Anxiety Attacks - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

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

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

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

Publisher, Health Care: Philip Parker, Ph.D. Editor(s): James Parker, M.D., Philip Parker, Ph.D. Publisher's note: The ideas, procedures, and suggestions contained in this book are not intended for the diagnosis or treatment of a health problem. As new medical or scientific information becomes available from academic and clinical research, recommended treatments and drug therapies may undergo changes. The authors, editors, and publisher have attempted to make the information in this book up to date and accurate in accord with accepted standards at the time of publication. The authors, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of this book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised to always check product information (package inserts) for changes and new information regarding dosage and contraindications before prescribing any drug or pharmacological product. Caution is especially urged when using new or infrequently ordered drugs, herbal remedies, vitamins and supplements, alternative therapies, complementary therapies and medicines, and integrative medical treatments. Cataloging-in-Publication Data Parker, James N., 1961Parker, Philip M., 1960Anxiety Attacks: 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: 0-597-83737-6 1. Anxiety Attacks-Popular works. I. Title.

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

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

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Acknowledgements The collective knowledge generated from academic and applied research summarized in various references has been critical in the creation of this book which is best viewed as a comprehensive compilation and collection of information prepared by various official agencies which produce publications on anxiety attacks. 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 ANXIETY ATTACKS ................................................................................... 3 Overview........................................................................................................................................ 3 Federally Funded Research on Anxiety Attacks ............................................................................ 3 E-Journals: PubMed Central ....................................................................................................... 10 The National Library of Medicine: PubMed ................................................................................ 10 CHAPTER 2. NUTRITION AND ANXIETY ATTACKS ......................................................................... 25 Overview...................................................................................................................................... 25 Finding Nutrition Studies on Anxiety Attacks ........................................................................... 25 Federal Resources on Nutrition ................................................................................................... 28 Additional Web Resources ........................................................................................................... 29 CHAPTER 3. ALTERNATIVE MEDICINE AND ANXIETY ATTACKS ................................................... 31 Overview...................................................................................................................................... 31 National Center for Complementary and Alternative Medicine.................................................. 31 Additional Web Resources ........................................................................................................... 37 General References ....................................................................................................................... 44 CHAPTER 4. DISSERTATIONS ON ANXIETY ATTACKS ..................................................................... 45 Overview...................................................................................................................................... 45 Dissertations on Anxiety Attacks ................................................................................................ 45 Keeping Current .......................................................................................................................... 51 CHAPTER 5. CLINICAL TRIALS AND ANXIETY ATTACKS ................................................................ 53 Overview...................................................................................................................................... 53 Recent Trials on Anxiety Attacks ................................................................................................ 53 Keeping Current on Clinical Trials ............................................................................................. 57 CHAPTER 6. PATENTS ON ANXIETY ATTACKS ................................................................................ 59 Overview...................................................................................................................................... 59 Patents on Anxiety Attacks ......................................................................................................... 59 Patent Applications on Anxiety Attacks ..................................................................................... 66 Keeping Current .......................................................................................................................... 68 CHAPTER 7. BOOKS ON ANXIETY ATTACKS ................................................................................... 69 Overview...................................................................................................................................... 69 Book Summaries: Online Booksellers........................................................................................... 69 The National Library of Medicine Book Index ............................................................................. 73 Chapters on Anxiety Attacks ....................................................................................................... 73 CHAPTER 8. MULTIMEDIA ON ANXIETY ATTACKS ......................................................................... 75 Overview...................................................................................................................................... 75 Bibliography: Multimedia on Anxiety Attacks............................................................................ 75 APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 79 Overview...................................................................................................................................... 79 NIH Guidelines............................................................................................................................ 79 NIH Databases............................................................................................................................. 81 Other Commercial Databases....................................................................................................... 83 The Genome Project and Anxiety Attacks ................................................................................... 83 APPENDIX B. PATIENT RESOURCES ................................................................................................. 87 Overview...................................................................................................................................... 87 Patient Guideline Sources............................................................................................................ 87 Associations and Anxiety Attacks ............................................................................................... 91 Finding Associations.................................................................................................................... 92 APPENDIX C. FINDING MEDICAL LIBRARIES .................................................................................. 95 Overview...................................................................................................................................... 95 Preparation................................................................................................................................... 95

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Finding a Local Medical Library.................................................................................................. 95 Medical Libraries in the U.S. and Canada ................................................................................... 95 ONLINE GLOSSARIES................................................................................................................ 101 Online Dictionary Directories ................................................................................................... 103 ANXIETY ATTACKS DICTIONARY ........................................................................................ 105 INDEX .............................................................................................................................................. 137

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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 anxiety attacks 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 anxiety attacks, 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 anxiety attacks, 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 anxiety attacks. 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 anxiety attacks, 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 anxiety attacks. 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 ANXIETY ATTACKS Overview In this chapter, we will show you how to locate peer-reviewed references and studies on anxiety attacks.

Federally Funded Research on Anxiety Attacks The U.S. Government supports a variety of research studies relating to anxiety attacks. 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 anxiety attacks. 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 anxiety attacks. The following is typical of the type of information found when searching the CRISP database for anxiety attacks: •

Project Title: A NOVEL THERAPY FOR DEPRESSION WITH CO-OCCURRING PANIC Principal Investigator & Institution: Frank, Ellen; Professor; Psychiatry; University of Pittsburgh at Pittsburgh 350 Thackeray Hall Pittsburgh, Pa 15260 Timing: Fiscal Year 2001; Project Start 01-APR-2001; Project End 31-MAR-2004

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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: Complication of major depression by the co-occurrence of panic attacks or panic disorder is both common and clinically significant. Patients with this condition show more severe symptom profiles, greater risk of suicidality, poorer psychosocial functioning, and a poorer response to traditional depression treatments. The primary aim of the current proposal is to develop an effective yet efficient psychotherapeutic intervention for patients with major depression complicated by panic symptoms. This new treatment, interpersonal psychotherapy for depression with panic symptoms (I PTPS), will adapt and integrate components of cognitive behavior therapy (CBT) for panic and anxiety (Barlow & Craske, 1989) into the therapeutic framework of interpersonal psychotherapy for depression (IPT, Kierman et al., 1984) to treat this clinically severe yet treatment-resistant condition. Conceptually, this integrated treatment approach will seek to promote active resolution of interpersonal problems while concurrently addressing symptoms of panic and anxiety that interfere with active interpersonal problem solving. In Phase I of the proposed study, 12 patients with major depression complicated by panic symptoms will be treated with a 16-session course of the newly developed treatment. Specific aims of Phase I include the development, elaboration, and iterative refinement of a treatment manual for IPT-PS; development of therapist training procedures; and the development of measures of treatment adherence, competence, and satisfaction. In Phase II, 24 patients with depression complicated by panic symptoms will be randomly assigned to treatment using IPT-PS, and will be compared with 12 patients randomly assigned to receive standard IPT. Specific aims of this pilot study include: finalizing the treatment manual and measures of treatment adherence, competence, and satisfaction; testing treatment satisfaction with IPT-PS; evaluating characteristics of treatment responders and non-responders; and generating treatment effect size estimates for use in planning a larger efficacy/effectiveness study of IPT-PS. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: AMYGDALA PRIMING MECHANISM UNDERLYING THE PANIC RESPONSE Principal Investigator & Institution: Thielen, Shelley K.; Psychiatry; Indiana UnivPurdue Univ at Indianapolis 620 Union Drive, Room 618 Indianapolis, in 462025167 Timing: Fiscal Year 2001; Project Start 23-FEB-2001; Project End 31-JAN-2003 Summary: Anxiety disorders are the most common of all mental health illnesses. Panic disorder (PD), a DSM recognized anxiety disorder, has a lifetime prevalence of 3.5%. The delay of treatment of this illness is further complicated by comorbidity with alcohol abuse or depression. These patients are also at increased risk of suicide. Rats bilaterally implanted with guide cannulae into the basolateral nucleus of the amygdala and injected for a maximum of 6 days with a subthreshold dose of the GABAA antagonist bicuculline methiodide exhibit an increase in heart rate (> 50 beats per minute), blood pressure, respiratory rate, and anxiety- like behavior, measured using the social interaction test on day 4 to 6 of drug treatment. The response exhibited by these rats is reminiscent of the symptoms experienced by panic disorder patients. Further, the BLA nucleus has been identified to be involved in the defense reaction as well as in conditioned fear- both responses are relevant to the development of the panic response. The objective of this research is utilize the primed rat to study the mechanisms underlying the panic response. Specifically, this research is aimed to: 1) determine the whether the panic-provoking agents yohimbine and fenfluramine are able to provoke similar responses in the BLA- primed rat; 2) determine if drugs effective in treating human panic attacks attenuate the panic response in the primed rat; and, 3) determine if the primed rat exhibits conditioned place avoidance. The methods used to explore the

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first aim will involve quantitating any change in heart rate, blood pressure, or respiratory rate during and after intravenous infusion of the panic provoking agent. Infusion of the drugs will be randomized and behavior will be measured after the monitoring period using the social interaction test. In this test the experimental rat will be paired with an untreated weight-matched (within 10 grams) rat in a 91 square cm arena for five minutes. Each rat will have been habituated to the arena and the lighting conditions prior to testing. Test duration will be 5 minutes. For the second aim, a Pavlovian conditioning test called conditioned place avoidance will be used to determine whether repeated intra- amygdala injections of BMI are aversive and therefore possibly indicative of the development of avoidance of the floor associated with the stimulus. Animals will be conditioned using tactile cues- floors constructed from perforated stainless steel or from stainless steel rods. For the third aim, BLAprimed rats will be treated twice daily for seven days with a prototypical SSRI or TCA and then challenged with an intra- amygdala injection of BMW. Treatments will be administered intraperitoneally, both acutely and chronically. The animal will be assessed for changes in response to the intra- amygdala injection of BMI. These three points will be used to study the underlying mechanism of the panic response. This mechanism of provoking the panic response is potentially beneficial in further understanding the neurobiology of the panic response on both the behavioral and cellular level. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: CBT TREATMENT OF PANIC DISORDER IN COMORBID ALCOHOLICS Principal Investigator & Institution: Kushner, Matt G.; Associate Professor; Psychiatry; University of Minnesota Twin Cities 200 Oak Street Se Minneapolis, Mn 554552070 Timing: Fiscal Year 2001; Project Start 01-SEP-2001; Project End 31-AUG-2004 Summary: (provided by applicant): Alcohol use disorders are among the most serious and costly health problems of our time. Studies have been consistent in finding an increased risk of alcohol use disorder among those suffering with the anxiety syndrome, panic disorder "comorbidity". Further, studies suggest that panic disorder can contribute to risk for a new onset of alcohol disorder and to risk for relapse following alcoholism treatment. Both theory and research suggests that relapse in comorbid individuals stems, in part, from the tendency to drink as a means of coping with persistent anxiety and panic symptoms. These findings led us to hypothesize that addressing the panic symptoms of comorbid patients would improve the outcome of comorbid individuals undergoing alcoholism treatment Cognitive behavioral therapy (CBT) for panic disorder would appear to be an ideal intervention for testing this nypothesis; however, the effect of CBT treatment on panic disorder in comorbid individuals remains unknown. Further, conventional CBT treatments do not address the inter-relationship of panic symptoms and pathological alcohol use that is potentially relevant to the persistence of both disorders in comorbid individuals. Therefore, we are proposing an experimental/developmental program (P.21) with a series of research stages aimed at testing the value of CBT for panic among comorbid patients. In stage 1 (conducted in year 1), we will use approximately 4-6 comorbid alcoholism treatment patients as subjects in four separate pilot tests, each focused on one of the four core elements of the panic treatment program, Master your Anxiety and Panic (MAP), along with supplemental material pertinent to comorbidity. Pre- and post-tests along with expert consensus will be used to evaluate whether the material and techniques are working properly, with any problematic materials being modified as needed. In the

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stage 2 study (year 2 and 3), thirty comorbid patients undergoing a community-based alcoholism treatment will receive either the 10-session MAP program as modified in stage 1 (MMAP) or a 10-session control treatment (progressive muscle relaxation training; PMRT). (Note that PMRT is structured and credible but has been shown to have minimal effects on either alcoholism treatment outcome or panic disorder symptoms.) We hypothesize that those receiving fix MMAP program will demonstrate fewer panic attacks and less intense panic attacks following the study treatments. We also hypothesize that at a 3-month follow-up assessment, subjects in the MMAP group will demonstrate a lower overall rate of several standard alcohol use outcomes as well as time to those outcomes when present. Beyond these directional hypotheses, an important goal of the stage 2 study is to provide effect size parameters indicating the clinical importance of the MMAP intervention. It is expected that the stage 1 and 2 studies proposed here will provide the foundation for an RO1 application to conduct a larger-scale stage 3 study to confirm the value of supplementing standard alcoholism treatment with the MMAP program for comorbid patients. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: COGNITIVE/BEHAVIORAL ADOLESCENCE

TREATMENT

OF

PANIC

IN

Principal Investigator & Institution: Mattis, Sara G.; Psychology; Boston University Charles River Campus 881 Commonwealth Avenue Boston, Ma 02215 Timing: Fiscal Year 2001; Project Start 01-AUG-1998; Project End 31-JUL-2003 Summary: (Adapted from Applicant's Abstract): While Panic Control Treatment (PCT) has been found to be widely effective in the treatment of panic disorder in adults, no large-scale controlled treatment studies have evaluated the use of similar cognitivebehavioral approaches in the treatment of adolescents with panic disorder. Given that late adolescence has been suggested as the initial peak age for onset of panic disorder, the purpose of this project is to establish an empirically validated intervention aimed at treating panic disorder at its earliest stages. Specifically, the aims of this project are: to evaluate the effectiveness of a developmental adaptation of PCT for the treatment of panic disorder in adolescents; to determine the long-term impact of such treatment through follow-up assessment; and to assess the impact of treatment on the quality of life of adolescents beyond the specific symptoms of panic disorder. A total of 52 adolescents (aged 12 to 17) with a diagnosis of panic disorder, assessed via the Anxiety Disorders Interview Schedule, will be randomly assigned to either an immediate PCT treatment condition or to a self-monitoring waitlist in which participants will wait approximately 12 weeks prior to receiving PCT. All participants will undergo a pretreatment and a posttreatment/waitlist assessment, as well as three follow-up assessments, conducted 3-, 6-, and 12 months following completion of treatment. Assessments will consist of diagnostic interviews with adolescents and their parent(s), a behavioral and physiological assessment of response to symptom induction tasks designed to elicit sensations similar to naturally occurring panic, and self-report measures of anxiety, anxiety sensitivity, depression, and fear. Participants will also be asked to self-monitor their panic attacks as well as daily anxiety and depression. It is hypothesized that adolescents receiving PCT will evidence greater improvement than those in the waitlist group, and will continue to show improvement at follow-up, on panic-specific variables (e.g., frequency of panic attacks), psychopathology variables (e.g., anxiety sensitivity score), behavioral and physiological variables (e.g., average change in heart rate from baseline to the symptom induction tasks), and clinical severity ratings of panic disorder.

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Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: PANIC AND SMOKING CESSATION Principal Investigator & Institution: Zvolensky, Michael J.; Assistant Professor; Psychology; University of Vermont & St Agric College 340 Waterman Building Burlington, Vt 05405 Timing: Fiscal Year 2003; Project Start 15-JUL-2003; Project End 30-APR-2005 Summary: (provided by applicant): Smokers with a history of panic attacks represent a common, albeit understudied, segment of the smoking population who may be at heightened risk for continued nicotine dependence and its associated morbidity and mortality. Though researchers have attempted to understand the impact of certain emotional disorders on the relative degree of success in smoking cessation, research has not examined the impact of panic-related problems on smoking cessation outcomes. To address this gap in the existing literature, the present R21 proposal seeks to test the extent to which a history of panic attacks interferes with successful smoking cessation. The project also will clarify theoretically relevant negative emotional processes involved with smoking cessation more generally. Findings from the proposed investigation should result in improved methods of identifying smokers at-risk for relapse, so that they may be targeted for nicotine dependence treatments that will meet their specific needs. The proposed study employs a prospective design to follow for three months a sample of 84 smokers with and without a history of panic attacks after they attempt to quit smoking on their own. Subjects will complete a diagnostic interview and a medical screening, provide saliva for cotinine analysis, and will complete a set of self-report measures assessing theoretically relevant emotional and smoking characteristics. They also will complete a well-established voluntary hyperventilation challenge procedure on a day prior to their cessation attempt on which they will come to the laboratory not smoking for a 12-hour experimental abstinence period. Beginning on quit day and also at days 3, 7, 14, 28, and 90, subjects will return to the study center for assessment of smoking outcomes, psychological/emotional status, and withdrawal symptoms. Because smokers with panic attacks may represent a recalcitrant group of smokers who are at-risk for continued nicotine dependence, these research findings should hold considerable clinical and public health significance and may result in the development of specialized treatment approaches for this population. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: RESPIRATORY & AUTONOMIC PATHOPHYSIOLOGY--PANIC DISORDER Principal Investigator & Institution: Roth, Walton T.; Psychiatry and Behavioral Sci; Stanford University Stanford, Ca 94305 Timing: Fiscal Year 2001; Project Start 15-MAY-1997; Project End 30-APR-2003 Summary: As is now more widely recognized, Panic Disorder often results in considerable emotional suffering and a reduction in quality of life. Although progress has been made in identifying its biological substrates, much about its pathophysiology and etiology remains obscure. Latest research findings in our laboratory and laboratories of other research groups point towards a central role for respiratory mechanisms. Experiments are proposed to investigate markers and mechanisms of Panic Disorder in and outside the laboratory. Respiratory, sympathetic, and parasympathetic measures in Panic Disorder patients of two types, those with and without prominent respiratory symptoms, will be examined and compared to measures

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in two groups without panic attacks, Generalized Anxiety Disorder patients and controls. In the laboratory the relative importance of several possible respiratory mechanisms will be determined by examining probe-specific and group-specific effects of several kinds of probes: increased inspired CO2, increased inspiratory resistance load, and decreased inspired O2. Each is known to produce feelings of suffocation at moderate intensities, and sometimes panic in Panic Disorder patients at high intensities. Respiratory responses to a noise stressor not directly linked to suffocation fears will serve as a comparison. To resolve contradictions in the literature about slower recovery from voluntary hyperventilation in Panic Disorder, which was a specific marker for Panic Disorder in one of our recent experiments, the effects of different durations of hyperventilation will be examined. In another experiment, central and peripheral chemoreceptor thresholds and sensitivities will be distinguished in Panic Disorder for the first time. Outside the laboratory two ways of recording pCO2 (transcutaneous vs. nasal prongs) will be compared methodologically, and it will be determined whether valid indices of respiratory sinus arrhythmia that take into account variations in breathing will distinguish patients with panic attack-related driving phobia from controls. The significance of this proposal lies in the possibility of its establishing specific and sensitive physiological markers of Panic Disorder, which could lead to better diagnosis and more appropriate treatment, facilitate research in the molecular genetics of Panic Disorder, and lead to a better understanding of dysfunctional biological control mechanisms. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: SLEEP IN PTSD/PANIC: A MULTIMODAL NATURALISTIC STUDY Principal Investigator & Institution: Sheikh, Javaid I.; Psychiatry and Behavioral Sci; Stanford University Stanford, Ca 94305 Timing: Fiscal Year 2003; Project Start 22-SEP-2003; Project End 30-JUN-2007 Summary: (provided by applicant): The past decade has seen exciting advances in our understanding of central fear systems, information regarding the extended amygdala, the broader limbic system, their targets and modulating structures, is providing new avenues for the formation of testable models of anxiety disorders that are amongst the most common psychiatric illnesses. Panic disorder (PD) and posttraumatic stress disorder (PTSD) are prime candidates for explication by reference to central fear systems. Further, because they converge and diverge in important ways, PD and PTSD challenge our understanding of how central fear systems can support related yet distinct anxiety syndromes. A strong version of this challenge is presented by the sleep disturbances of PD and PTSD. Both are associated with subjectively disturbed sleep continuity, nocturnal paroxysmal episodes (nocturnal panic attacks and trauma-related nightmares, respectively), and, our data would suggest, suppression of sleep movement. Nevertheless, these two anxiety disorders appear to exhibit divergent modifications of nocturnal respiration, elevated tidal volume variability in PD, versus accelerated respiration in association with nightmares in PTSD. The aim of this project is to lay the foundation for a more comprehensive account of the interaction of sleep and fear systems in PD and PTSD by optimally quantifying domains in which they converge and diverge: arousals from sleep, sleep movements and sleep respiration. In this study, sleep data will be obtained from 180 community-residents, unmedicated, female and male subjects with PD (30 with and 30 without a history of nocturnal panic attacks), PTSD (30 with and 30 without a history of trauma-related nightmares), comorbid PD and PTSD (30), and normal controls. The proposed methods represent an advanced approach to

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naturalistic sleep data acquisition, combining an initial phase of ambulatory polysomnography (PSG) with extended (21+days) actigraphy and auditory sonography. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: TRAIT MARKER FOR PANIC DISORDER Principal Investigator & Institution: Coryell, William H.; Professor; Psychiatry; University of Iowa Iowa City, Ia 52242 Timing: Fiscal Year 2001; Project Start 01-APR-1997; Project End 31-MAR-2003 Summary: (Applicant's Abstract): According to substantial evidence, an abnormal threshold for suffocation alarm underlies panic disorder. This project aims to determine whether this abnormality, as manifested in panic attacks following carbon dioxide inhalation, constitutes a trait marker for panic disorder. The following describes a highrisk paradigm to test both sensitivity and specificity. The project also seeks to refine the definitions and thresholds used to identify meaningful hypersensitivity to CO2 and to explore relationships between such hypersensitivity and morbid childhood separation anxiety. Finally, it will assess the relationship between CO2 hypersensitivity, morbid childhood separation anxiety sensitivity. It will thus work toward a synthesis of etiological theories. Never-ill subjects will be grouped by family history to yield 64 at high risk for panic disorder, 22 at high risk for affective disorder and 22 at high risk for neither disorder. Another two groups of never-ill subjects will be identified through ill probands attending an outpatient facility; 33 will have a proband with primary depression complicated by panic attacks and 22 will have a proband with panic disorder complicated by secondary depression. All high-risk subjects will undergo structured diagnostic interviews and a CO2 inhalation test. In addition, for each highrisk subject, the ill family member who defines the pedigree will be interviewed directly. According to predictions, panic attacks will occur only among subjects with a family history of autonomous panic disorder. Moreover, a relationship will emerge between hypersensitivity to CO2 inhalation and a history of morbid childhood separation anxiety. Raters will maintain annual contact with subjects using brief telephone interviews. If the study's predictions are sustained, subsequent efforts will be directed toward lengthening the follow-up period and toward an eventual, ten-year diagnostic reassessment. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: TREATMENT REFRACTORY PANIC DISORDER Principal Investigator & Institution: Simon, Naomi M.; Massachusetts General Hospital 55 Fruit St Boston, Ma 02114 Timing: Fiscal Year 2001; Project Start 15-FEB-2000; Project End 31-JAN-2005 Summary: This is an application for a Mentored Patient-Oriented Research Career Development Award with a focus on developing expertise in the study of treatment refractory panic disorder. The candidate proposes to build upon her expertise studying novel therapeutics for panic disorder, and obtain training to assess "next-step" psychopharmacologic and cognitive-behavioral therapy approaches for patients who remain symptomatic despite initial intervention. Panic disorder with or without agoraphobia is a common anxiety disorder, and when broader measures assessing remission including panic attacks, anticipatory anxiety, agoraphobic avoidance, and functional and quality of life measures are used, it is clear that many patients remain symptomatic and significantly impaired despite initial treatment. However, there is minimal data to guide clinicians in their approach to these patients, and the proposed

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study is designed as an initial step in addressing this issue in a systematic manner. Research Plan: The primary study is a three phase, twenty-four week clinical trial in which patients who remain symptomatic at the end of one phase enter the next. Phase I is a six-week open sertraline treatment trial to prospectively determine treatment refractoriness. Phase II is a six-week double-blind three arm randomized trial of sertraline at continued dose, sertraline at elevated dose, and sertraline plus clonazepam. Phase III is a twelve-week randomized single-blind trial of the addition of cognitivebehavioral therapy versus "medication optimization" with sertraline and clonazepam. Environment: The proposed study will be based at the Massachusetts General Hospital and will complement a program of training and supervised research under the mentorship of Dr. Mark Pollack, with consultation from experts. Career Development Plan: Training will emphasize skills necessary for designing and carrying out studies to evaluate treatment interventions for patients with panic disorder who remain symptomatic despite initial intervention, and will include work at the Harvard School of Public Health on research methodology and statistics, and supervision with consultants regarding training in outcome assessment, cognitive-behavioral therapy training, and strategies to study the transmission of findings regarding panic treatment to primary care and community settings that will lay the foundation for future independent investigation by the candidate in this area. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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

Pentagastrin-induced release of free fatty acids in healthy volunteers and patients with panic disorder: effect of pretreatment with ethinyl estradiol. by Morrow JD, McManus K, Tait GR, Bellavance F, Chrapko W, Lara N, Le Melledo JM.; 2003 Mar; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=161733

The National Library of Medicine: PubMed One of the quickest and most comprehensive ways to find academic studies in both English and other languages is to use PubMed, maintained by the National Library of Medicine.6 3 4

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

With PubMed Central, NCBI is taking the lead in preservation and maintenance of open access to electronic literature, just as NLM has done for decades with printed biomedical literature. PubMed Central aims to become a world-class library of the digital age. 5 The value of PubMed Central, in addition to its role as an archive, lies in the availability of data from diverse sources stored in a common format in a single repository. Many journals already have online publishing operations, and there is a growing tendency to publish material online only, to the exclusion of print. 6 PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM) at the National Institutes of Health (NIH). The PubMed database was developed in conjunction

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

5-HT1A responsivity in patients with panic disorder before and after treatment with aerobic exercise, clomipramine or placebo. Author(s): Broocks A, Meyer T, Opitz M, Bartmann U, Hillmer-Vogel U, George A, Pekrun G, Wedekind D, Ruther E, Bandelow B. Source: European Neuropsychopharmacology : the Journal of the European College of Neuropsychopharmacology. 2003 May; 13(3): 153-64. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12729940&dopt=Abstract

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A contemporary protocol to assist primary care physicians in the treatment of panic and generalized anxiety disorders. Author(s): Rollman BL, Herbeck Belnap B, Reynolds CF, Schulberg HC, Shear MK. Source: General Hospital Psychiatry. 2003 March-April; 25(2): 74-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12676419&dopt=Abstract

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A study of the phenomenology of panic attacks in patients from India. Author(s): Neerakal I, Srinivasan K. Source: Psychopathology. 2003 March-April; 36(2): 92-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12766319&dopt=Abstract

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Amygdalar atrophy in panic disorder patients detected by volumetric magnetic resonance imaging. Author(s): Massana G, Serra-Grabulosa JM, Salgado-Pineda P, Gasto C, Junque C, Massana J, Mercader JM, Gomez B, Tobena A, Salamero M. Source: Neuroimage. 2003 May; 19(1): 80-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12781728&dopt=Abstract

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Anger-associated panic attacks in Cambodian refugees with PTSD; a multiple baseline examination of clinical data. Author(s): Hinton D, Hsia C, Um K, Otto MW. Source: Behaviour Research and Therapy. 2003 June; 41(6): 647-54. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12732373&dopt=Abstract

with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text journal articles at Web sites of participating publishers. Publishers that participate in PubMed supply NLM with their citations electronically prior to or at the time of publication.

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Antidepressant treatment of recurrent anxiety attacks and night terrors. Author(s): Logan DG. Source: Ohio State Med J. 1979 October; 75(10): 653-5. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=492648&dopt=Abstract

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Anxiety and panic attacks in the medically ill. Author(s): Strain JJ, Liebowitz MR, Klein DF. Source: The Psychiatric Clinics of North America. 1981 August; 4(2): 333-50. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6116227&dopt=Abstract

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Anxiety attacks in a patient with a right temporal lobe meningioma. Author(s): Ghadirian AM, Gauthier S, Bertrand S. Source: The Journal of Clinical Psychiatry. 1986 May; 47(5): 270-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3700348&dopt=Abstract

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Anxiety attacks with subsequent agoraphobia. Author(s): Mendel JG, Klein DF. Source: Comprehensive Psychiatry. 1969 May; 10(3): 190-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5805667&dopt=Abstract

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Anxiety induced by cardiac perceptions in patients with panic attacks: a field study. Author(s): Pauli P, Marquardt C, Hartl L, Nutzinger DO, Holzl R, Strian F. Source: Behaviour Research and Therapy. 1991; 29(2): 137-45. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2021376&dopt=Abstract

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Anxiety sensitivity and 35% CO2 reactivity in patients with panic disorder. Author(s): Perna G, Romano P, Caldirola D, Cucchi M, Bellodi L. Source: Journal of Psychosomatic Research. 2003 June; 54(6): 573-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12781312&dopt=Abstract

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Anxiety sensitivity and its relationship to spontaneous and cued panic attacks in college students. Author(s): Asmundson GJ, Norton GR. Source: Behaviour Research and Therapy. 1993 February; 31(2): 199-201. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8442745&dopt=Abstract

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Anxiety sensitivity and nonclinical panic attacks. Author(s): Cox BJ, Endler NS, Norton GR, Swinson RP. Source: Behaviour Research and Therapy. 1991; 29(4): 367-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1888327&dopt=Abstract

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Anxiety sensitivity and panic attacks in a nonclinical population. Author(s): Donnell CD, McNally RJ. Source: Behaviour Research and Therapy. 1990; 28(1): 83-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2302152&dopt=Abstract

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Anxiety sensitivity and panic attacks in an asthmatic population. Author(s): Carr RE, Lehrer PM, Rausch LL, Hochron SM. Source: Behaviour Research and Therapy. 1994 May; 32(4): 411-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8192640&dopt=Abstract

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Anxiety sensitivity as a predictor of the development of panic symptoms, panic attacks, and panic disorder: a prospective study. Author(s): Plehn K, Peterson RA. Source: Journal of Anxiety Disorders. 2002; 16(4): 455-74. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12213039&dopt=Abstract

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Anxiety sensitivity in first-degree relatives of patients with panic disorder. Author(s): van Beek N, Griez E. Source: Behaviour Research and Therapy. 2003 August; 41(8): 949-57. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12880648&dopt=Abstract

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Anxiety sensitivity in social phobia: comparison between social phobics with and without panic attacks. Author(s): Scott EL, Heimberg RG, Jack MS. Source: Depression and Anxiety. 2000; 12(4): 189-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11195754&dopt=Abstract

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Anxiety symptoms and panic attacks preceding pancreatic cancer diagnosis. Author(s): Passik SD, Roth AJ. Source: Psycho-Oncology. 1999 May-June; 8(3): 268-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10390740&dopt=Abstract

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Anxiety with panic disorder linked to chromosome 9q in Iceland. Author(s): Thorgeirsson TE, Oskarsson H, Desnica N, Kostic JP, Stefansson JG, Kolbeinsson H, Lindal E, Gagunashvili N, Frigge ML, Kong A, Stefansson K, Gulcher JR. Source: American Journal of Human Genetics. 2003 May; 72(5): 1221-30. Epub 2003 April 04. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12679899&dopt=Abstract

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Are benzodiazepines still the medication of choice for patients with panic disorder with or without agoraphobia? Author(s): Bruce SE, Vasile RG, Goisman RM, Salzman C, Spencer M, Machan JT, Keller MB. Source: The American Journal of Psychiatry. 2003 August; 160(8): 1432-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12900305&dopt=Abstract

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Association between the CCK-A receptor gene and panic disorder. Author(s): Ise K, Akiyoshi J, Horinouchi Y, Tsutsumi T, Isogawa K, Nagayama H. Source: American Journal of Medical Genetics. 2003 April 1; 118B(1): 29-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12627462&dopt=Abstract

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Asthma and panic attacks among youth in the community. Author(s): Goodwin RD, Pine DS, Hoven CW. Source: The Journal of Asthma : Official Journal of the Association for the Care of Asthma. 2003 April; 40(2): 139-45. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12765315&dopt=Abstract

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Asthma and the risk of panic attacks among adults in the community. Author(s): Goodwin RD, Eaton WW. Source: Psychological Medicine. 2003 July; 33(5): 879-85. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12877402&dopt=Abstract

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Asthma: anxiety attacks. Author(s): Hek G, Carswell F. Source: Community Outlook. 1986 July 16; : 23-4. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3637132&dopt=Abstract

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Bayesian analysis of a previously published genome screen for panic disorder reveals new and compelling evidence for linkage to chromosome 7. Author(s): Logue MW, Vieland VJ, Goedken RJ, Crowe RR. Source: American Journal of Medical Genetics. 2003 August 15; 121B(1): 95-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12898582&dopt=Abstract

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Brain regions showing increased activation by threat-related words in panic disorder. Author(s): Maddock RJ, Buonocore MH, Kile SJ, Garrett AS. Source: Neuroreport. 2003 March 3; 14(3): 325-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12634477&dopt=Abstract

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Breathing training for treating panic disorder. Useful intervention or impediment? Author(s): Meuret AE, Wilhelm FH, Ritz T, Roth WT. Source: Behavior Modification. 2003 October; 27(5): 731-54. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14531164&dopt=Abstract

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Causal modeling of relations among learning history, anxiety sensitivity, and panic attacks. Author(s): Stewart SH, Taylor S, Jang KL, Cox BJ, Watt MC, Fedoroff IC, Borger SC. Source: Behaviour Research and Therapy. 2001 April; 39(4): 443-56. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11280342&dopt=Abstract

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Chronicity, relapse, and illness--course of panic disorder, social phobia, and generalized anxiety disorder: findings in men and women from 8 years of follow-up. Author(s): Yonkers KA, Bruce SE, Dyck IR, Keller MB. Source: Depression and Anxiety. 2003; 17(3): 173-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12768651&dopt=Abstract

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Cognitive-behavioral therapy for panic disorder: a review of treatment elements, strategies, and outcomes. Author(s): Rayburn NR, Otto MW. Source: Cns Spectr. 2003 May; 8(5): 356-62. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12766691&dopt=Abstract

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Coping strategies of panic and control subjects undergoing lactate infusion during magnetic resonance imaging confinement. Author(s): Nazemi H, Dager SR. Source: Comprehensive Psychiatry. 2003 May-June; 44(3): 190-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12764706&dopt=Abstract

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Correlates of therapeutic response in panic disorder presenting with palpitations: heart rate variability, sleep, and placebo effect. Author(s): Baker B, Khaykin Y, Devins G, Dorian P, Shapiro C, Newman D. Source: Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie. 2003 July; 48(6): 381-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12894612&dopt=Abstract

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Current trends in clinical research on panic attacks, agoraphobia, and related anxiety disorders. Author(s): Klerman GL. Source: The Journal of Clinical Psychiatry. 1986 June; 47 Suppl: 37-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2872209&dopt=Abstract

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Deporting “Ah Sin” to save the white race: moral panic, racialization, and the extension of Canadian drug laws in the 1920s. Author(s): Carstairs C. Source: Can Bull Med Hist. 1999; 16(1): 65-88. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14531400&dopt=Abstract

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Diurnal rhythms and symptom severity in panic disorder. A preliminary study of 24hour changes in panic attacks, generalised anxiety, and avoidance behaviour. Author(s): Geraci MF, Uhde TW. Source: The British Journal of Psychiatry; the Journal of Mental Science. 1992 October; 161: 512-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1393338&dopt=Abstract

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Dream anxiety attacks (nightmares). Author(s): Erman MK. Source: The Psychiatric Clinics of North America. 1987 December; 10(4): 667-74. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3332324&dopt=Abstract

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Effect of alprazolam and diazepam on anxiety and panic attacks in panic disorder: a controlled study. Author(s): Dunner DL, Ishiki D, Avery DH, Wilson LG, Hyde TS. Source: The Journal of Clinical Psychiatry. 1986 September; 47(9): 458-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2875064&dopt=Abstract

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Effects of alprazolam on cholecystokinin-tetrapeptide-induced panic and hypothalamic-pituitary-adrenal-axis activity: a placebo-controlled study. Author(s): Zwanzger P, Eser D, Aicher S, Schule C, Baghai TC, Padberg F, Ella R, Moller HJ, Rupprecht R. Source: Neuropsychopharmacology : Official Publication of the American College of Neuropsychopharmacology. 2003 May; 28(5): 979-84. Epub 2003 March 26. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12700707&dopt=Abstract

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Effects of selective serotonin reuptake inhibitors on cholesterol levels in patients with panic disorder. Author(s): Bailey DL, Le Melledo JM. Source: Journal of Clinical Psychopharmacology. 2003 June; 23(3): 317-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12826997&dopt=Abstract

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Erectile dysfunction: prevalence and relationship to depression, alcohol abuse and panic disorder. Author(s): Okulate G, Olayinka O, Dogunro AS. Source: General Hospital Psychiatry. 2003 May-June; 25(3): 209-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12748034&dopt=Abstract

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Evaluation of regional cerebral blood flow changes in panic disorder with Tc99mHMPAO SPECT. Author(s): Eren I, Tukel R, Polat A, Karaman R, Unal S. Source: Psychiatry Research. 2003 June 30; 123(2): 135-43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12850252&dopt=Abstract

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Experiential cognitive therapy in the treatment of panic disorders with agoraphobia: a controlled study. Author(s): Vincelli F, Anolli L, Bouchard S, Wiederhold BK, Zurloni V, Riva G. Source: Cyberpsychology & Behavior : the Impact of the Internet, Multimedia and Virtual Reality on Behavior and Society. 2003 June; 6(3): 321-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12855090&dopt=Abstract

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Family history of anxiety disorders in control subjects with lactate-induced panic attacks. Author(s): Balon R, Jordan M, Pohl R, Yeragani VK. Source: The American Journal of Psychiatry. 1989 October; 146(10): 1304-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2782475&dopt=Abstract

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Frontal brain hypoactivity as a biological substrate of anxiety in patients with panic disorders. Author(s): Akiyoshi J, Hieda K, Aoki Y, Nagayama H. Source: Neuropsychobiology. 2003; 47(3): 165-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12759561&dopt=Abstract

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High altitudes, anxiety, and panic attacks: is there a relationship? Author(s): Roth WT, Gomolla A, Meuret AE, Alpers GW, Handke EM, Wilhelm FH. Source: Depression and Anxiety. 2002; 16(2): 51-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12219335&dopt=Abstract

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Increased sympathetic response to standing in panic disorder. Author(s): Coupland NJ, Wilson SJ, Potokar JP, Bell C, Nutt DJ. Source: Psychiatry Research. 2003 May 1; 118(1): 69-79. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12759163&dopt=Abstract

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Intermittent anxiety attacks in a young man. Author(s): Archer TP, Mazzaferri EL. Source: Hosp Pract (Off Ed). 1999 April 15; 34(4): 136-7, 141-2. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10212638&dopt=Abstract

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Law & psychiatry: dangerous persons, moral panic, and the uses of psychiatry. Author(s): Appelbaum PS. Source: Psychiatric Services (Washington, D.C.). 2003 April; 54(4): 441-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12663831&dopt=Abstract

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Long-term maintenance and discontinuation of imipramine therapy in panic disorder with agoraphobia. Author(s): Mavissakalian MR, Perel JM. Source: Archives of General Psychiatry. 1999 September; 56(9): 821-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12884888&dopt=Abstract

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Management of anxiety and panic attacks in immediate care facilities. Author(s): Ross CA, Walker JR, Norton GR, Neufeld K. Source: General Hospital Psychiatry. 1988 March; 10(2): 129-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3360311&dopt=Abstract

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Maternal panic disorder: infant temperament, neurophysiology, and parenting behaviors. Author(s): Warren SL, Gunnar MR, Kagan J, Anders TF, Simmens SJ, Rones M, Wease S, Aron E, Dahl RE, Sroufe LA. Source: Journal of the American Academy of Child and Adolescent Psychiatry. 2003 July; 42(7): 814-25. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12819441&dopt=Abstract

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Neurobiological mechanisms of panic anxiety: biochemical and behavioral correlates of yohimbine-induced panic attacks. Author(s): Charney DS, Woods SW, Goodman WK, Heninger GR. Source: The American Journal of Psychiatry. 1987 August; 144(8): 1030-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3037926&dopt=Abstract

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Neurosteroid secretion in panic disorder. Author(s): Brambilla F, Biggio G, Pisu MG, Bellodi L, Perna G, Bogdanovich-Djukic V, Purdy RH, Serra M. Source: Psychiatry Research. 2003 May 30; 118(2): 107-16. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12798975&dopt=Abstract

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No evidence that panic attacks are associated with the white coat effect in hypertension. Author(s): Davies SJ, Jackson PR, Ramsay LE, Ghahramani P, Palmer RL, Hippisley-Cox J. Source: Journal of Clinical Hypertension (Greenwich, Conn.). 2003 March-April; 5(2): 145-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12671328&dopt=Abstract

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Panic attacks and generalized anxiety states. Author(s): Saucier RP. Source: The Nurse Practitioner. 1984 August; 9(8): 35-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6472742&dopt=Abstract

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Panic attacks, spike-wave activity, and limbic dysfunction. A case report. Author(s): Gallinat J, Stotz-Ingenlath G, Lang UE, Hegerl U. Source: Pharmacopsychiatry. 2003 May; 36(3): 123-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12806571&dopt=Abstract

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Panic control treatment for agoraphobia. Author(s): Craske MG, DeCola JP, Sachs AD, Pontillo DC. Source: Journal of Anxiety Disorders. 2003; 17(3): 321-33. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12727125&dopt=Abstract

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Panic disorder and depression: a psychodynamic exploration of comorbidity. Author(s): Rudden M, Busch FN, Milrod B, Singer M, Aronson A, Roiphe J, Shapiro T. Source: The International Journal of Psycho-Analysis. 2003 August; 84(Pt 4): 997-1015. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=13678503&dopt=Abstract

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Panic disorder treated with the antihistamine chlorpheniramine. Author(s): Hellbom E, Humble M. Source: Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology. 2003 March; 90(3): 361; Author Reply 361-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12669904&dopt=Abstract

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Panic disorder: a tightening vortex of misery. Author(s): Keltner NL, Perry BA, Williams AR. Source: Perspectives in Psychiatric Care. 2003 January-March; 39(1): 38-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12724966&dopt=Abstract

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Panic in the emergency room. Author(s): Lynch P, Galbraith KM. Source: Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie. 2003 July; 48(6): 361-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12894609&dopt=Abstract

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Panic-related outcomes in patients with a personal physician. Author(s): Katerndahl D. Source: Family Medicine. 2003 March; 35(3): 209-14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12670115&dopt=Abstract

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Pentagastrin-induced release of free fatty acids in healthy volunteers and patients with panic disorder: effect of pretreatment with ethinyl estradiol. Author(s): Morrow JD, McManus K, Tait GR, Bellavance F, Chrapko W, Lara N, Le Melledo JM. Source: Journal of Psychiatry & Neuroscience : Jpn. 2003 March; 28(2): 127-33. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12670129&dopt=Abstract

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Perceived criticism predicts severity of anxiety symptoms after behavioral treatment in patients with obsessive-compulsive disorder and panic disorder with agoraphobia. Author(s): Renshaw KD, Chambless DL, Steketee G. Source: Journal of Clinical Psychology. 2003 April; 59(4): 411-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12652634&dopt=Abstract

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Personality and symptom sensitivity predictors of alprazolam withdrawal in panic disorder. Author(s): Roy-Byrne P, Russo J, Pollack M, Stewart R, Bystrisky A, Bell J, Rosenbaum J, Corrigan MH, Stolk J, Rush AJ, Ballenger J. Source: Psychological Medicine. 2003 April; 33(3): 511-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12701671&dopt=Abstract

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Phenomenology of panic attacks reflects human evolutionary history of separation anxiety. Author(s): Matthews S, Charlton BG. Source: Ir Med J. 2000 September; 93(6): 184-5. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11105445&dopt=Abstract

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Positive association between panic disorder and polymorphism of the serotonin 2A receptor gene. Author(s): Inada Y, Yoneda H, Koh J, Sakai J, Himei A, Kinoshita Y, Akabame K, Hiraoka Y, Sakai T. Source: Psychiatry Research. 2003 May 1; 118(1): 25-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12759158&dopt=Abstract

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Predicting panic disorder among patients with chest pain: an analysis of the literature. Author(s): Huffman JC, Pollack MH. Source: Psychosomatics. 2003 May-June; 44(3): 222-36. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12724504&dopt=Abstract

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Predictors and outcomes in people told that they have panic attacks. Author(s): Katerndahl DA. Source: Depression and Anxiety. 2003; 17(2): 98-100. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12621599&dopt=Abstract

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Preinfusion anxiety and laboratory-induced panic attacks in panic disorder patients. Author(s): Yeragani VK, Rainey JM Jr, Pohl R, Balon R, Berchou R, Jolly S, Lycaki H. Source: The Journal of Clinical Psychiatry. 1988 August; 49(8): 302-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3045100&dopt=Abstract

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Preinfusion anxiety predicts lactate-induced panic attacks in normal controls. Author(s): Yeragani VK, Pohl R, Balon R, Weinberg P, Berchou R, Rainey JM. Source: Psychosomatic Medicine. 1987 July-August; 49(4): 383-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3615766&dopt=Abstract

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Psychogenic hearing loss with panic anxiety attack after the onset of acute inner ear disorder. Author(s): Mori S, Fujieda S, Yamamoto T, Takahashi N, Saito T, Saito H. Source: Orl; Journal for Oto-Rhino-Laryngology and Its Related Specialties. 2002 January-February; 64(1): 41-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11891398&dopt=Abstract

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Reduction of CO2-induced anxiety in patients with panic attacks after repeated CO2 exposure. Author(s): van den Hout MA, van der Molen GM, Griez E, Lousberg H, Nansen A. Source: The American Journal of Psychiatry. 1987 June; 144(6): 788-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3109265&dopt=Abstract

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Response of patients with panic disorder and symptoms of hypomania to cognitive behavior therapy for panic. Author(s): Bowen RC, D'Arcy C. Source: Bipolar Disorders. 2003 April; 5(2): 144-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12680905&dopt=Abstract

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Risk and panic in late modernity: implications of the converging sites of social anxiety. Author(s): Hier SP. Source: The British Journal of Sociology. 2003 March; 54(1): 3-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12745816&dopt=Abstract

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SARS: prudence, not panic. Author(s): Schabas R. Source: Cmaj : Canadian Medical Association Journal = Journal De L'association Medicale Canadienne. 2003 May 27; 168(11): 1432-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12771074&dopt=Abstract

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Seizure disorder presenting as panic attack. Author(s): Arun P, Chavan BS, Kumar N. Source: Indian Journal of Medical Sciences. 2002 October; 56(10): 486-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12712758&dopt=Abstract

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Self-reports of panic attacks and manifest anxiety in adolescents. Author(s): King NJ, Gullone E, Tonge BJ, Ollendick TH. Source: Behaviour Research and Therapy. 1993 January; 31(1): 111-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8417721&dopt=Abstract

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Serotonergic modulation of the balance system in panic disorder: an open study. Author(s): Perna G, Alpini D, Caldirola D, Raponi G, Cesarani A, Bellodi L. Source: Depression and Anxiety. 2003; 17(2): 101-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12621600&dopt=Abstract

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Sertraline versus imipramine treatment of comorbid panic disorder and major depressive disorder. Author(s): Lepola U, Arato M, Zhu Y, Austin C. Source: The Journal of Clinical Psychiatry. 2003 June; 64(6): 654-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12823079&dopt=Abstract

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Sleep panic attacks: an association with childhood anxiety and adult psychopathology. Author(s): Labbate LA, Pollack MH, Otto MW, Langenauer S, Rosenbaum JF. Source: Biological Psychiatry. 1994 July 1; 36(1): 57-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8080905&dopt=Abstract

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Smoking increases the risk of panic: findings from a prospective community study. Author(s): Isensee B, Wittchen HU, Stein MB, Hofler M, Lieb R. Source: Archives of General Psychiatry. 2003 July; 60(7): 692-700. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12860773&dopt=Abstract

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Somatic anxiety attacks and propranolol. Author(s): Easton JD, Sherman DG. Source: Archives of Neurology. 1976 October; 33(10): 689-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=973806&dopt=Abstract

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Successful treatment of severe anxiety attacks with tricyclic antidepressants: a potential mechanism of action. Author(s): Jobson K, Linnoila M, Gillam J, Sullivan JL. Source: The American Journal of Psychiatry. 1978 July; 135(7): 863-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=665806&dopt=Abstract

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Temporal lobe seizures simulating anxiety attacks. Author(s): Cavenar JO, Harris MA. Source: Us Navy Med. 1979 September; 70(9): 22-3. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=299381&dopt=Abstract

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The amygdala, panic disorder, and cardiovascular responses. Author(s): Shekhar A, Sajdyk TJ, Gehlert DR, Rainnie DG. Source: Annals of the New York Academy of Sciences. 2003 April; 985: 308-25. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12724167&dopt=Abstract

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The cardiac anxiety syndrome--a subtype of panic attacks. Author(s): Maier W, Buller R, Rieger H, Benkert O. Source: Eur Arch Psychiatry Neurol Sci. 1985; 235(3): 146-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4092712&dopt=Abstract

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The impact of smoking on panic disorder: an initial investigation of a pathoplastic relationship. Author(s): Zvolensky MJ, Schmidt NB, McCreary BT. Source: Journal of Anxiety Disorders. 2003; 17(4): 447-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12826091&dopt=Abstract

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The public health service and film noir: a look back at Elia Kazan's Panic in the Streets (1950). Author(s): Stern AM, Markel H. Source: Public Health Reports (Washington, D.C. : 1974). 2003 May-June; 118(3): 178-83. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12766210&dopt=Abstract

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The relation of anxiety sensitivity to higher and lower order personality dimensions: implications for the etiology of panic attacks. Author(s): Lilienfeld SO. Source: Journal of Abnormal Psychology. 1997 November; 106(4): 539-44. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9358684&dopt=Abstract

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The relationship between agoraphobia symptoms and panic disorder in a non-clinical sample of adolescents. Author(s): Hayward C, Killen JD, Taylor CB. Source: Psychological Medicine. 2003 May; 33(4): 733-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12785475&dopt=Abstract

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The relationship of panic attacks to autonomically labile generalized anxiety. Author(s): Koehler K, Vartzopoulos D, Ebel H. Source: Comprehensive Psychiatry. 1988 March-April; 29(2): 91-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3370973&dopt=Abstract

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The role of anxiety sensitivity in the pathogenesis of panic: prospective evaluation of spontaneous panic attacks during acute stress. Author(s): Schmidt NB, Lerew DR, Jackson RJ. Source: Journal of Abnormal Psychology. 1997 August; 106(3): 355-64. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9241937&dopt=Abstract

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Therapeutic response to benzodiazepine in panic disorder subtypes. Author(s): Valenca AM, Nardi AE, Mezzasalma MA, Nascimento I, Zin WA, Lopes FL, Versiani M. Source: Sao Paulo Medical Journal = Revista Paulista De Medicina. 2003 March 5; 121(2): 77-80. Epub 2003 July 14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12870055&dopt=Abstract

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Three patients with concomitant panic attacks and seizure disorder: possible clues to the neurology of anxiety. Author(s): Weilburg JB, Bear DM, Sachs G. Source: The American Journal of Psychiatry. 1987 August; 144(8): 1053-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3605426&dopt=Abstract

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Transcriptional activities of cholecystokinin promoter haplotypes and their relevance to panic disorder susceptibility. Author(s): Ebihara M, Ohba H, Hattori E, Yamada K, Yoshikawa T. Source: American Journal of Medical Genetics. 2003 April 1; 118B(1): 32-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12627463&dopt=Abstract

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Unemployment and emergency room visits predict poor treatment outcome in primary care panic disorder. Author(s): Roy-Byrne PP, Russo J, Cowley DS, Katon WJ. Source: The Journal of Clinical Psychiatry. 2003 April; 64(4): 383-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12716237&dopt=Abstract

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CHAPTER 2. NUTRITION AND ANXIETY ATTACKS Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and anxiety attacks.

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

A comparison of sodium bicarbonate and sodium lactate infusion in the induction of panic attacks. Author(s): Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY. Source: Gorman, J M Battista, D Goetz, R R Dillon, D J Liebowitz, M R Fyer, A J Kahn, J P Sandberg, D Klein, D F Arch-Gen-Psychiatry. 1989 February; 46(2): 145-50 0003-990X

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A risk-benefit assessment of pharmacological treatments for panic disorder. Author(s): Department of Psychiatry, University of Cincinnati College of Medicine, Ohio, USA. Source: Bennett, J A Moioffer, M Stanton, S P Dwight, M Keck, P E Drug-Saf. 1998 June; 18(6): 419-30 0114-5916

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Adrenergic status in anxiety disorders: platelet alpha 2-adrenergic receptor binding, blood pressure, pulse, and plasma catecholamines in panic and generalized anxiety disorder patients and in normal subjects. Author(s): Department of Psychiatry, University of Michigan Medical Center, Ann Arbor. Source: Cameron, O G Smith, C B Lee, M A Hollingsworth, P J Hill, E M Curtis, G C Biol-Psychiatry. 1990 July 1; 28(1): 3-20 0006-3223

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Behavioral, sympathetic and adrenocortical responses to yohimbine in panic disorder patients and normal controls. Author(s): Section on Anxiety and Affective Disorders, National Institute of Mental Health, Bethesda, MD 20892, USA. Source: Gurguis, G N Vitton, B J Uhde, T W Psychiatry-Res. 1997 June 16; 71(1): 27-39 0165-1781

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Cholecystokinin tetrapeptide induces panic-like attacks in healthy volunteers. Preliminary findings. Author(s): Department of Psychiatry, McGill University, Montreal, Quebec, Canada. Source: de Montigny, C Arch-Gen-Psychiatry. 1989 June; 46(6): 511-7 0003-990X

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Clomipramine. An overview of its pharmacological properties and a review of its therapeutic use in obsessive compulsive disorder and panic disorder. Author(s): ADIS Drug Information Services, Auckland, New Zealand. Source: McTavish, D Benfield, P Drugs. 1990 January; 39(1): 136-53 0012-6667

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Dorsal periaqueductal gray-induced aversion as a simulation of panic anxiety: elements of face and predictive validity. Author(s): Pharma Division, F. Hoffman-La Roche Ltd., Basel, Switzerland. Source: Jenck, F Moreau, J L Martin, J R Psychiatry-Res. 1995 July 28; 57(2): 181-91 01651781

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Double-blind, controlled, crossover trial of inositol versus fluvoxamine for the treatment of panic disorder. Author(s): Ministry of Health Mental Health Center, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer-Sheba, Israel. Source: Palatnik, A Frolov, K Fux, M Benjamin, J J-Clin-Psychopharmacol. 2001 June; 21(3): 335-9 0271-0749

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Effect of medroxyprogesterone pretreatment on pentagastrin-induced panic symptoms in females with panic disorder. Author(s): Department of Psychiatry, University of Alberta Hospital, 8440-112 St., Edmonton, T6G 2B7, Alberta, Canada. [email protected] Source: Le Melledo, J Jhangri, G S Lott, P Tait, G R McManus, K Geddes, M Chrapko, W Lara, N Psychiatry-Res. 2001 April 15; 101(3): 237-42 0165-1781

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Efficacy of divalproex sodium in patients with panic disorder and mood instability who have not responded to conventional therapy. Author(s): Department of Psychiatry, University of Saskatchewan, Saskatoon. Source: Baetz, M Bowen, R C Can-J-Psychiatry. 1998 February; 43(1): 73-7 0706-7437

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Elevated serum lactate associated with panic attacks induced by hyperventilation. Author(s): Department of Psychiatry, University of California, Davis School of Medicine, Sacramento. Source: Maddock, R J Carter, C S Gietzen, D W Psychiatry-Res. 1991 September; 38(3): 301-11 0165-1781

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Endocrine, cardiovascular, and behavioral effects of intravenous protirelin in patients with panic disorder. Author(s): Section on Anxiety and Affective Disorders, National Institute of Mental Health, Bethesda, Md 20892. Source: Stein, M B Uhde, T W Arch-Gen-Psychiatry. 1991 February; 48(2): 148-56 0003990X

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Evidence for hypothalamo-growth hormone dysfunction in panic disorder: profile of growth hormone (GH) responses to clonidine, yohimbine, caffeine, glucose, GRF and TRH in panic disorder patients versus healthy volunteers. Author(s): Section on Anxiety and Affective Disorders, National Institute of Mental Health, Bethesda, Maryland 20892. Source: Uhde, T W Tancer, M E Rubinow, D R Roscow, D B Boulenger, J P Vittone, B Gurguis, G Geraci, M Black, B Post, R M Neuropsychopharmacology. 1992 February; 6(2): 101-18 0893-133X

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Exogenous factors in panic disorder: clinical and research implications. Author(s): Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle 98195. Source: Roy Byrne, P P Uhde, T W J-Clin-Psychiatry. 1988 February; 49(2): 56-61 01606689

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Induced panic attacks shift gamma-aminobutyric acid type A receptor modulatory neuroactive steroid composition in patients with panic disorder: preliminary results. Author(s): Max Planck Institute of Psychiatry, Munich, Germany. [email protected] Source: Strohle, A Romeo, E di Michele, F Pasini, A Hermann, B Gajewsky, G Holsboer, F Rupprecht, R Arch-Gen-Psychiatry. 2003 February; 60(2): 161-8 0003-990X

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Neurobiological mechanisms of panic anxiety: biochemical and behavioral correlates of yohimbine-induced panic attacks. Source: Charney, D S Woods, S W Goodman, W K Heninger, G R Am-J-Psychiatry. 1987 August; 144(8): 1030-6 0002-953X

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Panic attacks. A neurochemical overview of models and mechanisms. Author(s): Colman Psychopharmacology Unit, School of Medical Sciences, University Walk, Bristol. Source: Nutt, D Lawson, C Br-J-Psychiatry. 1992 February; 160165-78 0007-1250

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Panic disorder: treatment with valproate. Author(s): Department of Psychiatry, University of Iowa, Iowa City 52242. Source: Woodman, C L Noyes, R J-Clin-Psychiatry. 1994 April; 55(4): 134-6 0160-6689

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Sleep panic attacks: new clinical findings and theoretical implications. Author(s): Section on Anxiety and Affective Disorders, NIMH, Bethesda, MD 20892. Source: Mellman, T A Uhde, T W Am-J-Psychiatry. 1989 September; 146(9): 1204-7 0002953X

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The effects of physostigmine infusion on patients with panic disorder. Author(s): Department of Psychiatry, University of California, San Diego, School of Medicine and Psychiatry Service, La Jolla 92093. Source: Rapaport, M H Risch, S C Gillin, J C Golshan, S Janowsky, D Biol-Psychiatry. 1991 April 1; 29(7): 658-64 0006-3223

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Valproate treatment of panic disorder and lactate-induced panic attacks. Author(s): Department of Psychiatry, University of Cincinnati College of Medicine, Ohio 45267-0559. Source: Keck, P E Taylor, V E Tugrul, K C McElroy, S L Bennett, J A Biol-Psychiatry. 1993 April 1; 33(7): 542-6 0006-3223

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Valproic acid and panic disorder. Author(s): Royal Victoria Hospital, Montreal, Quebec. Source: Primeau, F Fontaine, R Beauclair, L Can-J-Psychiatry. 1990 April; 35(3): 248-50 0706-7437

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

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

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

Vitamins Niacin Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,892,00.html Vitamin B Complex Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,962,00.html

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Minerals Calcium/magnesium Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,937,00.html Chondroitin Alternative names: chondroitin sulfate, sodium chondroitin sulfate Source: Integrative Medicine Communications; www.drkoop.com Chondroitin Source: Prima Communications, Inc.www.personalhealthzone.com Magnesium Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com

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Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,890,00.html Quercetin Source: Integrative Medicine Communications; www.drkoop.com •

Food and Diet Chondroitin Sulfate Source: Healthnotes, Inc.; www.healthnotes.com Coffee Source: Healthnotes, Inc.; www.healthnotes.com Guava Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/foods_view/0,1523,139,00.html Milk Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/foods_view/0,1523,95,00.html Omega-3 Fatty Acids Source: Integrative Medicine Communications; www.drkoop.com

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CHAPTER 3. ALTERNATIVE MEDICINE AND ANXIETY ATTACKS Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to anxiety attacks. 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 anxiety attacks 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 “anxiety attacks” (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 anxiety attacks: •

A case of panic disorder treated with breathing retraining. Author(s): Rapee RM. Source: Journal of Behavior Therapy and Experimental Psychiatry. 1985 March; 16(1): 63-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3998176&dopt=Abstract

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A review of the usefulness of the standard EEG in psychiatry. Author(s): Hughes JR. Source: Clin Electroencephalogr. 1996 January; 27(1): 35-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8719500&dopt=Abstract

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A role-play Rorschach procedure. Author(s): Bricklin B.

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Source: Journal of Personality Assessment. 1975 October; 39(5): 453-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1185500&dopt=Abstract •

A scoring system for capnogram biofeedback: preliminary findings. Author(s): Landis B, Romano PM. Source: Applied Psychophysiology and Biofeedback. 1998 June; 23(2): 75-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9789622&dopt=Abstract

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Anxiety and depression in relation to respiratory symptoms and asthma. Author(s): Janson C, Bjornsson E, Hetta J, Boman G. Source: American Journal of Respiratory and Critical Care Medicine. 1994 April; 149(4 Pt 1): 930-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8143058&dopt=Abstract

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Anxiety disorders: diagnosis and treatment. Author(s): Jack RA, Mathew RJ. Source: Compr Ther. 1985 July; 11(7): 31-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2863030&dopt=Abstract

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Anxiety management for persistent generalised anxiety. Author(s): Butler G, Cullington A, Hibbert G, Klimes I, Gelder M. Source: The British Journal of Psychiatry; the Journal of Mental Science. 1987 October; 151: 535-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3328992&dopt=Abstract

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Anxiety management training for anxiety states: positive compared with negative self-statements. Author(s): Ramm E, Marks IM, Yuksel S, Stern RS. Source: The British Journal of Psychiatry; the Journal of Mental Science. 1982 April; 140: 367-73. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7093613&dopt=Abstract

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Application of the relaxation technique in general hospital psychiatry. Author(s): Hosaka T, Yamamoto K, Ikeda K, Taniyama F, Yanagisawa J. Source: Psychiatry and Clinical Neurosciences. 1995 December; 49(5-6): 259-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8726110&dopt=Abstract

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Applied relaxation training for generalised anxiety and panic attacks: the efficacy of a learnt coping strategy on subjective reports. Author(s): Tarrier N, Main CJ.

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Source: The British Journal of Psychiatry; the Journal of Mental Science. 1986 September; 149: 330-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3535980&dopt=Abstract •

Applied relaxation vs cognitive behavior therapy in the treatment of panic disorder. Author(s): Ost LG, Westling BE. Source: Behaviour Research and Therapy. 1995 February; 33(2): 145-58. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7887873&dopt=Abstract

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Autonomic instability during relaxation in panic disorder. Author(s): Roth WT, Wilhelm FH, Trabert W. Source: Psychiatry Research. 1998 August 17; 80(2): 155-64. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9754695&dopt=Abstract

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Carbon dioxide inhalation treatments of neurotic anxiety. An overview. Author(s): Wolpe J. Source: The Journal of Nervous and Mental Disease. 1987 March; 175(3): 129-33. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3102688&dopt=Abstract

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Cognitive-behavioral therapy in patients with ankylosing spondylitis in a German self-help organization. Author(s): Basler HD, Rehfisch HP. Source: Journal of Psychosomatic Research. 1991; 35(2-3): 345-54. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1710669&dopt=Abstract

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Diagnosis, management and prognosis of a group of 128 patients with non-epileptic attack disorder. Part I. Author(s): Betts T, Boden S. Source: Seizure : the Journal of the British Epilepsy Association. 1992 March; 1(1): 19-26. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1344315&dopt=Abstract

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Dizziness and panic in China: associated sensations of zang fu organ disequilibrium. Author(s): Park L, Hinton D. Source: Culture, Medicine and Psychiatry. 2002 June; 26(2): 225-57. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12211326&dopt=Abstract

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Drug preferences of alcoholic polydrug abusers with and without panic. Author(s): Jensen CF, Cowley DS, Walker RD. Source: The Journal of Clinical Psychiatry. 1990 May; 51(5): 189-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1970811&dopt=Abstract

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Effectiveness of self-management programmes and relaxation training in the treatment of bronchial asthma: relationships with trait anxiety and emotional attack triggers. Author(s): Vazquez MI, Buceta JM. Source: Journal of Psychosomatic Research. 1993 January; 37(1): 71-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8421262&dopt=Abstract

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Electrodermal activity in anxiety disorders. Author(s): Birket-Smith M, Hasle N, Jensen HH. Source: Acta Psychiatrica Scandinavica. 1993 November; 88(5): 350-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8296577&dopt=Abstract

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Four cases of panic disorder successfully treated with Kampo (Japanese herbal) medicines: Kami-shoyo-san and Hange-koboku-to. Author(s): Mantani N, Hisanaga A, Kogure T, Kita T, Shimada Y, Terasawa K. Source: Psychiatry and Clinical Neurosciences. 2002 December; 56(6): 617-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12485303&dopt=Abstract

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Hyperventilation and panic attacks. Author(s): Kenardy J, Oei TP, Evans L. Source: The Australian and New Zealand Journal of Psychiatry. 1990 June; 24(2): 261-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2118758&dopt=Abstract

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Hyperventilation is not diagnostically specific to panic patients. Author(s): van den Hout MA, Hoekstra R, Arntz A, Christiaanse M, Ranschaert W, Schouten E. Source: Psychosomatic Medicine. 1992 March-April; 54(2): 182-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1565755&dopt=Abstract

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Hyperventilation syndrome: a chimera? Author(s): Bass C. Source: Journal of Psychosomatic Research. 1997 May; 42(5): 421-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9194014&dopt=Abstract

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Long-term effects of biofeedback-induced facial relaxation on measures of asthma severity in children. Author(s): Kotses H, Harver A, Segreto J, Glaus KD, Creer TL, Young GA. Source: Biofeedback Self Regul. 1991 March; 16(1): 1-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2012823&dopt=Abstract

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Low dose desipramine treatment of cocaine-related panic attacks. Author(s): Bystritsky A, Ackerman DL, Pasnau RO.

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Source: The Journal of Nervous and Mental Disease. 1991 December; 179(12): 755-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1744635&dopt=Abstract •

Medico-psychological interventions in male asthmatic children: an evaluation of physiological change. Author(s): Hock RA, Rodgers CH, Reddi C, Kennard DW. Source: Psychosomatic Medicine. 1978 May; 40(3): 210-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=351664&dopt=Abstract

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Mode of action of the triazolobenzodiazepines in the treatment of panic attacks: a hypothesis. Author(s): Van Gool D, Igodt P, De Cuyper H. Source: European Neuropsychopharmacology : the Journal of the European College of Neuropsychopharmacology. 1992 December; 2(4): 433-41. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1362662&dopt=Abstract

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Panic attacks during relaxation and relaxation-induced anxiety: a hyperventilation interpretation. Author(s): Ley R. Source: Journal of Behavior Therapy and Experimental Psychiatry. 1988 December; 19(4): 253-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3148637&dopt=Abstract

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Peptides and anxiety: a dose-response evaluation of pentagastrin in healthy volunteers. Author(s): McCann UD, Slate SO, Geraci M, Uhde TW. Source: Anxiety. 1994-95; 1(6): 258-67. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9160584&dopt=Abstract

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Pharmacokinetics and pharmacodynamics of cannabinoids. Author(s): Grotenhermen F. Source: Clinical Pharmacokinetics. 2003; 42(4): 327-60. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12648025&dopt=Abstract

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Prediction of migraine using psychophysiological and personality measures. Author(s): Leijdekkers ML, Passchier J. Source: Headache. 1990 June; 30(7): 445-53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2401627&dopt=Abstract

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Premenstrual dysphoric disorders: a diversified cluster of vulnerability traits to depression. Author(s): Halbreich U.

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Source: Acta Psychiatrica Scandinavica. 1997 March; 95(3): 169-76. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9111848&dopt=Abstract •

Psychoimmunoendocrine aspects of panic disorder. Author(s): Brambilla F, Bellodi L, Perna G, Battaglia M, Sciuto G, Diaferia G, Petraglia F, Panerai A, Sacerdote P. Source: Neuropsychobiology. 1992; 26(1-2): 12-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1335559&dopt=Abstract

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Psychophysiological response patterns in panic disorder. Author(s): Hoehn-Saric R, McLeod DR, Zimmerli WD. Source: Acta Psychiatrica Scandinavica. 1991 January; 83(1): 4-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2011954&dopt=Abstract

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Psychotherapeutic intervention in angina: I. A critical review. Author(s): Razin AM. Source: General Hospital Psychiatry. 1984 October; 6(4): 250-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6489743&dopt=Abstract

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Rational self-directed hypnotherapy: a treatment for panic attacks. Author(s): Der DF, Lewington P. Source: Am J Clin Hypn. 1990 January; 32(3): 160-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2296917&dopt=Abstract

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Relaxation-induced EEG alterations in panic disorder patients. Author(s): Knott V, Bakish D, Lusk S, Barkely J. Source: Journal of Anxiety Disorders. 1997 July-August; 11(4): 365-76. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9276782&dopt=Abstract

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Respiratory control: its contribution to the treatment of panic attacks. A controlled study. Author(s): Hibbert GA, Chan M. Source: The British Journal of Psychiatry; the Journal of Mental Science. 1989 February; 154: 232-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2673476&dopt=Abstract

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Skin conductance feedback and panic attacks. Author(s): Gilbert C. Source: Biofeedback Self Regul. 1986 September; 11(3): 251-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3607092&dopt=Abstract

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Strychnine effects on ultrasound-elicited behaviours in Lister hooded rats. Author(s): Commissaris RL, Beckett SR, Marsden CA. Source: Psychopharmacology. 1998 March; 136(2): 162-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9551773&dopt=Abstract

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The efficacy of breathing retraining and the centrality of hyperventilation in panic disorder: a reinterpretation of experimental findings. Author(s): Ley R. Source: Behaviour Research and Therapy. 1991; 29(3): 301-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1883310&dopt=Abstract

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

General Overview Abnormal Pap Smear Source: Healthnotes, Inc.; www.healthnotes.com Alcohol Withdrawal Source: Healthnotes, Inc.; www.healthnotes.com

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Angina Source: Integrative Medicine Communications; www.drkoop.com Anorexia Nervosa Source: Integrative Medicine Communications; www.drkoop.com Anxiety Source: Healthnotes, Inc.; www.healthnotes.com Anxiety and Panic Attacks Source: Prima Communications, Inc.www.personalhealthzone.com Ascariasis Source: Integrative Medicine Communications; www.drkoop.com Cervical Dysplasia Source: Integrative Medicine Communications; www.drkoop.com Colds and Flus Source: Prima Communications, Inc.www.personalhealthzone.com Common Cold/sore Throat Source: Healthnotes, Inc.; www.healthnotes.com Diabetes Source: Healthnotes, Inc.; www.healthnotes.com Diabetes Mellitus Source: Integrative Medicine Communications; www.drkoop.com Fainting Source: Integrative Medicine Communications; www.drkoop.com Gallstones Source: Healthnotes, Inc.; www.healthnotes.com Gestational Hypertension Source: Healthnotes, Inc.; www.healthnotes.com Guinea Worm Disease Source: Integrative Medicine Communications; www.drkoop.com Hepatitis Source: Healthnotes, Inc.; www.healthnotes.com High Blood Pressure Source: Integrative Medicine Communications; www.drkoop.com Hookworm Source: Integrative Medicine Communications; www.drkoop.com

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Hypertension Source: Integrative Medicine Communications; www.drkoop.com Immune Function Source: Healthnotes, Inc.; www.healthnotes.com Insulin Resistance Syndrome Source: Healthnotes, Inc.; www.healthnotes.com Lactose Intolerance Source: Healthnotes, Inc.; www.healthnotes.com Loiasis Source: Integrative Medicine Communications; www.drkoop.com Lupus Source: Integrative Medicine Communications; www.drkoop.com Lymphatic Filariasis Source: Integrative Medicine Communications; www.drkoop.com Osteoarthritis Source: Healthnotes, Inc.; www.healthnotes.com Parkinson's Disease Source: Integrative Medicine Communications; www.drkoop.com Pinworm Source: Integrative Medicine Communications; www.drkoop.com Post Traumatic Stress Disorder Source: Integrative Medicine Communications; www.drkoop.com Prostate Cancer Source: Integrative Medicine Communications; www.drkoop.com PTSD Source: Integrative Medicine Communications; www.drkoop.com Rheumatoid Arthritis Source: Healthnotes, Inc.; www.healthnotes.com River Blindness Source: Integrative Medicine Communications; www.drkoop.com Roundworms Source: Integrative Medicine Communications; www.drkoop.com Schizophrenia Source: Healthnotes, Inc.; www.healthnotes.com

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Sexual Dysfunction Source: Integrative Medicine Communications; www.drkoop.com Stress Source: Integrative Medicine Communications; www.drkoop.com Syncope Source: Integrative Medicine Communications; www.drkoop.com Systemic Lupus Erythematosus Source: Integrative Medicine Communications; www.drkoop.com Threadworm Source: Integrative Medicine Communications; www.drkoop.com Trichinosis Source: Integrative Medicine Communications; www.drkoop.com Vertigo Source: Healthnotes, Inc.; www.healthnotes.com Visceral Larva Migrans Source: Integrative Medicine Communications; www.drkoop.com Whipworm Source: Integrative Medicine Communications; www.drkoop.com •

Alternative Therapy Acupressure Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,662,00.html Alexander Technique Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,665,00.html Aromatherapy Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,664,00.html Autoregulation Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/a.html Bach Flower Remedies Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com

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Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,673,00.html Biofeedback Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,675,00.html Holistic Referrals Source: Healthnotes, Inc.; www.healthnotes.com Hypnotherapy Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,706,00.html Light Therapy Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,713,00.html Meditation Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,717,00.html Qigong Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,729,00.html Reiki Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,731,00.html Tai Chi Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,737,00.html Therapeutic Touch Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,739,00.html Yoga Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,746,00.html

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Chinese Medicine Jiulixiang Alternative names: Murraya Jasminorage; Folium et Cacumen Murrayae Source: Chinese Materia Medica Tubeimu Alternative names: Paniculate Bolbostemma; Rhizoma Bolbostemmae Source: Chinese Materia Medica Xuchangqing Alternative names: Paniculate Swallowwort Root; Radix Cynanchi Paniculati Source: Chinese Materia Medica

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Herbs and Supplements Achillea Alternative names: Yarrow; Achillea millefolium L. Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Alprazolam Source: Healthnotes, Inc.; www.healthnotes.com Andrographis Alternative names: Andrographis paniculata Source: Healthnotes, Inc.; www.healthnotes.com Andrographis Source: Prima Communications, Inc.www.personalhealthzone.com Antidepressants Source: Healthnotes, Inc.; www.healthnotes.com Astragalus Mem Alternative names: Huang-Qi; Astragalus membranaceus Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Benzodiazepines Source: Healthnotes, Inc.; www.healthnotes.com Camellia Sinensis Source: Integrative Medicine Communications; www.drkoop.com Gaba (gamma-amino Butyric Acid) Source: Healthnotes, Inc.; www.healthnotes.com Green Tea Alternative names: Camellia sinensis Source: Integrative Medicine Communications; www.drkoop.com Inositol Source: Healthnotes, Inc.; www.healthnotes.com

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Inositol Source: Prima Communications, Inc.www.personalhealthzone.com Kava Source: Prima Communications, Inc.www.personalhealthzone.com Kava Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,798,00.html Lactase Source: Healthnotes, Inc.; www.healthnotes.com Lycopene Source: Healthnotes, Inc.; www.healthnotes.com Matricaria Alternative names: Chamomile; Matricaria chamomilla Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Piper Alternative names: Kava; Piper methysticum Forst.f Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Same (s-adenosylmethionine) Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,818,00.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 Stevia Alternative names: Sweetleaf; Stevia rebaudiana Bertoni Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Suma Alternative names: Pfaffia paniculata , Hebanthe paniculata Source: Healthnotes, Inc.; www.healthnotes.com Suma Source: Prima Communications, Inc.www.personalhealthzone.com Syzygium Clove Alternative names: Clove, Jamun; Syzygium sp. Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org

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Tribulus Puncture Alternative names: Puncture Vine, Goathead; Tribulus terrestris L. Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Valerian Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10064,00.html Yohimbe Alternative names: Pausinystalia yohimbe Source: Healthnotes, Inc.; www.healthnotes.com

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

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CHAPTER 4. DISSERTATIONS ON ANXIETY ATTACKS Overview In this chapter, we will give you a bibliography on recent dissertations relating to anxiety attacks. 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 “anxiety attacks” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on anxiety attacks, we have not necessarily excluded non-medical dissertations in this bibliography.

Dissertations on Anxiety Attacks 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 anxiety attacks. 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 Comparison of Medical Hypnoanalysis and Cognitive Hypnotherapy for Treatment of Agoraphobia, Panic Disorder and Severe Anxiety (hypnotherapy) by Scott, John Atwood, Jr., Edd from Memphis State University, 1991, 152 pages http://wwwlib.umi.com/dissertations/fullcit/9127656

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A Study of Locus of Control and the Effectiveness of Cognitive-behavioral Group Therapy in the Treatment of Persons with Panic Disorder by Mitchell, Christopher Gerard, Dsw from The Catholic University of America, 1997, 135 pages http://wwwlib.umi.com/dissertations/fullcit/9728797

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American Church Attitudes toward Social Catastrophe: the Panic of 1873 As a Case Study by Cashdollar, Charles David, Phd from University of Pennsylvania, 1969, 257 pages http://wwwlib.umi.com/dissertations/fullcit/6921330

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Arrabal: the Permutations of 'panic' Ceremony. by Broad, Yolanda Stern, Phd from Brown University, 1978, 196 pages http://wwwlib.umi.com/dissertations/fullcit/7906522

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Banking and Financial Panics by Donaldson, Robert Glendon, Phd from Brown University, 1989, 103 pages http://wwwlib.umi.com/dissertations/fullcit/9002221

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Banking and Politics in the States: the Democratic Party after the Panic of 1837 by Sharp, James Roger, Phd from University of California, Berkeley, 1966, 481 pages http://wwwlib.umi.com/dissertations/fullcit/6708650

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Banking Panics and Bank Suspension of Convertibility by Gorton, Gary Bernard, Phd from The University of Rochester, 1983, 196 pages http://wwwlib.umi.com/dissertations/fullcit/8403151

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Baring Brothers and the Panic of 1837 (great Britain) by Austin, Peter Evans; Phd from The University of Texas at Austin, 1999, 375 pages http://wwwlib.umi.com/dissertations/fullcit/9959454

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Between Panic and Rapture: Travel and the Politics of Mobility in the United States, 1831-1911 by Simpson, David Mark, Phd from Duke University, 1996, 303 pages http://wwwlib.umi.com/dissertations/fullcit/9707769

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Bubble or Depositors' Discipline? a Study of the Argentine Banking Panic (december 1994-may 1995) by Schumacher, Liliana Beatriz, Phd from The University of Chicago, 1996, 161 pages http://wwwlib.umi.com/dissertations/fullcit/9636843

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Child Sexual Abuse, Moral Panic, and the Mass Media: a Case Study in the Social Construction of Deviance by Gorelick, Steven M., Phd from City University of New York, 1995, 288 pages http://wwwlib.umi.com/dissertations/fullcit/9530873

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Closing Pandora's Box. Panic and Agoraphobia: Treatments and Mediators by Reilly, Kevin Patrick; Phd from Lehigh University, 2003, 196 pages http://wwwlib.umi.com/dissertations/fullcit/3073960

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Cognitive Treatment of Panic Disorder: a Test of Outcome, Process, and Theory by Sokol, Leslie Ellen, Phd from University of Pennsylvania, 1989, 87 pages http://wwwlib.umi.com/dissertations/fullcit/8922611

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Cognitive-behavioral Treatment for Panic Disorder with Agoraphobia an Evaluation of Cognitive and Exposure Components of Treatment by Rowan, Vivienne C; Phd from The University of Manitoba (canada), 1989 http://wwwlib.umi.com/dissertations/fullcit/NL54836

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Contested Suburbs: Space and Its Representation in Moral Panics by Simmons, Stacey L.; Phd from University of New Orleans, 2002, 251 pages http://wwwlib.umi.com/dissertations/fullcit/3061357

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Differences in Cognitive Responses to Fear among Individuals Diagnosed As Panic Disorder, Generalized Anxiety Disorder, Agoraphobia with Panic Attacks, and Simple Phobia by Dattilio, Frank Mark, Phd from Temple University, 1987, 232 pages http://wwwlib.umi.com/dissertations/fullcit/8711320

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'dread and Curious Alteration': Republican Panic and Personal Intimation in Early American Fiction (charles Brockden Brown) by Shapiro, Stephen Aaron, Phd from Yale University, 1995, 341 pages http://wwwlib.umi.com/dissertations/fullcit/9537764

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Effect of Behavioral, Cognitive/behavioral, and Drug Treatments on the Catastrophic Fears of Agoraphobic Patients (panic-related Fears, Fear) by Brouillard, Mary Ellison, Phd from Stanford University, 1989, 167 pages http://wwwlib.umi.com/dissertations/fullcit/9011464

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Existential Phenomenological Case Studies Investigating the Experience of Panic by Ferlic, David G., Edd from University of Southern California, 1988 http://wwwlib.umi.com/dissertations/fullcit/f3857236

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Explaining Hard Times: Political Economy and the Panic of 1819 in Philadelphia (pennsylvania) by Lehman, J. David, Phd from University of California, Los Angeles, 1992, 442 pages http://wwwlib.umi.com/dissertations/fullcit/9310858

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Financial Instability and Monetary Institutions: Essays in Monetary Theory (bank Panics, Seignorage, Fiscal Crises, Monetarist Arithmetic, Public Debt) by Parcu, Pier Luigi, Phd from University of California, Los Angeles, 1985, 220 pages http://wwwlib.umi.com/dissertations/fullcit/8601909

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'for God's Sake Do Something': White-slavery Narratives and Moral Panic in Turn-ofthe-century American Cities (illinois) by Lagler, Amy R.; Phd from Michigan State University, 2000, 393 pages http://wwwlib.umi.com/dissertations/fullcit/3000572

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Frenzied Fictions: the Writing of Panic in the American Marketplace, 1873--1913 by Zimmerman, David Andrew; Phd from University of California, Berkeley, 2000, 333 pages http://wwwlib.umi.com/dissertations/fullcit/3002341

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Interpersonal Transactions and the Experience of Panic of Women: a Study of Membership (anxiety) by Shuler, Audrey Flood, Phd from Virginia Commonwealth University, 1994, 210 pages http://wwwlib.umi.com/dissertations/fullcit/9431423

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Issues and Factions: New York State Politics from the Panic of 1837 to the Election of 1848 by Mcgee, Patricia E., Phd from St. John's University (new York), 1970, 272 pages http://wwwlib.umi.com/dissertations/fullcit/7022256

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'it's the End of the World As We Know It (and I Feel Fine)': Keith Haring, Postmodern Hieroglyphics, Panic Graffiti, the Fun Apocalypse, and the Languages of Hyperreality (haring Keith) by Strasser, Brendan David, Phd from Bowling Green State University, 1992, 811 pages http://wwwlib.umi.com/dissertations/fullcit/9319755

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Legacy of Change: the Panic of 1819 and Debtor Relief Legislation in the Western States by Jones, Thomas Bard, Edd from Cornell University, 1968, 222 pages http://wwwlib.umi.com/dissertations/fullcit/6905023

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Lesbian Panic: the Homoerotics of Narrative in Modern British Women's Fiction by Smith, Patricia Juliana, Phd from University of California, Los Angeles, 1995, 331 pages http://wwwlib.umi.com/dissertations/fullcit/9601274

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Mid-victorian Toronto: Panic, Policy and Public Response, 1857-1873 by Jarvis, Eric James, Phd from The University of Western Ontario (canada), 1979 http://wwwlib.umi.com/dissertations/fullcit/f1748710

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Moral Panics: towards a New Model (michel Foucault) by Chimonas, Susan Christine; Phd from University of Michigan, 2000, 282 pages http://wwwlib.umi.com/dissertations/fullcit/9990865

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National Security Panics: Overestimating Threats to National Security by Cramer, Jane Kellett; Phd from Massachusetts Institute of Technology, 2002 http://wwwlib.umi.com/dissertations/fullcit/f902897

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Panic and Self States: an Ethnomethodological Approach by Mahoney, Donna Marie; Phd from Institute for Clinical Social Work (chicago), 2000, 100 pages http://wwwlib.umi.com/dissertations/fullcit/9979951

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Panic Diaries: Cybernetics, Psychiatry, and the Technoscientific Control of Social Disease by Orr, Jacqueline Tracy, Phd from University of California, Berkeley, 1999, 392 pages http://wwwlib.umi.com/dissertations/fullcit/9931350

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Panic Disorder and Chronic Hyperventilation by Lynch, Patrick Bruce; Phd from University of Calgary (canada), 1989 http://wwwlib.umi.com/dissertations/fullcit/NL54277

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Panic Disorder with Dissociation: a Comparative Study by Schimmel, Tara Faith; Psyd from Carlos Albizu University, 2002, 73 pages http://wwwlib.umi.com/dissertations/fullcit/3070511

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Panic Disorder: a Review of Genetic Studies, Effects of Pregnancy on Clinical Course, and Treatment Options by Harrelson, Laura Leanne; Ms from Sarah Lawrence College, 2002, 34 pages http://wwwlib.umi.com/dissertations/fullcit/1408526

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Panic Fiction: Women and Antebellum Economics by Templin, Mary; Phd from The University of Wisconsin - Madison, 2001, 284 pages http://wwwlib.umi.com/dissertations/fullcit/3012442

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Perceptions of College Students Diagnosed with Panic Disorder with Agoraphobia: Academic, Psychosocial, and Environmental Views of Their College Experience by Angle, Susan Pugh; Phd from Virginia Polytechnic Institute and State University, 1999, 251 pages http://wwwlib.umi.com/dissertations/fullcit/3000292

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Perceptions of College Students Diagnosed with Panic Disorder with Agoraphobia: Academic, Psychosocial, and Environmental Views of Their College Experience by Angle, Susan Pugh; Phd from Virginia Polytechnic Institute and State University, 1999, 251 pages http://wwwlib.umi.com/dissertations/fullcit/3015755

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Personality Traits and Maternal Care in the Etiology of Panic Disorder with Agoraphobia by Balice, Guy Francis, Phd from University of California, Los Angeles, 1997, 94 pages http://wwwlib.umi.com/dissertations/fullcit/9721287

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Policing the Web: Cyberporn, Moral Panics, and the Social Construction of Social Problems by Panepinto, Joseph Richard, Phd from University of Massachusetts Amherst, 1998, 158 pages http://wwwlib.umi.com/dissertations/fullcit/9841908

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Psychotherapeutic Process in Psychodynamic Psychotherapy for Panic Disorder and Co-morbid Depression by Goldman, Heather Ann; Phd from Long Island University, the Brooklyn Center, 2002, 89 pages http://wwwlib.umi.com/dissertations/fullcit/3049628

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Ritual, Liminality and Chaos in Fernando Arrabal's Panic Theater (spain) by Waid, Alexander; Phd from The University of North Carolina at Chapel Hill, 2000, 185 pages http://wwwlib.umi.com/dissertations/fullcit/9993392

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Sex Panics and City Papers: Mass Media and Public Controversy over the Traffic in Women by Soderlund, Gretchen; Phd from University of Illinois at Urbana-champaign, 2002, 270 pages http://wwwlib.umi.com/dissertations/fullcit/3070442

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Strange Bedfellows: Religion, Feminism, and Fundamentalism in the Satanic Panic by Jarrett, Kelly Jo; Phd from Duke University, 2000, 358 pages http://wwwlib.umi.com/dissertations/fullcit/9977649

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The Antiabolitionist Panic: Slavery, Abolition, and Politics in the United States South, 1835--1844 by Wyly-jones, Susan; Phd from Harvard University, 2000, 501 pages http://wwwlib.umi.com/dissertations/fullcit/9972460

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The Austrian Business Cycle Theory and the Panics of 1837 and 1857: an Application and Critical Reappraisal by Patton, Timothy John, Phd from Golden Gate University, 1993, 273 pages http://wwwlib.umi.com/dissertations/fullcit/9326125

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The Banking Panic of 1926 (florida, Georgia) by Vickers, Raymond Bernard, Phd from The Florida State University, 1990, 350 pages http://wwwlib.umi.com/dissertations/fullcit/9025566

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The Cognitive Psychophysiological Model of Panic: an Experimental Lab Study (anxiety, Learned Helplessness) by Przybylowicz, Stanley H., Phd from Wayne State University, 1991, 194 pages http://wwwlib.umi.com/dissertations/fullcit/9215140

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The Contingency Theory of Leadership As a Flag-factor Predictor of Group Panic Behavior. by Weinberg, Sanford Bruce, Phd from The University of Michigan, 1975, 135 pages http://wwwlib.umi.com/dissertations/fullcit/7529345

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The Effectiveness of Existential Art Therapy on Locus of Control, Self-efficacy, and Self-esteem on the Mobility and Cognitions of Individuals Diagnosed with Panic Disorder by Crystal, Jennifer Page; Phd from Wayne State University, 2001, 175 pages http://wwwlib.umi.com/dissertations/fullcit/3037066

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The Effects of Acceptance Versus Suppression of Emotion on Subjective and Psychophysicological Response to Carbon Dioxide Challenge in Patients with Panic Disorder by Levitt, Jill Tracy; Phd from Boston University, 2003, 188 pages http://wwwlib.umi.com/dissertations/fullcit/3068040

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The Effects of Panic Anxiety and Risk of Victimization on the Fear of Victimization in the Elderly by Mahone, Gerald Lynn, Phd from The University of Texas at Austin, 1989, 144 pages http://wwwlib.umi.com/dissertations/fullcit/9016931

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The Emergency Broadcast System: Panicked Bodies and Strange Voices in 30s America by Miller, Edward D., Phd from New York University, 1998, 335 pages http://wwwlib.umi.com/dissertations/fullcit/9831741

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The Financial Panic of 1857: Two Monetary Approaches to the Economic History of the United States, 1842-59. by Acosta, Edmundo Olvera, Phd from Washington University, 1978, 264 pages http://wwwlib.umi.com/dissertations/fullcit/7911482

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The Impact of Panic Disorder on Asthma by Feldman, Jonathan Mark; Phd from Rutgers the State University of New Jersey - New Brunswick, 2002, 82 pages http://wwwlib.umi.com/dissertations/fullcit/3066703

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The Incidence of Panic Disorder Presentation Related to Perimenopausal Women by Balentine, Pamela Virginia; Phd from Capella University, 2002, 95 pages http://wwwlib.umi.com/dissertations/fullcit/3068399

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The Invasion Process Revisited: Hispanic, Black, and Asian Residential Succession and Transition by Woolbright, Louie Albert, Phd from The University of Chicago, 1985 http://wwwlib.umi.com/dissertations/fullcit/T-29330

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The Panic of 1819 in Pennsylvania. by Blackson, Robert Markle, Phd from The Pennsylvania State University, 1978, 613 pages http://wwwlib.umi.com/dissertations/fullcit/7818745

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The Panic of 1857 and the Coming of the Civil War by Huston, James Lynn, Phd from University of Illinois at Urbana-champaign, 1980, 1035 pages http://wwwlib.umi.com/dissertations/fullcit/8026527

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The Response of Public and Private Philanthropy to the Panic of 1819 in New York City. by Bonelli, Vincent Francis, Phd from Fordham University, 1976, 255 pages http://wwwlib.umi.com/dissertations/fullcit/7625710

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The Role of the Financial Panic of 1927 and Failure of the 15th Bank in the Economic Decline of the Japanese Aristocracy by Schalow, Thomas Richard, Phd from Princeton University, 1989, 255 pages http://wwwlib.umi.com/dissertations/fullcit/9002712

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The Search for Moral Order: the Panic of 1819 and the Culture of the Early American Republic by Kidd, Sarah Alice; Phd from University of Missouri - Columbia, 2002, 538 pages http://wwwlib.umi.com/dissertations/fullcit/3052186

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Urban Nightmares: the Panic over the Post-industrial City in the Media and Public Discourse by Macek, Stephen Harold; Phd from University of Minnesota, 2001, 345 pages http://wwwlib.umi.com/dissertations/fullcit/3026488

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Keeping Current Ask the medical librarian at your library if it has full and unlimited access to the ProQuest Digital Dissertations database. From the library, you should be able to do more complete searches via http://wwwlib.umi.com/dissertations.

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CHAPTER 5. CLINICAL TRIALS AND ANXIETY ATTACKS Overview In this chapter, we will show you how to keep informed of the latest clinical trials concerning anxiety attacks.

Recent Trials on Anxiety Attacks The following is a list of recent trials dedicated to anxiety attacks.8 Further information on a trial is available at the Web site indicated. •

Brain Chemical Receptor Effects in Patients with Panic Disorder and Post-Traumatic Stress Disorder Condition(s): Panic Disorder; Posttraumatic Stress Disorder; Major Depressive Disorder Study Status: This study is currently recruiting patients. Sponsor(s): National Institute of Mental Health (NIMH) Purpose - Excerpt: The purpose of this study is to examine how certain brain chemicals work in patients with Panic Disorder (PD) and Post-Traumatic Stress Disorder (PTSD) with and without major depressive disorder (MDD). Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00025974

•

Evaluation of Clonazepam and Paroxetine for Panic Disorder with Depression Condition(s): Panic Disorder Study Status: This study is currently recruiting patients. Sponsor(s): National Institute of Mental Health (NIMH)

8

These are listed at www.ClinicalTrials.gov.

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Purpose - Excerpt: The purpose of this study is to examine the safety and effectiveness of the drug combination paroxetine and clonazepam in treating people with panic disorder (PD) and major depression. Phase(s): Phase IV Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00031317 •

Interactive Computer Treatment for Panic Disorder Condition(s): Panic Disorder Study Status: This study is currently recruiting patients. Sponsor(s): National Institute of Mental Health (NIMH) Purpose - Excerpt: The purpose of this study is to develop an interactive computer based version of cognitive behavioral therapy (CBT) and compare its effectiveness to book based CBT for the treatment of panic disorder. Phase(s): Phase I Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00063375

•

Panic Disorder Study Condition(s): Panic Disorder Study Status: This study is currently recruiting patients. Sponsor(s): Wyeth-Ayerst Research Purpose - Excerpt: The primary objective of this study is to determine the efficacy, safety, and tolerability of a flexible dose of venlafaxine extended-release (ER) capsules administered for 10 weeks in the treatment of adult outpatients with panic disorder (PD) in a placebo-controlled phase III study. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00038896

•

Therapy for Depression with Co-occurring Panic or Anxiety Symptoms Condition(s): Depression; Mood Disorder; Anxiety Disorder; Panic Disorder; Major Depressive Disorder Study Status: This study is currently recruiting patients. Sponsor(s): National Institute of Mental Health (NIMH) Purpose - Excerpt: The purpose of this study is to develop and test a new therapy designed to treat depressed patients with co-occurring symptoms of panic or anxiety. Phase(s): Phase I; Phase II Study Type: Interventional

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Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00051207 •

Treatment of Panic Disorder: Long Term Strategies Condition(s): Panic Disorder; Agoraphobia Study Status: This study is currently recruiting patients. Sponsor(s): National Institute of Mental Health (NIMH) Purpose - Excerpt: Cognitive behavior therapy (CBT) with or without medication has been used in the treatment of panic disorder (PD). The purpose of this study is 1) to determine whether nine months of maintenance cognitive-behavior therapy (CBT) significantly improves the likelihood of sustained improvement; and 2) to determine the acute acceptability and efficacy of medication therapy or continued CBT alone among patients who fail to respond sufficiently to an initial course of CBT alone. It has been found that patients with PD respond as well to CBT or medication alone as they do to a combination of the two. Since the combined treatments are expensive and CBT is associated with less risk of medical toxicity compared to medications, CBT alone will be used first. All patients will first receive CBT alone. If the patient responds to this therapy, the patient will be assigned randomly (like tossing a coin) to 1 of 2 groups. One group will continue to receive CBT (maintenance therapy) for 9 months. The other group of responders will not receive any further therapy. If a patient does not respond to CBT alone, he/she will be assigned randomly to 1 of 2 different groups. One group will receive paroxetine; the other will continue to receive CBT for a longer period. The response to treatment will be evaluated to see which regimen works best to treat PD. The study will last approximately 3 years. An individual may be eligible for this study if he/she has panic disorder with no more than mild agoraphobia (fear of being in public places) and is at least 18 years old. Phase(s): Phase III Study Type: Interventional Contact(s): Katherine Shear, PhD 1-412-624-1340 [email protected]; Susan Ray, PhD [email protected] or [email protected] Web Site: http://clinicaltrials.gov/ct/show/NCT00000368

•

Vestibular Dysfunction In Adult Patients With Panic Disorder With or Without Agoraphobia Condition(s): Anxiety Disorder; Panic Disorder Study Status: This study is currently recruiting patients. Sponsor(s): National Center for Research Resources (NCRR); University of Pittsburgh Purpose - Excerpt: Objectives: I. Determine whether the prevalence of abnormalities on clinical vestibular (balance) tests is higher in panic disorder with agoraphobia than in uncomplicated panic disorder and nonpanic anxiety disorder. II. Determine whether the prevalence of abnormalities on audiological tests of cochlear or brainstem function is elevated in panic disorder without agoraphobia or nonpanic anxiety disorder. III. Determine whether symptom patterns can be identified that are indicative of vestibular abnormalities in panic disorder. IV. Determine whether vestibular dysfunction can be induced by psychosomatic mechanisms. Study Type: Interventional Contact(s): see Web site below

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Web Site: http://clinicaltrials.gov/ct/show/NCT00004367 •

Panic Disorder Study Condition(s): Panic Disorder Study Status: This study is not yet open for patient recruitment. Sponsor(s): Wyeth-Ayerst Research Purpose - Excerpt: The primary objective is to determine the efficacy, safety, and tolerability of venlafaxine extended release (ER) capsules in the treatment of outpatients with panic disorder (PD) in comparison to those of placebo. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00044772

•

Phase II Double-Blind, Placebo-Controlled Study of the Reinforcing Effects of Alprazolam in Patients with Anxiety Condition(s): Anxiety Disorder; Panic Disorder Study Status: This study is completed. Sponsor(s): National Institute on Drug Abuse (NIDA); University of Texas Purpose - Excerpt: Objectives: I. Determine whether the benzodiazepine alprazolam reinforces self-medication behavior in anxious patients with varying histories of using other drugs. II. Establish outpatient methods for the study of self-medication and drug reinforcement in patients vulnerable to prescription drug abuse or dependence. III. Evaluate the influence of alcohol and other non-prescription drug use as determinants of vulnerability in these patients. IV. Identify personality, attitudinal, or other variables that might predict different patterns of self-medication. V. Assess the effects of cognitive-behavioral therapy on alprazolam self-medication. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00004373

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Pilot Study of Vestibular Rehabilitation Training for Panic Disorder With Vestibular Dysfunction Condition(s): Vestibular Diseases; Agoraphobia; Panic Disorder Study Status: This study is completed. Sponsor(s): National Center for Research Resources (NCRR); University of Pittsburgh Purpose - Excerpt: Objectives: I. Evaluate whether vestibular rehabilitation training is of value in reducing anxiety symptoms in patients with panic disorder with or without agoraphobia who have vestibular dysfunction as identified by clinical vestibular tests. Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00004366

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•

Randomized Study of Cognitive-Behavioral Therapy vs Imipramine and Their Combination for Panic Disorder Condition(s): Panic Disorder Study Status: This study is completed. Sponsor(s): National Institute of Mental Health (NIMH); Long Island Jewish Medical Center Purpose - Excerpt: Objectives: I. Determine which treatment is most effective for patients with panic disorder: cognitive-behavioral therapy (CBT) plus imipramine (IMI), CBT plus placebo, CBT alone, IMI alone, or placebo alone. Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00004834

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 “anxiety attacks” (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/

•

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 ANXIETY ATTACKS 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 “anxiety attacks” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on anxiety attacks, we have not necessarily excluded non-medical patents in this bibliography.

Patents on Anxiety Attacks By performing a patent search focusing on anxiety attacks, 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 anxiety attacks: •

1,4-benzodiazepines with 6-membered heterocyclic rings to treat panic and anxiety disorder Inventor(s): Bock; Mark G. (Hatfield, PA), Evans; Ben E. (Lansdale, PA), Freidinger; Roger M. (Lansdale, PA) Assignee(s): Merck & Co., Inc. (Rahway, NJ) Patent Number: 5,177,071 Date filed: June 17, 1991 Abstract: Pharmaceutical compositions containing 6-membered heterocyclic rings are disclosed which are useful in the treatment of panic disorder or anxiety disorder. Excerpt(s): This application is related to Merck U.S. patent application Ser. No. 378,444, filed Jul. 10, 1986. Cholecystokinins (CCK) and gastrin are structurally-related neuropeptides which exist in gastrointestinal tissue and in the central nervous system (see, V. Mutt, Gastrointestinal Hormones, G. B. J. Glass, Ed., Raven Press, N.Y., p. 169 and G. Nisson, ibid, p. 127). The isolation of the 33-amino acid polypeptide, cholecystokinin (CCK-33), from porcine intestine, Mutt, V. et al., "Structure of Porcine Cholecystokininpancreozymin. 1. Cleavage with Thrombin and Trypsin", European J. Biochem. 6, 156, (1968), was followed by the discovery that it occurs in numerous molecular forms at various sites throughout the peripheral and central nervous systems, Larsson, L. et al., "Localization and Molecular Heterogeneity of Cholecystokinin in the Central and Peripheral Nervous System", Brain Res., 165, 201 (1979). In the mammalian brain the predominant fragments are the carboxy terminal octapeptide, H--Asp-Tyr(SO.sub.3 H)--Met--Gly--Trp--Met--Asp--Phe--NH.sub.2 (CCK-8s, CCK.sub.26-33) and tetrapeptide, CCK-4 (CCK.sub.30-33). Web site: http://www.delphion.com/details?pn=US05177071__

•

Blood levels of CCK peptides relative to panic disorder treatment Inventor(s): Sheehan; David V. (Lutz, FL), Talbot; Janet D. (Lutz, FL), Thomas; Thomas N. (Palm Harbor, FL) Assignee(s): University of South Florida (Tampa, FL) Patent Number: 5,558,987 Date filed: November 18, 1994 Abstract: A method of treating a patient having a panic disorder, the patient having an elevated CCK peptide plasma level, by lowering the plasma CCK peptide level of the patient. A further method provides a diagnosis of panic disorder in a patient by detecting if that patient's plasma contains elevated CCK peptide levels. A further method determines the efficacy of the drug for the treatment of panic disorder by detecting the ability of the drug to lower elevated CCK peptide levels in a model for panic disorder. Additionally, a method of dosing a patient having elevated CCK peptide levels with an antipanic disorder drug is characterized by administering the drug to a patient and monitoring the lowering of the elevated plasma CCK peptide levels of the patient.

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Excerpt(s): The present invention relates to the relationship between cholecystokinin (CCK) and panic disorder. More specifically, the present invention provides 1) a method of treating a patient having a panic disorder, 2) a method of diagnosing panic disorder in a patient, 3) a method of determining the efficacy of a drug for the treatment of panic disorder, and 4) a method of predicting the vulnerability of a patient to panic disorder. The present invention relates to the relationship between panic disorder and cholecystokinin (CCK). Panic disorder affects 3.6% of the general population(1) and 1014% of patients in cardiology practices (2,3). It is a chronic relapsing illness(4,5) characterized by paroxysmal anxiety attacks that strike suddenly and for no apparent reason. Seventy-five percent of its victims are women(6). It has a unimodal age of onset (mean 23 years) rarely starting before age 12 or after age 45(7) and is 12 times more frequent in the 25-44 age group than in the 65+ age group(6). Panic disorder is more common in monozygotic than in dizygotic twins(8). Its inheritance pattern is consistent with single locus genetics (9,10,11) and preliminary evidence implicates the long arm of chromosome 16(12). It is associated with an increased risk of mitral valve prolapse(13), hypertension(14), alcohol abuse and dependence(15), and has an excess mortality from suicide and among men from cardiovascular death(16). The lack of understanding of the biochemical basis of panic disorder is hampering the development of drugs effective in the treatment of this disorder. Web site: http://www.delphion.com/details?pn=US05558987__ •

Cholecystokinin antagonists useful in the treatment of panic attacks Inventor(s): Woodruff; Geoffrey N. (Herts, GB) Assignee(s): Warner-Lambert Company (Morris Plains, NJ) Patent Number: 5,318,981 Date filed: March 17, 1993 Abstract: Unnatural dipeptoids of.alpha.-substituted Try-Phe derivatives are useful as agents in the treatment of panic disorders. These dipeptoids are Cholecystokinin-B Receptor (CCK.sub.B) antagonists having utility in the prevention of panic attacks in patients prone to these attacks. Excerpt(s): The neuropeptide cholecystokinin-8 (CCK-8) is an important neuromodulator and neurotransmitter in the brain. There are two types of CCK receptor which are currently referred to as CCK.sub.A and CCK.sub.B receptors. The major of the CCK receptor types in brain is the CCK.sub.B receptor (Review by Woodruff & Hughes, Annual Review of Pharmacology Toxicology 31:469-501 (1991)). The functional role of CCK in brain is not fully understood. Recently there has been evidence that CCK is involved in anxiety and that CCK.sub.B antagonists have an anxiolytic action in animal models of anxiety (Hughes, et al, Proc Natnl Acad Sci, USA 87:6728-6732 (1990). It has recently been shown (de Montigny, C Arch Gen Psychiatry 46:511-517 (1989); Bradwejn J, Koszyckl, D, and Metesissian, G, Can J Psychiatr 35:83-85 (1990) that the injection of the tetrapeptide cholecystokinin (30-33) (CCK-4) into human volunteers or into patients suffering from panic disorder precipitates a panic attack. The tetrapeptide cholecystokinin (30-33) (CCK-4) is a substance that stimulates CCK.sub.B receptors, i.e., is a CCK.sub.B antagonist. The injection of the tetrapeptide cholecystokinin (30-33) (CCK-4) into the cerebral ventricles of the brain of rats precipitates the onset of an anxiogenic reaction. This anxiogenic response can be prevented by pretreatment of the rats with the CCK.sub.B antagonist CI-988 (Sing, et al, Proc Natnl Acad Sci USA 88:11301133 (1991)).

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Web site: http://www.delphion.com/details?pn=US05318981__ •

Gepirone for alleviation of panic disorders Inventor(s): Kurtz; Neil (Weston, CT), Newton; Roger E. (Evansville, IN), Temple, Jr.; Davis L. (Wallingford, CT) Assignee(s): Bristol-Myers Company (New York, NY) Patent Number: 4,782,060 Date filed: July 29, 1987 Abstract: Gepirone and its pharmaceutically acceptable salts are useful in alleviation of panic disorders which can take the form of clinical syndromes comprising, for example, panic attacks, agoraphobia and phobic anxiety. Excerpt(s): This invention is concerned with a drug bio-affecting body-treating process which employs the pyrimidine compound 4,4-dimethyl-1-[4-[4-(2-pyrimidinyl)-1piperazinyl]butyl]-2,6-piperidinedi one or a pharmaceutically acceptable acid addition salt thereof. The synthesis of the compound and the disclosure of its anxiolytic properties are described in the following patents and publications. 1. D. L. Temple, Jr., U.S. Pat. No. 4,423,049, issued Dec. 27, 1983. Web site: http://www.delphion.com/details?pn=US04782060__

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Method for alleviation of panic disorders Inventor(s): Kurtz; Neil M. (Westport, CT), Newton; Roger E. (Evansville, IN), Temple, Jr.; Davis L. (Wallingford, CT) Assignee(s): Bristol-Myers Company (New York, NY) Patent Number: 4,634,703 Date filed: October 25, 1985 Abstract: Buspirone and its pharmaceutically acceptable salts are useful in alleviation of panic disorders which can take the form of clinical syndromes comprising, for example, panic attacks, agoraphobia and phobic anxiety. 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]8-azaspiro[4.5]decane-7,9-dio ne 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=US04634703__

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Method for the treatment of panic disorder Inventor(s): Schweizer; Edward E. (Wilmington, DE) Assignee(s): Trustees of the University of Pennsylvania (Philadelphia, PA) Patent Number: 5,166,202 Date filed: December 13, 1991

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Abstract: Midazolam and its pharmaceutically acceptable salts are useful in the treatment of panic disorder, panic attacks and the prevention of panic attacks. Excerpt(s): This invention relates to a method for treatment of panic disorder. More particularly, a method of treating panic disorder with intranasal midazolam is provided. Panic disorder is an illness which is estimated to afflict 1.5-2% of the adult population. The hallmark of panic disorder is the sudden, crescendo panic attack which may be as fleeting as a few minutes in duration, or may persist for over an hour before subsiding. The majority of patients suffering from panic disorder report an average attack frequency (four 4-symptom attacks) of less than one per day, which is true even for many moderate-to-severely ill patients such as those treated in the large Cross-National Collaborative Panic Study (Ballenger, J. C. et al., "Alprazolam in panic disorder and agoraphobia: results from a multicenter trial. I. Efficacy in short-term treatment," Arch Gen Psychiatry, 45:413-422 (1988)). Current treatment strategies for panic disorder focus on attempts to control and prevent these intermittent, but severe and often disabling panic attacks, and thereby to reduce the associated inter-episode anticipatory anxiety, phobic avoidance, and somatic preoccupations. To accomplish this effectively with drug therapy requires daily doses of high potency benzodiazepines such as alprazolam, or daily doses of antidepressants such as imipramine. Web site: http://www.delphion.com/details?pn=US05166202__ •

Method for treating panic disorder Inventor(s): Sikter; Andras (Budapest, HU) Assignee(s): S+V Engineering Kft. (Budapest, HU) Patent Number: 5,348,749 Date filed: November 5, 1992 Abstract: A method for treating panic disorder, which comprises administering to a human suffering from panic disorder 0.03 to 1.5 mmoles of zinc and 2 to 100 mmoles of magnesium and 2 to 60 mmoles of phosphorus and 3 to 90 mmoles of potassium as a daily dose in a composition consisting essentially of zinc, magnesium, phosphorus and potassium, in a weight ratio of 1-15:25-200:50-200:100-500, respectively. Excerpt(s): This application is a continuation-in-part of co-pending international application No. PCT/HU91/00018 filed May 10, 1991, which designates the United States. The invention relates to a method for treating panic disorder in humans, by administration of a novel pharmaceutical composition comprising zinc, magnesium, phosphorus and potassium in a determined ratio. It is known that mineral substances and trace elements are of vital importance in the human (generally in living) organism(s). A great number of publications deal with the effect of the given elements (such as zinc, potassium, magnesium and phosphorus) applied separately. Web site: http://www.delphion.com/details?pn=US05348749__

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Method of treating symptoms of panic attacks Inventor(s): Cox; Stephen M. (Lexington, KY), Lawrence; Lowell J. (Richmond, KY) Assignee(s): PTRL East, Inc. (Richmond, KY) Patent Number: 6,432,172 Date filed: March 7, 1996 Abstract: A method is provided for treating an individual for the symptoms of panic disorder and related maladies including agoraphobia, social phobia and claustrophobia. The method includes the step of reducing the levels of carbon dioxide being inspired by the individual. Excerpt(s): The present invention relates generally to the medical treatment field and, more particularly, to a method of treating the symptoms of panic attacks resulting from panic disorder, agoraphobia, social phobia and claustrophobia. Anxiety has been defined as a feeling of fear, dread or apprehension that arises without a clear or appropriate justification. Anxiety includes a number of symptoms that are physical, psychological and behavioral in nature. Anxiety during a panic attack may manifest itself in a number of physical signs that are typically produced from over activity of the sympathetic nervous system or even from tension in the skeletal muscles. These physical manifestations include palpitations, dry mouth, dilation of the pupils, sweating, throat tightening, trembling, dizziness and even nausea. Psychological manifestations include irritability, restlessness and loss of concentration. Behavioral manifestations primarily include avoidance behavior: that is, running away from the feared object or situation. This avoidance behavior is commonly associated with specific environments including shopping malls, stores, restaurants, church services, meetings, classes, automobiles (particularly on bridges, in tunnels or in congested traffic), airplanes and elevators. Many of these "agoraphobic environments" may be characterized as an enclosed space with a high ratio of the number of people to the volume of air in the enclosed space. Of course, where a relatively large number of individuals are exhaling carbon dioxide (CO.sub.2) into a relatively small volume of enclosed space the ambient level of carbon dioxide rises. In fact the CO.sub.2 level may rise by as much as 200% or more above the level present in the ambient outdoor atmosphere. Web site: http://www.delphion.com/details?pn=US06432172__

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Methods for treating anxiety and panic Inventor(s): Brown; Jason Peter (Stapleford, GB), Gee; Nicolas Steven (Stansted, GB), Singh; Lakhbir (Haddenham, GB), Woodruff; Geoffrey Neil (Dassels, GB) Assignee(s): Warner-Lambert Company (Morris Plains, NJ) Patent Number: 5,792,796 Date filed: June 6, 1995 Abstract: The instant invention is novel uses of known cyclic amino acids. Such compounds as gabapentin are useful in the treatment of anxiety and in the treatment and/or prevention of panic attacks. Excerpt(s): The present invention relates to novel therapeutic uses of a known compound, gabapentin, its derivatives, and pharmaceutically acceptable salts. The present invention concerns a method for treating and/or preventing anxiety in a mammal in need of such treatment. It also concerns treating and/or preventing panic

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attacks in a mammal. U.S. Pat. No. 5,084,479 concerns a method for treating neurodegenerative disorders. Such neurodegenerative disorders are, for example, Alzheimer's disease, Huntingdon's disease, Parkinson's disease, and Amyotrophic Lateral Sclerosis. It also covers treating those neurodegenerative disorders termed acute brain injury. These include but are not limited to: stroke, head trauma, and asphyxia. Web site: http://www.delphion.com/details?pn=US05792796__ •

Reboxetine for treatment obsessive compulsive disorders and panic disorder Inventor(s): Dubini; Adriana (Milan, IT), McCall; John Michael (Kalamazoo, MI), Taylor; Duncan Paul (Kalamazoo, MI), Von Voigtlander; Philip F. (Plainwell, MI), Wong; Erik Ho Fong (Portage, MI) Assignee(s): Pharmacia and Upjohn Company (Kalamazoo, MI) Patent Number: 6,391,876 Date filed: October 19, 2000 Abstract: This invention relates to the use of reboxetine in the treatment of Obsessive Compulsive Disorders and Panic Disorders. Excerpt(s): This invention describes new treatments for several nervous system disorders, including: Obsessive Compulsive Disorders, and panic Disorder. The treatment involves the administration of the drug reboxetine. The introduction of tricyclic antidepressants in the early 1960s has provided a major advance in the treatment of neuropsychiatric disorders. Reactive and endogenous depressions, diagnoses formerly carrying grave prognostic implications, have become, with the introduction of the tricyclic, manageable disorders with a much smaller toll on the patient and the society as a whole. The early tricyclic compounds were reuptake inhibitors of all the catecholamines released in the synaptic cleft, thus resulting in prolongation and enhancement of the dopamine (DA), noradrenaline (NA) and serotonin (5-hydroxytryptamine=5-HT) action. Lack of selectivity also causes undesired side effects particularly on the acetylcholine (especially the muscarinic component), and histamine mediated neurotransmission. Web site: http://www.delphion.com/details?pn=US06391876__

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Treatment of panic attacks Inventor(s): Hogg; Sandra (Frederiksberg, DK), Jessa; Maria (Warsawa, PL), Sanchez; Connie (Glostrup, DK) Assignee(s): H. Lundbeck A/S (Valby-Copenhagen, DK) Patent Number: 6,262,061 Date filed: October 6, 2000 Abstract: The compound 1'-[4-[1-(4-fluorophenyl)-1H-indole-3-yl]-1-butyl]spiro[isobenzo-furan-1( 3H),4'-piperidine] is active in models predictive of effect on panic attacks and is useful for the preparation of a medicament for the treatment of diseases associated with panic attacks. Excerpt(s): The present invention relates to the use of the compound 1'-[4-[1-(4fluorophenyl)-1H-indole-3-yl]-1-butyl]-spiro[isobenzofuran-1(3 H),4'-piperidine] or a

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pharmaceutically acceptable salt thereof for the preparation of medicaments for the treatment of panic attacks. International Patent Publication No. WO 92/22554 describes a series of sigma receptor ligands considered useful for the treatment of a range of psychic and neurological disorders. The structure activity relationship of these compounds has been further investigated by Perregaard, J. et al., J. Med. Chem., 1995, 38, 11,p. 1998-2008. which is the subject of the present invention. This compound was shown in Perregaard, J. et al., J. Med. Chem., 1995, 38, 11, p. 1998-2008 to be a potent and selective sigma ligand, in particular a sigma, ligand. Furthermore, the anxiolytic potential of the compound was tested in the black/white exploration test in rats, which is an animal model predictive for effect in the treatment of generalised anxiety disorder. It was found to be active over a large dose range. Results of further tests in generalised anxiety disorder models are reported in J. Pharmacol Exp Ther., 1997, 283, No. 2. Web site: http://www.delphion.com/details?pn=US06262061__ •

Use of 5-HT.sub.3 receptor antagonists in treating panic disorders or obsessive compulsive disorders Inventor(s): Azcona; Alberto E. (Basel, CH), Taylor; Pamela (Basel, CH) Assignee(s): Sandoz Ltd. (Basel, CH) Patent Number: 5,530,008 Date filed: January 24, 1994 Abstract: 5-HT.sub.3 Receptor antagonists are useful in treating panic disorders or obsessive compulsive disorders. Excerpt(s): The present invention relates to a new use, in particular a new pharmaceutical use, for the compound group comprising 5HT.sub.3 receptor antagonists, said compound group being referred to hereinafter collectively as COMPOUNDS OF THE INVENTION. 5-HT.sub.3 receptor antagonists are a well known class of compounds. Spatial models for 5-HT.sub.3 receptors and 5-HT.sub.3 antagonists have been proposed recently by M. F. Hibert and S. Peroutka. They are typically compounds which act on 5-HT.sub.3 receptors on the e.g. isolated rabbit heart or vagus nerve by antagonizing the action of 5-HT thereon. They may have a pA.sub.2 greater than 6 or preferably more than 8 or 9.5-HT.sub.3 antagonists may be selective for 5-HT.sub.3 receptors as compared to other serotonin receptors or dopamine receptors. vi) a compound specifically or generically disclosed in DE 3,740,352 A, WO 8803801 A, EP 266,899 A, GB 2,192,885 A, GB 2,208,862 A, EP 219,929 A, EP 219,193 A, EP 212,398 A, EP 210,840 A, EP 191,562 A, EP 248,843 A, WO 89/09217, the contents of which are incorporated herein by reference. Web site: http://www.delphion.com/details?pn=US05530008__

Patent Applications on Anxiety Attacks 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

10

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

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several years.) The following patent applications have been filed since December 2000 relating to anxiety attacks: •

Polymorphic DNAs and their use for diagnosis of susceptibility to panic disorder Inventor(s): Hattori, Eiji; (Saitama, JP), Yoshikawa, Takeo; (Saitama, JP) Correspondence: MORRISON & FOERSTER LLP; 3811 VALLEY CENTRE DRIVE; SUITE 500; SAN DIEGO; CA; 92130-2332; US Patent Application Number: 20020160390 Date filed: December 7, 2001 Abstract: The present invention relates to a method for diagnosing panic disorder, said method being based on the determination of the class of polymorphism of the short tandem repeat (STR) complex in the upstream region of human cholecystokinin gene. The polymorphic DNA comprises a DNA sequence, having a general formula (1):5'(GGAA).sub.n1X(GGAG).sub.n2(GGAA).sub.n3(GGGA).sub.n4GAG(AGAC).sub.n 5Y(G- GAA).sub.n63' (1)wherein X denotes a DNA sequence of SEQ ID NO: 1, Y denotes a DNA sequence of SEQ ID NO:2 and each of n1, n2, n3, n4, n5 and n6 denotes independently 0 or a positive integral number, whereby said DNA ranging from 363 to 399 base pairs in length. The invention also relates to an assay kit used for implementing said method. Excerpt(s): This application claims priority to Japanese Patent Application No. 2000375090, filed on Dec. 8, 2000. The present invention relates to novel polymorphisms, and more specifically, to polymorphisms of the short tandem repeat type in the 5'-upstream region of human cholecystokinin gene, and their use, i.e. a method and a kit for diagnosis of susceptibility to panic disorder. Panic disorder is a common and genetically complex mental illness, characterized by recurrent and unexpected panic attacks. It exhibits a lifetime prevalence rate of between 1.2/100 to 2.4/100 in the general population (Weissman, M. M. et al., Arch. Gen. Psychiatry, 1997; 54, 305-309). Family studies have consistently shown a higher prevalence ranging from between 7.7% to 20.5% in the first-degree relatives of probands. Twin studies have shown concordance rates of 25% for MZ twins and 10% for DZ twins (Skre, I. et al., Acta Psychiatr Scand. 1993; 88, 85-92). These epidemiological studies suggest involvement of genetic factors in the development of this disease. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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System and method for sensing and evaluating physiological parameters and modeling an adaptable predictive analysis for symptoms management Inventor(s): Geatz, Michael W.; (Maple Groove, MN), Roiger, Richard J.; (Mankato, MN) Correspondence: Stuart R. Hemphill; DORSEY & WHITNEY LLP; Intellectual Property Department; 50 South Sixth Street, Suite 1500; Minneapolis; MN; 55402-1498; US Patent Application Number: 20030144829 Date filed: January 24, 2003 Abstract: A system senses various physiological parameters of a patient such as heart rate or temperature to evaluate the patient and predict when an episode of a chronic symptom may occur. The system further includes a modeling component which generates an individualized predictive model for a given patient wherein the patient's previous episodes of the symptom are utilized to shape the model. The system tests the

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model to assure accuracy and can revise the model as necessary. Once the model is established, the system monitors patient parameters and can alert the patient to the expected onset of the symptom and/or automatically administer an appropriate drug or other therapy to control the expected symptom. The system is applicable to allergic reactions, anxiety attacks, attention deficit hyperactivity disorders, backaches, depression, dizziness, drowsiness, epileptic seizures, fatigue, heart malfunction, hunger pangs, joint or other pain, loss of motor control, migraines, motion sickness, muscle spasm, nausea, nicotine fits, numbness, shaking, shortness of breath, sleep or sleep disorders, tremors, unconsciousness, vision impairment or other chronic symptoms. Excerpt(s): This patent application claims priority from provisional patent application No. 60/351,575, filed Jan. 25, 2002. This invention relates generally to medical devices, and more specifically to a method and apparatus for sensing and reacting to patient physiological data. Many people suffer from chronic or recurring symptoms or various other unpleasant or disturbing indications caused by a wide variety of medical ailments. Some possibilities include: allergic reactions, anxiety attacks, attention deficit hyperactivity disorders, backaches, depression, dizziness, drowsiness, epileptic seizures, fatigue, heart malfunction, hunger pangs, joint or other pain, loss of motor control, migraines, motion sickness, muscle spasm, nausea, nicotine "fit", numbness, shaking, shortness of breath, sleep or sleep disorders, tremors, unconsciousness, and vision impairment. In fact, approximately 1 in 5 people suffer from some sort of chronic acute symptoms during their lifetime. Understandably, these people desire and seek relief from the medical community. A typical patient suffering from such chronic symptoms might spend anywhere from $500 to $35,000 annually to treat or minimize their symptoms. Treatments for symptoms involve various drug and/or physical therapies, chiropractic care, acupuncture, meditation and yoga. 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 anxiety attacks, you can access the U.S. Patent Office archive via the Internet at the following Web address: http://www.uspto.gov/patft/index.html. You will see two broad options: (1) Issued Patent, and (2) Published Applications. To see a list of issued patents, perform the following steps: Under “Issued Patents,” click “Quick Search.” Then, type “anxiety attacks” (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 anxiety attacks. You can also use this procedure to view pending patent applications concerning anxiety attacks. Simply go back to http://www.uspto.gov/patft/index.html. Select “Quick Search” under “Published Applications.” Then proceed with the steps listed above.

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CHAPTER 7. BOOKS ON ANXIETY ATTACKS Overview This chapter provides bibliographic book references relating to anxiety attacks. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on anxiety attacks include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.

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

Agoraphobia and Panic: A Guide to Psychological Treatment by Jeffrey E. Hecker, et al (2000); ISBN: 0205129064; http://www.amazon.com/exec/obidos/ASIN/0205129064/icongroupinterna

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Autobiography of an Agoraphobic: One Man's Struggle With Panic Disorder by Michael R. Patrick (2003); ISBN: 1410786307; http://www.amazon.com/exec/obidos/ASIN/1410786307/icongroupinterna

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Behaving Badly: Social Panics and Moral Outrage-Victorian and Modern Parallels by Judith Rowbotham (Editor), et al (2003); ISBN: 0754609650; http://www.amazon.com/exec/obidos/ASIN/0754609650/icongroupinterna

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Client Monitoring Forms Package for Anxiety and Panic with Other by David H. Barlow, Michelle G. Craske (2000); ISBN: 015813236X; http://www.amazon.com/exec/obidos/ASIN/015813236X/icongroupinterna

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•

Client Workbook for Anxiety and Panic with Worksheet by David H. Barlow (2000); ISBN: 0158132327; http://www.amazon.com/exec/obidos/ASIN/0158132327/icongroupinterna

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Conquering Panic and Anxiety Disorders: Success Stories, Strategies, and Other Good News by Jenna Glatzer (Editor), Paul Foxman (Commentary) (2002); ISBN: 0897933818; http://www.amazon.com/exec/obidos/ASIN/0897933818/icongroupinterna

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Constructing Panic: The Discourse of Agoraphobia by Lisa Capps, Elinor Ochs (1996); ISBN: 0674165489; http://www.amazon.com/exec/obidos/ASIN/0674165489/icongroupinterna

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Don't Forget To Look Up : A Christian's Guide to Overcoming Anxiety and Panic Attacks by Angela K. Brittain (1998); ISBN: 0966200306; http://www.amazon.com/exec/obidos/ASIN/0966200306/icongroupinterna

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Don't Panic: In Control of Panic and Anxiety by Eve Russell (2001); ISBN: 0954187105; http://www.amazon.com/exec/obidos/ASIN/0954187105/icongroupinterna

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Dr. Susan Lark's Anxiety & Stress Self Help Book: Effective Solutions for Nervous Tension, Emotional Distress, Anxiety, & Panic by Susan M. Lark (1996); ISBN: 0890877750; http://www.amazon.com/exec/obidos/ASIN/0890877750/icongroupinterna

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Everything You Need to Know About Anxiety and Panic Attacks (Need to Know Library) by John Giacobello (2000); ISBN: 0823932192; http://www.amazon.com/exec/obidos/ASIN/0823932192/icongroupinterna

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How to Cope with Panic Attacks (2000); ISBN: 1874690502; http://www.amazon.com/exec/obidos/ASIN/1874690502/icongroupinterna

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How to Quit Smoking Without Pills, Pain or Panic by Hugh F. Pyle (2000); ISBN: 0873983882; http://www.amazon.com/exec/obidos/ASIN/0873983882/icongroupinterna

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I Made It Through the Rain: A Story About Overcoming Panic Disorder by Robert E. Sterling (2002); ISBN: 0595214053; http://www.amazon.com/exec/obidos/ASIN/0595214053/icongroupinterna

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Living With Panic Disorder by John Tsilimparis (2003); ISBN: 141370297X; http://www.amazon.com/exec/obidos/ASIN/141370297X/icongroupinterna

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Master Your Panic and Take Back Your Life: Twelve Treatment Sessions to Conquer Panic, Anxiety & Agoraphobia by Denise F. Beckfield (2003); ISBN: 1886230471; http://www.amazon.com/exec/obidos/ASIN/1886230471/icongroupinterna

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Mastery of Your Anxiety and Panic : Therapist Guide (3 Ed ed) by Michelle G. Craske, David H. Barlow (2000); ISBN: 0158132319; http://www.amazon.com/exec/obidos/ASIN/0158132319/icongroupinterna

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Men on the Verge of a His-Panic Breakdown by Guillermo Reyes (1998); ISBN: 0871298996; http://www.amazon.com/exec/obidos/ASIN/0871298996/icongroupinterna

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Mental Health Disorders Sourcebook: Basic Information About Schizophrenia, Depression, Bipolar Disorder, Panic Disorder, Obsessive-Compulsive Disorder, Phobias and Other Anxiety Disorder (Health Reference Series, Vol 9) by Karen Bellenir (Editor) (1997); ISBN: 0780800400; http://www.amazon.com/exec/obidos/ASIN/0780800400/icongroupinterna

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My Heart's a Suitcase & Low Level Panic by Clare McIntyre (1997); ISBN: 1854592467; http://www.amazon.com/exec/obidos/ASIN/1854592467/icongroupinterna

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Natural Relief for Anxiety: Complementary Strategies for Easing Fear, Panic, and Worry by Edward S., Ph.D. Kubany, et al (2004); ISBN: 1572243724; http://www.amazon.com/exec/obidos/ASIN/1572243724/icongroupinterna

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No Fear: Overcoming Panic Attacks and Phobias by Alice Neville (2003); ISBN: 0340861339; http://www.amazon.com/exec/obidos/ASIN/0340861339/icongroupinterna

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No More Panic Attacks: A 30-Day Plan for Conquering Anxiety by Jennifer, M.D. Shoquist, Diane Stafford (2002); ISBN: 1564146081; http://www.amazon.com/exec/obidos/ASIN/1564146081/icongroupinterna

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Overcome Your Panic! A Strategy Guidebook by Robert H. Phillips (2001); ISBN: 1888614064; http://www.amazon.com/exec/obidos/ASIN/1888614064/icongroupinterna

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Overcoming Anxiety: Panic Attacks and Anxiety Disorders (Health Body, Healthy Soul Series) by David Hazard (2003); ISBN: 0736911944; http://www.amazon.com/exec/obidos/ASIN/0736911944/icongroupinterna

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Overcoming Panic Disorder and Agoraphobia: Client Manual by Elke Zuercher-White (1999); ISBN: 1572241470; http://www.amazon.com/exec/obidos/ASIN/1572241470/icongroupinterna

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Overcoming Panic: A Self-Help Guide Using Cognitive Behavioral Techniques (Overcoming Series) by Derrick Silove, Vijaya Manicavasagar (2001); ISBN: 0814797938; http://www.amazon.com/exec/obidos/ASIN/0814797938/icongroupinterna

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Panic and Agoraphobia Scale (PAS): Manual by Borwin Bandelow (1999); ISBN: 0889372160; http://www.amazon.com/exec/obidos/ASIN/0889372160/icongroupinterna

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Panic Attacks by Breton (1996); ISBN: 0091813158; http://www.amazon.com/exec/obidos/ASIN/0091813158/icongroupinterna

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Panic Disorder and Agoraphobia : A Guide by John H., M.D. Greist, James W., M.D. Jefferson (1998); ISBN: 1890802158; http://www.amazon.com/exec/obidos/ASIN/1890802158/icongroupinterna

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Panic Disorder and Agoraphobia: A Guide by John H. Greist, James W. Jefferson (2001); ISBN: 1890802263; http://www.amazon.com/exec/obidos/ASIN/1890802263/icongroupinterna

•

Panic Disorder: Assessment and Treatment Through a Wide-Angle Lens by Frank M. Dattilio, Jesus A. Salas-Auvert (2000); ISBN: 1891944355; http://www.amazon.com/exec/obidos/ASIN/1891944355/icongroupinterna

•

Panic Disorder: The Medical Point of View: There Is No Need to Suffer! by William D., Md. Kernodle, et al (1997); ISBN: 0963153331; http://www.amazon.com/exec/obidos/ASIN/0963153331/icongroupinterna

•

Perspectives on Anxiety, Panic, and Fear (Nebraska Symposium on Motivation , Vol 43) by Debra A. Hope (Editor) (1996); ISBN: 080322382X; http://www.amazon.com/exec/obidos/ASIN/080322382X/icongroupinterna

•

Phobia Free: A Medical Breakthrough Linking 90% of All Phobias and Panic Attacks to a Hidden Physical Problem by Harold N., Md Levinson, Steven Carter (1999); ISBN:

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1567313183; http://www.amazon.com/exec/obidos/ASIN/1567313183/icongroupinterna •

Power over Panic: Answers for Anxiety by Carol M. Christensen (2003); ISBN: 0781439116; http://www.amazon.com/exec/obidos/ASIN/0781439116/icongroupinterna

•

Practice Guideline for the Treatment of Patients With Panic Disorder by Psychiatric Press Incorporated (Editor), et al (1998); ISBN: 0890423113; http://www.amazon.com/exec/obidos/ASIN/0890423113/icongroupinterna

•

Psychodynamic Approaches to the Adolescent With Panic Disorder by Barbara Milrod, et al (2004); ISBN: 1575242303; http://www.amazon.com/exec/obidos/ASIN/1575242303/icongroupinterna

•

Questions Most Asked About Anxiety and Phobias: A Lively, Down-To-Earth Guide for Overcoming Panic by Jane D. Miller (1998); ISBN: 096548730X; http://www.amazon.com/exec/obidos/ASIN/096548730X/icongroupinterna

•

Surviving Panic Disorder: What You Need to Know by Stuart Shipko M. D. (2003); ISBN: 1410787346; http://www.amazon.com/exec/obidos/ASIN/1410787346/icongroupinterna

•

The Earl Campbell Story: A Football Great's Battle With Panic Disorder by Earl Campbell (Editor), et al (1999); ISBN: 1550223917; http://www.amazon.com/exec/obidos/ASIN/1550223917/icongroupinterna

•

The Panic Attack, Anxiety and Phobia Solutions Handbook by Muriel K. MacFarlane, United Research Publishers (1997); ISBN: 188705300X; http://www.amazon.com/exec/obidos/ASIN/188705300X/icongroupinterna

•

The Sky Is Falling: Understanding and Coping With Phobias, Panic, and ObsessiveCompulsive Disorders by Raeann Dumont, Aaron T. Beck (1997); ISBN: 0393316033; http://www.amazon.com/exec/obidos/ASIN/0393316033/icongroupinterna

•

Therapist Guide for Anxiety, Panic, and Agoraphobia Therapist Kit with Other by Michelle G. Craske, David H. Barlow (2000); ISBN: 0158132300; http://www.amazon.com/exec/obidos/ASIN/0158132300/icongroupinterna

•

Understanding Panic and Other Anxiety Disorders (Understanding Health and Sickness Series) by Benjamin A. Root (2000); ISBN: 1578062454; http://www.amazon.com/exec/obidos/ASIN/1578062454/icongroupinterna

•

Understanding Panic Attacks and Overcoming Fear by Roger Baker (2003); ISBN: 0745951236; http://www.amazon.com/exec/obidos/ASIN/0745951236/icongroupinterna

•

When Panic Attacks by Aine Tubridy (2003); ISBN: 0717136140; http://www.amazon.com/exec/obidos/ASIN/0717136140/icongroupinterna

•

Working With Groups to Overcome Panic, Anxiety, and Phobias by Carol Goldman (Contributor), Shirley Babior (2003); ISBN: 1570251177; http://www.amazon.com/exec/obidos/ASIN/1570251177/icongroupinterna

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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 “anxiety attacks” (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 •

Anxiety and panic attacks Author: Campbell, Nancy R.; Year: 2001; Mankato, Minn.: LifeMatters, c2001; ISBN: 0736810307 http://www.amazon.com/exec/obidos/ASIN/0736810307/icongroupinterna

•

Anxiety disorders, panic attacks, and phobias: proceedings of the Key Biscayne Research Conference on Anxiety Disorders, Panic Attacks, and Phobias, Key Biscayne, Florida, 9-11, December 1982 Author: Schatzberg, Alan F.; Year: 1988; Oxford; New York: Pergamon Press, 1988

Chapters on Anxiety Attacks In order to find chapters that specifically relate to anxiety attacks, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and anxiety attacks 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 “anxiety attacks” (or synonyms) into the “For these words:” box.

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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CHAPTER 8. MULTIMEDIA ON ANXIETY ATTACKS Overview In this chapter, we show you how to keep current on multimedia sources of information on anxiety attacks. We start with sources that have been summarized by federal agencies, and then show you how to find bibliographic information catalogued by the National Library of Medicine.

Bibliography: Multimedia on Anxiety Attacks 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 anxiety attacks (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 anxiety attacks: •

What you really need to know about---anxiety, phobias, and panic attacks [videorecording] Source: Videos for Patients; a Video Arts production for Videos for Patients; Year: 1996; Format: Videorecording; [Mississauga, Ont.]: Medical Audio Visual Communications, c1996

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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 Institute12: •

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

12

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

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•

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

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

•

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

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

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

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

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

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

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

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

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

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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.13 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:14 •

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

13

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

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•

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

•

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

The NLM Gateway15 The NLM (National Library of Medicine) Gateway is a Web-based system that lets users search simultaneously in multiple retrieval systems at the U.S. National Library of Medicine (NLM). It allows users of NLM services to initiate searches from one Web interface, providing one-stop searching for many of NLM’s information resources or databases.16 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “anxiety attacks” (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 1462 6 701 2 1 2172

HSTAT17 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.18 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.19 Simply search by “anxiety attacks” (or synonyms) at the following Web site: http://text.nlm.nih.gov.

15

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

16

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). 17 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 18 19

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

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

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Coffee Break: Tutorials for Biologists20 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.21 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.22 This site has new articles every few weeks, so it can be considered an online magazine of sorts. It is intended for general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/.

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

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

•

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

The Genome Project and Anxiety Attacks In the following section, we will discuss databases and references which relate to the Genome Project and anxiety attacks. 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).23 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. 20 Adapted 21

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

The figure that accompanies each article is frequently supplied by an expert external to NCBI, in which case the source of the figure is cited. The result is an interactive tutorial that tells a biological story. 22 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process. 23 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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To search the database, go to http://www.ncbi.nlm.nih.gov/Omim/searchomim.html. Type “anxiety attacks” (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 anxiety attacks: •

Panic Disorder Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?167870 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

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•

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 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

•

Books: Online books, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=books

•

Genome: Complete genome assemblies, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Genome

•

NCBI’s Protein Sequence Information Survey Results: Web site: http://www.ncbi.nlm.nih.gov/About/proteinsurvey/

•

Nucleotide Sequence Database (Genbank): Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Nucleotide

•

OMIM: Online Mendelian Inheritance in Man, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=OMIM

•

PopSet: Population study data sets, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Popset

•

ProbeSet: Gene Expression Omnibus (GEO), Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=geo

•

Protein Sequence Database: Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Protein

•

PubMed: Biomedical literature (PubMed), Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed

•

Structure: Three-dimensional macromolecular structures, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Structure

•

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

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select the database that you would like to search. The databases available are listed in the drop box next to “Search.” Enter “anxiety attacks” (or synonyms) into the search box and click “Go.” Jablonski’s Multiple Congenital Anomaly/Mental Retardation (MCA/MR) Syndromes Database24 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 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 Database25 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 “anxiety attacks” (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).

24 Adapted from the National Library of Medicine: http://www.nlm.nih.gov/mesh/jablonski/about_syndrome.html. 25 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 anxiety attacks 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 anxiety attacks. 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 anxiety attacks. 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 “anxiety attacks”:

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•

Other guides Disasters and Emergency Preparedness http://www.nlm.nih.gov/medlineplus/disastersandemergencypreparedness.html Heart Attack http://www.nlm.nih.gov/medlineplus/heartattack.html Obsessive-Compulsive Disorder http://www.nlm.nih.gov/medlineplus/obsessivecompulsivedisorder.html Panic Disorder http://www.nlm.nih.gov/medlineplus/panicdisorder.html Post-Traumatic Stress Disorder http://www.nlm.nih.gov/medlineplus/posttraumaticstressdisorder.html

Within the health topic page dedicated to anxiety attacks, the following was listed: •

General/Overviews Answers to Your Questions About Panic Disorder Source: American Psychological Association http://www.apa.org/pubinfo/panic.html Closer Look at Panic Disorder Source: American Psychiatric Association http://www.medem.com/MedLB/article_detaillb.cfm?article_ID=ZZZXHSH3DM C&sub_cat=47 Panic Attack Source: Anxiety Disorders Association of America http://www.adaa.org/AnxietyDisorderInfor/PanicDisAgor.cfm

•

Treatment Anxiety Disorders Information: Guide to Treatment Source: Anxiety Disorders Association of America http://www.adaa.org/AnxietyDisorderInfor/GuidetoTre.cfm Getting Treatment for Panic Disorder Source: National Institute of Mental Health http://www.nimh.nih.gov/anxiety/getpd.cfm Medications Source: National Institute of Mental Health http://www.nimh.nih.gov/publicat/medicate.cfm Psychosocial Treatments Source: National Alliance for the Mentally Ill http://www.nami.org/Content/ContentGroups/Helpline1/Psychosocial_Treatme nts.htm

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Children Bedtime Panic Attacks: 'My Child Gets Hysterical Before Bedtime' Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=AN00430 Panic Disorder in Children and Adolescents Source: American Academy of Child and Adolescent Psychiatry http://www.aacap.org/publications/factsfam/panic.htm

•

From the National Institutes of Health Facts About Panic Disorder Source: National Institute of Mental Health http://www.nimh.nih.gov/anxiety/panicfacts.cfm Understanding Panic Disorder Source: National Institute of Mental Health http://www.nimh.nih.gov/anxiety/upd.cfm

•

Organizations Anxiety Disorders Association of America http://www.adaa.org/ National Institute of Mental Health http://www.nimh.nih.gov/ National Mental Health Association http://www.nmha.org/

•

Research Anxiety Disorders Research at the National Institute of Mental Health Source: National Institute of Mental Health http://www.nimh.nih.gov/publicat/anxresfact.cfm Panic Disorder and Depression in Parents Linked to Mental Disorders in Children Source: American Psychiatric Association http://www.medem.com/search/article_display.cfm?path=n:&mstr=/ZZZXJC3KJ HC.html&soc=APA&srch_typ=NAV_SERCH

•

Statistics Numbers Count: Mental Disorders in America Source: National Institute of Mental Health http://www.nimh.nih.gov/publicat/numbers.cfm

•

Teenagers All About Anxiety Source: Nemours Foundation http://kidshealth.org/teen/your_mind/mental_health/anxiety.html

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You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the search box and click “Search.” This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system (mostly patient-oriented information). It also has the disadvantage of generating unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search. The 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 “anxiety attacks” (or synonyms). The following was recently posted: •

Major depression, panic disorder and generalized anxiety disorder in adults in primary care Source: Institute for Clinical Systems Improvement - Private Nonprofit Organization; 1996 January (revised 2002 May); 55 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3350&nbr=2576&a mp;string=anxiety+AND+attacks

•

Practice guideline for the treatment of patients with panic disorder. Source: American Psychiatric Association - Medical Specialty Society; 1998 May; 86 pages http://www.guideline.gov/summary/summary.aspx?doc_id=1429&nbr=669&am p;string=anxiety+AND+attacks 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: •

Panic Disorder: A Real Illness Source: National Institute of Mental Health, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=6565 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 anxiety attacks. 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

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

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

•

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

•

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

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

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

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

•

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

Associations and Anxiety Attacks The following is a list of associations that provide information on and resources relating to anxiety attacks: •

Anxiety Disorders Association of America Address: 8730 Georgia Avenue, Suite 600; Silver Springs, MD 20912 Telephone: (240) 485-1001 Fax: (240) 485-1035 Email: [email protected] Web Site: http://www.adaa.org Background: The mission of the Anxiety Disorders Association of America (ADAA) is to promote the prevention and cure of anxiety disorders and to improve the lives of all affected individuals. ADAA offers several materials concerning anxiety disorders including a quarterly newsletter that contains clinical information and updates, news on the latest events that ADAA is sponsoring, and personal accounts from affected individuals and members who share their experiences. ADAA also sponsors a variety of events each year including "National Anxiety Disorders Screening Day" and an annual national conference.

•

Emotions Anonymous Address: P.O. Box 4245; St. Paul, MN 55104 Telephone: (651) 647-9712 Fax: (651) 647-1593 Email: [email protected]

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Web Site: http://www.EmotionsAnonymous.org Background: Emotions Anonymous (EA) is an international not-for-profit self-help group that follows a twelve step program (similar to Alcoholics Anonymous) for individuals seeking emotional health and wellness. EA sponsors support group meetings for the purpose of facilitating mutual help by the sharing of experiences, strength, and hope and working toward recovery from emotional difficulties. Individuals for whom EA has proved beneficial include those experiencing problems such as anger, depression, panic or anxiety, phobias, grief, broken or strained relationships, difficulty expressing emotions, low self-esteem, obsessive or compulsive behavior, worry, tension, and a variety of other emotional problems. Founded in 1971, EA has grown to encompass approximately 1,300 chapters in 39 countries. EA is an anonymous program that protects the confidentiality of its members at all times. Chapters: 1,300

Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to anxiety attacks. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with anxiety attacks. 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 anxiety attacks. 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 “anxiety attacks” (or a synonym), and you will receive information on all relevant organizations listed in the database. Health Hotlines directs you to toll-free numbers to over 300 organizations. You can access this database directly at http://www.sis.nlm.nih.gov/hotlines/. On this page, you are given the option to search by keyword or by browsing the subject list. When you have received your search results, click on the name of the organization for its description and contact information.

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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 “anxiety attacks”. 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 “anxiety attacks” (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 “anxiety attacks” (or a synonym) into the search box, and click “Submit Query.”

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

Preparation Your local public library and medical libraries have interlibrary loan programs with the National Library of Medicine (NLM), one of the largest medical collections in the world. According to the NLM, most of the literature in the general and historical collections of the National Library of Medicine is available on interlibrary loan to any library. If you would like to access NLM medical literature, then visit a library in your area that can request the publications for you.26

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

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

26

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

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libraries recommended by the National Library of Medicine (sorted alphabetically by name of the U.S. state or Canadian province where the library is located)27: •

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)

•

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/

•

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

27

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

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•

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

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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

•

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

•

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

•

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

•

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

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

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

•

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

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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

•

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

•

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

•

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

•

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

•

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

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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/

•

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

•

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

•

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

•

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

•

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

•

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

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

•

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

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

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

•

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

•

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

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

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

•

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

•

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

•

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

•

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

•

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

•

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

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

Basic Guidelines for Anxiety Attacks Panic disorder Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000924.htm Panic disorder with agoraphobia Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000923.htm

•

Signs & Symptoms for Anxiety Attacks 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 Blushing Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003241.htm

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Chest pain Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003079.htm Depression Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003213.htm Dizziness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003093.htm Facial paralysis Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003028.htm Faintness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003092.htm Flushing Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003241.htm Heartburn Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003114.htm Nausea Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003117.htm Numbness 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 Shortness of breath Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003075.htm Skin, clammy Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003216.htm Sleep disturbances Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003210.htm Stress Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003211.htm Sweating Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003218.htm Tingling Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003206.htm Trembling Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003192.htm

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•

Diagnostics and Tests for Anxiety Attacks Cocaine Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003578.htm

•

Nutrition for Anxiety Attacks Caffeine Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002445.htm

•

Background Topics for Anxiety Attacks Alcohol use Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001944.htm Cardiovascular Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002310.htm Central nervous system Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002311.htm Choking Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000047.htm Endocrine Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002351.htm Exercise Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001941.htm Physical examination Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002274.htm Respiratory Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002290.htm Stimulants Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002308.htm Substance abuse Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001945.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

104 Anxiety Attacks

•

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

•

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

•

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

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ANXIETY ATTACKS DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Abdominal: Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs. [NIH] Aberrant: Wandering or deviating from the usual or normal course. [EU] ACE: Angiotensin-coverting enzyme. A drug used to decrease pressure inside blood vessels. [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] Acrylonitrile: A highly poisonous compound used widely in the manufacture of plastics, adhesives and synthetic rubber. [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] Adenosine: A nucleoside that is composed of adenine and d-ribose. Adenosine or adenosine derivatives play many important biological roles in addition to being components of DNA and RNA. Adenosine itself is a neurotransmitter. [NIH] 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] 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] Aerobic Exercise: A type of physical activity that includes walking, jogging, running, and dancing. Aerobic training improves the efficiency of the aerobic energy-producing systems that can improve cardiorespiratory endurance. [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

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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] 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] Alertness: A state of readiness to detect and respond to certain specified small changes occurring at random intervals in the environment. [NIH] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] 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] 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] Amine: An organic compound containing nitrogen; any member of a group of chemical compounds formed from ammonia by replacement of one or more of the hydrogen atoms by organic (hydrocarbon) radicals. The amines are distinguished as primary, secondary, and tertiary, according to whether one, two, or three hydrogen atoms are replaced. The amines include allylamine, amylamine, ethylamine, methylamine, phenylamine, propylamine, and many other compounds. [EU] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amnestic: Nominal aphasia; a difficulty in finding the right name for an object. [NIH] Amphetamines: Analogs or derivatives of amphetamine. Many are sympathomimetics and central nervous system stimulators causing excitation, vasopression, bronchodilation, and to varying degrees, anorexia, analepsis, nasal decongestion, and some smooth muscle relaxation. [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

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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] 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] 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] Angina: Chest pain that originates in the heart. [NIH] Angina Pectoris: The symptom of paroxysmal pain consequent to myocardial ischemia usually of distinctive character, location and radiation, and provoked by a transient stressful situation during which the oxygen requirements of the myocardium exceed the capacity of the coronary circulation to supply it. [NIH] 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] Antagonism: Interference with, or inhibition of, the growth of a living organism by another living organism, due either to creation of unfavorable conditions (e. g. exhaustion of food supplies) or to production of a specific antibiotic substance (e. g. penicillin). [NIH] 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] Anticholinergic: An agent that blocks the parasympathetic nerves. Called also parasympatholytic. [EU] 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]

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Antihistamine: A drug that counteracts the action of histamine. The antihistamines are of two types. The conventional ones, as those used in allergies, block the H1 histamine receptors, whereas the others block the H2 receptors. Called also antihistaminic. [EU] Anxiety: Persistent feeling of dread, apprehension, and impending disaster. [NIH] Anxiety Disorders: Disorders in which anxiety (persistent feelings of apprehension, tension, or uneasiness) is the predominant disturbance. [NIH] Anxiolytic: An anxiolytic or antianxiety agent. [EU] Aqueous: Having to do with water. [NIH] Arrhythmia: Any variation from the normal rhythm or rate of the heart beat. [NIH] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Asphyxia: A pathological condition caused by lack of oxygen, manifested in impending or actual cessation of life. [NIH] Assay: Determination of the amount of a particular constituent of a mixture, or of the biological or pharmacological potency of a drug. [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] Atrophy: Decrease in the size of a cell, tissue, organ, or multiple organs, associated with a variety of pathological conditions such as abnormal cellular changes, ischemia, malnutrition, or hormonal changes. [NIH] Auditory: Pertaining to the sense of hearing. [EU] Autonomic: Self-controlling; functionally independent. [EU] Autonomic Nervous System: The enteric, parasympathetic, and sympathetic nervous systems taken together. Generally speaking, the autonomic nervous system regulates the internal environment during both peaceful activity and physical or emotional stress. Autonomic activity is controlled and integrated by the central nervous system, especially the hypothalamus and the solitary nucleus, which receive information relayed from visceral afferents; these and related central and sensory structures are sometimes (but not here) considered to be part of the autonomic nervous system itself. [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] 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] 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

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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] Bicuculline: Isoquinoline alkaloid from Dicentra cucullaria and other plants that is a competitive antagonist at GABA-A receptors and thus causes convulsions. [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] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [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] Bladder: The organ that stores urine. [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 Fluids: Liquid components of living organisms. [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]

Bronchi: The larger air passages of the lungs arising from the terminal bifurcation of the trachea. [NIH] Bronchial: Pertaining to one or more bronchi. [EU] Caffeine: A methylxanthine naturally occurring in some beverages and also used as a pharmacological agent. Caffeine's most notable pharmacological effect is as a central nervous system stimulant, increasing alertness and producing agitation. It also relaxes smooth muscle, stimulates cardiac muscle, stimulates diuresis, and appears to be useful in the treatment of some types of headache. Several cellular actions of caffeine have been observed, but it is not entirely clear how each contributes to its pharmacological profile. Among the most important are inhibition of cyclic nucleotide phosphodiesterases, antagonism of adenosine receptors, and modulation of intracellular calcium handling. [NIH]

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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] Cannabidiol: Compound isolated from Cannabis sativa extract. [NIH] Cannabinoids: Compounds extracted from Cannabis sativa L. and metabolites having the cannabinoid structure. The most active constituents are tetrahydrocannabinol, cannabinol, and cannabidiol. [NIH] Cannabinol: A physiologically inactive constituent of Cannabis sativa L. [NIH] Capsules: Hard or soft soluble containers used for the oral administration of medicine. [NIH] Carbon Dioxide: A colorless, odorless gas that can be formed by the body and is necessary for the respiration cycle of plants and animals. [NIH] Carboxy: Cannabinoid. [NIH] Carcinogenic: Producing carcinoma. [EU] Cardiac: Having to do with the heart. [NIH] Cardiology: The study of the heart, its physiology, and its functions. [NIH] Cardiorespiratory: Relating to the heart and lungs and their function. [EU] Cardioselective: Having greater activity on heart tissue than on other tissue. [EU] Cardiovascular: Having to do with the heart and blood vessels. [NIH] Carotid Body: A small cluster of chemoreceptive and supporting cells located near the bifurcation of the internal carotid artery. The carotid body, which is richly supplied with fenestrated capillaries, senses the pH, carbon dioxide, and oxygen concentrations in the blood and plays a crucial role in their homeostatic control. [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] Catecholamine: A group of chemical substances manufactured by the adrenal medulla and secreted during physiological stress. [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 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] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] Cerebral Aqueduct: Narrow channel in the mesencephalon that connects the third and fourth ventricles. [NIH] 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] Chemoreceptor: A receptor adapted for excitation by chemical substances, e.g., olfactory and gustatory receptors, or a sense organ, as the carotid body or the aortic (supracardial) bodies, which is sensitive to chemical changes in the blood stream, especially reduced

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oxygen content, and reflexly increases both respiration and blood pressure. [EU] 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] Chest Pain: Pressure, burning, or numbness in the chest. [NIH] Chimera: An individual that contains cell populations derived from different zygotes. [NIH] Chiropractic: A system of treating bodily disorders by manipulation of the spine and other parts, based on the belief that the cause is the abnormal functioning of a nerve. [NIH] Chlorpheniramine: A histamine H1 antagonist used in allergic reactions, hay fever, rhinitis, urticaria, and asthma. It has also been used in veterinary applications. One of the most widely used of the classical antihistaminics, it generally causes less drowsiness and sedation than promethazine. [NIH] 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] Cholinergic: Resembling acetylcholine in pharmacological action; stimulated by or releasing acetylcholine or a related compound. [EU] Chondroitin sulfate: The major glycosaminoglycan (a type of sugar molecule) in cartilage. [NIH]

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] 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]

Clonazepam: An anticonvulsant used for several types of seizures, including myotonic or atonic seizures, photosensitive epilepsy, and absence seizures, although tolerance may develop. It is seldom effective in generalized tonic-clonic or partial seizures. The mechanism of action appears to involve the enhancement of gaba receptor responses. [NIH] Clonic: Pertaining to or of the nature of clonus. [EU] 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

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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] Cochlea: The part of the internal ear that is concerned with hearing. It forms the anterior part of the labyrinth, is conical, and is placed almost horizontally anterior to the vestibule. [NIH]

Cochlear: Of or pertaining to the cochlea. [EU] 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] Cognitive Therapy: A direct form of psychotherapy based on the interpretation of situations (cognitive structure of experiences) that determine how an individual feels and behaves. It is based on the premise that cognition, the process of acquiring knowledge and forming beliefs, is a primary determinant of mood and behavior. The therapy uses behavioral and verbal techniques to identify and correct negative thinking that is at the root of the aberrant behavior. [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

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addition to (complementary) or instead of (alternative) standard treatments. These practices are not considered standard medical approaches. CAM includes dietary supplements, megadose vitamins, herbal preparations, special teas, massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complementary medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used to enhance or complement the standard treatments. Complementary medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complete remission: The disappearance of all signs of cancer. Also called a complete response. [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] Concomitant: Accompanying; accessory; joined with another. [EU] Conjunctiva: The mucous membrane that lines the inner surface of the eyelids and the anterior part of the sclera. [NIH] Consultation: A deliberation between two or more physicians concerning the diagnosis and the proper method of treatment in a case. [NIH] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Controlled study: An experiment or clinical trial that includes a comparison (control) group. [NIH]

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] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Cortical: Pertaining to or of the nature of a cortex or bark. [EU] Cotinine: 1-Methyl-5-(3-pyridyl)-2-pyrrolidinone antidepressant. Synonym: Scotine. [NIH]

fumarate.

Stimulant

proposed

as

Cranial: Pertaining to the cranium, or to the anterior (in animals) or superior (in humans) end of the body. [EU] 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] Cyclic: Pertaining to or occurring in a cycle or cycles; the term is applied to chemical

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compounds that contain a ring of atoms in the nucleus. [EU] 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] Decarboxylation: The removal of a carboxyl group, usually in the form of carbon dioxide, from a chemical compound. [NIH] Dendritic: 1. Branched like a tree. 2. Pertaining to or possessing dendrites. [EU] 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] Derealization: Is characterized by the loss of the sense of reality concerning one's surroundings. [NIH] Desipramine: A tricyclic dibenzazepine compound that potentiates neurotransmission. Desipramine selectively blocks reuptake of norepinephrine from the neural synapse, and also appears to impair serotonin transport. This compound also possesses minor anticholingeric activity, through its affinity to muscarinic receptors. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Diastolic: Of or pertaining to the diastole. [EU] 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] Dilatation: The act of dilating. [NIH] Dilation: A process by which the pupil is temporarily enlarged with special eye drops (mydriatic); allows the eye care specialist to better view the inside of the eye. [NIH] Dimethyl: A volatile metabolite of the amino acid methionine. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Diuresis: Increased excretion of urine. [EU] Dizziness: An imprecise term which may refer to a sense of spatial disorientation, motion of the environment, or lightheadedness. [NIH] 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

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effects including its actions as an inotropic agent and as a renal vasodilator. [NIH] Drive: A state of internal activity of an organism that is a necessary condition before a given stimulus will elicit a class of responses; e.g., a certain level of hunger (drive) must be present before food will elicit an eating response. [NIH] Dysphoric: A feeling of unpleasantness and discomfort. [NIH] Dyspnea: Difficult or labored breathing. [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] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Electrons: Stable elementary particles having the smallest known negative charge, present in all elements; also called negatrons. Positively charged electrons are called positrons. The numbers, energies and arrangement of electrons around atomic nuclei determine the chemical identities of elements. Beams of electrons are called cathode rays or beta rays, the latter being a high-energy biproduct of nuclear decay. [NIH] Embryo: The prenatal stage of mammalian development characterized by rapid morphological changes and the differentiation of basic structures. [NIH] Endoscopic: A technique where a lateral-view endoscope is passed orally to the duodenum for visualization of the ampulla of Vater. [NIH] Endotoxins: Toxins closely associated with the living cytoplasm or cell wall of certain microorganisms, which do not readily diffuse into the culture medium, but are released upon lysis of the cells. [NIH] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]

Enzymatic: Phase where enzyme cuts the precursor protein. [NIH] Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Epidemiological: Relating to, or involving epidemiology. [EU] Epinephrine: The active sympathomimetic hormone from the adrenal medulla in most species. It stimulates both the alpha- and beta- adrenergic systems, causes systemic vasoconstriction and gastrointestinal relaxation, stimulates the heart, and dilates bronchi and cerebral vessels. It is used in asthma and cardiac failure and to delay absorption of local anesthetics. [NIH] 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] ERV: The expiratory reserve volume is the largest volume of gas that can be expired from the end-expiratory level. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]

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Estrogen: One of the two female sex hormones. [NIH] Ethinyl Estradiol: A semisynthetic estrogen with high oral estrogenic potency. It is often used as the estrogenic component in oral contraceptives. [NIH] Evoke: The electric response recorded from the cerebral cortex after stimulation of a peripheral sense organ. [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] Exocrine: Secreting outwardly, via a duct. [EU] Expiration: The act of breathing out, or expelling air from the lungs. [EU] Expiratory: The volume of air which leaves the breathing organs in each expiration. [NIH] Expiratory Reserve Volume: The extra volume of air that can be expired with maximum effort beyond the level reached at the end of a normal, quiet expiration. Common abbreviation is ERV. [NIH] Extracellular: Outside a cell or cells. [EU] Extrapyramidal: Outside of the pyramidal tracts. [EU] Facial: Of or pertaining to the face. [EU] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fatigue: The state of weariness following a period of exertion, mental or physical, characterized by a decreased capacity for work and reduced efficiency to respond to stimuli. [NIH]

Fats: One of the three main classes of food and a source of energy in the body. Bile dissolves fats, and enzymes break them down. This process moves fats into cells. [NIH] Fatty acids: A major component of fats that are used by the body for energy and tissue development. [NIH] Fenfluramine: A centrally active drug that apparently both blocks serotonin uptake and provokes transport-mediated serotonin release. [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] Forearm: The part between the elbow and the wrist. [NIH] Friction: Surface resistance to the relative motion of one body against the rubbing, sliding, rolling, or flowing of another with which it is in contact. [NIH] 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] 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 Acid: Hydrochloric acid present in gastric juice. [NIH] Gastrin: A hormone released after eating. Gastrin causes the stomach to produce more acid. [NIH]

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Gastrointestinal: Refers to the stomach and intestines. [NIH] Gastrointestinal tract: The stomach and intestines. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]

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] Genetics: The biological science that deals with the phenomena and mechanisms of heredity. [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] 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] Glycosaminoglycan: A type of long, unbranched polysaccharide molecule. Glycosaminoglycans are major structural components of cartilage and are also found in the cornea of the eye. [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] Gravidity: Pregnancy; the condition of being pregnant, without regard to the outcome. [EU] Growth: The progressive development of a living being or part of an organism from its earliest stage to maturity. [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] 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] 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]

Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] 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

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entorhinal cortex in the hippocampal formation. [NIH] Histamine: 1H-Imidazole-4-ethanamine. A depressor amine derived by enzymatic decarboxylation of histidine. It is a powerful stimulant of gastric secretion, a constrictor of bronchial smooth muscle, a vasodilator, and also a centrally acting neurotransmitter. [NIH] Histidine: An essential amino acid important in a number of metabolic processes. It is required for the production of histamine. [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] 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] 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] Hydrolysis: The process of cleaving a chemical compound by the addition of a molecule of water. [NIH] Hypersensitivity: Altered reactivity to an antigen, which can result in pathologic reactions upon subsequent exposure to that particular antigen. [NIH] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Hyperthyroidism: Excessive functional activity of the thyroid gland. [NIH] Hyperventilation: A pulmonary ventilation rate faster than is metabolically necessary for the exchange of gases. It is the result of an increased frequency of breathing, an increased tidal volume, or a combination of both. It causes an excess intake of oxygen and the blowing off of carbon dioxide. [NIH] Hypnotherapy: Sleeping-cure. [NIH] Hypnotic: A drug that acts to induce sleep. [EU] Hypomania: An abnormality of mood resembling mania (persistent elevated or expansive mood, hyperactivity, inflated self-esteem, etc.) but of lesser intensity. [EU] 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] 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]

Immunity: Nonsusceptibility to the invasive or pathogenic microorganisms or to the toxic effect of antigenic substances. [NIH]

effects

of

foreign

Impairment: In the context of health experience, an impairment is any loss or abnormality of

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psychological, physiological, or anatomical structure or function. [NIH] Impotence: The inability to perform sexual intercourse. [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] Infusion: A method of putting fluids, including drugs, into the bloodstream. Also called intravenous infusion. [NIH] Inhalation: The drawing of air or other substances into the lungs. [EU] Inner ear: The labyrinth, comprising the vestibule, cochlea, and semicircular canals. [NIH] Inositol: An isomer of glucose that has traditionally been considered to be a B vitamin although it has an uncertain status as a vitamin and a deficiency syndrome has not been identified in man. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1379) Inositol phospholipids are important in signal transduction. [NIH] Inotropic: Affecting the force or energy of muscular contractions. [EU] Insulator: Material covering the metal conductor of the lead. It is usually polyurethane or silicone. [NIH] Intermittent: Occurring at separated intervals; having periods of cessation of activity. [EU] Intestinal: Having to do with the intestines. [NIH] Intestine: A long, tube-shaped organ in the abdomen that completes the process of digestion. There is both a large intestine and a small intestine. Also called the bowel. [NIH] Intoxication: Poisoning, the state of being poisoned. [EU] Intracellular: Inside a cell. [NIH] Intravenous: IV. Into a vein. [NIH] Intrinsic: Situated entirely within or pertaining exclusively to a part. [EU] Intrinsic Factor: A glycoprotein secreted by the cells of the gastric glands that is required for the absorption of vitamin B 12. Deficiency of intrinsic factor results in pernicious anemia. [NIH]

Invasive: 1. Having the quality of invasiveness. 2. Involving puncture or incision of the skin or insertion of an instrument or foreign material into the body; said of diagnostic techniques. [EU]

Involuntary: Reaction occurring without intention or volition. [NIH] Ions: An atom or group of atoms that have a positive or negative electric charge due to a 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] Ischemia: Deficiency of blood in a part, due to functional constriction or actual obstruction of a blood vessel. [EU] Joint: The point of contact between elements of an animal skeleton with the parts that surround and support it. [NIH] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA

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fragments are up to 50 kilobases long. [NIH] Labile: 1. Gliding; moving from point to point over the surface; unstable; fluctuating. 2. Chemically unstable. [EU] Labyrinth: The internal ear; the essential part of the organ of hearing. It consists of an osseous and a membranous portion. [NIH] Lag: The time elapsing between application of a stimulus and the resulting reaction. [NIH] 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] Library Services: Services offered to the library user. They include reference and circulation. [NIH]

Ligands: A RNA simulation method developed by the MIT. [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] Lipid: Fat. [NIH] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Lobe: A portion of an organ such as the liver, lung, breast, or brain. [NIH] Lordosis: The anterior concavity in the curvature of the lumbar and cervical spine as viewed from the side. The term usually refers to abnormally increased curvature (hollow back, saddle back, swayback). It does not include lordosis as normal mating posture in certain animals ( = posture + sex behavior, animal). [NIH] Magnetic Resonance Imaging: Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques. [NIH] Maintenance therapy: Treatment that is given to help a primary (original) treatment keep working. Maintenance therapy is often given to help keep cancer in remission. [NIH] Major Histocompatibility Complex: The genetic region which contains the loci of genes which determine the structure of the serologically defined (SD) and lymphocyte-defined (LD) transplantation antigens, genes which control the structure of the immune response-

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associated (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] Malnutrition: A condition caused by not eating enough food or not eating a balanced diet. [NIH]

Mania: Excitement of psychotic proportions manifested by mental and physical hyperactivity, disorganization of behaviour, and elevation of mood. [EU] Manifest: Being the part or aspect of a phenomenon that is directly observable : concretely expressed in behaviour. [EU] Meatus: A canal running from the internal auditory foramen through the petrous portion of the temporal bone. It gives passage to the facial and auditory nerves together with the auditory branch of the basilar artery and the internal auditory veins. [NIH] 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] Medicament: A medicinal substance or agent. [EU] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Medroxyprogesterone: (6 alpha)-17-Hydroxy-6-methylpregn-4-ene-3,20-dione. A synthetic progestational hormone used in veterinary practice as an estrus regulator. [NIH] 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] 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] Meningioma: A type of tumor that occurs in the meninges, the membranes that cover and protect the brain and spinal cord. Meningiomas usually grow slowly. [NIH] Menopause: Permanent cessation of menstruation. [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] Metabolite: Any substance produced by metabolism or by a metabolic process. [EU] Methionine: A sulfur containing essential amino acid that is important in many body functions. It is a chelating agent for heavy metals. [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] Microbe: An organism which cannot be observed with the naked eye; e. g. unicellular

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animals, lower algae, lower fungi, bacteria. [NIH] Microbiology: The study of microorganisms such as fungi, bacteria, algae, archaea, and viruses. [NIH] Midazolam: A short-acting compound, water-soluble at pH less than 4 and lipid-soluble at physiological pH. It is a hypnotic-sedative drug with anxiolytic and amnestic properties. It is used for sedation in dentistry, cardiac surgery, endoscopic procedures, as preanesthetic medication, and as an adjunct to local anesthesia. Because of its short duration and cardiorespiratory stability, it is particularly useful in poor-risk, elderly, and cardiac patients. [NIH]

Mitral Valve: The valve between the left atrium and left ventricle of the heart. [NIH] Mitral Valve Prolapse: Abnormal protrusion of one or both of the leaflets of the mitral valve into the left atrium during systole. This may be accompanied by mitral regurgitation, systolic murmur, nonejection click, or cardiac arrhythmia. [NIH] 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] Molecular Structure: The location of the atoms, groups or ions relative to one another in a molecule, as well as the number, type and location of covalent bonds. [NIH] 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] Motility: The ability to move spontaneously. [EU] Motion Sickness: Sickness caused by motion, as sea sickness, train sickness, car sickness, and air sickness. [NIH] Mucins: A secretion containing mucopolysaccharides and protein that is the chief constituent of mucus. [NIH] Mucosa: A mucous membrane, or tunica mucosa. [EU] Muscle Relaxation: That phase of a muscle twitch during which a muscle returns to a resting position. [NIH] Mydriatic: 1. Dilating the pupil. 2. Any drug that dilates the pupil. [EU] Myocardial infarction: Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Nausea: An unpleasant sensation in the stomach usually accompanied by the urge to vomit. Common causes are early pregnancy, sea and motion sickness, emotional stress, intense pain, food poisoning, and various enteroviruses. [NIH] NCI: National Cancer Institute. NCI, part of the National Institutes of Health of the United

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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] Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Neural: 1. Pertaining to a nerve or to the nerves. 2. Situated in the region of the spinal axis, as the neutral arch. [EU] Neurology: A medical specialty concerned with the study of the structures, functions, and diseases of the nervous system. [NIH] Neuromuscular: Pertaining to muscles and nerves. [EU] Neuromuscular Junction: The synapse between a neuron and a muscle. [NIH] 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] 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] Neurophysiology: The scientific discipline concerned with the physiology 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] Neurotic: 1. Pertaining to or characterized by neurosis. 2. A person affected with a neurosis. [EU]

Neurotransmitters: Endogenous signaling molecules that alter the behavior of neurons or effector cells. Neurotransmitter is used here in its most general sense, including not only messengers that act directly to regulate ion channels, but also those that act through second messenger systems, and those that act at a distance from their site of release. Included are neuromodulators, neuroregulators, neuromediators, and neurohumors, whether or not acting at synapses. [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] 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

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the brain arising from the locus ceruleus. It is also found in plants and is used pharmacologically as a sympathomimetic. [NIH] Nuclear: A test of the structure, blood flow, and function of the kidneys. The doctor injects a mildly radioactive solution into an arm vein and uses x-rays to monitor its progress through the kidneys. [NIH] Nuclei: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nursing Care: Care given to patients by nursing service personnel. [NIH] On-line: A sexually-reproducing population derived from a common parentage. [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] Oxygen Consumption: The oxygen consumption is determined by calculating the difference between the amount of oxygen inhaled and exhaled. [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] Pancreatic cancer: Cancer of the pancreas, a salivary gland of the abdomen. [NIH] Panic: A state of extreme acute, intense anxiety and unreasoning fear accompanied by disorganization of personality function. [NIH] Panic Disorder: A type of anxiety disorder characterized by unexpected panic attacks that last minutes or, rarely, hours. Panic attacks begin with intense apprehension, fear or terror and, often, a feeling of impending doom. Symptoms experienced during a panic attack include dyspnea or sensations of being smothered; dizziness, loss of balance or faintness; choking sensations; palpitations or accelerated heart rate; shakiness; sweating; nausea or other form of abdominal distress; depersonalization or derealization; paresthesias; hot flashes or chills; chest discomfort or pain; fear of dying and fear of not being in control of oneself or going crazy. Agoraphobia may also develop. Similar to other anxiety disorders, it may be inherited as an autosomal dominant trait. [NIH] Paralysis: Loss of ability to move all or part of the body. [NIH] Paresthesias: Abnormal touch sensations, such as burning or prickling, that occur without an outside stimulus. [NIH] Parity: The number of offspring a female has borne. It is contrasted with gravidity, which refers to the number of pregnancies, regardless of outcome. [NIH] Paroxetine: A serotonin uptake inhibitor that is effective in the treatment of depression. [NIH]

Paroxysmal: Recurring in paroxysms (= spasms or seizures). [EU] Partial remission: The shrinking, but not complete disappearance, of a tumor in response to therapy. Also called partial response. [NIH] Pathogenesis: The cellular events and reactions that occur in the development of disease. [NIH]

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Pathologic: 1. Indicative of or caused by a morbid condition. 2. Pertaining to pathology (= branch of medicine that treats the essential nature of the disease, especially the structural and functional changes in tissues and organs of the body caused by the disease). [EU] Pathophysiology: Altered functions in an individual or an organ due to disease. [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] Pentagastrin: A synthetic polypeptide that has effects like gastrin when given parenterally. It stimulates the secretion of gastric acid, pepsin, and intrinsic factor, and has been used as a diagnostic aid. [NIH] Pepsin: An enzyme made in the stomach that breaks down proteins. [NIH] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Periaqueductal Gray: Central gray matter surrounding the cerebral aqueduct in the mesencephalon. Physiologically it is probably involved in rage reactions, the lordosis reflex, feeding responses, bladder tonus, and pain. [NIH] Pharmacodynamics: The study of the biochemical and physiological effects of drugs and the mechanisms of their actions, including the correlation of actions and effects of drugs with their chemical structure; also, such effects on the actions of a particular drug or drugs. [EU] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] 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] 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 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] 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] Physostigmine: A cholinesterase inhibitor that is rapidly absorbed through membranes. It can be applied topically to the conjunctiva. It also can cross the blood-brain barrier and is used when central nervous system effects are desired, as in the treatment of severe

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anticholinergic toxicity. [NIH] Pilot study: The initial study examining a new method or treatment. [NIH] Pituitary Gland: A small, unpaired gland situated in the sella turcica tissue. It is connected to the hypothalamus by a short stalk. [NIH] Placebo Effect: An effect usually, but not necessarily, beneficial that is attributable to an expectation that the regimen will have an effect, i.e., the effect is due to the power of suggestion. [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] Poisoning: A condition or physical state produced by the ingestion, injection or inhalation of, or exposure to a deleterious agent. [NIH] 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] Potassium: An element that is in the alkali group of metals. It has an atomic symbol K, atomic number 19, and atomic weight 39.10. It is the chief cation in the intracellular fluid of muscle and other cells. Potassium ion is a strong electrolyte and it plays a significant role in the regulation of fluid volume and maintenance of the water-electrolyte balance. [NIH] 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] 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] 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] 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]

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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] Problem Solving: A learning situation involving more than one alternative from which a selection is made in order to attain a specific goal. [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 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] Promethazine: A phenothiazine derivative with histamine H1-blocking, antimuscarinic, and sedative properties. It is used as an antiallergic, in pruritus, for motion sickness and sedation, and also in animals. [NIH] Promoter: A chemical substance that increases the activity of a carcinogenic process. [NIH] Prone: Having the front portion of the body downwards. [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] Propranolol: A widely used non-cardioselective beta-adrenergic antagonist. Propranolol is used in the treatment or prevention of many disorders including acute myocardial infarction, arrhythmias, angina pectoris, hypertension, hypertensive emergencies, hyperthyroidism, migraine, pheochromocytoma, menopause, and anxiety. [NIH] Prospective study: An epidemiologic study in which a group of individuals (a cohort), all free of a particular disease and varying in their exposure to a possible risk factor, is followed over a specific amount of time to determine the incidence rates of the disease in the exposed and unexposed groups. [NIH] 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] Protirelin: A tripeptide hormone that originates in the hypothalamus and stimulates the secretion of thyrotropin from the pituitary gland. In humans, it also acts as a prolactinreleasing factor. It is also a neurotransmitter in the central nervous system. [NIH]

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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] 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] Psychopathology: The study of significant causes and processes in the development of mental illness. [NIH] Psychosomatic: Pertaining to the mind-body relationship; having bodily symptoms of psychic, emotional, or mental origin; called also psychophysiologic. [EU] Psychotherapy: A generic term for the treatment of mental illness or emotional disturbances primarily by verbal or nonverbal communication. [NIH] Psychotropic: Exerting an effect upon the mind; capable of modifying mental activity; usually applied to drugs that effect the mental state. [EU] 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] 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] 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 Ventilation: The total volume of gas per minute inspired or expired measured in liters per minute. [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]

Pupil: The aperture in the iris through which light passes. [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] Radiopharmaceutical: Any medicinal product which, when ready for use, contains one or more radionuclides (radioactive isotopes) included for a medicinal purpose. [NIH] Rage: Fury; violent, intense anger. [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] Rape: Unlawful sexual intercourse without consent of the victim. [NIH] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and

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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] Recombinant: A cell or an individual with a new combination of genes not found together in either parent; usually applied to linked genes. [EU] Rectum: The last 8 to 10 inches of the large intestine. [NIH] 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] Refractory: Not readily yielding to treatment. [EU] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Regurgitation: A backward flowing, as the casting up of undigested food, or the backward flowing of blood into the heart, or between the chambers of the heart when a valve is incompetent. [EU] Relapse: The return of signs and symptoms of cancer after a period of improvement. [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] Respiration: The act of breathing with the lungs, consisting of inspiration, or the taking into the lungs of the ambient air, and of expiration, or the expelling of the modified air which contains more carbon dioxide than the air taken in (Blakiston's Gould Medical Dictionary, 4th ed.). This does not include tissue respiration (= oxygen consumption) or cell respiration (= cell respiration). [NIH] Retina: The ten-layered nervous tissue membrane of the eye. It is continuous with the optic nerve and receives images of external objects and transmits visual impulses to the brain. Its outer surface is in contact with the choroid and the inner surface with the vitreous body. The outer-most layer is pigmented, whereas the inner nine layers are transparent. [NIH] Rhinitis: Inflammation of the mucous membrane of the nose. [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] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [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] Rubber: A high-molecular-weight polymeric elastomer derived from the milk juice (latex) of

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Hevea brasiliensis and other trees. It is a substance that can be stretched at room temperature to atleast twice its original length and after releasing the stress, retractrapidly, and recover its original dimensions fully. Synthetic rubber is made from many different chemicals, including styrene, acrylonitrile, ethylene, propylene, and isoprene. [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] Schizoid: Having qualities resembling those found in greater degree in schizophrenics; a person of schizoid personality. [NIH] Schizophrenia: A mental disorder characterized by a special type of disintegration of the personality. [NIH] Schizotypal Personality Disorder: A personality disorder in which there are oddities of thought (magical thinking, paranoid ideation, suspiciousness), perception (illusions, depersonalization), speech (digressive, vague, overelaborate), and behavior (inappropriate affect in social interactions, frequently social isolation) that are not severe enough to characterize schizophrenia. [NIH] Screening: Checking for disease when there are no symptoms. [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] Security Measures: Regulations to assure protection of property and equipment. [NIH] Sedative: 1. Allaying activity and excitement. 2. An agent that allays excitement. [EU] 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] Semicircular canal: Three long canals of the bony labyrinth of the ear, forming loops and opening into the vestibule by five openings. [NIH] Semisynthetic: Produced by chemical manipulation of naturally occurring substances. [EU] Sensor: A device designed to respond to physical stimuli such as temperature, light, magnetism or movement and transmit resulting impulses for interpretation, recording, movement, or operating control. [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] Serotonin: A biochemical messenger and regulator, synthesized from the essential amino

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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] Serrated: Having notches or teeth on the edge as a saw has. [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] 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] Signal Transduction: The intercellular or intracellular transfer of information (biological activation/inhibition) through a signal pathway. In each signal transduction system, an activation/inhibition signal from a biologically active molecule (hormone, neurotransmitter) is mediated via the coupling of a receptor/enzyme to a second messenger system or to an ion channel. Signal transduction plays an important role in activating cellular functions, cell differentiation, and cell proliferation. Examples of signal transduction systems are the GABA-postsynaptic receptor-calcium ion channel system, the receptor-mediated T-cell activation pathway, and the receptor-mediated activation of phospholipases. Those coupled to membrane depolarization or intracellular release of calcium include the receptormediated activation of cytotoxic functions in granulocytes and the synaptic potentiation of protein kinase activation. Some signal transduction pathways may be part of larger signal transduction pathways; for example, protein kinase activation is part of the platelet activation signal pathway. [NIH] Signs and Symptoms: Clinical manifestations that can be either objective when observed by a physician, or subjective when perceived by the patient. [NIH] Skeletal: Having to do with the skeleton (boney part of the body). [NIH] Skeleton: The framework that supports the soft tissues of vertebrate animals and protects many of their internal organs. The skeletons of vertebrates are made of bone and/or cartilage. [NIH] 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] Smooth muscle: Muscle that performs automatic tasks, such as constricting blood vessels. [NIH]

Social Environment: The aggregate of social and cultural institutions, forms, patterns, and processes that influence the life of an individual or community. [NIH]

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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] Sodium Bicarbonate: A white, crystalline powder that is commonly used as a pH buffering agent, an electrolyte replenisher, systemic alkalizer and in topical cleansing solutions. [NIH] Sodium Lactate: The sodium salt of racemic or inactive lactic acid. It is a hygroscopic agent used intravenously as a systemic and urinary alkalizer. [NIH] Soma: The body as distinct from the mind; all the body tissue except the germ cells; all the axial body. [NIH] Somatic: 1. Pertaining to or characteristic of the soma or body. 2. Pertaining to the body wall in contrast to the viscera. [EU] Spasm: An involuntary contraction of a muscle or group of muscles. Spasms may involve skeletal muscle or smooth muscle. [NIH] Spatial disorientation: Loss of orientation in space where person does not know which way is up. [NIH] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Specificity: Degree of selectivity shown by an antibody with respect to the number and types of antigens with which the antibody combines, as well as with respect to the rates and the extents of these reactions. [NIH] Spectrum: A charted band of wavelengths of electromagnetic vibrations obtained by refraction and diffraction. By extension, a measurable range of activity, such as the range of bacteria affected by an antibiotic (antibacterial s.) or the complete range of manifestations of a disease. [EU] Sperm: The fecundating fluid of the male. [NIH] Spike: The activation of synapses causes changes in the permeability of the dendritic membrane leading to changes in the membrane potential. This difference of the potential travels along the axon of the neuron and is called spike. [NIH] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] Spondylitis: Inflammation of the vertebrae. [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]

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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] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Stroke: Sudden loss of function of part of the brain because of loss of blood flow. Stroke may be caused by a clot (thrombosis) or rupture (hemorrhage) of a blood vessel to the brain. [NIH] Styrene: A colorless, toxic liquid with a strong aromatic odor. It is used to make rubbers, polymers and copolymers, and polystyrene plastics. [NIH] 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] Substance P: An eleven-amino acid neurotransmitter that appears in both the central and peripheral nervous systems. It is involved in transmission of pain, causes rapid contractions of the gastrointestinal smooth muscle, and modulates inflammatory and immune responses. [NIH]

Substrate: A substance upon which an enzyme acts. [EU] Suppression: A conscious exclusion of disapproved desire contrary with repression, in which the process of exclusion is not conscious. [NIH] Sympathetic Nervous System: The thoracolumbar division of the autonomic nervous system. Sympathetic preganglionic fibers originate in neurons of the intermediolateral column of the spinal cord and project to the paravertebral and prevertebral ganglia, which in turn project to target organs. The sympathetic nervous system mediates the body's response to stressful situations, i.e., the fight or flight reactions. It often acts reciprocally to the parasympathetic system. [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] Synapses: Specialized junctions at which a neuron communicates with a target cell. At classical synapses, a neuron's presynaptic terminal releases a chemical transmitter stored in synaptic vesicles which diffuses across a narrow synaptic cleft and activates receptors on the postsynaptic membrane of the target cell. The target may be a dendrite, cell body, or axon of another neuron, or a specialized region of a muscle or secretory cell. Neurons may also communicate through direct electrical connections which are sometimes called electrical synapses; these are not included here but rather in gap junctions. [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

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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] Systemic: Affecting the entire body. [NIH] Systole: Period of contraction of the heart, especially of the ventricles. [NIH] Systolic: Indicating the maximum arterial pressure during contraction of the left ventricle of the heart. [EU] Temperament: Predisposition to react to one's environment in a certain way; usually refers to mood changes. [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] Tetrahydrocannabinol: A psychoactive compound extracted from the resin of Cannabis sativa (marihuana, hashish). The isomer delta-9-tetrahydrocannabinol (THC) is considered the most active form, producing characteristic mood and perceptual changes associated with this compound. Dronabinol is a synthetic form of delta-9-THC. [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] Thorax: A part of the trunk between the neck and the abdomen; the chest. [NIH] Threshold: For a specified sensory modality (e. g. light, sound, vibration), the lowest level (absolute threshold) or smallest difference (difference threshold, difference limen) or intensity of the stimulus discernible in prescribed conditions of stimulation. [NIH] Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] 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] Tidal Volume: The volume of air inspired or expired during each normal, quiet respiratory cycle. Common abbreviations are TV or V with subscript T. [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] Tonic: 1. Producing and restoring the normal tone. 2. Characterized by continuous tension. 3. A term formerly used for a class of medicinal preparations believed to have the power of restoring normal tone to tissue. [EU] Tonus: A state of slight tension usually present in muscles even when they are not

Dictionary 135

undergoing active contraction. [NIH] Tooth Preparation: Procedures carried out with regard to the teeth or tooth structures preparatory to specified dental therapeutic and surgical measures. [NIH] Topical: On the surface of the body. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Trace element: Substance or element essential to plant or animal life, but present in extremely small amounts. [NIH] Traction: The act of pulling. [NIH] Transcutaneous: Transdermal. [EU] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [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] 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]

Trees: Woody, usually tall, perennial higher plants (Angiosperms, Gymnosperms, and some Pterophyta) having usually a main stem and numerous branches. [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] 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] Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [NIH] Urticaria: A vascular reaction of the skin characterized by erythema and wheal formation due to localized increase of vascular permeability. The causative mechanism may be allergy, infection, or stress. [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]

136 Anxiety Attacks

Vagus Nerve: The 10th cranial nerve. The vagus is a mixed nerve which contains somatic afferents (from skin in back of the ear and the external auditory meatus), visceral afferents (from the pharynx, larynx, thorax, and abdomen), parasympathetic efferents (to the thorax and abdomen), and efferents to striated muscle (of the larynx and pharynx). [NIH] Vasodilator: An agent that widens blood vessels. [NIH] VE: The total volume of gas either inspired or expired in one minute. [NIH] Vector: Plasmid or other self-replicating DNA molecule that transfers DNA between cells in nature or in recombinant DNA technology. [NIH] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Venlafaxine: An antidepressant drug that is being evaluated for the treatment of hot flashes in women who have breast cancer. [NIH] Venous: Of or pertaining to the veins. [EU] Ventricle: One of the two pumping chambers of the heart. The right ventricle receives oxygen-poor blood from the right atrium and pumps it to the lungs through the pulmonary artery. The left ventricle receives oxygen-rich blood from the left atrium and pumps it to the body through the aorta. [NIH] Vertebrae: A bony unit of the segmented spinal column. [NIH] Vestibular: Pertaining to or toward a vestibule. In dental anatomy, used to refer to the tooth surface directed toward the vestibule of the mouth. [EU] Vestibule: A small, oval, bony chamber of the labyrinth. The vestibule contains the utricle and saccule, organs which are part of the balancing apparatus of the ear. [NIH] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Virulence: The degree of pathogenicity within a group or species of microorganisms or viruses as indicated by case fatality rates and/or the ability of the organism to invade the tissues of the host. [NIH] Viscera: Any of the large interior organs in any one of the three great cavities of the body, especially in the abdomen. [NIH] Visceral: , from viscus a viscus) pertaining to a viscus. [EU] Visceral Afferents: The sensory fibers innervating the viscera. [NIH] Vitamin A: A substance used in cancer prevention; it belongs to the family of drugs called retinoids. [NIH] Wheelchairs: Chairs mounted on wheels and designed to be propelled by the occupant. [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] 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]

137

INDEX A Abdominal, 105, 124 Aberrant, 105, 112 ACE, 105 Acetylcholine, 65, 105, 111 Acrylonitrile, 105, 130 Adaptation, 6, 105 Adenosine, 105, 109, 125 Adjustment, 105 Adolescence, 6, 105 Adrenergic, 26, 105, 114, 115, 127, 133, 136 Adverse Effect, 105, 126, 131 Aerobic, 11, 105 Aerobic Exercise, 11, 105 Affinity, 105, 106, 114, 132 Age of Onset, 61, 106 Agonist, 106, 114, 123 Alertness, 106, 109 Algorithms, 106, 109 Alkaloid, 106, 109, 111, 123, 136 Alternative medicine, 106 Amine, 106, 118 Amino Acids, 64, 106, 123, 125, 126, 127, 129, 135 Amnestic, 106, 116, 122 Amphetamines, 106, 112 Amygdala, 4, 8, 23, 106, 120, 130 Anaesthesia, 106, 119 Anaphylatoxins, 107, 112 Anatomical, 107, 108, 119 Anesthesia, 107, 122 Angina, 36, 38, 107, 127 Angina Pectoris, 107, 127 Animal model, 61, 66, 107 Antagonism, 107, 109 Antibacterial, 107, 132 Antibiotic, 107, 132 Antibody, 106, 107, 112, 118, 121, 132 Anticholinergic, 107, 126 Anticonvulsant, 107, 111 Antidepressant, 12, 107, 111, 113, 118, 136 Antigen, 106, 107, 112, 118, 121 Antigen-Antibody Complex, 107, 112 Antihistamine, 19, 108 Anxiety Disorders, 6, 8, 11, 13, 15, 17, 19, 23, 26, 34, 36, 70, 71, 72, 73, 88, 89, 108, 124 Anxiolytic, 61, 62, 66, 108, 122

Aqueous, 108 Arrhythmia, 8, 108, 122 Arterial, 108, 118, 127, 134 Arteries, 108, 109, 113, 121, 122 Asphyxia, 65, 108 Assay, 67, 108 Atrium, 108, 122, 136 Atrophy, 11, 108 Auditory, 9, 108, 121, 136 Autonomic, 33, 105, 108, 123, 133 Autonomic Nervous System, 108, 133 B Bacteria, 107, 108, 122, 132, 135 Bacterial Physiology, 105, 108 Basal Ganglia, 108, 120 Base, 67, 108, 119, 134 Behavior Therapy, 31, 35, 55, 108 Benzene, 108, 109 Benzodiazepines, 14, 42, 60, 63, 109 Bicuculline, 4, 109 Bile, 109, 116, 120, 132 Biochemical, 18, 27, 61, 109, 125, 130 Biotechnology, 10, 73, 81, 109 Bladder, 109, 125 Blood Platelets, 109, 131 Blood pressure, 4, 26, 109, 111, 118, 122, 132 Blood vessel, 105, 109, 110, 119, 131, 133, 134, 136 Blood-Brain Barrier, 109, 125 Body Fluids, 109, 132 Bowel, 109, 114, 119 Bowel Movement, 109, 114 Branch, 99, 109, 121, 125, 128, 132, 134 Bronchi, 109, 115 Bronchial, 34, 109, 118 C Caffeine, 27, 103, 109 Calcium, 29, 109, 110, 112, 131 Cannabidiol, 110 Cannabinoids, 35, 110 Cannabinol, 110 Capsules, 54, 56, 110 Carbon Dioxide, 9, 49, 64, 110, 114, 118, 129 Carboxy, 60, 110 Carcinogenic, 109, 110, 127, 132 Cardiac, 12, 23, 109, 110, 115, 122, 132

138 Anxiety Attacks

Cardiology, 61, 110 Cardiorespiratory, 105, 110, 122 Cardioselective, 110, 127 Cardiovascular, 23, 27, 61, 103, 110, 131 Carotid Body, 110 Case report, 19, 110 Catecholamine, 110, 114 Cell Respiration, 110, 129 Central Nervous System, 60, 105, 106, 108, 109, 110, 111, 116, 117, 125, 127, 131 Cerebral, 17, 61, 108, 109, 110, 113, 115, 116, 117, 125, 134 Cerebral Aqueduct, 110, 125 Cerebrum, 110 Chemoreceptor, 8, 110 Chemotactic Factors, 111, 112 Chest Pain, 20, 111 Chimera, 34, 111 Chiropractic, 68, 111 Chlorpheniramine, 19, 111 Cholecystokinin, 16, 24, 26, 60, 61, 67, 111 Cholesterol, 16, 109, 111, 132 Cholinergic, 111, 123, 130 Chondroitin sulfate, 29, 111 Chromosome, 13, 14, 61, 111, 120 Chronic, 48, 61, 67, 68, 111 Clinical trial, 3, 10, 53, 57, 81, 111, 113, 128 Clomipramine, 11, 26, 111 Clonazepam, 10, 53, 54, 111 Clonic, 111 Cloning, 109, 111 Coca, 111 Cocaine, 34, 103, 111 Cochlea, 112, 119 Cochlear, 55, 112 Cofactor, 112, 127 Cognition, 112 Cognitive behavior therapy, 4, 21, 33, 55, 112 Cognitive Therapy, 17, 112 Comorbidity, 4, 5, 19, 112 Complement, 10, 107, 112, 113, 121 Complementary and alternative medicine, 31, 44, 112 Complementary medicine, 31, 113 Complete remission, 113, 129 Computational Biology, 81, 113 Concomitant, 24, 113 Conjunctiva, 113, 125 Consultation, 10, 113 Contraindications, ii, 113 Controlled study, 16, 17, 36, 113

Conventional therapy, 27, 113 Conventional treatment, 113 Convulsions, 107, 109, 113 Coronary, 107, 113, 121, 122 Coronary Thrombosis, 113, 121, 122 Cortical, 113, 130 Cotinine, 7, 113 Cranial, 113, 117, 136 Cues, 5, 113 Curative, 113, 134 Cyclic, 64, 109, 113 D Databases, Bibliographic, 81, 114 Decarboxylation, 114, 118 Dendritic, 114, 132 Depersonalization, 114, 124, 130 Depressive Disorder, 22, 53, 54, 114 Derealization, 114, 124 Desipramine, 34, 114 Diagnostic procedure, 59, 114 Diastolic, 114, 118 Digestion, 109, 114, 119, 120, 133 Digestive system, 58, 114 Dilatation, 114, 127 Dilation, 64, 114 Dimethyl, 62, 114 Direct, iii, 112, 114, 129, 133 Diuresis, 109, 114 Dizziness, 33, 64, 68, 102, 114, 124 Dopamine, 65, 66, 112, 114 Drive, ii, vi, 4, 25, 115 Dysphoric, 35, 114, 115 Dyspnea, 115, 124 E Effector, 105, 112, 115, 123 Efficacy, 4, 27, 32, 37, 49, 54, 55, 56, 60, 61, 63, 115, 135 Electrolyte, 115, 126, 132 Electrons, 108, 115, 119 Embryo, 115, 119 Endoscopic, 115, 122 Endotoxins, 112, 115 Environmental Health, 80, 82, 115 Enzymatic, 110, 112, 115, 118 Enzyme, 105, 115, 125, 127, 131, 133 Epidemiological, 67, 115 Epinephrine, 105, 114, 115, 123, 135 Epithalamus, 115, 120 ERV, 23, 82, 115, 116 Esophagus, 114, 115, 125, 133 Estrogen, 116, 127 Ethinyl Estradiol, 10, 20, 116

Index 139

Evoke, 116, 133 Excitation, 106, 110, 116 Exocrine, 111, 116, 124 Expiration, 116, 129 Expiratory, 115, 116 Expiratory Reserve Volume, 115, 116 Extracellular, 116, 132 Extrapyramidal, 114, 116 F Facial, 34, 102, 116, 121 Family Planning, 81, 116 Fatigue, 68, 116 Fats, 109, 111, 116 Fatty acids, 10, 20, 116 Fenfluramine, 4, 116 Fluvoxamine, 26, 116 Forearm, 109, 116 Friction, 116 G GABA, 109, 111, 116, 131 Gallbladder, 105, 111, 114, 116 Ganglia, 105, 116, 123, 133 Gas, 110, 115, 116, 118, 128, 136 Gastric, 116, 118, 119, 125 Gastric Acid, 116, 125 Gastrin, 60, 116, 118, 125 Gastrointestinal, 60, 111, 115, 117, 131, 133 Gastrointestinal tract, 111, 117, 131 Gene, 14, 20, 67, 73, 109, 117 Generator, 117 Genetics, 8, 13, 14, 24, 61, 117 Gland, 117, 118, 124, 126, 130, 133, 134 Glucose, 27, 117, 119, 130 Glycosaminoglycan, 111, 117 Gonadal, 117, 132 Governing Board, 117, 126 Gravidity, 117, 124 Growth, 27, 105, 107, 117, 126, 134, 135 Gyrus Cinguli, 117, 120 H Haplotypes, 24, 117 Headache, 35, 109, 117 Hemorrhage, 117, 133 Hemostasis, 117, 131 Heredity, 117 Hippocampus, 117, 120, 130 Histamine, 65, 107, 108, 111, 118, 127 Histidine, 118 Homologous, 118, 133, 134 Hormonal, 108, 118 Hormone, 27, 115, 116, 118, 121, 127, 131, 134

Hydrogen, 106, 108, 118, 122 Hydrolysis, 118, 126, 127 Hypersensitivity, 9, 118 Hypertension, 18, 38, 39, 61, 117, 118, 127 Hyperthyroidism, 118, 127 Hyperventilation, 7, 8, 27, 34, 35, 37, 48, 118 Hypnotherapy, 36, 41, 45, 118 Hypnotic, 118, 122 Hypomania, 21, 118 Hypothalamic, 16, 118 Hypothalamus, 108, 118, 120, 126, 127, 130 I Id, 29, 37, 89, 90, 91, 98, 100, 118 Imipramine, 18, 22, 57, 63, 111, 118 Immunity, 118 Impairment, 68, 118, 121 Impotence, 119, 136 Indicative, 5, 55, 69, 119, 125 Induction, 6, 26, 119, 127 Infarction, 119 Infusion, 5, 15, 26, 28, 119 Inhalation, 9, 33, 119, 126 Inner ear, 21, 119 Inositol, 26, 42, 43, 119 Inotropic, 115, 119 Insulator, 119 Intermittent, 17, 63, 119 Intestinal, 111, 119 Intestine, 60, 109, 119, 120 Intoxication, 119, 136 Intracellular, 109, 119, 126, 129, 131 Intravenous, 5, 27, 119 Intrinsic, 106, 119, 125 Intrinsic Factor, 119, 125 Invasive, 118, 119, 120 Involuntary, 119, 122, 129, 132 Ions, 108, 115, 118, 119, 122 Ischemia, 107, 108, 119 J Joint, 68, 119 K Kb, 80, 119 L Labile, 24, 112, 120 Labyrinth, 112, 119, 120, 130, 136 Lag, 120 Large Intestine, 114, 119, 120, 129, 131 Larynx, 120, 136 Library Services, 98, 120 Ligands, 66, 120 Limbic, 8, 19, 106, 117, 120

140 Anxiety Attacks

Limbic System, 8, 106, 117, 120 Linkage, 14, 120 Lipid, 120, 122 Liver, 105, 109, 111, 114, 116, 120 Lobe, 23, 120 Lordosis, 120, 125 M Magnetic Resonance Imaging, 11, 15, 120 Maintenance therapy, 55, 120 Major Histocompatibility Complex, 117, 120 Malnutrition, 108, 121 Mania, 118, 121 Manifest, 22, 64, 121 Meatus, 121, 136 Mediate, 114, 121 Mediator, 111, 121, 131 Medicament, 65, 121 MEDLINE, 81, 121 Medroxyprogesterone, 27, 121 Meiosis, 121, 133, 134 Membrane, 112, 113, 120, 121, 122, 125, 129, 131, 132, 133 Memory, 121 Meninges, 110, 121 Meningioma, 12, 121 Menopause, 121, 127 Mental Disorders, 58, 89, 121, 128 Mental Health, iv, 3, 4, 26, 27, 53, 54, 55, 57, 58, 70, 80, 82, 88, 89, 90, 121, 128 Metabolite, 111, 114, 121 Methionine, 114, 121 MI, 34, 65, 104, 121 Microbe, 121, 135 Microbiology, 105, 122 Midazolam, 63, 122 Mitral Valve, 61, 122 Mitral Valve Prolapse, 61, 122 Modeling, 15, 67, 122 Modification, 15, 122, 128 Molecular, 8, 60, 81, 83, 109, 113, 122, 127, 129, 135 Molecular Structure, 122, 135 Molecule, 107, 108, 111, 112, 115, 116, 117, 118, 122, 128, 131, 136 Monitor, 6, 122, 124 Motility, 122, 131 Motion Sickness, 68, 122, 127 Mucins, 122, 130 Mucosa, 111, 122, 127 Muscle Relaxation, 6, 122 Mydriatic, 114, 122, 136

Myocardial infarction, 113, 121, 122, 127 Myocardium, 107, 121, 122 N Nausea, 64, 68, 102, 122, 124 NCI, 1, 57, 79, 122 Necrosis, 119, 121, 122, 123 Need, 64, 70, 71, 72, 73, 75, 93, 105, 123, 134 Nerve, 105, 107, 111, 121, 123, 129, 133, 135, 136 Neural, 114, 123, 130 Neurology, 22, 24, 123 Neuromuscular, 105, 123 Neuromuscular Junction, 105, 123 Neurons, 112, 116, 123, 133 Neuropeptide, 61, 123 Neurophysiology, 18, 123 Neurosis, 123, 125 Neurotic, 33, 123 Neurotransmitters, 123 Nicotine, 7, 68, 123 Nonverbal Communication, 123, 128 Norepinephrine, 105, 114, 123 Nuclear, 108, 115, 120, 123, 124, 134 Nuclei, 106, 115, 120, 124, 130 Nucleus, 4, 108, 114, 121, 124, 127, 130 Nursing Care, 124 O On-line, 101, 124 Outpatient, 9, 56, 124 Oxygen Consumption, 124, 129 P Palliative, 124, 134 Pancreas, 105, 114, 124 Pancreatic, 13, 111, 124 Pancreatic cancer, 13, 124 Paralysis, 102, 124 Paresthesias, 124 Parity, 124 Paroxetine, 53, 54, 55, 124 Paroxysmal, 8, 61, 107, 124 Partial remission, 124, 129 Pathogenesis, 24, 124 Pathologic, 113, 118, 125 Pathophysiology, 7, 125 Pedigree, 9, 125 Pentagastrin, 10, 20, 27, 35, 125 Pepsin, 125 Peptide, 60, 111, 125, 126, 127, 134 Periaqueductal Gray, 26, 125 Pharmacodynamics, 35, 125 Pharmacologic, 107, 125, 135

Index 141

Pharynx, 125, 136 Phobia, 8, 13, 15, 46, 64, 71, 72, 125 Phobic Disorders, 125 Phospholipids, 119, 125 Phosphorus, 63, 110, 125 Physiologic, 106, 125, 129 Physiology, 110, 123, 125 Physostigmine, 28, 125 Pilot study, 4, 126 Pituitary Gland, 126, 127 Placebo Effect, 15, 126 Plants, 106, 109, 110, 111, 117, 124, 126, 130, 135 Plasma, 26, 60, 117, 126 Poisoning, 119, 122, 126 Polymorphic, 67, 126 Polymorphism, 20, 67, 126 Polypeptide, 60, 125, 126, 127 Potassium, 63, 126 Potentiate, 126 Practicability, 126, 135 Practice Guidelines, 82, 90, 126 Precursor, 114, 115, 123, 126, 135 Prescription drug abuse, 56, 126 Prevalence, 4, 16, 55, 67, 126 Probe, 8, 127 Problem Solving, 4, 127 Progesterone, 127, 132 Progression, 107, 127 Progressive, 6, 117, 123, 127 Projection, 123, 127 Prolactin, 127 Promethazine, 111, 127 Promoter, 24, 127 Prone, 61, 127 Prophase, 127, 133, 134 Propranolol, 22, 127 Prospective study, 13, 127 Protein S, 73, 109, 127, 129 Proteins, 106, 107, 112, 122, 125, 126, 127, 129, 131 Proteolytic, 112, 127 Protirelin, 27, 127 Protocol, 11, 128 Psychiatric, 8, 12, 16, 18, 19, 72, 88, 89, 90, 121, 128 Psychic, 66, 123, 128, 130 Psychopathology, 6, 11, 22, 128 Psychosomatic, 12, 21, 33, 34, 35, 55, 128 Psychotherapy, 4, 49, 112, 128 Psychotropic, 62, 128 Public Health, 7, 10, 23, 82, 128

Public Policy, 81, 128 Publishing, 10, 128 Pulmonary, 109, 118, 128, 136 Pulmonary Artery, 109, 128, 136 Pulmonary Ventilation, 118, 128 Pulse, 26, 122, 128 Pupil, 114, 122, 128 Q Quality of Life, 6, 7, 9, 128 R Race, 16, 128, 132 Radiopharmaceutical, 117, 128 Rage, 125, 128 Randomized, 5, 10, 57, 115, 128 Rape, 128 Receptor, 14, 20, 26, 27, 53, 61, 66, 105, 107, 110, 111, 114, 128, 131 Receptors, Serotonin, 129, 131 Recombinant, 129, 136 Rectum, 109, 114, 116, 120, 129 Refer, 1, 112, 114, 129, 136 Reflex, 125, 129 Refraction, 129, 132 Refractory, 9, 129 Regimen, 55, 115, 126, 129 Regurgitation, 122, 129 Relapse, 5, 7, 15, 129 Reliability, 129 Remission, 9, 120, 129 Respiration, 8, 110, 111, 122, 129 Retina, 129 Rhinitis, 111, 129 Ribosome, 129, 135 Risk factor, 127, 129 Rod, 129 Role-play, 31, 129 Rubber, 105, 129 S Saliva, 7, 130 Salivary, 114, 124, 130 Salivary glands, 114, 130 Saponins, 130, 132 Schizoid, 130, 136 Schizophrenia, 39, 70, 130, 136 Schizotypal Personality Disorder, 114, 130, 136 Screening, 7, 111, 130 Secretion, 18, 118, 122, 125, 127, 130 Security Measures, 130 Sedative, 118, 122, 127, 130 Seizures, 23, 68, 111, 124, 130 Semicircular canal, 119, 130

142 Anxiety Attacks

Semisynthetic, 116, 130 Sensor, 130 Septal, 120, 130 Septal Nuclei, 120, 130 Serotonin, 16, 20, 65, 66, 111, 114, 116, 124, 129, 130, 131, 135 Serrated, 131 Sertraline, 10, 22, 131 Serum, 27, 107, 112, 131 Sex Characteristics, 105, 131 Shock, 131, 135 Side effect, 65, 105, 131, 135 Signal Transduction, 119, 131 Signs and Symptoms, 129, 131 Skeletal, 64, 131, 132 Skeleton, 119, 131 Skull, 131, 134 Small intestine, 118, 119, 131 Smooth muscle, 106, 107, 109, 118, 131, 132, 133 Social Environment, 128, 131 Sodium, 26, 27, 29, 132 Sodium Bicarbonate, 26, 132 Sodium Lactate, 26, 132 Soma, 132 Somatic, 22, 63, 105, 120, 121, 132, 136 Spasm, 68, 132 Spatial disorientation, 114, 132 Specialist, 92, 114, 132 Species, 115, 121, 128, 132, 136 Specificity, 9, 106, 132 Spectrum, 132 Sperm, 111, 132 Spike, 19, 132 Spinal cord, 110, 111, 121, 123, 129, 132, 133 Spondylitis, 33, 132 Steel, 5, 132 Steroid, 27, 130, 132 Stimulant, 109, 113, 118, 133 Stimulus, 5, 115, 116, 120, 124, 125, 129, 133, 134 Stomach, 105, 114, 115, 116, 117, 118, 122, 125, 131, 133 Stress, 8, 24, 39, 40, 53, 70, 88, 102, 108, 110, 122, 130, 133, 135 Stroke, 58, 65, 80, 133 Styrene, 130, 133 Subclinical, 130, 133 Substance P, 121, 130, 133 Substrate, 17, 133 Suppression, 8, 49, 133

Sympathetic Nervous System, 64, 108, 133 Sympathomimetic, 114, 115, 124, 133 Symptomatic, 9, 133 Synapses, 123, 132, 133 Synapsis, 133 Synaptic, 65, 123, 131, 133, 134 Synaptic Transmission, 123, 134 Systemic, 40, 109, 115, 132, 134 Systole, 122, 134 Systolic, 118, 122, 134 T Temperament, 18, 134 Temporal, 12, 23, 106, 117, 121, 134 Temporal Lobe, 12, 106, 134 Tetrahydrocannabinol, 110, 134 Thalamus, 115, 120, 134 Therapeutics, 9, 134 Thorax, 134, 136 Threshold, 9, 118, 134 Thrombosis, 127, 133, 134 Thyrotropin, 127, 134 Tidal Volume, 8, 118, 134 Tissue, 60, 107, 108, 109, 110, 111, 116, 121, 122, 123, 126, 129, 131, 132, 133, 134 Tolerance, 111, 134 Tonic, 111, 134 Tonus, 125, 134 Tooth Preparation, 105, 135 Topical, 132, 135 Toxic, iv, 108, 118, 123, 133, 135 Toxicity, 55, 126, 135 Toxicology, 61, 82, 135 Trace element, 63, 135 Traction, 135 Transcutaneous, 8, 135 Transfection, 109, 135 Translating, 135 Translation, 135 Transmitter, 105, 114, 121, 123, 133, 135 Trauma, 8, 65, 117, 123, 135 Treatment Outcome, 6, 24, 135 Trees, 130, 135 Tricyclic, 22, 65, 111, 114, 118, 135 Tryptophan, 131, 135 Tyrosine, 114, 135 U Unconscious, 118, 135 Urinary, 132, 135 Urticaria, 111, 135 V Vaccine, 128, 135 Vagus Nerve, 66, 136

Index 143

Vasodilator, 115, 118, 136 VE, 136 Vector, 136 Vein, 119, 124, 136 Venlafaxine, 54, 56, 136 Venous, 127, 136 Ventricle, 106, 115, 117, 118, 122, 128, 134, 136 Vertebrae, 132, 136 Vestibular, 55, 56, 136 Vestibule, 112, 119, 130, 136 Veterinary Medicine, 81, 136

Virulence, 135, 136 Viscera, 132, 136 Visceral, 40, 108, 120, 136 Visceral Afferents, 108, 136 Vitamin A, 119, 136 W Wheelchairs, 136 Withdrawal, 7, 20, 37, 136 X Xenograft, 107, 136 Y Yohimbine, 4, 18, 26, 27, 136

144 Anxiety Attacks