LCOHOLISM A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R EFERENCES
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 Ó2003 by ICON Group International, Inc. Copyright Ó2003 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., 1960Alcoholism: 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: 0-597-83548-9 1. Alcoholism-Popular works. I. Title.
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Disclaimer This publication is not intended to be used for the diagnosis or treatment of a health problem. It is sold with the understanding that the publisher, editors, and authors are not engaging in the rendering of medical, psychological, financial, legal, or other professional services. References to any entity, product, service, or source of information that may be contained in this publication should not be considered an endorsement, either direct or implied, by the publisher, editors, or authors. ICON Group International, Inc., the editors, and the authors are not responsible for the content of any Web pages or publications referenced in this publication.
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Acknowledgements The collective knowledge generated from academic and applied research summarized in various references has been critical in the creation of this book which is best viewed as a comprehensive compilation and collection of information prepared by various official agencies which produce publications on alcoholism. 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 ALCOHOLISM ........................................................................................... 3 Overview ....................................................................................................................................... 3 The Combined Health Information Database ................................................................................ 3 Federally Funded Research on Alcoholism .................................................................................... 8 E-Journals: PubMed Central ....................................................................................................... 58 The National Library of Medicine: PubMed................................................................................ 59 CHAPTER 2. NUTRITION AND ALCOHOLISM................................................................................ 277 Overview ................................................................................................................................... 277 Finding Nutrition Studies on Alcoholism................................................................................. 277 Federal Resources on Nutrition................................................................................................. 281 Additional Web Resources......................................................................................................... 282 CHAPTER 3. ALTERNATIVE MEDICINE AND ALCOHOLISM ......................................................... 285 Overview ................................................................................................................................... 285 National Center for Complementary and Alternative Medicine ............................................... 285 Additional Web Resources......................................................................................................... 292 General References..................................................................................................................... 297 CHAPTER 4. DISSERTATIONS ON ALCOHOLISM ........................................................................... 299 Overview ................................................................................................................................... 299 Dissertations on Alcoholism...................................................................................................... 299 Keeping Current ........................................................................................................................ 324 CHAPTER 5. CLINICAL TRIALS AND ALCOHOLISM ...................................................................... 325 Overview ................................................................................................................................... 325 Recent Trials on Alcoholism...................................................................................................... 325 Keeping Current on Clinical Trials ........................................................................................... 346 CHAPTER 6. PATENTS ON ALCOHOLISM ...................................................................................... 349 Overview ................................................................................................................................... 349 Patents on Alcoholism ............................................................................................................... 349 Patent Applications on Alcoholism ........................................................................................... 368 Keeping Current ........................................................................................................................ 372 CHAPTER 7. BOOKS ON ALCOHOLISM .......................................................................................... 373 Overview ................................................................................................................................... 373 Book Summaries: Federal Agencies ........................................................................................... 373 Book Summaries: Online Booksellers ........................................................................................ 375 The National Library of Medicine Book Index........................................................................... 381 Chapters on Alcoholism............................................................................................................. 382 Directories ................................................................................................................................. 383 CHAPTER 8. MULTIMEDIA ON ALCOHOLISM ............................................................................... 385 Overview ................................................................................................................................... 385 Video Recordings....................................................................................................................... 385 Bibliography: Multimedia on Alcoholism.................................................................................. 388 CHAPTER 9. PERIODICALS AND NEWS ON ALCOHOLISM ............................................................ 391 Overview ................................................................................................................................... 391 News Services and Press Releases ............................................................................................. 391 Newsletter Articles .................................................................................................................... 396 Academic Periodicals covering Alcoholism ............................................................................... 397 APPENDIX A. PHYSICIAN RESOURCES.......................................................................................... 401 Overview ................................................................................................................................... 401 NIH Guidelines ......................................................................................................................... 401 NIH Databases .......................................................................................................................... 403 Other Commercial Databases .................................................................................................... 406
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Contents The Genome Project and Alcoholism..........................................................................................406 APPENDIX B. PATIENT RESOURCES ...............................................................................................411 Overview ....................................................................................................................................411 Patient Guideline Sources ..........................................................................................................411 Finding Associations ..................................................................................................................419 APPENDIX C. RESEARCHING MEDICATIONS .................................................................................421 Overview ....................................................................................................................................421 U.S. Pharmacopeia .....................................................................................................................421 Commercial Databases ...............................................................................................................423 APPENDIX D. FINDING MEDICAL LIBRARIES ................................................................................425 Overview ....................................................................................................................................425 Preparation .................................................................................................................................425 Finding a Local Medical Library ................................................................................................425 Medical Libraries in the U.S. and Canada .................................................................................425
ONLINE GLOSSARIES ................................................................................................................431 Online Dictionary Directories ...................................................................................................435 ALCOHOLISM DICTIONARY ...................................................................................................437 INDEX...............................................................................................................................................505
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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 alcoholism 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 alcoholism, 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 alcoholism, 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 alcoholism. 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 alcoholism, 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 alcoholism. The Editors
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From the NIH, National Cancer Institute (NCI): http://www.cancer.gov/cancerinfo/ten-things-to-know.
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CHAPTER 1. STUDIES ON ALCOHOLISM Overview In this chapter, we will show you how to locate peer-reviewed references and studies on alcoholism.
The Combined Health Information Database The Combined Health Information Database summarizes studies across numerous federal agencies. To limit your investigation to research studies and alcoholism, 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 “alcoholism” (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: ·
Assessing Alcoholism as a Risk Factor for Acquired Immunodeficiency Syndrome (AIDS) Source: Social Science & Medicine; Vol. 27, No. 11. Contact: Pergamon Press, 660 White Plains Rd, Tarrytown, NY, 10591, (914) 524-9200. Summary: This article reviews alcohol abuse as feature of the homosexual experience, suggesting it may merit consideration as a risk factor in relation to AIDS. The presumably high prevalence of alcohol abuse among homosexuals and the damaging effects of alcohol on the immune system are discussed as a basis for linking alcoholism, homosexuality, and AIDS. The implications of the potential effects of alcohol misuse are presented in terms of high risk populations and the need for additional preventive measures and research. The authors also cite studies linking intravenous drug abuse
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with alcohol use in AIDS patients, leading them to suggest further investigation of these cofactors. ·
Comparison of the Michigan Alcoholism Screening Test and the Michigan Alcoholism Screening Test-Geriatric Version in Screening for Higher Alcohol Use Among Dementia Caregivers Source: Journal of Mental Health and Aging. 1(2): 147-155. 1995. Summary: This journal article focuses on the identification of alcohol abuse among family caregivers of people with dementia. The Michigan Alcoholism Screening Test (MAST) and the Michigan Alcoholism Screening Test-Geriatric Version (MAST-G) were developed and validated as screening tools to identify alcohol abuse in adults and older adults, respectively. Many studies of alcohol problems in older adults have focused on hospital and medical clinic populations. This investigation compares the MAST and the MAST-G in a sample of 60 community dwelling caregivers (75 percent of whom over age 50) of older adults with dementia. The authors found the MAST-G to have acceptable levels of reliability and validity and to be more reliable and valid with this population than the MAST. The MAST-G appears useful for determining alcohol abuse by caregivers of people with dementia. 5 tables, 1 figure, 21 references. (AA-M).
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Viral Hepatitis and Alcoholism Source: Alcohol Health and Research World. 16(1): 48-56. 1992. Summary: This article reviews studies that suggest alcoholic patients have an increased risk of viral hepatitis. The author notes that the reasons for the increased risk are unclear but may be related to social habits and conditions sometimes associated with alcoholism (e.g., intravenous drug use, poverty, and 'unsafe' sexual habits). The author summarizes the features of viral hepatitis and analyzes the studies investigating the association between alcoholism and viral hepatitis. Specific topics addressed include the clinical features of viral hepatitis infections, including transmission and symptoms; the types of viral hepatitis; the effects of viral hepatitis on bilirubin metabolism; screening for viral hepatitis; and the association of hepatitis viruses and alcoholism, especially hepatitis B and hepatitis C. The author concludes that further understanding of the association between alcoholism and viral hepatitis could lead to improved prevention and treatment programs.
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Adverse Childhood Experiences, Alcoholic Parents, and Later Risk of Alcoholism and Depression Source: Psychiatric Services. 53(8):1001-1009, August 2002. Summary: Researchers examined how growing up with alcoholic parents and having adverse childhood experiences (ACE's) are related to the risk of alcoholism and depression in adulthood. The ACE Study involved adults visiting Kaiser Permanente's San Diego Health Appraisal Clinic. The researchers mailed questionnaires to the 13,494 plan members who completed standardized medical evaluations between August 1995 and March 1996. A total of 9,508 adults responded. There were no significant differences between respondents and nonrespondents in health risk behaviors or history of disease. Measures included (1) parental alcohol abuse; and (2) ACE's, including verbal abuse, physical abuse, sexual abuse, having a battered mother, household substance abuse, mental illness in household, parental separation or divorce, and incarcerated household member. The respondents completed a questionnaire that assessed personal alcoholism and depression. Results showed that (1) of the respondents, 54 percent were women, the
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mean age was 56.6 years, most were white, and 42 percent were college graduates; (2) 20.3 percent of respondents reported parental alcohol abuse; (3) the prevalence of parental alcohol abuse declined with the age of the respondent and was higher among women; (4) those who reported parental alcohol abuse were two to three times as likely to report histories of childhood emotional abuse, physical abuse, sexual abuse, and parental separation or divorce; (5) those who reported parental alcohol abuse were two to five times as likely to have lived with a household member who used illicit drugs, had mental illness, attempted suicide, or were criminals; and (6) those who reported parental alcohol abuse were three to eight times as likely to have had a battered mother. Other results showed that (1) respondents with higher ACE scores were more likely to have a personal history of alcoholism, and (2) depression was not more prevalent among respondents who had alcohol-abusing parents. The researchers conclude that children in alcoholic households are more likely to have ACE's. 4 tables, 83 references. ·
Longitudinal Study of Family Practice Residents' Attitude Toward Alcoholism Source: Family Medicine. 26(7):447-451, July-August 1994. Summary: Researchers analyzed whether the experience of residency training at a public hospital, combined with a didactic program emphasizing community resources, would result in changes in residents' baseline attitudes toward alcoholism. Six successive classes of family practice residents in the University of California Medical Education Program Family Practice Residency comprised the study population. The didactic curriculum in alcoholism and chemical dependency consisted of a series of structured readings on the disease model of alcoholism and the effect of the alcoholic on the family system, viewing of videotapes demonstrating functional interviewing and intervention techniques, and visits to community-based treatment programs serving both the private and public sectors. These experiences took place during block rotations in community medicine in the first and second year of the residency. The clinical responsibilities of the residents occurred primarily at a 427-bed county facility serving a largely indigent population with a high prevalence of alcohol- and drug-related problems and complications. Researchers administered the Marcus Alcoholism Questionnaire (MAQ) both before and after residency training. The questionnaire contained nine scales on areas of opinion about alcoholism. Each item was rated on a seven-point scale, with a rating of one meaning disagree and a rating of seven meaning agree. Repeat testing took place no earlier than the final 6 weeks of the 3-year residency program. Researchers obtained complete data for 43 family practice residents with an average age of 29.3. Researchers compared initial scores with an expert sample from the Toronto Alcohol and Drug Research Foundation. They found that residents were significantly more likely to agree that a periodic excessive drinker can be an alcoholic, that alcoholism is not an illness, and that alcohol is a harmless voluntary indulgence. Researchers also compared residents' initial and final scores. They found no significant changes between the residents' entry and exit attitudes on 6 of 9 scales. Findings suggest that residents enter their postgraduate medical training with primarily well-developed and functional attitudes toward alcoholism and that the residency experience does not necessarily lead to deterioration in these attitudes. 3 tables, 12 references.
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Indian Health Service Approach to Alcoholism Among American Indians and Alaska Natives Source: Public Health Reports. 103(6):621-627, November-December 1988. Summary: In the operation of its 158 alcohol and substance abuse programs, the Indian Health Service (IHS) is moving toward prevention efforts. Education about alcohol and
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Alcoholism
its effects is a routine part of services provided adults by the IHS. Prenatal care includes education about fetal alcohol syndrome. A survey of school and community prevention activities among Native Americans in 1987 found that a number of schools were presenting prevention curricula, such as Here's Looking at You, Project Charlie, and Beginning Alcohol and Addiction Basic Education Studies (BABES), which emphasize values and attitude clarification, decision making, and information on the physical and emotional effects of alcohol and substance abuse. More than 1,500 persons participated in prevention programs in schools attended by Native American children, including teachers, parents, and alcoholism counselors. Student and parent groups included peer counseling, Students Against Drunk Driving, Mothers Against Drunk Driving, and Chemical People. Community-based programs provide alcohol and drug education and activities designed to build coping skills, develop decision making, promote family strengths, and teach effective parenting. An initiative by the Secretary of Health and Human Services made clear the importance of continuing prevention programs. While major barriers to prevention activities in the past have been traditional attitudes of not interfering with individual decisions and lack of community sanctions against alcohol use, the experience of the Alkali Lake community in Canada has demonstrated a new attitude of mobilizing tribal resources in alcohol abuse prevention programs. ·
En los Paises en Desarrollo. La Educacion para la Salud en la Prevencion Primaria del Alcoholismo. (Developing Countries. Health Education in the Primary Prevention of Alcoholism) Source: Hygie (Paris). 4(2):48-52, June 1985. Summary: In most developing nations, alcoholism is as big a problem for economic development as illiteracy or disease. Several studies point out the extent of the alcoholism problem in Latin America, where the consumption of alcohol is rooted in national traditions. In Chile, alcoholics make up 5 percent of the population and excessive drinkers make up 15 percent. The authors have developed a program to control alcoholism in Pudahuel, a poverty-stricken district of Santiago. The program has four stages. The first consists of informing community leaders, teachers, and parents of how to carry out primary prevention. In stage two, teachers are shown how to use the didactic material available. Stage three provides programmed activities for students and parents. The last stage is devoted to preventive activities in the community.
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Neuropsychiatric Aspects of Alcohol Abuse in the Elderly Source: Geriatric Medicine Today. 9(7): 60-67. July 1990. Summary: The number of elderly persons who abuse alcohol is estimated at four million in the United States. Medical morbidity and mortality associated with alcohol abuse in the elderly is significantly higher than that associated with a younger cohort or with those elderly who do not abuse alcohol. Elderly persons who abuse alcohol may experience an acceleration of the aging process, depression, and dementia. Primary-care physicians need to be educated about the prevalence of this problem and its signs and symptoms and must routinely screen their elderly patients for its presence. Treatment involves breaking through the patient's denial, followed by detoxification and rehabilitation. Treatment is easier to carry out in elderly than in younger patients. 29 references. (AA).
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Relationship of Acute Transfusion-Associated Hepatitis to the Development of Cirrhosis in the Presence of Alcohol Abuse Source: Annals of Internal Medicine. 134(2): 120-124. January 16, 2001. Contact: Available from American College of Physicians. American Society of Internal Medicine. 190 North Independence Mall West, Philadelphia, PA 19106-1572. Website: www.acponline.org. Summary: Although concomitant (occurring at the same time) alcoholism is widely believed to enhance liver disease progression in persons with hepatitis C virus (HCV) infection, this relationship has not been well quantified. This article reports on a study undertaken to quantify the relationship of transfusion associated HCV infection and history of heavy alcohol abuse to the development of cirrhosis (liver scarring). The retrospective cohort study featured extensive followup of 1,030 patients in prospective investigations of transfusion associated viral hepatitis conducted in the United States between 1968 and 1980. Development of cirrhosis and history of heavy alcohol abuse were determined from review of interviews with patients or their proxies, medical records, death certificates, and autopsy and biopsy reports. The absolute risk for cirrhosis was 17 percent among patients with transfusion associated HCV; 3.2 percent among patients with transfusion associated nonA, nonB, nonC hepatitis; and 2.8 percent among controls. A history of heavy alcohol abuse was associated with a fourfold increased risk for cirrhosis. Hepatitis C virus infection plus a history of heavy alcohol abuse led to a substantial increase in risk for cirrhosis, compared with controls without such a history. The authors stress that this finding emphasizes the need to counsel such patients about their drinking habits. 2 tables. 19 references.
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Adverse Childhood Experiences and Personal Alcohol Abuse as an Adult Source: Addictive Behaviors. 27(5):713-725, September-October 2002. Summary: Researchers examined the relationship of adverse childhood events (ACE's) to the later risk of heavy alcohol use, self-reported alcohol abuse, and alcoholism. They administered surveys to adults visiting Kaiser Permanente's San Diego Health Appraisal Clinic in two waves; 9,508 of 13,494 adults responded in the first wave, and 8,667 of 13,330 adults responded in the second wave for a final cohort of 18,175 respondents. ACE's included (1) verbal abuse, (2) physical abuse, (3) sexual abuse, (4) having a battered mother, (5) household substance abuse, (6) mental illness in household, (7) parental separation or divorce, (8) incarcerated household member, and (9) alcohol use/misuse. Twenty-four percent of women and 18 percent of men reported that at least one parent was an alcoholic, and it was usually the father. The prevalence of each category of ACE was higher for women than for men, except physical abuse. At least one of the categories of ACE's was reported by 61 percent of the respondents. Each of the eight ACE's was associated with a higher risk of alcohol abuse as an adult. The risk of heavy drinking, self-reported alcoholism, and marrying an alcoholic were increased twofold to fourfold by the presence of multiple ACE's, regardless of parental alcoholism. The researchers conclude that (1) ACE's showed a strong, graded relationship to each of the measures of alcohol misuse and abuse for persons with or without a parental history of alcoholism; and (2) alcohol treatment programs for adults should incorporate prevention and treatment of ACE's in affected families and educate participants and family members about child development and the burden that ACE's place on children as they grow up. 1 figure, 4 tables, 28 references.
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Bottoms Up: An Alcohol Abuse Prevention Model for College Campuses Source: Health Values: Achieving High Level Wellness. 4(5):222-228, September-October 1980. Summary: The Alcohol Education Project (AEP) at Southern Illinois University at Carbondale is a replication of a college alcohol-abuse prevention model initiated by the National Institute on Alcohol Abuse and Alcoholism. The AEP, which has been funded for 3 years at $100,000 per year, is staffed by one full-time project director with a school and public health background, one full-time education specialist, one half-time alcohol education specialist, four peer educators, one graduate assistant performing evaluation tasks, one evaluation consultant, and one full-time secretary. The project's activities include needs assessment, training and use of peer educators, community development work, determination of special target populations, early identification of those experiencing problems with alcohol, information dissemination, and evaluation. The systems approach employed by AEP involves the cooperation of the student health program, student housing, the student center, the counseling center, and the alcohol services of the local community mental health center. In the area of intensive approaches, more than 100 single-session workshop groups involving over 1,900 students have met in the first 18 months of the program. AEP is evaluated through an annual survey of a random sample comprising 5 percent of the student population, an annual survey of all professional staff who deal with student problems, client feedback forms, a review of institutional records, and evaluation of residence hall programming. 7 references.
Federally Funded Research on Alcoholism The U.S. Government supports a variety of research studies relating to alcoholism. These studies are tracked by the Office of Extramural Research at the National Institutes of Health.2 CRISP (Computerized Retrieval of Information on Scientific Projects) is a searchable database of federally funded biomedical research projects conducted at universities, hospitals, and other institutions. Search the CRISP Web site at http://crisp.cit.nih.gov/crisp/crisp_query.generate_screen. You will have the option to perform targeted searches by various criteria, including geography, date, and topics related to alcoholism. 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 alcoholism. The following is typical of the type of information found when searching the CRISP database for alcoholism: ·
Project Title: A FORTY-YEAR FOLLOWUP OF MEN AT HIGH RISK FOR ALCOHOLISM Principal Investigator & Institution: Penick, Elizabeth C. Psychiatry; University of Kansas Medical Center Msn 1039 Kansas City, Ks 66160 Timing: Fiscal Year 2002; Project Start 1-MAY-2002; Project End 0-APR-2005
Healthcare projects are funded by the National Institutes of Health (NIH), Substance Abuse and Mental Health Services (SAMHSA), Health Resources and Services Administration (HRSA), Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDCP), Agency for Healthcare Research and Quality (AHRQ), and Office of Assistant Secretary of Health (OASH).
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Summary: In January, 2001 the forty-year followup phase of the U.S.-Danish Longitudinal Study of Alcoholism was initiated with funds provided by the government of Denmark. No funds were available to support the U.S. component of this longitudinal, high-risk alcoholism study that was first organized by the late Donald W. Goodwin, MD in 1976 and supported on two previous occasions by NIAAA (1979, 1989). We are requesting funds to support the continued U. S. involvement in this unique, prospective, high-risk study of male alcoholism. The 20-year followup phase compared high-risk sons of alcoholic fathers to low-risk sons of nonalcoholic fathers on hundreds of variables, extending back to their birth (before any became alcohol dependent) identifying dozens of putative risk factors. The 30-year followup found that 29 of 73 risk factors predicted alcohol drinking at that point in time. This final, 40-- year followup study assumes that most of the subjects will have passed the age of risk for developing alcoholism and that some who did drink alcoholically in the past, no longer do so. The 40-year followup will test the predictive power of previously found risk factors and will identify other influences, over the subjects lifetime, that independently and collectively initiated, sustained or protected the individual from alcoholic drinking. From the onset, this joint U.S.-Denmark study of alcoholism separated the research into two components. The Danish component was responsible for identifying, locating and examining the 357 subjects initially selected for study from a large birth cohort developed in Copenhagen. The U.S. component accepted responsibility for protocol development, instrumentation, data entry and primary data analyses. The U. S. component created the existing data system that codes information obtained from all phases of the study, including the neonatal phase, the 20-year phase, the 30-year phase and now the 40- year followup phase. A total of 8,262 separate pieces of information on each subject have now been integrated into a single SAS database. A 100-page Dictionary of Variables is available that contains the name, location, range, and code definitions of each variable. More information will be added during the 40-year followup that will include a thorough review of drinking and its effects as well as a systematic survey of the major DSM-IV syndromes. The fact that most of the information was collected prospectively, and from independent sources at different stages of the subjects' lives, provides the rare opportunity to search for, antecedents, and causes of male alcoholism in an enormously rich and varied database. Marc Schuckit, MD, a researcher experienced in conducting high-risk, longitudinal studies of alcoholism, will serve as our major consultant. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen ·
Project Title: ADULT OFFSPRING OF ALCOHOLISM DISCORDANT TWINS Principal Investigator & Institution: Jacob, Theodore; Chairman; Palo Alto Institute for Res & Edu Palo Alto, Ca 943040038 Timing: Fiscal Year 2001; Project Start 1-MAR-1998; Project End 8-FEB-2004 Summary: The purpose of this study is to clarify the role of family genetic and family environmental influences in the development of alcoholism. In pursuing this objective, we will implement a twin-family design whereby data are obtained from MZ and DZ co-twins who are concordant and discordant for alcoholism and from their spouses and adult offspring. The opportunity to obtain such data is made available by our access to the Vietnam Era Twin (VET) Registry, a nationally distributed panel of over thirty-two hundred twin pairs recently assessed using structured psychiatric interviews. Given these data, we will be able to address four specific aims: (1) To determine the extent to which offspring of alcoholic versus nonalcoholic co-twins differ in regards to alcohol abuse, other psychopathology, and socio-educational-occupational- interpersonal
10 Alcoholism
achievements; (2) To determine how genetic and environmental influences vary in relation to different types of paternal alcoholism; (3) To determine the genetic and nongenetic contributions that spouse influences make in accounting for offspring outcomes; and (4) To determine what moderators and mediators associated with childhood (in particular, behavioral undercontrol and affect regulation) and young adulthood (in particular, young adult transition events, social networks, and young adult-parent relationships) serve to qualify and/or account for risk-outcome relationships and what kinds of influences best explain these associations. In this effort, we are particularly interested in understanding gene-environment correlations and gene- environment interactions that characterize the development and expression of alcoholism, drawing on the powerful yet infrequently used twin family design. Beyond simply estimating the strength of genetic/environmental influences, we hope to identify and clarify genetically-based and environmentally-based influences that help explain how family history of alcoholism predisposes individuals to alcoholism outcomes, and that increase or decrease the likelihood of adverse outcomes among high risk individuals. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen ·
Project Title: AFFECTIVE AND CONATIVE CHANGES IN ALCOHOLISM Principal Investigator & Institution: Berman, Marlene O. Professor of Psychiatry and Neurology; Psychology; Boston University Charles River Campus 881 Commonwealth Avenue Boston, Ma 02215 Timing: Fiscal Year 2001; Project Start 1-DEC-1996; Project End 0-NOV-2001 Summary: This is an application for an ADAMHA Senior Scientist Award (SSA). The SSA would permit the PI (a) to devote all of her research efforts to alcoholism; (b)to expand her research and mentoring activities concerned with gender issues in alcoholism; and (c) to gain valuable experience with structural and functional neuroimaging techniques. In conjunction with 2RO1 AA 07112-09, investigations are planned to examine changes in affect (emotion) and conation (intention) in abstinent alcoholics. Secondary aims of the research are to expand studies of age-related changes and gender differences in emotional and intentional functions. The importance of the research is fourfold: (1) Putative sites of alcohol-related brain damage involve separate frontal systems which are tied to different perceptual/cognitive aspects of emotional and intentional behaviors; (2) gender differences in alcohol- related neurobehavioral functions are ripe for experimental exploration; (3) the literature on whether emotional changes have reciprocal effects on perception and cognition in alcoholism is equivocal and controversial; and (4) even though affective and conative abnormalities have been clinically apparent in alcoholic groups, neuropsychological studies have focused primarily on cognitive changes unrelated to emotion and intention. In the proposed experiments we will enlist the participation of right- handed male and female research subjects ranging in age from 20 to 75 years. The experimental groups will include abstinent alcoholics with and without Korsakoff's syndrome. Patterns and levels of performances by the alcoholics will be compared to those of age-matched nonalcoholic subjects, in order to evaluate the ways in which behavioral consequences of aging and alcoholism are parallel, divergent, or interactive. Additionally, patients with rightfrontal or bilateral frontal lobe damage from cerebrovascular accidents will provide the necessary control comparisons for neurobehavioral changes linked directly to focal brain damage. These groups were chosen specifically to clarify frontal system contributions to deficits of Korsakoff and non-Korsakoff alcoholics. We also will be able to evaluate hypotheses about greater right- than left-hemisphere functional decline in
Studies 11
the alcoholic and aging groups, and in women compared to men. It is expected that results of the proposed studies will show clear evidence of frontal-mediated affective and conative changes in alcoholics (most notably in the Korsakoff patients), but that these changes will not be conspicuous in aging populations uncomplicated by alcoholism. By contrast, certain aspects of perceptual functioning will be compromised by aging - whether or not a history of alcohol abuse exists. Finally, women will display different performance patterns than men. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen ·
Project Title: ALCOHOLISM AND SUICIDE Principal Investigator & Institution: Conner, Kenneth R. Assistant Professor; Psychiatry; University of Rochester Orpa - Rc Box 270140 Rochester, Ny 14627 Timing: Fiscal Year 2002; Project Start 1-APR-2002; Project End 1-MAR-2003 Summary: (provided by applicant): Alcoholism is a potent risk factor for suicide and attempted suicide, yet there is a paucity of controlled data on the factors that distinguish alcoholics who take their own lives or make medically serious suicide attempts. To address this gap in knowledge, the investigators will conduct secondary analyses on a dataset gathered in the Canterbury region of New Zealand between 1991 and 1994 for the Canterbury Suicide Project (CSP). The CSP identified and collected data on adult suicide victims (N=193) and medically serious suicide attempters (N=240) and a community control group (N=984). Diagnostic data using best-estimate methods including DSM-III-R alcohol dependence (past month) are available. Data on other diagnoses (mood, psychotic, antisocial personality, drug use disorders), stressful life events, and personality traits were also gathered. In Aim 1, two predisposing factors, major depression and antisocial personality disorder (ASP), will be investigated as potential moderators (effect modifiers) of the association between alcoholism and suicidal behavior. In Aim 2, two precipitating factors, conjugal disruptions and other stressful life events, will be evaluated as potential mediators (intermediate effects) of the relationship between alcoholism and suicidal behavior, and between ASP and suicidal behavior. Primary analyses will be based on polytmous regression models and specifically, unordered logistic regression models with two case groups (suicides, serious attempts) and a reference group (community controls). This will allow for direct comparisons between each case group and the reference group as well as between the case groups. Results will be expressed in terms of odds ratios and asymmetric confidence intervals. Goodness-of-fit will be assessed using standard procedures. Secondary analyses will include estimates of relative risk and population attributable risk for suicide and serious attempts associated with alcohol dependence and other diagnostic conditions, and explore potential gender differences in risk factors for suicidal behavior. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: ALCOHOLISM AND THE MINORITY TEEN: PROBLEMS IN DIAGNOSIS Principal Investigator & Institution: Lee, Christina S. Applied Psychology; New York University 15 Washington Place New York, Ny 10003 Timing: Fiscal Year 2001; Project Start 1-APR-2001 Summary: This study will investigate how patient race and gender influences initial clinical evaluations of alcohol dependency. Clinicians have been shown to be biased in their assessment of patients based on patient gender and race, but few studies have
12 Alcoholism
investigated the theoretical basis of this bias. Are minority teens over-diagnosed with alcoholism? Does this result in improper treatment? Are white teens, including females, with alcoholism over diagnosed? By studying clinician judgement, this study has the potential to reduce bias. In this experimental between-subjects design, participants (medical students) will be randomly assigned to four groups. They will read one case study (stimuli) or a teenager with symptoms of alcohol dependency and will then complete a questionnaire. The stimuli will be identical except for race and gender (the manipulated conditions). Hypothesis 1: Patient race and gender will affect diagnosis, prognosis, treatment-decisions. Hypothesis 2: Patient race and gender will influence clinician attributions about the cause of drinking, judgements of responsibility, affective responses, and desire to help. A 2x2 MANOVA will analyze differences on the dependent measures with respect to race and gender. Separate univariate analyses of variance will determine which dependent measures were significantly affected by the manipulation. The long term objectives are to improve the treatment of alcohol dependent adolescents by studying how stereotyping affects clinician decision-making and identifying barriers to appropriate treatment. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen ·
Project Title: ALCOHOLISM IN WOMEN WITH ANOREXIA AND BULIMIA NERVOSA Principal Investigator & Institution: Herzog, David B. Professor; Massachusetts General Hospital 55 Fruit St Boston, Ma 02114 Timing: Fiscal Year 2003; Project Start 5-MAY-2003; Project End 0-APR-2005 Summary: (provided by applicant): This is a revised submission of a proposal to conduct secondary analyses of alcoholism (ALC) in women with eating disorders (EDs). The co-occurrence of ALC and EDs has been well documented. To date, there have been no prospective studies reporting on the course and sequence of comorbid EDs and ALC. The aims of this study are to 1) describe the association between ALC and EDs 2) examine the longitudinal sequence of comorbidity in terms of onset, remission, relapse, and mortality and 3) test a conceptual model that describes the nature of the association between ALC and EDs. The data will also allow for the analysis of longitudinal patterns of alcohol consumption in women with ALC and EDs. A longitudinal, prospective, naturalistic study of 246 treatment-seeking women with AN and BN has been conducted for a median of 9 years with a low attrition rate of 7%. Extensive data on weekly assessments of ED symptomatology, ALC, comorbid psychopathology, and treatment participation, as well as monthly ratings of psychosocial functioning have been gathered. At entry into the longitudinal study, 42 (17%) participants reported a history of ALC. During the course of 9-year follow-up, 24 (12%) of the women with no history of ALC were diagnosed with ALC prospectively, resulting in a total of 66 (27%) women reporting a lifetime history of ALC in the sample. During the course of followup, 6 women from this subset have died, resulting in 60 remaining subjects with a lifetime history of ALC2 Preliminary analyses show fatal outcome was associated with severity of ALC over the course of follow-up, even after controlling for age and duration of ED episode at intake (LRT = 11.0, df= 1, p =.0009). [Lifetime history of ALC was marked in three of the four deaths by suicide, and severity of ALC over the course of the study was associated with increased rates of suicide attempts in women with AN (LRT = 7.02, df = 1, p =.008).] Findings from this study will inform clinicians and patients about the nature of the association between ALC land EDs, underscore interactions between course and outcome variables, and assist in the design of future ALC and ED treatment studies.
Studies 13
Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen ·
Project Title: CANDIDATES
ALCOHOLISM
TREATMENT
IN
LIVER
TRANSPLANT
Principal Investigator & Institution: Weinrieb, Robert M. Assistant Professor; Psychiatry; University of Pennsylvania 3451 Walnut Street Philadelphia, Pa 19104 Timing: Fiscal Year 2001; Project Start 2-SEP-1999; Project End 1-AUG-2004 Summary: Alcoholism is the most common root cause of end stage liver disease in the United States. By the time cirrhosis with liver failure is diagnosed, there are often no viable alternatives to liver transplantation even for the then-abstinent alcoholic. Liver transplant surgery is costly and donor organs are scarce. Once selected for transplant, patients typically wait two years for an organ and must remain "medically and psychologically stable". Data from our studies indicate that 15 percent of listed alcoholic liver transplant candidates admit drinking - and we believe this may be an underestimate. Further, studies have shown that cirrhotic alcoholics who continue to drink have high rates of mortality. Once listed, alcoholic patients are typically referred off-site for alcohol treatment or to AA meetings. But, our research has shown that greater than 50 percent of alcoholic patients who received liver transplants never attended formal substance abuse treatment or AA. Based on the data from these pilot efforts and from the larger literature on promising therapies for alcohol dependence, we plan to test a modified and expanded version of Motivational Enhancement Therapy (MET) combined with case management techniques (STD-MET), for use in the treatment of alcoholics awaiting liver transplant. We will test this integrated alcohol treatment in a randomized controlled design comparing two samples of 100 listed alcoholic liver transplant patients, each receiving supplemental treatments for their alcoholism over a six month period while listed. Both groups will receive standard referral to AA and community treatment. One group will receive on-site, integrated STD-MET while the second group will receive an equal number of sessions, on-site, viewing alcohol educational videos (STD-VID). Hypotheses: 1.During the pre-transplant "wait list" period - patients receiving STD-MET will show better engagement into the liver transplant regimen, reduced drinking and better general function than patients assigned to (STD-VID). STD-MET group will show: a) greater compliance with appointments and medical regimen - measured by standard measures of attendance, medical status, recall and understanding of their medication regimen, b) more awareness and acceptance of alcohol, smoking and/or other drug problems - measured by the (SOCRATES) stage of change, c) more attendance at standard off-site alcohol treatment programs and AA meetings - measured by standard checks on treatment attendance as well as TSR from subjects and collaterals, d) greater and more lasting reductions in drinking, cigarette and other drug use - measured by urine screens, breathalyzer, self-report and collateral TLFB measures, e) lower levels of depression and anxiety - measured by the BDI, BAI and the ASI psychiatric scale every three months, f) less mortality and morbidity prior to organ transplant - than the STD-VID group. 2. For patients who ultimately receive a liver transplant - STD-MET patients will show better general recovery than patients assigned to the alcohol education video series STD-VID. The STD-MET will show: a) fewer complications during during hospitalization measured by standard surgical records, b) better general function at one- month post hospital discharge-measured by standard medical evaluation and ASI than the STD-VID group. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: ALCOHOLISM, SLEEP AND THE BRAIN Principal Investigator & Institution: Colrain, Ian; Director; Sri International 333 Ravenswood Ave Menlo Park, Ca 94025 Timing: Fiscal Year 2003; Project Start 1-JUN-2003; Project End 1-MAY-2008 Summary: (provided by applicant): Acute and chronic alcohol consumption causes sleep disturbances, which may never resolve and may be a key factor in alcoholism relapse. Alcohol-related sleep deficits also become more pronounced with advancing age. The most consistently reported finding of altered sleep in alcoholics is a reduction in spontaneously occurring slow wave sleep (SWS), defined by the presence of delta EEG activity. Further, alcoholics with reduced baseline SWS have an increased likelihood of relapse. External stimulation during sleep can elicit K-complexes, which when averaged produce a large N550 component thought to have the same generator as SWS delta activity. Given the potential value of sleep markers in predicting relapse, it would be advantageous to employ a probe of the sleeping nervous system that can be under experimenter control rather than one that relies on the traditional observation of spontaneous sleep physiological indices. We have demonstrated that sleep-evoked N550 component amplitudes are smaller and K-complexes are produced on a smaller number of trials in elderly than young controls. Our preliminary study indicates that alcoholics have even smaller N550 than would be expected for their age. A candidate generator of the K-complex and N550 is frontal cortical gray matter, which is especially reduced in older alcoholics. Sex differences in brain structure and electrophysiological indices of sleep also occur in alcoholism and aging, and objective study of them may further contribute to our understanding of relevant mechanisms of alcoholism-related sleep disturbance. We propose to test the following hypotheses: Hypothesis 1: Recently detoxified, chronic alcoholics will have smaller N550 amplitudes, lower evoked Kcomplex proportions, lower SWS levels and delta EEG power compared to sex- and agematched controls. Hypothesis 2: Low evoked K-complex production rates, small N550 amplitude, low SWS levels and delta EEG power will be associated with small prefrontal gray matter volume. Hypothesis 3: Alcoholic men will have greater sleep abnormalities than alcoholic women. Hypothesis 4: Small amplitude, production rate and power of sleep electrophysiological variables in recently detoxified alcoholics will predict early relapse Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: ALCOHOLISM--EPIDEMIOLOGIC HIGH RISK FAMILY STUDY Principal Investigator & Institution: Bucholz, Kathleen K. Research Professor; Washington University Lindell and Skinker Blvd St. Louis, Mo 63130 Timing: Fiscal Year 2001 Summary: This project represents a new paradigm for epidemiologic research on alcoholism: it nests a high risk genetic/family study within an epidemiologic framework. Advantages over existing studies are: ascertainment of families from a representative sample; systemic selection of families at high and low risk of alcoholism; direct assessments of multiple family members, including up to 3 offspring and parents; longitudinal follow-up of the offspring; over-sample of minority families; and collection of DNA for future assessments of genetic risk/protective factors. This design permits testing of hypothesis relating to sibling and peer influences on adolescent/young adult alcohol problems, which more conventional parents-one child designs, and even more specialized twin-family designs, may tested in a limited way. Families are ascertained through birth records of adolescents and young adults born in Missouri (ensuring
Studies 15
comparability with Project 1), and biological mothers administered a telephone screening interview to identify potentially high risk families. All families screening positive, and a subsample of those screening negative will be invited for the second stage, where biological mothers and fathers (or best informant) will be administered a telephone diagnostic interview and question to assess own and co-parent's history of DSM-I alcohol abuse or dependent, as well as history of behavioral and emotional problems of the proband and up to 2 siblings aged 13-25. Probands and up to 2 of their siblings from families where fathers were reported by mothers to have 3 or more symptoms of alcohol dependence ("high risk", 100 AA, 100 W) and those from families where fathers were not so reported, or who screened negative ("controls": 150 AA, 150 W) will be invited for telephone diagnostic interview at baseline and again at 2 years, with brief telephone diagnostic interview at baseline and again at 2 years, with brief telephone follow up interviews in other years along with annual questionnaire assessments. Data will be used to test hypotheses about (i) sibling and peer influences on alcohol and other substance involvement and problems, (ii) relationships between parenting style, parental alcoholism and co-morbidity, and offspring alcoholism, (iii) relationships between co-morbidity, temperament, traumatic events and this chronic stress, and offspring alcoholism, and (iv) the modification of these relationships by ethnicity. Results from this project will provide an important check on the generalizability of finds from other projects that rely upon specialized twin-family designs. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen ·
Project Title: BEHAVIORAL DISINHIBITION IN EARLY-ONSET ALCOHOLISM Principal Investigator & Institution: Finn, Peter R. Psychology; Indiana University Bloomington P.O. Box 1847 Bloomington, in 47402 Timing: Fiscal Year 2002; Project Start 1-MAY-2002; Project End 1-JAN-2007 Summary: This application requests five years of support to investigate the incentivemotivational and cognitive processes underlying the association between behavioral disinhibition and early-onset alcohol problems. In addition, the study investigates potential psychosocial processes that distinguish early-onset alcoholism without antisocial problems from antisocial early- onset alcoholism. The project takes a theoretically based, multifactorial perspective (model) on the mechanisms that influence behavior disinhibition in subjects with early-onset alcoholism. This model describes the roles for individual differences in sensitivity to rewards and punishments, working memory capacity, signal saliency, and executive cognitive function in the processes affecting behavioral disnihibition in antisocial early-onset alcoholism. The first aim of this project is to investigate the roles that working memory capacity, sensitivity to punishments and rewards, and signal saliency play in modulating behavioral inhibition and activation in antisocial and non-antisocial early-onset alcoholism. Responses to rewards and punishments are assessed on different incentive- motivational tasks that tap different processes that affect behavioral disinhibition, such as passive avoidance learning on a series of go/ no go tasks, the influence of magnitude of rewards and punishments on decision making, and the discounting of future versus present rewards. Tasks involve the manipulation of reward and punishment saliency and the manipulation of type of punishment to assess specific disinhibitory mechanisms. The second aim of this project is to investigate the psychosocial mechanisms, such as affiliation with college fraternities/sororities, planful excessive drinking in social contexts, and having difficulties with difficulties with development transitions, that distinguish non antisocial alcoholism from antisocial alcoholism. The result of this study
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should (1) provide valuable information about the mechanisms that serve to predispose to, and maintain, early onset alcohol problems, and (2) serve to inform prevention and treatment efforts for early onset alcohol problems. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen ·
Project Title: BEHAVIORAL ALCOHOLISM
GENETIC
STUDY
OF
RELIGIOSITY
AND
Principal Investigator & Institution: Haber, Jon R.; Palo Alto Institute for Res & Edu Palo Alto, Ca 943040038 Timing: Fiscal Year 2001; Project Start 1-JUL-2001; Project End 0-JUN-2003 Summary: (provided by applicant): Although religion and spirituality have always been thought to influence a wide range of human experience, the scientific study of this phenomenon has not kept pace with the growing evidence of its relevance to health, medical, and alcoholism concerns. This application seeks small grant support (R03) for secondary analyses involving data from three large-scale NIAAA-supported twin projects involving adolescent twins and adult twins. Given these data, we can elaborate on recent behavioral- genetic findings that have bearing on the relationship between religion and alcoholism; in particular how religion can impact the transmission and development of alcoholism across generations. The specific aims are: (1) to examine interaction of effects between religion and those variables thought to be genetic precursors to alcoholism and between religion and alcoholism variables per se; (2) to examine the moderating role that religion can play in qualifying the impact of family history of alcoholism on offspring alcoholism and other negative outcomes, and (3) to conduct preliminary examinations relevant to future research directions including (a) the multidimensional nature of religiosity; (b) the relationship between religiosity and other individual difference variables;(c) how religiosity is related to other models of alcoholism etiology; and (d) consideration of developmental issues (each data set utilizes a cohort sequential design) regarding the moderating role of religiosity on development and course of alcoholism and other disorders. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen ·
Project Title: BEHAVIORAL/PHARMACOLOGIC TREATMENT OF ALCOHOLISM Principal Investigator & Institution: Miller, William R. Distinguished Professor; Psychology; University of New Mexico Albuquerque Albuquerque, Nm 87131 Timing: Fiscal Year 2001; Project Start 0-SEP-1997; Project End 1-AUG-2003 Summary: The University of New Mexico's Center on Alcoholism, Substance Abuse, and Addictions (CASAA) offers to participate as a Clinical Research Unit (CRU) in the multisite trial, Combined Behavioral/Pharmacological Treatment of Alcoholism. Although the trial protocol will ultimately be determined by the trial's Steering Committee, this proposal reflects how CASAA might approach the project. Our factorial design for the main (Phase M) trial crosses four levels of medication (placebo, acamprosate, naltrexone, and combined medications) with two levels of behavioral intervention (Cognitive-Behavioral Therapy and Motivational Enhancement Therapy), both modified from manuals and experience in Project MATCH. Following the initial treatment period (months 1-3), clients are assigned at random to receive or not receive augmented treatment during months 4-6. This embedded trial will provide reliable information about main effects of longer (augmented) versus shorter treatment, and about client characteristics associated with differential benefit from augmented treatment. Augmentation will be retained within each behavioral treatment modality, so
Studies 17
as not to confound the interpretableness of follow-up data. The prospective validity of various 'nonresponder' classification systems can be tested via retrospective analyses within this design. In addition to feasibility testing of procedures, the preliminary (Phase II) study will evaluate the main effect of extensive pretreatment and follow-up assessment on treatment outcomes, a crucial issue because such reactivity could wash out main or interaction effects of trial treatments - a critique unaddressed in Project MATCH. Clients in the Phase II study will all be given the both acamprosate and naltrexone, and further randomized within a 2x2 factorial design to receive either extensive or minimal assessment, and, either CBT or MET. The Phase II study design also allows evaluation of whether a client's knowledge that drinking reports will be verified via collateral interviews affects the accuracy of self-reports. Main trial clients will be randomly assigned to therapists within conditions, so that (unlike in Project MATCH), true tests of client/therapist matches can be conducted in this large sample. Prior to randomization, all clients will be challenged with an initial medication dose (which exerts immediate aversive effects in a minority of individuals), to diminish potentially problematic differential attrition from medication and placebo groups. Naturalistic involvement in Alcoholics Anonymous and other mutual help organizations will be studied to determine whether it interacts with these treatments to enhance outcomes. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen ·
Project Title: BEHAVIORAL/PHARMACOLOGIC TREATMENT OF ALCOHOLISM Principal Investigator & Institution: Williams, Lauren D. Assistant Professor; Psychiatry and Behavioral Scis; University of Miami Box 016159 Miami, Fl 33101 Timing: Fiscal Year 2002; Project Start 0-SEP-1997; Project End 1-AUG-2003 Summary: PRELIMINARY STUDY: Noncompliance is the leading cause of nonresponse to drug. This 1-year preliminary study randomly assigns 80 outpatients with alcohol dependence to 2 strategies for monitoring compliance (Medication Event Monitoring System [MEMS] vs. blister pack) in relation to plasma levels of naltrexone and 6-betanaltrexol, and to 2 strategies for enhancing compliance (compliance counseling vs. usual care) in a 2X2 design. All subjects receive 8 weeks of Medication Management Therapy (MMT) and naltrexone to assess acceptability and rate of compliance with the dosing regimen and minimally intensive therapy condition proposed for the main study. MAIN STUDY: New advances in outpatient pharmacologic and behavioral treatments of alcohol dependence have generally occurred independently of each other. The objective of the main study is to evaluate the relative efficacy of combined treatments in a 2X4 multicenter, double-blind, randomized, placebo-controlled comparison of 4 pharmacotherapy conditions (acamprosate, naltrexone, placebo, and acamprosate/naltrexone in combination) administered in conjunction with either the cognitive behavioral therapy typically administered by an alcoholism treatment specialist, or a manualized MMT that may be suitable for managed care settings. Primary outcome measures are time to first drink, time to first heavy drinking day, and cumulative abstinence duration. Treatment duration is 6 months with 1 year of posttreatment follow-up. Subjects for the multicenter study are 1200 outpatients meeting DSM IV criteria for alcohol dependence, recruited across 6-8 centers. NONRESPONDER STUDY: A response evaluation will be made at 3 months post-randomization in the main study. Approximately 400 nonresponders to active medication will be available for a 12-week comparison of alternative pharmacotherapy strategies commonly used in general clinical practice. All other subjects will remain in the originally assigned treatment condition in the main study. Nonresponders to monotherapy will be
18 Alcoholism
randomized to the alternative monotherapy or combination treatment, nonresponders to combination treatment will be randomized to increased doses of acamprosate or naltrexone. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen ·
Project Title: BIOLOGICAL BASES OF ALCOHOLISM Principal Investigator & Institution: Cunningham, Christopher L. Professor; Behavioral Neuroscience; Oregon Health & Science University Portland, or 972393098 Timing: Fiscal Year 2001; Project Start 0-SEP-1987; Project End 0-JUN-2002 Summary: This program for Ph.D. and postdoctoral students will train specialists who will be able to conduct preclinical research at levels ranging from the molecular to the behavioral on biological mechanisms underlying the development, maintenance, and elimination of alcoholism. Twenty members of the graduate faculty of the Oregon Health Sciences University will train postdoctoral research fellows and graduate students matriculating into programs in Behavioral Neuroscience or Neuroscience. Training will include firm curricular grounding in the basic sciences, specific training in the pharmacology of alcohol and other abused drugs, exposure to clinical and psychosocial aspects of human alcoholism, and extensive and continuous participation in basic research. The focus of our training opportunities is on biological processes involved in the etiology of problem drinking and alcoholism. Our general approach is interdisciplinary, emphasizing genetic, molecular, physiological, pharmacological and psychological/ behavioral processes. The research questions addressed by trainees fall into four general areas: (a) genetic bases for alcohol and drug responses, (b) learned and unlearned determinants of alcohol and drug reward, biological bases for selfadministration of alcohol and drugs, and (d) stress and the biology of alcoholism and drug abuse. These areas reflect the research interests and expertise of a participating faculty using behavioral, systems-level, and cellular/molecular methods. Their shared biobehavioral perspective is consistent with growing evidence indicating that many forms of human alcoholism are best understood in terms of an interaction between genetic and environmental factors. Areas of faculty collaboration include: studies of genetic determinants of alcohol and drug responses; neuroendocrine and neuroactive steroid participation in alcohol's effects; studies of dopaminergic, gabaergic and glutaminergic systems involved in alcohol and drug effects; study of learned and unlearned determinants of responses to alcohol and other drugs, particularly their rewarding effects and self-administration; and studies of sensitivity, tolerance, and dependence/withdrawal phenomena for alcohol and all major classes of drugs of abuse. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: BRAIN ALCOHOL MRS AND FAMILY HISTORY OF ALCOHOLISM Principal Investigator & Institution: Mendelson, Md;; Mc Lean Hospital (Belmont, Ma) Belmont, Ma 02478 Timing: Fiscal Year 2001; Project Start 1-MAY-1999; Project End 0-APR-2003 Summary: This project is designed to examine the covariance between family history of alcoholism and in vivo detection of brain alcohol with proton magnetic resonance spectroscopic imaging (MRSI). There is an abundant literature which suggests that one effect of alcohol is to increase brain cell membrane rigidity and reduce partitioning of alcohol into the bilipid neuronal membrane layer. Recently we discovered that magnetic resonance spectroscopy (MRS) detection of brain alcohol is about two fold higher in heavy drinkers than in occasional drinkers after administration of an identical dose of
Studies 19
alcohol. One implication of our finding is that MRS detection of alcohol in brain may be a biological correlate of chronic alcohol exposure. Although the precise mechanism(s) underlying greater MRS alcohol detectability in heavy drinkers are unknown, we postulate that this difference may result from reduced ethanol partitioning into the hydrophobic core of the neuronal membranes and reduced hydration of phospholipid headgroups with ethanol on the extensive axonal membrane surface. We have refined the analytic procedures for MRSI detection of brain alcohol by suitable manipulation of the times (echo times TE=20 ms and 270 ms) at which the alcohol signals are collected. In vivo proton MRSI enables amplified signals from nuclei in specific molecular entities (e.g., the methyl group in ethanol) to be detected from a chosen voxel of interest (VOI) in the human brain in vivo. Moreover, our preliminary data show that acutely- induced alcohol tolerance can be detected in men after two consecutive drinks. We propose to determine brain alcohol levels with MRSI detection techniques in men and women who differ in current alcohol consumption and family history of alcoholism. Women and men will be selected with objective criteria for family history of alcoholism and current drinking patterns (occasional versus heavy drinkers). Inclusion criteria will be based in part on the Semi-Structured Assessment for the Genetics of Alcoholism (SSAGA). Retrospective reports of alcohol use will be validated by daily monitoring of alcohol intake, health and mental status with an Interactive Telephone Voice response program. MRSI measurements of alcohol detection in brain will be complemented by well validated psychomotor, cognitive and perceptual test assessments. Subjects will be studied under controlled research ward conditions. Alcohol (2.2 ml, 2.75 ml and 3.3 ml of 40 percent ethanol per kg of body weight) or placebo will be administered in a counter-balanced order. Women will be studied during the mid-follicular phase of the menstrual cycle (days 6-8) and cycle phase will be verified with hormonal measures. Results of the proposed study will show whether increased detection of brain alcohol is associated with a family history of alcoholism, current alcohol intake or an interaction of both in women and men. Data obtained will show if there are significant gender differences in MRSI- detected brain alcohol levels. In vivo MRSI detection or brain alcohol may prove to be a useful tool to ascertain risk for development of alcohol problems in women and men with a positive family history of alcoholism. To the best of our knowledge there have been no previous investigations of the concordance of neurobiological, genetic and alcohol consumption variables which may influence occurrence of alcohol dependence in men and women. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen ·
Project Title: BRIEF INTERVENTION FOR ALCOHOLISM VIA COMPUTER SOFTWARE Principal Investigator & Institution: Hester, Reid K. Director; Behavior Therapy Associates, Llp 3810 Osuna Rd Ne, Ste 1 Albuquerque, Nm 87109 Timing: Fiscal Year 2001; Project Start 1-JUN-1999; Project End 1-AUG-2003 Summary: The goals of this project are to develop, evaluate, and disseminate an interactive computer software program that provides a brief motivational intervention for individuals with alcohol problems. The intervention will consist of integrated Assessment, Feedback and Decision Making modules. The program will use the FRAMES elements common to effective brief motivational interventions. The target population ranges from at-risk drinkers to individuals with alcohol dependence. The goals of Phase I were to develop a limited prototype of all three modules and evaluate its technical merit and feasibility. This has been accomplished and feasibility has been demonstrated. The goals of Phase II include the completion of the Windows prototype
20 Alcoholism
and the development of a parallel web application. The program will be beta tested and revised accordingly. Finally, a controlled clinical trial with a 12 month follow-up will assess the efficacy of the program. The public health implications are far reaching. The costs of medical care, lost work, and alcohol-related injuries for alcohol abusers are well known. If computer-based brief motivational interventions can be provided at low cost, the savings could be significant. PROPOSED COMMERCIAL APPLICATIONS: This program could meet the needs of health-oriented web sites, primary healthcare and mental healthcare providers, EAP programs, and behavioral healthcare organizations by providing a cost-effective brief motivational intervention for heavy drinkers. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen ·
Project Title: CENTER FOR THE TRANSLATIONAL NEUROSCIENCE OF ALCOHOLISM Principal Investigator & Institution: Krystal, John H. Kent Professor and Deputy Chair for Rese; Psychiatry; Yale University 47 College Street, Suite 203 New Haven, Ct 065208047 Timing: Fiscal Year 2001; Project Start 4-JUN-2001; Project End 1-MAY-2006 Summary: A gap remains in the translation of basic research advances into clinical neuroscience insights related to alcoholism.. This gap persists despite a growing array of outstanding basic and clinical studies in the field of alcoholism research. A new generation of psychopharmacology, neuroimaging, and molecular genetic studies rooted in molecular neuroscience with broad clinical implications may contribute to bridging the gap between basic and clinical research. The CTNA is designed to bridge the gap between the basic and clinical neuroscience of alcoholism. It will attempt to: 1. Conduct programmatic research that will identify factors modulating glutamatergic circuitry that contribute to ethanol reward, vulnerability to self-administration, and dependence; 2. Build from basic neuroscience insights to hypotheses regarding the etiology, pathophysiology, and treatment of alcoholism; 3. Facilitate transdisciplinary research within projects and between projects; 4. Establish a mechanism to review and fund pilot promising pilot projects; 5. Provide career development activities for graduate and medical students, postdoctoral trainees, and junior faculty that will promote their development and retention within the field of alcoholism research; 6. Promote ethnical and humane clinical neuroscience studies of alcoholism. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: CEREBELLAR STRUCTURE AND FUNCTION IN ALCOHOLISM Principal Investigator & Institution: Sullivan, Edith V. Associate Professor; Psychiatry and Behavioral Sci; Stanford University Stanford, Ca 94305 Timing: Fiscal Year 2001; Project Start 1-APR-1996; Project End 0-JUN-2004 Summary: This application sets forth work to extend our program of research into cerebellar substrates of cognitive and motor deficits associated with chronic alcoholism. Our recent quantitative MRI studies have confirmed our speculations that significant cerebellar tissue volume deficits are present in nonamnesic alcoholics and that these deficits extend to the superior vermian lobules and lateral cerebellar hemispheres. Further, these volume deficits have functional consequences because the severity of ataxia correlates with the extent of vermian shrinkage. These observations may have clinical significance and serve to identify risk factors for falling in alcoholics, even in those who remain abstinent. Given the complexity of standing balance, we now propose to decompose the component processes of postural stability to identify loci of
Studies 21
impairment and to determine if the ability to make use of haptic sensory cues used to maintain balance is impaired in chronic alcoholics. In addition, we have observed significant alcohol-related deficits in nonverbal working and contextual memory. These memory tasks are also known to activate prefrontal cortex and selective regions of the lateral cerebellar hemispheres in functional imaging paradigms in healthy nonalcoholic controls. These brain regions and cognitive functions are disrupted in chronic alcoholics but a causal relationship has yet to be demonstrated. The contribution of a compromised fronto-cerebellar circuit to the cognitive deficits of chronic alcoholism will be directly assessed with functional Magnetic Resonance Imaging (fMRI). The work to date suggests separate but complementary paths to explore the importance of cerebellar dysmorphology and its contribution to functional impairment in alcoholism. The proposed work draws upon neuropsychological testing, physiological analysis of postural stability, and brain imaging with structural and functional MRI. Accordingly, we propose to 1) identify the component processes of the balance disturbances manifested by alcoholics with force platform analyses under challenge conditions, 2) explore brain functions subserved by neuroanatomical loci deficient in volume in alcoholics with fMRI paradigms that specifically activate these regions in normals, and 3) quantify the effects of chronic alcoholism on the volumes of the principal frontocerebellar circuitry nodes with quantitative MRI. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen ·
Project Title: CHRONIC ALCOHOLISM: RELATION TO FRONTAL SYSTEM INTEGRITY Principal Investigator & Institution: Dirksen, Courtney L. Psychiatry; Boston University Medical Campus 715 Albany St, 560 Boston, Ma 02118 Timing: Fiscal Year 2001; Project Start 1-JUN-2001 Summary: Long Term Objectives 1. To define and understand confabulation as it relates to residual memory impairments preceded by chronic alcoholism in order to refine objective ways of looking at and assessing alcoholism-related cognitive impairments. 2. To identify neuroanatomical substrates damaged in chronic alcoholism and to gain an understanding of how they relate to confabulation and memory impairments. Specific Aims 1. To compare alcoholic patients (with and without Korsakoff's syndrome) with other neurological groups (patients with Parkinson's disease, damage of dorsolateral prefrontal cortex, or anterior communicating artery aneurysm disease), and nonalcoholic neurologically intact controls on tests of source memory and frontal lobe function. In doing so, we hope to gain an understanding of how confabulation relates to source memory and frontal system dysfunction, and how frontal dysfunction and source memory impairments can be used to identify and understand confabulation. 2. To examine the same patient groups tin Object Alternation and procedural memory tasks in order to differentiate the effects of basal ganglia vs. limbic system damage. All subjects will be assessed for frontal lobe, basal ganglia, and limbic system integrity. Fifteen participants in each group will be tested using the Autobiographical Memory Inventory, a Life Events test, a Mirror Tracing task, an Object Alternation task, a verbal fluency task (FAS), and the Wisconsin Card Sorting Test. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: COMBINED PHARMACOTHERAPIES FOR ALCOHOLISM Principal Investigator & Institution: Johnson, Bankole A. Wurzbach Distinguished Professor and Dep; Psychiatry; University of Texas Hlth Sci Ctr San Ant 7703 Floyd Curl Dr San Antonio, Tx 78229
22 Alcoholism
Timing: Fiscal Year 2001; Project Start 0-SEP-2001; Project End 1-JUL-2005 Summary: Recent scientific and clinical interest in combining therapeutic agents for the treatment of alcoholism are based on the fact that derangement of multipleneurotransmitter systems are likely to underlie biological predisposition to the disease. Thus, combining effective medications working at different neurotransmitters should produce a synergistic or at least an added clinical response. In animals, the combination of the 5-HT3 antagonist, ondansetron, and the mu receptor antagonist, naltrexone show synergism of action at reducing ethanol consumption. Alcoholics with an early onset of disease are effectively treated by ondansetron, and those with a family history of alcoholism in first degree relatives may have the best clinical outcome to treatment with naltrexone. Given that family history of alcoholism is associated with an early onset of disease, it reasonable for us to predict that the combination of ondansetron and naltrexone should be more optimal than either alone for the treatment of Early Onset Alcoholics (EOA). Indeed, preliminary clinical data from our group provide strong support that the medication combination is an effective treatment for EOA. We will test this hypothesis by comparing the effectiveness of ondansetron (4 mg/kg) and naltrexone(50 mg/day), both alone and in combination, in treating EOA vs. Late Onset Alcoholics (LOA) (total N of 45 subjects/cell x 8 cells = 360) in a randomized, doubleblind, placebo-controlled, 12-week (1 week of single-blind placebo followed by 11 weeks of the double-blind condition) outpatient clinical trial. All subjects will receive standardized Cognitive Behavioral Therapy, and follow-up at 1, 3, 6, and 9 months posttreatment. Specifically, we predict that: 1) EOA, compared with LOA, will be more responsive to treatment with either ondansetron or naltrexone alone, and 2) that the combination of ondansetron and naltrexone will be superior to either medication alone in the treatment of EOA. We will have the unique opportunity to test with adequate power the secondary hypothesis that the combination of ondansetron and naltrexone will be better tolerated than naltrexone alone, thereby improving compliance. This is because nausea is an important side-effect of naltrexone which can limit compliance, and as shown in our preliminary study, ondansetron by having anti-nausea and antiemetic properties counteracts this naltrexone side-effect. We support NIAAA's mission to develop effective pharmacotherapies as adjuncts to psychotherapy for the treatment of alcoholism. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen ·
Project Title: COMBINING ALCOHOLISM
BRIEF
AND
PHARMACOTHERAPIES
FOR
Principal Investigator & Institution: Zweben, Allen; Associate Professor; None; University of Wisconsin Milwaukee Box 413, 2200 Kenwood Blvd Milwaukee, Wi 53201 Timing: Fiscal Year 2001; Project Start 0-SEP-1997; Project End 1-AUG-2003 Summary: Recent alcoholism treatment research indicates that both structured psychosocial treatments designed to enhance motivation for abstinence, such as 4-6 sessions of Motivational, Enhancement Treatment (MET), provide equivalent and good post-treatment drinking outcomes for alcohol-dependent subjects, when compared with more intensive treatments such as Twelve Step Facilitation. Two medications, naltrexone (NTX) and acamprosate (AC), have beer found superior to placebo in prolonging abstinence and reducing posttreatment heavy drinking, when delivered 12 or more sessions of psychosocial treatment for alcoholism. Given the high expense of more intensive psychosocial treatments, as well as the increasing emphasis on lowintensity intervention in managed care organizations, it is important to determine if good alcoholism treatment outcomes can be achieved by combinations of these
Studies 23
medications and moderate- or low-intensity psychosocial treatments for alcohol dependence. Our research group has had substantial success in conducting pharmacotherapy, MET, and brief intervention studies of alcoholics including alcoholics who are members of managed care organizations. We now propose a double-blind, randomized controlled clinical trial comparing four medication conditions [placebo (PBO), NTX, AC, and the combination of NT) and AC], combined in randomized, single-blind fashion with either a moderate intensity psychosocial treatment, MET or a brief behavioral intervention, Brief MET (BMET), in the treatment of alcohol dependence. BMET is a briefer form of MET that employs only psychoeducational approaches, such its feedback, advice, goal formation, and referral to self-help groups and other community resources. Treatment will be provided for six months, with follow-up assessments conducted at the end of active treatment and every three months during the one-year post-treatment follow-up period. We hypothesize that both medications, and their combination, will provide superior outcomes to placebo (PBO) treatment, when combined with either MET or BMET. We also hypothesize that MET and BMET will not significantly differ in their effectiveness. To test the feasibility and efficacy of BMET, a pilot study involving 40 subjects will be conducted for a one year period preceding the implementation of the main phase of the proposed study Subject outcomes in both the pilot and main studies will assess several alcohol-related domains: percent days abstinent, drinks per drinking day, time (days) to relapse, drinking related problems, biologic indices of heavy drinking (Carbohydrate-Deficient Transferrin and GGT), and compliance with these modifications. A cost-effectiveness analysis will be conducted along with these clinical outcome analyses, so that the results will be applicable to managed care organizations, where substantial numbers of alcoholdependent clients receive health care treatment. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen ·
Project Title: COMPARISON OF CBT AND MET PLUS NALTREXONE FOR ALCOHOLISM Principal Investigator & Institution: Anton, Raymond F. Professor of Psychiatry; Psychiatry and Behavioral Scis; Medical University of South Carolina 171 Ashley Ave Charleston, Sc 29425 Timing: Fiscal Year 2001; Project Start 0-SEP-1992; Project End 1-AUG-2002 Summary: APPLICANT'S ABSTRACT: Advances in the neurobiology of alcoholism have led to the investigation of medications or its treatment. Simultaneously, investigation of psychosocial interventions utilizing sound scientific clinical trial methodologies have occurred. The intersection of these events has led to the examination of alcoholism treatments which combine psychosocial treatment with phamacotherapy. Currently our group is evaluating the efficacy of the opiate antagonist medication naltrexone combined with 12 weekly sessions of Cognitive Behavioral Therapy (CBT) for outpatient alcoholics. This treatment shows evidence of high rates of completion and compliance. This continuation proposal will compare CET (12 sessions) with a more time limited (4 sessions) Motivational Enhancement Therapy to which naltrexone or placebo medication is added. In this randomized clinical trial 160 alcohol dependent outpatients, after 5 days of abstinence, will receive one of the two psychosocial therapies and either naltrexone or placebo over a 12 week treatment period. Abstinence rates, alcohol use, and time to alcohol relapse will be evaluated in all four group along with measures of alcohol craving, biological measures of alcohol consumption (CDT and GGT), drinking consequences, changes in self-efficacy for avoiding alcohol, and medication compliance (urinary riboflavin maker). All study
24 Alcoholism
participants will be assessed at 3 and 6 months after completing the treatment protocol utilizing the same outcome variables. Therapy will be provided by trained therapists according to manuals produced during Project MATCH, the large multi-site psychotherapy study in which our center participated. Quality control of therapy will be achieved by direct supervision and rating of random therapy tapes. State-of-the-art alcohol and craving assessment instruments, biologic markers, and compliance measures will be utilized to assess outcome to treatment. Results of this trial should allow evaluation of whether less intense, and potentially less costly, therapies with good patient acceptance could, when combined with efficacious medication, have equivalent results with a proven more intensive and skill requiring approach. As such, these results will provide data regarding the types of treatment likely to benefit outpatient alcoholics when applied in other health care settings where issues of clinical acceptability and cost might be consideration. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen ·
Project Title: CONTROLS FOR ASSOCIATION STUDIES OF ALCOHOLISM Principal Investigator & Institution: Kidd, Kenneth K. Professor of Genetics and Psychiatry; Genetics; Yale University 47 College Street, Suite 203 New Haven, Ct 065208047 Timing: Fiscal Year 2003; Project Start 1-AUG-1992; Project End 0-APR-2008 Summary: (provided by applicant): Alcoholism is a significant public health problem because of its prevalence and the high morbidity to patients and high impact on their relatives. The alcohol dehydrogenase (ADH) cluster of genes and the aldehydedehydrogenase 2 locus. (ALDH2) are known to affect alcohol metabolism and the genetic susceptibility to alcoholism in some populations, primarily populations of East Asian ancestry. Our new haplotype analyses of the ADH gene cluster show significant linkage disequilibrium and attribute the effect on alcoholism in the Chinese sample analyzed to only one haplotype. Recent work by others similarly finds a single relevant haplotype at the ALDH2 locus. Other data suggest that alleles not yet identified at these loci may be relevant to alcoholism and/or alcohol metabolism in Asian and other populations. Considered with the realization of the complexity of global human genetic diversity (developed in part from previous work on this grant), these data support undertaking a comprehensive global survey of genetic variation at the ADH gene cluster and at the ALDH2 locus. Therefore we propose to extend the study of the haplotypes across these entire regions, by identifying polymorphisms encompassing the entire region with each gene covered at molecularly short distances and type the most informative markers on at least 38 in-lab population samples representing all major parts of the world. A combination of known and new makers encompassing ALDH2 will similarly be studied. Collaborators in China, India, and Africa will continue to help develop better coverage of populations in their regions for ADH and ALDH2 haplotypes. Studies of other higher primates (chimpanzees, gorillas, orangutans) to determine the direction of mutation for each human polymorphism will illuminate the evolutionary origins of the existing variation. We will continue to collaborate with other researchers to examine these haplotypes in three different sets of individuals with alcoholism, one Chinese, one German, and one Australian (Northern European ancestry) and communicate our polymorphism and haplotype data to collaborators working on the COGA and NIAAA linkage studies of alcoholism. Thus, this complex and multifaceted project will provide the necessary population genetic basis for further studies of the ADH and ALDH2 loci as related to alcoholism and will undertake different applications to alcoholism and alcohol metabolism using haplotype
Studies 25
approaches. Indications of the importance to alcoholism of different genetic variants and of which haplotypes may harbor cryptic but functionally relevant variation will result from these studies. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen ·
Project Title: DOPAMINE TRANSMISSION IN ALCOHOLISM Principal Investigator & Institution: Abi-Dargham, Anissa; Irving Associate Professor; New York State Psychiatric Institute 1051 Riverside Dr New York, Ny 10032 Timing: Fiscal Year 2001; Project Start 6-SEP-2000; Project End 1-AUG-2003 Summary: (Adapted from applicant's abstract) The neurobiology of alcoholism in humans is still poorly understood. Experiments in rodents have suggested that the mesolimbic dopaminergic system is critically involved in the rewarding properties of alcohol, and that a deficit of mesolimbic dopamine (DA) transmission might constitute a risk factor for developing alcoholism. Furthermore, it has been suggested that low mesolimbic D2 receptor transmission might be implicated in alcohol craving and vulnerability to relapse. However, relatively little data is available to support the relevance of these preclinical studies to alcoholism in humans. Recent developments in brain imaging technology make it possible to test these hypotheses in alcoholic subjects. The general aim of this proposal is to test the hypothesis that alcoholism is associated with a deficit in mesolimbic DA function. Using neuroreceptor imaging and a state of the art positron emission tomography (PET) scanner, the investigators propose to evaluate the association between alcoholism and alteration in pre- and post synaptic parameters of dopamine transmission in the ventral striatum: 1) D2 receptor availability; 2) amphetamine-induced intrasynaptic dopamine release. D2 receptors's availability will be measured as the binding potential of the radiotracer [~ ~C]raclopride. The amphetamine-induced intrasynaptic DA release will be evaluated by the displacement of [~C]raclopride from D2 receptors following the amphetamine challenge. D2 receptor availability (specific aim #1) and amphetamine-induced intrasynaptic DA release (specific aim #2) will be measured in 24 recently abstinent alcoholics (within 3 to 4 weeks of abstinence) and 24 healthy controls matched for age, gender, ethnicity, parental socioeconomic status and nicotine dependence. The hypotheses are that, compared to matched control subjects, alcoholics will display lower D2 receptors availability and blunted amphetamine-induced DA release in the ventral striatum, and that these abnormalities will correlate with severity of alcoholism and intensity of alcohol craving. This study will provide a comprehensive description of synaptic dopaminergic parameters in alcoholism. If indeed deficits in DA function are found in chronic alcoholics, the investigators can examine as a second step, possibly in the renewal of this application, whether these deficits represent a toxic effect of alcohol or a vulnerability factor. Understanding the neurochemical abnormalities underlying vulnerability to alcoholism would guide future treatment interventions and risk prevention strategies. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: EARLY STRESS & ALCOHOLISM: NEUROBIOLOGICAL ANALYSIS Principal Investigator & Institution: Friedman, David P. Professor; Physiology and Pharmacology; Wake Forest University Health Sciences Winston-Salem, Nc 27157 Timing: Fiscal Year 2003; Project Start 1-FEB-2003; Project End 1-JAN-2007 Summary: (provided by applicant): Alcohol abuse and alcoholism are major burdens for our society. While the development of alcoholism is influenced by many factors, stress is
26 Alcoholism
believed to be one important etiological element. Indeed, chronic stress has been shown to alter neurotransmission in many brain systems and alter the rewarding properties of a variety of abused drugs, including alcohol. Moreover, stress during childhood contributes to an array of poor outcomes later in life including depression, anxiety disorders, and substance abuse. Little is known about the neurobiolgoical basis of the response to stress and how that might alter the way a subject responds to alcohol. Strikingly, many of the brain regions, including the orbital and medial prefrontal cortex, the amygdala and the hippocampus, that have been shown to modulate the response to stress, are also part of the brain reward circuitry, which modifies the response to drugs. This commonality of neural circuitry suggests that these regions may play a role in mediating the effects of stress on alcohol consumption. In addition, serotonin, which innervates all of the areas listed above, along with the hypothalamus, is a key neurotransmitter in the stress response, and plays a role in modifying the response to drugs as well. One model of chronic stress is produced when infant monkeys are separated from their mothers at birth and reared in a nursery. Nursery reared monkeys show an array of cognitive, behavioral, and physiological differences from normal monkeys, including dysregulation of their brain serotonin systems and a propensity to drink excessively when exposed to alcohol. Thus, the goals of this project are to: 1) study the differences in the densities of the serotonin transporter, serotonin receptors, and in serotonin gene between nursery-reared and mother-reared monkeys; 2) to characterize the drinking behaviors of these two groups of monkeys in fixed-dose and ad lib drinking environments; and to examine the changes in the serotonin system in fixeddose vs. ad lib drinking environments. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen ·
Project Title: ELEVENTH CONGRESS: INT. SOC. BIOMED. RES. ALCOHOLISM Principal Investigator & Institution: Harris, R Adron. Director; Ctr for Alcohol & Addict Res; University of Texas Austin 101 E. 27Th/Po Box 7726 Austin, Tx 78712 Timing: Fiscal Year 2002; Project Start 1-MAY-2002; Project End 0-APR-2003 Summary: This application requests funds for the partial payment of travel and conference-related expenses of non-US resident scientists (invited speakers and young/new investigators) and for U.S. minority scientists to attend the Eleventh Congress of the International Society of Biomedical Research in Alcoholism (ISBRA). This meeting will be held in San Francisco, California on June 28 through July 3, 2002. The ISBRA Congresses are now the only worldwide scientific meetings for all areas of alcohol research. In addition to biomedical aspects, they also cover biobehavioral and clinical research. The ISBRA Congresses are held biannually and, since the founding of ISBRA, meetings have been held in Germany, USA, Finland, Japan, Canada, UK,. Australia, and Denmark. This will be the third time that the ISBRA Congress will be held in the United States. It will have a large impact on alcohol research not only in North America, but also the European countries, as well as Asian and Pacific Rim countries and Australia. The Congress will meet jointly with the US-based Research Society on Alcoholism (RSA). The program will feature topics of priority interest to the international alcohol research community and provide opportunities for discussion of collaborative research. At present, 43% of the ISBRA membership is non-U.S. based. Accordingly, attendance by non-U.S. scientists is absolutely essential for the success of the meeting; 41 of the 76 proposed invited speakers will be from outside of the U.S. This application requests funding for travel and registration fee for 30 invited speakers, travel registration fee and partial living expenses for 27 young/new investigators and 6
Studies 27
minority students/young investigators and partial coverage of publication costs of the Congress proceedings. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen ·
Project Title: EMOTION AND CRAVING IN ALCOHOLISM WITH COMORBID PTSD Principal Investigator & Institution: Coffey, Scott F. Psychiatry; State University of New York at Buffalo 402 Crofts Hall Buffalo, Ny 14260 Timing: Fiscal Year 2001; Project Start 9-SEP-2001; Project End 1-AUG-2003 Summary: (provided by applicant): Post-traumatic stress disorder (PTSD) is one of the most frequently occurring disorders in persons seeking treatment for alcohol dependence (AD). Moreover, AD individuals with comorbid PTSD have poorer alcohol treatment outcomes than AD individuals with or without other psychiatric conditions. Despite the high level of comorbidity between these disorders, there is little laboratorybased research directed at understanding the mechanism(s) by which PTSD may affect important aspects of AD, such as craving. One possible mechanism may be negative emotions (e.g., fear, anxiety) experienced by individuals with PTSD when remembering or encountering aspects of a prior traumatic event (e.g., physical or sexual assault). Recently, research has shown that imaginal exposure to a personalized trauma cue increases negative emotion and alcohol craving in individuals with comorbid AD and PTSD. In addition, research has consistently demonstrated that AD only individuals respond with greater craving, for alcohol in response to negative emotional cues. Taken together, these findings suggest that reducing negative emotions may be one way to reduce craving for alcohol in individuals with comorbid AD-PTSD. One well-validated method to reduce negative emotional reactivity in PTSD populations is by exposing PTSD patients to imaginal trauma cues for an extended period of time. However, it has yet to be demonstrated that a reduction in negative emotion leads to a reduction in alcohol craving in alcoholics with PTSD. The current application is designed to fill that void by combining a laboratory-based method to assess emotion and craving with an empirically supported approach to reduce trauma-related negative emotion. Using a cue reactivity paradigm previously used with an AD-PTSD comorbid sample, we propose to assess cue-elicited craving and emotion prior to and following repeated imaginal exposure to an individualized trauma cue. Craving and emotion will be assessed by physiological arousal and self-report following exposure to trauma and alcohol cues singly and in combination. The primary aim of this project is to test if prolonged and repeated imaginal exposure to a trauma cue will modify the emotional reactivity, physiological arousal, and alcohol craving elicited by that cue. Success in demonstrating that a reduction in negative emotion leads to a concomitant reduction in alcohol craving will enhance our understanding of the relation between emotion and craving in individuals with comorbid AD-PTSD, and will provide empirical support to justify the use of imaginal trauma cue exposure treatment for AD individuals with PTSD. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: ENHANCED ALCOHOLISM TREATMENT STRATEGIES Principal Investigator & Institution: O'malley, Stephanie S. Professor; Psychiatry; Yale University 47 College Street, Suite 203 New Haven, Ct 065208047 Timing: Fiscal Year 2001; Project Start 1-APR-1999; Project End 1-MAR-2004 Summary: This application seeks renewal of an Independent Scientist Award to permit the candidate to devote full time effort to human research and research mentoring with
28 Alcoholism
the goal of improving alcoholism treatment by developing better methods of psychosocial and pharmacological treatments. To this end, the applicant has followed two paths: clinical studies of naltrexone in combination with psychotherapy and laboratory studies designed to examine the effects of these same medications on responses to alcohol and alcohol self-administration. Using these methods, future research efforts will focus on pharmacotherapies, such as acamprosate, that target other aspects of alcohol dependence and may be effective alone or in combination with naltrexone. The renewal of the K02 award will include an expanded emphasis on abstinence initiation and withdrawal symptomatology, and medications the purport to attenuate protracted withdrawal, and advanced statistical techniques to evaluate change. The Research Plan provides a detailed description of a laboratory study designed to provide critical information about the effects of acamprosate on central aspects of alcohol dependence: withdrawal and loss of control drinking. Acamprosate is approved for treatment in Europe based on studies showing that acamprosate improved rates of abstinence. However, there is little information regarding whether acamprosate reduces relapse following a lapse and on whether acamprosate attenuates withdrawal as hypothesized. One hundred-twenty nontreatment seeking alcohol dependent volunteers will be randomized to receive placebo or one of two doses of acamprosate and studied in the laboratory to assess the effects of the medication on alcohol withdrawal symptomatology, alcohol intoxication and alcohol self-administration. Better characterization of these effects will be important for determining the optimal sequencing and timing of pharmacotherapies such as acamprosate and for increasing the overall success rate for achieving and maintaining abstinence. The Career Development Plan include collaborations with investigators at the Scripps Institute, Brown University and the University of Missouri and selected course work in statistical methods. The objective of the career development plan will be to acquire an understanding of preclinical models to study homeostatic mechanisms involved in addiction and the effect of pharmacological interventions during acute withdrawal, protracted withdrawal, and relapse. In addition, a major objective will be to acquire training in statistical methods appropriate for the analysis of change and mediational processes in longitudinal data sets, including hierchical linear modeling, repeat event time analysis, regression analyses, and structural equation modeling. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen ·
Project Title: EVALUATION OF A NONHUMAN PRIMATE MODEL OF ALCOHOLISM Principal Investigator & Institution: Flory, Graham S. Pharmacology; University of Michigan at Ann Arbor 3003 South State, Room 1040 Ann Arbor, Mi 481091274 Timing: Fiscal Year 2001; Project Start 1-JUL-2001 Summary: Alcoholism is a major public health problem in the United States, resulting in the annual death of tens of thousands of Americans and costing billions of dollars. The development of animal models of alcoholism will play an important role in understanding the biological factors that contribute to the development of alcoholism and provide a means of testing novel medications for its treatment. To date, the vast majority of animal studies utilize the oral route of ethanol self-administration. The factors controlling the oral self-administration of ethanol by laboratory animals, however, have not been clearly identified and controlled for. The specific aim of the proposed research is to combine the techniques of oral, intravenous, and intragastric ethanol self-administration in such a manner as to dissociate the respective contribution to the overall reinforcing value of ethanol made by taste, route of administration, and
Studies 29
the rate at which it is absorbed into the bloodstream. With the development of these novel techniques, it will be possible to accurately characterize individual differences in an animal?s propensity to self-administer ethanol for its pharmacological, rather than gustatory, properties. These data will subsequently be used as a basis for future studies of the neuroanatomical correlates of excessive ethanol intake. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen ·
Project Title: FACTORS AFFECTING USE OF MEDICATION TO TREAT ALCOHOLISM Principal Investigator & Institution: Mark, Tami L.; Medstat Group, Inc. 777 E Eisenhower Pky Ann Arbor, Mi 48108 Timing: Fiscal Year 2001; Project Start 1-JUL-2000; Project End 1-OCT-2003 Summary: In January 1995, naltrexone, marketed under the name REVIATM became the first medication approved by the Food and Drug Administration for alcoholism treatment in almost 50 years. The ifficacy of naltrexone, as an adjunct to therapy, in decreasing the mean number of drinking days per week, the frequency of relapse, and subjective craving for alcohol with few side effects has been shown in double blind randomized clinical trials. Despite the evidence of its efficacy, reports of its use indicate that it is not as widespread as might be expected. Total prescription of Revia in 1998 (including prescription for narcotic treatment) were 13,000 per month, only slightly more than the number of prescriptions in 1996. The 1992 National Longitudinal Alcohol Epidemiologic Survey estimated that 13.7 million adults met the criteria for alcohol abuse and alcohol dependence during the year preceding the interview (Grant, 1995). The one-day census of specialty substance abuse providers (NDATUS) indicates that in 1996, there were 677,000 clients in treatment for alcoholism. This figure excludes persons receiving treatment for alcoholism in institutions specializing in mental health care and in primary care settings. Thus, perhaps only 2 percent of persons receiving alcoholism treatment are being treated with naltrexone. Given the low utilization of naltrexone in the face of its apparent efficacy, it is critical to understand the barriers to the adoption of this important new pharmacological tool. The goal of this proposed research is to identify the factors that are influencing the use of naltrexone and to gain insight into its perceived efficacy among practitioners. Towards this end, the primarily aims of this study are: (1) to identify factors influencing use of naltrexone and their relative importance; (2) to determine whether other new medications to treat alcoholism are likely to face barriers to prescribing; (3) to identify methods that physicians used to overcome barriers to prescribing naltrexone; (4) to collect information on the types of patients being prescribed naltrexone and the circumstances under which it is being prescribed. We propose to collect this information through experts panels and a national survey of physicians specialized in treating substance abuse. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: GENES FOR ALCOHOLISM SUSCEPTIBILITY Principal Investigator & Institution: Foroud, Tatiana M. Associate Professor; Molecular and Medical Genetics; Indiana Univ-Purdue Univ at Indianapolis 620 Union Drive, Room 618 Indianapolis, in 462025167 Timing: Fiscal Year 2001; Project Start 1-AUG-1999; Project End 1-JUL-2004 Summary: Much of my previous research has focused on the initial linkage analyses of both human and animal alcoholism-related traits. While these studies have provided initial linkage results that are quite exciting and suggest the presence of genes
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underlying these traits, the power of these data to identify and confirm additional loci is poorly understood. In this K02 application I propose substantial career development which will allow me to bridge the gap between the genetic analyses of human and animal data. In order to achieve this goal, I will pursue intensive career development with two researchers, John Blangero, Ph.D. at the Southwest Foundation for Biomedical Research and Zhao-Beng Zeng, at North Carolina State University, both of whom have provided significant methodological development in the field of quantitative linkage analysis. The specific aims of this application propose to utilize some of the most recently developed analytic methods to increase the power of locus detection in genetic studies of human alcoholism and alcohol seeking behaviors in the rat. To complement these studies, I propose simulation studies to evaluate the power of our analytic methods to detect genes of small to moderate effect and genes acting on the phenotype through gene-gene and gene-environment interactions. These studies will result in more sophisticated genetic analyses of alcoholism related data, as well as the development of optimum sampling designs for more efficient gene identification. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen ·
Project Title: GENETIC ALCOHOLISM
ARCHITECTURE
OF
RISK
FOR
ANTISOCIAL
Principal Investigator & Institution: Stoltenberg, Scott F. Psychiatry; University of Michigan at Ann Arbor 3003 South State, Room 1040 Ann Arbor, Mi 481091274 Timing: Fiscal Year 2001; Project Start 1-MAR-2000; Project End 8-FEB-2005 Summary: This is an application for a Mentored Research Scientist Development Award (K01). This award is requested to provide an opportunity for the candidate to complete a transition from basic behavior-genetic research to a clinically based program of research focused on understanding the influence of heredity on risk for antisocial alcoholism (AAL) and its comorbid disorders (CDs). The training setting is the University of Michigan Department of Psychiatry and Mental Health Research Institute. It is clear that alcoholism is not a Mendelian trait, the factors associated with its intergenerational transmission are multiple and interacting. This proposal is designed to provide the candidate with experience on several fronts, all of which will be necessary to better understand the complexities of the etiology and developmental trajectories of AAL and its CDs within a developmental systems framework. These fronts include (a) multivariate statistics, (b) molecular genetics, (c) longitudinal/developmental study designs and (d) complex adaptive systems. Implementation of these skills in the conduct of small scale research projects will position the candidate for submission of an R01 application during the award period. This application describes studies that would take place during the MRSDA period that would enable the candidate to enhance his scientific skills along each of these fronts. The major study proposed would serve to collect and archive genetic samples from 291 families participating in the University of Michigan/Michigan State University Longitudinal Study directed by Dr. Robert A. Zucker, that are well characterized phenotypically. Candidate gene analyses will be conducted to assess potential associations between genes in the serotonergic system and behavioral undercontrol in children, a risk factor for developing AAL. This sample represents an important resource to study risk for AAL and its CDs. Archiving the genetic samples will position the candidate to take advantage of expected technological advances in rapid and large-scale scoring of single nucleotide polymorphisms (SNPs) and in complexity-oriented analytic techniques. Other projects proposed include secondary analysis of a family-based genetic study data set, the development of molecular genetic markers and additional candidate gene analyses. This award would
Studies 31
enhance the candidate's potential for developing an independent research program to study the genetics of antisocial alcoholism and its comorbid disorders. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen ·
Project Title: GENETIC LINKAGE OF ALCOHOLISM Principal Investigator & Institution: Crowe, Raymond R.; University of Iowa Iowa City, Ia 52242 Timing: Fiscal Year 2001 Summary: This is a study of neurophysiological and biochemical markers of vulnerability to alcoholism including localization of susceptibility genes using genetic linkage analysis. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: GENOTYPE:PHENOTYPE ASSOCIATIONS IN ALCOHOLISM Principal Investigator & Institution: Mulligan, Connie J. Anthropology; University of Florida Gainesville, Fl 32611 Timing: Fiscal Year 2001; Project Start 1-JUN-2001; Project End 1-MAY-2003 Summary: APPLICANT'S ABSTRACT: The challenge for the new century lies in the detailed analysis of complex disease systems wherein multiple genes, as well as environmental influences, are responsible for the manifestation of a diverse set of symptoms that characterize the disease. The major obstacle in the study of complex diseases is to identify significant associations between genetic variants (genotypes) and symptoms or conditions of the disorder (phenotypes). Using recently developed methods of linkage analysis, the proposed study will determine phenotypically significant polymorphisms involved in alcoholism and alcohol-related disorders. Genetic variants will be assayed in DNA extracts that have associated, clinical diagnoses of alcohol dependence, related physiological responses, and psychiatric conditions. Detailed haplotypes based on these genetic variants will then be constructed and tested for association with the clinical diagnoses utilizing linkage analysis and nested cladistic analysis methods. The resulting data will have both practical and theoretical applications. Novel variants involved in alcoholism and alcohol-related disorders will be identified. Of broader impact, the proposed study will be used as a model system for the investigation of any complex disease. The identification of significant genotype:phenotype associations is the key to understanding the etiology of complex disease systems and to developing improved methods of prevention and treatment. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: HYPOTHALAMIC-PITUITARY-ADRENAL AXIS AND ALCOHOLISM Principal Investigator & Institution: Wand, Gary S. Professor; Medicine; Johns Hopkins University 3400 N Charles St Baltimore, Md 21218 Timing: Fiscal Year 2001; Project Start 1-AUG-1995; Project End 0-APR-2005 Summary: Rodent studies suggest a link between stress, mesolimbic dopamine generation and abnormal reinforcement from drugs of abuse. It has been posited that the ability of stress to increase mesolimbic dopamine production results in sensitization of the reward pathway to drugs of abuse. Indeed, rats will consume more alcohol and other drugs following stress and post-stress alcohol drinking is attenuated by adrenalectomy. During the last funding period, we established that persons at increased risk for alcoholism (e.g., offspring of alcoholics) are more sensitive to Naloxone, have
32 Alcoholism
altered HPA axis dynamics and altered hypothalamic opioid activity, which can be identified before the onset of heavy drinking. Moreover, we had shown that chronic heavy drinking induces even more dramatic derangement in HPA axis dynamics, affecting mood and perhaps increasing the chances of relapse following withdrawal. Lastly, we showed that chronic Naltrexone administration blunted alcohol-induced activation of the HPA axis as well as blunting subjective "liking" of alcohol "high". We hypothesize that hypercortisolemia induced by alcoholism or family history of alcoholism alters mesolimbic dopamine production leading to abnormal reinforcement. The experiments outlined in this competitive renewal are a direct extension of our findings from the previous funding period. As well as interacting with 3 other RO-1 proposals through the IRPG, the experiments outlined in this application "stand alone". Fist, we will extend our previous findings and determine if high- risk subjects have a more labile HPA axis in response to a psychological stress. Second, we will ascertain whether high cortisol reponders to Naloxone will also be high cortisol responders to "real life" stress. Third, we will determine whether 1) family history of alcoholism, 2) personality measures or 3) anxiety measures interact to alter HPA axis dynamics. Fourth, using PET imaging, we will determine if high-risk nonalcoholics make more dopamine compared to low risk subjects. We will test the hypothesis that high cortisol secretors are also high dopamine releasers as the rodent literature predicts. Finally, 5 and 10-year follow-up studies will determine if high cortisol production or high dopamine release is independent risk factors for alcoholism. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen ·
Project Title: IDENTIFYING GENES PREDISPOSING TO ALCOHOLISM Principal Investigator & Institution: Johnson, Thomas E. Professor; Inst of Behavioral Genetics; University of Colorado at Boulder Boulder, Co 80309 Timing: Fiscal Year 2001; Project Start 9-SEP-1994; Project End 1-AUG-2004 Summary: This is an application for renewal of an NIH Research Career Award (RCA). The primary purpose of the application is to reduce the applicant's teaching load to a level that will allow him to pursue ongoing research on the genetic basis of alcohol action. A typical teaching load in the Department of Psychology is four full-semester courses per year. The only exceptions are faculty who have career research awards. I have initiated a study wherein we are identifying and mapping mouse genes of relevance to alcoholism using the Long-Sleep (LS) and Short-Sleep (SS) lines of mice that were selectively bred for differential sensitivity to the anesthetizing action of alcohol. We have localized major QTLs for this trait are are closing on the genes underlying the phenotype using congenic strain analysis. During the tenure of this award I will pursue research in the biological and molecular basis of alcohol action both in this model as well as the DBA/2 by C57BL/6 mouse model for alcohol preference/avoidance. I am currently in the third year of a 4-year R01 to map genes leading to neurosensitivity to ethanol and have an application pending to identify new QTLs for a variety of traits using a series of 110 RIs from the ILS by ISS strains. The RSDA will also provide the opportunity for increased interactions with personnel in the Department of Pharmacology at the University of Colorado Health Sciences Center (UCHSC) which includes Drs. Richard Deitrich, and James Sikela and members of their respective laboratories as well as Dr. Gene Erwin in the School of Pharmacy also at the UCHSC. Active collaborations are already underway with Drs. Deitrich, Erwin, Adron Harris (now at U. Texas) and Sikela. I will continue to develop my expertise in DNA sequencing and bioinformatics and to learn microarray methodologies to test the hypothesis that particular genes are involved in alcohol action. Additional educational
Studies 33
experience will be obtained by regular attendance of the annual meeting of the Research Society on Alcoholism (RSA), the biannual meeting of the Gordon Conference on QTL Mapping as well as specialized meetings on the molecular genetic basis of alcohol action, as these conferences should arise. I will continue to develop my knowledge of QTL mapping by discussions and interactions with colleagues both at CU and elsewhere who are expert both in the molecular basis of gene detection and analysis. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen ·
Project Title: IMAGING DOPAMINE RELEASE/ENDOCRINE CHANGES IN ALCOHOLISM Principal Investigator & Institution: Wong, Dean F. Vice Chair for Research; Radiology; Johns Hopkins University 3400 N Charles St Baltimore, Md 21218 Timing: Fiscal Year 2001; Project Start 8-SEP-2000; Project End 1-AUG-2005 Summary: (Adapted from the Investigator's Abstract) The overall goal of this R01 and its companion IRPG proposals is to determine if there is altered dopamine neurotransmission in high risk nonalcoholics which predates the development of alcoholism and whether this dopaminergic defect is further deranged by chronic alcoholism. This R01 will examine dopamine release in chronic alcoholics and controls with PET scanning procedures and will relate this information to response to a Naloxone challenge. The investigators propose a model that alcoholism results from a deficiency of mesolimbic dopamine D2 receptors. An individual's low D2 receptor activity can be the result of genetic variance in the D2 receptor itself caused by the presence of the A1 D2 receptor allele, down regulation secondary to increased dopamine release secondary to stress-induced hypercortisolemia due to an anxious/depressed personality type or novelty seeking behavior, and the toxic effects of alcohol abuse per se. If the initial D2 receptor deficits are exacerbated by alcohol abuse one can envision a positive feedback loop hard to break. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: IMAGING SEROTONIN TRANSPORTER IN ALCOHOLISM WITH PET Principal Investigator & Institution: Szabo, Zsolt; Associate Professor; Johns Hopkins University 3400 N Charles St Baltimore, Md 21218 Timing: Fiscal Year 2001 Summary: Impaired serotonin (5-HT) function has been implicated as a possible factor in the biological vulnerability for alcoholism, but most studies of the 5-HT system have been performed in animals or, if performed in humans, they involved only indirect measurements to assess the 5-HT system in the brain. The status of the 5-HT neurons in the brain of living alcohol dependent individuals remains unknown. To investigate the 5-HT system of the brain, quantitative PET studies of the brain 5-HT transporter (5-HTT; an established marker of serotonin neuron integrity) are proposed using [11C]McN5652 as radioligand for four groups of human subjects: family negative (FHN) controls, family history positive (FHP) controls, FHN recovering alcoholics, and FHP recovering alcoholics. The hypothesis to be tested is that radioligand binding to the 5-HT transporter is significantly reduced as a function of both alcoholism and family history of alcoholism. Serotonin function will also be measured by quantification of plasma prolactin and cortisol increase in response to fluoxetine. The genetic aspect of 5-HT impairment will be investigated by measuring the frequency of specific polymorphisms of the 5-HTT gene. The hypothesis is that FHP alcoholics and FHP controls will have a
34 Alcoholism
higher frequency of the s-variant allele, the allele, which has been associated with reduced 5-HTT expression/function in in vitro studies. The frequency of the s-variant allele is predicted to be higher in subjects with reduced 5-HTT densities (as determined by PET) and with reduced hormonal responses to fluoxetine. The results of this project will lead to better understanding of the role of serotonin in the biological vulnerability for alcoholism and may lead to improved approaches to prevent and treat alcoholism. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen ·
Project Title: INHERITED SUSCEPTABILITY TO ALCOHOLISM Principal Investigator & Institution: Manowitz, Paul; Psychiatry; Univ of Med/Dent NjR W Johnson Med Sch Robert Wood Johnson Medical Sch Piscataway, Nj 08854 Timing: Fiscal Year 2001; Project Start 1-AUG-1999; Project End 0-APR-2003 Summary: The role of genetic factors in alcoholism is well-established. Like most common diseases, it is likely that mutations at several or many different loci predispose to alcoholism. One mutation that may predispose to alcoholism is a mutation at nucleotide 1788 of the arylsulfatase A locus. A consequence of the amino acid alteration due to this mutation is that the enzyme lacks an oligosaccharide moiety and is metabolically labile in the cell. The arylsulfatase A activity is reduced in cells homozygous for this mutation. Alcoholic patients have an excess of homozygotes with this mutation compared with the prevalence observed in nonalcoholic populations. Acceptance of these previous findings has been limited by the fact that all population studies of genotype and disease frequency are vulnerable to undetected stratification. Confounders such as ethnic origins and social class can affect both the exposure (genotype) and the outcome (disease). This proposal is designed to study arylsulfatase A and other candidate genes for a possible relationship to alcoholism and behavioral/neuropsychological deficits without the influence of stratification confounders. The major hypothesis that candidate gene mutations are predisposing to alcoholism will be tested by comparing the frequency of such mutations or homozygosity for such mutations among patients with alcohol dependence to that in their sibs. A secondary goal of this research is to examine the relationship between the mutations and behavioral/neuropsychological deficits, particularly behavioral undercontrol and executive dysfunction. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: ALCOHOLISM
INTEGRATED
NEUROINFORMATICS
RESOURCE
FOR
Principal Investigator & Institution: Hunter, Lawrence E. Director; Pharmacology; University of Colorado Hlth Sciences Ctr Uchsc at Fitzsimons Aurora, Co 800450508 Timing: Fiscal Year 2001; Project Start 7-SEP-2001; Project End 1-AUG-2006 Summary: (provided by applicant): The aim of this proposal is to establish an Integrated Neuroinformatics Resource on Alcoholism (INRA) as the informatics core component of the Integrative Neuroscience Initiative on Alcoholism Consortium (INIA). The overall goal of the INRA will be to create an integrated, multiresolution repository of neuroscience data, ranging from molecules to behavior for collaborative research on alcoholism. As the neuroinformatics core of the INIAC, the INRA will enable the integration of all data generated by all components of the INIAC. Furthermore, it will support synthesis of new knowledge through computational neurobiology tools for exploratory analysis including visualization, data mining and simulation. The INRA will represent a synthesis of emerging approaches in bioinformatics and existing
Studies 35
methods of neuroinformatics to provide the INIAC a versatile toolbox of computational methods for elucidating the effects of alcohol on the nervous system. The specific aims of the INRA will be: (i) implementation of an informatics infrastructure for integrating complex neuroscience data, from molecules to behavior, generated by the consortium and relevant data available in the public domain; (ii) development of an integrated secure web-based environment so that consortium members can interactively visualize, search and update the integrated neuroscience knowledge; and (iii) development of data mining tools, including biomolecular sequence analysis, gene expression array analysis, characterization of Biochemical pathways, and natural language processing to support hypothesis generation and testing regarding ethanol Consumption and neuroadaptation to alcohol. We will also collaborate with related neuroscience projects to utilize existing resources for brain atlases, neuronal circuits and neuronal properties. The INRA will The made available to the INIAC through a Neb-based system through interactive graphical user interfaces that will seamlessly integrate tools for data entry, modification, search, retrieval and mining. The core of the INRA will be based on robust knowledge management methods and tools that will Effectively integrate disparate forms of neuroscience data and make it amenable to complex inferences. Our proposed strategy ensures that the informatics resource is: (i) flexible and scalable to address the evolving needs of the INIAC, and (ii) highly intuitive and user-friendly to ensure optimal utilization by the INIAC members. The proposed INRA is a novel system for Collaborative research in neuroscience and alcoholism which will be developed by an interdisciplinary team of experts in Bioinformatics, computational biology, neuroscience and alcoholism research. We believe the INRA will greatly enhance the Dace of discovery in the area of ethanol consumption and neuroadaptation to alcohol within the INIAC as well as the general research community. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen ·
Project Title: IRPG4:NOVEL PHENOTYPES FOR GENETICS OF ALCOHOLISM Principal Investigator & Institution: Taylor, Robert E. Chairman and Professor; Pharmacology; Howard University 2400 6Th St Nw Washington, Dc 20059 Timing: Fiscal Year 2001; Project Start 0-SEP-1999; Project End 1-AUG-2004 Summary: Alcoholism affects social, environmental and medical outcomes in African Americans with devastating economic consequences. The overall goal of the research proposed by the Howard University Interactive Research Program (Howard-IRPG) is to increase understanding of the genetic susceptibility to alcoholism and alcoholism risk among African Americans. The research is based on the conceptual model that genetic influence is manifest in each of three conditions necessary for alcoholism: behavioral disinhibition, the capacity to consume large quantities of alcohol, and the development of physical dependence. Behavioral disinhibition may be associated with increased risk for alcoholism and neural disinhibition may underlie the behavior. The Howard-IRPG is one of eight proposed IRPG sites whose long- term goal is the elucidation of novel heritable phenotypes that contribute to alcoholism susceptibility and severity. Using the IRPG ascertainment criteria, we plan to identify, screen, recruit, and perform ascertainment and assessment studies on a cohort of 50 densely affected urban African American families and 20 control families. These studies will quantify phenotypes of high risk of alcohol abuse and dependence as defined by specific diagnostic criteria, estimate the heritability of specific phenotypic traits and determine their association and linkage to candidate genes and quantitative trait loci (QTLs). These assessments will include the heritability of quantitative phenotypes of neural disinhibition and the correlation with clinical diagnoses of predisposing and/or co-morbid Axis I and II
36 Alcoholism
disorders. The BrAC clamping procedure will be used to define novel phenotypes of the acute response to alcohol and the alcohol elimination rate. We will contribute a significant cohort of African Americans for a genome wide survey analysis, candidate gene association studies and the determination of genetic polymorphism required to test these hypotheses since African Americans may have significant, genetically-determined differences in ethanol metabolism. In addition, The Howard IRPG combines the availability of many recruitment sites and an existing scientific and administrative team to meet the challenge of recruiting large numbers of informative African American families; offers substantial existing training/experience in the administration of similar test instruments and procedures such as the SSAGA and the BrAC clamping technique; availability of a new, NIH-funded GCRC with the ability to support the BrAC clamping Shared Resource; and the existing administrative and scientific infrastructure of a NIAAA Collaborative Minority Alcohol Research Center. These studies will be accomplished through significant interaction with all of the proposed IRPG member sites. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen ·
Project Title: IRPG5 R01:NOVEL PHENOTYPES FOR GENETICS OF ALCOHOLISM Principal Investigator & Institution: Li, Ting-Kai; Director; Medicine; Indiana UnivPurdue Univ at Indianapolis 620 Union Drive, Room 618 Indianapolis, in 462025167 Timing: Fiscal Year 2001; Project Start 0-SEP-1999; Project End 1-JUL-2004 Summary: The Indiana University interactive research program project (IU-IRPG) is one of eight proposed IRPGs whose long-term goal is the elucidation of heritable phenotypes and underlying genetic mechanisms that contribute to alcoholism (alcohol dependence) susceptibility and severity. To this end, the relationships among established and potentially alcoholism-relevant phenotypic traits and their association and linkage to candidate genes and quantitative trait loci (QTLs) will be studied in a cohort of densely affected and control families from ethnically diverse populations. In the proposed studies, the heritability of quantitative measures of central nervous system (CNS) disinhibition will be determined and correlated with clinical diagnoses of predisposing and/or comorbid Axis I and II psychiatric disorders. Intermediate phenotypes considered to be fundamental elements of alcohol dependence will be assessed using quantitative scales, their heritability determined, and their relationship to severity of alcoholism analyzed. The genes that underlie these phenotypes will be sought through a genome wide survey and candidate gene association studies. The IUIRPG proposes to ascertain a fair share of the genetically informative population necessary for these goals and to assess them for novel phenotypes of neural disinhibition. In addition, we will use the BrAC clamping procedure to define novel phenotypes of the acute response to alcohol and the alcohol elimination rate. We will estimate the heritability of these phenotypes and of the quantitative clinical phenotypes relating to quantity-frequency of drinking, tolerance, loss of control, craving for alcohol, and physical withdrawal. Finally we will contribute half the genotyping and genetic analyses required to test our hypotheses, and will provide data management services for portions of the IRPG database. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: IRPG8 R01:NOVEL PHENOTYPES FOR GENETICS OF ALCOHOLISM Principal Investigator & Institution: Tischfield, Jay A. Professor and Chair of Genetics; Biological Sciences; Rutgers the St Univ of Nj New Brunswick Asb Iii New Brunswick, Nj 08901
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Timing: Fiscal Year 2002; Project Start 1-MAY-2000; Project End 0-APR-2005 Summary: The Rutgers University Cell and DNA Repository (RUCDR, IRPG site 8, Shared Resource XI) will support the broad objectives of the eight site, investigator initiated IRPG "Novel Phenotypes for Genetic Analysis of Alcoholism". The seven participating IRPG sites will submit blood obtained from phenotypically well characterized individuals in families that exhibit multiple, well-documented histories of alcoholism as well as individuals from control families. RUCDR will utilize the blood to produce transformed lymphocyte cell lines (LCLS) from which DNA is extracted. RUCDR then submits the DNAs to the genotyping laboratories (Shared Resource VIII) for molecular analysis of marker allele polymorphisms. Statistical analyses of the genotype data will ultimately permit the identification of quantitative trait loci (QTLS) that play major roles in alcoholism susceptibility and severity. The current IRPG approach is to ascertain linkage of novel quantitative phenotypes to polymorphic micro satellite repeat loci, initially at 10 centimorgan intervals but at greater resolution as the data warrant. Linkage to candidate genes will also be tested. Novel alcoholism phenotypes include quantitative indices of neurophysiological disinhibition, dependence, withdrawal, craving, and tolerance. However, a definition of the chromosomal location and, subsequently, the identity of genes involved in the expression of these novel phenotypes will require unknown amounts of high quality DNA from individual subjects. Relatively large amounts of DNA can only be assured with a renewable resource (e.g. viable LCL cultures). A LCL and DNA repository facilitates gene identification through linkage studies and may also foster future metabolic and biochemical analyses of alcoholism related phenotypes that are expressed in LCLs. Thus, the LCL and DNA banks provide an extremely valuable, long-term, renewable resource for investigations of both the genetic and physiologic bases of alcoholism. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen ·
Project Title: TREATMENT
LEVELS
OF
CARE
AND
OUTCOMES
IN
ALCOHOLISM
Principal Investigator & Institution: Magura, Stephen; Deputy Executive Director; National Development & Res Institutes Research Institutes, Inc. New York, Ny 10010 Timing: Fiscal Year 2002; Project Start 5-SEP-1997; Project End 1-AUG-2002 Summary: APPLICANT'S ABSTRACT: There is little research on the feasibility, outcomes and cost-effectiveness of using uniform patient placement criteria to match the type and intensity of alcoholism treatment to the individual needs of patients. The aims of the study are: 1. To determine the outcomes of implementing the American Society of Addiction Medicine (ASAM) Patient Placement Criteria in a multi-modality alcoholism treatment program. The study will compare outcomes for patients receiving the ASAM-recommended Level of Care ("matches") with outcomes for patients not receiving the recommended Level of Care ("mismatches"). Only patients mismatched due to external constraints will be included in the study; patients self-selecting their treatment will be excluded. 2. To determine the cost-effectiveness of implementing the ASAM Patient Placement Criteria, by comparing treatment costs and outcomes for matched vs. mismatched patients. 3. To examine the long-term aspects of alcoholism treatment utilization and recovery processes using longitudinal research. It is hypothesized that specific pre-treatment and treatment process variables will predict outcomes independently of ASAM Level of Care match and continuity of care. 4. Based on these results, to develop recommendations for revising the ASAM Patient Placement Criteria. The method will be a prospective longitudinal study of 320 alcohol-dependent
38 Alcoholism
patients (120 matched, 200 mismatched) admitted to a multi-modality treatment program Three Levels of Care characterized by substantial numbers of mismatches will be assessed: Level III (residential rehabilitation), Level II ( intensive outpatient), and Level I (regular outpatient or aftercare). Primary outcomes assessed at 3 and 12 month follow-ups will be alcohol/drug use and consequences, employment, psychological status, legal involvement. The independent and joint effects of pretreatment and treatment process variables (e.g., psychiatric comorbidity, reimbursement mode, stage of recovery, therapeutic alliance, appropriateness of Level of Care, continuity of care, intensity of treatment, specific services ) on patient outcomes will be determined. Using treatment cost data and outcome results, a cost-effectiveness analysis of matching and mismatching at different Levels of Care will be conducted. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen ·
Project Title: SERTRALINE
M-CPP
PET
SCANNING
OF
ALCOHOLISM:EFFECTS
OF
Principal Investigator & Institution: Buchsbaum, Monte S. Professor; Psychiatry; Mount Sinai School of Medicine of Nyu of New York University New York, Ny 10029 Timing: Fiscal Year 2002; Project Start 6-SEP-2002; Project End 0-JUN-2007 Summary: (provided by applicant): A significant body of preclinical and clinical work demonstrates the involvement of the serotonin system in alcoholism. Recent publication of two successful clinical trials of serotonin medications holds significant promise for the field. One study demonstrated a significant effect of the SSRI sertraline in late-onset (type A) alcoholics, while the other demonstrated efficacy of the 5-HT3-antagonist ondansetron in early-onset alcoholics. No other predictors of treatment response have been developed in alcoholism. Neuroimaging, particularly positron emission tomography (PET) scanning, offers a powerful tool to identify specific brain regions that may underlie or be associated with alcoholism. Neuroendocrine, physiological, subjective and recently [18 F] fluoro-deoxy-glucose (FDG) PET scanning responses to the broad spectrum serotonin agonist m-CPP have all been used to examine the serotonin system in alcoholism, and have previously been used to predict the clinical response to serotonin medications in other psychiatric disorders. FDG PET scanning has also recently begun to offer us an understanding of the regional pharmacotherapeutic treatment response to a serotonergic medication in depression, and in other disorders, but has yet to do so in alcoholism. We propose a clinical trial of a serotonergic medication in alcoholism, with the addition of a predictive serotonin neuroimaging and neuroendocrine probe before the study, and a follow up imaging scan at the end of the study. We will take 100 recently abstinent alcoholics, prescribe 200mg of sertraline together with weekly cognitive behavioral psychotherapy, and follow them for a 12week period. We will perform an m-CPP FDG PET scan and a placebo FDG PET scan on completion of withdrawal prior to the trial, and an FDG PET scan on completion of the trial. Our aims are: firstly, to study changes in regional cerebral metabolism measured by FDG-PET scan induced by serotonin probe m-CPP relative to placebo FDG-PET scans in a group of alcoholics, and compare them with a group of healthy controls; secondly, to correlate the m-CPP induced changes in brain metabolism with the clinical response in a treatment trial of sertraline in the group of alcoholics over a 12-week period; and lastly, to assess the effect of sertraline on changes in placebo FDG- PET scans' regional metabolism, and to correlate changes in brain metabolism with treatment outcome. We hypothesize there will be group of clinical responders and non-responders in response to sertraline, and that the degree of serotonergic response, cerebral regional metabolic, hormonal, physiological or subjective, to the m-CPP challenge prior to the trial will
Studies 39
predict the treatment response to sertraline in the trial. We would also hypothesize normalization of the FDG-PET scans in the treatment responsive sertraline group. This study should help identify a group of treatment responders to sertraline, examine whether that treatment response can be predicted using neuroimaging and neuroendocrine techniques, and identify what brain regions are implicated at baseline and in response to treatment. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen ·
Project Title: MEDIATION AND MODERATION OF GENETIC RISK FOR ALCOHOLISM Principal Investigator & Institution: Prescott, Carol A. Assistant Professor; Psychiatry; Virginia Commonwealth University Richmond, Va 232980568 Timing: Fiscal Year 2001; Project Start 1-FEB-1998; Project End 1-JAN-2003 Summary: The candidate is applying for a mentored research scientist development award. Kenneth Kendler, M.D., a world-renowned researcher in the genetic epidemiology of psychiatric disorders, will be her primary preceptor. The training setting in the Virginia Institute for Psychiatric and Behavioral Genetics, a multidisciplinary institute located in the Medical College of Virginia/Virginia Commonwealth University. Research conducted during the past decade has implicated genetic factors in alcohol use, abuse and dependence. An important focus of research in the next decade will be to understand the mechanisms by which these influences operate. The overall goal of the proposed research is to identify mechanisms for transmission of vulnerability to alcohol use and alcoholism. Specific aims include: studying genetic contributions to lifetime risk for alcohol use, abuse and dependence, as well as changes in alcohol consumption and symptomatology; investigating the basis for the association between alcohol-related behaviors and a variety of proposed "risk factors"; studying the basis of the co-occurrence of alcoholism and a variety of other forms of psychopathology; and identifying the role of personality traits and comorbid psychopathology as potential mediators and moderators of genetic vulnerability. To accomplish these goals, the candidate will obtain training in advanced statistical methods and apply them to data collected from personal interviews with over 9,000 twins and their parents ascertained through the population-based Virginia Twin Registry. The candidate's future career goal is to develop comprehensive etiological models for alcohol use and alcoholism by combining behavior genetic designs with behavioral pharmacology paradigms and molecular genetic data. To facilitate this, the candidate will obtain training in behavioral pharmacology and molecular genetics. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: MOLECULAR GENETIC FACTORS IN ALCOHOLISM Principal Investigator & Institution: Lappalainen, Jaakko A. Psychiatry; Yale University 47 College Street, Suite 203 New Haven, Ct 065208047 Timing: Fiscal Year 2002; Project Start 1-SEP-2002; Project End 1-AUG-2007 Summary: (provided by applicant): This K08 application seeks support for additional research training in modem genetic methods, and their use in unraveling the genetic basis of alcoholism. Specifically, further training is sought in advanced statistical genetic and high-throughput genotyping and mutation detection methods. Training is also sought in the application of genetic methods on the research of endophenotypes of alcoholism, such as differences in interindividual response to alcohol. These training objectives will complement the applicant's previous training in neuropharmacology
40 Alcoholism
(Ph.D.), genetics of alcoholism (NIAAA DICBR) and clinical psychiatry (residency, completed 2001), and will make his career goals in research on the genetic basis of alcoholism possible. The training goals will be advanced through two research projects. The first project aims to identify genes for increased risk for alcohol dependence, which have been previously mapped to a specific area of the chromosome 1. Because of the limitations of the genetic linkage techniques in precision, the identified region is very broad and contains several genes. The applicant will fine-map this region using linkage disequilibrium-based techniques, such as the transmission disequilibrium test (TDT), in order to narrow the region containing the gene for predisposition to alcoholism. This is then followed by attempts to identify the gene and its variants using mutation scanning and further mapping. The second project aims to identify the behavioral and neurochemical pathways that connect the Pro7 allele of the functional Neuropeptide Y (NPY) Pro7Leu polymorphism to predisposition for alcohol dependence. Previous large population studies (including one by the applicant) have suggested that the Pro7 allele predisposes to alcohol dependence. We will use a prospective genotyping strategy, and testing for behavioral and neurochemical responses to test doses of alcohol and yohimbine in individuals who carry and who do not carry the Pro7 allele, in order to elucidate the functional differencebetween the Pro7 and L4eu7 Aeles, and their relationship to predisposition for alcoholism. Tne applicant is mentored by Dr. Joel Gelernter (primary) and Dr. John Krystal (co-mentor), who are both exceptionally wellqualified to supervise this type of comprehensive plan, which aims to provide advanced training for an MD, PhD psychiatrist in modem genetic technologies and their application to finding genetic risk factors for alcoholism. Dr. Jeffrey C. Long (University of Michigan) will be the statistical genetics consultant in this project. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen ·
Project Title: MULTIDISCIPLINARY ALCOHOLISM RESEARCH TRAINING PROGRAM Principal Investigator & Institution: Zucker, Robert A. Professor of Psychology; Psychiatry; University of Michigan at Ann Arbor 3003 South State, Room 1040 Ann Arbor, Mi 481091274 Timing: Fiscal Year 2001; Project Start 1-JUL-1990; Project End 0-JUN-2003 Summary: APPLICANT'S ABSTRACT: Since the last competing renewal was submitted in 1994, this program has successfully trained 2 psychiatrists and 4 psychologists, and training for 5 additional Ph.D.'s and 1 M.D. is in progress. The research application is for continued postdoctoral research training of psychiatrists and psychologists whose long term objective is a research/academic career. Within a fertile multidisciplinary research environment focusing upon clinical and preclinical phenomena related to alcoholism as both a chronic condition and an evolving, developmentally varying symptomatic matrix, this program would continue an already successful training venture. Two postresidency psychiatrists and 3 psychologists are to be trained each year in a two year program that includes training in research methodology, the enhancement of trainees' clinical knowledge, and participation in closely mentored research experiences that will enable the trainee to move into an independent investigative career. Training is enhanced by the program's location within the University of Michigan Alcohol Research Center (UMARC), which has its thematic focus the investigation of problems of aging and alcohol. A broad menu of related projects on: (a) the neurobiology of chronic alcoholism, (b) the etiology of alcoholism as tracked longitudinally, and life course manifestations of alcohol related difficulty at a number of different points in the life cycle, insure that trainees have a wide range of mentoring faculty with very substantial
Studies 41
research experience. A graded set of research, clinical, and didactic experiences, set within the context of UMARC's operating structure, ensures that the program is cohesive despite the broad array of research opportunities available. Seven Core faculty and 10 mentoring faculty provide training for the fellows. The primary departmental home for the program is the Department of Psychiatry and its associated clinical facilities, but the availability of research opportunities is enhanced by ongoing alcohol research collaborations with a substantial number of other departments/institutes at the university. Funds are requested to support a total of 6 physician trainees (4 for two years, and two at one year each, at the beginning and end of the award period) and 8 postdoctoral psychologist trainees (6+2). Placements of program graduates, as well as the quality of already ongoing and accepted trainees, indicates that the program has been quite successful in establishing individuals in academic track research careers. An effective track record in the recruitment of minority doctoral level fellows continues to be sustained over the current grant period. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen ·
Project Title: NALTREXONE AND CBT FOR PATIENTS WITH ALCOHOLISM AND PTSD Principal Investigator & Institution: Foa, Edna B. Professor; Psychiatry; University of Pennsylvania 3451 Walnut Street Philadelphia, Pa 19104 Timing: Fiscal Year 2001; Project Start 9-SEP-2000; Project End 1-JUL-2005 Summary: APPLICANT'S ABSTRACT: This proposed investigation extends prior research efforts by Edna Foa and Joseph Volpicelli in the evaluation of pharmacological and cognitive-behavioral treatments for alcohol dependence (AD) and post- traumatic stress disorder (PTSD), and capitalizes on their combined expertise in evaluating a comprehensive treatment program developed for patients with comorbid AD and PTSD. The comorbidity of AD and PTSD is a significant public mental health problem because the risk for AD dramatically increases among individuals with trauma history or PTSD and vice versa. The two disorders are thought to form a vicious cycle in which PTSD leads to abuse of alcohol; alcohol abuse impedes recovery from the traumatic experience thus contributing to the maintenance of PTSD; and PTSD in turn further escalates and entrenches alcohol abuse. Although promising treatments for AD and PTSD have been identified, comprehensive programs that address both disorders simultaneously have not been empirically tested. Specifically, the opiate antagonist naltrexone has been well established as an efficacious treatment for AD, but research has not specifically addressed its efficacy in patents with PTSD, who are especially prone to treatment attrition and noncompliance. Similarly, cognitive- behavioral treatment of PTSD by prolonged exposure (PE) is the most validated psychosocial treatment for PTSD; however, its efficacy in patients who abuse alcohol is unknown because AD is typically an exclusion criterion in such research. In the proposed study we will evaluate the efficacy of combining these empirically validated treatments for a group of patients who exhibit comorbid AD and PTSD. The proposed study compares four, 6-month treatment conditions in a 2 (naltrexone vs. placebo) by 2 (PE vs. No PE) research design. The four conditions are: 1) 100mg. naltrexone with PE; 2) naltrexone alone; 3) pill placebo with PE; 4) pill placebo alone. An enhanced medication management intervention will accompany all treatment conditions. PE will be provided by experienced psychologists trained in manual protocols. The study will include 200 patients (50/group) diagnosed with AD and comorbid PTSD. Symptoms will be evaluated before, during, and at the end of treatment, and at 9 and 12 months following study entry. Our primary study objective is to compare the short and long term effects
42 Alcoholism
of the combined treatments to those of each treatment in isolation on symptoms of AD and of PTSD. This study offers a model for combining and evaluating interventions in diverse treatment modalities for addressing comorbidity in AD, in a major step toward the development of theoretically driven and empirically validated treatments for difficult to treat populations. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen ·
Project Title: NALTREXONE TREATMENT FOR ALCOHOLISM Principal Investigator & Institution: Krishnan-Sarin, Suchitra; Assistant Professor; Yale University 47 College Street, Suite 203 New Haven, Ct 065208047 Timing: Fiscal Year 2001; Project Start 4-JUN-2001; Project End 1-MAY-2006 Summary: Evidence from both preclinical studies and retrospective data from clinical trials indicate that opioid antagonists reduce alcohol drinking, especially continued alcohol drinking following lapse in drinking, as well as reduce craving for alcohol. However, the cascade of events that mediates this efficacy of opioid antagonists is still unknown. Increased knowledge of this mechanism may help to further understanding of the processes mediating continued alcohol drinking and result in the development of more effective treatments of alcohol dependence. Family history of alcoholism is known to be a significant risk factor for development of heavy alcohol drinking and understanding the biological basis of developing this genetic risk would also advance our ability to develop better treatments for this disorder. Our group has prospectively demonstrated using a laboratory paradigm of alcohol self-administration that naltrexone does indeed reducer alcohol consumption during an ad-libitum alcohol selfadministration period following exposure to a priming drink of alcohol. We would now like to extend these findings to a laboratory model of relapse to alcohol that includes an alcohol deprivation period prior to the self-administration session. The results from this laboratory paradigm would more closely model evidence from clinical trials of naltrexone for alcohol dependence which indicate that one of the most important effects of naltrexone is to prevent relapse following a lapse of abstinence. The results of our self- administration paradigm also indicate that naltrexone induces HPA activation as evidenced by increased cortisol levels, that could either mediate naltrexone's effects or be a marker of naltrexone's efficacy. Recent evidence indicates that a genetic risk of alcoholism results in an attenuated release of cortisol in response to the opioid antagonist naloxone suggesting that the sensitivity of the endogenous opioid system to alcohol is altered by increased genetic risk. Therefore, we will conduct this study in heavy drinkers with or without a family history of alcoholism and address the following specific aims: 1) To evaluate the efficacy of six days of pretreatment with one of three doses of naltrexone (o,50 and 100 mg/day) using a laboratory model consisting of four days of alcohol deprivation following by exposure to a priming drink of alcohol and subsequent ad-libitum drinking and 2) To evaluate the influence of family history of alcoholism on the efficacy of naltrexone using a laboratory model consisting of four days of alcohol deprivation followed by exposure to a drinking drink of alcohol and subsequent ad- libitum alcohol drinking. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: NALTREXONE ALCOHOLISM
TREATMENT
IN
COMORBID
PTSD
AND
Principal Investigator & Institution: Brady, Kathleen T. Professor; Medical University of South Carolina 171 Ashley Ave Charleston, Sc 29425
Studies 43
Timing: Fiscal Year 2001; Project Start 0-DEC-1995; Project End 0-NOV-2005 Summary: There has been much recent interest in the relationship between stress, alcohol use disorders and relapse to alcohol use. Animal studies have consistently demonstrated a connection between a number of experimentally-induced stressors and both the initiation of alcohol use and reinstatement after a period of human laboratory procedures have been used to investigate the relationship between experimentallyinduced stressors and craving, a likely precursor to relapse in real world situations. Dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis, one of the main hormonal systems involved in the stress response, is seen with chronic alcohol consumption. This dysregulation may play a role in stress-reduced relapse. The endogenous opiate response system is also involved in the regulation of the HPA axis stress response and has been implicated in the pathophysiology of alcohol use disorders. Opiate antagonists, such as naltrexone, decrease alcohol craving and relapse in alcohol-dependent individuals and have effects on HPA axis function. Our research group is investigating the relationship between Post- traumatic Stress Disorder (PTSD) and alcohol use disorders. These disorders commonly co-occur and individuals with PTSD may use alcohol in an attempt to dampen traumatic memories and decrease painful symptoms of PTSD. Dysregulation of the HPA axis is a key pathophysiologic characteristic of PTSD. Our recent work indicates greater alcohol craving in alcoholism as compared to individuals with alcoholism only. In this component, the physiologic and subjective responsiveness (including alcohol craving) and response of the HPA axis to a stressful task will be explored in a group of individuals with alcohol dependence without PTSD, PTSD without alcohol dependence, and no PTSD or alcohol dependence. Following the initial stress task and procedure, subjects will be randomly assigned to receive 6 days of naltrexone or matching placebo and the stress task procedure will be repeated. In summary, this project is designed to build upon the ongoing research in the area of PTSD and alcohol use disorders by further exploration of the neurobiologic interface between alcoholism and PTSD. This study may provide valuable information about the role of the HPA axis and the opiate system in stress-induced relapse. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen ·
Project Title: NEUROPHYSIOLOGY IN CHILDREN AT HIGH RISK FOR ALCOHOLISM Principal Investigator & Institution: Porjesz, Bernice; Associate Professor; Psychiatry; Suny Downstate Medical Center 450 Clarkson Ave New York, Ny 11203 Timing: Fiscal Year 2001; Project Start 1-JUL-1982; Project End 1-AUG-2006 Summary: (provided by applicant): For the past twenty years it has been repeatedly observed that the P3(00) component of the event-related potential (ERP) is not only significantly lower in alcoholics, but also in young offspring of alcoholics at high risk (HR) for developing alcoholism. These observations suggested that reduced amplitudes of the P3 component in HR individuals might antecede the development of alcohol dependence. There is some evidence that reduced P3 voltage in childhood and adolescence in HR individuals is associated with externalizing disorders (conduct disorder, attention deficit hyperactivity, oppositional defiant disorder and adult antisocial behavior) and increased substance use, and may predict later substance and alcohol abuse. A meta-analysis of all HR studies concluded that the low amplitude P3 in HR individuals provides a reliable phenotypic marker of alcoholism, and it has been postulated to be indicative of increased Central Nervous System (CNS) disinhibition. Thus P3 as a potential vulnerability marker may provide insight into some causative pathophysiology process involved in the development of alcohol dependence. Here it is
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hypothesized that the P3 amplitude may index some CNS vulnerability (e.g. disinhibition) which may result in any one of a number of adverse conditions, such as alcohol dependence, drug abuse, antisocial personality, attention deficit hyperactivity disorder, conduct disorder, oppositional disorder, etc. The research strategy used to date has been based on a familial high-risk model, because it is well known that children of alcoholics are at high risk to develop alcohol dependence. In the present renewal a complementary strategy is proposed based on a "neurophysiological high-risk" model. In this model, individuals are hypothesized to be at high-risk based solely on their extreme scores on neurophysiological features (e.g. visual P3 amplitude), well established to be associated with a number of clinical conditions such as alcohol dependence, substance abuse, etc. Several scientific issues will be examined with the use of this novel approach, using innovative neurophysiological assays and methods. Specifically, electrophysiological measures (P3 and other measures) will be recorded in a large randomly ascertained sample of adolescents (15-17). The P3b amplitude provides a quantitative variable that typically yields a normal distribution in the general population. This distribution will be divided into the lower, upper and middle third. These three groups based on P3b amplitude will provide the basis for subsequent dependent variables, such as other EEG/ERP experiments, the clinical data to be collected (externalizing symptoms, other psychiatric symptoms, alcohol use, drug use, family history of psychiatric disorders, etc.). It is hypothesized that those individuals at the low end of the P3 amplitude distribution will manifest more evidence of electrophysiological disinhibition, externalizing traits, and substance use. Moreover, it is proposed that individuals with low P3b amplitude will manifest significantly greater prevalence of externalizing traits, alcohol and drug abuse compared to subjects with high P3b amplitude when retested four years later (ages 19-21). Retesting will begin in the last year of this application, and will continue in the future. The identification of individuals with neuroelectric deficits will have great utility in prevention initiatives. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen ·
Project Title: NMDA RECEPTOR FUNCTION AND FAMILIAL ALCOHOLISM RISK Principal Investigator & Institution: Petrakis, Ismene L. Associate Professor; Yale University 47 College Street, Suite 203 New Haven, Ct 065208047 Timing: Fiscal Year 2001; Project Start 4-JUN-2001; Project End 1-MAY-2006 Summary: The capacity of ethanol to block N-methyl-D-aspartate (NMDA) glutamate receptors contributes to its behavioral effects in animals and humans. Data comparing alcoholics and healthy subjects has furthermore suggested that ethanol dependence is associated with dysregulation of the NMDA receptor and NMDA receptor-related factors may play a role in alcohol use and misuse. Studies conducted by our group and other investigators have shown that alcoholics appear to be less sensitive to the aversive effects of NMDA antagonists, such as ketamine (specifically dissociated and psychotogenic effects). Additionally, alcoholics continue to experience the rewarding effects of NMDA antagonists when they show evidence of cross-tolerance to many other aspects of NMDA antagonist response. Altered sensitivity to ketamine may be state-ortrait dependent. Individuals with a paternal family history of alcoholism have a higher risk for developing alcoholism and are less sensitive to the effects of alcohol ingestion in a laboratory setting (i.e. less subjective intoxication), than healthy subjects without a family history of alcoholism. These and other data have suggested that these individuals may lack the warning signs to stop drinking when consuming modest alcoholism will experience less dysphoric, anxiogenic and psychotogenic effects to ketamine infusion
Studies 45
when compared to family history negative (FHN) age- matched control subjects. All subjects will complete 3 test days (placebo, ketamine 0.1 mg/kg, or ketamine 0.5 mg/kg) in a randomized, balanced order under double-blind conditions. Primary outcome measures include the Biphasic Alcohol Effects Scale (BAES), Visual Analog Scales (VAS) for high, and similarity to ethanol and mood states, the Sensation Scale (ethanol-like sensations), Brief Psychiatric Rating Scale (BPRS) for psychosis, and the Clinician Administered Dissociative States Scale (CADS) to measure perceptual responses to ketamine. NMDA dysregulation associated with alcoholism may represent and underlying vulnerability, and individuals with this vulnerability may experience a blunting of the dysphoric and psychotogenic effects of alcohol, which in turn contributes to alcohol misuse and to the transition from moderate alcohol use to excessive drinking. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen ·
Project Title: NOVEL MOLECULES TO TREAT ALCOHOLISM Principal Investigator & Institution: Chen, Hao;; Novascreen Biosciences Corporation 7170 Standard Dr Hanover, Md 21076 Timing: Fiscal Year 2003; Project Start 5-SEP-2003; Project End 9-FEB-2004 Summary: (provided by applicant): Current treatments for alcohol abuse and dependency are marginally effective. Application of naltrexone, an opiate antagonist, appears to have only a moderate effect in reducing drinking and is not sufficiently effective in treating some sub-populations of problematic alcohol consumers or in preventing relapses. Recent attempts of using multiple drug combinations, where each individual drug addresses a different target set or neurotransmitter system, appear to improve efficacy in curtailing alcohol consumption. Concerns of multiple drug combination regimens, however, are the combined drug side effects, toxicology and pharmacokinetic issues, adding to the stress on the already stressed liver. Developing and evaluating new and more potent medications for alcoholism is still a high priority. Single agents that address multiple CNS targets may be especially attractive. The proposed Phase I research is focused on finding novel small organic molecules with modulating activities at specific membrane receptors in multiple CNS target classes. The successful execution of the proposed research will produce a suite of novel molecules that selectively modulate activity at different opiate receptor subtypes and concurrently at a specific serotonergic receptor subtype. The compounds may be used as research tools to aid in the understanding alcohol addiction and abuse, and later become the basis for therapeutics to treat alcoholism. The success of our approach will rely on the innovative integration of in silico and in vitro screening methods and large readily accessible chemical libraries. The ensuing Phase II research will focus on improving the pharmacological properties of the active compounds in order to enhance the potential for finding new and safe medications for treating alcoholism. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: PARENT ALCOHOLISM AND OFFSPRING SUBSTANCE USE Principal Investigator & Institution: Marshal, Michael P. Psychology; Arizona State University P.O. Box 873503 Tempe, Az 852873503 Timing: Fiscal Year 2001; Project Start 6-MAR-2001 Summary: The central goal of the proposed project is to test the mediating role of marital functioning on the relation between parental alcoholism and adolescent/young adult offspring drug use/abuse. Research shows that spouses of alcoholics are at
46 Alcoholism
increased risk for marital problems, and that children of dysfunctional marriages are at increased risk for drug use/abuse; however, this mediator model has not been tested. Two secondary goals of this project are to test: (a) the longitudinal and reciprocal relations between trajectories of spouses' alcohol use/abuse and marital functioning; and (b) the family and parenting processes that account for the relation between parents' marital functioning and offspring drug use/abuse. These goals will make important contributions to drug use/abuse theory and help to identify appropriate family variables for substance use prevention and intervention programs. These goals will be accomplished using five waves of data from an ongoing study of substance use and abuse in children of alcoholics and nonalcoholic controls that began in 1988, and will be tested using advanced statistical techniques including latent curve and hierarchical linear modeling. Families were recruited from community sources, and DSM-111 alcoholism diagnoses were obtained via face-to-face interviews with the parents. The mean age of these children at Wave 1 was 12.5 years, 24% were Hispanic, and 46% were female. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen ·
Project Title: PATHWAYS TO ALCOHOLISM THROUGH PSYCHOPATHOLOGY Principal Investigator & Institution: Zhang, Heping; Professor; Epidemiology and Public Health; Yale University 47 College Street, Suite 203 New Haven, Ct 065208047 Timing: Fiscal Year 2001; Project Start 1-MAY-2000; Project End 0-APR-2003 Summary: (Adapted from Investigator's Abstract) The purpose of this project is to examine the major psychopathologic pathways to alcoholism. To achieve this goal, the following questions will be addressed. (1) What is the relationship between alcoholism and psychiatric disorders (namely, anxiety disorders, affective disorders and behavior disorders)? (2) How do psychiatric disorders influence the transitions between different stages of alcoholism? (3) Does the comorbidity between psychiatric disorders and alcoholism differ for females and males at different developmental stages? Several existing data sets using diverse study designs and samples will be used to identify the magnitude of comorbidity between specific disorders and each of the stages of alcoholism ranging from exposure to use to problematic use to dependence. Retrospective and prospective data will be used simultaneously to examine the links between psychopathology and each of the stages of the development of alcohol disorders, as well as the rate of transition between stages. Multiple statistical approaches for studying associations, transitions and subtypes including Cox models, tree-based methods and latent class approaches will be employed. Results from different studies will be synthesized to either replicate patterns of comorbidity or to generate hypotheses regarding inconsistencies across studies, using techniques of metaanalysis such as combining likelihoods from different studies. The investigators state that the aggregation of data from studies using multiple designs, samples and methods will provide stronger evidence of the consistency and stability of the link between psychiatric disorders and the stages of development of alcoholism than could be derived from a single study. They further state that identifying these pathways will ultimately assist in the development of an empirical basis for the primary prevention of secondary alcoholism. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: PET IMAGING OF BRAIN OPIOID RECEPTORS IN ALCOHOLISM Principal Investigator & Institution: Frost, J James. Professor; Radiology; Johns Hopkins University 3400 N Charles St Baltimore, Md 21218
Studies 47
Timing: Fiscal Year 2001; Project Start 1-JUL-1999; Project End 1-MAR-2003 Summary: Alcohol abuse and alcoholism is a major public health problem in the United States, but little is known of the neurochemical pathways in the human brain that mediate the reinforcing and other properties of ethanol. The brain's endogenous opioid system is known to play an important role in reward mechanisms and recently it has been targeted in treatment efforts using the opiate antagonist naltrexone. The rationale for using opioid blockade in the treatment of alcoholism is well founded in experimental animal models of human alcohol use and abuse, but we know little about the underlying differences in the endogenous opioid system between healthy individuals and alcoholics. Positron emission tomography (PET) is a non-invasive imaging method that can be used to image and quantitate a number of neuromarkers and mu opioid receptors can be imaged in the human brain by PET using the well-validated ligand C11 carfentanil. Our long-term goal is to better understand the function of the endogenous brain opioid system in alcohol use and abuse, and determine if it is involved in increasing the risk of alcoholism. The use of PET to measure regional mu opioid receptors is an approach that could provide new insight into the role of the endogenous opioid system in alcoholism. The specific aims of this study are: l) Measure regional mu opioid receptor binding by PET in non-alcoholic men and women with a positive family history of alcoholism. 2) Measure regional brain mu opioid receptor binding by PET in FHP and FHN alcoholic men and women and relate regional binding to behavioral measures of alcohol abuse; and 3) Measure the change in regional mu opioid receptor binding during one month controlled abstinence from ethanol in alcoholic men and women. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen ·
Project Title: PHARMACOTHERAPY OF ALCOHOLISM AND COMORBID INSOMNIA Principal Investigator & Institution: Brower, Kirk J. Associate Professor of Psychiatry; Psychiatry; University of Michigan at Ann Arbor 3003 South State, Room 1040 Ann Arbor, Mi 481091274 Timing: Fiscal Year 2001; Project Start 7-SEP-1999; Project End 1-AUG-2004 Summary: Kirk J. Brower, M.D., an associate professor of psychiatry with tenure at the University of Michigan (UM) Medical School, is applying for the Midcareer Investigator Award in Patient-Oriented Research. The UM Department of Psychiatry provides a rich environment for alcohol research, including a large base of NIH funding and an established Alcohol Research Center that is currently engaged in multiple clinical studies. Dr. Brower, broad-certified in addiction psychiatry, is Executive Director of Chelsea Arbor Treatment Center, the dedicated facility in the Department that exclusively treats people with alcohol and other drug problems. He is also the director of the ACGME-accredited fellowship program in addiction psychiatry at UM and coprincipal investigator on the Department s NIAAA T32 Training Grant for postdoctoral research fellows. He mentors this year s competitively selected (one per year) ACNP Glaxo Wellcome Research Fellow in Clinical Neuropharmacology. Dr. Brower s longterm career goals are to develop and disseminate new therapeutic options for patients with alcoholism and alcohol abuse who are likely to relapse despite current or conventional treatments. Comorbid insomnia, craving, and mood disturbances are targeted because they may increase relapse risk via neurobiological mechanisms that are amenable to pharmacotherapy. Dr. Brower s short-term career goals are to increase his expertise in sleep medicine, sleep research, and pharmacotherapy trials. His career development plan includes advanced coursework in clinical research design and
48 Alcoholism
biostatistics, focused activity in sleep medicine at the University of Michigan, and special leave to visit other institutions where exemplary sleep research and/or state-ofthe-art pharmacotherapy trials for alcoholism are being conducted. Dr. Brower has current research funding from Pfizer, Inc. to study the effects of sertraline on the sleep of depressed alcoholics. The proposed research project is a randomized, double-blind, placebo-controlled trial gabapentin for treating alcoholism and comorbid insomnia. This 6-week trial with an additional 6-week follow-up period will investigate the effects of medication on both sleep and drinking outcomes, and it will utilize polysomnographic measures as potential neurophysiological predictors of treatment outcome. Given the high prevalence, costs and comorbidity of alcoholism and insomnia, this topic requires considerably more research attention than it has received. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen ·
Project Title: PILOT--CRF ALCOHOLISM
AND
ANANDAMIDE
IN
CSF
IN
HUMAN
Principal Investigator & Institution: Darko, Denis F.; Scripps Research Institute 10550 N Torrey Pines Rd San Diego, Ca 92037 Timing: Fiscal Year 2003; Project Start 3-MAR-2003; Project End 8-FEB-2008 Summary: Building upon the Center's focus on neuroadaptation, this Pilot Project will collect data on molecular links of excessive drinking in human subjects, examining measures theoretically related to alcoholism for which the experiments have not yet been pursued to collect supporting data. This novel experiment will collect pilot data on corticotropin-releasing factor (allostasis/stress model) and anandamide (neuronal ethanol target model) in CSF in humans. The pilot data will be used to pursue NIH funding to expand investigation in these areas. The project will enrich the Center's overall research effort by extending the knowledge of the basic nature of alcohol's action to the human, and has attracted Dr. Darko, with his experience in the measurement and psychoactive effects of peptides, as a new investigator to the area of alcohol research. The Pilot Project Component is designed as a 2-year study to compare 2 groups that differ on alcohol use. Two hypotheses will be tested: (1) individuals with increased subjective distress without alcohol (alcoholics abstinent 30 to 60 days) will have higher levels of CRF in CSF than subjects without such distress (social drinkers); and (2) subjects with exposure to alcohol (social drinkers) will have higher levels of CSF anandamide (AEA) than subjects without recent alcohol exposure (alcoholics abstinent 30 to 60 days). These results examining mechanisms in the human with this method will provide exciting bases for continuing to define the underlying molecular components of alcoholism and neuroadaptation in the human. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen ·
Project Title: TREATMENTS
PRESSURE-BASED
PHARMACOLOGICAL
ALCOHOLISM
Principal Investigator & Institution: Davies, Daryl L. Pharmacology and Nutrition; University of Southern California 2250 Alcazar Street, Csc-219 Los Angeles, Ca 90033 Timing: Fiscal Year 2003; Project Start 1-MAY-2003; Project End 0-APR-2006 Summary: (provided by applicant): The present exploratory R21 grant proposal builds on our NIAAA funded research showing that increased atmospheric pressure is a direct, mechanistic antagonist for ethanol that blocks and reverses a broad spectrum of ethanol's behavioral effects, and ethanol's action on neurotransmitter-gated receptors, without causing changes in behavior or baseline receptor function. These qualities of
Studies 49
pressure antagonism of ethanol hold out the possibility of developing therapeutic agents that antagonize ethanol without causing adverse effects. However, we do not feel that pressure per se represents a viable therapeutic tool for treating alcoholism. Therefore, the present proposal represents the first step in a strategy for translating current knowledge regarding pressure antagonism of ethanol to the development of novel pharmacotherapeutic agents for treating alcoholism. The long-term goal of the proposed work is to develop pharmacological agents that mimic pressure and antagonize ethanol's action on molecular targets within receptors without causing changes in normal function of the receptors or behavior. The primary goal of this proposal is to begin to determine the molecular mechanism of pressure antagonism of ethanol and potential targets for pharmacological agents. Specific Aim 1. Identify the molecular sites of action of pressure antagonism of ethanol in glycine, GABAA and GABAP receptors. Aim I will be accomplished by combining molecular approaches with hyperbaric two-electrode voltage clamp techniques in Xenopus oocytes recently developed by our laboratory. Phase I will test the hypothesis that pressure antagonizes ethanol by acting on putative ethanol 'binding pockets." Phase 2 will test the hypothesis that pressure antagonizes ethanol by acting on specific amino acids or regions within TM21TM3 of glycine, GABAA and/or GABAP receptors. Specific Aim 2, will develop molecular models for the site(s) and mechanism(s) of pressure antagonism of ethanol. This aim will be accomplished using methods developed by our collaborators to model ethanol's sites of action in LGICS. We will apply this strategy using data from Aim 1 results to model pressures site(s) and mechanism(s) of action in these receptors. Models like those to be generated from Aim 2 will be used in future proposals to design pharmacological agents that can mimic pressure's action on molecular targets mediating alcohol antagonism. These agents can form the bases of novel prevention and treatment strategies for alcoholism and alcohol abuse. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen ·
Project Title: PSYCHOLOGICAL WELLNESS AND ALCOHOLISM TREATMENT OUTCOME Principal Investigator & Institution: Alterman, Arthur I. Professor of Psychology in Psychiatry; Psychiatry; University of Pennsylvania 3451 Walnut Street Philadelphia, Pa 19104 Timing: Fiscal Year 2003; Project Start 1-SEP-2003; Project End 1-JUL-2006 Summary: (provided by applicant): This is an R21 application for innovative/developmental research by an experienced alcoholism investigator. The study of psychological characteristics of patients that are predictive of response to alcoholism treatment has to a large extent focused on negative characteristics such as depression, anxiety, antisocial personality, or hostility, i.e., psychological illness. Although a growing literature has shown that various dimensions of psychological wellness of individuals and patients are associated with positive health outcomes in general, there has been only limited investigation of whether such characteristics are predictive also of response to treatment. The proposed research is designed, first, to determine the underlying dimensionality of a number of measures of psychological wellness such as optimism, personal meaning, perceived wellness, spirituality, or vitality and once this is accomplished to determine whether such positive psychological characteristics are predictive of a more positive response to treatment in alcohol dependent patients. Further, the research inquires whether the contribution of dimensions of psychological wellness to prediction of treatment outcomes is independent of prediction by psychological and physical illness. The extent to which
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changes in psychological wellness over time is predictive of longer term alcohol and substance use, receipt of additional alcoholism and substance abuse treatments, and physical and mental status will also be determined. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen ·
Project Title: PSYCHOPHYSIOLOGICAL PRECURSORS OF ALCOHOLISM Principal Investigator & Institution: Lovallo, William R. Professor; Psychiatry and Behavioral Scis; University of Oklahoma Hlth Sciences Ctr Health Sciences Center Oklahoma City, Ok 73126 Timing: Fiscal Year 2001; Project Start 0-SEP-2001; Project End 0-JUN-2006 Summary: (provided by applicant): Our long-term goal is to develop a better understanding of persons at risk for alcoholism. Alcohol addiction is a behavioral disorder that has genetic and environmental contributions. Prevalence within families and adoption studies indicate that the risk for alcoholism is one expression of more basic traits that have heritable components. The planned studies are based on the hypothesis that central nervous system processes that integrate emotional behavior are altered in persons at high risk for alcoholism relative to low risk persons. We predict that altered emotion processing will have three markers that should distinguish highrisk individuals. These are: 1) the person's characteristic balance of positive to negative emotions, 2) emotion-related changes in the stress hormone, cortisol, and 3) a measure of emotion-related change in central activation, the startle eyeblink. A random telephone survey of the Oklahoma City area will be used to identify 180 men and women, 18-25 years of age, who are low risk, having a negative family history of alcoholism and social drinking patterns, or high risk, with a positive family history and social drinking patterns. Two related studies are proposed. In Study 1, we will compare the groups using a standard paradigm to examine startle eyeblink magnitude and the emotion modulation of startle that normally occurs to negative and positive emotionproducing stimuli. In Study 2, we will extend that paradigm by examining the emotion modulation of the startle eyeblink together with cortisol responses to a negatively affective challenge. Normal affective response to events depends on interactions among the frontal cortex and limbic areas, while the expression of emotions via motoric and endocrine responses depends on normal regulation by the hypothalamus and brainstem. A finding of consistent changes in affective experience, along with altered peripheral physiological responses, can provide insights into the underlying alterations in emotional behavior in risk for alcoholism. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: PSYCHOTHERAPY PROCESS IN ALCOHOLISM TREATMENT MATCHING Principal Investigator & Institution: Longabaugh, Richard H. Professor of Psychiatry and Human Behavi; Ctr for Alcohol & Addict Studs; Brown University Providence, Ri 02912 Timing: Fiscal Year 2001; Project Start 1-AUG-2000; Project End 1-JUL-2003 Summary: APPLICANT'S ABSTRACT: Recent research on patient-treatment matching effects in alcohol treatment has produced mixed and inconclusive results. Further, psychotherapy treatments (e.g., cognitive behavioral and motivational enhancement therapies) continue to demonstrate roughly equivalent efficacy, despite different theoretical stances and purported mechanisms of patient change. The specific objective of this project is to identify how treatment effectiveness is impacted by the interaction
Studies 51
between patient characteristics and the process of psychotherapy. This study will utilize an archival data set of patient information and videotaped psychotherapy treatment from Project MATCH, a randomized clinical trial originally designed to evaluate patient-treatment matching effects across 3 psychosocial treatments for alcoholism. The proposed research will compliment Project MATCH's analyses of manualized treatments by examining underlying processes present in all of the treatments. The 168 patients from Project MATCH's Brown University research unit will be selected for this study. Patient and therapy process dimensions that have shown promise for predicting the effectiveness of alcoholism treatment will be selected from a model of patienttreatment matching called Systematic Treatment Selection (STS). Project MATCH data can be used to test 3 such matching hypotheses from the STS model. Each hypothesis specifies ideal relationships between a patient characteristic and a therapy process variable. The 3 patient attributes of focus will be: (1) emotional distress, (2) an externalizing coping style, and (3) psychological reactance. For each of these patient attributes, the STS model specifies treatment processes that will result in optimal outcomes. The 3 corresponding therapy process variables will be the extent to which therapist interventions with each patient (1) attempt to increase or decrease a patient's emotional arousal level, (2) are insight or behavior focused, and (3) are directive or nondirective. These aspects of therapy will be measured by the STS Therapy Rating Scale, which will be completed by two trained observers on 4 selected therapy sessions for each patient. The relationship between each patient-therapy interaction (e.g., patient reactance and the directiveness of therapy interventions) and alcohol use outcomes will be assessed at the three-month and one year post-treatment follow-ups. This study will reveal new information about the importance of tailoring therapist interventions to patients seeking treatment for alcoholism. Such information will significantly enhance alcoholism treatment effectiveness. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen ·
Project Title: QUANTITATIVE MR IMAGING AND SPECTROSCOPY IN ALCOHOLISM Principal Investigator & Institution: Mason, Graeme F. Assistant Professor; Psychiatry; Yale University 47 College Street, Suite 203 New Haven, Ct 065208047 Timing: Fiscal Year 2002; Project Start 1-MAY-2002; Project End 0-APR-2007 Summary: Magnetic resonance spectroscopy (MRS) and imaging (MRI) allow studies of brain amino acid neurotransmitters in vivo. Recent developments of MR permit not only measurements of neurotransmitter levels, but of synthesis and release, also. The technique is enhanced by the candidate's use of mathematics to interpret measurements quantitatively. The candidate applied an unusual background in MRS, MRI, math, and neurochemistry to alcoholism and (2) improve his education in pharmacology, diagnosis, and treatment of alcoholism. The program will combine MR with other measurements to study neurotransmission and energetics, improve mathematical models of neurotransmission and metabolism, and apply them to pharmacology of alcoholism. His other long term goal is dissemination of MR methods and mathematics for study design and interpretation. The leaders of Psychiatry at Yale have deliberately fostered integration of basic and clinical research, and they have invested heavily in MR research. For education and collaboration with the candidate, there are NIAAA and VA Alcohol Research Centers and laboratories and faculty who are well-established in the field of alcoholism. The grant will free the candidate from other commitments so that he can focus on learning about and researching alcoholism. The development plan has three parts: (1) Education in diagnosis, treatment, neurochemistry, and pathophysiology
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of alcoholism, (2) Research for more detailed knowledge of pathways of neurotransmitter metabolism, clinical correlates of the basic data, and validation of models of neurotransmission. Two projects are proposed. (1) Measure rates of brain glutamate neurotransmission and glucose utilization in alcohol-dependent patients during detoxification, testing for correlations of those parameters with each other and with measures of cognitive function and electrophysiology, which is funded through the NIAAA Center for Translational Neuroscience in Alcoholism (CTNA) at Yale. (2) Validate and further develop the mathematical models of glutamate and GABA neurotransmission, combining measurements of isotopic labeling in rats with microdialysis measurements of ECF levels of brain glutamate, glutamine, and GABA. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen ·
Project Title: RISK FACTORS FOR ALCOHOLISM IN NATIVE AMERICANS Principal Investigator & Institution: Ehlers, Cindy L. Associate Member; Scripps Research Institute 10550 N Torrey Pines Rd San Diego, Ca 92037 Timing: Fiscal Year 2001; Project Start 6-SEP-1994; Project End 1-MAY-2005 Summary: Certain tribes of Native Americans have very high rates of alcoholism and other alcohol related disease when compared to Euroamericans, African Americans, and Asian American samples. These ethnic differences in rates of alcoholism are thought to reflect a combination of sociocultural and biological factors. Within the biological realm few studies have evaluated whether ethnic and/or racial diversities exist in physiological markers of alcoholism risk. Recent data do suggest that there is genetic diversity in biologic sensitivity to alcohol among ethnic groups. The source of the differences in alcohol sensitivity results, in part, from genetic differences in metabolic factors, i.e., polymorphisms of the genes that regulate alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH), as well as inborn differences in brain cellular responses to alcohol. The overall objective of the proposed studies is to extend our previous investigations, which evaluated risk factors for the development of alcoholism as well as biological responses to alcohol and placebo challenge. Our studies suggest that Native American men have a quantitatively different response to alcohol than EuroAmerican and Asian American men using subjective (feelings of intoxication) as well as objective (EEGs, ERPs, cardiovascular responsivity, hormone levels) measures of intoxication. We believe that this diversity in level of response to alcohol may, in part, account for their increased risk for the development of alcoholism. In order to explore this further, these studies will be extended to Native American women age 18-25 years who will be tested for biologic response to alcohol and placebo using a modification of the same alcohol challenge protocol from our previous studies. Our preliminary studies in Native Americans ages 8-11 years will also be extended in order to determine whether specific risk factors might be present in young boys and girls prior to any alcohol exposure. A follow-up study of both the children and young adults will be carried out to deter-mine if factors identified at the initial interview are predictive of the development of alcohol- related life problems. Additionally, 18-50 year old Native American adult sibling-pairs and family members with and without alcohol dependence will be assessed using a structured diagnostic interview (SSAGA). These assessments will serve as the basis for future genetic analyses. These studies have the potential to verify whether Native Americans have any specific biological or behavioral factors that may help to explain the high risk for alcoholism within the tribes evaluated. The identification of such variables may potentially be useful in the development of specific prevention and treatment programs for this population as well as other Native American tribes.
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Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen ·
Project Title: SUBTYPES
SERTRALINE
PHARMACOTHERAPY
FOR
ALCOHOLISM
Principal Investigator & Institution: Kranzler, Henry R. Professor of Psychiatry; Psychiatry; University of Connecticut Sch of Med/Dnt Bb20, Mc 2806 Farmington, Ct 060302806 Timing: Fiscal Year 2003; Project Start 5-JUN-2003; Project End 1-MAY-2008 Summary: (provided by applicant): Despite the FDA approval of naltrexone and the anticipated approval of acamprosate for the treatment of alcohol dependence, other pharmacological options are needed, particularly those with demonstrated acceptability to prescribers, if medications are to play an important role in alcoholism treatment. Selective serotonin reuptake inhibitors (SSRI' s) are the most widely prescribed psychotropic medications in the world. A variety of SSRI's have been evaluated as potential adjuncts to the psychosocial treatment of alcohol dependence. Many studies have shown positive effects of these medications in the treatment of alcohol dependence, though a substantial number of studies have failed to provide evidence of efficacy. In a patient-treatment matching study, we found a significant interactive effect of alcoholic subtype and fiuoxetine on drinking outcomes. Using a similar approach, Pettinati et al. observed an interaction of alcoholic subtype with sertraline, with a significant advantage for sertraline among later-onset, Type A alcoholics. Johnson et al., in a placebo-controlled study of the 5-HT_ antagonist ondansetron, found a doseresponse relationship between the medication and reduced drinking in early-onset, but not late-onset alcoholics. Together, these findings help to explain variable findings in the literature on the use of serotonergic medications to treat alcohol dependence and provide the basis for evaluating a differential therapeutic approach using these medications. The present proposal, which has been revised in response to comments by reviewers, is to conduct a prospective, randomized, double-blind test of the hypothesis that sertraline is efficacious among late-onset alcoholics (i.e., those with alcoholism onset >25 years), but is not superior to placebo among early-onset alcoholics (i.e., those with alcoholism onset C receptor polymorphism among patients suffering from alcoholism, major depression, anxiety disorders and narcolepsy. Author(s): Fehr C, Grintschuk N, Szegedi A, Anghelescu I, Klawe C, Singer P, Hiemke C, Dahmen N. Source: Psychiatry Research. 2000 December 4; 97(1): 1-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11104852&dopt=Abstract
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The idea of alcoholism: changing perceptions of alcoholism and treatment in British Columbia, 1870-1988. Author(s): Ajzenstadt M, Burtch B. Source: Health Can Soc. 1994; 2(1): 9-33. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11608995&dopt=Abstract
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The impact of Alcohol and Alcoholism among substance abuse journals. Author(s): Jones AW. Source: Alcohol and Alcoholism (Oxford, Oxfordshire). 1999 January-February; 34(1): 25-34. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10075398&dopt=Abstract
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The impact of familial alcoholism on alcohol reactivity in female social drinkers. Author(s): Lundahl LH, Lukas SE. Source: Experimental and Clinical Psychopharmacology. 2001 February; 9(1): 101-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11519625&dopt=Abstract
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The impact of paternal alcoholism and maternal social position on boys' school adjustment, pubertal maturation and sexual behavior: a test of two competing hypotheses. Author(s): Malo J, Tremblay RE. Source: Journal of Child Psychology and Psychiatry, and Allied Disciplines. 1997 February; 38(2): 187-97. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9232465&dopt=Abstract
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The impact of redefining affection status for alcoholism on affected-sib-pair analysis. Author(s): Fann CS, Shugart YY, Lachman H, Collins A, Chang CJ. Source: Genetic Epidemiology. 1999; 17 Suppl 1: S151-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10597428&dopt=Abstract
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The importance of a positive family history of alcoholism, parental rejection and emotional warmth, behavioral problems and peer substance use for alcohol problems in teenagers: a path analysis. Author(s): Barnow S, Schuckit MA, Lucht M, John U, Freyberger HJ. Source: J Stud Alcohol. 2002 May; 63(3): 305-15. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12086131&dopt=Abstract
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The importance of family context in alcoholism. Author(s): Vaz-Serra A, Canavarro MC, Ramalheira C. Source: Alcohol and Alcoholism (Oxford, Oxfordshire). 1998 January-February; 33(1): 37-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9539175&dopt=Abstract
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The influence of alcoholism and cirrhosis on benzodiazepine receptor function. Author(s): Fluck E, Fernandes C, File SE, Curran HV, Marshall J. Source: Pharmacology, Biochemistry, and Behavior. 1998 April; 59(4): 949-54. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9586854&dopt=Abstract
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The influence of perceived social support on the relationship between family history of alcoholism and drinking behaviors. Author(s): Ohannessian CM, Hesselbrock VM. Source: Addiction (Abingdon, England). 1993 December; 88(12): 1651-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8130704&dopt=Abstract
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The interpersonal and psychological functioning of women who experienced childhood physical abuse, incest, and parental alcoholism. Author(s): Fox KM, Gilbert BO. Source: Child Abuse & Neglect. 1994 October; 18(10): 849-58. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7804892&dopt=Abstract
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The Israel Society for the Prevention of Alcoholism. Author(s): Weiss S, Gefen L. Source: Addiction (Abingdon, England). 2003 March; 98(3): 255-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12603225&dopt=Abstract
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The key relative's impact on treatment and course of alcoholism. Author(s): Fichter MM, Frick U. Source: European Archives of Psychiatry and Clinical Neuroscience. 1993; 243(2): 87-94. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8218432&dopt=Abstract
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The link between family history and early onset alcoholism: earlier initiation of drinking or more rapid development of dependence? Author(s): Dawson DA. Source: J Stud Alcohol. 2000 September; 61(5): 637-46. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11022800&dopt=Abstract
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The MacAndrew Alcoholism Scale: severity of alcohol abuse and parental alcoholism. Author(s): Sher KJ, McCrady BS. Source: Addictive Behaviors. 1984; 9(1): 99-102. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6741673&dopt=Abstract
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The Medical Council on Alcoholism (MCA) and its journal Alcohol and Alcoholism. Author(s): Evans M. Source: Alcohol and Alcoholism (Oxford, Oxfordshire). 2000 January; 35(1): 3-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10684768&dopt=Abstract
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The natural history of alcoholism and its relationship to liver transplantation. Author(s): Vaillant GE. Source: Liver Transpl Surg. 1997 May; 3(3): 304-10. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9346756&dopt=Abstract
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The neurobiology of alcohol abuse and alcoholism: building knowledge, creating hope. Author(s): Gordis E. Source: Drug and Alcohol Dependence. 1998 June-July; 51(1-2): 9-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9716926&dopt=Abstract
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The obsessive compulsive drinking scale: A new method of assessing outcome in alcoholism treatment studies. Author(s): Anton RF, Moak DH, Latham PK. Source: Archives of General Psychiatry. 1996 March; 53(3): 225-31. Erratum In: Arch Gen Psychiatry 1996 July; 53(7): 576. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8611059&dopt=Abstract
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The opioid receptor system and alcoholism: a genetic perspective. Author(s): Town T, Schinka J, Tan J, Mullan M. Source: European Journal of Pharmacology. 2000 December 27; 410(2-3): 243-248. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11134673&dopt=Abstract
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The pharmacological treatment of alcoholism: from basic science to clinical medicine. Author(s): Verbanck PM. Source: Alcohol and Alcoholism (Oxford, Oxfordshire). 1995 November; 30(6): 757-64. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8679016&dopt=Abstract
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The politicization of alcohol in the USSR and its impact on the study and treatment of alcoholism. Author(s): Korolenko C, Minevich V, Segal B. Source: Int J Addict. 1994 August; 29(10): 1269-85. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7995671&dopt=Abstract
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The possibility of the use of interferon in the treatment of alcoholism. Author(s): Aliev NA, Mustafaev MA. Source: Neuroscience and Behavioral Physiology. 1993 July-August; 23(4): 377-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7692347&dopt=Abstract
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The practicality of using the SMAST and AUDIT to screen for alcoholism among adolescents in an urban private family practice. Author(s): Foster AI, Blondell RD, Looney SW. Source: J Ky Med Assoc. 1997 March; 95(3): 105-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9071854&dopt=Abstract
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The prevalence of alcoholism and its relation to cause of hospitalization and longterm mortality in male somatic inpatients. Author(s): Wallerstedt S, Denison H, Sandstrom J, Westin J. Source: Journal of Internal Medicine. 1995 March; 237(3): 339-44. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7891056&dopt=Abstract
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The psychometric assessment of alcoholism in forensic groups: the MacAndrew scale and response bias. Author(s): Wasyliw OE, Haywood TW, Grossman LS, Cavanaugh JL Jr. Source: Journal of Personality Assessment. 1993 April; 60(2): 252-66. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8473964&dopt=Abstract
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The reduction of health care costs associated with alcoholism treatment: a 14-year longitudinal study. Author(s): Holder HD, Blose JO. Source: J Stud Alcohol. 1992 July; 53(4): 293-302. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1619923&dopt=Abstract
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The relation of parent alcoholism to adolescent substance use: a longitudinal followup study. Author(s): Chassin L, Curran PJ, Hussong AM, Colder CR. Source: Journal of Abnormal Psychology. 1996 February; 105(1): 70-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8666713&dopt=Abstract
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The relationship between alcoholism and unipolar depression--a controlled family study. Author(s): Maier W, Lichtermann D, Minges J. Source: Journal of Psychiatric Research. 1994 May-June; 28(3): 303-17. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7932289&dopt=Abstract
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The relationship between bipolar disorder and alcoholism: a controlled family study. Author(s): Maier W, Lichtermann D, Minges J, Delmo C, Heun R. Source: Psychological Medicine. 1995 July; 25(4): 787-96. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7480456&dopt=Abstract
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The relationship between mortality and intensity of inpatient alcoholism treatment. Author(s): Bunn JY, Booth BM, Cook CA, Blow FC, Fortney JC. Source: American Journal of Public Health. 1994 February; 84(2): 211-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8296942&dopt=Abstract
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The relationship between the family density of alcoholism and externalizing symptoms among 146 children. Author(s): Barnow S, Schuckit M, Smith TL, Preuss U, Danko G. Source: Alcohol and Alcoholism (Oxford, Oxfordshire). 2002 July-August; 37(4): 383-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12107042&dopt=Abstract
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The relationship between two intermediate phenotypes for alcoholism: low voltage alpha EEG and low P300 ERP amplitude. Author(s): Enoch MA, White KV, Harris CR, Rohrbaugh JW, Goldman D. Source: J Stud Alcohol. 2002 September; 63(5): 509-17. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12380845&dopt=Abstract
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The relationship of alcoholism and alcohol abuse to the abuse of other drugs. Author(s): Kaufman E. Source: The American Journal of Drug and Alcohol Abuse. 1982; 9(1): 1-17. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7171070&dopt=Abstract
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The relationship of parental alcoholism and family dysfunction to stress among college students. Author(s): Fischer KE, Kittleson M, Ogletree R, Welshimer K, Woehlke P, Benshoff J. Source: Journal of American College Health : J of Ach. 2000 January; 48(4): 151-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10650732&dopt=Abstract
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The reliability of alcoholism history in patients with alcohol-related cirrhosis. Author(s): Yates WR, Labrecque DR, Pfab D. Source: Alcohol and Alcoholism (Oxford, Oxfordshire). 1998 September-October; 33(5): 488-94. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9811201&dopt=Abstract
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The Research Society on Alcoholism (RSA): 1976-2000. Author(s): Lieber CS. Source: Alcoholism, Clinical and Experimental Research. 2000 October; 24(10): 1475-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11045852&dopt=Abstract
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The Research Society on Alcoholism. Author(s): Israel Y, Lieber CS. Source: Addiction (Abingdon, England). 2002 May; 97(5): 483-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12033649&dopt=Abstract
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The risk for psychiatric illness in siblings of schizophrenics: the impact of psychotic and non-psychotic affective illness and alcoholism in parents. Author(s): Kendler KS, Karkowski-Shuman L, Walsh D. Source: Acta Psychiatrica Scandinavica. 1996 July; 94(1): 49-55. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8841677&dopt=Abstract
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The risk of liver and bile duct cancer in patients with chronic viral hepatitis, alcoholism, or cirrhosis. Author(s): Kuper H, Ye W, Broome U, Romelsjo A, Mucci LA, Ekbom A, Adami HO, Trichopoulos D, Nyren O. Source: Hepatology (Baltimore, Md.). 2001 October; 34(4 Pt 1): 714-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11584367&dopt=Abstract
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The role of biomarkers in alcoholism medication trials. Author(s): Allen JP, Litten RZ, Strid N, Sillanaukee P. Source: Alcoholism, Clinical and Experimental Research. 2001 August; 25(8): 1119-25. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11505042&dopt=Abstract
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The role of glutamatergic neurotransmission in the pathophysiology of alcoholism. Author(s): Tsai G, Coyle JT. Source: Annual Review of Medicine. 1998; 49: 173-84. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9509257&dopt=Abstract
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The role of laboratory tests in alcoholism treatment. Author(s): Allen JP, Litten RZ. Source: Journal of Substance Abuse Treatment. 2001 January; 20(1): 81-5. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11239731&dopt=Abstract
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The role of stress in alcohol use, alcoholism treatment, and relapse. Author(s): Brady KT, Sonne SC. Source: Alcohol Research & Health : the Journal of the National Institute on Alcohol Abuse and Alcoholism. 1999; 23(4): 263-71. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10890823&dopt=Abstract
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The roles of social class of origin, achieved social class and intergenerational social mobility in explaining social-class inequalities in alcoholism among young men. Author(s): Hemmingsson T, Lundberg I, Diderichsen F. Source: Social Science & Medicine (1982). 1999 October; 49(8): 1051-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10475669&dopt=Abstract
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The Roscommon Family Study. IV. Affective illness, anxiety disorders, and alcoholism in relatives. Author(s): Kendler KS, McGuire M, Gruenberg AM, O'Hare A, Spellman M, Walsh D. Source: Archives of General Psychiatry. 1993 December; 50(12): 952-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8250681&dopt=Abstract
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The safety profile of naltrexone in the treatment of alcoholism. Results from a multicenter usage study. The Naltrexone Usage Study Group. Author(s): Croop RS, Faulkner EB, Labriola DF. Source: Archives of General Psychiatry. 1997 December; 54(12): 1130-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9400350&dopt=Abstract
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The search for biological/genetic markers of alcoholism. Author(s): Devor EJ. Source: Alcohol Alcohol Suppl. 1993; 2: 45-9. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7748337&dopt=Abstract
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The SECCAT survey: I. The costs and consequences of alcoholism. Author(s): McKenna M, Chick J, Buxton M, Howlett H, Patience D, Ritson B. Source: Alcohol and Alcoholism (Oxford, Oxfordshire). 1996 November; 31(6): 565-76. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9010547&dopt=Abstract
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The SECCAT Survey: II. The Alcohol Related Problems Questionnaire as a proxy for resource costs and quality of life in alcoholism treatment. Study of Socio-Economic Consequences and Costs of Alcoholism and Treatment. Author(s): Patience D, Buxton M, Chick J, Howlett H, McKenna M, Ritson B. Source: Alcohol and Alcoholism (Oxford, Oxfordshire). 1997 January-February; 32(1): 79-84. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9131895&dopt=Abstract
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The Self-Rating of the Effects of alcohol (SRE) form as a retrospective measure of the risk for alcoholism. Author(s): Schuckit MA, Smith TL, Tipp JE. Source: Addiction (Abingdon, England). 1997 August; 92(8): 979-88. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9376780&dopt=Abstract
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The shift away from specialist psychiatric units in the management of alcoholism--a student's view. Author(s): Gilbody JS. Source: Alcohol and Alcoholism (Oxford, Oxfordshire). 1992 May; 27(3): 211-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1333210&dopt=Abstract
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The structure of the genetic and environmental risk factors for six major psychiatric disorders in women. Phobia, generalized anxiety disorder, panic disorder, bulimia, major depression, and alcoholism. Author(s): Kendler KS, Walters EE, Neale MC, Kessler RC, Heath AC, Eaves LJ. Source: Archives of General Psychiatry. 1995 May; 52(5): 374-83. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7726718&dopt=Abstract
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The TaqI A1 allele of the dopamine D2 receptor gene and alcoholism in Brazil: association and interaction with stress and harm avoidance on severity prediction. Author(s): Bau CH, Almeida S, Hutz MH. Source: American Journal of Medical Genetics. 2000 June 12; 96(3): 302-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10898904&dopt=Abstract
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The therapeutic alliance and its relationship to alcoholism treatment participation and outcome. Author(s): Connors GJ, Carroll KM, DiClemente CC, Longabaugh R, Donovan DM. Source: Journal of Consulting and Clinical Psychology. 1997 August; 65(4): 588-98. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9256560&dopt=Abstract
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The thyrotropin releasing hormone stimulation test in alcoholism. Author(s): Pienaar WP, Roberts MC, Emsley RA, Aalbers C, Taljaard FJ. Source: Alcohol and Alcoholism (Oxford, Oxfordshire). 1995 September; 30(5): 661-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8554651&dopt=Abstract
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The treatment of alcoholism in France. Author(s): Batel P. Source: Drug and Alcohol Dependence. 1995 September; 39 Suppl 1: S15-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8565793&dopt=Abstract
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The treatment of anxiety in patients with alcoholism. Author(s): Frances RJ, Borg L. Source: The Journal of Clinical Psychiatry. 1993 May; 54 Suppl: 37-43. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8509356&dopt=Abstract
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The tridimensional personality model: influencing variables in a sample of detoxified alcohol dependents. European Fluvoxamine in Alcoholism Study Group. Author(s): Meszaros K, Willinger U, Fischer G, Schonbeck G, Aschauer HN. Source: Comprehensive Psychiatry. 1996 March-April; 37(2): 109-14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8654059&dopt=Abstract
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The Tridimensional Personality Questionnaire as a predictor of relapse in detoxified alcohol dependents. The European Fluvoxamine in Alcoholism Study Group. Author(s): Meszaros K, Lenzinger E, Hornik K, Fureder T, Willinger U, Fischer G, Schonbeck G, Aschauer HN. Source: Alcoholism, Clinical and Experimental Research. 1999 March; 23(3): 483-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10195822&dopt=Abstract
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The use of a symptom checklist (SCL-90-R) as an easy method to estimate the relapse risk after alcoholism detoxification. Author(s): Lucht M, Jahn U, Barnow S, Freyberger HJ. Source: European Addiction Research. 2002 November; 8(4): 190-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12457060&dopt=Abstract
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The use of sodium valproate in the treatment of alcoholism. Author(s): Minuk GY, Rockman GE, German GB, Duerksen DR, Borrett G, Hoeschen L. Source: J Addict Dis. 1995; 14(2): 67-74. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8541361&dopt=Abstract
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The validity of the MAST in psychiatric settings: a meta-analytic integration. Michigan Alcoholism Screening Test. Author(s): Teitelbaum L, Mullen B. Source: J Stud Alcohol. 2000 March; 61(2): 254-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10757136&dopt=Abstract
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The validity of the Michigan Alcoholism Screening Test (MAST). Author(s): Storgaard H, Nielsen SD, Gluud C. Source: Alcohol and Alcoholism (Oxford, Oxfordshire). 1994 September; 29(5): 493-502. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7811333&dopt=Abstract
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The WHO/ISBRA study on state and trait markers in alcoholism: progress report. Author(s): Tabakoff B. Source: Alcoholism, Clinical and Experimental Research. 1996 November; 20(8 Suppl): 243A-247A. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8947273&dopt=Abstract
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Therapeutic alliance and the retention of couples in conjoint alcoholism treatment. Author(s): Raytek HS, McGrady BS, Epstein EE, Hirsch LS. Source: Addictive Behaviors. 1999 May-June; 24(3): 317-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10400272&dopt=Abstract
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Thirty-year follow-up of men at high risk for alcoholism. Author(s): Goodwin DW, Knop J, Jensen P, Gabrielli WF Jr, Schulsinger F, Penick EC. Source: Annals of the New York Academy of Sciences. 1994 February 28; 708: 97-101. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8154693&dopt=Abstract
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Thyrotropin and prolactin responses to thyrotropin-releasing hormone in young men at high or low risk for alcoholism. Author(s): Garbutt JC, Miller LP, Mundle L, Senger M, Mason GA. Source: Alcoholism, Clinical and Experimental Research. 1995 October; 19(5): 1133-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8561281&dopt=Abstract
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Thyrotropin response to thyrotropin-releasing hormone in young men at high or low risk for alcoholism. Author(s): Garbutt JC, Miller LP, Karnitschnig JS, Mason GA. Source: Annals of the New York Academy of Sciences. 1994 February 28; 708: 129-33. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8154673&dopt=Abstract
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Time is now for bold 21st century approaches for studying alcohol abuse and alcoholism. Author(s): Holder HD. Source: Alcoholism, Clinical and Experimental Research. 2001 September; 25(9): 1247-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11584141&dopt=Abstract
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Tobacco use, problem drinking, and alcoholism. Author(s): Bobo JK. Source: Clinical Obstetrics and Gynecology. 2002 December; 45(4): 1169-80. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12438893&dopt=Abstract
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Toward a comprehensive theory of alcoholism. Author(s): Meyer RE. Source: Annals of the New York Academy of Sciences. 1994 February 28; 708: 238-50. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8154686&dopt=Abstract
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Towards a standardisation for the methodology in treatment research of alcohol abuse and alcoholism. Author(s): Lesch OM. Source: Clinical Neuropharmacology. 1992; 15 Suppl 1 Pt A: 307A-308A. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1498851&dopt=Abstract
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Traditional and western healing practices for alcoholism in American Indians and Alaska Natives. Author(s): Abbott PJ. Source: Substance Use & Misuse. 1998 November; 33(13): 2605-46. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9818991&dopt=Abstract
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Trait markers for alcoholism: clinical utility. Author(s): Farren CK, Tipton KF. Source: Alcohol and Alcoholism (Oxford, Oxfordshire). 1999 September-October; 34(5): 649-65. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10528806&dopt=Abstract
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Treating alcoholism through a narrative approach. Case study and rationale. Author(s): Kaminsky D, Rabinowitz S, Kasan R. Source: Can Fam Physician. 1996 April; 42: 673-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8653035&dopt=Abstract
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Treating alcoholism: an age-specific intervention that works for older patients. Author(s): Peterson M, Zimberg S. Source: Geriatrics. 1996 October; 51(10): 45-9; Quiz 50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8863757&dopt=Abstract
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Treating anxiety in patients with alcoholism. Author(s): Nunes EV, McGrath PJ, Quitkin FM. Source: The Journal of Clinical Psychiatry. 1995; 56 Suppl 2: 3-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7844104&dopt=Abstract
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Treatment evaluation of alcoholism: non pharmacological interventions. Author(s): Besson J, Barrias J, Borg S, Verbanck P. Source: Alcohol Alcohol Suppl. 1993; 2: 145-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7748292&dopt=Abstract
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Treatment of alcoholism among schizophrenic outpatients: 4-year outcomes. Author(s): Drake RE, McHugo GJ, Noordsy DL. Source: The American Journal of Psychiatry. 1993 February; 150(2): 328-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8422088&dopt=Abstract
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Treatment of alcoholism and nicotine dependence. Author(s): Zucker RS. Source: Jama : the Journal of the American Medical Association. 1996 September 11; 276(10): 783-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8769586&dopt=Abstract
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Treatment of alcoholism as a chronic disorder. Author(s): O'Brien CP. Source: Alcohol (Fayetteville, N.Y.). 1994 November-December; 11(6): 433-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7865139&dopt=Abstract
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Treatment of alcoholism as a chronic disorder. Author(s): O'Brien CP. Source: Exs. 1994; 71: 349-59. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8032166&dopt=Abstract
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Treatment of alcoholism using psychedelic drugs: a review of the program of research. Author(s): Mangini M. Source: J Psychoactive Drugs. 1998 October-December; 30(4): 381-418. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9924844&dopt=Abstract
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Treatment of alcoholism. Author(s): Mezciems PE, Cunningham GM. Source: Cmaj : Canadian Medical Association Journal = Journal De L'association Medicale Canadienne. 1994 May 1; 150(9): 1383-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8168001&dopt=Abstract
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Treatment of alcoholism. Author(s): Jansson B. Source: Exs. 1994; 71: 333-40. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8032164&dopt=Abstract
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Treatment outcome in alcoholism - a comparison of self-report and the biological markers carbohydrate-deficient transferrin and gamma-glutamyl transferase. Author(s): Mundle G, Ackermann K, Gunthner A, Munkes J, Mann K. Source: European Addiction Research. 1999 June; 5(2): 91-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10394040&dopt=Abstract
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Treatment settings for persons with alcoholism: evidence for matching clients to inpatient versus outpatient care. Author(s): Rychtarik RG, Connors GJ, Whitney RB, McGillicuddy NB, Fitterling JM, Wirtz PW. Source: Journal of Consulting and Clinical Psychology. 2000 April; 68(2): 277-89. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10780128&dopt=Abstract
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Trends in alcoholism among male doctors in Scotland. Author(s): Harrison D, Chick J. Source: Addiction (Abingdon, England). 1994 December; 89(12): 1613-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7866245&dopt=Abstract
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Trial of interferon in chronic alcoholism. Author(s): Aliyev NN. Source: Psychiatry Research. 1994 December; 54(3): 307-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7792335&dopt=Abstract
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Tryptophan and 5-hydroxytryptamine metabolism in alcoholism. Author(s): Badawy AA, Morgan CJ, Thomas R. Source: Alcohol Alcohol Suppl. 1993; 2: 231-5. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7748305&dopt=Abstract
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Tryptophan metabolism and disposition in relation to alcohol and alcoholism. Author(s): Badawy AA. Source: Advances in Experimental Medicine and Biology. 1996; 398: 75-82. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8906244&dopt=Abstract
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Tryptophan metabolism in alcoholism. Author(s): Badawy AA. Source: Advances in Experimental Medicine and Biology. 1999; 467: 265-74. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10721064&dopt=Abstract
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Tryptophan metabolism in alcoholism. Tryptophan but not excitatory amino acid availability to the brain is increased before the appearance of the alcohol-withdrawal syndrome in men. Author(s): Badawy AA, Rommelspacher H, Morgan CJ, Bradley DM, Bonner A, Ehlert A, Blum S, Spies CD. Source: Alcohol and Alcoholism (Oxford, Oxfordshire). 1998 November-December; 33(6): 616-25. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9872350&dopt=Abstract
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Tuberculosis and alcoholism in Croatia. Author(s): Breitenfeld D, Trkanjec Z, Thaller V, Breitenfeld T, DeSyo D, Golik-Gruber V. Source: Coll Antropol. 1998 December; 22 Suppl: 217-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9951167&dopt=Abstract
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Two methods of estimating health costs linked to alcoholism in France (with a note on social costs). Author(s): Reynaud M, Gaudin-Colombel AF, Le Pen C. Source: Alcohol and Alcoholism (Oxford, Oxfordshire). 2001 January-February; 36(1): 89-95. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11139423&dopt=Abstract
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Understanding alcoholism relapse. A case study illustrating the integration of two theories. Author(s): Wing DM. Source: The Nurse Practitioner. 1994 April; 19(4): 67-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8035964&dopt=Abstract
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Undiagnosed alcoholism & prescription drug misuse among the elderly. Special considerations for home assessment. Author(s): Scott CM, Popovich DJ. Source: Caring. 2001 January; 20(1): 20-3; Quiz 24-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11190975&dopt=Abstract
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Use of acamprosate and different kinds of psychosocial support in relapse prevention of alcoholism. Results from a non-blind, multicentre study. Author(s): Soyka M, Preuss U, Schuetz C. Source: Drugs in R&D. 2002; 3(1): 1-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11881521&dopt=Abstract
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Use of serotonin (5-hydroxytryptamine) reuptake inhibitors in the treatment of alcoholism. Author(s): Lejoyeux M. Source: Alcohol Alcohol Suppl. 1996 March; 1: 69-75. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9845041&dopt=Abstract
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Use of serotonin (5-hydroxytryptamine) reuptake inhibitors in the treatment of alcoholism. Author(s): Lejoyeux M. Source: Alcohol and Alcoholism (Oxford, Oxfordshire). 1996 March; 31 Suppl 1: 69-75. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8737004&dopt=Abstract
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Use of the TWEAK test in screening for alcoholism/heavy drinking in three populations. Author(s): Chan AW, Pristach EA, Welte JW, Russell M. Source: Alcoholism, Clinical and Experimental Research. 1993 December; 17(6): 1188-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8116829&dopt=Abstract
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Using acquired knowledge and new technologies in alcoholism treatment trials. Author(s): Flannery BA, Allen JP, Pettinati HM, Rohsenow DJ, Cisler RA, Litten RZ. Source: Alcoholism, Clinical and Experimental Research. 2002 March; 26(3): 423-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11923598&dopt=Abstract
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Using adapted short MASTs for assessing parental alcoholism: reliability and validity. Author(s): Crews TM, Sher KJ. Source: Alcoholism, Clinical and Experimental Research. 1992 June; 16(3): 576-84. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1626659&dopt=Abstract
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Using naltrexone in inpatient alcoholism treatment. Author(s): Knox PC, Donovan DM. Source: J Psychoactive Drugs. 1999 October-December; 31(4): 373-88. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10681104&dopt=Abstract
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Using stated preference modeling to forecast the effect of medication attributes on prescriptions of alcoholism medications. Author(s): Mark TL, Swait J. Source: Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research. 2003 July-August; 6(4): 474-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12859589&dopt=Abstract
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Utilization of outpatient mental health services after inpatient alcoholism treatment. Author(s): Booth BM, Cook CA, Blow FC, Bunn JY. Source: J Ment Health Adm. 1992 Spring; 19(1): 21-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10128720&dopt=Abstract
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Validation of the Cross-Cultural Alcoholism Screening Test (CCAST). Author(s): Gorenc KD, Peredo S, Pacurucu S, Llanos R, Vincente B, Lopez R, Abreu LF, Paez E. Source: Archives of Medical Research. 1999 September-October; 30(5): 399-410. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10596461&dopt=Abstract
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Validation of the Michigan Alcoholism Screening Test--Thai version in northeast Thailand. Author(s): Nanakorn S, Fukuda K, Tangseree T, Treethiptikhun S, Nakamura J, Ogimoto I, Inutsuka H. Source: Kurume Med J. 1998; 45(4): 313-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9914717&dopt=Abstract
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Validation of the Short Michigan Alcoholism Screening Test Thai version in northeastern Thailand. Author(s): Nanakorn S, Fukuda K, Ogimoto I, Tangseree T, Treethiptikhun S. Source: Southeast Asian J Trop Med Public Health. 2000 December; 31(4): 780-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11414429&dopt=Abstract
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Validity of the diagnostic interview schedule for detecting alcoholism in psychiatric inpatients. Author(s): Goethe JW, Fischer EH. Source: The American Journal of Drug and Alcohol Abuse. 1995 November; 21(4): 56571. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8561103&dopt=Abstract
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Validity of the Michigan Alcoholism Screening Test (MAST) for the detection of alcohol-related problems among male geriatric outpatients. Author(s): Hirata ES, Almeida OP, Funari RR, Klein EL. Source: The American Journal of Geriatric Psychiatry : Official Journal of the American Association for Geriatric Psychiatry. 2001 Winter; 9(1): 30-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11156749&dopt=Abstract
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Variants of alcoholism: patterns in development, course, and prognosis. Author(s): Vrublevsky AG. Source: Annals of the New York Academy of Sciences. 1994 February 28; 708: 86-96. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8154692&dopt=Abstract
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Various mechanisms of death and their possible association with alcoholism. Author(s): Thomsen JL. Source: Forensic Science International. 1996 June 14; 79(3): 199-204. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8682415&dopt=Abstract
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Verbal creativity, depression and alcoholism. An investigation of one hundred American and British writers. Author(s): Post F. Source: The British Journal of Psychiatry; the Journal of Mental Science. 1996 May; 168(5): 545-55. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8733792&dopt=Abstract
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Vigilance and iconic memory in children at high risk for alcoholism. Author(s): Steinhauer SR, Locke J, Hill SY. Source: J Stud Alcohol. 1997 July; 58(4): 428-34. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9203124&dopt=Abstract
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Violence and alcoholism in the family: how are the children affected? Author(s): Malpique C, Barrias P, Morais L, Salgado M, Pinto Da Costa I, Rodriques M. Source: Alcohol and Alcoholism (Oxford, Oxfordshire). 1998 January-February; 33(1): 42-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9539176&dopt=Abstract
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Visual P3a in male subjects at high risk for alcoholism. Author(s): Rodriguez Holguin S, Porjesz B, Chorlian DB, Polich J, Begleiter H. Source: Biological Psychiatry. 1999 July 15; 46(2): 281-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10418704&dopt=Abstract
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Visual-spatial learning in nonalcoholic young adults with and those without a family history of alcoholism. Author(s): Garland MA, Parsons OA, Nixon SJ. Source: J Stud Alcohol. 1993 March; 54(2): 219-24. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8459716&dopt=Abstract
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Visuospatial perception, construction and memory in alcoholism. Author(s): Beatty WW, Hames KA, Blanco CR, Nixon SJ, Tivis LJ. Source: J Stud Alcohol. 1996 March; 57(2): 136-43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8683962&dopt=Abstract
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Vitamin A and E blood levels in erythrodermic and pustular psoriasis associated with chronic alcoholism. Author(s): Marrakchi S, Kim I, Delaporte E, Briand G, Degand P, Maibach HI, Thomas P. Source: Acta Dermato-Venereologica. 1994 July; 74(4): 298-301. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7976092&dopt=Abstract
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Vitamin D in schizophrenia, major depression and alcoholism. Author(s): Schneider B, Weber B, Frensch A, Stein J, Fritz J. Source: Journal of Neural Transmission (Vienna, Austria : 1996). 2000; 107(7): 839-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11005548&dopt=Abstract
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Vitreous humor carbohydrate-deficient transferrin concentrations in the postmortem diagnosis of alcoholism. Author(s): Osuna E, Perez-Carceles MD, Moreno M, Bedate A, Conejero J, Abenza JM, Martinez P, Luna A. Source: Forensic Science International. 2000 February 28; 108(3): 205-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10737467&dopt=Abstract
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Voice of the victims--the key to consensus and support for alcoholism research. Author(s): O'Neill JT. Source: Alcohol Alcohol Suppl. 1996 March; 1: 83-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9845043&dopt=Abstract
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Voice of the victims--the key to consensus and support for alcoholism research. Author(s): O'Neill JT. Source: Alcohol and Alcoholism (Oxford, Oxfordshire). 1996 March; 31 Suppl 1: 83-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8737006&dopt=Abstract
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Volunteer assistance in the treatment of chronic alcoholism. Author(s): Leigh G, Hodgins DC, Milne R, Gerrish R. Source: The American Journal of Drug and Alcohol Abuse. 1999 August; 25(3): 543-59. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10473014&dopt=Abstract
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Vulnerability to alcoholism in women. Genetic and cultural factors. Author(s): Hill SY. Source: Recent Dev Alcohol. 1995; 12: 9-28. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7624558&dopt=Abstract
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Washington Report: National Institute on Alcohol Abuse and Alcoholism. Author(s): Noble EP. Source: J Stud Alcohol. 1978 March; 39(3): 578-89. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=206788&dopt=Abstract
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What can the DRD2/alcoholism story teach us about association studies in psychiatric genetics? Author(s): Neiswanger K, Kaplan BB, Hill SY. Source: American Journal of Medical Genetics. 1995 August 14; 60(4): 272-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7485260&dopt=Abstract
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What if alcoholism had not been invented? The dynamics of American alcohol mythology. Author(s): Mulford HA. Source: Addiction (Abingdon, England). 1994 May; 89(5): 517-20; Discussion 521-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8044119&dopt=Abstract
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What is inherited in the predisposition to alcoholism: new model or more muddle? Author(s): Tarter RE. Source: Alcoholism, Clinical and Experimental Research. 2000 February; 24(2): 246-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10698381&dopt=Abstract
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What is inherited in the predisposition toward alcoholism? A proposed model. Author(s): Begleiter H, Porjesz B. Source: Alcoholism, Clinical and Experimental Research. 1999 July; 23(7): 1125-35. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10443977&dopt=Abstract
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When alcoholism hits home. Author(s): Ianelli J. Source: The American Journal of Nursing. 1997 July; 97(7): 68-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9247383&dopt=Abstract
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When the stigma is gone (is this alcoholism?). A parable. Author(s): Cruse JR. Source: S D J Med. 1992 September; 45(9): 267-8. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1411490&dopt=Abstract
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Who cares whether alcoholism is a disease? Author(s): Meyers D. Source: The Medical Journal of Australia. 1992 April 6; 156(7): 512. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1532628&dopt=Abstract
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WHO/ISBRA Study on State and Trait Markers of Alcohol Use and Dependence: analysis of demographic, behavioral, physiologic, and drinking variables that contribute to dependence and seeking treatment. International Society on Biomedical Research on Alcoholism. Author(s): Glanz J, Grant B, Monteiro M, Tabakoff B; WHO/ISBRA Study on State and Trait Markers of Alcohol Use and Dependence Investigators. Source: Alcoholism, Clinical and Experimental Research. 2002 July; 26(7): 1047-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12170115&dopt=Abstract
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WHP/ISBRA study on state and trait markers in alcoholism. Author(s): Tabakoff B, Helander A, Conigrave KM, Martinez L, Hoffman PL, Whitfield J, Degenhardt L, Saunders J, Baron A, Glanz J; Members of WHO/ISBRA Study Group. Source: Alcoholism, Clinical and Experimental Research. 2001 May; 25(5 Suppl Isbra): 99S-103S. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11391057&dopt=Abstract
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Why alcoholism is a disease. Author(s): Maltzman I. Source: J Psychoactive Drugs. 1994 January-March; 26(1): 13-31. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8027903&dopt=Abstract
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Why there is no gene for alcoholism. Author(s): Devor EJ. Source: Behavior Genetics. 1993 March; 23(2): 145-51. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8512529&dopt=Abstract
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Women and alcoholism: how a male-as-norm bias affects research, assessment, and treatment. Author(s): Wilke D. Source: Health & Social Work. 1994 February; 19(1): 29-35. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8168775&dopt=Abstract
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Women and minorities representation in alcoholism treatment research. Author(s): Williams LD, Mason BJ, Goldberg G, Cutler RB. Source: Psychopharmacology Bulletin. 1996; 32(2): 201-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8783889&dopt=Abstract
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Work control, work demands, and work social support in relation to alcoholism among young men. Author(s): Hemmingsson T, Lundberg I. Source: Alcoholism, Clinical and Experimental Research. 1998 June; 22(4): 921-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9660323&dopt=Abstract
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CHAPTER 2. NUTRITION AND ALCOHOLISM Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and alcoholism.
Finding Nutrition Studies on Alcoholism 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 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 “alcoholism” (or synonyms) into the search box, and click “Go.” To narrow the search, you can also select the “Title” field.
7 Adapted from http://ods.od.nih.gov. IBIDS is produced by the Office of Dietary Supplements (ODS) at the National Institutes of Health to assist the public, healthcare providers, educators, and researchers in locating credible, scientific information on dietary supplements. IBIDS was developed and will be maintained through an interagency partnership with the Food and Nutrition Information Center of the National Agricultural Library, U.S. Department of Agriculture.
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The following is a typical result when searching for recently indexed consumer information on alcoholism: ·
Alcohol abuse: an important cause of severe hyperhomocysteinemia. Author(s): Department of Medicine, New York Methodist Hospital, Brooklyn, NY 11215, USA. Source: Carmel, R James, S J Nutr-Revolume 2002 July; 60(7 Pt 1): 215-21 0029-6643
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Leaky gut of alcoholism. Source: Nutr-Rev. Washington, D.C. : Nutrition Foundation. March 1985. volume 43 (3) page 72-74. 0029-6643
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Medical allies against alcoholism. Author(s): Alcohol Disorders Research Unit, University of Miami School of Medicine, USA. Source: Mason, B Health-News. 1999 June 25; 5(8): 3-4 1081-5880
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Nutrition and alcoholism in rats. Source: Anonymous Nutr-Revolume 1988 January; 46(1): 28-30 0029-6643
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Tryptophan metabolism in alcoholism. Source: Badawy, A.A.B. Nutr-res-rev. Wallingford, Oxon, U.K. : CAB International. June 2002. volume 15 (1) page 123-152. 0954-4224
The following information is typical of that found when using the “Full IBIDS Database” to search for “alcoholism” (or a synonym): ·
A large randomized placebo controlled study of auricular acupuncture for alcohol dependence. Author(s): Center for Addiction and Alternative Medicine Research, Minneapolis, MN 55404, USA. Source: Bullock, Milton L Kiresuk, Thomas J Sherman, Robert E Lenz, Scott K Culliton, Patricia D Boucher, Tacey A Nolan, Christopher J J-Subst-Abuse-Treat. 2002 March; 22(2): 71-7 0740-5472
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Absorption and utilization of nutrients in alcoholism. Source: Feinman, L. Alcohol-Health-Res-World-Natl-Inst-Alcohol-Abuse-Alcohol. Washington, D.C. : U.S. Department of Health and Human Services. 1989. volume 13 (3) page 206-210. ill. 0090-838X
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Acute axonal polyneuropathy in chronic alcoholism and malnutrition. Author(s): Department of Neurology, Regionaal Ziekenhuis Heilig Hart, Leuven, Belgium. Source: Vandenbulcke, M Janssens, J Acta-Neurol-Belg. 1999 September; 99(3): 198-201 0300-9009
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Alcoholism abolishes the effects of melatonin on growth hormone secretion in humans. Author(s): Centro di Alcologia-Istituto di Clinica Medica Generale e Terapia Medica, Parma, Italy. Source: Coiro, V Vescovi, P P Neuropeptides. 1998 June; 32(3): 211-4 0143-4179
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Alcoholism and folate homeostasis. Source: Halsted, C.H. Bristol-Myers-Squibb-Mead-Johnson-Nutr-Symp. San Diego, Calif. : Academic Press. 1989. volume 7 page 249-266. charts.
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Alcoholism and pancreatitis. Source: Korsten, M.A. Alcohol-Health-Res-World-Natl-Inst-Alcohol-Abuse-Alcohol. Washington, D.C. : U.S. Department of Health and Human Services. 1989. volume 13 (3) page 232-237. ill. 0090-838X
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Animal models of alcoholism: neurobiology of high alcohol-drinking behavior in rodents. Author(s): Department of Psychiatry, Indiana University School of Medicine, Indianapolis 46202-4887, USA. Source: McBride, W J Li, T K Crit-Rev-Neurobiol. 1998; 12(4): 339-69 0892-0915
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Application of herbal mixtures in rehabilitation after alcoholism. Source: Petri, G. Takach, G. Plant-Med. Stuttgart, W. Ger. : Georg Thieme Verlag. December 1990. volume 56 (6) page 692-693. 0032-0943
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Comparison of hypericum extracts with imipramine and fluoxetine in animal models of depression and alcoholism. Author(s): CNS Research, Bayer AG, Wuppertal, Germany.
[email protected] Source: De Vry, J Maurel, S Schreiber, R de Beun, R Jentzsch, K R EurNeuropsychopharmacol. 1999 December; 9(6): 461-8 0924-977X
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Drug treatments for alcoholism. Source: Anonymous Harv-Ment-Health-Lett. 2002 April; 18(10): 4-7 1057-5022
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Effects of chronic experimental alcoholism on the epithelium of the uterine horn of rats (Rattus norvegicus albinus). Author(s): Department of Morphology and Pathology, Federal University of Sao Carlos, Sao Paulo, Brazil.
[email protected] Source: Martinez, M Garcia, P J Cagnon, V H Mello Junior, W Padovani, C R Martinez, F E J-Submicrosc-Cytol-Pathol. 2001 Jan-April; 33(1-2): 107-15 1122-9497
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Essential fatty acids in the treatment of the alcohol dependence syndrome. Source: Glen, A.I.M. Glen, E.M.T. Macdonald, F.K. Macdonell, L.E.F. Mackenzie, J.R. Montgomery, D.J. Manku, M.S. Horrobin, D.F. Morse, N. Alcoholic beverages / edited by G.G. Birch and M.G. Lindley. London : Elsevier Applied Science, c1985. page 203-221. ill. ISBN: 0853343268
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Evolutionary origins of human alcoholism in primate frugivory. Author(s): Section of Integrative Biology, University of Texas Austin 78712, USA. Source: Dudley, R Q-Rev-Biol. 2000 March; 75(1): 3-15 0033-5770
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Fermenting fruit and the historical ecology of ethanol ingestion: is alcoholism in modern humans an evolutionary hangover? Author(s): Section of Integrative Biology, University of Texas at Austin, 78712, USA.
[email protected] Source: Dudley, Robert Addiction. 2002 April; 97(4): 381-8 0965-2140
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Maintenance of homeostasis of endogenous ethanol as a method for the therapy of alcoholism. Author(s): Department for the Therapy of Alcohol Dependence, V. M. Bekhterev Psychoneurological Institute, St. Petersburg. Source: Nikolaenko, V N Bull-Exp-Biol-Med. 2001 March; 131(3): 231-3 0007-4888
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Marijuana use in alcoholism: demographic characteristics and effects on therapy. Source: Benzer, D. Cushman, P. Jr. Current controversies in alcoholism / Barry Stimmel, editor. New York : Haworth Press, c1983. page 53-60. ISBN: 0866562257
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Morphological effects on the hard palatine mucosa of Calomys callosus submitted to experimental chronic alcoholism. Author(s): Department of Morphology and Pathology, Federal University of Sao Carlos, SP, Brazil.
[email protected] Source: Martinez, M Martinez, F E da Cunha, M R Segatelli, T M Pinheiro, P F Almeida, C C J-Submicrosc-Cytol-Pathol. 2002 January; 34(1): 77-83 1122-9497
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Morphology of the seminal vesicle of Calomys callosus submitted to experimental chronic alcoholism. Author(s): Department of Morphology and Pathology, Federal University of Sao Carlos, SP, Brazil.
[email protected] Source: Martinez, M Mattos, E C Mello, W J Cagnon, V H Martinez, F E J-SubmicroscCytol-Pathol. 2001 October; 33(4): 453-61 1122-9497
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Morphometric analysis of the endometrial epithelium of rats (Rattus norvegicus albinus) submitted to chronic experimental alcoholism. Author(s): Department of Morphology and Pathology, Federal University of Sao Carlos, Brazil.
[email protected] Source: Martinez, M Martinez, F E Garcia, P J Cagnon, V H Mello Junior, W Padovani, C R J-Submicrosc-Cytol-Pathol. 1999 October; 31(4): 469-75 1122-9497
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Naltrexone for alcohol dependence: a randomized controlled trial. Author(s): The Australian National Centre for War-related PTSD at the Austin Repatriation Medical Centre, Heidelberg, Melbourne, Australia. Source: Morris, P L Hopwood, M Whelan, G Gardiner, J Drummond, E Addiction. 2001 November; 96(11): 1565-73 0965-2140
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Nutritional advice and diet instruction in alcoholism treatment. Source: Hauser, M.B. Iber, F.L. Alcohol-Health-Res-World-Natl-Inst-Alcohol-AbuseAlcohol. Washington, D.C. : U.S. Department of Health and Human Services. 1989. volume 13 (3) page 261-266. ill. 0090-838X
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Outpatient cognitive behavioural therapy programme for alcohol dependence: impact of naltrexone use on outcome. Author(s): Department of Psychiatry, University of Queensland, Brisbane, Australia.
[email protected] Source: Feeney, G F Young, R M Connor, J P Tucker, J McPherson, A Aust-N-Z-JPsychiatry. 2001 August; 35(4): 443-8 0004-8674
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Physiological effects of wine. His share in alcoholism [cardio-vascular diseases, procyamidins, free radicals]. Author(s): Universite de Bordeaux-2 (France). UFR de Medecine et de Pharmacie Source: Masquelier, J. Bulletin-de-l'OIV (France). (Jul-August 1988). volume 61(689-690) page 554-578. 0029-7127
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Potential use of medicinal plants in the treatment of alcoholism. Author(s): Bernard B. Brodie Department of Neuroscience, University of Cagliari, Via Porcell 4, 09124, Cagliari, Italy. Source: Carai, M A Agabio, R Bombardelli, E Bourov, I Gessa, G L Lobina, C Morazzoni, P Pani, M Reali, R Vacca, G Colombo, G Fitoterapia. 2000 August; 71 Suppl 1: S38-42 0367-326X
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Role of selenium depletion in the etiopathogenesis of depression in patient with alcoholism. Source: Sher, L Med-Hypotheses. 2002 September; 59(3): 330-3 0306-9877
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Should a lower treatment line be used when treating paracetamol poisoning in patients with chronic alcoholism?: a case against. Author(s): National Poisons Information Service, London, United Kingdom. Source: Dargan, P I Jones, A L Drug-Saf. 2002; 25(9): 625-32 0114-5916
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Sleep and the cholinergic rem sleep induction test in patients with primary alcoholism. Author(s): Department of Psychiatry and Psychotherapy, University of Freiburg, Freiburg, D-79104, Germany. Source: Gann, H J Faulmann, A Kiemen, A Klein, T Ebert, D Backhaus, J Hornyak, M Voderholzer, U Hohagen, F Berger, M Riemann, D Sleep-Res-Online. 1998; 1(2): 92-5 1096-214X
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Treating alcohol dependence in a district general hospital. Source: Burnill, R Daly, C Hosp-Med. 2002 July; 63(7): 416-20 1462-3935
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Zhirno-kislotnyi i lipidnyi sostav trombotsitov u bo'lnykh alkogolizmom. [Fatty acid and lipid levels in the blood platelets of patients with alcoholism] Source: Iusupova, I U Ostremskii, V D Markova, M N Miloserdova, T I Kariukhin, V A Gematol-Transfuziol. 1989 June; 34(6): 31-7 0234-5730
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/
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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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WebMDÒHealth: 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 alcoholism; 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 (some Web sites are subscription based): ·
Vitamins Pantothenic Acid Source: Healthnotes, Inc. www.healthnotes.com Vitamin A Source: Prima Communications, Inc.www.personalhealthzone.com Vitamin B complex Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,962,00.html Vitamin B1 Source: Prima Communications, Inc.www.personalhealthzone.com Vitamin B12 Source: Healthnotes, Inc. www.healthnotes.com Vitamin C Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,904,00.html Vitamin E Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,906,00.html
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Vitamin K Source: Prima Communications, Inc.www.personalhealthzone.com ·
Minerals Carnitine (L-Carnitine) Source: Integrative Medicine Communications; www.drkoop.com Chromium Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10018,00.html L-Carnitine Source: Integrative Medicine Communications; www.drkoop.com Lecithin and choline Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10040,00.html Magnesium Source: Healthnotes, Inc. www.healthnotes.com Magnesium Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,890,00.html Zinc Source: Integrative Medicine Communications; www.drkoop.com Zinc Source: Prima Communications, Inc.www.personalhealthzone.com
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Food and Diet Low Back Pain Source: Healthnotes, Inc. www.healthnotes.com
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CHAPTER 3. ALTERNATIVE MEDICINE AND ALCOHOLISM Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to alcoholism. 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 alcoholism 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 “alcoholism” (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 alcoholism: ·
A large randomized placebo controlled study of auricular acupuncture for alcohol dependence. Author(s): Bullock ML, Kiresuk TJ, Sherman RE, Lenz SK, Culliton PD, Boucher TA, Nolan CJ. Source: Journal of Substance Abuse Treatment. 2002 March; 22(2): 71-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11932132&dopt=Abstract
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A pilot study exploring the effect of kudzu root on the drinking habits of patients with chronic alcoholism. Author(s): Shebek J, Rindone JP. Source: Journal of Alternative and Complementary Medicine (New York, N.Y.). 2000 February; 6(1): 45-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10706235&dopt=Abstract
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A review of the treatment of alcoholism. Author(s): McLellan AS. Source: N J Med. 1996 August; 93(8): 39-42. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8797340&dopt=Abstract
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A Russian-American approach to the treatment of alcoholism in Russia: preliminary results. Author(s): Levine BG, Nebelkopf E. Source: J Psychoactive Drugs. 1998 January-February; 30(1): 25-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9565206&dopt=Abstract
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A trial of "standard" outpatient alcoholism treatment vs. a minimal treatment control. Author(s): Davis WT, Campbell L, Tax J, Lieber CS. Source: Journal of Substance Abuse Treatment. 2002 July; 23(1): 9-19. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12127464&dopt=Abstract
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Acupuncture in alcoholism treatment: a randomized out-patient study. Author(s): Sapir-Weise R, Berglund M, Frank A, Kristenson H. Source: Alcohol and Alcoholism (Oxford, Oxfordshire). 1999 July-August; 34(4): 629-35. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10456592&dopt=Abstract
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Adverse effects of paclitaxel in patients with alcohol abuse histories. Author(s): Henderson-Martin B. Source: Clinical Journal of Oncology Nursing. 2000 January-February; 4(1): 11-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10865578&dopt=Abstract
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Alcoholics Anonymous and 12-step alcoholism treatment programs. Author(s): Humphreys K. Source: Recent Dev Alcohol. 2003; 16: 149-64. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12638636&dopt=Abstract
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Alcoholism among indigent inpatients: identification and intervention by internal medicine residents. Author(s): Cerise FP, Scarinci IC, Thibodaux R, Cannatella M, Stark S, Brantley PJ. Source: Southern Medical Journal. 1998 January; 91(1): 27-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9438398&dopt=Abstract
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Alcoholism treatment in the United States. An overview. Author(s): Fuller RK, Hiller-Sturmhofel S.
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Source: Alcohol Research & Health : the Journal of the National Institute on Alcohol Abuse and Alcoholism. 1999; 23(2): 69-77. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10890799&dopt=Abstract ·
Altered emotion-modulated startle in young adults with a family history of alcoholism. Author(s): Miranda R Jr, Meyerson LA, Buchanan TW, Lovallo WR. Source: Alcoholism, Clinical and Experimental Research. 2002 April; 26(4): 441-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11981118&dopt=Abstract
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Auditory P3a deficits in male subjects at high risk for alcoholism. Author(s): Hada M, Porjesz B, Chorlian DB, Begleiter H, Polich J. Source: Biological Psychiatry. 2001 April 15; 49(8): 726-38. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11313040&dopt=Abstract
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Characteristics of injection drug users derived from a large family study of alcoholism. Author(s): Dinwiddie SH. Source: Comprehensive Psychiatry. 1997 July-August; 38(4): 218-29. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9202879&dopt=Abstract
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Clinical characteristics of alcoholism in alcohol-dependent subjects with and without a history of alcohol treatment. Author(s): Raimo EB, Daeppen JB, Smith TL, Danko GP, Schuckit MA. Source: Alcoholism, Clinical and Experimental Research. 1999 October; 23(10): 1605-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10549991&dopt=Abstract
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Cognitive-behavioral treatment for depression in alcoholism. Author(s): Brown RA, Evans DM, Miller IW, Burgess ES, Mueller TI. Source: Journal of Consulting and Clinical Psychology. 1997 October; 65(5): 715-26. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9337490&dopt=Abstract
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Comorbid alcoholism and depression: treatment issues. Author(s): Thase ME, Salloum IM, Cornelius JD. Source: The Journal of Clinical Psychiatry. 2001; 62 Suppl 20: 32-41. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11584873&dopt=Abstract
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Comparison of hypericum extracts with imipramine and fluoxetine in animal models of depression and alcoholism. Author(s): De Vry J, Maurel S, Schreiber R, de Beun R, Jentzsch KR.
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Source: European Neuropsychopharmacology : the Journal of the European College of Neuropsychopharmacology. 1999 December; 9(6): 461-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10625112&dopt=Abstract ·
Concurrent alcoholism and social anxiety disorder: a first step toward developing effective treatments. Author(s): Randall CL, Thomas S, Thevos AK. Source: Alcoholism, Clinical and Experimental Research. 2001 February; 25(2): 210-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11236835&dopt=Abstract
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Constraint, alcoholism, and electrodermal response in aversive classical conditioning and mismatch novelty paradigms. Author(s): Finn PR, Justus AN, Mazas C, Rorick L, Steinmetz JE. Source: Integrative Physiological and Behavioral Science : the Official Journal of the Pavlovian Society. 2001 April-June; 36(2): 154-67. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11666043&dopt=Abstract
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Effects of disulfiram on positron emission tomography and neuropsychological studies in severe chronic alcoholism. Author(s): Gilman S, Adams KM, Johnson-Greene D, Koeppe RA, Junck L, Kluin KJ, Martorello S, Heumann M, Hill E. Source: Alcoholism, Clinical and Experimental Research. 1996 November; 20(8): 1456-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8947325&dopt=Abstract
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Electrophysiological evidence of abnormal activation of the cerebral network of involuntary attention in alcoholism. Author(s): Polo MD, Escera C, Yago E, Alho K, Gual A, Grau C. Source: Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology. 2003 January; 114(1): 134-46. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12495774&dopt=Abstract
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Electrophysiological indication for a link between serotonergic neurotransmission and personality in alcoholism. Author(s): Herrmann MJ, Sonnek G, Weijers HG, Wiesbeck GA, Boning J, Fallgatter AJ. Source: Progress in Neuro-Psychopharmacology & Biological Psychiatry. 2002 January; 26(1): 157-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11853107&dopt=Abstract
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Employee alcoholism in the healthcare setting. Author(s): Syre TR. Source: Hospital Topics. 1994 Winter; 72(1): 9-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10136315&dopt=Abstract
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Gender differences in help-utilization and the 8-year course of alcohol abuse. Author(s): Timko C, Moos RH, Finney JW, Connell EG. Source: Addiction (Abingdon, England). 2002 July; 97(7): 877-89. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12133127&dopt=Abstract
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Genetic association between reduced P300 amplitude and the DRD2 dopamine receptor A1 allele in children at high risk for alcoholism. Author(s): Hill SY, Locke J, Zezza N, Kaplan B, Neiswanger K, Steinhauer SR, Wipprecht G, Xu J. Source: Biological Psychiatry. 1998 January 1; 43(1): 40-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9442343&dopt=Abstract
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Genetic basis of event-related potentials and their relationship to alcoholism and alcohol use. Author(s): Porjesz B, Begleiter H. Source: Journal of Clinical Neurophysiology : Official Publication of the American Electroencephalographic Society. 1998 January; 15(1): 44-57. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9502512&dopt=Abstract
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Genetics and alcoholism: implications for advanced practice psychiatric/mental health nursing. Author(s): Kutlenios RM. Source: Archives of Psychiatric Nursing. 1998 June; 12(3): 154-61. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9628046&dopt=Abstract
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Help-seeking for alcohol-related problems: social contexts surrounding entry into alcoholism treatment or Alcoholics Anonymous. Author(s): George AA, Tucker JA. Source: J Stud Alcohol. 1996 July; 57(4): 449-57. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8776687&dopt=Abstract
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Herbal remedies for alcoholism: promises and possible pitfalls. Author(s): Overstreet DH, Keung WM, Rezvani AH, Massi And M, Lee DY. Source: Alcoholism, Clinical and Experimental Research. 2003 February; 27(2): 177-85. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12605067&dopt=Abstract
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Human GABAA receptor alpha 1 and alpha 3 subunits genes and alcoholism. Author(s): Parsian A, Cloninger CR. Source: Alcoholism, Clinical and Experimental Research. 1997 May; 21(3): 430-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9161602&dopt=Abstract
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Influence of acupuncture and pharmacotherapy on sensitivity of sensory systems to alcohol irritants in patients with alcoholism. Author(s): Timofeev MF. Source: The American Journal of Chinese Medicine. 1996; 24(2): 177-84. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8874675&dopt=Abstract
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Intercessory prayer in the treatment of alcohol abuse and dependence: a pilot investigation. Author(s): Walker SR, Tonigan JS, Miller WR, Corner S, Kahlich L. Source: Alternative Therapies in Health and Medicine. 1997 November; 3(6): 79-86. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9375433&dopt=Abstract
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Isoflavonoid compounds extracted from Pueraria lobata suppress alcohol preference in a pharmacogenetic rat model of alcoholism. Author(s): Lin RC, Guthrie S, Xie CY, Mai K, Lee DY, Lumeng L, Li TK. Source: Alcoholism, Clinical and Experimental Research. 1996 June; 20(4): 659-63. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8800381&dopt=Abstract
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Jesus, peyote, and the holy people: alcohol abuse and the ethos of power in Navajo healing. Author(s): Garrity JF. Source: Med Anthropol Q. 2000 December; 14(4): 521-42. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11224979&dopt=Abstract
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Long-term outcome in 306 males with alcoholism. Author(s): Noda T, Imamichi H, Kawata A, Hirano K, Ando T, Iwata Y, Yoneda H. Source: Psychiatry and Clinical Neurosciences. 2001 December; 55(6): 579-86. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11737790&dopt=Abstract
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Naltrexone in alcohol dependence: a randomised controlled trial of effectiveness in a standard clinical setting. Author(s): Latt NC, Jurd S, Houseman J, Wutzke SE. Source: The Medical Journal of Australia. 2002 June 3; 176(11): 530-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12064984&dopt=Abstract
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New pharmacotherapies for alcohol dependence. Author(s): Graham R, Wodak AD, Whelan G. Source: The Medical Journal of Australia. 2002 July 15; 177(2): 103-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12098353&dopt=Abstract
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One hundred years of alcoholism: the Twentieth Century. Author(s): Mann K, Hermann D, Heinz A.
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Source: Alcohol and Alcoholism (Oxford, Oxfordshire). 2000 January; 35(1): 10-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10684770&dopt=Abstract ·
Osteoreflectory treatment of alcohol abstinence syndrome and craving for alcohol in patients with alcoholism. Author(s): Yankovskis G, Beldava I, Livina B. Source: Acupuncture & Electro-Therapeutics Research. 2000; 25(1): 9-16. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10830971&dopt=Abstract
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Outcome of treatment for alcohol abuse and involvement in Alcoholics Anonymous among previously untreated problem drinkers. Author(s): Timko C, Moos RH, Finney JW, Moos BS. Source: J Ment Health Adm. 1994 Spring; 21(2): 145-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10133776&dopt=Abstract
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Polydrug use in adolescent drinkers with and without DSM-IV alcohol abuse and dependence. Author(s): Martin CS, Kaczynski NA, Maisto SA, Tarter RE. Source: Alcoholism, Clinical and Experimental Research. 1996 September; 20(6): 10991108. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8892534&dopt=Abstract
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Potential use of medicinal plants in the treatment of alcoholism. Author(s): Carai MA, Agabio R, Bombardelli E, Bourov I, Gessa GL, Lobina C, Morazzoni P, Pani M, Reali R, Vacca G, Colombo G. Source: Fitoterapia. 2000 August; 71 Suppl 1: S38-42. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10930711&dopt=Abstract
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Recovery from alcoholism: a spiritual journey. Author(s): Bowden JW. Source: Issues in Mental Health Nursing. 1998 July-August; 19(4): 337-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9782855&dopt=Abstract
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Skin-conductance orienting deficits and increased alcoholism in schizotypal criminals. Author(s): Raine A, Bihrle S, Venables PH, Mednick SA, Pollock V. Source: Journal of Abnormal Psychology. 1999 May; 108(2): 299-306. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10369040&dopt=Abstract
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Social and community resources and long-term recovery from treated and untreated alcoholism. Author(s): Humphreys K, Moos RH, Cohen C.
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Source: J Stud Alcohol. 1997 May; 58(3): 231-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9130214&dopt=Abstract ·
The effect of a history of alcohol dependence in adult major depression. Author(s): Rae AM, Joyce PR, Luty SE, Mulder RT. Source: Journal of Affective Disorders. 2002 August; 70(3): 281-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12128240&dopt=Abstract
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Traditional and western healing practices for alcoholism in American Indians and Alaska Natives. Author(s): Abbott PJ. Source: Substance Use & Misuse. 1998 November; 33(13): 2605-46. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9818991&dopt=Abstract
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Treating alcoholism: an age-specific intervention that works for older patients. Author(s): Peterson M, Zimberg S. Source: Geriatrics. 1996 October; 51(10): 45-9; Quiz 50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8863757&dopt=Abstract
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Visuospatial perception, construction and memory in alcoholism. Author(s): Beatty WW, Hames KA, Blanco CR, Nixon SJ, Tivis LJ. Source: J Stud Alcohol. 1996 March; 57(2): 136-43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8683962&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.comÒ: 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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WebMDÒHealth: 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 alcoholism; 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 (some Web sites are subscription based): ·
General Overview Alcohol Withdrawal Source: Healthnotes, Inc. www.healthnotes.com Alcoholism Source: Integrative Medicine Communications; www.drkoop.com Alcoholism Source: Integrative Medicine Communications; www.drkoop.com Alzheimer's Disease, Non-Alzheimer's Dementia, and Normal Age-Related Memory Loss Source: Prima Communications, Inc.www.personalhealthzone.com Amenorrhea Source: Integrative Medicine Communications; www.drkoop.com Blood Pressure, High Source: Integrative Medicine Communications; www.drkoop.com Bone Loss Source: Integrative Medicine Communications; www.drkoop.com Brain Inflammation, Meningitis Source: Integrative Medicine Communications; www.drkoop.com Cancer Prevention and Diet Source: Healthnotes, Inc. www.healthnotes.com Cardiomyopathy Source: Healthnotes, Inc. www.healthnotes.com Cirrhosis Source: Integrative Medicine Communications; www.drkoop.com Congestive Heart Failure Source: Integrative Medicine Communications; www.drkoop.com Dementia Source: Integrative Medicine Communications; www.drkoop.com
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Diabetes Source: Healthnotes, Inc. www.healthnotes.com Erectile Dysfunction Source: Healthnotes, Inc. www.healthnotes.com Gastritis Source: Healthnotes, Inc. www.healthnotes.com Heart Attack Source: Healthnotes, Inc. www.healthnotes.com Heart Failure, Congestive Source: Integrative Medicine Communications; www.drkoop.com Hepatitis Source: Healthnotes, Inc. www.healthnotes.com High Blood Pressure Source: Integrative Medicine Communications; www.drkoop.com High Cholesterol Source: Healthnotes, Inc. www.healthnotes.com High Triglycerides Source: Healthnotes, Inc. www.healthnotes.com Hypertension Source: Integrative Medicine Communications; www.drkoop.com Hypothyroidism Source: Healthnotes, Inc. www.healthnotes.com Liver Cirrhosis Source: Healthnotes, Inc. www.healthnotes.com Liver Disease Source: Integrative Medicine Communications; www.drkoop.com Meningitis Source: Integrative Medicine Communications; www.drkoop.com Menstruation, Absence of Source: Integrative Medicine Communications; www.drkoop.com Osteoporosis Source: Integrative Medicine Communications; www.drkoop.com Pancreas, Inflammation of Source: Integrative Medicine Communications; www.drkoop.com
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Pancreatic Insufficiency Source: Healthnotes, Inc. www.healthnotes.com Pancreatitis Source: Integrative Medicine Communications; www.drkoop.com Peptic Ulcer Source: Integrative Medicine Communications; www.drkoop.com Premenstrual Syndrome Source: Healthnotes, Inc. www.healthnotes.com Senile Dementia Source: Integrative Medicine Communications; www.drkoop.com Ulcer, Peptic Source: Integrative Medicine Communications; www.drkoop.com Vitamin B12 Deficiency Source: Healthnotes, Inc. www.healthnotes.com ·
Alternative Therapy Art therapy Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,671,00.html Biofeedback Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,675,00.html Native American medicine Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,721,00.html Relaxation Techniques Source: Integrative Medicine Communications; www.drkoop.com Urine therapy Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,744,00.html
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Herbs and Supplements Beta-Carotene Source: Prima Communications, Inc.www.personalhealthzone.com
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Dandelion Alternative names: Taraxacum officinale Source: Healthnotes, Inc. www.healthnotes.com Gamma-Linolenic Acid (GLA) Source: Integrative Medicine Communications; www.drkoop.com GLA Source: Integrative Medicine Communications; www.drkoop.com Glutamine Source: Integrative Medicine Communications; www.drkoop.com Glutamine Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10030,00.html Guaraná Alternative names: Paullinia cupana Source: Healthnotes, Inc. www.healthnotes.com Kava Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,798,00.html Kudzu Alternative names: Pueraria lobata Source: Healthnotes, Inc. www.healthnotes.com Kudzu Source: Prima Communications, Inc.www.personalhealthzone.com Kudzu Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,858,00.html Lipotropic combination Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,861,00.html Milk Thistle Alternative names: Silybum marianum, Carduus marianus Source: Healthnotes, Inc. www.healthnotes.com Milk thistle Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10044,00.html
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NAC (N-acetylcysteine) Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,809,00.html Pueraria Alternative names: Kudzu; Pueraria lobata Source: Alternative Medicine Foundation, Inc. www.amfoundation.org Hyperlink: http://www.herbmed.org/ SAMe Source: Healthnotes, Inc. www.healthnotes.com Soy isoflavones Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10057,00.html St. John's wort Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,824,00.html Taurine Source: Prima Communications, Inc.www.personalhealthzone.com Valerian Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10064,00.html
General References A good place to find general background information on CAM is the National Library of Medicine. It has prepared within the MEDLINEplus system an information topic page dedicated to complementary and alternative medicine. To access this page, go to the MEDLINEplus site at http://www.nlm.nih.gov/medlineplus/alternativemedicine.html. This Web site provides a general overview of various topics and can lead to a number of general sources.
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CHAPTER 4. DISSERTATIONS ON ALCOHOLISM Overview In this chapter, we will give you a bibliography on recent dissertations relating to alcoholism. We will also provide you with information on how to use the Internet to stay current on dissertations. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical dissertations that use the generic term “alcoholism” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on alcoholism, we have not necessarily excluded nonmedical dissertations in this bibliography.
Dissertations on Alcoholism ProQuest Digital Dissertations, the largest archive of academic dissertations available, is located at the following Web address: http://wwwlib.umi.com/dissertations. From this archive, we have compiled the following list covering dissertations devoted to alcoholism. You will see that the information provided includes the dissertation’s title, its author, and the institution with which the author is associated. The following covers recent dissertations found when using this search procedure: ·
A Case Control Study of ACOA Problems in an Employee Assistance Program (adult Children of Alcoholics, Alcoholism) by Martin, Patricia Ann, Edd from The Johns Hopkins University, 1992, 234 pages http://wwwlib.umi.com/dissertations/fullcit/9229372
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A Comparative Study of the Effectiveness of Recovered Alcoholic and Non-alcoholic Alcoholism Counselors on Specific Counseling Skills and the Differential Effect of Micro-counseling Training. by Buzzetta, Frank, Edd from University of South Dakota, 1975, 126 pages http://wwwlib.umi.com/dissertations/fullcit/7602397
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A Comparison of Black and White Male Alcoholics on Alcoholism-treatment Outcome (alcoholism Treatment) by Moore-pollock, Sally, Phd from University of Missouri - Kansas City, 1990, 130 pages http://wwwlib.umi.com/dissertations/fullcit/9119036
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A Comparison of Male and Female Alcoholics' Response to Treatment Process in an Outpatient Alcoholism Treatment Center by Karn, Elissa Richards, Edd from Temple University, 1989, 179 pages http://wwwlib.umi.com/dissertations/fullcit/9007359
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A Comparison of the Effectiveness and Attitudes of Professional and Paraprofessional Alcoholism Counselors by Fuller, Marilyn Greenfield, Phd from Wayne State University, 1985, 76 pages http://wwwlib.umi.com/dissertations/fullcit/8514134
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A Comparison of the Effects of Short-term Small Groups and Lectures on the Knowledge, Attitudes and Behavior of Pharmacy Students Concerning Alcohol/alcoholism by Benson, Sidney Bruce, Phd from University of Minnesota, 1996, 523 pages http://wwwlib.umi.com/dissertations/fullcit/9632352
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A Comparison of the Impact of an Alcohol Education Program with Al-anon on Knowledge and Attitudes about Alcoholism and Perceptions of the Family Environment (systems Theory, Change, Relationships) by Trama, Jo Ann, Phd from The Ohio State University, 1984, 257 pages http://wwwlib.umi.com/dissertations/fullcit/8426493
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A Critical Assessment of the National Institute on Alcohol Abuse and Alcoholism (niaaa) Funding Policies and Practices of Alcoholism Research by Bovelle, Elliott Irving, Phd from Brandeis U., the F. Heller Grad. Sch. for Adv. Stud. in Soc. Wel., 1980, 370 pages http://wwwlib.umi.com/dissertations/fullcit/8024550
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A Descriptive Study of the Factors Related to the Incidence of Alcoholism among Black Males in Metropolitan Detroit (michigan, Men) by Worley, Curtis Gene, Edd from Wayne State University, 1990, 168 pages http://wwwlib.umi.com/dissertations/fullcit/9118951
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A Diagnostic Assessment of Alcohol Abuse and Dependence and Personality Variables of First Offender Dui Participants by Lank, Brigitte Lee; Phd from California Institute of Integral Studies, 2002, 231 pages http://wwwlib.umi.com/dissertations/fullcit/3068742
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A Follow-up Study on Adolescent Males and Females Who Completed Chemical Dependency Treatment during 1980 (alcoholism, Responsible Use, Maturation; Minnesota) by Keenan, David William, Edd from University of South Dakota, 1984, 121 pages http://wwwlib.umi.com/dissertations/fullcit/8417716
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A Graduate-level Course on the Family Therapy of Alcoholism: a Delphi Study by Eastwood, Matthew Mark, Phd from Purdue University, 1990, 158 pages http://wwwlib.umi.com/dissertations/fullcit/9031315
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A History of the Concept of Alcoholism As a Disease by Wilkerson, Albert Ernest, Jr, Dsw from University of Pennsylvania, 1966, 330 pages http://wwwlib.umi.com/dissertations/fullcit/6700188
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A Mile to Avalon: the Role of Alcoholism in the Life and Work of John Berryman by Jones, Sonya L., Phd from Emory University, 1983, 159 pages http://wwwlib.umi.com/dissertations/fullcit/8316284
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A Minister Equipped for Facilitating Alcoholism Recovery in and Through a Christian Church--a Journey by Scarem, Roy Harold, Jr., Dmin from Fuller Theological Seminary, Doctor of Ministry Program, 1988, 246 pages http://wwwlib.umi.com/dissertations/fullcit/8825363
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A Model of Utilization of Care for Alcoholism Services (help-seeking) by Frost, Abbie Kathryn, Phd from Case Western Reserve University, 1984, 232 pages http://wwwlib.umi.com/dissertations/fullcit/8425576
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A Power-status Theory of Alcoholism and Recovery Tested on an Inner-city Treatment Population (ecological Model, Blacks, Puerto Ricans, Place of Birth, Theoretical Constructs, New York City) by Mark, Frances Okun, Phd from St. John's University (new York), 1986, 429 pages http://wwwlib.umi.com/dissertations/fullcit/8613752
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A Reinforcement-guidance Approach to Alcoholism by Hunt, George Murrell, Jr., Phd from Southern Illinois University at Carbondale, 1972, 49 pages http://wwwlib.umi.com/dissertations/fullcit/7222482
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A Role for Nursing in Teaching and Counseling Wives of Alcoholics: a Comparison of Two Group Approaches (alcoholism) by Fisk, Nancy Bartot, Edd from University of Massachusetts, 1989, 227 pages http://wwwlib.umi.com/dissertations/fullcit/9011724
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A Silent Story: an Analysis of the Effects of Parental Alcoholism on African-american Adults. Do the Effects Parallel or Diverge Those from White Adults? by Mcneal, Cosandra, Phd from The University of Nebraska - Lincoln, 1996, 140 pages http://wwwlib.umi.com/dissertations/fullcit/9712518
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A Sociocultural Study of Alcoholism and Heroin Addiction. by Carney, Francis Joseph, Jr., Phd from Tufts University, 1974, 669 pages http://wwwlib.umi.com/dissertations/fullcit/7521220
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A Study of the Impact of an Employee Assistance Program on the Medical Care Costs of Employees and Their Family Members (alcoholism) by Kenward, Kevin, Phd from Washington University, 1983, 198 pages http://wwwlib.umi.com/dissertations/fullcit/8402204
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A Study of the Occurrence and Characteristics of Burnout among Alcoholismtreatment Professionals by Starr, David Rood, Phd from University of Idaho, 1980, 95 pages http://wwwlib.umi.com/dissertations/fullcit/8100393
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A Survey of the Effects of Stress, Cognitive Flexibility and Trust upon the Effectiveness of Staff Communication in the National Alcoholism Delivery System by Woodlock, Brenda Karpluk, Phd from Case Western Reserve University, 1982, 112 pages http://wwwlib.umi.com/dissertations/fullcit/8224709
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A Systems Approach to Primary Prevention in Alcoholism. by Yancy, Susan Rosenthal, Edd from University of Massachusetts, 1976, 175 pages http://wwwlib.umi.com/dissertations/fullcit/7622312
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302 Alcoholism
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A Verification of the Role of Control in the Progression of and Recovery from Alcoholism by Lindstrom, Wayne W., Phd from Case Western Reserve University, 1986, 160 pages http://wwwlib.umi.com/dissertations/fullcit/8627841
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Addiction Treatment: the Policy of Separate Alcoholism and Drug Abuse Services by Camp, Joy Mary, Phd from Brandeis U., the F. Heller Grad. Sch. for Adv. Stud. in Soc. Wel., 1982, 199 pages http://wwwlib.umi.com/dissertations/fullcit/8222728
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Adolescent Development and Parental Alcohol Use Patterns (alcoholism) by Carroll, Kathleen Marie, Phd from Virginia Polytechnic Institute and State University, 1991, 175 pages http://wwwlib.umi.com/dissertations/fullcit/9214571
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Adult Adhd and Severity of Alcoholism: Their Significance in Treatment for Alcoholism by Hays, Charlotte Ann; Phd from Fielding Graduate Institute, 2002, 243 pages http://wwwlib.umi.com/dissertations/fullcit/3056045
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Adult Children of Alcoholics: Is There Such a Person? (codependency, Alcoholism) by Scriven, Paul Albert, Phd from University of California, Santa Barbara, 1994, 139 pages http://wwwlib.umi.com/dissertations/fullcit/9500297
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Alcohol Abuse and Violent Crime: a Contemporary Examination and Comparison of Adult Male and Female Violent and Nonviolent Criminal Offenders by Haley, Don Randall; Phd from Louisiana State University and Agricultural & Mechanical College, 2000, 203 pages http://wwwlib.umi.com/dissertations/fullcit/9998678
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Alcohol Control Policies and Their Relation to Alcohol Consumption and Alcoholism by Colon, Israel, Phd from Brandeis U., the F. Heller Grad. Sch. for Adv. Stud. in Soc. Wel., 1980, 117 pages http://wwwlib.umi.com/dissertations/fullcit/8012754
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Alcohol Treatment Utilization of Older Alcohol Abusers: a Case Study of Older Veterans in Ohio by Heath-crump, Ossie M. Stroud; Phd from Cornell University, 2001, 190 pages http://wwwlib.umi.com/dissertations/fullcit/9995138
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Alcohol-induced Dissociation in Humans a Possible Treatment Technique for Alcoholism by Madill, Mary-frances; Advdeg from Queen's University at Kingston (canada), 1967 http://wwwlib.umi.com/dissertations/fullcit/NK01468
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Alcoholism and Alienation among Blue Collar Workers: Test of a Causal Theory by Archer, Janet, Phd from The Johns Hopkins University, 1981, 74 pages http://wwwlib.umi.com/dissertations/fullcit/8120007
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Alcoholism and Communication: a Coordinated Management of Meaning Approach to the Study of 'repeaters'. (volumes I and Ii) by Balmert, Michael E., Phd from University of Kansas, 1987, 439 pages http://wwwlib.umi.com/dissertations/fullcit/8813383
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Alcoholism and Depression in Women by Turner, Sandra G., Phd from Rutgers the State University of New Jersey - New Brunswick, 1987, 116 pages http://wwwlib.umi.com/dissertations/fullcit/8803523
Dissertations 303
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Alcoholism and Employee Assistance Programs in the Public Sector: Past, Present, and Future Prospects (voluntary Programs) by Rivera, Miriam Veronica, Dba from State University of New York at Albany, 1984, 209 pages http://wwwlib.umi.com/dissertations/fullcit/8416986
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Alcoholism and Higher Education: a Study of Perceptions That Administrators Have Concerning Effects of the Disease of Alcoholism by Miller, Steven Paul, Edd from University of Pittsburgh, 1994, 143 pages http://wwwlib.umi.com/dissertations/fullcit/9431540
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Alcoholism and Impaired Object Relations in Females (borderline, Child Abuse) by Gleissner, Margaret First, Dsw from The University of Alabama, 1985, 215 pages http://wwwlib.umi.com/dissertations/fullcit/8521371
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Alcoholism and Incarcerated Adolescent Males: Knowledge and Testing (mast, Macandrew, Alcadd Test) by Zeh, Robert Stephen, Phd from The University of Akron, 1985, 298 pages http://wwwlib.umi.com/dissertations/fullcit/8503594
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Alcoholism and Marital Consent by Morris, Patrick S. Phd from University of Ottawa (canada), 1999, 389 pages http://wwwlib.umi.com/dissertations/fullcit/NQ45188
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Alcoholism and Mortality in Poland and Eastern Europe: the Social Consequences of Democratization by Zimny, Mark Joseph; Phd from Yale University, 2000, 192 pages http://wwwlib.umi.com/dissertations/fullcit/9973802
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Alcoholism and Social Structure: a Sociological Study of Illness, Deviance and Social Response. by Dean, Alfred, Phd from The University of North Carolina at Chapel Hill, 1965, 589 pages http://wwwlib.umi.com/dissertations/fullcit/6604701
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Alcoholism and Suicide among Females by Maxson, Charles Elvin, Phd from University of California, Los Angeles, 1981, 339 pages http://wwwlib.umi.com/dissertations/fullcit/8122822
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Alcoholism and the Menstrual Cycle by Charette, Lina; Phd from University of Ottawa (canada), 1989 http://wwwlib.umi.com/dissertations/fullcit/NL56380
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Alcoholism and the Minority Teen: Problems in Diagnosis by Lee, Christina Sunmi; Phd from New York University, 2002, 182 pages http://wwwlib.umi.com/dissertations/fullcit/3045720
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Alcoholism As a Stigmatizing Condition: Professional Responses. by Corley, Mary Coulson, Phd from University of Kentucky, 1974, 165 pages http://wwwlib.umi.com/dissertations/fullcit/7518469
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Alcoholism Counseling, Intervention, and Prevention: Aspects of Pastoral Care for the U.s. Navy Chaplain (united States) by Latty, Allan Robert, Dmin from Fuller Theological Seminary, School of Theology, 1984, 168 pages http://wwwlib.umi.com/dissertations/fullcit/8425173
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Alcoholism in Complex Society: an Alternative Theory. by Pottieger, Anne Elizabeth, Phd from University of Delaware, 1977, 176 pages http://wwwlib.umi.com/dissertations/fullcit/7720555
304 Alcoholism
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Alcoholism Prevention in the Local Community by the Spiritual Means of Agape Love by Shields, Doyle Ellsworth, Dmin from School of Theology at Claremont, 1980, 177 pages http://wwwlib.umi.com/dissertations/fullcit/8018700
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Alcoholism Program Planning and Recruitment: an Impact Evaluation. by Doraz, Walter Eugene, Phd from Washington State University, 1975, 151 pages http://wwwlib.umi.com/dissertations/fullcit/7604352
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Alcoholism Training Impact on First Year Medical Students by Hart, Joanna Leslie, Phd from The Ohio State University, 1979, 234 pages http://wwwlib.umi.com/dissertations/fullcit/8009284
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Alcoholism Treatment and Its Effect on Subsequent Health Care Costs: a Medicaid Study of Cost Differences by Treatment Setting by Kemp, Edmund Paul, Dpa from Western Michigan University, 1987, 123 pages http://wwwlib.umi.com/dissertations/fullcit/8721473
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Alcoholism Treatment As an Interactive Phenomenon: the Impact of Client Characteristics on Treatment Participation by Hanson, Meredith J., Dsw from Columbia University, 1987, 254 pages http://wwwlib.umi.com/dissertations/fullcit/8724030
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Alcoholism Treatment Outcomes (outpatient, Inpatient, Black) by Redd, Marva Lloyd, Phd from Washington University, 1984, 238 pages http://wwwlib.umi.com/dissertations/fullcit/8503132
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Alcoholism, Drunkenness and the Law by Tao, Lung-sheng, Jsd from Cornell University, 1969, 304 pages http://wwwlib.umi.com/dissertations/fullcit/7005811
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Alcoholism, Gender and the Rationality - Irrationality Dimension by Bechard, Thomas Joseph, Dsw from Adelphi University, School of Social Work, 1981, 163 pages http://wwwlib.umi.com/dissertations/fullcit/8106924
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Alcoholism, Native and Non-native Treatment Technologies and the Discourse of Difference by Henley, Kelly Lynn; Ma from University of Windsor (canada), 2002, 95 pages http://wwwlib.umi.com/dissertations/fullcit/MQ67642
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Alcoholism, Psychopathology and Sensation-seeking: Differences between Male Dui First Offenders and Recidivists by Astley, William Stephen, Phd from University of Pittsburgh, 1994, 151 pages http://wwwlib.umi.com/dissertations/fullcit/9426704
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Alcoholism, Selves and Others. by Ward, David Andrew, Phd from University of Florida, 1975, 115 pages http://wwwlib.umi.com/dissertations/fullcit/7612146
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Alcoholism: Group Therapy and Four Psychological Factors of Dominance, Socialization, Responsibility and Self-acceptance by Pignato, Salvatore Anthony, Edd from The George Washington University, 1981, 185 pages http://wwwlib.umi.com/dissertations/fullcit/8129880
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Alcoholism: Puerto Rican Male and Female Social Context of Drinking Patterns and Their Familistic Ambience by De Ortiz, Sheila Archilla, Phd from The Ohio State University, 1981, 301 pages http://wwwlib.umi.com/dissertations/fullcit/8207239
Dissertations 305
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Alcoholism: the Influence of Gender on Its Clinical Course by Romness, Sharon Lee, Phd from Northwestern University, 1986, 47 pages http://wwwlib.umi.com/dissertations/fullcit/8621863
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American Indian Youth Alcohol Abuse and Alcoholism Prevention Project (maryland) by White, Jack Chapman, Phd from The Union for Experimenting Colleges and Universities, 1982, 764 pages http://wwwlib.umi.com/dissertations/fullcit/8309714
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An Analysis of a Systems Approach to the Treatment of Alcoholism: Response to Planned Intervention. by Sackin, Claire G., Phd from University of Pittsburgh, 1976, 258 pages http://wwwlib.umi.com/dissertations/fullcit/7619927
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An Employee Alcoholism Program for Public Education. by Harris, Jimmy Dale, Phd from University of Idaho, 1976, 200 pages http://wwwlib.umi.com/dissertations/fullcit/7619895
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An Ethical Analysis of Alcoholism in Light of Aristotle's Virtue Ethics by Milligan, Maureen Ann, Phd from Marquette University, 1991, 371 pages http://wwwlib.umi.com/dissertations/fullcit/9133802
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An Evaluation Model for Alcoholism Programs. by Bhatia, Pritam Singh, Phd from Case Western Reserve University, 1976, 140 pages http://wwwlib.umi.com/dissertations/fullcit/7711970
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An Examination of Standards and Training for Alcoholism Counselors and Their Relationship to Research Findings Concerning Alcoholism Treatment Effectiveness. by O'donnell, John Brian, Edd from University of Northern Colorado, 1977, 163 pages http://wwwlib.umi.com/dissertations/fullcit/7730854
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An Exploration of the Relationship between Alcoholism and Poverty in Families by Mortvedt, Marjory Marvin, Phd from Iowa State University, 1971, 321 pages http://wwwlib.umi.com/dissertations/fullcit/7212576
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An Exploratory Ecological Evaluation of an Alcoholism Treatment Program: a Methodological and Substantive Investigation. by Palkon, Dennis Stanley, Phd from University of Pittsburgh, 1977, 192 pages http://wwwlib.umi.com/dissertations/fullcit/7801892
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An Exploratory Study of Family Origin Factors, Psychosocial Development, and Prealcoholism by Ellis, Mavonna Marie, Phd from Oklahoma State University, 1988, 106 pages http://wwwlib.umi.com/dissertations/fullcit/8900405
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An Exploratory Study of Perceptions of Drinking and Alcoholism among African American Male Collegians by Miles, Vincent Edward; Phd from Indiana University of Pennsylvania, 2001, 214 pages http://wwwlib.umi.com/dissertations/fullcit/3027907
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An Exploratory Study of the Effects of Alcoholism on Families That Remain Intact by Masterson, Patricia Jane, Phd from Kent State University, 1979, 258 pages http://wwwlib.umi.com/dissertations/fullcit/8011465
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An Investigation of the Relationship between the Vocational Needs, Occupational Reinforcers, and Job Satisfaction of Alcoholism Counselors by Hunt, Steven, Phd from University of Southern California, 1989 http://wwwlib.umi.com/dissertations/fullcit/f3139796
306 Alcoholism
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An Investigation of the Relationship of Parental Alcoholism and Family Dysfunction to Stress and Problem Drinking among College Students by Fischer, Kathy Emma, Phd from Southern Illinois University at Carbondale, 1996, 199 pages http://wwwlib.umi.com/dissertations/fullcit/9738044
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Analysis of Specific Alcohol Risk Characteristics of Participants in the United States Air Force Supervisor Alcohol Abuse Education Program by Shoemaker, Gary L., Edd from The George Washington University, 1983, 203 pages http://wwwlib.umi.com/dissertations/fullcit/8324490
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Analysis of State Markers for Alcohol Consumption and Trait Markers for Alcohol Dependence and Depression by Martinez, Larry Dean; Phd from University of Colorado Health Sciences Center, 2002, 186 pages http://wwwlib.umi.com/dissertations/fullcit/3056500
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Anomy and Alcoholism: a Causal And/or Concomitant Relationship by Phillips, Lorne Archer, Phd from Washington State University, 1973, 92 pages http://wwwlib.umi.com/dissertations/fullcit/7329298
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Antecedent Familial Factors and Extent of Adult Alcoholism (childhood Experiences) by Namie, Ruth Florence, Phd from California School of Professional Psychology Berkeley/alameda, 1993, 150 pages http://wwwlib.umi.com/dissertations/fullcit/9303623
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Attitudes of Clinical Social Workers toward Alcoholism (alcoholism Attitudes, Social Workers) by Al-damigh, Sami Abdulaziz, Phd from University of Illinois at Urbanachampaign, 1992, 213 pages http://wwwlib.umi.com/dissertations/fullcit/9236385
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Barriers to Alcoholism and Other Drug Abuse Treatment for Women: Comparing Alaska Native and Non-native Women by Mann, Cheryl; Phd from Case Western Reserve University, 1999, 186 pages http://wwwlib.umi.com/dissertations/fullcit/9948411
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Belongingness - the Critical Variable in the Residential Treatment of Alcoholism by Machell, David Francis, Edd from Fordham University, 1984, 140 pages http://wwwlib.umi.com/dissertations/fullcit/8409262
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Career Choice and Dysfunctional Childhood Background of College Students Entering Nursing and Computer Science Programs (nursing Students, Computer Science Students, Alcoholism) by Frey, Joanne Howland Regan, Phd from Boston College, 1992, 147 pages http://wwwlib.umi.com/dissertations/fullcit/9329305
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Career Indecision among Adult Children of Alcoholics: the Effectiveness of a Decision-making Skill Training Intervention (adult Children of Alcoholics, Alcoholism) by Lyda, Cheryl R., Edd from Idaho State University, 1991, 101 pages http://wwwlib.umi.com/dissertations/fullcit/9129321
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Case Studies in Policy-making: the Establishment of State Alcoholism Programs in New England by Davis, Howard Eckert, Phd from Yale University, 1962, 324 pages http://wwwlib.umi.com/dissertations/fullcit/7123145
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Central Serotonin Dysfunction in Alcohol Dependence: an Experimental Approach Using Acute Tryptophan Depletion by Chu, Alan Yao-chi; Msc from University of Toronto (canada), 2002, 122 pages http://wwwlib.umi.com/dissertations/fullcit/MQ74128
Dissertations 307
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Children of Alcoholics: a Comparative and Intervention Study (alcoholism) by Morey, Connie Kay, Phd from The University of Wisconsin - Madison, 1992, 234 pages http://wwwlib.umi.com/dissertations/fullcit/9221924
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Children of Alcoholics: High-risk Students in the Classroom (alcoholism) by Mellander, Donna Hass, Edd from Seattle University, 1989, 355 pages http://wwwlib.umi.com/dissertations/fullcit/8923211
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Chinese Drinking Behaviors in Los Angeles (california, Asian-american, Crossculture, Multivariate Analysis, Scales/index, Alcoholism) by Chi, Iris, Dsw from University of California, Los Angeles, 1985, 197 pages http://wwwlib.umi.com/dissertations/fullcit/8603939
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Clinical Social Workers' Beliefs about and Practice with Problem Drinkers (alcoholism, Substance Abuse) by Schmidt, Carolyn Lee, Phd from The Ohio State University, 1984, 178 pages http://wwwlib.umi.com/dissertations/fullcit/8426472
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Codependency As a Function of Identity Development (alcoholism) by Harrington, Judith Ann, Phd from The University of Alabama, 1994, 115 pages http://wwwlib.umi.com/dissertations/fullcit/9429229
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College Student Expectations about Counseling by a Peer or Professional Counselor for Two Types of Problems (counseling Expectations, Peer Counselor, Depression, Alcoholism) by Weathington, Faith Myer, Edd from Auburn University, 1991, 83 pages http://wwwlib.umi.com/dissertations/fullcit/9217914
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Control Orientation: a Personality Dimension among Alcoholics and Its Implications for Alcoholism Treatment by Hawkins, Michael Keith, Phd from Marquette University, 1972, 128 pages http://wwwlib.umi.com/dissertations/fullcit/7327505
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Cooperation between Alcoholics Anonymous Members and Alcoholism Treatment Centers in Georgia by Kurtz, Linda Farris, Dpa from University of Georgia, 1983, 249 pages http://wwwlib.umi.com/dissertations/fullcit/8314732
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Couples in Recovery from Alcoholism: Long-term and Developmental Processes by Navarra, Robert J. Psyd from California Institute of Integral Studies, 2002, 143 pages http://wwwlib.umi.com/dissertations/fullcit/3042888
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Critical Training Requirements for Alcoholism Counselors Working with First Generation Puerto Rican Males in New York City by Aguirre-molina, Marilyn Norat, Edd from Columbia University Teachers College, 1980, 267 pages http://wwwlib.umi.com/dissertations/fullcit/8022093
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Cultural and Rhetorical Perspectives of Alcoholism (cultural Perspectives) by Michalski, Louis Richard, Phd from The University of Texas at Arlington, 1991, 270 pages http://wwwlib.umi.com/dissertations/fullcit/9131754
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Cultural Stress and Alcoholism: a Study of Their Relationship among Navaho Alcoholic Men by Savard, Robert Joseph, Phd from University of Minnesota, 1968, 222 pages http://wwwlib.umi.com/dissertations/fullcit/6901532
308 Alcoholism
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Derivation of an Scl-90 Alcoholism Scale. by Nathan, Howard Wayne, Phd from University of Maryland College Park, 1976, 79 pages http://wwwlib.umi.com/dissertations/fullcit/7724156
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Descriptive Variables Related to the Continued Sobriety of Former Alcohol Abusers by Cooper, Calvin Crump, Edd from Peabody College for Teachers of Vanderbilt University, 1981, 82 pages http://wwwlib.umi.com/dissertations/fullcit/8208443
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Determinants of Advertising Regulation Attitudes: the Alcoholism Field and Alcohol Advertising by Witkowski, Terrence Henry, Phd from University of California, Berkeley, 1980, 293 pages http://wwwlib.umi.com/dissertations/fullcit/8029632
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Determinants of Residential and Nonresidential Alcoholism Treatment Success: an Investigation of Multivariate Causation of Treatment Outcome by Laney, David Lee, Phd from University of Minnesota, 1988, 119 pages http://wwwlib.umi.com/dissertations/fullcit/8905836
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Differences between Black, Mexican-american, and White Probationers on the Revised Macandrew Alcoholism Scale of the Mmpi-2 (alcoholism) by Rowell, Robert Kevin, Phd from Texas A&m University, 1992, 209 pages http://wwwlib.umi.com/dissertations/fullcit/9315132
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Differences in Leadership Styles between Administrators Who Grew Up in Alcoholic Households and Administrators Who Grew Up in Non-alcoholic Households (alcoholism, Adult Children of Alcoholics) by Lariviere, Sara Denise, Edd from University of La Verne, 1991, 121 pages http://wwwlib.umi.com/dissertations/fullcit/9219069
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Differential Impact of Parental Alcoholism on Children's Apperceptions by Lord, Daniel Bryer, Phd from The University of Michigan, 1982, 154 pages http://wwwlib.umi.com/dissertations/fullcit/8304536
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Domestic Violence and Alcoholism: a Study of Service Providers' Attitudes and Beliefs by Lester, Lois Butterworth, Dsw from City University of New York, 1989, 220 pages http://wwwlib.umi.com/dissertations/fullcit/9000042
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Drinking and Sobriety in Japan (alcoholism) by Smith, Stephen Richard, Phd from Columbia University, 1988, 304 pages http://wwwlib.umi.com/dissertations/fullcit/8815701
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Drinking Patterns among Seasonal Agricultural Workers, 1982 (alcoholism, Blacks, Rural, Drug Abuse, Family Structures, Migrants) by Morales, Richard, Phd from Syracuse University, 1985, 218 pages http://wwwlib.umi.com/dissertations/fullcit/8524430
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Drinking Practices, Problem Drinking, and Alcoholism among Urban Puerto Rican Men by Garrido, Pedro Jose, Phd from Boston College, 1984, 245 pages http://wwwlib.umi.com/dissertations/fullcit/8512599
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Drug Addiction and Alcoholism As Qualifying Impairments for Social Security Disability Benefits: the History, Controversies, and Congressional Response by Hunt, Sharon Rose; Phd from Brandeis U., the F. Heller Grad. Sch. for Adv. Stud. in Soc. Wel., 2000, 384 pages http://wwwlib.umi.com/dissertations/fullcit/3001242
Dissertations 309
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Early Childhood Curriculum Development and Its Relationship to Addressing Alcoholism and Chemical Dependency: a Case Study of Head Start Teachers Engaged in a Change Process by Klein, Nancy Joan, Edd from Columbia University Teachers College, 1996, 264 pages http://wwwlib.umi.com/dissertations/fullcit/9713882
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Effects of Alcoholism on Leisure: a Family Perspective by Harrison, Oce, Edd from Boston University, 1994, 247 pages http://wwwlib.umi.com/dissertations/fullcit/9422453
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Effects of an Educationally Oriented Alcoholism Treatment Program in a Rural Area (evaluation, Rehabilitation, Residential) by Randolph-prince, Alice Jean, Phd from Southern Illinois University at Carbondale, 1984, 122 pages http://wwwlib.umi.com/dissertations/fullcit/8425142
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Effects of Familial Alcoholism on Treatment Outcomes in Alcohol-dependent Patients by Allen, Shirley Summer, Phd from University of Missouri - Columbia, 1991, 135 pages http://wwwlib.umi.com/dissertations/fullcit/9209918
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Effects of Parental Alcoholism on Interpersonal Coping in College-aged Children (adult Children of Alcoholics, Alcoholism) by Smith, Judith Lynn, Phd from Ohio University, 1993, 149 pages http://wwwlib.umi.com/dissertations/fullcit/9335079
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Effects of Parental Alcoholism, Family Violence and Social Support on the Intergenerational Transmission of Alcoholism in Adult Women by Finkelstein, Norma B., Phd from Brandeis U., the F. Heller Grad. Sch. for Adv. Stud. in Soc. Wel., 1987, 307 pages http://wwwlib.umi.com/dissertations/fullcit/8722493
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Effects of the Alcoholism Awareness Workshop on Air Force Nurses' Attitudes toward and Knowledge of Alcoholism (nurses) by Jones, Jason Augustine, Edd from The American University, 1991, 234 pages http://wwwlib.umi.com/dissertations/fullcit/9207144
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Evaluation Problems in Alcohol Abuse Policies in New York State School Districts by Chen, Chuan-cheng, Edd from State University of New York at Albany, 1987, 275 pages http://wwwlib.umi.com/dissertations/fullcit/8805391
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Experiential Learning about Alcoholism: Non-alcoholic Teenagers and Faculty's Experiences in a Live-in Alcoholism Treatment Center by Saks-bobik, Gila A., Phd from The University of Michigan, 1980, 205 pages http://wwwlib.umi.com/dissertations/fullcit/8106219
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Exploration of Individually Perceived Sanctions against Alcoholic Drinking and the Onset of Alcoholism by Lane, Mildred J., Phd from Ohio University, 1990, 136 pages http://wwwlib.umi.com/dissertations/fullcit/9024121
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Exploring Spirituality As a Factor in Transcending Parental Alcoholism for Adult Children of Alcoholics in a 12-step Recovery Program by Atkinson, Dixie; Phd from Southern Illinois University at Carbondale, 2000, 257 pages http://wwwlib.umi.com/dissertations/fullcit/9982034
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Factor Analyses of the Alcadd Test and the Manson Evaluation for Dui Drivers (drunk, Alcoholism, Drinking) by Smetters, Harriet L., Phd from The Ohio State University, 1986, 355 pages http://wwwlib.umi.com/dissertations/fullcit/8625294
310 Alcoholism
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Factors Related to Suicide Proneness among Adolescents (parental Alcoholism, Alcoholism) by Nelson, Sharon Lea, Phd from University of Maryland College Park, 1991, 214 pages http://wwwlib.umi.com/dissertations/fullcit/9222742
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Factors Relating to the Etiology of Alcoholism in Men and Women by Weinstein, Bette Ann, Dsw from The Catholic University of America, 1995, 103 pages http://wwwlib.umi.com/dissertations/fullcit/9531320
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Familial and Nonfamilial Alcoholism among Inpatient Alcoholic Males: a Multivariate Analysis Using the Mmpi (manova) by Talcott, Gerald Wayne, Phd from University of Missouri - Columbia, 1984, 141 pages http://wwwlib.umi.com/dissertations/fullcit/8425657
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Family Interactional Patterns during a Family-based Intensive Outpatient Treatment Program for Chemical Dependency (alcoholism) by Gafford, Sally H., Phd from Saint Louis University, 1994, 203 pages http://wwwlib.umi.com/dissertations/fullcit/9531397
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Family Process As a Mediator of the Effects of Parental Divorce and Alcoholism on Young Adult Dating Relationships by Reedy, Brad Michael; Phd from Brigham Young University, 2002, 67 pages http://wwwlib.umi.com/dissertations/fullcit/3041270
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Family Rituals, Perceived Parental Rejection and the Intergenerational Transmission of Alcoholism by Brass-dayle, Jutta, Phd from The University of New Mexico, 1987, 155 pages http://wwwlib.umi.com/dissertations/fullcit/8809276
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Family Stress and Illness Behavior: the Effects of Alcoholism, Other Major Illness, and Role Stress on Family Members' Utilization of Hmo Services (health Maintenance Organization) by Putnam, Sandra Lee, Phd from Brown University, 1987, 361 pages http://wwwlib.umi.com/dissertations/fullcit/8715548
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Freedom and Alcoholism by Renouf, Robert Wilson, Dmin from School of Theology at Claremont, 1981, 75 pages http://wwwlib.umi.com/dissertations/fullcit/8121644
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Gendered and Racialized Constructions of Alcoholism in the Postwar Era by Reyes Bell, Stephanie Lynn; Phd from University of California, Irvine, 2001, 179 pages http://wwwlib.umi.com/dissertations/fullcit/9993243
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Helping the Alcoholic: Education, Stigma and Social Control in Alcoholism Treatment by Neeley, Beverly Evon, Phd from University of California, San Diego, 1983, 205 pages http://wwwlib.umi.com/dissertations/fullcit/8319133
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Historical Development of Alcoholism Control Programs in Industry from 1940-1978. by Surles, Carol Diann Smith, Phd from The University of Michigan, 1978, 119 pages http://wwwlib.umi.com/dissertations/fullcit/7907179
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How Are Alcoholic Veterans Treated?: Differential Use of Modalities in Alcoholism Treatment Units of the Veterans Administration by Camacho-salinas, Rosie Lee, Phd from Brandeis U., the F. Heller Grad. Sch. for Adv. Stud. in Soc. Wel., 1984, 121 pages http://wwwlib.umi.com/dissertations/fullcit/8410462
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Ideology in Alcoholism Treatment: a Case Study by Tremper, Melvin Henry, Phd from Rutgers the State University of New Jersey - New Brunswick, 1981, 251 pages http://wwwlib.umi.com/dissertations/fullcit/8122136
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'i'll Never Touch Another Drop': Images of Alcoholism and Temperance in American Popular Culture, 1874 - 1919. by Silverman, Joan L., Phd from New York University, 1979, 366 pages http://wwwlib.umi.com/dissertations/fullcit/7925526
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Illegitimate Illness and the Sick Role: Social Workers and Alcoholism by Chalfant, Hugh Paul, Phd from University of Notre Dame, 1970, 321 pages http://wwwlib.umi.com/dissertations/fullcit/7015471
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Illinois Department of Alcoholism and Substance Abuse Counselor Training Programs: an Impact Study (alcoholism, Substance Abuse) by Lott, Sandra Brodersenschneider Hinrichs, Phd from Illinois State University, 1989, 235 pages http://wwwlib.umi.com/dissertations/fullcit/9014751
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Indigenization Process of Alcoholism Treatment from the American to the Indian Context by Venkataraman, Jayashree, Phd from University of Illinois at Urbanachampaign, 1996, 270 pages http://wwwlib.umi.com/dissertations/fullcit/9702701
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Integration Versus Separation of Alcoholism and Drug Abuse Programming. by Lambert, Mckinney Dow, Iii, Phd from Washington University, 1976, 219 pages http://wwwlib.umi.com/dissertations/fullcit/7704042
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Intergenerational Transmission of Alcoholism: Environmental and Identity Variables by Leavell, Hugh Rodman, Phd from The Florida State University, 1988, 168 pages http://wwwlib.umi.com/dissertations/fullcit/8814422
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Issues of Countertransference for Recovering Alcoholism Counselors by Moore, Alice Carole, Edd from Fairleigh Dickinson University, 1987, 134 pages http://wwwlib.umi.com/dissertations/fullcit/8811706
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Late Onset Alcoholism in a Midwestern Setting: a Matter of Complexity (alcoholism) by Adams, Scot Leo, Phd from The University of Nebraska - Lincoln, 1990, 94 pages http://wwwlib.umi.com/dissertations/fullcit/9108205
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Law/alcoholism in Black S. Africa (alcoholism, South Africa) by Sithole, Rejoice Dorothy Thokozile, Phd from Washington University, 1990, 374 pages http://wwwlib.umi.com/dissertations/fullcit/9103171
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Legal Aspects of Dealing with Alcoholism/alcohol Abuse of Professional Employees in the Public School Setting by Warburton, Kathleen Carol, Phd from Kent State University, 1987, 220 pages http://wwwlib.umi.com/dissertations/fullcit/8919798
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Levels of Intellectual Skills among Comorbidity Subtypes in a Chronic Alcoholism Population by Michaleas, Gerry Nickolas, Phd from Boston College, 1993, 121 pages http://wwwlib.umi.com/dissertations/fullcit/9329310
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Loss of Control in Alcoholism an Operant Analysis of Drinking Behavior in Alcoholics and Moderate Drinkers by Thio, Khai Tie; Advdeg from Queen's University at Kingston (canada), 1970 http://wwwlib.umi.com/dissertations/fullcit/NK05339
312 Alcoholism
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Making the Loop: the Institutional Cycle of Alcoholism Rehabilitation by Wiseman, Jacqueline Pindell, Phd from University of California, Berkeley, 1968, 579 pages http://wwwlib.umi.com/dissertations/fullcit/6915026
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Male Client Self-reports of Domestic Violence Reduction Following Employee Assistance Program Intervention for Alcohol Abuse by Maiden, R. Paul, Phd from University of Maryland at Baltimore, 1994, 145 pages http://wwwlib.umi.com/dissertations/fullcit/9819190
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Masculinity Ideology, Couple Relationships, and Recovery from Alcoholism by Kazansky, Miriam; Phd from Alliant International University, San Francisco Bay, 2002, 59 pages http://wwwlib.umi.com/dissertations/fullcit/3052989
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Maternal Alcoholism and Family Life: a Cultural Model for Research and Intervention by Ames, Genevieve Marie Westhues, Phd from Univ. of Calif., San Francisco with the Univ. of Calif., Berkeley, 1982, 275 pages http://wwwlib.umi.com/dissertations/fullcit/8400016
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Native American Alcoholism: an Issue of Survival by Colorado, Pamela, Phd from Brandeis U., the F. Heller Grad. Sch. for Adv. Stud. in Soc. Wel., 1986, 231 pages http://wwwlib.umi.com/dissertations/fullcit/8722511
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Neuropsychological Differences between Patients Diagnosed with Schizophrenia and Comorbid Schizophrenia and Alcohol Dependence by Nazzaro, Dolores Marie; Phd from University of Pittsburgh, 2002, 168 pages http://wwwlib.umi.com/dissertations/fullcit/3054318
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Organizational Acceptance of Individual Differences As Perceived by Persons Affiliated with Two Twelve-step Recovery Programs (alcoholism) by Helmle, Karen Eleanor, Phd from The University of Wisconsin - Madison, 1984, 166 pages http://wwwlib.umi.com/dissertations/fullcit/8414239
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Parental Alcoholism and Career Decision Attitudes: an Evaluation of Two Models (alcoholism) by Serling, Deborah Anne, Phd from The Ohio State University, 1992, 320 pages http://wwwlib.umi.com/dissertations/fullcit/9238270
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Parental Alcoholism and Children's Social Skills by Norton, Marsha Dean; Phd from Louisiana State University and Agricultural & Mechanical College, 1999, 187 pages http://wwwlib.umi.com/dissertations/fullcit/9960087
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Parental Alcoholism and Coping: a Comparison of Female Children of Alcoholics with Female Children of Non-alcoholics (girls, Alcoholism, Children of Alcoholics) by Kelly, Virginia Ann, Phd from The University of North Carolina at Greensboro, 1993, 167 pages http://wwwlib.umi.com/dissertations/fullcit/9402484
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Parental Attitudes toward Drinking and the Prevalence and Character of Filial Alcoholism by Gibbins, R. J; Phd from University of Toronto (canada), 1962 http://wwwlib.umi.com/dissertations/fullcit/NK00004
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Pastoral Gatekeeper Participation in Community Alcohol Abuse Prevention by Merrigan, Daniel Michael, Edd from Boston University School of Education, 1983, 306 pages http://wwwlib.umi.com/dissertations/fullcit/8319921
Dissertations 313
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Patients' Social Class and Physicians' Diagnosis of Alcoholism (referral, Attitudes, Treatment) by White, Joyce Zasorin-connors, Phd from Case Western Reserve University, 1986, 249 pages http://wwwlib.umi.com/dissertations/fullcit/8611471
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People with Physical Disabilities in the Process of Recovery from Alcoholism: Barriers They Encountered and Coping Methods They Used (alcoholism) by Valentine, Laurette Margaret, Phd from University of California, Santa Barbara, 1990, 153 pages http://wwwlib.umi.com/dissertations/fullcit/9135781
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Perceptions of the Twelve Step Program As Curriculum (alcoholism) by Burke, Robert Wayne, Phd from Indiana University, 1993, 477 pages http://wwwlib.umi.com/dissertations/fullcit/9404340
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Performance-related Outcome Measures and Participation in a Job-based Alcoholism Counseling Program by Howard, William C., Phd from Brandeis U., the F. Heller Grad. Sch. for Adv. Stud. in Soc. Wel., 1989, 189 pages http://wwwlib.umi.com/dissertations/fullcit/8923564
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Personality and Organizational Correlates of Conflict Resolution Modes Used by Boundary Personnel in a Planning Consortium of Alcoholism Agencies. by Bell, Eugene Court, Phd from University of Houston, 1974, 182 pages http://wwwlib.umi.com/dissertations/fullcit/7508244
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Planning in a Developing Health Sector: State Level Planning for Alcoholism Services by Staff, Clarice Ann, Dsw from Columbia University, 1989, 253 pages http://wwwlib.umi.com/dissertations/fullcit/9005940
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Power Motivation and Inhibition in Hospitalized Alcoholics: an Examination of the Power Motivation Theory of Alcoholism by Key, John Chase, Phd from Brandeis University, 1972, 190 pages http://wwwlib.umi.com/dissertations/fullcit/7220808
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Practitioners' Attitudes toward Current Conceptions of Alcoholism: Policy Implications for Treatment and Control by Bermas, Neal F., Phd from Brandeis U., the F. Heller Grad. Sch. for Adv. Stud. in Soc. Wel., 1980, 128 pages http://wwwlib.umi.com/dissertations/fullcit/8112860
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Precarious Politics: Alcoholism and Public Policy. by Beauchamp, Dan Edward, Phd from The Johns Hopkins University, 1973, 398 pages http://wwwlib.umi.com/dissertations/fullcit/7316632
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Predicting Alcoholism in Selected College-age Women by Fernandez, Katheryn Riddle, Phd from The Ohio State University, 1995, 136 pages http://wwwlib.umi.com/dissertations/fullcit/9544562
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Prediction As a Tool in Alcoholism Treatment. by Dagadakis, Zaharenia Stamatios, Phd from Washington State University, 1979, 120 pages http://wwwlib.umi.com/dissertations/fullcit/7923475
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Presence of Paradoxical Patterns of Response in Alcoholism Counseling. by Feeney, Don Joseph, Jr, Phd from Loyola University of Chicago, 1979, 150 pages http://wwwlib.umi.com/dissertations/fullcit/7921785
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Prevention of Alcoholism with Implications for Elementary and Secondary School Education. by Owen, Roger D., Phd from University of Oregon, 1976, 229 pages http://wwwlib.umi.com/dissertations/fullcit/7704749
314 Alcoholism
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Primary Care Practitioners' Response to Drinking Problems among Their Patients (alcoholism, Physicians, Involvement) by Rohman, Mary E., Phd from Brandeis U., the F. Heller Grad. Sch. for Adv. Stud. in Soc. Wel., 1984, 155 pages http://wwwlib.umi.com/dissertations/fullcit/8422732
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Primary Prevention of Alcoholism: Interorganizational Coordination Approach by Earle, Richard Miller, Phd from Washington University, 1980, 374 pages http://wwwlib.umi.com/dissertations/fullcit/8103676
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Probation and Parole Officers' Perceptions of Alcoholism and Alcoholics by Berger, Elizabeth Ann Barnhill, Phd from Oklahoma State University, 1980, 379 pages http://wwwlib.umi.com/dissertations/fullcit/8113295
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Psychocultural Dimensions of Alcoholism, Witchcraft, Ethnic Relations, and Asceticism: a Comparative Study by Maghbouleh, Mitra D., Phd from University of California, Irvine, 1979, 347 pages http://wwwlib.umi.com/dissertations/fullcit/8005324
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Reader-responses of Pregnant Adolescents and Teenage Mothers to Young Adult Novels Portraying Protagonists with Problems Similar and Dissimilar to the Readers' (literary Transactions, Reader-text Relationship, Alcoholism) by Poe, Elizabeth Ann, Phd from University of Colorado at Boulder, 1986, 235 pages http://wwwlib.umi.com/dissertations/fullcit/8618987
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Reducing the Pain, Healing the Wound or Breaking the Cycle: Organizational Approaches to Alcoholism Prevention (prevention Theory) by Bush, Irene Rubenstein, Dsw from City University of New York, 1993, 210 pages http://wwwlib.umi.com/dissertations/fullcit/9315449
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Relapse in Alcoholism Treatment: Supportive Families and Posttreatment Therapy by Frigo, Daniel Callistus, Phd from Washington University, 1982, 119 pages http://wwwlib.umi.com/dissertations/fullcit/8310928
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Relationships between Children of Alcoholics' Attributions for Parental Drinking and School Outcomes (alcoholism) by Golan, Shari, Phd from University of California, Los Angeles, 1992, 88 pages http://wwwlib.umi.com/dissertations/fullcit/9221868
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Reported Antecedents and Correlates of Alcoholism among Treated Married Alcoholics by Pérodeau, Guillème Marcelle; Phd from York University (canada), 1985 http://wwwlib.umi.com/dissertations/fullcit/NK66184
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Respectability and Internal Processing Stereotypes: a Test of Interactionist Propositions in an Alcoholism Treatment Agency by Hahn, Jeffery Lynn, Phd from Kent State University, 1980, 334 pages http://wwwlib.umi.com/dissertations/fullcit/8100686
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Returning to Traditional Beliefs and Practices: a Solution for Indian Alcoholism by Lawrence, Elden Eugene; Phd from South Dakota State University, 1999, 101 pages http://wwwlib.umi.com/dissertations/fullcit/9954053
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Risk for Early Smoking Onset in a High-risk Population: Contributions of Early Child Behavioral Risk and Heterogeneity of Parental Smoking and Alcoholism by Mun, Eun Young; Phd from Michigan State University, 2002, 251 pages http://wwwlib.umi.com/dissertations/fullcit/3053782
Dissertations 315
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Screening for Problematic Drinking in Women: Validity of the Michigan Alcoholism Screening Test (mast) by Scifres, Stephanie Lynn; Phd from Pacific Graduate School of Psychology, 2002, 98 pages http://wwwlib.umi.com/dissertations/fullcit/3062669
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Selected Counselor Variables and Their Relationship to Counseling Process in Alcoholism Treatment. by Lawson, Gary Wayne, Phd from Southern Illinois University at Carbondale, 1975, 100 pages http://wwwlib.umi.com/dissertations/fullcit/7613259
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Selected Psychological Needs and Vocational Interests of Recovering Chemically Dependent Roman Catholic Women Religious in Relation to Their Ongoing Recovery Process (alcoholism, Sisters, Nuns) by Bellville, David C., Phd from Boston University, 1985, 277 pages http://wwwlib.umi.com/dissertations/fullcit/8422369
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Self-efficacy and Empowerment: a Study of Women in Recovery from Alcoholism by Hohman, Melinda M., Phd from Arizona State University, 1995, 166 pages http://wwwlib.umi.com/dissertations/fullcit/9539564
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Sex-role Identity and Alcohol Abuse in Women by Lindeman, Roberta Fae S., Edd from University of Nevada, Reno, 1992, 84 pages http://wwwlib.umi.com/dissertations/fullcit/9233455
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Sexual Dysfunction As a Symptom of Alcoholism by Buck, Nancy Shores, Phd from Bryn Mawr College, the Grad. Sch. of Social Work and Social Research, 1992, 179 pages http://wwwlib.umi.com/dissertations/fullcit/9227900
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Sexual Dysfunctioning of Males Undergoing Treatment for Alcoholism by Holosko, Michael John, Phd from University of Pittsburgh, 1979, 185 pages http://wwwlib.umi.com/dissertations/fullcit/8007931
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Short-term Economic Change and Deviance (mental Illness, Drug Abuse, Alcoholism) by Zent, Michael Robert, Phd from The University of Texas at Austin, 1985, 260 pages http://wwwlib.umi.com/dissertations/fullcit/8527676
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Sibling Personality Characteristics Associated with the Presence and Absence of Alcoholism by Pilato, Ronald W. Psyd from The Wright Institute, 2002, 150 pages http://wwwlib.umi.com/dissertations/fullcit/3034538
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Social Dimensions of Alcoholism: a Correlational and Typological Analysis by Whitehead, Paul Charles, Phd from University of Massachusetts, 1969, 136 pages http://wwwlib.umi.com/dissertations/fullcit/6919158
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Social Forces Affecting Curriculum Development for Employee Assistance Programs. (volumes I and Ii) (alcoholism) by Doss, George James, Phd from Cornell University, 1993, 651 pages http://wwwlib.umi.com/dissertations/fullcit/9318800
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Social Role Enactment and the Onset, Maintenance and Cessation of Alcohol Dependence in Women by Lundy, Colleen, Phd from The Florida State University, 1985, 217 pages http://wwwlib.umi.com/dissertations/fullcit/8528706
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Social Support and Coping with Spousal Alcoholism and Alzheimer's Disease by Reibstein, Ruth Joy, Edd from Boston University, 1989, 177 pages http://wwwlib.umi.com/dissertations/fullcit/8918515
316 Alcoholism
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Socialization, Inconsistencies, and Alcoholism: a Study of Attitudes by Ingersoll, Richard Lucien, Phd from The University of Iowa, 1965, 114 pages http://wwwlib.umi.com/dissertations/fullcit/6506695
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Solution-focused Brief Therapy in Alcoholism Treatment: the Impact of Clinicians' Views of Alcoholism (chemical Dependency, Addictions) by Osborn, Cynthia Jane, Phd from Ohio University, 1996, 233 pages http://wwwlib.umi.com/dissertations/fullcit/9628288
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Sources of Stress, Severity of Alcoholism, and Reported Effects of Treatment. by Ogbru, Benjamin A., Phd from University of Pittsburgh, 1975, 163 pages http://wwwlib.umi.com/dissertations/fullcit/7607348
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Stressors Encountered by Older Adults during Recovery from Alcoholism by Stephan, Jane F., Ded from Ball State University, 1991, 142 pages http://wwwlib.umi.com/dissertations/fullcit/9133281
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Subtype of Alcoholism and Hyperactivity by Beebe, Russell Scott, Phd from The University of Memphis, 1995, 44 pages http://wwwlib.umi.com/dissertations/fullcit/9535136
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Subtypes of Alcohol Involvement and Their Relationships to Exits from Homelessness (alcoholism) by Gregoire, Thomas Kenneth, Phd from University of Kansas, 1994, 225 pages http://wwwlib.umi.com/dissertations/fullcit/9528363
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Taming the Green Serpent: Alcoholism, Autocracy, and Russian Society, 1881-1914 by Mckee, William Arthur, Phd from University of California, Berkeley, 1997, 568 pages http://wwwlib.umi.com/dissertations/fullcit/9827035
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Technology and Client Selection in a System of Alcoholism Facilities by Gibson, Stephen Frank, Phd from Brandeis U., the F. Heller Grad. Sch. for Adv. Stud. in Soc. Wel., 1983, 228 pages http://wwwlib.umi.com/dissertations/fullcit/8327160
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Temptation to Use Alcohol among University Students with a High Risk for Alcohol Abuse by Iuraduri, Cristina D. Ma from Southern Connecticut State University, 2002, 40 pages http://wwwlib.umi.com/dissertations/fullcit/1412199
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Testing a Model of Internalized Anomie (alcoholism, Egonomie) by Glass, John Edward, Phd from University of North Texas, 1995, 110 pages http://wwwlib.umi.com/dissertations/fullcit/9612606
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The Alcoholism Movement in America: a Study in Cultural Innovation. by Johnson, Bruce Holley, Phd from University of Illinois at Urbana-champaign, 1973, 494 pages http://wwwlib.umi.com/dissertations/fullcit/7405603
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The Alcoholism of the Text (ernest Hemingway, Eugene O'neill, Anne Sexton, Jack Spicer) by Johnstone, Rosemarie, Phd from University of Minnesota, 1995, 150 pages http://wwwlib.umi.com/dissertations/fullcit/9604961
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The American Discovery of Alcoholism, 1933-1939 (deviance) by Roizen, Ronald Peter Boris William, Phd from University of California, Berkeley, 1991, 344 pages http://wwwlib.umi.com/dissertations/fullcit/9203698
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The Association between Sex Roles and Recovery from Alcoholism in Women by Ducote, D'ann, Phd from Texas Tech University, 1983, 112 pages http://wwwlib.umi.com/dissertations/fullcit/8316838
Dissertations 317
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The Attitudes of Registered Nurses toward Alcoholism and the Alcoholic by Steele, Jeanne Mckeag, Phd from The Ohio State University, 1979, 267 pages http://wwwlib.umi.com/dissertations/fullcit/8001837
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The Biographical Inventory As a Predictive Instrument in the Selection of Indians for Training As Paraprofessional Alcoholism Counselors. by Crompton, Don Walter, Dsw from The University of Utah, 1976, 162 pages http://wwwlib.umi.com/dissertations/fullcit/7619953
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The Bottle in the Sideboard: Alcoholism As a Defining Force in 'the Sound and the Fury' (faulkner William) by Bauman, Marcy Lassota, Phd from Michigan State University, 1991, 227 pages http://wwwlib.umi.com/dissertations/fullcit/9129436
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The Capacity for Intimacy in Wives of Alcoholics (alcoholism, Codependency) by Troise, Frank Paul, Dsw from Adelphi University, School of Social Work, 1991, 119 pages http://wwwlib.umi.com/dissertations/fullcit/9207651
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The Character and Process of Recovery from Alcoholism and the Influence of Psychological Variables from Gestalt Therapy Homeostasis Theory by Roche, Kenneth E., Phd from Kent State University, 1986, 181 pages http://wwwlib.umi.com/dissertations/fullcit/8705815
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The Comparative Quality of Helping Relationship Offered by Recovering Alcoholic Paraprofessional Counselors, Nonalcoholic Paraprofessional Counselors, and Professional Counselors in an Alcoholism Treatment Interview by Marshall, James Edward, Phd from Southern Illinois University at Carbondale, 1981, 115 pages http://wwwlib.umi.com/dissertations/fullcit/8206472
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The Concept of Alcoholism by Breitenbucher, Frances Joan, Phd from Georgia State University, 1982, 143 pages http://wwwlib.umi.com/dissertations/fullcit/8212699
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The Daily Experiences of Women with Alcoholism Teaching Tales about Women's Process by Klaich, Katherine, Phd from University of Washington, 1996, 398 pages http://wwwlib.umi.com/dissertations/fullcit/9716865
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The Design and Implementation of an Evaluation Model for a Residential Alcoholism Treatment Program by Senesac, Richard Michael, Phd from The Florida State University, 1981, 223 pages http://wwwlib.umi.com/dissertations/fullcit/8118508
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The Detoxification of Skid Row: a Field Investigation into the Implementation of the Uniform Alcoholism and Intoxication Treatment Act. by Regier, Marilyn Claire, Phd from Brandeis University, 1977, 341 pages http://wwwlib.umi.com/dissertations/fullcit/7725046
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The Development of Alcoholism among Roman Catholic and Protestant Episcopal Clergymen by Sorensen, Andrew Aaron, Phd from Yale University, 1971, 231 pages http://wwwlib.umi.com/dissertations/fullcit/7217179
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The Development of an Mmpi Based Scale to Measure Personal Responsibility (alcoholism) by Federman, Robert William, Edd from Texas Tech University, 1983, 121 pages http://wwwlib.umi.com/dissertations/fullcit/8409187
318 Alcoholism
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The Development of Clinical Methods for the Drinking Increasers and Decreasers Interview (alcoholism, Innovation, Family Treatment) by Santa, Cathleen Ann, Phd from The University of Michigan, 1986, 196 pages http://wwwlib.umi.com/dissertations/fullcit/8612620
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The Developmental Effects of Alcoholism in the Adolescent by Harris, Kitty Scaling, Phd from Texas Tech University, 1983, 181 pages http://wwwlib.umi.com/dissertations/fullcit/8316843
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The Dimensions and Variables of Alcoholism by Macdermaid, Susan Ann, Phd from University of Michigan, 1998, 127 pages http://wwwlib.umi.com/dissertations/fullcit/9840595
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The Disease Concept of Alcoholism: Correlates of Alcoholics Anonymous Membership (substance Abuse) by White, Stephen Thomas, Edd from University of Maine, 1991, 194 pages http://wwwlib.umi.com/dissertations/fullcit/9218016
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The Effect of an Alcoholism Education Program on Student Nurses' Attitudes toward Alcoholism by Long, Patricia, Edd from St. John's University (new York), 1985, 205 pages http://wwwlib.umi.com/dissertations/fullcit/8526102
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The Effect of Parental Symptoms, Parental Relationships, and Parenting Practices on the Intergenerational Transmission of Alcoholism and Depression by Holmes, Sandra Johnson, Phd from Washington University, 1989, 220 pages http://wwwlib.umi.com/dissertations/fullcit/8924396
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The Effect of Shared History of Alcoholism on Client Perceptions of Counselor Characteristics (chemical Dependency, Substance Abuse) by Simmering, John August, Phd from Oklahoma State University, 1985, 74 pages http://wwwlib.umi.com/dissertations/fullcit/8603577
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The Effect of Situational Factors on the Outcome of the Alcoholism Intervention (confrontation, Decision Theory) by Loneck, Barry Martin, Phd from Case Western Reserve University, 1985, 200 pages http://wwwlib.umi.com/dissertations/fullcit/8525260
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The Effect of Spirituality on Recovery from Alcoholism: a Comparison between Sober and Relapsed Alcoholics by Much, Mandell Joseph, Phd from Temple University, 1991, 131 pages http://wwwlib.umi.com/dissertations/fullcit/9207884
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The Effects of a 36-hour Marine Corps Substance Abuse Awareness Seminar on Supervisors' Knowledge and Perceptions of an Employee Alcoholism Program by Baker, Kay Louise, Phd from The American University, 1993, 224 pages http://wwwlib.umi.com/dissertations/fullcit/9422770
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The Effects of Age and Psychiatric Disorder on Criminality in a Jailed Population (alcoholism, Drug Abuse, Antisocial Personality, Mental Illness) by Koerber, Anne, Phd from Northwestern University, 1989, 166 pages http://wwwlib.umi.com/dissertations/fullcit/9015387
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The Effects of an Inpatient Alcoholism Treatment Program, with Two Variations, on Measurements of Depression, Hopelessness, Loss and Grief by Mcgovern, Thomas Francis, Edd from Texas Tech University, 1983 http://wwwlib.umi.com/dissertations/fullcit/f2697445
Dissertations 319
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The Effects of Family History of Alcoholism on the Pattern of Motivation for Drinking and the Level of Consumption in Young Adult Offspring by Khazrai, Farzaneh S. A., Phd from Syracuse University, 1994, 206 pages http://wwwlib.umi.com/dissertations/fullcit/9516435
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The Effects of Incarceration on Behavior Patterns of Dui Second Offenders Using Tfa Systems (tm) (recidivism, Alcoholism) by West, Paul Lee, Edd from Virginia Polytechnic Institute and State University, 1992, 283 pages http://wwwlib.umi.com/dissertations/fullcit/9222313
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The Effects of Training in Human Relations, Problem-solving and Program Development Skills As Compared to Traditional Training Methods for Alcoholism Workers. by Valle, Stephen Kurt, Scd from Boston University, the Sargent College of Allied Health Professions, 1976, 259 pages http://wwwlib.umi.com/dissertations/fullcit/7611706
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The Experience of Alcoholism among a Select Number of Women in Southeastern Kentucky: a Phenomenological Investigation by Lawson-goins, Helen Fay; Phd from Union Institute and University, 2002, 132 pages http://wwwlib.umi.com/dissertations/fullcit/3056124
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The Foxborough Experiment: Medicalizing Inebriety at the Massachusetts Hospital for Dipsomaniacs and Inebriates, 1833-1919 (alcoholism, Dipsomaniacs) by Tracy, Sarah Whitney, Phd from University of Pennsylvania, 1992, 299 pages http://wwwlib.umi.com/dissertations/fullcit/9308672
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The History of Alcoholism Treatment in the United States by Brent, Suzanne Stokes, Phd from University of North Texas, 1996, 369 pages http://wwwlib.umi.com/dissertations/fullcit/9718591
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The Identification of Continuing Education Needs of Alcoholism Professionals in Nebraska. by Collins, Thomas Harold, Phd from The University of Nebraska - Lincoln, 1973, 157 pages http://wwwlib.umi.com/dissertations/fullcit/7503401
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The Impact of a Smoking Cessation Program on Alcohol Lapse and Relapse Rates in Adult Males Clinically Treated for Alcoholism by Rissinger, Elaine Sheets, Edd from Temple University, 1992, 157 pages http://wwwlib.umi.com/dissertations/fullcit/9218105
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The Impact of Alcoholism and Recovery on Spouses of Alcoholics: a Study of Stress, Coping and Marital Adjustment by O'conner, Mary Ann, Phd from Syracuse University, 1985, 182 pages http://wwwlib.umi.com/dissertations/fullcit/8524432
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The Impact of Alcoholism in the Family of Origin on the Identity, Social Intimacy, and Coping Mechanisms of College Youth by Passarello, Lauren Christine, Phd from The Florida State University, 1988, 178 pages http://wwwlib.umi.com/dissertations/fullcit/8822463
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The Impact of Family Environment on Coping with Spouse Impairment in Alcoholism and Alzheimer's Disease (alzheimer Disease) by Golden, Lisa Anne, Edd from Boston University, 1989, 173 pages http://wwwlib.umi.com/dissertations/fullcit/8920097
320 Alcoholism
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The Impact of Federal Sector Unions upon Supervisory Implementation of the Federal Alcoholism and Equal Employment Opportunity Policies by Hunt, Richard Earl, Phd from Cornell University, 1977, 368 pages http://wwwlib.umi.com/dissertations/fullcit/8116576
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The Impact of Parental Alcoholism on Ego Development and Affective Disorders in Offspring (alcoholism, Adult Children of Alcoholics) by Guerra, Linda L., Phd from Temple University, 1991, 149 pages http://wwwlib.umi.com/dissertations/fullcit/9207860
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The Implications of a Large Scale Occupational Alcoholism Prevention Program upon Actualizing Levels of Participants by Moore, Thomas Lewis, Phd from United States International University, 1979, 70 pages http://wwwlib.umi.com/dissertations/fullcit/8005197
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The Impoverished Self and Alcoholism: Content and Structure of Self-cognitions in Alcohol Dependence and Recovery by Corte, Colleen M. Phd from University of Michigan, 2002, 163 pages http://wwwlib.umi.com/dissertations/fullcit/3057933
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The Influence of Perceived Organizational Power, Responsibility, and Autonomy on Alcoholism among Social Workers by King, Henry Brazell, Jr., Dsw from The Catholic University of America, 1987, 138 pages http://wwwlib.umi.com/dissertations/fullcit/8800085
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The Management of Blue Collar Alcoholism: an Ethnography of an Industrial Containment System by Sherry, John Francis, Jr., Phd from University of Illinois at Urbana-champaign, 1983, 254 pages http://wwwlib.umi.com/dissertations/fullcit/8310007
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The Mediating Effects of Shame in an Examination of Childhood Sexual Abuse As a Factor in Women's Recovery from Alcoholism by Wiechelt, Shelly A. Phd from University of Pittsburgh, 1999, 137 pages http://wwwlib.umi.com/dissertations/fullcit/9945158
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The Medina Project: Relationships between Demographic Intake Variables and Alcoholism Rehabilitation Outcomes. by Klein, John Paul, Drph from The Univ. of Texas H.s.c. at Houston Sch. of Public Health, 1975, 161 pages http://wwwlib.umi.com/dissertations/fullcit/7705250
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The Natural History of Alcoholism: a Validity Study of E. M. Jellinek's Ordering of Experiences in the Course of Alcoholism by Salkin, Warren Dore, Phd from The University of Akron, 1983, 200 pages http://wwwlib.umi.com/dissertations/fullcit/8315782
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The Perceived Attitudes of Medical and Health School Faculty Deans Concerning Selected Factors of Employee Assistance Programs (counseling, Alcoholism, Drug Abuse) by Scherschell, Jack Roland, Phd from University of North Texas, 1984, 120 pages http://wwwlib.umi.com/dissertations/fullcit/8414119
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The Perceptions of a Puerto Rican Mother Regarding Her Alcoholism and Its Effects on Her Childrearing Practices by Rivera Cintron, Lucy, Phd from The Pennsylvania State University, 1996, 169 pages http://wwwlib.umi.com/dissertations/fullcit/9702372
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The Politics of Alcoholism: Building an Arena around a Social Problem. by Wiener, Carolyn Licht, Phd from University of California, San Francisco, 1978, 392 pages http://wwwlib.umi.com/dissertations/fullcit/8001347
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The Politics of Temperance: Nicholas Ii's Campaign against Alcohol Abuse (russia) by Schulkin, Marc Lee, Phd from Harvard University, 1985, 339 pages http://wwwlib.umi.com/dissertations/fullcit/8602266
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The Ranking of Identified and Classified Knowledges, Behaviors, and Attitudes Appropriate for the Training of Paraprofessional Alcoholism Counselors As Perceived by Clinical Staff Members of Differing Position, Ethnic Background, and Socioeconomic Status. by Smith, Barbara Edythe, Edd from State University of New York at Albany, 1977, 199 pages http://wwwlib.umi.com/dissertations/fullcit/7729175
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The Relationship between Alcoholism, Context of Retirement Variables and Coping with Stressful Situations in a Military Population (stress) by Durand, Peter Fairbanks, Phd from Rutgers the State University of New Jersey - New Brunswick, 1994, 246 pages http://wwwlib.umi.com/dissertations/fullcit/9431081
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The Relationship between Parental Alcoholism and Lexithymia in Adult Children of Alcoholics by Lataille, Edward Paul, Phd from California School of Professional Psychology - San Diego, 1987 http://wwwlib.umi.com/dissertations/fullcit/f4266100
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The Relationship between Pretreatment Environmental Stressors and Alcohol Relapse among Male Alcohol Abusers (stressors, Men) by Strowig, Andrew Britton, Phd from University of Minnesota, 1992, 144 pages http://wwwlib.umi.com/dissertations/fullcit/9306524
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The Relationship between Spiritual Awareness and Recovery from Alcoholism by Brewster, Albert Louis, Phd from University of Pittsburgh, 1989, 215 pages http://wwwlib.umi.com/dissertations/fullcit/9010027
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The Relationship of Career Indecision to Anxiety, Problem-solving, and Parental Alcoholism among College Students (adult Children of Alcoholics, Alcoholics) by Williams, Margaret Hamilton, Phd from University of South Carolina, 1990, 102 pages http://wwwlib.umi.com/dissertations/fullcit/9101508
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The Relationship of Meaning, Religious Involvement, and Alcoholism among Midwest American Jewry by Haines, Patricia Evelyn, Phd from Kent State University, 1992, 191 pages http://wwwlib.umi.com/dissertations/fullcit/9224486
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The Relationship of Pain Perception in Newly Sober, Chemically Dependent Persons: As Moderated by Depression and Locus of Control (alcoholism, Substance Abuse) by Sims, Linda Wooding, Phd from The University of Akron, 1986, 129 pages http://wwwlib.umi.com/dissertations/fullcit/8613647
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The Relationship of Parental Alcoholism, Psychological Separation, and Parental Rejection, to Depression in College Students by Williams, Richard Craig, Phd from University of Minnesota, 1988, 270 pages http://wwwlib.umi.com/dissertations/fullcit/8826496
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The Relationship of Time Management and Lifestyle Organization to Problem Drinking in College Students (alcoholism, Substance Abuse) by Mckee, Kevin Francis, Edd from The University of Tennessee, 1994, 117 pages http://wwwlib.umi.com/dissertations/fullcit/9518123
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The Role of Alcohol Expectancies and Quality of Aa Participation in Recovery from Alcoholism by Kahler, Joseph Keith, Phd from The University of Texas at Austin, 1987, 148 pages http://wwwlib.umi.com/dissertations/fullcit/8717449
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The Role of Faith in the Process of Recovering from Alcoholism by Hall, Homer Alexander, Dmin from Drew University, 1984, 165 pages http://wwwlib.umi.com/dissertations/fullcit/8500721
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The Role of Personal Networks in the Recovery from Alcoholism by Macdonald, J. Grant; Phd from University of Toronto (canada), 1982 http://wwwlib.umi.com/dissertations/fullcit/NK58266
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The Role of Personal Networks in the Recovery from Alcoholism by Macdonald, John Grant, Phd from University of Toronto (canada), 1982 http://wwwlib.umi.com/dissertations/fullcit/f3350293
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The Role of the Sodium Pump in the Regulation of Liver Metabolism in Experimental Alcoholism by Bernstein, Jaime; Phd from University of Toronto (canada), 1974 http://wwwlib.umi.com/dissertations/fullcit/NK27789
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The Sober Alcoholic Woman: a Portrait (alcoholism, Recovery) by Hennessey-heine, Bonnie, Phd from Walden University, 1995, 168 pages http://wwwlib.umi.com/dissertations/fullcit/9536781
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The Social Construction of the Codependency Construct: College Students' Evaluation of 'codependent' Characteristics in Themselves and Others (substance Abuse, Alcoholism) by Hollabaugh, Lisa Carole, Phd from Southern Illinois University at Carbondale, 1995, 210 pages http://wwwlib.umi.com/dissertations/fullcit/9536547
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The Social Organization of the Diagnosis of Alcoholism: Physicians' Definitions and Responses to Elderly Alcoholics (physicians' Attitudes) by Mignon, Sylvia Isabel, Phd from Northeastern University, 1991, 219 pages http://wwwlib.umi.com/dissertations/fullcit/9205761
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The Staged Model of Addictions Recovery: a Guide for Healing for Psychotherapists and Recovering Individuals (alcoholism) by Picucci, Michael, Phd from The Union Institute, 1994, 287 pages http://wwwlib.umi.com/dissertations/fullcit/9509286
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The Theological and Psychological Dynamics of Transformation in the Recovery from the Disease of Alcoholism by Albers, Robert Herbert, Phd from School of Theology at Claremont, 1982, 452 pages http://wwwlib.umi.com/dissertations/fullcit/8221501
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The Use and Implementation of Occupational Alcoholism Programs by Supervisors: an Analysis of Barriers. by Googins, Bradley Kenneth, Phd from Brandeis U., the F. Heller Grad. Sch. for Adv. Stud. in Soc. Wel., 1979, 201 pages http://wwwlib.umi.com/dissertations/fullcit/7922701
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The Use of the Natal Chart in the Identification of Alcoholism and a Comparison of Its Diagnostic Efficacy with the Mmpi. by Macharg, Suzanne Jane, Phd from University of Southern California, 1975 http://wwwlib.umi.com/dissertations/fullcit/f3839206
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The Utilization of Student Research and Gestalt Organizational Theory in the Development of Alcoholism and Substance Abuse Curriculum (alcoholism
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Curriculum) by Goldstein, Mel L., Dsw from City University of New York, 1991, 417 pages http://wwwlib.umi.com/dissertations/fullcit/9119631 ·
Toward Rhetorical Immunity: Narratives of Alcoholism and Recovery by O'reilly, Edmund Bernard, Phd from University of Pennsylvania, 1988, 630 pages http://wwwlib.umi.com/dissertations/fullcit/8824778
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Traffic Accidents and Alcoholism: a Public Administration Problem. by Sprott, Blythe, Phd from University of Southern California, 1976 http://wwwlib.umi.com/dissertations/fullcit/f3533686
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Treatment of Alcoholism: the American Experience, 1850--2000 by Mathews, Patricia Spaniol; Phd from The Florida State University, 2001, 277 pages http://wwwlib.umi.com/dissertations/fullcit/3034055
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Treatment Success in Occupational Alcoholism Programs by Judd, Peter Michael, Phd from Brandeis U., the F. Heller Grad. Sch. for Adv. Stud. in Soc. Wel., 1980, 190 pages http://wwwlib.umi.com/dissertations/fullcit/8024555
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Utilization of Alcoholism Services by Mexican Americans: a Case Study in Social Networks and Ethnic Marginality by Horton, Patrick Allen, Phd from University of California, Santa Barbara, 1981, 226 pages http://wwwlib.umi.com/dissertations/fullcit/8215857
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Variations in Population Characteristics and Outcome Criteria in the Evaluation of Outpatient Alcoholism Treatment by Santoni, Richard Anthony, Phd from University of Southern California, 1972, 114 pages http://wwwlib.umi.com/dissertations/fullcit/7221701
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When Words Aren't Enough... a Study of the Use of Art Therapy in the Treatment of Chemically Dependent Adolescents with Special Focus upon the Spiritual Dimension (addiction, Alcoholism, Drug Abuse, Healing and Art, Intervention) by Burke, Kathleen, Phd from The Union for Experimenting Colleges and Universities, 1985, 360 pages http://wwwlib.umi.com/dissertations/fullcit/8523669
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Women and Alcoholism: from 'rock Bottom' to Recovery. the Reconstruction of a Fractured Identity by James, Avril; Phd from University of Essex (united Kingdom), 2002 http://wwwlib.umi.com/dissertations/fullcit/f877425
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Women and Alcoholism: the Impact of Family of Origin Issues during Recovery and Relapse by Hall, Patti K., Phd from The Florida State University, 1994, 229 pages http://wwwlib.umi.com/dissertations/fullcit/9510126
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Women in Transition: a Time of Potential Alcohol Abuse (prevention) by Baldwin, Janice Irene, Phd from University of California, Santa Barbara, 1985, 401 pages http://wwwlib.umi.com/dissertations/fullcit/8609695
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Women of Alcoholic Fathers: a Comparative Study of Alcoholic and Nonalcoholic Women's Sexuality (female Alcoholism, Physical, Emotional, Sexual Abuse) by Miller, Constance Rose, Psyd from University of Northern Colorado, 1986, 217 pages http://wwwlib.umi.com/dissertations/fullcit/8629385
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Women's Perceptions of Alcoholism Treatment Experiences in Federally Subsidized, Residential Programs by Omeltschenko, Lauretta P., Edd from University of Cincinnati, 1998, 378 pages http://wwwlib.umi.com/dissertations/fullcit/9835686
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Women's Recovery from Alcoholism by Hunt, Carlene Letitia, Edd from Peabody College for Teachers of Vanderbilt University, 1989, 237 pages http://wwwlib.umi.com/dissertations/fullcit/8921124
Keeping Current Ask the medical librarian at your library if it has full and unlimited access to the ProQuest Digital Dissertations database. From the library, you should be able to do more complete searches via http://wwwlib.umi.com/dissertations.
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CHAPTER 5. CLINICAL TRIALS AND ALCOHOLISM Overview In this chapter, we will show you how to keep informed of the latest clinical trials concerning alcoholism.
Recent Trials on Alcoholism The following is a list of recent trials dedicated to alcoholism.8 Further information on a trial is available at the Web site indicated. ·
Behavioral Counseling for Alcohol Dependent Smokers (nicotine patch) Condition(s): Alcoholism; Smoking Study Status: This study is currently recruiting patients. Sponsor(s): National Institute on Alcohol Abuse and Alcoholism (NIAAA) Purpose - Excerpt: This study is to evaluate the effectiveness of a mood management intervention on abstinent alcoholic smokers with a history of major depression. The second aim is to determine the effect of smoking treatments on alcohol abstinence and to identify factors associated with smoking and alcohol outcomes (e.g., more days of abstinence). A randomized, two-group design will be used to evaluate the added benefit of mood management compared to a state-of-the-art smoking cessation treatment. Treatment will consist of 8 weekly group sessions and 1, 3, 6, and 12-month follow-up. Phase(s): Phase IV Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00004551
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Behavioral Therapy Plus Naltrexone for Alcoholism Condition(s): Alcoholism Study Status: This study is currently recruiting patients.
8
These are listed at www.ClinicalTrials.gov.
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Sponsor(s): National Institute on Alcohol Abuse and Alcoholism (NIAAA) Purpose - Excerpt: This study will compare cognitive behavioral therapy with a timelimited motivational enhancement therapy to which naltrexone (Revia) or placebo medication is added. In this randomized clinical trial, 160 alcohol-dependent outpatients, after 5 days of abstinence, will receive one of the two psychosocial therapies and either naltrexone (Revia) or placebo for a 12-week treatment period. Abstinence rates, alcohol use, and time to alcohol relapse will be evaluated in all four groups along with measures of alcohol craving, biological measures of alcohol consumption, drinking consequences, changes in self-confidence for avoiding alcohol, and medication compliance. All study participants will be assessed for measures of outcome variables at 3 and 6 months after completing the treatment protocol. Phase(s): Phase IV Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000456 ·
Behavioral/Drug Therapy for Alcohol-Nicotine Dependence (naltrexone/nicotine patch) Condition(s): Alcoholism; Smoking Study Status: This study is currently recruiting patients. Sponsor(s): National Institute on Alcohol Abuse and Alcoholism (NIAAA) Purpose - Excerpt: This study will develop a behavioral and drug relapse prevention program for individuals who are dependent on both alcohol and tobacco. The study's goal is to show that individuals receiving nicotine replacement therapy and naltrexone (Revia) with behavior therapy will have higher rates of abstinence from both smoking and drinking than individuals who do not receive the drug therapies. Individuals will be placed in a 12-week outpatient treatment program with followup assessments 1, 3, and 6 months after treatment. Phase(s): Phase IV Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000447
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Brain Function in Response to Motivational Stimuli Condition(s): Drug Dependence Study Status: This study is currently recruiting patients. Sponsor(s): National Institute on Alcohol Abuse and Alcoholism (NIAAA) Purpose - Excerpt: This study seeks more information about the biology of substance dependency by exploring the brain areas involved in feeling positive and negative emotions. Specifically, it will determine whether a brain chemical called dopamine affects activity in certain brain regions during performance of a game that involves winning and losing money. Brain activity will be examined using magnetic resonance imaging (MRI), a test that uses a magnetic field and radio waves to produce images of brain structure and function. Young to middle-aged healthy adults may participate in this study. Candidates will be screened with a medical history, physical examination,
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electrocardiogram (EKG), psychiatric interview, and blood and urine tests. Participants will be assigned to one of the two study procedures, as follows: Tyrosine/Phenylalanine This study requires two overnight stays at the NIH Clinical Center. For each stay, subjects are admitted to the hospital the afternoon before the MRI scan. From the time of admission until after the scan, their diets are restricted to food relatively low in amino acids, prepared by NIH dietitians. The next day, participants undergo MRI scanning. For this procedure, the subject lies on a table that is moved into the scanner, a metal cylindrical machine. Earplugs are worn to muffle loud noises that occur with electrical switching of the radio frequency circuits. Imaging of brain structure takes about 10 to 15 minutes. Additional scans are then taken to measure brain activity while the subject plays simple computer games for money. These scans take about another 20 to 45 minutes. Five hours before the MRI, the subject drinks one of two beverages containing amino acids. A different beverage is given for each of the two visits: one drink lacks the essential amino acids tyrosine and phenylalanine, from which the body makes dopamine; the other contains balanced amounts of these two amino acids. Finally, subjects fill out mood-rating questionnaires before and after drinking each of the beverages. Dextroamphetamine This study requires two outpatient visits to the NIH Clinical Center. For one visit, participants are given an injection of 0.2 mg/kg body weight of the drug dextroamphetamine; for the other, they are given an injection of saline (salt water). After each injection, they undergo MRI scanning while playing computer games for money, as described above. They will fill out mood-rating questionnaires before and after each brain scan. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00047866 ·
Bupropion as a Smoking Cessation Aid in Alcoholics Condition(s): Alcoholism; Smoking Study Status: This study is currently recruiting patients. Sponsor(s): National Institute on Alcohol Abuse and Alcoholism (NIAAA) Purpose - Excerpt: The purpose of this study is to test the use of time-released bupropion (Wellbutrin) in patients receiving treatment for alcohol abuse/dependence as an aid to stop smoking. Patients will receive either a time-released bupropion or placebo. Both groups will receive nicotine replacement therapy during the 9 week study. A final followup assessment will be conducted 6 months from the start of treatment. Phase(s): Phase IV Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00044434
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Combination Nicotine Replacement for Alcoholic Smokers Condition(s): Smoking; Alcoholism Study Status: This study is currently recruiting patients. Sponsor(s): National Institute on Alcohol Abuse and Alcoholism (NIAAA)
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Purpose - Excerpt: The overall objective of the study is to develop recommendations for treatment programs to help alcoholic smokers to stop smoking. A sample of 175 alcohol dependent cigarette smokers will be recruited from the community and treated in a 6month outpatient alcohol and tobacco treatment program. The 175 patients will be divided into two groups. One group will receive an active nicotine patch and active nicotine gum. The other group will receive an active nicotine patch and placebo nicotine gum. Followup assessments will be conducted for 1-year from the beginning of treatment. Phase(s): Phase IV Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00064844 ·
COMBINE (acamprosate/naltrexone) Condition(s): Alcoholism Study Status: This study is currently recruiting patients. Sponsor(s): National Institute on Alcohol Abuse and Alcoholism (NIAAA) Purpose - Excerpt: Combine is a multicenter, randomized clinical trial that will evaluate combinations of three interventions for treating alcohol dependence. The goal is to determine whether improvement in treatment outcomes can be achieved by various combinations of drug and behavioral interventions. Two of the interventions will consist of pharmacological treatment with naltrexone (Revia) or acamprosate (Campral). The third intervention is a multicomponent behavioral therapy including such components as motivational enhancement therapy, cognitive behavioral therapy, and referral to selfhelp groups, including AA. All three interventions will include a component supporting compliance to medications and reduction in drinking. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00006206
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Combined Pharmacotherapies for Alcoholism (naltrexone/odansetron) Condition(s): Alcoholism Study Status: This study is currently recruiting patients. Sponsor(s): National Institute on Alcohol Abuse and Alcoholism (NIAAA) Purpose - Excerpt: This study will compare the effectiveness of ondansetron (Zofran) and naltrexone (ReVia) both alone and in combination in treating Early Onset Alcoholics versus Late Onset Alcoholics. All subjects will received standardized Cognitive Behavioral Therapy. Followup assessments will be completed at 1, 3, 6, and 9 months after treatment. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00027079
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Comparing Gabapentin and Lorazepam for Treating Alcohol Withdrawal Condition(s): Alcoholism Study Status: This study is currently recruiting patients. Sponsor(s): National Institute on Alcohol Abuse and Alcoholism (NIAAA) Purpose - Excerpt: This study will evaluate a safe and useful medication for outpatient detoxification that is as effective as benzodiazepines in the short-term, and more effective in the protracted withdrawal period. Gabapentin (Neurontin) will be compared to a standard benzodiazepine, lorazepam (Ativan), for its effectiveness in treating alcohol withdrawal. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00011297
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Drug Therapy for Alcohol Dependence in Alaska Natives (naltrexone/sertraline) Condition(s): Alcoholism Study Status: This study is currently recruiting patients. Sponsor(s): National Institute on Alcohol Abuse and Alcoholism (NIAAA) Purpose - Excerpt: This study will assess the ability of naltrexone (Revia) to reduce the risk of relapse in Alaska natives with alcohol dependence. The study will also examine whether a combination of naltrexone and sertraline (Zoloft) yields better abstinence rates than naltrexone used alone. Alaska Native individuals will be recruited into a 16 week outpatient study. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000451
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Drug Treatment for Alcoholism (ondansetron) Condition(s): Alcoholism Study Status: This study is currently recruiting patients. Sponsor(s): National Institute on Alcohol Abuse and Alcoholism (NIAAA) Purpose - Excerpt: This study is to determine if alcoholics who differ on genetic variations of serotonin activity respond differently to ondansetron (Zofran) treatment. Subjects will receive one week of single-blind placebo lead-in followed by randomization to 11 weeks of double-blind treatment with ondansetron or placebo. All subjects will receive weekly cognitive behavioral therapy and have brain imaging and genetic testing. Participants will be scheduled for followup assessments at 1, 2, 3, 6, and 9 months after treatment. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below
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Web Site: http://clinicaltrials.gov/ct/show/NCT00006205 ·
Drug Treatment for Depressed Alcoholics (naltrexone/fluoxetine) Condition(s): Alcoholism; Depression Study Status: This study is currently recruiting patients. Sponsor(s): National Institute on Alcohol Abuse and Alcoholism (NIAAA) Purpose - Excerpt: This study will examine the effects of combing naltrexone and fluoxetine (Prozac) versus fluoxetine and placebo in alcoholics with co-occurring major depression. Both groups will actively participate in the 6-month study, which includes weekly individual Dual Disorders Recovery Counseling during the first month and every two weeks during the second through sixth months, plus the naltrexone and fluoxetine or fluoxetine and placebo. Subjects will complete follow-up assessments at 9 and 12 months. Phase(s): Phase IV Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00006204
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Effect of Fluoxetine (Prozac) on Domestic Violence Condition(s): Domestic Violence Study Status: This study is currently recruiting patients. Sponsor(s): National Institute on Alcohol Abuse and Alcoholism (NIAAA) Purpose - Excerpt: This study will evaluate whether fluoxetine (Prozac), used together with traditional psychotherapy, can reduce aggression in people who are physically violent towards their spouses or significant others. Treatment for domestic violence has centered on behavioral therapies, such as anger management and self-control exercises. Recent studies have shown that fluoxetine-a drug commonly used to treat depression and panic disorder-can decrease acts of aggression. Men and women between the ages of 18 and 65 who have a history of inflicting physical aggression on a spouses or significant others in the past year (with at least one episode occurring not under the influence of alcohol) may be eligible for this study. Participants spouses or significant others will also be asked to participate. All potential participants will be screened with a medical and psychiatric evaluation and history, breath alcohol analysis, blood tests, urine drug screen and electrocardiogram. Those enrolled will undergo the following procedures: Perpetrator -Interview and questionnaires - Participants will be interviewed by a social worker about past and current mental health and use of alcohol and illicit drugs and will complete questionnaires assessing emotional state and personality, depression, anxiety, aggression and alcohol consumption. Some of the questionnaires will be repeated at monthly intervals. -Physical performance testing - Performance and speed will be measured in three separate training sessions that involve repeatedly pressing a button on a button box console, earning points worth money. -Dyadic interaction paradigm - Participants will interact with their spouse/significant other in a small room, first discussing a neutral topic, such as the day's events, and then a subject that has been a source of conflict. -Fluoxetine administration - Participants will be randomly assigned to receive either 10 mg. of fluoxetine or placebo (identical capsules with no active ingredients) once a day for 3 days, then twice a day, increasing up to four capsules a day if there are no serious side effects. Blood will be drawn once a month to
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measure drug levels. At the end of 3 months, participants taking placebo may remain in the study and receive fluoxetine. -Clinic visits - Participants are followed in the clinic weekly for the first month, then twice a month for the next 2 months for adjustment of number of pills, evaluation of aggressive behavior and alcohol consumption, and therapy for issues of self-esteem, anger management and communication skills. Couples therapy aimed at conflict resolution and improving communication skills will be offered. -Genetic tests (optional) - Blood will be drawn to determine if there is a relationship between genes involved in a chemical process (serotonin reuptake) that is influenced by fluoxetine and the participant's response to the drug. Spouse/Significant other: Spouses/significant others will complete several questionnaires once a month (total 4 times) to rate their partners' behavior while in the study. They will also participate in the dyadic interaction paradigm described above at the beginning and end of the study. Phase(s): Phase II; MEDLINEplus consumer health information Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00011765 ·
Effect of Polyunsaturated Fatty Acids on Cardiovascular and Motor Responses Under Stress Condition(s): Healthy Study Status: This study is currently recruiting patients. Sponsor(s): National Institute on Alcohol Abuse and Alcoholism (NIAAA) Purpose - Excerpt: This research study is designed to find out if increasing the dietary intake of polyunsaturated fats improves concentration, motor skills and cardiovascular responses under stress. These polyunsaturated fats may also change the chemicals in the brain that control these responses. Specifically, these polyunsaturated fats may raise brain levels of neurotransmitters called dopamine and serotonin. Polyunsaturated fats are important for improving the function of both the brain and the heart. People cannot make these polyunsaturated fats and they can only be obtained from the oils that we eat. For three months subjects will take 8 capsules a day that contain either corn oils flavored with fish oils or fish oil that taste a little like corn oils. Subjects will not be told which oils we expect to work better. An initial evaluation will determine if subjects fit the criteria necessary to enter the study. A battery of tests will be conducted twice, once before starting the capsules and again after three months of taking the capsules. These batteries of tests will include an MRI of the head, paper and pencil tests to evaluate changes in mood, and tests of concentration and motor skills and cardiovascular responses under stress. Two lumbar punctures will be performed to collect cerebrospinal fluid so that changes in neurotransmitters can be evaluated. Subjects will be on a no seafood diet to equalize their dietary intake of polyunsaturated fatty acids. Subjects will be expected to complete all parts of this study. Phase(s): Phase I; MEDLINEplus consumer health information Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00014027
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Genetic Factors and Interrelationships for Sexual Orientation, Susceptibility to HIV and Kaposi's Sarcoma, Alcoholism and Psychological Traits, and Histocompatibility Antigens Condition(s): Alcoholism; HIV Infection; Homosexuality; Kaposi's Sarcoma Study Status: This study is currently recruiting patients. Sponsor(s): National Cancer Institute (NCI) Purpose - Excerpt: We propose to test, by DNA linkage analysis of family pedigree members, the following interrelated hypotheses: 1) that sexual orientation is genetically influenced; 2) that the development of Kaposi's sarcoma and other outcomes of HIV infection in male homosexuals is affected by host susceptibility genes, circulating sex hormone levels, or HLA haplotype; and 3) that alcoholism and other psychobehavioral conditions are associated with homosexuality on a genetic basis and/or influenced by candidate behavioral loci. The subjects for these studies will be self-identified male and female homosexual probands and their relatives from families in which there are at least two individuals with homosexual orientation. All subjects will be adults, and will be referred through NIH physicians, private practitioners, and gay and lesbian organizations. Subjects will undergo a sexual orientation and behaviors interview, a psychiatric interview, and phlebotomy for HIV testing, HLA determination, endocrine measurements, and preparation of DNA from cultured lymphocytes. The DNA samples will be analyzed for a series of genetic markers that span the human genome and for candidate loci chosen for function. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00001294
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Improving Substance Abuse Treatment Aftercare Adherence and Outcome Condition(s): Substance Abuse; Alcoholism Study Status: This study is currently recruiting patients. Sponsor(s): Department of Veterans Affairs Purpose - Excerpt: Although substance abuse treatment aftercare participation is strongly related to positive treatment outcomes, aftercare participation rates are low and relatively few interventions have been developed that improve aftercare adherence and outcome. We have shown in preliminary studies that contracting, prompting with feedback, and providing social reinforcement independently increase aftercare participation and improve treatment outcome. We propose a randomized clinical trial to examine a behaviorally based substance abuse treatment adherence intervention. We have 3 goals: 1) to compare the effectiveness of an aftercare intervention consisting of a participation contract, attendance prompts with feedback, and attendance reinforcers (CPR) to a standard treatment (STX) on adherence to aftercare therapy; 2) to assess the effects of this intervention on treatment outcome; and 3) to understand the process by which this intervention works. Over a 1.5-year period, we will recruit 160 veterans seeking residential or intensive outpatient treatment at the Salem VAMC's Substance Abuse Residential Rehabilitation Treatment Program (SARRTP) who can participate in aftercare therapy. Our population is highly similar to those in SARRTP's throughout the VAMC (95% male, 52% Caucasian, 48% minority, 44 years mean age, 47% alcohol dependent, 16% drug dependent, 37% both alcohol and drug dependent, and 36% dual diagnosis). In this randomized clinical trial, participants will be assigned to the STX or the CPR condition. Treatment adherence and outcome will be measured 3-, 6- and 12-
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months after participants enter treatment and will be compared to baseline levels using structured interviews, questionnaires, urine alcohol and drug screens, VAMC databases, medical records, and therapist ratings. The basic study design is a repeated measures nested cohort design, with an intervention group and a standard care group. The primary outcome, abstinence rate, will be analyzed using a logistic regression model in which the parameters of interest are estimated using Generalized Estimating Equations (GEE). We will analyze secondary outcomes using both marginal and linear mixedeffects models. Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00057187 ·
Naltrexone, Craving, and Drinking Condition(s): Alcoholism Study Status: This study is currently recruiting patients. Sponsor(s): National Institute on Alcohol Abuse and Alcoholism (NIAAA) Purpose - Excerpt: This 5-week study will examine the effects of naltrexone on alcohol craving, drinking rates, and reaction to drinking-related triggers, or cues, in participants' everyday environment and in laboratory sessions. Participants will monitor and record their daily desires to drink, environmental circumstances in which urges occur, and drinking behavior using a palm top computer. Participants will receive naltrexone or a placebo. One week after receiving medication, all participants will be asked to respond to alcohol-related cues that may or may not arouse the desire to drink. Phase(s): Phase IV Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00006203
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Pharmacological Intervention Project (fluoxetine) Condition(s): Alcoholism Study Status: This study is currently recruiting patients. Sponsor(s): National Institute on Alcohol Abuse and Alcoholism (NIAAA) Purpose - Excerpt: This is a large scale study involving fluoxetine (Prozac) versus a placebo in the treatment of adolescents with alcohol use disorder and major depression. All individuals will receive treatment for 12 weeks with a followup phase lasting 9 months. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00027378
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Post-Treatment Effects of Naltrexone Condition(s): Alcoholism
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Study Status: This study is currently recruiting patients. Sponsor(s): National Institute on Alcohol Abuse and Alcoholism (NIAAA) Purpose - Excerpt: The aims of this protocol are to compare 3 and 6 months of naltrexone treatment coupled with two psychotherapies that differ in scope and intensity. The effect of these treatments will be assessed with patients who differ in their psychosocial need and resources at their disposal, and in their level of cravings for alcohol. Phase(s): Phase IV Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00006449 ·
Role of Dopamine in Response to Alcohol Condition(s): Alcohol Drinking Study Status: This study is currently recruiting patients. Sponsor(s): National Institute on Alcohol Abuse and Alcoholism (NIAAA) Purpose - Excerpt: This study will examine the role of the brain chemical dopamine in people's response to alcohol consumption. Dopamine is thought to influence whether people have a strong or weak response to alcohol and how pleasurable that response is. The findings of this study may shed light on why some people are at higher risk of developing problem drinking behaviors. Healthy normal volunteers between 21 and 25 years of age who have never had a serious problem with alcohol abuse or drug abuse may be eligible for this study. Candidates will be screened with a medical history and physical examination, and will be interviewed about their smoking and drinking behaviors. Participants will undergo test procedures on two separate days, as follows: Test Day 1 Upon arrival at the Clinical Center, participants will take a breathalyzer test for alcohol and provide a urine sample for a drug screen. Women will also have a urine pregnancy test. They will then lie on a hospital bed and two intravenous catheters (IV lines) will be placed, one into each arm. One line will be used to collect blood samples during the test session; the other will be used to infuse alcohol into the bloodstream. The alcohol will rapidly increase the blood alcohol level to between 0.06 and 0.08 grams per deciliter. (0.08 g/dL is the level at which a person is charge with driving under the influence of alcohol in all States.) Before, during, and after the infusion, subjects will be asked about their feelings in response to the alcohol, such as confusion, elation, level of discomfort or dizziness, ability to concentrate, and so forth. At 35 and 60 minutes after the infusion begins, subjects will take a body sway test. This involves standing on a machine to determine how the alcohol has affected the sense of balance. Subjects will then relax in the clinic for a few hours. During this time, a blood sample will be collected and a questionnaire will be given hourly until the blood alcohol level has gone down to 0.02 g/dL. When the alcohol level has declined to 0.02 g/dL (usually 3 to 4 hours after the infusion), the subject will be sent home in a taxi. Test Day 2 Participants will again take a breathalyzer test for alcohol and provide a urine sample for drug screen and, for women, a pregnancy test. Subjects will lie on a hospital bed and three IV lines will be inserted, one to draw blood samples, one to infuse alcohol, and one to give raclopride, a radioactive substance used for positron emission tomography (PET) scanning. For PET, the subject lies on a table in the scanner with a mask placed over his or her head to help hold the head still during the scan. After a brief scan to adjust the machine, a small amount of radioactive water (O-15 water) is injected through the IV line and a series of
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pictures is taken over a period of about 1 minute. These images show how the radioactive water distributes in the brain, indicating blood flow. After the water scan, raclopride is given through the IV line and more pictures of the brain are taken over the next 2 hours. Blood samples are collected during and after the raclopride scan. During this procedure, subjects are asked the same questions about their feelings in response to the alcohol as they did during the earlier session. After he scans, they will be monitored in the clinic with hourly blood tests and questionnaires until the blood alcohol concentration decreases to 0.02 g/dL and will then be sent home in a taxi. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00050219 ·
Serotonin in Alcoholism Condition(s): Alcoholism; Healthy Study Status: This study is currently recruiting patients. Sponsor(s): National Institute on Alcohol Abuse and Alcoholism (NIAAA) Purpose - Excerpt: This study uses positron emission tomography (PET) scanning to study how serotonin works in alcoholics. Serotonin is a chemical that allows brain cells to communicate. There is evidence that people with alcoholism have altered serotonin; their brains begin to make and break down serotonin more slowly than people who do not drink. PET scans use radioactive substances injected into the body. A special camera detects the radiation emitted by the radioactive fluid and a computer processes the radioactivity into images of the brain, which show the activity of brain chemicals like serotonin. People with alcohol dependency may participate in this study. Candidates are screened with a medical history, including questions about alcohol and drug use, physical examination, blood tests, breath alcohol tests, electrocardiogram (ECG), urine test for illicit drugs and, for women, a pregnancy test, and a stool test for hidden blood. They also undergo magnetic resonance imaging (MRI) scan of the brain and complete questionnaires on their alcohol and drug history. Participants undergo the following tests and procedures: - Diet low in tryptophan. Tryptophan is an amino acid from which serotonin is made. - Brain MRI before starting the study to make sure brain structure is normal. - Lumbar puncture (spinal tap) to collect a small sample of cerebrospinal fluid (CSF). A local anesthetic is given and a needle is inserted in the space between the bones (vertebrae) in the lower back. About 2 tablespoons of fluid is collected through the needle. - Arterial catheter (plastic tube) placed in an artery in the wrist area for drawing blood samples. The skin is numbed with a local anesthetic for placement of the catheter. - Intravenous (IV) catheter placed in a vein for injecting the radioactive isotope used in the PET scan. - Two PET scans - baseline and active. - Amino acid drink (orange flavored) before the active PET scan. The drink lowers tryptophan levels. - Amino acid capsules - 23 amino acid capsules are taken with the orange drink. - Genetic analysis to help understand serotonin and alcoholism. A blood sample is collected for DNA testing and possibly establishment of a cell line (collection of cells that are grown in the laboratory from an original tissue specimen) for other genetic studies. Patients are admitted to the intensive care unit for the lumbar puncture and arterial line procedures. After these procedures are complete, the patient is transferred by stretcher to the PET suite for scanning. During the two scans, blood samples are drawn from the artery and a small amount of CSF is collected each hour of the study. Each PET scanning session lasts about 3 hours. The study lasts 36 hours, during which time the subject remains in bed.
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Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00011752 ·
Timing of Smoking Intervention in Alcohol Treatment (nicotine patch) Condition(s): Alcoholism; Smoking Study Status: This study is currently recruiting patients. Sponsor(s): National Institute on Alcohol Abuse and Alcoholism (NIAAA) Purpose - Excerpt: This study will attempt to determine the best time to begin a smoking cessation program in individuals who undergo intensive treatment for alcohol dependence. The goal of this trial is to determine whether a smoking cessation program is more effective if it occurs at the same time as or after treatment for alcohol dependence. The study also will attempt to determine the effect of smoking cessation programs on the outcome of treatment for alcohol dependence. Phase(s): Phase IV Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000444
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Tobacco Dependence in Alcoholism Treatment (nicotine patch/naltrexone) Condition(s): Alcoholism; Smoking Study Status: This study is currently recruiting patients. Sponsor(s): National Institute on Alcohol Abuse and Alcoholism (NIAAA) Purpose - Excerpt: The purpose of this study is to determine the effectiveness of naltrexone (Revia) in reducing drinking and smoking in patients with both nicotine and alcohol dependence. Individuals will be randomly assigned to a 12-week trial of a fixed daily dose of either naltrexone (Revia) and nicotine replacement patch or placebos. All individuals will receive weekly coping skills and smoking-cessation behavioral therapy. Followup interviews will be conducted 3 and 6 months after treatment to determine smoking and drinking status and persistence of any dependence symptoms. Phase(s): Phase IV Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000437
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Trazodone for Sleep Disturbance in Early Alcohol Recovery Condition(s): Alcoholism Study Status: This study is currently recruiting patients. Sponsor(s): National Institute on Alcohol Abuse and Alcoholism (NIAAA) Purpose - Excerpt: This study is a randomized, double-blind clinical trial comparing trazodone (Desyrel) and placebo among sleep-disturbed, alcohol-dependent individuals shortly after discharge from an inpatient detoxification program. Subjects will undergo a baseline assessment and random assignment to trazodone or identical placebo for 12
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weeks. All persons completing the alcohol detoxification at Stanley Street Treatment and Resources (SSTAR) will be screened. (SSTAR of Rhode Island provides detoxification services to non/underinsured persons of Rhode Island.) Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00027053 ·
Treating Alcohol Use In Older Adults With Depression Condition(s): Alcoholism; Depression Study Status: This study is currently recruiting patients. Sponsor(s): Department of Veterans Affairs Medical Research Service Purpose - Excerpt: The purpose of this study is to test the efficacy combining a treatment for depression with a treatment for alcohol dependence. Phase(s): Phase IV Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00018824
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Treatment for Alcoholism and Post-Traumatic Stress Disorder (naltrexone) Condition(s): Alcoholism; Post-Traumatic Stress Disorder Study Status: This study is currently recruiting patients. Sponsor(s): National Institute on Alcohol Abuse and Alcoholism (NIAAA) Purpose - Excerpt: This study will evaluate naltrexone and cognitive-behavioral therapy treatments for alcohol dependence and post-traumatic stress disorder (PTSD). Subjects will be randomly assigned a 6-month treatment of either: 1) naltrexone alone, 2) naltrexone with PTSD psychosocial therapy, 3) a placebo with PTSD psychosocial therapy, or 4) placebo alone. An enhanced medication management intervention will accompany all treatment conditions. Followup assessments will be completed at 9 and 12 months after treatment. Phase(s): Phase IV Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00006489
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Treatment of Adolescents with Comorbid Alcohol Use and Attention Deficit Hyperactivity Disorder (bupropion) Condition(s): Alcoholism; Attention Deficit Hyperactivity Disorder Study Status: This study is currently recruiting patients. Sponsor(s): National Institute on Alcohol Abuse and Alcoholism (NIAAA) Purpose - Excerpt: This study will compare the effectiveness of sustained release bupropion (Wellbutrin) versus a placebo in the treatment of adolescents with comorbid
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alcohol use disorder and attention deficit hyperactivity disorder. Adolescents, ages 1418 will be recruited from community treatment programs for a 16-week trial with follow-up assessments. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00029614 ·
Treatment Plan to Decrease Drug Exposure in HIV Infected Adolescents Condition(s): HIV Infections Study Status: This study is currently recruiting patients. Sponsor(s): National Institute of Child Health and Human Development (NICHD); National Institute on Drug Abuse (NIDA); National Institute of Mental Health (NIMH); National Institute on Alcohol Abuse and Alcoholism (NIAAA) Purpose - Excerpt: This study will attempt to stimulate the immune system in HIV infected adolescents and young adults so that it can better control the HIV infection. When anti-HIV drugs are stopped for a period of time, the virus "grows back." This may stimulate the immune system, which may then be more effective in controlling the virus. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00067574
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Genetic Factors and Interrelationships for Cancer Risk-Related Behaviors and Complex Traits Condition(s): Acquired Immunodeficiency Syndrome; Alcoholism; HIV Infection; Neoplasm; Smoking Study Status: This study is no longer recruiting patients. Sponsor(s): National Cancer Institute (NCI) Purpose - Excerpt: We propose to conduct a multifactorial genetic study of cancer riskrelated behaviors and other complex human characteristics. The main areas of interest are tobacco smoking, excess alcohol consumption, psychological traits, and HIV/AIDS susceptibility and progression. The subjects will be adult male and female probands who display one or more of the phenotypes of interest together with their brothers, sisters and parents. Information on tobacco and alcohol use, psychological and personality traits, sexual behavior, HIV status and progression, and other characteristics with possible genetic components will be obtained through structured interviews and questionnaires. DNA will be prepared from blood samples and typed for a series of candidate genes chosen for function and for random polymorphic markers. By correlating the genotypic and phenotypic information, we hope to identify individual loci that interactively contribute to many different aspects of human health and disease. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00001500
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Acamprosate Treatment: Mechanisms of Action Condition(s): Alcoholism Study Status: This study is completed. Sponsor(s): National Institute on Alcohol Abuse and Alcoholism (NIAAA) Purpose - Excerpt: This study will examine whether pretreatment with two doses of acamprosate for seven days prior to abstinence lessens the intensity of acute withdrawal from alcohol compared with a placebo. Subjects will be randomly assigned to receive either one of two doses of acramprosate or placebo for seven days. This will be followed by a four- day inpatient period when withdrawal will be monitored. Additional drinking information will be obtained at a three month followup interview. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00004552
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Behavior and Naltrexone Treatment for Alcoholics Condition(s): Alcoholism Study Status: This study is completed. Sponsor(s): National Institute on Alcohol Abuse and Alcoholism (NIAAA) Purpose - Excerpt: The study's purpose is to improve alcoholism treatment by investigating the combined effectiveness of a psychotherapy (Coping Skills Training and Cue Exposure Treatment - CSTCET) with naltrexone in a randomized clinical trial. Individuals will receive 2 weeks of CSTCET or a control treatment as inpatients followed by 12 consecutive weeks of receiving either naltrexone or placebo as outpatients. Followups at 24, 48, and 72 weeks after treatment is completed. Phase(s): Phase IV Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000449
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Disulfiram for Cocaine-Alcohol Abuse - 3 Condition(s): Alcohol-Related Disorders; Cocaine-Related Disorders Study Status: This study is completed. Sponsor(s): National Institute on Drug Abuse (NIDA); VA Connecticut Healthcare System Purpose - Excerpt: To evaluate disulfiram for cocaine-alcohol abuse. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000278
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Drug Therapy for Alcohol Detoxification Condition(s): Alcoholism Study Status: This study is completed. Sponsor(s): National Institute on Alcohol Abuse and Alcoholism (NIAAA) Purpose - Excerpt: This project will provide relevant clinical information for primary care practitioners treating alcohol withdrawal syndrome in outpatient settings. This double-blind, placebo- controlled clinical trial will compare the effectiveness of lorazepam (Ativan) and carbamazepine (Tegretol) in alcoholics who meet the criteria for a diagnosis of uncomplicated alcohol withdrawal syndrome. Participants are randomized to five days of treatment with a 1-week posttreatment followup. Phase(s): Phase IV Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000441
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Drug Treatment for Alcoholics with Bipolar Disorder Condition(s): Alcoholism; Bipolar Disorder Study Status: This study is completed. Sponsor(s): National Institute on Alcohol Abuse and Alcoholism (NIAAA) Purpose - Excerpt: The purpose of this study is to test the effectiveness of sodium valproate (Depacon) in treating individuals with alcohol dependence and comorbid bipolar disorder. Recruited individuals will receive drug therapy as inpatients and then followed as outpatients for six months. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000439
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Drug Treatment for Alcoholics with Post-Traumatic Stress Disorder Condition(s): Alcoholism; Post-Traumatic Stress Disorder Study Status: This study is completed. Sponsor(s): National Institute on Alcohol Abuse and Alcoholism (NIAAA) Purpose - Excerpt: This study will investigate the use of sertraline (Zoloft) to decrease alcohol consumption and crime-related post-traumatic stress disorder in those individuals with both disorders. This will be a 12-week, placebo-controlled, doubleblind outpatient trial. All subjects will receive cognitive behavioral therapy in addition to a placebo or sertraline. Comprehensive evaluation will be done at study entry; treatment termination; and 6, 9, and 12 months after study entry. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000446
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Naltrexone for Early Problem Drinkers Condition(s): Alcoholism Study Status: This study is completed. Sponsor(s): National Institute on Alcohol Abuse and Alcoholism (NIAAA) Purpose - Excerpt: Early problem drinkers are prevalent in the United States. Recent controlled trials have shown that brief interventions in the primary care setting can reduce drinking and alcohol-related problems in patients who lack evidence of alcohol dependence. Although naltrexone (Revia) has been approved for the treatment of alcohol dependence, few pharmacotherapy studies have been undertaken with early problem drinkers. This study is an 8-week trial of naltrexone versus placebo, combined with coping skills treatment that either focuses on targeted use of medication or serves as background to daily use of the medication. A total of 160 early problem drinkers recruited through screening in primary care medical settings will be randomly assigned to one of four treatment groups. Followup evaluations will be conducted at the end of treatment and again 3, 6, and 12 months. Phase(s): Phase IV Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000455
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Naltrexone for Relapse Prevention Condition(s): Alcoholism Study Status: This study is completed. Sponsor(s): National Institute on Alcohol Abuse and Alcoholism (NIAAA) Purpose - Excerpt: This study is to evaluate the safety and effectiveness of an injectable slow releasing preparation of naltrexone to reduce alcohol consumption and risk of relapse in alcohol-dependent subjects. Individuals will receive either naltrexone or a placebo injection for a total of three months, with two subsequent followup visits spanning a 6- month period. Phase(s): Phase IV Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000442
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Naltrexone Maintenance Treatment of Alcoholism Condition(s): Alcoholism Study Status: This study is completed. Sponsor(s): National Institute on Alcohol Abuse and Alcoholism (NIAAA) Purpose - Excerpt: The purpose of this study is to determine the long-term effectiveness of naltrexone treatment in alcohol-dependent patients who respond to short-term treatment. Those who respond to short-term treatment will be randomized to a 1-year, double-blind, placebo-controlled maintenance phase with a 6-month posttreatment followup. Phase(s): Phase IV
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Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000450 ·
Naltrexone Treatment for Alcoholic Women Condition(s): Alcoholism; Eating Disorder Study Status: This study is completed. Sponsor(s): National Institute on Alcohol Abuse and Alcoholism (NIAAA) Purpose - Excerpt: This study will assess naltrexone's effectiveness in treating alcoholism in women and provide information on its potential value in treating eating disorders common among alcoholic women. Alcoholic women with and without both eating disorders and depression will be randomly assigned to placebo or naltrexone treatment. Each group will receive behavioral therapy for 12 weeks, with followup 6 months after treatment. Phase(s): Phase IV Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000448
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Naltrexone Treatment for Alcoholism Condition(s): Alcoholism Study Status: This study is completed. Sponsor(s): National Institute on Alcohol Abuse and Alcoholism (NIAAA) Purpose - Excerpt: This study will evaluate the effectiveness of the medication naltrexone (Revia) for treating alcoholism. Individuals will be inpatients for a 2 week period and provide assessments of their alcohol withdrawal symptoms, craving, and mood. Following hospital discharge, individuals will be assigned randomly to receive naltrexone daily, naltrexone twice a day or a placebo. This part of the study will last 12 weeks, with regular measurements of drinking level, craving and mood. Assessments will be conducted 6 and 12 months after the beginning of the study. Phase(s): Phase IV Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000438
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Naltrexone Treatment of Alcohol Dependence Condition(s): Alcoholism Study Status: This study is completed. Sponsor(s): National Institute on Alcohol Abuse and Alcoholism (NIAAA) Purpose - Excerpt: The long-range goal of this ongoing research program is to find more effective treatments for alcohol dependence by combining medication with the appropriate psychosocial support. This proposal has three specific aims: (1) to compare the effectiveness of naltrexone (Revia) in three types of treatment settings; (2) to assess
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the effects of psychosocial support on medication compliance and treatment retention; and (3) to investigate the individual characteristics that may predict who is likely to benefit from additional psychosocial support versus simple medication management. Phase(s): Phase IV Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000452 ·
Ondansetron Treatment for Alcoholism Condition(s): Alcoholism Study Status: This study is completed. Sponsor(s): National Institute on Alcohol Abuse and Alcoholism (NIAAA) Purpose - Excerpt: The purpose of this study is to: a) evaluate the effectiveness of ondansetron (Zofran) in the treatment of alcohol dependent patients; b) investigate whether early versus late onset alcoholism predicts treatment outcome; and c) determine whether the early and late onset groups respond differently to treatment. Individuals will be "typed" into early onset and late onset alcoholism groups. Individuals will be randomly assigned to a 12-week outpatient treatment program. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000443
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Pharmacologic Relapse Prevention for Alcoholic Smokers Condition(s): Alcoholism; Smoking Study Status: This study is completed. Sponsor(s): National Institute on Alcohol Abuse and Alcoholism (NIAAA) Purpose - Excerpt: This study will compare the long-term use of bupropion (Wellbutrin) and placebo for reducing the rate of smoking relapse in recovering alcoholics who achieved initial abstinence from smoking with nicotine patch therapy. The study will also determine the cessation rate in the 8th week of treatment among recovering alcoholics using a nicotine patch. The patch dose is projected to serve as a 100-percent replacement. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000457
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Preliminary Human Trial of NPI-028 Condition(s): Alcoholism Study Status: This study is not yet open for patient recruitment. Sponsor(s): National Center for Complementary and Alternative Medicine (NCCAM)
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Purpose - Excerpt: This research will determine whether the Chinese herbal medicine (NPI-028) can make a significant contribution to the management of withdrawal and to follow-up treatment aimed at preventing or managing relapse in both women and men alcoholics. The herbal preparation has been used historically in the treatment of alcohol intoxication and is still prescribed in China and Southeast Asia. Efficacy has been documented but awaits the application of current research methods to establish efficacy, safety, and probable mechanisms of action. Preclinical studies have been carried out in alcohol-preferring rats and vervet monkeys to test efficacy in reducing voluntary alcohol intake, measure tolerance effects, and toxicological affects. The proposed human trial will develop a placebo, establish quality control, test methods of administration, and examine compliance issues. Following these preliminary steps, a placebo controlled trial will be conducted using 160 subjects (80 subjects per treatment condition with 40 of each gender). Alcohol use, craving, health status, psychological status, and at rates will be assessed using established measures that are current in addiction research. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00010907 ·
Prevention and Treatment of Hypertension Study (PATHS) Condition(s): Cardiovascular Diseases; Heart Diseases; Hypertension; Vascular Diseases Study Status: This study is completed. Sponsor(s): National Heart, Lung, and Blood Institute (NHLBI); National Institute on Alcohol Abuse and Alcoholism (NIAAA) Purpose - Excerpt: To evaluate the long-term effect of reduction of alcohol intake on blood pressure in moderate but non-dependent drinkers with mild hypertension or high normal blood pressure. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000474
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Sertraline and Cognitive Therapy in Depressed Alcoholics Condition(s): Alcoholism; Depression Study Status: This study is completed. Sponsor(s): National Institute on Alcohol Abuse and Alcoholism (NIAAA) Purpose - Excerpt: This study will assess whether individuals treated with sertraline (Zoloft) and cognitive behavior therapy will experience improvement with their depression and consume less alcohol than individuals treated with a placebo and cognitive behavior therapy. This is a 12-week, random assignment, placebo-controlled, double-blind study with followup assessments 1 and 3 months after treatment. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below
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Web Site: http://clinicaltrials.gov/ct/show/NCT00000458 ·
Sertraline and Naltrexone for Alcohol Dependence Condition(s): Alcoholism Study Status: This study is completed. Sponsor(s): National Institute on Alcohol Abuse and Alcoholism (NIAAA) Purpose - Excerpt: This study is a double-blind, placebo-controlled outpatient trial to improve, through the addition of sertraline (Zoloft), the abstinence and relapse rates in alcohol- dependent individuals currently taking naltrexone (Revia). Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000440
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Sertraline for Alcohol Dependence and Depression Condition(s): Alcoholism; Depression Study Status: This study is completed. Sponsor(s): National Institute on Alcohol Abuse and Alcoholism (NIAAA) Purpose - Excerpt: This study will examine depressed alcoholic outpatients to assess whether combining naltrexone (Revia) and sertraline (Zoloft) will result in greater reductions in both drinking and depression over either medication alone or placebo. A secondary aim is to determine whether certain patient features will predict response to sertraline, naltrexone or the combination of the two drugs. Subjects will be randomized into treatment groups for 16 weeks. The followup phase includes two visits at 6 and 9 months after treatment. Phase(s): Phase IV Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00004554
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Smoking Cessation in Alcoholism Treatment Condition(s): Alcoholism; Smoking Study Status: This study is completed. Sponsor(s): National Institute on Alcohol Abuse and Alcoholism (NIAAA) Purpose - Excerpt: This study is designed to increase understanding of the processes that affect the treatment outcome of individuals with both alcohol and nicotine dependence. Treatment outcome methodology will be combined with a computerized self-monitoring methodology to examine the extent to which smoking serves as a cue for alcohol craving and/or as a response to alcohol craving in treated alcoholics. Subjects will be veterans participating in the Substance Abuse Day Programs at the Newington and West Haven campuses of the VA Connecticut Healthcare System. Nonveteran women will be recruited from the community and enrolled in the day program. Subjects will be randomly assigned to one of the following two conditions: (1) intensive smoking
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cessation therapy (counseling plus nicotine replacement using nicotine patches) concurrent with alcohol treatment, or (2) brief smoking cessation advice concurrent with alcohol treatment. Phase(s): Phase IV Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000454 ·
Use of Naltrexone in a Clinical Setting Condition(s): Alcoholism Study Status: This study is completed. Sponsor(s): National Institute on Alcohol Abuse and Alcoholism (NIAAA) Purpose - Excerpt: This 12-week trial will compare individuals receiving naltrexone or placebo plus substance abuse counseling therapy versus those receiving only substance abuse counseling therapy in a rural, nonacademic setting. A followup period of 12 months is included. The effect on service utilization and the cost of the addition of naltrexone to treatment services for alcohol dependence also will be assessed. The study will expand existing research concerning the effectiveness of naltrexone in clinical trials versus a clinical setting. Phase(s): Phase IV Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000445
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 “alcoholism” (or synonyms). While ClinicalTrials.gov is the most comprehensive listing of NIH-supported clinical trials available, not all trials are in the database. The database is updated regularly, so clinical trials are continually being added. The following is a list of specialty databases affiliated with the National Institutes of Health that offer additional information on trials: ·
For clinical studies at the Warren Grant Magnuson Clinical Center located in Bethesda, Maryland, visit their Web site: http://clinicalstudies.info.nih.gov/
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For clinical studies conducted at the Bayview Campus in Baltimore, Maryland, visit their Web site: http://www.jhbmc.jhu.edu/studies/index.html
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For cancer trials, visit the National Cancer Institute: http://cancertrials.nci.nih.gov/
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For eye-related trials, visit and search the Web page of the National Eye Institute: http://www.nei.nih.gov/neitrials/index.htm
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For heart, lung and blood trials, visit the Web page of the National Heart, Lung and Blood Institute: http://www.nhlbi.nih.gov/studies/index.htm
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For trials on aging, visit and search the Web site of the National Institute on Aging: http://www.grc.nia.nih.gov/studies/index.htm
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For rare diseases, visit and search the Web site sponsored by the Office of Rare Diseases: http://ord.aspensys.com/asp/resources/rsch_trials.asp
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For alcoholism, visit the National Institute on Alcohol Abuse and Alcoholism: http://www.niaaa.nih.gov/intramural/Web_dicbr_hp/particip.htm
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For trials on infectious, immune, and allergic diseases, visit the site of the National Institute of Allergy and Infectious Diseases: http://www.niaid.nih.gov/clintrials/
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For trials on arthritis, musculoskeletal and skin diseases, visit newly revised site of the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health: http://www.niams.nih.gov/hi/studies/index.htm
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For hearing-related trials, visit the National Institute on Deafness and Other Communication Disorders: http://www.nidcd.nih.gov/health/clinical/index.htm
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For trials on diseases of the digestive system and kidneys, and diabetes, visit the National Institute of Diabetes and Digestive and Kidney Diseases: http://www.niddk.nih.gov/patient/patient.htm
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For drug abuse trials, visit and search the Web site sponsored by the National Institute on Drug Abuse: http://www.nida.nih.gov/CTN/Index.htm
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For trials on mental disorders, visit and search the Web site of the National Institute of Mental Health: http://www.nimh.nih.gov/studies/index.cfm
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For trials on neurological disorders and stroke, visit and search the Web site sponsored by the National Institute of Neurological Disorders and Stroke of the NIH: http://www.ninds.nih.gov/funding/funding_opportunities.htm#Clinical_Trials
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CHAPTER 6. PATENTS ON ALCOHOLISM 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 “alcoholism” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on alcoholism, we have not necessarily excluded nonmedical patents in this bibliography.
Patents on Alcoholism By performing a patent search focusing on alcoholism, 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 alcoholism: ·
Allelic association of the human dopamine (D.sub.2) receptor gene in compulsive disorders such as alcoholism Inventor(s): Sheridan; P. J. (San Antonio, TX), Noble; E. P. (Los Angeles, CA), Blum; Kenneth (San Antonio, TX) Assignee(s): Board of Regents, The University of Texas System (Austin, TX), Regents of the University of California (Berkeley, CA) Patent Number: 5,210,016 Date filed: January 23, 1992 Abstract: In an important embodiment, the present invention concerns a method for diagnosing compulsive disease predisposition of an individual. The method comprises initially obtaining a DNA sample of said individual and then determining the presence or absence of a particular human D.sub.2 receptor gene allele in said sample. Detection of said allele in the sample is indicative of predilection to compulsive disease. A most preferred embodiment is to detect predisposition to alcoholism, particularly because said allele has been found to be present in a majority of clinically diagnosed alcoholics. The human D.sub.2 receptor gene A1 allele is most preferably detected in said sample. Excerpt(s): The present invention relates to the first molecular genetic evidence, through the use of RFLP analysis, that an allele in the human dopamine (D.sub.2) receptor gene is more significantly associated with human brain tissue from alcoholics than with brain tissue obtained from nonalcoholics. The occurrence of this disease-associated polymorphism has a high predictive value in the classification of, at least, one probable subtype of alcoholics. ... The identification of a genetic marker that is closely linked to alcoholism means that the gene's inheritance can be followed, leading to simple tests for diagnosing carriers and future disease victims, and potential gene therapy. ... Some authors believe that dopaminergic cells are implicated in the rewarding action of alcohol (23) and of opiates (2). In contrast, others (3) argue that at least alcohols/opiates and alcohol reinforcing effects are mediated primarily by nonadrenergic and not dopaminergic systems in the brain. Whether or not multiple systems exist, the question of several parallel reward mechanisms, or a very few, even one, is yet to be fully resolved. The cause and effect of compulsive behavior diseases, including alcoholism, appears to be biogenic. Regardless of the number of systems involved, the ability to identify an allelic gene segment associated with specific compulsive behavior is a significant step forward in developing predictive tests for compulsive behavior patterns. Web site: http://www.delphion.com/details?pn=US05210016__
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Combination of an opioid antagonist and a selective serotonin reuptake inhibitor for treatment of alcoholism and alcohol dependence Inventor(s): Cook; Leonard (Newark, DE) Assignee(s): Dupont Pharmaceuticals Company (Wilmington, DE) Patent Number: 6,071,918 Date filed: July 21, 1999
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Abstract: The invention relates to a method of treating alcoholism and alcohol dependence in a mammal comprising administering to the mammal a therapeutically effective amount of a synergistic combination of: (i) at least one opioid antagonist, and (ii) at least one selective serotonin reuptake inhibitor. The invention also relates to compositions and kits containing the same. Excerpt(s): This invention relates to a method of treating alcoholism and alcohol dependence in a mammal comprising administering to the mammal a therapeutically effective amount of a synergistic combination of: (i) at least one opioid antagonist, and (ii) at least one selective serotonin reuptake inhibitor. This invention also relates to compositions and kits containing the same. ... The present invention is based on the theory that an unexpected and surprising synergy will be found with a combination therapy involving opioid antagonists and selective serotonin reuptake inhibitors which has been neither disclosed nor suggested by the prior art. Such a therapy would provide a new and highly beneficial method for the treatment of alcohol dependence. ... Disulfiram (Antabuse.RTM.) and Naltrexone (Trexan.RTM.) are the only FDA approved products that are currently available for adjunctive use in the treatment of alcohol abuse (T. W. Rall, in: Goodman and Gilman's The Pharmacological Basis of Therapeutics, A. G. Gilman et al., 8th Edition, Chap. 17, pp. 378-379, Pergamon Press, 1990). Disulfiram works by blocking the intermediary metabolism of alcohol. Most alcohol is normally metabolized to acetaldehyde which is further oxidized to innocuous byproducts which are excreted or recycled through energy-producing or other biosynthetic pathways. When alcohol is consumed in the presence of disulfiram, blood acetaldehyde concentrations increase to many-fold higher than normal values and produce markedly adverse behavioral and physiological responses that are collectively described as the "acetaldehyde syndrome." Psychological theory suggests that patients will avoid further consumption of alcohol to avoid these alarming and potentially life-threatening responses. Web site: http://www.delphion.com/details?pn=US06071918__ ·
Detection of a carbohydrate biomarker directly associated with chronic alcoholism Inventor(s): Raguthu; Simhachalam (Staten Island, NY), Pullarkat; Premilia S. (Staten Island, NY), Pullarkat; Raju K. (Staten Island, NY) Assignee(s): Research Foundation for Mental Hygiene (Albany, NY) Patent Number: 5,958,785 Date filed: August 22, 1997 Abstract: Chronic or long-term alcohol consumption is detected and diagnosed by determining the levels of an alcohol-specific ethanol glycoconjugate biomarker, identified as ethyl .beta.-glucuronide, in body fluids (e.g. urine) of subjects by calorimetric reaction using qualitative and quantitative assay methods. Ethyl glucuronide has been newly observed and detected as a direct indicator of chronic alcohol consumption, and can be isolated and purified. Economical and reproducible assay methods, such as a chromatographic spot assay, ascending or thin layer chromatography assay, and high pressure liquid chromatography assay provide reliable, objective, and sensitive methods for detecting and monitoring a chronic alcoholic condition. Both the presence of the alcohol-specific ethyl glucuronide and a substantial increase in its levels are diagnostic of chronic alcoholism. Since ethyl glucuronide is produced and appears as a direct response to chronic alcohol intake as determined by the present methods, this carbohydrate is considered to be a unique
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biomarker for the detection of alcoholism, with virtually no possibility of false positive results. Excerpt(s): The present invention relates to detectable carbohydrate biomarkers of alcohol consumption and to novel and improved methods for the detection and monitoring of chronic alcoholism. ... Alcoholism is a major health and economic problem which imposes broad reaching concerns not only to the afflicted individuals, but to society at large. In the United States alone, at least ten to twenty million people are classified as chronic alcoholics and long-term alcohol abusers. In addition, other countries have serious problems with chronic alcohol consumption as well as with the objective diagnosis and detection of long-term alcohol use. ... It is known that chronic (i.e. over a period of weeks, months, or longer) alcoholic and long-term alcohol users rarely admit their excessive consumption of alcohol. In spite of attempts to standardize the diagnosis of alcohol abuse and chronic alcoholism based on operational and functional criteria, many problems exist in the detection and diagnosis of alcohol-related disorders. One major problem is that patient cooperation is required, and often, alcoholics do not approach their physicians to ask for help specifically to stop their excessive or pathological drinking. Unfortunately, even when questioned directly by their physicians, alcoholics rarely disclose the true extent of their alcohol consumption, and often deny and minimize any association between their use of alcohol and their other symptoms or problems. Because it is difficult to detect and diagnose alcoholism and alcohol abuse in patients, physicians frequently misdiagnose or under-diagnose alcohol-related disorders. Web site: http://www.delphion.com/details?pn=US05958785__ ·
Detection of novel carbohydrates directly associated with chronic alcoholism Inventor(s): Pullarkat; Premila S. (Staten Island, NY), Raguthu; Simhachalam (Staten Island, NY), Pullarkat; Raju K. (Staten Island, NY) Assignee(s): Research Foundation for Mental Hygiene, Inc. (Albany, NY) Patent Number: 5,747,346 Date filed: May 27, 1994 Abstract: Chronic or long-term alcohol consumption is detected and monitored by determining the level of a newly-observed, alcohol-specific carbohydrate in body fluids (e.g. urine) of subjects by calorimetric reaction using qualitative and quantitative assay methods. The alcohol-specific carbohydrate have been identified as a novel ethyl glucuronide. Ethyl glucuronide is observed and detected in direct response to alcohol consumption in body fluids, and can be isolated and purified. Simple, economical, and reproducible assay methods, such as a spot assay and an ascending or thin layer chromatography assay, provide reliable, objective, and sensitive methods for detecting and monitoring a chronic alcoholic condition. Both the presence of the alcohol-specific ethyl glucuronide and a substantial increase in its levels are indicative of chronic alcoholism. Since the novel ethyl glucuronide is produced and appears as a direct response to chronic alcohol intake, the novel carbohydrate is considered to be a unique biomarker for the detection of alcoholism, with virtually no possibility of false positive results. Excerpt(s): The present invention describes the isolation and characterization of a novel carbohydrate biomarker of alcohol consumption and relates generally to improvements in detecting and monitoring chronic alcoholism. ... Alcoholism is a major health and
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economic problem which imposes broad reaching concerns not only to the afflicted individuals, but to society at large. In the United States alone, at least ten to twenty million people are classified as chronic alcoholics and long-term alcohol abusers. In addition, other countries have serious problems with chronic alcohol consumption as well as with the objective diagnosis and detection of long-term alcohol use. ... It is known that chronic (i.e. over a period of weeks, months, or longer) alcoholic and longterm alcohol users rarely admit their excessive consumption of alcohol. In spite of attempts to standardize the diagnosis of alcohol abuse and chronic alcoholism based on operational and functional criteria, many problems exist in the detection and diagnosis of alcohol-related disorders. One major problem is that patient cooperation is required, and often, alcoholics do not approach their physicians to ask for help specifically to stop their excessive or pathological drinking. Unfortunately, even when questioned directly by their physicians, alcoholics rarely disclose the true extent of their alcohol consumption, and often deny and minimize any association between their use of alcohol and their other symptoms or problems. Because it is difficult to detect and diagnose alcoholism and alcohol abuse in patients, physicians frequently misdiagnose or underdiagnose alcohol-related disorders. Web site: http://www.delphion.com/details?pn=US05747346__ ·
Galanthamine containing transdermal applicator for the treatment of alcoholism Inventor(s): Opitz; K. (Munster, DE) Assignee(s): LTS Lohmann Therapie-Systeme GmbH & Co. (Neuwied, DE), KG and Hefa-Frenon Arzneimittel GmbH & Co. KG. (Werne, DE) Patent Number: 5,932,238 Date filed: September 29, 1992 Abstract: Galanthamine and the pharmaceutically suitable acid addition salts thereof can be used for the treatment of alcoholism; these compounds are released from adequate pharmaceutic formulations which are administered, e.g., orally, transdermally, or otherwise parenterally, in a continuous and controlled manner. Excerpt(s): The present invention relates to the use of galanthamine as well as the pharmaceutically suitable acid addition salts thereof for the treatment of alcoholism. These compounds are released in a continuous and controlled manner from adequate pharmaceutical formulations which are administered, e.g., orally, transdermally or otherwise parenterally. ... The present invention in particular provides pharmaceutical formulations which release suitable compounds in a controlled manner to treat alcoholism. ... Whereas today the acute withdrawal and the treatment of the perilous alcoholic delirium in special wards do not constitute medical problems, there is still no satisfying treatment of chronic alcoholism. About 80% of the treated alcoholics get a relapse within the term of one year. They are in need of a remedy against the alcohol desire resulting in the relapse, which remedy is reliably effective and well tolerated. Web site: http://www.delphion.com/details?pn=US05932238__
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Hemoglobin marker of alcoholism Inventor(s): Hoberman; Henry D. (New Rochelle, NY) Assignee(s): Albert Einstein College of Medicine of Yeshiva University a Division of (Bronx, NY) Patent Number: 4,463,098 Date filed: October 3, 1983 Abstract: An in vitro method for identifying alcoholism and alcohol abuse in humans is disclosed which comprises the isolation and measurement of a unique and stable form of glycosylated hemoglobin. Excerpt(s): This invention relates to a method for measuring alcohol intake in humans. This invention further relates to a method for providing a dose-time record of alcohol consumption. ... To the present time, efforts to identify markers of alcoholism have relied chiefly on evaluating changes in liver biochemistry reflected in the blood by changes in the concentrations of certain amino acids. See Shaw, et al, 1976, Plasma aamino-n-butyric acid to leucine ratio: An empirical biochemical marker of alcoholism, Science, 194: 1057. ... Accumulating evidence indicates, however, that probes that depend on the development of abnormalities of liver function lack the specificity required of a test that, in principle, should do no more than reflect a dose-time record of alcohol consumption. See Morgan, M. Y., et al, 1977, Ratio of plasma a-amino-n-butyric acid to leucine as an empirical marker of alcoholism: Diagnostic value, Science, 197: 1183; Eriksson, S., et al, 1979, Plasma a-amino-n-butyric acid/leucine ratio in alcoholism, N. Eng. J. Med. 300L 93; Kristensson, H., et al, 1977, Serum glutamyl-transferase in alcoholism, Lancet, 1: 609; and Whitehead, T. P., et al, 1978, Biochemical and hematological markers of alcohol intake, Lancet, 1: 978. Web site: http://www.delphion.com/details?pn=US04463098__
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Identification of individuals predisposed toward alcohol abuse Inventor(s): Tabakoff; Boris (2952 S. Haven Dr., Annapolis, MD 21401) Assignee(s): none reported Patent Number: 4,770,996 Date filed: June 12, 1986 Abstract: A method and an assay for ascertaining individuals likely to be predisposed to alcohol abuse is disclosed. The contemplated method ascertains the relative adenylate cyclase and monoamine oxidase activities of blood platelets and includes the steps of isolating platelets from the blood of an individual, assaying the isolated platelets for adenylate cyclase and monoamine oxidase activities, and comparing the observed activities. Excerpt(s): The present invention relates to clinical assays and in particular to assays related to identification of individuals predisposed toward alcoholism. ... One of the major means of reducing the damage due to a pathologic process is early intervention. In this regard, diagnostic tools would have considerable value to the physician. The development of a diagnostic criterion to identify individuals at risk for becoming alcoholic is currently based upon the clear demonstration that genetic factors are important to the development of alcohol-related problems in a significant portion of the alcoholic population, Schuckit, in Medical and Social Aspects of Alcohol Abuse, B.
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Tabakoff et al., (eds.), p. 31, Plenum Press, N.Y. (1983). Thus, gene products which predispose an individual to alcohol-related problems, or closely linked gene products, could be used as "markers" to identify individuals potentially at risk for developing alcohol-related health and social problems. Early identification of "predisposed" individuals could allow primary intervention and prevention efforts to be instituted. ... Although substantial work has been directed at exploring biochemical or physiological candidates for "markers," the quest is far from complete. Such studies have included examination of blood groups, Hill et al., J. Stud. Alc. 36:981 (1972), color blindness, Cruze-Coke et al., Lancet 2:1281 (1966), and enzymes related to the metabolism of ethanol, Agarwal et al., Pharmacol. Biochem. Behav. 18(Suppl. 1):89 (1983). These approaches have not proved to be successful. More recently, Schuchkit, Pharmacol. Biochem. Behav. 13(Supp. 1):9 (1980), has reported that sons of alcoholics ("family history-positive" individuals) generate, ethanol-derived blood acetaldehyde levels twice those generated by matched family history-negative individuals. Since these studies have been criticized with regard to methods employed for measurement of acetaldehyde, Eriksson, Science 207:1383 (1980), the utility of this measure must await the resolution of this controversy. Also, Von Knorring et al., Acta Psychiatrica Scandinavia 72:51 (1985) have suggested that platelet monoamine oxidase activity measures could be of value in identifying particular subgroups of alcoholics. However, examination of the presented data casts doubt that monoamine oxidase activity, in and of itself, is a distinguishing parameter for identifying individuals predisposed to alcoholism. Web site: http://www.delphion.com/details?pn=US04770996__ ·
Injectable fomulations of disulfiram for the treatment of alcoholism Inventor(s): Phillips; Michael (1740 Hinman Ave., Apt. 3B, Evanston, IL 60201) Assignee(s): none reported Patent Number: 4,678,809 Date filed: February 1, 1985 Abstract: The disclosure is of the use of an injectable formulation of disulfiram for the treatment of alcoholism. One formulation comprises disulfiram and a biodegradable polymer. Another formulation comprises a slurry of disulfiram in normal saline. After injection, disulfiram is released from the injection site in a sustained-release manner. Excerpt(s): The present invention concerns an improved injectable formulation of the drug disulfiram, for use in the treatment of alcoholism. ... Disulfiram (DSF) is a drug widely used in the treatment of alcoholism. Anyone who consumes ethyl alcohol after pretreatment with DSF (taken orally) will experience the subjectively unpleasant Disulfiram-Ethanol Reaction (DER) characterized by nausea, palpitations, flushing, hyperventilation and hypotension. In theory, treatment of an alcoholic patient with DSF should discourage a relapse into impulsive drinking. In practice, DSF therapy often ends in failure when the patient stops taking the drug and resumes drinking after the effects have worn off. An alternative approach, parenteral therapy with subcutaneous implants of sterile DSF tablets has been widely practiced for many years but it is now clear that these implants are inactive placebos which can not elicit a true DER in alcoholic humans. Alcoholics implanted with DSF tablets do not experience a DER after drinking alcohol, nor do they drink significantly less alcohol than those implanted with an inactive placebo. These failures of therapy are probably due to subtherapeutic dosage as well as the poor bioavailability of DSF tablets in the subcutaneous milieu where they
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often become encapsulated by fibrotic tissue. The following references describe relevant prior art methods: Bergstrom et al., Lancet 1:49-50, 1982; Kline and Kingstone, Can Med Assoc. J. 116:1382-1383, 1977; Lewis et al., Can Psychiatr. Assoc J. 20:283-286, 1975. ... Detoxification of an alcoholic induces a remission of the disease which may be followed by an acute relapse into abusive drinking at any time; treatment with an effective sustained-release formulation of DSF is likely to prolong the duration of the initial remission and lengthen the period between subsequent relapses. Web site: http://www.delphion.com/details?pn=US04678809__ ·
Marker for individuals susceptible to alcoholism Inventor(s): Park; David (New York, NY), Ricketts; Michael (Somerset, NJ), Poretz; Ronald D. (Marlboro, NJ), Manowitz; Paul (East Brunswick, NJ) Assignee(s): Algene LLC (East Brunswick, NJ) Patent Number: 5,736,325 Date filed: August 31, 1994 Abstract: The present invention relates to methods for diagnosis of susceptibility to alcoholism or the pathological effects of alcoholism based on detection of a genetic marker in an individual. The present invention is directed generally to methods and associated compositions and kits for detecting the presence of arylsulfatase A (ASA) pseudodeficiency (PD) mutations in humans. Detection of these mutations has been surprisingly found to be a strong indicator for susceptibility to alcoholism and/or susceptibility to alcohol's pathological effects, as well as an important marker in evaluating the likelihood of metachromatic leukodystrophy (MLD). Excerpt(s): The present invention relates to methods for diagnosis of susceptibility to alcoholism or the pathological effects of alcoholism based on detection of a genetic marker in an individual. ... A large number of adoption and twin studies indicate that there is a genetic factor or factors to at least some forms of alcoholism (Goodwin, 1979, Arch. Gen. Psychiatry 36:57-61). However, to date, the only genetic factor that has been clearly identified in alcoholism is a deficiency in aldehyde dehydrogenase activity. This deficiency leads to a reduction, not an increase, in the rate of alcoholism. ... Earlier studies showed that arylsulfatase A (ASA) electrophoresed in native polyacrylamide gels and stained for enzymatic activity exhibited a variety of electrophoretic patterns, some of which were more likely to be found in alcoholic patients than in non-alcoholic psychiatric and normal control subjects (Hulyalkar et al., 1984, Alcoh.: Clin. Exp. Res. 8:337-341). However, lacking any biochemical explanation for these observations, no correlation with a genetic basis or marker for alcoholism was possible. Web site: http://www.delphion.com/details?pn=US05736325__
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Method and means for treating alcoholism by extinguishing the alcohol-drinking response using a transdermally administered opiate antagonist Inventor(s): Sinclair; John D. (Espoo, FI) Assignee(s): Alko Ltd. (Helsinki, FI) Patent Number: 5,096,715 Date filed: November 20, 1989
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Abstract: A method for treating alcoholism by extinguishing the alcohol-drinking response in which an opiate antagonist is transdermally administered to a subject and a device for transdermally administering the antagonist. The device is a package containing a fixed dose of opiate antagonist, a vehicle and a permeation enhancer. Excerpt(s): This invention relates to the treatment of alcoholism and particularly to an extinction method of treating alcoholism using a transdermally administered opiate antagonist. The invention also relates to a device for the rapid, transdermal administration or delivery of a fixed dose of the opiate antagonist. ... A method for treating alcoholism by extinguishing the alcohol-drinking response is described in copending United States patent application Ser. No. 205,758, the disclosure of which is incorporated herein in its entirety by reference. In this extinction method, an opiate antagonist is administered to a subject suffering from alcoholism in a daily dosage sufficient to block the stimulatory effect of alcohol and, while the amount of antagonist in the subject's body is sufficient to block the stimulatory effect of alcohol, the subject is made to drink an alcoholic beverage. The steps of administration of the opiate antagonist and drinking of an alcoholic beverage are continued until the alcoholdrinking response is extinguished. ... Existing methods for administering opiate antagonists, however, are inadequate for use in the extinction of the alcohol-drinking response. Web site: http://www.delphion.com/details?pn=US05096715__ ·
Method for the inhibition of ALDH-I useful in the treatment of alcohol dependence or alcohol abuse Inventor(s): Vallee; Bert L. (Brookline, MA), Keung; Wing-Ming (Wayland, MA) Assignee(s): The Endowment for Research in Human Biology, Inc. (Boston, MA) Patent Number: 5,624,910 Date filed: May 24, 1994 Abstract: Method for inhibiting aldehyde dehydrogenase activity using daidzin and/or daidzin analog and/or daidzin or daidzin analog in combination with a factor or factors which increase the bioavailability of the daidzin or daidzin analog, as ALDH-I inhibitory compounds or compositions. Such inhibitory compounds or compositions are useful as pharmaceutical compositions in methods for the treatment of alcohol dependence (i.e., alcoholism) or alcohol abuse, for alcohol sensitization, for extinguishing an alcohol-drinking response, for suppressing an urge for alcohol, for inducing alcohol intolerance, for preventing alcoholism in an individual with or without a susceptibility or predisposition to alcoholism or alcohol abuse, and for limiting alcohol consumption in an individual whether or not genetically predisposed. Excerpt(s): Alcohol abuse and alcohol dependence (i.e., alcoholism) are serious public health problems of modern society. In the United States alone, an estimated 13 million adults exhibit symptoms of alcohol dependence due to excessive alcohol intake, and an additional 7 million abuse alcohol without showing symptoms of dependence according to U.S. Government projections from studies conducted in the mid-1980s. Alcohol dependence and abuse are very expensive: in economic and medical terms, it will cost the U.S. well over $200 billion in 1991 with no prospect of falling or leveling off. The social and psychological damages inflicted on individuals as a consequence of alcohol abuse, e.g., children born with fetal alcohol syndrome (FAS) and victims of alcoholrelated accidental death, homicide, suicide, etc., are immense. ... While it is generally
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accepted that alcoholism and alcohol abuse are afflictions with staggering international economic, social, medical, and psychological repercussions, success in preventing or otherwise ameliorating the consequences of these problems has been an elusive goal. Only very recently the public view that alcoholism and alcohol abuse are remediable solely by moral imperatives has been changed to include an awareness of alcoholism and alcohol abuse as physiological aberrations whose etiology may be understood and for which therapy may be found through scientific pursuits. Both alcohol abuse and dependence arise as a result of different, complex, and as yet incompletely understood processes. At present, alcohol research is in the mainstream of scientific efforts. ... Prior to our research (for example, see Blair and Vallee, 1966, Biochemistry 5:2026-2034), ADH in man was thought to exist in but one or two forms, primarily in the liver, where it was considered the exclusive enzyme for the metabolism of ethanol. Currently, four different classes of ADH encompassing over twenty ADH isozymes have been identified and isolated from human tissues. There is no reason to believe that all of these ADH isozymes are necessary to catalyze the metabolism of a single molecule, ethanol, even though all of them can interact with it. We have proposed that the normal function of these isozymes is to metabolize other types of alcohols that participate in critical, physiologically important processes, and that ethanol interferes with their function (Vallee, 1966, Therapeutic Notes 14:71-74). Further, we predicted that individual differences in alcohol tolerance might well be based on both qualitative and quantitative differences in isozyme endowment (Vallee, 1966, supra). Web site: http://www.delphion.com/details?pn=US05624910__ ·
Method for treating alcohol dependence Inventor(s): Overstreet; David (Chapel Hill, NC), Rezvani; Amir Hosein (Chapel Hill, NC), Pei; Yue-Hu (Durham, NC), Lee; David Yue-Wei (Chapel Hill, NC) Assignee(s): Natural Pharmacia International, Inc. (Research Triangle Park, NC) Patent Number: 5,783,189 Date filed: April 23, 1996 Abstract: Isoflavonoids containing a carbon-carbon linked .beta.-D-glucose moiety at the C-8 position and isolated from the Chinese herbal plant Pueraria lobata are useful for treating alcohol dependence. Excerpt(s): The present invention relates to methods of treating and preventing alcohol dependence with a class of isoflavonoids containing a carbon-carbon linked .beta.-Dglucose moiety at the C-8 position. ... Alcoholism and alcohol related diseases are threatening human health at an alarming rate and are posing major medical, social, and economic problems. In the United States alone, 10% of the population is affected by alcoholism and an even higher percentage consume excessive amounts of alcohol. Recently, adolescent drinking has become a serious threat to the health of our next generation. Thus, there is an urgent need for the development of effective therapeutic agents for treating alcohol abuse and alcoholism. ... Despite greater effort devoted to treatment research in recent years, definitive, effective remediation of alcoholism remains a challenging goal. Much current research in the treatment of alcoholism has been centered around the clinical use of drugs in the management of alcohol withdrawal. The benzodiaze-pines are most frequently used and newer medications are being investigated (Litten and Allen, 1991; O'Malley et al., 1992a; Soyka, 1995a,b). The antidipsotropic agent disulfiram was the first and until recently the only drug approved for the treatment of alcohol dependence in the United States.
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Web site: http://www.delphion.com/details?pn=US05783189__ ·
Method for treating alcoholism and eliminating and preventing alcohol intoxication Inventor(s): Revici; Emanuel (1111 Park Ave., New York, NY 10028) Assignee(s): none reported Patent Number: 4,368,206 Date filed: December 21, 1979 Abstract: The invention relates to a method of treating alcoholism and for aiding in controlling alcohol intoxication in humans by the internal administration of a composition produced by heating certain allylically unsaturated compounds sufficient to substantially increase the peroxide titer. The incorporation of sulfur in the composition during the heating has been found to be particularly advantageous. Excerpt(s): There has been much recent interest in the study of alcoholism involving biological, psychological, and sociological investigations. Publications such as the various "Proceedings of the . . . Annual Alcoholism Conference" and "Recent Advances in Studies of Alcoholism", obtainable from the Superintendent of Documents, U.S. Government Printing Office, Washington, D.C. 20402, indicate the rather intensive scientific investigations in this area. Some of these studies are concerned with the effect on a host produced by certain chemicals in combination with alcohol. ... An article by E. B. Truitt and M. J. Walsh appearing at p. 100 et sequa of "Proceedings of the First Annual Alcoholism Conference of the National Institute on Alcohol Abuse and Alcoholism", DHEW Publication No. (NIH) 74-675 (1973) discloses a number of chemicals and drugs which have been reported to have anti-alcohol effects. Included in this list are disulfiram (tetraethylthiuram disulfide--see also U.S. Pat. No. 2,567,814 Jacobsen et al), calcium carbimide (see also U.S. Pat. No. 2,998,350 de Grunigen et al), and thiocyanates which are used specifically for their anti-alcohol properties. ... U.S. Pat. No. 3,860,719 Marshall discloses the use of 2-[(3,4-dichlorophenoxy)methyl]-2imidazoline hydrochloride (fenmetozole HCl) for combating ethanol intoxication in mammals. Web site: http://www.delphion.com/details?pn=US04368206__
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Method for treating alcoholism with nalmefene Inventor(s): Scheinin; Harry (Piispanristi, FI), Sinclair; John D. (Espoo, FI), Lammintausta; Risto (Turku, FI) Assignee(s): Alko Ltd. (Helsinki, FI), Orion-Yhtyma Oy (Espoo, FI) Patent Number: 5,086,058 Date filed: June 4, 1990 Abstract: A method for treating alcoholism. The alcohol-drinking response of alcoholics is extinguished by having them drink alcoholic beverages while nalmefene, an opiate antagonist, blocks the positive reinforcement effect of ethanol in the brain. Excerpt(s): The present invention relates to a treatment for alcohol abuse in which the alcohol-drinking response is extinguished over a limited number of sessions by being emitted while reinforcement from alcohol is blocked with nalmefene. ... U.S. Pat. No. 4,882,335 discloses a method for treating alcoholism in which the learned response of
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alcohol drinking is extinguished by being emitted while the reinforcement from alcohol in the brain is blocked with an opiate antagonist. ... The antagonists disclosed for use in the method described in U.S. Pat. No. 4,882,335, however, have various disadvantages. Of the antagonists specifically disclosed, i.e., naloxone, naltrexone, cycloazocine, diprenorphine, etazocine, levalorphan, metazocine, nalorphine and salts thereof, only naloxone and naltrexone are approved for general use. Naloxone cannot be taken orally. Naltrexone can be taken orally but because of a high first-pass metabolism, its oral availability is only 5%. Variability in first-pass metabolism also makes oral dosing with naltrexone less predictable than desired. Web site: http://www.delphion.com/details?pn=US05086058__ ·
Method for treating patients suffering from anxiety neurosis and anxietylike neurosis, and alcoholism Inventor(s): Bruinvels; Jacques (DE Bilt, NL), Pepplinkhuizen; Lolke (Rotterdam, NL) Assignee(s): Erasmus Universiteit Rotterdam (Rotterdam, NL) Patent Number: 4,156,013 Date filed: June 9, 1978 Abstract: Patients suffering from anxiety neurosis and anxietylike neurosis often accompanied by alcoholism are treated by administration of medicine containing a .beta.-(p-halogen phenyl)-.GAMMA.-aminobutyric acid as active compound. As a result these patients were totally freed from the above mentioned complaints. Excerpt(s): The invention relates to a process for the preparation of a medicine having anti-anxiety neurosis and anti-anxietylike neurosis activity and to a medicine having such activity. ... From clinical trials it appeared that patients having anxiety neurosis, as defined by Woodruff, R. A., Goodwin, D. W. and Guze, S. B. and Wheeler, E. O., White, P. D., Reed, E. W. and Cohen, M. E., did not show any amelioration upon administration of known anxiolytics. ... The symptoms of anxiety neurosis, as defined by Woodruff and Wheeler, are in decreasing significancy: palpitation, tires easily, breathlessness, nervousness, chest pain, sighing, dizziness, faintness, apprehensiveness, headache, paresthesias, weakness, trembling, breath unsatisfactory, insomnia, unhappiness, shakiness, fatigued all the time, sweating, fear of death, smothering, syncope, urinary frequency, vomiting and diarrhea and anorexia. Web site: http://www.delphion.com/details?pn=US04156013__
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Method for treatment of alcohol abuse Inventor(s): Casten; George P. (Evansville, IN), Shrotryia; Rajesh (Woodbridge, CT) Assignee(s): Bristol-Myers Company (New York, NY) Patent Number: 4,777,173 Date filed: March 25, 1987 Abstract: Buspirone and its pharmaceutically acceptable salts are useful in the treatment of alcohol abuse. Excerpt(s): This invention is concerned with a drug bioaffecting body-treating process which employs the pyrimidine compound 8-[4-[4-(2-pyrimidinyl)-1-piperazinyl]butyl]-
Patents 361
8-azaspiro [4.5]decane-7,9-dione or a pharmaceutically acceptable acid addition salt thereof. ... The synthesis of the compound and the disclosure of its psychotropic properties are described in the following patents and publications. ... 1. Y. H. Wu, et al., J. Med. Chem., 15.477 (1972). Web site: http://www.delphion.com/details?pn=US04777173__ ·
Method of employing therapeutic composition comprising ammonium or substituted ammonium compounds for treatment of alcoholism Inventor(s): Revici; Emanuel (New York, NY) Assignee(s): The Vinoxen Company (New York, NY) Patent Number: 4,346,082 Date filed: February 27, 1981 Abstract: This invention relates to a method of treating alcoholism and for eliminating, reducing or preventing alcohol intoxication or the manifestations of alcohol intoxication in humans by administering thereto a therapeutic composition comprising an ammonium compound or compounds, said compounds and each of said compounds having a pH greater than 5.0 when in aqueous solution at a concentration of 5 grams per 100 grams of solution (5 weight percent), and particularly ammonium salt compounds containing ammonium cations and sulfur anions. Excerpt(s): Various pharmaceutical uses of ammonium compounds have long been recognized. For example, the following ammonium compounds (as listed in Hackh's Chemical Dictionary, 4th Ed. McGraw-Hill, New York pages 37-40) have the following medicinal uses as indicated therein. Ammonium acetate is used as an antipyretic and diaphoretic antidote in formaldehyde poisoning; ammonium benzoate has been used as an antipyretic, diuretic and alternative; ammonium bromide is used to treat neuralgia; ammonium carbamate is used as a stimulant; ammonium carbonate carbamate (Hartshorn salt) is used as a heart stimulant; ammonium chloride is used as an expectorant, stimulant diuretic or disphoretic, as well as externally; ammonium formate is used as an antiseptic; ammonium hypophosphite is a nerve tonic; ammonium thiosulfate can be used as an antiseptic, ammonium iodide is used to treat syphilis and leprosy; ammonium persulfate is used as a disinfectant; ammonium phosphate can be used as an antirheumatic; ammonium salicylate is used as an antirheumatic, antipyretic, expectorant, and bactericide; and ammonium valerate is a hypnotic, sedative, and tonic. Ammonium thiosulfate has long been a standard industrial commodity, and U.S. Pat. No. 3,350,168 to Ziegler indicates that U.S. consumption of ammonium thiosulfate totaled 30,000 tons per year at the time of such patent. U.S. Pat. No. 3,890,428 to Jayawant and U.S. Pat. No. 3,973,793 to Netzger et al. indicates that ammonium thiosulfate has long been employed as a photographic fixer. ... A publication entitled "Testing for a `Sobering Pill`," DOT HS-801 208 (1974), available from National Technical Information Service, Springfield, Va. 22151, discloses that a number of compounds, including ammonium chloride, were investigated to determine their potential for blocking or neutralizing the effect of alcohol on a human brain. While the most effective amethystic agent (a preventive antidote of drunkenness) found was L-dopa, with respect to ammonium chloride, which has a relatively low molar pH in aqueous solution, the publication concludes that ammonium chloride does not appear to act as an amethystic agent. ... None of the reference teaches the use of the compositions of the present invention as a treatment for alcoholism or eliminating and preventing alcohol intoxication or the manifestations of alcohol intoxication.
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Web site: http://www.delphion.com/details?pn=US04346082__ ·
Method of preparing and using isoflavones for the treatment of alcoholism Inventor(s): Empie; Mark (Forsyth, IL), Gugger; Eric (Latham, IL) Assignee(s): Archer Daniels Midland Company (Decatur, IL) Patent Number: 6,399,072 Date filed: July 13, 2000 Abstract: A composition is prepared by extracting phytochemicals from plant matter for treatment of alcohol dependency. This composition is enriched preferably with two or more fractions of plant matter, namely: isoflavones, lignans, saponins, sapogenins, catechins and phenolic acids. Soy is the preferred source of these chemicals; however, other plants may also be used, such as wheat, psyllium, rice, oats, red clover, kudzu, alfalfa, flax, and cocoa. The composition is a dietary supplement for treatment of alcoholism. The isoflavone may be any in a group including malonyl, acetyl, glucoside, and aglycone. The composition is in a concentrated form to be delivered in an easy to consume dosage, such as a pill, tablet, liquid, capsule, or a food supplement including a health bars. Excerpt(s): This invention relates to compositions extracted from vegetable matter and more particularly to phytochemicals, including saponogenins and saponins, lignans, phenolic acids, catechins and isoflavones, and especially those extracted from a family of plants including soy, flax, tea, and cocoa and methods of using these compositions as nutritional supplements or food additives. ... As used herein, the term "isoflavone" includes malonyl, acetyl, glucoside, and aglycone forms of the isoflavones. ... Alcoholism is, perhaps, the most widespread addiction which is responsible for more deaths than the rest of the addictive drugs combined. It is also one of the addictions which is the most difficult to overcome. It is thought that one of the more successful treatments for helping recovering alcoholics is a use of a phytochemicals, especially isoflavones, as a source of supplemental hormones. However, it is also thought that there are superior results when a plurality of such phytochemicals are consumed in combinations. Web site: http://www.delphion.com/details?pn=US06399072__
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Method of treating alcohol dependence Inventor(s): Bonin; Wilfred P. (Houston, TX) Assignee(s): Bonin Centers, Inc. (Houston, TX) Patent Number: 5,418,255 Date filed: January 13, 1993 Abstract: Disclosed is a method of treating alcohol dependence in which an ethanol solution is intravenously administered. The ethanol concentration is preferably about 5 to 25% by volume, and more preferably about 10 to 20% by volume. The solution is administered over several days in progressively decreasing quantities. For those treated for the first time, it is preferred that the treatment program extend over ten days. Patients previously treated who re-lapse into drinking can usually be effectively retreated with a program lasting for a shorter period, such as for six days.
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Excerpt(s): The invention relates to a treatment for alcohol dependence involving intravenous infusion of an alcohol solution. ... Alcohol dependence (also known as alcoholism) is well recognized as substance abuse disorder. See Diagnostic and Statistical Manual of Mental Disorders 3rd. Ed. (1980), American Psychiatric Association, Washington D.C., ("DSM III") at p. 169. Alcohol dependence is more common among family members than in the general population, indicating that there is a genetic factor involved in this disease. DSM III at p. 169. ... Alcohol dependence can be diagnosed where there is either tolerance to increased amounts of alcohol, or withdrawal symptoms when drinking is ceased or reduced. It can also be diagnosed where there is a pattern of pathological alcohol use, or impairment in social or occupational functioning due to alcohol use. The latter diagnostic criteria involve the behavior which often causes serious problems for both the alcoholic and those close to him or her. Such behavior includes violence while intoxicated, absence from work, loss of employment, legal problems related to alcohol--e.g., arrests for intoxicated behavior or traffic accidents while intoxicated--and arguments or difficulties with family or friends because of excessive alcohol use. DSM III at p. 170. Web site: http://www.delphion.com/details?pn=US05418255__ ·
Method of treating alcoholism Inventor(s): Shiba; Motoharu (Ohmiya, JA), Mitsuishi; Etsuko (Tokyo, JA), Nishii; Yasuho (Niiza, JA), Mizuno; Koji (Tokorozawa, JA), Hata; Shun-ichi (Yokohama, JA) Assignee(s): Chugai Seiyaku Kabushiki Kaisha (Tokyo, JA) Patent Number: 4,027,017 Date filed: July 7, 1975 Abstract: A pharmaceutical composition for treating alcoholism containing a uridine diphosphate glucuronic acid as an effective ingredient and a method of the use thereof are disclosed. Excerpt(s): This invention relates to a pharmaceutical composition and a method of use thereof; particularly it relates to a pharmaceutical composition containing a uridine diphosphate glucuronic acid as an effective ingredient for treatment of alcoholism and a method of use thereof. ... Ethanol has been generally taken as an alcoholic drink, but it often causes acute and chronic alcoholism. The intake of a large amount of alcoholic drinks in a short period of time depresses the central nervous system and, thus, causes acute alcoholism such as drunkenness, dead drunkenness and coma. When taking a large amount of alcoholic liquor regularly becomes a habit, certain serious physical and mental disorders known as chronic alcoholism result. In these cases, it has been observed that the amount of neutral lipid accumulated in the liver is unusually high and this becomes a cause of liver disorder. ... An object of the invention is to provide a pharmaceutical composition for treatment of alcoholism which comprises a uridine diphosphate glucuronic acid in an amount sufficient to realize treatment of alcoholism and a pharmaceutically acceptable carrier, and another object of this invention is to provide a method of treating alcoholism by the use of the pharmaceutical composition for treatment of alcoholism. Web site: http://www.delphion.com/details?pn=US04027017__
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Method of treating alcoholism and complications resulting therefrom Inventor(s): Peddaiahgari; Seetharamulu (San Antonio, TX) Assignee(s): BioNumerik Pharmaceuticals, Inc. (San Antonio, TX) Patent Number: 6,245,815 Date filed: April 15, 2000 Abstract: This invention relates to a method of treating patients afflicted with alcoholism. The method includes administering to a patient in need of treatment an effective amount of a thiol or reducible disulfide compound according to the formula set forth in the specification. Excerpt(s): This invention relates to a method for treating a patient suffering from alcoholism, or from complications caused thereby. The method involves administering an effective amount of a disulfide or thiol-containing compound to a patient suffering from alcoholism or from complications of alcoholism. ... Alcoholism has been and continues to be the foremost social problem of our era. Each year, alcohol is blamed for thousands of highways deaths and injuries, thousands of lost work hours, hospital costs due to related complications, and many other societal problems. ... Effective treatments for alcoholism include psychological support and reinforcement through support groups. Like other substance abuse treatment programs, alcohol support groups are heavily dependent on the desire of the individual to treat his/her dependence. Web site: http://www.delphion.com/details?pn=US06245815__
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Method of treating nutritional deficiency during cardiac cachexia, diabetes, hypoglycemia, gastroenterology, lipid, cell glycogen and keratin-related skin conditions and alcoholism Inventor(s): Goren; Alvin J. (North Bergen, NJ), Gans; Arnold M. (Closter, NJ), Gorenberg; Eli M. (Fair Lawn, NJ) Assignee(s): Control Drug Inc. (Port Redding, NJ) Patent Number: 4,053,589 Date filed: June 22, 1976 Abstract: A method of treating nutritional deficiency during cardiac cachexia, diabetes, hypoglycemia, gastroenterology, skin conditions related to lipid, cell glycogen and keratin deficiencies and alcoholism which comprises ingestion of a pre-digested protein composition containing all of the essential amino acids and having a palatable taste and odor. Excerpt(s): This invention relates to a method and composition for providing a highly efficient source of nutrition without undesirable side effects, and it especially relates to the provision of a source of protein in concentrated but highly palatable form. ... One of the most significant aspects of the present invention is its utilization in the prevention of nutritional deficiency which is caused by disease or which is an undesirable condition in the treatment of a disease or surgical procedure. ... The crucial effect in the body's response to nutritional deficiency or starvation is the preservation of the size and character of the body cell mass. The term "body cell mass" denotes the total mass of living, functioning, energy-exchanging, and mitotically active cells of the body comprising two large groups of tissues, namely skeletal muscle and visceral parenchyma.
Patents 365
Web site: http://www.delphion.com/details?pn=US04053589__ ·
Methods and assays useful in the treatment of alcohol dependence or alcohol abuse Inventor(s): Vallee; Bert L. (Boston, MA), Keung; Wing-Ming (Wayland, MA) Assignee(s): The Endowment for Research in Human Biology (Boston, MA) Patent Number: 6,121,010 Date filed: May 12, 1999 Abstract: A method for the treatment of alcohol abuse using daidzin and compounds analogous to daidzin is disclosed. Also disclosed is a method for screening compounds having antidipsotropic activity. Excerpt(s): Embodiments of the present invention relate in general to novel methods useful in the treatment of alcohol dependence or alcohol abuse. Embodiments of the present invention also relate to novel assay systems useful in initial screening of compounds having an antidipsotropic effect. Such compounds are useful in therapeutic methods of reducing alcohol consumption as a treatment for alcohol dependence or alcohol abuse. ... Alcohol abuse and alcohol dependence (i.e., alcoholism) are serious public health problems of modern society. In the United States alone, an estimated 13 million adults exhibit symptoms of alcohol dependence due to excessive alcohol intake, and an additional 7 million abuse alcohol without showing symptoms of dependence according to U.S. Government projections from studies conducted in the mid-1980s. Alcohol dependence and abuse are very expensive: in economic and medical terms, it will cost the U.S. well over $200 billion in 1991 with no prospect of falling or leveling off. The social and psychological damages inflicted on individuals as a consequence of alcohol abuse, e.g., children born with fetal alcohol syndrome (FAS) and victims of alcohol-related accidental death, homicide, suicide, etc., are immense. ... While it is generally accepted that alcoholism and alcohol abuse are afflictions with staggering international economic, social, medical, and psychological repercussions, success in preventing or otherwise ameliorating the consequences of these problems has been an elusive goal. Only very recently the public view that alcoholism and alcohol abuse are remediable solely by moral imperatives has been changed to include an awareness of alcoholism and alcohol abuse as physiological aberrations whose etiology may be understood and for which therapy may be found through scientific pursuits. Both alcohol abuse and dependence arise as a result of different, complex, and as yet incompletely understood processes. At present, alcohol research is in the mainstream of scientific efforts. Web site: http://www.delphion.com/details?pn=US06121010__
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Pharmaceutic formulation for the treatment of alcoholism Inventor(s): Opitz; Klaus (Munster, DE) Assignee(s): Hefa-Frenon Arzneimittel GmbH & Co. KG (Werne, DE), LTS Lohmann Therapie-Systeme GmbH + Co. KG (Neuwied, DE) Patent Number: 5,519,017 Date filed: May 5, 1994
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Abstract: Galanthamine and the pharmaceutically suitable acid addition salts thereof can be used for the treatment of alcoholism; these compounds are released from adequate pharmaceutic formulations which are administered, e.g., orally, transdermally, or otherwise parenterally, in a continuous and controlled manner. Excerpt(s): The present invention relates to the use of galanthamine as well as the pharmaceutically suitable acid addition salts thereof for the treatment of alcoholism. These compounds are released in a continuous and controlled manner from adequate pharmaceutical formulations which are administered, e.g., orally, transdermally or otherwise parenterally. ... The present invention in particular provides pharmaceutical formulations which release suitable compounds in a controlled manner to treat alcoholism. ... Whereas today the acute withdrawal and the treatment of the perilous alcoholic delirium in special wards do not constitute medical problems, there is still no satisfying treatment of chronic alcoholism. About 80% of the treated alcoholics get a relapse within the term of one year. They are in need of a remedy against the alcohol desire resulting in the relapse, which remedy is reliably effective and well tolerated. Web site: http://www.delphion.com/details?pn=US05519017__ ·
Prevention and treatment of alcoholism by the use of dietary chromium Inventor(s): Dobbins; John P. (615 Allen Ave., San Marino, CA 91108) Assignee(s): none reported Patent Number: 5,013,752 Date filed: April 16, 1990 Abstract: Prevention of or therapeutically curing the disease of alcoholism comprises supplementing the diet with biologically available chromium, such as naturally occurring chelated chromium. A food bar containing chromium picolinate is also disclosed. Excerpt(s): This invention relates generally to the treatment of alcoholism, and more particularly, to supplementing the diet with assimilable chelated chromium, for this purpose. ... The assimilation of an adequate quantity of physiologically important micronutrients is essential to the health of both humans and animals. Failure of the body to ingest and absorb the necessary amounts of essential micronutrients (e.g., vitamins and/or minerals) can lead to improper functioning of the metabolic processes as well as to a variety of diseases and associated symptoms. For example, anemia is correlated with an iron deficiency, and goiter is correlated with an iodine deficiency. ... Dr. Walter Merz of the Human Nutrition Laboratory in Bethesda, Md., was the first scientist to describe the occurrence and function of chromium in biological systems (Physiological Rev. 49:163, 1969). This was followed in 1970 by the proclamation of Dr. Henry A. Schroeder, Professor of Physiology Emeritus at the Darmouth Medical School, that chromium deficiency was a factor in atherosclerosis (Jour. Chronic Diseases 23:123). Regrettably, this knowledge was not then recognized, accepted, and applied to medical practice. Most recently, Gary W. Evans, PhD, and Muriel B. Gilman at Bemidji State University, Mont. 56601, have prepared a paper (for 1989 publication in one of the journals of the American Chemical Society) titled "Anabolic Effect of Chromium Picolinate". Therein they identify metabolic mechanisms showing how ingestion of naturally occurring chromium beneficially decreases LD ("bad") cholesterol and increases HD ("good") cholesterol in blood serum. They link these observations to "death from heart disease" and to treatment and prevention of diabetes.
Patents 367
Web site: http://www.delphion.com/details?pn=US05013752__ ·
Safe pharmaceutical composition for treating and preventing alcohol abuse and increasing immune function Inventor(s): Liu; Yaguang (67-08 168th St., Flushing, NY 11365) Assignee(s): none reported Patent Number: 5,834,605 Date filed: July 7, 1997 Abstract: The safe pharmaceutical composition and processed are provided for treating and preventing alcohol abuse and increasing immune function. The pharmaceutical composition is composed of Puerarin derivatives, which includes Puerarin, Daidzein or Genistia. Excerpt(s): This invention relates to a safe and natural pharmaceutical composition for treating and preventing alcohol abuse and increasing immune function contains Puerarin derivatives. The processes for producing Puerarin derivatives and related pharmacological effect are provided. ... Alcohol abuse (alcoholism) is a major medical and public health problem in many societies. About 10% of all deaths in the United States may be directly alcohol-related. Alcohol abuse leads to increase risk especially by motor vehicle and fire and other accidents. Alcohol abuse is also leads work and family problems and associated with brain damage, cancer, heart attacks and high blood pressure. ... Antabuse (disulfiram) and tranquilizers are sometimes used for treating alcohol abuse. However, they are neither an instant solution to the problems of alcoholism, nor a complete therapy. Also, they have side effects. Web site: http://www.delphion.com/details?pn=US05834605__
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Use of gamma-hydroxybutyric acid amides in the treatment of drug addiction and in particular of alcoholism Inventor(s): Cacciaglia; Roberto (Ospedaletti, IT), Guano; Lorenza (Sanremo, IT), Loche; Antonella (Sanremo, IT), Perlini; Vincenzo (Matelica, IT) Assignee(s): Laboratoric Farmaceutico C.T. S.r.l. (Sanremo, IT) Patent Number: 6,436,998 Date filed: September 2, 1999 Abstract: The present invention relates to the use of .gamma.-hydroxybutyric acid amides in the treatment of drug addiction and alcoholism, more particularly in reducing chronic alcoholics' desire for and habit of consuming alcoholic drinks and in the treatment of the syndrome of abstinence from alcohol. Excerpt(s): The present invention relates to the use of amides of .gamma.hydroxybutyric acid, herein referred to as GHB, in the treatment of drug addiction, such as heroine, cocaine and, in particular, in the treatment of alcoholism, and more particularly in reducing chronic alcoholics desire for and habit of consuming alcoholic drinks and in the treatment of abstinence syndrome. ... The salts of 4-hydroxybutyric acid, e.g. the sodium salt, proved to be effective both in the treatment of the syndrome of abstinence from alcohol and in reducing the desire for and addiction to alcohol in alcoholic patients and disclosed in EP-A-344,704 and in the treatment of drug addiction,
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as reported in WO 93/00083. One of the advantages of said salts is that they do not cause the inconveniences of Disulfiram (Antabuse.RTM.), a drug having several untoward effects, such as for example the symptoms known as the "acetaldehyde syndrome", which may also result in fatality. ... The sodium salt of GHB is absorbed very quickly by the gastroenteric apparatus with a maximum concentration peak already at about 35-40 min after administration. However, it presents a half-life time of about 20-25 min, its elimination from the body being rather quick [EP-A-635,265]. Web site: http://www.delphion.com/details?pn=US06436998__ ·
Use of sulbutiamine in the treatment of Parkinson's disease, schizophrenia, alcoholism, and dysthymia Inventor(s): Perret; Laurent (Paris, FR), Le Ridant; Alain (Neuilly sur Seine, FR), Ollat; Helene (Nesle la Gilberde, FR) Assignee(s): Adir et Compagnie (Courbevoie, FR) Patent Number: 5,863,925 Date filed: October 3, 1997 Abstract: The invention relates to the use of sulbutiamine and pharmaceutical compositions thereof for the treatment of Parkinson's Disease, Schizophrenia, alcoholism, and dysthymia. Excerpt(s): The present invention relates to the use of sulbutiamine and pharmaceutical compositions thereof for the treatment of certain psychomotor and psychointellectual disorders, characterized by the delay, the slowing and the depression of behavioral and intellectual responses demanding the strategic mobilization of percepts and mental concepts. These disorders are observed in particular in Parkinson's patients, deficient schizophrenics, alcoholics, major depressives and dysthymics. ... Sulbutiamine is an active principle which is already known and described in the literature. The special medicament patent 5921 M has described this product as an agent having the activity of vitamin B.sub.1, capable of causing a raised vitamin B.sub.1 blood level and able to exert effects with respect to all the symptoms of B.sub.1 avitaminosis. ... The special medicament patent 5921 M likewise mentions that for these therapeutic ends, the product is used in the form of tablets containing 5 to 50 mg of product per unit dose. Web site: http://www.delphion.com/details?pn=US05863925__
Patent Applications on Alcoholism 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 alcoholism:
10
This has been a common practice outside the United States prior to December 2000.
Patents 369
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Combination treatment for alcoholism and alcohol dependence Inventor(s): Howard, Harry R. JR. ; (Bristol, CT) Correspondence: PFIZER INC; 150 EAST 42ND STREET; 5TH FLOOR - STOP 49; NEW YORK; NY; 10017-5612; US Patent Application Number: 20030130322 Date filed: May 22, 2002 Abstract: The present invention relates to a method of treating alcoholism or alcohol dependence in a mammal, including a human, by administering to the mammal a monoamine reuptake inhibitor in combination with an opioid antagonist. It also relates to pharmaceutical compositions containing a pharmaceutically acceptable carrier, a monoamine reuptake inhibitor and an opioid antagonist. Excerpt(s): The present invention relates to a method of treating alcoholism or alcohol dependence in a mammal, including a human, by administering to the mammal a biaryl ether derivative, as described below, in combination with an opioid antagonist. This invention also relates to pharmaceutical compositions containing a pharmaceutically acceptable carrier, a biaryl ether derivative, as described below, and an opioid antagonist. ... The biaryl ether derivatives referred to above that are employed in the methods and pharmaceutical compositions of this invention exhibit activity as monoamine (e.g., serotonin, dopamine, norepinephrine) reuptake inhibitors. These biaryl ether derivatives are referred to in U.S. patent application Ser. No. 09/692,335, filed Oct. 19, 2000, and in International Patent Application No. WO 00150380, published Aug. 31, 2000. ... each Z is selected independently from hydrogen, halo (i.e., chloro, fluoro, bromo or iodo), (C.sub.1-C.sub.4)alkyl optionally substituted with from one to three fluorine atoms, and (C.sub.1-C.sub.4)alkoxy; and (c) a pharmaceutically acceptable carrier; wherein the active agents "a" and "b" above are present in amounts that render the composition effective in treating alcoholism or alcohol dependence. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Compositions and methods for increasing compliance with therapies using aldehyde dehydrogenase inhibitors and treating alcoholism Inventor(s): Lederman, Seth ; (New York, NY) Correspondence: Pillsbury Winthrop LLP; 1600 Tysons Boulevard; McLean; VA; 22102; US Patent Application Number: 20030087814 Date filed: November 4, 2002 Abstract: Compositions and methods for treating, preventing, or reducing alcoholism, in particular methods for increasing patient compliance with therapies that require the intake of an ALDH inhibitor comprising the step of administering a monoamine oxidase B inhibitor. Excerpt(s): This patent application claims the benefit of the filing date of U.S. Patent Application No. 60/338,901 filed on Nov. 5, 2001, the entire contents of which are hereby expressly incorporated by reference. ... The present invention relates to compositions and methods for increasing patient compliance with therapies comprising the administration of aldehyde dehydrogenase inhibitors, and for preventing, ameliorating or treating alcoholism. Such compositions and methods may be used to
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facilitate alcohol cessation, and may comprise a combination of aldehyde dehydrogenase inhibitors and monoamine oxidase inhibitors. ... Alcohol is a commonly abused drug. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), problematic alcohol use is divided into alcohol abuse and alcohol dependence. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html ·
Method and device for detecting and monitoring alcoholism and related diseases using microarrays Inventor(s): Harris, Adron ; (Austin, TX), Mayfield, Dayne ; (Austin, TX), Lewohl, Joanne ; (Brisbane, AU), Dodd, Peter ; (Brisbane, AU) Correspondence: CHALKER FLORES, LLP; 12700 PARK CENTRAL, STE. 455; DALLAS; TX; 75251; US Patent Application Number: 20030104457 Date filed: November 7, 2002 Abstract: A device and method for detecting, diagnosing, and or monitoring alcoholism and related disease states is disclosed. The device includes a substrate and one or more alcoholism-specific nucleic acids attached to the substrate. The substrate is contacted by a sample collected from a person with alcoholism or alcohol abuse or an alcohol related disease state, wherein contact occurs under pre-selected binding conditions that provides information that can be collected and recorded by a computer. Excerpt(s): The present invention relates in general to the method and device for detecting, monitoring or diagnosing alcoholism and related disease states, and more particularly, to the method and device for analyzing the progression of alcoholism and related disease states in a subject, preferably a human patient, using microarrays. ... Without limiting the scope of the invention, its background is described in connection with the method of detecting, diagnosing or monitoring alcoholism and its progression in a person using nucleic acid microarrays, as an example. ... Heretofore, in this field, the diagnosis and or detection of alcoholism or alcohol abuse and related behaviors has in practice depended on interviews, review of past records, or clinical impression. (Allen, J P, Columbus M, and Fertig J. 1995. Assessment in Alcoholism Treatment: An Overview. In: NIAAA Treatment Handbook Series 4, Assessing Alcohol Problems: A Guide for Clinicians and Researchers. NIH Publication No. 95-3745. pp. 1-9) Generally, items from the medical history and clinical signs are combined to form a diagnostic index. In addition, these items can be compared with the alcohol consumption history, CAGE questionnaire, and early indicator questionnaires that also form part of the index. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
Patents 371
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Method of treating alcoholism or alcohol abuse Inventor(s): Karhuvaara, Sakari ; (Turku, FI), Sonck, Tuuli I. ; (Turku, FI), Kurkela, Kauko O.A. ; (Espoo, FI), Puhakka, Olli ; (Littoinen, FI) Correspondence: STERNE, KESSLER, GOLDSTEIN & FOX PLLC; 1100 NEW YORK AVENUE, N.W., SUITE 600; WASHINGTON; DC; 20005-3934; US Patent Application Number: 20030153590 Date filed: August 13, 2002 Abstract: The present invention relates to a method of treating alcoholism or alcohol abuse by administering to a subject a pharmaceutically effective amount of an opioid antagonist before imminent drinking. Particularly, the present invention relates to a method of treating alcoholism or alcohol abuse by administering transmucosally to a subject a pharmaceutically effective amount of an opioid antagonist before imminent drinking. Preferably, the opioid antagonist used in the method is nalmefene or a pharmaceutically acceptable salt thereof. The invention also relates to a method of treating alcoholism or alcohol abuse by administering to a subject before imminent drinking a transmucosal preparation comprising a pharmaceutically effective amount of an opioid antagonist, wherein the transmucosal preparation has rapid onset of action. Advantageously, a FAH+ subject is treated. Further, the invention relates to a method of treating alcoholism or alcohol abuse of a FAH+ subject, comprising extinguishing an alcohol-drinking response by administering to the FAH+ subject a pharmaceutically effective amount of nalmefene or a pharmaceutically acceptable salt thereof. Excerpt(s): This application claims the priority benefit under 35 U.S.C. .sctn.119(e) of U.S. Provisional Application No. 60/311,796, filed Aug. 14, 2001, and U.S. Provisional Application No. 60/330,510, filed Oct. 23, 2001. The entirety of each of these documents is incorporated by reference herein. ... The present invention relates to a method of treating alcoholism or alcohol abuse. In one aspect, the present invention relates to a method of treating alcoholism or alcohol abuse in a family history positive (FAH+ or FHP) subject by administering to the FAH+ subject a pharmaceutically effective amount of an opioid antagonist, especially nalmefene. ... In another aspect, the present invention relates to a method of treating alcoholism or alcohol abuse by administering to a subject a pharmaceutically effective amount of an opioid antagonist before imminent drinking. Specifically, a FAH+ subject is treated. Particularly, the present invention reelates to a method of treating alcoholism or alcohol abuse by administering transmucosally to a subject a pharmaceutically effective amount of an opioid antagonist before imminent drinking. More particularly, the invention relates to a method of treating alcoholism or alcohol abuse by administering to a subject a pharmaceutically effective amount of nalmefene or a pharmaceutically acceptable salt thereof transmucosally before imminent drinking. The invention also relates to a method of treating alcoholism or alcohol abuse by administering to a subject a transmucosal preparation comprising a pharmaceutically effective amount of an opioid antagonist before imminent drinking, wherein the transmucosal preparation has rapid onset of action. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Use of y-hydroxybutyric acid amides in the treatment of drug addiction and in particular of alcoholism Inventor(s): Guano, Lorenza ; (Sanremo, IT), Perlini, Vincenzo ; (Matelica, IT), Loche, Antonella ; (Sanremo, IT), Cacciaglia, Roberto ; (Ospedaletti, IT) Correspondence: James V. Costigan, Esq.; HEADMAN & COSTIGAN, P.C.; Suite 2003; 1185 Avenue of the Americas; New York; NY; 10036-2646; US Patent Application Number: 20020165224 Date filed: December 11, 2001 Abstract: Gamma-hydroxybutryic acid amides are used in the treatment of drug addiction and especially in the treatment of alcoholism. Excerpt(s): The present invention relates to the use of amides of .gamma.hydroxybutyric acid, herein referred to as GHB, in the treatment of drug addiction, such as heroine, cocaine and, in particular, in the treatment of alcoholism, and more particularly in reducing chronic alcoholics desire for and habit of consuming alcoholic drinks and in the treatment of abstinence syndrome. ... The salts of 4-hydroxybutyric acid, e.g. the sodium salt, proved to be effective both in the treatment of the syndrome of abstinence from alcohol and in reducing the desire for and addiction to alcohol in alcoholic patients and disclosed in EP-A- 344,704 and in the treatment of drug addiction, as reported in WO 93/00083. One of the advantages of said salts is that they do not cause the inconveniences of Disulfiram (Antabuse.RTM.), a drug having several untoward effects, such as for example the symptoms known as the "acetaldehyde syndrome", which may also result in fatality. ... The sodium salt of GHB is absorbed very quickly by the gastroenteric apparatus with a maximum concentration peak already at about 35-40 min after administration. However, it presents a half-life time of about 20-25 min, its elimination from the body being rather quick [EP-A-635,265]. 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 alcoholism, you can access the U.S. Patent Office archive via the Internet at the following Web address: http://www.uspto.gov/main/patents.htm. Under “Services,” click on “Search Patents.” You will see two broad options: (1) Patent Grants, and (2) Patent Applications. To see a list of granted patents, perform the following steps: Under “Patent Grants,” click “Quick Search.” Then, type “alcoholism” (or synonyms) into the “Term 1” box. After clicking on the search button, scroll down to see the various patents which have been granted to date on alcoholism. You can also use this procedure to view pending patent applications concerning alcoholism. Simply go back to the following Web address: http://www.uspto.gov/main/patents.htm. Under “Services,” click on “Search Patents.” Select “Quick Search” under “Patent Applications.” Then proceed with the steps listed above.
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CHAPTER 7. BOOKS ON ALCOHOLISM Overview This chapter provides bibliographic book references relating to alcoholism. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on alcoholism 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 “alcoholism” (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 alcoholism: ·
AIDS, Alcoholism and Drug Abuse: Dilemmas in the Workplace; Employers' Rights and Responsibilities, Volume II Contact: National Legal Center for the Public Interest, 1000 16th St NW Ste 301, Washington, DC, 20036, (202) 296-1683. Summary: This monograph looks at the problems that Acquired immunodeficiency syndrome (AIDS), alcoholism, and drug abuse can cause in the workplace. This, the second volume, examines employers' rights and responsibilities. The first chapter presents a general background on Human immunodeficiency virus (HIV). It explains the widespread problem of AIDS, how a virus infects the body, how HIV causes disease, the clinical picture of HIV infection, routes of HIV transmission, and the treatment of viral infections. The second chapter looks at employers' rights and responsibilities with regard to AIDS. It examines legal principles concerning AIDS in the workplace, and business interests and AIDS. The third chapter studies the treatment of HIV infection as a handicap, including making accommodations and the legislative response to AIDS as
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a handicap. The next chapter is drawn from a speech made by Surgeon General C. Everett Koop before the AIDS Interfaith Council meeting in Houston, TX, on May 27, 1988. The final chapter looks at the need for achieving a drug-free workplace. ·
The Response of State Agencies to AIDS, Addiction, and Alcoholism Source: AIDS and Substance Abuse. Contact: Haworth Press, Incorporated, Harrington Park Press, Incorporated, 12 W 32 St, New York, NY, 10001, (212) 563-4247. Summary: This book chapter advocates that reducing the spread of Acquired immunodeficiency syndrome (AIDS) within Intravenous drug users (IVDU's) would not only reduce the overall toll of the disease but also limit its spread to the population at large. Human immunodeficiency virus (HIV) infection can be minimized by reducing or eliminating certain high-risk activities. Primary strategies include educating IV drug users about the hazards of sharing needles, enrolling them in treatment programs, promoting use of new or sterilized syringes and needles, and discouraging high-risk sexual activity among HIV-infected persons.
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AIDS and Alcoholism: The Parallels Source: Acquired Immune Deficiency Syndrome and Chemical Dependency. Contact: US Government Printing Office, PO Box 371954, Pittsburgh, PA, 15250-7954, (202) 512-1800, http://www.access.gpo.gov. Summary: AIDS and alcoholism are seen as similar public health problems because they both involve moral as well as medical considerations. Some may see AIDS as a threat to the public health from a deviant minority and propose prohibition-style measures while others see the central issue as a threat to at-risk groups from a bigoted majority. The conflict must be resolved in order to protect the health and rights of the public.
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Encyclopedia of Alcoholism. 2nd ed Source: New York, NY: Facts on File, Inc. 1991. 346 p. Contact: Available from Facts on File, Inc. 460 Park Avenue South, New York, NY 10016. (212) 683-2244. PRICE: $45. Shipping and handling free if prepaid. ISBN: 081601955X. Summary: This volume presents a dictionary approach to information about alcoholism. With more than 600 entries, the encyclopedia defines and explains all facets of alcoholism: biological, medical and psychological areas, its social and economic impact, legal implications, terminology used in the treatment of the disease, slang, organizations that deal with alcoholism, various theories on the causes of the disease, and the prevalence of alcohol abuse around the world and what different countries have tried to do about controlling it. Entries of interest to those in the field of digestive diseases include those about alcoholic hepatitis, alcoholic liver disease, alcoholic myopathy, black Americans, blood sugar, cirrhosis, diabetes, diseases, gastrointestinal tract, hemochromatosis, hypoglycemia, intestine, liver, Mallory-Weiss syndrome, nutrition, pancreas, post-necrotic cirrhosis, stomach, and Switzerland. Appendices include tables and figures and sources of information. A subject index is included. 620 references.
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Barriers to the Recognition of Links Between Drugs and Alcohol Abuse and AIDS Source: Acquired Immune Deficiency Syndrome and Chemical Dependency.
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Contact: US Government Printing Office, PO Box 371954, Pittsburgh, PA, 15250-7954, (202) 512-1800, http://www.access.gpo.gov. Summary: The lack of a coordinated program to deal with AIDS infection and substance abuse appears to reduce the effectiveness of treatment programs because health care providers are reluctant to discuss sexual practice histories and may fear that inquiring about a patient's drug and alcohol use patterns will elicit a sense of rejection. Another reason is since the patient is going to die anyway, there is no point in bothering about drug and alcohol use, ignoring the possibility that medical and psychological problems may be remedied if a drug or alcohol abuse problem is recognized and treated. Concern for the health care provider's own safety is also a contributing factor. ·
Alcohol Abuse, Suicidal Behavior, and AIDS Source: Acquired Immune Deficiency Syndrome and Chemical Dependency. Contact: US Government Printing Office, PO Box 371954, Pittsburgh, PA, 15250-7954, (202) 512-1800, http://www.access.gpo.gov. Summary: Suicidal tendencies appear to be common among AIDS patients, aggravated by substance abuse. In addition, self-destructive substance abusers have, in a few cases, selected AIDS as the form of suicide. A priority must be the education of staff in addressing counter-transference issues in order to effectively identify and treat patients at risk of self-destructive behavior.
Book Summaries: Online Booksellers Commercial Internet-based booksellers, such as Amazon.com and Barnes&Noble.com, offer summaries which have been supplied by each title’s publisher. Some summaries also include customer reviews. Your local bookseller may have access to in-house and commercial databases that index all published books (e.g. Books in PrintÒ). IMPORTANT NOTE: Online booksellers typically produce search results for medical and non-medical books. When searching for “alcoholism” at online booksellers’ Web sites, you may discover non-medical books that use the generic term “alcoholism” (or a synonym) in their titles. The following is indicative of the results you might find when searching for “alcoholism” (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): ·
A Ghost in the Closet: Is There an Alcoholic Hiding? an Honest Look at Alcoholism by Dale Mitchel; ISBN: 1568385706; http://www.amazon.com/exec/obidos/ASIN/1568385706/icongroupinterna
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A Path to Sobriety, the Inside Passage: A Common Sense Book on Understanding Alcoholism and Addiction by Dennis L. Siluk (2002); ISBN: 0595655793; http://www.amazon.com/exec/obidos/ASIN/0595655793/icongroupinterna
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A Woman Like You: Life Stories of Women Reovering from Alcoholism and Addiction by Rachel V; ISBN: 006250701X; http://www.amazon.com/exec/obidos/ASIN/006250701X/icongroupinterna
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Addiction, Change & Choice: The New View of Alcoholism by Vince Fox, et al; ISBN: 0961328975; http://www.amazon.com/exec/obidos/ASIN/0961328975/icongroupinterna
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Al Anon Faces Alcoholism by Al-Anon Family Group Headquarters Inc; ISBN: 091003401X; http://www.amazon.com/exec/obidos/ASIN/091003401X/icongroupinterna
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Alcohol and Alcoholism: Effects on Brain and Development by John H. Hannigan (Editor), et al (1999); ISBN: 0805826866; http://www.amazon.com/exec/obidos/ASIN/0805826866/icongroupinterna
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Alcohol Problems and Alcoholism; ISBN: 0029275407; http://www.amazon.com/exec/obidos/ASIN/0029275407/icongroupinterna
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Alcoholics Anonymous: The Story of How Many Thousands of Men and Women Have Recovered from Alcoholism by Hazelden; ISBN: 091585600X; http://www.amazon.com/exec/obidos/ASIN/091585600X/icongroupinterna
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Alcoholics Anonymous: The Story of How Many Thousands of Men and Women Have Recovered from Alcoholism by Alcoholics Anonymous World Service (2002); ISBN: 1893007162; http://www.amazon.com/exec/obidos/ASIN/1893007162/icongroupinterna
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Alcoholics Anonymous: The Story of How Many Thousands of Men and Women Have Recovered from Alcoholism/B-1 by Bill W., et al (1976); ISBN: 0916856003; http://www.amazon.com/exec/obidos/ASIN/0916856003/icongroupinterna
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Alcoholism by Douglas M. Baker, David Lane; ISBN: 0906006066; http://www.amazon.com/exec/obidos/ASIN/0906006066/icongroupinterna
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Alcoholism and Other Drug Problems by James E. Royce (Preface), David Scratchley (1996); ISBN: 0684823144; http://www.amazon.com/exec/obidos/ASIN/0684823144/icongroupinterna
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Alcoholism and Pathological Gambling: Similarities and Differences by Arthur Herscovitch; ISBN: 1556911467; http://www.amazon.com/exec/obidos/ASIN/1556911467/icongroupinterna
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Alcoholism and Substance Abuse in Special Populations by Gary W. Lawson, Ann W. Lawson (Editor) (1989); ISBN: 0834200074; http://www.amazon.com/exec/obidos/ASIN/0834200074/icongroupinterna
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Alcoholism and the Family: A Guide to Treatment and Prevention by Ann W. Lawson, Gary W. Lawson (1998); ISBN: 0834210584; http://www.amazon.com/exec/obidos/ASIN/0834210584/icongroupinterna
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Alcoholism and Women: The Background and the Psychology (Studies in Jungian Psychology by Jungian Analysts, 11) by Jan Bauer; ISBN: 0919123104; http://www.amazon.com/exec/obidos/ASIN/0919123104/icongroupinterna
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Alcoholism the Biochemical Connection: A Breakthrough Seven-Week SelfTreatment Program by Joan Mathews Larson, et al; ISBN: 0679414932; http://www.amazon.com/exec/obidos/ASIN/0679414932/icongroupinterna
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Alcoholism Treatment: A Social Work Perspective by Katherine S. Van Wormer; ISBN: 0830413871; http://www.amazon.com/exec/obidos/ASIN/0830413871/icongroupinterna
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Alcoholism, Drug Addiction, and the Road to Recovery: Life on the Edge by Barry Stimmel; ISBN: 0789005530; http://www.amazon.com/exec/obidos/ASIN/0789005530/icongroupinterna
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Alcoholism: Its Cause and Cure from the View-Point of Science of Mind by Ernest Holmes (2000); ISBN: 0917849299; http://www.amazon.com/exec/obidos/ASIN/0917849299/icongroupinterna
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Alcoholism: The Genetic Inheritance by Kathleen Whalen Fitzgerald, et al; ISBN: 0385199333; http://www.amazon.com/exec/obidos/ASIN/0385199333/icongroupinterna
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Alcoholism: The Hidden Addiction. by Ebbe Curtis Hoff; ISBN: 0816402485; http://www.amazon.com/exec/obidos/ASIN/0816402485/icongroupinterna
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Alcoholism: Treatment in Transition by Griffith Edwards (Editor); ISBN: 0839141327; http://www.amazon.com/exec/obidos/ASIN/0839141327/icongroupinterna
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Alcoholism's Children: Acoas in Priesthood and Religious Life by Sean D. Sammon (1989); ISBN: 081890545X; http://www.amazon.com/exec/obidos/ASIN/081890545X/icongroupinterna
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Alternatives to Abstinence: A New Look at Alcoholism and the Choices in Treatment by Heather Ogilvie, et al (2001); ISBN: 1578260817; http://www.amazon.com/exec/obidos/ASIN/1578260817/icongroupinterna
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Becoming Alcoholic: Alcoholics Anonymous and the Reality of Alcoholism by David R. Rudy (1986); ISBN: 080931245X; http://www.amazon.com/exec/obidos/ASIN/080931245X/icongroupinterna
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Beyond the Booze Battle: What to Do When Alcoholism or Chemical Dependency... by Ruth Maxwell; ISBN: 0345354745; http://www.amazon.com/exec/obidos/ASIN/0345354745/icongroupinterna
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Beyond the Influence: Understanding and Defeating Alcoholism by Katherine Ketcham, et al; ISBN: 0553380141; http://www.amazon.com/exec/obidos/ASIN/0553380141/icongroupinterna
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Billy: Billy Carter's Reflections on His Struggle With Fame, Alcoholism and Cancer by Billy Carter, et al; ISBN: 0926028073; http://www.amazon.com/exec/obidos/ASIN/0926028073/icongroupinterna
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Blessed Are the Addicts: The Spiritual Side of Alcoholism, Addiction and Recovery by John A. Martin; ISBN: 0394584015; http://www.amazon.com/exec/obidos/ASIN/0394584015/icongroupinterna
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Children of Alcoholism: The Struggle for Self and Intimacy in Adult Life by Barbara L. Wood (1987); ISBN: 0814792197; http://www.amazon.com/exec/obidos/ASIN/0814792197/icongroupinterna
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Cool Water: Alcoholism, Mindfulness, and Ordinary Recovery by Bill Alexander, William Alexander (1997); ISBN: 157062254X; http://www.amazon.com/exec/obidos/ASIN/157062254X/icongroupinterna
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Couple Therapy for Alcoholism: A Cognitive-Behavioral Treatment Manual by Phylis J. Wakefield, et al; ISBN: 1572300701; http://www.amazon.com/exec/obidos/ASIN/1572300701/icongroupinterna
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Courage to Be Me: Living With Alcoholism by Al-Anon Family Group Headquarters (1996); ISBN: 0910034303; http://www.amazon.com/exec/obidos/ASIN/0910034303/icongroupinterna
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Desire and Craving: A Cultural Theory of Alcoholism (Suny Series in New Social Studies on Alcohol and Drugs) by Pertti Alasuutari (1992); ISBN: 0791410986; http://www.amazon.com/exec/obidos/ASIN/0791410986/icongroupinterna
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Escaping the Self: Alcoholism, Spirituality, Masochism, and Other Flights from the Burden of Selfhood by Roy F. Baumeister; ISBN: 0465020534; http://www.amazon.com/exec/obidos/ASIN/0465020534/icongroupinterna
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Fighting the Good Fight: One Family's Struggle Against Adolescent Alcoholism by Victoria C. G. Greenleaf, Remi J. Cadoret (2002); ISBN: 1879384434; http://www.amazon.com/exec/obidos/ASIN/1879384434/icongroupinterna
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Food for Recovery : The Complete Nutritional Companion for Overcoming Alcoholism, Drug Addiction, and Eating Disorders by Joseph D., M.D. Beasley, Susan Knightly; ISBN: 0517881810; http://www.amazon.com/exec/obidos/ASIN/0517881810/icongroupinterna
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Handbook of Alcoholism by Gerald, MD Zernig (Editor), et al; ISBN: 084937801X; http://www.amazon.com/exec/obidos/ASIN/084937801X/icongroupinterna
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Handbook of Alcoholism Treatment Approaches (3rd Edition) by Reid K. Hester (Author), et al; ISBN: 0205360645; http://www.amazon.com/exec/obidos/ASIN/0205360645/icongroupinterna
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Heavy Drinking: The Myth of Alcoholism As a Disease by Herbert Fingarette (1989); ISBN: 0520067541; http://www.amazon.com/exec/obidos/ASIN/0520067541/icongroupinterna
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Hollywood Shot by Shot: Alcoholism in American Cinema (Communication and Social Order) by Norman K. Denzin (1991); ISBN: 0202303454; http://www.amazon.com/exec/obidos/ASIN/0202303454/icongroupinterna
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I'll Quit Tomorrow : A Practical Guide to Alcoholism Treatment by Vernon E. Johnson (Author) (1990); ISBN: 0062504339; http://www.amazon.com/exec/obidos/ASIN/0062504339/icongroupinterna
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Intensive Psychotherapy of Alcoholism by Gary B. Forrest, Gary G. Forrest (1995); ISBN: 1568213603; http://www.amazon.com/exec/obidos/ASIN/1568213603/icongroupinterna
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Introduction To Alcoholism Counseling: A Bio-Psycho-Social Approach by Jerome D. Levin; ISBN: 1560323582; http://www.amazon.com/exec/obidos/ASIN/1560323582/icongroupinterna
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Last Call: Poems on Alcoholism, Addiction, and Deliverance by Sarah Gorham (Editor), Jeffrey Skinner (Editor) (1997); ISBN: 0964115182; http://www.amazon.com/exec/obidos/ASIN/0964115182/icongroupinterna
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Love First: A New Approach to Intervention for Alcoholism and Drug Addiction (A Hazelden Guidebook) by Jeff Jay, Debra Erickson Jay; ISBN: 1568385218; http://www.amazon.com/exec/obidos/ASIN/1568385218/icongroupinterna
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Marty Mann's New primer on alcoholism : how people drink, how to recognize alcoholics, and what to do about them by Marty Mann; ISBN: 0030295955; http://www.amazon.com/exec/obidos/ASIN/0030295955/icongroupinterna
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My Name Is Sonny Bliss: A Novel About Alcoholism and Recovery by Tom W (2000); ISBN: 1588201384; http://www.amazon.com/exec/obidos/ASIN/1588201384/icongroupinterna
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New Light on Alcoholism: God, Sam Shoemaker, and A. A. by Dick B., et al (1999); ISBN: 1885803273; http://www.amazon.com/exec/obidos/ASIN/1885803273/icongroupinterna
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Nutrition and the Mind: Dietary Approaches to Mental Illness from Alcoholism to Migraines To... by Gary Null; ISBN: 1568580215; http://www.amazon.com/exec/obidos/ASIN/1568580215/icongroupinterna
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On the Military Firing Line in the Alcoholism Treatment Program: The Air Force Sergeant Who Beat Alcoholism and Taught Others to Do the Same by Sgt Bill S, Glenn F. Chesnut PH. D. (Contributor) (2003); ISBN: 0595283829; http://www.amazon.com/exec/obidos/ASIN/0595283829/icongroupinterna
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Outwitting Your Alcoholic: Exploring and Escaping from the Strange World of Alcoholism by Kenneth Lucas (1998); ISBN: 1882883381; http://www.amazon.com/exec/obidos/ASIN/1882883381/icongroupinterna
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Practical Approaches to Alcoholism Psychotherapy by Sheldon Zimberg (1985); ISBN: 0306400863; http://www.amazon.com/exec/obidos/ASIN/0306400863/icongroupinterna
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Prevention of Alcoholism Through Nutrition by Roger Williams; ISBN: 0553246852; http://www.amazon.com/exec/obidos/ASIN/0553246852/icongroupinterna
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Psychological Theories of Drinking and Alcoholism, Second Edition by Kenneth E. Leonard (Editor), Howard T. Blane (Editor); ISBN: 1572304103; http://www.amazon.com/exec/obidos/ASIN/1572304103/icongroupinterna
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Recent Developments in Alcoholism by Marc Galanter (Editor) (1984); ISBN: 0306415348; http://www.amazon.com/exec/obidos/ASIN/0306415348/icongroupinterna
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Recoveries: True Stories by People Who Conquered Addictions and Compulsions: Alcoholism, Anorexia Nervosa, Bulimia, Cigarette Smoking, Cocaine, Nar by Lindsey Hall (Editor), Leigh Cohn (Editor); ISBN: 0936077115; http://www.amazon.com/exec/obidos/ASIN/0936077115/icongroupinterna
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Recovering from Alcoholism (Soundwave 2000/Audio Cassette) by Steven Halpern (1993); ISBN: 1878625128; http://www.amazon.com/exec/obidos/ASIN/1878625128/icongroupinterna
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Seven Weeks to Sobriety: The Proven Program to Fight Alcoholism Through Nutrition by Joan Mathews-Larson, Joan Mathews Larson; ISBN: 0449908968; http://www.amazon.com/exec/obidos/ASIN/0449908968/icongroupinterna
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Shame Guilt and Alcoholism: Treatment Issues in Clinical Practice (The Addictions Treatment Series) by Ronald T. Potter-Efron (1989); ISBN: 0866568565; http://www.amazon.com/exec/obidos/ASIN/0866568565/icongroupinterna
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Shame, Guilt, and Alcoholism: Treatment Issues in Clinical Pratices by Ronald, Msw, Phd Potter-Efron, Ronald T. Potter-Efron (2002); ISBN: 078901517X; http://www.amazon.com/exec/obidos/ASIN/078901517X/icongroupinterna
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Sober...and Staying That Way: The Missing Link in the Cure for Alcoholism by Susan Powter (1999); ISBN: 0684847973; http://www.amazon.com/exec/obidos/ASIN/0684847973/icongroupinterna
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Sobering Tales: Narratives of Alcoholism and Recovery by Edmund B. O'Reilly (1997); ISBN: 1558490655; http://www.amazon.com/exec/obidos/ASIN/1558490655/icongroupinterna
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Straight Talk About Alcoholism by Robert A. Liebelt, Abraham J. Twerski (Illustrator); ISBN: 0886876818; http://www.amazon.com/exec/obidos/ASIN/0886876818/icongroupinterna
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Suicide in Alcoholism by George E. Murphy (1992); ISBN: 0195071530; http://www.amazon.com/exec/obidos/ASIN/0195071530/icongroupinterna
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Sweet Mystery: A Southern Memoir of Family Alcoholism, Mental Illness, and Recovery by Judith Hillman Paterson; ISBN: 0374524998; http://www.amazon.com/exec/obidos/ASIN/0374524998/icongroupinterna
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Terry: My Daughter's Life-And-Death Struggle With Alcoholism by George S. McGovern (1997); ISBN: 0452278236; http://www.amazon.com/exec/obidos/ASIN/0452278236/icongroupinterna
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The 100 Best Treatment Centers for Alcoholism and Drug Abuse by Linda Sunshine (Contributor), John W. Wright; ISBN: 0380754894; http://www.amazon.com/exec/obidos/ASIN/0380754894/icongroupinterna
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The 2002 Official Patient's Sourcebook on Alcoholism by Icon Health Publications, et al (2002); ISBN: 0597831343; http://www.amazon.com/exec/obidos/ASIN/0597831343/icongroupinterna
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The Art of Moderation : An Alternative to Alcoholism by John Michael, Sharon Jones; ISBN: 1565500849; http://www.amazon.com/exec/obidos/ASIN/1565500849/icongroupinterna
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The Craving Brain : A bold new approach to breaking free from *drug addiction *overeating *alcoholism *gambling by Ronald A. Ruden (Author) (2000); ISBN: 0060928999; http://www.amazon.com/exec/obidos/ASIN/0060928999/icongroupinterna
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The Heart of Addiction: A New Approach to Understanding and Managing Alcoholism and Other Addictive Behaviors by Lance M. Dodes (2002); ISBN: 0060198117; http://www.amazon.com/exec/obidos/ASIN/0060198117/icongroupinterna
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The Natural History of Alcoholism Revisited by George E. Vaillant (1995); ISBN: 0674603788; http://www.amazon.com/exec/obidos/ASIN/0674603788/icongroupinterna
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The Secret History of Alcoholism: The Story of Famous Alcoholoics and Their Destructive Behavior by James Graham; ISBN: 1852308915; http://www.amazon.com/exec/obidos/ASIN/1852308915/icongroupinterna
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The Twelve-Step Facilitation Handbook: A Systematic Approach to Early Recovery from Alcoholism and Addiction by Joseph Nowinski, Stuart Baker; ISBN: 0787940496; http://www.amazon.com/exec/obidos/ASIN/0787940496/icongroupinterna
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Treating Alcoholism by Stephanie Brown (Editor), Irvin D. Yalom; ISBN: 0787900680; http://www.amazon.com/exec/obidos/ASIN/0787900680/icongroupinterna
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Treatment Matching in Alcoholism by Thomas F. Babor (Editor), Frances K. Del Boca (Editor) (2002); ISBN: 0521651123; http://www.amazon.com/exec/obidos/ASIN/0521651123/icongroupinterna
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Treatment of Alcoholism and Other Addictions: A Self-Psychology Approach by Jerome David Levin (1991); ISBN: 0876685211; http://www.amazon.com/exec/obidos/ASIN/0876685211/icongroupinterna
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Twelve Jewish Steps to Recovery: A Personal Guide to Turning from Alcoholism and Other Addictions by Kerry M. Olitzky, et al (1992); ISBN: 1879045095; http://www.amazon.com/exec/obidos/ASIN/1879045095/icongroupinterna
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Under the Influence: A Guide to the Myths and Realities of Alcoholism by James Robert Milam, Katherine Ketcham; ISBN: 0553274872; http://www.amazon.com/exec/obidos/ASIN/0553274872/icongroupinterna
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Understanding Alcoholism: Answers to Questions People Ask by Carolyn Johnson; ISBN: 0310522811; http://www.amazon.com/exec/obidos/ASIN/0310522811/icongroupinterna
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Up and Down the Mountain: Helping Children Cope With Parental Alcoholism by Gail Zawacki (Illustrator), Pamela Leib Higgins (1994); ISBN: 0882821334; http://www.amazon.com/exec/obidos/ASIN/0882821334/icongroupinterna
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Visions of Addiction: Major Contemporary Perspectives on Addiction and Alcoholism by Stanton Peele (Editor) (1988); ISBN: 0669130923; http://www.amazon.com/exec/obidos/ASIN/0669130923/icongroupinterna
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White Knuckles & Wishful Thinking: Learning From the Moment of Relapse in Alcoholism and Other Addictions by George Manter Duwors, et al; ISBN: 0889372241; http://www.amazon.com/exec/obidos/ASIN/0889372241/icongroupinterna
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With a Lot of Help from Our Friends: The Politics of Alcoholism by Nancy Olson (2003); ISBN: 0595270379; http://www.amazon.com/exec/obidos/ASIN/0595270379/icongroupinterna
The National Library of Medicine Book Index The National Library of Medicine at the National Institutes of Health has a massive database of books published on healthcare and biomedicine. Go to the following Internet site, http://locatorplus.gov/, and then select “Search LOCATORplus.” Once you are in the search area, simply type “alcoholism” (or synonyms) into the search box, and select “books only.” From there, results can be sorted by publication date, author, or relevance. The following was recently catalogued by the National Library of Medicine:11 ·
A handbook on alcoholism. Author: Mackey, Herbert Owen.; Year: 1965; London, Macmillan, 1964
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A study in alcoholism; clinical, social-psychiatric and genetic investigations. [Translated by Donald Burton]. Author: Åmark, Curt.; Year: 1964; Stockholm, 1951
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Alcoholism [by] Neil Kessel and Henry Walton. Author: Kessel, Neil.; Year: 1965; [Baltimore] Penguin Books [1965]
11 In addition to LOCATORPlus, in collaboration with authors and publishers, the National Center for Biotechnology Information (NCBI) is currently adapting biomedical books for the Web. The books may be accessed in two ways: (1) by searching directly using any search term or phrase (in the same way as the bibliographic database PubMed), or (2) by following the links to PubMed abstracts. Each PubMed abstract has a "Books" button that displays a facsimile of the abstract in which some phrases are hypertext links. These phrases are also found in the books available at NCBI. Click on hyperlinked results in the list of books in which the phrase is found. Currently, the majority of the links are between the books and PubMed. In the future, more links will be created between the books and other types of information, such as gene and protein sequences and macromolecular structures. See http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Books.
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Alcoholism education: an annotated bibliography for educators. Prepared by Alcohol Education Committee. Author: Colorado. Alcoholism Division.; Year: 1964; Denver, 1966
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Alcoholism; its facets and phases. Author: Block, Marvin A. (Marvin Avram),; Year: 1939; New York, Day [c1965]
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An evaluation of the effect of treatment on the rehabilitation of alcoholics; a report undertaken for the Alcoholism Foundation of British Columbia, by Reginald A. H. Robson [et al.]. Author: Alcoholism Foundation of British Columbia.; Year: 1961; Vancouver, 1963
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California's alcoholism; problems, resources. Author: California. Division of Alcoholic Rehabilitation.; Year: 1964; Berkeley, 1964
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Facts about alcoholism and the use of alcohol in Colorado, with a comparison to national and international data. Author: Colorado. Alcoholism Division.; Year: 1962; Denver, 1966
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Identifying problem drinkers in a household health survey; a description of field procedures and analytical techniques developed to measure the prevalence of alcoholism. Author: National Center for Health Statistics (U.S.); Year: 1964; Washington, 1966
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New York City alcoholism study; a report, 1962. William J. Plunkert, study director; Douglas Holmes, research coordinator and principal investigator. Author: National Council on Alcoholism.; Year: 1963; [New York, 1962]
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Physician's manual on alcoholism. Author: Cohen, Saul.; Year: 1965; Saskatoon, Modern Press, 1966
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Report on alcoholism: community agency attitudes and their impact on treatment services, by David J. Pittman and Muriel W. Sterne. Author: National Clearinghouse for Mental Health Information (U.S.); Year: 1963; Bethesda, Md. [1965]
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Treatment of alcoholism; guest editor: Marvin A. Block. Treatment of arteriosclerotic heart disease; guest editors: Arthur C. DeGraff and Solomon Fisch. Author: Block, Marvin A. (Marvin Avram),; Year: 1965; [New York] Hoeber 1966
Chapters on Alcoholism In order to find chapters that specifically relate to alcoholism, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and alcoholism 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 “alcoholism” (or synonyms) into the “For these words:” box. The following is a typical result when searching for book chapters on alcoholism: ·
Debilitating Diseases: Osteoporosis, Alcoholism, Arthritis, and Renal Disease Source: in Frank-Spohrer, G.C. Community Nutrition: Applying Epidemiology to Contemporary Practice. Gaithersburg, MD: Aspen Publishers, Inc. 1996. p. 535-557. Contact: Available from Aspen Publishers, Inc. 7201 McKinney Circle, Frederick, MD 21701. (800) 638-8437. PRICE: $48.00. ISBN: 0834207842.
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Summary: This chapter on debilitating diseases, including osteoporosis, alcoholism, arthritis, and renal disease, is from a nursing text on community nutrition. The author describes the occurrence and etiology of these four diseases, identifies secondary and tertiary prevention approaches for each one, and lists and enumerates the role of dietary components in the secondary prevention of these diseases. One chart summarizes the general dietary recommendations for renal patients. The author also relates suggestions to the Healthy People 2000 objectives. 4 figures. 7 tables. 59 references. ·
Deafness and Alcohol Abuse Source: in Lala, F.J.J., Jr. Counseling the Deaf Substance Abuser. Chicago, IL: Adams Press. 1998. p. 76-138. Contact: Available from Midas Management Company. P.O. Box 27740, Las Vegas, NV 89126-1740. PRICE: $28.95 plus shipping and handling. ISBN: 0966375300. Summary: This chapter on deafness and alcohol abuse is from a book intended to focus attention on the problem of substance abuse in the Deaf community. It attempts to help people affected by addiction, and provide preventive information and incentives to preclude the development of alcoholism and substance abuse in the next generation. Originally published as the author's dissertation, the book states that up to 35 percent of people with significant hearing impairment have abused substances, including alcohol. This is almost double the estimated rate of comparable abuse among people who do not have impaired hearing. This chapter presents a broad overview on alcoholism as it relates to deafness. The author discusses basic information about alcoholism; reviews both short and long term physical, mental, emotional, and social effects of alcohol abuse; outlines current thought regarding the etiology and epidemiology of alcoholism, including predisposing influences, such as genetics; discusses sociocultural and psychological interweaving factors which can contribute to or maintain alcohol abuse; and provides a listing of some variables that may influence an individual's willingness to seek treatment for alcohol addiction. 2 tables.
Directories In addition to the references and resources discussed earlier in this chapter, a number of directories relating to alcoholism have been published that consolidate information across various sources. The Combined Health Information Database lists the following, which you may wish to consult in your local medical library:12 ·
Directory of drug and alcohol abuse treatment services for pregnant women in Rhode Island Source: Providence, RI: Rhode Island Department of Health. 1990. 10 pp. Contact: Available from Tricia Leddy, Program Director, Rhode Island Department of Health, RIte Start, Cannon Building, Room 302, 75 Davis Street, Providence, RI 02908. Telephone: (800) 346-1004. Available at no charge. Request publication by mail only.
12 You will need to limit your search to “Directory” and “diseasex” using the "Detailed Search" option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find directories, use the drop boxes at the bottom of the search page where “You may refine your search by.” For publication date, select “All Years.” Select your preferred language and the format option “Directory.” Type “diseasex” (or synonyms) into the “For these words:” box. You should check back periodically with this database as it is updated every three months.
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Summary: The purpose of this directory is to assist maternity care providers in referring pregnant women to the appropriate drug and/or alcohol treatment program in Rhode Island. This directory was developed by the RIte Start Program, Rhode Island Department of Health, with information from the Division of Substance Abuse in the Rhode Island Department of Mental Health, Retardation and Hospitals, and the Rhode Island Council on Alcoholism. The RIte Start Program provides comprehensive maternity care for uninsured women, living in Rhode Island, who are not eligible for medical assistance and who meet income guidelines.
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CHAPTER 8. MULTIMEDIA ON ALCOHOLISM Overview In this chapter, we show you how to keep current on multimedia sources of information on alcoholism. We start with sources that have been summarized by federal agencies, and then show you how to find bibliographic information catalogued by the National Library of Medicine.
Video Recordings An excellent source of multimedia information on alcoholism is the Combined Health Information Database. You will need to limit your search to “Videorecording” and “alcoholism” using the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find video productions, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Videorecording (videotape, videocassette, etc.).” Type “alcoholism” (or synonyms) into the “For these words:” box. The following is a typical result when searching for video recordings on alcoholism: ·
AIDS and Chemical Dependency Contact: Hazelden Foundation, Educational Materials, PO Box 176, Center City, MN, 55012-0176, (651) 213-4000, http://www.hazelden.org. Summary: This is a videorecording of a lecture given by a physician to an audience of health professionals, explaining the relationship between chemical dependency and Acquired immunodeficiency syndrome (AIDS). Both drug addiction and alcoholism increase the risk of Human immunodeficiency virus (HIV) transmission, either by needle sharing or by decreased awareness of safer sexual practices. In addition, they weaken the immune system, increasing opportunistic infections in HIV-positive persons. The use of antibody testing to identify HIV-positive persons and get them into treatment programs which strengthen their immune systems is also discussed.
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HIV/AIDS: Substance Abuse Issues Contact: Ohio State University, Department of Family Medicine, AIDS Education and Training Center, 1314 Kinnear Rd Area 300, Columbus, OH, 43212, (614) 292-4056. Summary: This videorecording presents a teleconference on the relationship between alcoholism and/or drug abuse and Acquired immunodeficiency syndrome (AIDS), caused by Human immunodeficiency virus (HIV). The four participants -Rebecca Ashery, Director, AIDS Education, National Institute on Drug Abuse (NIDA); Ruth Frankenfield, DaytonColumbus AIDS/Outreach; Ron Rucker, Certified Counselor, Cincinnati Health Department; and Dr. Ted Parran, Associate Director, Chemical Dependency, St. Vincent Charity Hospital -- discuss treatment programs available to assist health professionals with care of Intravenous drug users (IVDU's), medical management issues, psychosocial management, and counseling and support services. The videorecording describes HIV transmission through IV-needle sharing or through sexual intercourse with an IVDU and emphasizes the need for educational programs, outreach, and behavior modification in HIV prevention among this population. Several participants outline research programs and AIDS training programs for staff members of substance-abuse facilities. This teleconference included a phone-in questionandanswer session.
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Aging Brain Source: Sacramento, CA: Department of Aging. 1987. (videocassette, 6 handouts and 6 page training manual.). Contact: California Department of Aging, Training and Education Section. 1600 K Street, Sacramento, CA 95814. (916) 322-3110. PRICE: $10.00. Summary: This tape contains seven training segments designed for administrators and staff working in residential facilities for the aged. It reviews commonly held beliefs about aging that may negatively influence the care given to aging residents and how these myths developed. According to the tape, many believe that aged people are naturally "senile". Aged people can either accept this belief and act accordingly, creating a self-fulfilling prophecy in which they relinquish their independence to those caring for them, or they can rebel against their caregivers. Several studies related to aging are reviewed that suggest that there are only minor differences between the mental capacities of the young and aged. Treatable diseases that can affect the aged person's mental abilities are described including drug overdoses, malnutrition, dehydration, blood clots, brain tumors, depression, alcoholism, liver failure, kidney failure, drastic environmental changes, thyroid problems, heart failure, infections, diabetes, constipation, and emphysema. Organic brain syndromes, incurable diseases that affect mental capability, also are reviewed, including multi-infarct dementia, Pick's disease, Creutzfeldt-Jakob disease, Korsakoff's syndrome, Parkinson's disease, and Alzheimer's disease. Specific attention is given to changes in the brain that occur as the disease progresses, the symptoms, and possible risk factors and causes of the disease. Contact points for the Alzheimer's Association are provided for further information.
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Question of Epilepsy Source: Landover, MD, Epilepsy Foundation of America, 1 30-minute VHS videotape, 1989. Contact: Epilepsy Foundation of America, 4351 Garden City Drive, Landover, MD 20785. (301) 459-3700. (800) 332-4050.
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Summary: Question of Epilepsy is a 30-minute VHS videotape presenting seven dramatizations of questions about epilepsy. In the first scene, an extended family is gathered for a family event and casually discusses the epilepsy of Paul, an adolescent family member. They mention its psychosocial impact on others and how they and he have adjusted to coping with epilepsy. The second dramatization deals with the causes of epilepsy. After a children's bicycle race, two young boys go riding without their helmets. The father of one boy calls him back and reminds him to wear a helmet whenever he rides a bicycle. The father tells the other boy's mother about a child who rode a bike without a helmet and received a head injury that caused epilepsy. The father mentions that anyone can develop epilepsy at any age; other causes of epilepsy include rare diseases, birth defects, and alcoholism. In the third scene, a man and a woman are editing a videotape showing elementary school students enacting what to do when a person has a seizure. The editors discuss what to do and not to do when someone has a seizure, such as never putting something in the person's mouth. After the editors edit the tape, they show it in its entirety. The fourth dramatization asks the question, Are all seizures the same? Coworkers in a floral shop discuss types of seizures, including whole brain involvement and partial seizures. In the fifth scene, a retirement group discusses anticonvulsants and their use. A woman mentions that she is concerned because her elderly husband recently had to start taking anticonvulsants. A retired pharmacist says that it is not uncommon for people over age 60 to develop epilepsy, that the anticonvulsant drugs help people with epilepsy live normal lives, and that the Epilepsy Foundation of America is a good source of additional information about epilepsy. In the sixth scene, a boys' high school basketball team practices in the gym. One boy talks about his seizures and describes being on anticonvulsant drugs. The boy's parents and the coach met and discussed the boy's epilepsy before he joined the team. The coach read material from the Epilepsy Foundation of America and was convinced that the young man could do anything anyone else could do. The boy says that the coach's belief in him has given him self-confidence. The seventh scene is entitled what is the biggest problem people with epilepsy face. Two office workers discuss applicants for a position. One has stated on her application that she has epilepsy, which causes one of the workers to drop her from further consideration for the job. The other worker convinces him to call the woman and find out more about her epilepsy and if it will interfere with her work. This worker states that the company wants to hire the best person for the job, and that may be the person with epilepsy. ·
Another chance to change: A teenager's struggle with relapse and recovery Source: Minneapolis, MN: Johnson Institute. 1991. 1 videotape (30 minutes, VHS), 1 facilitator's guide (12 pp.). Contact: Available from Johnson Institute, 7151 Metro Boulevard, Minneapolis, MN 55439-2122. Telephone: (800) 231-5165 or (612) 944- 0511. $495 plus $4.25 for the shipping and handling. Preview is $35.00. Summary: This videotape is a dramatization of an adolescent's struggle with relapse and recovery from alcoholism and drug use. It is a sequel to the Johnson Institute videotape, 'Choices and Consequences.' Designed for junior and senior high students, parents, teachers, counselors, and other professionals working with youth, the film highlights relapse risk factors and warning signs, help that can be offered to recovering adolescents, and how peers, parents, mentors, school professionals and employers can work together to provide a support system to prevent relapse in a recovering adolescent alcoholic. A facilitator's guide includes an overview of relapse risk factors, a synopsis of
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the video, suggestions for using the videotape, discussion questions, and participant's information sheets. ·
Different like me Source: Minneapolis, MN: Johnson Institute. 1990. 1 videotape (30 minutes, VHS) or 16 mm film, 1 facilitator's guide (9 pp.). Contact: Available from Johnson Institute, 7151 Metro Boulevard, Minneapolis, MN 55439-2122. Telephone: (800) 231-5165 or (612) 944- 0511. Videocassette $495.00, 16 mm film $545.00 plus $4.25 for shipping and handling. Summary: This video recording focuses on the home life and school life of an adolescent with an alcoholic parent. Eventually the protagonist joins a Children of Alcoholics support group. The target audience is adolescents, parents, teachers, counselors and other professionals working with high-risk youths. Objectives of the videotape include assisting adolescents in accepting and understanding their reactions and the impact of alcohol and other drug use by family members, recognizing that many other students are in painful family situations, and seeking support through school and community programs. A nine-page facilitator's guide accompanies the videotape that includes an overview of the videotape and alcoholism, information on Children of Alcoholics, a role identification chart for teachers, discussion questions, and recommended readings.
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Families in trouble: Learning to cope Source: Pleasantville, NY: Sunburst Communications. 1990. 1 videotape (35 minutes, VHS 1/2 inch). Contact: Available from Sunburst Communications, 101 Castleton Street, P.O. Box 40, Pleasantville, NY 10570-9971. Telephone: (800) 431-1934 / fax: (914) 747-4109. $199.00 plus 6 percent shipping and handling. Summary: This videotape helps adolescents struggling with family trouble understand that they are not at fault for someone else's problems. It tells the stories of three adolescents who experience the coping process by dealing with the crises they face at home: divorce, sibling alcoholism, and child abuse. It also helps adolescents understand family dynamics and the important of family roles. The learning objectives include: illustrate a step-by-step process for use in a crisis situation; demonstrate the importance of identifying and acknowledging one's feelings; encourage adolescents to talk about their problems; explain the importance of family roles; and identify possible community resources.
Bibliography: Multimedia on Alcoholism 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 alcoholism (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 alcoholism (for more information, follow the hyperlink indicated):
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Alcoholism: a critical illness [slide] Source: Lauraine A. Thomas; produced by Robert J. Brady; Year: 1977; Format: Slide; Bowie, Md.: The Company, c1977
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Alcoholism: a family problem [videorecording] Source: Joseph V. Fisher, in cooperation with Office of Educational Services; Year: 1978; Format: Videorecording; Chapel Hill, N. C.: Health Sciences Consortium, c1978
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Alcoholism and drug abuse [sound recording] Source: American Psychiatric Association; produced by Audio-Digest Foundation; Year: 1976; Format: Sound recording; Glendale, Calif.: The Foundation, p1976
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Alcoholism in the 70's [videorecording] Source: Academy of Health Sciences, Health Sciences Media Division; [made by] TV Branch, Health Sciences Media Division, AHS, USA; Year: 1977; Format: Videorecording; Fort Sam Houston, Tex.: The Academy: [for sale by its Health Sciences Media Division], 1977
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Dynamics of alcoholism [slide] Source: Lauraine A. Thomas; produced by Robert J. Brady Co; Year: 1977; Format: Slide; Bowie, Md.: The Company, c1977
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Intervention therapy in alcoholism [slide] Source: Lauraine A. Thomas; produced by Robert J. Brady Co; Year: 1977; Format: Slide; Bowie, Md.: The Company, c1977
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New perspectives on alcoholism [sound recording] Source: produced by KNXT, in cooperation with the Division of Career and Continuing Education, Los Angeles Unified School District; Year: 1975; Format: Sound recording; Long Beach, Calif.: Southerby Production, c1975
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Nutritional approaches to alcoholism [sound recording] Source: Huxley Institute for Biosocial Research; Year: 1978; Format: Sound recording; New York: The Institute, [1978]
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Pathophysiology of alcohol abuse [slide] Source: Lauraine A. Thomas; produced by Robert J. Brady Co; Year: 1977; Format: Slide; Bowie, Md.: The Company, c1977
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Recognizing alcoholism in the hospital patient [slide] Source: Lauraine A. Thomas; produced by Robert J. Brady; Year: 1977; Format: Slide; Bowie, Md.: The Company, c1977
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The Diagnosis and treatment of alcoholism [videorecording] Source: Penn State Television, WPSX-TV; Year: 1978; Format: Videorecording; University Park, Pa.: Pennsylvania State Univ.: [for loan and sale by its Audio-Visual Services], c1978
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The Physician's role [videorecording]: diagnosis and management of alcoholism and alcohol related disorders Source: University of Tennessee Research Corporation, Southern Area Alcohol Education and Training Program, inc., Memphis Mental Health Institute; Year: 1977; Format: Videorecording; Memphis: The Corporation; [Atlanta: for sale by The Program], c1977
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CHAPTER 9. PERIODICALS AND NEWS ON ALCOHOLISM Overview In this chapter, we suggest a number of news sources and present various periodicals that cover alcoholism.
News Services and Press Releases One of the simplest ways of tracking press releases on alcoholism 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 “alcoholism” (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 alcoholism. 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 “alcoholism” (or synonyms). The following was recently listed in this archive for alcoholism: ·
Taste test may predict alcoholism risk Source: Reuters Health eLine Date: June 19, 2003 http://www.reutershealth.com/archive/2003/06/19/eline/links/20030619elin009.htm l
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More women being treated for alcoholism in Austria Source: Reuters Health eLine Date: June 10, 2003
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Long-term alcohol abuse affects hormones Source: Reuters Health eLine Date: May 21, 2003
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Long term hormone effects of alcoholism revealed Source: Reuters Medical News Date: May 20, 2003
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Topiramate helps initiate abstinence during treatment for alcohol dependence Source: Reuters Industry Breifing Date: May 15, 2003
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Czar's freak show helps fight Russian alcoholism Source: Reuters Health eLine Date: April 28, 2003
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Moscow plans crackdown on rampant alcoholism Source: Reuters Health eLine Date: April 01, 2003
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Alcohol industry says study on alcohol abuse flawed Source: Reuters Health eLine Date: February 26, 2003
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Major depression associated with past alcohol dependence Source: Reuters Medical News Date: October 10, 2002
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Neuropeptide Y polymorphism implicated in alcoholism Source: Reuters Medical News Date: September 19, 2002
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Appetite-linked gene also tied to alcoholism Source: Reuters Health eLine Date: September 18, 2002
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Forest sees quarterly profit well above estimates; FDA rejects application on alcoholism drug Source: Reuters Industry Breifing Date: July 02, 2002
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CORRECTION: Brain imaging provides clues for alcoholism treatment Source: Reuters Medical News Date: June 05, 2002
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CT scanning provides clues for alcoholism treatment Source: Reuters Medical News Date: June 03, 2002
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High alcoholism, low stress seen among rescuers Source: Reuters Health eLine Date: May 10, 2002
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FDA advisory panel will debate efficacy of alcoholism drug Source: Reuters Industry Breifing Date: May 09, 2002
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Forest files NDA for drug to treat alcoholism Source: Reuters Industry Breifing Date: February 27, 2002
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Brief physician intervention reduces alcohol abuse over long term Source: Reuters Medical News Date: January 28, 2002
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Alcoholism increases risk of high-risk adenomas and colon cancer Source: Reuters Medical News Date: January 07, 2002
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Anti-alcohol dependence drug doesn't work: study Source: Reuters Health eLine Date: December 12, 2001
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Naltrexone found not useful for treatment of severe alcohol dependence Source: Reuters Industry Breifing Date: December 11, 2001
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Drug, alcohol abuse on rise in US after Sept. 11 Source: Reuters Health eLine Date: December 05, 2001
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Forest licenses US rights to Merck KgaA alcoholism drug Source: Reuters Industry Breifing Date: October 23, 2001
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Brain receptors linked to alcoholism in rat study Source: Reuters Health eLine Date: September 18, 2001
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Alcoholism associated with a decreased risk of endometrial cancer Source: Reuters Medical News Date: August 02, 2001
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Cholecystokinin peptide fragment treats alcoholism in rats Source: Reuters Medical News Date: May 25, 2001
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Brain imbalance linked to alcoholism Source: Reuters Medical News Date: March 22, 2001
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Women report more disability from alcoholism than men Source: Reuters Medical News Date: March 15, 2001
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Women report being more disabled by alcoholism Source: Reuters Health eLine Date: March 15, 2001
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Women's brains are more vulnerable to alcoholism Source: Reuters Health eLine Date: February 08, 2001
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Mexico sees alcoholism rising, esp. among urban men Source: Reuters Health eLine Date: January 25, 2001
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Adolescent alcohol abuse linked to increased psychopathology in adulthood Source: Reuters Medical News Date: January 15, 2001
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Gene mutation could increase alcoholism risk Source: Reuters Health eLine Date: December 26, 2000
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Alcoholism changes brain's genetic wiring Source: Reuters Health eLine Date: December 14, 2000
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Alcohol abuse undermines ability to focus Source: Reuters Health eLine Date: December 14, 2000
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Anxiety-linked drinking ups alcoholism risk Source: Reuters Health eLine Date: November 20, 2000
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Many believe alcoholism a genetic disorder Source: Reuters Health eLine Date: October 05, 2000
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Ondansetron effective for treatment of early-onset, but not late-onset, alcoholism Source: Reuters Industry Breifing Date: August 23, 2000
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Nicotine dependence linked to risk for alcohol dependence Source: Reuters Medical News Date: August 09, 2000
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Genetic link suggested between nicotine and alcohol dependence Source: Reuters Health eLine Date: August 08, 2000
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Alcoholism, problem gambling may share roots Source: Reuters Health eLine Date: July 17, 2000
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"Date rape" drug used in treatment of alcoholism Source: Reuters Health eLine Date: June 28, 2000
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Alcoholism drug found effective against cocaine habit Source: Reuters Health eLine Date: June 15, 2000
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.
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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 “alcoholism” (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 “alcoholism” (or synonyms). If you know the name of a company that is relevant to alcoholism, 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 “alcoholism” (or synonyms).
Newsletter Articles Use the Combined Health Information Database, and limit your search criteria to “newsletter articles.” Again, you will need to use the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. Go to the bottom of the search page where “You may refine your search by.” Select the dates and language that you prefer. For the format option, select “Newsletter Article.” Type “alcoholism” (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 alcoholism: ·
Experiments in Good Taste Source: Food Insight. p. 1, 4-5. March/April 1995.
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Contact: International Food Information Council (IFIC), Foundation. 1100 Connecticut Avenue, N.W., Suite 430, Washington, D.C. 20036. (202) 296-6540; E-mail:
[email protected]. Summary: This article brings readers up-to-date on research in the area of the physiology of taste. Topics covered include how the taste buds taste food; the biochemistry of taste; genetic differences in taste sensitivity; the so-called 'supertasters' who are highly sensitive to taste; differences in the fungiform papillae of the tongues of supertasters; non-genetic factors that may heighten or diminish the sense of taste, including nutritional factors, the sense of smell, and drug effects; the relationship between taste sensitivity and food preferences; taster status and alcoholism; and if and how taster status affects overall eating patterns. The author concludes with a brief mention of future research in the area of taste and the ability to follow a restricted diet. ·
Making the Most of Education and Support: CKD Patient Looks with Hope to the Future Source: Renal Rehabilitation Report. 10(2): S10. Summer 2002. Contact: Available from Life Options Rehabilitation Program. Medical Education Institute, Inc, 414 D'Onofrid Drive., Suite 200, Madison, WI 53719. (608) 833-8033. Email:
[email protected]. Summary: From coping with the diagnosis to preparing for dialysis or transplant, life with chronic kidney disease (CKD) can be full of challenge and uncertainty. This brief newsletter article offers evidence that a positive attitude is a vital component to rebuilding a life altered by kidney disease. The article shares the story of a 64 year old man with chronic kidney disease, John Mudie. John describes his own understanding of kidney disease and his approach to gathering information and educating himself about kidney disease and its treatments. In addition, he describes the importance of support systems in dealing with chronic disease; in his case, not only kidney disease, but also bipolar disorder and alcoholism. He also describes how his experiences with kidney disease have helped him to learn to live in the moment and enjoy life, to realize just how precious it is.
Academic Periodicals covering Alcoholism Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to alcoholism. In addition to these sources, you can search for articles covering alcoholism that have been published by any of the periodicals listed in previous chapters. To find the latest studies published, go to http://www.ncbi.nlm.nih.gov/pubmed, type the name of the periodical into the search box, and click “Go.” If you want complete details about the historical contents of a journal, you can also visit the following Web site: http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi. Here, type in the name of the journal or its abbreviation, and you will receive an index of published articles. At http://locatorplus.gov/, you can retrieve more indexing information on medical periodicals (e.g. the name of the publisher). Select the button “Search LOCATORplus.” Then type in the name of the journal and select the advanced search option “Journal Title Search.”
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APPENDICES
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APPENDIX A. PHYSICIAN RESOURCES Overview In this chapter, we focus on databases and Internet-based guidelines and information resources created or written for a professional audience.
NIH Guidelines Commonly referred to as “clinical” or “professional” guidelines, the National Institutes of Health publish physician guidelines for the most common diseases. Publications are available at the following by relevant Institute13: ·
Office of the Director (OD); guidelines consolidated across agencies available at http://www.nih.gov/health/consumer/conkey.htm
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National Institute of General Medical Sciences (NIGMS); fact sheets available at http://www.nigms.nih.gov/news/facts/
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National Library of Medicine (NLM); extensive encyclopedia (A.D.A.M., Inc.) with guidelines: http://www.nlm.nih.gov/medlineplus/healthtopics.html
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National Cancer Institute (NCI); guidelines available at http://www.cancer.gov/cancerinfo/list.aspx?viewid=5f35036e-5497-4d86-8c2c714a9f7c8d25
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National Eye Institute (NEI); guidelines available at http://www.nei.nih.gov/order/index.htm
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National Heart, Lung, and Blood Institute (NHLBI); guidelines available at http://www.nhlbi.nih.gov/guidelines/index.htm
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National Human Genome Research Institute (NHGRI); research available at http://www.genome.gov/page.cfm?pageID=10000375
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National Institute on Aging (NIA); guidelines available at http://www.nia.nih.gov/health/
13
These publications are typically written by one or more of the various NIH Institutes.
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·
National Institute on Alcohol Abuse and Alcoholism (NIAAA); guidelines available at http://www.niaaa.nih.gov/publications/publications.htm
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National Institute of Allergy and Infectious Diseases (NIAID); guidelines available at http://www.niaid.nih.gov/publications/
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National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); fact sheets and guidelines available at http://www.niams.nih.gov/hi/index.htm
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National Institute of Child Health and Human Development (NICHD); guidelines available at http://www.nichd.nih.gov/publications/pubskey.cfm
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National Institute on Deafness and Other Communication Disorders (NIDCD); fact sheets and guidelines at http://www.nidcd.nih.gov/health/
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National Institute of Dental and Craniofacial Research (NIDCR); guidelines available at http://www.nidr.nih.gov/health/
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National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); guidelines available at http://www.niddk.nih.gov/health/health.htm
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National Institute on Drug Abuse (NIDA); guidelines available at http://www.nida.nih.gov/DrugAbuse.html
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National Institute of Environmental Health Sciences (NIEHS); environmental health information available at http://www.niehs.nih.gov/external/facts.htm
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National Institute of Mental Health (NIMH); guidelines available at http://www.nimh.nih.gov/practitioners/index.cfm
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National Institute of Neurological Disorders and Stroke (NINDS); neurological disorder information pages available at http://www.ninds.nih.gov/health_and_medical/disorder_index.htm
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National Institute of Nursing Research (NINR); publications on selected illnesses at http://www.nih.gov/ninr/news-info/publications.html
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National Institute of Biomedical Imaging and Bioengineering; general information at http://grants.nih.gov/grants/becon/becon_info.htm
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Center for Information Technology (CIT); referrals to other agencies based on keyword searches available at http://kb.nih.gov/www_query_main.asp
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National Center for Complementary and Alternative Medicine (NCCAM); health information available at http://nccam.nih.gov/health/
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National Center for Research Resources (NCRR); various information directories available at http://www.ncrr.nih.gov/publications.asp
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Office of Rare Diseases; various fact sheets available at http://rarediseases.info.nih.gov/html/resources/rep_pubs.html
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Centers for Disease Control and Prevention; various fact sheets on infectious diseases available at http://www.cdc.gov/publications.htm
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NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.14 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:15 ·
Bioethics: Access to published literature on the ethical, legal, and public policy issues surrounding healthcare and biomedical research. This information is provided in conjunction with the Kennedy Institute of Ethics located at Georgetown University, Washington, D.C.: http://www.nlm.nih.gov/databases/databases_bioethics.html
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HIV/AIDS Resources: Describes various links and databases dedicated to HIV/AIDS research: http://www.nlm.nih.gov/pubs/factsheets/aidsinfs.html
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NLM Online Exhibitions: Describes “Exhibitions in the History of Medicine”: http://www.nlm.nih.gov/exhibition/exhibition.html. Additional resources for historical scholarship in medicine: http://www.nlm.nih.gov/hmd/hmd.html
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Biotechnology Information: Access to public databases. The National Center for Biotechnology Information conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information for the better understanding of molecular processes affecting human health and disease: http://www.ncbi.nlm.nih.gov/
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Population Information: The National Library of Medicine provides access to worldwide coverage of population, family planning, and related health issues, including family planning technology and programs, fertility, and population law and policy: http://www.nlm.nih.gov/databases/databases_population.html
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Cancer Information: Access to cancer-oriented databases: http://www.nlm.nih.gov/databases/databases_cancer.html
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Profiles in Science: Offering the archival collections of prominent twentieth-century biomedical scientists to the public through modern digital technology: http://www.profiles.nlm.nih.gov/
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Chemical Information: Provides links to various chemical databases and references: http://sis.nlm.nih.gov/Chem/ChemMain.html
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Clinical Alerts: Reports the release of findings from the NIH-funded clinical trials where such release could significantly affect morbidity and mortality: http://www.nlm.nih.gov/databases/alerts/clinical_alerts.html
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Space Life Sciences: Provides links and information to space-based research (including NASA): http://www.nlm.nih.gov/databases/databases_space.html
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MEDLINE: Bibliographic database covering the fields of medicine, nursing, dentistry, veterinary medicine, the healthcare system, and the pre-clinical sciences: http://www.nlm.nih.gov/databases/databases_medline.html
14 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). 15 See http://www.nlm.nih.gov/databases/databases.html.
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·
Toxicology and Environmental Health Information (TOXNET): Databases covering toxicology and environmental health: http://sis.nlm.nih.gov/Tox/ToxMain.html
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Visible Human Interface: Anatomically detailed, three-dimensional representations of normal male and female human bodies: http://www.nlm.nih.gov/research/visible/visible_human.html The Combined Health Information Database
A comprehensive source of information on clinical guidelines written for professionals is the Combined Health Information Database. You will need to limit your search to one of the following: Brochure/Pamphlet, Fact Sheet, or Information Package, and “alcoholism” 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 “alcoholism” (or synonyms) into the “For these words:” box. The following is a sample result: ·
Policy Statement on AIDS, Alcoholism and Other Drug Dependencies Contact: National Council on Alcoholism, 1511 K St NW, Washington, DC, 20005, (202) 737-8122. National Council on Alcoholism and Drug Dependence, Inc., 12 W 21st St, New York, NY, 10010, (212) 206-6770. Summary: This policy statement sets forth the position of the National Council on Alcoholism regarding the role of alcohol and/or other drugs in the spread of the Human immunodeficiency virus (HIV) and Acquired immunodeficiency syndrome (AIDS). The epidemiology of the AIDS epidemic is reviewed. Policy is proposed that addresses confidentiality, the role of alcohol on risk-taking, the right to health care, and Federal and State initiatives. Implementation is proposed through affiliate outreach, legislative activity, coalitions, seminars, and conferences.
·
New York Division of Alcoholism and Alcohol Abuse Administrative Bulletin Contact: New York Division of Alcoholism and Alcohol Abuse, 1450 Western Ave, Albany, NY, 12203, (518) 473-3460. Summary: This report examines the relationship between Acquired immunodeficiency syndrome (AIDS) and alcohol use and the impact of AIDS on recovering alcoholics and alcoholics in-and not-in-treatment. The AIDS-related policies and procedures for the alcoholism treatment system are provided. They cover diagnosis and testing; treatment of seropositive individuals; special treatment populations; legal issues; discharge planning; staff education and training; and employee policies. Appendixes list New York State antibody counseling and testing sites, information resources, and hotlines.
The NLM Gateway16 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 16
Adapted from NLM: http://gateway.nlm.nih.gov/gw/Cmd?Overview.x.
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(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.17 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “alcoholism” (or synonyms) into the search box and click “Search.” The results will be presented in a tabular form, indicating the number of references in each database category. Results Summary Category Journal Articles Books / Periodicals / Audio Visual Consumer Health Meeting Abstracts Other Collections Total
Items Found 54010 4088 275 194 180 58747
HSTAT18 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.19 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.20 Simply search by “alcoholism” (or synonyms) at the following Web site: http://text.nlm.nih.gov.
Coffee Break: Tutorials for Biologists21 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.22 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.23 This site has new articles
17 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). 18 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 19 The HSTAT URL is http://hstat.nlm.nih.gov/. 20 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. 21 Adapted from http://www.ncbi.nlm.nih.gov/Coffeebreak/Archive/FAQ.html. 22 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. 23 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each
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every few weeks, so it can be considered an online magazine of sorts. It is intended for general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/.
Other Commercial Databases In addition to resources maintained by official agencies, other databases exist that are commercial ventures addressing medical professionals. Here are some examples that may interest you: ·
CliniWeb International: Index and table of contents to selected clinical information on the Internet; see http://www.ohsu.edu/cliniweb/.
·
Medical World Search: Searches full text from thousands of selected medical sites on the Internet; see http://www.mwsearch.com/.
The Genome Project and Alcoholism In the following section, we will discuss databases and references which relate to the Genome Project and alcoholism.
Online Mendelian Inheritance in Man (OMIM) The Online Mendelian Inheritance in Man (OMIM) database is a catalog of human genes and genetic disorders authored and edited by Dr. Victor A. McKusick and his colleagues at Johns Hopkins and elsewhere. OMIM was developed for the World Wide Web by the National Center for Biotechnology Information (NCBI).24 The database contains textual information, pictures, and reference information. It also contains copious links to NCBI’s Entrez database of MEDLINE articles and sequence information. To search the database, go to http://www.ncbi.nlm.nih.gov/Omim/searchomim.html. Type “alcoholism” (or synonyms) into the search box, and click “Submit Search.” If too many results appear, you can narrow the search by adding the word “clinical.” Each report will have additional links to related research and databases. In particular, the option “Database Links” will search across technical databases that offer an abundance of information. The following is an example of the results you can obtain from the OMIM for alcoholism: ·
Alcoholism Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?103780
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. 24 Adapted from http://www.ncbi.nlm.nih.gov/. Established in 1988 as a national resource for molecular biology information, NCBI creates public databases, conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information--all for the better understanding of molecular processes affecting human health and disease.
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Genes and Disease (NCBI - Map) The Genes and Disease database is produced by the National Center for Biotechnology Information of the National Library of Medicine at the National Institutes of Health. This Web site categorizes each disorder by system of the body. Go to http://www.ncbi.nlm.nih.gov/disease/, and browse the system pages to have a full view of important conditions linked to human genes. Since this site is regularly updated, you may wish to revisit it from time to time. The following systems and associated disorders are addressed: ·
Cancer: Uncontrolled cell division. Examples: Breast and ovarian cancer, Burkitt lymphoma, chronic myeloid leukemia, colon cancer, lung cancer, malignant melanoma, multiple endocrine neoplasia, neurofibromatosis, p53 tumor suppressor, pancreatic cancer, prostate cancer, Ras oncogene, RB: retinoblastoma, von Hippel-Lindau syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Cancer.html
·
Immune System: Fights invaders. Examples: Asthma, autoimmune polyglandular syndrome, Crohn’s disease, DiGeorge syndrome, familial Mediterranean fever, immunodeficiency with Hyper-IgM, severe combined immunodeficiency. Web site: http://www.ncbi.nlm.nih.gov/disease/Immune.html
·
Metabolism: Food and energy. Examples: Adreno-leukodystrophy, atherosclerosis, Best disease, Gaucher disease, glucose galactose malabsorption, gyrate atrophy, juvenile-onset diabetes, obesity, paroxysmal nocturnal hemoglobinuria, phenylketonuria, Refsum disease, Tangier disease, Tay-Sachs disease. Web site: http://www.ncbi.nlm.nih.gov/disease/Metabolism.html
·
Muscle and Bone: Movement and growth. Examples: Duchenne muscular dystrophy, Ellis-van Creveld syndrome, Marfan syndrome, myotonic dystrophy, spinal muscular atrophy. Web site: http://www.ncbi.nlm.nih.gov/disease/Muscle.html
·
Nervous System: Mind and body. Examples: Alzheimer disease, amyotrophic lateral sclerosis, Angelman syndrome, Charcot-Marie-Tooth disease, epilepsy, essential tremor, fragile X syndrome, Friedreich’s ataxia, Huntington disease, Niemann-Pick disease, Parkinson disease, Prader-Willi syndrome, Rett syndrome, spinocerebellar atrophy, Williams syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Brain.html
·
Signals: Cellular messages. Examples: Ataxia telangiectasia, Cockayne syndrome, glaucoma, male-patterned baldness, SRY: sex determination, tuberous sclerosis, Waardenburg syndrome, Werner syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Signals.html
·
Transporters: Pumps and channels. Examples: Cystic fibrosis, deafness, diastrophic dysplasia, Hemophilia A, long-QT syndrome, Menkes syndrome, Pendred syndrome, polycystic kidney disease, sickle cell anemia, Wilson’s disease, Zellweger syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Transporters.html
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Entrez Entrez is a search and retrieval system that integrates several linked databases at the National Center for Biotechnology Information (NCBI). These databases include nucleotide sequences, protein sequences, macromolecular structures, whole genomes, and MEDLINE through PubMed. Entrez provides access to the following databases: ·
3D Domains: Domains from Entrez Structure, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=geo
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Books: Online books, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=books
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Genome: Complete genome assemblies, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Genome
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NCBI’s Protein Sequence Information Survey Results: Web site: http://www.ncbi.nlm.nih.gov/About/proteinsurvey/
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Nucleotide Sequence Database (Genbank): Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Nucleotide
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OMIM: Online Mendelian Inheritance in Man, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=OMIM
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PopSet: Population study data sets, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Popset
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ProbeSet: Gene Expression Omnibus (GEO), Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=geo
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Protein Sequence Database: Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Protein
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PubMed: Biomedical literature (PubMed), Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed
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Structure: Three-dimensional macromolecular structures, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Structure
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Taxonomy: Organisms in GenBank, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Taxonomy
To access the Entrez system at the National Center for Biotechnology Information, go to http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?CMD=search&DB=genome, and then select the database that you would like to search. The databases available are listed in the drop box next to “Search.” Enter “alcoholism” (or synonyms) into the search box and click “Go.”
Jablonski’s Multiple Congenital Anomaly/Mental Retardation (MCA/MR) Syndromes Database25 This online resource has been developed to facilitate the identification and differentiation of syndromic entities. Special attention is given to the type of information that is usually 25 Adapted from the National Library of Medicine: http://www.nlm.nih.gov/mesh/jablonski/about_syndrome.html.
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limited or completely omitted in existing reference sources due to space limitations of the printed form. At http://www.nlm.nih.gov/mesh/jablonski/syndrome_toc/toc_a.html, you can search across syndromes using an alphabetical index. Search by keywords at http://www.nlm.nih.gov/mesh/jablonski/syndrome_db.html. The Genome Database26 Established at Johns Hopkins University in Baltimore, Maryland in 1990, the Genome Database (GDB) is the official central repository for genomic mapping data resulting from the Human Genome Initiative. In the spring of 1999, the Bioinformatics Supercomputing Centre (BiSC) at the Hospital for Sick Children in Toronto, Ontario assumed the management of GDB. The Human Genome Initiative is a worldwide research effort focusing on structural analysis of human DNA to determine the location and sequence of the estimated 100,000 human genes. In support of this project, GDB stores and curates data generated by researchers worldwide who are engaged in the mapping effort of the Human Genome Project (HGP). GDB’s mission is to provide scientists with an encyclopedia of the human genome which is continually revised and updated to reflect the current state of scientific knowledge. Although GDB has historically focused on gene mapping, its focus will broaden as the Genome Project moves from mapping to sequence, and finally, to functional analysis. To access the GDB, simply go to the following hyperlink: http://www.gdb.org/. Search “All Biological Data” by “Keyword.” Type “alcoholism” (or synonyms) into the search box, and review the results. If more than one word is used in the search box, then separate each one with the word “and” or “or” (using “or” might be useful when using synonyms).
26
Adapted from the Genome Database: http://gdbwww.gdb.org/gdb/aboutGDB.html - mission.
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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 alcoholism 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 alcoholism. 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 alcoholism. 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 “alcoholism”:
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·
Guides on alcoholism Alcoholism http://www.nlm.nih.gov/medlineplus/alcoholism.html
·
Other Guides Alcohol and Youth http://www.nlm.nih.gov/medlineplus/alcoholandyouth.html Alcohol Consumption http://www.nlm.nih.gov/medlineplus/alcoholconsumption.html Alcoholism http://www.nlm.nih.gov/medlineplus/alcoholism.html Fetal Alcohol Syndrome http://www.nlm.nih.gov/medlineplus/fetalalcoholsyndrome.html Marijuana Abuse http://www.nlm.nih.gov/medlineplus/marijuanaabuse.html Pregnancy and Substance Abuse http://www.nlm.nih.gov/medlineplus/pregnancyandsubstanceabuse.html Sleep Apnea http://www.nlm.nih.gov/medlineplus/sleepapnea.html
Within the health topic page dedicated to alcoholism, the following was listed: ·
General/Overviews Alcohol: What to Do If It's a Problem for You Source: American Academy of Family Physicians http://familydoctor.org/healthfacts/006/
·
Diagnosis/Symptoms Problem Drinking -- How to Recognize It Source: American Academy of Family Physicians http://familydoctor.org/handouts/755.html
·
Treatment Naltrexone for Alcoholism Source: American Academy of Family Physicians http://familydoctor.org/handouts/130.html Understanding Alcohol Use Disorders and Their Treatment Source: American Psychological Association http://helping.apa.org/therapy/alcohol.html
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·
Specific Conditions/Aspects Alcohol Alert: Cognitive Impairment and Recovery From Alcoholism Source: National Institute on Alcohol Abuse and Alcoholism http://www.niaaa.nih.gov/publications/aa53.htm Alcohol Withdrawal Syndrome Source: American Academy of Family Physicians http://familydoctor.org/handouts/007.html Driving Safely by Avoiding Alcohol Source: American Medical Association http://www.medem.com/MedLB/article_detaillb.cfm?article_ID=ZZZUHGJ928C &sub_cat=465 Post-Traumatic Sress Disorder (PTSD) and Problems with Alcohol Use Source: Dept. of Veterans Affairs, National Center for PTSD http://www.ncptsd.org/facts/specific/fs_alcohol.html Smoking Cessation in Recovering Alcoholics Source: American Academy of Family Physicians http://familydoctor.org/handouts/269.html
·
Children Children of Alcoholics: Important Facts Source: National Association for Children of Alcoholics http://www.nacoa.net/impfacts.htm Questions and Answers About Addiction: Alcoholism Source: National Association for Children of Alcoholics http://www.nacoa.net/addictqa.htm
·
From the National Institutes of Health Alcoholism: Getting the Facts Source: National Institute on Alcohol Abuse and Alcoholism http://www.niaaa.nih.gov/publications/booklet.htm FAQ' s on Alcohol Abuse and Alcoholism Source: National Institute on Alcohol Abuse and Alcoholism http://www.niaaa.nih.gov/faq/q-a.htm
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Latest News U.S. Survey Reveals Millions of New Drug Abusers Source: 09/05/2003, Reuters Health http://www.nlm.nih.gov//www.nlm.nih.gov/medlineplus/news/fullstory_13893 .html
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Men What About Men's Health? Alcohol and Drug Abuse Source: National Women's Health Information Center http://www.4women.gov/mens/index.cfm?page=110&text=no
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·
Organizations Al-Anon/Alateen Source: Al-Anon, Alateen http://www.al-anon.alateen.org/ Alcoholics Anonymous http://www.alcoholics-anonymous.org/ National Association for Children of Alcoholics http://www.nacoa.net/index.htm National Clearinghouse for Alcohol and Drug Information Source: Dept. of Health and Human Services, Substance Abuse and Mental Health Services Administration http://www.health.org/ National Council on Alcoholism and Drug Dependence http://www.ncadd.org National Institute on Alcohol Abuse and Alcoholism http://www.niaaa.nih.gov/
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Prevention/Screening National Alcohol Screening Day Source: National Institute on Alcohol Abuse and Alcoholism http://www.collegedrinkingprevention.gov/Faculty/alcoholscreeningday.aspx
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Research Alcohol Alert: Craving Research, Implications for Treatment Source: National Institute on Alcohol Abuse and Alcoholism http://www.niaaa.nih.gov/publications/aa54.htm Alcohol Alert: Economic Perspectives in Alcoholism Research Source: National Institute on Alcohol Abuse and Alcoholism http://www.niaaa.nih.gov/publications/aa51.htm Finding and Treating Alcohol Problems in Primary Care Source: American College of Physicians http://www.annals.org/cgi/content/full/138/5/I-49 Mouse Model Links Alcohol Intake to Marijuana-Like Brain Compounds: New Pathway Presents Target for Medication Development Source: National Institute on Alcohol Abuse and Alcoholism http://www.nih.gov/news/pr/jan2003/niaaa-20.htm
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Statistics Alcoholism and Drug Dependence Are America's Number One Health Problem Source: National Council on Alcoholism and Drug Dependence http://www.ncadd.org/facts/numberoneprob.html FASTATS: Alcohol Use Source: National Center for Health Statistics http://www.cdc.gov/nchs/fastats/alcohol.htm
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·
Women Alcohol Alert: Are Women More Vulnerable to Alcohol's Effects? Source: National Institute on Alcohol Abuse and Alcoholism http://www.niaaa.nih.gov/publications/aa46-text.htm
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 alcoholism. 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: ·
Alcoholism Source: Rochester, NY: Substance and Alcohol Intervention Services for the Deaf (SAISD), Rochester Institute of Technology (RIT). 1996. 2 p. Contact: Available from Substance and Alcohol Intervention Services for the Deaf (SAISD). Rochester Institute of Technology (RIT), Hale-Andrews Student Life Center, 115 Lomb Memorial Drive, Rochester, NY 14623-5608. Voice/TTY (716) 475-4978; Fax (716) 475-7375; E-mail:
[email protected]. PRICE: Single copy free. Summary: This brochure provides basic information for deaf people about alcoholism. The brochure defines alcoholism, lists the symptoms of alcohol abuse, describes the physical damage that can be caused by alcohol, and discusses relapses. The brochure also includes a section listing places and organizations where readers can get help, including interpreted Alcoholics Anonymous meetings, hospitals, employee assistance programs, doctors, alcoholism counselors, the National Council on Alcoholism and Drug Dependency (NCADD), and Substance and Alcohol Intervention Services for the Deaf (SAISD). The front cover of the brochure is illustrated with the sign for alcohol.
·
The fact is: Alcoholism tends to run in families Source: Rockville, MD: Alcohol, Drug Abuse, and Mental Health Administration, U.S. Department of Health and Human Services. 1992. 2 pp. Contact: Available from National Clearinghouse for Alcohol and Drug Information, P.O. Box 2345, Rockville, MD 20847-2345. Telephone: (301) 468-2600 or (800) 729-6686 or (800) 487-4889 TDD / fax: (301) 468-6433 / e-mail:
[email protected] / Web site: http://www.health.org. Available at no charge.
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Summary: This brochure provides questions and answers about children of alcoholics (COAs). The common characteristics of COAs, their risks and problems, and how to help COAs are discussed. A list of organizations able to provide information and referrals is included. ·
NCADD fact sheet: Alcoholism, other drug addictions and related problems among women Source: New York, NY: National Council on Alcoholism and Drug Dependence. 1990. 2 pp. Contact: Available from Jeffrey Hon, Director of Public Information, National Council on Alcoholism and Drug Dependence, 12 West 21st Street, Eighth Floor, New York, NY 10010. Telephone: (212) 206-6770 or (800) NCA-CALL / fax: (212) 645-1690 / e-mail:
[email protected] / Web site: http://www.ncadd.org. Available at no charge. Summary: NCADD Fact Sheet: Alcoholism, Other Drug Addictions and Related Problems Among Women discusses consumption patterns and practices, physiological effects of alcohol, and treatment issues.
·
Treatment options for alcohol abuse: Information for health care purchasers Source: Washington, DC: Washington Business Group on Health. 1991. 24 pp. Contact: Available from Quality Resource Center, Washington Business Group on Health, 777 North Capitol Street, N.E., Suite 800, Washington, DC 20002. Telephone: (202) 408-9320. $30.00. Summary: This booklet is intended to help companies appropriately manage alcohol abusing employees at the worksite and purchase high quality, cost-effective alcoholism treatment for their employees who require such care. The report provides an introduction and overview of alcoholism; discusses appropriate worksite intervention strategies; summarizes the state of the art regarding patient assessment; outcomes measurement and clinical guidelines research; draws implications of the information for purchasers and their employees in terms of benefit design and patient-centered systems of delivery; provides corporate examples of innovative programs addressing alcohol treatment; and gives resources for further information.
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 “alcoholism” (or synonyms). The following was recently posted: ·
Naltrexone and alcoholism treatment Source: Substance Abuse and Mental Health Services Administration (U.S.) - Federal Government Agency [U.S.]; 1998; 94 pages http://www.guideline.gov/summary/summary.aspx?doc_id=1565&nbr=791&am p;string=alcoholism
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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: ·
Alcoholism: Getting the Facts Source: National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=3207
·
Calendar and Events - National Institute on Alcohol Abuse and Alcoholism Summary: Browse this page for an up-to-date listing of upcoming conferences and national meetings relevant to this Institute's services and programs. Source: National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=3802
·
Drink Too Much, Risk Too Much -- Alcohol Abuse, HIV, and Latinos Summary: This article discusses alcohol abuse among Hispanics and the increased risk of contracting HIV for those who drink too much. Source: National Council of La Raza, Institute for Hispanic Health (IHH) http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=6067
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FAQ' s on Alcohol Abuse and Alcoholism Summary: The National Institute on Alcohol Abuse and Alcoholism (NIAAA) provides answers online to some of the most commonly asked questions received at the agency about alcoholism. Source: National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=3803
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How Are Alcohol and Drugs Affecting Your Life? – A Self-Test For Teenagers Summary: This online self-test can help teens decide if they are at risk for developing alcoholism and/or dependence on another drug. Source: National Council on Alcoholism and Drug Dependence, Inc. http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=5667
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·
Journal of Addictive Diseases Summary: A quarterly journal that focuses on educating physicians and other health care providers involved in the treatment of individuals suffering from alcoholism or other addictions. Source: American Society of Addiction Medicine http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=1950
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National Institute on Alcohol Abuse and Alcoholism Publications Summary: Also available In: Source: National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=329
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NIAAA Alcohol and Alcohol Problems Science Database (ETOH) Summary: The Alcohol and Alcohol Problems Science Database, commonly referred to as ETOH, is the most comprehensive online resource covering all aspects of alcohol abuse and alcoholism. Source: National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=6298
·
The Fact Is...Alcoholism Tends to Run in Families Summary: More than 10 percent of children of alcoholics develop a drinking problem. Source: National Clearinghouse for Alcohol and Drug Information, Center for Substance Abuse Prevention http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=931 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 alcoholism. 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
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Family Village: http://www.familyvillage.wisc.edu/specific.htm
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Google: http://directory.google.com/Top/Health/Conditions_and_Diseases/
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Med Help International: http://www.medhelp.org/HealthTopics/A.html
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Open Directory Project: http://dmoz.org/Health/Conditions_and_Diseases/
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Yahoo.com: http://dir.yahoo.com/Health/Diseases_and_Conditions/
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WebMDÒHealth: http://my.webmd.com/health_topics
Finding Associations There are a number of Internet directories that provide lists of medical associations with information on or resources relating to alcoholism. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with alcoholism.
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 alcoholism. 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 “alcoholism” (or a synonym), and you will receive information on all relevant organizations listed in the database. Health Hotlines directs you to toll-free numbers to over 300 organizations. You can access this database directly at http://www.sis.nlm.nih.gov/hotlines/. On this page, you are given the option to search by keyword or by browsing the subject list. When you have received
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your search results, click on the name of the organization for its description and contact information.
The Combined Health Information Database Another comprehensive source of information on healthcare associations is the Combined Health Information Database. Using the “Detailed Search” option, you will need to limit your search to “Organizations” and “alcoholism”. 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 “alcoholism” (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 “alcoholism” (or a synonym) into the search box, and click “Submit Query.”
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APPENDIX C. 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 alcoholism. 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 DIÒ Advice for the PatientÒ can be accessed through the National Library of Medicine of the National Institutes of Health. The database is partially derived from lists of federally approved medications in the Food and Drug Administration’s (FDA) Drug Approvals database, 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 alcoholism. 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 alcoholism: Ascorbic Acid (Vitamin C) ·
Systemic - U.S. Brands: Ascorbicap; Cecon; Cee-500; Cemill; Cenolate; Cetane; Cevi-Bid; Flavorcee; Ortho/CS; Sunkist http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202071.html
Benzodiazepines ·
Systemic - U.S. Brands: Alprazolam Intensol; Ativan; Dalmane; Diastat; Diazepam Intensol; Dizac; Doral; Halcion; Klonopin; Librium; Lorazepam Intensol; Paxipam; ProSom; Restoril; Serax; Tranxene T-Tab; Tranxene-SD; Tranxene-SD Half Strength; Valium; Xanax http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202084.html
Disulfiram ·
Systemic - U.S. Brands: Antabuse http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202603.html
Folic Acid (Vitamin B 9 ) ·
Systemic - U.S. Brands: Folvite http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202250.html
Lithium ·
Systemic - U.S. Brands: Cibalith-S; Eskalith; Lithane; Lithobid; Lithonate; Lithotabs http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202330.html
Naltrexone ·
Systemic - U.S. Brands: ReVia http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202388.html
Niacin (Vitamin B 3 ) ·
Systemic - U.S. Brands: Endur-Acin; Nia-Bid; Niac; Niacels; Niacor; Nico-400; Nicobid Tempules; Nicolar; Nicotinex Elixir; Slo-Niacin http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202405.html
Paraldehyde ·
Systemic - U.S. Brands: Paral http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202440.html
Pyridoxine (Vitamin B 6 ) ·
Systemic - U.S. Brands: Beesix; Doxine; Nestrex; Pyri; Rodex http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202493.html
Thiamine (Vitamin B 1 ) ·
Systemic - U.S. Brands: Biamine http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202560.html
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Urea ·
Intra-Amniotic - U.S. Brands: Ureaphil http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202584.html
Vitamin B 12 ·
Systemic - U.S. Brands: Alphamin; Cobex; Cobolin-M; Crystamine; Crysti-12; Cyanoject; Cyomin; Hydrobexan; Hydro-Cobex; Hydro-Crysti-12; HydroxyCobal; LA-12; Nascobal; Neuroforte-R; Primabalt; Rubramin PC; Shovite; Vibal; Vibal LA; Vitabee 12 http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202596.html
Vitamin D and Related Compounds ·
Systemic - U.S. Brands: Calciferol; Calciferol Drops; Calcijex; Calderol; DHT; DHT Intensol; Drisdol; Drisdol Drops; Hectorol; Hytakerol; Rocaltrol; Zemplar http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202597.html
Zinc Supplements ·
Systemic - U.S. Brands: Orazinc; Verazinc; Zinc 15; Zinc-220; Zinca-Pak; Zincate http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202622.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 ConsultÔ Mosby’s Drug ConsultÔ database (also available on CD-ROM and book format) covers 45,000 drug products including generics and international brands. It provides prescribing information, drug interactions, and patient information. Subscription information is available at the following hyperlink: http://www.mosbysdrugconsult.com/.
PDRhealth The PDRhealth database is a free-to-use, drug information search engine that has been written for the public in layman’s terms. It contains FDA-approved drug information adapted from the Physicians’ Desk Reference (PDR) database. PDRhealth can be searched by brand name, generic name, or indication. It features multiple drug interactions reports. Search PDRhealth at http://www.pdrhealth.com/drug_info/index.html.
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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. If you have any questions about a medical treatment, the FDA may have an office near you. Look for their number in the blue pages of the phone book. You can also contact the FDA through its toll-free number, 1-888-INFO-FDA (1-888-463-6332), or on the World Wide Web at www.fda.gov.
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APPENDIX D. 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.27
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. 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 libraries recommended by the National
27
Adapted from the NLM: http://www.nlm.nih.gov/psd/cas/interlibrary.html.
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Library of Medicine (sorted alphabetically by name of the U.S. state or Canadian province where the library is located)28: ·
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/
28
Abstracted from http://www.nlm.nih.gov/medlineplus/libraries.html.
Finding Medical Libraries 427
·
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/
Finding Medical Libraries 429
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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/
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New York: Choices in Health Information (New York Public Library) - NLM Consumer Pilot Project participant, http://www.nypl.org/branch/health/links.html
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New York: Health Information Center (Upstate Medical University, State University of New York, Syracuse), http://www.upstate.edu/library/hic/
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New York: Health Sciences Library (Long Island Jewish Medical Center, New Hyde Park), http://www.lij.edu/library/library.html
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New York: ViaHealth Medical Library (Rochester General Hospital), http://www.nyam.org/library/
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Ohio: Consumer Health Library (Akron General Medical Center, Medical & Consumer Health Library), http://www.akrongeneral.org/hwlibrary.htm
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Oklahoma: The Health Information Center at Saint Francis Hospital (Saint Francis Health System, Tulsa), http://www.sfh-tulsa.com/services/healthinfo.asp
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Oregon: Planetree Health Resource Center (Mid-Columbia Medical Center, The Dalles), http://www.mcmc.net/phrc/
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Pennsylvania: Community Health Information Library (Milton S. Hershey Medical Center, Hershey), http://www.hmc.psu.edu/commhealth/
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Pennsylvania: Community Health Resource Library (Geisinger Medical Center, Danville), http://www.geisinger.edu/education/commlib.shtml
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Pennsylvania: HealthInfo Library (Moses Taylor Hospital, Scranton), http://www.mth.org/healthwellness.html
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Pennsylvania: Hopwood Library (University of Pittsburgh, Health Sciences Library System, Pittsburgh), http://www.hsls.pitt.edu/guides/chi/hopwood/index_html
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Pennsylvania: Koop Community Health Information Center (College of Physicians of Philadelphia), http://www.collphyphil.org/kooppg1.shtml
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Pennsylvania: Learning Resources Center - Medical Library (Susquehanna Health System, Williamsport), http://www.shscares.org/services/lrc/index.asp
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Pennsylvania: Medical Library (UPMC Health System, Pittsburgh), http://www.upmc.edu/passavant/library.htm
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Quebec, Canada: Medical Library (Montreal General Hospital), http://www.mghlib.mcgill.ca/
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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
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MedicineNet.com Medical Dictionary (MedicineNet, Inc.): http://www.medterms.com/Script/Main/hp.asp
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Merriam-Webster Medical Dictionary (Inteli-Health, Inc.): http://www.intelihealth.com/IH/
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Multilingual Glossary of Technical and Popular Medical Terms in Eight European Languages (European Commission) - Danish, Dutch, English, French, German, Italian, Portuguese, and Spanish: http://allserv.rug.ac.be/~rvdstich/eugloss/welcome.html
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On-line Medical Dictionary (CancerWEB): http://cancerweb.ncl.ac.uk/omd/
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Rare Diseases Terms (Office of Rare Diseases): http://ord.aspensys.com/asp/diseases/diseases.asp
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Technology Glossary (National Library of Medicine) - Health Care Technology: http://www.nlm.nih.gov/nichsr/ta101/ta10108.htm
Beyond these, MEDLINEplus contains a very patient-friendly encyclopedia covering every aspect of medicine (licensed from A.D.A.M., Inc.). The ADAM Medical Encyclopedia can be accessed at http://www.nlm.nih.gov/medlineplus/encyclopedia.html. ADAM is also available on commercial Web sites such as drkoop.com (http://www.drkoop.com/) and Web MD (http://my.webmd.com/adam/asset/adam_disease_articles/a_to_z/a). The NIH suggests the following Web sites in the ADAM Medical Encyclopedia when searching for information on alcoholism: ·
Basic Guidelines for Alcoholism Alcohol dependence Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000944.htm Alcoholism Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000944.htm Alcoholism - resources Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002199.htm Liver disease Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000205.htm
·
Signs & Symptoms for Alcoholism Abdominal pain Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003120.htm
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Agitation Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003212.htm Anxiety Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003211.htm Cessation of menses Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003149.htm Confusion Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003205.htm Depression Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003213.htm Erythema Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003220.htm GI bleeding Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003133.htm Gynecomastia Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003165.htm Hallucinations Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003258.htm High blood pressure Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003082.htm Hyperpigmentation Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003242.htm Impotence Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003164.htm Insomnia Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003210.htm Jaundice Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003243.htm Memory loss Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003257.htm Nausea Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003117.htm Nausea and vomiting Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003117.htm
Online Glossaries 433
Nausea and vomiting Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003117.htm Numbness and tingling Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003206.htm Palpitations Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003081.htm Seizures Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003200.htm Tachycardia Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003077.htm Telangiectasia Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003284.htm Tension Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003211.htm Tingling Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003206.htm Vomiting Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003117.htm ·
Diagnostics and Tests for Alcoholism Alkaline phosphatase Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003470.htm Aspartate aminotransferase Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003472.htm AST Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003472.htm Biopsy Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003416.htm Blood urea nitrogen Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003474.htm Cortisol level Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003693.htm Erosion Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003225.htm
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Granulocyte Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003440.htm HDL Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003496.htm Hematocrit Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003646.htm Liver function tests Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003436.htm MRI Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003335.htm Platelet count Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003647.htm Total protein Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003483.htm Toxicology screen Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003578.htm Uric acid Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003476.htm White blood cell count Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003643.htm ·
Nutrition for Alcoholism Balanced diet Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002449.htm Vitamins Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002399.htm
·
Background Topics for Alcoholism Acute Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002215.htm Alcohol consumption Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001944.htm Alcohol use Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001944.htm Alcoholism - support group Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002199.htm
Online Glossaries 435
Bleeding Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000045.htm Cardiovascular Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002310.htm Chronic Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002312.htm Drug dependence - resources Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002169.htm Hepatic Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002378.htm Incidence Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002387.htm Peripheral Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002273.htm Physical examination Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002274.htm Self-help group Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002150.htm Substance abuse Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001945.htm Support group Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002150.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
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Patient Education: Glossaries (DMOZ Open Directory Project): http://dmoz.org/Health/Education/Patient_Education/Glossaries/
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Web of Online Dictionaries (Bucknell University): http://www.yourdictionary.com/diction5.html#medicine
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ALCOHOLISM DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. 5-hydroxyindoleacetic acid: 5HIAA. A break-down product of serotonin that is excreted in the urine. Serotonin is a hormone found in high levels in many body tissues. Serotonin and 5HIAA are produced in excess amounts by carcinoid tumors, and levels of these substances may be measured in the urine to test for carcinoid tumors. [NIH] Abdomen: That portion of the body that lies between the thorax and the pelvis. [NIH] 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] Aberrant: Wandering or deviating from the usual or normal course. [EU] Aborigines: Native inhabitants or indigenous individuals of a country. [NIH] Absenteeism: Chronic absence from work or other duty. [NIH] Absolute risk: The observed or calculated probability of an event in a population under study, as contrasted with the relative risk. [NIH] Acatalasia: A rare autosomal recessive disorder resulting from the absence of catalase activity. Though usually asymptomatic, a syndrome of oral ulcerations and gangrene may be present. [NIH] Acceptor: A substance which, while normally not oxidized by oxygen or reduced by hydrogen, can be oxidized or reduced in presence of a substance which is itself undergoing oxidation or reduction. [NIH] ACE: Angiotensin-coverting enzyme. A drug used to decrease pressure inside blood vessels. [NIH] Acetaldehyde: A colorless, flammable liquid used in the manufacture of acetic acid, perfumes, and flavors. It is also an intermediate in the metabolism of alcohol. It has a general narcotic action and also causes irritation of mucous membranes. Large doses may cause death from respiratory paralysis. [NIH] Acetylcholine: A neurotransmitter. Acetylcholine in vertebrates is the major transmitter at neuromuscular junctions, autonomic ganglia, parasympathetic effector junctions, a subset of sympathetic effector junctions, and at many sites in the central nervous system. It is generally not used as an administered drug because it is broken down very rapidly by cholinesterases, but it is useful in some ophthalmological applications. [NIH] Acetylcysteine: The N-acetyl derivative of cysteine. It is used as a mucolytic agent to reduce the viscosity of mucous secretions. It has also been shown to have antiviral effects in patients with HIV due to inhibition of viral stimulation by reactive oxygen intermediates. [NIH]
Achievement: Success in bringing an effort to the desired end; the degree or level of success attained in some specified area (esp. scholastic) or in general. [NIH] Acidity: L. aciditas) the quality of being acid or sour; containing acid (hydrogen ions). [EU] 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]
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Activities of Daily Living: The performance of the basic activities of self care, such as dressing, ambulation, eating, etc., in rehabilitation. [NIH] Adaptation: 1. the adjustment of an organism to its environment, or the process by which it enhances such fitness. 2. the normal ability of the eye to adjust itself to variations in the intensity of light; the adjustment to such variations. 3. the decline in the frequency of firing of a neuron, particularly of a receptor, under conditions of constant stimulation. 4. in dentistry, (a) the proper fitting of a denture, (b) the degree of proximity and interlocking of restorative material to a tooth preparation, (c) the exact adjustment of bands to teeth. 5. in microbiology, the adjustment of bacterial physiology to a new environment. [EU] Adenylate Cyclase: An enzyme of the lyase class that catalyzes the formation of cyclic AMP and pyrophosphate from ATP. EC 4.6.1.1. [NIH] Adipocytes: Fat-storing cells found mostly in the abdominal cavity and subcutaneous tissue. Fat is usually stored in the form of tryglycerides. [NIH] Adjustment: The dynamic process wherein the thoughts, feelings, behavior, and biophysiological mechanisms of the individual continually change to adjust to the environment. [NIH] Adolescence: The period of life beginning with the appearance of secondary sex characteristics and terminating with the cessation of somatic growth. The years usually referred to as adolescence lie between 13 and 18 years of age. [NIH] Adrenal Cortex: The outer layer of the adrenal gland. It secretes mineralocorticoids, androgens, and glucocorticoids. [NIH] Adrenal Glands: Paired glands situated in the retroperitoneal tissues at the superior pole of each kidney. [NIH] Adrenal Medulla: The inner part of the adrenal gland; it synthesizes, stores and releases catecholamines. [NIH] Adrenergic: Activated by, characteristic of, or secreting epinephrine or substances with similar activity; the term is applied to those nerve fibres that liberate norepinephrine at a synapse when a nerve impulse passes, i.e., the sympathetic fibres. [EU] Adverse effect: An unwanted side effect of treatment. [NIH] Aerobic: In biochemistry, reactions that need oxygen to happen or happen when oxygen is present. [NIH] Aetiology: Study of the causes of disease. [EU] Afferent: Concerned with the transmission of neural impulse toward the central part of the nervous system. [NIH] Affinity: 1. inherent likeness or relationship. 2. a special attraction for a specific element, organ, or structure. 3. chemical affinity; the force that binds atoms in molecules; the tendency of substances to combine by chemical reaction. 4. the strength of noncovalent chemical binding between two substances as measured by the dissociation constant of the complex. 5. in immunology, a thermodynamic expression of the strength of interaction between a single antigen-binding site and a single antigenic determinant (and thus of the stereochemical compatibility between them), most accurately applied to interactions among simple, uniform antigenic determinants such as haptens. Expressed as the association constant (K litres mole -1), which, owing to the heterogeneity of affinities in a population of antibody molecules of a given specificity, actually represents an average value (mean intrinsic association constant). 6. the reciprocal of the dissociation constant. [EU] Age of Onset: The age or period of life at which a disease or the initial symptoms or manifestations of a disease appear in an individual. [NIH]
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Ageing: A physiological or morphological change in the life of an organism or its parts, generally irreversible and typically associated with a decline in growth and reproductive vigor. [NIH] Aggravation: An increasing in seriousness or severity; an act or circumstance that intensifies, or makes worse. [EU] Agonist: In anatomy, a prime mover. In pharmacology, a drug that has affinity for and stimulates physiologic activity at cell receptors normally stimulated by naturally occurring substances. [EU] Agoraphobia: Obsessive, persistent, intense fear of open places. [NIH] Alcohol Dehydrogenase: An enzyme that catalyzes reversibly the final step of alcoholic fermentation by reducing an aldehyde to an alcohol. In the case of ethanol, acetaldehyde is reduced to ethanol in the presence of NADH and hydrogen. The enzyme is a zinc protein which acts on primary and secondary alcohols or hemiacetals. EC 1.1.1.1. [NIH] Alcohol Drinking: Behaviors associated with the ingesting of alcoholic beverages, including social drinking. [NIH] Alcoholics Anonymous: An organization of self-proclaimed alcoholics who meet frequently to reinforce their practice of abstinence. [NIH] Alcohol-Related Disorders: Disorders related to or resulting from abuse or mis-use of alcohol. [NIH] Aldehyde Dehydrogenase: An enzyme that oxidizes an aldehyde in the presence of NAD+ and water to an acid and NADH. EC 1.2.1.3. Before 1978, it was classified as EC 1.1.1.70. [NIH]
Alkaloid: A member of a large group of chemicals that are made by plants and have nitrogen in them. Some alkaloids have been shown to work against cancer. [NIH] Alleles: Mutually exclusive forms of the same gene, occupying the same locus on homologous chromosomes, and governing the same biochemical and developmental process. [NIH] Allergen: A antigenic substance capable of producing immediate-type hypersensitivity (allergy). [EU] 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] Ameliorated: A changeable condition which prevents the consequence of a failure or accident from becoming as bad as it otherwise would. [NIH] Ameliorating: A changeable condition which prevents the consequence of a failure or accident from becoming as bad as it otherwise would. [NIH] Amenorrhea: Absence of menstruation. [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]
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Amino Acid Neurotransmitters: Amino acids released by neurons as intercellular messengers. Among the amino acid neurotransmitters are glutamate (glutamic acid) and GABA which are, respectively, the most common excitatory and inhibitory neurotransmitters in the central nervous system. [NIH] Amino Acid Sequence: The order of amino acids as they occur in a polypeptide chain. This is referred to as the primary structure of proteins. It is of fundamental importance in determining protein conformation. [NIH] 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] Amnesia: Lack or loss of memory; inability to remember past experiences. [EU] Amnestic: Nominal aphasia; a difficulty in finding the right name for an object. [NIH] Amphetamine: A powerful central nervous system stimulant and sympathomimetic. Amphetamine has multiple mechanisms of action including blocking uptake of adrenergics and dopamine, stimulation of release of monamines, and inhibiting monoamine oxidase. Amphetamine is also a drug of abuse and a psychotomimetic. The l- and the d,l-forms are included here. The l-form has less central nervous system activity but stronger cardiovascular effects. The d-form is dextroamphetamine. [NIH] Amygdala: Almond-shaped group of basal nuclei anterior to the inferior horn of the lateral ventricle of the brain, within the temporal lobe. The amygdala is part of the limbic system. [NIH]
Anaesthesia: Loss of feeling or sensation. Although the term is used for loss of tactile sensibility, or of any of the other senses, it is applied especially to loss of the sensation of pain, as it is induced to permit performance of surgery or other painful procedures. [EU] Anal: Having to do with the anus, which is the posterior opening of the large bowel. [NIH] 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] Anemia: A reduction in the number of circulating erythrocytes or in the quantity of hemoglobin. [NIH] Anesthesia: A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures. [NIH] Aneurysm: A sac formed by the dilatation of the wall of an artery, a vein, or the heart. [NIH] Animal model: An animal with a disease either the same as or like a disease in humans. Animal models are used to study the development and progression of diseases and to test new treatments before they are given to humans. Animals with transplanted human cancers or other tissues are called xenograft models. [NIH] Anorexia: Clinical manifestation consisting of a physiopathological lack or loss of appetite accompanied by an aversion to food and the inability to eat. [NIH] Anorexia Nervosa: The chief symptoms are inability to eat, weight loss, and amenorrhea. [NIH]
Antagonism: Interference with, or inhibition of, the growth of a living organism by another living organism, due either to creation of unfavorable conditions (e. g. exhaustion of food
Dictionary 441
supplies) or to production of a specific antibiotic substance (e. g. penicillin). [NIH] Anthropology: The science devoted to the comparative study of man. [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]
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] Anticonvulsant: An agent that prevents or relieves convulsions. [EU] Antidepressant: A drug used to treat depression. [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] Antioxidant: A substance that prevents damage caused by free radicals. Free radicals are highly reactive chemicals that often contain oxygen. They are produced when molecules are split to give products that have unpaired electrons. This process is called oxidation. [NIH] Antipsychotic: Effective in the treatment of psychosis. Antipsychotic drugs (called also neuroleptic drugs and major tranquilizers) are a chemically diverse (including phenothiazines, thioxanthenes, butyrophenones, dibenzoxazepines, dibenzodiazepines, and diphenylbutylpiperidines) but pharmacologically similar class of drugs used to treat schizophrenic, paranoid, schizoaffective, and other psychotic disorders; acute delirium and dementia, and manic episodes (during induction of lithium therapy); to control the movement disorders associated with Huntington's chorea, Gilles de la Tourette's syndrome, and ballismus; and to treat intractable hiccups and severe nausea and vomiting. Antipsychotic agents bind to dopamine, histamine, muscarinic cholinergic, a-adrenergic, and serotonin receptors. Blockade of dopaminergic transmission in various areas is thought to be responsible for their major effects : antipsychotic action by blockade in the mesolimbic and mesocortical areas; extrapyramidal side effects (dystonia, akathisia, parkinsonism, and tardive dyskinesia) by blockade in the basal ganglia; and antiemetic effects by blockade in the chemoreceptor trigger zone of the medulla. Sedation and autonomic side effects (orthostatic hypotension, blurred vision, dry mouth, nasal congestion and constipation) are caused by blockade of histamine, cholinergic, and adrenergic receptors. [EU] Antiseptic: A substance that inhibits the growth and development of microorganisms without necessarily killing them. [EU] Antiviral: Destroying viruses or suppressing their replication. [EU] Anus: The opening of the rectum to the outside of the body. [NIH] Anxiety: Persistent feeling of dread, apprehension, and impending disaster. [NIH]
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Anxiety Disorders: Disorders in which anxiety (persistent feelings of apprehension, tension, or uneasiness) is the predominant disturbance. [NIH] Anxiolytic: An anxiolytic or antianxiety agent. [EU] Apolipoproteins: The protein components of lipoproteins which remain after the lipids to which the proteins are bound have been removed. They play an important role in lipid transport and metabolism. [NIH] Apoptosis: One of the two mechanisms by which cell death occurs (the other being the pathological process of necrosis). Apoptosis is the mechanism responsible for the physiological deletion of cells and appears to be intrinsically programmed. It is characterized by distinctive morphologic changes in the nucleus and cytoplasm, chromatin cleavage at regularly spaced sites, and the endonucleolytic cleavage of genomic DNA (DNA fragmentation) at internucleosomal sites. This mode of cell death serves as a balance to mitosis in regulating the size of animal tissues and in mediating pathologic processes associated with tumor growth. [NIH] Aqueous: Having to do with water. [NIH] Aromatic: Having a spicy odour. [EU] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Artery: Vessel-carrying blood from the heart to various parts of the body. [NIH] Aspartate: A synthetic amino acid. [NIH] Astringent: Causing contraction, usually locally after topical application. [EU] Astrocytes: The largest and most numerous neuroglial cells in the brain and spinal cord. Astrocytes (from "star" cells) are irregularly shaped with many long processes, including those with "end feet" which form the glial (limiting) membrane and directly and indirectly contribute to the blood brain barrier. They regulate the extracellular ionic and chemical environment, and "reactive astrocytes" (along with microglia) respond to injury. Astrocytes have high- affinity transmitter uptake systems, voltage-dependent and transmitter-gated ion channels, and can release transmitter, but their role in signaling (as in many other functions) is not well understood. [NIH] Asymptomatic: Having no signs or symptoms of disease. [NIH] Ataxia: Impairment of the ability to perform smoothly coordinated voluntary movements. This condition may affect the limbs, trunk, eyes, pharnyx, larnyx, and other structures. Ataxia may result from impaired sensory or motor function. Sensory ataxia may result from posterior column injury or peripheral nerve diseases. Motor ataxia may be associated with cerebellar diseases; cerebral cortex diseases; thalamic diseases; basal ganglia diseases; injury to the red nucleus; and other conditions. [NIH] Atmospheric Pressure: The pressure at any point in an atmosphere due solely to the weight of the atmospheric gases above the point concerned. [NIH] Atrial: Pertaining to an atrium. [EU] Atrioventricular: Pertaining to an atrium of the heart and to a ventricle. [EU] Atrium: A chamber; used in anatomical nomenclature to designate a chamber affording entrance to another structure or organ. Usually used alone to designate an atrium of the heart. [EU] Attenuated: Strain with weakened or reduced virulence. [NIH] Auditory: Pertaining to the sense of hearing. [EU]
Dictionary 443
Autodigestion: Autolysis; a condition found in disease of the stomach: the stomach wall is digested by the gastric juice. [NIH] Autonomic: Self-controlling; functionally independent. [EU] Autonomic Neuropathy: A disease of the nerves affecting mostly the internal organs such as the bladder muscles, the cardiovascular system, the digestive tract, and the genital organs. These nerves are not under a person's conscious control and function automatically. Also called visceral neuropathy. [NIH] Autopsy: Postmortem examination of the body. [NIH] Avoidance Learning: experience. [NIH]
A response to a cue that is instrumental in avoiding a noxious
Axonal: Condition associated with metabolic derangement of the entire neuron and is manifest by degeneration of the distal portion of the nerve fiber. [NIH] Axons: Nerve fibers that are capable of rapidly conducting impulses away from the neuron cell body. [NIH] Bacteremia: The presence of viable bacteria circulating in the blood. Fever, chills, tachycardia, and tachypnea are common acute manifestations of bacteremia. The majority of cases are seen in already hospitalized patients, most of whom have underlying diseases or procedures which render their bloodstreams susceptible to invasion. [NIH] Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH] Bacterial Physiology: Physiological processes and activities of bacteria. [NIH] Basal Ganglia: Large subcortical nuclear masses derived from the telencephalon and located in the basal regions of the cerebral hemispheres. [NIH] Basal Ganglia Diseases: Diseases of the basal ganglia including the putamen; globus pallidus; claustrum; amygdala; and caudate nucleus. Dyskinesias (most notably involuntary movements and alterations of the rate of movement) represent the primary clinical manifestations of these disorders. Common etiologies include cerebrovascular disease; neurodegenerative diseases; and craniocerebral trauma. [NIH] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU] Beer: An alcoholic beverage usually made from malted cereal grain (as barley), flavored with hops, and brewed by slow fermentation. [NIH] Behavior Therapy: The application of modern theories of learning and conditioning in the treatment of behavior disorders. [NIH] Benzene: Toxic, volatile, flammable liquid hydrocarbon biproduct of coal distillation. It is used as an industrial solvent in paints, varnishes, lacquer thinners, gasoline, etc. Benzene causes central nervous system damage acutely and bone marrow damage chronically and is carcinogenic. It was formerly used as parasiticide. [NIH] Benzodiazepines: A two-ring heterocyclic compound consisting of a benzene ring fused to a diazepine ring. Permitted is any degree of hydrogenation, any substituents and any Hisomer. [NIH] Beta-Endorphin: A peptide consisting of amino acid sequence 61-91 of the endogenous pituitary hormone beta-lipotropin. The first four amino acids show a common tetrapeptide
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sequence with methionine- and leucine enkephalin. The compound shows opiate-like activity. Injection of beta-endorphin induces a profound analgesia of the whole body for several hours. This action is reversed after administration of naloxone. [NIH] Bewilderment: Impairment or loss of will power. [NIH] Bilateral: Affecting both the right and left side of body. [NIH] Bile: An emulsifying agent produced in the LIVER and secreted into the DUODENUM. Its composition includes BILE ACIDS AND SALTS, CHOLESTEROL, and ELECTROLYTES. It aids DIGESTION of fats in the duodenum. [NIH] Bile duct: A tube through which bile passes in and out of the liver. [NIH] Biliary: Having to do with the liver, bile ducts, and/or gallbladder. [NIH] Biliary Tract: The gallbladder and its ducts. [NIH] Bilirubin: A bile pigment that is a degradation product of HEME. [NIH] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biological Factors: Compounds made by living organisms that contribute to or influence a phenomenon or process. They have biological or physiological activities. [NIH] Biological Markers: Measurable and quantifiable biological parameters (e.g., specific enzyme concentration, specific hormone concentration, specific gene phenotype distribution in a population, presence of biological substances) which serve as indices for health- and physiology-related assessments, such as disease risk, psychiatric disorders, environmental exposure and its effects, disease diagnosis, metabolic processes, substance abuse, pregnancy, cell line development, epidemiologic studies, etc. [NIH] Biological response modifier: BRM. A substance that stimulates the body's response to infection and disease. [NIH] Biomarkers: Substances sometimes found in an increased amount in the blood, other body fluids, or tissues and that may suggest the presence of some types of cancer. Biomarkers include CA 125 (ovarian cancer), CA 15-3 (breast cancer), CEA (ovarian, lung, breast, pancreas, and GI tract cancers), and PSA (prostate cancer). Also called tumor markers. [NIH] Biomolecular: A scientific field at the interface between advanced computing and biotechnology. [NIH] Biopsy: Removal and pathologic examination of specimens in the form of small pieces of tissue from the living body. [NIH] Biosynthesis: The building up of a chemical compound in the physiologic processes of a living organism. [EU] 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] Biotransformation: The chemical alteration of an exogenous substance by or in a biological system. The alteration may inactivate the compound or it may result in the production of an active metabolite of an inactive parent compound. The alteration may be either nonsynthetic (oxidation-reduction, hydrolysis) or synthetic (glucuronide formation, sulfate conjugation, acetylation, methylation). This also includes metabolic detoxication and clearance. [NIH]
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Biphasic: Having two phases; having both a sporophytic and a gametophytic phase in the life cycle. [EU] Bipolar Disorder: A major affective disorder marked by severe mood swings (manic or major depressive episodes) and a tendency to remission and recurrence. [NIH] Bladder: The organ that stores urine. [NIH] Blastocyst: The mammalian embryo in the post-morula stage in which a fluid-filled cavity, enclosed primarily by trophoblast, contains an inner cell mass which becomes the embryonic disc. [NIH] Blister: Visible accumulations of fluid within or beneath the epidermis. [NIH] Blister pack: A package consisting of a clear plastic overlay affixed to a cardboard backing for protecting and displaying a product. [EU] 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 Platelets: Non-nucleated disk-shaped cells formed in the megakaryocyte and found in the blood of all mammals. They are mainly involved in blood coagulation. [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] Blood-Brain Barrier: Specialized non-fenestrated tightly-joined endothelial cells (tight junctions) that form a transport barrier for certain substances between the cerebral capillaries and the brain tissue. [NIH] Body Composition: The relative amounts of various components in the body, such as percent body fat. [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 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]
Bulimia: Episodic binge eating. The episodes may be associated with the fear of not being able to stop eating, depressed mood, or self-deprecating thoughts (binge-eating disorder)
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and may frequently be terminated by self-induced vomiting (bulimia nervosa). [NIH] Bupropion: A unicyclic, aminoketone antidepressant. The mechanism of its therapeutic actions is not well understood, but it does appear to block dopamine uptake. The hydrochloride is available as an aid to smoking cessation treatment. [NIH] Buspirone: An anxiolytic agent and a serotonin receptor agonist belonging to the azaspirodecanedione class of compounds. Its structure is unrelated to those of the benzodiazepines, but it has an efficacy comparable to diazepam. [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] Capsules: Hard or soft soluble containers used for the oral administration of medicine. [NIH] Carbamazepine: An anticonvulsant used to control grand mal and psychomotor or focal seizures. Its mode of action is not fully understood, but some of its actions resemble those of phenytoin; although there is little chemical resemblance between the two compounds, their three-dimensional structure is similar. [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] Carcinoid: A type of tumor usually found in the gastrointestinal system (most often in the appendix), and sometimes in the lungs or other sites. Carcinoid tumors are usually benign. [NIH]
Carcinoma: Cancer that begins in the skin or in tissues that line or cover internal organs. [NIH]
Cardiac: Having to do with the heart. [NIH] Cardiomyopathy: A general diagnostic term designating primary myocardial disease, often of obscure or unknown etiology. [EU] 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] Cardiovascular System: The heart and the blood vessels by which blood is pumped and circulated through the body. [NIH] Case report: A detailed report of the diagnosis, treatment, and follow-up of an individual patient. Case reports also contain some demographic information about the patient (for example, age, gender, ethnic origin). [NIH] Case series: A group or series of case reports involving patients who were given similar treatment. Reports of case series usually contain detailed information about the individual patients. This includes demographic information (for example, age, gender, ethnic origin) and information on diagnosis, treatment, response to treatment, and follow-up after treatment. [NIH]
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Catalase: An oxidoreductase that catalyzes the conversion of hydrogen peroxide to water and oxygen. It is present in many animal cells. A deficiency of this enzyme results in acatalasia. EC 1.11.1.6. [NIH] Catalyse: To speed up a chemical reaction. [EU] Catechol: A chemical originally isolated from a type of mimosa tree. Catechol is used as an astringent, an antiseptic, and in photography, electroplating, and making other chemicals. It can also be man-made. [NIH] Catecholamine: A group of chemical substances manufactured by the adrenal medulla and secreted during physiological stress. [NIH] Catheter: A flexible tube used to deliver fluids into or withdraw fluids from the body. [NIH] Caudal: Denoting a position more toward the cauda, or tail, than some specified point of reference; same as inferior, in human anatomy. [EU] Causal: Pertaining to a cause; directed against a cause. [EU] Cause of Death: Factors which produce cessation of all vital bodily functions. They can be analyzed from an epidemiologic viewpoint. [NIH] 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 Death: The termination of the cell's ability to carry out vital functions such as metabolism, growth, reproduction, responsiveness, and adaptability. [NIH] Cell Division: The fission of a cell. [NIH] Cell membrane: Cell membrane = plasma membrane. The structure enveloping a cell, enclosing the cytoplasm, and forming a selective permeability barrier; it consists of lipids, proteins, and some carbohydrates, the lipids thought to form a bilayer in which integral proteins are embedded to varying degrees. [EU] Cell Respiration: The metabolic process of all living cells (animal and plant) in which oxygen is used to provide a source of energy for the cell. [NIH] 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] Centrifugation: A method of separating organelles or large molecules that relies upon differential sedimentation through a preformed density gradient under the influence of a gravitational field generated in a centrifuge. [NIH] Cerebellar: Pertaining to the cerebellum. [EU] Cerebellar Diseases: Diseases that affect the structure or function of the cerebellum. Cardinal manifestations of cerebellar dysfunction include dysmetria, gait ataxia, and muscle hypotonia. [NIH] Cerebellum: Part of the metencephalon that lies in the posterior cranial fossa behind the brain stem. It is concerned with the coordination of movement. [NIH] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] Cerebral Cortex: The thin layer of gray matter on the surface of the cerebral hemisphere that develops from the telencephalon and folds into gyri. It reaches its highest development in man and is responsible for intellectual faculties and higher mental functions. [NIH]
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Cerebrospinal: Pertaining to the brain and spinal cord. [EU] Cerebrospinal fluid: CSF. The fluid flowing around the brain and spinal cord. Cerebrospinal fluid is produced in the ventricles in the brain. [NIH] Cerebrovascular: Pertaining to the blood vessels of the cerebrum, or brain. [EU] Cerebrum: The largest part of the brain. It is divided into two hemispheres, or halves, called the cerebral hemispheres. The cerebrum controls muscle functions of the body and also controls speech, emotions, reading, writing, and learning. [NIH] Cervix: The lower, narrow end of the uterus that forms a canal between the uterus and vagina. [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 Development: The continuous sequential physiological and psychological maturing of the child from birth up to but not including adolescence. It includes healthy responses to situations, but does not include growth in stature or size (= growth). [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] Chlormethiazole: A sedative and anticonvulsant often used in the treatment of alcohol withdrawal. Chlormethiazole has also been proposed as a neuroprotective agent. The mechanism of its therapeutic activity is not entirely clear, but it does potentiate gaba receptors response and it may also affect glycine receptors. [NIH] Cholecystokinin: A 33-amino acid peptide secreted by the upper intestinal mucosa and also found in the central nervous system. It causes gallbladder contraction, release of pancreatic exocrine (or digestive) enzymes, and affects other gastrointestinal functions. Cholecystokinin may be the mediator of satiety. [NIH] Cholesterol: The principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils. [NIH] Cholesterol Esters: Fatty acid esters of cholesterol which constitute about two-thirds of the cholesterol in the plasma. The accumulation of cholesterol esters in the arterial intima is a characteristic feature of atherosclerosis. [NIH] Choline: A basic constituent of lecithin that is found in many plants and animal organs. It is important as a precursor of acetylcholine, as a methyl donor in various metabolic processes, and in lipid metabolism. [NIH] Cholinergic: Resembling acetylcholine in pharmacological action; stimulated by or releasing acetylcholine or a related compound. [EU] Chorda Tympani Nerve: A branch of the facial (7th cranial) nerve which passes through the middle ear and continues through the petrotympanic fissure. The chorda tympani nerve carries taste sensation from the anterior two-thirds of the tongue and conveys parasympathetic efferents to the salivary glands. [NIH] Chromatin: The material of chromosomes. It is a complex of DNA, histones, and nonhistone proteins (chromosomal proteins, non-histone) found within the nucleus of a cell. [NIH]
Chromosomal: Pertaining to chromosomes. [EU]
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Chromosome: Part of a cell that contains genetic information. Except for sperm and eggs, all human cells contain 46 chromosomes. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Chylomicrons: A class of lipoproteins that carry dietary cholesterol and triglycerides from the small intestines to the tissues. [NIH] Cirrhosis: A type of chronic, progressive liver disease. [NIH] CIS: Cancer Information Service. The CIS is the National Cancer Institute's link to the public, interpreting and explaining research findings in a clear and understandable manner, and providing personalized responses to specific questions about cancer. Access the CIS by calling 1-800-4-CANCER, or by using the Web site at http://cis.nci.nih.gov. [NIH] Cisplatin: An inorganic and water-soluble platinum complex. After undergoing hydrolysis, it reacts with DNA to produce both intra and interstrand crosslinks. These crosslinks appear to impair replication and transcription of DNA. The cytotoxicity of cisplatin correlates with cellular arrest in the G2 phase of the cell cycle. [NIH] Clamp: A u-shaped steel rod used with a pin or wire for skeletal traction in the treatment of certain fractures. [NIH] Clinical Medicine: The study and practice of medicine by direct examination of the patient. [NIH]
Clinical study: A research study in which patients receive treatment in a clinic or other medical facility. Reports of clinical studies can contain results for single patients (case reports) or many patients (case series or clinical trials). [NIH] Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] Clomipramine: A tricyclic antidepressant similar to imipramine that selectively inhibits the uptake of serotonin in the brain. It is readily absorbed from the gastrointestinal tract and demethylated in the liver to form its primary active metabolite, desmethylclomipramine. [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] Coca: Any of several South American shrubs of the Erythroxylon genus (and family) that yield cocaine; the leaves are chewed with alum for CNS stimulation. [NIH] Cocaine: An alkaloid ester extracted from the leaves of plants including coca. It is a local anesthetic and vasoconstrictor and is clinically used for that purpose, particularly in the eye, ear, nose, and throat. It also has powerful central nervous system effects similar to the amphetamines and is a drug of abuse. Cocaine, like amphetamines, acts by multiple mechanisms on brain catecholaminergic neurons; the mechanism of its reinforcing effects is thought to involve inhibition of dopamine uptake. [NIH] Cofactor: A substance, microorganism or environmental factor that activates or enhances the action of another entity such as a disease-causing agent. [NIH] Cognition: Intellectual or mental process whereby an organism becomes aware of or obtains knowledge. [NIH] Cognitive behavior therapy: A system of psychotherapy based on the premise that distorted or dysfunctional thinking, which influences a person's mood or behavior, is common to all psychosocial problems. The focus of therapy is to identify the distorted thinking and to replace it with more rational, adaptive thoughts and beliefs. [NIH]
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Cohort Effect: Variation in health status arising from different causal factors to which each birth cohort in a population is exposed as environment and society change. [NIH] Collagen: A polypeptide substance comprising about one third of the total protein in mammalian organisms. It is the main constituent of skin, connective tissue, and the organic substance of bones and teeth. Different forms of collagen are produced in the body but all consist of three alpha-polypeptide chains arranged in a triple helix. Collagen is differentiated from other fibrous proteins, such as elastin, by the content of proline, hydroxyproline, and hydroxylysine; by the absence of tryptophan; and particularly by the high content of polar groups which are responsible for its swelling properties. [NIH] Colloidal: Of the nature of a colloid. [EU] Colon: The long, coiled, tubelike organ that removes water from digested food. The remaining material, solid waste called stool, moves through the colon to the rectum and leaves the body through the anus. [NIH] Community Medicine: A branch of medicine concerned with the total health of the individual within the home environment and in the community, and with the application of comprehensive care to the prevention and treatment of illness in the entire community. [NIH] Comorbidity: The presence of co-existing or additional diseases with reference to an initial diagnosis or with reference to the index condition that is the subject of study. Comorbidity may affect the ability of affected individuals to function and also their survival; it may be used as a prognostic indicator for length of hospital stay, cost factors, and outcome or survival. [NIH] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix 'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] 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
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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] Complete remission: The disappearance of all signs of cancer. Also called a complete response. [NIH] Compliance: Distensibility measure of a chamber such as the lungs (lung compliance) or bladder. Compliance is expressed as a change in volume per unit change in pressure. [NIH] Compulsions: In psychology, an irresistible urge, sometimes amounting to obsession to perform a particular act which usually is carried out against the performer's will or better judgment. [NIH] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Computed tomography: CT scan. A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called computerized tomography and computerized axial tomography (CAT) scan. [NIH] Computerized axial tomography: A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called CAT scan, computed tomography (CT scan), or computerized tomography. [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] Confidence Intervals: A range of values for a variable of interest, e.g., a rate, constructed so that this range has a specified probability of including the true value of the variable. [NIH] Confusion: A mental state characterized by bewilderment, emotional disturbance, lack of clear thinking, and perceptual disorientation. [NIH] Conjugated: Acting or operating as if joined; simultaneous. [EU] Conjugation: 1. the act of joining together or the state of being conjugated. 2. a sexual process seen in bacteria, ciliate protozoa, and certain fungi in which nuclear material is exchanged during the temporary fusion of two cells (conjugants). In bacterial genetics a form of sexual reproduction in which a donor bacterium (male) contributes some, or all, of its DNA (in the form of a replicated set) to a recipient (female) which then incorporates differing genetic information into its own chromosome by recombination and passes the recombined set on to its progeny by replication. In ciliate protozoa, two conjugants of separate mating types exchange micronuclear material and then separate, each now being a fertilized cell. In certain fungi, the process involves fusion of two gametes, resulting in union of their nuclei and formation of a zygote. 3. in chemistry, the joining together of two compounds to produce another compound, such as the combination of a toxic product with some substance in the body to form a detoxified product, which is then eliminated. [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
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tissue cells embedded in a large amount of extracellular matrix. [NIH] Consciousness: Sense of awareness of self and of the environment. [NIH] Constipation: Infrequent or difficult evacuation of feces. [NIH] Constriction: The act of constricting. [NIH] Consumption: Pulmonary tuberculosis. [NIH] Contamination: The soiling or pollution by inferior material, as by the introduction of organisms into a wound, or sewage into a stream. [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] Control group: In a clinical trial, the group that does not receive the new treatment being studied. This group is compared to the group that receives the new treatment, to see if the new treatment works. [NIH] Controlled clinical trial: A clinical study that includes a comparison (control) group. The comparison group receives a placebo, another treatment, or no treatment at all. [NIH] Conventional therapy: A currently accepted and widely used treatment for a certain type of disease, based on the results of past research. Also called conventional treatment. [NIH] Conventional treatment: A currently accepted and widely used treatment for a certain type of disease, based on the results of past research. Also called conventional therapy. [NIH] Convulsions: A general term referring to sudden and often violent motor activity of cerebral or brainstem origin. Convulsions may also occur in the absence of an electrical cerebral discharge (e.g., in response to hypotension). [NIH] Cor: The muscular organ that maintains the circulation of the blood. c. adiposum a heart that has undergone fatty degeneration or that has an accumulation of fat around it; called also fat or fatty, heart. c. arteriosum the left side of the heart, so called because it contains oxygenated (arterial) blood. c. biloculare a congenital anomaly characterized by failure of formation of the atrial and ventricular septums, the heart having only two chambers, a single atrium and a single ventricle, and a common atrioventricular valve. c. bovinum (L. 'ox heart') a greatly enlarged heart due to a hypertrophied left ventricle; called also c. taurinum and bucardia. c. dextrum (L. 'right heart') the right atrium and ventricle. c. hirsutum, c. villosum. c. mobile (obs.) an abnormally movable heart. c. pendulum a heart so movable that it seems to be hanging by the great blood vessels. c. pseudotriloculare biatriatum a congenital cardiac anomaly in which the heart functions as a three-chambered heart because of tricuspid atresia, the right ventricle being extremely small or rudimentary and the right atrium greatly dilated. Blood passes from the right to the left atrium and thence disease due to pulmonary hypertension secondary to disease of the lung, or its blood vessels, with hypertrophy of the right ventricle. [EU] Corn Oil: Oil from corn or corn plant. [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
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myocardial infarction. [NIH] Corpus: The body of the uterus. [NIH] Corpus Callosum: Broad plate of dense myelinated fibers that reciprocally interconnect regions of the cortex in all lobes with corresponding regions of the opposite hemisphere. The corpus callosum is located deep in the longitudinal fissure. [NIH] Cortex: The outer layer of an organ or other body structure, as distinguished from the internal substance. [EU] Cortical: Pertaining to or of the nature of a cortex or bark. [EU] Cortisol: A steroid hormone secreted by the adrenal cortex as part of the body's response to stress. [NIH] Cost of Illness: The personal cost of acute or chronic disease. The cost to the patient may be an economic, social, or psychological cost or personal loss to self, family, or immediate community. The cost of illness may be reflected in absenteeism, productivity, response to treatment, peace of mind, quality of life, etc. It differs from health care costs, meaning the societal cost of providing services related to the delivery of health care, rather than personal impact on individuals. [NIH] Cranial: Pertaining to the cranium, or to the anterior (in animals) or superior (in humans) end of the body. [EU] Criterion: A standard by which something may be judged. [EU] Critical Illness: A disease or state in which death is possible or imminent. [NIH] Cues: Signals for an action; that specific portion of a perceptual field or pattern of stimuli to which a subject has learned to respond. [NIH] Curative: Tending to overcome disease and promote recovery. [EU] Cutaneous: Having to do with the skin. [NIH] Cyclic: Pertaining to or occurring in a cycle or cycles; the term is applied to chemical compounds that contain a ring of atoms in the nucleus. [EU] Cystathionine beta-Synthase: A multifunctional pyridoxal phosphate enzyme. In the second stage of cysteine biosynthesis it catalyzes the reaction of homocysteine with serine to form cystathionine with the elimination of water. Deficiency of this enzyme leads to hyperhomocysteinemia and homocystinuria. EC 4.2.1.22. [NIH] Cysteine: A thiol-containing non-essential amino acid that is oxidized to form cystine. [NIH] Cytochrome: Any electron transfer hemoprotein having a mode of action in which the transfer of a single electron is effected by a reversible valence change of the central iron atom of the heme prosthetic group between the +2 and +3 oxidation states; classified as cytochromes a in which the heme contains a formyl side chain, cytochromes b, which contain protoheme or a closely similar heme that is not covalently bound to the protein, cytochromes c in which protoheme or other heme is covalently bound to the protein, and cytochromes d in which the iron-tetrapyrrole has fewer conjugated double bonds than the hemes have. Well-known cytochromes have been numbered consecutively within groups and are designated by subscripts (beginning with no subscript), e.g. cytochromes c, c1, C2, ... New cytochromes are named according to the wavelength in nanometres of the absorption maximum of the a-band of the iron (II) form in pyridine, e.g., c-555. [EU] Cytogenetics: A branch of genetics which deals with the cytological and molecular behavior of genes and chromosomes during cell division. [NIH] Cytokine: Small but highly potent protein that modulates the activity of many cell types, including T and B cells. [NIH]
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Cytoplasm: The protoplasm of a cell exclusive of that of the nucleus; it consists of a continuous aqueous solution (cytosol) and the organelles and inclusions suspended in it (phaneroplasm), and is the site of most of the chemical activities of the cell. [EU] Cytotoxic: Cell-killing. [NIH] Cytotoxic chemotherapy: Anticancer drugs that kill cells, especially cancer cells. [NIH] Databases, Bibliographic: Extensive collections, reputedly complete, of references and citations to books, articles, publications, etc., generally on a single subject or specialized subject area. Databases can operate through automated files, libraries, or computer disks. The concept should be differentiated from factual databases which is used for collections of data and facts apart from bibliographic references to them. [NIH] Deamination: The removal of an amino group (NH2) from a chemical compound. [NIH] Death Certificates: Official records of individual deaths including the cause of death certified by a physician, and any other required identifying information. [NIH] Decision Making: The process of making a selective intellectual judgment when presented with several complex alternatives consisting of several variables, and usually defining a course of action or an idea. [NIH] Degenerative: Undergoing degeneration : tending to degenerate; having the character of or involving degeneration; causing or tending to cause degeneration. [EU] Dehydration: The condition that results from excessive loss of body water. [NIH] Deletion: A genetic rearrangement through loss of segments of DNA (chromosomes), bringing sequences, which are normally separated, into close proximity. [NIH] Delivery of Health Care: The concept concerned with all aspects of providing and distributing health services to a patient population. [NIH] Delusion: A false belief, not susceptible to argument or reason, and determined, pathologically, by some form of mental disorder. [NIH] Dementia: An acquired organic mental disorder with loss of intellectual abilities of sufficient severity to interfere with social or occupational functioning. The dysfunction is multifaceted and involves memory, behavior, personality, judgment, attention, spatial relations, language, abstract thought, and other executive functions. The intellectual decline is usually progressive, and initially spares the level of consciousness. [NIH] Dendrites: Extensions of the nerve cell body. They are short and branched and receive stimuli from other neurons. [NIH] Density: The logarithm to the base 10 of the opacity of an exposed and processed film. [NIH] Dental Caries: Localized destruction of the tooth surface initiated by decalcification of the enamel followed by enzymatic lysis of organic structures and leading to cavity formation. If left unchecked, the cavity may penetrate the enamel and dentin and reach the pulp. The three most prominent theories used to explain the etiology of the disase are that acids produced by bacteria lead to decalcification; that micro-organisms destroy the enamel protein; or that keratolytic micro-organisms produce chelates that lead to decalcification. [NIH]
Dentate Gyrus: Gray matter situated above the gyrus hippocampi. It is composed of three layers. The molecular layer is continuous with the hippocampus in the hippocampal fissure. The granular layer consists of closely arranged spherical or oval neurons, called granule cells, whose axons pass through the polymorphic layer ending on the dendrites of pyramidal cells in the hippocampus. [NIH] Dentist-Patient Relations: The psychological relations between the dentist and patient. [NIH]
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Depersonalization: Alteration in the perception of the self so that the usual sense of one's own reality is lost, manifested in a sense of unreality or self-estrangement, in changes of body image, or in a feeling that one does not control his own actions and speech; seen in depersonalization disorder, schizophrenic disorders, and schizotypal personality disorder. Some do not draw a distinction between depersonalization and derealization, using depersonalization to include both. [EU] Depressive Disorder: An affective disorder manifested by either a dysphoric mood or loss of interest or pleasure in usual activities. The mood disturbance is prominent and relatively persistent. [NIH] Deprivation: Loss or absence of parts, organs, powers, or things that are needed. [EU] Derealization: Is characterized by the loss of the sense of reality concerning one's surroundings. [NIH] Dermatitis: Any inflammation of the skin. [NIH] Detergents: Purifying or cleansing agents, usually salts of long-chain aliphatic bases or acids, that exert cleansing (oil-dissolving) and antimicrobial effects through a surface action that depends on possessing both hydrophilic and hydrophobic properties. [NIH] Detoxification: Treatment designed to free an addict from his drug habit. [EU] Deuterium: Deuterium. The stable isotope of hydrogen. It has one neutron and one proton in the nucleus. [NIH] Developing Countries: Countries in the process of change directed toward economic growth, that is, an increase in production, per capita consumption, and income. The process of economic growth involves better utilization of natural and human resources, which results in a change in the social, political, and economic structures. [NIH] Dextroamphetamine: The d-form of amphetamine. It is a central nervous system stimulant and a sympathomimetic. It has also been used in the treatment of narcolepsy and of attention deficit disorders and hyperactivity in children. Dextroamphetamine has multiple mechanisms of action including blocking uptake of adrenergics and dopamine, stimulating release of monamines, and inhibiting monoamine oxidase. It is also a drug of abuse and a psychotomimetic. [NIH] Diabetes Mellitus: A heterogeneous group of disorders that share glucose intolerance in common. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Diastolic: Of or pertaining to the diastole. [EU] Diencephalon: The paired caudal parts of the prosencephalon from which the thalamus, hypothalamus, epithalamus, and subthalamus are derived. [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 the mouth, esophagus, stomach, small and large intestines, and rectum. [NIH] Dihydrotestosterone: Anabolic agent. [NIH] Dilatation: The act of dilating. [NIH] Dilated cardiomyopathy: Heart muscle disease that leads to enlargement of the heart's chambers, robbing the heart of its pumping ability. [NIH]
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Diploid: Having two sets of chromosomes. [NIH] Discrete: Made up of separate parts or characterized by lesions which do not become blended; not running together; separate. [NIH] Discrimination: The act of qualitative and/or quantitative differentiation between two or more stimuli. [NIH] Disease Progression: The worsening of a disease over time. This concept is most often used for chronic and incurable diseases where the stage of the disease is an important determinant of therapy and prognosis. [NIH] Disorientation: The loss of proper bearings, or a state of mental confusion as to time, place, or identity. [EU] Disposition: A tendency either physical or mental toward certain diseases. [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] Disulfiram: A carbamate derivative used as an alcohol deterrent. It is a relatively nontoxic substance when administered alone, but markedly alters the intermediary metabolism of alcohol. When alcohol is ingested after administration of disulfiram, blood acetaldehyde concentrations are increased, followed by flushing, systemic vasodilation, respiratory difficulties, nausea, hypotension, and other symptoms (acetaldehyde syndrome). It acts by inhibiting aldehyde dehydrogenase. [NIH] Diverticula: Plural form of diverticulum. [NIH] Diverticulitis: Inflammation of a diverticulum or diverticula. [NIH] Diverticulum: A pathological condition manifested as a pouch or sac opening from a tubular or sacular organ. [NIH] Dizziness: An imprecise term which may refer to a sense of spatial disorientation, motion of the environment, or lightheadedness. [NIH] Domestic Violence: Deliberate, often repetitive, physical abuse by one family member against another: marital partners, parents, children, siblings, or any other member of a household. [NIH] Dopa: The racemic or DL form of DOPA, an amino acid found in various legumes. The dextro form has little physiologic activity but the levo form (levodopa) is a very important physiologic mediator and precursor and pharmacological agent. [NIH] Dopamine: An endogenous catecholamine and prominent neurotransmitter in several systems of the brain. In the synthesis of catecholamines from tyrosine, it is the immediate precursor to norepinephrine and epinephrine. Dopamine is a major transmitter in the extrapyramidal system of the brain, and important in regulating movement. A family of dopaminergic receptor subtypes mediate its action. Dopamine is used pharmacologically for its direct (beta adrenergic agonist) and indirect (adrenergic releasing) sympathomimetic effects including its actions as an inotropic agent and as a renal vasodilator. [NIH] Double-blind: Pertaining to a clinical trial or other experiment in which neither the subject nor the person administering treatment knows which treatment any particular subject is receiving. [EU] Drinking Behavior: Behaviors associated with the ingesting of water and other liquids; includes rhythmic patterns of drinking (time intervals - onset and duration), frequency and satiety. [NIH] Drug Combinations: Single preparations containing two or more active agents, for the purpose of their concurrent administration as a fixed dose mixture. It is differentiated from
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combination drug therapy in which two or more drugs are administered separately for a combined effect. [NIH] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Drug Resistance: Diminished or failed response of an organism, disease or tissue to the intended effectiveness of a chemical or drug. It should be differentiated from drug tolerance which is the progressive diminution of the susceptibility of a human or animal to the effects of a drug, as a result of continued administration. [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] Duct: A tube through which body fluids pass. [NIH] Duodenum: The first part of the small intestine. [NIH] Dyes: Chemical substances that are used to stain and color other materials. The coloring may or may not be permanent. Dyes can also be used as therapeutic agents and test reagents in medicine and scientific research. [NIH] Dynorphins: A class of opioid peptides including dynorphin A, dynorphin B, and smaller fragments of these peptides. Dynorphins prefer kappa-opioid receptors (receptors, opioid, kappa) and have been shown to play a role as central nervous system transmitters. [NIH] Dysphoric: A feeling of unpleasantness and discomfort. [NIH] Dyspnea: Difficult or labored breathing. [NIH] 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] Ejaculation: The release of semen through the penis during orgasm. [NIH] Elective: Subject to the choice or decision of the patient or physician; applied to procedures that are advantageous to the patient but not urgent. [EU] Electric shock: A dangerous patho-physiological effect resulting from an electric current passing through the body of a human or animal. [NIH] Electrocardiogram: Measurement of electrical activity during heartbeats. [NIH] Electrode: Component of the pacing system which is at the distal end of the lead. It is the interface with living cardiac tissue across which the stimulus is transmitted. [NIH] Electrons: Stable elementary particles having the smallest known negative charge, present in all elements; also called negatrons. Positively charged electrons are called positrons. The numbers, energies and arrangement of electrons around atomic nuclei determine the chemical identities of elements. Beams of electrons are called cathode rays or beta rays, the latter being a high-energy biproduct of nuclear decay. [NIH] Electrophoresis: An electrochemical process in which macromolecules or colloidal particles with a net electric charge migrate in a solution under the influence of an electric current. [NIH]
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Electrophysiological: Pertaining to electrophysiology, that is a branch of physiology that is concerned with the electric phenomena associated with living bodies and involved in their functional activity. [EU] Electroplating: Coating with a metal or alloy by electrolysis. [NIH] Elementary Particles: Individual components of atoms, usually subatomic; subnuclear particles are usually detected only when the atomic nucleus decays and then only transiently, as most of them are unstable, often yielding pure energy without substance, i.e., radiation. [NIH] Embolism: Blocking of a blood vessel by a blood clot or foreign matter that has been transported from a distant site by the blood stream. [NIH] Embryo: The prenatal stage of mammalian development characterized by rapid morphological changes and the differentiation of basic structures. [NIH] Emetic: An agent that causes vomiting. [EU] Emphysema: A pathological accumulation of air in tissues or organs. [NIH] Empirical: A treatment based on an assumed diagnosis, prior to receiving confirmatory laboratory test results. [NIH] Encephalopathy: A disorder of the brain that can be caused by disease, injury, drugs, or chemicals. [NIH] Endemic: Present or usually prevalent in a population or geographical area at all times; said of a disease or agent. Called also endemial. [EU] Endocrine System: The system of glands that release their secretions (hormones) directly into the circulatory system. In addition to the endocrine glands, included are the chromaffin system and the neurosecretory systems. [NIH] Endogenous: Produced inside an organism or cell. The opposite is external (exogenous) production. [NIH] Endometrial: Having to do with the endometrium (the layer of tissue that lines the uterus). [NIH]
Endometrium: The layer of tissue that lines the uterus. [NIH] Endorphins: One of the three major groups of endogenous opioid peptides. They are large peptides derived from the pro-opiomelanocortin precursor. The known members of this group are alpha-, beta-, and gamma-endorphin. The term endorphin is also sometimes used to refer to all opioid peptides, but the narrower sense is used here; opioid peptides is used for the broader group. [NIH] Endotoxic: Of, relating to, or acting as an endotoxin (= a heat-stable toxin, associated with the outer membranes of certain gram-negative bacteria. Endotoxins are not secreted and are released only when the cells are disrupted). [EU] Endotoxin: Toxin from cell walls of bacteria. [NIH] Energy balance: Energy is the capacity of a body or a physical system for doing work. Energy balance is the state in which the total energy intake equals total energy needs. [NIH] Enkephalin: A natural opiate painkiller, in the hypothalamus. [NIH] Entorhinal Cortex: Cortex where the signals are combined with those from other sensory systems. [NIH] Environmental Exposure: The exposure to potentially harmful chemical, physical, or biological agents in the environment or to environmental factors that may include ionizing radiation, pathogenic organisms, or toxic chemicals. [NIH]
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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] Epidemic: Occurring suddenly in numbers clearly in excess of normal expectancy; said especially of infectious diseases but applied also to any disease, injury, or other healthrelated event occurring in such outbreaks. [EU] Epidemiologic Studies: Studies designed to examine associations, commonly, hypothesized causal relations. They are usually concerned with identifying or measuring the effects of risk factors or exposures. The common types of analytic study are case-control studies, cohort studies, and cross-sectional studies. [NIH] Epidemiological: Relating to, or involving epidemiology. [EU] Epidermis: Nonvascular layer of the skin. It is made up, from within outward, of five layers: 1) basal layer (stratum basale epidermidis); 2) spinous layer (stratum spinosum epidermidis); 3) granular layer (stratum granulosum epidermidis); 4) clear layer (stratum lucidum epidermidis); and 5) horny layer (stratum corneum epidermidis). [NIH] Epigastric: Having to do with the upper middle area of the abdomen. [NIH] Epinephrine: The active sympathomimetic hormone from the adrenal medulla in most species. It stimulates both the alpha- and beta- adrenergic systems, causes systemic vasoconstriction and gastrointestinal relaxation, stimulates the heart, and dilates bronchi and cerebral vessels. It is used in asthma and cardiac failure and to delay absorption of local anesthetics. [NIH] Epithalamus: The dorsal posterior subdivision of the diencephalon. The epithalamus is generally considered to include the habenular nuclei (habenula) and associated fiber bundles, the pineal body, and the epithelial roof of the third ventricle. The anterior and posterior paraventricular nuclei of the thalamus are included with the thalamic nuclei although they develop from the same pronuclear mass as the epithalamic nuclei and are sometimes considered part of the epithalamus. [NIH] Epithelial: Refers to the cells that line the internal and external 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] 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] Esophageal Varices: Stretched veins in the esophagus that occur when the liver is not working properly. If the veins burst, the bleeding can cause death. [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] Ether: One of a class of organic compounds in which any two organic radicals are attached
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directly to a single oxygen atom. [NIH] Ethnic Groups: A group of people with a common cultural heritage that sets them apart from others in a variety of social relationships. [NIH] Evacuation: An emptying, as of the bowels. [EU] Evoke: The electric response recorded from the cerebral cortex after stimulation of a peripheral sense organ. [NIH] Evoked Potentials: The electric response evoked in the central nervous system by stimulation of sensory receptors or some point on the sensory pathway leading from the receptor to the cortex. The evoked stimulus can be auditory, somatosensory, or visual, although other modalities have been reported. Event-related potentials is sometimes used synonymously with evoked potentials but is often associated with the execution of a motor, cognitive, or psychophysiological task, as well as with the response to a stimulus. [NIH] Excitation: An act of irritation or stimulation or of responding to a stimulus; the addition of energy, as the excitation of a molecule by absorption of photons. [EU] Excitatory: When cortical neurons are excited, their output increases and each new input they receive while they are still excited raises their output markedly. [NIH] Exhaustion: The feeling of weariness of mind and body. [NIH] Exocrine: 1. secreting outwardly, via a duct;. [EU] Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] Exon: The part of the DNA that encodes the information for the actual amino acid sequence of the protein. In many eucaryotic genes, the coding sequences consist of a series of exons alternating with intron sequences. [NIH] Extracellular: Outside a cell or cells. [EU] Extracellular Space: Interstitial space between cells, occupied by fluid as well as amorphous and fibrous substances. [NIH] Extrapyramidal: Outside of the pyramidal tracts. [EU] Extravasation: A discharge or escape, as of blood, from a vessel into the tissues. [EU] Eye Movements: Voluntary or reflex-controlled movements of the eye. [NIH] Facial: Of or pertaining to the face. [EU] Facial Expression: Observable changes of expression in the face in response to emotional stimuli. [NIH] Facial Nerve: The 7th cranial nerve. The facial nerve has two parts, the larger motor root which may be called the facial nerve proper, and the smaller intermediate or sensory root. Together they provide efferent innervation to the muscles of facial expression and to the lacrimal and salivary glands, and convey afferent information for taste from the anterior two-thirds of the tongue and for touch from the external ear. [NIH] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Family Practice: A medical specialty concerned with the provision of continuing, comprehensive primary health care for the entire family. [NIH] Family Relations: Behavioral, psychological, and social relations among various members of the nuclear family and the extended family. [NIH] Fat: Total lipids including phospholipids. [NIH] Fatal Outcome: Death resulting from the presence of a disease in an individual, as shown
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by a single case report or a limited number of patients. This should be differentiated from death, the physiological cessation of life and from mortality, an epidemiological or statistical concept. [NIH] Fathers: Male parents, human or animal. [NIH] Fatigue: The feeling of weariness of mind and body. [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] Femoral: Pertaining to the femur, or to the thigh. [EU] Fenfluramine: A centrally active drug that apparently both blocks serotonin uptake and provokes transport-mediated serotonin release. [NIH] Fermentation: An enzyme-induced chemical change in organic compounds that takes place in the absence of oxygen. The change usually results in the production of ethanol or lactic acid, and the production of energy. [NIH] Fetal Alcohol Syndrome: A disorder occurring in children born to alcoholic women who continue to drink heavily during pregnancy. Common abnormalities are growth deficiency (prenatal and postnatal), altered morphogenesis, mental deficiency, and characteristic facies - small eyes and flattened nasal bridge. Fine motor dysfunction and tremulousness are observed in the newborn. [NIH] Fibroblasts: Connective tissue cells which secrete an extracellular matrix rich in collagen and other macromolecules. [NIH] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH] Fish Oils: Oils high in unsaturated fats extracted from the bodies of fish or fish parts, especially the livers. Those from the liver are usually high in vitamin A. The oils are used as dietary supplements, in soaps and detergents, as protective coatings, and as a base for other food products such as vegetable shortenings. [NIH] Fish Products: Food products manufactured from fish (e.g., fish flour, fish meal). [NIH] Fissure: Any cleft or groove, normal or otherwise; especially a deep fold in the cerebral cortex which involves the entire thickness of the brain wall. [EU] Fixation: 1. the act or operation of holding, suturing, or fastening in a fixed position. 2. the condition of being held in a fixed position. 3. in psychiatry, a term with two related but distinct meanings : (1) arrest of development at a particular stage, which like regression (return to an earlier stage), if temporary is a normal reaction to setbacks and difficulties but if protracted or frequent is a cause of developmental failures and emotional problems, and (2) a close and suffocating attachment to another person, especially a childhood figure, such as one's mother or father. Both meanings are derived from psychoanalytic theory and refer to 'fixation' of libidinal energy either in a specific erogenous zone, hence fixation at the oral, anal, or phallic stage, or in a specific object, hence mother or father fixation. 4. the use of a fixative (q.v.) to preserve histological or cytological specimens. 5. in chemistry, the process whereby a substance is removed from the gaseous or solution phase and localized, as in carbon dioxide fixation or nitrogen fixation. 6. in ophthalmology, direction of the gaze so that the visual image of the object falls on the fovea centralis. 7. in film processing, the chemical removal of all undeveloped salts of the film emulsion, leaving only the developed silver to form a permanent image. [EU] Fluorine: A nonmetallic, diatomic gas that is a trace element and member of the halogen
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family. It is used in dentistry as flouride to prevent dental caries. [NIH] Fluoxetine: The first highly specific serotonin uptake inhibitor. It is used as an antidepressant and often has a more acceptable side-effects profile than traditional antidepressants. [NIH] Flupenthixol: This tranquilizer seems to be a dopamine-receptor blocker. It works primarily on the D2 receptors, with some effects on the D1 receptors. Craving in some cocaine addicts becomes manageable but is not eliminated. [NIH] Flushing: A transient reddening of the face that may be due to fever, certain drugs, exertion, stress, or a disease process. [NIH] Fluvoxamine: A selective serotonin reuptake inhibitor. It is effective in the treatment of depression, obsessive-compulsive disorders, anxiety, panic disorders, and alcohol amnestic disorders. [NIH] Folate: A B-complex vitamin that is being studied as a cancer prevention agent. Also called folic acid. [NIH] Fold: A plication or doubling of various parts of the body. [NIH] Folic Acid: N-(4-(((2-Amino-1,4-dihydro-4-oxo-6-pteridinyl)methyl)amino)benzoyl)-Lglutamic acid. A member of the vitamin B family that stimulates the hematopoietic system. It is present in the liver and kidney and is found in mushrooms, spinach, yeast, green leaves, and grasses. Folic acid is used in the treatment and prevention of folate deficiencies and megaloblastic anemia. [NIH] Follicular Phase: The period of the menstrual cycle that begins with menstruation and ends with ovulation. [NIH] Follow-Up Studies: Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease. [NIH]
Food Preferences: The selection of one food over another. [NIH] Forearm: The part between the elbow and the wrist. [NIH] Free Radicals: Highly reactive molecules with an unsatisfied electron valence pair. Free radicals are produced in both normal and pathological processes. They are proven or suspected agents of tissue damage in a wide variety of circumstances including radiation, damage from environment chemicals, and aging. Natural and pharmacological prevention of free radical damage is being actively investigated. [NIH] Frontal Lobe: The anterior part of the cerebral hemisphere. [NIH] GABA: The most common inhibitory neurotransmitter in the central nervous system. [NIH] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] Gamma-Glutamyltransferase: An enzyme that catalyzes reversibly the transfer of a glutamyl group from a glutamyl-peptide and an amino acid to a peptide and a glutamylamino acid. EC 2.3.2.2. [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] Gastric: Having to do with the stomach. [NIH] Gastric Emptying: The evacuation of food from the stomach into the duodenum. [NIH]
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Gastrin: A hormone released after eating. Gastrin causes the stomach to produce more acid. [NIH]
Gastrointestinal: Refers to the stomach and intestines. [NIH] Gastrointestinal tract: The stomach and intestines. [NIH] Gelatin: A product formed from skin, white connective tissue, or bone collagen. It is used as a protein food adjuvant, plasma substitute, hemostatic, suspending agent in pharmaceutical preparations, and in the manufacturing of capsules and suppositories. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]
Gene Expression: The phenotypic manifestation of a gene or genes by the processes of gene action. [NIH] Gene Therapy: The introduction of new genes into cells for the purpose of treating disease by restoring or adding gene expression. Techniques include insertion of retroviral vectors, transfection, homologous recombination, and injection of new genes into the nuclei of single cell embryos. The entire gene therapy process may consist of multiple steps. The new genes may be introduced into proliferating cells in vivo (e.g., bone marrow) or in vitro (e.g., fibroblast cultures) and the modified cells transferred to the site where the gene expression is required. Gene therapy may be particularly useful for treating enzyme deficiency diseases, hemoglobinopathies, and leukemias and may also prove useful in restoring drug sensitivity, particularly for leukemia. [NIH] Generator: Any system incorporating a fixed parent radionuclide from which is produced a daughter radionuclide which is to be removed by elution or by any other method and used in a radiopharmaceutical. [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] Genetic Markers: A phenotypically recognizable genetic trait which can be used to identify a genetic locus, a linkage group, or a recombination event. [NIH] Genetic Screening: Searching a population or individuals for persons possessing certain genotypes or karyotypes that: (1) are already associated with disease or predispose to disease; (2) may lead to disease in their descendants; or (3) produce other variations not known to be associated with disease. Genetic screening may be directed toward identifying phenotypic expression of genetic traits. It includes prenatal genetic screening. [NIH] Genetic testing: Analyzing DNA to look for a genetic alteration that may indicate an increased risk for developing a specific disease or disorder. [NIH] Genetics: The biological science that deals with the phenomena and mechanisms of heredity. [NIH] Genital: Pertaining to the genitalia. [EU] Genotype: The genetic constitution of the individual; the characterization of the genes. [NIH] Geriatric: Pertaining to the treatment of the aged. [EU] Germ Cells: The reproductive cells in multicellular organisms. [NIH] Gland: An organ that produces and releases one or more substances for use in the body. Some glands produce fluids that affect tissues or organs. Others produce hormones or participate in blood production. [NIH]
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Glomerular: Pertaining to or of the nature of a glomerulus, especially a renal glomerulus. [EU]
Glomeruli: Plural of glomerulus. [NIH] Glomerulonephritis: Glomerular disease characterized by an inflammatory reaction, with leukocyte infiltration and cellular proliferation of the glomeruli, or that appears to be the result of immune glomerular injury. [NIH] Glossopharyngeal Nerve: The 9th cranial nerve. The glossopharyngeal nerve is a mixed motor and sensory nerve; it conveys somatic and autonomic efferents as well as general, special, and visceral afferents. Among the connections are motor fibers to the stylopharyngeus muscle, parasympathetic fibers to the parotid glands, general and taste afferents from the posterior third of the tongue, the nasopharynx, and the palate, and afferents from baroreceptors and chemoreceptors of the carotid sinus. [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] Glutamate: Excitatory neurotransmitter of the brain. [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] Glutathione Peroxidase: An enzyme catalyzing the oxidation of 2 moles of glutathione in the presence of hydrogen peroxide to yield oxidized glutathione and water. EC 1.11.1.9. [NIH]
Glycine: A non-essential amino acid. It is found primarily in gelatin and silk fibroin and used therapeutically as a nutrient. It is also a fast inhibitory neurotransmitter. [NIH] Glycogen: A sugar stored in the liver and muscles. It releases glucose into the blood when cells need it for energy. Glycogen is the chief source of stored fuel in the body. [NIH] Glycoprotein: A protein that has sugar molecules attached to it. [NIH] Glycosylation: The chemical or biochemical addition of carbohydrate or glycosyl groups to other chemicals, especially peptides or proteins. Glycosyl transferases are used in this biochemical reaction. [NIH] Gonadal: Pertaining to a gonad. [EU] 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] Grasses: A large family, Gramineae, of narrow-leaved herbaceous monocots. Many grasses produce highly allergenic pollens and are hosts to cattle parasites and toxic fungi. [NIH] Growth: The progressive development of a living being or part of an organism from its
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earliest stage to maturity. [NIH] Guanine: One of the four DNA bases. [NIH] Guanosine Triphosphate: Guanosine 5'-(tetrahydrogen triphosphate). A guanine nucleotide containing three phosphate groups esterified to the sugar moiety. [NIH] Gyrus Cinguli: One of the convolutions on the medial surface of the cerebral hemisphere. It surrounds the rostral part of the brain and interhemispheric commissure and forms part of the limbic system. [NIH] Habitual: Of the nature of a habit; according to habit; established by or repeated by force of habit, customary. [EU] Haematological: Relating to haematology, that is that branch of medical science which treats of the morphology of the blood and blood-forming tissues. [EU] Haematology: The science of the blood, its nature, functions, and diseases. [NIH] Half-Life: The time it takes for a substance (drug, radioactive nuclide, or other) to lose half of its pharmacologic, physiologic, or radiologic activity. [NIH] Handicap: A handicap occurs as a result of disability, but disability does not always constitute a handicap. A handicap may be said to exist when a disability causes a substantial and continuing reduction in a person's capacity to function socially and vocationally. [NIH] Haploid: An organism with one basic chromosome set, symbolized by n; the normal condition of gametes in diploids. [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] Headache: Pain in the cranial region that may occur as an isolated and benign symptom or as a manifestation of a wide variety of conditions including subarachnoid hemorrhage; craniocerebral trauma; central nervous system infections; intracranial hypertension; and other disorders. In general, recurrent headaches that are not associated with a primary disease process are referred to as headache disorders (e.g., migraine). [NIH] Health Status: The level of health of the individual, group, or population as subjectively assessed by the individual or by more objective measures. [NIH] Heart attack: A seizure of weak or abnormal functioning of the heart. [NIH] Heart failure: Loss of pumping ability by the heart, often accompanied by fatigue, breathlessness, and excess fluid accumulation in body tissues. [NIH] Heart Transplantation: The transference of a heart from one human or animal to another. [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] Hematoma: An extravasation of blood localized in an organ, space, or tissue. [NIH] Heme: The color-furnishing portion of hemoglobin. It is found free in tissues and as the prosthetic group in many hemeproteins. [NIH] Hemochromatosis: A disease that occurs when the body absorbs too much iron. The body stores the excess iron in the liver, pancreas, and other organs. May cause cirrhosis of the liver. Also called iron overload disease. [NIH] Hemoglobin:
One of the fractions of glycosylated hemoglobin A1c. Glycosylated
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hemoglobin is formed when linkages of glucose and related monosaccharides bind to hemoglobin A and its concentration represents the average blood glucose level over the previous several weeks. HbA1c levels are used as a measure of long-term control of plasma glucose (normal, 4 to 6 percent). In controlled diabetes mellitus, the concentration of glycosylated hemoglobin A is within the normal range, but in uncontrolled cases the level may be 3 to 4 times the normal conentration. Generally, complications are substantially lower among patients with Hb levels of 7 percent or less than in patients with HbA1c levels of 9 percent or more. [NIH] Hemoglobinopathies: A group of inherited disorders characterized by structural alterations within the hemoglobin molecule. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hemostasis: The process which spontaneously arrests the flow of blood from vessels carrying blood under pressure. It is accomplished by contraction of the vessels, adhesion and aggregation of formed blood elements, and the process of blood or plasma coagulation. [NIH]
Hepatic: Refers to the liver. [NIH] Hepatitis: Inflammation of the liver and liver disease involving degenerative or necrotic alterations of hepatocytes. [NIH] Hepatitis A: Hepatitis caused by hepatovirus. It can be transmitted through fecal contamination of food or water. [NIH] Hepatitis C: A form of hepatitis, similar to type B post-transfusion hepatitis, but caused by a virus which is serologically distinct from the agents of hepatitis A, B, and E, and which may persist in the blood of chronic asymptomatic carriers. Hepatitis C is parenterally transmitted and associated with transfusions and drug abuse. [NIH] Hepatitis Viruses: Any of the viruses that cause inflammation of the liver. They include both DNA and RNA viruses as well viruses from humans and animals. [NIH] Hepatitis, Alcoholic: An acute or chronic degenerative and inflammatory lesion of the liver in the alcoholic which is potentially progressive though sometimes reversible. It does not necessarily include steatosis, fibrosis, or cirrhosis of alcoholics, although it is frequently associated with these conditions. It is characterized by liver cell necrosis, infiltration by polymorphonuclear leukocytes and lymphocytes, and Mallory bodies. The morphologic changes of chronic alcoholic hepatitis are not likely to be confused with chronic hepatitis. [NIH]
Hepatocyte: A liver cell. [NIH] Hepatovirus: A genus of picornaviridae causing infectious hepatitis naturally in humans and experimentally in other primates. It is transmitted through fecal contamination of food or water. [NIH] Hereditary: Of, relating to, or denoting factors that can be transmitted genetically from one generation to another. [NIH] Heredity: 1. the genetic transmission of a particular quality or trait from parent to offspring. 2. the genetic constitution of an individual. [EU] Heritability: The proportion of observed variation in a particular trait that can be attributed to inherited genetic factors in contrast to environmental ones. [NIH] Hippocampus: A curved elevation of gray matter extending the entire length of the floor of the temporal horn of the lateral ventricle (Dorland, 28th ed). The hippocampus, subiculum, and dentate gyrus constitute the hippocampal formation. Sometimes authors include the entorhinal cortex in the hippocampal formation. [NIH]
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Homeostasis: The processes whereby the internal environment of an organism tends to remain balanced and stable. [NIH] Homicide: The killing of one person by another. [NIH] 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] Homosexuality: Sexual attraction or relationship between members of the same sex. [NIH] Homozygotes: An individual having a homozygous gene pair. [NIH] 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] Hydration: Combining with water. [NIH] Hydrogen: The first chemical element in the periodic table. It has the atomic symbol H, atomic number 1, and atomic weight 1. It exists, under normal conditions, as a colorless, odorless, tasteless, diatomic gas. Hydrogen ions are protons. Besides the common H1 isotope, hydrogen exists as the stable isotope deuterium and the unstable, radioactive isotope tritium. [NIH] Hydrogen Peroxide: A strong oxidizing agent used in aqueous solution as a ripening agent, bleach, and topical anti-infective. It is relatively unstable and solutions deteriorate over time unless stabilized by the addition of acetanilide or similar organic materials. [NIH] Hydrogenation: Specific method of reduction in which hydrogen is added to a substance by the direct use of gaseous hydrogen. [NIH] Hydrolysis: The process of cleaving a chemical compound by the addition of a molecule of water. [NIH] Hydrophobic: Not readily absorbing water, or being adversely affected by water, as a hydrophobic colloid. [EU] Hydroxylation: Hydroxylate, to introduce hydroxyl into (a compound or radical) usually by replacement of hydrogen. [EU] Hydroxyproline: A hydroxylated form of the imino acid proline. A deficiency in ascorbic acid can result in impaired hydroxyproline formation. [NIH] Hyperbaric: Characterized by greater than normal pressure or weight; applied to gases under greater than atmospheric pressure, as hyperbaric oxygen, or to a solution of greater specific gravity than another taken as a standard of reference. [EU] Hyperbaric oxygen: Oxygen that is at an atmospheric pressure higher than the pressure at sea level. Breathing hyperbaric oxygen to enhance the effectiveness of radiation therapy is being studied. [NIH] Hyperhomocysteinemia: An inborn error of methionone metabolism which produces an excess of homocysteine in the blood. It is often caused by a deficiency of cystathionine betasynthase and is a risk factor for coronary vascular disease. [NIH] Hypericum: Genus of perennial plants in the family Clusiaceae (Hypericaceae). Herbal and homeopathic preparations are used for depression, neuralgias, and a variety of other conditions. Contains flavonoids, glycosides, mucilage, tannins, and volatile oils (oils, essential). [NIH] Hypersensitivity: Altered reactivity to an antigen, which can result in pathologic reactions
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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] Hypertrophy: General increase in bulk of a part or organ, not due to tumor formation, nor to an increase in the number of cells. [NIH] Hypnotic: A drug that acts to induce sleep. [EU] Hypoglycemia: Abnormally low blood sugar [NIH] Hypotension: Abnormally low blood pressure. [NIH] Hypothalamic: Of or involving the hypothalamus. [EU] Hypothalamus: Ventral part of the diencephalon extending from the region of the optic chiasm to the caudal border of the mammillary bodies and forming the inferior and lateral walls of the third ventricle. [NIH] Id: The part of the personality structure which harbors the unconscious instinctive desires and strivings of the individual. [NIH] Idiopathic: Describes a disease of unknown cause. [NIH] Imipramine: The prototypical tricyclic antidepressant. It has been used in major depression, dysthymia, bipolar depression, attention-deficit disorders, agoraphobia, and panic disorders. It has less sedative effect than some other members of this therapeutic group. [NIH]
Immune response: (antigens). [NIH]
The activity of the immune system against foreign substances
Immune system: The organs, cells, and molecules responsible for the recognition and disposal of foreign ("non-self") material which enters the body. [NIH] Immunization: Deliberate stimulation of the host's immune response. Active immunization involves administration of antigens or immunologic adjuvants. Passive immunization involves administration of immune sera or lymphocytes or their extracts (e.g., transfer factor, immune RNA) or transplantation of immunocompetent cell producing tissue (thymus or bone marrow). [NIH] Immunodeficiency: The decreased ability of the body to fight infection and disease. [NIH] Immunodeficiency syndrome: The inability of the body to produce an immune response. [NIH]
Immunogenic: Producing immunity; evoking an immune response. [EU] Immunosuppression: Deliberate prevention or diminution of the host's immune response. It may be nonspecific as in the administration of immunosuppressive agents (drugs or radiation) or by lymphocyte depletion or may be specific as in desensitization or the simultaneous administration of antigen and immunosuppressive drugs. [NIH] Impairment: In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function. [NIH] Implantation: The insertion or grafting into the body of biological, living, inert, or radioactive material. [EU] Impotence: The inability to perform sexual intercourse. [NIH] Impulsive Behavior: An act performed without delay, reflection, voluntary direction, or obvious control in response to a stimulus. [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]
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Incest: Sexual intercourse between persons so closely related that they are forbidden by law to marry. [NIH] Indicative: That indicates; that points out more or less exactly; that reveals fairly clearly. [EU]
Induction: The act or process of inducing or causing to occur, especially the production of a specific morphogenetic effect in the developing embryo through the influence of evocators or organizers, or the production of anaesthesia or unconsciousness by use of appropriate agents. [EU] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infection: 1. invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. an infectious disease. [EU]
Infiltration: The diffusion or accumulation in a tissue or cells of substances not normal to it or in amounts of the normal. Also, the material so accumulated. [EU] Informed Consent: Voluntary authorization, given to the physician by the patient, with full comprehension of the risks involved, for diagnostic or investigative procedures and medical and surgical treatment. [NIH] Infuse: To pour (a liquid) into something. [EU] Infusion: A method of putting fluids, including drugs, into the bloodstream. Also called intravenous infusion. [NIH] Ingestion: Taking into the body by mouth [NIH] 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] Inotropic: Affecting the force or energy of muscular contractions. [EU] Inpatients: Persons admitted to health facilities which provide board and room, for the purpose of observation, care, diagnosis or treatment. [NIH] Insight: The capacity to understand one's own motives, to be aware of one's own psychodynamics, to appreciate the meaning of symbolic behavior. [NIH] Insomnia: Difficulty in going to sleep or getting enough sleep. [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] Intensive Care: Advanced and highly specialized care provided to medical or surgical
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patients whose conditions are life-threatening and require comprehensive care and constant monitoring. It is usually administered in specially equipped units of a health care facility. [NIH]
Interferon: A biological response modifier (a substance that can improve the body's natural response to disease). Interferons interfere with the division of cancer cells and can slow tumor growth. There are several types of interferons, including interferon-alpha, -beta, and gamma. These substances are normally produced by the body. They are also made in the laboratory for use in treating cancer and other diseases. [NIH] Interferon-alpha: One of the type I interferons produced by peripheral blood leukocytes or lymphoblastoid cells when exposed to live or inactivated virus, double-stranded RNA, or bacterial products. It is the major interferon produced by virus-induced leukocyte cultures and, in addition to its pronounced antiviral activity, it causes activation of NK cells. [NIH] Interleukin-1: A soluble factor produced by monocytes, macrophages, and other cells which activates T-lymphocytes and potentiates their response to mitogens or antigens. IL-1 consists of two distinct forms, IL-1 alpha and IL-1 beta which perform the same functions but are distinct proteins. The biological effects of IL-1 include the ability to replace macrophage requirements for T-cell activation. The factor is distinct from interleukin-2. [NIH] Interleukin-10: Factor that is a coregulator of mast cell growth. It is produced by T-cells and B-cells and shows extensive homology with the Epstein-Barr virus BCRFI gene. [NIH] Interleukin-12: A heterodimeric cytokine that stimulates the production of interferon gamma from T-cells and natural killer cells, and also induces differentiation of Th1 helper cells. It is an initiator of cell-mediated immunity. [NIH] Interleukin-2: Soluble substances elaborated by antigen- or mitogen-stimulated Tlymphocytes which induce DNA synthesis in naive lymphocytes. [NIH] Interleukin-6: Factor that stimulates the growth and differentiation of human B-cells and is also a growth factor for hybridomas and plasmacytomas. It is produced by many different cells including T-cells, monocytes, and fibroblasts. [NIH] Intermittent: Occurring at separated intervals; having periods of cessation of activity. [EU] Internal Medicine: A medical specialty concerned with the diagnosis and treatment of diseases of the internal organ systems of adults. [NIH] Intervention Studies: Epidemiologic investigations designed to test a hypothesized causeeffect relation by modifying the supposed causal factor(s) in the study population. [NIH] 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] Intravenous: IV. Into a vein. [NIH] Involuntary: Reaction occurring without intention or volition. [NIH] Ion Channels: Gated, ion-selective glycoproteins that traverse membranes. The stimulus for channel gating can be a membrane potential, drug, transmitter, cytoplasmic messenger, or a mechanical deformation. Ion channels which are integral parts of ionotropic neurotransmitter receptors are not included. [NIH] Ions: An atom or group of atoms that have a positive or negative electric charge due to a
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gain (negative charge) or loss (positive charge) of one or more electrons. Atoms with a positive charge are known as cations; those with a negative charge are anions. [NIH] 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 vesicants and those that penetrate sebaceous glands and cause abscesses are pustulants; tear gases and mustard gases are also irritants. [NIH] Isoflavones: 3-Phenylchromones. Isomeric form of flavones in which the benzene group is attached to the 3 position of the benzopyran ring instead of the 2 position. [NIH] Jealousy: An irrational reaction compounded of grief, loss of self-esteem, enmity against the rival and self criticism. [NIH] Joint: The point of contact between elements of an animal skeleton with the parts that surround and support it. [NIH] Karyotypes: The characteristic chromosome complement of an individual, race, or species as defined by their number, size, shape, etc. [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] Ketamine: A cyclohexanone derivative used for induction of anesthesia. Its mechanism of action is not well understood, but ketamine can block NMDA receptors (receptors, NMethyl-D-Aspartate) and may interact with sigma receptors. [NIH] Keto: It consists of 8 carbon atoms and within the endotoxins, it connects poysaccharide and lipid A. [NIH] Ketoacidosis: Acidosis accompanied by the accumulation of ketone bodies (ketosis) in the body tissues and fluids, as in diabetic acidosis. [EU] Ketone Bodies: Chemicals that the body makes when there is not enough insulin in the blood and it must break down fat for its energy. Ketone bodies can poison and even kill body cells. When the body does not have the help of insulin, the ketones build up in the blood and then "spill" over into the urine so that the body can get rid of them. The body can also rid itself of one type of ketone, called acetone, through the lungs. This gives the breath a fruity odor. Ketones that build up in the body for a long time lead to serious illness and coma. [NIH] Ketosis: A condition of having ketone bodies build up in body tissues and fluids. The signs of ketosis are nausea, vomiting, and stomach pain. Ketosis can lead to ketoacidosis. [NIH] Kidney Disease: Any one of several chronic conditions that are caused by damage to the cells of the kidney. People who have had diabetes for a long time may have kidney damage. Also called nephropathy. [NIH] Labile: 1. gliding; moving from point to point over the surface; unstable; fluctuating. 2. chemically unstable. [EU] Lactation: The period of the secretion of milk. [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] Larynx: An irregularly shaped, musculocartilaginous tubular structure, lined with mucous membrane, located at the top of the trachea and below the root of the tongue and the hyoid bone. It is the essential sphincter guarding the entrance into the trachea and functioning secondarily as the organ of voice. [NIH]
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Latency: The period of apparent inactivity between the time when a stimulus is presented and the moment a response occurs. [NIH] Latent: Phoria which occurs at one distance or another and which usually has no troublesome effect. [NIH] Leptin: A 16-kD peptide hormone secreted from white adipocytes and implicated in the regulation of food intake and energy balance. Leptin provides the key afferent signal from fat cells in the feedback system that controls body fat stores. [NIH] Lesion: An area of abnormal tissue change. [NIH] Leucine: An essential branched-chain amino acid important for hemoglobin formation. [NIH]
Leukemia: Cancer of blood-forming tissue. [NIH] Leukocytes: White blood cells. These include granular leukocytes (basophils, eosinophils, and neutrophils) as well as non-granular leukocytes (lymphocytes and monocytes). [NIH] Levodopa: The naturally occurring form of dopa and the immediate precursor of dopamine. Unlike dopamine itself, it can be taken orally and crosses the blood-brain barrier. It is rapidly taken up by dopaminergic neurons and converted to dopamine. It is used for the treatment of parkinsonism and is usually given with agents that inhibit its conversion to dopamine outside of the central nervous system. [NIH] Library Services: circulation. [NIH]
Services offered to the library user. They include reference and
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] Ligaments: Shiny, flexible bands of fibrous tissue connecting together articular extremities of bones. They are pliant, tough, and inextensile. [NIH] Limbic: Pertaining to a limbus, or margin; forming a border around. [EU] Limbic System: A set of forebrain structures common to all mammals that is defined functionally and anatomically. It is implicated in the higher integration of visceral, olfactory, and somatic information as well as homeostatic responses including fundamental survival behaviors (feeding, mating, emotion). For most authors, it includes the amygdala, epithalamus, gyrus cinguli, hippocampal formation (see hippocampus), hypothalamus, parahippocampal gyrus, septal nuclei, anterior nuclear group of thalamus, and portions of the basal ganglia. (Parent, Carpenter's Human Neuroanatomy, 9th ed, p744; NeuroNames, http://rprcsgi.rprc.washington.edu/neuronames/index.html (September 2, 1998)). [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] Linkage Disequilibrium: Nonrandom association of linked genes. This is the tendency of the alleles of two separate but already linked loci to be found together more frequently than would be expected by chance alone. [NIH] Lipid: Fat. [NIH] Lipid A: Lipid A is the biologically active component of lipopolysaccharides. It shows strong endotoxic activity and exhibits immunogenic properties. [NIH] Lipid Peroxidation: Peroxidase catalyzed oxidation of lipids using hydrogen peroxide as an electron acceptor. [NIH] Lipomatosis: A disorder consisting of the accumulation of abnormal localized, or tumorlike fat in the tissues. [NIH]
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Lipopolysaccharides: Substance consisting of polysaccaride and lipid. [NIH] Lipoprotein: Any of the lipid-protein complexes in which lipids are transported in the blood; lipoprotein particles consist of a spherical hydrophobic core of triglycerides or cholesterol esters surrounded by an amphipathic monolayer of phospholipids, cholesterol, and apolipoproteins; the four principal classes are high-density, low-density, and very-lowdensity lipoproteins and chylomicrons. [EU] Lithium: An element in the alkali metals family. It has the atomic symbol Li, atomic number 3, and atomic weight 6.94. Salts of lithium are used in treating manic-depressive disorders. [NIH] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Liver cancer: A disease in which malignant (cancer) cells are found in the tissues of the liver. [NIH] Liver Cirrhosis: Liver disease in which the normal microcirculation, the gross vascular anatomy, and the hepatic architecture have been variably destroyed and altered with fibrous septa surrounding regenerated or regenerating parenchymal nodules. [NIH] Liver scan: An image of the liver created on a computer screen or on film. A radioactive substance is injected into a blood vessel and travels through the bloodstream. It collects in the liver, especially in abnormal areas, and can be detected by the scanner. [NIH] Liver Transplantation: The transference of a part of or an entire liver from one human or animal to another. [NIH] Lobe: A portion of an organ such as the liver, lung, breast, or brain. [NIH] Localization: The process of determining or marking the location or site of a lesion or disease. May also refer to the process of keeping a lesion or disease in a specific location or site. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Locomotion: Movement or the ability to move from one place or another. It can refer to humans, vertebrate or invertebrate animals, and microorganisms. [NIH] Longitudinal Studies: Studies in which variables relating to an individual or group of individuals are assessed over a period of time. [NIH] Longitudinal study: Also referred to as a "cohort study" or "prospective study"; the analytic method of epidemiologic study in which subsets of a defined population can be identified who are, have been, or in the future may be exposed or not exposed, or exposed in different degrees, to a factor or factors hypothesized to influence the probability of occurrence of a given disease or other outcome. The main feature of this type of study is to observe large numbers of subjects over an extended time, with comparisons of incidence rates in groups that differ in exposure levels. [NIH] Long-Term Care: Care over an extended period, usually for a chronic condition or disability, requiring periodic, intermittent, or continuous care. [NIH] Loop: A wire usually of platinum bent at one end into a small loop (usually 4 mm inside diameter) and used in transferring microorganisms. [NIH] Lorazepam: An anti-anxiety agent with few side effects. It also has hypnotic, anticonvulsant, and considerable sedative properties and has been proposed as a preanesthetic agent. [NIH] Low-density lipoprotein: Lipoprotein that contains most of the cholesterol in the blood. LDL carries cholesterol to the tissues of the body, including the arteries. A high level of LDL
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increases the risk of heart disease. LDL typically contains 60 to 70 percent of the total serum cholesterol and both are directly correlated with CHD risk. [NIH] Lumbar: Pertaining to the loins, the part of the back between the thorax and the pelvis. [EU] Lumbar puncture: A procedure in which a needle is put into the lower part of the spinal column to collect cerebrospinal fluid or to give anticancer drugs intrathecally. Also called a spinal tap. [NIH] Luteal Phase: The period of the menstrual cycle that begins with ovulation and ends with menstruation. [NIH] Lutein Cells: The cells of the corpus luteum which are derived from the granulosa cells and the theca cells of the Graafian follicle. [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] 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] Magnetic Resonance Spectroscopy: Spectroscopic method of measuring the magnetic moment of elementary particles such as atomic nuclei, protons or electrons. It is employed in clinical applications such as NMR Tomography (magnetic resonance imaging). [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] Malaria: A protozoan disease caused in humans by four species of the genus Plasmodium (P. falciparum (malaria, falciparum), P. vivax (malaria, vivax), P. ovale, and P. malariae) and transmitted by the bite of an infected female mosquito of the genus Anopheles. Malaria is endemic in parts of Asia, Africa, Central and South America, Oceania, and certain Caribbean islands. It is characterized by extreme exhaustion associated with paroxysms of high fever, sweating, shaking chills, and anemia. Malaria in animals is caused by other species of plasmodia. [NIH] Malaria, Falciparum: Malaria caused by Plasmodium falciparum. This is the severest form of malaria and is associated with the highest levels of parasites in the blood. This disease is characterized by irregularly recurring febrile paroxysms that in extreme cases occur with acute cerebral, renal, or gastrointestinal manifestations. [NIH] Malaria, Vivax: Malaria caused by Plasmodium vivax. This form of malaria is less severe than malaria, falciparum, but there is a higher probability for relapses to occur. Febrile paroxysms often occur every other day. [NIH] 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]
Mammary: Pertaining to the mamma, or breast. [EU] Mania: Excitement of psychotic proportions manifested by mental and physical hyperactivity, disorganization of behaviour, and elevation of mood. [EU]
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Manic: Affected with mania. [EU] Manic-depressive psychosis: One of a group of psychotic reactions, fundamentally marked by severe mood swings and a tendency to remission and recurrence. [NIH] Manifest: Being the part or aspect of a phenomenon that is directly observable : concretely expressed in behaviour. [EU] Man-made: Ionizing radiation emitted by artificial or concentrated natural, radioactive material or resulting from the operation of high voltage apparatus, such as X-ray apparatus or particle accelerators, of nuclear reactors, or from nuclear explosions. [NIH] Marital Therapy: A form of psychotherapy involving the husband and wife and directed to improving the marital relationship. [NIH] Mediate: Indirect; accomplished by the aid of an intervening medium. [EU] Mediator: An object or substance by which something is mediated, such as (1) a structure of the nervous system that transmits impulses eliciting a specific response; (2) a chemical substance (transmitter substance) that induces activity in an excitable tissue, such as nerve or muscle; or (3) a substance released from cells as the result of the interaction of antigen with antibody or by the action of antigen with a sensitized lymphocyte. [EU] Medical Assistance: Financing of medical care provided to public assistance recipients. [NIH]
Medical Records: illnesses. [NIH]
Recording of pertinent information concerning patient's illness or
MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Megaloblastic: anaemia. [EU]
A large abnormal red blood cell appearing in the blood in pernicious
Meiosis: A special method of cell division, occurring in maturation of the germ cells, by means of which each daughter nucleus receives half the number of chromosomes characteristic of the somatic cells of the species. [NIH] Melanin: The substance that gives the skin its color. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Memory: Complex mental function having four distinct phases: (1) memorizing or learning, (2) retention, (3) recall, and (4) recognition. Clinically, it is usually subdivided into immediate, recent, and remote memory. [NIH] Meninges: The three membranes that cover and protect the brain and spinal cord. [NIH] Menstrual Cycle: The period of the regularly recurring physiologic changes in the endometrium occurring during the reproductive period in human females and some primates and culminating in partial sloughing of the endometrium (menstruation). [NIH] Menstruation: The normal physiologic discharge through the vagina of blood and mucosal tissues from the nonpregnant uterus. [NIH] Mental: Pertaining to the mind; psychic. 2. (L. mentum chin) pertaining to the chin. [EU] Mental deficiency: A condition of arrested or incomplete development of mind from inherent causes or induced by disease or injury. [NIH] Mental Disorders: Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function. [NIH] Mental Health: The state wherein the person is well adjusted. [NIH]
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Mental Health Services: Organized services to provide mental health care. [NIH] Mental Processes: Conceptual functions or thinking in all its forms. [NIH] Mentors: Senior professionals who provide guidance, direction and support to those persons desirous of improvement in academic positions, administrative positions or other career development situations. [NIH] Mesolimbic: Inner brain region governing emotion and drives. [NIH] Meta-Analysis: A quantitative method of combining the results of independent studies (usually drawn from the published literature) and synthesizing summaries and conclusions which may be used to evaluate therapeutic effectiveness, plan new studies, etc., with application chiefly in the areas of research and medicine. [NIH] Metabolic acidosis: (met-ah-BOL-ik as-id-O-sis): A condition in which the blood is too acidic. It may be caused by severe illness or sepsis (bacteria in the bloodstream). [NIH] Metabolite: Any substance produced by metabolism or by a metabolic process. [EU] Methamphetamine: A central nervous system stimulant and sympathomimetic with actions and uses similar to dextroamphetamine. The smokable form is a drug of abuse and is referred to as crank, crystal, crystal meth, ice, and speed. [NIH] Methionine: A sulfur containing essential amino acid that is important in many body functions. It is a chelating agent for heavy metals. [NIH] Methyltransferase: A drug-metabolizing enzyme. [NIH] MI: Myocardial infarction. Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Microbiology: The study of microorganisms such as fungi, bacteria, algae, archaea, and viruses. [NIH] Microcirculation: The vascular network lying between the arterioles and venules; includes capillaries, metarterioles and arteriovenous anastomoses. Also, the flow of blood through this network. [NIH] Microdialysis: A technique for measuring extracellular concentrations of substances in tissues, usually in vivo, by means of a small probe equipped with a semipermeable membrane. Substances may also be introduced into the extracellular space through the membrane. [NIH] Microglia: The third type of glial cell, along with astrocytes and oligodendrocytes (which together form the macroglia). Microglia vary in appearance depending on developmental stage, functional state, and anatomical location; subtype terms include ramified, perivascular, ameboid, resting, and activated. Microglia clearly are capable of phagocytosis and play an important role in a wide spectrum of neuropathologies. They have also been suggested to act in several other roles including in secretion (e.g., of cytokines and neural growth factors), in immunological processing (e.g., antigen presentation), and in central nervous system development and remodeling. [NIH] Microsomal: Of or pertaining to microsomes : vesicular fragments of endoplasmic reticulum formed after disruption and centrifugation of cells. [EU] Microtubules: Slender, cylindrical filaments found in the cytoskeleton of plant and animal cells. They are composed of the protein tubulin. [NIH] Microwaves: That portion of the electromagnetic spectrum lying between UHF (ultrahigh frequency) radio waves and heat (infrared) waves. Microwaves are used to generate heat, especially in some types of diathermy. They may cause heat damage to tissues. [NIH]
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Mitochondria: Parts of a cell where aerobic production (also known as cell respiration) takes place. [NIH] Mitochondrial Swelling: Increase in volume of mitochondria due to an influx of fluid; it occurs in hypotonic solutions due to osmotic pressure and in isotonic solutions as a result of altered permeability of the membranes of respiring mitochondria. [NIH] Mitosis: A method of indirect cell division by means of which the two daughter nuclei normally receive identical complements of the number of chromosomes of the somatic cells of the species. [NIH] Modeling: A treatment procedure whereby the therapist presents the target behavior which the learner is to imitate and make part of his repertoire. [NIH] Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] Monitor: An apparatus which automatically records such physiological signs as respiration, pulse, and blood pressure in an anesthetized patient or one undergoing surgical or other procedures. [NIH] Monoamine: Enzyme that breaks down dopamine in the astrocytes and microglia. [NIH] Monoamine Oxidase: An enzyme that catalyzes the oxidative deamination of naturally occurring monoamines. It is a flavin-containing enzyme that is localized in mitochondrial membranes, whether in nerve terminals, the liver, or other organs. Monoamine oxidase is important in regulating the metabolic degradation of catecholamines and serotonin in neural or target tissues. Hepatic monoamine oxidase has a crucial defensive role in inactivating circulating monoamines or those, such as tyramine, that originate in the gut and are absorbed into the portal circulation. (From Goodman and Gilman's, The Pharmacological Basis of Therapeutics, 8th ed, p415) EC 1.4.3.4. [NIH] Monocytes: Large, phagocytic mononuclear leukocytes produced in the vertebrate bone marrow and released into the blood; contain a large, oval or somewhat indented nucleus surrounded by voluminous cytoplasm and numerous organelles. [NIH] Mononuclear: A cell with one nucleus. [NIH] Monotherapy: A therapy which uses only one drug. [EU] Mood Disorders: Those disorders that have a disturbance in mood as their predominant feature. [NIH] Morphine: The principal alkaloid in opium and the prototype opiate analgesic and narcotic. Morphine has widespread effects in the central nervous system and on smooth muscle. [NIH] Morphogenesis: The development of the form of an organ, part of the body, or organism. [NIH]
Morphological: Relating to the configuration or the structure of live organs. [NIH] Morphology: The science of the form and structure of organisms (plants, animals, and other forms of life). [NIH] Motility: The ability to move spontaneously. [EU] Motion Sickness: Sickness caused by motion, as sea sickness, train sickness, car sickness, and air sickness. [NIH]
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Motor Skills: Performance of complex motor acts. [NIH] Mucins: A secretion containing mucopolysaccharides and protein that is the chief constituent of mucus. [NIH] Mucolytic: Destroying or dissolving mucin; an agent that so acts : a mucopolysaccharide or glycoprotein, the chief constituent of mucus. [EU] Mucosa: A mucous membrane, or tunica mucosa. [EU] Multicenter study: A clinical trial that is carried out at more than one medical institution. [NIH]
Muscle relaxant: An agent that specifically aids in reducing muscle tension, as those acting at the polysynaptic neurons of motor nerves (e.g. meprobamate) or at the myoneural junction (curare and related compounds). [EU] Muscle Spindles: Mechanoreceptors found between skeletal muscle fibers. Muscle spindles are arranged in parallel with muscle fibers and respond to the passive stretch of the muscle, but cease to discharge if the muscle contracts isotonically, thus signaling muscle length. The muscle spindles are the receptors responsible for the stretch or myotactic reflex. [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] Mydriatic: 1. dilating the pupil. 2. any drug that dilates the pupil. [EU] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Myopathy: Any disease of a muscle. [EU] Naloxone: A specific opiate antagonist that has no agonist activity. It is a competitive antagonist at mu, delta, and kappa opioid receptors. [NIH] Naltrexone: Derivative of noroxymorphone that is the N-cyclopropylmethyl congener of naloxone. It is a narcotic antagonist that is effective orally, longer lasting and more potent than naloxone, and has been proposed for the treatment of heroin addiction. The FDA has approved naltrexone for the treatment of alcohol dependence. [NIH] Narcissism: A psychoanalytic term meaning self-love. [NIH] Narcolepsy: A condition of unknown cause characterized by a periodic uncontrollable tendency to fall asleep. [NIH] Narcosis: A general and nonspecific reversible depression of neuronal excitability, produced by a number of physical and chemical aspects, usually resulting in stupor. [NIH] Narcotic: 1. pertaining to or producing narcosis. 2. an agent that produces insensibility or stupor, applied especially to the opioids, i.e. to any natural or synthetic drug that has morphine-like actions. [EU] Natural killer cells: NK cells. A type of white blood cell that contains granules with enzymes that can kill tumor cells or microbial cells. Also called large granular lymphocytes (LGL). [NIH] Natural Language Processing: Computer processing of a language with rules that reflect and describe current usage rather than prescribed usage. [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]
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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] Necrosis: A pathological process caused by the progressive degradative action of enzymes that is generally associated with severe cellular trauma. It is characterized by mitochondrial swelling, nuclear flocculation, uncontrolled cell lysis, and ultimately cell death. [NIH] Need: A state of tension or dissatisfaction felt by an individual that impels him to action toward a goal he believes will satisfy the impulse. [NIH] Needle Sharing: Usage of a single needle among two or more people for injecting drugs. Needle sharing is a high-risk behavior for contracting infectious disease. [NIH] Needs Assessment: Systematic identification of a population's needs or the assessment of individuals to determine the proper level of services needed. [NIH] Neonatal: Pertaining to the first four weeks after birth. [EU] Neoplasm: A new growth of benign or malignant tissue. [NIH] Nephropathy: Disease of the kidneys. [EU] Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH]
Nervi: The physiological cup of the optic nerve head. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Networks: Pertaining to a nerve or to the nerves, a meshlike structure of interlocking fibers or strands. [NIH] Neural: 1. pertaining to a nerve or to the nerves. 2. situated in the region of the spinal axis, as the neutral arch. [EU] Neuroendocrine: Having to do with the interactions between the nervous system and the endocrine system. Describes certain cells that release hormones into the blood in response to stimulation of the nervous system. [NIH] Neurogenic: Loss of bladder control caused by damage to the nerves controlling the bladder. [NIH] Neuroleptic: A term coined to refer to the effects on cognition and behaviour of antipsychotic drugs, which produce a state of apathy, lack of initiative, and limited range of emotion and in psychotic patients cause a reduction in confusion and agitation and normalization of psychomotor activity. [EU] Neuronal: Pertaining to a neuron or neurons (= conducting cells of the nervous system). [EU]
Neurons: The basic cellular units of nervous tissue. Each neuron consists of a body, an axon, and dendrites. Their purpose is to receive, conduct, and transmit impulses in the nervous system. [NIH] Neuropathy: A problem in any part of the nervous system except the brain and spinal cord. Neuropathies can be caused by infection, toxic substances, or disease. [NIH] Neuropeptide: A member of a class of protein-like molecules made in the brain. Neuropeptides consist of short chains of amino acids, with some functioning as neurotransmitters and some functioning as hormones. [NIH]
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Neuropeptide Y: A 36-amino acid peptide present in many organs and in many sympathetic noradrenergic neurons. It has vasoconstrictor and natriuretic activity and regulates local blood flow, glandular secretion, and smooth muscle activity. The peptide also stimulates feeding and drinking behavior and influences secretion of pituitary hormones. [NIH]
Neuropharmacology: The branch of pharmacology dealing especially with the action of drugs upon various parts of the nervous system. [NIH] Neurosis: Functional derangement due to disorders of the nervous system which does not affect the psychic personality of the patient. [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] Neutrophils: Granular leukocytes having a nucleus with three to five lobes connected by slender threads of chromatin, and cytoplasm containing fine inconspicuous granules and stainable by neutral dyes. [NIH] Niacin: Water-soluble vitamin of the B complex occurring in various animal and plant tissues. Required by the body for the formation of coenzymes NAD and NADP. Has pellagra-curative, vasodilating, and antilipemic properties. [NIH] Nickel: A trace element with the atomic symbol Ni, atomic number 28, and atomic weight 58.69. It is a cofactor of the enzyme urease. [NIH] Nicotine: Nicotine is highly toxic alkaloid. It is the prototypical agonist at nicotinic cholinergic receptors where it dramatically stimulates neurons and ultimately blocks synaptic transmission. Nicotine is also important medically because of its presence in tobacco smoke. [NIH] 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] Nonverbal Communication: Transmission of emotions, ideas, and attitudes between individuals in ways other than the spoken language. [NIH] Norepinephrine: Precursor of epinephrine that is secreted by the adrenal medulla and is a widespread central and autonomic neurotransmitter. Norepinephrine is the principal transmitter of most postganglionic sympathetic fibers and of the diffuse projection system in the brain arising from the locus ceruleus. It is also found in plants and is used pharmacologically as a sympathomimetic. [NIH] Normal Distribution: Continuous frequency distribution of infinite range. Its properties are as follows: 1) continuous, symmetrical distribution with both tails extending to infinity; 2) arithmetic mean, mode, and median identical; and 3) shape completely determined by the mean and standard deviation. [NIH] Nuclear: A test of the structure, blood flow, and function of the kidneys. The doctor injects a mildly radioactive solution into an arm vein and uses x-rays to monitor its progress through the kidneys. [NIH] Nuclear Family: A family composed of spouses and their children. [NIH] Nuclei: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH]
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Nucleic acid: Either of two types of macromolecule (DNA or RNA) formed by polymerization of nucleotides. Nucleic acids are found in all living cells and contain the information (genetic code) for the transfer of genetic information from one generation to the next. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Obsessive-Compulsive Disorder: An anxiety disorder characterized by recurrent, persistent obsessions or compulsions. Obsessions are the intrusive ideas, thoughts, or images that are experienced as senseless or repugnant. Compulsions are repetitive and seemingly purposeful behavior which the individual generally recognizes as senseless and from which the individual does not derive pleasure although it may provide a release from tension. [NIH] Odds Ratio: The ratio of two odds. The exposure-odds ratio for case control data is the ratio of the odds in favor of exposure among cases to the odds in favor of exposure among noncases. The disease-odds ratio for a cohort or cross section is the ratio of the odds in favor of disease among the exposed to the odds in favor of disease among the unexposed. The prevalence-odds ratio refers to an odds ratio derived cross-sectionally from studies of prevalent cases. [NIH] Ondansetron: A competitive serotonin type 3 receptor antagonist. It is effective in the treatment of nausea and vomiting caused by cytotoxic chemotherapy drugs, including cisplatin, and it has reported anxiolytic and neuroleptic properties. [NIH] Oocytes: Female germ cells in stages between the prophase of the first maturation division and the completion of the second maturation division. [NIH] Opacity: Degree of density (area most dense taken for reading). [NIH] Opiate: A remedy containing or derived from opium; also any drug that induces sleep. [EU] Opioid Peptides: The endogenous peptides with opiate-like activity. The three major classes currently recognized are the enkephalins, the dynorphins, and the endorphins. Each of these families derives from different precursors, proenkephalin, prodynorphin, and proopiomelanocortin, respectively. There are also at least three classes of opioid receptors, but the peptide families do not map to the receptors in a simple way. [NIH] Opium: The air-dried exudate from the unripe seed capsule of the opium poppy, Papaver somniferum, or its variant, P. album. It contains a number of alkaloids, but only a few morphine, codeine, and papaverine - have clinical significance. Opium has been used as an analgesic, antitussive, antidiarrheal, and antispasmodic. [NIH] Opportunistic Infections: An infection caused by an organism which becomes pathogenic under certain conditions, e.g., during immunosuppression. [NIH] Optic Chiasm: The X-shaped structure formed by the meeting of the two optic nerves. At the optic chiasm the fibers from the medial part of each retina cross to project to the other side of the brain while the lateral retinal fibers continue on the same side. As a result each half of the brain receives information about the contralateral visual field from both eyes. [NIH]
Optic Nerve: The 2nd cranial nerve. The optic nerve conveys visual information from the retina to the brain. The nerve carries the axons of the retinal ganglion cells which sort at the optic chiasm and continue via the optic tracts to the brain. The largest projection is to the lateral geniculate nuclei; other important targets include the superior colliculi and the suprachiasmatic nuclei. Though known as the second cranial nerve, it is considered part of the central nervous system. [NIH] Optic nerve head: The circular area (disc) where the optic nerve connects to the retina. [NIH]
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Orbit: One of the two cavities in the skull which contains an eyeball. Each eye is located in a bony socket or orbit. [NIH] Orbital: Pertaining to the orbit (= the bony cavity that contains the eyeball). [EU] Osteonecrosis: Death of a bone or part of a bone, either atraumatic or posttraumatic. [NIH] Osteoporosis: Reduction of bone mass without alteration in the composition of bone, leading to fractures. Primary osteoporosis can be of two major types: postmenopausal osteoporosis and age-related (or senile) osteoporosis. [NIH] Outpatient: A patient who is not an inmate of a hospital but receives diagnosis or treatment in a clinic or dispensary connected with the hospital. [NIH] Ovulation: The discharge of a secondary oocyte from a ruptured graafian follicle. [NIH] Ovum: A female germ cell extruded from the ovary at ovulation. [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]
Oxidation-Reduction: A chemical reaction in which an electron is transferred from one molecule to another. The electron-donating molecule is the reducing agent or reductant; the electron-accepting molecule is the oxidizing agent or oxidant. Reducing and oxidizing agents function as conjugate reductant-oxidant pairs or redox pairs (Lehninger, Principles of Biochemistry, 1982, p471). [NIH] Oxidative Stress: A disturbance in the prooxidant-antioxidant balance in favor of the former, leading to potential damage. Indicators of oxidative stress include damaged DNA bases, protein oxidation products, and lipid peroxidation products (Sies, Oxidative Stress, 1991, pxv-xvi). [NIH] Paclitaxel: Antineoplastic agent isolated from the bark of the Pacific yew tree, Taxus brevifolia. Paclitaxel stabilizes microtubules in their polymerized form and thus mimics the action of the proto-oncogene proteins c-mos. [NIH] 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] Pancreatic: Having to do with the pancreas. [NIH] Pancreatitis: Acute or chronic inflammation of the pancreas, which may be asymptomatic or symptomatic, and which is due to autodigestion of a pancreatic tissue by its own enzymes. It is caused most often by alcoholism or biliary tract disease; less commonly it may be associated with hyperlipaemia, hyperparathyroidism, abdominal trauma (accidental or operative injury), vasculitis, or uraemia. [EU] Panic: A state of extreme acute, intense anxiety and unreasoning fear accompanied by disorganization of personality function. [NIH] Panic Disorder: A type of anxiety disorder characterized by unexpected panic attacks that last minutes or, rarely, hours. Panic attacks begin with intense apprehension, fear or terror
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and, often, a feeling of impending doom. Symptoms experienced during a panic attack include dyspnea or sensations of being smothered; dizziness, loss of balance or faintness; choking sensations; palpitations or accelerated heart rate; shakiness; sweating; nausea or other form of abdominal distress; depersonalization or derealization; paresthesias; hot flashes or chills; chest discomfort or pain; fear of dying and fear of not being in control of oneself or going crazy. Agoraphobia may also develop. Similar to other anxiety disorders, it may be inherited as an autosomal dominant trait. [NIH] Paresthesias: Abnormal touch sensations, such as burning or prickling, that occur without an outside stimulus. [NIH] Parkinsonism: A group of neurological disorders characterized by hypokinesia, tremor, and muscular rigidity. [EU] Partial remission: The shrinking, but not complete disappearance, of a tumor in response to therapy. Also called partial response. [NIH] Parturition: The act or process of given birth to a child. [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] Pathologic Processes: The abnormal mechanisms and forms involved in the dysfunctions of tissues and organs. [NIH] Pathophysiology: Altered functions in an individual or an organ due to disease. [NIH] Patient Compliance: regimen. [NIH]
Voluntary cooperation of the patient in following a prescribed
Patient Education: The teaching or training of patients concerning their own health needs. [NIH]
Pedigree: A record of one's ancestors, offspring, siblings, and their offspring that may be used to determine the pattern of certain genes or disease inheritance within a family. [NIH] Pedophilia: A sexual disorder occuring in a person 16 years or older and that is recurrent with intense sexually arousing fantasies, sexual urges, or behaviors involving sexual activity with a prepubescent child (generally age 13 or younger). (from APA, DSM-IV, 1994). [NIH] Peer Group: Group composed of associates of same species, approximately the same age, and usually of similar rank or social status. [NIH] Pelvis: The lower part of the abdomen, located between the hip bones. [NIH] Penicillin: An antibiotic drug used to treat infection. [NIH] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Perception: The ability quickly and accurately to recognize similarities and differences among presented objects, whether these be pairs of words, pairs of number series, or multiple sets of these or other symbols such as geometric figures. [NIH] Perennial: Lasting through the year of for several years. [EU] Perfusion: Bathing an organ or tissue with a fluid. In regional perfusion, a specific area of the body (usually an arm or a leg) receives high doses of anticancer drugs through a blood vessel. Such a procedure is performed to treat cancer that has not spread. [NIH]
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Peripheral blood: Blood circulating throughout the body. [NIH] Peripheral Nerves: The nerves outside of the brain and spinal cord, including the autonomic, cranial, and spinal nerves. Peripheral nerves contain non-neuronal cells and connective tissue as well as axons. The connective tissue layers include, from the outside to the inside, the epineurium, the perineurium, and the endoneurium. [NIH] Peripheral Nervous System: The nervous system outside of the brain and spinal cord. The peripheral nervous system has autonomic and somatic divisions. The autonomic nervous system includes the enteric, parasympathetic, and sympathetic subdivisions. The somatic nervous system includes the cranial and spinal nerves and their ganglia and the peripheral sensory receptors. [NIH] Peripheral Neuropathy: Nerve damage, usually affecting the feet and legs; causing pain, numbness, or a tingling feeling. Also called "somatic neuropathy" or "distal sensory polyneuropathy." [NIH] Personality Disorders: A major deviation from normal patterns of behavior. [NIH] PH: The symbol relating the hydrogen ion (H+) concentration or activity of a solution to that of a given standard solution. Numerically the pH is approximately equal to the negative logarithm of H+ concentration expressed in molarity. pH 7 is neutral; above it alkalinity increases and below it acidity increases. [EU] Pharmacist: A person trained to prepare and distribute medicines and to give information about them. [NIH] Pharmacokinetic: The mathematical analysis of the time courses of absorption, distribution, and elimination of drugs. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Pharmacotherapy: A regimen of using appetite suppressant medications to manage obesity by decreasing appetite or increasing the feeling of satiety. These medications decrease appetite by increasing serotonin or catecholamine—two brain chemicals that affect mood and appetite. [NIH] Pharynx: The hollow tube about 5 inches long that starts behind the nose and ends at the top of the trachea (windpipe) and esophagus (the tube that goes to the stomach). [NIH] Phenotype: The outward appearance of the individual. It is the product of interactions between genes and between the genotype and the environment. This includes the killer phenotype, characteristic of yeasts. [NIH] Phenylalanine: An aromatic amino acid that is essential in the animal diet. It is a precursor of melanin, dopamine, noradrenalin, and thyroxine. [NIH] Phenytoin: An anticonvulsant that is used in a wide variety of seizures. It is also an antiarrhythmic and a muscle relaxant. The mechanism of therapeutic action is not clear, although several cellular actions have been described including effects on ion channels, active transport, and general membrane stabilization. The mechanism of its muscle relaxant effect appears to involve a reduction in the sensitivity of muscle spindles to stretch. Phenytoin has been proposed for several other therapeutic uses, but its use has been limited by its many adverse effects and interactions with other drugs. [NIH] Phobia: A persistent, irrational, intense fear of a specific object, activity, or situation (the phobic stimulus), fear that is recognized as being excessive or unreasonable by the individual himself. When a phobia is a significant source of distress or interferes with social functioning, it is considered a mental disorder; phobic disorder (or neurosis). In DSM III phobic disorders are subclassified as agoraphobia, social phobias, and simple phobias. Used as a word termination denoting irrational fear of or aversion to the subject indicated by the
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stem to which it is affixed. [EU] Phobic Disorders: Anxiety disorders in which the essential feature is persistent and irrational fear of a specific object, activity, or situation that the individual feels compelled to avoid. The individual recognizes the fear as excessive or unreasonable. [NIH] Phospholipids: Lipids containing one or more phosphate groups, particularly those derived from either glycerol (phosphoglycerides; glycerophospholipids) or sphingosine (sphingolipids). They are polar lipids that are of great importance for the structure and function of cell membranes and are the most abundant of membrane lipids, although not stored in large amounts in the system. [NIH] Phosphorus: A non-metallic element that is found in the blood, muscles, nevers, bones, and teeth, and is a component of adenosine triphosphate (ATP; the primary energy source for the body's cells.) [NIH] Phosphorylation: The introduction of a phosphoryl group into a compound through the formation of an ester bond between the compound and a phosphorus moiety. [NIH] Phototherapy: Treatment of disease by exposure to light, especially by variously concentrated light rays or specific wavelengths. [NIH] Physical Examination: Systematic and thorough inspection of the patient for physical signs of disease or abnormality. [NIH] Physiologic: Having to do with the functions of the body. When used in the phrase "physiologic age," it refers to an age assigned by general health, as opposed to calendar age. [NIH]
Physiology: The science that deals with the life processes and functions of organismus, their cells, tissues, and organs. [NIH] Pigment: A substance that gives color to tissue. Pigments are responsible for the color of skin, eyes, and hair. [NIH] Pilot Projects: Small-scale tests of methods and procedures to be used on a larger scale if the pilot study demonstrates that these methods and procedures can work. [NIH] Pilot study: The initial study examining a new method or treatment. [NIH] Pituitary Hormones: Hormones secreted by the anterior and posterior lobes of the pituitary gland and the pars intermedia, an ill-defined region between the two. Their secretion is regulated by the hypothalamus. [NIH] Pituitary-Adrenal System: The interactions between the anterior pituitary and adrenal glands, in which corticotropin (ACTH) stimulates the adrenal cortex and adrenal cortical hormones suppress the production of corticotropin by the anterior pituitary. [NIH] Placebos: Any dummy medication or treatment. Although placebos originally were medicinal preparations having no specific pharmacological activity against a targeted condition, the concept has been extended to include treatments or procedures, especially those administered to control groups in clinical trials in order to provide baseline measurements for the experimental protocol. [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] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH]
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Platelets: A type of blood cell that helps prevent bleeding by causing blood clots to form. Also called thrombocytes. [NIH] Platinum: Platinum. A heavy, soft, whitish metal, resembling tin, atomic number 78, atomic weight 195.09, symbol Pt. (From Dorland, 28th ed) It is used in manufacturing equipment for laboratory and industrial use. It occurs as a black powder (platinum black) and as a spongy substance (spongy platinum) and may have been known in Pliny's time as "alutiae". [NIH]
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] Polyarthritis: An inflammation of several joints together. [EU] Polymorphic: Occurring in several or many forms; appearing in different forms at different stages of development. [EU] Polymorphism: The occurrence together of two or more distinct forms in the same population. [NIH] Polypeptide: A peptide which on hydrolysis yields more than two amino acids; called tripeptides, tetrapeptides, etc. according to the number of amino acids contained. [EU] Polyunsaturated fat: An unsaturated fat found in greatest amounts in foods derived from plants, including safflower, sunflower, corn, and soybean oils. [NIH] Pontine: A brain region involved in the detection and processing of taste. [NIH] Portal Pressure: The venous pressure measured in the portal vein. [NIH] Posterior: Situated in back of, or in the back part of, or affecting the back or dorsal surface of the body. In lower animals, it refers to the caudal end of the body. [EU] Postmenopausal: Refers to the time after menopause. Menopause is the time in a woman's life when menstrual periods stop permanently; also called "change of life." [NIH] Postnatal: Occurring after birth, with reference to the newborn. [EU] Postoperative: After surgery. [NIH] Post-traumatic: Occurring as a result of or after injury. [EU] Post-traumatic stress disorder: A psychological disorder that develops in some individuals after a major traumatic experience such as war, rape, domestic violence, or accident. [NIH] Postural: Pertaining to posture or position. [EU] Potentiate: A degree of synergism which causes the exposure of the organism to a harmful substance to worsen a disease already contracted. [NIH] Practicability: A non-standard characteristic of an analytical procedure. It is dependent on the scope of the method and is determined by requirements such as sample throughout and costs. [NIH] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Precipitating Factors: Factors associated with the definitive onset of a disease, illness, accident, behavioral response, or course of action. Usually one factor is more important or more obviously recognizable than others, if several are involved, and one may often be
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regarded as "necessary". Examples include exposure to specific disease; amount or level of an infectious organism, drug, or noxious agent, etc. [NIH] Preclinical: Before a disease becomes clinically recognizable. [EU] Precursor: Something that precedes. In biological processes, a substance from which another, usually more active or mature substance is formed. In clinical medicine, a sign or symptom that heralds another. [EU] Predisposition: A latent susceptibility to disease which may be activated under certain conditions, as by stress. [EU] Prefrontal Cortex: The rostral part of the frontal lobe, bounded by the inferior precentral fissure in humans, which receives projection fibers from the mediodorsal nucleus of the thalamus. The prefrontal cortex receives afferent fibers from numerous structures of the diencephalon, mesencephalon, and limbic system as well as cortical afferents of visual, auditory, and somatic origin. [NIH] Premenstrual: Occurring before menstruation. [EU] Premenstrual Syndrome: A syndrome occurring most often during the last week of the menstrual cycle and ending soon after the onset of menses. Some of the symptoms are emotional instability, insomnia, headache, nausea, vomiting, abdominal distension, and painful breasts. [NIH] Prenatal: Existing or occurring before birth, with reference to the fetus. [EU] Prescription drug abuse: Using two or more drugs interchangeably in an attempt to counteract the adverse effects of one with the other or to potentiate the effects of one with the other, so that an interdependent habit requiring both is formed. [NIH] Presynaptic: Situated proximal to a synapse, or occurring before the synapse is crossed. [EU] Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from incidence, which refers to the number of new cases in the population at a given time. [NIH] Primary Prevention: Prevention of disease or mental disorders in susceptible individuals or populations through promotion of health, including mental health, and specific protection, as in immunization, as distinguished from the prevention of complications or after-effects of existing disease. [NIH] Private Sector: That distinct portion of the institutional, industrial, or economic structure of a country that is controlled or owned by non-governmental, private interests. [NIH] Probe: An instrument used in exploring cavities, or in the detection and dilatation of strictures, or in demonstrating the potency of channels; an elongated instrument for exploring or sounding body cavities. [NIH] Professional Practice: The use of one's knowledge in a particular profession. It includes, in the case of the field of biomedicine, professional activities related to health care and the actual performance of the duties related to the provision of health care. [NIH] Progesterone: Pregn-4-ene-3,20-dione. The principal progestational hormone of the body, secreted by the corpus luteum, adrenal cortex, and placenta. Its chief function is to prepare the uterus for the reception and development of the fertilized ovum. It acts as an antiovulatory agent when administered on days 5-25 of the menstrual cycle. [NIH] Progression: Increase in the size of a tumor or spread of cancer in the body. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Projection:
A defense mechanism, operating unconsciously, whereby that which is
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emotionally unacceptable in the self is rejected and attributed (projected) to others. [NIH] Prolactin: Pituitary lactogenic hormone. A polypeptide hormone with a molecular weight of about 23,000. It is essential in the induction of lactation in mammals at parturition and is synergistic with estrogen. The hormone also brings about the release of progesterone from lutein cells, which renders the uterine mucosa suited for the embedding of the ovum should fertilization occur. [NIH] Proline: A non-essential amino acid that is synthesized from glutamic acid. It is an essential component of collagen and is important for proper functioning of joints and tendons. [NIH] Promoter: A chemical substance that increases the activity of a carcinogenic process. [NIH] Prone: Having the front portion of the body downwards. [NIH] Pro-Opiomelanocortin: A precursor protein, MW 30,000, synthesized mainly in the anterior pituitary gland but also found in the hypothalamus, brain, and several peripheral tissues. It incorporates the amino acid sequences of ACTH and beta-lipotropin. These two hormones, in turn, contain the biologically active peptides MSH, corticotropin-like intermediate lobe peptide, alpha-lipotropin, endorphins, and methionine enkephalin. [NIH] Prophase: The first phase of cell division, in which the chromosomes become visible, the nucleus starts to lose its identity, the spindle appears, and the centrioles migrate toward opposite poles. [NIH] Propofol: A widely used anesthetic. [NIH] Prospective Studies: Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. [NIH] Prospective study: An epidemiologic study in which a group of individuals (a cohort), all free of a particular disease and varying in their exposure to a possible risk factor, is followed over a specific amount of time to determine the incidence rates of the disease in the exposed and unexposed groups. [NIH] Prostate: A gland in males that surrounds the neck of the bladder and the urethra. It secretes a substance that liquifies coagulated semen. It is situated in the pelvic cavity behind the lower part of the pubic symphysis, above the deep layer of the triangular ligament, and rests upon the rectum. [NIH] 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
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nucleus of the light hydrogen atom, i.e., the hydrogen ion. [NIH] Proto-Oncogene Proteins: Products of proto-oncogenes. Normally they do not have oncogenic or transforming properties, but are involved in the regulation or differentiation of cell growth. They often have protein kinase activity. [NIH] Proto-Oncogene Proteins c-mos: Cellular proteins encoded by the c-mos genes. They function in the cell cycle to maintain maturation promoting factor in the active state and have protein-serine/threonine kinase activity. Oncogenic transformation can take place when c-mos proteins are expressed at the wrong time. [NIH] Protozoan: 1. any individual of the protozoa; protozoon. 2. of or pertaining to the protozoa; protozoal. [EU] Proxy: A person authorized to decide or act for another person, for example, a person having durable power of attorney. [NIH] Psychiatric: Pertaining to or within the purview of psychiatry. [EU] Psychiatry: The medical science that deals with the origin, diagnosis, prevention, and treatment of mental disorders. [NIH] Psychic: Pertaining to the psyche or to the mind; mental. [EU] Psychoactive: Those drugs which alter sensation, mood, consciousness or other psychological or behavioral functions. [NIH] Psychogenic: Produced or caused by psychic or mental factors rather than organic factors. [EU]
Psychology: The science dealing with the study of mental processes and behavior in man and animals. [NIH] Psychomotor: Pertaining to motor effects of cerebral or psychic activity. [EU] Psychopathology: The study of significant causes and processes in the development of mental illness. [NIH] Psychopharmacology: The study of the effects of drugs on mental and behavioral activity. [NIH]
Psychosis: A mental disorder characterized by gross impairment in reality testing as evidenced by delusions, hallucinations, markedly incoherent speech, or disorganized and agitated behaviour without apparent awareness on the part of the patient of the incomprehensibility of his behaviour; the term is also used in a more general sense to refer to mental disorders in which mental functioning is sufficiently impaired as to interfere grossly with the patient's capacity to meet the ordinary demands of life. Historically, the term has been applied to many conditions, e.g. manic-depressive psychosis, that were first described in psychotic patients, although many patients with the disorder are not judged psychotic. [EU] Psychotherapy: A generic term for the treatment of mental illness or emotional disturbances primarily by verbal or nonverbal communication. [NIH] Psychotomimetic: Psychosis miming. [NIH] Psychotropic: Exerting an effect upon the mind; capable of modifying mental activity; usually applied to drugs that effect the mental state. [EU] Public Assistance: Financial assistance to impoverished persons for the essentials of living through federal, state or local government programs. [NIH] Public Health: Branch of medicine concerned with the prevention and control of disease and disability, and the promotion of physical and mental health of the population on the international, national, state, or municipal level. [NIH]
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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] Public Sector: The area of a nation's economy that is tax-supported and under government control. [NIH] Publishing: "The business or profession of the commercial production and issuance of literature" (Webster's 3d). It includes the publisher, publication processes, editing and editors. Production may be by conventional printing methods or by electronic publishing. [NIH]
Pulmonary: Relating to the lungs. [NIH] Pulmonary Artery: The short wide vessel arising from the conus arteriosus of the right ventricle and conveying unaerated blood to the lungs. [NIH] Pulmonary hypertension: Abnormally high blood pressure in the arteries of the lungs. [NIH]
Pulse: The rhythmical expansion and contraction of an artery produced by waves of pressure caused by the ejection of blood from the left ventricle of the heart as it contracts. [NIH]
Punishment: The application of an unpleasant stimulus or penalty for the purpose of eliminating or correcting undesirable behavior. [NIH] Pustular: Pertaining to or of the nature of a pustule; consisting of pustules (= a visible collection of pus within or beneath the epidermis). [EU] Pyridoxal: 3-Hydroxy-5-(hydroxymethyl)-2-methyl-4- pyridinecarboxaldehyde. [NIH] Quality of Life: A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral and social environment. [NIH] Race: A population within a species which exhibits general similarities within itself, but is both discontinuous and distinct from other populations of that species, though not sufficiently so as to achieve the status of a taxon. [NIH] Raclopride: A substituted benzamide that has antipsychotic properties. It is a dopamine D2 receptor antagonist. [NIH] Radio Waves: That portion of the electromagnetic spectrum beyond the microwaves, with wavelengths as high as 30 KM. They are used in communications, including television. Short Wave or HF (high frequency), UHF (ultrahigh frequency) and VHF (very high frequency) waves are used in citizen's band communication. [NIH] Radioactive: Giving off radiation. [NIH] Radioactivity: The quality of emitting or the emission of corpuscular or electromagnetic radiations consequent to nuclear disintegration, a natural property of all chemical elements of atomic number above 83, and possible of induction in all other known elements. [EU] Radiopharmaceutical: Any medicinal product which, when ready for use, contains one or more radionuclides (radioactive isotopes) included for a medicinal purpose. [NIH] Random Allocation: A process involving chance used in therapeutic trials or other research endeavor for allocating experimental subjects, human or animal, between treatment and control groups, or among treatment groups. It may also apply to experiments on inanimate objects. [NIH] Randomization: Also called random allocation. Is allocation of individuals to groups, e.g., for experimental and control regimens, by chance. Within the limits of chance variation, random allocation should make the control and experimental groups similar at the start of an investigation and ensure that personal judgment and prejudices of the investigator do
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not influence allocation. [NIH] Randomized: Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments. [NIH] Randomized clinical trial: A study in which the participants are assigned by chance to separate groups that compare different treatments; neither the researchers nor the participants can choose which group. Using chance to assign people to groups means that the groups will be similar and that the treatments they receive can be compared objectively. At the time of the trial, it is not known which treatment is best. It is the patient's choice to be in a randomized trial. [NIH] Rape: Unlawful sexual intercourse without consent of the victim. [NIH] Reality Testing: The individual's objective evaluation of the external world and the ability to differentiate adequately between it and the internal world; considered to be a primary ego function. [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] Receptors, Serotonin: Cell-surface proteins that bind serotonin and trigger intracellular changes which influence the behavior of cells. Several types of serotonin receptors have been recognized which differ in their pharmacology, molecular biology, and mode of action. [NIH] Recombination: The formation of new combinations of genes as a result of segregation in crosses between genetically different parents; also the rearrangement of linked genes due to crossing-over. [NIH] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Recur: To occur again. Recurrence is the return of cancer, at the same site as the original (primary) tumor or in another location, after the tumor had disappeared. [NIH] Recurrence: The return of a sign, symptom, or disease after a remission. [NIH] Red blood cells: RBCs. Cells that carry oxygen to all parts of the body. Also called erythrocytes. [NIH] Red Nucleus: A pinkish-yellow portion of the midbrain situated in the rostral mesencephalic tegmentum. It receives a large projection from the contralateral half of the cerebellum via the superior cerebellar peduncle and a projection from the ipsilateral motor cortex. [NIH] Reductase: Enzyme converting testosterone to dihydrotestosterone. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Reflex: An involuntary movement or exercise of function in a part, excited in response to a stimulus applied to the periphery and transmitted to the brain or spinal cord. [NIH] Refraction: A test to determine the best eyeglasses or contact lenses to correct a refractive error (myopia, hyperopia, or astigmatism). [NIH] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Relapse: The return of signs and symptoms of cancer after a period of improvement. [NIH] Relative risk: The ratio of the incidence rate of a disease among individuals exposed to a specific risk factor to the incidence rate among unexposed individuals; synonymous with risk ratio. Alternatively, the ratio of the cumulative incidence rate in the exposed to the cumulative incidence rate in the unexposed (cumulative incidence ratio). The term relative risk has also been used synonymously with odds ratio. This is because the odds ratio and relative risk approach each other if the disease is rare ( 5 percent of population) and the
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number of subjects is large. [NIH] Reliability: Used technically, in a statistical sense, of consistency of a test with itself, i. e. the extent to which we can assume that it will yield the same result if repeated a second time. [NIH]
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] Research Design: A plan for collecting and utilizing data so that desired information can be obtained with sufficient precision or so that an hypothesis can be tested properly. [NIH] Residential Facilities: Long-term care facilities which provide supervision and assistance in activities of daily living with medical and nursing services when required. [NIH] Respiration: The act of breathing with the lungs, consisting of inspiration, or the taking into the lungs of the ambient air, and of expiration, or the expelling of the modified air which contains more carbon dioxide than the air taken in (Blakiston's Gould Medical Dictionary, 4th ed.). This does not include tissue respiration (= oxygen consumption) or cell respiration (= cell respiration). [NIH] Respiratory Paralysis: Complete or severe weakness of the muscles of respiration. This condition may be associated with motor neuron diseases; peripheral nerve disorders; neuromuscular junction diseases; spinal cord diseases; injury to the phrenic nerve; and other disorders. [NIH] Retina: The ten-layered nervous tissue membrane of the eye. It is continuous with the optic nerve and receives images of external objects and transmits visual impulses to the brain. Its outer surface is in contact with the choroid and the inner surface with the vitreous body. The outer-most layer is pigmented, whereas the inner nine layers are transparent. [NIH] Retinal: 1. pertaining to the retina. 2. the aldehyde of retinol, derived by the oxidative enzymatic splitting of absorbed dietary carotene, and having vitamin A activity. In the retina, retinal combines with opsins to form visual pigments. One isomer, 11-cis retinal combines with opsin in the rods (scotopsin) to form rhodopsin, or visual purple. Another, all-trans retinal (trans-r.); visual yellow; xanthopsin) results from the bleaching of rhodopsin by light, in which the 11-cis form is converted to the all-trans form. Retinal also combines with opsins in the cones (photopsins) to form the three pigments responsible for colour vision. Called also retinal, and retinene1. [EU] Retinal Ganglion Cells: Cells of the innermost nuclear layer of the retina, the ganglion cell layer, which project axons through the optic nerve to the brain. They are quite variable in size and in the shapes of their dendritic arbors, which are generally confined to the inner plexiform layer. [NIH] Retinoid: Vitamin A or a vitamin A-like compound. [NIH] Retrospective: Looking back at events that have already taken place. [NIH] Retroviral vector: RNA from a virus that is used to insert genetic material into cells. [NIH] Riboflavin: Nutritional factor found in milk, eggs, malted barley, liver, kidney, heart, and leafy vegetables. The richest natural source is yeast. It occurs in the free form only in the retina of the eye, in whey, and in urine; its principal forms in tissues and cells are as FMN and FAD. [NIH] Ribosome: A granule of protein and RNA, synthesized in the nucleolus and found in the cytoplasm of cells. Ribosomes are the main sites of protein synthesis. Messenger RNA attaches to them and there receives molecules of transfer RNA bearing amino acids. [NIH]
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Rickets: A condition caused by deficiency of vitamin D, especially in infancy and childhood, with disturbance of normal ossification. The disease is marked by bending and distortion of the bones under muscular action, by the formation of nodular enlargements on the ends and sides of the bones, by delayed closure of the fontanelles, pain in the muscles, and sweating of the head. Vitamin D and sunlight together with an adequate diet are curative, provided that the parathyroid glands are functioning properly. [EU] Rigidity: Stiffness or inflexibility, chiefly that which is abnormal or morbid; rigor. [EU] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Risk-Taking: Undertaking a task involving a challenge for achievement or a desirable goal in which there is a lack of certainty or a fear of failure. It may also include the exhibiting of certain behaviors whose outcomes may present a risk to the individual or to those associated with him or her. [NIH] Ritanserin: A selective and potent serotonin-2 antagonist that is effective in the treatment of a variety of syndromes related to anxiety and depression. The drug also improves the subjective quality of sleep and decreases portal pressure. [NIH] Rod: A reception for vision, located in the retina. [NIH] Role-play: In this method, a conflict is artificially constructed, and the trainee is given a strategic position in it. [NIH] Saline: A solution of salt and water. [NIH] Saliva: The clear, viscous fluid secreted by the salivary glands and mucous glands of the mouth. It contains mucins, water, organic salts, and ptylin. [NIH] Salivary: The duct that convey saliva to the mouth. [NIH] Salivary glands: Glands in the mouth that produce saliva. [NIH] Saponins: Sapogenin glycosides. A type of glycoside widely distributed in plants. Each consists of a sapogenin as the aglycon moiety, and a sugar. The sapogenin may be a steroid or a triterpene and the sugar may be glucose, galactose, a pentose, or a methylpentose. Sapogenins are poisonous towards the lower forms of life and are powerful hemolytics when injected into the blood stream able to dissolve red blood cells at even extreme dilutions. [NIH] Sarcoma: A connective tissue neoplasm formed by proliferation of mesodermal cells; it is usually highly malignant. [NIH] Satellite: Applied to a vein which closely accompanies an artery for some distance; in cytogenetics, a chromosomal agent separated by a secondary constriction from the main body of the chromosome. [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 severe emotional disorder of psychotic depth characteristically marked
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by a retreat from reality with delusion formation, hallucinations, emotional disharmony, and regressive behavior. [NIH] Schizotypal Personality Disorder: A personality disorder in which there are oddities of thought (magical thinking, paranoid ideation, suspiciousness), perception (illusions, depersonalization), speech (digressive, vague, overelaborate), and behavior (inappropriate affect in social interactions, frequently social isolation) that are not severe enough to characterize schizophrenia. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Seafood: Marine fish and shellfish used as food or suitable for food. (Webster, 3d ed) shellfish and fish products are more specific types of seafood. [NIH] Seasonal Affective Disorder: A syndrome characterized by depressions that recur annually at the same time each year, usually during the winter months. Other symptoms include anxiety, irritability, decreased energy, increased appetite (carbohydrate cravings), increased duration of sleep, and weight gain. SAD (seasonal affective disorder) can be treated by daily exposure to bright artificial lights (phototherapy), during the season of recurrence. [NIH] 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] Sedative: 1. allaying activity and excitement. 2. an agent that allays excitement. [EU] Segregation: The separation in meiotic cell division of homologous chromosome pairs and their contained allelomorphic gene pairs. [NIH] Seizures: Clinical or subclinical disturbances of cortical function due to a sudden, abnormal, excessive, and disorganized discharge of brain cells. Clinical manifestations include abnormal motor, sensory and psychic phenomena. Recurrent seizures are usually referred to as epilepsy or "seizure disorder." [NIH] Selection Bias: The introduction of error due to systematic differences in the characteristics between those selected and those not selected for a given study. In sampling bias, error is the result of failure to ensure that all members of the reference population have a known chance of selection in the sample. [NIH] Selenium: An element with the atomic symbol Se, atomic number 34, and atomic weight 78.96. It is an essential micronutrient for mammals and other animals but is toxic in large amounts. Selenium protects intracellular structures against oxidative damage. It is an essential component of glutathione peroxidase. [NIH] Self-Help Groups: Organizations which provide an environment encouraging social interactions through group activities or individual relationships especially for the purpose of rehabilitating or supporting patients, individuals with common health problems, or the elderly. They include therapeutic social clubs. [NIH] Semen: The thick, yellowish-white, viscid fluid secretion of male reproductive organs discharged upon ejaculation. In addition to reproductive organ secretions, it contains spermatozoa and their nutrient plasma. [NIH] Senile: Relating or belonging to old age; characteristic of old age; resulting from infirmity of old age. [NIH] Sensitization: 1. administration of antigen to induce a primary immune response; priming; immunization. 2. exposure to allergen that results in the development of hypersensitivity. 3.
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the coating of erythrocytes with antibody so that they are subject to lysis by complement in the presence of homologous antigen, the first stage of a complement fixation test. [EU] Sepsis: The presence of bacteria in the bloodstream. [NIH] Septal: An abscess occurring at the root of the tooth on the proximal surface. [NIH] Septal Nuclei: Neural nuclei situated in the septal region. They have afferent and cholinergic efferent connections with a variety of forebrain and brainstem areas including the hippocampus, the lateral hypothalamus, the tegmentum, and the amygdala. Included are the dorsal, lateral, medial, and triangular septal nuclei, septofimbrial nucleus, nucleus of diagonal band, nucleus of anterior commissure, and the nucleus of stria terminalis. [NIH] Sequence Analysis: A multistage process that includes the determination of a sequence (protein, carbohydrate, etc.), its fragmentation and analysis, and the interpretation of the resulting sequence information. [NIH] Sequencing: The determination of the order of nucleotides in a DNA or RNA chain. [NIH] Seroconversion: The change of a serologic test from negative to positive, indicating the development of antibodies in response to infection or immunization. [EU] Serologic: Analysis of a person's serum, especially specific immune or lytic serums. [NIH] Serotonin: A biochemical messenger and regulator, synthesized from the essential amino acid L-tryptophan. In humans it is found primarily in the central nervous system, gastrointestinal tract, and blood platelets. Serotonin mediates several important physiological functions including neurotransmission, gastrointestinal motility, hemostasis, and cardiovascular integrity. Multiple receptor families (receptors, serotonin) explain the broad physiological actions and distribution of this biochemical mediator. [NIH] Serotonin Agonists: Agents that have an affinity for serotonin receptors and are able to mimic the effects of serotonin by stimulating the physiologic activity at the cell receptors. These compounds are used as antidepressants, anxiolytics, and in the treatment of migraine. [NIH]
Sertraline: A selective serotonin uptake inhibitor that is used in the treatment of depression. [NIH] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] Sex Characteristics: Those characteristics that distinguish one sex from the other. The primary sex characteristics are the ovaries and testes and their related hormones. Secondary sex characteristics are those which are masculine or feminine but not directly related to reproduction. [NIH] Shame: An emotional attitude excited by realization of a shortcoming or impropriety. [NIH] Shock: The general bodily disturbance following a severe injury; an emotional or moral upset occasioned by some disturbing or unexpected experience; disruption of the circulation, which can upset all body functions: sometimes referred to as circulatory shock. [NIH]
Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Signs and Symptoms: Clinical manifestations that can be either objective when observed by a physician, or subjective when perceived by the patient. [NIH] Skeletal: Having to do with the skeleton (boney part of the body). [NIH] Skeleton: The framework that supports the soft tissues of vertebrate animals and protects
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many of their internal organs. The skeletons of vertebrates are made of bone and/or cartilage. [NIH] Skull: The skeleton of the head including the bones of the face and the bones enclosing the brain. [NIH] Small intestine: The part of the digestive tract that is located between the stomach and the large intestine. [NIH] Smoking Cessation: Discontinuation of the habit of smoking, the inhaling and exhaling of tobacco smoke. [NIH] Smooth muscle: Muscle that performs automatic tasks, such as constricting blood vessels. [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] Social Class: A stratum of people with similar position and prestige; includes social stratification. Social class is measured by criteria such as education, occupation, and income. [NIH]
Social Environment: The aggregate of social and cultural institutions, forms, patterns, and processes that influence the life of an individual or community. [NIH] Social Mobility: The movement or shifting of membership between or within social classes by individuals or by groups. [NIH] Social Support: Support systems that provide assistance and encouragement to individuals with physical or emotional disabilities in order that they may better cope. Informal social support is usually provided by friends, relatives, or peers, while formal assistance is provided by churches, groups, etc. [NIH] Social Work: The use of community resources, individual case work, or group work to promote the adaptive capacities of individuals in relation to their social and economic environments. It includes social service agencies. [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] Soybean Oil: Oil from soybean or soybean plant. [NIH] Spatial disorientation: Loss of orientation in space where person does not know which way is up. [NIH] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Spectroscopic: The recognition of elements through their emission spectra. [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
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a disease. [EU] Sperm: The fecundating fluid of the male. [NIH] Spermatozoa: Mature male germ cells that develop in the seminiferous tubules of the testes. Each consists of a head, a body, and a tail that provides propulsion. The head consists mainly of chromatin. [NIH] Sphincter: A ringlike band of muscle fibres that constricts a passage or closes a natural orifice; called also musculus sphincter. [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] Spinal Nerves: The 31 paired peripheral nerves formed by the union of the dorsal and ventral spinal roots from each spinal cord segment. The spinal nerve plexuses and the spinal roots are also included. [NIH] Spinal tap: A procedure in which a needle is put into the lower part of the spinal column to collect cerebrospinal fluid or to give anticancer drugs intrathecally. Also called a lumbar puncture. [NIH] Sporadic: Neither endemic nor epidemic; occurring occasionally in a random or isolated manner. [EU] Stabilization: The creation of a stable state. [EU] Staging: Performing exams and tests to learn the extent of the cancer within the body, especially whether the disease has spread from the original site to other parts of the body. [NIH]
Steatosis: Fatty degeneration. [EU] Steel: A tough, malleable, iron-based alloy containing up to, but no more than, two percent carbon and often other metals. It is used in medicine and dentistry in implants and instrumentation. [NIH] Steroid: A group name for lipids that contain a hydrogenated cyclopentanoperhydrophenanthrene ring system. Some of the substances included in this group are progesterone, adrenocortical hormones, the gonadal hormones, cardiac aglycones, bile acids, sterols (such as cholesterol), toad poisons, saponins, and some of the carcinogenic hydrocarbons. [EU] Stimulant: 1. producing stimulation; especially producing stimulation by causing tension on muscle fibre through the nervous tissue. 2. an agent or remedy that produces stimulation. [EU]
Stimulus: That which can elicit or evoke action (response) in a muscle, nerve, gland or other excitable issue, or cause an augmenting action upon any function or metabolic process. [NIH]
Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Stool: The waste matter discharged in a bowel movement; feces. [NIH] Stool test: A test to check for hidden blood in the bowel movement. [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] Striatum: A higher brain's domain thus called because of its stripes. [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]
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Stupor: Partial or nearly complete unconsciousness, manifested by the subject's responding only to vigorous stimulation. Also, in psychiatry, a disorder marked by reduced responsiveness. [EU] 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] Subiculum: A region of the hippocampus that projects to other areas of the brain. [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]
Substance-Related Disorders: Disorders related to substance abuse, the side effects of a medication, toxin exposure, and alcohol-related disorders. [NIH] Substrate: A substance upon which an enzyme acts. [EU] Sulfur: An element that is a member of the chalcogen family. It has an atomic symbol S, atomic number 16, and atomic weight 32.066. It is found in the amino acids cysteine and methionine. [NIH] Sumatriptan: A serotonin agonist that acts selectively at 5HT1 receptors. It is used in the treatment of migraines. [NIH] Support group: A group of people with similar disease who meet to discuss how better to cope with their cancer and treatment. [NIH] Sympathomimetic: 1. mimicking the effects of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. 2. an agent that produces effects similar to those of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. Called also adrenergic. [EU] Symptomatic: Having to do with symptoms, which are signs of a condition or disease. [NIH] Symptomatology: 1. that branch of medicine with treats of symptoms; the systematic discussion of symptoms. 2. the combined symptoms of a disease. [EU] Synapse: The region where the processes of two neurons come into close contiguity, and the nervous impulse passes from one to the other; the fibers of the two are intermeshed, but, according to the general view, there is no direct contiguity. [NIH] Synapsis: The pairing between homologous chromosomes of maternal and paternal origin during the prophase of meiosis, leading to the formation of gametes. [NIH] Synaptic: Pertaining to or affecting a synapse (= site of functional apposition between neurons, at which an impulse is transmitted from one neuron to another by electrical or chemical means); pertaining to synapsis (= pairing off in point-for-point association of homologous chromosomes from the male and female pronuclei during the early prophase of meiosis). [EU] Synaptic Transmission: The communication from a neuron to a target (neuron, muscle, or secretory cell) across a synapse. In chemical synaptic transmission, the presynaptic neuron releases a neurotransmitter that diffuses across the synaptic cleft and binds to specific synaptic receptors. These activated receptors modulate ion channels and/or secondmessenger systems to influence the postsynaptic cell. Electrical transmission is less common in the nervous system, and, as in other tissues, is mediated by gap junctions. [NIH]
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Synergistic: Acting together; enhancing the effect of another force or agent. [EU] Systemic: Affecting the entire body. [NIH] Tachycardia: Excessive rapidity in the action of the heart, usually with a heart rate above 100 beats per minute. [NIH] Tachypnea: Rapid breathing. [NIH] Taste Buds: Small sensory organs which contain gustatory receptor cells, basal cells, and supporting cells. Taste buds in humans are found in the epithelia of the tongue, palate, and pharynx. They are innervated by the chorda tympani nerve (a branch of the facial nerve) and the glossopharyngeal nerve. [NIH] Tear Gases: Gases that irritate the eyes, throat, or skin. Severe lacrimation develops upon irritation of the eyes. [NIH] Technology Transfer: Spread and adoption of inventions and techniques from one geographic area to another, from one discipline to another, or from one sector of the economy to another. For example, improvements in medical equipment may be transferred from industrial countries to developing countries, advances arising from aerospace engineering may be applied to equipment for persons with disabilities, and innovations in science arising from government research are made available to private enterprise. [NIH] Telencephalon: Paired anteriolateral evaginations of the prosencephalon plus the lamina terminalis. The cerebral hemispheres are derived from it. Many authors consider cerebrum a synonymous term to telencephalon, though a minority include diencephalon as part of the cerebrum (Anthoney, 1994). [NIH] Temperament: Predisposition to react to one's environment in a certain way; usually refers to mood changes. [NIH] Temperance: Abstinence from alcohol. [NIH] Temporal: One of the two irregular bones forming part of the lateral surfaces and base of the skull, and containing the organs of hearing. [NIH] Temporal Lobe: Lower lateral part of the cerebral hemisphere. [NIH] Testosterone: A hormone that promotes the development and maintenance of male sex characteristics. [NIH] Thalamic: Cell that reaches the lateral nucleus of amygdala. [NIH] Thalamic Diseases: Disorders of the centrally located thalamus, which integrates a wide range of cortical and subcortical information. Manifestations include sensory loss, movement disorders; ataxia, pain syndromes, visual disorders, a variety of neuropsychological conditions, and coma. Relatively common etiologies include cerebrovascular disorders; craniocerebral trauma; brain neoplasms; brain hypoxia; intracranial hemorrhages; and infectious processes. [NIH] Thalamus: Paired bodies containing mostly gray substance and forming part of the lateral wall of the third ventricle of the brain. The thalamus represents the major portion of the diencephalon and is commonly divided into cellular aggregates known as nuclear groups. [NIH]
Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Thiamine: 3-((4-Amino-2-methyl-5-pyrimidinyl)methyl)-5-(2methylthiazolium chloride. [NIH]
hydroxyethyl)-4-
Thigh: A leg; in anatomy, any elongated process or part of a structure more or less comparable to a leg. [NIH]
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Third Ventricle: A narrow cleft inferior to the corpus callosum, within the diencephalon, between the paired thalami. Its floor is formed by the hypothalamus, its anterior wall by the lamina terminalis, and its roof by ependyma. It communicates with the fourth ventricle by the cerebral aqueduct, and with the lateral ventricles by the interventricular foramina. [NIH] Thorax: A part of the trunk between the neck and the abdomen; the chest. [NIH] Threshold: For a specified sensory modality (e. g. light, sound, vibration), the lowest level (absolute threshold) or smallest difference (difference threshold, difference limen) or intensity of the stimulus discernible in prescribed conditions of stimulation. [NIH] Thrombocytes: Blood cells that help prevent bleeding by causing blood clots to form. Also called platelets. [NIH] Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] Thyroid: A gland located near the windpipe (trachea) that produces thyroid hormone, which helps regulate growth and metabolism. [NIH] Thyroid Gland: A highly vascular endocrine gland consisting of two lobes, one on either side of the trachea, joined by a narrow isthmus; it produces the thyroid hormones which are concerned in regulating the metabolic rate of the body. [NIH] Thyroid Hormones: Hormones secreted by the thyroid gland. [NIH] Thyrotropin: A peptide hormone secreted by the anterior pituitary. It promotes the growth of the thyroid gland and stimulates the synthesis of thyroid hormones and the release of thyroxine by the thyroid gland. [NIH] Thyroxine: An amino acid of the thyroid gland which exerts a stimulating effect on thyroid metabolism. [NIH] 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] 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] 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] Trace element: Substance or element essential to plant or animal life, but present in extremely small amounts. [NIH] Trachea: The cartilaginous and membranous tube descending from the larynx and branching into the right and left main bronchi. [NIH]
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Traction: The act of pulling. [NIH] Transaminase: Aminotransferase (= a subclass of enzymes of the transferase class that catalyse the transfer of an amino group from a donor (generally an amino acid) to an acceptor (generally 2-keto acid). Most of these enzymes are pyridoxal-phosphate-proteins. [EU]
Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Transferases: Transferases are enzymes transferring a group, for example, the methyl group or a glycosyl group, from one compound (generally regarded as donor) to another compound (generally regarded as acceptor). The classification is based on the scheme "donor:acceptor group transferase". (Enzyme Nomenclature, 1992) EC 2. [NIH] Transfusion: The infusion of components of blood or whole blood into the bloodstream. The blood may be donated from another person, or it may have been taken from the person earlier and stored until needed. [NIH] Translating: Conversion from one language to another language. [NIH] Translation: The process whereby the genetic information present in the linear sequence of ribonucleotides in mRNA is converted into a corresponding sequence of amino acids in a protein. It occurs on the ribosome and is unidirectional. [NIH] Transmitter: A chemical substance which effects the passage of nerve impulses from one cell to the other at the synapse. [NIH] Transplantation: Transference of a tissue or organ, alive or dead, within an individual, between individuals of the same species, or between individuals of different species. [NIH] Trauma: Any injury, wound, or shock, must frequently physical or structural shock, producing a disturbance. [NIH] Treatment Outcome: Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, practicability, etc., of these interventions in individual cases or series. [NIH]
Tremor: Cyclical movement of a body part that can represent either a physiologic process or a manifestation of disease. Intention or action tremor, a common manifestation of cerebellar diseases, is aggravated by movement. In contrast, resting tremor is maximal when there is no attempt at voluntary movement, and occurs as a relatively frequent manifestation of Parkinson disease. [NIH] Tricuspid Atresia: Absence of the orifice between the right atrium and ventricle, with the presence of an atrial defect through which all the systemic venous return reaches the left heart. As a result, there is left ventricular hypertrophy because the right ventricle is absent or not functional. [NIH] Tricyclic: Containing three fused rings or closed chains in the molecular structure. [EU] Tryptophan: An essential amino acid that is necessary for normal growth in infants and for nitrogen balance in adults. It is a precursor serotonin and niacin. [NIH] Tryptophan Hydroxylase: An enzyme that catalyzes the hydroxylation of tryptophan to 5hydroxytryptophan in the presence of NADPH and molecular oxygen. It is important in the biosynthesis of serotonin. EC 1.14.16.4 [NIH] Tuberculosis: Any of the infectious diseases of man and other animals caused by species of Mycobacterium. [NIH] Tumor marker: A substance sometimes found in an increased amount in the blood, other body fluids, or tissues and which may mean that a certain type of cancer is in the body.
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Examples of tumor markers include CA 125 (ovarian cancer), CA 15-3 (breast cancer), CEA (ovarian, lung, breast, pancreas, and gastrointestinal tract cancers), and PSA (prostate cancer). Also called biomarker. [NIH] Tumor Necrosis Factor: Serum glycoprotein produced by activated macrophages and other mammalian mononuclear leukocytes which has necrotizing activity against tumor cell lines and increases ability to reject tumor transplants. It mimics the action of endotoxin but differs from it. It has a molecular weight of less than 70,000 kDa. [NIH] Tunica: A rather vague term to denote the lining coat of hollow organs, tubes, or cavities. [NIH]
Tyramine: An indirect sympathomimetic. Tyramine does not directly activate adrenergic receptors, but it can serve as a substrate for adrenergic uptake systems and monoamine oxidase so it prolongs the actions of adrenergic transmitters. It also provokes transmitter release from adrenergic terminals. Tyramine may be a neurotransmitter in some invertebrate nervous systems. [NIH] Tyrosine: A non-essential amino acid. In animals it is synthesized from phenylalanine. It is also the precursor of epinephrine, thyroid hormones, and melanin. [NIH] Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [NIH] Unsaturated Fats: A type of fat. [NIH] Uraemia: 1. an excess in the blood of urea, creatinine, and other nitrogenous end products of protein and amino acids metabolism; more correctly referred to as azotemia. 2. in current usage the entire constellation of signs and symptoms of chronic renal failure, including nausea, vomiting anorexia, a metallic taste in the mouth, a uraemic odour of the breath, pruritus, uraemic frost on the skin, neuromuscular disorders, pain and twitching in the muscles, hypertension, edema, mental confusion, and acid-base and electrolyte imbalances. [EU]
Urban Population: The inhabitants of a city or town, including metropolitan areas and suburban areas. [NIH] Urea: A compound (CO(NH2)2), formed in the liver from ammonia produced by the deamination of amino acids. It is the principal end product of protein catabolism and constitutes about one half of the total urinary solids. [NIH] Urease: An enzyme that catalyzes the conversion of urea and water to carbon dioxide and ammonia. EC 3.5.1.5. [NIH] Ureters: Tubes that carry urine from the kidneys to the bladder. [NIH] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]
Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [NIH] Urinary Retention: Inability to urinate. The etiology of this disorder includes obstructive, neurogenic, pharmacologic, and psychogenic causes. [NIH] Urinary tract: The organs of the body that produce and discharge urine. These include the kidneys, ureters, bladder, and urethra. [NIH] Urinate: To release urine from the bladder to the outside. [NIH] Urine: Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra. [NIH] Uterus: The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in
Dictionary 503
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] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vasculitis: Inflammation of a blood vessel. [NIH] 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] Vasodilator: An agent that widens blood vessels. [NIH] VE: The total volume of gas either inspired or expired in one minute. [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] Venter: Belly. [NIH] Ventral: 1. pertaining to the belly or to any venter. 2. denoting a position more toward the belly surface than some other object of reference; same as anterior in human anatomy. [EU] Ventricle: One of the two pumping chambers of the heart. The right ventricle receives oxygen-poor blood from the right atrium and pumps it to the lungs through the pulmonary artery. The left ventricle receives oxygen-rich blood from the left atrium and pumps it to the body through the aorta. [NIH] Ventricular: Pertaining to a ventricle. [EU] Vertebrae: A bony unit of the segmented spinal column. [NIH] Vesicular: 1. composed of or relating to small, saclike bodies. 2. pertaining to or made up of vesicles on the skin. [EU] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Video Recording: The storing or preserving of video signals for television to be played back later via a transmitter or receiver. Recordings may be made on magnetic tape or discs (videodisc recording). [NIH] Viral: Pertaining to, caused by, or of the nature of virus. [EU] Viral Hepatitis: Hepatitis caused by a virus. Five different viruses (A, B, C, D, and E) most commonly cause this form of hepatitis. Other rare viruses may also cause hepatitis. [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] Visceral: , from viscus a viscus) pertaining to a viscus. [EU] Viscosity: A physical property of fluids that determines the internal resistance to shear
504 Alcoholism
forces. [EU] Vitamin D: The vitamin that mediates intestinal calcium absorption, bone calcium metabolism, and probably muscle activity. It usually acts as a hormone precursor, requiring 2 stages of metabolism before reaching actual hormonal form. It is isolated from fish liver oils and used in the treatment and prevention of rickets. [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] Void: To urinate, empty the bladder. [NIH] Volition: Voluntary activity without external compulsion. [NIH] Voyeurism: A paraphilia characterized by repetitive looking at unsuspecting people, usually strangers, who are either naked, in the act of disrobing, or engaging in sexual activity, as the method for achieving sexual excitement. [NIH] Vulva: The external female genital organs, including the clitoris, vaginal lips, and the opening to the vagina. [NIH] War: Hostile conflict between organized groups of people. [NIH] Weight Gain: Increase in body weight over existing weight. [NIH] White blood cell: A type of cell in the immune system that helps the body fight infection and disease. White blood cells include lymphocytes, granulocytes, macrophages, and others. [NIH]
Windpipe: A rigid tube, 10 cm long, extending from the cricoid cartilage to the upper border of the fifth thoracic vertebra. [NIH] 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] 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] Yohimbine: A plant alkaloid with alpha-2-adrenergic blocking activity. Yohimbine has been used as a mydriatic and in the treatment of impotence. It is also alleged to be an aphrodisiac. [NIH] Zygote: The fertilized ovum. [NIH]
505
INDEX 5 5-hydroxyindoleacetic acid, 437 A Abdomen, 437, 445, 459, 470, 473, 483, 497, 500 Abdominal, 431, 437, 438, 482, 483, 487 Aberrant, 437 Aborigines, 437 Absenteeism, 437, 453 Absolute risk, 7, 437 Acatalasia, 437, 447 Acceptor, 437, 472, 482, 501 ACE, 4, 7, 437 Acetaldehyde, 437, 439, 456 Acetylcholine, 437, 448, 480 Acetylcysteine, 297, 437 Achievement, 437, 493 Acidity, 437, 484 Acidosis, 437, 471 Activities of Daily Living, 438, 492 Adaptation, 438 Adenylate Cyclase, 438 Adipocytes, 438, 472 Adjustment, 319, 331, 438 Adolescence, 44, 59, 438, 448 Adrenal Cortex, 438, 453, 485, 487 Adrenal Glands, 438, 485 Adrenal Medulla, 438, 447, 459, 480 Adrenergic, 438, 441, 456, 459, 498, 502, 504 Adverse effect, 50, 286, 438, 484, 487, 495 Aerobic, 438, 477 Aetiology, 438 Afferent, 438, 460, 472, 487, 495 Affinity, 438, 439, 442, 495, 496 Age of Onset, 55, 438 Ageing, 439 Aggravation, 439 Agonist, 39, 439, 446, 456, 478, 480, 498 Agoraphobia, 439, 468, 483, 484 Alcohol Dehydrogenase, 24, 53, 439 Alcohol Drinking, 9, 32, 43, 334, 439 Alcohol-Related Disorders, 31, 339, 439, 498 Aldehyde Dehydrogenase, 53, 57, 58, 439, 456 Alkaloid, 439, 449, 477, 480, 504 Alleles, 24, 439, 472 Allergen, 439, 494 Alternative medicine, 396, 439 Ameliorated, 439 Ameliorating, 439 Amenorrhea, 293, 439, 440 Amino Acid Neurotransmitters, 53, 440
Amino Acid Sequence, 440, 443, 460, 463, 488 Ammonia, 440, 464, 502 Amnesia, 440 Amnestic, 440, 462 Amphetamine, 25, 440, 455 Amygdala, 26, 440, 443, 472, 495, 499 Anaesthesia, 440, 469 Anal, 19, 30, 31, 55, 440, 459, 461, 473 Anaphylatoxins, 440, 450 Anatomical, 440, 442, 448, 468, 476 Anemia, 440, 462, 465, 474 Anesthesia, 440, 471 Aneurysm, 21, 440, 503 Animal model, 29, 48, 56, 279, 287, 440 Anorexia, 379, 440, 502 Anorexia Nervosa, 379, 440 Antagonism, 50, 440 Anthropology, 31, 441 Antibacterial, 441, 496 Antibiotic, 441, 483, 496 Antibody, 385, 404, 438, 441, 450, 467, 469, 475, 495 Anticonvulsant, 387, 441, 446, 448, 473, 484 Antidepressant, 441, 446, 449, 462, 468 Antigen, 438, 441, 450, 467, 468, 469, 470, 475, 476, 494 Antigen-Antibody Complex, 441, 450 Antioxidant, 441, 482 Antipsychotic, 441, 479, 490 Antiseptic, 441, 447 Antiviral, 437, 441, 470 Anus, 440, 441, 445, 450 Anxiety Disorders, 26, 47, 442, 483 Anxiolytic, 442, 446, 481 Apolipoproteins, 442, 473 Apoptosis, 442 Aqueous, 442, 443, 454, 467 Aromatic, 442, 484 Arterial, 335, 442, 448, 452, 468, 488 Arteries, 442, 445, 452, 473, 476, 490 Artery, 21, 335, 440, 442, 452, 490, 493 Aspartate, 45, 433, 442, 471 Astringent, 442, 447 Astrocytes, 442, 476, 477 Asymptomatic, 437, 442, 466, 482 Ataxia, 20, 442, 447, 499 Atmospheric Pressure, 50, 442, 467 Atrial, 442, 452, 501 Atrioventricular, 442, 452 Atrium, 442, 452, 501, 503 Attenuated, 32, 43, 442
506 Alcoholism
Auditory, 287, 442, 460, 487 Autodigestion, 443, 482 Autonomic, 437, 441, 443, 464, 480, 484 Autonomic Neuropathy, 443 Autopsy, 7, 443 Avoidance Learning, 15, 443 Axonal, 19, 278, 443 Axons, 443, 454, 481, 484, 492 B Bacteremia, 443 Bacteria, 441, 443, 451, 454, 458, 461, 476, 495, 496, 500, 503 Bacterial Physiology, 438, 443 Basal Ganglia, 21, 441, 442, 443, 472 Basal Ganglia Diseases, 442, 443 Base, 40, 48, 443, 454, 461, 463, 471, 499, 502 Beer, 22, 443 Behavior Therapy, 19, 326, 344, 443 Benzene, 443, 471 Benzodiazepines, 329, 422, 443, 446 Beta-Endorphin, 443 Bewilderment, 444, 451 Bilateral, 10, 444 Bile, 444, 462, 473, 497 Bile duct, 444 Biliary, 444, 482 Biliary Tract, 444, 482 Bilirubin, 4, 444 Biochemical, 31, 35, 38, 376, 439, 444, 464, 495 Biological Factors, 29, 53, 444 Biological Markers, 444 Biological response modifier, 444, 470 Biomarkers, 444 Biomolecular, 35, 444 Biopsy, 7, 433, 444 Biosynthesis, 444, 453, 501 Biotechnology, 60, 381, 396, 403, 444 Biotransformation, 444 Biphasic, 46, 445 Bipolar Disorder, 340, 397, 445 Bladder, 443, 445, 451, 479, 488, 502, 504 Blastocyst, 445, 451 Blister, 17, 445 Blister pack, 17, 445 Blood Cell Count, 445, 465 Blood Coagulation, 445, 446 Blood Platelets, 281, 445, 495 Blood pressure, 344, 432, 445, 446, 468, 477, 490, 496 Blood vessel, 437, 445, 446, 448, 452, 458, 473, 483, 496, 497, 500, 503 Blood-Brain Barrier, 445, 472 Body Composition, 445 Body Fluids, 444, 445, 457, 496, 501
Bone Marrow, 443, 445, 463, 468, 477 Bone scan, 445, 493 Bowel, 440, 445, 455, 470, 497 Bowel Movement, 445, 455, 497 Branch, 389, 429, 445, 448, 450, 453, 458, 465, 480, 483, 489, 496, 498, 499 Bulimia, 379, 445 Bupropion, 327, 337, 343, 446 Buspirone, 446 C Calcium, 446, 450, 504 Capsules, 330, 331, 335, 446, 463 Carbamazepine, 340, 446 Carbohydrate, 23, 446, 464, 494, 495 Carcinogenic, 443, 446, 469, 488, 497 Carcinoid, 437, 446 Carcinoma, 446 Cardiac, 446, 452, 457, 459, 478, 497 Cardiomyopathy, 293, 446 Cardiovascular, 54, 331, 344, 435, 440, 443, 446, 495 Cardiovascular disease, 446 Cardiovascular System, 443, 446 Case report, 446, 449, 461 Case series, 446, 449 Catalase, 437, 447 Catalyse, 447, 501 Catechol, 447 Catecholamine, 447, 456, 484 Catheter, 335, 447 Caudal, 447, 455, 468, 486 Causal, 21, 302, 306, 447, 450, 459, 470 Cause of Death, 447, 454 Cell, 18, 22, 34, 37, 335, 439, 440, 442, 443, 444, 445, 447, 448, 449, 450, 451, 453, 454, 458, 459, 460, 463, 466, 468, 469, 470, 475, 476, 477, 479, 480, 482, 485, 486, 488, 489, 491, 492, 494, 495, 498, 499, 501, 502, 504 Cell Death, 442, 447, 479 Cell Division, 443, 447, 453, 475, 477, 485, 488, 494 Cell membrane, 18, 447, 485 Cell Respiration, 447, 477, 492 Cellulose, 447, 485 Centrifugation, 447, 465, 476 Cerebellar, 20, 442, 447, 491, 501 Cerebellar Diseases, 442, 447, 501 Cerebellum, 447, 491 Cerebral Cortex, 442, 447, 460, 461 Cerebrospinal, 331, 335, 448, 474, 497 Cerebrospinal fluid, 331, 335, 448, 474, 497 Cerebrovascular, 10, 443, 446, 448, 499 Cerebrum, 447, 448, 499 Cervix, 448 Chemotactic Factors, 448, 450
Index 507
Child Development, 7, 448 Chin, 448, 475 Chlormethiazole, 448 Cholecystokinin, 394, 448 Cholesterol, 294, 448, 449, 452, 473, 497 Cholesterol Esters, 448, 473 Choline, 283, 448 Cholinergic, 281, 441, 448, 480, 495 Chorda Tympani Nerve, 448, 499 Chromatin, 442, 448, 480, 497 Chromosomal, 37, 448, 493 Chromosome, 40, 60, 449, 451, 465, 471, 472, 493, 494 Chylomicrons, 449, 473 Cirrhosis, 7, 13, 293, 374, 449, 465, 466 CIS, 449, 492 Cisplatin, 449, 481 Clamp, 50, 57, 58, 449 Clinical Medicine, 449, 487 Clinical study, 449, 452 Clomipramine, 449 Cloning, 444, 449 Coca, 449 Cocaine, 339, 379, 395, 449, 462 Cofactor, 449, 480, 488 Cognition, 10, 449, 479 Cognitive behavior therapy, 344, 449 Cohort Effect, 450 Collagen, 439, 450, 461, 463, 488 Colloidal, 450, 457 Colon, 302, 393, 450, 471 Community Medicine, 5, 450 Complement, 30, 40, 440, 450, 451, 471, 474, 495 Complementary and alternative medicine, 285, 297, 450 Complementary medicine, 285, 450 Complete remission, 451, 492 Compliance, 13, 17, 22, 23, 326, 328, 343, 344, 451 Compulsions, 379, 451, 481 Computational Biology, 35, 403, 451 Computed tomography, 451, 493 Computerized axial tomography, 451, 493 Conception, 58, 451 Concomitant, 7, 27, 306, 451 Confidence Intervals, 11, 451 Confusion, 334, 432, 451, 456, 479, 502 Conjugated, 451, 453 Conjugation, 444, 451 Connective Tissue, 445, 450, 451, 461, 462, 463, 484, 493 Consciousness, 452, 454, 489 Constipation, 386, 441, 452 Constriction, 452, 493 Contamination, 452, 466
Contraindications, ii, 452 Control group, 11, 452, 485, 490 Controlled clinical trial, 20, 23, 340, 452 Conventional therapy, 452 Conventional treatment, 49, 452 Convulsions, 441, 452 Cor, 49, 452, 485, 488 Corn Oil, 331, 452 Coronary, 446, 452, 467, 476 Coronary heart disease, 446, 452 Coronary Thrombosis, 452, 476 Corpus, 453, 474, 487, 500 Corpus Callosum, 453, 500 Cortex, 51, 453, 458, 460, 487, 491 Cortical, 14, 453, 460, 485, 487, 494, 499 Cortisol, 32, 34, 43, 51, 433, 453 Cost of Illness, 453 Cranial, 447, 448, 453, 460, 464, 465, 481, 484 Criterion, 42, 453 Critical Illness, 389, 453 Cues, 21, 27, 333, 453 Curative, 453, 480, 493, 499 Cutaneous, 453, 471 Cyclic, 438, 453 Cystathionine beta-Synthase, 453, 467 Cysteine, 437, 453, 498 Cytochrome, 453 Cytogenetics, 453, 493 Cytokine, 453, 470 Cytoplasm, 442, 447, 454, 477, 480, 492 Cytotoxic, 454, 481 Cytotoxic chemotherapy, 454, 481 D Databases, Bibliographic, 403, 454 Deamination, 454, 477, 502 Death Certificates, 7, 454 Decision Making, 6, 15, 19, 454 Degenerative, 454, 466 Dehydration, 386, 454 Deletion, 442, 454 Delivery of Health Care, 453, 454 Delusion, 454, 494 Dementia, 4, 6, 293, 295, 386, 441, 454 Dendrites, 454, 479 Density, 447, 454, 473, 481 Dental Caries, 454, 462 Dentate Gyrus, 454, 466 Dentist-Patient Relations, 454 Depersonalization, 455, 483, 494 Depressive Disorder, 455, 473 Deprivation, 43, 455 Derealization, 455, 483 Dermatitis, 455 Detergents, 455, 461 Detoxification, 6, 53, 317, 329, 336, 340, 455
508 Alcoholism
Deuterium, 455, 467 Developing Countries, 6, 455, 499 Dextroamphetamine, 327, 440, 455, 476 Diabetes Mellitus, 455, 464, 466 Diagnostic procedure, 349, 396, 455 Diastolic, 455, 468 Diencephalon, 455, 459, 468, 487, 499, 500 Digestion, 445, 455, 470, 473, 497 Digestive system, 347, 455 Digestive tract, 443, 455, 496 Dihydrotestosterone, 455, 491 Dilatation, 440, 455, 487, 503 Dilated cardiomyopathy, 455 Diploid, 456, 485 Discrete, 55, 456 Discrimination, 456 Disease Progression, 7, 456 Disorientation, 451, 456 Disposition, 456 Distal, 443, 456, 457, 484 Disulfiram, 288, 339, 422, 456 Diverticula, 456 Diverticulitis, 456 Diverticulum, 456 Dizziness, 334, 456, 483 Domestic Violence, 308, 312, 330, 456, 486 Dopa, 456, 472 Double-blind, 17, 22, 23, 46, 49, 55, 329, 336, 340, 341, 344, 345, 456 Drinking Behavior, 26, 279, 307, 311, 333, 334, 456, 480 Drug Combinations, 46, 456 Drug Interactions, 423, 457 Drug Resistance, 457 Drug Tolerance, 457, 500 Duct, 457, 460, 493 Duodenum, 444, 457, 462, 497 Dyes, 457, 480 Dynorphins, 457, 481 Dysphoric, 45, 455, 457 Dyspnea, 457, 483 E Eating Disorders, 12, 342, 378, 457 Effector, 437, 450, 457 Efficacy, 17, 20, 23, 29, 39, 42, 43, 46, 52, 54, 315, 322, 337, 344, 393, 446, 457, 501 Ejaculation, 457, 494 Elective, 457 Electric shock, 457 Electrocardiogram, 327, 330, 335, 457 Electrode, 50, 457 Electrons, 441, 443, 457, 471, 474, 482 Electrophoresis, 457 Electrophysiological, 14, 45, 288, 458 Electroplating, 447, 458 Elementary Particles, 457, 458, 474, 488
Embolism, 458 Embryo, 445, 458, 469 Emetic, 22, 458 Emphysema, 386, 458 Empirical, 28, 47, 58, 301, 458 Encephalopathy, 458 Endemic, 458, 474, 497 Endocrine System, 458, 479 Endogenous, 43, 44, 48, 60, 279, 443, 456, 458, 481 Endometrial, 280, 394, 458 Endometrium, 458, 475 Endorphins, 458, 480, 481, 488 Endotoxic, 458, 472 Endotoxin, 458, 502 Energy balance, 458, 472 Enkephalin, 444, 458, 488 Entorhinal Cortex, 458, 466 Environmental Exposure, 444, 458 Environmental Health, 402, 404, 459 Enzymatic, 439, 446, 450, 454, 459, 492 Epidemic, 404, 459, 497 Epidemiologic Studies, 444, 459 Epidemiological, 459, 461 Epidermis, 445, 459, 490 Epigastric, 459, 482 Epinephrine, 438, 456, 459, 480, 502 Epithalamus, 455, 459, 472 Epithelial, 459 Epithelium, 279, 280, 459 Erythrocyte Indices, 445, 459 Erythrocytes, 440, 445, 459, 491, 495 Esophageal, 459 Esophageal Varices, 459 Esophagus, 455, 459, 484, 497 Estrogen, 459, 488 Ether, 459 Ethnic Groups, 53, 460 Evacuation, 452, 460, 462 Evoke, 460, 497 Evoked Potentials, 460 Excitation, 460, 480 Excitatory, 440, 460, 464 Exhaustion, 440, 460, 474 Exocrine, 448, 460, 482 Exogenous, 444, 458, 460 Exon, 460 Extracellular, 442, 451, 452, 460, 461, 476, 496 Extracellular Space, 460, 476 Extrapyramidal, 441, 456, 460 Extravasation, 460, 465 Eye Movements, 460 F Facial, 448, 460, 499 Facial Expression, 460
Index 509
Facial Nerve, 460, 499 Family Planning, 403, 460 Family Practice, 5, 460 Family Relations, 460 Fat, 438, 445, 452, 460, 471, 472, 486, 502 Fatal Outcome, 12, 460 Fathers, 9, 15, 323, 461 Fatigue, 461, 465 Fatty acids, 279, 331, 461, 496 Feces, 452, 461, 497 Femoral, 461 Fenfluramine, 461 Fermentation, 439, 443, 461 Fetal Alcohol Syndrome, 6, 57, 58, 412, 461 Fibroblasts, 461, 470 Fibrosis, 461, 466 Fish Oils, 331, 461 Fish Products, 461, 494 Fissure, 448, 453, 454, 461, 487 Fixation, 461, 495 Fluorine, 461 Fluoxetine, 34, 279, 287, 330, 333, 462 Flupenthixol, 462 Flushing, 456, 462 Fluvoxamine, 462 Folate, 278, 462 Fold, 18, 461, 462 Folic Acid, 422, 462 Follicular Phase, 19, 462 Follow-Up Studies, 32, 462 Food Preferences, 397, 462 Forearm, 445, 462 Free Radicals, 280, 441, 462 Frontal Lobe, 10, 21, 462, 487 G GABA, 53, 440, 448, 462 Gallbladder, 437, 444, 448, 455, 462 Gamma-Glutamyltransferase, 462 Ganglia, 21, 437, 443, 462, 479, 484 Gas, 440, 461, 462, 467, 478, 480, 503 Gastric, 443, 462 Gastric Emptying, 462 Gastrin, 463, 467 Gastrointestinal, 374, 446, 448, 449, 459, 463, 474, 495, 498, 502 Gastrointestinal tract, 374, 449, 463, 495, 502 Gelatin, 463, 464 Gene Expression, 35, 463 Gene Therapy, 463 Generator, 14, 463 Genetic Code, 463, 481 Genetic Markers, 31, 332, 463 Genetic Screening, 463 Genetic testing, 329, 463 Genital, 443, 463, 504 Genotype, 32, 34, 37, 59, 463, 484
Geriatric, 4, 6, 463 Germ Cells, 463, 475, 481, 497 Gland, 438, 463, 482, 485, 488, 494, 497, 500 Glomerular, 464 Glomeruli, 464 Glomerulonephritis, 464 Glossopharyngeal Nerve, 464, 499 Glucose, 39, 53, 447, 455, 464, 466, 469, 493 Glucose Intolerance, 455, 464 Glutamate, 45, 53, 440, 464 Glutamic Acid, 440, 462, 464, 480, 488 Glutamine, 53, 296, 464 Glutathione Peroxidase, 464, 494 Glycine, 50, 439, 448, 464, 480 Glycogen, 464 Glycoprotein, 464, 478, 502 Glycosylation, 464 Gonadal, 464, 497 Governing Board, 464, 486 Graft, 464, 467 Grasses, 462, 464 Guanine, 465 Guanosine Triphosphate, 465 Gyrus Cinguli, 465, 472 H Habitual, 465 Haematological, 465 Haematology, 465 Half-Life, 465 Handicap, 373, 465 Haploid, 465, 485 Haplotypes, 24, 31, 465 Headache, 465, 487 Health Status, 344, 450, 465 Heart attack, 446, 465 Heart failure, 386, 465 Heart Transplantation, 465 Hematocrit, 434, 445, 459, 465 Hematoma, 465 Heme, 453, 465 Hemochromatosis, 374, 465 Hemoglobin, 440, 445, 459, 465, 466, 472 Hemoglobinopathies, 463, 466 Hemorrhage, 465, 466, 497 Hemostasis, 466, 495 Hepatic, 435, 466, 473, 477 Hepatitis, 4, 7, 294, 374, 466, 503 Hepatitis A, 4, 466 Hepatitis C, 4, 7, 466 Hepatitis Viruses, 4, 466 Hepatitis, Alcoholic, 374, 466 Hepatocyte, 466 Hepatovirus, 466 Hereditary, 466 Heredity, 30, 463, 466 Heritability, 36, 37, 466
510 Alcoholism
Hippocampus, 26, 454, 466, 472, 495, 498 Homeostasis, 278, 279, 317, 467 Homicide, 467 Homologous, 439, 463, 467, 494, 495, 498 Homosexuality, 3, 332, 467 Homozygotes, 34, 467 Hormonal, 19, 34, 39, 43, 467, 504 Host, 332, 467, 468, 503 Hydration, 19, 467 Hydrogen, 437, 439, 443, 446, 447, 455, 464, 467, 472, 477, 482, 484, 489 Hydrogen Peroxide, 447, 464, 467, 472 Hydrogenation, 443, 467 Hydrolysis, 444, 449, 467, 486, 488 Hydrophobic, 19, 455, 467, 473 Hydroxylation, 467, 501 Hydroxyproline, 439, 450, 467 Hyperbaric, 50, 467 Hyperbaric oxygen, 467 Hyperhomocysteinemia, 278, 453, 467 Hypericum, 279, 287, 467 Hypersensitivity, 439, 467, 494 Hypertension, 294, 344, 446, 465, 468, 502 Hypertrophy, 452, 468, 501 Hypnotic, 468, 473 Hypoglycemia, 374, 468 Hypotension, 441, 452, 456, 468 Hypothalamic, 32, 43, 468 Hypothalamus, 26, 51, 455, 458, 468, 472, 485, 488, 495, 500 I Id, 282, 292, 327, 416, 419, 428, 430, 468, 476 Idiopathic, 468 Imipramine, 279, 287, 449, 468 Immune response, 441, 468, 474, 494, 498, 503 Immune system, 3, 338, 385, 468, 474, 503, 504 Immunization, 468, 487, 494, 495 Immunodeficiency, 3, 338, 373, 374, 385, 386, 404, 468 Immunodeficiency syndrome, 373, 374, 385, 386, 404, 468 Immunogenic, 468, 472 Immunosuppression, 468, 481 Impairment, 21, 34, 319, 383, 413, 442, 444, 468, 475, 489 Implantation, 451, 468 Impotence, 432, 468, 504 Impulsive Behavior, 468 In vitro, 34, 46, 463, 468 In vivo, 18, 53, 463, 468, 476 Incest, 469 Indicative, 44, 375, 469, 483, 503 Induction, 281, 441, 469, 471, 488, 490
Infarction, 453, 469, 476 Infiltration, 464, 466, 469 Informed Consent, 469 Infuse, 334, 469 Infusion, 45, 55, 334, 469, 501 Ingestion, 45, 279, 469, 486 Initiation, 28, 43, 59, 469 Initiator, 469, 470 Inotropic, 456, 469 Inpatients, 286, 339, 340, 342, 469 Insight, 29, 44, 48, 52, 55, 396, 469 Insomnia, 49, 432, 469, 487 Insulin, 469, 471 Insulin-dependent diabetes mellitus, 469 Intensive Care, 30, 335, 469 Interferon, 470 Interferon-alpha, 470 Interleukin-1, 470 Interleukin-10, 470 Interleukin-12, 470 Interleukin-2, 470 Interleukin-6, 470 Intermittent, 470, 473 Internal Medicine, 7, 286, 470 Intervention Studies, 23, 470 Intestinal, 448, 470, 504 Intestinal Mucosa, 448, 470 Intestine, 374, 445, 470, 471 Intoxication, 28, 45, 54, 317, 344, 470, 504 Intracellular, 469, 470, 491, 494 Intravenous, 3, 4, 29, 334, 335, 374, 386, 469, 470 Involuntary, 288, 443, 470, 478, 491 Ion Channels, 442, 470, 484, 498 Ions, 437, 443, 467, 470 Irritants, 290, 471 Isoflavones, 297, 471 J Jealousy, 471 Joint, 9, 38, 471 K Karyotypes, 463, 471 Kb, 402, 471 Ketamine, 45, 471 Keto, 471, 501 Ketoacidosis, 471 Ketone Bodies, 471 Ketosis, 471 Kidney Disease, 347, 397, 402, 471 L Labile, 32, 34, 450, 471 Lactation, 471, 488 Large Intestine, 455, 470, 471, 491, 496 Larynx, 471, 500 Latency, 472 Latent, 47, 472, 487
Index 511
Leptin, 472 Lesion, 466, 472, 473 Leucine, 444, 472 Leukemia, 463, 472 Leukocytes, 445, 448, 466, 470, 472, 477, 480, 502 Levodopa, 456, 472 Library Services, 428, 472 Life cycle, 41, 445, 472 Ligaments, 452, 472 Limbic, 21, 51, 440, 465, 472, 487 Limbic System, 21, 440, 465, 472, 487 Linkage Disequilibrium, 24, 40, 472 Lipid, 281, 442, 448, 469, 471, 472, 473, 482 Lipid A, 472 Lipid Peroxidation, 472, 482 Lipomatosis, 472 Lipopolysaccharides, 472, 473 Lipoprotein, 57, 58, 473 Lithium, 422, 441, 473 Liver cancer, 473 Liver Cirrhosis, 294, 473 Liver scan, 473, 493 Liver Transplantation, 13, 473 Lobe, 21, 473, 488 Localization, 31, 473 Localized, 33, 454, 461, 465, 469, 472, 473, 477, 485 Locomotion, 473, 485 Longitudinal Studies, 9, 473 Longitudinal study, 12, 38, 473 Long-Term Care, 48, 473 Loop, 33, 312, 473 Lorazepam, 329, 340, 422, 473 Low-density lipoprotein, 473 Lumbar, 331, 335, 474, 497 Lumbar puncture, 331, 335, 474, 497 Luteal Phase, 474 Lutein Cells, 474, 488 Lymphocyte, 37, 441, 468, 474, 475 M Magnetic Resonance Imaging, 21, 326, 335, 474, 493 Magnetic Resonance Spectroscopy, 18, 474 Major Histocompatibility Complex, 465, 474 Malaria, 474 Malaria, Falciparum, 474 Malaria, Vivax, 474 Malignant, 473, 474, 479, 493 Malnutrition, 278, 386, 474 Mammary, 474 Mania, 474, 475 Manic, 441, 445, 473, 475, 489 Manic-depressive psychosis, 475, 489 Manifest, 36, 45, 443, 475 Man-made, 447, 475
Marital Therapy, 475 Mediate, 43, 48, 456, 475 Mediator, 47, 310, 448, 456, 475, 495 Medical Assistance, 384, 475 Medical Records, 7, 333, 475 MEDLINE, 403, 475 Megaloblastic, 462, 475 Meiosis, 475, 498 Melanin, 475, 484, 502 Membrane, 18, 46, 442, 447, 450, 470, 471, 475, 476, 478, 484, 485, 492 Memory, 15, 21, 292, 293, 432, 440, 454, 475 Meninges, 447, 475 Menstrual Cycle, 19, 303, 462, 474, 475, 487 Menstruation, 294, 439, 462, 474, 475, 487 Mental deficiency, 461, 475 Mental Disorders, 347, 475, 487, 489 Mental Health Services, v, 8, 405, 414, 416, 476 Mental Processes, 476, 489 Mentors, 48, 387, 476 Mesolimbic, 25, 32, 33, 441, 476 Meta-Analysis, 44, 476 Metabolic acidosis, 476 Metabolite, 444, 449, 476 Methamphetamine, 476 Methionine, 444, 476, 488, 498 Methyltransferase, 476 MI, 435, 476 Microbiology, 438, 476 Microcirculation, 473, 476 Microdialysis, 53, 476 Microglia, 442, 476, 477 Microsomal, 476 Microtubules, 476, 482 Microwaves, 476, 490 Mitochondria, 477 Mitochondrial Swelling, 477, 479 Mitosis, 442, 477 Modeling, 28, 47, 477 Modification, 15, 35, 54, 386, 439, 477, 490 Molecule, 441, 443, 450, 457, 460, 466, 467, 477, 482, 491 Monitor, 333, 477, 480 Monoamine, 440, 455, 477, 502 Monoamine Oxidase, 440, 455, 477, 502 Monocytes, 470, 472, 477 Mononuclear, 477, 502 Monotherapy, 17, 477 Mood Disorders, 477 Morphine, 477, 478, 481 Morphogenesis, 461, 477 Morphological, 280, 439, 458, 477 Morphology, 279, 280, 465, 477 Motility, 477, 495 Motion Sickness, 477, 478
512 Alcoholism
Motor Skills, 331, 478 Mucins, 478, 493 Mucolytic, 437, 478 Mucosa, 280, 478, 488 Multicenter study, 17, 478 Muscle relaxant, 478, 484 Muscle Spindles, 478, 484 Mustard Gas, 471, 478 Mydriatic, 478, 504 Myocardium, 476, 478 Myopathy, 374, 478 N Naloxone, 32, 33, 43, 444, 478 Narcissism, 478 Narcolepsy, 455, 478 Narcosis, 478 Narcotic, 29, 437, 477, 478 Natural killer cells, 470, 478 Natural Language Processing, 35, 478 Nausea, 22, 432, 433, 441, 456, 471, 478, 481, 483, 487, 502 NCI, 1, 332, 338, 347, 401, 449, 479 Necrosis, 442, 466, 469, 476, 479 Need, 3, 6, 7, 334, 373, 374, 382, 383, 385, 386, 396, 404, 420, 438, 464, 479, 500 Needle Sharing, 385, 386, 479 Needs Assessment, 8, 479 Neonatal, 9, 479 Neoplasm, 338, 479, 493 Nephropathy, 471, 479 Nerve, 438, 440, 442, 443, 448, 454, 460, 464, 475, 477, 479, 481, 484, 492, 497, 501 Nervi, 479 Nervous System, 14, 35, 37, 44, 51, 437, 438, 440, 443, 447, 448, 449, 455, 457, 460, 462, 464, 465, 472, 475, 476, 477, 479, 480, 481, 484, 495, 498, 502 Networks, 10, 322, 323, 479 Neural, 26, 36, 37, 438, 476, 477, 479, 495 Neuroendocrine, 18, 39, 57, 58, 479 Neurogenic, 479, 502 Neuroleptic, 441, 479, 481 Neuronal, 18, 35, 49, 57, 478, 479, 484 Neurons, 34, 440, 449, 454, 460, 462, 472, 478, 479, 480, 498 Neuropathy, 443, 479, 484 Neuropeptide, 40, 392, 479, 480 Neuropeptide Y, 40, 392, 480 Neuropharmacology, 40, 48, 480 Neurosis, 480, 484 Neurotransmitter, 22, 26, 46, 50, 53, 437, 439, 456, 462, 464, 470, 480, 498, 502 Neutrophils, 472, 480 Niacin, 422, 480, 501 Nickel, 480
Nicotine, 25, 325, 326, 327, 328, 336, 343, 345, 395, 480 Nitrogen, 433, 439, 461, 464, 480, 501 Nonverbal Communication, 480, 489 Norepinephrine, 438, 456, 480 Normal Distribution, 45, 480 Nuclear, 443, 451, 457, 460, 472, 475, 479, 480, 490, 492, 499 Nuclear Family, 460, 480 Nuclei, 19, 440, 451, 457, 459, 463, 474, 477, 480, 481, 488, 495 Nucleic acid, 463, 480, 481 O Obsessive-Compulsive Disorder, 462, 481 Odds Ratio, 11, 481, 491 Ondansetron, 22, 39, 54, 328, 329, 343, 395, 481 Oocytes, 50, 481 Opacity, 454, 481 Opiate, 23, 42, 44, 46, 48, 444, 458, 477, 478, 481 Opioid Peptides, 457, 458, 481 Opium, 477, 481 Opportunistic Infections, 385, 481 Optic Chiasm, 468, 481 Optic Nerve, 479, 481, 492 Optic nerve head, 479, 481 Orbit, 482 Orbital, 26, 482 Osteonecrosis, 482 Osteoporosis, 294, 382, 383, 482 Ovulation, 462, 474, 482 Ovum, 472, 482, 487, 488, 504 Oxidation, 437, 441, 444, 453, 464, 472, 482 Oxidation-Reduction, 444, 482 Oxidative Stress, 482 P Paclitaxel, 286, 482 Palate, 464, 482, 499 Palliative, 482, 499 Pancreas, 294, 374, 437, 444, 455, 465, 469, 482, 502 Pancreatic, 295, 448, 482 Pancreatitis, 279, 295, 482 Panic, 330, 462, 468, 482 Panic Disorder, 330, 462, 468, 482 Paresthesias, 483 Parkinsonism, 441, 472, 483 Partial remission, 483, 492 Parturition, 483, 488 Patch, 325, 326, 328, 336, 343, 483 Pathogenesis, 483 Pathologic, 437, 442, 444, 452, 467, 483, 503 Pathologic Processes, 442, 483 Pathophysiology, 20, 44, 53, 56, 389, 483 Patient Compliance, 483
Index 513
Patient Education, 415, 426, 428, 435, 483 Pedigree, 332, 483 Pedophilia, 483 Peer Group, 59, 483 Pelvis, 437, 474, 483, 502 Penicillin, 441, 483 Peptide, 394, 439, 443, 448, 462, 472, 480, 481, 483, 486, 488, 500 Perception, 10, 292, 321, 455, 483, 494 Perennial, 467, 483 Perfusion, 483 Peripheral blood, 470, 484 Peripheral Nerves, 484, 497 Peripheral Nervous System, 480, 484, 498 Peripheral Neuropathy, 484 Personality Disorders, 484 PH, 291, 379, 484 Pharmacist, 387, 484 Pharmacokinetic, 46, 484 Pharmacologic, 17, 343, 440, 465, 484, 500, 502 Pharmacotherapy, 17, 23, 49, 290, 341, 484 Pharynx, 484, 499 Phenotype, 30, 32, 33, 444, 484 Phenylalanine, 327, 484, 502 Phenytoin, 446, 484 Phobia, 484 Phobic Disorders, 484, 485 Phospholipids, 460, 473, 485 Phosphorus, 446, 485 Phosphorylation, 485 Phototherapy, 485, 494 Physical Examination, 326, 334, 335, 485 Physiologic, 38, 44, 439, 444, 456, 465, 475, 485, 491, 495, 501 Physiology, 26, 397, 444, 458, 485 Pigment, 444, 485 Pilot Projects, 20, 485 Pilot study, 23, 285, 485 Pituitary Hormones, 480, 485 Pituitary-Adrenal System, 485 Placebos, 336, 485 Plants, 280, 291, 439, 448, 449, 464, 467, 477, 480, 485, 486, 493, 500 Plasma, 17, 34, 447, 448, 463, 464, 466, 485, 494 Platelets, 486, 500 Platinum, 449, 473, 486 Pneumonia, 452, 486 Poisoning, 281, 470, 478, 486 Polyarthritis, 486 Polymorphic, 37, 338, 454, 486 Polypeptide, 439, 440, 450, 486, 488 Polyunsaturated fat, 331, 486 Pontine, 486 Portal Pressure, 486, 493
Posterior, 440, 442, 447, 459, 464, 482, 485, 486 Postmenopausal, 482, 486 Postnatal, 461, 486 Postoperative, 486 Post-traumatic, 27, 337, 340, 486 Post-traumatic stress disorder, 27, 337, 340, 486 Postural, 20, 486 Potentiate, 448, 486, 487 Practicability, 486, 501 Practice Guidelines, 405, 416, 486 Precipitating Factors, 11, 486 Preclinical, 18, 25, 28, 39, 41, 43, 344, 487 Precursor, 43, 448, 456, 457, 458, 459, 472, 480, 484, 487, 488, 501, 502, 504 Predisposition, 22, 40, 59, 60, 487, 499 Prefrontal Cortex, 21, 26, 487 Premenstrual, 295, 487 Premenstrual Syndrome, 295, 487 Prenatal, 6, 458, 461, 463, 487 Prescription drug abuse, 487 Presynaptic, 480, 487, 498 Primary Prevention, 6, 47, 301, 314, 487 Private Sector, 487 Probe, 14, 39, 476, 487 Professional Practice, 487 Progesterone, 487, 488, 497 Progression, 302, 338, 440, 487 Progressive, 449, 454, 457, 464, 466, 479, 487 Projection, 480, 481, 487, 491 Prolactin, 34, 488 Proline, 450, 467, 488 Promoter, 488 Prone, 42, 488 Pro-Opiomelanocortin, 458, 481, 488 Prophase, 481, 488, 498 Propofol, 488 Prospective Studies, 12, 488 Prospective study, 473, 488 Prostate, 444, 488, 502 Protein C, 440, 442, 473, 488, 502 Protein S, 381, 444, 463, 488, 492 Proteolytic, 450, 488 Protocol, 9, 16, 24, 54, 326, 334, 485, 488 Protons, 467, 474, 488 Proto-Oncogene Proteins, 482, 489 Proto-Oncogene Proteins c-mos, 482, 489 Protozoan, 474, 489 Proxy, 489 Psychic, 475, 480, 489, 494 Psychoactive, 49, 286, 489, 504 Psychogenic, 489, 502 Psychomotor, 19, 446, 479, 489 Psychopathology, 9, 12, 40, 47, 304, 394, 489 Psychosis, 46, 441, 489
514 Alcoholism
Psychotherapy, 22, 24, 28, 39, 52, 281, 330, 339, 378, 379, 449, 475, 489 Psychotomimetic, 440, 455, 489 Psychotropic, 54, 489 Public Assistance, 475, 489 Public Policy, 313, 403, 490 Public Sector, 5, 303, 490 Publishing, 60, 490 Pulmonary, 445, 452, 490, 503 Pulmonary Artery, 445, 490, 503 Pulmonary hypertension, 452, 490 Pulse, 477, 490 Punishment, 15, 490 Pustular, 490 Pyridoxal, 453, 490, 501 Q Quality of Life, 453, 490 R Race, 11, 387, 456, 471, 490 Raclopride, 25, 334, 490 Radio Waves, 326, 476, 490 Radioactive, 334, 335, 445, 465, 467, 468, 473, 475, 480, 490, 493 Radioactivity, 335, 490 Radiopharmaceutical, 463, 490 Random Allocation, 490 Randomization, 17, 55, 329, 490 Randomized clinical trial, 23, 29, 52, 326, 328, 332, 339, 491 Rape, 395, 486, 491 Reality Testing, 489, 491 Receptors, Serotonin, 491, 495 Recombination, 451, 463, 491 Rectum, 441, 445, 450, 455, 462, 471, 488, 491 Recur, 491, 494 Recurrence, 445, 475, 491, 494 Red blood cells, 459, 491, 493 Red Nucleus, 442, 491 Reductase, 491 Refer, 1, 450, 456, 458, 461, 473, 479, 489, 491, 500 Reflex, 460, 478, 491 Refraction, 491, 496 Regimen, 13, 17, 457, 483, 484, 491 Relative risk, 11, 437, 491 Reliability, 4, 492 Remission, 12, 445, 475, 491, 492 Research Design, 42, 49, 492 Residential Facilities, 386, 492 Respiration, 477, 492 Respiratory Paralysis, 437, 492 Retina, 481, 492, 493 Retinal, 481, 492 Retinal Ganglion Cells, 481, 492 Retinoid, 57, 58, 492
Retrospective, 7, 17, 19, 43, 47, 492 Retroviral vector, 463, 492 Riboflavin, 24, 492 Ribosome, 492, 501 Rickets, 493, 504 Rigidity, 18, 483, 485, 493 Risk-Taking, 404, 493 Ritanserin, 493 Rod, 449, 493 Role-play, 493 S Saline, 327, 493 Saliva, 493 Salivary, 448, 455, 460, 493 Salivary glands, 448, 455, 460, 493 Saponins, 493, 497 Sarcoma, 332, 493 Satellite, 37, 493 Scans, 39, 327, 335, 493 Schizoid, 493, 504 Schizotypal Personality Disorder, 455, 494, 504 Seafood, 331, 494 Seasonal Affective Disorder, 494 Sebaceous, 471, 494 Sebaceous gland, 471, 494 Secretion, 278, 469, 471, 476, 478, 480, 485, 494 Sedative, 448, 468, 473, 494 Segregation, 491, 494 Seizures, 387, 433, 446, 484, 494 Selection Bias, 494 Selenium, 280, 494 Self-Help Groups, 23, 328, 494 Semen, 457, 488, 494 Senile, 295, 386, 482, 494 Sensitization, 32, 494 Sepsis, 476, 495 Septal, 472, 495 Septal Nuclei, 472, 495 Sequence Analysis, 35, 495 Sequencing, 28, 33, 495 Seroconversion, 495 Serologic, 495 Serotonin, 26, 34, 39, 54, 306, 329, 331, 335, 437, 441, 446, 449, 461, 462, 477, 480, 481, 484, 491, 493, 495, 498, 501 Serotonin Agonists, 495 Sertraline, 39, 49, 54, 329, 340, 344, 345, 495 Serum, 440, 450, 474, 495, 502 Sex Characteristics, 438, 495, 499 Shame, 320, 379, 495 Shock, 495, 501 Side effect, 29, 46, 330, 421, 438, 441, 473, 495, 498, 500 Signs and Symptoms, 6, 491, 492, 495, 502
Index 515
Skeletal, 449, 478, 495 Skeleton, 471, 495, 496 Skull, 482, 496, 499 Small intestine, 449, 457, 467, 470, 496 Smoking Cessation, 319, 325, 327, 336, 345, 346, 413, 446, 496 Smooth muscle, 440, 477, 480, 496, 498 Soaps, 461, 496 Social Class, 34, 313, 496 Social Environment, 490, 496 Social Mobility, 496 Social Support, 55, 309, 315, 496 Social Work, 304, 306, 307, 311, 315, 317, 320, 330, 376, 496 Sodium, 322, 340, 496 Soybean Oil, 486, 496 Spatial disorientation, 456, 496 Specialist, 8, 17, 419, 496 Species, 459, 471, 474, 475, 477, 483, 490, 496, 501, 503, 504 Spectroscopic, 18, 474, 496 Spectrum, 39, 50, 476, 490, 496 Sperm, 449, 497 Spermatozoa, 494, 497 Sphincter, 471, 497 Spinal cord, 442, 447, 448, 475, 479, 484, 491, 492, 497 Spinal Nerves, 484, 497 Spinal tap, 335, 474, 497 Sporadic, 497 Stabilization, 484, 497 Staging, 493, 497 Steatosis, 466, 497 Steel, 449, 497 Steroid, 18, 453, 493, 497 Stimulant, 440, 455, 476, 497 Stimulus, 457, 460, 468, 470, 472, 483, 484, 490, 491, 497, 500 Stomach, 374, 437, 443, 455, 459, 462, 463, 467, 471, 478, 484, 496, 497 Stool, 335, 450, 471, 497 Stool test, 335, 497 Stress, 7, 15, 18, 26, 32, 33, 42, 43, 46, 49, 51, 60, 301, 306, 307, 310, 316, 319, 321, 331, 337, 340, 393, 447, 453, 462, 478, 482, 487, 497 Striatum, 25, 497 Stroke, 347, 402, 446, 497 Stupor, 478, 498 Subacute, 469, 498 Subclinical, 469, 494, 498 Subiculum, 466, 498 Substance P, 476, 494, 498 Substance-Related Disorders, 498 Substrate, 498, 502 Sulfur, 476, 498
Sumatriptan, 498 Support group, 388, 434, 435, 498 Sympathomimetic, 440, 455, 456, 459, 476, 480, 498, 502 Symptomatic, 41, 482, 498 Symptomatology, 12, 28, 40, 498 Synapse, 438, 487, 498, 501 Synapsis, 498 Synaptic, 25, 480, 498 Synaptic Transmission, 480, 498 Synergistic, 22, 488, 499 Systemic, 14, 422, 423, 445, 456, 459, 469, 499, 501 T Tachycardia, 433, 443, 499 Tachypnea, 443, 499 Taste Buds, 397, 499 Tear Gases, 471, 499 Technology Transfer, 499 Telencephalon, 443, 447, 499 Temperament, 15, 499 Temperance, 311, 321, 499 Temporal, 440, 466, 499 Temporal Lobe, 440, 499 Testosterone, 491, 499 Thalamic, 442, 459, 499 Thalamic Diseases, 442, 499 Thalamus, 455, 459, 472, 487, 499 Therapeutics, 46, 291, 424, 477, 499 Thiamine, 422, 499 Thigh, 461, 499 Third Ventricle, 459, 468, 499, 500 Thorax, 437, 474, 500 Threshold, 468, 500 Thrombocytes, 486, 500 Thrombosis, 488, 497, 500 Thyroid, 386, 500, 502 Thyroid Gland, 500 Thyroid Hormones, 500, 502 Thyrotropin, 500 Thyroxine, 484, 500 Tin, 21, 433, 484, 486, 500 Tolerance, 18, 19, 37, 45, 57, 58, 344, 464, 500 Tomography, 25, 39, 48, 288, 334, 335, 451, 474, 500 Toxic, v, 25, 33, 443, 451, 458, 464, 479, 480, 494, 500 Toxicity, 457, 500 Toxicology, 46, 404, 434, 500 Toxin, 458, 498, 500 Trace element, 461, 480, 500 Trachea, 471, 484, 500 Traction, 449, 501 Transaminase, 501 Transfection, 444, 463, 501
516 Alcoholism
Transferases, 464, 501 Transfusion, 7, 466, 501 Translating, 50, 501 Translation, 20, 439, 501 Transmitter, 437, 442, 456, 470, 475, 480, 501, 502, 503 Transplantation, 468, 474, 501 Trauma, 27, 42, 443, 465, 479, 482, 499, 501 Tremor, 483, 501 Tricuspid Atresia, 452, 501 Tricyclic, 449, 468, 501 Tryptophan, 278, 306, 335, 450, 495, 501 Tryptophan Hydroxylase, 501 Tuberculosis, 452, 501 Tumor marker, 444, 501 Tumor Necrosis Factor, 502 Tunica, 478, 502 Tyramine, 477, 502 Tyrosine, 327, 456, 502 U Unconscious, 468, 502 Unsaturated Fats, 461, 502 Uraemia, 482, 502 Urban Population, 502 Urea, 423, 433, 502 Urease, 480, 502 Ureters, 502 Urethra, 488, 502 Urinary, 24, 502 Urinary Retention, 502 Urinary tract, 502 Urinate, 502, 504 Urine, 13, 295, 327, 330, 333, 334, 335, 437, 445, 471, 492, 502 Uterus, 448, 453, 458, 475, 487, 502, 503 V Vaccine, 488, 503 Vagina, 448, 475, 503, 504 Vaginal, 503, 504 Vascular, 280, 344, 467, 469, 473, 476, 500, 503 Vasculitis, 482, 503
Vasodilation, 456, 503 Vasodilator, 456, 503 VE, 332, 345, 503 Vein, 335, 440, 470, 480, 486, 493, 503 Venous, 445, 486, 488, 501, 503 Venous blood, 445, 503 Venter, 503 Ventral, 25, 468, 497, 503 Ventricle, 440, 442, 452, 466, 490, 500, 501, 503 Ventricular, 452, 501, 503 Vertebrae, 335, 497, 503 Vesicular, 476, 503 Veterinary Medicine, 403, 503 Video Recording, 385, 388, 503 Viral, 4, 7, 373, 437, 503 Viral Hepatitis, 4, 7, 503 Virulence, 442, 500, 503 Virus, 7, 338, 373, 374, 385, 386, 404, 466, 470, 492, 503 Visceral, 443, 464, 472, 503 Viscosity, 437, 503 Vitamin D, 423, 493, 504 Vitro, 504 Vivo, 19, 504 Void, 27, 504 Volition, 470, 504 Voyeurism, 504 Vulva, 504 W War, 280, 478, 486, 504 Weight Gain, 494, 504 White blood cell, 434, 441, 472, 474, 478, 504 Windpipe, 484, 500, 504 X Xenograft, 440, 504 X-ray, 451, 475, 480, 493, 504 Y Yeasts, 484, 504 Yohimbine, 41, 504 Z Zygote, 451, 504
Index 517
518 Alcoholism
