute (NCI) Purpose - Excerpt: Fever and infection are serious complications of cancer treatment such as bone marrow transplant, especially when white blood cell counts are low. When the number of white blood cells is below 500, the person has a condition called neutropenia and has a high risk of developing an infection. At the first sign of fever, antibiotics are started. However, antibiotics do not kill fungus germs, and fungal infections may be difficult to treat. Thus, the prevention of fungal infections in this population is important. The only medicine approved for prevention of fungal infections is fluconazole, which prevents some but not all types of such infections. A new antifungal medication called FK463 works against more types of fungal infections than fluconazole does. This study will compare the effectiveness, safety, and tolerance of FK463 as compared with fluconazole. Eight hundred patients will be enrolled in this study. They will be randomly assigned to receive either fluconazole or FK463. Before the medicine is begun, a physical exam as well as a blood sample, mouth swab, urine sample, and chest x-ray will be done. The fluconazole or FK463 will be administered once a day for one hour into the bloodstream through a catheter in the vein. Blood tests will be taken twice a week. Cultures from the blood, mouth, and urine will be taken throughout the study. X-rays and CT scans will only be taken if a fungal infection is suspected. If fever develops, blood will be drawn to check for fungi. If fever and neutropenia continue for more than 4 days, FK463 or fluconazole will be stopped and a standard medication called amphotericin B will be started. Both FK463 and fluconazole will be administered until white blood cell count returns to greater than 500 (signifying recovery from neutropenia), or up to 42 days after transplantation. Patients will be evaluated 4 weeks after the medicine is stopped. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00001937

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Fluconazole Prophylaxis of Thrush in AIDS Condition(s): Acquired Immunodeficiency Syndrome; Candidiasis; Oral Candidiasis Study Status: This study is completed.

50 Yeast Infections

Sponsor(s): National Institute of Allergy and Infectious Diseases (NIAID) Purpose - Excerpt: This is a placebo-controlled trial of intermittent fluconazole prophylaxis (200 mg orally three times a week) in the prevention of thrush. Phase(s): Phase IV Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00001542 •

Non-Comparative Study of Fluconazole in Patients With Serious Mycoses and Who Cannot Be Treated With Conventional Antifungal Therapy Condition(s): Candidiasis; Mycoses; HIV Infections Study Status: This study is completed. Sponsor(s): Pfizer Purpose - Excerpt: The primary purpose of this protocol is to provide fluconazole for the treatment of individual patients who require therapy for serious or life-threatening systemic fungal infection, who have failed on conventional antifungal therapy or have had unacceptable reactions to conventional antifungal therapy, and who are ineligible for other established fluconazole clinical trial protocols. Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00002038

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Oral Manifestations of Human Immunodeficiency Virus Infection in High Risk Groups Condition(s): HIV Infections; Candidiasis, Oral Study Status: This study is completed. Sponsor(s): National Institute of Dental and Craniofacial Research (NIDCR); Columbia University Purpose - Excerpt: Objectives: I. Evaluate the development of oral manifestations of human immunodeficiency virus infection in relationship to the onset of immunologic alterations and systemic symptoms in different risk groups: gay/bisexual men, male intravenous drug users, and female intravenous drug users. II. Evaluate the immune and inflammatory response to periodontal and other microbial pathogens. III. Evaluate the bacterial species infecting the oral cavity in patients in these risk groups. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00004781

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Randomized Comparative Study of Fluconazole Versus Clotrimazole Troches in the Prevention of Serious Fungal Infection in Patients With AIDS or Advanced AIDSRelated Complex. (A Nested Study of ACTG 081) Condition(s): Candidiasis; Mycoses; HIV Infections Study Status: This study is completed.

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Sponsor(s): Pfizer; National Institute of Allergy and Infectious Diseases (NIAID) Purpose - Excerpt: To study the effectiveness, safety, and tolerance of fluconazole versus clotrimazole troches (lozenges) as prophylaxis (preventive treatment) against fungal infections in patients enrolled in ACTG 081 (a study of prophylaxis against pneumocystosis, toxoplasmosis, and serious bacterial infection). Primarily, to compare the rates of invasive infections by C. neoformans, endemic mycoses, and Candida. To compare the mortality rates due to fungal infections between two antifungal prophylactic treatments. Secondarily, to assess the effect of prophylaxis on the incidence of severe fungal infections, defined as invasive infections and esophageal candidiasis and less severe mucocutaneous infection. Serious fungal infections are significant complicating and life-threatening occurrences in patients with advanced HIV infection. Oropharyngeal candidiasis is found in almost all such patients, and causes pain, difficulty in swallowing, and loss of appetite. Similarly, esophageal candidiasis causes illness in the population. Cryptococcosis, endemic mycoses, and coccidioidomycosis also cause significant illness and death in AIDS patients. Once established, fungal infections in AIDS patients generally require continuous suppressive therapy because attempts at curing these infections are usually unsuccessful. Fluconazole has a number of characteristics that would make it a logical candidate to examine as a prophylactic agent in patients with advanced HIV infection. Animal studies have shown it to be prophylactic in models of candidiasis, cryptococcosis, histoplasmosis, and coccidioidomycosis. Initial experience in patients with active cryptococcal meningitis appears favorable, and studies of oropharyngeal candidiasis show it to be effective. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000676 •

Randomized, Controlled, Double-Blind Study of Itraconazole Oral Solution Versus Fluconazole Tablets for the Treatment of Esophageal Candidiasis. Condition(s): Candidiasis, esophageal; HIV Infections Study Status: This study is completed. Sponsor(s): Janssen Pharmaceutica Purpose - Excerpt: To evaluate the safety and efficacy of itraconazole oral solution versus fluconazole tablets for the treatment of esophageal candidiasis in immunocompromised patients. Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00002132

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Safety and Effectiveness of Fluconazole Versus SCH 56592 to Treat Thrush in HIVPositive Patients Condition(s): Candidiasis, Oral; HIV Infections Study Status: This study is completed. Sponsor(s): Schering-Plough

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Purpose - Excerpt: The purpose of this study is to compare the safety and effectiveness of 2 treatments for thrush (a fungal infection of the mouth and throat) in HIV-positive patients. Fluconazole is a drug that is commonly used to treat thrush. SCH 56592 is a new drug that will be compared to fluconazole. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00002446 •

Safety and Effectiveness of Giving L-743,872 to Patients with Thrush That Has Not Been Cured With Fluconazole Condition(s): Candidiasis, Oral; HIV Infections Study Status: This study is terminated. Sponsor(s): Merck Research Laboratories Purpose - Excerpt: The purpose of this study is to see if it is safe and effective to give L743,872 to patients with thrush, an AIDS-related yeast infection of the mouth, that has not been cured with fluconazole treatment. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00005920

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Safety and Effectiveness of Giving Lamisil to HIV-Positive Subjects With Thrush Who Have Not Responded to Fluconazole Treatment Condition(s): Candidiasis, Oral; HIV Infections Study Status: This study is completed. Sponsor(s): Novartis Pharmaceuticals Purpose - Excerpt: The purpose of this study is to see if it is safe and effective to give Lamisil to HIV-positive patients with thrush (a fungal infection) that has not responded to fluconazole. Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00002394

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The Effect of Oral Candidiasis on the Speech Production, Feeding Skills, and SelfConcept of Children and Adolescents with Symptomatic HIV Infection Condition(s): Candidiasis, Oral; Eating Disorders; HIV Infections; Speech Disorders Study Status: This study is completed. Sponsor(s): National Cancer Institute (NCI) Purpose - Excerpt: The main objectives of this study are: 1) to determine whether various levels of severity of oral candidiasis (thrush) in the child are associated with different levels of speech production, feeding skills, and self-concept, and 2) to assess the effect of the reduction of oral thrush over time on the speech function, feeding skills,

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and self-concept in HIV-infected patients who already are receiving various antifungal medications for treatment of their thrush (Note: Decisions regarding antifungal therapy are made completely independent from this study). Children with HIV disease, ages 621 years, who have oral thrush are eligible to paricipate in the study. The child and his/her parent will be asked to complete a variety of measures at specific time intervals over approximately one month during visits to the National Institutes of Health for treatment on other protocols. First, a nurse will rate the location and severity of thrush in the child's mouth. Then the parent will complete questionnaires assessing the effect of oral thrush on the child's feeding and speech skills and everyday functioning. Finally, the child will be administered a brief speech and oral-motor evaluation and will complete some questionnaires about how the thrush affects his/her day-to-day activities and self-concept. The results of this study may help to better understand the cause of expressive language deficits observed in some children with HIV infection. More specifically, it will determine if any speech and feeding problems of HIV-infected children are associated with oral thrush. Learning more about the impact of oral thrush on the speech, feeding, and the self-concept of children with HIV disease may be used for parent and patient education and to develop rehabilitative recommendations to benefit HIV-infected patients with oral thrush. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00001448 •

The Safety and Effectiveness of Intravenous Anidulafungin as a Treatment for Patients with Invasive Candidiasis. Condition(s): Candidiasis Study Status: This study is completed. Sponsor(s): Vicuron Pharmaceuticals Purpose - Excerpt: Anidulafungin may be effective for the treatment of invasive Candida infections. The purpose of the study is to find the balance between dose tolerance and effectiveness of several doses for the treatment of United States patients with invasive candidiasis. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00037219

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The Safety and Effectiveness of Peridex in Preventing or Delaying Fungal Infections of the Mouth in HIV-Infected Patients Condition(s): Candidiasis, Oral; HIV Infections Study Status: This study is completed. Sponsor(s): Procter & Gamble Pharmaceuticals Purpose - Excerpt: To evaluate the safety and effectiveness of Peridex (an oral rinse containing chlorhexidine gluconate) for preventing the occurrence of clinically-evident microbiologically-documented oral candidiasis in HIV-positive patients, who are at risk of the disease based on previous history of candidiasis.

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Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00002431 •

Voriconazole to Prevent Systemic Fungal Infections in Children Condition(s): Aspergillosis; Candidiasis; Fungal diseases; Mycoses Study Status: This study is completed. Sponsor(s): National Cancer Institute (NCI) Purpose - Excerpt: This study will examine how children's bodies metabolize and eliminate the anti-fungal drug voriconazole. The results will yield information needed to make recommendations for safe and effective dosing of the drug in children. Children with reduced immune function-such as those receiving drugs for cancer treatment-are at high risk for serious fungal infections. Children between 2 and 12 years old who need treatment to prevent fungal infections may be eligible for this study. Candidates will be screened with a physical examination, eye examination, and blood and urine tests. Children in the study will be hospitalized for 21 days. They will receive voriconazole twice a day (every 12 hours) for 8 days, infused through a vein over a period of 1 to 2 hours. The dose will be determined based on the individual child's weight. Blood samples will be collected at various intervals before and after the infusions on days 1, 2, 4 and 8 to determine the amount of drug in the blood. On day 8, the child will have another physical and eye examination, as well as additional blood and urine tests. If additional treatment is required, voriconazole may be continued for up to day 21. (Children who require the drug for more than 21 days may receive it under another research protocol.) On the last day of treatment, the child will have another physical examination, and blood and urine tests. These procedures will be repeated again at 30 to 35 days following the last dose of drug. A small sample of blood will also be analyzed for genetic information related to the rate of metabolism of voriconazole-that is, how fast or slow it is cleared (eliminated) by the liver. Voriconazole is effective against several different fungi. It may protect children against serious fungal infections with fewer side effects than standard available therapy. Phase(s): Phase I Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00005912

Keeping Current on Clinical Trials The U.S. National Institutes of Health, through the National Library of Medicine, has developed ClinicalTrials.gov to provide current information about clinical research across the broadest number of diseases and conditions. The site was launched in February 2000 and currently contains approximately 5,700 clinical studies in over 59,000 locations worldwide, with most studies being conducted in the United States. ClinicalTrials.gov receives about 2 million hits per month and hosts approximately 5,400 visitors daily. To access this database, simply go to the Web site at http://www.clinicaltrials.gov/ and search by “yeast infections” (or synonyms).

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While ClinicalTrials.gov is the most comprehensive listing of NIH-supported clinical trials available, not all trials are in the database. The database is updated regularly, so clinical trials are continually being added. The following is a list of specialty databases affiliated with the National Institutes of Health that offer additional information on trials: •

For clinical studies at the Warren Grant Magnuson Clinical Center located in Bethesda, Maryland, visit their Web site: http://clinicalstudies.info.nih.gov/

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For clinical studies conducted at the Bayview Campus in Baltimore, Maryland, visit their Web site: http://www.jhbmc.jhu.edu/studies/index.html

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For cancer trials, visit the National Cancer Institute: http://cancertrials.nci.nih.gov/

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For eye-related trials, visit and search the Web page of the National Eye Institute: http://www.nei.nih.gov/neitrials/index.htm

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For heart, lung and blood trials, visit the Web page of the National Heart, Lung and Blood Institute: http://www.nhlbi.nih.gov/studies/index.htm

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For trials on aging, visit and search the Web site of the National Institute on Aging: http://www.grc.nia.nih.gov/studies/index.htm

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For rare diseases, visit and search the Web site sponsored by the Office of Rare Diseases: http://ord.aspensys.com/asp/resources/rsch_trials.asp

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For alcoholism, visit the National Institute on Alcohol Abuse and Alcoholism: http://www.niaaa.nih.gov/intramural/Web_dicbr_hp/particip.htm

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For trials on infectious, immune, and allergic diseases, visit the site of the National Institute of Allergy and Infectious Diseases: http://www.niaid.nih.gov/clintrials/

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For trials on arthritis, musculoskeletal and skin diseases, visit newly revised site of the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health: http://www.niams.nih.gov/hi/studies/index.htm

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For hearing-related trials, visit the National Institute on Deafness and Other Communication Disorders: http://www.nidcd.nih.gov/health/clinical/index.htm

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For trials on diseases of the digestive system and kidneys, and diabetes, visit the National Institute of Diabetes and Digestive and Kidney Diseases: http://www.niddk.nih.gov/patient/patient.htm

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For drug abuse trials, visit and search the Web site sponsored by the National Institute on Drug Abuse: http://www.nida.nih.gov/CTN/Index.htm

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For trials on mental disorders, visit and search the Web site of the National Institute of Mental Health: http://www.nimh.nih.gov/studies/index.cfm

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For trials on neurological disorders and stroke, visit and search the Web site sponsored by the National Institute of Neurological Disorders and Stroke of the NIH: http://www.ninds.nih.gov/funding/funding_opportunities.htm#Clinical_Trials

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CHAPTER 5. PATENTS ON YEAST INFECTIONS Overview Patents can be physical innovations (e.g. chemicals, pharmaceuticals, medical equipment) or processes (e.g. treatments or diagnostic procedures). The United States Patent and Trademark Office defines a patent as a grant of a property right to the inventor, issued by the Patent and Trademark Office.9 Patents, therefore, are intellectual property. For the United States, the term of a new patent is 20 years from the date when the patent application was filed. If the inventor wishes to receive economic benefits, it is likely that the invention will become commercially available within 20 years of the initial filing. It is important to understand, therefore, that an inventor’s patent does not indicate that a product or service is or will be commercially available. The patent implies only that the inventor has “the right to exclude others from making, using, offering for sale, or selling” the invention in the United States. While this relates to U.S. patents, similar rules govern foreign patents. In this chapter, we show you how to locate information on patents and their inventors. If you find a patent that is particularly interesting to you, contact the inventor or the assignee for further information. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical patents that use the generic term “yeast infections” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on yeast infections, we have not necessarily excluded nonmedical patents in this bibliography.

Patents on Yeast Infections By performing a patent search focusing on yeast infections, you can obtain information such as the title of the invention, the names of the inventor(s), the assignee(s) or the company that owns or controls the patent, a short abstract that summarizes the patent, and a few excerpts from the description of the patent. The abstract of a patent tends to be more technical in nature, while the description is often written for the public. Full patent descriptions contain much more information than is presented here (e.g. claims, references, figures, diagrams, etc.). We will tell you how to obtain this information later in the chapter. The following is an 9Adapted

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

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example of the type of information that you can expect to obtain from a patent search on yeast infections: •

Anti-LPS factor from horseshoe crabs and methods of use Inventor(s): Wainwright; Norman R. (Falmouth, MA) Assignee(s): Marine Biological Laboratory (Woods Hole, MA) Patent Number: 5,780,429 Date filed: December 22, 1995 Abstract: This invention is directed to pharmaceutical and cosmetic compositions comprising anti-lipopolysaccharide (anti-LPS) factor proteins derived from horseshoe crabs, either in the native form or produced by recombinant means. The pharmaceutical formulations, which may include anti-LPS factor proteins alone or in combination with other antimicrobials, may be used in the treatment of gram-negative bacterial infections, endotoxemia, septic shock, gram-positive bacterial infections, and yeast infections. The anti-LPS factor protein-containing pharmaceuticals can be formulated for systemic or topical administration. They may also be used to control mold growth. Anti-LPS factor proteins can be used in cosmetic compositions or skin or hair preparations as antimicrobial preservatives, either alone or in combination with conventional preservatives, to prevent or control the growth of bacteria, yeast and mold. Excerpt(s): The present invention is in the field of antibacterial pharmaceutical compositions and in the field of antimicrobial preservatives. Endotoxins are high molecular weight lipopolysaccharide complexes that are released when gram-negative bacteria are disrupted, such as occurs during antibiotic therapy when bacteria are lysed. Endotoxins, an outer wall constituent of the gram-negative bacteria, are potent stimulators of the inflammatory response which produce pyrogenic reactions upon intravenous administration. While an inflammatory response that is measured is beneficial in fighting infection, it can be damaging to the host when it is uncontrolled, as is the case with septic shock. Bacterial endotoxin is a complex of lipid, carbohydrate and protein. It is characterized by an overall negative charge, heat stability and high molecular weight. Highly purified endotoxin is a lipopolysaccharide (LPS) that does not contain protein. It is the lipopolysaccharide component of bacterial endotoxins that causes endotoxemia and septic shock. Web site: http://www.delphion.com/details?pn=US05780429__

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Apparatus and method for immediate diagnosis of vaginal yeast infections Inventor(s): Cerra; Michael C. (3052 Marston Way, San Jose, CA 95148) Assignee(s): none reported Patent Number: 5,353,803 Date filed: June 18, 1993 Abstract: Apparatus and method for immediate diagnosis of exudative vaginal yeast infections, using a sample of vaginal discharge, dying the yeast present in the discharge with a fluorescent dye specifically sensitive to yeast, and subjecting the dye to ultraviolet radiation to determine the level of visible fluorescence, with the level of fluorescence indicating the presence or absence of the high number of yeast associated with a vaginal infection.

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Excerpt(s): The present invention relates generally to a method and apparatus for immediate diagnosis of exudative vaginal yeast infections. In particular, this invention relates to a method and apparatus which permit diagnosis or ruling-out of vaginal yeast infections without culturing yeast, thereby permitting immediate diagnosis through fluorescence of a dyed sample of the vaginal exudate. Vaginal yeast infections are a common problem affecting women of all ages. Vaginal anti-yeast prescriptions numbered 13 million in 1990 in the U.S. The infection results from the overgrowth of yeast which are often normally present but in much smaller numbers. The symptoms of a yeast infection include vaginal itching, discharge, soreness, irritation or burning. Since a vaginal yeast infection is strictly due to the presence of large numbers of the responsible organism, diagnosis and treatment would seem to be simple. However, other more serious vaginal infections can present a similar clinical picture which usually includes local itching, a vaginal discharge, and possibly abdominal pain and fever. For example, bacterial vaginosis, bacterial trichomoniasis, chlamydial infections, and gonorrhea can resemble yeast infections, especially to women without medical training. Presently, over-the-counter anti-yeast medications have been approved for treating vaginal yeast infections. The availability of these medications encourages women to selfdiagnose and self-treat a potentially serious medical problem, without a medical examination, based upon a hope that the problem may simply be due to yeast. Selfdiagnosis without diagnostic data is dangerous, since proper treatment may be delayed or the wrong treatment may be undertaken, possibly leading to invasive infections or sterility due to pelvic inflammatory disease. Web site: http://www.delphion.com/details?pn=US05353803__ •

Apparatus, method, and test kit for diagnosis of vaginal yeast infections Inventor(s): Samuels; Bernard (5624 Evelyn Ct., New Orleans, LA 70124) Assignee(s): none reported Patent Number: 4,953,560 Date filed: December 7, 1989 Abstract: A home diagnosis device for vaginal yeast infections comprising a support stick; a swab having loosely woven fibers attached to one end of the support stick; a growth media for culturing and diagnosing vaginal yeast infection infiltrated between the loosely woven fibers of the swab. A home diagnosis device for vaginal yeast infections comprising: an outer tube; a cap, detachably connected to one end of the outer tube; a swab element having loosely woven fibers; a growth media for culturing and diagnosing vaginal yeast infection infiltrated between the loosely woven fibers of the swab element; and a holder for the swab element slideably mounted inside the outer tube. A method for the home diagnosis of vaginal yeast infections comprising the steps of: inserting a tube into the vagina containing a swab element of loosely woven fibers between which is infiltrated a growth media for culturing and diagnosing vaginal yeast infection; sliding the swab element out of the tube and into contact with vaginal secretion; retracting the swab element into the tube and out of contact with the vaginal secretion; capping the tube; culturing the vaginal secretion in the tube containing the swab element; and examining the swab for indications of vaginal yeast infection. Excerpt(s): The present invention relates to a diagnostic test for vaginal yeast infections. In particular, the present invention relates to a diagnostic test using a novel swab element of loosely packed fibers between which is infiltrated a media for culturing vaginal yeast that produces unexpectedly large and easily discernible colonies that

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simplify self diagnosis of a vaginal yeast infection. More particularly, the invention relates to a swab element that is large enough for a woman to easily and safely insert into and remove from her own vagina. If vaginal yeast is present it is picked up by the swab element and penetrates below the surface of the media and between the loosely packed fibers where it begins to grow. Yeast growth between the fibers proceeds rapidly and results in large colonies that produce a visible discoloration of the surface of the swab element. Many types of vaginal discharge are normal and not indicative of any infection. When a woman detects what she suspects is an abnormal discharge she may wait to see if it goes away or she may try to treat herself using readily available overthe-counter remedies before visiting her physician for treatment. Delaying treatment or self treatment often results in an exacerbation of the infection. Similarly, vaginal itching, while not normal, is not necessarily indicative of any infection. When a woman detects vaginal itching, however, she suspects an infection and usually seeks medical attention immediately. Frequently, the itching is due to an allergy or physical irritation rather than an infection. Because bath soap is the most common cause of such irritation many times no specific treatment is necessary. If the cause of the itching is not an infection, the condition is likely to be resolved spontaneously or through minor self treatment. Web site: http://www.delphion.com/details?pn=US04953560__ •

Bis-imidazolyl-bisphenylmethane and salts thereof Inventor(s): Plempel; Manfred (Wuppertal-Elberfeld, DT), Buchel; Karl Heinz (Wuppertal-Elberfeld, DT), Regel; Erik (Wuppertal, DT) Assignee(s): Bayer Aktiengesellschaft (DT) Patent Number: 3,985,766 Date filed: October 31, 1969 Abstract: Bis-imidazolyl-bisphenylmethane derivatives and pharmaceutically acceptable non-toxic salts thereof are useful as antimycotics especially against dermatomycosis caused by Trichophyton and Microsporium species and also against yeast infections of the skin and internal organs. Excerpt(s): The present invention is concerned with bis-imidazolyl-bisphenylmethanes, salts thereof, processes for their production, pharmaceutical compositions containing such compounds and methods of treating fungal infections pathogenic to humans and animals and methods of treating yeast infections pathogenic to humans and animals. More particularly, the compounds of the present invention are bis-imidazolylbisphenylmethanes which may be substituted in one or both of the imidazolyl moieties and one or both of the phenyl moieties. The compounds of the present invention are particularly useful as antimycotics especially against dermatomycosis caused by Trichophyton and Microsporium species and also against yeast infections of the skin and internal organs. And includes salts of such compounds. Web site: http://www.delphion.com/details?pn=US03985766__

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•

Chlorhexidine and glutaraldehyde mouthwash Inventor(s): Torchinsky; Alick (1035 Champagnac, C.P. 821, St. Adele, Quebec, CA) Assignee(s): none reported Patent Number: 5,549,885 Date filed: February 3, 1995 Abstract: A pharmaceutical composition contains chlorhexidine and glutaraldehyde in a pharmaceutically acceptable carrier; in the form of a mouthwash, the composition is effective in controlling fungal or yeast infections in the oral cavity, such as associated with subjects suffering from AIDS, cancer and periodontal diseases; in particular the composition is effective against fungi of the genus Candida including Candida albicans and Candida krusei. Excerpt(s): This invention relates to a pharmaceutical composition and a method of treatment; more especially the invention is concerned with such a composition in the form of a mouthwash for treatment of fungal or yeast infections in the oral cavity; and with a method of treating subjects with fungal or yeast infections. Fungal or yeast infections in the mouth and throat are exhibited by patients suffering from AIDS, cancer and periodontal disorders. There is no satisfactory treatment for these infections. Web site: http://www.delphion.com/details?pn=US05549885__

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Composition and method for treatment of vaginal yeast infections Inventor(s): Reinhard; Mark S. (1148 Tillers Ridge Dr., Richmond, VA 23235), Burlingham; Byron T. (Greenville, NC) Assignee(s): Reinhard; Mark S. (Richmond, VA) Patent Number: 5,573,765 Date filed: August 13, 1994 Abstract: A composition for the treatment of vaginal yeast which promotes normal vaginal bacterial growth during treatment, comprising a yeast-inhibitory agent selected from one or more of the group consisting of ethylene glycol, propylene glycol, and glycerol, an effectively buffered aqueous acetate solution and cells of a Lactobacillus species. In the composition the concentration of acetate is effective to establish a pH of the composition in the range of from about 5 to about 7, the presence of unionized acetate inhibits yeast selectively compared to the bacteria, and the proportions of the yeast inhibitory agent and the buffering solution are effective to allow the active yeastinhibitor agent to inhibit the vaginal yeast Candida. A method of treatment of vaginal yeast while promoting normal vaginal bacterial growth, by intravaginal application of the composition described above, is disclosed. Excerpt(s): This invention relates generally to compositions having utility for the treatment of vaginal yeast while promoting normal bacterial growth, and to a method of treatment of vaginal yeast conditions. Yeast infections, also termed Candidiasis, moniliasis, or Monilia vaginitis, are among the most frequently occurring of vaginal infections. These vaginal infections are caused by fungus-like yeasts of the genus Candida (formerly Monilia), and specifically the species including C. albicans, C. tropicalis, C. psuedotropicalis, and C. stellatoidea. These Candida fungal microorganisms, also known as Monilia, normally grow and thrive at low concentrations in the mouth, gastrointestinal tract, and vagina, coexisting with the

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normal biological flora in these regions, without adverse effect on health or physiological function. In the vaginal the homeostasis between these Candida fungi and the normal vaginal flora nonetheless may be upset by changes in vaginal pH, or other conditions upsetting the vaginal equilibrium or otherwise lowering resistance to infection. Monilia overgrowth then may occur, resulting in a thick, white colored vaginal discharge which often is likened to cottage cheese in consistency, and associated with a strong odor. This condition occurs frequently in women during pregnancy, or as a result of conditions such as diabetes, treatment with antibiotics, steroids or immunosuppressive therapy, or hormonal changes occurring during the menstrual cycle. Web site: http://www.delphion.com/details?pn=US05573765__ •

Diagnosis of fungal infections with a chitinase Inventor(s): Laine; Roger A. (Baton Rouge, LA), Lo; Wai C. J. (Baton Rouge, LA) Assignee(s): Board of Supervisors of Louisiana State University and Agricultural and (Baton Rouge, LA) Patent Number: 5,587,292 Date filed: March 9, 1995 Abstract: A novel method for detecting chitin, and for diagnosing fungal infections (including yeast infections), with a chitinase or other chitin-specific binding protein. This method should allow the convenient, broad spectrum diagnosis of fungal infections in tissue samples or in body fluids. Fungal infections are a particular problem in immunocompromised hosts such as AIDS patients, where they can cause opportunistic infections. This invention overcomes difficulties experienced by prior methods of diagnosing fungal infections. Excerpt(s): This invention pertains to the diagnosis of fungal infections, particularly to the diagnosis of fungal infections with a chitinase. Fungal infections are a major problem today, particularly in immunocompromised hosts such as acquired immune deficiency syndrome (AIDS) patients. As many as five million people worldwide are currently, believed to be infected with the human immunodeficiency virus (HIV). HIV, a retrovirus, causes AIDS. AIDS is characterized by profound derangement in cellmediated immunity, leading to multiple opportunistic infections and unusual neoplasms. Opportunistic diseases are the predominant causes of morbidity and mortality in AIDS patients. Pneumocystis carinii pneumonia (PCP) is by far the most commonly reported (56%) opportunistic infection in AIDS patients in America and Europe. Pneumocystis carinii has recently been reclassified as a fungus according to molecular taxonomy. Twenty-four other infections and neoplastic diseases were listed as indicators of AIDS in the 1987 revision of the Center for Disease (CDC) case definition. In the 1988 revision of the definition of AIDS by CDC and the World Health Organization (WHO), candidosis of the esophagus, trachea, bronchi, or lungs and meningeal cryptococcosis were recognized as important "indicator" diseases. In the presence of laboratory evidence of HIV infection, disseminated coccidioidomycosis and histoplasmosis are also considered indicative of AIDS. It has been estimated that 58-81% of all AIDS patients contract a fungal infection at some time during the prodromal stage or after developing AIDS, and that 10-20% have died as a direct consequence of fungal infections. Major mycoses related to AIDS include candidosis, cryptococcosis (yeasts), histoplasmosis, and coccidioidomycosis (dimorphic fungi). Deep, severe, but relatively rare mycoses related to AIDS include penicilliosis, blastomycosis,

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paracoccidioidomycosis, sporotdchosis, aspergillosis, mucormycosis, yeast infections, and nocardiosis. Web site: http://www.delphion.com/details?pn=US05587292__ •

Liquid ear cleansing composition Inventor(s): Harless; Stanley J. (Omaha, NE) Assignee(s): Harlmen, Inc. (Omaha, NE) Patent Number: 4,769,171 Date filed: May 11, 1987 Abstract: A liquid ear cleansing composition for topical application to ears is disclosed. The composition has a pH of about 1.9 to about 2.7 and includes an acid buffer system. The composition also includes propylene glycol as a solvent, a thickening agent and a surface active agent. The ear cleansing composition is effective against yeast infections in dissolving ear wax and as a carrier material for topical application of antibiotics and steroids. Excerpt(s): The present invention relates to a liquid ear cleansing composition. More particularly, the present invention relates to a liquid ear cleansing composition comprising a buffered acid solution for eliminating yeast infections and dissolving ear wax. Yeast infections are a major problem among animals and humans and often develop as a result of administration of antibiotics given to treat other types of unrelated infections. Yeast infections are known to thrive in the environment that is created by administration of antibiotics. Yeast infections commonly occur in the ears or other orifices of the body and are presently treated by the topical application of a composition known to be harmful to the yeast organism. One such composition used to treat yeast infections is a mixture of vinegar and water, the active ingredient of which is acetic acid. It has been found that an acidic environments of this type tend to eliminate yeast infections. Web site: http://www.delphion.com/details?pn=US04769171__

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Method for reducing dental plaque and pellicle precursor of plaque Inventor(s): Miller, Jr.; Taylor C. (Montgomery, AL) Assignee(s): Cameo, Inc. (Toledo, OH) Patent Number: 4,258,028 Date filed: August 27, 1979 Abstract: A method for reducing dental plaque, pellicle and infections of the teeth, the present invention essentially comprises application of an effective amount of nundecylenic acid or an effective substitute therefor according to the invention to the teeth, gums and mouth. The effective ingredient employed according to the method of the invention can either be applied directly to the teeth and tissues in a substantially inert carrier such as in a dentifrice paste for personal oral use or can be applied directly by a dental practitioner. Practice of the present method improves the condition of the gums and other tissues of the mouth, acts to prevent yeast and other infections, reduces the incidence of tooth decay caused by parasitic bacteria, reduces the bacteria count in the mouth to provide a more hygienic oral environment, substantially reduces plaque

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formation present on the teeth prior to treatment according to the invention, and essentially acts to prevent new plaque from forming on the teeth with continued treatment. The method employs treatment of the teeth by brushing or irrigating with a dental preparation containing an active ingredient comprising up to about two percent undecylenic acid and up to about 20 percent by weight of zinc undecylenate based on the total dental preparation. Excerpt(s): The invention generally relates to treatment methods for the improvement of the health of the teeth, gums, and mouth, the invention particularly providing methods for the reduction and prevention of pellicle and plaque on the teeth and of infections of the teeth, gums, and mouth. Proper oral hygiene as presently practiced requires that the substance known as "plaque" which forms on the surfaces of the teeth be removed in order to eliminate a source of potential injury to the teeth and gums as well as to allow usual oral hygiene methods to be more effective. The removal of plaque is, therefore, not for cosmetic purposes although such purposes are also served when plaque is removed from the teeth. Prior methods for removing plaque have essentially been mechanical in nature, the toothbrush being used for personal hygiene by the patient. Abrasive compounds are also applied by the dentist to the teeth by rotary "polishing" instruments which mechanically "scour" plaque from the teeth. These prior treatments, while effective, at best only eliminate the gross build-up on the teeth, thin layers of plaque remaining after such treatments due to the undesirability of grinding or abrading the enamel surfaces of the teeth which can result from a too enthusiastic practice of the prior methods. The necessity for plaque control is due to the very nature of this rather complex material. Essentially, pellicle, a precursor of plaque, deposits in rough areas or at or under the free margin of the gingiva. Plaque is generally considered to be a deposit of material on the surface of a tooth, the deposit usually being a growth of bacteria. Plaque also acts as a nucleus for formation of a dental calculus which typically comprises calcium phosphate, calcium carbonate, and organic matter which forms as a deposit on the surface of the teeth. Plaque has different forms and combinations of forms depending on individual oral conditions, the syndrome typically referred to as plaque usually not being recognized as having the complexity which it exhibits. The complex nature of plaque is elucidated only partially by an appreciation of the fact that plaque can be at least partially bacterial and/or fungal in nature as well as being an actual deposit of inorganic and organic materials. The very complexity of the syndrome referred to as plaque has caused the dental practitioner to feel the need for even more effective treatment and preventative tools than have heretofore been available. The present invention provides such a tool and, concurrently, provides treatment methods otherwise useful for generally treating oral infections, including yeast infections, and for maintaining a high level of oral health. In particular, practice of the present invention acts to reduce tooth decay and gum diseases inter alia by reducing the bacteria count in the mouth, the reduction of the bacteria count to a desired and safe level due to the present methods being one cause for the reduction of tooth decay and gum diseases provided by the invention. Web site: http://www.delphion.com/details?pn=US04258028__

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Method for treating fungal infections Inventor(s): Shih; Chuan (Carmel, IN), Williams; Daniel Charles (Fishers, IN) Assignee(s): Eli Lilly and Company (Indianapolis, IN) Patent Number: 6,180,679 Date filed: October 20, 1999 Abstract: The present invention provides a method for controlling fungal growth, mycotic infections, yeast infections and parasitic infections using a therapeutically effective amount of a compound selected from Compounds (I-V). Further provided is a method for providing mdr inhibition using a therapeutically effective amount of a compound of formula (IA). Also provided is an antifungal composition comprising at least five percent (5%) by weight of a compound selected from Compounds (I-V). Excerpt(s): This invention relates to the fields of pharmaceutical and organic chemistry and provides cryptophycin compounds useful for treating fungal infections. The incidence of serious, life-threatening, fungal infections is increasing at an alarming rate. The number of Candida albicans bloodstream infections in non-teaching hospitals increased by 370% between 1980 and 1990. At the same time the incidence of bloodstream infections by C. albicans in teaching hospitals increased by 487% in the same time period. With the exception of coagulase negative staphylococci, statistically, C. albicans represents the fastest growing area of concern in hospital acquired bloodstream infections (Banerjee et al., 1991, American Journal of Medicine 91 (3B): 86S89S). The rising incidence of nosocomial fungal infections is being fueled by changing medical practices, including invasive surgical procedures addressing such problems as joint replacement and open heart surgery, increased use of cancer chemotherapy, and the AIDS epidemic. All of these processes compromise the immune system and provide an environment in which fungal infections can be established. Web site: http://www.delphion.com/details?pn=US06180679__

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Method for treating hoof thrush and hoof rot Inventor(s): Pavlich; Frederick M. (300 Crestview Dr., Fox River Grove, IL 60021) Assignee(s): none reported Patent Number: 4,859,694 Date filed: February 10, 1988 Abstract: This invention relates to a new and unexpectedly effective method of treating and preventing the recurrence of thrush, a disease of the hoof and frog tissue, in horses. The method comprises administering a therapeutically effective amount of metronidazole in a carrier directly on a thrush infected area for a treatment period effective to cure the thrush infection. The method may also be applied to the treatment of the analogous hoof disease in sheep, goats and cattle known as hoof rot. Excerpt(s): This invention relates to a method of treating hoof thrush in horses and the analogous disease of hoof rot in sheep and cattle. Hoof thrush is a disease of the hoof and frog tissue in horses caused by a variety of pathogens, primarily Spherophorus necrophorus, an anaerobic bacterium. Hoof rot is the analogous hoof disease in sheep, goats and cattle also primarily caused by Spherophorus necrophorus. Merck Veterinary Manual, 6th Edition, Fraser, C. M., Ed. (1986) at pp. 983-84; Ensminger, M. E., The stockman's Handbook, 1st Ed., The Interstate Printers and Publishers (1955) at p.378-79;

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The Sheepman's Production Handbook, Scott, G. E., Ed., Abegg Printing (1970) at pp. 104-105. Most manure and dirt contains this bacterium and if allowed to pack into the foot and remain for very long, it will attack the hoof. Regular cleaning of the hoof prevents thrush from getting started by allowing air to reach the exposed area. Butler, D., Principles and Practice of Horseshoeing, Butler Publishing, (1974) at p. 176. Thrush is common in horses and poses a constant problem for owners and grooms. Horses that are particularly susceptible are those that are confined for most of their day and not exercised to a reasonable degree. The predisposing causes of thrush are thus unhygienic conditions, dirty uncleaned feet and lack of frog pressure resulting from poor shoeing or poor foot trimming. Adams, O.R., Lameness in Horses, 2nd Ed., Lea & Febiger (1966) at p. 354. The diagnostic signs of thrush disease (and similarly of hoof rot disease) include: (1) a strong, unpleasant odor and an increased amount of moisture associated with the hoof and frog tissue; (2) a black discharge from the sulcae of the frog tissue; (3) a softening and destruction of the frog tissue (a "cheesy" appearance of the frog); and (4) lameness. Diagnosis of hoof thrush in horses is based primarily on the odor and physical characteristics of the black discharge in the sulci of the frog. If thrush is not diagnosed and steps taken to treat it, extensive damage to the horse's foot may occur. In severe cases, the thrush infection may penetrate the horny tissues and involve the sensitive structure of the foot. In such cases, the prognosis is poor. The horse may be lame and the foot may show the same signs of infection that would be encountered in puncture wound of the foot. Adams, O.R., supra at p. 355. Similarly with hoof rot, the hoof rot infection may penetrate the horny tissues and the sheep, goat or cow infected may be lame, joint cavities may be involved, and the animal may show fever and depression, lose weight, and even die. The Stockman's Handbook, supra, at p. 378. Web site: http://www.delphion.com/details?pn=US04859694__ •

Method of treating candida and cryptococcus fungal infections by administering gentian Inventor(s): Chen; Yu (1520 Taylor Ave., Baltimore, MD 21234) Assignee(s): none reported Patent Number: 5,837,254 Date filed: November 14, 1996 Abstract: A method and preparations for the treatment of vaginal yeast and other yeast infections is provided for the treatment of infections caused by candida albicans and cryptococcus neoformans. The method and preparations of the invention can also be used for other yeast and fungal infections including systemic, mucosal and cutaneous caused by candida and cryptococcus. The vaginal antiyeast and antifungal preparations include, in addition to suppositories and mouth washes, troches, lotions, creams, tablets and capsules containing gentian preparations as an active ingredient obtained from the, plant Radix gentianae Longdancao other active ingredients which may also be present are American Radix Ginseng, Radix Scutellariae Basica Lensis and Fructus Gardeniae Jasminoidis. For systemic fungal infections gentian preparations from the plant Radix gentianae Longdancao are taken orally in the form of lozenges, tablets, capsules or in solution form for gargling or swallowing. The novel gentian preparations also can be applied topically for cutaneous yeast infections and are administered in the form of suppositories, lozenges and creams to treat mucosal yeast infections. The gentian oral preparations of the invention are capable of passing through the blood brain barrier as demonstrated by the cure of meningitis caused by cryptococcus in AIDS patients. The

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treatment and novel compositions of the invention are effective in controlling fungal and yeast infections in two days to two weeks and provide a non-toxic treatment of vaginal yeast and other fungal infections caused by cryptococcus and candida. Excerpt(s): The present invention pertains to a method and novel compositions containing gentian from the gentianaceae family of plants for the treatment of vaginal yeast infections and other fungal infections caused by various fungal and yeast forms such as candida and cryptococcus. More particularly, the invention pertains to novel compositions and preparations obtained from the root of the plant having the pharmaceutical name of Radix gentianae Longdancao for the treatment of vaginal yeast infections and other fungus and yeast infections caused by candida albicans and cryptococcus. The plant Radix gentianae Longdancao is also known by the botanical names Gentiana scabra Bge, Gentiana triflora Pall, Gentiana manshurica Kitag, Gentiana algida Pall, Gentiana regescens Fransh and Gentiana lutea which will be referred to collectively as Radix gentianae Longdancao. Radix gentianae Longdancao may be used to prepare novel antifungal preparations and novel medicaments in the form of topical creams, liquids, lotions, capsules, lozenges and suppositories. The novel preparations from Radix gentianae Longdancao may be applied topically or transmucosally to treat cutaneous and mucosal syndromes caused by candida infection or taken internally in the form of lotions, liquids, tablets and capsules for the treatment of systemic candida and cryptococcus infections. The novel method of treatment of candida and cryptococcus infection with novel preparations from Radix gentianae Longdancao is effective in treating not only cutaneous and mucosal candidiasis but also systemic candidiasis involving the bloodstream and metastatic invasion of the meninges, bones, joints, peritonium and myocardium. The novel Radix gentianae Longdancao preparations, when taken internally, pass through the digestive system and enter the blood stream for the treatment of systemic candida infections and pass the blood brain barrier to treat meningeal candidiasis and cryptococcus meningitis in AIDS patients. The novel preparations of the invention do not require injection or IV application for the treatment of fungal infections of candida albicans, candida tropicalis and other candida species referred to collectively as candida and cryptococcus neoformans and other cryptococcus species collectively referred to as cryptococcus. The novel Radix gentianae Longdancao preparations are advantageous over the prior art since they are nontoxic to the patient and may be utilized in patients having weak or compromised immune systems such as in the case of AIDS patients, leukemia, Hodgkin's disease, neutropenia, hematologic diseases and endocrinopathies. Web site: http://www.delphion.com/details?pn=US05837254__ •

Methods and kits for treating vulvovaginal candidiasis with miconazole nitrate Inventor(s): Upmalis; David H. (51 Declaration Dr., Newtown, PA 18940) Assignee(s): none reported Patent Number: 6,153,635 Date filed: November 20, 1998 Abstract: A method for treating vulvovaginal candidiasis including the steps of: (a) administering a single dose of an effective amount of miconazole nitrate in a pharmaceutically acceptable carrier intra-vaginally; and (b) applying miconazole nitrate in a pharmaceutically acceptable carrier to the vulva. Also a kit for the treatment of vulvovaginal candidiasis including: (a) a single dose of an effective amount of miconazole nitrate in a pharmaceutically acceptable carrier and in a form adapted to be

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administered intra-vaginally; and (b) an amount of miconazole nitrate in a pharmaceutically acceptable carrier adapted to be applied topically to the vulva. Excerpt(s): The present invention relates to methods for the treatment of vulvovaginal candidiasis with miconazole nitrate and more particularly to methods for the treatment of vulvovaginal candidiasis employing a single dose of miconazole nitrate applied intravaginally and additional doses of miconazole nitrate applied topically to the vulva. Vulvovaginal candidiasis is a relatively common form of yeast infection. Treatment of vulvovaginal candidiasis with the anti-fungal composition miconazole nitrate is well known. The most common regimen of treatment of vulvovaginal candidiasis with miconazole nitrate comprises the intra-vaginal application of a cream or other pharmaceutically acceptable carrier containing miconazole nitrate once a day for 1, 3 or 7 days depending upon the concentration of miconazole nitrate in the cream. Thus, commercial kits for the treatment of vulvovaginal candidiasis with miconazole nitrate comprise a supply of vaginal suppositories or cream containing miconazole nitrate and a suitable applicator for administering the miconazole nitrate intra-vaginally. While these methods of treating vulvovaginal candidiasis are highly effective, there is a certain amount of discomfort and inconvenience for the patient in having to repeatedly administer the miconazole nitrate intra-vaginally. Both of these disadvantages can affect patient compliance and, therefore, the effectiveness of the treatment. In addition, relief of symptoms can take 4-5 days or more. Web site: http://www.delphion.com/details?pn=US06153635__ •

Micro-encapsulated lactobacilli for medical applications Inventor(s): Ford; Larry C. (Irvine, CA) Assignee(s): Lafor Laboratories Limited (Newport Beach, CA) Patent Number: 5,733,568 Date filed: June 2, 1995 Abstract: Micro-encapsulated lactobacilli bacteria are orally administered to mammals, including humans, to treat or prevent antibiotic associated or other chronic or acute diarrhea. Micro-encapsulated lactobacilli bacteria are topically administered to the skin to treat or prevent recurrent skin infections, and are administered intra-vaginally to treat or prevent vaginal yeast infections. Excerpt(s): The present invention is directed to a pharmaceutical composition in the form of capsules, tablets, creams, foams, ointments, powders, suppositories or the like containing micro-encapsulated lactobacilli for oral, topical and intra-vaginal administration for the treatment or prevention of antibiotic associated diarrhea, skin and vaginal infections. Antibiotic associated diarrhea is a common side effect of broad spectrum anti-bacterial therapy, and is believed to be due to a shift in intestinal flora as a result of therapy with antibiotics, and particularly due to loss of lactobacilli in the intestinal flora. This condition can become life-threatening to the patient and is very difficult to treat when it is caused by a Clostridium difficile bacterical infection. It has been attempted in the prior art to treat antibiotic associated diarrhea with oral administration of lactobacilli. This type of therapy, however, has been proven to be of only limited success, for two primary reasons. First, orally administered lactobacilli, in accordance with the prior art, are exposed to the destructive action of gastric acid. Therefore only an inadequately small number of viable lactobacilli tend to reach the lower intestinal tract where they would be needed to reestablish a healthy lactobacilli

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flora. Second, transient lactose intolerance is frequently found in persons suffering from antibiotic associated diarrhea. (The temporary lactose intolerance is attributed by those skilled in the art to the loss of the brush border of the intestinal villa, caused by the antibiotic.) Moreover, this type of transient lactose intolerance frequently occurs even in persons who, otherwise under normal conditions, have no prior history of dairy product or lactose intolerance. Lactobacilli preparations in accordance with the prior art usually contain traces or remnants of the media in which the lactobacilli bacteria were grown and therefore contain lactose, lactulose and other disacharides. These in turn, upon reaching the lower intestines of persons suffering from antibiotic associated diarrhea, tend to make worse the transient lactose intolerance condition. In light of the foregoing, there is room for improvement in the prior art. More particularly, there is room in the prior art for improvement of pharmaceutical compositions and methods for the treatment of antibiotic associated diarrhea, and also for treatment or prevention of certain skin and vaginal infections. The present inventions provides such improvements. Web site: http://www.delphion.com/details?pn=US05733568__ •

Nucleic acid probes for candida parapsilosis and methods for detecting candidiasis in blood Inventor(s): Morrison; Christine J. (Atlanta, GA), Lott; Timothy J. (Atlanta, GA), Reiss; Errol (Chamblee, GA), Zakroff; Sandra (Clarkston, GA), Lasker; Brent (Atlanta, GA) Assignee(s): United States of America (Washington, DC) Patent Number: 5,688,644 Date filed: April 26, 1995 Abstract: Provided is an isolated double-stranded nucleic acid consisting essentially of the nucleotide sequences defined in the Sequence Listing by SEQ ID Nos:5-9. These are the ITS2 sequences for C. albicans, C. parapsilosis, C. tropicalis, C. glabrata and C. krusei. A method of diagnosing systemic candidiasis in a subject is also provided. The method comprises the steps of: (a) collecting blood from the subject into tubes containing detergent, polypropylene glycol, sodium poyantholesulfonate, and sodium ethylene diamine tetraacetic acid; (b) lysing Candida cells using ZYMOLYASE.RTM.100T.TM. enzyme mixture with agitation; (c) extracting and precipitating the DNA from the lysed cells; (d) amplifying the precipitated DNA using universal fungal primer pairs derived from the internal transcribed spacer regions of the Candida ribosomal DNA; and (e) detecting amplified DNA from Candida by hybridizing the amplified DNA with a probe that selectively hybridizes with Candida DNA, the presence of amplified DNA indicating systemic candidiasis. Excerpt(s): Candida albicans is a commensal of the gastrointestinal tract. C. albicans, and to a lesser extent several other related species, are of increasing importance as opportunistic pathogens in immunocompromised hosts. A dimorphic, diploid yeast with no known sexual cycle, C. albicans is an endogenous organism that can be isolated from skin and mucosal tissues of persons whose immune systems are intact. However, perturbations of the immune or endocrine systems can create opportunities for Candida species to convert from a commensal state to invade tissues either locally or systemically. An example of this opportunism is the oral-esophageal or vaginal candidiasis that is encountered in association with HIV infection. In C. albicans, the nuclear rDNA genes encoding the 5S, 18S, 5.8S, and 28S rRNAs are found as 50-100 copy tandem repeats of approximately 10 kb unit length on chromosome seven (Magee et al., 1987, Thrash-Bingham and Gorman, 1992). The 5S rDNA gene (121 bp) is flanked by two

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nontranscribed regions located between the small and large subunits, and collectively termed the intergenic spacer (IGS). Ribosomal 5.8S sequences have been compiled from a variety of eukaryotes (Dams et al., 1988). In addition, sequence analysis of the 5.8/28S internally transcribed spacer (ITS) region has shown strain variation within at least one fungal species (O'Donnell, 1992), while other species have demonstrated complete conservation (Mitchell et al., 1992). Strain-specific restriction polymorphisms (RFLPs) have previously been observed in the IGS region for C. albicans (Magee et al., 1987). An opportunistic fungus, C. albicans also causes systemic disease in severely immunocompromised hosts. It is the most causative species of disseminated candidiasis followed by C. tropicalis, C. parapsilosis, and C. glabrata (Odds, 1988). Dissemination occurs when Candida is spread via the bloodstream or by invasion of mucosal surfaces to internal organs (Odds, 1988). High-risk patient populations include individuals with malignancy or neutropenia, those receiving chemotherapy and/or multiple antibiotics, and those with indwelling catheters or low birth weight infants (Armstrong, 1989). Web site: http://www.delphion.com/details?pn=US05688644__ •

Replication-competent recombinant viral vaccines and method of producing same Inventor(s): Feinberg; Mark (San Francisco, CA), Reilly; Patricia Anne (Glen Rock, NJ), Weeks-Levy; Carolyn Louise (Valhalla, NY), Andino; Raul (New York, NY) Assignee(s): Whitehead Institute for Biomedical Research (Cambridge, MA), American Cynamid Company (Parsippany, NJ) Patent Number: 5,965,124 Date filed: January 31, 1995 Abstract: Replication-competent recombinant viruses, particularly replicationcompetent recombinant polioviruses, which include (1) exogenous nucleic acid sequences which encode an exogenous polypeptide and (2) a nucleic acid sequence which encodes an artificial proteolytic cleavage site for a viral or cellular protease which proteolytically processes (cleaves) the precursor protein produced by the parent virus and uses therefor. The recombinant precursor is cleaved into the usual array of constituent proteins, freeing the exogenous polypeptide. Replication-competent recombinant viruses are useful as vaccines against bacterial, viral, fungal and yeast infections, parasitic diseases, cancer and allergies. Excerpt(s): Presently, there are many types of vaccines used to immunize individuals against disease. Although those available are generally safe and, at least to some extent, effective in inducing an immune response, all have limitations. In addition, for some diseases, there is no effective vaccine. The development of alternatives to presentlyavailable vaccines and of new vaccines to protect against diseases for which no vaccine is currently available would be an important step in reducing the morbidity and mortality caused by many diseases. The present invention relates to replicationcompetent recombinant viruses which include exogenous nucleic acid sequences which encode an exogenous polypeptide or protein which is expressed as a component of a recombinant polyprotein precursor which is subsequently proteolytically processed by viral and/or cellular enzymes. As a result, the encoded exogenous polypeptide is released. The replication-competent viruses can be animal (non-human) viruses (e.g., vertebrate or mammalian viruses), human viruses, or plant viruses. It further relates to replication-competent recombinant viruses, particularly polioviruses, in which the recombinant genome includes an exogenous nucleic acid sequence (or sequences) encoding an exogenous polypeptide or polypeptides to be expressed and one or more

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nucleic acid sequences encoding the corresponding number of artificial proteolytic cleavage sites and which express the encoded polypeptide(s) and induce production of antibodies specific for the polypeptide(s) in a mammal into which they are introduced. Appropriately selected replication-competent viruses are useful to deliver the exogenous protein to an individual, such as a vertebrate, particularly mammals and even more particularly, humans into whom they are introduced. In the case of a plant virus, for example, a replication-competent plant virus can be inserted into seeds or the plant at another stage in its development in such a manner that the encoded exogenous polypeptide is expressed and processed. Such an exogenous polypeptide can be used, for example, to protect the plant against disease or attack by insects. The plants can be used to deliver the vaccine by oral consumption. The replication-competent recombinant viruses of the present invention include a wide variety of types of viruses, such as picornaviruses (e.g., enteroviruses, poliovirus, foot and mouth disease virus (FMDV), rhinovirus, echoviruses, Hepatitis A virus), Togaviruses (e.g., Sindbis virus and rubella virus), and Flaviviruses (e.g., yellow fever virus). The type of virus used is determined in part by the target exogenous antigen(s) to be expressed, the route by which the resulting recombinant viruses are to be administered, and the character of the immune response desired. Web site: http://www.delphion.com/details?pn=US05965124__ •

Serologic test for systemic candidiasis Inventor(s): Evans; George L. (Hopatcong, NJ), Protzman; Walter P. (Hopewell, NJ) Assignee(s): Schering Corporation (Kenilworth, NJ) Patent Number: 4,051,232 Date filed: August 12, 1975 Abstract: An in vitro test method for the diagnosis of systemic candidiasis in mammals is carried out with an antigen solution containing a specified concentration and ratio of protein antigen and mannan antigen whereby false readings are reduced. Excerpt(s): This invention relates to an in vitro test method for the diagnosis of systemic candidiasis. It additionally relates to a test plate and kit for this purpose. Systemic infections in mammals due to the Candida species of yeast have been recognized since the 1860's. In particular, Candida albicans is well-known as an ubiquitous opportunistic yeast that can cause fatal systemic infections in compromised hosts. The increasing use of antibiotics, chemotherapy, open heart surgery, transplants, indwelling catheters, and in general, the prolonging of life of seriously ill people has enabled systemic fungal infections to become much more prevalent. Should a reliable ddiagnosis of systemic candidiasis be made, then aggressive therapy could be promptly instituted. Since agents against systemic candidiasis, such as amphotericin B, have serious side effects, it is important not to begin such chemotherapy unless clearly warranted. Web site: http://www.delphion.com/details?pn=US04051232__

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Single blood test for detection of food allergy, candidiasis, microflora imbalance, intestinal barrier dysfunction and humoral immunodeficiencies Inventor(s): Vojdani; Aristo (Los Angeles, CA) Assignee(s): Immunosciences Lab, Inc. (Beverly Hills, CA) Patent Number: 6,103,480 Date filed: January 14, 1999 Abstract: A method for determining a cause for digestive and immune disorders is disclosed. The method determines the levels of antibodies against normal intestinal microflora and food antigens. It then compares the results to normal levels to determine the cause. The test can be used to diagnose food allergy or intolerance,microflora imbalance, gut barrier dysfunction, bacterial translocation, immunodeficiencies, candidiasis and autoimmunities. Excerpt(s): It is increasingly evident that human diseases are most often related to lifestyle, and should in theory be preventable. The stress of modem life, our reduced physical activity, and our consumption of manipulated and processed foods, and of chemicals--including pharmaceuticals--all contribute to our decreasing resistance to disease. Much evidence supports the fact that our genes, adapted during millions of years to the lifestyle of our prehistoric ancestors, tolerate poorly the dramatic changes in lifestyle that have occurred, especially in food habits during the past 100 years. Changes in food habits in Western countries that no doubt constitute stresses to the human body and that may predispose to inflammatory, infectious, ulcerative, degenerative, and neoplastic diseases include the following: the consumption of 100 lb refined sugar per individual per year; the 10-fold increase in sodium consumption; the fourfold increase in consumption of saturated fat; the doubled consumption of cholesterol; a much reduced consumption of vegetable fibres, and of minerals such as potassium, magnesium, calcium, and chromium; and a considerable reduction in consumption of omega-3 fats, membrane lipids, vitamins, and antioxidants. In severe disease, important food ingredients, such as arginine, glutamine, taurine, nucleic acids, vitamins, and antioxidants, such as glutathione, are often not supplied in large enough quantities. Perhaps even more important than the decrease in these food ingredients, is the fact that prehistoric food contained several thousand times more bacteria, mainly the so called probiotic bacteria. Prehistoric methods of food preservation were either drying, or, more commonly, storing in holes dug into the ground, where the food became naturally fermented. This is how Stone Age man learned to produce most of our still common fermented foods, such as beer, wine, green olives, and sauerkraut. Our modern lifestyle has dramatically reduced the availability of foods produced by natural fermentation. After the early identification of microbes, bacteria were regarded mainly as a source of disease, and unwanted in commercially manufactured food. Furthermore, the desire of the food industry to prolong shelf life promoted alternative production methods such as the use of enzymes instead of live bacteria. Combined with extensive hygiene measures practiced during delivery and in childcare, children in Western societies may have difficulty developing a satisfactory protective indigenous gut flora. It is not known, but suspected, that this could be connected to the increasing incidence of allergy, and infections seen among Western children. A series of studies were published about an ethnic group in New Guinea with a dramatically different diet to that of people in the Western world. This diet contained no processed foods like butter, margarine, lard, oils, refined sugar, or alcohol. Instead, the group's diet was rich in fibre, water, vitamins, minerals, and omega-3 fats such as docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA). Despite the fact that about 80% of the population smokes and has a heavy

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consumption of saturated fat from coconut, cerebrocardiovascular diseases are virtually absent and the incidence of diabetes and cancer is very low. The condition and function of the gastrointestinal (GI) tract are essential to our well being. After the respiratory tract, the GI tract constitutes the second largest body surface area, described to be somewhere between 250 and 400 m.sup.2, or comparable in size to a tennis court. During a normal lifetime 60 tons of food pass through this canal, which is important for well being, but also constitutes an enormous threat to the integrity of the digestive tract and the whole body. It is not surprising, therefore, that this organ is often affected by inflammatory diseases and cancer. The continuous challenges to the GI surfaces might be why most of the surface cells have a rapid turnover; most are replaced after three to four days in man and sometimes earlier in animals. Furthermore, the surface is protected by large quantities of important secretions, from saliva in the oral cavity to colonic secretion in the large bowel. These secretions contain factors of great importance for the lubrication of the mucosa and for functions of the GI tract, but also hundreds of ingredients of importance for intraluminal microbial defense. The secretory functions are extremely sensitive to foreign chemicals. About 50% of the 2000 pharmaceutical drugs registered in Sweden have reported GI side effects, for example, mouth dryness, nausea, vomiting, diarrhea, and constipation. It is hoped that future medicine will be more restrictive in the use of pharmaceuticals in general, and will use drugs with as few side effects as possible. Web site: http://www.delphion.com/details?pn=US06103480__ •

Thrush treatment composition and method Inventor(s): Stadtmueller; Ludwig A. (1232 Cambridge Ave., Plainfield, NJ 07062) Assignee(s): none reported Patent Number: 5,000,954 Date filed: October 27, 1989 Abstract: The present invention is directed to a composition of matter for and method of treating thrush and other equine infections. The composition includes the following: a. about 20% to about 35% by weight of formaldehyde and/or an active derivative thereof; b. about 5% to about 20% by weight of turpentine; c. about 10% to about 25% by weight of gentian violet; d. balance being an oily diluent. The preferred diluent is mineral oil. The method involves applying an effective amount of the composition to the diseased area. Excerpt(s): The present invention is directed to a composition for the treatment of thrush, such as equine thrush, and a method of treating thrush. The composition includes three critical elements including formaldehyde or its derivative, turpentine and gentian violet, along with a diluent. The method of the present invention involves using an effective amount of the composition, either topically or otherwise, on the affected area. Thrush is a well known and long recognized suppurative disease which spreads over time on affected areas of an animal such as a horse or donkey, destroying the frog and leaving open sores which eventually create significant pain and tenderness to the animal. Many treatments have been developed over the years and some utilize formalin or formaldehyde while others use metalo-organic compounds such as copper niacyanate. While these compositions treat some of the symptoms of thrush effectively, they do not always eliminate the thrush and frequently require multiple treatments before being effective. The present invention composition and method have been found to frequently totally eliminate thrush with a single application.

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Web site: http://www.delphion.com/details?pn=US05000954__ •

Tissue moisturizing and antimicrobial compositions Inventor(s): Mitra; Sekhar (Cincinnati, OH), Deckner; George Endel (Cincinnati, OH) Assignee(s): The Procter & Gamble Company (Cincinnati, OH) Patent Number: 5,686,089 Date filed: October 16, 1995 Abstract: The present invention relates to improved topical pharmaceutical compositions having improved aesthetics which are useful for imparting antimicrobial actives. In particular, it relates to topical moisturizing compositions containing one or more antimicrobial active compounds. These compositions are also useful for providing relief from symptoms associated with, for example, vaginal yeast infections. Excerpt(s): The present invention relates to improved topical pharmaceutical compositions having improved aesthetics which are useful for imparting antimicrobial actives. In particular, it relates to topical moisturizing compositions containing one or more antimicrobial active compounds. These compositions are also useful for providing relief from symptoms associated with, for example, vaginal yeast infections. Several environmental and pathologic conditions produce drying or desiccation of membranous tissue of the mammalian body. These conditions produce dry mouth (xerostomia), dry eye (sicca conditions) and dry vaginal, dry nasal or dry rectal mucosa, and/or dry skin that are aesthetically unpleasing and/or irritating to the individuals having such conditions. One method for moisturization of dry tissue uses an oily substance as the principal ingredient in the form of creams, lotions, or salves that are applied to the affected tissue in an attempt to prevent further dehydration of the tissue. They act by placing a water-impermeable hydrophobic barrier over the treated tissue. Petrolatum, mineral oil, lanolin and isopropyl myristate are examples of hydrophobic materials so used. These preparations alone provide only symptomatic relief. In addition, they impart a greasy, sticky feel to the skin and stain clothing. Web site: http://www.delphion.com/details?pn=US05686089__

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Topical treatment of fungal or yeast infections using p-tolyl diiodomethyl sulfone Inventor(s): Smith; Robert A. (Lindenhurst, IL) Assignee(s): Abbott Laboratories (North Chicago, IL) Patent Number: 4,185,120 Date filed: October 2, 1978 Abstract: By incorporating p-tolyl diiodomethyl sulfone into a topically acceptable base, the growth of yeast or fungi on the skin of warm-blooded animals can be alleviated, reversed or eliminated. Excerpt(s): Many warm-blooded animals, including humans, are often plagued with skin infections caused by certain yeasts or fungi that seem to survive and grow on such skin. Infections of this type are difficult to treat as they often resist treatment with antibacterials and/or antibiotics. Human fungal infections are normally separated into two classes: deep systemic mycoses, and superficial fungal infections. The most prevalent superficial infection is athlete's foot (dermatophytosis of the foot, tinea pedis).

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A third class of dermatophytic infection, or at least a somewhat different type, might be infections of the mucous membranes caused by trichomonal or monilial organisms. These types of vaginitis can be caused by a number of factors that predispose the tissue to infection by the monilial form, Candida albicans, such as prolonged use of tetracyclines, steroid therapy, diabetes and pregnancy. Most of the common pathogens associated with tinea pedis as well as with vaginitis, C. albicans, have been shown to succumb to very small amounts of TDS by in vitro studies. The present invention is therefore directed to alleviating skin infections caused by the more commonly recognized skin pathogens. Web site: http://www.delphion.com/details?pn=US04185120__ •

Treatment of female sexual dysfunction Inventor(s): Bennett; Sean R. (Denver, CO), Wilson; Leland F. (Menlo Park, CA), Spivack; Alfred P. (Menlo Park, CA), Gesundheit; Neil (Los Altos, CA), Hanamoto; Mark S. (Belmont, CA), Doherty, Jr.; Paul C. (Cupertino, CA), Place; Virgil A. (Kawaihae, HI) Assignee(s): ASIVI, LLC (Mountain View, CA) Patent Number: 6,306,841 Date filed: March 30, 2000 Abstract: Methods and formulations for treating female sexual dysfunction are provided. A pharmaceutical composition formulated so as to contain a selected vasoactive agent is administered to the vagina, vulvar area or urethra of the individual undergoing treatment. Suitable vasoactive agents are vasodilators, including naturally occurring prostaglandins, synthetic prostaglandin derivatives, endothelial-derived relaxation factors, vasoactive intestinal polypeptide agonists, smooth muscle relaxants, leukotriene inhibitors, and others. The formulations are also useful for preventing the occurrence of yeast infections, improving vaginal muscle tone and tissue health, enhancing vaginal lubrication, and minimizing excess collagen deposition. A clitoral drug delivery device is also provided. Excerpt(s): This invention relates generally to methods and pharmaceutical formulations for treating female sexual dysfunction, and more particularly relates to vaginal, vulvar and/or urethral administration of a vasoactive agent, such as a prostaglandin, in such treatment. The invention further relates to additional methods of using the present pharmaceutical formulations, including, but not limited to, the prevention of yeast infections and the improvement of vaginal muscle tone. Sexual response in women is generally classified into four stages: excitement, plateau, orgasm, and resolution. Masters and Johnson, Human Sexual Response (Boston, Mass.: Little, Brown & Co., 1966). With sexual arousal and excitement, vasocongestion and muscular tension increase progressively, primarily in the genitals, and is manifested by increased blood flow, elevated luminal oxygen tension, and vaginal surface lubrication as a result of plasma transudation that saturates the fluid reabsorptive capacity of the vaginal epithelium. Vasoactive intestinal polypeptide ("VIP") release may induce the physiological changes of sexual arousal and excitement, and may be the major neurotransmitter that participates in the innervation of the vaginal blood supply. Peptide histidine methionine has been co-located with VIP within nerve fibers that innervate small blood vessels, smooth muscle and epithelial cells in the vaginal tract. Sexual excitement is initiated by any of a number of psychogenic or somatogenic stimuli and must be reinforced to result in orgasm. With continued stimulation, excitement

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progresses in intensity into a plateau stage, from which the individual can shift into orgasm. The orgasmic stage is characterized by a rapid release from vasocongestion and muscular tension. Web site: http://www.delphion.com/details?pn=US06306841__ •

Use of polyols in combating yeast infection and polyol preparations for said use Inventor(s): Vargas Munita; Sergio Luis (Santiago, CL), Pearson; Julita (Kent, GB), Virkki; Markku (Espoo, FI), Pepper; Tammy (Weybridge, GB), Saunders; David (Farnham, GB) Assignee(s): Xyrofin Oy (Kotka, FI) Patent Number: 6,414,035 Date filed: September 25, 2000 Abstract: The invention relates to the use of polyols such as xylitol for the preparation of a composition to be administered in the treatment or prophylaxis of mucosal yeast infection in mammals, as well as to preparations for use in the systemic or topical therapeutic or prophylactic treatment of mucosal yeast infections. The invention relates specifically but not solely to the combating of infections caused by Candida s.p. in mucosa in connection with exocrine glands of the mammalian body. Excerpt(s): The present invention relates to the use of polyols such as xylitol for the preparation of a composition to be administered in the treatment or prophylaxis of mucosal yeast infection in mammals, as well as to preparations for use in the systemic or topical therapeutic or prophylactic treatment of mucosal yeast infections. The invention relates specifically but not solely to the combating of infections caused by Candida s.p. in mucosa in connection with exocrine glands of the mammalian body. Despite the availability of effective antifungal drugs, optimal prophylactic and therapeutic approaches for mucositis are still controversial. Factors that might have a stimulatory effect on fungal growth or decrease the effectiveness of antifungal therapy of mucositis have received little attention. Oral candidiasis is the most common opportunistic infection in AIDS, affecting up to 90% of the patients. It importantly interferes with nutrition. Studies suggest that the presence of oral candidiasis increases progression to AIDS, and that oral candidiasis is an independent risk factor for the development of Pneumocystis carinii pneumonia. Oral candidiasis is also one of the most common reasons for premature cessation of chemotherapy in cancer patients. Web site: http://www.delphion.com/details?pn=US06414035__

Patent Applications on Yeast Infections As of December 2000, U.S. patent applications are open to public viewing.10 Applications are patent requests which have yet to be granted. (The process to achieve a patent can take several years.) The following patent applications have been filed since December 2000 relating to yeast infections:

10

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

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Adhesive treatment for skin yeast infections Inventor(s): Hedgpeth, Daniel L. ; (Raleigh, NC) Correspondence: OLIFF & BERRIDGE, PLC; P.O. BOX 19928; ALEXANDRIA; VA; 22320; US Patent Application Number: 20030007948 Date filed: July 5, 2001 Abstract: A method of treating or preventing skin yeast infections, such as cutaneous candidiasis, includes applying a polymerizable monomer adhesive composition to an area of skin afflicted with or susceptible to a skin yeast infection, optionally with at least one of an additional anti-fungal agent or a skin care additive, and allowing the polymerizable monomer composition to polymerize to form a polymer film over the area of skin. Excerpt(s): The present invention relates to treatment and prevention of skin yeast infections such as cutaneous candidiasis. Monomer and polymer adhesives are used in both industrial (including household) and medical applications. Included among these adhesives are the 1,1-disubstituted ethylene monomers and polymers, such as the .alpha.-cyanoacrylates. Since the discovery of the adhesive properties of such monomers and polymers, they have found wide use due to the speed with which they cure, the strength of the resulting bond formed, and their relative ease of use. These characteristics have made the .alpha.-cyanoacrylate adhesives the primary choice for numerous applications such as bonding plastics, rubbers, glass, metals, wood, and, more recently, biological tissues. It is known that monomeric forms of .alpha.-cyanoacrylates are extremely reactive, polymerizing rapidly in the presence of even minute amounts of an initiator, including moisture present in the air or on moist surfaces such as animal (including human) tissue. Monomers of .alpha.-cyanoacrylates are anionically polymerizable or free radical polymerizable, or polymerizable by zwitterions or ion pairs to form polymers. Once polymerization has been initiated, the cure rate can be very rapid. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Method and formulation for treating candidiasis using morinda citrifolia Inventor(s): Ogden, Robert V. ; (Cedar Hills, UT), West, Brett Justin ; (Orem, UT), Jensen, Claude Jarakae ; (Cedar Hills, UT), Palu, Afa Kehaati ; (Orem, UT), Gerson, Scott ; (Brewster, NY) Correspondence: KIRTON AND MCCONKIE; 1800 EAGLE GATE TOWER; 60 EAST SOUTH TEMPLE; P O BOX 45120; SALT LAKE CITY; UT; 84145-0120; US Patent Application Number: 20030161901 Date filed: November 14, 2002 Abstract: The present invention features a novel use of processed ingredients from the Indian mulberry plant, and particularly a novel use of one or more processed Morinda citrifolia-based naturaceutical formulations comprising one or more of a processed Morinda citrifolia fruit juice, puree juice, oil or oil extract, dietary fiber, alcohol extract, etc., for inhibiting and preventing the overgrowth of Candida fungus and for treating Candidiasis and its associated symptoms.

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Excerpt(s): The present invention is directed toward methods and formulations for treating Candidiasis, and particularly towards various methods and naturaceutical formulations, compositions, and substances comprising Morinda citrifolia for inhibiting, blocking, and preventing the overgrowth of Candida albicans in mammals. There exists in the body literally billions of microorganisms that function to assist in everyday maintenance and development. This normal resident microbial population includes potential pathogens as well as organisms that help to keep the potential pathogens in check. Microorganisms Candida albicans, and other strains of Candida, are yeast or yeast-like fungi that are capable of growing on and within the human body and that normally or naturally inhabit our digestive system: the mouth, throat, intestines and genitourinary tract. Candida is a normal part of the bowel flora (the organisms that naturally live inside our intestines, and are not parasitic). It has many functions inside our digestive tract, one of them which is to recognize and destroy harmful bacteria. Without Candida albicans in our intestines we would be defenseless against many pathogenic bacteria. Under normal circumstances, a healthy individual can have millions of Candida albicans in their system. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Saliva test for detection of food allergy, candidiasis, microflora imbalance, intestinal barrier dysfunction and humoral immunodeficiencies Inventor(s): Vojdani, Aristo ; (Los Angeles, CA) Correspondence: KNOBBE MARTENS OLSON & BEAR LLP; 2040 MAIN STREET; FOURTEENTH FLOOR; IRVINE; CA; 92614; US Patent Application Number: 20030087320 Date filed: August 14, 2001 Abstract: A method for determining a cause for digestive and immune disorders is disclosed. The method determines the levels of antibodies against normal intestinal microflora and food antigens. It then compares the results to normal levels to determine the cause. The test can be used to diagnose food allergy or intolerance, microflora imbalance, gut barrier dysfunction, bacterial translocation, immunodeficiencies, candidiasis and autoimmunities. Excerpt(s): It is increasingly evident that human diseases are most often related to lifestyle and should in theory be preventable. The stress of modem life, our reduced physical activity, and our consumption of manipulated and processed foods, and of chemicals including pharmaceuticals--all contribute to our decreasing resistance to disease. Much evidence supports the fact that our genes, adapted during millions of years to the lifestyle of our prehistoric ancestors, tolerate poorly the dramatic changes in lifestyle that have occurred, especially in food habits during the past 100 years. Changes in food habits in Western countries that no doubt constitute stresses to the human body and that may predispose to inflammatory, infectious, ulcerative, degenerative, and neoplastic diseases include the following: the consumption of 100 lb. refined sugar per individual per year; the 10-fold increase in sodium consumption; the fourfold increase in consumption of saturated fat; the doubled consumption of cholesterol; a much reduced consumption of vegetable fibres, and of minerals such as potassium, magnesium, calcium, and chromium; and a considerable reduction in consumption of omega-3 fats, membrane lipids, vitamins, and antioxidants. In severe disease, important food ingredients, such as arginine, glutamine, taurine, nucleic acids, vitamins, and antioxidants, such as glutathione, are often not supplied in large enough quantities.

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Perhaps, even more important than the decrease in these food ingredients is the fact that prehistoric food contained several thousand times more bacteria, mainly the so called probiotic bacteria. Prehistoric methods of food preservation were either drying or, more commonly, storing in holes dug into the ground, where the food became naturally fermented. This is how Stone Age man learned to produce most of our still common fermented foods, such as beer, wine, green olives, and sauerkraut. Our modern lifestyle has dramatically reduced the availability of foods produced by natural fermentation. After the early identification of microbes, bacteria were regarded mainly as a source of disease, and unwanted in commercially manufactured food. Furthermore, the desire of the food industry to prolong shelf life promoted alternative production methods, such as the use of enzymes instead of live bacteria. With extensive hygiene measures practiced during delivery and in childcare, children in Western societies may have difficulty developing a satisfactory protective indigenous gut flora. It is not known, but suspected, that this could be connected to the increasing incidence of allergies and infections seen among Western children. A series of studies were published about an ethnic group in New Guinea with a dramatically different diet to that of people in the Western world. This diet contained no processed foods like butter, margarine, lard, oils, refined sugar, or alcohol. Instead, the group's diet was rich in fibre, water, vitamins, minerals, and omega-3 fats, such as docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA). Despite the fact that about 80% of the population smokes and has a heavy consumption of saturated fat from coconut, cerebrocardiovascular diseases are virtually absent and the incidence of diabetes and cancer is very low. The condition and function of the gastrointestinal (GI) tract are essential to our well-being. After the respiratory tract, the GI tract constitutes the second largest body surface area, described to be somewhere between 250 and 400 m.sup.2, or comparable in size to a tennis court. During a normal lifetime, 60 tons of food pass through this canal, which is important for well being, but also constitutes an enormous threat to the integrity of the digestive tract and the whole body. It is not surprising, therefore, that this organ is often affected by inflammatory diseases and cancer. The continuous challenges to the GI surfaces might be why most of the surface cells have a rapid turnover; most are replaced after three to four days in man and sometimes earlier in animals. Furthermore, the surface is protected by large quantities of important secretions, from saliva in the oral cavity to colonic secretion in the large bowel. These secretions contain factors of great importance for the lubrication of the mucosa and for functions of the GI tract, but also hundreds of ingredients of importance for intraluminal microbial defense. The secretory functions are extremely sensitive to foreign chemicals. About 50% of the 2000 pharmaceutical drugs registered in Sweden have reported GI side effects, for example, mouth dryness, nausea, vomiting, diarrhea, and constipation. It is hoped that future medicine will be more restrictive in the use of pharmaceuticals in general and will use drugs with as few side effects as possible. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

Keeping Current In order to stay informed about patents and patent applications dealing with yeast infections, you can access the U.S. Patent Office archive via the Internet at the following Web address: http://www.uspto.gov/patft/index.html. You will see two broad options: (1) Issued Patent, and (2) Published Applications. To see a list of issued patents, perform the following steps: Under “Issued Patents,” click “Quick Search.” Then, type “yeast infections” (or

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synonyms) into the “Term 1” box. After clicking on the search button, scroll down to see the various patents which have been granted to date on yeast infections. You can also use this procedure to view pending patent applications concerning yeast infections. Simply go back to http://www.uspto.gov/patft/index.html. Select “Quick Search” under “Published Applications.” Then proceed with the steps listed above.

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CHAPTER 6. BOOKS ON YEAST INFECTIONS Overview This chapter provides bibliographic book references relating to yeast infections. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on yeast infections include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.

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

Serving Individuals with Diabetes who are Blind or Visually Impaired: A Resource Guide for Vocational Rehabilitation Counselors Source: Mississippi State, MS: Rehabilitation Research and Training Center on Blindness and Low Vision, Mississippi State University. 1997. 227 p. Contact: Available from Rehabilitation Research and Training Center on Blindness and Low Vision, Mississippi State University. Publications Manager, P.O. Drawer 6189, Mississippi State, MS 39762. (601) 325-2001 or (601) 325-8693. Fax (601) 325-8989. TDD (601) 325-8693. PRICE: $25.00 in any format. Summary: This resource guide is designed to help counselors better serve individuals with diabetes who are blind or visually impaired. The guide refers readers to a large collection of resources on various diabetes publications, medications, and appliances. Five sections cover an introduction to diabetes; self management; current medical issues;

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employment issues; and emotional aspects of diabetes. Topics include myths about diabetes; diabetic eye disease; new nutrition guidelines for diabetes management; oral diabetes medications; diabetes and medications; insulin and measurement devices and systems; maintaining the proper temperature of insulin; blood glucose control; 'talking' blood glucose monitoring systems; and noninvasive glucose monitors. The authors also discuss diabetes and the feet; kidney failure, dialysis, and transplantation; pancreas transplantation; arthritis and diabetes; diabetes and This resource gu; hypoglycemia; diabetic peripheral neuropathy; diabetes and men's sexual health; cardiovascular health; diabetic ketoacidosis; diabetic dermopathy; diabetes and the Individualized Written Rehabilitation Program (IWRP); the use of Braille; health insurance; and scleral shells. The book's appendix includes lists of diabetes-related organizations, publications, listservs, and World Wide Web sites; sources of low-sugar products and products for the blind; and diabetes equipment and supplies, including insulin syringe magnifiers. The resource guide is available in large print, Braille, audiocassette, and computer diskette. •

Nutrition for Women: The Complete Guide Source: New York: Henry Holt. 475p., 1995. Contact: Henry Holt, 115 West 18th St., New York, NY 10011. Summary: Somer, a registered dietitian, has created a comprehensive book on nutrition for women. She discusses nutrition in general, offering guidelines for a healthy diet, including how to plan and prepare such a diet. In addition, she lists 10 keys to maintaining that healthy diet, including setting realistic goals, developing a plan, rewarding efforts, handling relapses, and developing support. Special chapters cover vitamin and mineral supplements, weight management, female athletes, pregnancy and breast-feeding, and nutrition for seniors. Special health concerns of women, such as breast cancer, fertility, and Somer, a registe, are discussed with reference to the influence of diet on such conditions. A glossary is included.

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

A Self-help Guide to Thrush; ISBN: 0903652668; http://www.amazon.com/exec/obidos/ASIN/0903652668/icongroupinterna

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A Woman's Guide to Yeast Infections by Naomi Baumslag, et al; ISBN: 0671746995; http://www.amazon.com/exec/obidos/ASIN/0671746995/icongroupinterna

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Candida, the Silent Epidemic: Vital Information to Detect, Combat and Prevent Yeast Infections by Gail Burton; ISBN: 0970325606; http://www.amazon.com/exec/obidos/ASIN/0970325606/icongroupinterna

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Conquering Yeast Infections: The Non-Drug Solution for Men and Women by S. Colet Lahoz; ISBN: 1571970169; http://www.amazon.com/exec/obidos/ASIN/1571970169/icongroupinterna

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Finally There's Help for Yeast Infections by Cheryl M. Ufkin (1996); ISBN: 1889868035; http://www.amazon.com/exec/obidos/ASIN/1889868035/icongroupinterna

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Health Benefits of Probiotics (Latest Research Showing Benefits for Digestion, Cholesterol, Yeast Infection, Immune System, Colon Cancer, Ulcers, etc) by Beth LeyJacobs (2000); ISBN: 1890766100; http://www.amazon.com/exec/obidos/ASIN/1890766100/icongroupinterna

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Oral Candidosis by Lakshman P. Sawaranayake, T. Wallace (Editor); ISBN: 0723609837; http://www.amazon.com/exec/obidos/ASIN/0723609837/icongroupinterna

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Pathogenic Yeasts and Yeast Infections by Esther Segal, Gerald L. Baum; ISBN: 0849364264; http://www.amazon.com/exec/obidos/ASIN/0849364264/icongroupinterna

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Tame the Yeast Beast!: Self-Help for Yeast Infections (All Women's Health Inthe 90s) by Celina Poy-Wing (1994); ISBN: 0963878301; http://www.amazon.com/exec/obidos/ASIN/0963878301/icongroupinterna

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The Bible Cure for Candida and Yeast Infections by Don, Md. Colbert, Don Colbert (2001); ISBN: 0884197433; http://www.amazon.com/exec/obidos/ASIN/0884197433/icongroupinterna

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The Candida Control Cookbook: What You Should Know and What You Should Eat to Manage Yeast Infections by Gail Burton, Michael E., MD Rosenbaum (Introduction); ISBN: 0944031803; http://www.amazon.com/exec/obidos/ASIN/0944031803/icongroupinterna

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The Deception of the Thrush by David Parrott (1986); ISBN: 0722320493; http://www.amazon.com/exec/obidos/ASIN/0722320493/icongroupinterna

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The Practical Encyclopedia of Sex and Health: From Aphrodisiacs and Hormones to Potency, Stress, Vasectomy and Yeast Infection by Stefan Bechtel, Prevention Magazine (Editor) (1993); ISBN: 0875961630; http://www.amazon.com/exec/obidos/ASIN/0875961630/icongroupinterna

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Thrush (Thorsons's Women's Health Series) by Jane Butterworth; ISBN: 0722525036; http://www.amazon.com/exec/obidos/ASIN/0722525036/icongroupinterna

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Thrush: How to Prevent and Treat Yeast Infection (Thorsons Health Series) by Jane Butterworth; ISBN: 0722536224; http://www.amazon.com/exec/obidos/ASIN/0722536224/icongroupinterna

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Thrush: What It Is and What to Do About It by Ros Asquith (Illustrator); ISBN: 1854484893; http://www.amazon.com/exec/obidos/ASIN/1854484893/icongroupinterna

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Victims of Thrush and Cystitis by Angela Kilmartin; ISBN: 0099406608; http://www.amazon.com/exec/obidos/ASIN/0099406608/icongroupinterna

Chapters on Yeast Infections In order to find chapters that specifically relate to yeast infections, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search

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to book chapters and yeast infections 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 “yeast infections” (or synonyms) into the “For these words:” box. The following is a typical result when searching for book chapters on yeast infections: •

Skin Problems Source: in Gill-Thompson, N.N. Thompson, S.J. You and Your Ileostomy: Simple Explanations of Psychological and Physical Problems. Akron, OH: Worldwide Home Health Center. 1991. p. 83-91. Contact: Available from Worldwide Home Health Center. 926 East Tallmadge Avenue, Akron, OH 44310. (216) 633-0366 or (800) 621-5938 (Ohio), (800) 223-5938 (National). PRICE: $12 plus $3 postage. Summary: This chapter, from a patient education manual about ileostomies, discusses skin care and skin problems. Topics include commonly encountered skin problems, the importance of correct use of appliances, prevention of skin problems, product reactions, yeast infections, products used to treat skin problems, and the importance of consulting health care providers for help in solving any problems or questions. A chart of the most common problems with ileostomies, along with their recommended solutions, is included. 6 figures.

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

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Diabetes Source: in Carlson, K.J. Eisenstat, S.A. Ziporyn, T. Harvard Guide to Women's Health. Cambridge, MA: Harvard University Press. 1996. p. 200-204. Contact: Available from Harvard University Press. Customer Service Department, 79 Garden Street, Cambridge, MA 02138. (800) 448-2242. Fax (800) 962-4983. PRICE: $24.95 (paperback). ISBN: 0674367693 (paperback).

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Summary: This chapter on diabetes mellitus is from a consumer handbook of women's health. Topics include the different types of diabetes, strategies for controlling blood glucose levels, recurrent yeast infections in women with diabetes, and other concerns for women with diabetes, including cardiovascular disease, eating disorders, contraception, and pregnancy. The chapter concludes with a list of other related chapters in the book. The authors emphasize the emotional and social issues that may impact women's health. They also discuss how common diseases and their treatments are different for women than for men. 2 figures. •

Cystitis and Interstitial Cystitis Source: in Crook, W.G. Yeast Connection and the Woman. Jackson, TN: Professional Books, Inc. 1995. p. 147-158. Contact: Available from Professional Books, Inc. 680 West Forest Avenue, Box 3246, Jackson, TN 38301. (901) 423-5400. Fax (901) 423-5402. PRICE: $17.95. ISBN: 0933478224. Summary: This chapter, from a book on yeast infections in women, covers cystitis and interstitial cystitis (IC). The author reprints many suggestions from self-help guides and comments from patients who have struggled through the often-lengthy process of having IC diagnosed. Topics include the use and overuse of antibiotics, symptoms, therapeutic options, including drug therapy and dietary modification, risk factors for cystitis, and the role of yeast infections in chronic cystitis, including interstitial cystitis. 4 references.

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CHAPTER 7. MULTIMEDIA ON YEAST INFECTIONS Overview In this chapter, we show you how to keep current on multimedia sources of information on yeast infections. We start with sources that have been summarized by federal agencies, and then show you how to find bibliographic information catalogued by the National Library of Medicine.

Bibliography: Multimedia on Yeast Infections The National Library of Medicine is a rich source of information on healthcare-related multimedia productions including slides, computer software, and databases. To access the multimedia database, go to the following Web site: http://locatorplus.gov/. Select “Search LOCATORplus.” Once in the search area, simply type in yeast infections (or synonyms). Then, in the option box provided below the search box, select “Audiovisuals and Computer Files.” From there, you can choose to sort results by publication date, author, or relevance. The following multimedia has been indexed on yeast infections: •

Counseling patients with vaginal yeast infection [videorecording]: an educational video for nurses Source: Advanced Care Products, Ortho Pharmaceutical Corp; Year: 1993; Format: Videorecording; Raritan, N.J.: OPC, c1993

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CHAPTER 8. INFECTIONS

PERIODICALS AND NEWS ON YEAST

Overview In this chapter, we suggest a number of news sources and present various periodicals that cover yeast infections.

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

Many women may misdiagnose yeast infection Source: Reuters Health eLine Date: February 28, 2002 http://www.reutershealth.com/archive/2002/02/28/eline/links/20020228elin008.htm l

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•

Breast milk may fight yeast infection in newborns Source: Reuters Health eLine Date: May 23, 2001

•

New version of Monistat 3 Combination Pack for yeast infection approved Source: Reuters Industry Breifing Date: February 09, 2001

•

Taro gets NDA approval for vaginal yeast infection treatment Source: Reuters Industry Breifing Date: April 17, 2000

•

HIV drugs do not affect HPV, yeast infection Source: Reuters Health eLine Date: July 02, 1998

•

12th World AIDS Conference: HAART does not reduce cervical neoplasia, candidiasis in HIV-positive women Source: Reuters Medical News Date: July 01, 1998

•

Women Use OTC Products Improperly For Self-Treatment Of Candidiasis Source: Reuters Medical News Date: March 18, 1997

•

FDA Approves Nonprescription Drug For One-Day Treatment Of Vaginal Candidiasis Source: Reuters Medical News Date: February 14, 1997

•

Yogurt Fights Yeast Infections Source: Reuters Health eLine Date: November 26, 1996

•

Fluconazole Effective In Prevention Of Yeast Infections In HIV-Positive Women Source: Reuters Medical News Date: July 10, 1996

•

Risk Factors For Vulvovaginal Candidiasis Identified Source: Reuters Medical News Date: March 04, 1996

•

Yeast Infection Mimics Acne Source: Reuters Medical News Date: August 08, 1995

Periodicals and News 91

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 “yeast infections” (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 “yeast infections” (or synonyms). If you know the name of a company that is relevant to yeast infections, 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 “yeast infections” (or synonyms).

Newsletter Articles Use the Combined Health Information Database, and limit your search criteria to “newsletter articles.” Again, you will need to use the “Detailed Search” option. Go directly

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to the following hyperlink: http://chid.nih.gov/detail/detail.html. Go to the bottom of the search page where “You may refine your search by.” Select the dates and language that you prefer. For the format option, select “Newsletter Article.” Type “yeast infections” (or synonyms) into the “For these words:” box. You should check back periodically with this database as it is updated every three months. The following is a typical result when searching for newsletter articles on yeast infections: •

Recurrent Oral Yeast Infections Source: Moisture Seekers Newsletter. 14(9): 12. Winter 1996. Contact: Available from Sjogren's Syndrome Foundation, Inc. 8120 Woodmont Avenue, Suite 530, Bethesda MD 20814-1437. (301) 718-0300 or (800) 475-6473. Fax (301) 718-0322. Website: www.sjogrens.org. Summary: This brief newsletter article features a question on recurrent oral yeast infections. A reader asks, 'I have frequent bouts with very painful yeast infections in my mouth. How should this be treated and is there anything I can do to prevent this from occurring?' Two physicians reply to this question. Topics include the relationship of yeast infections to Sjogren's syndrome and other causes of xerostomia (dry mouth); diagnostic considerations; treatment options, including liquid medications used as a rinse and systemic treatments; yeast infections in patients with dentures; and dietary modifications that may help to prevent recurrence.

•

Problems Associated with the Dry and Sore Mouth of Sjogren's Syndrome: Recognition and Management of Yeast Infections Source: Moisture Seekers Newsletter. 12(7-8): 1,3-5. July-August 1994. Contact: Available from Sjogren's Syndrome Foundation, Inc. 8120 Woodmont Avenue, Suite 530, Bethesda MD 20814-1437. (301) 718-0300 or (800) 475-6473. Fax (301) 718-0322. Website: www.sjogrens.org. Summary: This article discusses the problems associated with the dry and sore mouth of Sjogren's syndrome, particularly the recognition and management of yeast infections. Topics include the definition of xerostomia (dry mouth); the oscillating character of Sjogren's; presenting symptoms; the etiology of oral mucositis and soreness in Sjogren's patients; treatment recommendations; Candida infections (yeast); fissuring of the tongue; antibiotic treatments; burning mouth syndrome; risk factors for yeast infections; specific drugs used to treat yeast infections, including nystatin and clotrimazole; the use of mouthrinses; yeast infections and dentures; problems with angular cheilitis; the use of Benadryl; medication side effects; and self-care considerations. The author provides a brief list of suggested readings. 7 references.

Academic Periodicals covering Yeast Infections Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to yeast infections. In addition to these sources, you can search for articles covering yeast infections 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.”

Periodicals and News 93

If you want complete details about the historical contents of a journal, you can also visit the following Web site: http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi. Here, type in the name of the journal or its abbreviation, and you will receive an index of published articles. At http://locatorplus.gov/, you can retrieve more indexing information on medical periodicals (e.g. the name of the publisher). Select the button “Search LOCATORplus.” Then type in the name of the journal and select the advanced search option “Journal Title Search.”

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CHAPTER 9. RESEARCHING MEDICATIONS Overview While a number of hard copy or CD-ROM resources are available for researching medications, a more flexible method is to use Internet-based databases. Broadly speaking, there are two sources of information on approved medications: public sources and private sources. We will emphasize free-to-use public sources.

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

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following drugs have been mentioned in the Pharmacopeia and other sources as being potentially applicable to yeast infections: Antifungals, Azole •

Systemic - U.S. Brands: Diflucan; Nizoral; Sporanox http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202697.html

•

Vaginal - U.S. Brands: FemCare; Femizol-M; Femstat 3; Gyne-Lotrimin; GyneLotrimin Combination Pack; Gyne-Lotrimin3; Gyne-Lotrimin3 Combination Pack; Miconazole-7; Monistat 1; Monistat 3; Monistat 3 Combination Pack; Monistat 5 Tampon; Monistat 7; Monistat 7 Combination Pack; http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202294.html

Clindamycin •

Vaginal - U.S. Brands: Cleocin http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202700.html

Metronidazole •

Vaginal - U.S. Brands: MetroGel-Vaginal http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202704.html

Nystatin •

Oral - U.S. Brands: Mycostatin; Nilstat; Nystex http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202417.html

Sulconazole •

Topical - U.S. Brands: Exelderm http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202691.html

Terbinafine •

Topical - U.S. Brands: Lamisil http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202666.html

Commercial Databases In addition to the medications listed in the USP above, a number of commercial sites are available by subscription to physicians and their institutions. Or, you may be able to access these sources from your local medical library.

Mosby’s Drug Consult Mosby’s Drug Consult database (also available on CD-ROM and book format) covers 45,000 drug products including generics and international brands. It provides prescribing information, drug interactions, and patient information. Subscription information is available at the following hyperlink: http://www.mosbysdrugconsult.com/.

Researching Medications 97

PDRhealth The PDRhealth database is a free-to-use, drug information search engine that has been written for the public in layman’s terms. It contains FDA-approved drug information adapted from the Physicians’ Desk Reference (PDR) database. PDRhealth can be searched by brand name, generic name, or indication. It features multiple drug interactions reports. Search PDRhealth at http://www.pdrhealth.com/drug_info/index.html. Other Web Sites Drugs.com (www.drugs.com) reproduces the information in the Pharmacopeia as well as commercial information. You may also want to consider the Web site of the Medical Letter, Inc. (http://www.medletter.com/) which allows users to download articles on various drugs and therapeutics for a nominal fee.

Researching Orphan Drugs Although the list of orphan drugs is revised on a daily basis, you can quickly research orphan drugs that might be applicable to yeast infections by using the database managed by the National Organization for Rare Disorders, Inc. (NORD), at http://www.rarediseases.org/. Scroll down the page, and on the left toolbar, click on “Orphan Drug Designation Database.” On this page (http://www.rarediseases.org/search/noddsearch.html), type “yeast infections” (or synonyms) into the search box, and click “Submit Query.” When you receive your results, note that not all of the drugs may be relevant, as some may have been withdrawn from orphan status. Write down or print out the name of each drug and the relevant contact information. From there, visit the Pharmacopeia Web site and type the name of each orphan drug into the search box at http://www.nlm.nih.gov/medlineplus/druginformation.html. You may need to contact the sponsor or NORD for further information. NORD conducts “early access programs for investigational new drugs (IND) under the Food and Drug Administration’s (FDA’s) approval ‘Treatment INDs’ programs which allow for a limited number of individuals to receive investigational drugs before FDA marketing approval.” If the orphan product about which you are seeking information is approved for marketing, information on side effects can be found on the product’s label. If the product is not approved, you may need to contact the sponsor. The following is a list of orphan drugs currently listed in the NORD Orphan Drug Designation Database for yeast infections: •

recombinant human monoclonal antibody to hsp90 (trade name: Mycograb) http://www.rarediseases.org/nord/search/nodd_full?code=1307

•

Amphotercin B lipid complex (trade name: Abelcet) http://www.rarediseases.org/nord/search/nodd_full?code=548

If you have any questions about a medical treatment, the FDA may have an office near you. Look for their number in the blue pages of the phone book. You can also contact the FDA

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through its toll-free number, 1-888-INFO-FDA (1-888-463-6332), or on the World Wide Web at www.fda.gov.

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APPENDICES

101

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

NIH Guidelines Commonly referred to as “clinical” or “professional” guidelines, the National Institutes of Health publish physician guidelines for the most common diseases. Publications are available at the following by relevant Institute11: •

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

11

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

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•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

Physician Resources 103

NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.12 Physician-oriented resources provide a wide variety of information related to the biomedical and health sciences, both past and present. The format of these resources varies. Searchable databases, bibliographic citations, full-text articles (when available), archival collections, and images are all available. The following are referenced by the National Library of Medicine:13 •

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

12

Remember, for the general public, the National Library of Medicine recommends the databases referenced in MEDLINEplus (http://medlineplus.gov/ or http://www.nlm.nih.gov/medlineplus/databases.html). 13 See http://www.nlm.nih.gov/databases/databases.html.

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•

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

•

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

A comprehensive source of information on clinical guidelines written for professionals is the Combined Health Information Database. You will need to limit your search to one of the following: Brochure/Pamphlet, Fact Sheet, or Information Package, and “yeast infections” using the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find associations, use the drop boxes at the bottom of the search page where “You may refine your search by.” For the publication date, select “All Years.” Select your preferred language and the format option “Fact Sheet.” Type “yeast infections” (or synonyms) into the “For these words:” box. The following is a sample result: •

Self Care Manual for the HIV Infected Person Contact: Erika Aaron, 3216 Logan St, Philadilphia, PA, 19141, (215) 848-1744. Summary: This self-care manual features practical information for people infected with HIV. Using a checklist format, with simple directions, it describes: 1) symptoms that should receive medical attention; 2) food safety (storage and preparation); 3) safer sexual practices; 4) diarrhea; 5) women's issues (yeast infections, PAP tests, pregnancy, sexually transmitted diseases); 6) skin care; 7) drug and alcohol use; 8) fever; 9) home medical supplies; and 10) infection control techniques. HIV infection, its transmission, its testing, and its treatment are also covered.

The NLM Gateway14 The NLM (National Library of Medicine) Gateway is a Web-based system that lets users search simultaneously in multiple retrieval systems at the U.S. National Library of Medicine (NLM). It allows users of NLM services to initiate searches from one Web interface, providing one-stop searching for many of NLM’s information resources or databases.15 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “yeast infections” (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.

14 15

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

The NLM Gateway is currently being developed by the Lister Hill National Center for Biomedical Communications (LHNCBC) at the National Library of Medicine (NLM) of the National Institutes of Health (NIH).

Physician Resources 105

Results Summary Category Journal Articles Books / Periodicals / Audio Visual Consumer Health Meeting Abstracts Other Collections Total

Items Found 7385 25 86 184 0 7680

HSTAT16 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.17 These documents include clinical practice guidelines, quickreference guides for clinicians, consumer health brochures, evidence reports and technology assessments from the Agency for Healthcare Research and Quality (AHRQ), as well as AHRQ’s Put Prevention Into Practice.18 Simply search by “yeast infections” (or synonyms) at the following Web site: http://text.nlm.nih.gov.

Coffee Break: Tutorials for Biologists19 Coffee Break is a general healthcare site that takes a scientific view of the news and covers recent breakthroughs in biology that may one day assist physicians in developing treatments. Here you will find a collection of short reports on recent biological discoveries. Each report incorporates interactive tutorials that demonstrate how bioinformatics tools are used as a part of the research process. Currently, all Coffee Breaks are written by NCBI staff.20 Each report is about 400 words and is usually based on a discovery reported in one or more articles from recently published, peer-reviewed literature.21 This site has new articles every few weeks, so it can be considered an online magazine of sorts. It is intended for general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/.

16

Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html.

17

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

18

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. 19 Adapted from http://www.ncbi.nlm.nih.gov/Coffeebreak/Archive/FAQ.html. 20

The figure that accompanies each article is frequently supplied by an expert external to NCBI, in which case the source of the figure is cited. The result is an interactive tutorial that tells a biological story. 21 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process.

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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/.

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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 yeast infections 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 yeast infections. 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 yeast infections. 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 “yeast infections”:

108 Yeast Infections

•

Guides on yeast infections Candidiasis http://www.nlm.nih.gov/medlineplus/candidiasis.html

•

Other guides AIDS and Infections http://www.nlm.nih.gov/medlineplus/aidsandinfections.html Fungal Infections http://www.nlm.nih.gov/medlineplus/fungalinfections.html Infant and Newborn Care http://www.nlm.nih.gov/medlineplus/infantandnewborncare.html Mouth Disorders http://www.nlm.nih.gov/medlineplus/mouthdisorders.html Sexually Transmitted Diseases http://www.nlm.nih.gov/medlineplus/sexuallytransmitteddiseases.html Throat Disorders http://www.nlm.nih.gov/medlineplus/throatdisorders.html Tinea Infections http://www.nlm.nih.gov/medlineplus/tineainfections.html Vaginal Diseases http://www.nlm.nih.gov/medlineplus/vaginaldiseases.html

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

General/Overviews Candidiasis: Diaper Rash, Oral Thrush, Vaginal Yeast Infection Source: Nemours Foundation http://kidshealth.org/parent/infections/common/candidiasis.html

•

Diagnosis/Symptoms Genital Problems in Men: Self-Care Flowcharts Source: American Academy of Family Physicians http://familydoctor.org/flowcharts/539.html Genital Problems in Women: Self-Care Flowcharts Source: American Academy of Family Physicians http://familydoctor.org/flowcharts/537.html Mouth Problems: Self-Care Flowcharts Source: American Academy of Family Physicians http://familydoctor.org/flowcharts/509.html Yeast Infection? Are You Sure? Source: Interstitial Cystitis Association http://www.ichelp.org/FeatureArticles/YeastInfectionAreYouSure.html

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•

Treatment FDA Updates Safety Information for Miconazole Vaginal Cream and Suppositories Source: Food and Drug Administration http://www.fda.gov/bbs/topics/ANSWERS/2001/ANS01071.html Yogurt: Can It Cure Yeast Infections? Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=AN00608

•

Specific Conditions/Aspects Dubious “Yeast Allergies” Source: Quackwatch, Inc. http://www.quackwatch.org/01QuackeryRelatedTopics/candida.html Frequently Asked Questions about Yeast Infections http://www.4woman.gov/faq/yeast.pdf Genital Candidiasis (Vulvovaginal Candidiasis (VVC), Vaginal Yeast Infections) Source: National Center for Infectious Diseases http://www.cdc.gov/ncidod/dbmd/diseaseinfo/candidiasis_gen_g.htm Invasive Candidiasis Source: National Center for Infectious Diseases http://www.cdc.gov/ncidod/dbmd/diseaseinfo/candidiasis_inv_g.htm Oral Thrush Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=DS00408 Oropharyngeal Candidiasis (OPC, Thrush) Source: National Center for Infectious Diseases http://www.cdc.gov/ncidod/dbmd/diseaseinfo/candidiasis_opc_g.htm Vaginal Yeast Infections Source: American Academy of Family Physicians http://familydoctor.org/handouts/206.html Yeast Infections: When They Keep Coming Back Source: American Academy of Family Physicians http://familydoctor.org/handouts/597.html

•

Men Yeast Infection in Men Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=HO00172

•

Organizations National Center for Infectious Diseases, Division of Bacterial and Mycotic Diseases http://www.cdc.gov/ncidod/dbmd/

110 Yeast Infections

National Institute of Allergy and Infectious Diseases http://www.niaid.nih.gov/ •

Research Identification of Yeast Mating Habits Opens New Doors to Candida Research Source: National Institute of Allergy and Infectious Diseases http://www.niaid.nih.gov/newsroom/releases/candida.htm

•

Teenagers Yeast Infections Source: Nemours Foundation http://kidshealth.org/teen/infections/fungal/yeast_infections.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 yeast infections. 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: •

Yeast Infections Contact: Community AIDS Treatment Information Exchange, PO Box 1104, Toronto, (416) 203-7122, http://www.catie.ca. Summary: This fact sheet, for women with the human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS), provides information on yeast infections. It discusses yeast infections and identifies women who are at risk for this opportunistic infection; it lists the symptoms and describes the tests used to diagnose yeast infections; and it examines how HIV-positive women can help to prevent yeast infections. The fact sheet discusses some of the medical treatments used for HIV-positive women co-infected with yeast infections.

•

Diabetes and Vaginal Yeast Infection: A Balancing Act Source: Raritan, NJ: Ortho Pharmaceutical Corporation. 1993. 15 p. Contact: Available from Ortho Pharmaceutical Corporation. Raritan, NJ 08869. (908) 2186000. PRICE: Single copy free. Order Number: 633-01-2-10770/PV3-3046.

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Summary: Written in a question-and-answer format, this brochure for women with diabetes defines vaginal yeast infections and discusses how high blood glucose levels can contribute to yeast overgrowth, other causes of vaginal infections, preventive measures to minimize or avoid infections, how vaginal infections are treated, selfmanagement with over-the-counter products for yeast infections, and recommendations for use of said antifungal agents. The brochure is produced by the manufacturer of one of the antifungal agents available. •

What Is Yeast Infection? Contact: California Department of Health Services, Office of AIDS, California AIDS Clearinghouse, 1443 N Martel Ave, Los Angeles, CA, 90046-4207, (323) 845-4180, http://www.hivinfo.org/cac/cachouse.shtml. Summary: This information sheet discusses the facts about yeast infections as a sexually transmitted disease (STD). The information sheet explains how yeast infections are transmitted, the symptoms in women and men, possible causes of yeast infection, prevention and, treatment.

•

Candidiasis (Afta, Infeccion de Levadura). [Candidiasis (Thrush, Yeast Infection)] Contact: National AIDS Treatment Information Project, Beth Israel Deaconess Medical Center, Beth Israel Hospital, 330 Brookline Ave Libby Bldg 317, Boston, MA, 02215, (617) 667-5520, http://www.natip.org. Summary: This fact sheet, written for individuals with the human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS), presents information about candidiasis, a term for infections (such as esophagitis, thrush, and vaginitis) caused by the yeast Candida, which can involve the mouth, throat, esophagus, vagina, or skin. Candidiasis can often signal the onset of HIV/AIDS, as it is a common sign of the weakening of the immune system. Some of the symptoms of candidiasis include soreness or a bad taste in the mouth, creamy white patches, red spots on the tongue or roof of the mouth, cracks and redness in the skin at the corners of the mouth, difficulty swallowing, and pain in the chest. Candidiasis is often diagnosed using a combination of visual and laboratory examinations. Medical therapy can be topical. Systemic treatment is needed for Candida esophagitis. In HIV-positive individuals, candidiasis can be prevented with topical medicines or through alternative/complementary treatments. A table is provided that identifies some topical and systemic medications available to treat candidiasis.

•

Candidiasis: Diaper Rash, Oral Thrush, Vaginal Yeast Infection Source: KidsHealth. June 2001. 3 p. Contact: Nemours Foundation. Website: www.kidshealth.org. Summary: This fact sheet provides an overview of different types of candidiasis that can affect children. Diaper rash is the most common form of candidiasis, appearing in healthy newborns and older babies, and is characterized by red, tender skin, especially in skin folds and creases. Diaper rash can be prevented by changing cloth diapers as soon as they get wet or soiled and thoroughly rinsing soaps and other irritants from the diapers. Zinc oxide and other nonprescription ointments can be applied. Oral thrush is candidiasis of the mouth and appears in healthy newborns or older children. The fungus causes cracks in the corners of the mouth and yellow or white patches on the lips, tongue, palate and inside the cheeks. In healthy children, thrush requires no treatment.

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In children with cancer or HIV, treatment is necessary to prevent infection spreading to other organs. Another common ailment is Candida paronychia, which infects the skin around the nails. The cuticles around the nails become red, swollen, and painful. Antifungal medications are prescribed to treat this disorder. Candida vulvovaginitis, or yeast infections, affect older girls and women and are characterized by vaginal itching, redness, and thick white discharge. To prevent vaginal candidiasis, keep the vagina area clean, avoid vaginal sprays and douches, wear cotton underpants, and change into dry clothing after swimming. •

Candidiasis (Thrush) Contact: University of New Mexico School of Medicine, New Mexico AIDS Education and Training Center, New Mexico AIDS InfoNet, PO Box 810, Arroyo Seco, NM, 87514, (505) 776-8032, http://www.aidsinfonet.org. Summary: This information sheet discusses candidiasis (thrush), a fungal infection caused by common yeast and the most common opportunistic infection (OI) in people whose immune systems have been damaged by the human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS). Candidiasis can infect the mouth, throat, or vagina. In the mouth, the infection is called thrush and looks like white patches similar to cottage cheese or red spots. It can cause sore throat, pain when swallowing, nausea, and loss of appetite. There is no way to prevent exposure to this fungus, and there is no way to prevent an outbreak of it. Treatments for candidiasis can be local or systemic. The fact sheet lists the local anti-fungal treatments for candidiasis, and describes systemic and natural treatments for this infection.

•

Candidiasis Contact: University of New Mexico School of Medicine, New Mexico AIDS Education and Training Center, New Mexico AIDS InfoNet, PO Box 810, Arroyo Seco, NM, 87514, (505) 776-8032, http://www.aidsinfonet.org. Summary: This information sheet discusses candidiasis (thrush), a fungal infection caused by common yeast and the most common opportunistic infection (OI) in people whose immune system has been damaged by the human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS). Candidiasis can infect the mouth, throat, or vagina. In the mouth, the infection is called thrush and looks like white patches similar to cottage cheese or red spots. It can cause sore throat, pain when swallowing, nausea, and loss of appetite. There is no way to prevent exposure to this fungus, and there is no way to prevent an outbreak of it. Treatments for candidiasis can be local or systemic. The fact sheet lists the local anti-fungal treatments for candidiasis and describes systemic and natural treatments for this infection.

•

Candidiasis (Yeast, Monilia) Contact: Washington Department of Social and Health Services, Office of Disease Prevention and Control, Office on AIDS, Airdustrial Pk, Olympia, WA, 98504-0095, (360) 586-3887. Summary: This fact sheet, for women, discusses the sexually transmitted disease (STD), candidiasis. Candidiasis, also known as yeast or monilia, is a common vaginal infection. This fact sheet provides information on the causes, symptoms, testing, and treatment of yeast infections. It also provides a telephone number for individuals interested in learning more about candidiasis.

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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 “yeast infections” (or synonyms). The following was recently posted: •

2002 national guideline on the management of vulvovaginal candidiasis Source: Association for Genitourinary Medicine - Medical Specialty Society; 1999 August (revised 2002); Various pagings http://www.guideline.gov/summary/summary.aspx?doc_id=3033&nbr=2259&a mp;string=thrush

•

Practice guidelines for the treatment of candidiasis Source: Infectious Diseases Society of America - Medical Specialty Society; 2000 April; 17 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2670&nbr=1896&a mp;string=candidiasis Healthfinder™

Healthfinder™ is sponsored by the U.S. Department of Health and Human Services and offers links to hundreds of other sites that contain healthcare information. This Web site is located at http://www.healthfinder.gov. Again, keyword searches can be used to find guidelines. The following was recently found in this database: •

Fact Sheets on Childhood Diseases and Conditions Summary: A resource for parents and child care providers, these fact sheets address many common childhood diseases -- yeast Infections (thrush), cold sores, head lice, pinkeye and the common cold, and more Source: National Center for Infectious Diseases, Centers for Disease Control and Prevention http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=1354 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 yeast infections. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html.

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Additional Web Sources

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

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

•

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

•

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

•

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

•

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

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

•

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

Associations and Yeast Infections The following is a list of associations that provide information on and resources relating to yeast infections: •

Immune Deficiency Foundation Telephone: (410) 321-6647 Toll-free: (800) 296-4433 Fax: (410) 321-9165 Email: [email protected] Web Site: http://www.primaryimmune.org Background: The Immune Deficiency Foundation is a national not-for-profit voluntary health organization that was founded in 1980 by a group of parents with children affected by primary immune deficiency diseases. The Foundation has concentrated on creating a national focus for these disorders by supporting research, physician training, and patient and family education. The objectives of the Foundation are to promote and support scientific research into the causes, prevention, treatment, and cure of primary immune deficiency diseases; to promote training in medical research and clinical treatment; to gather, coordinate, and disseminate information concerning research and treatment of these disorders; to conduct education campaigns to increase public awareness; and to establish support systems for affected individuals and families throughout the United States. The Foundation produces a variety of educational materials including general information booklets, illustrated booklets for children, and a slide set entitled 'Our Immune System.'.

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

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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 yeast infections. For more information, see the NHIC’s Web site at http://www.health.gov/NHIC/ or contact an information specialist by calling 1-800-336-4797. Directory of Health Organizations The Directory of Health Organizations, provided by the National Library of Medicine Specialized Information Services, is a comprehensive source of information on associations. The Directory of Health Organizations database can be accessed via the Internet at http://www.sis.nlm.nih.gov/Dir/DirMain.html. It is composed of two parts: DIRLINE and Health Hotlines. The DIRLINE database comprises some 10,000 records of organizations, research centers, and government institutes and associations that primarily focus on health and biomedicine. To access DIRLINE directly, go to the following Web site: http://dirline.nlm.nih.gov/. Simply type in “yeast infections” (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 “yeast infections”. 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 “yeast infections” (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 “yeast infections” (or a synonym) into the search box, and click “Submit Query.”

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

Preparation Your local public library and medical libraries have interlibrary loan programs with the National Library of Medicine (NLM), one of the largest medical collections in the world. According to the NLM, most of the literature in the general and historical collections of the National Library of Medicine is available on interlibrary loan to any library. If you would like to access NLM medical literature, then visit a library in your area that can request the publications for you.22

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

22

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

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libraries recommended by the National Library of Medicine (sorted alphabetically by name of the U.S. state or Canadian province where the library is located)23: •

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

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

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

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

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

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

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California: Gateway Health Library (Sutter Gould Medical Foundation)

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

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

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

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

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

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

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

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

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

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

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

23

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

Finding Medical Libraries 119

•

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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•

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

•

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

•

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

•

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

•

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

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

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

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

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

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

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

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

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

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

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

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•

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

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

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

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

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

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

•

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

•

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

•

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

•

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

•

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

•

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

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

Basic Guidelines for Yeast Infections Yeast infections and yogurt Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001964.htm

•

Nutrition for Yeast Infections Yogurt Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002463.htm

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

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

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•

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

•

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

•

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

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YEAST INFECTIONS 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] Acid Phosphatase: An enzyme that catalyzes the conversion of an orthophosphoric monoester and water to an alcohol and orthophosphate. EC 3.1.3.2. [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] Acute leukemia: A rapidly progressing cancer of the blood-forming tissue (bone marrow). [NIH]

Acute myelogenous leukemia: AML. A quickly progressing disease in which too many immature blood-forming cells are found in the blood and bone marrow. Also called acute myeloid leukemia or acute nonlymphocytic leukemia. [NIH] Acute myeloid leukemia: AML. A quickly progressing disease in which too many immature blood-forming cells are found in the blood and bone marrow. Also called acute myelogenous leukemia or acute nonlymphocytic leukemia. [NIH] Acute nonlymphocytic leukemia: A quickly progressing disease in which too many immature blood-forming cells are found in the blood and bone marrow. Also called acute myeloid leukemia or acute myelogenous leukemia. [NIH] Adhesives: Substances that cause the adherence of two surfaces. They include glues (properly collagen-derived adhesives), mucilages, sticky pastes, gums, resins, or latex. [NIH] Adrenal Cortex: The outer layer of the adrenal gland. It secretes mineralocorticoids, androgens, and glucocorticoids. [NIH] Adverse Effect: An unwanted side effect of treatment. [NIH] Aerosol: A solution of a drug which can be atomized into a fine mist for inhalation therapy. [EU]

Affinity: 1. Inherent likeness or relationship. 2. A special attraction for a specific element, organ, or structure. 3. Chemical affinity; the force that binds atoms in molecules; the tendency of substances to combine by chemical reaction. 4. The strength of noncovalent chemical binding between two substances as measured by the dissociation constant of the complex. 5. In immunology, a thermodynamic expression of the strength of interaction between a single antigen-binding site and a single antigenic determinant (and thus of the stereochemical compatibility between them), most accurately applied to interactions among simple, uniform antigenic determinants such as haptens. Expressed as the association constant (K litres mole -1), which, owing to the heterogeneity of affinities in a population of antibody molecules of a given specificity, actually represents an average value (mean intrinsic association constant). 6. The reciprocal of the dissociation constant. [EU] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alimentary: Pertaining to food or nutritive material, or to the organs of digestion. [EU]

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Alkaline: Having the reactions of an alkali. [EU] Alleles: Mutually exclusive forms of the same gene, occupying the same locus on homologous chromosomes, and governing the same biochemical and developmental process. [NIH] Alpha Particles: Positively charged particles composed of two protons and two neutrons, i.e., helium nuclei, emitted during disintegration of very heavy isotopes; a beam of alpha particles or an alpha ray has very strong ionizing power, but weak penetrability. [NIH] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Amber: A yellowish fossil resin, the gum of several species of coniferous trees, found in the alluvial deposits of northeastern Germany. It is used in molecular biology in the analysis of organic matter fossilized in amber. [NIH] Amifostine: A phosphorothioate proposed as a radiation-protective agent. It causes splenic vasodilation and may block autonomic ganglia. [NIH] Amino acid: Any organic compound containing an amino (-NH2 and a carboxyl (- COOH) group. The 20 a-amino acids listed in the accompanying table are the amino acids from which proteins are synthesized by formation of peptide bonds during ribosomal translation of messenger RNA; all except glycine, which is not optically active, have the L configuration. Other amino acids occurring in proteins, such as hydroxyproline in collagen, are formed by posttranslational enzymatic modification of amino acids residues in polypeptide chains. There are also several important amino acids, such as the neurotransmitter y-aminobutyric acid, that have no relation to proteins. Abbreviated AA. [EU] Amino Acid 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] 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] Analog: In chemistry, a substance that is similar, but not identical, to another. [NIH] Anaphylatoxins: The family of peptides C3a, C4a, C5a, and C5a des-arginine produced in the serum during complement activation. They produce smooth muscle contraction, mast cell histamine release, affect platelet aggregation, and act as mediators of the local inflammatory process. The order of anaphylatoxin activity from strongest to weakest is C5a, C3a, C4a, and C5a des-arginine. The latter is the so-called "classical" anaphylatoxin but shows no spasmogenic activity though it contains some chemotactic ability. [NIH] Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] Androgens: A class of sex hormones associated with the development and maintenance of the secondary male sex characteristics, sperm induction, and sexual differentiation. In addition to increasing virility and libido, they also increase nitrogen and water retention and stimulate skeletal growth. [NIH] Animal model: An animal with a disease either the same as or like a disease in humans. Animal models are used to study the development and progression of diseases and to test

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new treatments before they are given to humans. Animals with transplanted human cancers or other tissues are called xenograft models. [NIH] Antibacterial: A substance that destroys bacteria or suppresses their growth or reproduction. [EU] Antibiotic: A drug used to treat infections caused by bacteria and other microorganisms. [NIH]

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] Antifungal: Destructive to fungi, or suppressing their reproduction or growth; effective against fungal infections. [EU] Antifungal Agents: Substances that destroy fungi by suppressing their ability to grow or reproduce. They differ from fungicides, industrial because they defend against fungi present in human or animal tissues. [NIH] Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Antigen-Antibody Complex: The complex formed by the binding of antigen and antibody molecules. The deposition of large antigen-antibody complexes leading to tissue damage causes immune complex diseases. [NIH] 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] Antimycotic: Suppressing the growth of fungi. [EU] Antineoplastic: Inhibiting or preventing the development of neoplasms, checking the maturation and proliferation of malignant cells. [EU] Antioxidants: Naturally occurring or synthetic substances that inhibit or retard the oxidation of a substance to which it is added. They counteract the harmful and damaging effects of oxidation in animal tissues. [NIH] Anuria: Inability to form or excrete urine. [NIH] Anus: The opening of the rectum to the outside of the body. [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]

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Arteries: The vessels carrying blood away from the heart. [NIH] Aspergillosis: Infections with fungi of the genus Aspergillus. [NIH] Assay: Determination of the amount of a particular constituent of a mixture, or of the biological or pharmacological potency of a drug. [EU] Autonomic: Self-controlling; functionally independent. [EU] Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH] Bacterial Infections: Infections by bacteria, general or unspecified. [NIH] Bacterial Translocation: The passage of viable bacteria from the gastrointestinal tract to extra-intestinal sites, such as the mesenteric lymph node complex, liver, spleen, kidney, and blood. Factors that promote bacterial translocation include overgrowth with gram-negative enteric bacilli, impaired host immune defenses, and injury to the intestinal mucosa resulting in increased intestinal permeability. These mechanisms can act in concert to promote synergistically the systemic spread of indigenous translocating bacteria to cause lethal sepsis. [NIH] Bactericidal: Substance lethal to bacteria; substance capable of killing bacteria. [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] Beclomethasone: An anti-inflammatory, synthetic glucocorticoid. It is used topically as an anti-inflammatory agent and in aerosol form for the treatment of asthma. [NIH] Beer: An alcoholic beverage usually made from malted cereal grain (as barley), flavored with hops, and brewed by slow fermentation. [NIH] Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]

Bile: An emulsifying agent produced in the liver and secreted into the duodenum. Its composition includes bile acids and salts, cholesterol, and electrolytes. It aids digestion of fats in the duodenum. [NIH] Bile Acids: Acids made by the liver that work with bile to break down fats. [NIH] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biological response modifier: BRM. A substance that stimulates the body's response to infection and disease. [NIH] Biopsy: Removal and pathologic examination of specimens in the form of small pieces of tissue from the living body. [NIH] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Bladder: The organ that stores urine. [NIH] Blastomycosis: A fungal infection that may appear in two forms: 1) a primary lesion characterized by the formation of a small cutaneous nodule and small nodules along the

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lymphatics that may heal within several months; and 2) chronic granulomatous lesions characterized by thick crusts, warty growths, and unusual vascularity and infection in the middle or upper lobes of the lung. [NIH] Blood Cell Count: A count of the number of leukocytes and erythrocytes per unit volume in a sample of venous blood. A complete blood count (CBC) also includes measurement of the hemoglobin, hematocrit, and erythrocyte indices. [NIH] Blood Coagulation: The process of the interaction of blood coagulation factors that results in an insoluble fibrin clot. [NIH] Blood Glucose: Glucose in blood. [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber. Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Body Fluids: Liquid components of living organisms. [NIH] Bone Marrow: The soft tissue filling the cavities of bones. Bone marrow exists in two types, yellow and red. Yellow marrow is found in the large cavities of large bones and consists mostly of fat cells and a few primitive blood cells. Red marrow is a hematopoietic tissue and is the site of production of erythrocytes and granular leukocytes. Bone marrow is made up of a framework of connective tissue containing branching fibers with the frame being filled with marrow cells. [NIH] Bone Marrow Transplantation: The transference of bone marrow from one human or animal to another. [NIH] Bone scan: A technique to create images of bones on a computer screen or on film. A small amount of radioactive material is injected into a blood vessel and travels through the bloodstream; it collects in the bones and is detected by a scanner. [NIH] Bowel: The long tube-shaped organ in the abdomen that completes the process of digestion. There is both a small and a large bowel. Also called the intestine. [NIH] Bowel Movement: Body wastes passed through the rectum and anus. [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] Burning Mouth Syndrome: A group of painful oral symptoms associated with a burning or similar sensation. There is usually a significant organic component with a degree of functional overlay; it is not limited to the psychophysiologic group of disorders. [NIH] Calcium: A basic element found in nearly all organized tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. [NIH] Candidiasis: Infection with a fungus of the genus Candida. It is usually a superficial infection of the moist cutaneous areas of the body, and is generally caused by C. albicans; it

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most commonly involves the skin (dermatocandidiasis), oral mucous membranes (thrush, def. 1), respiratory tract (bronchocandidiasis), and vagina (vaginitis). Rarely there is a systemic infection or endocarditis. Called also moniliasis, candidosis, oidiomycosis, and formerly blastodendriosis. [EU] Candidosis: An infection caused by an opportunistic yeasts that tends to proliferate and become pathologic when the environment is favorable and the host resistance is weakened. [NIH]

Carbohydrate: An aldehyde or ketone derivative of a polyhydric alcohol, particularly of the pentahydric and hexahydric alcohols. They are so named because the hydrogen and oxygen are usually in the proportion to form water, (CH2O)n. The most important carbohydrates are the starches, sugars, celluloses, and gums. They are classified into mono-, di-, tri-, polyand heterosaccharides. [EU] Carcinogenic: Producing carcinoma. [EU] Carcinogens: Substances that increase the risk of neoplasms in humans or animals. Both genotoxic chemicals, which affect DNA directly, and nongenotoxic chemicals, which induce neoplasms by other mechanism, are included. [NIH] Cardiovascular: Having to do with the heart and blood vessels. [NIH] Cardiovascular disease: Any abnormal condition characterized by dysfunction of the heart and blood vessels. CVD includes atherosclerosis (especially coronary heart disease, which can lead to heart attacks), cerebrovascular disease (e.g., stroke), and hypertension (high blood pressure). [NIH] Case report: A detailed report of the diagnosis, treatment, and follow-up of an individual patient. Case reports also contain some demographic information about the patient (for example, age, gender, ethnic origin). [NIH] Catheter: A flexible tube used to deliver fluids into or withdraw fluids from the body. [NIH] Caustic: An escharotic or corrosive agent. Called also cauterant. [EU] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Cell Division: The fission of a cell. [NIH] Cell membrane: Cell membrane = plasma membrane. The structure enveloping a cell, enclosing the cytoplasm, and forming a selective permeability barrier; it consists of lipids, proteins, and some carbohydrates, the lipids thought to form a bilayer in which integral proteins are embedded to varying degrees. [EU] Cellobiose: A disaccharide consisting of two glucose units in beta (1-4) glycosidic linkage. Obtained from the partial hydrolysis of cellulose. [NIH] Cellulitis: An acute, diffuse, and suppurative inflammation of loose connective tissue, particularly the deep subcutaneous tissues, and sometimes muscle, which is most commonly seen as a result of infection of a wound, ulcer, or other skin lesions. [NIH] Cellulose: A polysaccharide with glucose units linked as in cellobiose. It is the chief constituent of plant fibers, cotton being the purest natural form of the substance. As a raw material, it forms the basis for many derivatives used in chromatography, ion exchange materials, explosives manufacturing, and pharmaceutical preparations. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Cerebrovascular: Pertaining to the blood vessels of the cerebrum, or brain. [EU] Cervical: Relating to the neck, or to the neck of any organ or structure. Cervical lymph

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nodes are located in the neck; cervical cancer refers to cancer of the uterine cervix, which is the lower, narrow end (the "neck") of the uterus. [NIH] Cervix: The lower, narrow end of the uterus that forms a canal between the uterus and vagina. [NIH] Character: In current usage, approximately equivalent to personality. The sum of the relatively fixed personality traits and habitual modes of response of an individual. [NIH] Cheilitis: Inflammation of the lips. It is of various etiologies and degrees of pathology. [NIH] 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] Child Care: Care of children in the home or institution. [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] Chlorhexidine: Disinfectant and topical anti-infective agent used also as mouthwash to prevent oral plaque. [NIH] Chlorophyll: Porphyrin derivatives containing magnesium that act to convert light energy in photosynthetic organisms. [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] Chromium: A trace element that plays a role in glucose metabolism. It has the atomic symbol Cr, atomic number 24, and atomic weight 52. According to the Fourth Annual Report on Carcinogens (NTP85-002,1985), chromium and some of its compounds have been listed as known carcinogens. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Chronic Disease: Disease or ailment of long duration. [NIH] Clinical resistance: The failure of a cancer to shrink after treatment. [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] Clotrimazole: An imidazole derivative with a broad spectrum of antimycotic activity. It inhibits biosynthesis of the sterol ergostol, an important component of fungal cell membranes. Its action leads to increased membrane permeability and apparent disruption of enzyme systems bound to the membrane. [NIH] Coccidioidomycosis: An infectious disease caused by a fungus, Coccidioides immitis, that is prevalent in the western United States and is acquired by inhalation of dust containing the spores. [NIH] Cofactor: A substance, microorganism or environmental factor that activates or enhances the action of another entity such as a disease-causing agent. [NIH] Collagen: A polypeptide substance comprising about one third of the total protein in

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mammalian organisms. It is the main constituent of skin, connective tissue, and the organic substance of bones and teeth. Different forms of collagen are produced in the body but all consist of three alpha-polypeptide chains arranged in a triple helix. Collagen is differentiated from other fibrous proteins, such as elastin, by the content of proline, hydroxyproline, and hydroxylysine; by the absence of tryptophan; and particularly by the high content of polar groups which are responsible for its swelling properties. [NIH] Colloidal: Of the nature of a colloid. [EU] Commensal: 1. Living on or within another organism, and deriving benefit without injuring or benefiting the other individual. 2. An organism living on or within another, but not causing injury to the host. [EU] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix 'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Complementary and alternative medicine: CAM. Forms of treatment that are used in addition to (complementary) or instead of (alternative) standard treatments. These practices are not considered standard medical approaches. CAM includes dietary supplements, megadose vitamins, herbal preparations, special teas, massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complementary medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used to enhance or complement the standard treatments. Complementary medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Computed tomography: CT scan. A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray

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machine. Also called computerized tomography and computerized axial tomography (CAT) scan. [NIH] Conception: The onset of pregnancy, marked by implantation of the blastocyst; the formation of a viable zygote. [EU] Concomitant: Accompanying; accessory; joined with another. [EU] Congestion: Excessive or abnormal accumulation of blood in a part. [EU] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Constipation: Infrequent or difficult evacuation of feces. [NIH] Constitutional: 1. Affecting the whole constitution of the body; not local. 2. Pertaining to the constitution. [EU] Consumption: Pulmonary tuberculosis. [NIH] Contraception: Use of agents, devices, methods, or procedures which diminish the likelihood of or prevent conception. [NIH] Contracture: A condition of fixed high resistance to passive stretch of a muscle, resulting from fibrosis of the tissues supporting the muscles or the joints, or from disorders of the muscle fibres. [EU] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Controlled study: An experiment or clinical trial that includes a comparison (control) group. [NIH]

Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary heart disease: A type of heart disease caused by narrowing of the coronary arteries that feed the heart, which needs a constant supply of oxygen and nutrients carried by the blood in the coronary arteries. When the coronary arteries become narrowed or clogged by fat and cholesterol deposits and cannot supply enough blood to the heart, CHD results. [NIH] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Corticosteroid: Any of the steroids elaborated by the adrenal cortex (excluding the sex hormones of adrenal origin) in response to the release of corticotrophin (adrenocorticotropic hormone) by the pituitary gland, to any of the synthetic equivalents of these steroids, or to angiotensin II. They are divided, according to their predominant biological activity, into three major groups: glucocorticoids, chiefly influencing carbohydrate, fat, and protein metabolism; mineralocorticoids, affecting the regulation of electrolyte and water balance; and C19 androgens. Some corticosteroids exhibit both types of activity in varying degrees, and others exert only one type of effect. The corticosteroids are used clinically for hormonal replacement therapy, for suppression of ACTH secretion by the anterior pituitary, as antineoplastic, antiallergic, and anti-inflammatory agents, and to suppress the immune response. Called also adrenocortical hormone and corticoid. [EU] Crowns: A prosthetic restoration that reproduces the entire surface anatomy of the visible natural crown of a tooth. It may be partial (covering three or more surfaces of a tooth) or

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complete (covering all surfaces). It is made of gold or other metal, porcelain, or resin. [NIH] Cryptococcosis: Infection with a fungus of the species Cryptococcus neoformans. [NIH] Curative: Tending to overcome disease and promote recovery. [EU] Cutaneous: Having to do with the skin. [NIH] Cyanoacrylates: A group of compounds having the general formula CH2=C(CN)-COOR; it polymerizes on contact with moisture; used as tissue adhesive; higher homologs have hemostatic and antibacterial properties. [NIH] Cystitis: Inflammation of the urinary bladder. [EU] Cytoprotection: The process by which chemical compounds provide protection to cells against harmful agents. [NIH] Cytosine: A pyrimidine base that is a fundamental unit of nucleic acids. [NIH] Cytotoxic: Cell-killing. [NIH] Dairy Products: Raw and processed or manufactured milk and milk-derived products. These are usually from cows (bovine) but are also from goats, sheep, reindeer, and water buffalo. [NIH] Degenerative: Undergoing degeneration : tending to degenerate; having the character of or involving degeneration; causing or tending to cause degeneration. [EU] Dental Abutments: Natural teeth or teeth roots used as anchorage for a fixed or removable denture or other prosthesis (such as an implant) serving the same purpose. [NIH] Dentures: An appliance used as an artificial or prosthetic replacement for missing teeth and adjacent tissues. It does not include crowns, dental abutments, nor artificial teeth. [NIH] Depigmentation: Removal or loss of pigment, especially melanin. [EU] Dermal: Pertaining to or coming from the skin. [NIH] Dermatology: A medical specialty concerned with the skin, its structure, functions, diseases, and treatment. [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] Diarrhea: Passage of excessively liquid or excessively frequent stools. [NIH] Dietary Fiber: The remnants of plant cell walls that are resistant to digestion by the alimentary enzymes of man. It comprises various polysaccharides and lignins. [NIH] Dietitian: An expert in nutrition who helps people plan what and how much food to eat. [NIH]

Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Digestive system: The organs that take in food and turn it into products that the body can use to stay healthy. Waste products the body cannot use leave the body through bowel movements. The digestive system includes the salivary glands, mouth, esophagus, stomach, liver, pancreas, gallbladder, small and large intestines, and rectum. [NIH] Digestive tract: The organs through which food passes when food is eaten. These organs are

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the mouth, esophagus, stomach, small and large intestines, and rectum. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Disinfectant: An agent that disinfects; applied particularly to agents used on inanimate objects. [EU] Distal: Remote; farther from any point of reference; opposed to proximal. In dentistry, used to designate a position on the dental arch farther from the median line of the jaw. [EU] Dross: Residue remaining in an opium pipe which has been smoked; contains 50 % of the morphine present in the original drug. [NIH] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Drug Tolerance: Progressive diminution of the susceptibility of a human or animal to the effects of a drug, resulting from its continued administration. It should be differentiated from drug resistance wherein an organism, disease, or tissue fails to respond to the intended effectiveness of a chemical or drug. It should also be differentiated from maximum tolerated dose and no-observed-adverse-effect level. [NIH] Dura mater: The outermost, toughest, and most fibrous of the three membranes (meninges) covering the brain and spinal cord; called also pachymeninx. [EU] Dystrophy: Any disorder arising from defective or faulty nutrition, especially the muscular dystrophies. [EU] Eating Disorders: A group of disorders characterized by physiological and psychological disturbances in appetite or food intake. [NIH] Effector: It is often an enzyme that converts an inactive precursor molecule into an active second messenger. [NIH] Efficacy: The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control trial. [NIH] Electrocardiogram: Measurement of electrical activity during heartbeats. [NIH] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Electron microscope: A microscope (device used to magnify small objects) that uses electrons (instead of light) to produce an enlarged image. An electron microscopes shows tiny details better than any other type of microscope. [NIH] 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]

Embryo: The prenatal stage of mammalian development characterized by rapid morphological changes and the differentiation of basic structures. [NIH] Emollient: Softening or soothing; called also malactic. [EU] Encapsulated: Confined to a specific, localized area and surrounded by a thin layer of tissue. [NIH]

Endemic: Present or usually prevalent in a population or geographical area at all times; said of a disease or agent. Called also endemial. [EU] Endocarditis: Exudative and proliferative inflammatory alterations of the endocardium, characterized by the presence of vegetations on the surface of the endocardium or in the endocardium itself, and most commonly involving a heart valve, but sometimes affecting

136 Yeast Infections

the inner lining of the cardiac chambers or the endocardium elsewhere. It may occur as a primary disorder or as a complication of or in association with another disease. [EU] Endogenous: Produced inside an organism or cell. The opposite is external (exogenous) production. [NIH] Endotoxins: Toxins closely associated with the living cytoplasm or cell wall of certain microorganisms, which do not readily diffuse into the culture medium, but are released upon lysis of the cells. [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] Epigastric: Having to do with the upper middle area of the abdomen. [NIH] Epithelial: Refers to the cells that line the internal and external surfaces of the body. [NIH] Epithelial Cells: Cells that line the inner and outer surfaces of the body. [NIH] Epithelium: One or more layers of epithelial cells, supported by the basal lamina, which covers the inner or outer surfaces of the body. [NIH] Equipment and Supplies: Expendable and nonexpendable equipment, supplies, apparatus, and instruments that are used in diagnostic, surgical, therapeutic, scientific, and experimental procedures. [NIH] Erysipelas: An acute infection of the skin caused by species of streptococcus. This disease most frequently affects infants, young children, and the elderly. Characteristics include pink-to-red lesions that spread rapidly and are warm to the touch. The commonest site of involvement is the face. [NIH] Erythema: Redness of the skin produced by congestion of the capillaries. This condition may result from a variety of causes. [NIH] Erythrasma: A chronic bacterial infection of major folds of the skin, caused by Corynebacterium minutissimum. [NIH] Erythrocyte Indices: Quantification of size and cell hemoglobin content or concentration of the erythrocyte, usually derived from erythrocyte count, blood hemoglobin concentration, and hematocrit. Includes the mean cell volume (MCV), mean cell hemoglobin (MCH), and mean cell hemoglobin concentration (MCHC). Use also for cell diameter and thickness. [NIH] Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH] Esophageal: Having to do with the esophagus, the muscular tube through which food passes from the throat to the stomach. [NIH] Esophagitis: Inflammation, acute or chronic, of the esophagus caused by bacteria, chemicals, or trauma. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]

Estrogen: One of the two female sex hormones. [NIH] Ethanol: A clear, colorless liquid rapidly absorbed from the gastrointestinal tract and distributed throughout the body. It has bactericidal activity and is used often as a topical disinfectant. It is widely used as a solvent and preservative in pharmaceutical preparations as well as serving as the primary ingredient in alcoholic beverages. [NIH]

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Ethinyl Estradiol: A semisynthetic estrogen with high oral estrogenic potency. It is often used as the estrogenic component in oral contraceptives. [NIH] Evacuation: An emptying, as of the bowels. [EU] Excrete: To get rid of waste from the body. [NIH] Exocrine: Secreting outwardly, via a duct. [EU] Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] Extensor: A muscle whose contraction tends to straighten a limb; the antagonist of a flexor. [NIH]

Extracellular: Outside a cell or cells. [EU] 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] Feces: The excrement discharged from the intestines, consisting of bacteria, cells exfoliated from the intestines, secretions, chiefly of the liver, and a small amount of food residue. [EU] Fermentation: An enzyme-induced chemical change in organic compounds that takes place in the absence of oxygen. The change usually results in the production of ethanol or lactic acid, and the production of energy. [NIH] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH] Fluconazole: Triazole antifungal agent that is used to treat oropharyngeal candidiasis and cryptococcal meningitis in AIDS. [NIH] Flucytosine: A fluorinated cytosine analog that is used as an antifungal agent. [NIH] Fold: A plication or doubling of various parts of the body. [NIH] Food Habits: Acquired or learned food preferences. [NIH] Food Preferences: The selection of one food over another. [NIH] Frameshift: A type of mutation which causes out-of-phase transcription of the base sequence; such mutations arise from the addition or delection of nucleotide(s) in numbers other than 3 or multiples of 3. [NIH] Frameshift Mutation: A type of mutation in which a number of nucleotides not divisible by three is deleted from or inserted into a coding sequence, thereby causing an alteration in the reading frame of the entire sequence downstream of the mutation. These mutations may be induced by certain types of mutagens or may occur spontaneously. [NIH] Friction: Surface resistance to the relative motion of one body against the rubbing, sliding, rolling, or flowing of another with which it is in contact. [NIH] Fungi: A kingdom of eukaryotic, heterotrophic organisms that live as saprobes or parasites, including mushrooms, yeasts, smuts, molds, etc. They reproduce either sexually or asexually, and have life cycles that range from simple to complex. Filamentous fungi refer to those that grow as multicelluar colonies (mushrooms and molds). [NIH] Fungicides, Industrial: Chemicals that kill or inhibit the growth of fungi in agricultural applications, on wood, plastics, or other materials, in swimming pools, etc. [NIH] Fungus: A general term used to denote a group of eukaryotic protists, including mushrooms, yeasts, rusts, moulds, smuts, etc., which are characterized by the absence of

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chlorophyll and by the presence of a rigid cell wall composed of chitin, mannans, and sometimes cellulose. They are usually of simple morphological form or show some reversible cellular specialization, such as the formation of pseudoparenchymatous tissue in the fruiting body of a mushroom. The dimorphic fungi grow, according to environmental conditions, as moulds or yeasts. [EU] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] Gamma Rays: Very powerful and penetrating, high-energy electromagnetic radiation of shorter wavelength than that of x-rays. They are emitted by a decaying nucleus, usually between 0.01 and 10 MeV. They are also called nuclear x-rays. [NIH] Ganglia: Clusters of multipolar neurons surrounded by a capsule of loosely organized connective tissue located outside the central nervous system. [NIH] 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] Gastrointestinal tract: 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]

Genetic Code: The specifications for how information, stored in nucleic acid sequence (base sequence), is translated into protein sequence (amino acid sequence). The start, stop, and order of amino acids of a protein is specified by consecutive triplets of nucleotides called codons (codon). [NIH] Genital: Pertaining to the genitalia. [EU] Genitourinary: Pertaining to the genital and urinary organs; urogenital; urinosexual. [EU] 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] Glucocorticoid: A compound that belongs to the family of compounds called corticosteroids (steroids). Glucocorticoids affect metabolism and have anti-inflammatory and immunosuppressive effects. They may be naturally produced (hormones) or synthetic (drugs). [NIH] Glucose: D-Glucose. A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. [NIH] Glucose Intolerance: A pathological state in which the fasting plasma glucose level is less than 140 mg per deciliter and the 30-, 60-, or 90-minute plasma glucose concentration following a glucose tolerance test exceeds 200 mg per deciliter. This condition is seen frequently in diabetes mellitus but also occurs with other diseases. [NIH] Glutamic Acid: A non-essential amino acid naturally occurring in the L-form. Glutamic acid (glutamate) is the most common excitatory neurotransmitter in the central nervous system. [NIH]

Glutamine: A non-essential amino acid present abundantly throught the body and is involved in many metabolic processes. It is synthesized from glutamic acid and ammonia. It is the principal carrier of nitrogen in the body and is an important energy source for many cells. [NIH] Glycine: A non-essential amino acid. It is found primarily in gelatin and silk fibroin and

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used therapeutically as a nutrient. It is also a fast inhibitory neurotransmitter. [NIH] Glycopeptides: Proteins which contain carbohydrate groups attached covalently to the polypeptide chain. The protein moiety is the predominant group with the carbohydrate making up only a small percentage of the total weight. [NIH] Glycoside: Any compound that contains a carbohydrate molecule (sugar), particularly any such natural product in plants, convertible, by hydrolytic cleavage, into sugar and a nonsugar component (aglycone), and named specifically for the sugar contained, as glucoside (glucose), pentoside (pentose), fructoside (fructose) etc. [EU] Glycosidic: Formed by elimination of water between the anomeric hydroxyl of one sugar and a hydroxyl of another sugar molecule. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Graft: Healthy skin, bone, or other tissue taken from one part of the body and used to replace diseased or injured tissue removed from another part of the body. [NIH] Gram-negative: Losing the stain or decolorized by alcohol in Gram's method of staining, a primary characteristic of bacteria having a cell wall composed of a thin layer of peptidoglycan covered by an outer membrane of lipoprotein and lipopolysaccharide. [EU] 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 Annulare: Benign granulomatous disease of unknown etiology characterized by a ring of localized or disseminated papules or nodules on the skin and palisading histiocytes surrounding necrobiotic tissue resulting from altered collagen structures. [NIH] Gravis: Eruption of watery blisters on the skin among those handling animals and animal products. [NIH] Growth: The progressive development of a living being or part of an organism from its earliest stage to maturity. [NIH] Habitual: Of the nature of a habit; according to habit; established by or repeated by force of habit, customary. [EU] Hair follicles: Shafts or openings on the surface of the skin through which hair grows. [NIH] Haplotypes: The genetic constitution of individuals with respect to one member of a pair of allelic genes, or sets of genes that are closely linked and tend to be inherited together such as those of the major histocompatibility complex. [NIH] Heart attack: A seizure of weak or abnormal functioning of the heart. [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] Hematologic Diseases: Disorders of the blood and blood forming tissues. [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

140 Yeast Infections

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] Hemolytic: A disease that affects the blood and blood vessels. It destroys red blood cells, cells that cause the blood to clot, and the lining of blood vessels. HUS is often caused by the Escherichia coli bacterium in contaminated food. People with HUS may develop acute renal failure. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [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] Heterotrophic: Pertaining to organisms that are consumers and dependent on other organisms for their source of energy (food). [NIH] Heterozygotes: Having unlike alleles at one or more corresponding loci on homologous chromosomes. [NIH] Histology: The study of tissues and cells under a microscope. [NIH] Homogeneous: Consisting of or composed of similar elements or ingredients; of a uniform quality throughout. [EU] Homologous: Corresponding in structure, position, origin, etc., as (a) the feathers of a bird and the scales of a fish, (b) antigen and its specific antibody, (c) allelic chromosomes. [EU] Hormonal: Pertaining to or of the nature of a hormone. [EU] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] Host: Any animal that receives a transplanted graft. [NIH] Humoral: Of, relating to, proceeding from, or involving a bodily humour - now often used of endocrine factors as opposed to neural or somatic. [EU] Humour: 1. A normal functioning fluid or semifluid of the body (as the blood, lymph or bile) especially of vertebrates. 2. A secretion that is itself an excitant of activity (as certain hormones). [EU] Hydrolases: Any member of the class of enzymes that catalyze the cleavage of the substrate and the addition of water to the resulting molecules, e.g., esterases, glycosidases (glycoside hydrolases), lipases, nucleotidases, peptidases (peptide hydrolases), and phosphatases (phosphoric monoester hydrolases). EC 3. [NIH] Hydrolysis: The process of cleaving a chemical compound by the addition of a molecule of water. [NIH] Hydroxyproline: A hydroxylated form of the imino acid proline. A deficiency in ascorbic acid can result in impaired hydroxyproline formation. [NIH] Hypersensitivity: Altered reactivity to an antigen, which can result in pathologic reactions upon subsequent exposure to that particular antigen. [NIH] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH]

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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] Imidazole: C3H4N2. The ring is present in polybenzimidazoles. [NIH] Immune function: Production and action of cells that fight disease or infection. [NIH] Immune response: The activity of the immune system against foreign substances (antigens). [NIH]

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

effects

of

foreign

Immunocompromised: Having a weakened immune system caused by certain diseases or treatments. [NIH] Immunodeficiency: The decreased ability of the body to fight infection and disease. [NIH] 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] Immunology: The study of the body's immune system. [NIH] Impairment: In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function. [NIH] Impetigo: A common superficial bacterial infection caused by staphylococcus aureus or group A beta-hemolytic streptococci. Characteristics include pustular lesions that rupture and discharge a thin, amber-colored fluid that dries and forms a crust. This condition is commonly located on the face, especially about the mouth and nose. [NIH] In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Incision: A cut made in the body during surgery. [NIH] 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]

Infection Control: Programs of disease surveillance, generally within health care facilities,

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designed to investigate, prevent, and control the spread of infections and their causative microorganisms. [NIH] Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Ingestion: Taking into the body by mouth [NIH] Inhalation: The drawing of air or other substances into the lungs. [EU] Initiation: Mutation induced by a chemical reactive substance causing cell changes; being a step in a carcinogenic process. [NIH] Initiator: A chemically reactive substance which may cause cell changes if ingested, inhaled or absorbed into the body; the substance may thus initiate a carcinogenic process. [NIH] 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] Interferon: A biological response modifier (a substance that can improve the body's natural response to disease). Interferons interfere with the division of cancer cells and can slow tumor growth. There are several types of interferons, including interferon-alpha, -beta, and gamma. These substances are normally produced by the body. They are also made in the laboratory for use in treating cancer and other diseases. [NIH] Interferon-alpha: One of the type I interferons produced by peripheral blood leukocytes or lymphoblastoid cells when exposed to live or inactivated virus, double-stranded RNA, or bacterial products. It is the major interferon produced by virus-induced leukocyte cultures and, in addition to its pronounced antiviral activity, it causes activation of NK cells. [NIH] 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] Intestinal: Having to do with the intestines. [NIH] Intestinal Mucosa: The surface lining of the intestines where the cells absorb nutrients. [NIH] Intestine: A long, tube-shaped organ in the abdomen that completes the process of digestion. There is both a large intestine and a small intestine. Also called the bowel. [NIH] Intoxication: Poisoning, the state of being poisoned. [EU] Intracellular: Inside a cell. [NIH] Intracellular Membranes: Membranes of subcellular structures. [NIH] Intramuscular: IM. Within or into muscle. [NIH] Intravenous: IV. Into a vein. [NIH] Invasive: 1. Having the quality of invasiveness. 2. Involving puncture or incision of the skin or insertion of an instrument or foreign material into the body; said of diagnostic techniques. [EU]

Ionizing: Radiation comprising charged particles, e. g. electrons, protons, alpha-particles, etc., having sufficient kinetic energy to produce ionization by collision. [NIH] Irritants: Drugs that act locally on cutaneous or mucosal surfaces to produce inflammation; those that cause redness due to hyperemia are rubefacients; those that raise blisters are

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vesicants and those that penetrate sebaceous glands and cause abscesses are pustulants; tear gases and mustard gases are also irritants. [NIH] Itraconazole: An antifungal agent that has been used in the treatment of histoplasmosis, blastomycosis, cryptococcal meningitis, and aspergillosis. [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] Ketoconazole: Broad spectrum antifungal agent used for long periods at high doses, especially in immunosuppressed patients. [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 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] Labile: 1. Gliding; moving from point to point over the surface; unstable; fluctuating. 2. Chemically unstable. [EU] Large Intestine: The part of the intestine that goes from the cecum to the rectum. The large intestine absorbs water from stool and changes it from a liquid to a solid form. The large intestine is 5 feet long and includes the appendix, cecum, colon, and rectum. Also called colon. [NIH] Lectin: A complex molecule that has both protein and sugars. Lectins are able to bind to the outside of a cell and cause biochemical changes in it. Lectins are made by both animals and plants. [NIH] Lethal: Deadly, fatal. [EU] Leucocyte: All the white cells of the blood and their precursors (myeloid cell series, lymphoid cell series) but commonly used to indicate granulocytes exclusive of lymphocytes. [NIH]

144 Yeast Infections

Leukaemia: An acute or chronic disease of unknown cause in man and other warm-blooded animals that involves the blood-forming organs, is characterized by an abnormal increase in the number of leucocytes in the tissues of the body with or without a corresponding increase of those in the circulating blood, and is classified according of the type leucocyte most prominently involved. [EU] Leukemia: Cancer of blood-forming tissue. [NIH] Leukocytes: White blood cells. These include granular leukocytes (basophils, eosinophils, and neutrophils) as well as non-granular leukocytes (lymphocytes and monocytes). [NIH] Leukoplakia: A white patch that may develop on mucous membranes such as the cheek, gums, or tongue and may become cancerous. [NIH] Library Services: Services offered to the library user. They include reference and circulation. [NIH]

Lice: A general name for small, wingless, parasitic insects, previously of the order Phthiraptera. Though exact taxonomy is still controversial, they can be grouped in the orders Anoplura (sucking lice), Mallophaga (biting lice), and Rhynchophthirina (elephant lice). [NIH] Life cycle: The successive stages through which an organism passes from fertilized ovum or spore to the fertilized ovum or spore of the next generation. [NIH] Ligands: A RNA simulation method developed by the MIT. [NIH] Linkage: The tendency of two or more genes in the same chromosome to remain together from one generation to the next more frequently than expected according to the law of independent assortment. [NIH] Lipid: Fat. [NIH] Liposomal: A drug preparation that contains the active drug in very tiny fat particles. This fat-encapsulated drug is absorbed better, and its distribution to the tumor site is improved. [NIH]

Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Liver scan: An image of the liver created on a computer screen or on film. A radioactive substance is injected into a blood vessel and travels through the bloodstream. It collects in the liver, especially in abnormal areas, and can be detected by the scanner. [NIH] Loading dose: A quantity higher than the average or maintenance dose, used at the initiation of therapy to rapidly establish a desired level of the drug [EU] Localized: Cancer which has not metastasized yet. [NIH] Lubricants: Oily or slippery substances. [NIH] Lubrication: The application of a substance to diminish friction between two surfaces. It may refer to oils, greases, and similar substances for the lubrication of medical equipment but it can be used for the application of substances to tissue to reduce friction, such as lotions for skin and vaginal lubricants. [NIH] Lupus: A form of cutaneous tuberculosis. It is seen predominantly in women and typically involves the nasal, buccal, and conjunctival mucosa. [NIH] Lymph: The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. [NIH] Lymph node: A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Also known as a lymph gland. Lymph nodes are spread out along lymphatic vessels and contain many lymphocytes, which filter the lymphatic fluid (lymph).

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[NIH]

Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. [NIH] Lymphatic system: The tissues and organs that produce, store, and carry white blood cells that fight infection and other diseases. This system includes the bone marrow, spleen, thymus, lymph nodes and a network of thin tubes that carry lymph and white blood cells. These tubes branch, like blood vessels, into all the tissues of the body. [NIH] 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] Lymphoid: Referring to lymphocytes, a type of white blood cell. Also refers to tissue in which lymphocytes develop. [NIH] Macrophage: A type of white blood cell that surrounds and kills microorganisms, removes dead cells, and stimulates the action of other immune system cells. [NIH] Magnetic Resonance Imaging: Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques. [NIH] Maintenance therapy: Treatment that is given to help a primary (original) treatment keep working. Maintenance therapy is often given to help keep cancer in remission. [NIH] Major Histocompatibility Complex: The genetic region which contains the loci of genes which determine the structure of the serologically defined (SD) and lymphocyte-defined (LD) transplantation antigens, genes which control the structure of the immune responseassociated (Ia) antigens, the immune response (Ir) genes which control the ability of an animal to respond immunologically to antigenic stimuli, and genes which determine the structure and/or level of the first four components of complement. [NIH] Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malnutrition: A condition caused by not eating enough food or not eating a balanced diet. [NIH]

Mannans: Polysaccharides consisting of mannose units. [NIH] Meat: The edible portions of any animal used for food including domestic mammals (the major ones being cattle, swine, and sheep) along with poultry, fish, shellfish, and game. [NIH]

MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Membrane Lipids: Lipids, predominantly phospholipids, cholesterol and small amounts of glycolipids found in membranes including cellular and intracellular membranes. These lipids may be arranged in bilayers in the membranes with integral proteins between the layers and peripheral proteins attached to the outside. Membrane lipids are required for active transport, several enzymatic activities and membrane formation. [NIH] Meninges: The three membranes that cover and protect the brain and spinal cord. [NIH] Meningitis: Inflammation of the meninges. When it affects the dura mater, the disease is termed pachymeningitis; when the arachnoid and pia mater are involved, it is called leptomeningitis, or meningitis proper. [EU]

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Mental: Pertaining to the mind; psychic. 2. (L. mentum chin) pertaining to the chin. [EU] Mental Disorders: Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function. [NIH] Mesenteric: Pertaining to the mesentery : a membranous fold attaching various organs to the body wall. [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] Microbe: An organism which cannot be observed with the naked eye; e. g. unicellular animals, lower algae, lower fungi, bacteria. [NIH] Microbiological: Pertaining to microbiology : the science that deals with microorganisms, including algae, bacteria, fungi, protozoa and viruses. [EU] Microbiology: The study of microorganisms such as fungi, bacteria, algae, archaea, and viruses. [NIH] 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] Microscopy: The application of microscope magnification to the study of materials that cannot be properly seen by the unaided eye. [NIH] Mineralocorticoids: A group of corticosteroids primarily associated with the regulation of water and electrolyte balance. This is accomplished through the effect on ion transport in renal tubules, resulting in retention of sodium and loss of potassium. Mineralocorticoid secretion is itself regulated by plasma volume, serum potassium, and angiotensin II. [NIH] Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] Monoclonal: An antibody produced by culturing a single type of cell. It therefore consists of a single species of immunoglobulin molecules. [NIH] Mononuclear: A cell with one nucleus. [NIH] Morphogenesis: The development of the form of an organ, part of the body, or organism. [NIH]

Morphological: Relating to the configuration or the structure of live organs. [NIH] Motion Sickness: Sickness caused by motion, as sea sickness, train sickness, car sickness, and air sickness. [NIH] Mucins: A secretion containing mucopolysaccharides and protein that is the chief constituent of mucus. [NIH] Mucocutaneous: Pertaining to or affecting the mucous membrane and the skin. [EU] Mucosa: A mucous membrane, or tunica mucosa. [EU] Mucositis: A complication of some cancer therapies in which the lining of the digestive system becomes inflamed. Often seen as sores in the mouth. [NIH]

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Multicenter study: A clinical trial that is carried out at more than one medical institution. [NIH]

Muscle Fibers: Large single cells, either cylindrical or prismatic in shape, that form the basic unit of muscle tissue. They consist of a soft contractile substance enclosed in a tubular sheath. [NIH] Muscular Atrophy: Derangement in size and number of muscle fibers occurring with aging, reduction in blood supply, or following immobilization, prolonged weightlessness, malnutrition, and particularly in denervation. [NIH] Muscular Dystrophies: A general term for a group of inherited disorders which are characterized by progressive degeneration of skeletal muscles. [NIH] Mustard Gas: Severe irritant and vesicant of skin, eyes, and lungs. It may cause blindness and lethal lung edema and was formerly used as a war gas. The substance has been proposed as a cytostatic and for treatment of psoriasis. It has been listed as a known carcinogen in the Fourth Annual Report on Carcinogens (NTP-85-002, 1985) (Merck, 11th ed). [NIH] Myasthenia: Muscular debility; any constitutional anomaly of muscle. [EU] Mycological: Relating to mycology, that is the science and study of fungi. [EU] Myelogenous: Produced by, or originating in, the bone marrow. [NIH] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Nausea: An unpleasant sensation in the stomach usually accompanied by the urge to vomit. Common causes are early pregnancy, sea and motion sickness, emotional stress, intense pain, food poisoning, and various enteroviruses. [NIH] NCI: National Cancer Institute. NCI, part of the National Institutes of Health of the United States Department of Health and Human Services, is the federal government's principal agency for cancer research. NCI conducts, coordinates, and funds cancer research, training, health information dissemination, and other programs with respect to the cause, diagnosis, prevention, and treatment of cancer. Access the NCI Web site at http://cancer.gov. [NIH] Necrobiosis Lipoidica: A degenerative disease of the dermal connective tissue characterized by the development of erythematous papules or nodules in the pretibial area. The papules form plaques covered with telangiectatic vessels. More than half of the affected patients have diabetes. [NIH] 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] Neoplasia: Abnormal and uncontrolled cell growth. [NIH] Neoplasm: A new growth of benign or malignant tissue. [NIH] Neoplastic: Pertaining to or like a neoplasm (= any new and abnormal growth); pertaining to neoplasia (= the formation of a neoplasm). [EU] Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Neural: 1. Pertaining to a nerve or to the nerves. 2. Situated in the region of the spinal axis, as the neutral arch. [EU]

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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] Neurotransmitter: Any of a group of substances that are released on excitation from the axon terminal of a presynaptic neuron of the central or peripheral nervous system and travel across the synaptic cleft to either excite or inhibit the target cell. Among the many substances that have the properties of a neurotransmitter are acetylcholine, norepinephrine, epinephrine, dopamine, glycine, y-aminobutyrate, glutamic acid, substance P, enkephalins, endorphins, and serotonin. [EU] Neutrons: Electrically neutral elementary particles found in all atomic nuclei except light hydrogen; the mass is equal to that of the proton and electron combined and they are unstable when isolated from the nucleus, undergoing beta decay. Slow, thermal, epithermal, and fast neutrons refer to the energy levels with which the neutrons are ejected from heavier nuclei during their decay. [NIH] 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] Nosocomial: Pertaining to or originating in the hospital, said of an infection not present or incubating prior to admittance to the hospital, but generally occurring 72 hours after admittance; the term is usually used to refer to patient disease, but hospital personnel may also acquire nosocomial infection. [EU] 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] Nucleotidases: A class of enzymes that catalyze the conversion of a nucleotide and water to a nucleoside and orthophosphate. EC 3.1.3.-. [NIH] Nystatin: Macrolide antifungal antibiotic complex produced by Streptomyces noursei, S. aureus, and other Streptomyces species. The biologically active components of the complex are nystatin A1, A2, and A3. [NIH] Ointments: Semisolid preparations used topically for protective emollient effects or as a vehicle for local administration of medications. Ointment bases are various mixtures of fats, waxes, animal and plant oils and solid and liquid hydrocarbons. [NIH] Oliguria: Clinical manifestation of the urinary system consisting of a decrease in the amount of urine secreted. [NIH] Oral Manifestations: Disorders of the mouth attendant upon non-oral disease or injury. [NIH]

Organ Transplantation: Transference of an organ between individuals of the same species or between individuals of different species. [NIH] Overdose: An accidental or deliberate dose of a medication or street drug that is in excess of what is normally used. [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]

Pachymeningitis: Inflammation of the dura mater of the brain, the spinal cord or the optic nerve. [NIH]

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Palate: The structure that forms the roof of the mouth. It consists of the anterior hard palate and the posterior soft palate. [NIH] Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU] 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] Pancreas Transplant: A surgical procedure that involves replacing the pancreas of a person who has diabetes with a healthy pancreas that can make insulin. The healthy pancreas comes from a donor who has just died or from a living relative. A person can donate half a pancreas and still live normally. [NIH] Pancreas Transplantation: The transference of a pancreas from one human or animal to another. [NIH] Parasite: An animal or a plant that lives on or in an organism of another species and gets at least some of its nutrition from that other organism. [NIH] Parasitic: Having to do with or being a parasite. A parasite is an animal or a plant that lives on or in an organism of another species and gets at least some of its nutrients from it. [NIH] Parenteral: Not through the alimentary canal but rather by injection through some other route, as subcutaneous, intramuscular, intraorbital, intracapsular, intraspinal, intrasternal, intravenous, etc. [EU] 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] Paronychia: Inflammation involving the folds of tissue surrounding the nail. Called also perionychia. [EU] Patch: A piece of material used to cover or protect a wound, an injured part, etc.: a patch over the eye. [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] Peptide Hydrolases: A subclass of enzymes from the hydrolase class that catalyze the hydrolysis of peptide bonds. Exopeptidases and endopeptidases make up the sub-subclasses for this group. EC 3.4. [NIH] Pericardium: The fibroserous sac surrounding the heart and the roots of the great vessels. [NIH]

Periodontics: A dental specialty concerned with the histology, physiology, and pathology of the tissues that support, attach, and surround the teeth, and of the treatment and prevention of disease affecting these tissues. [NIH] Peripheral Neuropathy: Nerve damage, usually affecting the feet and legs; causing pain,

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numbness, or a tingling feeling. Also called "somatic neuropathy" or "distal sensory polyneuropathy." [NIH] Pharmacodynamics: The study of the biochemical and physiological effects of drugs and the mechanisms of their actions, including the correlation of actions and effects of drugs with their chemical structure; also, such effects on the actions of a particular drug or drugs. [EU] Pharmacokinetic: The mathematical analysis of the time courses of absorption, distribution, and elimination of drugs. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] 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] Phosphoric Monoester Hydrolases: A group of hydrolases which catalyze the hydrolysis of monophosphoric esters with the production of one mole of orthophosphate. EC 3.1.3. [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 Examination: Systematic and thorough inspection of the patient for physical signs of disease or abnormality. [NIH] Physiology: The science that deals with the life processes and functions of organismus, their cells, tissues, and organs. [NIH] Pilot study: The initial study examining a new method or treatment. [NIH] Pituitary Gland: A small, unpaired gland situated in the sella turcica tissue. It is connected to the hypothalamus by a short stalk. [NIH] Plant Oils: Oils derived from plants or plant products. [NIH] Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Plaque: A clear zone in a bacterial culture grown on an agar plate caused by localized destruction of bacterial cells by a bacteriophage. The concentration of infective virus in a fluid can be estimated by applying the fluid to a culture and counting the number of. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Plasma cells: A type of white blood cell that produces antibodies. [NIH] Pneumonia: Inflammation of the lungs. [NIH] Poisoning: A condition or physical state produced by the ingestion, injection or inhalation of, or exposure to a deleterious agent. [NIH] Polymers: Compounds formed by the joining of smaller, usually repeating, units linked by covalent bonds. These compounds often form large macromolecules (e.g., polypeptides, proteins, plastics). [NIH] Polymorphic: Occurring in several or many forms; appearing in different forms at different stages of development. [EU]

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Polymorphism: The occurrence together of two or more distinct forms in the same population. [NIH] 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] 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] Prednisolone: A glucocorticoid with the general properties of the corticosteroids. It is the drug of choice for all conditions in which routine systemic corticosteroid therapy is indicated, except adrenal deficiency states. [NIH] 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] Promoter: A chemical substance that increases the activity of a carcinogenic process. [NIH] Prone: Having the front portion of the body downwards. [NIH] Prophylaxis: An attempt to prevent disease. [NIH] Propolis: Resinous substance obtained from beehives; contains many different substances which may have antimicrobial or antimycotic activity topically; its extracts are called propolis resin or balsam. Synonyms: bee bread; hive dross; bee glue. [NIH] Protein C: A vitamin-K dependent zymogen present in the blood, which, upon activation by thrombin and thrombomodulin exerts anticoagulant properties by inactivating factors Va and VIIIa at the rate-limiting steps of thrombin formation. [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] Proteolytic: 1. Pertaining to, characterized by, or promoting proteolysis. 2. An enzyme that promotes proteolysis (= the splitting of proteins by hydrolysis of the peptide bonds with formation of smaller polypeptides). [EU] Protocol: The detailed plan for a clinical trial that states the trial's rationale, purpose, drug or vaccine dosages, length of study, routes of administration, who may participate, and other aspects of trial design. [NIH] Protons: Stable elementary particles having the smallest known positive charge, found in the nuclei of all elements. The proton mass is less than that of a neutron. A proton is the nucleus of the light hydrogen atom, i.e., the hydrogen ion. [NIH] Protozoa: A subkingdom consisting of unicellular organisms that are the simplest in the

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animal kingdom. Most are free living. They range in size from submicroscopic to macroscopic. Protozoa are divided into seven phyla: Sarcomastigophora, Labyrinthomorpha, Apicomplexa, Microspora, Ascetospora, Myxozoa, and Ciliophora. [NIH] Pruritus: An intense itching sensation that produces the urge to rub or scratch the skin to obtain relief. [NIH] Psychic: Pertaining to the psyche or to the mind; mental. [EU] Psychoactive: Those drugs which alter sensation, mood, consciousness or other psychological or behavioral functions. [NIH] 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 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] Purulent: Consisting of or containing pus; associated with the formation of or caused by pus. [EU] Pustular: Pertaining to or of the nature of a pustule; consisting of pustules (= a visible collection of pus within or beneath the epidermis). [EU] Quiescent: Marked by a state of inactivity or repose. [EU] Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the waves/rays themselves; a stream of electromagnetic particles (electrons, neutrons, protons, alpha particles) or a mixture of these. The most common source is the sun. [NIH] Radioactive: Giving off radiation. [NIH] Radioimmunotherapy: Radiotherapy where cytotoxic radionuclides are linked to antibodies in order to deliver toxins directly to tumor targets. Therapy with targeted radiation rather than antibody-targeted toxins (immunotoxins) has the advantage that adjacent tumor cells, which lack the appropriate antigenic determinants, can be destroyed by radiation cross-fire. Radioimmunotherapy is sometimes called targeted radiotherapy, but this latter term can also refer to radionuclides linked to non-immune molecules (radiotherapy). [NIH] Radiological: Pertaining to radiodiagnostic and radiotherapeutic procedures, and interventional radiology or other planning and guiding medical radiology. [NIH] Radiology: A specialty concerned with the use of x-ray and other forms of radiant energy in the diagnosis and treatment of disease. [NIH] Radiotherapy: The use of ionizing radiation to treat malignant neoplasms and other benign conditions. The most common forms of ionizing radiation used as therapy are x-rays, gamma rays, and electrons. A special form of radiotherapy, targeted radiotherapy, links a cytotoxic radionuclide to a molecule that targets the tumor. When this molecule is an antibody or other immunologic molecule, the technique is called radioimmunotherapy. [NIH] Randomized: Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments. [NIH] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Recombinant: A cell or an individual with a new combination of genes not found together in either parent; usually applied to linked genes. [EU] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Recurrence: The return of a sign, symptom, or disease after a remission. [NIH]

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Refer: To send or direct for treatment, aid, information, de decision. [NIH] Refraction: A test to determine the best eyeglasses or contact lenses to correct a refractive error (myopia, hyperopia, or astigmatism). [NIH] Refractory: Not readily yielding to treatment. [EU] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Rehabilitative: Instruction of incapacitated individuals or of those affected with some mental disorder, so that some or all of their lost ability may be regained. [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] 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] Reversion: A return to the original condition, e. g. the reappearance of the normal or wild type in previously mutated cells, tissues, or organisms. [NIH] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Saliva: The clear, viscous fluid secreted by the salivary glands and mucous glands of the mouth. It contains mucins, water, organic salts, and ptylin. [NIH] Salivary: The duct that convey saliva to the mouth. [NIH] Salivary glands: Glands in the mouth that produce saliva. [NIH] Saturated fat: A type of fat found in greatest amounts in foods from animals, such as fatty cuts of meat, poultry with the skin, whole-milk dairy products, lard, and in some vegetable oils, including coconut, palm kernel, and palm oils. Saturated fat raises blood cholesterol more than anything else eaten. On a Step I Diet, no more than 8 to 10 percent of total calories should come from saturated fat, and in the Step II Diet, less than 7 percent of the day's total calories should come from saturated fat. [NIH] Scans: Pictures of structures inside the body. Scans often used in diagnosing, staging, and monitoring disease include liver scans, bone scans, and computed tomography (CT) or computerized axial tomography (CAT) scans and magnetic resonance imaging (MRI) scans. In liver scanning and bone scanning, radioactive substances that are injected into the bloodstream collect in these organs. A scanner that detects the radiation is used to create pictures. In CT scanning, an x-ray machine linked to a computer is used to produce detailed pictures of organs inside the body. MRI scans use a large magnet connected to a computer to create pictures of areas inside the body. [NIH] Schizoid: Having qualities resembling those found in greater degree in schizophrenics; a person of schizoid personality. [NIH] Schizophrenia: A mental disorder characterized by a special type of disintegration of the personality. [NIH] Schizotypal Personality Disorder: A personality disorder in which there are oddities of thought (magical thinking, paranoid ideation, suspiciousness), perception (illusions, depersonalization), speech (digressive, vague, overelaborate), and behavior (inappropriate affect in social interactions, frequently social isolation) that are not severe enough to

154 Yeast Infections

characterize schizophrenia. [NIH] Sclerosis: A pathological process consisting of hardening or fibrosis of an anatomical structure, often a vessel or a nerve. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Sebaceous: Gland that secretes sebum. [NIH] Sebaceous gland: Gland that secretes sebum. [NIH] Secretion: 1. The process of elaborating a specific product as a result of the activity of a gland; this activity may range from separating a specific substance of the blood to the elaboration of a new chemical substance. 2. Any substance produced by secretion. [EU] Secretory: Secreting; relating to or influencing secretion or the secretions. [NIH] Semisynthetic: Produced by chemical manipulation of naturally occurring substances. [EU] Sepsis: The presence of bacteria in the bloodstream. [NIH] Serology: The study of serum, especially of antigen-antibody reactions in vitro. [NIH] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] Sexually Transmitted Diseases: Diseases due to or propagated by sexual contact. [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] Small intestine: The part of the digestive tract that is located between the stomach and the large intestine. [NIH] Soaps: Sodium or potassium salts of long chain fatty acids. These detergent substances are obtained by boiling natural oils or fats with caustic alkali. Sodium soaps are harder and are used as topical anti-infectives and vehicles in pills and liniments; potassium soaps are soft, used as vehicles for ointments and also as topical antimicrobials. [NIH] Sodium: An element that is a member of the alkali group of metals. It has the atomic symbol Na, atomic number 11, and atomic weight 23. With a valence of 1, it has a strong affinity for oxygen and other nonmetallic elements. Sodium provides the chief cation of the extracellular body fluids. Its salts are the most widely used in medicine. (From Dorland, 27th ed) Physiologically the sodium ion plays a major role in blood pressure regulation, maintenance of fluid volume, and electrolyte balance. [NIH] Soft tissue: Refers to muscle, fat, fibrous tissue, blood vessels, or other supporting tissue of the body. [NIH] Solvent: 1. Dissolving; effecting a solution. 2. A liquid that dissolves or that is capable of dissolving; the component of a solution that is present in greater amount. [EU] 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]

Dictionary 155

Specificity: Degree of selectivity shown by an antibody with respect to the number and types of antigens with which the antibody combines, as well as with respect to the rates and the extents of these reactions. [NIH] Spectrum: A charted band of wavelengths of electromagnetic vibrations obtained by refraction and diffraction. By extension, a measurable range of activity, such as the range of bacteria affected by an antibiotic (antibacterial s.) or the complete range of manifestations of a disease. [EU] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] Spleen: An organ that is part of the lymphatic system. The spleen produces lymphocytes, filters the blood, stores blood cells, and destroys old blood cells. It is located on the left side of the abdomen near the stomach. [NIH] Splenectomy: An operation to remove the spleen. [NIH] Spores: The reproductive elements of lower organisms, such as protozoa, fungi, and cryptogamic plants. [NIH] Staging: Performing exams and tests to learn the extent of the cancer within the body, especially whether the disease has spread from the original site to other parts of the body. [NIH]

Staphylococcus: A genus of gram-positive, facultatively anaerobic, coccoid bacteria. Its organisms occur singly, in pairs, and in tetrads and characteristically divide in more than one plane to form irregular clusters. Natural populations of Staphylococcus are membranes of warm-blooded animals. Some species are opportunistic pathogens of humans and animals. [NIH] Staphylococcus aureus: Potentially pathogenic bacteria found in nasal membranes, skin, hair follicles, and perineum of warm-blooded animals. They may cause a wide range of infections and intoxications. [NIH] Steroids: Drugs used to relieve swelling and inflammation. [NIH] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Streptococci: A genus of spherical Gram-positive bacteria occurring in chains or pairs. They are widely distributed in nature, being important pathogens but often found as normal commensals in the mouth, skin, and intestine of humans and other animals. [NIH] Streptococcus: A genus of gram-positive, coccoid bacteria whose organisms occur in pairs or chains. No endospores are produced. Many species exist as commensals or parasites on man or animals with some being highly pathogenic. A few species are saprophytes and occur in the natural environment. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Stroke: Sudden loss of function of part of the brain because of loss of blood flow. Stroke may be caused by a clot (thrombosis) or rupture (hemorrhage) of a blood vessel to the brain. [NIH] Subacute: Somewhat acute; between acute and chronic. [EU] 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]

156 Yeast Infections

Subspecies: A category intermediate in rank between species and variety, based on a smaller number of correlated characters than are used to differentiate species and generally conditioned by geographical and/or ecological occurrence. [NIH] Substance P: An eleven-amino acid neurotransmitter that appears in both the central and peripheral nervous systems. It is involved in transmission of pain, causes rapid contractions of the gastrointestinal smooth muscle, and modulates inflammatory and immune responses. [NIH]

Substrate: A substance upon which an enzyme acts. [EU] Suppression: A conscious exclusion of disapproved desire contrary with repression, in which the process of exclusion is not conscious. [NIH] Suppressive: Tending to suppress : effecting suppression; specifically : serving to suppress activity, function, symptoms. [EU] Suspensions: Colloids with liquid continuous phase and solid dispersed phase; the term is used loosely also for solid-in-gas (aerosol) and other colloidal systems; water-insoluble drugs may be given as suspensions. [NIH] Symptomatic: Having to do with symptoms, which are signs of a condition or disease. [NIH] Systemic: Affecting the entire body. [NIH] Systemic lupus erythematosus: SLE. A chronic inflammatory connective tissue disease marked by skin rashes, joint pain and swelling, inflammation of the kidneys, inflammation of the fibrous tissue surrounding the heart (i.e., the pericardium), as well as other problems. Not all affected individuals display all of these problems. May be referred to as lupus. [NIH] Taurine: 2-Aminoethanesulfonic acid. A conditionally essential nutrient, important during mammalian development. It is present in milk but is isolated mostly from ox bile and strongly conjugates bile acids. [NIH] Tear Gases: Gases that irritate the eyes, throat, or skin. Severe lacrimation develops upon irritation of the eyes. [NIH] Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [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] Thrush: A disease due to infection with species of fungi of the genus Candida. [NIH] Thymoma: A tumor of the thymus, an organ that is part of the lymphatic system and is located in the chest, behind the breastbone. [NIH] 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] Tin: A trace element that is required in bone formation. It has the atomic symbol Sn, atomic number 50, and atomic weight 118.71. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tolerance: 1. The ability to endure unusually large doses of a drug or toxin. 2. Acquired drug tolerance; a decreasing response to repeated constant doses of a drug or the need for increasing doses to maintain a constant response. [EU]

Dictionary 157

Tomography: Imaging methods that result in sharp images of objects located on a chosen plane and blurred images located above or below the plane. [NIH] Topical: On the surface of the body. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxin: A poison; frequently used to refer specifically to a protein produced by some higher plants, certain animals, and pathogenic bacteria, which is highly toxic for other living organisms. Such substances are differentiated from the simple chemical poisons and the vegetable alkaloids by their high molecular weight and antigenicity. [EU] Toxoplasmosis: The acquired form of infection by Toxoplasma gondii in animals and man. [NIH]

Trace element: Substance or element essential to plant or animal life, but present in extremely small amounts. [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] Translation: The process whereby the genetic information present in the linear sequence of ribonucleotides in mRNA is converted into a corresponding sequence of amino acids in a protein. It occurs on the ribosome and is unidirectional. [NIH] Translocating: The attachment of a fragment of one chromosome to a non-homologous chromosome. [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] Tunica: A rather vague term to denote the lining coat of hollow organs, tubes, or cavities. [NIH]

Typhimurium: Microbial assay which measures his-his+ reversion by chemicals which cause base substitutions or frameshift mutations in the genome of this organism. [NIH] 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] 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]

Urinary: Having to do with urine or the organs of the body that produce and get rid of

158 Yeast Infections

urine. [NIH] Urinary tract: The organs of the body that produce and discharge urine. These include the kidneys, ureters, bladder, and urethra. [NIH] Urine: Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra. [NIH] Urogenital: Pertaining to the urinary and genital apparatus; genitourinary. [EU] Uterus: The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in which a fetus develops. Also called the womb. [NIH] Vaccine: A substance or group of substances meant to cause the immune system to respond to a tumor or to microorganisms, such as bacteria or viruses. [NIH] Vagina: The muscular canal extending from the uterus to the exterior of the body. Also called the birth canal. [NIH] Vaginal: Of or having to do with the vagina, the birth canal. [NIH] Vaginitis: Inflammation of the vagina characterized by pain and a purulent discharge. [NIH] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vasodilation: Physiological dilation of the blood vessels without anatomic change. For dilation with anatomic change, dilatation, pathologic or aneurysm (or specific aneurysm) is used. [NIH] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Venous: Of or pertaining to the veins. [EU] Venous blood: Blood that has given up its oxygen to the tissues and carries carbon dioxide back for gas exchange. [NIH] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Virulence: The degree of pathogenicity within a group or species of microorganisms or viruses as indicated by case fatality rates and/or the ability of the organism to invade the tissues of the host. [NIH] Virus: Submicroscopic organism that causes infectious disease. In cancer therapy, some viruses may be made into vaccines that help the body build an immune response to, and kill, tumor cells. [NIH] Vitamin A: A substance used in cancer prevention; it belongs to the family of drugs called retinoids. [NIH] Vitiligo: A disorder consisting of areas of macular depigmentation, commonly on extensor aspects of extremities, on the face or neck, and in skin folds. Age of onset is often in young adulthood and the condition tends to progress gradually with lesions enlarging and extending until a quiescent state is reached. [NIH] Vitro: Descriptive of an event or enzyme reaction under experimental investigation occurring outside a living organism. Parts of an organism or microorganism are used together with artificial substrates and/or conditions. [NIH] Vivo: Outside of or removed from the body of a living organism. [NIH] Voriconazole: A drug that treats infections caused by fungi. [NIH] Vulgaris: An affection of the skin, especially of the face, the back and the chest, due to chronic inflammation of the sebaceous glands and the hair follicles. [NIH] Vulva: The external female genital organs, including the clitoris, vaginal lips, and the

Dictionary 159

opening to the vagina. [NIH] Vulvovaginitis: Inflammation of the vulva and vagina, or of the vulvovaginal glands. [EU] 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]

Withdrawal: 1. A pathological retreat from interpersonal contact and social involvement, as may occur in schizophrenia, depression, or schizoid avoidant and schizotypal personality disorders. 2. (DSM III-R) A substance-specific organic brain syndrome that follows the cessation of use or reduction in intake of a psychoactive substance that had been regularly used to induce a state of intoxication. [EU] Xenograft: The cells of one species transplanted to another species. [NIH] Xerostomia: Decreased salivary flow. [NIH] X-ray: High-energy radiation used in low doses to diagnose diseases and in high doses to treat cancer. [NIH] Yeasts: A general term for single-celled rounded fungi that reproduce by budding. Brewers' and bakers' yeasts are Saccharomyces cerevisiae; therapeutic dried yeast is dried yeast. [NIH] 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]

161

INDEX A Abdominal, 125, 149 Acid Phosphatase, 6, 125 Acidosis, 125, 134 Acute leukemia, 12, 125 Acute myelogenous leukemia, 14, 125 Acute myeloid leukemia, 125 Acute nonlymphocytic leukemia, 125 Adhesives, 125 Adrenal Cortex, 125, 133 Adverse Effect, 125, 154 Aerosol, 125, 128, 156 Affinity, 125, 154 Algorithms, 125, 128 Alimentary, 125, 134, 149 Alkaline, 125, 126, 129 Alleles, 126, 140 Alpha Particles, 126, 152 Alternative medicine, 91, 126 Amber, 126, 141 Amifostine, 19, 126 Amino acid, 5, 126, 127, 138, 149, 151, 156, 157 Amino Acid Sequence, 126, 127, 138 Ammonia, 126, 138 Anaesthesia, 126, 141 Analog, 126, 137 Anaphylatoxins, 126, 132 Anatomical, 126, 131, 141, 154 Androgens, 125, 126, 133 Animal model, 22, 42, 126 Antibacterial, 5, 127, 134, 155 Antibiotic, 36, 92, 127, 148, 155 Antibodies, 127, 145, 150, 152 Antibody, 4, 22, 97, 125, 127, 132, 140, 141, 146, 152, 154, 155 Anticoagulant, 127, 151 Antifungal Agents, 4, 6, 48, 111, 127 Antigen, 11, 18, 125, 127, 132, 140, 141, 154 Antigen-Antibody Complex, 127, 132 Anti-infective, 127, 131, 154 Anti-inflammatory, 127, 128, 133, 138 Anti-Inflammatory Agents, 127, 133 Antimicrobial, 15, 17, 21, 32, 33, 34, 127, 151 Antimycotic, 127, 131, 151 Antineoplastic, 127, 133 Antioxidants, 127

Anuria, 127, 143 Anus, 127, 129 Arginine, 126, 127 Arterial, 127, 140, 151 Arteries, 127, 128, 129, 133, 146 Aspergillosis, 8, 48, 49, 54, 128, 143 Assay, 8, 11, 128, 157 Autonomic, 126, 128 B Bacteria, 127, 128, 136, 137, 139, 146, 154, 155, 157, 158 Bacterial Infections, 84, 128 Bacterial Translocation, 128 Bactericidal, 128, 136 Base, 128, 134, 137, 138, 143, 157 Beclomethasone, 19, 128 Beer, 128 Benign, 128, 139, 147, 152 Bile, 128, 138, 140, 144, 156 Bile Acids, 128, 156 Biochemical, 126, 128, 143, 150 Biological response modifier, 128, 142 Biopsy, 44, 128 Biotechnology, 7, 10, 91, 103, 128 Bladder, 128, 134, 157, 158 Blastomycosis, 128, 143 Blood Cell Count, 49, 129, 139 Blood Coagulation, 129, 156 Blood Glucose, 82, 85, 111, 129, 139, 142 Blood pressure, 129, 130, 140, 154 Blood vessel, 129, 130, 131, 140, 144, 145, 154, 155, 156, 158 Body Fluids, 129, 154 Bone Marrow, 15, 49, 125, 129, 145, 147 Bone Marrow Transplantation, 15, 129 Bone scan, 129, 153 Bowel, 129, 134, 142 Bowel Movement, 129, 134 Branch, 121, 129, 145, 149, 154, 156 Breakdown, 129, 134, 138 Buccal, 5, 129, 144 Burning Mouth Syndrome, 92, 129 C Calcium, 129, 132 Candidosis, 9, 12, 16, 83, 130 Carbohydrate, 130, 133, 139, 151 Carcinogenic, 130, 142, 151 Carcinogens, 130, 131, 147

162 Yeast Infections

Cardiovascular, 82, 85, 130 Cardiovascular disease, 85, 130 Case report, 11, 130 Catheter, 49, 130 Caustic, 130, 154 Cell Division, 128, 130, 150 Cell membrane, 130, 131, 150 Cellobiose, 5, 130 Cellulitis, 84, 130 Cellulose, 130, 138, 150 Central Nervous System, 15, 130, 138 Cerebrovascular, 130 Cervical, 90, 130 Cervix, 131 Character, 92, 131, 134 Cheilitis, 4, 92, 131 Chemotactic Factors, 131, 132 Child Care, 113, 131 Chin, 131, 146 Chlorhexidine, 53, 131 Chlorophyll, 131, 138 Cholesterol, 83, 128, 131, 133, 145, 153 Chromium, 131 Chronic, 4, 9, 12, 16, 18, 21, 22, 35, 85, 129, 131, 136, 141, 143, 144, 155, 156, 158 Chronic Disease, 131, 144 Clinical resistance, 42, 131 Clinical trial, 5, 41, 50, 55, 103, 131, 133, 147, 151, 152 Cloning, 128, 131 Clotrimazole, 13, 46, 50, 51, 92, 131 Coccidioidomycosis, 51, 131 Cofactor, 131, 151, 156 Collagen, 125, 126, 131, 139 Colloidal, 132, 135, 156 Commensal, 5, 132 Complement, 32, 126, 132, 145 Complementary and alternative medicine, 31, 40, 132 Complementary medicine, 31, 132 Computational Biology, 103, 132 Computed tomography, 132, 153 Conception, 133 Concomitant, 43, 133 Congestion, 133, 136 Connective Tissue, 129, 130, 132, 133, 137, 138, 144, 147, 156 Constipation, 133 Constitutional, 133, 147 Consumption, 133 Contraception, 85, 133 Contracture, 84, 133

Contraindications, ii, 133 Controlled study, 12, 133 Coronary, 130, 133, 146 Coronary heart disease, 130, 133 Coronary Thrombosis, 133, 146 Corticosteroid, 19, 133, 151 Crowns, 133, 134 Cryptococcosis, 51, 134 Curative, 134, 156 Cutaneous, 8, 9, 12, 14, 24, 31, 128, 129, 134, 142, 144 Cyanoacrylates, 134 Cystitis, 83, 85, 108, 134 Cytoprotection, 19, 134 Cytosine, 134, 137 Cytotoxic, 134, 152 D Dairy Products, 134, 153 Degenerative, 134, 147 Dental Abutments, 134 Dentures, 92, 134 Depigmentation, 134, 158 Dermal, 134, 147 Dermatology, 11, 15, 16, 22, 134 Diabetes Mellitus, 35, 85, 134, 138, 140 Diabetic Ketoacidosis, 82, 134 Diagnostic procedure, 57, 91, 134 Diarrhea, 104, 134 Dietary Fiber, 134 Dietitian, 82, 134 Digestion, 83, 125, 128, 129, 134, 142, 144, 155 Digestive system, 55, 134, 146 Digestive tract, 134, 154 Direct, iii, 95, 135, 153 Disinfectant, 131, 135, 136 Distal, 135, 150 Dross, 135, 151 Drug Interactions, 96, 97, 135 Drug Tolerance, 135, 156 Dura mater, 135, 145, 148 Dystrophy, 11, 12, 17, 135 E Eating Disorders, 52, 85, 135 Effector, 132, 135 Efficacy, 8, 14, 42, 45, 46, 47, 48, 49, 51, 135 Electrocardiogram, 41, 135 Electrolyte, 133, 135, 143, 146, 151, 154 Electron microscope, 16, 135 Electrophoresis, 13, 135 Embryo, 135, 141 Emollient, 135, 148

Index 163

Encapsulated, 135, 144 Endemic, 51, 135 Endocarditis, 130, 135 Endogenous, 6, 136 Endotoxins, 132, 136 Environmental Health, 102, 104, 136 Enzymatic, 126, 129, 132, 136, 145 Enzyme, 8, 125, 131, 135, 136, 137, 151, 156, 158, 159 Epigastric, 136, 149 Epithelial, 5, 136 Epithelial Cells, 5, 136 Epithelium, 22, 136 Equipment and Supplies, 82, 136 Erysipelas, 84, 136 Erythema, 84, 136 Erythrasma, 84, 136 Erythrocyte Indices, 129, 136 Erythrocytes, 129, 136 Esophageal, 5, 42, 43, 44, 45, 47, 51, 136 Esophagitis, 42, 44, 45, 47, 111, 136 Esophagus, 5, 42, 47, 111, 134, 135, 136, 155 Estrogen, 136, 137 Ethanol, 33, 136, 137 Ethinyl Estradiol, 4, 137 Evacuation, 133, 137 Excrete, 127, 137, 143 Exocrine, 137, 149 Exogenous, 21, 136, 137 Extensor, 137, 158 Extracellular, 6, 133, 137, 154 F Family Planning, 103, 137 Fat, 129, 133, 137, 143, 144, 153, 154 Fatty acids, 134, 137, 154 Feces, 133, 137 Fermentation, 128, 137 Fibrosis, 133, 137, 154 Fluconazole, 4, 5, 7, 8, 9, 13, 14, 15, 18, 34, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 90, 137 Flucytosine, 4, 137 Fold, 137, 146 Food Habits, 137 Food Preferences, 137 Frameshift, 137, 157 Frameshift Mutation, 137, 157 Friction, 137, 144 Fungi, 49, 54, 127, 128, 137, 138, 146, 147, 155, 156, 158, 159 Fungicides, Industrial, 127, 137

Fungus, 3, 22, 42, 49, 111, 112, 129, 131, 134, 137 G Gallbladder, 125, 134, 138 Gamma Rays, 138, 152 Ganglia, 126, 138, 147 Gas, 126, 138, 147, 148, 156, 158 Gastrointestinal, 5, 46, 128, 136, 138, 156 Gastrointestinal tract, 5, 128, 136, 138 Gene, 5, 7, 11, 21, 126, 128, 138 Genetic Code, 138, 148 Genital, 16, 18, 108, 109, 138, 158 Genitourinary, 113, 138, 158 Gland, 125, 138, 144, 149, 150, 154 Glucocorticoid, 128, 138, 151 Glucose, 5, 82, 129, 130, 131, 134, 138, 139, 142 Glucose Intolerance, 134, 138 Glutamic Acid, 138, 148 Glutamine, 138 Glycine, 126, 138, 148 Glycopeptides, 6, 139 Glycoside, 139, 140 Glycosidic, 130, 139 Governing Board, 139, 151 Graft, 139, 140 Gram-negative, 128, 139 Granulocytes, 139, 143, 159 Granuloma, 84, 139 Granuloma Annulare, 84, 139 Gravis, 17, 139 Growth, 6, 33, 126, 127, 137, 139, 142, 145, 147, 150 H Habitual, 131, 139 Hair follicles, 139, 155, 158 Haplotypes, 12, 139 Heart attack, 130, 139 Hematocrit, 129, 136, 139 Hematologic Diseases, 11, 139 Hemodialysis, 139, 143 Hemoglobin, 129, 136, 139 Hemolytic, 140, 141 Hemorrhage, 140, 155 Hepatic, 14, 140 Heredity, 138, 140 Heterotrophic, 137, 140 Heterozygotes, 17, 140 Histology, 140, 149 Homogeneous, 13, 140 Homologous, 126, 140, 157 Hormonal, 133, 140

164 Yeast Infections

Hormone, 133, 140, 142 Host, 5, 128, 130, 132, 140, 158 Humoral, 140 Humour, 140 Hydrolases, 6, 140, 150 Hydrolysis, 130, 140, 149, 150, 151 Hydroxyproline, 126, 132, 140 Hypersensitivity, 28, 35, 140 Hypertension, 130, 140 Hypoglycemia, 82, 141 I Id, 29, 34, 109, 113, 114, 120, 122, 141 Imidazole, 20, 131, 141 Immune function, 54, 141 Immune response, 22, 127, 133, 141, 145, 156, 158 Immune system, 6, 44, 111, 112, 141, 145, 158, 159 Immunity, 4, 16, 19, 22, 28, 141, 157 Immunocompromised, 5, 6, 20, 21, 44, 45, 47, 51, 141 Immunodeficiency, 4, 7, 8, 9, 10, 16, 17, 18, 48, 49, 50, 110, 111, 112, 141 Immunoglobulin, 4, 127, 141, 146 Immunologic, 50, 131, 141, 152 Immunology, 16, 19, 22, 125, 141 Impairment, 141, 146 Impetigo, 84, 141 In vitro, 4, 5, 22, 24, 33, 34, 42, 141, 154 In vivo, 5, 17, 34, 141 Incision, 141, 142 Indicative, 82, 141, 149, 158 Induction, 47, 126, 141 Infarction, 133, 141, 146 Infection Control, 104, 141 Inflammation, 4, 35, 127, 130, 131, 134, 136, 137, 142, 145, 148, 149, 150, 155, 156, 158, 159 Ingestion, 33, 142, 150 Inhalation, 125, 131, 142, 150 Initiation, 46, 142, 144 Initiator, 142 Insulin, 82, 84, 134, 142, 143, 149 Insulin-dependent diabetes mellitus, 142 Interferon, 15, 142 Interferon-alpha, 142 Intermittent, 4, 44, 50, 142 Interstitial, 85, 108, 142 Intestinal, 33, 128, 142 Intestinal Mucosa, 128, 142 Intestine, 129, 142, 143, 155 Intoxication, 142, 159

Intracellular, 141, 142, 145, 151 Intracellular Membranes, 142, 145 Intramuscular, 142, 149 Intravenous, 42, 46, 50, 53, 142, 149 Invasive, 5, 9, 12, 13, 14, 17, 18, 19, 21, 34, 41, 42, 44, 45, 48, 51, 53, 109, 141, 142, 145 Ionizing, 126, 142, 152 Irritants, 111, 142 Itraconazole, 4, 22, 47, 48, 51, 143 J Joint, 143, 156 K Kb, 102, 143 Ketoconazole, 4, 39, 45, 143 Ketone Bodies, 134, 143 Ketosis, 134, 143 Kidney Failure, 82, 143 Kidney Failure, Acute, 143 Kidney Failure, Chronic, 143 L Labile, 132, 143 Large Intestine, 134, 135, 142, 143, 152, 154 Lectin, 14, 21, 143 Lethal, 128, 143, 147 Leucocyte, 143, 144 Leukaemia, 17, 144 Leukemia, 144 Leukocytes, 129, 131, 139, 142, 144 Leukoplakia, 4, 12, 144 Library Services, 120, 144 Lice, 113, 144 Life cycle, 137, 144 Ligands, 5, 144 Linkage, 130, 144 Lipid, 97, 142, 144 Liposomal, 23, 144 Liver, 12, 44, 54, 125, 128, 134, 137, 138, 140, 144, 153 Liver scan, 144, 153 Loading dose, 48, 144 Localized, 135, 139, 141, 144, 150, 157 Lubricants, 144 Lubrication, 144 Lupus, 144, 156 Lymph, 128, 130, 140, 144, 145 Lymph node, 128, 131, 144, 145 Lymphatic, 141, 144, 145, 155, 156 Lymphatic system, 144, 145, 155, 156 Lymphocyte, 127, 145 Lymphoid, 127, 143, 145

Index 165

M Macrophage, 5, 145 Magnetic Resonance Imaging, 145, 153 Maintenance therapy, 15, 145 Major Histocompatibility Complex, 139, 145 Malignant, 127, 145, 147, 152 Malnutrition, 145, 147 Mannans, 138, 145 Meat, 145, 153 MEDLINE, 103, 145 Membrane, 130, 131, 132, 139, 145, 146, 150 Membrane Lipids, 145, 150 Meninges, 130, 135, 145 Meningitis, 51, 137, 143, 145 Mental, iv, 4, 55, 102, 105, 131, 146, 152, 153, 157 Mental Disorders, 55, 146 Mesenteric, 128, 146 MI, 22, 33, 124, 146 Microbe, 146, 157 Microbiological, 48, 146 Microbiology, 16, 18, 23, 32, 146 Microorganism, 131, 146, 158 Microscopy, 6, 146 Mineralocorticoids, 125, 133, 146 Modification, 85, 126, 146 Molecular, 14, 103, 105, 126, 128, 132, 146, 157 Molecule, 127, 128, 132, 135, 139, 140, 143, 146, 148, 152 Monoclonal, 97, 146 Mononuclear, 139, 146 Morphogenesis, 6, 146 Morphological, 135, 138, 146 Motion Sickness, 146, 147 Mucins, 146, 153 Mucocutaneous, 4, 16, 21, 22, 51, 146 Mucosa, 144, 146 Mucositis, 92, 146 Multicenter study, 19, 147 Muscle Fibers, 147 Muscular Atrophy, 11, 147 Muscular Dystrophies, 135, 147 Mustard Gas, 143, 147 Myasthenia, 17, 147 Mycological, 9, 32, 147 Myelogenous, 147 Myocardium, 146, 147 N Nausea, 112, 143, 147, 157

NCI, 1, 41, 46, 48, 49, 52, 54, 55, 101, 147 Necrobiosis Lipoidica, 84, 147 Need, 3, 54, 81, 83, 91, 97, 104, 115, 147, 156 Neonatal, 19, 21, 23, 24, 147 Neoplasia, 90, 147 Neoplasm, 147 Neoplastic, 147 Nerve, 131, 147, 148, 149, 154 Nervous System, 130, 147, 148, 156 Neural, 140, 147 Neuropathy, 148, 150 Neurotransmitter, 126, 138, 139, 148, 156 Neutrons, 126, 148, 152 Nitrogen, 126, 138, 143, 148 Nosocomial, 10, 23, 148 Nucleic acid, 134, 138, 148 Nucleotidases, 140, 148 Nystatin, 13, 29, 43, 45, 46, 48, 49, 92, 96, 148 O Ointments, 111, 148, 154 Oliguria, 143, 148 Oral Manifestations, 50, 148 Organ Transplantation, 6, 148 Overdose, 43, 148 Oxidation, 127, 134, 148 P Pachymeningitis, 145, 148 Palate, 111, 149 Palliative, 149, 156 Pancreas, 82, 125, 134, 142, 149 Pancreas Transplant, 82, 149 Pancreas Transplantation, 82, 149 Parasite, 149 Parasitic, 144, 149 Parenteral, 24, 149 Parenteral Nutrition, 24, 149 Paronychia, 112, 149 Patch, 144, 149 Pathogenesis, 15, 149 Pathologic, 125, 128, 130, 133, 140, 149, 158 Patient Education, 53, 84, 110, 118, 120, 124, 149 Peptide, 126, 140, 149, 151 Peptide Hydrolases, 140, 149 Pericardium, 149, 156 Periodontics, 11, 149 Peripheral Neuropathy, 82, 149 Pharmacodynamics, 7, 17, 150 Pharmacokinetic, 44, 150 Pharmacologic, 150, 157

166 Yeast Infections

Phospholipids, 137, 145, 150 Phosphoric Monoester Hydrolases, 140, 150 Phosphorus, 129, 150 Physical Examination, 54, 150 Physiology, 149, 150 Pilot study, 33, 150 Pituitary Gland, 133, 150 Plant Oils, 148, 150 Plants, 138, 139, 143, 150, 155, 157 Plaque, 131, 150 Plasma, 127, 130, 138, 140, 143, 146, 150 Plasma cells, 127, 150 Pneumonia, 133, 150 Poisoning, 142, 147, 150 Polymers, 150, 151 Polymorphic, 15, 150 Polymorphism, 21, 151 Polysaccharide, 127, 130, 151 Posterior, 149, 151 Potassium, 146, 151, 154 Practice Guidelines, 105, 113, 151 Prednisolone, 14, 151 Progression, 7, 126, 151 Progressive, 11, 43, 135, 139, 143, 147, 151 Promoter, 12, 151 Prone, 4, 151 Prophylaxis, 15, 42, 43, 49, 50, 51, 151, 153 Propolis, 33, 151 Protein C, 5, 126, 151 Protein S, 128, 138, 151 Proteins, 126, 127, 130, 132, 139, 145, 146, 148, 149, 150, 151, 154 Proteolytic, 132, 151 Protocol, 47, 50, 54, 151 Protons, 126, 142, 151, 152 Protozoa, 146, 151, 155 Pruritus, 84, 152 Psychic, 146, 152 Psychoactive, 152, 159 Public Policy, 103, 152 Pulmonary, 129, 133, 143, 152 Pulmonary Edema, 143, 152 Purulent, 152, 158 Pustular, 141, 152 Q Quiescent, 152, 158 R Radiation, 18, 20, 126, 138, 142, 152, 153, 159 Radioactive, 129, 144, 152, 153 Radioimmunotherapy, 152

Radiological, 48, 152 Radiology, 33, 152 Radiotherapy, 19, 20, 152 Randomized, 15, 42, 46, 48, 50, 51, 135, 152 Receptor, 127, 152 Recombinant, 97, 152 Rectum, 127, 129, 134, 135, 138, 143, 152 Recurrence, 92, 152 Refer, 1, 129, 132, 137, 144, 148, 152, 153, 157 Refraction, 153, 155 Refractory, 14, 17, 42, 48, 153 Regimen, 135, 153 Rehabilitative, 53, 153 Relapse, 4, 153 Remission, 145, 152, 153 Retinoids, 153, 158 Reversion, 153, 157 Risk factor, 12, 17, 85, 92, 153 S Saliva, 153 Salivary, 134, 153, 159 Salivary glands, 134, 153 Saturated fat, 153 Scans, 49, 153 Schizoid, 153, 159 Schizophrenia, 153, 154, 159 Schizotypal Personality Disorder, 153, 159 Sclerosis, 84, 154 Screening, 21, 131, 154 Sebaceous, 143, 154, 158 Sebaceous gland, 143, 154, 158 Secretion, 133, 140, 142, 146, 154 Secretory, 19, 28, 154 Semisynthetic, 137, 154 Sepsis, 128, 154 Serology, 16, 154 Serum, 4, 9, 33, 126, 132, 143, 146, 154 Sexually Transmitted Diseases, 104, 108, 154 Side effect, 54, 92, 95, 97, 125, 154, 157 Signs and Symptoms, 153, 154 Small intestine, 140, 142, 154 Soaps, 111, 154 Sodium, 146, 154 Soft tissue, 129, 154 Solvent, 136, 154 Somatic, 140, 150, 154 Specialist, 115, 154 Species, 7, 18, 24, 32, 33, 42, 50, 126, 134, 136, 146, 148, 149, 154, 155, 156, 157, 158, 159

Index 167

Specificity, 11, 125, 155 Spectrum, 12, 131, 143, 155 Spinal cord, 130, 131, 135, 145, 147, 148, 155 Spleen, 128, 145, 155 Splenectomy, 10, 155 Spores, 131, 155 Staging, 153, 155 Staphylococcus, 141, 155 Staphylococcus aureus, 141, 155 Steroids, 133, 138, 155 Stomach, 125, 134, 135, 136, 138, 140, 143, 147, 154, 155 Streptococci, 141, 155 Streptococcus, 136, 155 Stress, 7, 18, 83, 147, 155 Stroke, 55, 102, 130, 155 Subacute, 141, 155 Subclinical, 141, 155 Subcutaneous, 130, 149, 155 Subspecies, 154, 156 Substance P, 154, 156 Substrate, 140, 156 Suppression, 133, 156 Suppressive, 51, 156 Suspensions, 13, 156 Symptomatic, 16, 43, 52, 156 Systemic, 5, 9, 10, 14, 48, 50, 54, 92, 96, 111, 112, 128, 129, 130, 141, 151, 156, 157 Systemic lupus erythematosus, 14, 156 T Taurine, 156 Tear Gases, 143, 156 Therapeutics, 97, 156 Thrombin, 151, 156 Thrombomodulin, 151, 156 Thrombosis, 151, 155, 156 Thymoma, 17, 156 Thymus, 40, 145, 156 Tin, 150, 156 Tolerance, 45, 46, 49, 51, 53, 138, 156 Tomography, 133, 153, 157 Topical, 23, 29, 40, 96, 111, 131, 136, 154, 157 Toxic, iv, 44, 141, 148, 157 Toxicity, 47, 135, 157 Toxicology, 21, 104, 157 Toxin, 156, 157 Toxoplasmosis, 51, 157 Trace element, 131, 156, 157 Transfection, 128, 157 Transfer Factor, 4, 157

Translation, 126, 157 Translocating, 128, 157 Transplantation, 12, 49, 82, 143, 145, 157 Trauma, 136, 157 Tunica, 146, 157 Typhimurium, 32, 157 U Ulcer, 130, 157 Unconscious, 141, 157 Uremia, 143, 157 Ureters, 157, 158 Urethra, 157, 158 Urinary, 24, 134, 138, 148, 157, 158 Urinary tract, 24, 158 Urine, 33, 49, 54, 127, 128, 143, 148, 157, 158 Urogenital, 138, 158 Uterus, 131, 158 V Vaccine, 151, 158 Vagina, 5, 111, 112, 130, 131, 158, 159 Vaginal, 5, 8, 13, 15, 16, 20, 21, 22, 23, 33, 35, 42, 87, 90, 96, 108, 109, 110, 111, 112, 144, 158 Vaginitis, 4, 14, 35, 111, 130, 158 Vascular, 141, 158 Vasodilation, 126, 158 Vein, 49, 54, 142, 158 Venous, 129, 151, 158 Venous blood, 129, 158 Veterinary Medicine, 103, 158 Virulence, 5, 10, 157, 158 Virus, 4, 7, 8, 9, 10, 16, 17, 18, 50, 110, 111, 112, 142, 150, 158 Vitamin A, 82, 158 Vitiligo, 35, 84, 158 Vitro, 6, 8, 9, 158 Vivo, 6, 8, 9, 158 Voriconazole, 10, 48, 54, 158 Vulgaris, 37, 40, 158 Vulva, 158, 159 Vulvovaginitis, 112, 159 W White blood cell, 49, 127, 144, 145, 150, 159 Withdrawal, 43, 159 X Xenograft, 127, 159 Xerostomia, 92, 159 X-ray, 49, 132, 138, 152, 153, 159 Y Yeasts, 28, 44, 83, 130, 137, 159

168 Yeast Infections

Z

Zymogen, 151, 159

Index 169

170 Yeast Infections

Index 171

172 Yeast Infections

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