End-Stage Renal Disease - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

END-STAGE RENAL DISEASE A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENC...

Author: ICON Health Publications

19 downloads 1381 Views 3MB Size Report

This content was uploaded by our users and we assume good faith they have the permission to share this book. If you own the copyright to this book and it is wrongfully on our website, we offer a simple DMCA procedure to remove your content from our site. Start by pressing the button below!
Report copyright / DMCA form

DOWNLOAD PDF

END-STAGE RENAL DISEASE 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

ii

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

Publisher, Health Care: Philip Parker, Ph.D. Editor(s): James Parker, M.D., Philip Parker, Ph.D. Publisher's note: The ideas, procedures, and suggestions contained in this book are not intended for the diagnosis or treatment of a health problem. As new medical or scientific information becomes available from academic and clinical research, recommended treatments and drug therapies may undergo changes. The authors, editors, and publisher have attempted to make the information in this book up to date and accurate in accord with accepted standards at the time of publication. The authors, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of this book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised to always check product information (package inserts) for changes and new information regarding dosage and contraindications before prescribing any drug or pharmacological product. Caution is especially urged when using new or infrequently ordered drugs, herbal remedies, vitamins and supplements, alternative therapies, complementary therapies and medicines, and integrative medical treatments. Cataloging-in-Publication Data Parker, James N., 1961Parker, Philip M., 1960End-Stage Renal Disease: 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: 0-597-84412-7 1. End-Stage Renal Disease-Popular works. I. Title.

iii

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.

iv

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 end-stage renal disease. 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.

v

About the Editors James N. Parker, M.D. Dr. James N. Parker received his Bachelor of Science degree in Psychobiology from the University of California, Riverside and his M.D. from the University of California, San Diego. In addition to authoring numerous research publications, he has lectured at various academic institutions. Dr. Parker is the medical editor for 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.

vi

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

vii

Table of Contents FORWARD .......................................................................................................................................... 1 CHAPTER 1. STUDIES ON END-STAGE RENAL DISEASE .................................................................... 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on End-Stage Renal Disease ............................................................ 32 E-Journals: PubMed Central ....................................................................................................... 37 The National Library of Medicine: PubMed ................................................................................ 38 CHAPTER 2. NUTRITION AND END-STAGE RENAL DISEASE .......................................................... 87 Overview...................................................................................................................................... 87 Finding Nutrition Studies on End-Stage Renal Disease ............................................................. 87 Federal Resources on Nutrition ................................................................................................... 92 Additional Web Resources ........................................................................................................... 93 CHAPTER 3. ALTERNATIVE MEDICINE AND END-STAGE RENAL DISEASE .................................... 95 Overview...................................................................................................................................... 95 National Center for Complementary and Alternative Medicine.................................................. 95 Additional Web Resources ......................................................................................................... 100 General References ..................................................................................................................... 101 CHAPTER 4. DISSERTATIONS ON END-STAGE RENAL DISEASE .................................................... 103 Overview.................................................................................................................................... 103 Dissertations on End-Stage Renal Disease ................................................................................ 103 Keeping Current ........................................................................................................................ 105 CHAPTER 5. CLINICAL TRIALS AND END-STAGE RENAL DISEASE .............................................. 107 Overview.................................................................................................................................... 107 Recent Trials on End-Stage Renal Disease ................................................................................ 107 Keeping Current on Clinical Trials ........................................................................................... 108 CHAPTER 6. PATENTS ON END-STAGE RENAL DISEASE .............................................................. 111 Overview.................................................................................................................................... 111 Patents on End-Stage Renal Disease ......................................................................................... 111 Patent Applications on End-Stage Renal Disease...................................................................... 114 Keeping Current ........................................................................................................................ 117 CHAPTER 7. BOOKS ON END-STAGE RENAL DISEASE .................................................................. 119 Overview.................................................................................................................................... 119 Book Summaries: Federal Agencies............................................................................................ 119 Book Summaries: Online Booksellers......................................................................................... 121 Chapters on End-Stage Renal Disease ....................................................................................... 122 Directories.................................................................................................................................. 127 CHAPTER 8. MULTIMEDIA ON END-STAGE RENAL DISEASE ....................................................... 129 Overview.................................................................................................................................... 129 Video Recordings ....................................................................................................................... 129 CHAPTER 9. PERIODICALS AND NEWS ON END-STAGE RENAL DISEASE .................................... 131 Overview.................................................................................................................................... 131 News Services and Press Releases.............................................................................................. 131 Newsletter Articles .................................................................................................................... 133 Academic Periodicals covering End-Stage Renal Disease.......................................................... 137 APPENDIX A. PHYSICIAN RESOURCES .......................................................................................... 141 Overview.................................................................................................................................... 141 NIH Guidelines.......................................................................................................................... 141 NIH Databases........................................................................................................................... 143 Other Commercial Databases..................................................................................................... 145 APPENDIX B. PATIENT RESOURCES ............................................................................................... 147 Overview.................................................................................................................................... 147

viii Contents

Patient Guideline Sources.......................................................................................................... 147 Finding Associations.................................................................................................................. 153 APPENDIX C. FINDING MEDICAL LIBRARIES ................................................................................ 155 Overview.................................................................................................................................... 155 Preparation................................................................................................................................. 155 Finding a Local Medical Library................................................................................................ 155 Medical Libraries in the U.S. and Canada ................................................................................. 155 ONLINE GLOSSARIES................................................................................................................ 161 Online Dictionary Directories ................................................................................................... 164 END-STAGE RENAL DISEASE DICTIONARY ..................................................................... 165 INDEX .............................................................................................................................................. 221

1

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 end-stage renal disease 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 end-stage renal disease, 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 end-stage renal disease, 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 end-stage renal disease. 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 end-stage renal disease, 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 end-stage renal disease. The Editors

1

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

3

CHAPTER 1. STUDIES ON END-STAGE RENAL DISEASE Overview In this chapter, we will show you how to locate peer-reviewed references and studies on end-stage renal disease.

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

Advance Directives in End-Stage Renal Disease Inherently Involve Family and Staff Source: Advances in Renal Replacement Therapy. 5:(2): 109-119. April 1998. Contact: Available from W.B. Saunders Company. Periodicals Department, 6277 Sea Harbor Drive, Orlando, FL 32887-4800. (800) 654-2452. Summary: Advance directives (ADs) have a pivotal role in the practice of clinical nephrology. In this article, the authors offer their viewpoint on ADs, drawing on the present literature and on many case anecdotes from their own practice. The review focuses on the intrinsic value of an AD; the impact of family and staff on clinical outcome in general; family relationships and medical decision making, especially in the area of ADs, the importance of communication within families and between families

4

End-Stage Renal Disease

and staff, as characterized in family meetings; and the power of reconciliation when family members and staff let go. The authors note the difficult balance between treating aggressively to achieve desirable results but stopping just short of futility. Avoiding unwanted outcomes has prompted many individuals to spell out their wishes ahead of time to maintain control over their destiny and ensure personal dignity in their death. In the final analysis, the authors contend that ADs present the opportunity for approaching medical decision making in a manner that can lessen the stress of making difficult decisions for the patient and even promote peace of mind for all concerned family and staff. When staff members can address the situation with patients, family, and involved staff, the process of dying and the finality of death can be made somewhat less difficult. Case studies are provided to illustrate the concepts under discussion. 84 references. •

Epidemic of End-Stage Renal Disease Among African Americans: Where Do We Go From Here? Source: Renalife. 14(4): 5, 9, 13, 18, 29. Winter 1999. Contact: Available from American Association of Kidney Patients (AAKP). 100 South Ashley Drive, Suite 280, Tampa, FL 33602. (800) 749-AAKP or (813) 223-7099. E-mail: [email protected]. Website: www.aakp.org. Summary: African Americans develop end-stage renal disease (ESRD) at a rate four times that of the overall U.S. population. This article discusses three challenges and opportunities relevant to renal failure among the African American community: prevention, facilitating transplantation, and maximizing the delivery of high quality dialysis care. The author contends that special strategies to deliver quality care and improve outcomes in the African American dialysis patient should improve the care for all Americans at risk for kidney failure. Outreach programs to improve awareness and understanding for high risk patients (those with diabetes, high blood pressure, or family history of kidney disease) are crucial first steps in prevention in the African American community. However, implementation of screening and treatment programs is complicated by limited access to health care and cultural attitudes about health care. Factors that can impact transplantation include fears of discrimination in the organ allocation process, concerns about meeting posttransplant medication costs, and fear of the operation itself. The author emphasizes the importance of successful crosscultural communication, particularly in support of patient involvement in dialysis options and pretransplant care and education. Key aspects of health for improving outcomes in all hemodialysis patients are discussed, including dialysis adequacy, avoiding severe anemia, good nutrition, blood pressure control, diabetes control, preventing bone disease, and vascular access. The author also discusses patient compliance and nonadherence to drug regimens or dialysis schedules, and the factors related to each. The author reiterates the need for patience and confirmation of patient understanding as the core factors in successful crosscultural communication and education. 3 tables.

•

Clinical Correlates of Hypertensive End-Stage Renal Disease Source: American Journal of Kidney Diseases. 31(1): 28-34. January 1998. Contact: Available from W.B. Saunders Company. Periodicals Department, 6277 Sea Harbor Drive, Orlando, FL 32887-4800. (800) 654-2452 or (407) 345-4000. Summary: Although there has been much discussion regarding the etiology of hypertensive (high blood pressure) renal (kidney) disease, clinical characteristics of this condition have not been thoroughly studied. This article reports on an investigation that identified clinical correlates of hypertensive end stage renal disease (ESRD) in a

Studies

5

population of patients older than 50 years and that compared these clinical findings with those in a group of ESRD patients with certain known disorders (established diagnoses). Data regarding demographics, cause of ESRD, educational level, presence of diabetes mellitus, angina, myocardial infarction (heart attack), and peripheral vascular disease were obtained from the Southeastern Kidney Council for patients starting renal replacement therapy between January 1990 and August 1996. Data showed hypertensive ESRD diagnosed in 24 percent of white and 38 percent of black patients, while established diagnoses were present in 17 percent of white and 7 percent of black ESRD patients. The most common established diagnoses were polycystic kidney disease, specific glomerulonephritis (infection or inflammation of the filtering units of the kidneys), and nephrolithiasis (kidney stones) or obstruction. White patients were found more likely to be classified as having hypertensive ESRD if they were older, suffered from angina and other forms of atherosclerosis, smoked, and were less educated. For black patients, the presence of peripheral vascular disease and female gender were associated with an increased chance of being diagnosed as having hypertensive ESRD. The authors conclude that the unique association of hypertensive ESRD with atherosclerosis suggests that atherosclerosis is a risk factor for chronic renal failure and that a primary renal microvascular condition may lead to both hypertension and progressive renal insufficiency. 7 tables. 28 references. •

Family Caregivers: Caring for Aging End-Stage Renal Disease Partners Source: Advances in Renal Replacement Therapy. 5:(2): 98-108. April 1998. Contact: Available from W.B. Saunders Company. Periodicals Department, 6277 Sea Harbor Drive, Orlando, FL 32887-4800. (800) 654-2452. Summary: As the population of patients with end stage renal disease (ESRD) ages, increasingly their care and support burden falls on their families. This article focuses on the role changes, strains, and burdens for family caregivers, particularly spouses, in this situation. The author discusses the process of dramatic role changes and losses that occur within families and the resulting risks to dialysis patients and caregivers. The importance of constant assessment of caregivers by renal professionals is emphasized. Without reassessment, errors can be made in the area of how much dialysis patients can realistically be expected to do for themselves. As a general rule, however, both professionals and family caregivers should err on the side of encouraging as much independent and self-care as possible in patients. The author offers suggestions for families and professionals coping with role change and care burdens. The author raises concerns about American society shifting more care burdens onto families at a time of cultural change and stress on families, without providing enough societal support and programs to assist families adequately with care burdens of aging family members. Dialysis providers can be involved with direct patient and family care, as well as with essential debate at the professional and society level. 30 references. (AA-M).

•

Survival Improvement Among Patients with End-Stage Renal Disease: Trends over Time for Transplant Recipients and Wait-Listed Patients Source: JASN. Journal of the American Society of Nephrology. 12(6): 1293-1296. June 2001. Contact: Available from Lippincott Williams and Wilkins. 12107 Insurance Way, Hagerstown, MD 21740. (800) 638-6423. Summary: Both kidney transplant and dialysis outcomes have improved over recent years. In addition, transplantation has been shown to confer a survival benefit over

6


maintenance dialysis. This article reports on a study undertaken to determine whether the survival benefit of transplantation over maintenance dialysis has changed in the most recent eras. The study was based on data collected by the United States Renal Transplant Scientific Registry and the United States Renal Data System (USRDS). The study sample consisted of 104,000 patients placed on the renal transplant waiting list between 1988 and 1996, of which 73,707 subsequently received renal transplants. Overall annual adjusted death rates in the wait listed patients and transplant recipients per 1000 patient years decreased for both groups throughout the study period. From 1989 to 1996, the relative risk (RR) for patient death had decreased by 30 percent for transplant recipients and 23 percent for waitlisted patients. Slope analysis of the cause specific mortality rates for cardiovascular disease and infection showed nearly equivalent, linear decreases for both groups. Mortality (death) rates have improved overall and by categories of major cause of death for both renal transplant recipients and patients on the renal transplant waiting list. These favorable trends most likely represent equal advances in transplantation, dialysis, and general medical care. 6 figures. 1 table. 16 references. •

Impact of Anemia Correction on Cardiovascular Disease in End-Stage Renal Disease Source: Seminars in Nephrology. 20(4): 350-355. July 2000. Contact: Available from W.B. Saunders Company. Periodicals Department. 6277 Sea Harbor Drive, Orlando, FL 32887-4800. (800) 654-2452. Summary: Cardiovascular disease (CVD) is a major cause of mortality and morbidity in patients with end stage renal disease (ESRD). This article explores the impact of anemia correction on CVD in patients with ESRD. Anemia, a result of erythropoietin deficiency, is associated with increased all cause and cardiovascular mortality in this population, and predisposes patients to the development of symptomatic heart disease. Anemia is also associated with the development and progression of left ventricular echocardiographic disorders, which strongly predict cardiac failure and death. Left ventricular dilatation with compensatory hypertrophy, the major pattern of echocardiographic disease progression in hemodialysis patients, is a particularly strong predictor of late mortality. Partial correction of anemia with recombinant human erythropoietin likely reduces left ventricular mass and volume. Complete correction of anemia may prevent progressive left ventricular dilatation in patients with normal left ventricular volumes. A recent trial, however, reports excess mortality and vascular access loss in patients with preexisting symptomatic heart disease when anemia was completely corrected. Consequently, hematocrit (red blood cells) target ranges above 32 to 36 percent cannot be recommended in this population. Despite improvements seen in echocardiographic disease in patients without symptomatic heart disease, it is not yet possible to conclude that potential benefits derived from a normalized hematocrit will outweigh potential risks in this subgroup of dialysis patients. 1 figure. 5 tables. 34 references.

•

Survival After Acute Myocardial Infarction in Patients with End-Stage Renal Disease: Results from the Cooperative Cardiovascular Project Source: American Journal of Kidney Diseases. 35(6): 1044-1051. June 2000. Contact: Available from W.B. Saunders Company. Periodicals Department, 6277 Sea Harbor Drive, Orlando, FL 32887-4800. (800) 654-2452 or (407) 345-4000. Summary: Cardiovascular disease (CVD) is the most common cause of death in patients with end stage renal disease (ESRD). The optimal management strategy in this

Studies

7

population is unknown. This article reports on a study of 640 patients with ESRD and acute myocardial infarction during 1994 to 1995 as part of the Health Care Financing Administration's Cooperative Cardiovascular Project. The majority of patients were treated with medical therapy alone, 46 patients (7 percent) were treated with percutaneous transluminal coronary angioplasty (PTCA), and 29 patients (5 percent) underwent coronary artery bypass grafting (CABG). Patient characteristics and comorbid conditions were similar among the three groups. The overall 1 year mortality (death) rate was 53 percent. Advanced age, low or high body mass index, history of peripheral vascular disease or stroke, the inability to walk independently, and several indicators of cardiac dysfunction were associated with an increased relative risk (RR) for death. Survival curves differed significantly by treatment modality, with 1 year survival rates of 45 percent, 54 percent, and 69 percent in the medical therapy alone, PTCA, and CABG groups, respectively. There are no randomized clinical trial data to guide therapy of CVD in patients with ESRD. On the basis of this study and other available data, CABG may be the optimal therapy for CVD in ESRD. In light of the exceptionally poor outcomes observed for patients treated with medical therapy alone, it may be premature to dismiss PTCA as a therapeutic option in this population. 1 figure. 3 tables. 27 references. •

Diagnosis and Management of Coronary Artery Disease in Patients With End-Stage Renal Disease on Hemodialysis (editorial review) Source: JASN. Journal of the American Society of Nephrology. 7(10): 2044-2054. October 1996. Summary: Cardiovascular disease accounts for almost half of the total mortality in patients with end-stage renal disease (ESRD). The markedly increased prevalence of atherosclerotic cardiovascular disease in patients with ESRD is influenced, at least in part, by numerous risk factors for atherosclerosis, with hypertension, diabetes mellitus, and hypercholesterolemia being particularly important. This article reviews the diagnosis and management of coronary artery disease (CAD) in patients with ESRD on hemodialysis. Because atherosclerotic CAD, whether symptomatic or asymptomatic, is associated with an increased incidence of allograft failure and mortality, there is a need for careful evaluation for the presence of CAD in those persons who are under consideration for renal transplantation. Candidates with angina pectoris, previous myocardial infarction, or congestive heart failure are at particularly high risk of a cardiac event. Therefore, these patients should routinely undergo pretransplant coronary angiography and subsequent surgical revascularization if angina is refractory to medical therapy or CAD is extensive. In contrast, although young, nondiabetic transplant candidates without symptoms or electrocardiographic evidence of CAD have an increased relative risk of cardiac death when compared with age-matched control subjects, their absolute risk of such an event is very low. As a result, they do not require a cardiac evaluation before transplantation. For the remaining transplant candidates at neither low nor high risk of a fatal or nonfatal cardiac event, the authors routinely perform thallium imaging with dipyridamole or two-dimensional echocardiography with intravenous dobutamine. Percutaneous transluminal coronary angioplasty is not recommended in patients with ESRD because it appears to be accompanied by a high likelihood of acute and chronic complications. 5 figures. 2 tables. 96 references. (AA-M).

•

Anemia, Hypertension, and Myocardial Dysfunction in End-Stage Renal Disease Source: Seminars in Nephrology. 17(4): 257-269. July 1997.

8


Contact: Available from W.B. Saunders Company. Periodicals Department, 6277 Sea Harbor Drive, Orlando, FL 32887-4800. (800) 654-2452. Summary: Cardiovascular disease remains the major cause of mortality in patients with end-stage renal disease (ESRD). This article addresses myocardial dysfunction in patients with ESRD. The pathophysiology of cardiac dysfunction in ESRD is complex and not fully understood. However, it appears that the two major determinants of left ventricular (LV) hypertrophy and dysfunction are anemia and hypertension, both of which are very common in ESRD patients. Early and aggressive correction of anemia and hypertension may have a significant impact on cardiac disease in ESRD patients. The authors' discussion focuses on the management of anemia and hypertension, and the current information available on the pathogenesis and management of LV dysfunction in ESRD. The authors report on the use of various hypertensive agents, summarizing the side effects of these agents, as well as comorbid conditions influencing choice of drugs. The most current recommendation for treating anemia is to administer erythropoietin (EPO) to all anemic patients with advanced renal failure. The most likely etiology for a suboptimal response to EPO is iron deficiency. It is recommended that iron stores be checked and supplemented before EPO therapy is started. Even in the presence of adequate stores at the start of therapy, patients may rapidly deplete their iron stores during the hematopoietic response to EPO. The authors conclude that, due to the complexity of the pathogenesis of cardiac dysfunction in uremic patients, a multidimensional approach is necessary. Control of hypertension and correction of anemia are important in the longterm management of heart failure. 4 tables. 125 references. (AA-M). •

Cost Analysis of Ongoing Care of Patients with End-Stage Renal Disease: The Impact of Dialysis Modality and Dialysis Access Source: American Journal of Kidney Diseases. 40(3): 611-622. September 2002. Contact: Available from W.B. Saunders Company. Periodicals Department, 6277 Sea Harbor Drive, Orlando, FL 32887-4800. (800) 654-2452 or (407) 345-4000. Summary: Care of patients with end stage renal (kidney) disease (ESRD) is important and resource-intense. To enable ESRD programs to develop strategies for most costefficient care, an accurate estimate of the cost of caring for patients with ESRD is needed. This article reports on a study undertaken to develop an updated and accurate itemized description of costs and resources required to treat patients with ESRD on dialysis therapy and to contrast the differences in resources required for various dialysis modalities. The study included 166 patients who had been on dialysis therapy for longer than 6 months. Costs considered included those related to outpatient dialysis care, inpatient care, outpatient nondialysis care, and physician claims. Results showed overall annual cost of care for in-center care was US $51,252; for satellite care, $42,057; for home care hemodialysis $29,961; and for peritoneal dialysis $26,959. Among patients treated with hemodialysis, the costs of vascular access related care was lower by more than fivefold for patients who began the study period with a functioning native arteriovenous fistula compared with those treated with a permanent catheter or synthetic graft. The authors conclude that, to maximize the efficiency with which care is provided to patients with ESRD, dialysis programs should encourage the use of home or self care hemodialysis and peritoneal dialysis. 4 tables. 41 references.

•

Recreational Drug Use: A Neglected Risk Factor for End-Stage Renal Disease Source: American Journal of Kidney Diseases. 38(1): 49-56. July 2001.

Studies

9

Contact: Available from W.B. Saunders Company. Periodicals Department, 6277 Sea Harbor Drive, Orlando, FL 32887-4800. (800) 654-2452 or (407) 345-4000. Summary: Case series have suggested that heroin and cocaine users are at increased risk for renal (kidney) failure, but the contribution of heroin and other addictive drugs to the incidence of end stage renal disease (ESRD) in the general population remains unknown. This article reports on a study undertaken to clarify this issue. The authors conducted a case control study in the general population to examine associations between drug use and treated ESRD. Cases were 716 patients who started therapy for ESRD in 1991, identified through a regional registry. Controls were 361 persons of similar age (20 to 65 years) selected by random digit dialing. Main risk factors examined were the lifetime use of heroin, cocaine, and other addictive drugs, assessed by telephone interview. After adjustment for age, sex, race, socioeconomic status, and history of hypertension (high blood pressure) and diabetes, results showed that persons who had ever used heroin or other opiates (any amount) were at increased risk for ESRD. After adjustment for the same sociodemographic and medical history variables, the use of cocaine or crack and psychedelic drugs was also associated with ESRD, but these associations could not be separated from the effects of heroin use. The authors briefly discuss the mechanisms that may be involved in heroin induced renal disease. 4 tables. 32 references. •

Patient Satisfaction with Care and Behavioral Compliance in End-Stage Renal Disease Patients Treated with Hemodialysis Source: American Journal of Kidney Diseases. 39(6): 1236-1244. June 2002. Contact: Available from W.B. Saunders Company. Periodicals Department, 6277 Sea Harbor Drive, Orlando, FL 32887-4800. (800) 654-2452 or (407) 345-4000. Summary: Compliance with the hemodialysis (HD) prescription is an important predictor of patient outcome. Although there is interest in the concept of patient satisfaction with medical care and caregivers, relatively few such data exist regarding HD patients. This article reports on a study that examined whether associations exist between patient satisfaction with medical personnel, depressive affect, social support levels, and behavioral compliance with prescribed HD treatment. The study included 79 HD patients who went through an interview process that assessed depression, social support, and perception of satisfaction with dialysis staff. Medical and treatment data, Karnofsky functioning and severity of illness scores, and behavioral and laboratory compliance measures were determined. There was no association between patient satisfaction with care and level of depressive affect. A relationship was found between patient satisfaction with care with their nephrologist and attendance at dialysis sessions. Patients who had a poor perception of satisfaction with their nephrologist had poorer attendance at dialysis sessions. There was no relationship between behavioral compliance and patient perception of ancillary HD staff. In addition, patient perception of satisfaction with staff was related to perception of social support, protein catabolic rate, and serum albumin concentration, all of which have been linked to survival. The authors conclude that the nephrologist has a crucial role in patient compliance. These results suggest that interventions to improve patient perception of physician support may also improve patient adjustment and possibly survival. 6 tables. 28 references.

•

Simultaneous Pancreas-Kidney Transplant Compared with Kidney Transplant in Type 1 Diabetic Patients with End-Stage Renal Disease Source: Transplantation Proceedings. 34(1): 204-205. February 2002.

10


Contact: Available from Elsevier Science Inc. 655 Avenue of the Americas, New York, NY 10010. (212) 633-3730. Website: www.elsevier.com. Summary: Diabetic nephropathy (kidney disease) as a result of diabetes mellitus type 1 is the etiology (cause) of terminal renal (kidney) insufficiency in 6 percent of patients on a dialysis program and in 8.7 percent of kidney transplant patients. This group of patients can benefit from a combined pancreas-kidney transplant (PKT), rather than an isolated kidney transplant. So contend the authors of this study of simultaneous pancreas-kidney transplant compared with kidney transplant. The authors assess the number of rejections, kidney graft function, kidney and pancreas graft survival, and patient survival during the first 2 post transplant years. Patients who receive a PKT show acute rejection, kidney graft function, and patient survival rates that are comparable with those of diabetes patients receiving an isolated kidney transplant. However, morbidity is greater in the PKT group, as are complications, particularly in the first posttransplant year, which is reflected by longer hospital stays. Graft survival is significantly greater in the PKT group than in the KT group, probably due to the new immunosuppression used in the majority of the patients in this group, as a large part of them were transplanted more recently than the isolated kidney transplants. 8 references. •

End-Stage Renal Disease: Are We Ready for an Emerging Epidemic? (editorial) Source: Postgraduate Medicine. 108(1): 13-15. July 2000. Contact: Available from McGraw-Hill, Inc. 1221 Avenue of the Americas, New York, NY 10020. (612) 832-7869. Summary: End stage renal (kidney) disease (ESRD) has occupied a unique place in the U.S. health care system since 1972, when Social Security extended Medicare coverage to patients under age 65 with ESRD or chronic kidney failure who require dialysis or a kidney transplant. Since that time, more than a million such patients have entered the Medicare entitlement program. This editorial explores the readiness of the medical community to handle this emerging epidemic. The author discusses progress in reducing the rate of ESRD development in the United States; efforts that can further reduce the rate of kidney failure, primarily by concentrating on patients with chronic renal insufficiency in the period prior to dialysis or transplantation; and the growing role for primary care physicians in early recognition and treatment of patients with chronic renal insufficiency. The author contends that the decline in the number of specialists being trained in nephrology in the face of an increasing number of patients with ESRD raises questions as to the ability of health care providers to care for these patients in the future. One sidebar explains the role of the U.S. Renal Data System (USRDS), an agency that collects, analyzes, and distributes information about ESRD in the United States. 1 table. 2 references.

•

Incidence Trends and Mortality in End-Stage Renal Disease Attributed to Renovascular Disease in the United States Source: American Journal of Kidney Diseases. 37(6): 1184-1190. June 2001. Contact: Available from W.B. Saunders Company. Periodicals Department, 6277 Sea Harbor Drive, Orlando, FL 32887-4800. (800) 654-2452 or (407) 345-4000. Summary: End stage renal disease (ESRD) attributed to renovascular disease (RVD ESRD) has been incompletely characterized. This article reports on a study in which the authors determined incidence trends, clinical features, prior treatment, and survival of patients with RVD ESRD using the United States Renal Data System database. Primary

Studies

11

causes of ESRD were assessed in patients starting ESRD therapy during 1991 to 1997. The incidence of RVD ESRD increased from 1.4 percent of new ESRD cases to 2.1 percent of new ESRD cases; the annualized increase was 12.4 percent per year. This is a greater rate of increase than for ESRD from diabetes mellitus (DM ESRD; 8.3 percent per year) and ESRD overall (5.4 percent per year). The risk for RVD ESRD versus other cause ESRD correlated positively with age, and male sex, and negatively with black, Asian, and Native American race. The unadjusted prevalence of coronary heart disease, cerebrovascular disease (including stroke), and peripheral vascular disease was greater in patients with RVD ESRD versus other cause ESRD. Adjusted for age, race, sex, comorbidity (other illnesses present), and laboratory values, the survival of patients with RVD ESRD was similar to that for patients with other cause ESRD. These findings suggest that RVD ESRD is increasing faster than other cause ESRD and is not independently associated with an increased mortality risk. The authors conclude that strategies may exist to prevent progression to ESRD and merit priority for further study. 5 figures. 4 tables. 22 references. •

Understanding and Affirming the Sexual/Relationship Realities of End-Stage Renal Disease Patients and Their Significant Others Source: Advances in Renal Replacement Therapy. 5:(2): 81-88. April 1998. Contact: Available from W.B. Saunders Company. Periodicals Department, 6277 Sea Harbor Drive, Orlando, FL 32887-4800. (800) 654-2452. Summary: End stage renal disease (ESRD) frequently occurs within the social context of relationships and has many predictable consequences in the experience of patients and their significant others. This article offers suggestions for health care providers on understanding and affirming the sexual and relationship realities of ESRD patients and their significant others. The author stresses that relationship and sexual issues and concerns must be assessed early in the treatment process and be continually attended to as patients seek new levels of coping. Sex-role conflicts, changes in sexual functioning and sexual self-esteem, challenges to both physical and emotional intimacy, and the life altering consequences of chronic illness are all very real for ESRD patients. If professionals are untrained in the area of human sexuality and sex therapy or uncomfortable discussing these issues, which is often the case, they need to enlist others in the community to assist in the process. Individual and couple counseling must be available. Couple support groups are an especially effective vehicle in which to address the real life concerns of couples coping with chronic illness because they allow couples to help other couples. 32 references. (AA-M).

•

End-Stage Renal Disease Projections for Canada to 2005 Using Poisson and Markov Models Source: International Journal of Epidemiology. 27(2): 274-281. April 1998. Contact: Available from Oxford University Press. Journals Subscription Department, Great Clarendon Street, Oxford OX2 6DP, UK. 44 (0)1865 267907. Fax 44 (0)1865 267485. Summary: End stage renal disease (ESRD) incidence and prevalence are increasing in many countries worldwide. Due to the high cost of therapy, predicting future numbers of patients requiring dialysis and transplantation is necessary for health care planners. However, projecting therapy specific chronic disease prevalence is inherently problematic, and examples of suitable models and their application are sparse. This article describes and illustrates a method for projecting therapy specific ESRD prevalence in Canada for 1995 through 2005 using data obtained from the Canadian

12


Organ Replacement Register. The projections combine the Poisson model for incidence rates and a Markov model for patient followup. Model adequacy is empirically validated by data splitting. The results showed that large increases in ESRD prevalence are expected in Canada, with an average annual increase of 6.9 percent projected for 1995 to 2005. Upon validation, the projection model based on 1981 to 1987 data was able to predict 1994 prevalence within 1 percent, while projected therapy specific prevalences closely approximated those observed. The authors conclude that therapy specific ESRD prevalence was successfully projected using Poisson and Markov models. Where multistate prevalence forecasts are required, the method could be augmented for application to various other chronic diseases. 4 figures. 7 tables. 25 references. •

Trends in End-Stage Renal Disease: Epidemiology, Morbidity and Mortality Source: Postgraduate Medicine. 108(1): 124-126, 129-131, 135-136, 140, 142. July 2000. Contact: Available from McGraw-Hill, Inc. 1221 Avenue of the Americas, New York, NY 10020. (612) 832-7869. Summary: End stage renal disease (ESRD), which is often related to diabetes or hypertension, is a serious medical and economic public health problem throughout the world. An understanding of the scope of this condition, as well as the trends in its outcome, is essential for optimizing treatment of ESRD and establishing meaningful strategies for prevention. In this article, the author describes the epidemiology of ESRD and reviews the trends in morbidity and mortality for patients undergoing dialysis or renal (kidney) transplantation. The extraordinary mortality rate among patients with underlying comorbid conditions, such as diabetes or atherosclerotic vascular disease, points to areas needing special attention. However, the author notes that both mortality among dialysis patients and the rate at which ESRD has increased over the past decade are declining. The primary goal should be prevention of ESRD. Aggressive treatment of hypertension and hyperglycemia is likely to reduce the incidence of ESRD. The author concludes that screening for diabetes and hypertension may be a good approach to reducing ESRD rates, because many patients present with renal failure after prolonged periods of undiagnosed hypertension or type 2 diabetes. 6 figures. 15 references.

•

Growth Failure, Risk of Hospitalization and Death of Children with End-Stage Renal Disease Source: Pediatric Nephrology. 17(6): 450-455. June 2002. Contact: Available from Springer-Verlag. Service Center Secaucus, 44 Hartz Way, Secaucus, NJ 07094. (201) 348-4033. Summary: Growth failure remains a significant problem for children with chronic renal insufficiency and end stage renal disease (ESRD). This article reports on a study that examined whether growth failure is associated with more-frequent hospitalizations or higher mortality in children with kidney disease. The authors studied data on prevalent United States pediatric patients with ESRD in 1990 who were followed through 1995. Patients were categorized according to the standard deviation score (SDS) of their incremental growth during 1990. Among 1,112 prevalent pediatric dialysis and transplant patients, those with severe and moderate growth failure had higher hospitalization rates respectively than those with normal growth after adjustment for age, gender, race, cause and duration of ESRD, and treatment modality in 1990. Survival analysis showed 5 year survival rates of 85 percent and 90 percent for patients with severe and moderate growth failure, respectively, compared with 96 percent for patients with normal growth. A higher proportion of deaths in the severe and moderate growth

Studies

13

failure groups were attributed to infectious causes (22 percent and 18.7 percent, respectively) than in the normal growth group (15.6 percent). The authors conclude that growth failure is associated with a more complicated clinical course and increased risk of death for children with kidney failure. 1 figure. 3 tables. 15 references. •

Quality of Life in End-Stage Renal Disease Patients Source: American Journal of Kidney Diseases. 38(3): 443-464. September 2001. Contact: Available from W.B. Saunders Company. Periodicals Department, 6277 Sea Harbor Drive, Orlando, FL 32887-4800. (800) 654-2452 or (407) 345-4000. Summary: Health related quality of life (QOL) refers to the measure of a patient's functioning, well being, and general health perception in each of three domains: physical, psychological, and social. Along with survival and other types of clinical outcomes, patient QOL is an important indicator of the effectiveness of the medical care they receive. This review article points out the importance of QOL assessment throughout the different stages of kidney disease, from chronic renal (kidney) insufficiency (CRI), to the early stages of kidney disease, to end stage renal disease (ESRD). QOL of patients with ESRD is influenced by the disease itself and by the type of renal replacement therapy (hemodialysis, peritoneal dialysis, or transplantation). Numerous studies have identified the effect of such factors as anemia, age, comorbidity, and depression on QOL. Most of these factors appear during the predialysis period, and the adequate management of some of them could influence patient outcomes. Among replacement therapies, transplantation appears to give the best QOL for large groups of patients. No conclusive data exist to prove differences in QOL between hemodialysis patients and peritoneal dialysis patients. In the case of elderly patients or those with a high degree of comorbidity (the presence of other illnesses), the best treatment option should be assessed in each individual case, taking all possible factors into account. Finally, it has been proven that physical and mental function are inversely correlated with the risk for hospitalization and mortality (death). 1 figure. 7 tables. 163 references.

•

Hepatitis C Infection and the Patient with End-Stage Renal Disease Source: Hepatology. 36(1): 3-10. July 2002. Contact: Available from W.B. Saunders Company. 6277 Sea Harbor Drive, Orlando, FL 19106-3399. (800) 654-2452 or (407) 345-4000. Summary: Hepatitis C virus (HCV) remains common in patients with end stage renal (kidney) disease (ESRD) and is an important cause of liver disease in this population. This article considers HCV infection and the patient with end stage renal disease. Acquisition of HCV infection continues to occur in dialysis patients because of nosocomial (due to medical procedures or settings) spread. The natural history of HCV in dialysis patients remains controversial because the course of HCV typically extends over decades, whereas dialysis patients have higher morbidity and mortality (death) rates than those of the general population, limiting long term follow up. However, recent reports suggest that HCV infection affects the survival of chronic dialysis patients as well as renal transplant (RT) recipients. The severity of preexisting liver disease on pretransplantation liver biopsy may provide useful prognostic information about clinical outcome after RT; liver biopsy should be incorporated in the evaluation and management of RT candidates with HCV. Use of renal grafts from HCV-infected donors in recipients with HCV does not appear to result in a greater burden of liver disease. There is only limited data about interferon (IFN) therapy in chronic dialysis patients, although sustained responses are reported. Preliminary data on IFN plus ribavirin

14


therapy in dialysis patients with hepatitis C have given encouraging results, but randomized trials are needed. 1 figure. 3 tables. 51 references. •

Prevention and Treatment of Renal Osteodystrophy in Children with Chronic Renal Insufficiency and End-Stage Renal Disease Source: Seminars in Nephrology. 21(5): 441-450. September 2001. Contact: Available from W.B. Saunders Company. Periodicals Department. 6277 Sea Harbor Drive, Orlando, FL 32887-4800. (800) 654-2452. Summary: Histologic features associated with secondary hyperparathyroidism (overactive parathyroid gland) remain the predominant skeletal lesion in adults and children with chronic renal (kidney) failure. This article considers the prevention and treatment of renal osteodystrophy (bone disease associated with kidney disease) in children with chronic renal insufficiency (CRI) and end stage renal disease (ESRD). When instituted early, vitamin D therapy has been shown to slow the development and progression of the biochemical, radiographic, and histologic (cell structure) evidence of secondary hyperparathyroidism in patients with CRI. Aggressive parathyroid hormone suppression, however, has led to the increased prevalence of adynamic bone (bone that does not grow and change in response to the body's needs). Adynamic bone has been attributed partly to aggressive calcitriol therapy, administration of high amounts of exogenous calcium either as a phosphate binding agent or during dialysis therapy, presence of diabetes, older age, or previous parathyroidectomy (removal of the gland). Several vitamin D analogues are currently being evaluated in patients with chronic renal failure (CRF) to prevent complications associated with calcitriol therapy. In addition, calcium-free phosphate binding agents and the use of calcimimetic drugs may play a significant role in the effective management of secondary hyperparathyroidism in children with CRF. 2 figures. 73 references.

•

Reducing Cardiovascular Morbidity and Mortality from Hypertension in End-Stage Renal Disease Source: Current Opinion in Nephrology and Hypertension. 9(5): 497-500. September 2000. Contact: Available from Lippincott Williams and Wilkins. P.O. Box 1600, Hagerstown, MD 21741. (800) 638-3030 or (301) 223-2300. Fax (301) 223-2400. Website: www.currentopinion.com. Summary: Hypertension (high blood pressure) worsens with declining renal function and is an almost universal feature of end stage renal disease (ESRD). This article reviews research that focuses on ways to reduce cardiovascular morbidity and mortality from hypertension in ESRD. The authors note that treating hypertension (particularly with ACE inhibitors) clearly reduces the likelihood of cardiovascular disease in nonrenal populations, with greater absolute benefit in those who have greater severity of underlying cardiovascular disease. Patients with chronic renal diseases are at enormous cardiovascular risk. Although the approach to hypertension in patients with early renal insufficiency (the kidneys are functioning below healthy levels) has become more aggressive, the rationale has switched over the past decade from cardiovascular risk reduction to slowing the loss of renal function. However, reliance on observational studies, especially using mortality as the outcome, has not allowed a consistent, rational approach to the treatment of hypertension in dialysis patients. It is likely that hypertension in dialysis populations, as in other groups, is a risk factor for cardiovascular morbidity and mortality. 26 references (6 annotated).

Studies

•

15

Rapid Progression to End-Stage Renal Disease in Young Hypertensive African Americans with Proteinuria Source: Journal of the National Medical Association. 90(11): 649-655. November 1998. Summary: Hypertensive nephrosclerosis (kidney damage related to high blood pressure) remains the most common cause of end-stage renal disease (ESRD) in African Americans. This article reports on a study undertaken to examine whether renal histology corresponds with clinical hypertension in blacks with proteinuria (protein in the urine). Nondiabetic blacks with hypertension who satisfied inclusion criteria were enrolled in the study. Four male patients, each with a family history of hypertension and mean age 41 years, consented to kidney biopsy. Their mean arterial pressure was 116.5 mm Hg; mean urine protein excretion was 7.7 grams per day. All patients progressed to ESRD within a mean duration of 14 months; the mean rate of decline in glomerular filtration rate (GFR) was 53 mL per min per year, with an ESRD incidence of 80 percent per year. The histologic findings were consistent with previously described features of HN. Prominent glomerulosclerosis involved 30 to 75 percent of the glomeruli and extensive arteriolosclerosis or arteriosclerosis, tubular atrophy, and interstitial fibrosis. There was no evidence of immune complex disease by either immunofluorescence, electron microscopy, or serologic studies. The mean arterial pressure showed a strong but nonsignificant correlation with progression to ESRD and arteriosclerosis or arteriolosclerosis. Glomerular sclerosis correlated with the reciprocal of serum creatinine, interstitial fibrosis, and arteriosclerosis or arteriolosclerosis. Urine protein excretion correlated weakly with progress to ESRD. These results indicate a poor correlation between clinical findings and histologic features on renal biopsy in young hypertensive African Americans. Hypertension remains a major cause of ESRD among African Americans, and progression to ESRD may be rapid in patients with marked proteinuria. Early and aggressive intervention is warranted. 3 figures. 2 tables. 29 references. (AA-M).

•

Exercise, End-Stage Renal Disease, and Your Vascular Access Source: For Patients Only. 14(2): 19-23. March-April 2001. Contact: Available from For Patients Only. 18 East 41st Street, New York, NY 10017. (818) 704-5555. Fax (818) 704-6500. Summary: In this article, the author emphasizes the positive effects that exercise can have on the mind, body, and well being of patients with end stage renal disease (ESRD). The author first outlines the two main categories of exercise, isometric and isotonic, and explains how these affect muscle fiber length and tension as well as vascular resistance, blood pressure (BP), and mean arterial pressure changes. Isometric exercises increase muscle tension without changing fiber length; the immediate benefits of isometric exercises are to build and strengthen muscle. Isometric exercises include weight lifting, resistance training like push ups or chin ups, and grip strengthening exercises. Isotonic exercises shorten muscle fibers without increasing tension. Isotonic exercise primarily build endurance and include aerobic activities like running, swimming, and walking. The author outlines the benefits of exercise, which include lowered resting blood pressure readings, healthy body weight achieved and maintained, improved cholesterol profile, and reduced stress and anxiety. The author then addresses potential complications, especially for patients on dialysis and those who use a vascular access (VA) for their hemodialysis. Since the use of erythropoietin (EPO) to control the effects of anemia has become standard in the care of ESRD patients, anemia is less of a problem than it once was. The author reminds readers to stay aware of bone loss risk factors with

16


kidney disease and to incorporate these concerns in exercise plans. For patients who decide to participate in activities that involve the potential for collision or falls, the author offers strategies for protecting the vascular access, including the use of lightweight padded plastic arm guards. The author concludes by encouraging readers to consult with their nephrologist before undertaking any new exercise program. 1 figure. •

Adaptation of African-American Cultural and Food Preferences in End-Stage Renal Disease Diets Source: Advances in Renal Replacement Therapy. 4(1): 30-39. January 1997. Contact: Available from W.B. Saunders Company. Periodicals Department, 6277 Sea Harbor Drive, Orlando, FL 32887-4800. (800) 654-2452. Summary: In this article, the authors describe African American cultural and food preferences and how they can be adapted to end-stage renal disease (ESRD) diets. The authors stress that emphasis on culturally based and ethnically oriented food selection by nutrition health professionals is needed to effectively plan therapeutic diets. The authors document the influence of immigration on regional cuisine. Dominant patterns of typical African American ethnic menus for holidays and special celebrations are described. The article includes a list analysis of common foods in the African American culture, along with a glossary of ethnic food terms. Renal guidelines are presented for various stages of ESRD. A suggested sample menu for hemodialysis patients that incorporates African American preferences is included. The authors also discuss how health risks, such as hypertension and obesity, influence current eating trends of this population. Literacy skills and providing appropriate patient education materials are also discussed. The authors encourage readers to integrate appropriate information, cultural food preferences, intervention tools, teaching materials, and ethnic terminology in a suitable social setting to effectively communicate renal diet guidelines. 4 tables. 14 references. (AA-M).

•

End-Stage Renal Disease Therapy: An American Success Story (commentary) Source: JAMA. Journal of the American Medical Association. 275(14): 1118-1122. April 10, 1996. Summary: In this commentary, the author reflects on the U.S. End-Stage Renal Disease (ESRD) program. Topics include the cost of ESRD care; alleged excessive U.S. mortality in patients treated with dialysis; international comparisons of mortality in ESRD; U.S. ESRD acceptance rate compared to other countries; the European approach to ESRD treatment; the low kidney transplant rate in Japan; dialysis adequacy; statistical techniques and studies; and the ESRD program and Medicare after 20 years' experience. The author voices his skepticism over international comparisons of ESRD mortality and concludes that the U.S. ESRD program is a model of how a national health care system should work. 2 figures. 41 references.

•

Meaningful Rehabilitation of the End-Stage Renal Disease Patient Source: Seminars in Nephrology. 17(3): 246-252. May 1997. Contact: Available from W.B. Saunders Company. Periodicals Department, 6277 Sea Harbor Drive, Orlando, FL 32887-4800. (800) 654-2452. Summary: In this highly technological age, health care providers are called to attend to the patient as a whole person, with dreams and goals and a desire for purpose and meaning in life. In this article, the authors propose a broadened definition of

Studies

17

rehabilitation and a rehabilitation program designed to effect an improvement in the quality of life of each renal patient by aiming to restore meaningful existence in each of their lives. The authors emphasize that an individualized plan for rehabilitation can be constructed and implemented with far-reaching success when the focus is on the life goals of the patient, whether they be physical, social, psychological, or intellectual. Recommendations for physical, social, and intellectual rehabilitation strategies are noted. These programs not only enhance the quality of life of the patient with end-stage renal disease (ESRD) but are cost-effective, both at the societal level and at the level of the dialysis clinic. 3 tables. 20 references. (AA-M). •

Uremic Cardiomyopathy: Reducing the Cardiac Burden in End-Stage Renal Disease Source: Journal of Critical Illness. 13(10): 613-615, 619-623. October 1998. Contact: Available from Cliggott Publishing Company. 55 Holly Hill Lane, Greenwich, CT 06831-0010. (203) 661-0600. Summary: Left ventricular (LV) hypertrophy and dilatation and systolic dysfunction are common in patients receiving hemodialysis and are associated with significantly decreased survival and increased morbidity. In this article, the authors discuss abnormalities of LV structure and function. They cover the diagnosis of uremic cardiomyopathy, review data on the prevalence and outcomes of LV dysfunction, and explore interventions relevant to the management of these patients. Echocardiography is the standard diagnostic tool for cardiomyopathy in patients with end-stage renal disease (ESRD). The use of echocardiography to differentiate diastolic from systolic dysfunction can help guide patient management. With few controlled clinical trials specifically examining cardiomyopathy in uremic patients, management generally follows guidelines from studies in the general population. Aims of therapy are to improve quality of life by controlling symptoms of heart failure, ischemic heart disease, cardiac arrhythmias, and dialysis-associated hypotension; and to correct modifiable risk factors, such as hypertension, anemia, uremia, malnutrition, and aortic stenosis. Drug therapy requires great caution in this patient population, and should be begun only after careful consideration of risk and benefit. 1 figure. 6 tables. 38 references. (AA-M).

•

Depression and Marital Dissatisfaction in Patients with End-Stage Renal Disease and in Their Spouses Source: American Journal of Kidney Diseases. 38(4): 839-846. October 2001. Contact: Available from W.B. Saunders Company. Periodicals Department, 6277 Sea Harbor Drive, Orlando, FL 32887-4800. (800) 654-2452 or (407) 345-4000. Summary: Little research has been performed assessing patients with end stage renal (kidney) disease (ESRD) as parts of marital dyads or within family structures. Recent findings suggest patient interactions within such systems are associated with patient outcomes. This article reports on a study undertaken to evaluate the relationship between level of patient depression and spouse psychosocial status; 55 couples in which one partner was undergoing chronic hemodialysis therapy for ESRD were interviewed. Two variables that alone and in interaction with one another were expected to relate to the spouse's perceived level of depression and marital satisfaction were investigated: patient depression level and spouse's perceived social support. Depression was assessed using the Beck Depression Inventory (BDI). Spouses' levels of depressive affect correlated directly with patient BDI scores. A significant two-way interaction for spousal depression (patient depression and spousal support) supported viewing spouses' adjustment as a function of the interaction between spouse and patient factors.

18


Additionally, a main effect of perceived spousal social support on spousal marital satisfaction indicated that spouses reporting high levels of social support had the least marital strain. The severity of the patient's illness did not correlate with any of the predictor variables or measures of spousal adjustment, but spouses reported significantly lower functional status for patients than did nephrologists (kidney specialists). The authors conclude that spouse and patient levels of depression are related, although causal relationships cannot be determined by these studies. Moreover, spouse perception of marital satisfaction is related to depression scores. These findings suggest the patient with ESRD functions in a psychosocial dyad. Spouse psychosocial status could impact on the level of patient depression, and the spouse might be amenable to interventions that could improve patient outcome. 1 figure. 3 tables. 49 references. •

Survival and Development of Cardiovascular Disease by Modality of Treatment in Patients with End-Stage Renal Disease Source: JASN. Journal of the American Society of Nephrology. 12(11): 2411-2417. November 2001. Contact: Available from Lippincott Williams and Wilkins. 12107 Insurance Way, Hagerstown, MD 21740. (800) 638-6423. Summary: Patients undergoing dialysis are at high risk for cardiovascular disease (CVD). This article reports on a study that evaluated the influence of hemodialysis (HD) versus peritoneal dialysis (PD) on survival and the risk of developing new CVD. Of the 4,191 patients with end stage renal disease (ESRD) who started renal replacement treatment (RRT) in Lombardy (Italy) between 1994 and 1997, 4,064 were considered for analysis. Of these, 2,772 were on HD (mean age 60.9 years, 21.2 percent with diabetes) and 1,292 were on PD (mean age 63.6 years, 16 percent with diabetes). The 3,120 patients who were free of CVD at the start of RRT were included in the analysis of the risk of developing new CVD. The death rate was 13.3 per 100 patient years (13.0 on HD and 13.9 on PD); 197 (6.3 percent) of the 3,120 patients in the CVD analysis developed de novo (new) CVD (128 patients on HD and 69 patients on PD). After adjustment for age, gender, and established CVD and stratification by diabetes status, there was no significant between-treatment difference in 4 year survival or in new CVD. 3 figures. 3 tables. 27 references.

•

Optimizing End-Stage Renal Disease Therapy for the Patient with Diabetes Mellitus Source: Seminars in Nephrology. 17(4): 331-345. July 1997. Contact: Available from W.B. Saunders Company. Periodicals Department, 6277 Sea Harbor Drive, Orlando, FL 32887-4800. (800) 654-2452. Summary: Patients with diabetes represent the fastest growing segment of the end-stage renal disease (ESRD) population, which itself is growing at a rate of approximately 10 percent per year. This article presents strategies for optimizing ESRD therapy for patients with diabetes mellitus. The majority of patients with ESRD secondary to diabetes (67.7 percent) are treated by hemodialysis; 13.2 percent are treated by peritoneal dialysis, and 19.1 have functioning renal transplants. The number of patients over 60 years of age has increased steadily. The relative risk of death in patients with diabetes is markedly increased and is further exacerbated in patients with poor nutritional status. Patients with ESRD from diabetes challenge the nephrologist because they have the greatest number of comorbid conditions, the highest levels of physical dysfunction, and the greatest dependency in activities of daily living. Patients with

Studies

19

diabetes experience improved survival after either kidney transplant or enhanced Kt per V on dialysis. Therefore, the most important therapeutic intervention is to maximize renal replacement therapy, either by transplantation or by providing levels of dialysis adequacy higher than previously recommended. In addition, attention to several basic principles helps to guide therapy: control of hypertension, control of hyperglycemia, control of lipid abnormalities, treatment of malnutrition, and attention to the effects of erythropoietin. 4 figures. 107 references. (AA-M). •

Non-Traditional Cardiovascular Disease Risk Factors in End-Stage Renal Disease: Oxidate Stress and Hyperhomocysteinemia Source: Current Opinion in Nephrology and Hypertension. 9(5): 477-487. September 2000. Contact: Available from Lippincott Williams and Wilkins. P.O. Box 1600, Hagerstown, MD 21741. (800) 638-3030 or (301) 223-2300. Fax (301) 223-2400. Website: www.currentopinion.com. Summary: Patients with end stage renal disease (ESRD) have a greatly reduced life expectancy due largely to an accelerated rate of cardiovascular disease (CVD). This cannot be ascribed to the effects of their concurrent diseases, such as diabetes mellitus, nor to the well characterized CVD risk factors that include hypertension (high blood pressure), hypercholesterolemia (high levels of cholesterol in the blood), smoking, age, left ventricular hypertrophy, and an early CVD related death in a close relative. This article reports on studies investigating nontraditional cardiovascular disease risk factors in ESRD, notably oxidate stress and hyperhomocysteinemia. Studies in experimental animals have shown that oxidative stress and hyperhomocysteinemia culminate in abnormal vascular and endothelial regulation, functional nitric oxide deficiency, vascular hypertrophy, and atherosclerosis. Oxidative stress is accompanied by increased advanced glycation endproducts and oxidized low density lipoproteins. Studies of patients with ESRD provide extensive indirect evidence of increased oxidative stress and more than ninety percent are hyperhomocyteinemic. Presently, only uncontrolled or observational studies are available to assess the effects of antioxidant therapy for oxidative stress or folate therapy for hyperhomocysteinemia in these patients. Promising developments include the reports of beneficial effects of a vitamin E coated dialyzer, and the reduction in homocysteine levels in patients with ESRD given an intravenous folate metabolite. However, there is presently no therapy available to reverse fully oxidative stress or hyperhomocysteinemia. Therefore, the causative role of these nontraditional risk factors of cardiovascular disease remains untested. 3 figures. 1 table. 105 references.

•

End-Stage Renal Disease in African-Americans Source: Nephrology Nursing Journal. 27(6): 597-600. December 2000. Contact: Available from American Nephrology Nurses' Association. East Holly Avenue, Box 56, Pitman, NJ 08071-0056. (856) 256-2320. Fax (856) 589-7463. Website: www.annanurse.org. Summary: The African American community makes up approximately 12.4 percent of the total American population, but they account for 30.8 percent of patients diagnosed with end stage renal disease (ESRD). This article focuses first on theories explaining the high prevalence of ESRD in African Americans. Two major causes of ESRD, hypertension and type 2 diabetes, and their relationship to African Americans are explored. Morbidity, familial risk, and new incidences are addressed. Lastly, the author

20


proposes a screening project for African Americans at risk for ESRD. The author concludes that, whatever the reasons, the overwhelming fact is that African Americans are at significant risk for developing ESRD. Prevention and early treatment are the only way to halt the progression to ESRD for many African Americans. This is a formidable task due to the limitations many African Americans face: low socioeconomic status, low education status, little to no health insurance, and a focus on surviving day to day without a vision of the future. Potential screening programs could center at churches, schools, and low income neighborhoods (the latter through the use of health fairs). 22 references. •

Preventing Hepatitis B and Hepatitis C Virus Infections in End-Stage Renal Disease Patients: Back to Basics (editorial) Source: Hepatology. 29(1): 291-293. January 1999. Contact: Available from W.B. Saunders Company. 6277 Sea Harbor Drive, Orlando, FL 19106-3399. (800) 654-2452 or (407) 345-4000. Summary: The impact of hepatitis B (HBV) and C (HCV) on patient survival after kidney transplantation is controversial. This article comments on a study published in the journal that assessed the independent prognostic values of HBsAg and anti-HCV in a large renal transplant population. At 10 years, among all patients with HCV screening (n = 834), 4 variables had independent prognostic values in patient survival: age at transplantation, year of transplantation, biopsy proven cirrhosis, and presence of HCV antibodies. The authors of the commentary note that the findings of the study underscore the importance of preventing hepatitis B and C virus infections in end stage renal disease (ESRD). Patients with ESRD on chronic hemodialysis are at risk for both HBV and HCV infection, despite the success of longstanding infection control practices in the dialysis setting. The authors consider the reasons why infection control strategies are no longer universally implemented and discuss routine hemodialysis unit precautions that could prevent transmission of HBV if the precautions are routinely and rigorously followed. The transmission of HCV infection among chronic hemodialysis patients also might be related to failure to follow routine hemodialysis unit precautions. The authors conclude by reiterating that those responsible for the care of chronic hemodialysis patients should reacquaint themselves with the recommendations for preventing bloodborne pathogen transmission in this setting and ensure that they are performed. 17 references.

•

Disparities in Incidence of Diabetic End-Stage Renal Disease According to Race and Type of Diabetes Source: New England Journal of Medicine. 321(16): 1074-1079. October 19, 1989. Summary: The incidence of end-stage renal disease in patients with diabetes mellitus is reportedly higher among blacks than among whites. This article reports on a study of all black patients and white patients with diabetes and end-stage renal disease (470 blacks and 861 whites), reported to the Michigan Kidney Registry, who began treatment during 1974 through 1983. The authors also reviewed the medical records of a subpopulation of such patients (284 blacks and 310 whites) who were less than 65 years of age at the start of treatment for end-stage renal disease, to determine what type of diabetes they had. The authors found that the incidence of diabetic end-stage renal disease was 2.6-fold higher among blacks (after adjusting for the higher prevalence of diabetes among blacks). The excess risk occurred predominantly among blacks with noninsulindependent diabetes mellitus (NIDDM). Most black patients with diabetic end-stage

Studies

21

renal disease had NIDDM (77 percent), whereas most white patients with diabetic endstage renal disease had insulin-dependent diabetes mellitus (IDDM) (58 percent). The authors conclude, based on their own research and that of others, that at least some of the excess incidence of diabetic end-stage renal disease among blacks may be preventable. 25 references. (AA-M). •

Cumulative Risk for Developing End-Stage Renal Disease in the US Population Source: JASN. Journal of the American Society of Nephrology. 13(6): 1635-1644. June 2002. Contact: Available from Lippincott Williams and Wilkins. 12107 Insurance Way, Hagerstown, MD 21740. (800) 638-6423. Summary: The individual risk of developing end stage renal (kidney) disease (ESRD) and its overall impact on life expectancy is not known. This article reports on a study undertaken to determine the effect of ESRD on life expectancy for a group of 20 year olds and to compare this impact to that of several cancers for which population-based screening programs exist. A computer simulation, stratified by race (white, black) and by gender was used to calculate cumulative lifetime risk of ESRD, life years lost to ESRD, and cumulative Medicare payments for ESRD. Similar calculations were made for breast, prostate, and colorectal cancer. The cumulative lifetime risk of ESRD for a 20 year old black woman is 7.8 percent. Equivalent risks for black men are 7.3 percent, white men 2.5 percent, and white women 1.8 percent. Lost years of life attributable to ESRD are 1.09, 1.10, 0.40, and 0.32 years for black women, black men, white men, and white women, respectively. In blacks, ESRD is responsible for nearly as much loss of life years as breast cancer in women and more loss of life years than colorectal or prostate cancer in men. In addition, treatment costs for ESRD in this population are many fold more expensive than cumulative treatment costs of these cancers. The authors conclude that exploring new screening and treatment strategies may be warranted to prevent ESRD, particularly in the black population. 4 appendices. 3 figures. 5 tables. 25 references.

•

Good News, Bad News for Diabetic Versus Nondiabetic End-Stage Renal Disease: Incidence and Mortality (editorial) Source: ASAIO Journal. 45(3): 117-118. May-June 1999. Contact: Available from Lippincott-Raven Publishers. Journal Fulfillment Department, 12107 Insurance Way, Hagerstown, MD 21740. (800) 638-3030. Summary: The United States Renal Data System (USRDS) recently reexamined the trends of treated end stage renal disease (ESRD) incidence during the recent decade separately for those patients with diabetes and for those patients whose ESRD was recorded of all other causes, including unknown cause. Additionally, the USRDS evaluated trends in mortality (death) separately for diabetic and nondiabetic ESRD patients. This article reports on the marked differences in trends for both incidence and mortality for these two groups of patients on dialysis, those with diabetes as the cause of ESRD versus all others. The USRDS has reported gradually decreasing mortality trends, when adjusting for population changes in age, gender, race, and cause of ESRD. The most striking difference was seen for diabetes versus nondiabetes; There was a 31 percent reduction in mortality rates for diabetic ESRD patients and a 5 percent reduction for nondiabetic ESRD hemodialysis (HD) patients during the first year of therapy. For peritoneal dialysis (PD) patients, there has also been a greater reduction in mortality for diabetic patients than for nondiabetic patients. The incidence rate for treated ESRD has

22


been increasing for all age ranges, indicating a persistent change in either the true incidence of ESRD or in the access to treatment of the disease. A true increase in ESRD may be caused by toxins (e.g., greater use of nonsteroidal antiinflammatory drugs) or caused by improving survival from competing conditions such as atherosclerotic heart disease. The authors conclude that the improvements in mortality for diabetic patients make it unlikely that the increase in incidence rates could be caused primarily by referral of sicker diabetic patients for ESRD. 2 figures. 1 table. 5 references. •

Exercise Evaluation of Children with End-Stage Renal Disease Source: Advances in Renal Replacement Therapy. 6(2): 189-194. April 1999. Contact: Available from W.B. Saunders Company. Periodicals Department, 6277 Sea Harbor Drive, Orlando, FL 32887-4800. (800) 654-2452. Summary: The use of exercise testing in the assessment and management of various pediatric disorders has increased significantly during the past three decades. This article reviews the exercise evaluation of children with end stage renal disease (ESRD). With age appropriate equipment and exercise protocols, a well trained and enthusiastic staff can evaluate patients as young as 3 to 4 years of age. Pediatric exercise testing may be conducted using either a cycle ergometer or a treadmill. The decision of which method to use is based on the parameters to be evaluated during the test, physical stature of the child, administrator preference, and availability of equipment in the laboratory. For children with renal disease, who are often short and may have poor leg muscle mass, the treadmill is used most often. The exercise testing protocols should use slow initial speeds and no grade, increase in small increments, and have stages of 1 to 2 minutes' duration. The benefits of testing in children with renal disorders include the valuable information garnered regarding the overall functional capacity of the patient, efficacy of pharmacological or surgical interventions, and outcome of rehabilitation programs. 46 references. (AA-M).

•

Patients With HIV Infection and End-Stage Renal Disease Source: Advances in Renal Replacement Therapy. 3(4): 287-292. October 1996. Contact: Available from W.B. Saunders Company. Periodicals Department, 6277 Sea Harbor Drive, Orlando, FL 32887-4800. (800) 654-2452. Summary: There has been a steady increase in the number of dialysis patients with human immunodeficiency viral (HIV) infection. This article reviews the management of patients with HIV infection and end-stage renal disease (ESRD). HIV-associated nephropathy (HIVAN) is the most common cause of ESRD in this population. Although the major potential category of risk of HIV transmission is from the dialysis patient to staff, there are no data to indicate that this has occurred. The authors discuss current epidemiology, management of HIV-related complications in ESRD patients, and factors predicting survival in this patient population. The major risk factors for renal disease in HIV-positive patients are African American race, male gender, and intravenous drug use. The dialysis treatment method is usually and appropriately an individual choice, depending on the medical needs and personal preferences of the patient. Home peritoneal dialysis for HIV-infected patients offers clear benefits for patients and staff alike, as well as some potential disadvantages. The authors discuss the frequency and management of HIV-related infections and complications, including the use of prophylactic therapy for common infections, problems with malignancy, malnutrition and wasting, HIV-associated cognitive-motor complex, and the continued practice of polysubstance abuse (intravenous drug use, cocaine, alcohol). The authors conclude that

Studies

23

dialysis of patients with HIV infection is challenging and requires effective care to prolong survival. Sensitive issues regarding limitation of care, advance directives, and appropriate support for dying patients can create difficult and emotional decisions for care providers. 2 figures. 2 tables. 27 references. (AA-M). •

Improved Understanding of the Causes of End-Stage Renal Disease Source: Seminars in Nephrology. 17(3): 170-175. May 1997. Contact: Available from W.B. Saunders Company. Periodicals Department, 6277 Sea Harbor Drive, Orlando, FL 32887-4800. (800) 654-2452. Summary: This article attempts to improve understanding of the various causes of endstage renal disease (ESRD) by a discussion of currently attributed causes, potentially unattributed causes, and the reasons for growth in new ESRD cases. The author notes that the attributed causes of ESRD have varied over time and by region. In the United States, diabetes has long been the most common attributed cause of ESRD, accounting for 36 percent of incident cases in 1992. In contrast, diabetic ESRD is far less common in other countries. Hypertension and glomerulonephritis are the next most commonly attributed causes of ESRD, but these diagnoses are not necessarily based on consistent or uniform criteria. Mistaken classification of the cause of ESRD is possible in many cases. Emerging evidence suggests that other processes, including renovascular disease and analgesic ingestion, can cause or contribute to ESRD more often than they are recorded. The incidence of ESRD has been increasing at a rate of up to 9 percent per year. The author concludes that the likely reasons for ESRD growth include decreased competing risk from other diseases, increased referral and acceptance of patients with advanced renal failure, and increased renal disease. 1 figure. 1 table. 38 references. (AA-M).

•

Osteoporosis in End-Stage Renal Disease Source: Seminars in Nephrology. (19)2: 115-122. March 1999. Contact: Available from W.B. Saunders Company. Periodicals Department. 6277 Sea Harbor Drive, Orlando, FL 32887-4800. (800) 654-2452. Summary: This article describes how maintaining the intricate bone mineral homeostasis in patients with chronic renal failure (CRF) and renal osteodystrophy is a complex and challenging process. In addition to the well described high turnover bone disease caused by secondary hyperparathyroidism and low turnover disease in the form of osteomalacia (either from aluminum or a dynamic bone disease), osteopenia is also present in end-stage renal disease (ESRD) patients. In contrast to abnormalities in the ability of bone to remodel (osteodystrophy), osteopenia is a deficiency in bone mass or volume. The prevalence of fractures in dialysis patients, regardless of histomorphometry (e.g., their bone mineral density) appears to exceed that observed in elderly women. This osteopenia occurs in CRF patients secondary to multiple factors that include hypogonadism, medications (such as corticosteroids), immobilization, and the typical osteopenia associated with aging. Abnormalities in bone turnover may contribute to abnormalities in bone mass, and, conversely, decreased bone mass caused by other factors could amplify the risk of fracture in dialysis patients. 2 figures. 3 tables. 61 references. (AA-M).

•

Chronic Renal Failure, End-Stage Renal Disease, and Peritoneal Dialysis in Gitelman's Syndrome Source: American Journal of Kidney Diseases. 38(1): 165-168. July 2001.

24


Contact: Available from W.B. Saunders Company. Periodicals Department, 6277 Sea Harbor Drive, Orlando, FL 32887-4800. (800) 654-2452 or (407) 345-4000. Summary: This article discusses chronic renal (kidney) failure, end stage renal disease (ESRD), and peritoneal dialysis in patients with Gitelman's syndrome. A related sydrome, Bartter's syndrome is characterized by hypovolemia (low volume of circulating blood), hypotension (low blood pressure), and hypokalemia (low levels of potassium in the blood), conditions which can lead to a chronic nephropathy (kidney disease) culminating in ESRD and dialysis. This progression, however, has never been reported for Gitelman's syndrome, a variant of Bartter's syndrome that shows a milder clinical picture. This article is the first to document this progression (i.e., the development of ESRD in Gitelman's syndrome) as well as the first report of the use of peritoneal dialysis in either Bartter's syndrome or Gitelman's syndrome. The clinical course highlights the importance of and the need for careful control of hemodynamic (blood system) status in these patients to slow the progression of renal injury. The hemodynamic alterations that characterize Bartter's syndrome and Gitelman's syndrome patients suggest that for patients requiring renal replacement therapy, peritoneal dialysis (with modification of dialysis solutions) is a more appropriate treatment because of its less severe impact on these parameters. 2 tables. 25 references. •

End-Stage Renal Disease Network System Source: aakpRenalife. American Association of Kidney Patients Renalife. 14(5): 5, 13, 1819, 29. Spring 1999. Contact: Available from American Association of Kidney Patients (AAKP). 100 South Ashley Drive, Suite 280, Tampa, FL 33602. (800) 749-AAKP or (813) 223-7099. E-mail: [email protected]. Website: www.aakp.org. Summary: This article explains the end-stage renal disease (ESRD) Network system, organizations under contract with the Health Care Financing Administration (HCFA) of the Federal Government. The Networks were established for the purpose of assuring effective and efficient administration of benefits provided under the Social Security Act for individuals with ESRD. The Networks serve both as a monitoring organization and as a bridge between the Federal Government, the ESRD providers, and the ESRD patients. Written in a question and answer format, the article helps readers understand how the Network system works to ensure that patients are receiving safe and adequate treatments. The authors describe how the Network system began; how the Networks are set up; the members of the Network boards and committees; Network activities in the arena of patient rights, quality improvement, and data management; Network activities in patient services, including rehabilitation, education and information, and grievance resolution; and community outreach activities. The Networks operate in close tandem with the State survey agencies and each individual provider; together these groups are a team committed to protecting patients rights and keeping patients healthy and active. The article concludes with a list of ESRD Networks, their location, and contact information (telephone numbers and email addresses). 1 table.

•

Family Support and Survival Among African-American End-Stage Renal Disease Patients Source: Advances in Renal Replacement Therapy. 4(1): 13-21. January 1997. Contact: Available from W.B. Saunders Company. Periodicals Department, 6277 Sea Harbor Drive, Orlando, FL 32887-4800. (800) 654-2452.

Studies

25

Summary: This article investigates family support and survival among African Americans with end-stage renal disease (ESRD). Research suggests that survival among ESRD patients is related to the quality of family support. There is empirical evidence for low family support as a risk factor for early mortality among African American ESRD patients. This review article describes findings from studies linking family support and patient survival in African American ESRD patients. Family support is defined as sharing resources with the patient by family members during times of stress and illness. It also includes the encouragement of open and direct expression of feelings that may be characterized by anger and conflict. The author discusses findings that suggest treatment adherence as a mediator between family support and patient survival. Finally, the implications for clinical practice and future research with this population are discussed. The author recommends a family psychoeducational approach for helping atrisk African American ESRD patients and their families. This approach allows clinicians to simultaneously influence behaviors of several family members and address family dynamics that encourage unhealthy family support. Family problem-solving strategies focus on helping family members in renegotiating their expectations for caregiving and illness management and integrating new changes and demands into their family life. 1 table. 33 references. •

Is HCFA's Reimbursement Policy Controlling Quality of Care for End-Stage Renal Disease Patients? Source: ASAIO Journal. 47(5): 466-468. September-October 2001. Contact: Available from Lippincott-Raven Publishers. Journal Fulfillment Department, 12107 Insurance Way, Hagerstown, MD 21740. (800) 638-3030. Summary: This article is one in a series of articles representing presentations given at the ASAIO Conference on Daily Hemodialysis (New York, NY, June 2000). In this article, the authors report on the positive results obtained by a nocturnal home hemodialysis program and the concerns about the lack of reimbursement for this effective treatment for end stage renal disease (ESRD). Nocturnal DHD (nDHD), is usually performed overnight five to seven times a week, and averages 7 to 9 hours per treatment. The nDHD modality has reduced hospital days by 50 percent, erythropoietin use (to treat anemia) by 25 percent, and out of pocket medication expense for patients an average of over $1,000 per year. However, nDHD is not being offered to patients in the United States because of Health Care Financing Administration's (HCFA) three treatment payments per week reimbursement policy. This policy is a financial disincentive for nephrologists and the dialysis industry to provide daily dialysis as an option, resulting in reduced quality of care for ESRD patients. The authors report the details of their own data collection as the Lynchburg (Virginia) Nephrology Dialysis (LND) center. The cost analysis of the LND nightly home hemodialysis program demonstrates increased cost but significant savings. These data combine with other data that support daily hemodialysis as a new modality that will improve quality of care for ESRD patients and reduce overall cost to the Medicare ESRD program. 2 figures. 1 table. 9 references.

•

End-Stage Renal Disease: Measures to Prevent It or Slow Its Progression Source: Postgraduate Medicine. 100(5): 163-164, 166, 171-176. November 1996. Summary: This article outlines specific pharmacologic and dietary measures that can prevent or slow the progression of renal disease. Topics include the major causes of endstage renal disease (ESRD), i.e., diabetes mellitus and hypertension, and the role of primary prevention strategies for each; recommendations for slowing the progression of

26


renal disease; other causes of ESRD, including glomerulonephritis, vasculitis, and interstitial, cystic, obstructive, metabolic, cancerous, and hereditary conditions; the secondary prevention of ESRD through optimal blood pressure control; the antiproteinuric effect of ACE inhibitors; dietary modifications; and the importance of avoiding additional injury to kidneys. The authors emphasize the role of angiotensinconverting enzyme (ACE) inhibitors in achieving blood pressure control, the main preventive strategy. 26 references. (AA-M). •

End-Stage Renal Disease Attributable to Diabetes Mellitus Source: Annals of Internal Medicine. 121(12): 912-918. December 15, 1994. Summary: This article reports on a case-control study to determine the proportion of end-stage renal disease (ESRD) associated with diabetes mellitus in a biracial population, using population-attributable risk estimates. The participants were 716 patients newly-diagnosed with kidney failure, aged 20 to 64 years, and 361 age-matched controls. The measurement was a self-reported history of diabetes mellitus, including type, duration, treatment, and complications. Persons with insulin-dependent diabetes mellitus (IDDM) and noninsulin-dependent diabetes mellitus (NIDDM) were at greater risk for ESRD than were persons without diabetes. The odds ratio was only slightly increased for diabetes lasting less than 15 years, but the ratio increased more than 20fold for diabetes lasting 15 years or more. The population-attributable risk for kidney failure was 21 percent for IDDM and 21 percent for NIDDM. A similar proportion of ESRD was attributed to diabetes in whites (44 percent) and in blacks (41 percent). IDDM had a relatively greater effect on the incidence of kidney failure in whites; in contrast, NIDDM had a relatively greater effect on kidney failure in blacks. 2 figures. 3 tables. 27 references. (AA-M).

•

End-Stage Renal Disease and Systemic Lupus Erythematosus Source: American Journal of Medicine. 101(1): 100-107. July 1996. Summary: This article reports on a literature review to provide an overview of the course of systemic lupus erythematosus (SLE) following the onset of end-stage lupus nephropathy, regarding clinical and serological manifestations, survival on dialysis, and renal transplant outcomes. Results showed that there is a tendency for decreased clinical and serological lupus activity following the onset of end-stage renal disease (ESRD). Survival of lupus patients on dialysis is no different from that of non-SLE dialysis patients, and is better than that of several other rheumatic diseases. Following renal transplantation, there is no difference in patient or graft survival in lupus versus nonlupus patients. Like their nonlupus counterparts, SLE transplant patients do better with living relative grafts or regimens containing cyclosporin A or both. Transplantation during an acute exacerbation of SLE is controversial and may increase the risk of poor outcomes. 4 tables. 59 references. (AA-M).

•

Survival Advantage for Adult Hispanic Hemodialysis Patients? Findings from the End-Stage Renal Disease Clinical Performance Measures Project Source: JASN. Journal of the American Society of Nephrology. 14 (1): 180-186. January 2003. Contact: Available from Lippincott Williams and Wilkins. 12107 Insurance Way, Hagerstown, MD 21740. (800) 638-6423.

Studies

27

Summary: This article reports on a study that examined 1 year followup mortality (death) in Hispanic and non-Hispanic patients and its association with intermediate outcomes of dialysis care. Demographic and clinical information was collected on a national random sample of adult in-center hemodialysis (HD) patients for the period of October through December 1998. Of 8,336 patients, 994 (12 percent) were identified as Hispanic, 3,618 (43 percent) as non-Hispanic white, and 3,111 (37 percent) as nonHispanic Black. The adjusted 12 month mortality risk for Hispanics was 0.76 and for non-Hispanic Blacks 0.66 compared with non-Hispanic whites (referent group). Similar 12 month mortality risks were noted in the groups with diabetes mellitus or hypertension (high blood pressure) as the causes of end stage renal disease (ESRD) and among patients older than 65 years. These data suggest that adult Hispanic HD patients have a 12 month survival intermediate to non-Hispanic Blacks and non-Hispanic whites and experience equivalent or better intermediate outcomes of dialysis care compared with non-Hispanic whites. 3 tables. 31 references. •

Differences in Survival Between Black and White Patients with Diabetic End-Stage Renal Disease Source: Diabetes Care. 17(7): 681-687. July 1994. Contact: Available from American Diabetes Association. 1701 North Beauregard Street, Alexandria, VA 22311. (800) 232-3472. Website: www.diabetes.org. Summary: This article reports on a study to evaluate whether the longer survival of Blacks with diabetic end-stage renal disease (ESRD) relative to whites is due to racial differences in type of disease, comorbidity at ESRD onset, and ESRD treatment modality. The study also examined whether survival differences between Blacks and whites occur only in certain population subgroups. The Michigan Kidney Registry was used to ascertain all Blacks and whites (n = 594) with diabetic ESRD in southeastern Michigan with ESRD onset at age less than 65 years during 1974-1983. Patients were followed through 1988. Medical records were abstracted for type of diabetes, comorbidity at ESRD onset, and other factors. Median survival among IDDM patients was 27 months in Blacks and 17 months in whites, and among NIDDM patients was 30 months in Blacks and 16 months in whites. The authors concluded that survival after ESRD onset is longer in Blacks than in whites treated with dialysis, even after adjusting for comorbidity and other factors that affect survival. Survival did not differ by race among transplant patients.

•

Losartan Reduces the Costs Associated With Diabetic End-Stage Renal Disease Source: Diabetes Care. 26(3): 683-687. March 2003. Contact: Available from American Diabetes Association. 1701 North Beauregard Street, Alexandria, VA 22311. (800) 232-3472. Website: www.diabetes.org. Summary: This article reports on a study undertaken to evaluate the within-trial effect of losartan and conventional antihypertensive therapy (CT) compared with placebo and CT on the economic cost associated with end stage renal disease (ESRD). The study was a multinational double-blind randomized placebo-controlled clinical trial designed to evaluate the renal protective effects of losartan on a background of CT in patients with type 2 diabetes and nephropathy (kidney disease). The primary composite end point was doubling of serum creatinine, ESRD, or death. The results showed that losartan and CT compared with placebo and CT reduced the number of days with ESRD by 33.6 days per patient over 3.5 years. This reduction in ESRD days resulted in a decrease in cost associated with ESRD of $5,144 per patient. After accounting for the cost of losartan, the

28


reduction in ESRD days resulted in a net savings of $3,522 per patient over 3.5 years. The authors conclude that treatment with losartan in patients with type 2 diabetes and nephropathy not only reduced the incidence of ESRD, but also resulted in substantial cost savings. 1 figure. 4 tables. 13 references. •

Making Decisions About End-Stage Renal Disease Treatment: A Review of Theories and Issues Source: Advances in Renal Replacement Therapy. 4(1): 81-88. January 1997. Contact: Available from W.B. Saunders Company. Periodicals Department, 6277 Sea Harbor Drive, Orlando, FL 32887-4800. (800) 654-2452. Summary: This article reviews some of the theories of decision making and their implementation or usefulness in the end-stage renal disease setting. The interaction of patient and health care professional in circumstances of urgency, stress, and possible unpredictability is complex. The author first describes a decision analysis model often used in medical settings and then explains how decision analysis can provide an objective framework for determining which treatment modality will have the best outcome for the least cost. Because of the predictive nature of this model, it could be initiated at the time of diagnosis and provide a framework, not only for decision making, but also to initiate a clinical pathway for care planning. In addition, it may provide objective information to allow reconsideration of the treatment of individual patients who may not be responsive to and successful with ESRD treatment. The author then describes prospect theory and considers how it could apply to ESRD. Application of prospect theory to patient decision making should prompt health care professionals to inquire about patients' previous information to assess the framing that they may be using based on previous experiences, observations, information, and even misinformation. Furthermore, this theory of decision making allows the health care professional to better interpret the response to loss of kidney function that the patient may be expressing and that may also be creating barriers to immediate decision making about treatment. Two additional theories are considered: assessing models of the patient-physician relationship; and shared decision making, with patient autonomy. The author notes that no studies could be found that discuss the role of other staff (besides the physician) in patient decision making, yet these professionals often contribute the needed patient education and counseling that is a foundation of patient decision making. 62 references. (AA-M).

•

Iron Management in End-Stage Renal Disease Source: American Journal of Kidney Diseases. 29(3): 319-333. March 1997. Summary: This article reviews the many facets of iron management in end-stage renal disease (ESRD). The authors stress that one of the important components of successful anemia therapy in patients with ESRD treated with recombinant human erythropoietin is the maintenance of adequate available iron. To accomplish this task, iron status must be serially monitored and supplemental iron administered as needed. Among nonuremic subjects, the body's iron supply is tightly conserved, and iron deficiency usually develops only when chronic blood loss occurs. In patients with ESRD, iron deficiency occurs more frequently because of increased external losses of iron, decreased availability of the body's storage of iron, and perhaps a deficit in intestinal iron absorption. Detecting iron deficiency in these patients can be difficult because of the inaccuracy of available diagnostic tests. The goals of iron therapy in ESRD include the prevention of iron deficiency by chronically supplementing iron and the prompt

Studies

29

treatment of overt iron deficiency. Oral iron supplements are inexpensive and safe, but poor patient compliance and reduced intestinal absorption may limit their effectiveness. Intravenous iron supplements have a greater efficacy than oral iron, which must be weighed against the small risk of allergic reactions. The authors present strategies for using the various diagnostic tests and treatment modalities to effectively manage iron supply for predialysis, hemodialysis, and peritoneal dialysis patients. 3 figures. 5 tables. 104 references. (AA). •

Health Economic Evaluations: The Special Case of End-Stage Renal Disease Treatment Source: Medical Decision Making. 22: 417-430. September-October 2002. Contact: Available from Lippincott Williams and Wilkins. 12107 Insurance Way, Hagerstown, MD 21740. (800) 638-6423. Summary: This article synthesizes the evidence on the cost-effectiveness of renal replacement therapy (RRT) and discusses the findings in light of the frequent practice of using the cost-effectiveness of hemodialysis as a benchmark of societal willingness to pay. The authors conducted a meta-analysis of the medical and economic literature for economic evaluations of hemodialysis, peritoneal dialysis, and kidney transplantation. Cost-effectiveness ratios were translated into 2000 United States dollars per life-year (LY) saved. Thirteen studies published between 1968 and 1998 provided such information. The cost-effectiveness of center hemodialysis remained within a narrow range of $55,000 to $80,000 per LY in most studies despite considerable variation in methodology and imputed costs. The cost-effectiveness of home hemodialysis was found to be between $33,000 and $50,000 per LY. Kidney transplantation, however, has become more cost-effective over time, approaching $10,000 per LY. Estimates of the cost per LY gained from hemodialysis have been remarkably stable over the past 3 decades, after adjusting for price levels. The authors conclude that uses of the cost-effectiveness ratio of $55,000 per LY for center hemodialysis as a lower boundary of society's willingness to pay for an additional LY can be supported under certain assumptions. 4 figures. 3 tables. 35 references.

•

Insulin-Like Growth Factor I Treatment for End-Stage Renal Disease at the End of the Millennium (editorial) Source: Current Opinion in Nephrology and Hypertension. 9(1): 1-3. January 2000. Contact: Available from Lippincott Williams and Wilkins. P.O. Box 1600, Hagerstown, MD 21741. (800) 638-3030 or (301) 223-2300. Fax (301) 223-2400. Website: www.currentopinion.com. Summary: This editorial commentary serves as an introduction to a review article published in the same issue. The author of the commentary summarizes the history and current status of the use of insulin like growth factor I (IGF-I) treatment for end stage renal disease (ESRD). Much of the research that elucidated the usefulness of IGF-I consists of animal studies. The research study reported in this same issue assessed the use of a lower IGF-I dose (because of concerns about side effects with higher doses) given on an intermittent basis (4 days per week) to eliminate resistance to the action of the drug. The IGF-I is given to patients with reduced renal function in order to increase their glomerular filtration rate (GFR). When administered in this manner to individuals with ESRD for whom the initiation of dialysis was the next step, the IGF-I treatment caused a progressive improvement of renal function over a period of 1 month. The author of the commentary reminds readers that the use of IGF-I in humans still includes

30


some risk, including that of malignancy (cancer). No firm conclusions can be made on the basis of the small number of patients to whom IFG-I was given. However, given a choice between hemodialysis, peritoneal dialysis, or four injections per week of IGF-I, most patients would probably choose the IGF-I. 20 references. •

Hypertension in End-Stage Renal Disease Patients Source: Current Opinion in Nephrology and Hypertension. 9(3): 279-283. May 2000. Contact: Available from Lippincott Williams and Wilkins. P.O. Box 1600, Hagerstown, MD 21741. (800) 638-3030 or (301) 223-2300. Fax (301) 223-2400. Website: www.currentopinion.com. Summary: This review article discusses the prevalence, impact, and treatment of hypertension (high blood pressure) in patients on hemodialysis or peritoneal dialysis, and in patients who are renal (kidney) transplant recipients. The prevalence of hypertension is extremely high in end stage renal disease, and is a probable contributor to the epidemic of cardiovascular disease in end stage renal disease (ESRD). However, the lack of prospective, randomized clinical trials makes it difficult to precisely define treatment strategies. The authors conclude that at the present time, the guidelines developed by the National Kidney Foundation's Cardiovascular Disease Task Force should be followed. The Sixth Joint National Committee for Prevention, Detection, Evaluation and Treatment of High Blood Pressure (JNC VI) recently lowered their recommended target blood pressures in the general population. JNC VI defined optimal blood pressure in the general population as 120 over 80. Target blood pressure for patients receiving antihypertensive therapy is defined as 140 over 90. JNC VI recommends a target blood pressure of 125 over 75 for patients with chronic renal insufficiency (kidney function less than adequate). The authors note that all classes of antihypertensive drugs, except diuretics, are effective in treating hypertension in ESRD patients. 54 references (21 annotated).

•

Team's Three-Dimensional Approach to Assisting the End-Stage Renal Disease Family Source: Advances in Renal Replacement Therapy. 5(2): 134-140. April 1998. Contact: Available from W.B. Saunders Company. Periodicals Department, 6277 Sea Harbor Drive, Orlando, FL 32887-4800. (800) 654-2452. Summary: This review article identifies ways in which the interdisciplinary care team assists a family confronting end-stage renal disease (ESRD) for the first time. The developmental models of the family life cycle and the ESRD life cycle are used to understand the family's needs. The treatment team uses a three-dimensional approach of education, support, and communication to enhance family coping. The authors use one family's experiences as a case study for the concepts being presented. The authors describe how the patient, a 34 year old man, was able to make use of the intensive emotional support offered by the nursing, dietary, and social work staff. The patient became open to the staff's guidance on practical matters of treatment and dietary compliance. He was also able to become comfortable discussing with his physician and his wife his concerns about changes in his sexuality. The authors reiterate the importance of working with families as well as with the patients. Families face unique stressors in their efforts to support the ESRD patient. The team's informal, yet confidential, communication was instrumental for staying attentive to the couple's needs. Emotional support and encouragement of the patient and his family were

Studies

31

increased by all team members as he endured each new health crisis. 1 table. 12 references. (AA-M). •

Further Trends in the Etiology of End-Stage Renal Disease in African-Americans Source: Current Opinion in Nephrology and Hypertension. 6(3): 243-249. May 1997. Contact: Available from Rapid Science Publishers. 400 Market Street, Suite 750, Philadelphia, PA 19106-2199. (800) 552-5866 or (215) 574-2333. Fax (215) 574-2292. Summary: This review article summarizes the latest research contributions to understanding the many causes of the excess rates of end-stage renal disease (ESRD) among African Americans. Prospective data now show that even mild elevations in blood pressure are associated with an increased risk in ESRD. The prevalence of hypertension (high blood pressure) among black Americans has been declining, but remains much higher than among white people. Management of hypertension is the best avenue to prevent much of the excess burden of ESRD, but the relative merits of different agents and levels of blood pressure control are still under study. In addition, individuals with HIV-related ESRD represent a small but rapidly growing number of patients that are predominantly African American. Studies are under way to examine ethnic differences and risk factors for the earlier stages of renal disease as well as genetic mutations for non-Mendelian forms of ESRD. 3 figures. 52 references (11 annotated). (AA-M).

•

Permanent Hemodialysis Vascular Access Survival in Children and Adolescents with End-Stage Renal Disease Source: Kidney International. 62(5): 1864-1869. November 2002. Contact: Available from Blackwell Science, Inc. Journals Fulfillment Department, 350 Main Street, Malden, MA 02148. (781) 388-8250. Summary: Transplantation is the optimal therapy for children with end stage renal disease (ESRD), but in a subset of patients with peritoneal membrane failure, failed transplants, or poor social situations, chronic hemodialysis (HD) remains the only option. Long-term survival of arteriovenous fistulas (AVFs) and arteriovenous grafts (AVGs) in pediatric patients has not been well described. This article reports on a study of the survival of permanent vascular access in 34 pediatric ESRD patients treated with chronic HD between 1989 and 1995 and followed through 2000. Twenty-four AVFs and AVGs were created in 19 and 23 patients, respectively. Mean age and weight at insertion were 15.1 years (range 7.1 to 20.9 years) and 46 kilograms (18 to 81 kilograms) for AVFs and 13.3 years (3.8 to 21.1 years) and 41.5 kilograms (10.5 to 145 kilograms) for AVGs. Excluding primary failures, 1-year, 3-year, and 5-year patency rates for AVFs and AVGs were not significantly different. Patency did not correlate with patient weight or age at access creation. Primary access failure occurred more often in AVFs (8 of 24) than in AVGs (1 of 28). Access thrombosis (clotting), stenosis (narrowing), and infection occurred more frequently in AVG. The authors conclude that both AVF and AVG function well even in small pediatric patients and have survival rates equivalent to adult series and longer than cuffed venous catheters in pediatric patients. Both AVFs and AVGs are preferable for long-term HD access in pediatrics. 1 figure. 3 tables. 17 references.

32


Federally Funded Research on End-Stage Renal Disease The U.S. Government supports a variety of research studies relating to end-stage renal disease. 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 end-stage renal disease. 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 end-stage renal disease. The following is typical of the type of information found when searching the CRISP database for end-stage renal disease: •

Project Title: AMERICANS

GENETICS

OF

DIABETIC

NEPHROPATHY

IN

MEXICAN

Principal Investigator & Institution: Abboud, Hanna E.; Professor & Director; Medicine; University of Texas Hlth Sci Ctr San Ant 7703 Floyd Curl Dr San Antonio, Tx 78229 Timing: Fiscal Year 2002; Project Start 30-SEP-1999; Project End 31-AUG-2004 Summary: The prevalence of type 2 diabetes in Mexican Americans, a large minority ground in the United States, is two to three times higher than in Caucasians. The prevalence of end-stage renal disease (ESRD) in Mexican Americans with type 2 diabetes is almost 3-4 times higher than in Caucasians. The pathogenesis of diabetic nephropathy (DN) is not well understood but circumstantial evidence indicates the existence of a genetic basis for this disease. This grant application is a response to the RFA "Diabetic and Non- Diabetic Nephropathy Susceptibility Genes" (DK-99-005), and proposes to establish a Participating Investigation Center (PIC) at the University of Texas Health Science Center at San Antonio. As a family ascertainment center, the San Antonio PIC has the goal to ascertain approximately extended, multiplex families through ESRD patients recruited at dialysis and transplant clinics in San Antonio and South West Texas. In addition, this center will develop a quality control procedure for the family ascertainment. Questionnaires developed for this procedure will be available to all PICs. San Antonio is an 3excellent location to recruit and enroll Mexican American participants for genetic studies. Approximately 60% of inhabitants in San Antonio and South West Texas are Mexican Americans. More than half of the 5,700 ESRD patients in San Antonio and South West Texas are expected to be Mexican Americans. Therefore, the study population will be large enough to recruit the proposed set of 150 families. The San Antonio PIC proposes to perform three local research projects. (1) Phenotyping the set of families investigated in The San Antonio Family Diabetes Study (SAFADS, PI: Dr. M. Stern) for DN us under way. These families have already been genotyped with over 400 markers. We plan to have performed a variance component analysis (VCA) for the SAFADS families to identify possible candidate regions for DN genes by the end of 2 Healthcare projects are funded by the National Institutes of Health (NIH), Substance Abuse and Mental Health Services (SAMHSA), Health Resources and Services Administration (HRSA), Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDCP), Agency for Healthcare Research and Quality (AHRQ), and Office of Assistant Secretary of Health (OASH).

Studies

33

the first year of funding. (2) Based on these early linkage results, a candidate region/gene analysis will be performed with the newly identified "ESRD pedigrees" applying VCA. (3) We will conduct a medical anthropological study to investigate how ESRD patients and their "healthy" relatives experience type 2 diabetes and DN when these diseases cluster in families. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: HGF GENE THERAPY FOR CHRONIC RENAL FIBROSIS Principal Investigator & Institution: Liu, Youhua; Associate Professor; Pathology; University of Pittsburgh at Pittsburgh 350 Thackeray Hall Pittsburgh, Pa 15260 Timing: Fiscal Year 2002; Project Start 01-APR-2002; Project End 31-MAR-2006 Summary: (Provided by applicant): End-stage renal disease (ESRD) is one of the most devastating diseases with great morbidity and mortality, and the number of patients is on the rise worldwide. Despite diverse primary etiologies, the pathogenesis of chronic renal diseases progressing to ESRD is a remarkably monotonous process characterized by relentless accumulation of extracellular matrix (ECM) leading to widespread tissue fibrosis. Thus, developing a scheme to inhibit fibrosis appears to be a key strategy for the treatment of chronic renal disease. Preliminary studies in our laboratory suggest that hepatocyte growth factor (HGF) is an important regulator of extracellular matrix turnover leading to inhibition of tissue fibrosis in animal model of renal diseases. Because exogenous HGF is very unstable in blood circulation due to the rapid clearance by liver, we recently develop a gene transfer strategy using naked plasmid vector resulting in efficient expression of HGF protein in vivo. Based on these results, we hypothesize that delivery of HGF gene is an effective therapeutic strategy for the treatment of chronic renal disease. In this application, we propose to administrate HGF gene into animal model of progressive renal disease to evaluate its therapeutic efficacy. We will investigate the mechanism underlying HGF ameliorating renal fibrosis by examining the regulation of myofibroblast activation and TGF-Beta1 signaling. These will be accomplished in the following three specific aims: 1) to evaluate the efficacy of HGF gene therapy for chronic renal fibrosis; 2) to investigate the role of HGF in renal myofibroblast activation; 3) to elucidate the molecular mechanism underlying HGF blocking pro-fibrogenic cytokine TGF-Beta1 signaling. These studies will provide fundamental information such as the feasibility and efficacy of HGF gene therapy for chronic renal diseases, and will eventually lead to new therapeutic strategies to human chronic renal fibrosis, which is otherwise incurable. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

•

Project Title: IRON DELIVERY VIA HEMODIALYSATE IN ESRD Principal Investigator & Institution: Gupta, Ajay; Internal Medicine; Charles R. Drew University of Med & Sci 1621 E 120Th St Los Angeles, Ca 90059 Timing: Fiscal Year 2004; Project Start 01-FEB-2004; Project End 31-JAN-2006 Summary: (provided by applicant): Erythropoietin (EPO) is an effective therapy for anemia of end-stage renal disease (ESRD) and is used in almost all ESRD patients receiving chronic hemodialysis. EPO stimulated iron utilization, coupled with small but unavoidable loss of extra corporeal blood with hemodialysis, leads to iron deficiency in almost all patients. Adequate iron delivery, by oral or parenteral supplementation, is necessary for optimal EPO action. Compliance with oral iron is poor due to gastrointestinal toxicity. Therefore intravenous (i.v.) iron is administered to 50-75 percent of hemodialysis patients, either intermittently when iron deficiency develops or

34


at regular intervals to prevent iron depletion. Parenteral iron is a pro-oxidant, and may increase the risk of infections, inflammation and atherosclerosis by further enhancing oxidative stress and inflammation present in the majority of hemodialysis patients. Unlike the large polymeric iron complexes that are administered i.v., ferric pyrophosphate (FePPi), a monomeric iron salt (745 Da), can be delivered directly into the circulation when added to dialysis solutions. Fe(III) complexes tightly with pyrophosphate (PPi), thereby reducing dissociation and release of free iron. PPi anion is an antioxidant that promotes direct delivery of iron to transferrin, and iron transfer from transferrin to ferritin. FePPi is highly soluble in the acid concentrate and a concentrate fortified with FePPi can be used to generate a dialysate with defmed concentration of FePPi (Fe-HD). This is a double-blinded, randomized, controlled Phase II clinical trial to determine the safety and efficacy of FePPi added to the hemodialysis solutions in ESRD patients over a period of 9 months. Iron replete patients in=30) with no evidence of iron overload (transferrin saturation or TSAT< 40 percent, and ferritin < 800 lag/L), who have needed intravenous iron in the previous 2 months will be enrolled. Patients will be randomized to receive hemodialysis using Fe-HD or C-HD with every dialysis session for a total period of 9 months. The initial dose of dialysate iron will be 9 lag/dl if TSAT is 30-40 percent, and 11 lag/dl if TSAT is < 30 percent. Serum iron parameters (TSAT and ferritin) will be monitored every month. The dialysate iron concentration will be reduced to 9 lag/dl if pre-dialysis TSAT increases to 35-40 percent, and dialysate iron will be held if TSAT exceeds 40 percent. Dialysate iron will be restarted at 11 lag/dl if TSAT is < 30 percent and at 9 lag/dl if TSAT is 30-40 percent. Patients in both groups will receive 500 mg i.v. iron saccharate (Venofer(r)) in 5 divided doses at 5 consecutive dialysis sessions if TSAT is 800 lag/L). The acute and chronic effects of dialysate iron on serum levels of catalytically active iron and markers of inflammation and oxidative stress will be measured at the beginning and the end of the study. This Phase II study will provide preliminary evidence of the safety and efficacy of ferric pyrophosphate infusion via the dialysate, with the aim of preventing iron deficiency, and pave the way for a large, clinical trial of dialysate iron therapy. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: OXIDATIVE STRESS AND SYMPATHETIC NERVE ACTIVITY Principal Investigator & Institution: Campese, Vito M.; Medicine; University of Southern California 2250 Alcazar Street, Csc-219 Los Angeles, Ca 90033 Timing: Fiscal Year 2003; Project Start 24-JAN-2003; Project End 31-DEC-2006 Summary: (provided by applicant): Hypertension is a common manifestation of renal disease and greatly contributes to its progression as well as to cardiovascular morbidity. Clearly, hypertension is an important etiology in the pathogenesis of renal failure. In the United States, hypertension is the primary cause of end-stage renal disease in approximately 29 percent of dialysis patients. In conjunction with other diseases such as diabetes and chronic glomerulonephritides, hypertension, when uncontrolled, hastens the progression of renal disease. Cardiovascular disease is the leading cause of death in patients receiving maintenance hemodialysis and hypertension is considered the most important factor responsible for cardiovascular events in these patients. Adequate BP control may reduce the progression of renal disease and cardiovascular morbidity in these patients, but often this is difficult to achieve with currently available drugs. The old paradigm is that hypertension in renal disease is the result of activation of the reninangiotensin system and/or volume expansion. Our studies strongly support the notion that a renal injury may result in activation of renal afferent pathways that integrate with the central nervous system, and lead to stimulation of efferent SNS activity and

Studies

35

hypertension. Locally produced angiotensin II in the brain in response to these afferent stimuli seems to be responsible for SNS activation through inhibition of nitric oxide. Our hypothesis is that angiotensin-II activation of ROS may reduce NO availability in key brain region and result in increased SNS activity in a model of neurogenic hypertension caused by renal injury developed in our laboratory. To test this hypothesis we will pursue 3 specific Aims: 1. Test the hypothesis that locally produced Ang II mediates the activation of central SNS activity caused by phenol-renal injury. To this end, we will measure Ang II concentration in the dialysate collected from the PH using the microdialysis technique, and the expression of renin mRNA in the posterior hypothalamus. 2. Test the hypothesis that radical oxygen species (ROS) activated by Angiotensin II down-regulate nitric oxide production in the brain resulting in increased SNS activity. To this end, we will measure the concentration of reactive oxygen species (ROS) in the hypothalamus or rats with the phenol-renal injury or rats infused with Ang II in the lateral ventricle. In addition, we will evaluate the effects of anti-oxidants, or scavengers of ROS, and Ang II AT1 receptor antagonists on BP, sympathetic activation and ROS concentrations in the hypothalamic region. 3. Test the hypothesis that increased ROS production may result in NO inhibition and SNS activation in other forms of experimental hypertension, such as the DOCA-sait model, and the renovascular hypertension model. If our hypothesis were to be correct, administration of inhibitors of the renin-angiotensin system particularly if combined with antioxidants should result in better control of BP in these models. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: PATIENT-CENTERED APPROACH TO ADVANCE CARE PLANNING Principal Investigator & Institution: Kirchhoff, Karin T.; Professor; None; University of Wisconsin Madison 750 University Ave Madison, Wi 53706 Timing: Fiscal Year 2003; Project Start 11-AUG-2003; Project End 31-JUL-2007 Summary: (Provided by the Applicant) This application is re-submitted in response to PA-01-124, Patient-Centered Care: Customizing Care to Meet Patients' Needs. For a decade, attention has been given to the use of Advance Directives and Advance Care Planning (ACP) as ways to improve end-of-life care. We know from the literature, and from our own research on end-of-life care that these efforts have not been successful. The overriding inadequacy of past efforts is their lack of patient-centeredness. That is to say, they have not been grounded in a clear understanding of patients' preferences, values, and wishes, nor did they include surrogates. Based on theories regarding decision-making and patient education we have developed Patient-Centered Advance Care Planning (PC-ACP). This intervention is designed to improve patient and surrogate knowledge of ACP, increase the congruence between patient and surrogate in treatment decisions, decrease the patient's and surrogate's conflict in making such decisions, and increase the consistency between patient preferences and the actual care they receive. The ACP intervention is conducted with the patient in the presence of surrogate. The specific aims are (1) To test the efficacy of PC-ACP on patient and surrogate outcomes both immediately following receipt of the intervention and at six months and (2) To test the efficacy of PC-ACP on patient and surrogate outcomes at the time the patient first encounters a medical complication or during end-of-life care where the surrogate is required to make decisions. A randomized trial will be conducted with patients and surrogates experiencing conditions that put patients at high risk for dying within the next year - end-stage renal disease, and end-stage heart failure. Subjects (patient-surrogate pairs) will be randomized to PC-ACP or a control group. The control group will receive "usual care." Subjects will complete measures of clinical and

36


demographic data when they enter the study. Outcome measures will be assessed at two end points, at the time of the first medical complication that requires surrogate decision-making and/or at six months. If successful, the knowledge gained from this research will be useful in redesigning the federally mandated assessment of Advance Directives into an improved process of Advance Care Planning to better fit the spirit of the Patient Self Determination Act. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: ROLE OF KAP EXPRESSION IN THE DIABETIC KIDNEY Principal Investigator & Institution: Coschigano, Karen T.; None; Ohio University Athens Athens, Oh 45701 Timing: Fiscal Year 2002; Project Start 01-JUL-2002; Project End 30-JUN-2004 Summary: (provided by applicant): Kidney damage is a frequent complication of both type I and type II diabetes, often ending in kidney failure, or end-stage renal disease (ESRD). Diabetic nephropathy, the single most common cause of ESRD, is a progressive disease that takes several years to develop and often goes undiagnosed. The long-term goal of this project is to design specific, targeted markers and therapeutic approaches for the diagnosis, treatment, and prevention of human diabetic kidney disease. Toward this end, previous work identified a cDNA whose mRNA expression decreases markedly with increasing kidney damage, both in a diabetes-dependent and in a diabetesindependent mouse model of glomeruloscierosis. This cDNA encodes kidney androgenregulated protein (KAP), a kidney-specific protein found only in renal proximal tubule cells. Since decreasing levels of KAP mRNA are associated with progressive kidney damage, it is proposed that maintenance of high levels of KAP mRNA expression will protect the kidney from glomerular hypertrophy and diabetic damage. This hypothesis will be tested by expressing KAP mRNA in the kidneys of mice under the direction of a heterologous promoter and then assessing the extent of kidney damage after induction of diabetes by streptozotocin injection. Acceptance of the hypothesis could lead to the development of KAP as a therapeutic drug for the prevention of kidney damage. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

•

Project Title: ROLE OF SCAVENGER RECEPTORS IN RENAL FIBROSIS Principal Investigator & Institution: Eddy, Allison A.; Professor; Vanderbilt University 3319 West End Ave. Nashville, Tn 372036917 Timing: Fiscal Year 2002; Project Start 01-APR-1992; Project End 31-MAR-2007 Summary: Description (provided by applicant) Progressive renal disease is caused by a process of fibrosis that relentlessly destroys normal renal architecture and function. The number of patients with end-stage renal disease continues to rise exponentially, at an annual cost to Medicare that now exceeds $12 billion. The goal of the proposed studies is to determine how abnormalities of lipoprotein metabolism, which are frequently present in patients with renal disease, contribute to the pathogenesis of renal fibrosis. The overall hypothesis to be tested is that macrophage scavenger receptors process low density lipoproteins that have been oxidatively modified within the kidney to initiate fibrosis-promoting events. It is further hypothesized that this pathway worsens fibrosis in the face of hypercholesterolemia. Three Specific Aims are proposed. (1) To determine the effects of hypercholesterolemia on the severity of renal fibrosis and to delineate the pattern of renal scavenger receptor expression in murine models of renal fibrosis. (2) To investigate the role of the macrophage scavenger receptor class A type I/II (SR-AI/II) and scavenger receptor CD36 in renal fibrosis. (3) To elucidate intrarenal changes in pro-

Studies

37

oxidant and anti-oxidant enzymes that could promote lipoprotein oxidation in murine models of renal disease associated with hyperlipidemia. These in vivo studies will be based on four murine models of renal disease. The functional significance of the two best characterized macrophage scavenger receptors, which are also known to participate in atherogenesis, (SR-AI/II and CD36), will be determined by comparing renal disease severity between wild-type animals and scavenger receptor-deficient animals. Bone marrow transplantation studies will be done to distinguish between the role of renal and macrophage scavenger receptors. Our long-term objective is to provide a scientific basis for the development and use of new therapies for patients with progressive renal disease. It is anticipated that the results of the proposed studies will prove that hypercholesterolemia, intra-renal oxidation of low density lipoproteins and scavenger receptor-dependent interactions with oxLDL represent an important pathogenetic pathway of progressive renal damage. 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 “end-stage renal disease” (or synonyms) into the search box. This search gives you access to full-text articles. The following is a sample of items found for end-stage renal disease in the PubMed Central database: •

Effect of concomitant administration of piperacillin on the dispositions of isepamicin and gentamicin in patients with end-stage renal disease. by Halstenson CE, Wong MO, Herman CS, Heim-Duthoy KL, Teal MA, Affrime MB, Kelloway JH, Keane WF, Awni WM.; 1992 Sep; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=192195

•

Effect of concomitant administration of piperacillin on the dispositions of netilmicin and tobramycin in patients with end-stage renal disease. by Halstenson CE, Hirata CA, Heim-Duthoy KL, Abraham PA, Matzke GR.; 1990 Jan; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=171533

•

Gentamicin inactivation by piperacillin or carbenicillin in patients with end-stage renal disease. by Thompson MI, Russo ME, Saxon BJ, Atkin-Thor E, Matsen JM.; 1982 Feb; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=181871

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.

38


•

Influence of hemodialysis on plasma concentration-time profiles of mefloquine in two patients with end-stage renal disease: a prophylactic drug monitoring study. by Crevoisier CA, Joseph I, Fischer M, Graf H.; 1995 Aug; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=162850

•

Pharmacokinetics of ampicillin (2.0 grams) and sulbactam (1.0 gram) coadministered to subjects with normal and abnormal renal function and with end-stage renal disease on hemodialysis. by Blum RA, Kohli RK, Harrison NJ, Schentag JJ.; 1989 Sep; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=172685

•

Pharmacokinetics of cefoperazone (2.0 g) and sulbactam (1.0 g) coadministered to subjects with normal renal function, patients with decreased renal function, and patients with end-stage renal disease on hemodialysis. by Reitberg DP, Marble DA, Schultz RW, Whall TJ, Schentag JJ.; 1988 Apr; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=172210

•

Pharmacokinetics of meropenem in patients with various degrees of renal function, including patients with end-stage renal disease. by Chimata M, Nagase M, Suzuki Y, Shimomura M, Kakuta S.; 1993 Feb; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=187644

•

Steady-State Pharmacokinetics of Lamivudine in Human Immunodeficiency VirusInfected Patients with End-Stage Renal Disease Receiving Chronic Dialysis. by Bohjanen PR, Johnson MD, Szczech LA, Wray DW, Petros WP, Miller CR, Hicks CB.; 2002 Aug; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=127386

•

Tubulointerstitial Nephritis Due to a Mutant Polyomavirus BK Virus Strain, BKV(Cin), Causing End-Stage Renal Disease. by Smith RD, Galla JH, Skahan K, Anderson P, Linnemann CC Jr, Ault GS, Ryschkewitsch CF, Stoner GL.; 1998 Jun; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=104896

The National Library of Medicine: PubMed One of the quickest and most comprehensive ways to find academic studies in both English and other languages is to use PubMed, maintained by the National Library of Medicine.6 The advantage of PubMed over previously mentioned sources is that it covers a greater number of domestic and foreign references. It is also free to use. If the publisher has a Web site that offers full text of its journals, PubMed will provide links to that site, as well as to sites offering other related data. User registration, a subscription fee, or some other type of fee may be required to access the full text of articles in some journals. To generate your own bibliography of studies dealing with end-stage renal disease, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “end-stage renal 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 with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text journal articles at Web sites of participating publishers. Publishers that participate in PubMed supply NLM with their citations electronically prior to or at the time of publication.

Studies

39

disease” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for end-stage renal disease (hyperlinks lead to article summaries): •

A dynamic Web application within an n-tier architecture: a Multi-Source Information System for end-stage renal disease. Author(s): Ben Said M, Simonet A, Guillon D, Jacquelinet C, Gaspoz F, Dufour E, Mugnier C, Jais JP, Simonet M, Landais P. Source: Stud Health Technol Inform. 2003; 95: 95-100. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14663969&dopt=Abstract

•

A functional variant of the myeloperoxidase gene is associated with cardiovascular disease in end-stage renal disease patients. Author(s): Pecoits-Filho R, Stenvinkel P, Marchlewska A, Heimburger O, Barany P, Hoff CM, Holmes CJ, Suliman M, Lindholm B, Schalling M, Nordfors L. Source: Kidney International. Supplement. 2003 May; (84): S172-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12694338&dopt=Abstract

•

A need for an individualized approach to end-stage renal disease patients. Author(s): Horl WH. Source: Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association. 2002; 17 Suppl 6: 1721. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12091597&dopt=Abstract

•

A third kidney transplant: cost-effective treatment for end-stage renal disease? Author(s): Matas AJ, Gillingham KJ, Payne WD, Dunn DL, Gruessner RW, Sutherland DE, Schmidt W, Najarian JS. Source: Clinical Transplantation. 1996 December; 10(6 Pt 1): 516-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8996772&dopt=Abstract

•

A time for rediscovery: chronic hemofiltration for end-stage renal disease. Author(s): McCarthy JT, Moran J, Posen G, Leypoldt JK, Hull AR, Jaber BL, CorreaRotter R. Source: Seminars in Dialysis. 2003 May-June; 16(3): 199-207. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12753678&dopt=Abstract

•

A young patient with end-stage renal disease, dyspnoea, weakness, peripheral neuropathy and an unsuspected underlying disease. Author(s): Wichmann G, Passauer J, Fischer R, Weise M, Gross P. Source: Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association. 2003 August; 18(8): 1670-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12897114&dopt=Abstract

40


•

Absence of edema in HIV-infected patients with end-stage renal disease. Author(s): Perinbasekar S, Brod-Miller C, Mattana J. Source: Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology : Official Publication of the International Retrovirology Association. 1996 December 1; 13(4): 368-73. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8948376&dopt=Abstract

•

Acupoints massage in improving the quality of sleep and quality of life in patients with end-stage renal disease. Author(s): Tsay SL, Rong JR, Lin PF. Source: Journal of Advanced Nursing. 2003 April; 42(2): 134-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12670382&dopt=Abstract

•

Acupressure and fatigue in patients with end-stage renal disease-a randomized controlled trial. Author(s): Tsay SL. Source: International Journal of Nursing Studies. 2004 January; 41(1): 99-106. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14670399&dopt=Abstract

•

Acute coronary syndromes after renal transplantation in patients with end-stage renal disease resulting from diabetes. Author(s): Hypolite IO, Bucci J, Hshieh P, Cruess D, Agodoa LY, Yuan CM, Taylor AJ, Abbott KC. Source: American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons. 2002 March; 2(3): 274-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12096791&dopt=Abstract

•

Adaptation of African-American cultural and food preferences in end-stage renal disease diets. Author(s): Patel C, Nicol A. Source: Adv Ren Replace Ther. 1997 January; 4(1): 30-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8996618&dopt=Abstract

•

Adipose tissue as a source of inflammatory cytokines in health and disease: focus on end-stage renal disease. Author(s): Zoccali C, Mallamaci F, Tripepi G. Source: Kidney International. Supplement. 2003 May; (84): S65-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12694312&dopt=Abstract

Studies

41

•

Adverse events with rhGH treatment of patients with chronic renal insufficiency and end-stage renal disease. Author(s): Fine RN, Ho M, Tejani A, Blethen S. Source: The Journal of Pediatrics. 2003 May; 142(5): 539-45. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12756387&dopt=Abstract

•

An observational study of cardiovascular characteristics of long-term end-stage renal disease survivors. Author(s): Owen WF, Madore F, Brenner BM. Source: American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation. 1996 December; 28(6): 931-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8957049&dopt=Abstract

•

Angiotensin-converting enzyme inhibitors but not angiotensin II AT 1 receptor antagonists affect erythropoiesis in patients with anemia of end-stage renal disease. Author(s): Schiffl H, Lang SM. Source: Nephron. 1999 January; 81(1): 106-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9884431&dopt=Abstract

•

Aortic pulse wave velocity index and mortality in end-stage renal disease. Author(s): Blacher J, Safar ME, Guerin AP, Pannier B, Marchais SJ, London GM. Source: Kidney International. 2003 May; 63(5): 1852-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12675863&dopt=Abstract

•

Approach to patients with end-stage renal disease who need an arteriovenous fistula. Author(s): Malovrh M. Source: Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association. 2003 July; 18 Suppl 5: V50-2. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12817071&dopt=Abstract

•

Arterial media calcification in end-stage renal disease: impact on all-cause and cardiovascular mortality. Author(s): London GM, Guerin AP, Marchais SJ, Metivier F, Pannier B, Adda H. Source: Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association. 2003 September; 18(9): 1731-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12937218&dopt=Abstract

42


•

Aspects of quality of life through end-stage renal disease. Author(s): Franke GH, Reimer J, Philipp T, Heemann U. Source: Quality of Life Research : an International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation. 2003 March; 12(2): 103-15. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12639058&dopt=Abstract

•

Aspirin, beta-blocker, and angiotensin-converting enzyme inhibitor therapy in patients with end-stage renal disease and an acute myocardial infarction. Author(s): Berger AK, Duval S, Krumholz HM. Source: Journal of the American College of Cardiology. 2003 July 16; 42(2): 201-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12875751&dopt=Abstract

•

beta 2-Glycoprotein I-dependent and-independent anticardiolipin antibody in patients with end-stage renal disease. Author(s): Matsuda J, Saitoh N, Gohchi K, Tsukamoto M, Nakamura K, Kinoshita T. Source: Thrombosis Research. 1993 October 15; 72(2): 109-17. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8303648&dopt=Abstract

•

Beta 2-microglobulin elimination in end-stage renal disease patients on renal replacement therapy. Author(s): Stefanovic V, Kostic S, Djordjevic V, Mitic M, Bogicevic M. Source: Perit Dial Int. 1993; 13 Suppl 2: S520-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8399654&dopt=Abstract

•

Bilateral cytomegalovirus retinitis in a patient with systemic lupus erythematosus and end-stage renal disease. Author(s): Shahnaz S, Choksi MT, Tan IJ. Source: Mayo Clinic Proceedings. 2003 November; 78(11): 1412-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14601702&dopt=Abstract

•

Bioelectrical impedance analysis and assessment of body composition in end-stage renal disease. Author(s): Di Iorio BR, Bellizzi V. Source: Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association. 2003 September; 18(9): 1943-4; Author Reply 1944-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12937254&dopt=Abstract

Studies

43

•

Biomarkers of DNA damage in patients with end-stage renal disease: mitochondrial DNA mutation in hair follicles. Author(s): Liu CS, Ko LY, Lim PS, Kao SH, Wei YH. Source: Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association. 2001 March; 16(3): 561-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11239032&dopt=Abstract

•

Biphasic changes in nitric oxide generation in hemodialyzed patients with end-stage renal disease treated with recombinant human erythropoietin. Author(s): Kang ES, Wang YB, Cardenas R, Tevlin MT, Mishra S, Acchiardo SR. Source: The American Journal of the Medical Sciences. 2000 March; 319(3): 149-57. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10746825&dopt=Abstract

•

Biphasic effects of hemodialysis on platelet reactivity in patients with end-stage renal disease: a potential contributor to cardiovascular risk. Author(s): Aggarwal A, Kabbani SS, Rimmer JM, Gennari FJ, Taatjes DJ, Sobel BE, Schneider DJ. Source: American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation. 2002 August; 40(2): 315-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12148104&dopt=Abstract

•

Blood coagulation, fibrinolytic, and inhibitory proteins in end-stage renal disease: effect of hemodialysis. Author(s): Vaziri ND, Gonzales EC, Wang J, Said S. Source: American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation. 1994 June; 23(6): 828-35. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8203365&dopt=Abstract

•

Blood glucose and cholesterol control improved by continuous ambulatory peritoneal dialysis in patients with end-stage renal disease and diabetes mellitus. Author(s): Wikdahl AM, Granbom L, Sorensen JG, Stegmayr BG. Source: Perit Dial Int. 1993; 13 Suppl 2: S239-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8399577&dopt=Abstract

•

Blood glucose overestimation in diabetic patients on continuous ambulatory peritoneal dialysis for end-stage renal disease. Author(s): Oyibo SO, Pritchard GM, McLay L, James E, Laing I, Gokal R, Boulton AJ. Source: Diabetic Medicine : a Journal of the British Diabetic Association. 2002 August; 19(8): 693-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12147153&dopt=Abstract

44


•

Blood pressure and end-stage renal disease in men. Author(s): Klag MJ, Whelton PK, Randall BL, Neaton JD, Brancati FL, Ford CE, Shulman NB, Stamler J. Source: The New England Journal of Medicine. 1996 January 4; 334(1): 13-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7494564&dopt=Abstract

•

Blood pressure and risk of end-stage renal disease in a screened cohort. Author(s): Iseki K, Ikemiya Y, Fukiyama K. Source: Kidney International. Supplement. 1996 June; 55: S69-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8743514&dopt=Abstract

•

Blood pressure predicts risk of developing end-stage renal disease in men and women. Author(s): Tozawa M, Iseki K, Iseki C, Kinjo K, Ikemiya Y, Takishita S. Source: Hypertension. 2003 June; 41(6): 1341-5. Epub 2003 April 21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12707291&dopt=Abstract

•

Blood pressure variability as an adverse prognostic risk factor in end-stage renal disease. Author(s): Tozawa M, Iseki K, Yoshi S, Fukiyama K. Source: Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association. 1999 August; 14(8): 1976-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10462280&dopt=Abstract

•

Bone and mineral metabolism in childhood end-stage renal disease. Author(s): Salusky IB. Source: Pediatric Clinics of North America. 1995 December; 42(6): 1531-50. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8614599&dopt=Abstract

•

Bone densitometry: patients with end-stage renal disease. Author(s): Erlichman M, Holohan TV. Source: Health Technol Assess (Rockv). 1996 March; (8): 1-27. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8722234&dopt=Abstract

•

Bullous dermatosis of end-stage renal disease and aluminium. Author(s): Tercedor J, Lopez Hernandez B, Rodenas JM. Source: Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association. 1997 May; 12(5): 1083. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9175083&dopt=Abstract

Studies

45

•

Bullous dermatosis of end-stage renal disease: a possible association between abnormal porphyrin metabolism and aluminium. Author(s): Gafter U, Mamet R, Korzets A, Malachi T, Schoenfeld N. Source: Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association. 1996 September; 11(9): 1787-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8918623&dopt=Abstract

•

Burden of end-stage renal disease among indigenous peoples in Australia and New Zealand. Author(s): McDonald SP, Russ GR. Source: Kidney International. Supplement. 2003 February; (83): S123-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12864890&dopt=Abstract

•

Can we prevent end-stage renal disease due to hypertension or to diabetes mellitus? Author(s): Luke RG. Source: Jama : the Journal of the American Medical Association. 1992 December 2; 268(21): 3119-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1433743&dopt=Abstract

•

Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 37-2003. A 79-year-old man with coronary artery disease, peripheral vascular disease, end-stage renal disease, and abdominal pain and distention. Author(s): Kelsey PB, Chen S, Lauwers GY. Source: The New England Journal of Medicine. 2003 November 27; 349(22): 2147-55. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14645643&dopt=Abstract

•

Cause of death in patients with end-stage renal disease: assessing concordance of death certificates with registry reports. Author(s): Li SQ, Cass A, Cunningham J. Source: Aust N Z J Public Health. 2003; 27(4): 419-24. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14705305&dopt=Abstract

•

Cerebral, myocardial and cutaneous ischemic necrosis associated with calcific emboli from aortic and mitral valve calcification in a patient with end-stage renal disease. Author(s): Li Y, Muench A, McGregor DH, Wiegmann TB. Source: Clinical Nephrology. 2002 June; 57(6): 468-73. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12078952&dopt=Abstract

46


•

Changes of extracellular volumes measured by whole and segmental bioimpedance analysis during hemodialysis in end-stage renal disease (ESRD) patients. Author(s): Zaluska WT, Malecka T, Swatowski A, Ksiazek A. Source: Ann Univ Mariae Curie Sklodowska [med]. 2002; 57(2): 337-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12898859&dopt=Abstract

•

Clinical outcome of percutaneous transluminal coronary rotational atherectomy in patients with end-stage renal disease. Author(s): Aoki J, Ikari Y, Sugimoto T, Fukuda S, Hara K. Source: Circulation Journal : Official Journal of the Japanese Circulation Society. 2003 July; 67(7): 617-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12845186&dopt=Abstract

•

Clinical significance of falsely elevated vancomycin concentrations in end-stage renal disease. Author(s): Kim JS, Perkins RJ, Briceland LL, Tobin EH. Source: The Annals of Pharmacotherapy. 1999 January; 33(1): 116-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9972400&dopt=Abstract

•

Colestimide can be used as a phosphate binder to treat uraemia in end-stage renal disease patients. Author(s): Date T, Shigematsu T, Kawashita Y, Satake N, Morita K. Source: Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association. 2003 June; 18 Suppl 3: Iii90-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12771311&dopt=Abstract

•

Comparative cost-analysis of two different chronic care facilities for end-stage renal disease patients. Author(s): Jassal SV, Brissenden JE, Raisbeck A, Roscoe JM. Source: Geriatric Nephrology and Urology. 1998; 8(2): 69-76. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9893214&dopt=Abstract

•

Comparative study of renal replacement therapy in Korean diabetic end-stage renal disease patients: a single center study. Author(s): Choi SR, Lee SC, Kim BS, Yoon SY, Park HC, Kang SW, Choi KH, Kim YS, Ha SK, Park KI, Han DS, Lee HY. Source: Yonsei Medical Journal. 2003 June 30; 44(3): 454-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12833583&dopt=Abstract

Studies

47

•

Convergence of health ratings across nephrologists, nurses, and patients with endstage renal disease. Author(s): Devins GM, Paul LC, Barre PE, Mandin H, Taub K, Binik YM. Source: Journal of Clinical Epidemiology. 2003 April; 56(4): 326-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12767409&dopt=Abstract

•

Coronary artery calcification and end-stage renal disease: vascular biology and clinical implications. Author(s): Schoenhagen P, Tuzcu EM. Source: Cleve Clin J Med. 2002; 69 Suppl 3: S12-20. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12086231&dopt=Abstract

•

Coronary artery disease in end-stage renal disease: no longer a simple plumbing problem. Author(s): Stenvinkel P, Pecoits-Filho R, Lindholm B. Source: Journal of the American Society of Nephrology : Jasn. 2003 July; 14(7): 1927-39. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12819254&dopt=Abstract

•

Coronary revascularization improves long-term prognosis in diabetic and nondiabetic end-stage renal disease. Author(s): Aoki J, Ikari Y, Nakajima H, Sugimoto T, Hara K. Source: Circulation Journal : Official Journal of the Japanese Circulation Society. 2002 June; 66(6): 595-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12074280&dopt=Abstract

•

Coronary revascularization in patients with end-stage renal disease: risks, benefits, and optimal strategies. Author(s): Keeley EC, McCullough PA. Source: Reviews in Cardiovascular Medicine. 2003 Summer; 4(3): 125-30. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12949440&dopt=Abstract

•

Correlates for end-stage renal disease patients. Author(s): Yavuz N, Karatas M, Kilinc S. Source: Scandinavian Journal of Caring Sciences. 2000; 14(3): 179-83. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12035269&dopt=Abstract

•

Correlative factors of left ventricular hypertrophy in end-stage renal disease. Author(s): Dai Y, He SJ, Yu Y, Zhu LY, Peng B, Liu JB, Tang SC. Source: J Tongji Med Univ. 1993; 13(4): 252-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8151747&dopt=Abstract

48


•

Course of left ventricular hypertrophy and function in end-stage renal disease after renal transplantation. Author(s): Huting J. Source: The American Journal of Cardiology. 1992 December 1; 70(18): 1481-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1442622&dopt=Abstract

•

Cumulative risk for developing end-stage renal disease in the US population. Author(s): Kiberd BA, Clase CM. Source: Journal of the American Society of Nephrology : Jasn. 2002 June; 13(6): 1635-44. Erratum In: J Am Soc Nephrol. 2002 October; 13(10): 2617. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12039993&dopt=Abstract

•

Cytochrome P4502C9 activity in end-stage renal disease. Author(s): Dreisbach AW, Japa S, Gebrekal AB, Mowry SE, Lertora JJ, Kamath BL, Rettie AE. Source: Clinical Pharmacology and Therapeutics. 2003 May; 73(5): 475-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12732848&dopt=Abstract

•

Daily hemodialysis: challenges and opportunities in the delivery and financing of end-stage renal disease patient care. Author(s): Nissenson AR. Source: Adv Ren Replace Ther. 2001 October; 8(4): 286-92. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11593495&dopt=Abstract

•

Decreased salivary function in patients with end-stage renal disease requiring hemodialysis. Author(s): Kao CH, Hsieh JF, Tsai SC, Ho YJ, Chang HR. Source: American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation. 2000 December; 36(6): 1110-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11096033&dopt=Abstract

•

Depression and marital dissatisfaction in patients with end-stage renal disease and in their spouses. Author(s): Daneker B, Kimmel PL, Ranich T, Peterson RA. Source: American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation. 2001 October; 38(4): 839-46. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11576888&dopt=Abstract

•

Development of eclampsia and end-stage renal disease in a case of Sickle cell disease. Author(s): Goyal SB, Goyal RS. Source: Nephron. 1998 September; 80(1): 113-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9730728&dopt=Abstract

Studies

49

•

Diabetes mellitus, aortic stiffness, and cardiovascular mortality in end-stage renal disease. Author(s): Shoji T, Emoto M, Shinohara K, Kakiya R, Tsujimoto Y, Kishimoto H, Ishimura E, Tabata T, Nishizawa Y. Source: Journal of the American Society of Nephrology : Jasn. 2001 October; 12(10): 211724. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11562410&dopt=Abstract

•

Diagnosis and therapy of coronary artery disease in renal failure, end-stage renal disease, and renal transplant populations. Author(s): Logar CM, Herzog CA, Beddhu S. Source: The American Journal of the Medical Sciences. 2003 April; 325(4): 214-27. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12695727&dopt=Abstract

•

Dialysis for end-stage renal disease. Author(s): Hingorani S, Watkins SL. Source: Current Opinion in Pediatrics. 2000 April; 12(2): 140-5. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10763764&dopt=Abstract

•

Dialysis for end-stage renal disease. Determining a cost-effective approach. Author(s): Kirby L, Vale L. Source: International Journal of Technology Assessment in Health Care. 2001 Spring; 17(2): 181-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11446130&dopt=Abstract

•

Dialysis therapies for end-stage renal disease. Author(s): Gokal R, Hutchison A. Source: Seminars in Dialysis. 2002 July-August; 15(4): 220-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12191021&dopt=Abstract

•

Dialysis therapy in end-stage renal disease. Author(s): Kalia A. Source: Indian J Pediatr. 1999 March-April; 66(2): 255-62. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10798067&dopt=Abstract

•

Dialysis-related amyloidosis: an important cause of gastrointestinal symptoms in patients with end-stage renal disease. Author(s): Mogyorosi A, Schubert ML. Source: Gastroenterology. 1999 January; 116(1): 217-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9869623&dopt=Abstract

50


•

Dialyzer reuse and the treatment of patients with end-stage renal disease by hemodialysis. Author(s): Kimmel PL, Mishkin GJ. Source: Journal of the American Society of Nephrology : Jasn. 1998 November; 9(11): 2153-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9808105&dopt=Abstract

•

Dietary potassium and laxatives as regulators of colonic potassium secretion in endstage renal disease. Author(s): Mathialahan T, Sandle GI. Source: Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association. 2003 February; 18(2): 341-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12543890&dopt=Abstract

•

Differences and similarities between patients with and without end-stage renal disease, with regard to location of intracardiac calcification. Author(s): Bittrick J, D'Cruz IA, Wall BM, Mansour N, Mangold T. Source: Echocardiography (Mount Kisco, N.Y.). 2002 January; 19(1): 1-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11884249&dopt=Abstract

•

Digoxin intoxication in a patient with end-stage renal disease: efficacy of digoxinspecific Fab antibody fragments and peritoneal dialysis. Author(s): Caspi O, Zylber-Katz E, Gotsman O, Wolf DG, Caraco Y. Source: Therapeutic Drug Monitoring. 1997 October; 19(5): 510-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9357092&dopt=Abstract

•

Disordered sleep and noncompliance in a patient with end-stage renal disease. Author(s): Kimmel PL, Gavin C, Miller G, Mendelson WB, Wernli I, Neugarten J. Source: Adv Ren Replace Ther. 1997 January; 4(1): 55-67. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8996621&dopt=Abstract

•

Disturbances of acid-base balance and bone disease in end-stage renal disease. Author(s): Kraut JA. Source: Seminars in Dialysis. 2000 July-August; 13(4): 261-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10923356&dopt=Abstract

Studies

51

•

Does treated primary hypertension lead to end-stage renal disease? A 20-year followup of the Primary Prevention Study in Goteborg, Sweden. Author(s): Siewert-Delle A, Ljungman S, Andersson OK, Wilhelmsen L. Source: Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association. 1998 December; 13(12): 3084-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9870470&dopt=Abstract

•

Does treatment of vesicoureteric reflux in childhood prevent end-stage renal disease attributable to reflux nephropathy? Author(s): Craig JC, Irwig LM, Knight JF, Roy LP. Source: Pediatrics. 2000 June; 105(6): 1236-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10835063&dopt=Abstract

•

Double bag or Y-set versus standard transfer systems for continuous ambulatory peritoneal dialysis in end-stage renal disease. Author(s): Daly C, Campbell M, Cody J, Grant A, Donaldson C, Vale L, Lawrence P, MacLeod A, Wallace S, Khan I. Source: Cochrane Database Syst Rev. 2001; (2): Cd003078. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11406068&dopt=Abstract

•

Effects of hemodialysis on circulating adrenomedullin concentrations in patients with end-stage renal disease. Author(s): Toepfer M, Schlosshauer M, Sitter T, Burchardi C, Behr T, Schiffl H. Source: Blood Purification. 1998; 16(5): 269-74. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9917535&dopt=Abstract

•

Efficacy of ferric citrate as a phosphate-binding agent in end-stage renal disease. Author(s): Ghosh AK. Source: Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association. 2002 July; 17(7): 1354; Author Reply 1354. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12105267&dopt=Abstract

•

Empowerment of patients with end-stage renal disease--a randomized controlled trial. Author(s): Tsay SL, Hung LO. Source: International Journal of Nursing Studies. 2004 January; 41(1): 59-65. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14670395&dopt=Abstract

52


•

End-stage renal disease and acute glomerulonephritis in Goajiro Indians. Author(s): Herrera J, Rodriguez-Iturbe B. Source: Kidney International. Supplement. 2003 February; (83): S22-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12864870&dopt=Abstract

•

End-stage renal disease in developing countries. Author(s): Kher V. Source: Kidney International. 2002 July; 62(1): 350-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12081600&dopt=Abstract

•

End-stage renal disease in familial amyloidosis ATTR Val30Met: a definitive indication to combined liver-kidney transplantation. Author(s): Lobato L, Ventura A, Beirao I, Miranda HP, Seca R, Henriques AC, Teixeira M, Sarmento AM, Pereira MC. Source: Transplantation Proceedings. 2003 May; 35(3): 1116-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12947881&dopt=Abstract

•

End-stage renal disease in India and Pakistan: burden of disease and management issues. Author(s): Sakhuja V, Sud K. Source: Kidney International. Supplement. 2003 February; (83): S115-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12864888&dopt=Abstract

•

End-stage renal disease in indigenous Australians: a disease of disadvantage. Author(s): Cass A, Cunningham J, Snelling P, Wang Z, Hoy W. Source: Ethn Dis. 2002 Summer; 12(3): 373-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12148708&dopt=Abstract

•

End-stage renal disease in Indo-Asians in the North-West of England. Author(s): Trehan A, Winterbottom J, Lane B, Foley R, Venning M, Coward R, MacLeod AM, Gokal R. Source: Qjm : Monthly Journal of the Association of Physicians. 2003 July; 96(7): 499-504. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12881592&dopt=Abstract

•

End-stage renal disease in NIDDM: a consequence of microangiopathy alone? Author(s): Raine AE, Bilous RW. Source: Diabetologia. 1996 December; 39(12): 1673-5. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9081854&dopt=Abstract

Studies

53

•

End-stage renal disease in North Africa. Author(s): Barsoum RS. Source: Kidney International. Supplement. 2003 February; (83): S111-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12864887&dopt=Abstract

•

End-stage renal disease in patients with Fabry disease. Author(s): Obrador GT, Ojo A, Thadhani R. Source: Journal of the American Society of Nephrology : Jasn. 2002 June; 13 Suppl 2: S144-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12068027&dopt=Abstract

•

End-stage renal disease in sub-Saharan and South Africa. Author(s): Naicker S. Source: Kidney International. Supplement. 2003 February; (83): S119-22. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12864889&dopt=Abstract

•

End-stage renal disease in the Northern Territory: current and future treatment costs. Author(s): You J, Hoy W, Zhao Y, Beaver C, Eagar K. Source: The Medical Journal of Australia. 2002 May 20; 176(10): 461-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12065008&dopt=Abstract

•

End-stage renal disease: a slowly progressive systemic inflammatory response syndrome. Author(s): Ronco C, Levin NW. Source: Contrib Nephrol. 2002; (137): 379-85. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12101981&dopt=Abstract

•

End-stage renal disease: a state of chronic inflammation and hyperleptinemia. Author(s): Pecoits-Filho R, Lindholm B, Stenvinkel P. Source: European Journal of Clinical Investigation. 2003 June; 33(6): 527-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12795652&dopt=Abstract

•

Epidemiology of end-stage renal disease. Author(s): Roderick P. Source: Clinical Medicine (London, England). 2002 May-June; 2(3): 200-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12108467&dopt=Abstract

54


•

Estrogen absorption and metabolism in postmenopausal women with end-stage renal disease. Author(s): Ginsburg ES, Owen WF Jr, Greenberg LM, Shea BF, Lazarus JM, Walsh BW. Source: The Journal of Clinical Endocrinology and Metabolism. 1996 December; 81(12): 4414-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8954051&dopt=Abstract

•

Experience with efavirenz in end-stage renal disease. Author(s): Prime KP, Woolfson RG, Pakianathan MR. Source: International Journal of Std & Aids. 2003 July; 14(7): 497-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12869233&dopt=Abstract

•

Exposure to radiologic contrast media and an increased risk of treated end-stage renal disease. Author(s): Muntner P, Coresh J, Klag MJ, Whelton PK, Perneger TV. Source: The American Journal of the Medical Sciences. 2003 December; 326(6): 353-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14671499&dopt=Abstract

•

Factors contributing to catabolism in end-stage renal disease patients. Author(s): Bergstrom J, Wang T, Lindholm B. Source: Mineral and Electrolyte Metabolism. 1998; 24(1): 92-101. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9397422&dopt=Abstract

•

Familial clustering of end-stage renal disease in blacks with HIV-associated nephropathy. Author(s): Freedman BI, Soucie JM, Stone SM, Pegram S. Source: American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation. 1999 August; 34(2): 254-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10430971&dopt=Abstract

•

Familial clustering of end-stage renal disease in Mississippi. Author(s): Butkus DE. Source: J Miss State Med Assoc. 2002 March; 43(3): 71-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11944578&dopt=Abstract

•

Family caregivers: caring for aging end-stage renal disease partners. Author(s): Campbell AR. Source: Adv Ren Replace Ther. 1998 April; 5(2): 98-108. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9554543&dopt=Abstract

Studies

55

•

Family history of end-stage renal disease among hemodialyzed patients in Poland. Author(s): Gumprecht J, Zychma MJ, Moczulski DK, Gosek K, Grzeszczak W. Source: Journal of Nephrology. 2003 July-August; 16(4): 511-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14696752&dopt=Abstract

•

Family history of end-stage renal disease among incident dialysis patients. Author(s): Freedman BI, Soucie JM, McClellan WM. Source: Journal of the American Society of Nephrology : Jasn. 1997 December; 8(12): 1942-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9402097&dopt=Abstract

•

Family history of end-stage renal disease does not predict dialytic survival. Author(s): Freedman BI, Soucie JM, Kenderes B, Krisher J, Garrett LE, Caruana RJ, McClellan WM. Source: American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation. 2001 September; 38(3): 547-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11532687&dopt=Abstract

•

Family structure and patient survival in an African-American end-stage renal disease population: a preliminary investigation. Author(s): Turner-Musa J, Leidner D, Simmens S, Reiss D, Kimmel PL, Holder B. Source: Social Science & Medicine (1982). 1999 May; 48(10): 1333-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10369434&dopt=Abstract

•

Family support and survival among African-American end-stage renal disease patients. Author(s): Holder B. Source: Adv Ren Replace Ther. 1997 January; 4(1): 13-21. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8996616&dopt=Abstract

•

Fertility and contraception in end-stage renal disease. Author(s): Schmidt RJ, Holley JL. Source: Adv Ren Replace Ther. 1998 January; 5(1): 38-44. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9477214&dopt=Abstract

•

Financing of end-stage renal disease care: past, present, and future. Author(s): Farley DO. Source: Adv Ren Replace Ther. 1994 April; 1(1): 24-31. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7641085&dopt=Abstract

56


•

Focal segmental glomerulosclerosis progression to end-stage renal disease within 48 months is a risk factor for recurrence after pediatric renal transplantation. Author(s): Kim SJ, Kim M, Ha J, Jung IM, Lee TS, Cheong HI, Choi Y, Lee HS. Source: Transplantation Proceedings. 1999 February-March; 31(1-2): 1393-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10083616&dopt=Abstract

•

Forecast of the number of patients with end-stage renal disease in the United States to the year 2010. Author(s): Xue JL, Ma JZ, Louis TA, Collins AJ. Source: Journal of the American Society of Nephrology : Jasn. 2001 December; 12(12): 2753-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11729245&dopt=Abstract

•

Formal literature review of quality-of-life instruments used in end-stage renal disease. Author(s): Cagney KA, Wu AW, Fink NE, Jenckes MW, Meyer KB, Bass EB, Powe NR. Source: American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation. 2000 August; 36(2): 327-36. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10922311&dopt=Abstract

•

Forum of the End-Stage Renal Disease Networks' role in implementing the National Kidney Foundation-Dialysis Outcomes Quality Initiative Clinical Practice Guidelines. Author(s): Diamond LH, Daly DC. Source: Adv Ren Replace Ther. 1999 January; 6(1): 28-35. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9925147&dopt=Abstract

•

Free serum leptin but not bound leptin concentrations are elevated in patients with end-stage renal disease. Author(s): Widjaja A, Kielstein JT, Horn R, von zur Muhlen A, Kliem V, Brabant G. Source: Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association. 2000 June; 15(6): 84650. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10831639&dopt=Abstract

•

Frequency of administration of recombinant human erythropoietin for anaemia of end-stage renal disease in dialysis patients. Author(s): Cody J, Daly C, Campbell M, Donaldson C, Grant A, Khan I, Vale L, Wallace S, MacLeod A. Source: Cochrane Database Syst Rev. 2002; (4): Cd003895. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12519614&dopt=Abstract

Studies

57

•

Frequency, potential risk and therapeutic intervention in end-stage renal disease patients with antiphospholipid antibody syndrome: a multicenter study. Author(s): Vaidya S, Sellers R, Kimball P, Shanahan T, Gitomer J, Gugliuzza K, Fish JC. Source: Transplantation. 2000 April 15; 69(7): 1348-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10798752&dopt=Abstract

•

Future developments in the treatment of end-stage renal disease: a North American perspective. Author(s): Henderson LW. Source: American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation. 2000 April; 35(4 Suppl 1): S106-16. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10766009&dopt=Abstract

•

Future role of calcimimetics in end-stage renal disease. Author(s): Goodman WG, Turner SA. Source: Adv Ren Replace Ther. 2002 July; 9(3): 200-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12203202&dopt=Abstract

•

Gain in recombinant human erythropoietin dosage with continuous intravenous intradialytic administration for the treatment of anaemia in end-stage renal disease. Author(s): Liani M, Salvati F, Golato M, Cahen R. Source: Nephron. 1995; 69(2): 189. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7723913&dopt=Abstract

•

Gastroduodenal lesions and Helicobacter pylori in children with end-stage renal disease. Author(s): Emir S, Bereket G, Boyacioglu S, Varan B, Tunali H, Haberal M. Source: Pediatric Nephrology (Berlin, Germany). 2000 August; 14(8-9): 837-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10955940&dopt=Abstract

•

Gastrointestinal and hepatic disorders in end-stage renal disease and renal transplant recipients. Author(s): Abou-Saif A, Lewis JH. Source: Adv Ren Replace Ther. 2000 July; 7(3): 220-30. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10926110&dopt=Abstract

•

GBV-C/HGV infection in end-stage renal disease. Author(s): Fabrizi F, Martin P. Source: Journal of Nephrology. 1999 May-June; 12(3): 131-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10440510&dopt=Abstract

58


•

GBV-C/HGV infection in end-stage renal disease: a serological and virological survey. Author(s): Fabrizi F, Lunghi G, Pozzi C, Colzani S, Tentori F, Del Vecchio L, Corti M, Pagano A, Locatelli F. Source: Journal of Nephrology. 2000 January-February; 13(1): 68-74. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10720218&dopt=Abstract

•

Genetic analysis of nitric oxide and endothelin in end-stage renal disease. Author(s): Freedman BI, Yu H, Anderson PJ, Roh BH, Rich SS, Bowden DW. Source: Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association. 2000 November; 15(11): 1794-800. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11071967&dopt=Abstract

•

Genetic linkage analysis of growth factor loci and end-stage renal disease in African Americans. Author(s): Freedman BI, Yu H, Spray BJ, Rich SS, Rothschild CB, Bowden DW. Source: Kidney International. 1997 March; 51(3): 819-25. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9067916&dopt=Abstract

•

Genetic polymorphisms of the renin-angiotensin-aldosterone system in end-stage renal disease. Author(s): Lovati E, Richard A, Frey BM, Frey FJ, Ferrari P. Source: Kidney International. 2001 July; 60(1): 46-54. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11422735&dopt=Abstract

•

Genetic susceptibility to end-stage renal disease. Author(s): Schelling JR, Zarif L, Sehgal A, Iyengar S, Sedor JR. Source: Current Opinion in Nephrology and Hypertension. 1999 July; 8(4): 465-72. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10491742&dopt=Abstract

•

Genomic structure of the human plasma prekallikrein gene, identification of allelic variants, and analysis in end-stage renal disease. Author(s): Yu H, Anderson PJ, Freedman BI, Rich SS, Bowden DW. Source: Genomics. 2000 October 15; 69(2): 225-34. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11031105&dopt=Abstract

•

Glucose modulation of the disposal of an acute potassium load in patients with endstage renal disease. Author(s): Allon M, Dansby L, Shanklin N. Source: The American Journal of Medicine. 1993 May; 94(5): 475-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8498392&dopt=Abstract

Studies

59

•

Good news, bad news for diabetic versus nondiabetic end-stage renal disease: incidence and mortality. Author(s): Wolfe RA, Port FK. Source: Asaio Journal (American Society for Artificial Internal Organs : 1992). 1999 MayJune; 45(3): 117-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10360706&dopt=Abstract

•

Gouty arthritis in end-stage renal disease: clinical course and rarity of new cases. Author(s): Ifudu O, Tan CC, Dulin AL, Delano BG, Friedman EA. Source: American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation. 1994 March; 23(3): 347-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8128934&dopt=Abstract

•

Growth failure, risk of hospitalization and death for children with end-stage renal disease. Author(s): Furth SL, Hwang W, Yang C, Neu AM, Fivush BA, Powe NR. Source: Pediatric Nephrology (Berlin, Germany). 2002 June; 17(6): 450-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12107811&dopt=Abstract

•

Growth hormone treatment of children with chronic renal insufficiency, end-stage renal disease and following renal transplantation--update 1997. Author(s): Fine RN. Source: J Pediatr Endocrinol Metab. 1997 July-August; 10(4): 361-70. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9364361&dopt=Abstract

•

Gustatory sweating in a diabetic end-stage renal disease patient maintained on hemodialysis. Author(s): Ejaz AA, Zabaneh RI, Popli SS, Ing TS, Leehey DJ. Source: Nephron. 1995; 69(3): 337. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7753271&dopt=Abstract

•

Haematocrit and the risk of developing end-stage renal disease. Author(s): Iseki K, Ikemiya Y, Iseki C, Takishita S. Source: Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association. 2003 May; 18(5): 899905. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12686662&dopt=Abstract

•

Health economic evaluations: the special case of end-stage renal disease treatment. Author(s): Winkelmayer WC, Weinstein MC, Mittleman MA, Glynn RJ, Pliskin JS. Source: Medical Decision Making : an International Journal of the Society for Medical Decision Making. 2002 September-October; 22(5): 417-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12365484&dopt=Abstract

60


•

Hemodialysis improves myocardial interstitial edema and left ventricular diastolic function in patients with end-stage renal disease: noninvasive assessment by ultrasonic tissue characterization. Author(s): Fatema K, Hirono O, Takeishi Y, Nitobe J, Kaneko K, Ito M, Masakane I, Kubota I. Source: Heart and Vessels. 2002 September; 16(6): 227-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12382031&dopt=Abstract

•

Hemoglobin F levels in end-stage renal disease patients after correction of anemia with erythropoietin. Author(s): Sikole A, Efremov DG, Dimovski A, Efremov GD, Polenakovic M. Source: Nephron. 1993; 65(3): 482-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7507224&dopt=Abstract

•

Heparin-associated thrombocytopenia type II in a patient with end-stage renal disease: successful anticoagulation with the low-molecular-weight heparinoid Org 10172 during haemodialysis. Author(s): Greinacher A, Philippen KH, Kemkes-Matthes B, Mockl M, Mueller-Eckhardt C, Schaefer K. Source: Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association. 1993; 8(10): 1176-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7505906&dopt=Abstract

•

Hepatitis C infection and the patient with end-stage renal disease. Author(s): Fabrizi F, Poordad FF, Martin P. Source: Hepatology (Baltimore, Md.). 2002 July; 36(1): 3-10. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12085342&dopt=Abstract

•

Hepatitis C infection in children and adolescents with end-stage renal disease. Author(s): Molle ZL, Baqi N, Gretch D, Hidalgo G, Tejani A, Rabinowitz SS. Source: Pediatric Nephrology (Berlin, Germany). 2002 June; 17(6): 444-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12107810&dopt=Abstract

•

Hepatocyte growth factor and left ventricular geometry in end-stage renal disease. Author(s): Malatino LS, Cataliotti A, Benedetto FA, Stancanelli B, Bellanuova I, Belluardo P, Bonaiuto L, Tripepi G, Mallamaci F, Castellino P, Zoccali C. Source: Hypertension. 2003 January; 41(1): 88-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12511535&dopt=Abstract

Studies

61

•

High prevalence of fenfluramine-related aortic regurgitation in women with endstage renal disease secondary to Chinese herb nephropathy. Author(s): Unger P, Nortier J, Muniz Martinez MC, Plein D, Vandenbossche JL, Vereerstraeten P, Vanherweghem JL. Source: Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association. 2003 May; 18(5): 90610. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12686663&dopt=Abstract

•

High-dose intravenous melphalan with autologous stem cell transplantation in AL amyloidosis-associated end-stage renal disease. Author(s): Casserly LF, Fadia A, Sanchorawala V, Seldin DC, Wright DG, Skinner M, Dember LM. Source: Kidney International. 2003 March; 63(3): 1051-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12631087&dopt=Abstract

•

Histological pancreatitis in end-stage renal disease. Author(s): Araki T, Ueda M, Ogawa K, Tsuji T. Source: International Journal of Pancreatology : Official Journal of the International Association of Pancreatology. 1992 December; 12(3): 263-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1283864&dopt=Abstract

•

History of myocardial infarction and stroke among incident end-stage renal disease cases and population-based controls: an analysis of shared risk factors. Author(s): Muntner P, Coresh J, Klag MJ, Whelton PK, Perneger TV. Source: American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation. 2002 August; 40(2): 323-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12148105&dopt=Abstract

•

Homocysteine and vascular access thrombosis in end-stage renal disease patients: a retrospective study. Author(s): Bowden RG, Wyatt FB, Wilson R. Source: Journal of Nephrology. 2002 November-December; 15(6): 666-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12495281&dopt=Abstract

•

Homocysteinemia and vascular disease in end-stage renal disease. Author(s): Dennis VW, Robinson K. Source: Kidney International. Supplement. 1996 December; 57: S11-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8941916&dopt=Abstract

62


•

Hospitalization in the first year of renal replacement therapy for end-stage renal disease. Author(s): Metcalfe W, Khan IH, Prescott GJ, Simpson K, Macleod AM. Source: Qjm : Monthly Journal of the Association of Physicians. 2003 December; 96(12): 899-909. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14631056&dopt=Abstract

•

How to deal with children with end-stage renal disease and severe bladder dysfunction. Author(s): Nahas WC, Mazzucchi E, Arap MA, Antonopoulos IM, Piovesan AC, Neto ED, Arap S. Source: Transplantation Proceedings. 2003 March; 35(2): 849-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12644162&dopt=Abstract

•

Human immunodeficiency virus infection in end-stage renal disease patients. Author(s): Rao TK. Source: Seminars in Dialysis. 2003 May-June; 16(3): 233-44. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12753686&dopt=Abstract

•

Hydroxocobalamin reduces hyperhomocysteinemia in end-stage renal disease. Author(s): Elian KM, Hoffer LJ. Source: Metabolism: Clinical and Experimental. 2002 July; 51(7): 881-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12077735&dopt=Abstract

•

Hyperhomocysteinemia and end-stage renal disease: determinants and association with cardiovascular disease in Tunisian patients. Author(s): Fellah H, Feki M, Hsairi M, Sanhaji H, Kaabachi N, Ben Abdallah T, Massy ZA, Ben Maiz H, Lacour B, Mebazaa A. Source: Clinical Chemistry and Laboratory Medicine : Cclm / Fescc. 2003 May; 41(5): 675-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12812266&dopt=Abstract

•

Hyperphosphatemia in end-stage renal disease. Author(s): Indridason OS, Quarles LD. Source: Adv Ren Replace Ther. 2002 July; 9(3): 184-92. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12203200&dopt=Abstract

•

Illustrating the impact of including future costs in economic evaluations: an application to end-stage renal disease care. Author(s): Manns B, Meltzer D, Taub K, Donaldson C. Source: Health Economics. 2003 November; 12(11): 949-58. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14601157&dopt=Abstract

Studies

63

•

Impact of birth weight on familial aggregation of end-stage renal disease. Author(s): Fan ZJ, Lackland DT, Kenderes B, Krisher J, Freedman BI. Source: American Journal of Nephrology. 2003 March-April; 23(2): 117-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12481151&dopt=Abstract

•

Impact of dyslipidemia in end-stage renal disease. Author(s): Prichard SS. Source: Journal of the American Society of Nephrology : Jasn. 2003 September; 14(9 Suppl 4): S315-20. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12939388&dopt=Abstract

•

Improved patient survival in recipients of simultaneous pancreas-kidney transplant compared with kidney transplant alone in patients with type 1 diabetes mellitus and end-stage renal disease. Author(s): Mohan P, Safi K, Little DM, Donohoe J, Conlon P, Walshe JJ, O'Kelly P, Thompson CJ, Hickey DP. Source: The British Journal of Surgery. 2003 September; 90(9): 1137-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12945083&dopt=Abstract

•

Increased advanced glycation end products in atherosclerotic lesions of patients with end-stage renal disease. Author(s): Sakata N, Imanaga Y, Meng J, Tachikawa Y, Takebayashi S, Nagai R, Horiuchi S. Source: Atherosclerosis. 1999 January; 142(1): 67-77. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9920507&dopt=Abstract

•

Increased frequency of HLA A2/DR4 and A2/DR8 haplotypes in young saskatchewan aboriginal people with diabetic end-stage renal disease. Author(s): Dyck R, Bohm C, Klomp H. Source: American Journal of Nephrology. 2003 May-June; 23(3): 178-85. Epub 2003 April 16. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12700434&dopt=Abstract

•

Increased levels of low-density lipoprotein oxidation in patients with familial hypercholesterolemia and in end-stage renal disease patients on hemodialysis. Author(s): Van Tits L, De Graaf J, Hak-Lemmers H, Bredie S, Demacker P, Holvoet P, Stalenhoef A. Source: Laboratory Investigation; a Journal of Technical Methods and Pathology. 2003 January; 83(1): 13-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12533682&dopt=Abstract

64


•

Increased regional and transmyocardial dispersion of ventricular repolarization in end-stage renal disease. Author(s): Tun A, Khan IA, Wattanasauwan N, Win MT, Hussain A, Hla TA, Cherukuri VL, Vasavada BC, Sacchi TJ. Source: The Canadian Journal of Cardiology. 1999 January; 15(1): 53-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10024859&dopt=Abstract

•

Increased resting energy expenditure in patients with end-stage renal disease. Author(s): Neyra R, Chen KY, Sun M, Shyr Y, Hakim RM, Ikizler TA. Source: Jpen. Journal of Parenteral and Enteral Nutrition. 2003 January-February; 27(1): 36-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12549596&dopt=Abstract

•

Increased risk for cardiovascular mortality among malnourished end-stage renal disease patients. Author(s): Fung F, Sherrard DJ, Gillen DL, Wong C, Kestenbaum B, Seliger S, Ball A, Stehman-Breen C. Source: American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation. 2002 August; 40(2): 307-14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12148103&dopt=Abstract

•

Induction of fetal hemoglobin by recombinant human erythropoietin in patients with end-stage renal disease. Author(s): Salvati F. Source: Nephron. 1993; 65(2): 313. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7504213&dopt=Abstract

•

Induction of kidney allograft tolerance after transient lymphohematopoietic chimerism in patients with multiple myeloma and end-stage renal disease. Author(s): Buhler LH, Spitzer TR, Sykes M, Sachs DH, Delmonico FL, Tolkoff-Rubin N, Saidman SL, Sackstein R, McAfee S, Dey B, Colby C, Cosimi AB. Source: Transplantation. 2002 November 27; 74(10): 1405-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12451240&dopt=Abstract

•

Inflammation and atherosclerosis in end-stage renal disease. Author(s): Zoccali C, Mallamaci F, Tripepi G. Source: Blood Purification. 2003; 21(1): 29-36. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12566658&dopt=Abstract

Studies

65

•

Influence of age and end-stage renal disease on the stiffness of carotid wall material in hypertension. Author(s): Blacher J, London GM, Safar ME, Mourad JJ. Source: Journal of Hypertension. 1999 February; 17(2): 237-44. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10067793&dopt=Abstract

•

Influence of nutritional status on plasma and erythrocyte sulphur amino acids, sulphhydryls, and inorganic sulphate in end-stage renal disease. Author(s): Suliman ME, Barany P, Divino Filho JC, Qureshi AR, Stenvinkel P, Heimburger O, Anderstam B, Lindholm B, Bergstrom J. Source: Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association. 2002 June; 17(6): 1050-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12032196&dopt=Abstract

•

Infrainguinal arterial reconstruction for limb salvage in patients with end-stage renal disease. Author(s): Kimura H, Miyata T, Sato O, Furuya T, Iyori K, Shigematsu H. Source: European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery. 2003 January; 25(1): 29-34. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12525808&dopt=Abstract

•

Insulin resistance as an independent predictor of cardiovascular mortality in patients with end-stage renal disease. Author(s): Shinohara K, Shoji T, Emoto M, Tahara H, Koyama H, Ishimura E, Miki T, Tabata T, Nishizawa Y. Source: Journal of the American Society of Nephrology : Jasn. 2002 July; 13(7): 1894-900. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12089386&dopt=Abstract

•

Interactions between inflammation, oxidative stress, and endothelial dysfunction in end-stage renal disease. Author(s): Stenvinkel P. Source: Journal of Renal Nutrition : the Official Journal of the Council on Renal Nutrition of the National Kidney Foundation. 2003 April; 13(2): 144-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12671839&dopt=Abstract

•

Intravenous administration of vitamin B12 in the treatment of hyperhomocysteinemia associated with end-stage renal disease. Author(s): Vrentzos GE, Papadakis JA, Vardakis KE, Maliaraki N, Stilianou K, Arvanitis A, Sratigis S, Alivanis P, Margioris AN, Ganotakis ES. Source: Journal of Nephrology. 2003 July-August; 16(4): 535-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14696755&dopt=Abstract

66


•

Is continuous ambulatory peritoneal dialysis adequate long-term therapy for endstage renal disease? A critical assessment. Author(s): Diaz-Buxo JA. Source: Journal of the American Society of Nephrology : Jasn. 1992 November; 3(5): 1039-48. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1482746&dopt=Abstract

•

Keloids and end-stage renal disease. Author(s): Freedman BI, Morrow MA, Tuttle AB, Igwemezie BM, Rich SS, Sherertz EF. Source: Nephron. 1998 October; 80(2): 244-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9736834&dopt=Abstract

•

Kidney disease in the first-degree relatives of African-Americans with hypertensive end-stage renal disease. Author(s): Bergman S, Key BO, Kirk KA, Warnock DG, Rostant SG. Source: American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation. 1996 March; 27(3): 341-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8604702&dopt=Abstract

•

Kidney transplantation in children with end-stage renal disease caused by urologic abnormalities. Author(s): Kalicinski P, Kaminski A, Prokurat A, Prokurat S, Smirska E, Szymkiewicz C, Kaminski W. Source: Transplantation Proceedings. 1992 December; 24(6): 2760-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1465931&dopt=Abstract

•

Kidney-alone transplantation in diabetic patients with end-stage renal disease. Author(s): Morita K, Shindo J, Harada H, Takeuchi I, Chikaraishi T, Seki T, Hirano T, Nonomura K, Koyanagi T. Source: International Journal of Urology : Official Journal of the Japanese Urological Association. 1997 March; 4(2): 209-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9179699&dopt=Abstract

•

Knowledge of disease and dietary compliance in patients with end-stage renal disease. Author(s): Katz RC, Ashmore J, Barboa E, Trueblood K, McLaughlin V, Mathews L. Source: Psychological Reports. 1998 February; 82(1): 331-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9520569&dopt=Abstract

Studies

67

•

Kosovo 2002: the epidemiology of renal disease and the impact of 1999 Kosovo war on end-stage renal disease patients. Author(s): Barbullushi M, Elezi Y, Idrizi A. Source: Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association. 2002 December; 17(12): 2275-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12454253&dopt=Abstract

•

Laparoscopic bilateral hand-assisted nephrectomy: end-stage renal disease from tuberculosis, an unusual indication for nephrectomy before transplantation. Author(s): Casaccia M, Torelli P, Fontana I, Panaro F, Valente U. Source: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques. 2003 February; 13(1): 59-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12598763&dopt=Abstract

•

Large artery structure and function in hypertension and end-stage renal disease. Author(s): London GM, Guerin AP, Pannier B, Marchais SJ, Safar ME. Source: Journal of Hypertension. 1998 December; 16(12 Pt 2): 1931-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9886879&dopt=Abstract

•

L-arginine-nitric oxide pathway in end-stage renal disease. Author(s): Prabhakar SS. Source: American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation. 2002 January; 39(1): 195-8; Discussion 198-202. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11774121&dopt=Abstract

•

Late referral and modality choice in end-stage renal disease. Author(s): Winkelmayer WC, Glynn RJ, Levin R, Owen W Jr, Avorn J. Source: Kidney International. 2001 October; 60(4): 1547-54. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11576371&dopt=Abstract

•

Late referral for end-stage renal disease: a region-wide survey in the south west of England. Author(s): Roderick P, Jones C, Drey N, Blakeley S, Webster P, Goddard J, Garland S, Bourton L, Mason J, Tomson C. Source: Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association. 2002 July; 17(7): 1252-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12105249&dopt=Abstract

68


•

Left ventricular alterations and end-stage renal disease. Author(s): London GM. Source: Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association. 2002; 17 Suppl 1: 2936. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11812909&dopt=Abstract

•

Linkage analysis between loci in the renin-angiotensin axis and end-stage renal disease in African Americans. Author(s): Yu H, Bowden DW, Spray BJ, Rich SS, Freedman BI. Source: Journal of the American Society of Nephrology : Jasn. 1996 December; 7(12): 2559-64. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8989734&dopt=Abstract

•

Linkage analysis of candidate loci for end-stage renal disease due to diabetic nephropathy. Author(s): Iyengar SK, Fox KA, Schachere M, Manzoor F, Slaughter ME, Covic AM, Orloff SM, Hayden PS, Olson JM, Schelling JR, Sedor JR. Source: Journal of the American Society of Nephrology : Jasn. 2003 July; 14(7 Suppl 2): S195-201. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12819328&dopt=Abstract

•

Linkage heterogeneity of end-stage renal disease on human chromosome 10. Author(s): Freedman BI, Rich SS, Yu H, Roh BH, Bowden DW. Source: Kidney International. 2002 September; 62(3): 770-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12164858&dopt=Abstract

•

Linkage of creatinine clearance to chromosome 10 in Utah pedigrees replicates a locus for end-stage renal disease in humans and renal failure in the fawn-hooded rat. Author(s): Hunt SC, Hasstedt SJ, Coon H, Camp NJ, Cawthon RM, Wu LL, Hopkins PN. Source: Kidney International. 2002 October; 62(4): 1143-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12234284&dopt=Abstract

•

Lipid abnormalities and end-stage renal disease: implications for atherosclerotic cardiovascular disease? Author(s): Cressman MD, Hoogwerf BJ, Schreiber MJ, Cosentino FA. Source: Mineral and Electrolyte Metabolism. 1993; 19(3): 180-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8232105&dopt=Abstract

Studies

69

•

Lipoprotein (a) levels in those with high molecular weight apo (a) isoforms may remain low in a significant proportion of patients with end-stage renal disease. Author(s): Parsons DS, Reaveley DA, Pavitt DV, Misra M, Brown EA. Source: Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association. 2003 September; 18(9): 1848-53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12937234&dopt=Abstract

•

Losartan reduces the costs associated with diabetic end-stage renal disease: the RENAAL study economic evaluation. Author(s): Herman WH, Shahinfar S, Carides GW, Dasbach EJ, Gerth WC, Alexander CM, Cook JR, Keane WF, Brenner BM. Source: Diabetes Care. 2003 March; 26(3): 683-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12610022&dopt=Abstract

•

Low incidence of end-stage renal disease and chronic renal failure in type 2 diabetes: a 10-year prospective study. Author(s): Bruno G, Biggeri A, Merletti F, Bargero G, Ferrero S, Pagano G, Perin PC. Source: Diabetes Care. 2003 August; 26(8): 2353-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12882861&dopt=Abstract

•

Lower-extremity peripheral arterial disease among patients with end-stage renal disease. Author(s): O'Hare A, Johansen K. Source: Journal of the American Society of Nephrology : Jasn. 2001 December; 12(12): 2838-47. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11729255&dopt=Abstract

•

Low-molecular weight proteins in end-stage renal disease: potential toxicity and dialytic removal mechanisms. Author(s): Clark WR, Gao D. Source: Journal of the American Society of Nephrology : Jasn. 2002 January; 13 Suppl 1: S41-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11792761&dopt=Abstract

•

Low-molecular-weight heparin administration in patients with end-stage renal disease--a comment. Author(s): Lile J. Source: Pharmacotherapy. 2001 August; 21(8): 1017; Author Reply 1017-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11718492&dopt=Abstract

70


•

Magnitude of end-stage renal disease in IDDM: a 35 year follow-up study. Author(s): Krolewski M, Eggers PW, Warram JH. Source: Kidney International. 1996 December; 50(6): 2041-6. Erratum In: Kidney Int 1997 March; 51(3): 978. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8943488&dopt=Abstract

•

Malnutrition in end-stage renal disease: beyond inadequate nutrient intake. Author(s): Pupim LB, Cuppari L. Source: Nephrol News Issues. 2003 June; 17(7): 66-71. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12847964&dopt=Abstract

•

Management of patients with acute myocardial infarction and end-stage renal disease. Author(s): Conti CR. Source: Journal of the American College of Cardiology. 2003 July 16; 42(2): 209-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12875752&dopt=Abstract

•

Massive coronary artery calcification in a young adult with end-stage renal disease undergoing hemodialysis. Author(s): Rubboli A, La Vecchia L, Fontanelli A. Source: Ital Heart J. 2003 February; 4(2): 142-3. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12762280&dopt=Abstract

•

Medical decision-making and information needs in end-stage renal disease patients. Author(s): Orsino A, Cameron JI, Seidl M, Mendelssohn D, Stewart DE. Source: General Hospital Psychiatry. 2003 September-October; 25(5): 324-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12972223&dopt=Abstract

•

Medicare's end-stage renal disease program: current status and future prospects. Author(s): Nissenson AR, Rettig RA. Source: Health Aff (Millwood). 1999 January-February; 18(1): 161-79. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9926654&dopt=Abstract

•

Modification of elastin by pentosidine is associated with the calcification of aortic media in patients with end-stage renal disease. Author(s): Sakata N, Noma A, Yamamoto Y, Okamoto K, Meng J, Takebayashi S, Nagai R, Horiuchi S. Source: Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association. 2003 August; 18(8): 1601-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12897101&dopt=Abstract

Studies

71

•

Mortality benefit of angiotensin-converting enzyme inhibitors after cardiac events in patients with end-stage renal disease. Author(s): McCullough PA, Sandberg KR, Yee J, Hudson MP. Source: J Renin Angiotensin Aldosterone Syst. 2002 September; 3(3): 188-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12563570&dopt=Abstract

•

Muscle ubiquitin m-rNA levels in patients with end-stage renal disease on maintenance hemodialysis. Author(s): Bossola M, Muscaritoli M, Costelli P, Nanni G, Tazza L, Panocchia N, Busquets S, Argiles J, Lopez-Soriano FJ, Grieco G, Baccino FM, Fanelli FR, Castagneto M, Luciani G. Source: Journal of Nephrology. 2002 September-October; 15(5): 552-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12455723&dopt=Abstract

•

Mutations of mtDNA in renal cell tumours arising in end-stage renal disease. Author(s): Nagy A, Wilhelm M, Kovacs G. Source: The Journal of Pathology. 2003 February; 199(2): 237-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12533837&dopt=Abstract

•

Neglected bilateral femoral neck fractures in a patient with end-stage renal disease before chronic dialysis. Author(s): Hung KH, Lee CT, Gau YL, Chen JB. Source: Renal Failure. 2001 November; 23(6): 827-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11777322&dopt=Abstract

•

New markers of accelerated atherosclerosis in end-stage renal disease. Author(s): Rattazzi M, Puato M, Faggin E, Bertipaglia B, Grego F, Pauletto P. Source: Journal of Nephrology. 2003 January-February; 16(1): 11-20. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12649530&dopt=Abstract

•

New trends on health related quality of life assessment in end-stage renal disease patients. Author(s): Rebollo P, Ortega F. Source: International Urology and Nephrology. 2002; 33(1): 195-202. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12090331&dopt=Abstract

•

No significant influence of HLA determinants on susceptibility to hepatitis C virus infection in Caucasian patients with end-stage renal disease. Author(s): Chen DF, Endres W, Kliem V, Tillmann HL, Brunkhorst R, Koch KM, Manns MP, Stangel W. Source: Liver. 1996 December; 16(6): 384-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9021718&dopt=Abstract

72


•

Nocturnal hypoxemia: a neglected cardiovascular risk factor in end-stage renal disease? Author(s): Zoccali C, Mallamaci F, Tripepi G. Source: Blood Purification. 2002; 20(1): 120-3. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11803169&dopt=Abstract

•

Non-high-density lipoprotein cholesterol (non-HDL-C) as a predictor of cardiovascular mortality in patients with end-stage renal disease. Author(s): Nishizawa Y, Shoji T, Kakiya R, Tsujimoto Y, Tabata T, Ishimura E, Nakatani T, Miki T, Inaba M. Source: Kidney International. Supplement. 2003 May; (84): S117-20. Erratum In: Kidney Int Suppl. 2003 June; 63(6): 2345-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12694324&dopt=Abstract

•

Norepinephrine and concentric hypertrophy in patients with end-stage renal disease. Author(s): Zoccali C, Mallamaci F, Tripepi G, Parlongo S, Cutrupi S, Benedetto FA, Cataliotti A, Malatino LS; CREED investigators. Source: Hypertension. 2002 July; 40(1): 41-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12105136&dopt=Abstract

•

Nosocomial blood-stream infection in patients with end-stage renal disease: excess length of hospital stay, extra cost and attributable mortality. Author(s): Liu JW, Su YK, Liu CF, Chen JB. Source: The Journal of Hospital Infection. 2002 March; 50(3): 224-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11886200&dopt=Abstract

•

Nutrition and hydration status improve with exercise training using stationary cycling during hemodialysis (HD) in patients with end-stage renal disease (ESRD). Author(s): Zaluska A, Zaluska WT, Bednarek-Skublewska A, Ksiazek A. Source: Ann Univ Mariae Curie Sklodowska [med]. 2002; 57(2): 342-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12898860&dopt=Abstract

•

Nutritional problems associated with end-stage renal disease in the developing world. Author(s): Naicker S. Source: Artificial Organs. 2002 September; 26(9): 757-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12197928&dopt=Abstract

Studies

73

•

Octogenarians reaching end-stage renal disease: cohort study of decision-making and clinical outcomes. Author(s): Joly D, Anglicheau D, Alberti C, Nguyen AT, Touam M, Grunfeld JP, Jungers P. Source: Journal of the American Society of Nephrology : Jasn. 2003 April; 14(4): 1012-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12660336&dopt=Abstract

•

Off-pump coronary artery bypass grafting in patients with end-stage renal disease on hemodialysis. Author(s): Tashiro T, Nakamura K, Morishige N, Iwakuma A, Tachikawa Y, Shibano R, Iwahashi H, Zaitsu R, Hayashida Y, Koga S, Takeuchi K, Kimura M. Source: Journal of Cardiac Surgery. 2002 September-October; 17(5): 377-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12630533&dopt=Abstract

•

One-year immunological evaluation of chronic hemodialysis in end-stage renal disease patients. Author(s): Meier P, von Fliedner V, Markert M, van Melle G, Deppisch R, Wauters JP. Source: Blood Purification. 2000; 18(2): 128-37. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10838472&dopt=Abstract

•

Organ recovery from a donor with end-stage renal disease: a case study. Author(s): Alexander C. Source: Progress in Transplantation (Aliso Viejo, Calif.). 2001 June; 11(2): 104-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11871044&dopt=Abstract

•

Osteomyelitis associated with chronic periodontitis in a patient with end-stage renal disease: a case report. Author(s): Tomaselli DL Jr, Feldman RS, Krochtengel AL, Fernandez P. Source: Periodontal Clin Investig. 1993 Fall; 15(2): 8-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7919867&dopt=Abstract

•

Outcome data on pediatric dialysis patients from the end-stage renal disease clinical indicators project. Author(s): Brem AS, Lambert C, Hill C, Kitsen J, Shemin DG. Source: American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation. 2000 August; 36(2): 310-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10922309&dopt=Abstract

74


•

Outcome in patients with end-stage renal disease following heart or heart--lung transplantation receiving peritoneal dialysis. Author(s): Jayasena SD, Riaz A, Lewis CM, Neild GH, Thompson FD, Woolfson RG. Source: Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association. 2001 August; 16(8): 1681-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11477174&dopt=Abstract

•

Overview: end-stage renal disease in the developing world. Author(s): Barsoum RS. Source: Artificial Organs. 2002 September; 26(9): 737-46. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12197924&dopt=Abstract

•

Oxidative stress in end-stage renal disease: an emerging threat to patient outcome. Author(s): Locatelli F, Canaud B, Eckardt KU, Stenvinkel P, Wanner C, Zoccali C. Source: Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association. 2003 July; 18(7): 1272-80. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12808161&dopt=Abstract

•

Oxidized immunoglobulin G in patients with end-stage renal disease treated by hemodialysis. Author(s): Ahmed S, Gibbons N, Mattana J. Source: Ann Clin Lab Sci. 2003 Winter; 33(1): 11-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12661893&dopt=Abstract

•

Paradigms of public-private partnerships in end-stage renal disease care: the National Kidney Foundation Singapore. Author(s): Ramirez SP, Durai TT, Hsu SI. Source: Kidney International. Supplement. 2003 February; (83): S101-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12864885&dopt=Abstract

•

Past, present and future of end-stage renal disease therapy in the United States. Author(s): Uribarri J. Source: The Mount Sinai Journal of Medicine, New York. 1999 January; 66(1): 14-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9989100&dopt=Abstract

Studies

75

•

Patient satisfaction with care and behavioral compliance in end-stage renal disease patients treated with hemodialysis. Author(s): Kovac JA, Patel SS, Peterson RA, Kimmel PL. Source: American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation. 2002 June; 39(6): 1236-44. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12046037&dopt=Abstract

•

Pediatric end-stage renal disease: heart as a target. Author(s): Mitsnefes MM. Source: The Journal of Pediatrics. 2002 August; 141(2): 162-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12183707&dopt=Abstract

•

Peritoneal dialysis in elderly end-stage renal disease patients. Author(s): Suh H, Wadhwa NK, Cabralda T, Sokunbi D, Solomon M. Source: Adv Perit Dial. 1993; 9: 134-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8105907&dopt=Abstract

•

Peritoneal dialysis with trained home nurses in elderly and disabled end-stage renal disease patients. Author(s): Wadhwa NK, Suh H, Cabralda T, Sokol E, Sokunbi D, Solomon M. Source: Adv Perit Dial. 1993; 9: 130-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8105906&dopt=Abstract

•

Pregnancy in chronic renal insufficiency and end-stage renal disease. Author(s): Hou S. Source: American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation. 1999 February; 33(2): 235-52. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10023634&dopt=Abstract

•

Protein turnover and amino acid transport kinetics in end-stage renal disease. Author(s): Raj DS, Zager P, Shah VO, Dominic EA, Adeniyi O, Blandon P, Wolfe R, Ferrando A. Source: American Journal of Physiology. Endocrinology and Metabolism. 2004 January; 286(1): E136-43. Epub 2003 September 16. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=13129859&dopt=Abstract

•

Proteinuria patterns and their association with subsequent end-stage renal disease in IgA nephropathy. Author(s): Donadio JV, Bergstralh EJ, Grande JP, Rademcher DM. Source: Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association. 2002 July; 17(7): 1197-203. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12105241&dopt=Abstract

76


•

Psychological factors in end-stage renal disease: an emerging context for behavioral medicine research. Author(s): Christensen AJ, Ehlers SL. Source: Journal of Consulting and Clinical Psychology. 2002 June; 70(3): 712-24. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12090378&dopt=Abstract

•

Quality of life after combined kidney-pancreas or kidney transplantation in diabetic patients with end-stage renal disease. Author(s): Kiebert GM, van Oosterhout EC, van Bronswijk H, Lemkes HH, Gooszen HG. Source: Clinical Transplantation. 1994 June; 8(3 Pt 1): 239-45. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8061362&dopt=Abstract

•

Quality of life in adults with end-stage renal disease since childhood is only partially impaired. Author(s): Groothoff JW, Grootenhuis MA, Offringa M, Gruppen MP, Korevaar JC, Heymans HS. Source: Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association. 2003 February; 18(2): 310-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12543886&dopt=Abstract

•

Quality of life in end-stage renal disease patients after successful kidney transplantation: development of the ESRD symptom checklist - transplantation module. Author(s): Franke GH, Reimer J, Kohnle M, Luetkes P, Maehner N, Heemann U. Source: Nephron. 1999 September; 83(1): 31-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10461033&dopt=Abstract

•

Quality of life in end-stage renal disease patients. Author(s): Valderrabano F, Jofre R, Lopez-Gomez JM. Source: American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation. 2001 September; 38(3): 443-64. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11532675&dopt=Abstract

•

Quality of life in predialysis end-stage renal disease patients at the initiation of dialysis therapy. The NECOSAD Study Group. Author(s): Korevaar JC, Jansen MA, Merkus MP, Dekker FW, Boeschoten EW, Krediet RT. Source: Perit Dial Int. 2000 January-February; 20(1): 69-75. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10716587&dopt=Abstract

Studies

77

•

Quality of patient care in the Medicare End-Stage Renal Disease Program: the basis and implementation of the 1994-1997 End-Stage Renal Disease Health Care Quality Improvement Program. Author(s): McClellan WM. Source: Current Opinion in Nephrology and Hypertension. 1996 May; 5(3): 224-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8737857&dopt=Abstract

•

Quality outcomes and obstacles to their achievement in end-stage renal disease. Author(s): Fishbane S, Goldman R. Source: Seminars in Dialysis. 2002 January-February; 15(1): 30-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11874589&dopt=Abstract

•

Refractory hypertension and anemia in end-stage renal disease: an unusual manifestation of Kimura's disease. Author(s): Hsu PY, Yang HY, Lin CC, Kuo MC, Lin CL, Huang CC. Source: Renal Failure. 2003 May; 25(3): 499-507. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12803515&dopt=Abstract

•

Regional variability in the incidence of end-stage renal disease: an epidemiological approach. Author(s): Wimmer F, Oberaigner W, Kramar R, Mayer G. Source: Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association. 2003 August; 18(8): 1562-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12897095&dopt=Abstract

•

Relationship between human leukocyte antigen determinants and courses of hepatitis B virus infection in Caucasian patients with end-stage renal disease. Author(s): Chen DF, Kliem V, Endres W, Brunkhorst R, Tillmann HL, Koch KM, Manns MP, Stangel W. Source: Scandinavian Journal of Gastroenterology. 1996 December; 31(12): 1211-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8976014&dopt=Abstract

•

Relationship of hemodialysis access to finger gangrene in patients with end-stage renal disease. Author(s): Yeager RA, Moneta GL, Edwards JM, Landry GJ, Taylor LM Jr, McConnell DB, Porter JM. Source: Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter. 2002 August; 36(2): 245-9; Discussion 249. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12170204&dopt=Abstract

78


•

Renal artery stenosis as cause of end-stage renal disease to dilate always or sometimes? Author(s): Lameire N. Source: Acta Chir Belg. 2002 June; 102(3): 167-75. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12136535&dopt=Abstract

•

Renal failure in the ICU: comparison of the impact of acute renal failure and endstage renal disease on ICU outcomes. Author(s): Clermont G, Acker CG, Angus DC, Sirio CA, Pinsky MR, Johnson JP. Source: Kidney International. 2002 September; 62(3): 986-96. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12164882&dopt=Abstract

•

Renal transplantation for end-stage renal disease caused by systemic lupus erythematosus nephritis. Author(s): Clark WF, Jevnikar AM. Source: Semin Nephrol. 1999 January; 19(1): 77-85. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9952283&dopt=Abstract

•

Resistance training improves strength and functional measures in patients with endstage renal disease. Author(s): Headley S, Germain M, Mailloux P, Mulhern J, Ashworth B, Burris J, Brewer B, Nindl B, Coughlin M, Welles R, Jones M. Source: American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation. 2002 August; 40(2): 355-64. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12148109&dopt=Abstract

•

Response of hyperhomocysteinemia to folic acid supplementation in patients with end-stage renal disease. Author(s): Dierkes J, Domrose U, Ambrosch A, Bosselmann HP, Neumann KH, Luley C. Source: Clinical Nephrology. 1999 February; 51(2): 108-15. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10069646&dopt=Abstract

•

Risk factors for hospital death of patients with end-stage renal disease without previous diagnosis of severe chronic renal failure arriving in an emergency situation at the hospital. Author(s): Abdulkader RC, Zanetta DM, Oliveira GM, Burdmann EA. Source: Renal Failure. 2003 July; 25(4): 631-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12911168&dopt=Abstract

•

Self-efficacy training for patients with end-stage renal disease. Author(s): Tsay SL. Source: Journal of Advanced Nursing. 2003 August; 43(4): 370-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12887355&dopt=Abstract

Studies

79

•

Serum isoflavones and soya food intake in Japanese, Thai and American end-stage renal disease patients on chronic haemodialysis. Author(s): Fanti P, Stephenson TJ, Kaariainen IM, Rezkalla B, Tsukamoto Y, Morishita T, Nomura M, Kitiyakara C, Custer LJ, Franke AA. Source: Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association. 2003 September; 18(9): 1862-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12937236&dopt=Abstract

•

Sickle cell nephropathy at end-stage renal disease in the United States: patient characteristics and survival. Author(s): Abbott KC, Hypolite IO, Agodoa LY. Source: Clinical Nephrology. 2002 July; 58(1): 9-15. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12141416&dopt=Abstract

•

Sonographic reproducibility of a novel approach in the assessment of centralised access in end-stage renal disease. Author(s): Barth JD, Pahl M, Zhang L, Zonjee M, Vazeri N. Source: Int J Clin Pract. 2003 June; 57(5): 360-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12846337&dopt=Abstract

•

Steady-state pharmacokinetics of lamivudine in human immunodeficiency virusinfected patients with end-stage renal disease receiving chronic dialysis. Author(s): Bohjanen PR, Johnson MD, Szczech LA, Wray DW, Petros WP, Miller CR, Hicks CB. Source: Antimicrobial Agents and Chemotherapy. 2002 August; 46(8): 2387-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12121909&dopt=Abstract

•

Studies of prognostic factors in end-stage renal disease: an epidemiological and statistical critique. Author(s): Keough-Ryan T, Hutchinson T, MacGibbon B, Senecal M. Source: American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation. 2002 June; 39(6): 1196-205. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12046031&dopt=Abstract

•

Study of the polymorphism of angiotensinogen, anigiotensin-converting enzyme and angiotensin receptor in type II diabetes with end-stage renal disease in Taiwan. Author(s): Chang HR, Cheng CH, Shu KH, Chen CH, Lian JD, Wu MY. Source: J Chin Med Assoc. 2003 January; 66(1): 51-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12728975&dopt=Abstract

80


•

Suicidal behavior, satisfaction with life, and perceived social support in end-stage renal disease. Author(s): Soykan A, Arapaslan B, Kumbasar H. Source: Transplantation Proceedings. 2003 June; 35(4): 1290-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12826139&dopt=Abstract

•

Survival during renal replacement therapy for diabetic end-stage renal disease in Pima Indians. Author(s): Nelson RG, Hanson RL, Pettitt DJ, Knowler WC, Bennett PH. Source: Diabetes Care. 1996 December; 19(12): 1333-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8941459&dopt=Abstract

•

Sustained-release diltiazem reduces myocardial ischemic episodes in end-stage renal disease: a double-blind, randomized, crossover, placebo-controlled trial. Author(s): Cice G, Di Benedetto A, D'Andrea A, D'Isa S, Ferrara L, Russo PE, Iacono A, Calabro R. Source: Journal of the American Society of Nephrology : Jasn. 2003 April; 14(4): 1006-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12660335&dopt=Abstract

•

The 1998 report of the Japanese National Registry data on pediatric end-stage renal disease patients. Author(s): Hattori S, Yosioka K, Honda M, Ito H; Japanese Society for Pediatric Nephrology. Source: Pediatric Nephrology (Berlin, Germany). 2002 June; 17(6): 456-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12107812&dopt=Abstract

•

The challenge of cardiovascular risk factors in end-stage renal disease. Author(s): Covic A, Gusbeth-Tatomir P, Goldsmith DJ. Source: Journal of Nephrology. 2003 July-August; 16(4): 476-86. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14696749&dopt=Abstract

•

The excess incidence of diabetic end-stage renal disease among blacks. A populationbased study of potential explanatory factors. Author(s): Brancati FL, Whittle JC, Whelton PK, Seidler AJ, Klag MJ. Source: Jama : the Journal of the American Medical Association. 1992 December 2; 268(21): 3079-84. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1433738&dopt=Abstract

•

The impact of the Dialysis Outcomes Quality Initiative Guidelines on the care of the pediatric end-stage renal disease patient. Author(s): Jabs K, Warady BA. Source: Adv Ren Replace Ther. 1999 January; 6(1): 97-106. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9925157&dopt=Abstract

Studies

81

•

Thrombocytosis in diabetic and nondiabetic end-stage renal disease patients on peritoneal dialysis. Author(s): Sokunbi D, Wadhwa NK, Solomon M, Suh H. Source: Adv Perit Dial. 1993; 9: 156-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8105912&dopt=Abstract

•

Tolerance of mycophenolate mofetil in end-stage renal disease patients with ANCAassociated vasculitis. Author(s): Haubitz M, de Groot K. Source: Clinical Nephrology. 2002 June; 57(6): 421-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12078944&dopt=Abstract

•

Treatment of end-stage renal disease due to lupus nephritis: comparison of six patients treated with both peritoneal and hemodialysis. Author(s): Stock GG Jr, Krane NK. Source: Adv Perit Dial. 1993; 9: 147-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8105910&dopt=Abstract

•

Trends in the incidence of renal replacement therapy for end-stage renal disease in Europe, 1990-1999. Author(s): Stengel B, Billon S, Van Dijk PC, Jager KJ, Dekker FW, Simpson K, Briggs JD. Source: Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association. 2003 September; 18(9): 1824-33. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12937231&dopt=Abstract

•

Two Afro-Trinidadian siblings with end-stage renal disease. Author(s): Balkaran B, Ramcharan J, Rao AV, Ramanjaneyulu M, Roberts LA. Source: Annals of Tropical Paediatrics. 1998 September; 18(3): 249-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9924564&dopt=Abstract

•

Type II diabetes after combined kidney and pancreas transplantation for type I diabetes mellitus and end-stage renal disease. Author(s): Jones JW Jr, Mizrahi SS, Bentley FR. Source: Clinical Transplantation. 1996 December; 10(6 Pt 1): 574-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8996782&dopt=Abstract

82


•

Ultrasonic videodensitometric analysis of myocardium in end-stage renal disease treated with haemodialysis. Author(s): Di Bello V, Panichi V, Pedrinelli R, Giorgi D, Bianchi M, Bertini A, Taccola D, De Pietro S, Talini E, Paterni M, Giusti C. Source: Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association. 1999 September; 14(9): 2184-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10489229&dopt=Abstract

•

Understanding and affirming the sexual/relationship realities of end-stage renal disease patients and their significant others. Author(s): Dailey DM. Source: Adv Ren Replace Ther. 1998 April; 5(2): 81-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9554541&dopt=Abstract

•

Unilateral renal cell carcinoma with coexistent renal disease: a rare cause of end-stage renal disease. Author(s): Peces R, Alvarez-Navascues R. Source: Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association. 2001 February; 16(2): 291-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11158402&dopt=Abstract

•

Uremia therapy in patients with end-stage renal disease and human immunodeficiency virus infection: has the outcome changed in the 1990s? Author(s): Ifudu O, Mayers JD, Matthew JJ, Macey LJ, Brezsnyak W, Reydel C, McClendon E, Surgrue T, Rao TK, Friedman EA. Source: American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation. 1997 April; 29(4): 549-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9100043&dopt=Abstract

•

Uric acid nephropathy and end-stage renal disease--review of a non-disease. Author(s): Nickeleit V, Mihatsch MJ. Source: Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association. 1997 September; 12(9): 1832-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9306331&dopt=Abstract

•

Use of bolus intraperitoneal aminoglycosides for treating peritonitis in end-stage renal disease patients receiving continuous ambulatory peritoneal dialysis and continuous cycling peritoneal dialysis. Author(s): Mars RL, Moles K, Pope K, Hargrove P. Source: Adv Perit Dial. 2000; 16: 280-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11045311&dopt=Abstract

Studies

83

•

Use of electrotherapy to reverse expanding cutaneous gangrene in end-stage renal disease. Author(s): Goldman RJ, Brewley BI, Cohen R, Rudnick M. Source: Advances in Skin & Wound Care. 2003 December; 16(7): 363-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14688644&dopt=Abstract

•

Use of the medical differential diagnosis to achieve optimal end-stage renal disease outcomes. Author(s): Rodriguez RA. Source: Adv Ren Replace Ther. 1997 April; 4(2): 97-111. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9113226&dopt=Abstract

•

Usefulness of dobutamine stress echocardiography in detecting coronary artery disease in end-stage renal disease. Author(s): Reis G, Marcovitz PA, Leichtman AB, Merion RM, Fay WP, Werns SW, Armstrong WF. Source: The American Journal of Cardiology. 1995 April 1; 75(10): 707-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7900665&dopt=Abstract

•

Using renal transplantation to evaluate a simple approach for predicting the impact of end-stage renal disease therapies on patient survival: observed/expected life span. Author(s): Becker BN, Becker YT, Pintar TJ, Collins BH, Pirsch JD, Friedman A, Sollinger HW, Brazy PC. Source: American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation. 2000 April; 35(4): 653-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10739786&dopt=Abstract

•

Valacyclovir neurotoxicity in a patient with end-stage renal disease treated with continuous ambulatory peritoneal dialysis. Author(s): Okada T, Nakao T, Matsumoto H, Nagaoka Y, Iwasawa H, Nanri K, Yamazaki T. Source: Clinical Nephrology. 2002 August; 58(2): 168-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12227692&dopt=Abstract

•

Validity of a standard information protocol provided to end-stage renal disease patients and its effect on treatment selection. Author(s): Gomez CG, Valido P, Celadilla O, Bernaldo de Quiros AG, Mojon M. Source: Perit Dial Int. 1999 September-October; 19(5): 471-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11379861&dopt=Abstract

84


•

Validity of subjective global assessment as a nutritional marker in end-stage renal disease. Author(s): Cooper BA, Bartlett LH, Aslani A, Allen BJ, Ibels LS, Pollock CA. Source: American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation. 2002 July; 40(1): 126-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12087570&dopt=Abstract

•

Valvular and perivalvular abnormalities in end-stage renal disease. Author(s): Umana E, Ahmed W, Alpert MA. Source: The American Journal of the Medical Sciences. 2003 April; 325(4): 237-42. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12695729&dopt=Abstract

•

Vascular and cardiac infections in end-stage renal disease. Author(s): Manian FA. Source: The American Journal of the Medical Sciences. 2003 April; 325(4): 243-50. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12695730&dopt=Abstract

•

Vascular calcification in end-stage renal disease. Author(s): Goodman WG. Source: Journal of Nephrology. 2002 November-December; 15 Suppl 6: S82-5. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12515378&dopt=Abstract

•

Vesicoureteral reflux and end-stage renal disease. Author(s): Hensle TW, Fagelman E. Source: Curr Urol Rep. 2001 April; 2(2): 101. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12084276&dopt=Abstract

•

Vitamin B12 decreases, but does not normalize, homocysteine and methylmalonic acid in end-stage renal disease: a link with glycine metabolism and possible explanation of hyperhomocysteinemia in end-stage renal disease. Author(s): Hyndman ME, Manns BJ, Snyder FF, Bridge PJ, Scott-Douglas NW, Fung E, Parsons HG. Source: Metabolism: Clinical and Experimental. 2003 February; 52(2): 168-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12601627&dopt=Abstract

•

Vitamin B6 metabolism and homocysteine in end-stage renal disease and chronic renal insufficiency. Author(s): Lindner A, Bankson DD, Stehman-Breen C, Mahuren JD, Coburn SP. Source: American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation. 2002 January; 39(1): 134-45. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11774112&dopt=Abstract

Studies

85

•

Vitamin E supplementation increases circulating vitamin E metabolites tenfold in end-stage renal disease patients. Author(s): Smith KS, Lee CL, Ridlington JW, Leonard SW, Devaraj S, Traber MG. Source: Lipids. 2003 August; 38(8): 813-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14577659&dopt=Abstract

•

Well-informed patients with end-stage renal disease prefer peritoneal dialysis to hemodialysis. Author(s): Ahlmen J, Carlsson L, Schonborg C. Source: Perit Dial Int. 1993; 13 Suppl 2: S196-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8399564&dopt=Abstract

•

What is the best treatment for end-stage renal disease? Author(s): Sehgal AR. Source: The American Journal of Medicine. 2002 June 15; 112(9): 735-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12079717&dopt=Abstract

•

What is the best treatment for slowing the progression to end-stage renal disease (ESRD) in African Americans with hypertensive nephropathy? Author(s): McConaghy JR. Source: The Journal of Family Practice. 2001 September; 50(9): 744. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11674903&dopt=Abstract

•

Why is troponin T increased in the serum of patients with end-stage renal disease? Author(s): McNeil AR, Marshall M, Ellis CJ, Hawkins RC. Source: Clinical Chemistry. 1998 November; 44(11): 2377-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9808059&dopt=Abstract

•

Worldwide demographics and future trends in end-stage renal disease. Author(s): Port FK. Source: Kidney International. Supplement. 1993 June; 41: S4-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8320944&dopt=Abstract

87

CHAPTER 2. NUTRITION AND END-STAGE RENAL DISEASE Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and end-stage renal disease.

Finding Nutrition Studies on End-Stage Renal Disease 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 “end-stage renal disease” (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.

88


The following information is typical of that found when using the “Full IBIDS Database” to search for “end-stage renal disease” (or a synonym): •

Adaptation of African-American cultural and food preferences in end-stage renal disease diets. Author(s): Total Renal Care, San Leandro, CA, USA. Source: Patel, C Nicol, A Adv-Ren-Replace-Ther. 1997 January; 4(1): 30-9 1073-4449

•

Aluminum-citrate interaction in end-stage renal disease. Author(s): Medical College of Virginia, Richmond. Source: Rudy, D Sica, D A Comstock, T Davis, J Savory, J Schoolwerth, A C Int-J-ArtifOrgans. 1991 October; 14(10): 625-9 0391-3988

•

Angiotensin II type 1 receptor antagonist, losartan, causes regression of left ventricular hypertrophy in end-stage renal disease. Author(s): Department of Medicine II, Kansai Medical University, Moriguchi, Osaka, Japan. Source: Shibasaki, Y Masaki, H Nishiue, T Nishikawa, M Matsubara, H Iwasaka, T Nephron. 2002 March; 90(3): 256-61 0028-2766

•

Anorexia in end-stage renal disease: pathophysiology and treatment. Author(s): Servicio de Nefrolog a, Hospital Universitario de la Princesa, Diego de Le n, 62, 28006-Madrid, Spain. Source: Aguilera, A Selgas, R Diez, J J Bajo, M A Codoceo, R Alvarez, V Expert-OpinPharmacother. 2001 November; 2(11): 1825-38 1465-6566

•

Approach to hyperkalemic end-stage renal disease patients in the emergency department. Author(s): Department of Medicine, Yale University School of Medicine, New Haven, USA. Source: Perazella, M A Conn-Med. 1999 March; 63(3): 131-6 0010-6178

•

Approaches to the reversal of malnutrition, inflammation, and atherosclerosis in endstage renal disease. Author(s): Department of Medicine, Division of Nephrology, Gulhane Military Medical School, Ankara, Turkey. Source: Caglar, K Hakim, R M Ikizler, T A Nutr-Revolume 2002 November; 60(11): 37887 0029-6643

•

Assessment of inflammation and nutrition in patients with end-stage renal disease. Author(s): Division of Nephrology, University of California Davis Medical Centre, Sacramento, USA. [email protected] Source: Don, B R Kaysen, G A J-Nephrol. 2000 Jul-August; 13(4): 249-59 1120-3625

•

Association between plasma homocysteine concentrations and cardiac hypertrophy in end-stage renal disease. Author(s): Department of Internal Medicine, INSERM U 337, Broussais Hospital, APHP, Paris, France. Source: Blacher, J Demuth, K Guerin, A P Vadez, C Moatti, N Safar, M E London, G M JNephrol. 1999 Jul-August; 12(4): 248-55 1120-3625

•

Calcitriol administration in end-stage renal disease: intravenous or oral? Author(s): Duke University Medical Center, Durham, North Carolina 27710, USA. Source: Quarles, L D Indridason, O S Pediatr-Nephrol. 1996 June; 10(3): 331-6 0931-041X

Nutrition

89

•

Captopril in temporary, non-dialytic management of pulmonary edema in end-stage renal disease. Source: Hruby, Z W Kuzniar, J Szewczyk, Z Mater-Med-Pol. 1989 Apr-June; 21(2): 134-6 0025-5246

•

Cardiac disease in patients with end-stage renal disease. Author(s): Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA. Source: Staffeld, C G Pastan, S O Cardiol-Clin. 1995 May; 13(2): 209-23 0733-8651

•

Care of the diabetic patient with end-stage renal disease. Author(s): Department of Medicine, SUNY Health Science Center, Brooklyn 11203. Source: Markell, M S Friedman, E A Semin-Nephrol. 1990 May; 10(3): 274-86 0270-9295

•

Caring for a rehabilitation patient with chronic renal failure and end-stage renal disease. Source: Staney, S E Rehabil-Nurs. 1996 Nov-December; 21(6): 303-6, 325 0278-4807

•

Comparison of cellulose, modified cellulose and synthetic membranes in the haemodialysis of patients with end-stage renal disease. Author(s): Medicine and Therapeutics, University of Aberdeen, Polwarth Building, Foresterhill, Aberdeen, Scotland, UK, AB25 2ZD. [email protected] Source: MacLeod, A Daly, C Khan, I Vale, L Campbell, M Wallace, S Cody, J Donaldson, C Grant, A Cochrane-Database-Syst-Revolume 2001; (3): CD003234 1469-493X

•

Compliance, diet and cultural factors among black Americans with end-stage renal disease. Source: Berg, J Berg, B L J-Natl-Black-Nurses-Assoc. 1989 Spring-Summer; 3(2): 16-28 0885-6028

•

Continuous ambulatory peritoneal dialysis in diabetic patients with end-stage renal disease: experience with intraperitoneal insulin therapy. Author(s): Department of Internal Medicine and Nursing, Kaohsiung Medical College, Taiwan, Republic of China. Source: Chen, H C Lai, Y H Tsai, C Y Shin, S J Tsai, J H Gaoxiong-Yi-Xue-Ke-Xue-ZaZhi. 1991 February; 7(2): 56-61 0257-5655

•

Dialysis and transplantation affect cerebral abnormalities of end-stage renal disease. Author(s): Huntington Medical Research Institutes, Magnetic Resonance Unit, Pasadena, CA 91105, USA. Source: Michaelis, T Videen, J S Linsey, M S Ross, B D J-Magn-Reson-Imaging. 1996 Mar-April; 6(2): 341-7 1053-1807

•

Difficulty accepting lifestyle limitations after the abrupt onset of end-stage renal disease. Author(s): Nephrology Section, Portland Veterans Administration Medical Center, OR, USA. Source: Wolfson, M Strong, C Hamel, K Cummings Cosgrove, M Brown, R Adv-RenReplace-Ther. 1995 July; 2(3): 246-54 1073-4449

•

Disturbances of acid-base balance and bone disease in end-stage renal disease. Author(s): Division of Nephrology, VA Greater Los Angeles Health Care System, Los Angeles, CA 90073, USA. Source: Kraut, J A Semin-Dial. 2000 Jul-August; 13(4): 261-6 0894-0959

•

End-stage renal disease. Measures to prevent it or slow its progression. Author(s): University of Vermont College of Medicine, Burlington, USA.

90


Source: Hood, V L Gennari, F J Postgrad-Med. 1996 November; 100(5): 163-6, 171-6 00325481 •

Growth hormone treatment of children with chronic renal insufficiency, end-stage renal disease and following renal transplantation--update 1997. Author(s): Department of Pediatrics, SUNY, Stonybrook 11794-8111, USA. Source: Fine, R N J-Pediatr-Endocrinol-Metab. 1997 Jul-August; 10(4): 361-70

•

Homocysteine lowering effect of different multivitamin preparations in patients with end-stage renal disease. Author(s): Institute of Clinical Chemistry and Biochemistry, Magdeburg, Germany. Source: Dierkes, J Domrose, U Bosselmann, K P Neumann, K H Luley, C J-Ren-Nutr. 2001 April; 11(2): 67-72 1051-2276

•

Hyperphosphatemia in end-stage renal disease. Author(s): Department of Medicine, Division of Nephrology, University Hospital, Reykjavik, Iceland. Source: Indridason, O S Quarles, L D Adv-Ren-Replace-Ther. 2002 July; 9(3): 184-92 1073-4449

•

Impact of end-stage renal disease and dialysis on glycemic control. Source: Mak, R H Semin-Dial. 2000 Jan-February; 13(1): 4-8 0894-0959

•

Influence of nutritional status on plasma and erythrocyte sulphur amino acids, sulphhydryls, and inorganic sulphate in end-stage renal disease. Author(s): Division of Baxter Novum, Department of Clinical Science, Karolinska Institutet, Huddinge University Hospital, Stockholm, Sweden. Source: Suliman, M E Barany, P Divino Filho, J C Qureshi, A R Stenvinkel, P Heimburger, O Anderstam, B Lindholm, B Bergstrom, J Nephrol-Dial-Transplant. 2002 June; 17(6): 1050-6 0931-0509

•

Intraperitoneal administration of recombinant human growth hormone in children with end-stage renal disease. Author(s): Division of Nephrology, Children's Hospital and Regional Medical Center, 4800 Sand Point Way NE, Seattle, WA 98105, USA. Source: Gipson, D S Kausz, A T Striegel, J E Melvin, T R Astrom, L J Watkins, S L Pediatr-Nephrol. 2001 January; 16(1): 29-34 0931-041X

•

Iron therapy, advanced oxidation protein products, and carotid artery intima-media thickness in end-stage renal disease. Author(s): INSERM U507 and Service de Nephrologie, Hopital Necker, Paris, France. Source: Drueke, T Witko Sarsat, V Massy, Z Descamps Latscha, B Guerin, A P Marchais, S J Gausson, V London, G M Circulation. 2002 October 22; 106(17): 2212-7 1524-4539

•

Kidney-alone transplantation in diabetic patients with end-stage renal disease. Author(s): Department of Urology, Hokkaido University, School of Medicine, Sapporo, Japan. Source: Morita, K Shindo, J Harada, H Takeuchi, I Chikaraishi, T Seki, T Hirano, T Nonomura, K Koyanagi, T Int-J-Urol. 1997 March; 4(2): 209-11 0919-8172

•

Levocarnitine and muscle metabolism in patients with end-stage renal disease. Author(s): Assistant Professor of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA. Source: Goral, S J-Ren-Nutr. 1998 July; 8(3): 118-21 1051-2276

•

Lipids in end-stage renal disease. Author(s): Department of Medicine, [email protected]

University

of

Wurzburg,

Germany.

Nutrition

91

Source: Wanner, C J-Nephrol. 2002 Mar-April; 15(2): 202-4 1120-3625 •

Management of end-stage renal disease in children. Author(s): University of Tennessee, Department of Pharmacy, College of Pharmacy, Knoxville, USA. Source: Smith, P S Ann-Pharmacother. 1998 September; 32(9): 929-39 1060-0280

•

Methylenetetrahydrofolate reductase gene C677T polymorphism, plasma homocysteine and folate in end-stage renal disease dialysis and non-dialysis patients. Author(s): Department and Clinic of Internal Medicine, Diabetology and Nephrology, Silesian School of Medicine, Zabrze, Poland. [email protected] Source: Zychma, M J Gumprecht, J Grzeszczak, W Zukowska Szczechowska, E Nephron. 2002 September; 92(1): 235-9 0028-2766

•

Non-traditional cardiovascular disease risk factors in end-stage renal disease: oxidate stress and hyperhomocysteinemia. Author(s): Division of Nephrology and Hypertension, Georgetown University Medical Center, Washington, DC 20007, USA. Source: Kitiyakara, C Gonin, J Massy, Z Wilcox, C S Curr-Opin-Nephrol-Hypertens. 2000 September; 9(5): 477-87 1062-4821

•

Pathogenesis of parathyroid dysfunction in end-stage renal disease. Author(s): Minerva Center for Calcium and Bone Metabolism, Nephrology Services, Hadassah University Hospital, Jerusalem, Israel. [email protected] Source: Silver, J Adv-Ren-Replace-Ther. 2002 July; 9(3): 159-67 1073-4449

•

Pediatric end-stage renal disease: incidence, management, and prevention. Author(s): Milano Graduate School of Management, Health Services Management and Policy, New School University, New York, NY 10011, USA. Source: Balinsky, W J-Pediatr-Health-Care. 2000 Nov-December; 14(6): 304-8 0891-5245

•

Persistence of gadolinium in CSF: a diagnostic pitfall in patients with end-stage renal disease. Author(s): Department of Radiology, West Virginia University, 2278 HSCS, Morgantown, WV 26506-9235, USA. Source: Rai, A T Hogg, J P AJNR-Am-J-Neuroradiol. 2001 August; 22(7): 1357-61 01956108

•

Prevention and treatment of renal osteodystrophy in children with chronic renal insufficiency and end-stage renal disease. Author(s): Department of Pediatrics, University of Wisconsin Medical School, Madison, WI 53706, USA. [email protected] Source: Sanchez, C P Semin-Nephrol. 2001 September; 21(5): 441-50 0270-9295

•

Proteinuria patterns and their association with subsequent end-stage renal disease in IgA nephropathy. Author(s): Division of Nephrology, Department of Internal Medicine, Mayo Clinic and Foundation, Rochester, MN 55905, USA. [email protected] Source: Donadio, J V Bergstralh, E J Grande, J P Rademcher, D M Nephrol-DialTransplant. 2002 July; 17(7): 1197-203 0931-0509

•

Riboflavin is a determinant of total homocysteine plasma concentrations in end-stage renal disease patients. Author(s): Division of Nephrology and Dialysis, Department of Medicine III, University of Vienna, Vienna, Austria.

92


Source: Skoupy, S Fodinger, M Veitl, M Perschl, A Puttinger, H Rohrer, C Schindler, K Vychytil, A Horl, W H Sunder Plassmann, G J-Am-Soc-Nephrol. 2002 May; 13(5): 1331-7 1046-6673 •

Salt and hypertension in end-stage renal disease. Source: Kooman, J P Leunissen, K M Luik, A J Blood-Purif. 1998; 16(6): 301-11 0253-5068

•

Tolerance of mycophenolate mofetil in end-stage renal disease patients with ANCAassociated vasculitis. Author(s): Department of Nephrology, University Hospital Hannover, Germany. [email protected] Source: Haubitz, M de Groot, K Clin-Nephrol. 2002 June; 57(6): 421-4 0301-0430

•

Trace elements in end-stage renal disease. 1. Methodological aspects and the influence of water treatment and dialysis equipment. Author(s): Institute of Clinical Chemistry, First Faculty of Medicine, Charles University, Prague, Czech Republic. Source: Zima, T Tesar, V Mestek, O Nemecek, K Blood-Purif. 1999; 17(4): 182-6 0253-5068

•

Treatment of severe hypercalcemia with peritoneal dialysis in an infant with endstage renal disease. Author(s): Department of Pediatrics, UCLA School of Medicine. Source: Querfeld, U Salusky, I B Fine, R N Pediatr-Nephrol. 1988 July; 2(3): 323-5 0931041X

•

Type of hemodialysis and preference for behavioral involvement: interactive effects on adherence in end-stage renal disease. Author(s): Department of Psychology, University of Utah, Salt Lake City 84112. Source: Christensen, A J Smith, T W Turner, C W Holman, J M Gregory, M C HealthPsychol. 1990; 9(2): 225-36 0278-6133

•

Visceral protein status and caloric intake in exercising versus nonexercising individuals with end-stage renal disease. Author(s): Frasenius Medical Care (FMC), Kansas City Dialysis Center, Kansas City, MO, USA. Source: Frey, S Mir, A R Lucas, M J-Ren-Nutr. 1999 April; 9(2): 71-7 1051-2276

•

Vitamin B12 decreases, but does not normalize, homocysteine and methylmalonic acid in end-stage renal disease: a link with glycine metabolism and possible explanation of hyperhomocysteinemia in end-stage renal disease. Author(s): Division of Nephrology, Department of Medicine, University of Calgary, Calgary, Alberta, Canada. Source: Hyndman, M E Manns, B J Snyder, F F Bridge, P J Scott Douglas, N W Fung, E Parsons, H G Metabolism. 2003 February; 52(2): 168-72 0026-0495

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

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

•

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

Nutrition

93

•

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

•

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

•

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

•

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

•

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

•

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

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

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

95

CHAPTER 3. ALTERNATIVE MEDICINE AND END-STAGE RENAL DISEASE Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to end-stage renal disease. 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 end-stage renal disease 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 “end-stage renal disease” (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 end-stage renal disease: •

“Giving back” on their own time for nearly four decades. Author(s): Neumann ME. Source: Nephrol News Issues. 2003 January; 17(2): 26-7. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12629825&dopt=Abstract

•

A controlled trial of the effect of folate supplements on homocysteine, lipids and hemorheology in end-stage renal disease. Author(s): McGregor D, Shand B, Lynn K. Source: Nephron. 2000 July; 85(3): 215-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10867536&dopt=Abstract

96


•

Accelerated atherosclerosis, dyslipidemia, and oxidative stress in end-stage renal disease. Author(s): Mathur S, Devaraj S, Jialal I. Source: Current Opinion in Nephrology and Hypertension. 2002 March; 11(2): 141-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11856905&dopt=Abstract

•

Acupoints massage in improving the quality of sleep and quality of life in patients with end-stage renal disease. Author(s): Tsay SL, Rong JR, Lin PF. Source: Journal of Advanced Nursing. 2003 April; 42(2): 134-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12670382&dopt=Abstract

•

Acupressure and fatigue in patients with end-stage renal disease-a randomized controlled trial. Author(s): Tsay SL. Source: International Journal of Nursing Studies. 2004 January; 41(1): 99-106. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14670399&dopt=Abstract

•

Acupressure and quality of sleep in patients with end-stage renal disease--a randomized controlled trial. Author(s): Tsay SL, Chen ML. Source: International Journal of Nursing Studies. 2003 January; 40(1): 1-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12550145&dopt=Abstract

•

Adaptation of African-American cultural and food preferences in end-stage renal disease diets. Author(s): Patel C, Nicol A. Source: Adv Ren Replace Ther. 1997 January; 4(1): 30-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8996618&dopt=Abstract

•

Anorexia in end-stage renal disease: pathophysiology and treatment. Author(s): Aguilera A, Selgas R, Diez JJ, Bajo MA, Codoceo R, Alvarez V. Source: Expert Opinion on Pharmacotherapy. 2001 November; 2(11): 1825-38. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11825320&dopt=Abstract

•

Effect of calcium-channel blockers on calcium-phosphate metabolism in patients with end-stage renal disease. Author(s): Lippuner K, Zehnder HJ, Casez JP, Takkinen R, Descoeudres C, Jaeger P.

Alternative Medicine 97

Source: Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association. 1996 January; 11(1): 70-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8649655&dopt=Abstract •

Effects of dietary manipulation with fish oil on platelet receptors for von Willebrand factor and fibrinogen in patients with end-stage renal disease. Author(s): Liani M, Tresca E, Nubile G, Salvati F, Trolliet P, Cahen R. Source: Nephron. 1995; 69(2): 170. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7723901&dopt=Abstract

•

High prevalence of fenfluramine-related aortic regurgitation in women with endstage renal disease secondary to Chinese herb nephropathy. Author(s): Unger P, Nortier J, Muniz Martinez MC, Plein D, Vandenbossche JL, Vereerstraeten P, Vanherweghem JL. Source: Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association. 2003 May; 18(5): 90610. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12686663&dopt=Abstract

•

Homocysteine lowering effect of different multivitamin preparations in patients with end-stage renal disease. Author(s): Dierkes J, Domrose U, Bosselmann KP, Neumann KH, Luley C. Source: Journal of Renal Nutrition : the Official Journal of the Council on Renal Nutrition of the National Kidney Foundation. 2001 April; 11(2): 67-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11295026&dopt=Abstract

•

Hypertension as cause of end-stage renal disease: lessons from international registries. Author(s): Valderrabano F, Gomez-Campdera F, Jones EH. Source: Kidney International. Supplement. 1998 December; 68: S60-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9839286&dopt=Abstract

•

Intravenous iron supplementation in end-stage renal disease patients. Author(s): Matzke GR. Source: American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation. 1999 March; 33(3): 595-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10070926&dopt=Abstract

•

Long-term high dose intravenous calcitriol therapy in end-stage renal disease patients with severe secondary hyperparathyroidism. Author(s): Dressler R, Laut J, Lynn RI, Ginsberg N.

98


Source: Clinical Nephrology. 1995 May; 43(5): 324-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7634548&dopt=Abstract •

Parenteral iron use in the management of anemia in end-stage renal disease patients. Author(s): Bailie GR, Johnson CA, Mason NA. Source: American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation. 2000 January; 35(1): 1-12. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10620537&dopt=Abstract

•

Plasma homocysteine, vitamin B6, vitamin B12 and folic acid in end-stage renal disease during low-dose supplementation with folic acid. Author(s): Hong SY, Yang DH, Chang SK. Source: American Journal of Nephrology. 1998; 18(5): 367-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9730558&dopt=Abstract

•

Proteinuria patterns and their association with subsequent end-stage renal disease in IgA nephropathy. Author(s): Donadio JV, Bergstralh EJ, Grande JP, Rademcher DM. Source: Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association. 2002 July; 17(7): 1197-203. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12105241&dopt=Abstract

•

Psychosomatic research in end-stage renal disease: a framework for matching patient to treatment. Author(s): Christensen AJ, Moran PJ. Source: Journal of Psychosomatic Research. 1998 May; 44(5): 523-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9623872&dopt=Abstract

•

Remnant-like particle-cholesterol concentrations in patients with type 2 diabetes mellitus and end-stage renal disease. Author(s): Hirany S, O'Byrne D, Devaraj S, Jialal I. Source: Clinical Chemistry. 2000 May; 46(5): 667-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10794749&dopt=Abstract

•

Response of hyperhomocysteinemia to folic acid supplementation in patients with end-stage renal disease. Author(s): Dierkes J, Domrose U, Ambrosch A, Bosselmann HP, Neumann KH, Luley C. Source: Clinical Nephrology. 1999 February; 51(2): 108-15. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10069646&dopt=Abstract

•

Serum isoflavones and soya food intake in Japanese, Thai and American end-stage renal disease patients on chronic haemodialysis.


Author(s): Fanti P, Stephenson TJ, Kaariainen IM, Rezkalla B, Tsukamoto Y, Morishita T, Nomura M, Kitiyakara C, Custer LJ, Franke AA. Source: Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association. 2003 September; 18(9): 1862-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12937236&dopt=Abstract •

Supplementation with vitamin B12 decreases homocysteine and methylmalonic acid but also serum folate in patients with end-stage renal disease. Author(s): Dierkes J, Domrose U, Ambrosch A, Schneede J, Guttormsen AB, Neumann KH, Luley C. Source: Metabolism: Clinical and Experimental. 1999 May; 48(5): 631-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10337865&dopt=Abstract

•

Transplantation Report. 3: annual end-stage renal disease (ESRD). Demography and treatment: application of a mathematic model based on the compartment (kinetic) theory. The EDTA-ERA Registry. European Dialysis and Transplant AssociationEuropean Renal Association. Author(s): Berthoux FC, Jones EH, Mehls O, Valderrabano F. Source: Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association. 1996; 11 Suppl 1: 447. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8735564&dopt=Abstract

•

Trends in the incidence of renal replacement therapy for end-stage renal disease in Europe, 1990-1999. Author(s): Stengel B, Billon S, Van Dijk PC, Jager KJ, Dekker FW, Simpson K, Briggs JD. Source: Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association. 2003 September; 18(9): 1824-33. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12937231&dopt=Abstract

•

Tube feeding in children with end-stage renal disease. Author(s): Kuizon BD, Nelson PA, Salusky IB. Source: Mineral and Electrolyte Metabolism. 1997; 23(3-6): 306-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9387139&dopt=Abstract

•

Understanding and affirming the sexual/relationship realities of end-stage renal disease patients and their significant others. Author(s): Dailey DM. Source: Adv Ren Replace Ther. 1998 April; 5(2): 81-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9554541&dopt=Abstract

100


•

Use of electrotherapy to reverse expanding cutaneous gangrene in end-stage renal disease. Author(s): Goldman RJ, Brewley BI, Cohen R, Rudnick M. Source: Advances in Skin & Wound Care. 2003 December; 16(7): 363-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14688644&dopt=Abstract

•

Vitamin E supplementation increases circulating vitamin E metabolites tenfold in end-stage renal disease patients. Author(s): Smith KS, Lee CL, Ridlington JW, Leonard SW, Devaraj S, Traber MG. Source: Lipids. 2003 August; 38(8): 813-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14577659&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/

•


•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

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

General Overview Abdominal Wall Inflammation Source: Integrative Medicine Communications; www.drkoop.com


Amyloidosis Source: Integrative Medicine Communications; www.drkoop.com High Homocysteine Source: Healthnotes, Inc.; www.healthnotes.com Peritonitis Source: Integrative Medicine Communications; www.drkoop.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.

103

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

Dissertations on End-Stage Renal Disease 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 end-stage renal disease. 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 Double-Edged Sword: Physicians' Views of the End-Stage Renal Disease Program. (volumes I and II) (Renal Disease) by Buffenbarger, Nancy Louise, PhD from Michigan State University, 1990, 315 pages http://wwwlib.umi.com/dissertations/fullcit/9111570

•

Adolescent Compliance with Treatment Regimens for Treatment of End-Stage Renal Disease by Rader, Barbara, PhD from University of Washington, 1992, 187 pages http://wwwlib.umi.com/dissertations/fullcit/9230424

•

An Examination of Empowerment at a Kidney Center As Experienced by Persons Who Receive Hemodialysis Treatment for End-Stage Renal Disease by Bordelon, Thomas Dominique, EDD from Montana State University, 1997, 185 pages http://wwwlib.umi.com/dissertations/fullcit/9729954

104


•

Assessing Medical Service Delivery in the Public Sector: An Evaluation Model for the End-Stage Renal Disease Program (Medicare) by Clark, Nathanial, PhD from The University of Wisconsin - Milwaukee, 1984, 109 pages http://wwwlib.umi.com/dissertations/fullcit/8418233

•

Correlates of Psychological Well-Being and Return to Work Decisions after the Onset of End-Stage Renal Disease by Randolph, Corlis Yvonne; DSW from The Catholic University of America, 2001, 190 pages http://wwwlib.umi.com/dissertations/fullcit/3004185

•

Economic Analysis of End-Stage Renal Disease Treatments (Cost-Effectiveness, Logit; Maryland) by Garner, Thesia Isedora, PhD from University of Maryland College Park, 1984, 351 pages http://wwwlib.umi.com/dissertations/fullcit/8506527

•

End-Stage Renal Disease: Compliance, Adjustment, and Quality of Life (Renal Disease) by Lavine, Betsy Jane, PhD from The University of Southern Mississippi, 1991, 98 pages http://wwwlib.umi.com/dissertations/fullcit/9214329

•

End-Stage Renal Disease: Program Development in Nursing Education by Gordon, Janet Elizabeth, EDD from Temple University, 1993, 146 pages http://wwwlib.umi.com/dissertations/fullcit/9332799

•

Families Cope with Stress: A Study of Family Strengths in Families Where a Spouse Has End-Stage Renal Disease by Weber, William C., PhD from The University of Nebraska - Lincoln, 1981, 142 pages http://wwwlib.umi.com/dissertations/fullcit/8109989

•

From Personal Tragedy to Public Problem: Miracle Technologies and End-Stage Renal Disease Policy, 1960-1972 by Cafaro, Janice Ann, PhD from Case Western Reserve University, 1998, 206 pages http://wwwlib.umi.com/dissertations/fullcit/9833869

•

Helplessness, Depression, and Mood in End-Stage Renal Disease by Devins, Gerald Michael; PhD from McGill University (Canada), 1983 http://wwwlib.umi.com/dissertations/fullcit/NK54777

•

Hemodialysis in Alternative Settings: Case-Mix in Freestanding, Hospital-Based and Veterans Administration Facilities and Employability of End-Stage Renal Disease Patients (Freestanding Clinics) by Carter, Stuart, PhD from Brandeis U., the F. Heller Grad. Sch. for Adv. Stud. in Soc. Wel., 1991, 184 pages http://wwwlib.umi.com/dissertations/fullcit/9129516

•

Identifying Factors and Mechanisms on the Association of Birth Weight and EndStage Renal Disease by Fan, Zihong Joyce; PhD from Medical University of South Carolina, 2003, 127 pages http://wwwlib.umi.com/dissertations/fullcit/3105742

•

'If It's Not Broke, Don't Fix It': Patients' and Clinicians' Decision-Making for Treatment of End-Stage Renal Disease in the United States by Gordon, Elisa Jill, PhD from Case Western Reserve University, 1999, 653 pages http://wwwlib.umi.com/dissertations/fullcit/9927310

Dissertations 105

•

Mexican-American Women's Perspectives of End-Stage Renal Disease and the Hemodialysis Regimen: Psychosocial Influences on Compliance with Treatment Recommendations by Tijerina, Mary Sylvia; PhD from The University of Texas at Austin, 2000, 254 pages http://wwwlib.umi.com/dissertations/fullcit/9992924

•

Policy Analysis of End-Stage Renal Disease Using a Simulation Modeling Approach by Dai, Carolanne; MSC from Queen's University at Kingston (Canada), 2003, 122 pages http://wwwlib.umi.com/dissertations/fullcit/MQ81057

•

Politics and Crisis in Chronic Illness: The Social Epidemiology of End-Stage Renal Disease. by Plough, Alonzo Louis, PhD from Cornell University, 1978, 239 pages http://wwwlib.umi.com/dissertations/fullcit/7817876

•

The Effects of Instructional Strategies on Memory Retention in End-Stage Renal Disease Patients by Niccum, Kathleen Jean, EDD from Peabody College for Teachers of Vanderbilt University, 1994, 113 pages http://wwwlib.umi.com/dissertations/fullcit/9429732

•

The Lived Experience of Mothers Who Provide Care to Their Child with End-Stage Renal Disease by Nicholas, David Bruce, PhD from University of Toronto (Canada), 1998, 266 pages http://wwwlib.umi.com/dissertations/fullcit/NQ35265

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.

107

CHAPTER 5. CLINICAL TRIALS AND END-STAGE RENAL DISEASE Overview In this chapter, we will show you how to keep informed of the latest clinical trials concerning end-stage renal disease.

Recent Trials on End-Stage Renal Disease The following is a list of recent trials dedicated to end-stage renal disease.8 Further information on a trial is available at the Web site indicated. •

End- Stage Renal Disease - High Risk Transplant Recipients Condition(s): End-Stage Renal Disease Study Status: This study is currently recruiting patients. Sponsor(s): Wyeth-Ayerst Research Purpose - Excerpt: The incidence of efficacy failure at 12 months between two regimens. Phase(s): Phase IV Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00044720

•

Pediatric Kidney Transplant without Calcineurin Inhibitors Condition(s): End-Stage Renal Disease Study Status: This study is currently recruiting patients. Sponsor(s): National Institute of Allergy and Infectious Diseases (NIAID) Purpose - Excerpt: The purpose of this study is to see the effect of using drugs other than calcineurin inhibitors to improve the rate of kidney transplant failure. Kidney

8

These are listed at www.ClinicalTrials.gov.

108


transplantation can help children with end-stage kidney disease. However, it has been difficult to find treatment for donor graft rejection that does not have a lot of side effects. Researchers hope to find treatments (immunosuppressants) with fewer side effects. One approach is to avoid using calcineurin inhibitors and to try a new drug known as sirolimus instead. Another is to use steroids less often. This study will test whether using sirolimus, fewer steroid treatments, MMF, and certain antibodies will improve long-term graft survival in children receiving kidney transplants from living donors. Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00023231 •

Steroid Withdrawal in Pediatric Kidney Transplant Recipients Condition(s): End-Stage Renal Disease Study Status: This study is currently recruiting patients. Sponsor(s): National Institute of Allergy and Infectious Diseases (NIAID) Purpose - Excerpt: The purpose of this study is to examine the effects of withdrawing steroids on graft rejection and kidney functions in kidney transplant recipients. Graft survival has improved in recent years in children with kidney transplants. One bad side effect of steroid maintenance therapy has been growth retardation. Doctors believe steroids might be safely withdrawn in patients that are receiving other maintenance therapies. If steroids are removed, children might catch up in their growth and also might have fewer side effects of other kinds. This study measures whether steroid therapy can be withdrawn in a way that does not increase graft rejection. Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00023244

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 “end-stage renal disease” (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/

Clinical Trials 109

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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/

•

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

•

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

•

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

•

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

•

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

•

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

111

CHAPTER 6. PATENTS ON END-STAGE RENAL DISEASE 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 “endstage renal disease” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on end-stage renal disease, we have not necessarily excluded non-medical patents in this bibliography.

Patents on End-Stage Renal Disease By performing a patent search focusing on end-stage renal disease, 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. 9Adapted

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

112


The following is an example of the type of information that you can expect to obtain from a patent search on end-stage renal disease: •

Hybridomas and monoclonal antibodies specific for unique determinants of nephropathy-related immunoglobulin G and complexes thereof Inventor(s): McDonald; Thomas L. (Omaha, NE) Assignee(s): The Board of Regents of the University of Nebraska (lincoln, Ne) Patent Number: 5,534,431 Date filed: February 28, 1994 Abstract: A novel immunoglobulin-like glycoprotein is described which has been found to occur in high concentrations in the urine of patients with glomerulosclerosis of endstage renal disease. This nephropathy-related protein is also found at a high frequency in the urine of patients with a high risk of developing kidney disease, as well as in the urine of kidney transplant recipients who are experiencing early signs of organ failure or rejection. Although this glyco-protein has several antigenic epitopes which are identical to those on normal human IgG molecules, two monoclonal anti-bodies have been developed which bind epitopes which are unique to this nephropathy-related immunoglobulin-like molecule. Immunometric assays have been developed which permit this nephropathy-related protein to serve as an early and specific marker for kidney-related diseases. Excerpt(s): The present invention relates to novel immunological reagents and their use in assays for the detection of kidney disease or damage (hereinafter also sometimes called "nephropathy"), and, in particular, assays capable of detecting nephropathy at developmental stages not possible to detect with current methodologies. Fundamental to the present invention is the discovery of a human nephropathy-related protein which is a glycoprotein in the immunoglobulin class of globular proteins and which has been demonstrated to be associated with development of overt kidney disease. This nephropathy-related immunoglobulin-like protein (hereinafter referred to as "NRIg") is believed to be capable of serving as a very early and specific marker for kidney-related diseases. Thus, in one embodiment, the present invention relates to the isolation and purification of NRIg from human body fluids using the immune complex-capturing protein reagent described as "RhC" in U.S. Pat. No. 4,783,528. In another embodiment, the invention relates to the use of NRIg in its purified form for the preparation of highly specific antibodies for use in the assays of the present invention. An especially preferred embodiment of the present invention relates to the use of such antibodies, and immobilized RhC, in a unique and highly sensitive immunologic assay for detecting and/or determining the concentration of NRIg in urine as a predictor of the development of overt nephropathy. Web site: http://www.delphion.com/details?pn=US05534431__

•

Method of promoting erythropoiesis Inventor(s): DiZerega; Gere (Pasadena, CA), Rodgers; Kathleen E. (Long Beach, CA) Assignee(s): University of Southern California (los Angeles, Ca) Patent Number: 6,239,109 Date filed: February 8, 1999

Patents 113

Abstract: The present invention provides methods, compounds, pharmaceutical compositions, and kits for the augmentation of erythropoiesis by potentiating erythropoietin-induced differentiation with angiotensinogen, angiotensin I (AI), AI analogues, AI fragments and analogues thereof, angiotensin II analogues, AII fragments or analogues thereof or AII AT.sub.2 type 2 receptor agonists as a therapeutic adjunct. The method is useful for the treatment of congenital or acquired aplastic or hypoplastic anemia associated with chronic renal failure, end-stage renal disease, renal transplantation, cancer, AIDS, chemotherapy, radiotherapy, bone marrow transplantation and chronic diseases. Excerpt(s): The present invention relates to compounds, methods, compositions, and kits for the stimulation of erythropoiesis. More specifically, the present invention relates to methods, compositions, and kits that employ effective amounts of angiotensinogen, angiotensin I (AI), AI analogues, AI fragments and analogues thereof, angiotensin II analogues, AII fragments or analogues thereof or AII AT.sub.2 type 2 receptor agonists for stimulating erythropoiesis. Maintenance of an adequate supply of oxygen to the body tissues is vital to survival. In the United States alone, several million people suffer from anemia secondary to renal failure, chronic inflammatory disease and malignancies (U.S. Pat. No. 4,987,121, hereby incorporated by reference in its entirety). Since to a large degree the oxygen-carrying capacity of blood is governed by the concentration of erythrocytes in the blood, the appropriate regulation of erythropoiesis is also crucial. The early studies of Reissmann (Reissmann, K. R., Blood 5:372-80 (1950)) and Erslev (Erslev, A., Blood 8:349-57 (1953)) clearly demonstrated the hypoxia-induced stimulation of erythropoietin secretion. When erythropoietin is secreted from the erythropoietinproducing cells in response to hypoxia, it travels through the blood to its target organ, the hematopoietic tissues. In humans, the principal hematopoietic tissue is within the liver before birth, and in the bone marrow after birth. (Id.) There, erythropoietin binds specifically to its receptor on the erythroid progenitor cells called burst forming uniterythroid (BFU-E) and colony-forming unit-erythroid (CFU-E) and stimulates these cells to proliferate and differentiate (Spivak, J. L., Int. J. Cell Cloning 4:139-66 (1986)). BFU-E are the earliest erythroid progenitors and constitute 0.01%, approximately, of the nucleated bone marrow cells. CFU-E are derived from BFU-E, account for about 0.1% of marrow cells, and are much more responsive to erythropoietin than are BFU-E (Spivak, J. L., supra); Sawada, K., et al., J. Clin. Invest. 80:357-66 (1987)). Web site: http://www.delphion.com/details?pn=US06239109__ •

Prophylactics and remedies for renal diseases Inventor(s): Sanaka; Tsutomu (Tokyo, JP) Assignee(s): Ricom Shoji Corp. (tokyo, Jp) Patent Number: 6,261,588 Date filed: October 4, 1999 Abstract: A prophylactic or a remedy for renal diseases comprises a hydrophilic solventextract of mushroom as an effective component. The hydrophilic solvent-extract of mushroom according to the present invention possesses an effect of markedly improving and maintaining the renal functions of undialyzed patients suffering from renal disease. Therefore, the extract permits the substantial elimination or retardation of the initiation of any dialytic therapy, which has conventionally been inevitable for the end-stage renal disease patients.

114


Excerpt(s): The present invention relates to prophylactics and remedies for renal diseases and more specifically to prophylactics and remedies for renal diseases, which comprise, as an effective component, a hydrophilic solvent-extract of mushroom, prophylactics and remedies for progressive renal failure in undialyzed patients suffering from renal failure or foods having renal function-improving effect. Up to this time, there has never been known any decisively effective drug for maintaining or recovering the renal function of patients suffering from end-stage renal disease and the only existing means for prolonging the life of these patients are dialytic therapy and kidney transplantation, which would force a great burden upon these patients and which are attended with a danger of death. On the other hand, the hydrophilic solventextract of mushroom possesses an effect of suppressing production of, for instance, indole and scatol in feces and have accordingly been used as a deodorant, in particular, a food for deodorizing feces (see Japanese Un-Examined Patent Publication (hereunder referred to as "J.P. KOKAI") No. Hei 2-277456). However, it has never been known that the hydrophilic solvent-extract of mushroom is effective for the recovery from the symptoms of uremia, in particular, progressive renal failure in undialyzed patients suffering from end-stage renal disease. Web site: http://www.delphion.com/details?pn=US06261588__

Patent Applications on End-Stage Renal Disease As of December 2000, U.S. patent applications are open to public viewing.10 Applications are patent requests which have yet to be granted. (The process to achieve a patent can take several years.) The following patent applications have been filed since December 2000 relating to end-stage renal disease: •

Methods for the diagnosis of hemodialysis patients and utilization of such methods to improve the administration of intravenous levocarnitine treatments to hemodialysis patients Inventor(s): Lewis, Vyonne T.; (New Orleans, LA), Schreiber, Brian; (Neenah, WI) Correspondence: Hogan & Hartson Llp; IP Group, Columbia Square; 555 Thirteenth Street, N.W.; Washington; DC; 20004; US Patent Application Number: 20030225162 Date filed: January 31, 2003 Abstract: The disclosed invention pertains to methods for diagnosing clinical conditions that are common in hemodialysis patients and that may be related to abnormal carnitine metabolism resulting from hemodialysis. Further, the present invention pertains to methods for monitoring and improving the administration of therapeutic intravenous levocarnitine to such patients. Clinical algorithms have been developed for the clinical symptoms seen in end-stage renal disease (ESRD) patients that may be related to carnitine deficiency. Monitoring tools to assist healthcare professionals in implementing the clinical algorithms are also provided. Excerpt(s): The present application claims priority from U.S. Provisional Patent Application Serial No. 60/352,505, METHODS FOR THE DIAGNOSIS OF HEMODIALYSIS PATIENTS AND UTILIZATION OF SUCH METHODS TO IMPROVE

10

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

Patents 115

THE ADMINISTRATION OF INTRAVENOUS LEVOCARNITINE TREATMENTS TO HEMODIALYSIS PATIENTS, filed Jan. 31, 2002, which is hereby incorporated by reference. Furthermore, the present application is related in subject matter to U.S. Pat. No. 6,335,369, TREATING CHRONIC UREMIC PATIENTS UNDERGOING PERIODICAL DIALYSIS, issued Jan. 1, 2002, the specification of which is hereby incorporated by reference in its entirety. The present invention relates to methods for diagnosing and treating various conditions prevalent in hemodialysis patients with end stage renal disease. In particular, the present invention pertains to methods for diagnosing clinical conditions that are common in hemodialysis patients and that may be related to abnormal carnitine metabolism resulting from hemodialysis; thus, the present invention provides methods for monitoring and improving the administration of therapeutic intravenous levocarnitine to such patients. Studies indicate that more than 70% of the carnitine present in the plasma of a hemodialysis patient can be removed during a dialysis session. Carnitine is a naturally occurring substance in the human body required for energy metabolism at the cellular level because it transports fatty acid-derivatives into the inner aspect of the mitochondrionia to produce energy and removes various acyl moeities from the mitochondria and cells. Dialytic loss of carnitine by patients undergoing hemodialysis is thought to be attributable to the compound's relatively small molecular weight, high water solubility, and poor protein binding. Carnitine levels are further diminished in end stage renal disease patients by reduced renal synthesis and reduced intake of meat and dairy foods. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Methods for using JNK inhibitors for treating or preventing disease-related wasting Inventor(s): Zeldis, Jerome B.; (Princeton, NJ) Correspondence: Pennie And Edmonds; 1155 Avenue OF The Americas; New York; NY; 100362711 Patent Application Number: 20040034084 Date filed: May 22, 2003 Abstract: The present invention relates to methods useful for the treatment or prevention of disease-related wasting. The methods of the invention comprise the administration of an effective amount of a JNK Inhibitor. In one embodiment, the disease is HIV, AIDS, cancer, end-stage renal disease, kidney failure, chronic heart disease, obstructive pulmonary disease or tuberculosis. The methods can further comprise the administration of a therapeutic or prophylactic agent useful for the treatment or prevention of HIV, AIDS, cancer, end-stage renal disease, kidney failure, chronic heart disease, obstructive pulmonary disease, chronic infectious diseases (e.g., osteoarthritis and bacterial endocarditis), chronic inflammatory diseases (e.g., scleroderma and mixed connective tissue disease) or tuberculosis. Excerpt(s): This application claims the benefit of U.S. provisional application No. 60/383,202, filed May 24, 2003, the contents of which are incorporated by reference herein in their entirety. The present invention relates to methods useful for treating or preventing disease-related wasting in a patient, comprising administering an effective amount of a JNK Inhibitor to a patient in need thereof. The Jun N-terminal kinase (JNK) pathway is activated by exposure of cells to environmental stress or by treatment of cells with pro-inflammatory cytokines. Targets of the JNK pathway include the transcription factors c-jun and ATF2 (Whitmarsh A. J., and Davis R. J. J. Mol. Med. 74:589-607, 1996). These transcription factors are members of the basic leucine zipper (bZIP) group that

116


bind as homo- and hetero-dimeric complexes to AP-1 and AP-1-like sites in the promoters of many genes (Karin M., Liu Z. G. and Zandi E. Curr. Opin. Cell Biol. 9:240246, 1997). JNK binds to the N-terminal region of c-jun and ATF-2 and phosphorylates two sites within the activation domain of each transcription factor (Hibi M., Lin A., Smeal T, Minden A., Karin M. Genes Dev. 7:2135-2148, 1993; Mohit A. A., Martin M. H., and Miller C. A. Neuron 14:67-75, 1995). Three JNK enzymes have been identified as products of distinct genes (Hibi et al, supra; Mohit et al., supra). Ten different isoforms of JNK have been identified. These represent alternatively spliced forms of three different genes: JNK1, JNK2 and JNK3. JNK1 and 2 are ubiquitously expressed in human tissues, whereas JNK3 is selectively expressed in the brain, heart and testis (Dong C., Yang D., Wysk M., Whitmarsh A., Davis R., Flavell R. Science 270:1-4, 1998). Gene transcripts are alternatively spliced to produce four-JNK1 isoforms, four-JNK2 isoforms and two-JNK3 isoforms. JNK1 and 2 are expressed widely in mammalian tissues, whereas JNK3 is expressed almost exclusively in the brain. Selectivity of JNK signaling is achieved via specific interactions of JNK pathway components and by use of scaffold proteins that selectively bind multiple components of the signaling cascade. JIP1 (JNK-interacting protein-1) selectively binds the MAPK module, MLK 6 JNKK2 6 JNK. JIP-1 has no binding affinity for a variety of other MAPK cascade enzymes. Different scaffold proteins are likely to exist for other MAPK signaling cascades to preserve substrate specificity. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Regulation of human transketolase-like enzyme Inventor(s): Ramakrishnan, Shyam; (Brighton, MA) Correspondence: Banner & Witcoff; 1001 G Street N W; Suite 1100; Washington; DC; 20001; US Patent Application Number: 20030113329 Date filed: November 22, 2002 Abstract: Reagents which regulate human transketolase-like enzyme and reagents which bind to human transketolase-like enzyme gene products can play a role in preventing, ameliorating, or correcting dysfunctions or diseases including, but not limited to, cancer, anemia, and end-stage renal disease, including sensory periphery neuropathy associated with uremia. Excerpt(s): The invention relates to the regulation of a human transketolase-like enzyme. Transketolase contains Mg.sup.++ and a tightly bound thiamin pyrophosphate and transfers a glycoaldehyde group from D-xylulose 5-phosphate to D-ribose 5-phosphate to form the seven-carbon sugar phosphate D-sedoheptulose 7-phosphate and Dglyceraldehyde 3-phosphate, which is an intermediate of glycolysis. See Lehninger, BIOCHEMISTRY, 2d ed., at pages 468-49 (1975). Genes which code for transketolase have been isolated and described from Mus musculus (Schimmer et al., J. Biol. Chem. 271, 4993-98, 1996), from Saccharomyces cerevisiae (Flechter et al., Biochemistry 31, 1892-96, 1993; Sundstrom et al., J. Biol. Chem. 268, 24346-52, 1993; SchaffGerstenschlager et al., Eur. J. Biochem. 217, 487-92, 1993), from Hansenula polymorpha (Janowicz et al., Nucl. Acids Res. 13, 3043-62, 1985), from human erythrocytes (Abedinia et al., Biochem. Biophys. Res. Commun. 183, 1159-66, 1992; McCool et al., J. Biol. Chem. 268, 1397-404, 1993), from Rhodobacter sphaeroides (Chen et al., J. Biol. Chem. 266, 20447-52, 1992) and from Escherichia coli (Sprenger, Biochem. Biophys. Acta 1216, 30710, 1992; Tida et al., J. Bacteriol. 175, 5375-83, 1993). Two transketolase isoforms have

Patents 117

been described in plant tissues (Murphy and Walker, Planta 155, 316-20, 1982). Because of the importance of this enzyme in a variety of metabolic pathways, there is a need in the art to identify additional human transketolase-like enzymes which can be regulated to provide therapeutic effects. It is an object of the invention to provide reagents and methods of regulating a human transketolase-like enzyme. This and other objects of the invention are provided by one or more of the embodiments described below. 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 end-stage renal disease, 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 “end-stage renal disease” (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 end-stage renal disease. You can also use this procedure to view pending patent applications concerning end-stage renal disease. Simply go back to http://www.uspto.gov/patft/index.html. Select “Quick Search” under “Published Applications.” Then proceed with the steps listed above.

119

CHAPTER 7. BOOKS ON END-STAGE RENAL DISEASE Overview This chapter provides bibliographic book references relating to end-stage renal disease. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on end-stage renal disease include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.

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

Psychosocial Aspects of End-Stage Renal Disease: Issues of Our Times Source: Binghamton, NY: The Haworth Press. 1991. 218 p. Contact: Haworth Press. 10 Alice Street, Binghamton, NY 13904-1580. (607) 722-2493. PRICE: $39.95 plus $3 shipping and handling. ISBN: 1560241497. Summary: In this book, numerous specialists in the field of kidney disease offer insight into the psychosocial aspects of end-stage renal disease. Five sections explore renal disease and the family, the psychosocial dimensions of renal disease, ethical issues in the treatment of renal disease, staff/patient perspectives in the care of renal disease, and renal disease and special patient populations. Within these sections, 20 chapters cover topics including communication between the disciplines in health care provision, families coping with chronic illness, marital and family characteristics, hemodialysis, organ transplantation, dealing with death, illness intrusiveness, coping with the failure

120


of a renal transplant, bioethics, dialysis staff attitudes, patient perceptions, AIDS and end-stage renal disease, and care of the geriatric nephrology patient. •

Clinical Guide to Nutrition Care in End-Stage Renal Disease. 2nd ed Source: Chicago, IL: American Dietetic Association. 1994. 255 p. Contact: Available from American Dietetic Association. 216 West Jackson Boulevard Chicago, IL 60606-6995. (312) 899-0040. PRICE: $24 for members; $28 for non-members; plus shipping and handling. ISBN: 0880911247. Summary: This manual provides guidelines for the clinical nutrition care of patients with end-stage renal disease (ESRD). Designed for renal dietitians, the manual contains 14 chapters and 11 appendices covering topics including normal and diseased kidney anatomy and function; nutrition assessment in chronic renal failure; dietary treatment in the early stages of chronic renal failure; nutrition management of adult hemodialysis and peritoneal dialysis patients; the nutrition management of the adult renal transplant patient; nutrition management of the patient with diabetes and renal disease; nutrition recommendations for infants, children and adolescents with ESRD; enteral nutrition in end-stage renal disease; parenteral nutrition for the patient with renal failure; medications commonly prescribed in chronic renal failure; renal osteodystrophy; attaining nutrition goals for hyperlipidemic and obese renal patients; nutrition management of the patient with urolithiasis; nutrition care of the hospitalized patient with renal failure; helpful hints for common patient problems; the management of anemia in ESRD; pregnancy and dialysis; hyperdietism; forms and documents; disaster diet information for hemodialysis patients; guidelines for estimating renal dietitian staffing levels, and funding for ESRD nutrition services. One of the appendices lists professional organizations for renal dietitians and another provides a medication and manufacturer reference index. The volume concludes with a subject index.

•

Atlas of Diseases of the Kidney. Volume 5: Dialysis as Treatment of End-Stage Renal Disease/Transplantation as Treatment of End-Stage Renal Disease Source: Philadelphia, PA: Current Medicine, Inc. 1999. [270 p.]. Contact: Available from Blackwell Science, Inc. 350 Main Street, Malden, MA 02148. (800) 215-1000 or (781) 388-8250. Fax (781) 388-8270. E-mail: [email protected]. PRICE: $75.00 plus shipping and handling. ISBN: 0632043911. Summary: This volume is the last in a series of five that make up the Atlas of Diseases of the Kidney, a set that offers educational images including colored photographs, schematics, tables, and algorithms. In Volume 5, 7 chapters consider dialysis as treatment of end stage renal disease (ESRD), and 10 chapters cover transplantation as treatment of ESRD. The first section is organized to provide a systematic overview of dialytic procedures. The first chapter discusses the principles of dialysis and the mechanics of practical therapy. One essential feature of the dialysis procedure is the composition of dialysate, which is discussed in detail in the second chapter. Newer dialytic therapies such as high efficiency dialysis and continuous dialysis therapy techniques are discussed next; these treatments have resulted in shorter dialysis times in patients with chronic renal failure and have been useful in the management of complicated acute renal failure (ARF) patients. Other chapters cover peritoneal dialysis, problems with arteriovenous fistula access, dialysis prescription and methods of measuring urea, and several complications that afflict patients with renal failure who are on dialysis, including blood pressure regulation and chronic inflammation. The second section details transplantation, including several chapters on the evaluation of

Books

121

donors and recipients, including their posttransplant complications. One chapter addresses the technical aspects of transplantation, shows the operation, and provides the basis for making the diagnostic and therapeutic decisions necessary when a patient develops postoperative renal dysfunction. Other chapters cover combined kidney and pancreas transplantation, tissue typing and organ sharing, immunosuppressive drugs, and the management of renal transplant rejection. Finally, the special needs of pediatric transplantation and the intriguing area of recurrent disease are covered. Each chapter features a detailed introduction and lengthy captions for each of the illustrations and diagrams offered. A subject index for Volume 5 and a section of full color plates concludes the book.

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

A Clinical Guide to Nutrition Care in End-Stage Renal Disease by Jean Stover (Editor), American Dietetic Association; ISBN: 0880911247; http://www.amazon.com/exec/obidos/ASIN/0880911247/icongroupinterna

•

Advances in End-Stage Renal Diseases 2000: International Conference on Dialysis Ii, January 13-14, 2000, Tarpon Springs, Fla. by Nathan W. Levin (Editor), Claudio Ronco (Editor); ISBN: 3805570805; http://www.amazon.com/exec/obidos/ASIN/3805570805/icongroupinterna

•

Advances in End-Stage Renal Diseases 2001: International Conference on Dialysis Iii, Miami Beach, Fla., January 2001 by N. W. Levin (Editor), C. Ronco (Editor); ISBN: 3805571860; http://www.amazon.com/exec/obidos/ASIN/3805571860/icongroupinterna

•

Advances in End-Stage Renal Diseases 2002: International Conference on Dialysis Iv, January 23-25, 2002, Phoenix, Ariz. by Claudio Ronco (Editor), Nathan W. Levin (Editor); ISBN: 3805573723; http://www.amazon.com/exec/obidos/ASIN/3805573723/icongroupinterna

•

Advances in End-Stage Renal Diseases 2003: International Conference on Dialysis V, Miami, Fla., January 2003 by C. Ronco (Editor), N. W. Levin (Editor); ISBN: 3805575351; http://www.amazon.com/exec/obidos/ASIN/3805575351/icongroupinterna

•

Bone densitometry patients with end-stage renal disease (SuDoc HE 20.6512/7:996/8) by U.S. Dept of Health and Human Services; ISBN: B00010SRZO; http://www.amazon.com/exec/obidos/ASIN/B00010SRZO/icongroupinterna

•

End-stage renal disease : choosing a treatment that's right for you (SuDoc HE 20.3302:T 71/994) by U.S. Dept of Health and Human Services; ISBN: B00010K3S8; http://www.amazon.com/exec/obidos/ASIN/B00010K3S8/icongroupinterna

122


•

End-Stage Renal Disease: An Integrated Approach by William J., M.D. and Rabin, Pauline, L, M.D. Stone (Editor); ISBN: 0126722803; http://www.amazon.com/exec/obidos/ASIN/0126722803/icongroupinterna

•

Geriatric Nephrology: The Medical, Psychosocial, Nursing, Financial and Ethical Issues of Treating End-Stage Renal Diseases by D. G. Oreopoulos (Editor); ISBN: 0898387817; http://www.amazon.com/exec/obidos/ASIN/0898387817/icongroupinterna

•

Laboratory tests in end-stage renal disease patients undergoing dialysis (SuDoc HE 20.6512/7:994/2) by Ira Green; ISBN: B00010LRW4; http://www.amazon.com/exec/obidos/ASIN/B00010LRW4/icongroupinterna

•

Living on Medicine: A Cultural Study of End-Stage Renal Disease Among by Jeannie Devitt; ISBN: 1864650028; http://www.amazon.com/exec/obidos/ASIN/1864650028/icongroupinterna

•

Medicare End-Stage Renal Disease (kidney failure) Program : hearing before the Subcommittee on Health of the Committee on Ways and Means, House of Representatives, One Hundred Fourth Congress, first session, April 3, 1995 (SuDoc Y 4.W 36:104-40); ISBN: 0160529077; http://www.amazon.com/exec/obidos/ASIN/0160529077/icongroupinterna

•

Medicare millions in end-stage renal disease expenditures shifted to employer health plans : report to Congressional committees (SuDoc GA 1.13:HRD-93-31) by U.S. General Accounting Office; ISBN: B00010FYT6; http://www.amazon.com/exec/obidos/ASIN/B00010FYT6/icongroupinterna

•

Medicare: Millions in End-Stage Renal Disease Expenditures Shifted to Employer Health Plans; ISBN: 0788111892; http://www.amazon.com/exec/obidos/ASIN/0788111892/icongroupinterna

•

Psychosocial Aspects of End-Stage Renal Disease: Issues of Out Times by Mark A. Hardy; ISBN: 1560241497; http://www.amazon.com/exec/obidos/ASIN/1560241497/icongroupinterna

•

The Misfortunes of Others : End-Stage Renal Disease in the United Kingdom by Thomas Halper (Author), et al; ISBN: 0521350476; http://www.amazon.com/exec/obidos/ASIN/0521350476/icongroupinterna

Chapters on End-Stage Renal Disease In order to find chapters that specifically relate to end-stage renal disease, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and end-stage renal disease 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 “end-stage renal disease” (or synonyms) into the “For these words:” box. The following is a typical result when searching for book chapters on end-stage renal disease: •

Management of End-Stage Renal Disease in Diabetes Source: in Johnson, R.J. and Feehally, J. Comprehensive Clinical Nephrology. 2nd ed. Orlando, FL: Mosby, Inc. 2003. p. 451-462.

Books

123

Contact: Available from Mosby, Inc. Order Fulfillment Department, 6277 Sea Harbor Drive, Orlando FL 32887. (800) 321-5068. Fax (800)874-6418. E-mail: [email protected] Website: www.elsevierhealth.com. PRICE: $199.00. ISBN: 723432589. Summary: Diabetic nephropathy (kidney disease associated with diabetes mellitus) is the single largest cause of end stage renal (kidney) disease (ESRD) in American and European adults, accounting for over one third of all patients beginning renal replacement therapy (dialysis and transplantation). Diabetic nephropathy is a clinical syndrome characterized by persistent albuminuria (protein in the urine). Patients invariably develop associated hypertension (high blood pressure), a progressive increase in proteinuria, and a predictable and relentless decline in glomerular filtration rate (GFR, a measure of kidney function). This chapter on the management of ESRD in diabetes is from a comprehensive textbook that covers every clinical condition encountered in nephrology (the study of kidney disease). The author of this chapter covers the incidence of ESRD resulting from diabetic nephropathy, predialysis care for the person with diabetes, microvascular complications, macrovascular complications, blood pressure control, infection, metabolic complications, psychological and social care, peritoneal dialysis versus hemodialysis, survival and causes of death in people with diabetes and ESRD, the outcome of dialysis, hospitalization and technique survival, and kidney transplantation in patients with diabetes. The chapter is clinically focused and extensively illustrated in full color. 10 figures. 1 table. 34 references. •

Demographics of the End-Stage Renal Disease Population Source: in Nissenson, A.R.; Fine, R.N. Dialysis Therapy. Philadelphia, PA: Hanley and Belfus, Inc. 2002. p. 1-6. Contact: Available from Hanley and Belfus, Inc. Medical Publishers, 210 South 13th Street, Philadelphia, PA 19107. (215) 546-7293 or (215) 546-4995. (800) 962-1892. Fax: (215) 790-9330. Website: www.hanleyandbelfus.com. PRICE: $59.95; plus shipping and handling. ISBN: 1560534265. Summary: It has recently been estimated that the end stage renal (kidney) disease (ESRD) population in the United States alone will approach 700,000 by the end of 2010. The trend for patients to be older and to have significant comorbidities (other diseases at the same time) such as diabetes and hypertension (high blood pressure) is continuing and unlikely to change. Children continue to be treated with extended dialysis, especially in-center hemodialysis, despite the increased use of living related donors and being given priority for cadaver donor kidneys. This chapter on demographics of the ESRD population is from a textbook on dialysis therapy, which focuses on changes in the field of nephrology over the past decade. The authors note that the establishment of the United States Renal Data System (USRDS) was pivotal in characterizing the U.S. ESRD population and paved the way for numerous epidemiological studies. This and other international registries capture data on new and prevalent ESRD patients concerning age, gender, race, cause of ESRD, morbidity, and mortality. This chapter summarizes these data and concludes with information about the epidemiology of renal replacement treatment modality (who chooses which option), including hemodialysis (HD), peritoneal dialysis (PD), and kidney transplantation. 7 figures. 4 references.

•

End-Stage Renal Disease Source: in American Dietetic Association. Manual of Clinical Dietetics, Sixth Edition. Chicago, IL: American Dietetic Association. 2000. p.455-473.

124


Contact: Available from American Dietetic Association. 216 West Jackson Boulevard, Chicago, IL 60606. (800) 877-1600 or (312) 899-0040. Fax (312) 899-4899. PRICE: $59.95 for members, $70.00 for nonmembers. ISBN: 0880911875. Summary: Medical nutrition therapy (MNT) is indicated for patients with end stage renal disease (ESRD) requiring hemodialysis or peritoneal dialysis treatments. This chapter on ESRD is from a comprehensive manual of clinical dietetics designed to help dietitians, physicians, and nurses deliver quality nutrition care. In this chapter, the authors describe how to meet nutritional requirements and prevent malnutrition in patients with impaired renal function and how to maintain acceptable blood chemistries, blood pressure, and fluid status in patients with impaired renal (kidney) function. The chapter includes the purpose of nutrition care, the indications for use, a description of the diet, a definition of the disease or condition, and a discussion section that covers malnutrition, protein, energy, fat, potassium, sodium, fluid, phosphorus, calcium, vitamins, iron, zinc, magnesium, fiber, L-carnitine, diabetes, complicating diseases, assessment, and meal planning. Extensive tables offer food lists for ESRD and hemodialysis. 3 tables. 68 references. •

Options for Patients with End-Stage Renal Disease Source: in Danovitch, G.M., ed. Handbook of Kidney Transplantation. 3rd ed. Philadelphia, PA: Lippincott Williams and Wilkins. 2000. p. 1-16. Contact: Available from Lippincott Williams and Wilkins. P.O. Box 1600, Hagerstown, MD 21741. (800) 638-3030 or (301) 223-2300. Fax (301) 223-2365. PRICE: $42.00 plus shipping and handling. ISBN: 0781720664. Summary: This chapter is from a handbook of kidney transplantation that provides practical information on therapy, patient monitoring, and patient care management. In this chapter, the authors outline options for patients with end stage renal disease (ESRD). Despite advances in knowledge and skill in treating chronic renal failure (CRF), patients with ESRD often remain unwell even when maintained by regular dialysis. Constitutional symptoms of fatigue and malaise persist despite the dramatic improvement that followed the introduction of erythropoietin for the management of the anemia of CRF. Progressive cardiovascular disease (CVD), peripheral and autonomic neuropathy, bone disease, and sexual dysfunction are common even in patients who receive adequate amounts of dialysis. For most patients with ESRD, kidney transplantation offers the greatest potential for restoring a healthy, productive life. However, practitioners of kidney transplantation must consider the clinical effects of ESRD on the overall health of renal transplantation candidates when this therapeutic option is first considered. The authors consider the demographics of the ESRD population, then outline each of the treatment options, including hemodialysis, peritoneal dialysis, and transplantation. The authors focus on issues of patient selection and when to initiate ESRD therapy. 5 figures. 2 tables. 13 references.

•

End-Stage Renal Disease: Family Responses Source: in Hardy, M.A., et al., eds. Psychosocial Aspects of End-Stage Renal Disease: Issues of Our Times. Binghamton, NY: The Haworth Press. 1991. p. 5-14. Contact: Haworth Press. 10 Alice Street, Binghamton, NY 13904-1580. (607) 722-2493. PRICE: $32.95 plus $2.75 shipping and handling. ISBN: 1560241497. Summary: This chapter, from a book about the psychosocial aspects of end-stage renal disease (ESRD), reports on a study undertaken to investigate family responses to ESRD.

Books

125

Selection criteria for the research subjects required that all subjects be married and have at least one adult child. The total sample contained 9 subjects, all Caucasian, with ages ranging from 22 to 64 years. The researchers used the life transition theory to provide insights previously lacking in ESRD literature. Topics include uncertainty, informationseeking behaviors, accepting the irreversibility of the disease, reactivation, comparative testing, and normalization. The authors note that a significant variation was noted in the marital dyad's perception of patterns, and in those adult children living outside the immediate family environment. •

Erythropoietin Treatment of End-Stage Renal Disease: North American and Japanese Experience Source: in Garnick, M.B., ed. Erythropoietin in Clinical Applications. New York, NY: Marcel Dekker, Inc. 1990. p. 183-219. Contact: Available from Marcel Dekker, Inc. P.O. Box 5005, Monticello, NY 12701. (800) 228-1160 or (212) 696-9000. Fax (914) 796-1772. E-mail: [email protected]. PRICE: $110.00. ISBN: 0824783778. Summary: This chapter, from a book that presents an international perspective on the use of erythropoietin (EPO), focuses on EPO treatment in end-stage renal disease (ESRD) as it is used in North America and in Japan. Topics include the rHuEPO preparations that have been studied in clinical trials, notably epoetin alfa and epoetin beta; EPO measurements; EPO levels in ESRD patients; pharmacokinetic studies of the two preparations; clinical experience efficacy, as demonstrated by single-dose phase 1 studies, epoetin alfa ESRD studies, and epoetin beta ESRD studies; the elimination of transfusions with rHuEPO treatment; rHuEPO dosage requirements; nonhematological efficacy indicators, including exercise tolerance, rHuEPO effects on the CNS and on general quality of life; clinical experience safety, including effects on hypertension, thrombotic events, seizures, and other adverse reactions; iron requirements; dialysis management; coagulation laboratory findings; and pediatric ESRD studies. 3 figures. 12 tables. 47 references.

•

Nutrition Recommendations for Infants, Children, and Adolescents with End-Stage Renal Disease Source: in American Dietetic Association. Clinical Guide to Nutrition Care in End-Stage Renal Disease. Chicago, IL: American Dietetic Association. 1994. p. 79-97. Contact: Available from American Dietetic Association. 216 West Jackson Boulevard Chicago, IL 60606-6995. (312) 899-0040. PRICE: $24 for members; $28 for non-members; plus shipping and handling. ISBN: 0880911247. Summary: This chapter, from a manual that provides guidelines for the clinical nutrition care of patients with end-stage renal disease (ESRD), presents nutrition recommendations for infants, children, and adolescents with ESRD. Topics include assessment of nutritional status; formulation of the dietary prescription; and nutrition management, for predialysis, hemodialysis peritoneal dialysis and transplantation, of intake components including energy needs, protein, sodium, potassium, calcium and phosphorus, vitamins and minerals, and fluid requirements. Detailed tables summarize the recommendations in these areas, broken down by age of the child: infant (0-1 year), toddler (1-3 years), child (4-10 years), and adolescent (11-18 years). 4 tables. 30 references.

126

•


Peritoneal Dialysis in Diabetic End-Stage Renal Disease Patients Source: in Stein, J.H., ed. Peritoneal Dialysis. New York, NY: Churchill Livingstone Inc. 1990. p. 211-229. Contact: Available from Churchill Livingston Inc. 650 Avenue of the Americas, New York, NY 10114. (800) 553-5426. PRICE: $63 plus shipping and handling. ISBN: 0443087164. Summary: This chapter, from a medical compendium of articles about peritoneal dialysis, discusses peritoneal dialysis in patients with end-stage renal disease and diabetes. Topics include the benefits and drawbacks of continuous ambulatory peritoneal dialysis (CAPD), peritoneal access, dialysis schedules and techniques, the role of glucose as an osmotic agent for these patients, the effects of intraperitoneal insulin, blood glucose control during CAPD, clinical results, peritonitis, and technique-related complications. 4 tables. 67 references.

•

Etiologies and Indicators of Powerlessness in Persons with End-Stage Renal Disease Source: in Miller, J.F., ed. Coping with Chronic Illness: Overcoming Powerlessness. 2nd ed. Philadelphia, PA: F.A. Davis Company. 1992. p. 163-178. Contact: Available from F.A. Davis Company. 1915 Arch Street, Philadelphia, PA 191039954. (800) 323-3555 or (215) 440-3001. PRICE: $26.95 (as of 1996). ISBN: 0803661924. Summary: This chapter, from a nursing text on coping with chronic illness, discusses the physiologic, psychologic, role disturbance, and life change stressors that people with end-stage renal disease (ESRD) may face. The author presents a summarized review of literature of these stressors and reports observations of powerlessness in patients with chronic renal failure (CRF). The author makes conclusions about patient responses to powerlessness in order to help nurses identify behavioral indicators of the nursing diagnostic category of powerlessness in other chronically ill patients. The author focuses on strategies to help prevent and alleviate feelings of powerlessness in patients with chronic illness. 1 figure. 2 tables. 39 references. (AA-M).

•

Overview of the Management of Anemia in End-Stage Renal Disease Source: in American Dietetic Association. Clinical Guide to Nutrition Care in End-Stage Renal Disease. Chicago, IL: American Dietetic Association. 1994. p. 195-197. Contact: Available from American Dietetic Association. 216 West Jackson Boulevard Chicago, IL 60606-6995. (312) 899-0040. PRICE: $24 for members; $28 for non-members; plus shipping and handling. ISBN: 0880911247. Summary: This item is an appendix from a manual that provides guidelines for the clinical nutrition care of patients with end-stage renal disease (ESRD). In it the author provides an overview of the management of anemia in ESRD. Topics include the use of recombinant human erythropoietin (rHuEPO) in all modes of ESRD treatment; administration of rHuEPO in hemodialysis and peritoneal dialysis patients; how rHuEPO works to stimulate red blood cell production; monitoring of patients on rHuEPO; maintaining adequate iron status with iron supplementation; and evaluating overall nutritional and biochemical parameters of patients receiving rHuEPO. 14 references.

Books

•

127

Adequacy of Treatment for End-Stage Renal Disease in the United States Source: in Schrier, R.W., et al., eds. Advances in Internal Medicine. Vol 41. St. Louis, MO: Mosby-Year Book, Inc. 1996. p. 323-363. Contact: Available from Mosby Year-Book, Inc. 11830 Westline Industrial Drive, St. Louis, MO 63146. (800) 426-4545. Fax (800) 535-9935. E-mail: [email protected]. PRICE: $72.95. ISBN: 0815183143. ISSN: 00652822. Summary: Whatever the cause of chronic or irreversible renal failure, when damage is complete, appearance of the more severe of the uremic symptoms permits the diagnosis of end-stage renal disease (ESRD). This chapter, from a yearbook of advances in internal medicine, considers the adequacy of treatment for ESRD in the United States. Topics include the origin of treatments for ESRD and the historical perspective of the development of different types of dialysis; expanding availability of treatments for ESRD, including the federally supported hemodialysis program; management of the ESRD program; selection and acceptance to therapy for ESRD; ESRD treatments, including transplantation, hemodialysis, and peritoneal dialysis; factors influencing the choice of modality; the prescription for dialysis adequacy; medical management, including access to blood or peritoneum, anemia, bone disease, and transplant care; mortality and morbidity considerations; and deficiencies in quality of ESRD care, including mortality in international comparisons, and contributory factors such as comparative treatment efficiency, patient selection, the effect of capped reimbursement rates, shortcuts to reuse, and medical management. In the final section, the authors present suggestions for improving the medical management of patients with ESRD. They discuss pre-ESRD care, increasing the dialysis dose, the role of the hemodialyzer membrane, improving access to transplantation, improving patient care, the role for the government, resolving patient-professional discord, and data collection and analysis. The authors conclude that the U.S. experiences with ESRD can be used as a model for American health care. 5 tables. 94 references.

Directories In addition to the references and resources discussed earlier in this chapter, a number of directories relating to end-stage renal disease have been published that consolidate information across various sources. The Combined Health Information Database lists the following, which you may wish to consult in your local medical library:11 •

ESRD Provider Listing Source: Midlothian, VA: Mid-Atlantic Renal Coalition. 1997. 32 p. Contact: Available from Mid-Atlantic Renal Coalition. 1527 Huguenot Road, Midlothian, VA 23113. (804) 794-3757. PRICE: $50.00. Summary: This document lists end-stage renal disease (ESRD) service providers in network 5 (mid-Atlantic region, covering the District of Columbia, Maryland, Virginia,

11 You will need to limit your search to “Directory” and “end-stage renal disease” using the "Detailed Search" option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find directories, use the drop boxes at the bottom of the search page where “You may refine your search by.” For publication date, select “All Years.” Select your preferred language and the format option “Directory.” Type “end-stage renal disease” (or synonyms) into the “For these words:” box. You should check back periodically with this database as it is updated every three months.

128


and West Virginia). Organized by geographic location, the directory lists the provider address and telephone number, the provider number, facility type, and services offered. Services offered can include hemodialysis, isolation, and training services (notably in peritoneal dialysis). The directory concludes with an alphabetical listing of facilities by city within each State.

129

CHAPTER 8. MULTIMEDIA ON END-STAGE RENAL DISEASE Overview In this chapter, we show you how to keep current on multimedia sources of information on end-stage renal disease. We start with sources that have been summarized by federal agencies, and then show you how to find bibliographic information catalogued by the National Library of Medicine.

Video Recordings An excellent source of multimedia information on end-stage renal disease is the Combined Health Information Database. You will need to limit your search to “Videorecording” and “end-stage renal disease” using the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find video productions, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Videorecording (videotape, videocassette, etc.).” Type “end-stage renal disease” (or synonyms) into the “For these words:” box. The following is a typical result when searching for video recordings on endstage renal disease: •

End-Stage Renal Disease: Preventing Dialysis Through Early Recognition and Intervention Source: Secaucus, NJ: Network for Continuing Medical Education (NCME). 1992. Contact: Available from NCME. One Harmon Plaza, Secaucus, NJ 07094. (800) 223-0272 or, in New Jersey, (800) 624-2102, or (201) 867-3550. PRICE: $50 for 2-week rental or $75 for purchase. Available only to NCME subscribers; subscriber fees as of 1995 are $1,920 for VHS subscription, $2,120 for U-matic subscription. Summary: Although deaths in the United States from stroke and coronary artery disease are declining, the incidence of renal failure, another major consequence of hypertension, continues to grow. In this continuing education videotape program, viewers are taught early recognition of end-stage renal disease (ESRD) and appropriate intervention, in an attempt to eliminate or reduce the need for dialysis in hypertensive and diabetic

130


patients. The program focuses on the identification of the very early signs of kidney impairment and the appropriate modes of therapy. (AA-M).

131

CHAPTER 9. PERIODICALS AND NEWS ON END-STAGE RENAL DISEASE Overview In this chapter, we suggest a number of news sources and present various periodicals that cover end-stage renal disease.

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

Incidence of end-stage renal disease in type I diabetics declining Source: Reuters Medical News Date: August 08, 2003

132


•

Troponin and CRP levels predict mortality in end-stage renal disease patients Source: Reuters Medical News Date: July 16, 2003

•

Whirlpool use linked to injury in patient with end-stage renal disease Source: Reuters Medical News Date: February 07, 2003

•

Timing of nephrologist evaluation impacts survival in end-stage renal disease Source: Reuters Medical News Date: September 20, 2002

•

Late referral to specialist hastens death from end-stage renal disease Source: Reuters Medical News Date: October 19, 2000

•

Vitamin E may reduce cardiac events in patients with end-stage renal disease Source: Reuters Medical News Date: October 11, 2000

•

End-stage renal disease incidence unchanged by early treatment of reflux nephropathy Source: Reuters Medical News Date: June 12, 2000

•

Biocompatible dialysis membrane raises albumin in patients with end-stage renal disease Source: Reuters Medical News Date: April 25, 2000

•

Sulfonylurea use increases risk of prolonged hypoglycemia in end-stage renal disease Source: Reuters Medical News Date: March 22, 2000

•

Cancer risk elevated in patients with end-stage renal disease Source: Reuters Medical News Date: July 09, 1999 The NIH

Within MEDLINEplus, the NIH has made an agreement with the New York Times Syndicate, the AP News Service, and Reuters to deliver news that can be browsed by the public. Search news releases at http://www.nlm.nih.gov/medlineplus/alphanews_a.html. MEDLINEplus allows you to browse across an alphabetical index. Or you can search by date at the following Web page: http://www.nlm.nih.gov/medlineplus/newsbydate.html. Often, news items are indexed by MEDLINEplus within its search engine. Business Wire Business Wire is similar to PR Newswire. To access this archive, simply go to http://www.businesswire.com/. You can scan the news by industry category or company name.

Periodicals and News

133

Market Wire Market Wire is more focused on technology than the other wires. To browse the latest press releases by topic, such as alternative medicine, biotechnology, fitness, healthcare, legal, nutrition, and pharmaceuticals, access Market Wire’s Medical/Health channel at http://www.marketwire.com/mw/release_index?channel=MedicalHealth. Or simply go to Market Wire’s home page at http://www.marketwire.com/mw/home, type “end-stage renal disease” (or synonyms) into the search box, and click on “Search News.” As this service is technology oriented, you may wish to use it when searching for press releases covering diagnostic procedures or tests. Search Engines Medical news is also available in the news sections of commercial Internet search engines. See the health news page at Yahoo (http://dir.yahoo.com/Health/News_and_Media/), or you can use this Web site’s general news search page at http://news.yahoo.com/. Type in “end-stage renal disease” (or synonyms). If you know the name of a company that is relevant to end-stage renal disease, you can go to any stock trading Web site (such as http://www.etrade.com/) and search for the company name there. News items across various news sources are reported on indicated hyperlinks. Google offers a similar service at http://news.google.com/. BBC Covering news from a more European perspective, the British Broadcasting Corporation (BBC) allows the public free access to their news archive located at http://www.bbc.co.uk/. Search by “end-stage renal disease” (or synonyms).

Newsletter Articles Use the Combined Health Information Database, and limit your search criteria to “newsletter articles.” Again, you will need to use the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. Go to the bottom of the search page where “You may refine your search by.” Select the dates and language that you prefer. For the format option, select “Newsletter Article.” Type “end-stage renal disease” (or synonyms) into the “For these words:” box. You should check back periodically with this database as it is updated every three months. The following is a typical result when searching for newsletter articles on end-stage renal disease: •

Calcitriol Replacement in Renal Failure Source: OsteoDynamics. 3(1): 1-2. Spring 1995. Contact: Available from Abbott Renal Care. Abbott Laboratories, Abbott Park, IL 600643537. (800) 457-9472. Summary: In this newsletter article, the author familiarizes readers with the benefits of calcitriol replacement in patients on dialysis. Topics covered include the discovery and biosynthesis of calcitriol; its mechanism of action; how end-stage renal disease (ESRD) affects calcitriol; synthetic calcitriol (Calcijex); and present calcitriol uses. The author

134


notes that almost every patient who is referred to a dialysis unit for treatment of ESRD is already affected by low levels of calcitriol. Although symptoms may be minimal, or even absent, the consequences of long term calcitriol deprivation will worsen without treatment. •

Vegetarian Diets and Implications with Renal Disease Source: Networking News: [Nutrition and Education for the Public]. 19(2): 1, 12. Spring 1997. Contact: Available from Nutrition Education for the Public. 216 West Jackson Boulevard, Chicago, IL 60606-6995. Summary: Nutrition intervention for renal disease varies depending on a number of factors. This article considers vegetarian diets and their implications in patients with renal disease. Evidence indicates that dietary restriction of protein retards the progression of renal disease in both experimentally induced renal disease in animal models, and in some human nephropathies. The author notes that, when vegetable protein is substituted for animal protein in the diet, it seems to induce changes similar to those seen with a reduction in total dietary protein. A vegetarian diet may, however, make it difficult to minimize the metabolic derangements and uremic toxicity associated with renal disease, particularly with respect to phosphorus and potassium. Vegetarian diets are higher in fiber and lower in total fat, saturated fat, and cholesterol than nonvegetarian diets. Therefore, vegetarians tend to have lower rates of coronary artery disease, hypertension, noninsulin-dependent diabetes mellitus, and obesity than do nonvegetarians. These are all risk factors associated with the renal transplant patient. The author concludes by supporting the use of a vegetarian diet for the person with renal disease. The diet can be fairly easy to follow, acceptable, and palatable, with little interference in an individual's lifestyle. Consumption of a vegetarian diet may require an increase in the number of phosphate binders for patients in end-stage renal disease or on dialysis. Monitoring the patient for diet palatability and acceptance, and for signs of malnutrition are still important with the vegetarian diet. 9 references. (AA-M).

•

Renal Diets for Nursing Facilities: A Team Approach Source: Consultant Dietitian. 21(4): 1, 4-6. Spring 1997. Contact: Available from American Dietetic Association-Consultant Dietician-Health Care Facilities. 110 Ardis Street, Box 843, Hudson, IA 50643-0843. (319) 988-4636. Fax (319) 988-3091. Summary: This article outlines a team approach to a complex and intriguing challenge for the dietitian: nutrition for nursing facility residents who have end-stage renal disease (ESRD). The authors introduce reasons that malnutrition may be an issue for this population, including suboptimal dialysis, inadequate food intake, the emotional state of the resident, and anorexia subsequent to dialysis. The authors emphasize that efforts should be made to improve the nutritional status of these residents by recognizing their emotional needs as related to food preferences and choices. Selecting nutritional supplements depends on the resident's assisted needs, nutritional deficits, laboratory abnormalities, product availability, client palatability, and acceptance. Routine and consistent communication between the renal and consultant dietitians, as well as the other members of the health care team, helps prevent future health crises and allows for adequate documentation. The authors address the need for renal diet order simplification. A final section considers the rights of the resident, including the right to high quality medical care with appropriate nutrition therapy, respect for needs,


135

preservation of dignity, opportunities for free but guided choices, and respect for selfdetermination in decision making. 2 tables. 19 references. (AA-M). •

Living a Full Life on Dialysis Source: Renal Rehabilitation Report. 5(5): 1, 7, 8. September-October 1997. Contact: Available from Life Options Rehabilitation Program. Medical Education Institute, Inc, 414 D'Onofrid Drive., Suite 200, Madison, WI 53719. (608) 833-8033. Email: [email protected]. Summary: This article presents an introduction to a special issue on vocational rehabilitation and employment for dialysis patients. The author notes that, for most working-age Americans, being productive means, in part, being employed. There are, however, various factors that can make employment a challenge for dialysis patients. The article first reviews the symptoms of end-stage renal disease (ESRD) that may interfere with employment. Factors that are considered to be prerequisites to renal rehabilitation include anemia control, appropriate access management, dialysis adequacy, and optimum nutrition. The article then outlines and dispels five common misconceptions about the employment of people on dialysis. These are: patients with ESRD do not want to work; dialysis patients use too many sick days and are not as productive; hiring a dialysis patient will cause the employer's health insurance premiums to increase; dialysis patients require expensive employment accommodations; and dialysis patients who work automatically lose disability payments. The article concludes by offering strategies by which dialysis team members can play a role in combating the myths about ESRD and employment and helping patients manage the symptoms of ESRD. 4 references. (AA-M).

•

SSDI Case Study: Making Employment Work for You Source: Renal Rehabilitation Report. 5(5): 2-3. September-October 1997. Contact: Available from Life Options Rehabilitation Program. Medical Education Institute, Inc, 414 D'Onofrid Drive., Suite 200, Madison, WI 53719. (608) 833-8033. Email: [email protected]. Summary: This article, from a special issue on vocational rehabilitation and employment for dialysis patients, discusses some of the employment-related options for these patients. The author notes that some patients who are willing and able to work decide not to because of real or perceived fears about how choosing to work may affect their lives. Many of these patients fear the potential loss of financial benefits they receive, either through Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI). In response to these concerns, the Social Security Administration (SSA) implemented a series of work incentives to help persons with disabilities take greater advantage of employment opportunities. The article provides a case study that illustrates how SSDI work incentives helped one dialysis patient return to and maintain long term employment. The case study emphasizes the importance of working closely with social workers and the SSA to learn about all the possibilities that are available for people with end-stage renal disease.

•

Nutrition: Preserving Muscle and Providing Energy for Rehabilitation Source: Renal Rehabilitation Report. 6(3): 7. May-June 1998.

136


Contact: Available from Life Options Rehabilitation Program. Medical Education Institute, Inc, 414 D'Onofrid Drive., Suite 200, Madison, WI 53719. (608) 833-8033. Email: [email protected]. Summary: This brief article reviews the role of nutrition in patients with end-stage renal disease (ESRD), particularly the importance of adequate nutrition as a prerequisite for rehabilitation. Dialysis patients have an increased need for protein, however, due to such factors as anorexia, nausea, comorbid conditions, or restrictive and unpalatable diets, they often have difficulty taking in enough protein to meet this increased need. When inadequate dietary protein is combined with chronic renal failure, patients often experience loss of lean tissue mass (muscle), muscle fiber deterioration, and decreased muscle function. The article emphasizes that the need for adequate dietary protein intake must be balanced with other aspects of the renal diet, including control of sodium, potassium, calcium, phosphorus, fluids, and in the case of patients with diabetes, simple sugars. The article briefly discusses the use of recommendations for the assessment and monitoring of patients nutritional status. The article concludes that good nutrition can prevent or reverse the effects of malnutrition, enabling patients to preserve the strength and energy they need for rehabilitation. 5 references. •

Improving Quality of Life for Renal Patients: The Role of Self-Care in Renal Rehabilitation Source: Renal Rehabilitation Report. 4(4): 2-3. September-October 1996. Contact: Available from Life Options Rehabilitation Program. Medical Education Institute, Inc, 414 D'Onofrid Drive., Suite 200, Madison, WI 53719. (608) 833-8033. Email: [email protected]. Summary: This newsletter article explores how encouraging self care and autonomy can lead to better quality of life and improved outcomes in individuals with chronic illnesses, including end-stage renal disease (ESRD). The author first describes how kidney failure threatens personal autonomy on a number of levels (day to day scheduling, diet, fluid intake), and how the complexity of dialysis can be overwhelming to patients who subsequently defer to the treatment team. The author briefly describes interventions that improve patients' ability to care for themselves and participate in favorites activities and how those interventions result in better outcomes. Superior quality of life and improved survival consistently have been reported for renal transplant and home dialysis patients, groups which have in common a higher level of self care. The author describes Attribution Theory and the differences between internal and external locus of control. The article concludes with recommendations for encouraging self care. 6 references. (AA-M).

•

Nutritional Management of the Renal Transplant Recipient Source: Clinical Strategies: The AKF Newsletter for Nephrology Professionals. 3(2): 5, 10, 13-14. Fall 1996. Contact: Available from American Kidney Fund. 6110 Executive Boulevard, Suite 1010, Rockville, MD 20852. (800) 638-8299 or (301) 881-3052. Fax (301) 881-0898. Summary: This newsletter article reminds health care providers of the importance of the nutritional management of renal transplant recipients. The authors note that, although nutritional requirements have not been expressly defined for this population, diet can be used to lessen and in some cases prevent renal transplant-related complications. Topics include pre-transplant considerations, such as malnutrition, morbidity, mortality,


137

nutrition assessment parameters, obesity, end-stage renal disease (ESRD) and dyslipidemia, and renal osteodystrophy; issues for acute post-transplantation nutrition management, including protein catabolism and protein requirements, assessing fluid and electrolyte needs, maintaining appropriate hydration, hyperkalemia, posttransplant hypertension, drug-nutrient interactions, and hypophosphatemia; and longterm nutritional issues, including accelerated atherosclerosis, diet therapy and exercise, problems with weight gain, the management of obesity, preventing bone disease, hypertension, the development of post-transplant diabetes mellitus, and the role of diet in the progression of renal disease in the transplanted kidney. The authors conclude with suggestions of lifestyle changes to optimize outcome for kidney transplantations. 2 tables. 14 references. •

Present Status of Renal Transplantation Source: AUA News. 2(1): 14, 16. January-February 1997. Contact: Available from AUA News. Williams and Wilkins, 351 West Camden Street, Baltimore, MD 21201-2436. Summary: This newsletter article updates readers about the present status of renal transplantation. Topics include the critical donor organ shortage; use of living related, living unrelated, and nonheart-beating donors; newer immunosuppressive regimens; and xenotransplantation. The current rate of organ procurement in the United States is 17 per million population with 30 to 50 cadaveric kidneys per million potentially available. Only half of the general population is willing to donate or consent to familial organ donation. Despite the low complication rate, only 32 percent of transplant centers used living unrelated donors in 1992, which represents a twofold increase from 1988. The 1-year graft survival rate is 86.5 percent compared to 79.8 and 90.9 percent for cadaveric graft and living related donor, respectively, yet 31 percent of centers do not present living unrelated donor as an option. Newer immunosuppressive drugs, including FK506 and mycophenolate mofetil (MMF), can prolong graft survival. The major barrier to successful discordant xenotransplantation is hyperacute rejection (graft failure within minutes to hours because of preformed antibody deposition leading to vessel occlusion). The author concludes that the best way to address these renal transplantation issues is to prevent end-stage renal disease (ESRD) in the first place.

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

139

APPENDICES

141

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.

142


•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

Physician Resources

143

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.

144


•

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 “end-stage renal disease” (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 50086 522 963 115 102 51788

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 “end-stage renal disease” (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.

Physician Resources

145

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/.

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.

147

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 end-stage renal disease 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 end-stage renal disease. 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 end-stage renal disease. 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 “end-stage renal disease”:

148

•


Other guides Diabetic Kidney Problems http://www.nlm.nih.gov/medlineplus/diabetickidneyproblems.html Kidney Diseases http://www.nlm.nih.gov/medlineplus/kidneydiseases.html Kidney Failure and Dialysis http://www.nlm.nih.gov/medlineplus/kidneyfailureanddialysis.html Kidney Stones http://www.nlm.nih.gov/medlineplus/kidneystones.html Kidney Transplantation http://www.nlm.nih.gov/medlineplus/kidneytransplantation.html

Within the health topic page dedicated to end-stage renal disease, the following was listed: •

General/Overviews Dialysis Keeps People with Kidney Failure Alive: Are You Getting Adequate Hemodialysis? http://www.medicare.gov/publications/pubs/pdf/dialysise.pdf Kidney Failure http://www.nlm.nih.gov/medlineplus/tutorials/kidneyfailureloader.html Kidney Failure Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=DS00280

•

Treatment Kidney Failure: Choosing a Treatment That's Right for You Source: National Kidney and Urologic Diseases Information Clearinghouse http://kidney.niddk.nih.gov/kudiseases/pubs/choosingtreatment/index.htm Kidney Transplant http://www.kidney.org/general/aboutdisease/kidney_trans.pdf Treatment Methods for Kidney Failure: Hemodialysis Source: National Kidney and Urologic Diseases Information Clearinghouse http://kidney.niddk.nih.gov/kudiseases/pubs/hemodialysis/index.htm Treatment Methods for Kidney Failure: Peritoneal Dialysis Source: National Kidney and Urologic Diseases Information Clearinghouse http://kidney.niddk.nih.gov/kudiseases/pubs/peritoneal/index.htm Treatment Methods for Kidney Failure: Transplantation Source: National Kidney and Urologic Diseases Information Clearinghouse http://kidney.niddk.nih.gov/kudiseases/pubs/transplant/index.htm

•

Nutrition Eat Right to Feel Right on Hemodialysis http://kidney.niddk.nih.gov/kudiseases/pubs/eatright/index.htm

Patient Resources

149

Na-K-Phos Counter Source: American Association of Kidney Patients http://www.aakp.org/na-k-pho.htm Nutrition and Peritoneal Dialysis http://www.kidney.org/general/aboutdisease/nutri_pd.pdf Protein/Calorie Counter Source: American Association of Kidney Patients http://www.aakp.org/Prot/cal.htm •

Coping Coping Effectively: A Guide for Patients and Their Families http://www.kidney.org/general/aboutdisease/coping.pdf

•

Specific Conditions/Aspects Amyloidosis and Kidney Disease Source: National Kidney and Urologic Diseases Information Clearinghouse http://kidney.niddk.nih.gov/kudiseases/pubs/amyloidosis/index.htm Analgesic Nephropathy (Painkillers and the Kidneys) Source: National Kidney and Urologic Diseases Information Clearinghouse http://kidney.niddk.nih.gov/kudiseases/pubs/analgesicnephropathy/index.htm Anemia in Kidney Disease and Dialysis Source: National Kidney and Urologic Diseases Information Clearinghouse http://kidney.niddk.nih.gov/kudiseases/pubs/anemia/index.htm Financial Help for Treatment of Kidney Failure Source: National Kidney and Urologic Diseases Information Clearinghouse http://kidney.niddk.nih.gov/kudiseases/pubs/financialhelp/index.htm Inadequate Hemodialysis Increases the Risk of Premature Death Source: American Association of Kidney Patients http://www.aakp.org/hd-adv.htm JAMA Patient Page: Acute Renal Failure Source: American Medical Association http://www.medem.com/medlb/article_detaillb.cfm?article_ID=ZZZCFVFA09D& sub_cat=323 Just the Facts: Skin and Hair Problems on Dialysis http://www.lifeoptions.org/pdfs/teachtools/skinhafs.pdf Keeping Fit: Why Dialysis Patients Should Exercise Source: American Association of Kidney Patients http://www.aakp.org/Keeping_Fit.htm Kidney Failure and Cardiovascular Disease http://circ.ahajournals.org/cgi/reprint/108/16/e114.pdf Medicare Coverage of Kidney Dialysis and Kidney Transplant Services http://www.medicare.gov/Publications/Pubs/pdf/esrdCoverage.pdf Preparing for Emergencies: A Guide for People on Dialysis http://www.medicare.gov/publications/pubs/pdf/10150.pdf

150


Renal Osteodystrophy Source: National Kidney and Urologic Diseases Information Clearinghouse http://kidney.niddk.nih.gov/kudiseases/pubs/renalosteodystrophy/index.htm What do I Need to do Before Traveling as a Dialysis Patient? Source: American Association of Kidney Patients http://www.aakp.org/Traveling.htm What You Should Know about Dialyzer Reuse: A Guide for Hemodialysis Patients and Their Families http://www.kidney.org/general/aboutdisease/dialyzer_reuse.pdf •

Children School & Family Problems of Children with Kidney Failure Source: National Kidney and Urologic Diseases Information Clearinghouse http://kidney.niddk.nih.gov/kudiseases/pubs/childkidneydiseases/school_famil y_problems/index.htm Treatment Methods for Kidney Failure in Children Source: National Kidney and Urologic Diseases Information Clearinghouse http://kidney.niddk.nih.gov/kudiseases/pubs/childkidneydiseases/treatment_me thods/index.htm What's the Deal with Dialysis? Source: Nemours Foundation http://kidshealth.org/kid/feel_better/things/dialysis.html When Your Child Has a Chronic Kidney Disease Source: Nemours Foundation http://kidshealth.org/parent/medical/kidney/chronic_kidney_disease.html

•

Journals/Newsletters AAKP Kidney Beginnings: The Electronic Newsletter Source: American Association of Kidney Patients http://www.aakp.org/KidneyBegin.htm E-Kidney: Online Newsletter of the NKF Source: National Kidney Foundation http://www.kidney.org/general/eleckid/ Renal Flash Source: American Association of Kidney Patients http://www.aakp.org/Renal_Flash_Issues.htm

•

Latest News Blacks Unaware of Kidney Failure Risks Source: 03/08/2004, United Press International http://www.nlm.nih.gov//www.nlm.nih.gov/medlineplus/news/fullstory_16445 .html Drugs Cut Kidney Failure Risk in Lupus Patients Source: 03/04/2004, Reuters Health http://www.nlm.nih.gov//www.nlm.nih.gov/medlineplus/news/fullstory_16409

Patient Resources

151

.html FDA Approves First in a New Class of Drugs to Treat Hyperparathyroidism Associated with Renal Failure and in Patients with Parathyroid Cancer Source: 03/08/2004, Food and Drug Administration http://www.fda.gov/bbs/topics/ANSWERS/2004/ANS01282.html Heart Disease Goes beyond the Heart Source: 01/01/2004, American Heart Association http://www.americanheart.org/presenter.jhtml?identifier=3018016 •

Law and Policy Medigap Policies for People Under Age 65 with a Disability or End-Stage Renal Disease (ESRD) Source: Centers for Medicare & Medicaid Services http://www.medicare.gov/medigap/under65.asp

•

Organizations American Association of Kidney Patients http://www.aakp.org/ American Kidney Fund http://www.akfinc.org/ Life Options Rehabilitation Program http://www.lifeoptions.org/ National Institute of Diabetes and Digestive and Kidney Diseases http://www.niddk.nih.gov/ National Kidney and Urologic Diseases Information Clearinghouse Source: National Institute of Diabetes and Digestive and Kidney Diseases http://kidney.niddk.nih.gov/ National Kidney Foundation http://www.kidney.org/

•

Research FDA Approves First in a New Class of Drugs to Treat Hyperparathyroidism Associated with Renal Failure and in Patients with Parathyroid Cancer Source: Food and Drug Administration http://www.fda.gov/bbs/topics/ANSWERS/2004/ANS01282.html Hemodialysis Study Results Published Confirms Current Recommended Practice Source: National Institute of Diabetes and Digestive and Kidney Diseases http://www.nih.gov/news/pr/dec2002/niddk-18.htm Preventing Worsening Kidney Function in Patients Receiving Peritoneal Dialysis Source: American College of Physicians http://www.annals.org/cgi/content/full/139/2/I-32 Timing of Evaluation by Specialists for Patients with Chronic Kidney Disease Source: American College of Physicians http://www.annals.org/cgi/content/full/137/6/I-24

152

•


Statistics End Stage Renal Disease in the United States Source: National Kidney Foundation http://www.kidney.org/general/news/factsheet.cfm?id=38 Kidney and Urologic Disease Statistics for the United States Source: National Kidney and Urologic Diseases Information Clearinghouse http://kidney.niddk.nih.gov/kudiseases/pubs/kustats/index.htm Kidney Center Data Profile Source: Organ Procurement and Transplantation Network http://www.optn.org/organDatasource/stateData.asp?type=state&mqsd=1&displ ay=Kidney Kidney Disease Facts & Statistics: New Cases Statistics Source: American Society of Nephrology http://www.asn-online.org/facts_and_statistics/newcases.aspx Kidney Disease Facts & Statistics: Prevalence Source: American Society of Nephrology http://www.asn-online.org/facts_and_statistics/prevalence.aspx

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. 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: •

Kidney Disease of Diabetes Summary: This consumer fact sheet discusses diabetes and end-stage renal disease (ESRD) and the treatments and therapies involved. Source: National Kidney and Urologic Diseases Information Clearinghouse, National Institute of Diabetes and Digestive and Kidney Disease http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=2085 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 end-stage renal disease. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information

Patient Resources

153

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


•

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

•

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

•

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

•

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

•

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

•

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

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

154


Simply type in “end-stage renal disease” (or a synonym), and you will receive information on all relevant organizations listed in the database. Health Hotlines directs you to toll-free numbers to over 300 organizations. You can access this database directly at http://www.sis.nlm.nih.gov/hotlines/. On this page, you are given the option to search by keyword or by browsing the subject list. When you have received your search results, click on the name of the organization for its description and contact information. The Combined Health Information Database Another comprehensive source of information on healthcare associations is the Combined Health Information Database. Using the “Detailed Search” option, you will need to limit your search to “Organizations” and “end-stage renal disease”. 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 “end-stage renal disease” (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 “end-stage renal disease” (or a synonym) into the search box, and click “Submit Query.”

155

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.23

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

23

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

156


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)24: •

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

•

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

•

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

•

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

•

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

•

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

•

California: Gateway Health Library (Sutter Gould Medical Foundation)

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

24

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

Finding Medical Libraries 157

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

158


•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

Finding Medical Libraries 159

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

160


•

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

•

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

•

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

•

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

161

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 end-stage renal disease: •

Basic Guidelines for End-Stage Renal Disease End-stage renal disease Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000500.htm Esrd Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000500.htm

•

Signs & Symptoms for End-Stage Renal Disease Anemia Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000560.htm Blood in the vomit Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003118.htm Bruising Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003235.htm

162


Coma Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003202.htm Confusion Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003205.htm Decreased alertness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003202.htm Decreased sensation Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003206.htm Decreased urine output Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003147.htm Drowsiness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003208.htm Fatigue Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003088.htm General ill feeling Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003089.htm Headache Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003024.htm Hiccups Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003068.htm Impotence Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003164.htm Itching Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003217.htm Lethargy Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003088.htm Menstrual irregularities Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003263.htm Muscle twitching Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003296.htm Nail abnormalities Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003247.htm Nausea Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003117.htm

Online Glossaries 163

Nausea and vomiting Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003117.htm No urine output Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003147.htm Pruritus Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003217.htm Seizures Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003200.htm Somnolence Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003208.htm Stress Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003211.htm Vomiting Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003117.htm Weight loss Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003107.htm •

Diagnostics and Tests for End-Stage Renal Disease BUN Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003474.htm Creatinine Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003475.htm Creatinine clearance Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003611.htm Dialysis Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003421.htm Erythropoietin Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003683.htm Urine volume Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003425.htm

•

Nutrition for End-Stage Renal Disease Carbohydrate Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002469.htm Protein in diet Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002467.htm

164

•


Surgery and Procedures for End-Stage Renal Disease Kidney transplant Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003005.htm

•

Background Topics for End-Stage Renal Disease Acute Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002215.htm Chronic Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002312.htm Electrolyte Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002350.htm Electrolytes Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002350.htm Fractures Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000001.htm Kidney disease - support group Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002172.htm Metabolism Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002257.htm Support group Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002150.htm

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

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

•

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

165

END-STAGE RENAL DISEASE 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] Abdominal Pain: Sensation of discomfort, distress, or agony in the abdominal region. [NIH] Absolute risk: The observed or calculated probability of an event in a population under study, as contrasted with the relative risk. [NIH] Acceptor: A substance which, while normally not oxidized by oxygen or reduced by hydrogen, can be oxidized or reduced in presence of a substance which is itself undergoing oxidation or reduction. [NIH] 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] Actin: Essential component of the cell skeleton. [NIH] Activities of Daily Living: The performance of the basic activities of self care, such as dressing, ambulation, eating, etc., in rehabilitation. [NIH] Acute renal: A condition in which the kidneys suddenly stop working. In most cases, kidneys can recover from almost complete loss of function. [NIH] Acyl: Chemical signal used by bacteria to communicate. [NIH] Adenosine: A nucleoside that is composed of adenine and d-ribose. Adenosine or adenosine derivatives play many important biological roles in addition to being components of DNA and RNA. Adenosine itself is a neurotransmitter. [NIH] Adipocytes: Fat-storing cells found mostly in the abdominal cavity and subcutaneous tissue. Fat is usually stored in the form of tryglycerides. [NIH] Adjustment: The dynamic process wherein the thoughts, feelings, behavior, and biophysiological mechanisms of the individual continually change to adjust to the environment. [NIH] Adolescence: The period of life beginning with the appearance of secondary sex characteristics and terminating with the cessation of somatic growth. The years usually referred to as adolescence lie between 13 and 18 years of age. [NIH] Adrenal Cortex: The outer layer of the adrenal gland. It secretes mineralocorticoids, androgens, and glucocorticoids. [NIH] Adrenal Glands: Paired glands situated in the retroperitoneal tissues at the superior pole of each kidney. [NIH] 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] Afferent: Concerned with the transmission of neural impulse toward the central part of the

166


nervous system. [NIH] Afferent Pathways: Nerve structures through which impulses are conducted from a peripheral part toward a nerve center. [NIH] Affinity: 1. Inherent likeness or relationship. 2. A special attraction for a specific element, organ, or structure. 3. Chemical affinity; the force that binds atoms in molecules; the tendency of substances to combine by chemical reaction. 4. The strength of noncovalent chemical binding between two substances as measured by the dissociation constant of the complex. 5. In immunology, a thermodynamic expression of the strength of interaction between a single antigen-binding site and a single antigenic determinant (and thus of the stereochemical compatibility between them), most accurately applied to interactions among simple, uniform antigenic determinants such as haptens. Expressed as the association constant (K litres mole -1), which, owing to the heterogeneity of affinities in a population of antibody molecules of a given specificity, actually represents an average value (mean intrinsic association constant). 6. The reciprocal of the dissociation constant. [EU] Age of Onset: The age or period of life at which a disease or the initial symptoms or manifestations of a disease appear in an individual. [NIH] 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] Albumin: 1. Any protein that is soluble in water and moderately concentrated salt solutions and is coagulable by heat. 2. Serum albumin; the major plasma protein (approximately 60 per cent of the total), which is responsible for much of the plasma colloidal osmotic pressure and serves as a transport protein carrying large organic anions, such as fatty acids, bilirubin, and many drugs, and also carrying certain hormones, such as cortisol and thyroxine, when their specific binding globulins are saturated. Albumin is synthesized in the liver. Low serum levels occur in protein malnutrition, active inflammation and serious hepatic and renal disease. [EU] Albuminuria: More than normal amounts of a protein called albumin in the urine. Albuminuria may be a sign of kidney disease. [NIH] Aldosterone: (11 beta)-11,21-Dihydroxy-3,20-dioxopregn-4-en-18-al. A hormone secreted by the adrenal cortex that functions in the regulation of electrolyte and water balance by increasing the renal retention of sodium and the excretion of potassium. [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] Alimentary: Pertaining to food or nutritive material, or to the organs of digestion. [EU] Alkaline: Having the reactions of an alkali. [EU] 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] Allogeneic: Taken from different individuals of the same species. [NIH] Allograft: An organ or tissue transplant between two humans. [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]

Dictionary 167

Aluminum: A metallic element that has the atomic number 13, atomic symbol Al, and atomic weight 26.98. [NIH] Ameliorating: A changeable condition which prevents the consequence of a failure or accident from becoming as bad as it otherwise would. [NIH] Amino acid: Any organic compound containing an amino (-NH2 and a carboxyl (- COOH) group. The 20 a-amino acids listed in the accompanying table are the amino acids from which proteins are synthesized by formation of peptide bonds during ribosomal translation of messenger RNA; all except glycine, which is not optically active, have the L configuration. Other amino acids occurring in proteins, such as hydroxyproline in collagen, are formed by posttranslational enzymatic modification of amino acids residues in polypeptide chains. There are also several important amino acids, such as the neurotransmitter y-aminobutyric acid, that have no relation to proteins. Abbreviated AA. [EU] Amino Acid Sequence: The order of amino acids as they occur in a polypeptide chain. This is referred to as the primary structure of proteins. It is of fundamental importance in determining protein conformation. [NIH] Ammonia: A colorless alkaline gas. It is formed in the body during decomposition of organic materials during a large number of metabolically important reactions. [NIH] 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] Ampicillin: Semi-synthetic derivative of penicillin that functions as an orally active broadspectrum antibiotic. [NIH] Amyloidosis: A group of diseases in which protein is deposited in specific organs (localized amyloidosis) or throughout the body (systemic amyloidosis). Amyloidosis may be either primary (with no known cause) or secondary (caused by another disease, including some types of cancer). Generally, primary amyloidosis affects the nerves, skin, tongue, joints, heart, and liver; secondary amyloidosis often affects the spleen, kidneys, liver, and adrenal glands. [NIH] Anaemia: A reduction below normal in the number of erythrocytes per cu. mm., in the quantity of haemoglobin, or in the volume of packed red cells per 100 ml. of blood which occurs when the equilibrium between blood loss (through bleeding or destruction) and blood production is disturbed. [EU] Anaesthesia: Loss of feeling or sensation. Although the term is used for loss of tactile sensibility, or of any of the other senses, it is applied especially to loss of the sensation of pain, as it is induced to permit performance of surgery or other painful procedures. [EU] Analgesic: An agent that alleviates pain without causing loss of consciousness. [EU] Analog: In chemistry, a substance that is similar, but not identical, to another. [NIH] Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] Anemia: A reduction in the number of circulating erythrocytes or in the quantity of hemoglobin. [NIH] Anemic: Hypoxia due to reduction of the oxygen-carrying capacity of the blood as a result of a decrease in the total hemoglobin or an alteration of the hemoglobin constituents. [NIH] Anesthesia: A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures. [NIH]

168


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] Angioplasty: Endovascular reconstruction of an artery, which may include the removal of atheromatous plaque and/or the endothelial lining as well as simple dilatation. These are procedures performed by catheterization. When reconstruction of an artery is performed surgically, it is called endarterectomy. [NIH] Angiotensin-Converting Enzyme Inhibitors: A class of drugs whose main indications are the treatment of hypertension and heart failure. They exert their hemodynamic effect mainly by inhibiting the renin-angiotensin system. They also modulate sympathetic nervous system activity and increase prostaglandin synthesis. They cause mainly vasodilation and mild natriuresis without affecting heart rate and contractility. [NIH] Angiotensinogen: An alpha-globulin of which a fragment of 14 amino acids is converted by renin to angiotensin I, the inactive precursor of angiotensin II. It is a member of the serpin superfamily. [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] Anions: Negatively charged atoms, radicals or groups of atoms which travel to the anode or positive pole during electrolysis. [NIH] Anorexia: Lack or loss of appetite for food. Appetite is psychologic, dependent on memory and associations. Anorexia can be brought about by unattractive food, surroundings, or company. [NIH] Anoxia: Clinical manifestation of respiratory distress consisting of a relatively complete absence of oxygen. [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]

Antibodies: Immunoglobulin molecules having a specific amino acid sequence by virtue of which they interact only with the antigen that induced their synthesis in cells of the lymphoid series (especially plasma cells), or with an antigen closely related to it. [NIH] Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Anticoagulant: A drug that helps prevent blood clots from forming. Also called a blood thinner. [NIH] Antifungal: Destructive to fungi, or suppressing their reproduction or growth; effective against fungal infections. [EU]

Dictionary 169

Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Antihypertensive: An agent that reduces high blood pressure. [EU] Antimetabolite: A chemical that is very similar to one required in a normal biochemical reaction in cells. Antimetabolites can stop or slow down the reaction. [NIH] Antineoplastic: Inhibiting or preventing the development of neoplasms, checking the maturation and proliferation of malignant cells. [EU] Antioxidant: A substance that prevents damage caused by free radicals. Free radicals are highly reactive chemicals that often contain oxygen. They are produced when molecules are split to give products that have unpaired electrons. This process is called oxidation. [NIH] Antiviral: Destroying viruses or suppressing their replication. [EU] Anuria: Inability to form or excrete urine. [NIH] Anxiety: Persistent feeling of dread, apprehension, and impending disaster. [NIH] Aorta: The main trunk of the systemic arteries. [NIH] Apolipoproteins: The protein components of lipoproteins which remain after the lipids to which the proteins are bound have been removed. They play an important role in lipid transport and metabolism. [NIH] Aqueous: Having to do with water. [NIH] Arginine: An essential amino acid that is physiologically active in the L-form. [NIH] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Arteriolar: Pertaining to or resembling arterioles. [EU] Arterioles: The smallest divisions of the arteries located between the muscular arteries and the capillaries. [NIH] Arteriolosclerosis: Sclerosis and thickening of the walls of the smaller arteries (arterioles). Hyaline arteriolosclerosis, in which there is homogeneous pink hyaline thickening of the arteriolar walls, is associated with benign nephrosclerosis. Hyperplastic arteriolosclerosis, in which there is a concentric thickening with progressive narrowing of the lumina may be associated with malignant hypertension, nephrosclerosis, and scleroderma. [EU] Arteriosclerosis: Thickening and loss of elasticity of arterial walls. Atherosclerosis is the most common form of arteriosclerosis and involves lipid deposition and thickening of the intimal cell layers within arteries. Additional forms of arteriosclerosis involve calcification of the media of muscular arteries (Monkeberg medial calcific sclerosis) and thickening of the walls of small arteries or arterioles due to cell proliferation or hyaline deposition (arteriolosclerosis). [NIH] Arteriovenous: Both arterial and venous; pertaining to or affecting an artery and a vein. [EU] Arteriovenous Fistula: An abnormal communication between an artery and a vein. [NIH] Artery: Vessel-carrying blood from the heart to various parts of the body. [NIH] Articular: Of or pertaining to a joint. [EU] Assay: Determination of the amount of a particular constituent of a mixture, or of the

170


biological or pharmacological potency of a drug. [EU] Asymptomatic: Having no signs or symptoms of disease. [NIH] Atherectomy: Endovascular procedure in which atheromatous plaque is excised by a cutting or rotating catheter. It differs from balloon and laser angioplasty procedures which enlarge vessels by dilation but frequently do not remove much plaque. If the plaque is removed by surgical excision under general anesthesia rather than by an endovascular procedure through a catheter, it is called endarterectomy. [NIH] 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] Autodigestion: Autolysis; a condition found in disease of the stomach: the stomach wall is digested by the gastric juice. [NIH] Autologous: Taken from an individual's own tissues, cells, or DNA. [NIH] Autonomic: Self-controlling; functionally independent. [EU] Autonomic Neuropathy: A disease of the nerves affecting mostly the internal organs such as the bladder muscles, the cardiovascular system, the digestive tract, and the genital organs. These nerves are not under a person's conscious control and function automatically. Also called visceral neuropathy. [NIH] Azotemia: An excess of urea or other nitrogenous compounds in the blood. [EU] Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH] 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] Basement Membrane: Ubiquitous supportive tissue adjacent to epithelium and around smooth and striated muscle cells. This tissue contains intrinsic macromolecular components such as collagen, laminin, and sulfated proteoglycans. As seen by light microscopy one of its subdivisions is the basal (basement) lamina. [NIH] Behavioral Medicine: The interdisciplinary field concerned with the development and integration of behavioral and biomedical science, knowledge, and techniques relevant to health and illness and the application of this knowledge and these techniques to prevention, diagnosis, treatment, and rehabilitation. [NIH] Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]

Benzene: Toxic, volatile, flammable liquid hydrocarbon biproduct of coal distillation. It is used as an industrial solvent in paints, varnishes, lacquer thinners, gasoline, etc. Benzene causes central nervous system damage acutely and bone marrow damage chronically and is carcinogenic. It was formerly used as parasiticide. [NIH] Beta-Lactamases: Enzymes found in many bacteria which catalyze the hydrolysis of the amide bond in the beta-lactam ring. Well known antibiotics destroyed by these enzymes are penicillins and cephalosporins. EC 3.5.2.6. [NIH]

Dictionary 171

Bilateral: Affecting both the right and left side of body. [NIH] Bile: An emulsifying agent produced in the liver and secreted into the duodenum. Its composition includes bile acids and salts, cholesterol, and electrolytes. It aids digestion of fats in the duodenum. [NIH] Biliary: Having to do with the liver, bile ducts, and/or gallbladder. [NIH] Biliary Tract: The gallbladder and its ducts. [NIH] Bilirubin: A bile pigment that is a degradation product of heme. [NIH] Binding agent: A substance that makes a loose mixture stick together. For example, binding agents can be used to make solid pills from loose powders. [NIH] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biological response modifier: BRM. A substance that stimulates the body's response to infection and disease. [NIH] Biopsy: Removal and pathologic examination of specimens in the form of small pieces of tissue from the living body. [NIH] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Bladder: The organ that stores urine. [NIH] Blood Cell Count: A count of the number of leukocytes and erythrocytes per unit volume in a sample of venous blood. A complete blood count (CBC) also includes measurement of the hemoglobin, hematocrit, and erythrocyte indices. [NIH] Blood Coagulation: The process of the interaction of blood coagulation factors that results in an insoluble fibrin clot. [NIH] Blood Glucose: Glucose in blood. [NIH] Blood 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] Body Composition: The relative amounts of various components in the body, such as percent body fat. [NIH] Body Fluids: Liquid components of living organisms. [NIH] Body Mass Index: One of the anthropometric measures of body mass; it has the highest correlation with skinfold thickness or body density. [NIH] Bolus: A single dose of drug usually injected into a blood vessel over a short period of time. Also called bolus infusion. [NIH] Bolus infusion: A single dose of drug usually injected into a blood vessel over a short period of time. Also called bolus. [NIH]

172


Bone Marrow: The soft tissue filling the cavities of bones. Bone marrow exists in two types, yellow and red. Yellow marrow is found in the large cavities of large bones and consists mostly of fat cells and a few primitive blood cells. Red marrow is a hematopoietic tissue and is the site of production of erythrocytes and granular leukocytes. Bone marrow is made up of a framework of connective tissue containing branching fibers with the frame being filled with marrow cells. [NIH] Bone Marrow Cells: Cells contained in the bone marrow including fat cells, stromal cells, megakaryocytes, and the immediate precursors of most blood cells. [NIH] Bone Marrow Transplantation: The transference of bone marrow from one human or animal to another. [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] Bradykinin: A nonapeptide messenger that is enzymatically produced from kallidin in the blood where it is a potent but short-lived agent of arteriolar dilation and increased capillary permeability. Bradykinin is also released from mast cells during asthma attacks, from gut walls as a gastrointestinal vasodilator, from damaged tissues as a pain signal, and may be a neurotransmitter. [NIH] Branch: Most commonly used for branches of nerves, but applied also to other structures. [NIH]

Broad-spectrum: Effective against a wide range of microorganisms; said of an antibiotic. [EU] Buccal: Pertaining to or directed toward the cheek. In dental anatomy, used to refer to the buccal surface of a tooth. [EU] Buffers: A chemical system that functions to control the levels of specific ions in solution. When the level of hydrogen ion in solution is controlled the system is called a pH buffer. [NIH]

Cadaver: A dead body, usually a human body. [NIH] Calcifediol: The major circulating metabolite of vitamin D3 produced in the liver and the best indicator of the body's vitamin D stores. It is effective in the treatment of rickets and osteomalacia, both in azotemic and non-azotemic patients. Calcifediol also has mineralizing properties. [NIH] Calcification: Deposits of calcium in the tissues of the breast. Calcification in the breast can be seen on a mammogram, but cannot be detected by touch. There are two types of breast calcification, macrocalcification and microcalcification. Macrocalcifications are large deposits and are usually not related to cancer. Microcalcifications are specks of calcium that may be found in an area of rapidly dividing cells. Many microcalcifications clustered together may be a sign of cancer. [NIH] Calcineurin: A calcium- and calmodulin-binding protein present in highest concentrations in the central nervous system. Calcineurin is composed of two subunits. A catalytic subunit, calcineurin A, and a regulatory subunit, calcineurin B, with molecular weights of about 60 kD and 19 kD, respectively. Calcineurin has been shown to dephosphorylate a number of phosphoproteins including histones, myosin light chain, and the regulatory subunit of cAMP-dependent protein kinase. It is involved in the regulation of signal transduction and is the target of an important class of immunophilin-immunosuppressive drug complexes in T-lymphocytes that act by inhibiting T-cell activation. EC 3.1.3.-. [NIH] Calcitriol: The physiologically active form of vitamin D. It is formed primarily in the kidney by enzymatic hydroxylation of 25-hydroxycholecalciferol (calcifediol). Its production is stimulated by low blood calcium levels and parathyroid hormone. Calcitriol increases

Dictionary 173

intestinal absorption of calcium and phosphorus, and in concert with parathyroid hormone increases bone resorption. [NIH] Calcium: A basic element found in nearly all organized tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. [NIH] Calmodulin: A heat-stable, low-molecular-weight activator protein found mainly in the brain and heart. The binding of calcium ions to this protein allows this protein to bind to cyclic nucleotide phosphodiesterases and to adenyl cyclase with subsequent activation. Thereby this protein modulates cyclic AMP and cyclic GMP levels. [NIH] Caloric intake: Refers to the number of calories (energy content) consumed. [NIH] Capillary: Any one of the minute vessels that connect the arterioles and venules, forming a network in nearly all parts of the body. Their walls act as semipermeable membranes for the interchange of various substances, including fluids, between the blood and tissue fluid; called also vas capillare. [EU] Capsules: Hard or soft soluble containers used for the oral administration of medicine. [NIH] Carbenicillin: Broad-spectrum semisynthetic penicillin derivative used parenterally. It is susceptible to gastric juice and penicillinase and may damage platelet function. [NIH] Carbohydrates: The largest class of organic compounds, including starches, glycogens, cellulose, gums, and simple sugars. Carbohydrates are composed of carbon, hydrogen, and oxygen in a ratio of Cn(H2O)n. [NIH] Carcinogen: Any substance that causes cancer. [NIH] Carcinogenic: Producing carcinoma. [EU] Carcinoma: Cancer that begins in the skin or in tissues that line or cover internal organs. [NIH]

Cardiac: Having to do with the heart. [NIH] Cardiomyopathy: A general diagnostic term designating primary myocardial disease, often of obscure or unknown etiology. [EU] Cardiotonic: 1. Having a tonic effect on the heart. 2. An agent that has a tonic effect on the heart. [EU] Cardiovascular: Having to do with the heart and blood vessels. [NIH] Cardiovascular disease: Any abnormal condition characterized by dysfunction of the heart and blood vessels. CVD includes atherosclerosis (especially coronary heart disease, which can lead to heart attacks), cerebrovascular disease (e.g., stroke), and hypertension (high blood pressure). [NIH] Cardiovascular System: The heart and the blood vessels by which blood is pumped and circulated through the body. [NIH] Carnitine: Constituent of striated muscle and liver. It is used therapeutically to stimulate gastric and pancreatic secretions and in the treatment of hyperlipoproteinemias. [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] Catabolism: Any destructive metabolic process by which organisms convert substances into excreted compounds. [EU]

174


Catecholamine: A group of chemical substances manufactured by the adrenal medulla and secreted during physiological stress. [NIH] Catheter: A flexible tube used to deliver fluids into or withdraw fluids from the body. [NIH] Catheterization: Use or insertion of a tubular device into a duct, blood vessel, hollow organ, or body cavity for injecting or withdrawing fluids for diagnostic or therapeutic purposes. It differs from intubation in that the tube here is used to restore or maintain patency in obstructions. [NIH] Cations: Postively charged atoms, radicals or groups of atoms which travel to the cathode or negative pole during electrolysis. [NIH] Caudal: Denoting a position more toward the cauda, or tail, than some specified point of reference; same as inferior, in human anatomy. [EU] Causal: Pertaining to a cause; directed against a cause. [EU] Cause of Death: Factors which produce cessation of all vital bodily functions. They can be analyzed from an epidemiologic viewpoint. [NIH] Cefoperazone: Semisynthetic broad-spectrum cephalosporin with a tetrazolyl moiety that is resistant to beta-lactamase. It has been proposed especially against Pseudomonas infections. [NIH]

Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Cell membrane: Cell membrane = plasma membrane. The structure enveloping a cell, enclosing the cytoplasm, and forming a selective permeability barrier; it consists of lipids, proteins, and some carbohydrates, the lipids thought to form a bilayer in which integral proteins are embedded to varying degrees. [EU] Cell motility: The ability of a cell to move. [NIH] Cell proliferation: An increase in the number of cells as a result of cell growth and cell division. [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] Cell Transplantation: Transference of cells within an individual, between individuals of the same species, or between individuals of different species. [NIH] Cellobiose: A disaccharide consisting of two glucose units in beta (1-4) glycosidic linkage. Obtained from the partial hydrolysis of cellulose. [NIH] Cellulose: A polysaccharide with glucose units linked as in cellobiose. It is the chief constituent of plant fibers, cotton being the purest natural form of the substance. As a raw material, it forms the basis for many derivatives used in chromatography, ion exchange materials, explosives manufacturing, and pharmaceutical preparations. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Centrifugation: A method of separating organelles or large molecules that relies upon differential sedimentation through a preformed density gradient under the influence of a gravitational field generated in a centrifuge. [NIH] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] Cerebrovascular: Pertaining to the blood vessels of the cerebrum, or brain. [EU] Cerebrum: The largest part of the brain. It is divided into two hemispheres, or halves, called the cerebral hemispheres. The cerebrum controls muscle functions of the body and also

Dictionary 175

controls speech, emotions, reading, writing, and learning. [NIH] Character: In current usage, approximately equivalent to personality. The sum of the relatively fixed personality traits and habitual modes of response of an individual. [NIH] Chemotherapeutic agent: A drug used to treat cancer. [NIH] Chemotherapy: Treatment with anticancer drugs. [NIH] Chin: The anatomical frontal portion of the mandible, also known as the mentum, that contains the line of fusion of the two separate halves of the mandible (symphysis menti). This line of fusion divides inferiorly to enclose a triangular area called the mental protuberance. On each side, inferior to the second premolar tooth, is the mental foramen for the passage of blood vessels and a nerve. [NIH] Cholesterol: The principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils. [NIH] Cholesterol Esters: Fatty acid esters of cholesterol which constitute about two-thirds of the cholesterol in the plasma. The accumulation of cholesterol esters in the arterial intima is a characteristic feature of atherosclerosis. [NIH] Chromosomal: Pertaining to chromosomes. [EU] 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] Chronic Disease: Disease or ailment of long duration. [NIH] Chronic renal: Slow and progressive loss of kidney function over several years, often resulting in end-stage renal disease. People with end-stage renal disease need dialysis or transplantation to replace the work of the kidneys. [NIH] Chylomicrons: A class of lipoproteins that carry dietary cholesterol and triglycerides from the small intestines to the tissues. [NIH] Cirrhosis: A type of chronic, progressive liver disease. [NIH] Clinical study: A research study in which patients receive treatment in a clinic or other medical facility. Reports of clinical studies can contain results for single patients (case reports) or many patients (case series or clinical trials). [NIH] Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] 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] Coagulation: 1. The process of clot formation. 2. In colloid chemistry, the solidification of a sol into a gelatinous mass; an alteration of a disperse phase or of a dissolved solid which causes the separation of the system into a liquid phase and an insoluble mass called the clot or curd. Coagulation is usually irreversible. 3. In surgery, the disruption of tissue by physical means to form an amorphous residuum, as in electrocoagulation and photocoagulation. [EU] 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

176


amphetamines and is a drug of abuse. Cocaine, like amphetamines, acts by multiple mechanisms on brain catecholaminergic neurons; the mechanism of its reinforcing effects is thought to involve inhibition of dopamine uptake. [NIH] Cofactor: A substance, microorganism or environmental factor that activates or enhances the action of another entity such as a disease-causing agent. [NIH] Collagen: A polypeptide substance comprising about one third of the total protein in mammalian organisms. It is the main constituent of skin, connective tissue, and the organic substance of bones and teeth. Different forms of collagen are produced in the body but all consist of three alpha-polypeptide chains arranged in a triple helix. Collagen is differentiated from other fibrous proteins, such as elastin, by the content of proline, hydroxyproline, and hydroxylysine; by the absence of tryptophan; and particularly by the high content of polar groups which are responsible for its swelling properties. [NIH] Colloidal: Of the nature of a colloid. [EU] Colon: The long, coiled, tubelike organ that removes water from digested food. The remaining material, solid waste called stool, moves through the colon to the rectum and leaves the body through the anus. [NIH] Colorectal: Having to do with the colon or the rectum. [NIH] Colorectal Cancer: Cancer that occurs in the colon (large intestine) or the rectum (the end of the large intestine). A number of digestive diseases may increase a person's risk of colorectal cancer, including polyposis and Zollinger-Ellison Syndrome. [NIH] Comorbidity: The presence of co-existing or additional diseases with reference to an initial diagnosis or with reference to the index condition that is the subject of study. Comorbidity may affect the ability of affected individuals to function and also their survival; it may be used as a prognostic indicator for length of hospital stay, cost factors, and outcome or survival. [NIH] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix 'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Complementary and alternative medicine: CAM. Forms of treatment that are used in addition to (complementary) or instead of (alternative) standard treatments. These practices

Dictionary 177

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] Compliance: Distensibility measure of a chamber such as the lungs (lung compliance) or bladder. Compliance is expressed as a change in volume per unit change in pressure. [NIH] 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] Computer Simulation: Computer-based representation of physical systems and phenomena such as chemical processes. [NIH] Concentric: Having a common center of curvature or symmetry. [NIH] Conception: The onset of pregnancy, marked by implantation of the blastocyst; the formation of a viable zygote. [EU] Concomitant: Accompanying; accessory; joined with another. [EU] Congestive heart failure: Weakness of the heart muscle that leads to a buildup of fluid in body tissues. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Consciousness: Sense of awareness of self and of the environment. [NIH] Constipation: Infrequent or difficult evacuation of feces. [NIH] Constriction: The act of constricting. [NIH] Consumption: Pulmonary tuberculosis. [NIH] Contraception: Use of agents, devices, methods, or procedures which diminish the likelihood of or prevent conception. [NIH] Contractility: Capacity for becoming short in response to a suitable stimulus. [EU] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Contrast Media: Substances used in radiography that allow visualization of certain tissues. [NIH]

Contrast medium: A substance that is introduced into or around a structure and, because of the difference in absorption of x-rays by the contrast medium and the surrounding tissues, allows radiographic visualization of the structure. [EU] Control group: In a clinical trial, the group that does not receive the new treatment being studied. This group is compared to the group that receives the new treatment, to see if the new treatment works. [NIH] Controlled clinical trial: A clinical study that includes a comparison (control) group. The

178


comparison group receives a placebo, another treatment, or no treatment at all. [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 Angiography: Radiography of the vascular system of the heart muscle after injection of a contrast medium. [NIH] Coronary Artery Bypass: Surgical therapy of ischemic coronary artery disease achieved by grafting a section of saphenous vein, internal mammary artery, or other substitute between the aorta and the obstructed coronary artery distal to the obstructive lesion. [NIH] Coronary Circulation: The circulation of blood through the coronary vessels of the heart. [NIH]

Coronary heart disease: A type of heart disease caused by narrowing of the coronary arteries that feed the heart, which needs a constant supply of oxygen and nutrients carried by the blood in the coronary arteries. When the coronary arteries become narrowed or clogged by fat and cholesterol deposits and cannot supply enough blood to the heart, CHD results. [NIH] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Cortex: The outer layer of an organ or other body structure, as distinguished from the internal substance. [EU] Cortical: Pertaining to or of the nature of a cortex or bark. [EU] Corticosteroid: Any of the steroids elaborated by the adrenal cortex (excluding the sex hormones of adrenal origin) in response to the release of corticotrophin (adrenocorticotropic hormone) by the pituitary gland, to any of the synthetic equivalents of these steroids, or to angiotensin II. They are divided, according to their predominant biological activity, into three major groups: glucocorticoids, chiefly influencing carbohydrate, fat, and protein metabolism; mineralocorticoids, affecting the regulation of electrolyte and water balance; and C19 androgens. Some corticosteroids exhibit both types of activity in varying degrees, and others exert only one type of effect. The corticosteroids are used clinically for hormonal replacement therapy, for suppression of ACTH secretion by the anterior pituitary, as antineoplastic, antiallergic, and anti-inflammatory agents, and to suppress the immune response. Called also adrenocortical hormone and corticoid. [EU] Cortisol: A steroid hormone secreted by the adrenal cortex as part of the body's response to stress. [NIH] Cost Savings: Reductions in all or any portion of the costs of providing goods or services. Savings may be incurred by the provider or the consumer. [NIH] Creatinine: A compound that is excreted from the body in urine. Creatinine levels are measured to monitor kidney function. [NIH] Creatinine clearance: A test that measures how efficiently the kidneys remove creatinine and other wastes from the blood. Low creatinine clearance indicates impaired kidney function. [NIH] Curative: Tending to overcome disease and promote recovery. [EU] Cutaneous: Having to do with the skin. [NIH]

Dictionary 179

Cyclic: Pertaining to or occurring in a cycle or cycles; the term is applied to chemical compounds that contain a ring of atoms in the nucleus. [EU] Cystathionine beta-Synthase: A multifunctional pyridoxal phosphate enzyme. In the second stage of cysteine biosynthesis it catalyzes the reaction of homocysteine with serine to form cystathionine with the elimination of water. Deficiency of this enzyme leads to hyperhomocysteinemia and homocystinuria. EC 4.2.1.22. [NIH] Cytogenetics: A branch of genetics which deals with the cytological and molecular behavior of genes and chromosomes during cell division. [NIH] Cytokine: Small but highly potent protein that modulates the activity of many cell types, including T and B cells. [NIH] Cytomegalovirus: A genus of the family Herpesviridae, subfamily Betaherpesvirinae, infecting the salivary glands, liver, spleen, lungs, eyes, and other organs, in which they produce characteristically enlarged cells with intranuclear inclusions. Infection with Cytomegalovirus is also seen as an opportunistic infection in AIDS. [NIH] Cytomegalovirus Retinitis: Infection of the retina by cytomegalovirus characterized by retinal necrosis, hemorrhage, vessel sheathing, and retinal edema. Cytomegalovirus retinitis is a major opportunistic infection in AIDS patients and can cause blindness. [NIH] Cytotoxic: Cell-killing. [NIH] Dairy Products: Raw and processed or manufactured milk and milk-derived products. These are usually from cows (bovine) but are also from goats, sheep, reindeer, and water buffalo. [NIH] Data Collection: Systematic gathering of data for a particular purpose from various sources, including questionnaires, interviews, observation, existing records, and electronic devices. The process is usually preliminary to statistical analysis of the data. [NIH] De novo: In cancer, the first occurrence of cancer in the body. [NIH] Deamination: The removal of an amino group (NH2) from a chemical compound. [NIH] Death Certificates: Official records of individual deaths including the cause of death certified by a physician, and any other required identifying information. [NIH] Decision Making: The process of making a selective intellectual judgment when presented with several complex alternatives consisting of several variables, and usually defining a course of action or an idea. [NIH] Degenerative: Undergoing degeneration : tending to degenerate; having the character of or involving degeneration; causing or tending to cause degeneration. [EU] Density: The logarithm to the base 10 of the opacity of an exposed and processed film. [NIH] Deprivation: Loss or absence of parts, organs, powers, or things that are needed. [EU] Dermatosis: Any skin disease, especially one not characterized by inflammation. [EU] Developing Countries: Countries in the process of change directed toward economic growth, that is, an increase in production, per capita consumption, and income. The process of economic growth involves better utilization of natural and human resources, which results in a change in the social, political, and economic structures. [NIH] Diabetes Mellitus: A heterogeneous group of disorders that share glucose intolerance in common. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Dialysate: A cleansing liquid used in the two major forms of dialysis--hemodialysis and peritoneal dialysis. [NIH]

180


Dialysis Solutions: Solutions prepared for exchange across a semipermeable membrane of solutes below a molecular size determined by the cutoff threshold of the membrane material. [NIH] Dialyzer: A part of the hemodialysis machine. (See hemodialysis under dialysis.) The dialyzer has two sections separated by a membrane. One section holds dialysate. The other holds the patient's blood. [NIH] Diastole: Period of relaxation of the heart, especially the ventricles. [NIH] Diastolic: Of or pertaining to the diastole. [EU] Diencephalon: The paired caudal parts of the prosencephalon from which the thalamus, hypothalamus, epithalamus, and subthalamus are derived. [NIH] Dietetics: The study and regulation of the diet. [NIH] Dietitian: An expert in nutrition who helps people plan what and how much food to eat. [NIH]

Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Digestive system: The organs that take in food and turn it into products that the body can use to stay healthy. Waste products the body cannot use leave the body through bowel movements. The digestive system includes the salivary glands, mouth, esophagus, stomach, liver, pancreas, gallbladder, small and large intestines, and rectum. [NIH] Digestive tract: The organs through which food passes when food is eaten. These organs are the mouth, esophagus, stomach, small and large intestines, and rectum. [NIH] Dihydrotestosterone: Anabolic agent. [NIH] Dilatation: The act of dilating. [NIH] Dilate: Relax; expand. [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] Diltiazem: A benzothiazepine derivative with vasodilating action due to its antagonism of the actions of the calcium ion in membrane functions. It is also teratogenic. [NIH] Dipyridamole: A drug that prevents blood cell clumping and enhances the effectiveness of fluorouracil and other chemotherapeutic agents. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Discrimination: The act of qualitative and/or quantitative differentiation between two or more stimuli. [NIH] Disease Progression: The worsening of a disease over time. This concept is most often used for chronic and incurable diseases where the stage of the disease is an important determinant of therapy and prognosis. [NIH] Dissociation: 1. The act of separating or state of being separated. 2. The separation of a molecule into two or more fragments (atoms, molecules, ions, or free radicals) produced by the absorption of light or thermal energy or by solvation. 3. In psychology, a defense mechanism in which a group of mental processes are segregated from the rest of a person's mental activity in order to avoid emotional distress, as in the dissociative disorders (q.v.), or in which an idea or object is segregated from its emotional significance; in the first sense it is roughly equivalent to splitting, in the second, to isolation. 4. A defect of mental integration in which one or more groups of mental processes become separated off from normal consciousness and, thus separated, function as a unitary whole. [EU]

Dictionary 181

Dissociative Disorders: Sudden temporary alterations in the normally integrative functions of consciousness. [NIH] Distal: Remote; farther from any point of reference; opposed to proximal. In dentistry, used to designate a position on the dental arch farther from the median line of the jaw. [EU] Distention: The state of being distended or enlarged; the act of distending. [EU] Dobutamine: A beta-2 agonist catecholamine that has cardiac stimulant action without evoking vasoconstriction or tachycardia. It is proposed as a cardiotonic after myocardial infarction or open heart surgery. [NIH] Dopamine: An endogenous catecholamine and prominent neurotransmitter in several systems of the brain. In the synthesis of catecholamines from tyrosine, it is the immediate precursor to norepinephrine and epinephrine. Dopamine is a major transmitter in the extrapyramidal system of the brain, and important in regulating movement. A family of dopaminergic receptor subtypes mediate its action. Dopamine is used pharmacologically for its direct (beta adrenergic agonist) and indirect (adrenergic releasing) sympathomimetic effects including its actions as an inotropic agent and as a renal vasodilator. [NIH] Dorsal: 1. Pertaining to the back or to any dorsum. 2. Denoting a position more toward the back surface than some other object of reference; same as posterior in human anatomy; superior in the anatomy of quadrupeds. [EU] Double-blind: Pertaining to a clinical trial or other experiment in which neither the subject nor the person administering treatment knows which treatment any particular subject is receiving. [EU] Double-blinded: A clinical trial in which neither the medical staff nor the person knows which of several possible therapies the person is receiving. [NIH] Dreams: A series of thoughts, images, or emotions occurring during sleep which are dissociated from the usual stream of consciousness of the waking state. [NIH] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Drug Monitoring: The process of observing, recording, or detecting the effects of a chemical substance administered to an individual therapeutically or diagnostically. [NIH] Drug Tolerance: Progressive diminution of the susceptibility of a human or animal to the effects of a drug, resulting from its continued administration. It should be differentiated from drug resistance wherein an organism, disease, or tissue fails to respond to the intended effectiveness of a chemical or drug. It should also be differentiated from maximum tolerated dose and no-observed-adverse-effect level. [NIH] Duct: A tube through which body fluids pass. [NIH] Dyslipidemia: Disorders in the lipoprotein metabolism; classified as hypercholesterolemia, hypertriglyceridemia, combined hyperlipidemia, and low levels of high-density lipoprotein (HDL) cholesterol. All of the dyslipidemias can be primary or secondary. Both elevated levels of low-density lipoprotein (LDL) cholesterol and low levels of HDL cholesterol predispose to premature atherosclerosis. [NIH] Dyspnoea: Difficult or laboured breathing. [EU] Echocardiography: Ultrasonic recording of the size, motion, and composition of the heart and surrounding tissues. The standard approach is transthoracic. [NIH] Eclampsia: Onset of convulsions or coma in a previously diagnosed pre-eclamptic patient. [NIH]

Edema: Excessive amount of watery fluid accumulated in the intercellular spaces, most

182


commonly present in subcutaneous tissue. [NIH] Efferent: Nerve fibers which conduct impulses from the central nervous system to muscles and glands. [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] Elasticity: Resistance and recovery from distortion of shape. [NIH] Elastin: The protein that gives flexibility to tissues. [NIH] Electrocoagulation: Electrosurgical procedures used to treat hemorrhage (e.g., bleeding ulcers) and to ablate tumors, mucosal lesions, and refractory arrhythmias. [NIH] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Emboli: Bit of foreign matter which enters the blood stream at one point and is carried until it is lodged or impacted in an artery and obstructs it. It may be a blood clot, an air bubble, fat or other tissue, or clumps of bacteria. [NIH] Embryo: The prenatal stage of mammalian development characterized by rapid morphological changes and the differentiation of basic structures. [NIH] Empirical: A treatment based on an assumed diagnosis, prior to receiving confirmatory laboratory test results. [NIH] Endarterectomy: Surgical excision, performed under general anesthesia, of the atheromatous tunica intima of an artery. When reconstruction of an artery is performed as an endovascular procedure through a catheter, it is called atherectomy. [NIH] Endocarditis: Exudative and proliferative inflammatory alterations of the endocardium, characterized by the presence of vegetations on the surface of the endocardium or in the endocardium itself, and most commonly involving a heart valve, but sometimes affecting the inner lining of the cardiac chambers or the endocardium elsewhere. It may occur as a primary disorder or as a complication of or in association with another disease. [EU] Endocardium: The innermost layer of the heart, comprised of endothelial cells. [NIH] Endogenous: Produced inside an organism or cell. The opposite is external (exogenous) production. [NIH] Endothelium: A layer of epithelium that lines the heart, blood vessels (endothelium, vascular), lymph vessels (endothelium, lymphatic), and the serous cavities of the body. [NIH] Endothelium-derived: Small molecule that diffuses to the adjacent muscle layer and relaxes it. [NIH] Endotoxic: Of, relating to, or acting as an endotoxin (= a heat-stable toxin, associated with the outer membranes of certain gram-negative bacteria. Endotoxins are not secreted and are released only when the cells are disrupted). [EU] End-stage renal: Total chronic kidney failure. When the kidneys fail, the body retains fluid and harmful wastes build up. A person with ESRD needs treatment to replace the work of the failed kidneys. [NIH] Energy balance: Energy is the capacity of a body or a physical system for doing work. Energy balance is the state in which the total energy intake equals total energy needs. [NIH] Enteral Nutrition: Nutritional support given via the alimentary canal or any route connected to the gastrointestinal system (i.e., the enteral route). This includes oral feeding, sip feeding, and tube feeding using nasogastric, gastrostomy, and jejunostomy tubes. [NIH]

Dictionary 183

Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]

Enzymatic: Phase where enzyme cuts the precursor protein. [NIH] Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Enzyme Inhibitors: Compounds or agents that combine with an enzyme in such a manner as to prevent the normal substrate-enzyme combination and the catalytic reaction. [NIH] Epidemic: Occurring suddenly in numbers clearly in excess of normal expectancy; said especially of infectious diseases but applied also to any disease, injury, or other healthrelated event occurring in such outbreaks. [EU] Epidemiological: Relating to, or involving epidemiology. [EU] Epidermal: Pertaining to or resembling epidermis. Called also epidermic or epidermoid. [EU] Epigastric: Having to do with the upper middle area of the abdomen. [NIH] Epithelial: Refers to the cells that line the internal and external surfaces of the body. [NIH] Epithelial Cells: Cells that line the inner and outer surfaces of the body. [NIH] Epitopes: Sites on an antigen that interact with specific antibodies. [NIH] Epoetin alfa: A colony-stimulating factor that is made in the laboratory. It increases the production of red blood cells. [NIH] Ergometer: An instrument for measuring the force of muscular contraction. [NIH] Erythroblasts: Immature, nucleated erythrocytes occupying the stage of erythropoiesis that follows formation of erythroid progenitor cells and precedes formation of reticulocytes. Popularly called normoblasts. [NIH] Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH] Erythroid Progenitor Cells: Committed, erythroid stem cells derived from myeloid stem cells. The progenitor cells develop in two phases: erythroid burst-forming units (BFU-E) followed by erythroid colony-forming units (CFU-E). BFU-E differentiate into CFU-E on stimulation by erythropoietin, and then further differentiate into erythroblasts when stimulated by other factors. [NIH] Erythropoiesis: The production of erythrocytes. [EU] Erythropoietin: Glycoprotein hormone, secreted chiefly by the kidney in the adult and the liver in the fetus, that acts on erythroid stem cells of the bone marrow to stimulate proliferation and differentiation. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]

Eukaryotic Cells: Cells of the higher organisms, containing a true nucleus bounded by a nuclear membrane. [NIH] Excrete: To get rid of waste from the body. [NIH] Exercise Test: Controlled physical activity, more strenuous than at rest, which is performed in order to allow assessment of physiological functions, particularly cardiovascular and pulmonary, but also aerobic capacity. Maximal (most intense) exercise is usually required but submaximal exercise is also used. The intensity of exercise is often graded, using criteria such as rate of work done, oxygen consumption, and heart rate. Physiological data obtained from an exercise test may be used for diagnosis, prognosis, and evaluation of disease severity, and to evaluate therapy. Data may also be used in prescribing exercise by

184


determining a person's exercise capacity. [NIH] Exercise Tolerance: The exercise capacity of an individual as measured by endurance (maximal exercise duration and/or maximal attained work load) during an exercise test. [NIH]

Exocrine: Secreting outwardly, via a duct. [EU] Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] Extracellular: Outside a cell or cells. [EU] Extracellular Matrix: A meshwork-like substance found within the extracellular space and in association with the basement membrane of the cell surface. It promotes cellular proliferation and provides a supporting structure to which cells or cell lysates in culture dishes adhere. [NIH] Extracellular Space: Interstitial space between cells, occupied by fluid as well as amorphous and fibrous substances. [NIH] Extremity: A limb; an arm or leg (membrum); sometimes applied specifically to a hand or foot. [EU] Family Characteristics: Size and composition of the family. [NIH] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Family Relations: Behavioral, psychological, and social relations among various members of the nuclear family and the extended family. [NIH] Fat: Total lipids including phospholipids. [NIH] 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]

Fatty acids: A major component of fats that are used by the body for energy and tissue development. [NIH] Feces: The excrement discharged from the intestines, consisting of bacteria, cells exfoliated from the intestines, secretions, chiefly of the liver, and a small amount of food residue. [EU] Femoral: Pertaining to the femur, or to the thigh. [EU] Femoral Neck Fractures: Fractures of the short, constricted portion of the thigh bone between the femur head and the trochanters. It excludes intertrochanteric fractures which are hip fractures. [NIH] Femur: The longest and largest bone of the skeleton, it is situated between the hip and the knee. [NIH] Fenfluramine: A centrally active drug that apparently both blocks serotonin uptake and provokes transport-mediated serotonin release. [NIH] Ferritin: An iron-containing protein complex that is formed by a combination of ferric iron with the protein apoferritin. [NIH] Fetal Hemoglobin: The major component of hemoglobin in the fetus. This hemoglobin has two alpha and two gamma polypeptide subunits in comparison to normal adult hemoglobin, which has two alpha and two beta polypeptide subunits. Fetal hemoglobin concentrations can be elevated (usually above 0.5%) in children and adults affected by leukemia and several types of anemia. [NIH] Fetus: The developing offspring from 7 to 8 weeks after conception until birth. [NIH] Fibrin: A protein derived from fibrinogen in the presence of thrombin, which forms part of

Dictionary 185

the blood clot. [NIH] Fibrinogen: Plasma glycoprotein clotted by thrombin, composed of a dimer of three nonidentical pairs of polypeptide chains (alpha, beta, gamma) held together by disulfide bonds. Fibrinogen clotting is a sol-gel change involving complex molecular arrangements: whereas fibrinogen is cleaved by thrombin to form polypeptides A and B, the proteolytic action of other enzymes yields different fibrinogen degradation products. [NIH] Fibrinolytic: Pertaining to, characterized by, or causing the dissolution of fibrin by enzymatic action [EU] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH] Fluorouracil: A pyrimidine analog that acts as an antineoplastic antimetabolite and also has immunosuppressant. It interferes with DNA synthesis by blocking the thymidylate synthetase conversion of deoxyuridylic acid to thymidylic acid. [NIH] Folate: A B-complex vitamin that is being studied as a cancer prevention agent. Also called folic acid. [NIH] Fold: A plication or doubling of various parts of the body. [NIH] Folic Acid: N-(4-(((2-Amino-1,4-dihydro-4-oxo-6-pteridinyl)methyl)amino)benzoyl)-Lglutamic acid. A member of the vitamin B family that stimulates the hematopoietic system. It is present in the liver and kidney and is found in mushrooms, spinach, yeast, green leaves, and grasses. Folic acid is used in the treatment and prevention of folate deficiencies and megaloblastic anemia. [NIH] Follicles: Shafts through which hair grows. [NIH] Food Preferences: The selection of one food over another. [NIH] Foramen: A natural hole of perforation, especially one in a bone. [NIH] Forearm: The part between the elbow and the wrist. [NIH] Free Radicals: Highly reactive molecules with an unsatisfied electron valence pair. Free radicals are produced in both normal and pathological processes. They are proven or suspected agents of tissue damage in a wide variety of circumstances including radiation, damage from environment chemicals, and aging. Natural and pharmacological prevention of free radical damage is being actively investigated. [NIH] Gadolinium: An element of the rare earth family of metals. It has the atomic symbol Gd, atomic number 64, and atomic weight 157.25. Its oxide is used in the control rods of some nuclear reactors. [NIH] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] Gamma Rays: Very powerful and penetrating, high-energy electromagnetic radiation of shorter wavelength than that of x-rays. They are emitted by a decaying nucleus, usually between 0.01 and 10 MeV. They are also called nuclear x-rays. [NIH] Gangrene: Death and putrefaction of tissue usually due to a loss of blood supply. [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] Gastrin: A hormone released after eating. Gastrin causes the stomach to produce more acid. [NIH]

Gastrointestinal: Refers to the stomach and intestines. [NIH]

186


Gastrostomy: Creation of an artificial external opening into the stomach for nutritional support or gastrointestinal compression. [NIH] Gelatin: A product formed from skin, white connective tissue, or bone collagen. It is used as a protein food adjuvant, plasma substitute, hemostatic, suspending agent in pharmaceutical preparations, and in the manufacturing of capsules and suppositories. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]

Gene Expression: The phenotypic manifestation of a gene or genes by the processes of gene action. [NIH] Gene Therapy: The introduction of new genes into cells for the purpose of treating disease by restoring or adding gene expression. Techniques include insertion of retroviral vectors, transfection, homologous recombination, and injection of new genes into the nuclei of single cell embryos. The entire gene therapy process may consist of multiple steps. The new genes may be introduced into proliferating cells in vivo (e.g., bone marrow) or in vitro (e.g., fibroblast cultures) and the modified cells transferred to the site where the gene expression is required. Gene therapy may be particularly useful for treating enzyme deficiency diseases, hemoglobinopathies, and leukemias and may also prove useful in restoring drug sensitivity, particularly for leukemia. [NIH] Genital: Pertaining to the genitalia. [EU] Germ Cells: The reproductive cells in multicellular organisms. [NIH] Gland: An organ that produces and releases one or more substances for use in the body. Some glands produce fluids that affect tissues or organs. Others produce hormones or participate in blood production. [NIH] Glomerular: Pertaining to or of the nature of a glomerulus, especially a renal glomerulus. [EU]

Glomerular Filtration Rate: The volume of water filtered out of plasma through glomerular capillary walls into Bowman's capsules per unit of time. It is considered to be equivalent to inulin clearance. [NIH] Glomeruli: Plural of glomerulus. [NIH] Glomerulonephritis: Glomerular disease characterized by an inflammatory reaction, with leukocyte infiltration and cellular proliferation of the glomeruli, or that appears to be the result of immune glomerular injury. [NIH] Glomerulosclerosis: Scarring of the glomeruli. It may result from diabetes mellitus (diabetic glomerulosclerosis) or from deposits in parts of the glomerulus (focal segmental glomerulosclerosis). The most common signs of glomerulosclerosis are proteinuria and kidney failure. [NIH] Glomerulus: A tiny set of looping blood vessels in the nephron where blood is filtered in the kidney. [NIH] Glucose: D-Glucose. A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. [NIH] Glucose Intolerance: A pathological state in which the fasting plasma glucose level is less than 140 mg per deciliter and the 30-, 60-, or 90-minute plasma glucose concentration following a glucose tolerance test exceeds 200 mg per deciliter. This condition is seen frequently in diabetes mellitus but also occurs with other diseases. [NIH] Glucuronic Acid: Derivatives of uronic acid found throughout the plant and animal

Dictionary 187

kingdoms. They detoxify drugs and toxins by conjugating with them to form glucuronides in the liver which are more water-soluble metabolites that can be easily eliminated from the body. [NIH] Glutamic Acid: A non-essential amino acid naturally occurring in the L-form. Glutamic acid (glutamate) is the most common excitatory neurotransmitter in the central nervous system. [NIH]

Glyceraldehyde 3-Phosphate: An aldotriose which is an important intermediate in glycolysis and in tryptophan biosynthesis. [NIH] Glycine: A non-essential amino acid. It is found primarily in gelatin and silk fibroin and used therapeutically as a nutrient. It is also a fast inhibitory neurotransmitter. [NIH] Glycolysis: The pathway by which glucose is catabolized into two molecules of pyruvic acid with the generation of ATP. [NIH] Glycoprotein: A protein that has sugar molecules attached to it. [NIH] Gonadal: Pertaining to a gonad. [EU] Gonads: The gamete-producing glands, ovary or testis. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Grade: The grade of a tumor depends on how abnormal the cancer cells look under a microscope and how quickly the tumor is likely to grow and spread. Grading systems are different for each type of cancer. [NIH] Graft: Healthy skin, bone, or other tissue taken from one part of the body and used to replace diseased or injured tissue removed from another part of the body. [NIH] Graft Rejection: An immune response with both cellular and humoral components, directed against an allogeneic transplant, whose tissue antigens are not compatible with those of the recipient. [NIH] Graft Survival: The survival of a graft in a host, the factors responsible for the survival and the changes occurring within the graft during growth in the host. [NIH] Grafting: The operation of transfer of tissue from one site to another. [NIH] Graft-versus-host disease: GVHD. A reaction of donated bone marrow or peripheral stem cells against a person's tissue. [NIH] Gram-negative: Losing the stain or decolorized by alcohol in Gram's method of staining, a primary characteristic of bacteria having a cell wall composed of a thin layer of peptidoglycan covered by an outer membrane of lipoprotein and lipopolysaccharide. [EU] Grasses: A large family, Gramineae, of narrow-leaved herbaceous monocots. Many grasses produce highly allergenic pollens and are hosts to cattle parasites and toxic fungi. [NIH] Growth: The progressive development of a living being or part of an organism from its earliest stage to maturity. [NIH] Guanylate Cyclase: An enzyme that catalyzes the conversion of GTP to 3',5'-cyclic GMP and pyrophosphate. It also acts on ITP and dGTP. (From Enzyme Nomenclature, 1992) EC 4.6.1.2. [NIH] Haemodialysis: The removal of certain elements from the blood by virtue of the difference in the rates of their diffusion through a semipermeable membrane, e.g., by means of a haemodialyzer. [EU] Hair follicles: Shafts or openings on the surface of the skin through which hair grows. [NIH] Haplotypes: The genetic constitution of individuals with respect to one member of a pair of

188


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] Haptens: Small antigenic determinants capable of eliciting an immune response only when coupled to a carrier. Haptens bind to antibodies but by themselves cannot elicit an antibody response. [NIH] Health Education: Education that increases the awareness and favorably influences the attitudes and knowledge relating to the improvement of health on a personal or community basis. [NIH] Health Fairs: Community health education events focused on prevention of disease and promotion of health through audiovisual exhibits. [NIH] Heart attack: A seizure of weak or abnormal functioning of the heart. [NIH] Heart failure: Loss of pumping ability by the heart, often accompanied by fatigue, breathlessness, and excess fluid accumulation in body tissues. [NIH] Hematocrit: Measurement of the volume of packed red cells in a blood specimen by centrifugation. The procedure is performed using a tube with graduated markings or with automated blood cell counters. It is used as an indicator of erythrocyte status in disease. For example, anemia shows a low hematocrit, polycythemia, high values. [NIH] Hematopoietic tissue: Tissue in which new blood cells are formed. [NIH] Hemodialysis: The use of a machine to clean wastes from the blood after the kidneys have failed. The blood travels through tubes to a dialyzer, which removes wastes and extra fluid. The cleaned blood then flows through another set of tubes back into the body. [NIH] Hemodialysis Solutions: Solutions prepared for hemodialysis. The composition of the predialysis solution may be varied in order to determine the effect of solvated metabolites on anoxia, malnutrition, acid-base balance, etc. Of principal interest are the effect of the choice of buffers (e.g., acetate or carbonate), the addition of cations (Na+, K+, Ca2+), and addition of carbohydrates (glucose). [NIH] Hemodialyzer: Apparatus for hemodialysis performing the functions of human kidneys in place of the damaged organs; highly specialized medical equipment used for treating kidney failure by passing the body's toxic substances through an external artificial kidney. [NIH] Hemofiltration: Extracorporeal ultrafiltration technique without hemodialysis for treatment of fluid overload and electrolyte disturbances affecting renal, cardiac, or pulmonary function. [NIH] Hemoglobin: One of the fractions of glycosylated hemoglobin A1c. Glycosylated hemoglobin is formed when linkages of glucose and related monosaccharides bind to hemoglobin A and its concentration represents the average blood glucose level over the previous several weeks. HbA1c levels are used as a measure of long-term control of plasma glucose (normal, 4 to 6 percent). In controlled diabetes mellitus, the concentration of glycosylated hemoglobin A is within the normal range, but in uncontrolled cases the level may be 3 to 4 times the normal conentration. Generally, complications are substantially lower among patients with Hb levels of 7 percent or less than in patients with HbA1c levels of 9 percent or more. [NIH] Hemoglobin H: An abnormal hemoglobin composed of four beta chains. It is caused by the reduced synthesis of the alpha chain. This abnormality results in alpha-thalassemia. [NIH] Hemoglobinopathies: A group of inherited disorders characterized by structural alterations within the hemoglobin molecule. [NIH] Hemorheology: The study of the flow of blood in relation to the pressures, flow, volumes, and resistances in blood vessels in macroscopic, microscopic, and submicroscopic

Dictionary 189

dimensions. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Heparin: Heparinic acid. A highly acidic mucopolysaccharide formed of equal parts of sulfated D-glucosamine and D-glucuronic acid with sulfaminic bridges. The molecular weight ranges from six to twenty thousand. Heparin occurs in and is obtained from liver, lung, mast cells, etc., of vertebrates. Its function is unknown, but it is used to prevent blood clotting in vivo and vitro, in the form of many different salts. [NIH] Hepatic: Refers to the liver. [NIH] Hepatitis: Inflammation of the liver and liver disease involving degenerative or necrotic alterations of hepatocytes. [NIH] Hepatocyte: A liver cell. [NIH] Hepatocyte Growth Factor: Multifunctional growth factor which regulates both cell growth and cell motility. It exerts a strong mitogenic effect on hepatocytes and primary epithelial cells. Its receptor is proto-oncogene protein C-met. [NIH] Hereditary: Of, relating to, or denoting factors that can be transmitted genetically from one generation to another. [NIH] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Heterogeneity: The property of one or more samples or populations which implies that they are not identical in respect of some or all of their parameters, e. g. heterogeneity of variance. [NIH]

Hip Fractures: Fractures of the femur head, the femur neck, the trochanters, or the inter- or subtrochanteric region. Excludes fractures of the acetabulum and fractures of the femoral shaft below the subtrochanteric region. For the fractures of the femur neck the specific term femoral neck fractures is available. [NIH] Histology: The study of tissues and cells under a microscope. [NIH] Holidays: Days commemorating events. Holidays also include vacation periods. [NIH] Homeostasis: The processes whereby the internal environment of an organism tends to remain balanced and stable. [NIH] Homogeneous: Consisting of or composed of similar elements or ingredients; of a uniform quality throughout. [EU] Homologous: Corresponding in structure, position, origin, etc., as (a) the feathers of a bird and the scales of a fish, (b) antigen and its specific antibody, (c) allelic chromosomes. [EU] Hormonal: Pertaining to or of the nature of a hormone. [EU] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] Host: Any animal that receives a transplanted graft. [NIH] Human growth hormone: A protein hormone, secreted by the anterior lobe of the pituitary, which promotes growth of the whole body by stimulating protein synthesis. The human gene has already been cloned and successfully expressed in bacteria. [NIH] Humoral: Of, relating to, proceeding from, or involving a bodily humour - now often used of endocrine factors as opposed to neural or somatic. [EU] Hydration: Combining with water. [NIH] Hydrogen: The first chemical element in the periodic table. It has the atomic symbol H,

190


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] Hydrophilic: Readily absorbing moisture; hygroscopic; having strongly polar groups that readily interact with water. [EU] Hydrophobic: Not readily absorbing water, or being adversely affected by water, as a hydrophobic colloid. [EU] Hydroxylation: Hydroxylate, to introduce hydroxyl into (a compound or radical) usually by replacement of hydrogen. [EU] Hydroxyproline: A hydroxylated form of the imino acid proline. A deficiency in ascorbic acid can result in impaired hydroxyproline formation. [NIH] Hypercalcemia: Abnormally high level of calcium in the blood. [NIH] Hypercholesterolemia: Abnormally high levels of cholesterol in the blood. [NIH] Hyperglycemia: Abnormally high blood sugar. [NIH] Hyperhomocysteinemia: An inborn error of methionone metabolism which produces an excess of homocysteine in the blood. It is often caused by a deficiency of cystathionine betasynthase and is a risk factor for coronary vascular disease. [NIH] Hyperlipidemia: An excess of lipids in the blood. [NIH] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Hypertriglyceridemia: Condition of elevated triglyceride concentration in the blood; an inherited form occurs in familial hyperlipoproteinemia IIb and hyperlipoproteinemia type IV. It has been linked to higher risk of heart disease and arteriosclerosis. [NIH] Hypertrophy: General increase in bulk of a part or organ, not due to tumor formation, nor to an increase in the number of cells. [NIH] Hypoglycemia: Abnormally low blood sugar [NIH] Hypogonadism: Condition resulting from or characterized by abnormally decreased functional activity of the gonads, with retardation of growth and sexual development. [NIH] Hypotension: Abnormally low blood pressure. [NIH] Hypothalamic: Of or involving the hypothalamus. [EU] Hypothalamus: Ventral part of the diencephalon extending from the region of the optic chiasm to the caudal border of the mammillary bodies and forming the inferior and lateral walls of the third ventricle. [NIH] Hypovolemia: An abnormally low volume of blood circulating through the body. It may result in hypovolemic shock. [NIH] Hypoxemia: Deficient oxygenation of the blood; hypoxia. [EU] Hypoxia: Reduction of oxygen supply to tissue below physiological levels despite adequate perfusion of the tissue by blood. [EU] Id: The part of the personality structure which harbors the unconscious instinctive desires and strivings of the individual. [NIH] Immune response: The activity of the immune system against foreign substances (antigens). [NIH]

Immune system: The organs, cells, and molecules responsible for the recognition and

Dictionary 191

disposal of foreign ("non-self") material which enters the body. [NIH] Immunization: Deliberate stimulation of the host's immune response. Active immunization involves administration of antigens or immunologic adjuvants. Passive immunization involves administration of immune sera or lymphocytes or their extracts (e.g., transfer factor, immune RNA) or transplantation of immunocompetent cell producing tissue (thymus or bone marrow). [NIH] Immunodeficiency: The decreased ability of the body to fight infection and disease. [NIH] Immunofluorescence: A technique for identifying molecules present on the surfaces of cells or in tissues using a highly fluorescent substance coupled to a specific antibody. [NIH] Immunogenic: Producing immunity; evoking an immune response. [EU] Immunoglobulin: A protein that acts as an antibody. [NIH] Immunologic: The ability of the antibody-forming system to recall a previous experience with an antigen and to respond to a second exposure with the prompt production of large amounts of antibody. [NIH] Immunology: The study of the body's immune system. [NIH] Immunophilin: A drug for the treatment of Parkinson's disease. [NIH] Immunosuppressant: An agent capable of suppressing immune responses. [EU] Immunosuppressive: Describes the ability to lower immune system responses. [NIH] Impairment: In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function. [NIH] In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Indicative: That indicates; that points out more or less exactly; that reveals fairly clearly. [EU] Induction: The act or process of inducing or causing to occur, especially the production of a specific morphogenetic effect in the developing embryo through the influence of evocators or organizers, or the production of anaesthesia or unconsciousness by use of appropriate agents. [EU] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]

Infection Control: Programs of disease surveillance, generally within health care facilities, designed to investigate, prevent, and control the spread of infections and their causative microorganisms. [NIH] Infiltration: The diffusion or accumulation in a tissue or cells of substances not normal to it or in amounts of the normal. Also, the material so accumulated. [EU] Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical

192


signs of pain, heat, redness, swelling, and loss of function. [NIH] Infusion: A method of putting fluids, including drugs, into the bloodstream. Also called intravenous infusion. [NIH] Ingestion: Taking into the body by mouth [NIH] Initiation: Mutation induced by a chemical reactive substance causing cell changes; being a step in a carcinogenic process. [NIH] Inner ear: The labyrinth, comprising the vestibule, cochlea, and semicircular canals. [NIH] Inorganic: Pertaining to substances not of organic origin. [EU] Insight: The capacity to understand one's own motives, to be aware of one's own psychodynamics, to appreciate the meaning of symbolic behavior. [NIH] Insulin: A protein hormone secreted by beta cells of the pancreas. Insulin plays a major role in the regulation of glucose metabolism, generally promoting the cellular utilization of glucose. It is also an important regulator of protein and lipid metabolism. Insulin is used as a drug to control insulin-dependent diabetes mellitus. [NIH] Insulin-dependent diabetes mellitus: A disease characterized by high levels of blood glucose resulting from defects in insulin secretion, insulin action, or both. Autoimmune, genetic, and environmental factors are involved in the development of type I diabetes. [NIH] Interferon: A biological response modifier (a substance that can improve the body's natural response to disease). Interferons interfere with the division of cancer cells and can slow tumor growth. There are several types of interferons, including interferon-alpha, -beta, and gamma. These substances are normally produced by the body. They are also made in the laboratory for use in treating cancer and other diseases. [NIH] Interferon-alpha: One of the type I interferons produced by peripheral blood leukocytes or lymphoblastoid cells when exposed to live or inactivated virus, double-stranded RNA, or bacterial products. It is the major interferon produced by virus-induced leukocyte cultures and, in addition to its pronounced antiviral activity, it causes activation of NK cells. [NIH] Intermittent: Occurring at separated intervals; having periods of cessation of activity. [EU] Internal Medicine: A medical specialty concerned with the diagnosis and treatment of diseases of the internal organ systems of adults. [NIH] Interstitial: Pertaining to or situated between parts or in the interspaces of a tissue. [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] Intramuscular: IM. Within or into muscle. [NIH] Intraperitoneal: IP. Within the peritoneal cavity (the area that contains the abdominal organs). [NIH] Intravenous: IV. Into a vein. [NIH] Intrinsic: Situated entirely within or pertaining exclusively to a part. [EU] Inulin: A starch found in the tubers and roots of many plants. Since it is hydrolyzable to fructose, it is classified as a fructosan. It has been used in physiologic investigation for determination of the rate of glomerular function. [NIH] Involuntary: Reaction occurring without intention or volition. [NIH]

Dictionary 193

Ionizing: Radiation comprising charged particles, e. g. electrons, protons, alpha-particles, etc., having sufficient kinetic energy to produce ionization by collision. [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] Isoflavones: 3-Phenylchromones. Isomeric form of flavones in which the benzene group is attached to the 3 position of the benzopyran ring instead of the 2 position. [NIH] Isotonic: A biological term denoting a solution in which body cells can be bathed without a net flow of water across the semipermeable cell membrane. Also, denoting a solution having the same tonicity as some other solution with which it is compared, such as physiologic salt solution and the blood serum. [EU] Jejunostomy: Surgical formation of an opening through the abdominal wall into the jejunum, usually for enteral hyperalimentation. [NIH] Joint: The point of contact between elements of an animal skeleton with the parts that surround and support it. [NIH] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Keto: It consists of 8 carbon atoms and within the endotoxins, it connects poysaccharide and lipid A. [NIH] Kidney Disease: Any one of several chronic conditions that are caused by damage to the cells of the kidney. People who have had diabetes for a long time may have kidney damage. Also called nephropathy. [NIH] Kidney Failure: The inability of a kidney to excrete metabolites at normal plasma levels under conditions of normal loading, or the inability to retain electrolytes under conditions of normal intake. In the acute form (kidney failure, acute), it is marked by uremia and usually by oliguria or anuria, with hyperkalemia and pulmonary edema. The chronic form (kidney failure, chronic) is irreversible and requires hemodialysis. [NIH] Kidney Failure, Acute: A clinical syndrome characterized by a sudden decrease in glomerular filtration rate, often to values of less than 1 to 2 ml per minute. It is usually associated with oliguria (urine volumes of less than 400 ml per day) and is always associated with biochemical consequences of the reduction in glomerular filtration rate such as a rise in blood urea nitrogen (BUN) and serum creatinine concentrations. [NIH] Kidney Failure, Chronic: An irreversible and usually progressive reduction in renal function in which both kidneys have been damaged by a variety of diseases to the extent that they are unable to adequately remove the metabolic products from the blood and regulate the body's electrolyte composition and acid-base balance. Chronic kidney failure requires hemodialysis or surgery, usually kidney transplantation. [NIH] Kidney stone: A stone that develops from crystals that form in urine and build up on the inner surfaces of the kidney, in the renal pelvis, or in the ureters. [NIH] Kidney Transplantation: The transference of a kidney from one human or animal to another. [NIH] Kinetic: Pertaining to or producing motion. [EU] Lag: The time elapsing between application of a stimulus and the resulting reaction. [NIH] Lamivudine: A reverse transcriptase inhibitor and zalcitabine analog in which a sulfur atom

194


replaces the 3' carbon of the pentose ring. It is used to treat HIV disease. [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] Lens: The transparent, double convex (outward curve on both sides) structure suspended between the aqueous and vitreous; helps to focus light on the retina. [NIH] Leptin: A 16-kD peptide hormone secreted from white adipocytes and implicated in the regulation of food intake and energy balance. Leptin provides the key afferent signal from fat cells in the feedback system that controls body fat stores. [NIH] Leucine: An essential branched-chain amino acid important for hemoglobin formation. [NIH] Leukemia: Cancer of blood-forming tissue. [NIH] Leukocytes: White blood cells. These include granular leukocytes (basophils, eosinophils, and neutrophils) as well as non-granular leukocytes (lymphocytes and monocytes). [NIH] Library Services: Services offered to the library user. They include reference and circulation. [NIH]

Life cycle: The successive stages through which an organism passes from fertilized ovum or spore to the fertilized ovum or spore of the next generation. [NIH] Life Expectancy: A figure representing the number of years, based on known statistics, to which any person of a given age may reasonably expect to live. [NIH] Ligament: A band of fibrous tissue that connects bones or cartilages, serving to support and strengthen joints. [EU] 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] Lipid A: Lipid A is the biologically active component of lipopolysaccharides. It shows strong endotoxic activity and exhibits immunogenic properties. [NIH] Lipid Peroxidation: Peroxidase catalyzed oxidation of lipids using hydrogen peroxide as an electron acceptor. [NIH] Lipopolysaccharides: Substance consisting of polysaccaride and lipid. [NIH] Lipoprotein: Any of the lipid-protein complexes in which lipids are transported in the blood; lipoprotein particles consist of a spherical hydrophobic core of triglycerides or cholesterol esters surrounded by an amphipathic monolayer of phospholipids, cholesterol, and apolipoproteins; the four principal classes are high-density, low-density, and very-lowdensity lipoproteins and chylomicrons. [EU] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Living Donors: Non-cadaveric providers of organs for transplant to related or non-related recipients. [NIH] Lobe: A portion of an organ such as the liver, lung, breast, or brain. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Low-density lipoprotein: Lipoprotein that contains most of the cholesterol in the blood. LDL carries cholesterol to the tissues of the body, including the arteries. A high level of LDL increases the risk of heart disease. LDL typically contains 60 to 70 percent of the total serum

Dictionary 195

cholesterol and both are directly correlated with CHD risk. [NIH] Lung Transplantation: The transference of either one or both of the lungs from one human or animal to another. [NIH] Lupus: A form of cutaneous tuberculosis. It is seen predominantly in women and typically involves the nasal, buccal, and conjunctival mucosa. [NIH] Lupus Nephritis: Glomerulonephritis associated with systemic lupus erythematosus. It is classified into four histologic types: mesangial, focal, diffuse, and membranous. [NIH] Lymph: The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. [NIH] Lymph node: A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Also known as a lymph gland. Lymph nodes are spread out along lymphatic vessels and contain many lymphocytes, which filter the lymphatic fluid (lymph). [NIH]

Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. [NIH] Lymphocyte: A white blood cell. Lymphocytes have a number of roles in the immune system, including the production of antibodies and other substances that fight infection and diseases. [NIH] Lymphoid: Referring to lymphocytes, a type of white blood cell. Also refers to tissue in which lymphocytes develop. [NIH] Lytic: 1. Pertaining to lysis or to a lysin. 2. Producing lysis. [EU] Macrophage: A type of white blood cell that surrounds and kills microorganisms, removes dead cells, and stimulates the action of other immune system cells. [NIH] Maintenance therapy: Treatment that is given to help a primary (original) treatment keep working. Maintenance therapy is often given to help keep cancer in remission. [NIH] Major Histocompatibility Complex: The genetic region which contains the loci of genes which determine the structure of the serologically defined (SD) and lymphocyte-defined (LD) transplantation antigens, genes which control the structure of the immune responseassociated (Ia) antigens, the immune response (Ir) genes which control the ability of an animal to respond immunologically to antigenic stimuli, and genes which determine the structure and/or level of the first four components of complement. [NIH] Malaise: A vague feeling of bodily discomfort. [EU] Malignancy: A cancerous tumor that can invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malignant tumor: A tumor capable of metastasizing. [NIH] Malnutrition: A condition caused by not eating enough food or not eating a balanced diet. [NIH]

Mammary: Pertaining to the mamma, or breast. [EU] Mammogram: An x-ray of the breast. [NIH] Mandible: The largest and strongest bone of the face constituting the lower jaw. It supports the lower teeth. [NIH] Meat: The edible portions of any animal used for food including domestic mammals (the major ones being cattle, swine, and sheep) along with poultry, fish, shellfish, and game.

196


[NIH]

Medial: Lying near the midsaggital plane of the body; opposed to lateral. [NIH] Mediator: An object or substance by which something is mediated, such as (1) a structure of the nervous system that transmits impulses eliciting a specific response; (2) a chemical substance (transmitter substance) that induces activity in an excitable tissue, such as nerve or muscle; or (3) a substance released from cells as the result of the interaction of antigen with antibody or by the action of antigen with a sensitized lymphocyte. [EU] Medical Records: Recording of pertinent information concerning patient's illness or illnesses. [NIH] Medical Staff: Professional medical personnel who provide care to patients in an organized facility, institution or agency. [NIH] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Mefloquine: A phospholipid-interacting antimalarial drug (antimalarials). It is very effective against Plasmodium falciparum with very few side effects. [NIH] Megakaryocytes: Very large bone marrow cells which release mature blood platelets. [NIH] Megaloblastic: A large abnormal red blood cell appearing in the blood in pernicious anaemia. [EU] Melphalan: An alkylating nitrogen mustard that is used as an antineoplastic in the form of the levo isomer - melphalan, the racemic mixture - merphalan, and the dextro isomer medphalan; toxic to bone marrow, but little vesicant action; potential carcinogen. [NIH] Membrane: A 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] Menopause: Permanent cessation of menstruation. [NIH] Mental: Pertaining to the mind; psychic. 2. (L. mentum chin) pertaining to the chin. [EU] Mental Disorders: Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function. [NIH] Mental Health: The state wherein the person is well adjusted. [NIH] Mental Processes: Conceptual functions or thinking in all its forms. [NIH] Mesentery: A layer of the peritoneum which attaches the abdominal viscera to the abdominal wall and conveys their blood vessels and nerves. [NIH] Meta-Analysis: A quantitative method of combining the results of independent studies (usually drawn from the published literature) and synthesizing summaries and conclusions which may be used to evaluate therapeutic effectiveness, plan new studies, etc., with application chiefly in the areas of research and medicine. [NIH] Metabolite: Any substance produced by metabolism or by a metabolic process. [EU] Methylmalonic Acid: A malonic acid derivative which is a vital intermediate in the metabolism of fat and protein. Abnormalities in methylmalonic acid metabolism lead to methylmalonic aciduria. This metabolic disease is attributed to a block in the enzymatic conversion of methylmalonyl CoA to succinyl CoA. [NIH] MI: Myocardial infarction. Gross necrosis of the myocardium as a result of interruption of

Dictionary 197

the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Microbe: An organism which cannot be observed with the naked eye; e. g. unicellular animals, lower algae, lower fungi, bacteria. [NIH] Microcalcifications: Tiny deposits of calcium in the breast that cannot be felt but can be detected on a mammogram. A cluster of these very small specks of calcium may indicate that cancer is present. [NIH] Microdialysis: A technique for measuring extracellular concentrations of substances in tissues, usually in vivo, by means of a small probe equipped with a semipermeable membrane. Substances may also be introduced into the extracellular space through the membrane. [NIH] Microorganism: An organism that can be seen only through a microscope. Microorganisms include bacteria, protozoa, algae, and fungi. Although viruses are not considered living organisms, they are sometimes classified as microorganisms. [NIH] Microscopy: The application of microscope magnification to the study of materials that cannot be properly seen by the unaided eye. [NIH] Mineralization: The action of mineralizing; the state of being mineralized. [EU] Mitochondria: Parts of a cell where aerobic production (also known as cell respiration) takes place. [NIH] Mitral Valve: The valve between the left atrium and left ventricle of the heart. [NIH] Mixed Connective Tissue Disease: A syndrome with overlapping clinical features of systemic lupus erythematosus, scleroderma, polymyositis, and Raynaud's phenomenon. The disease is differentially characterized by high serum titers of antibodies to ribonucleasesensitive extractable (saline soluble) nuclear antigen and a "speckled" epidermal nuclear staining pattern on direct immunofluorescence. [NIH] Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] Monitor: An apparatus which automatically records such physiological signs as respiration, pulse, and blood pressure in an anesthetized patient or one undergoing surgical or other procedures. [NIH] Monoclonal: An antibody produced by culturing a single type of cell. It therefore consists of a single species of immunoglobulin molecules. [NIH] Monoclonal antibodies: Laboratory-produced substances that can locate and bind to cancer cells wherever they are in the body. Many monoclonal antibodies are used in cancer detection or therapy; each one recognizes a different protein on certain cancer cells. Monoclonal antibodies can be used alone, or they can be used to deliver drugs, toxins, or radioactive material directly to a tumor. [NIH] Motion Sickness: Sickness caused by motion, as sea sickness, train sickness, car sickness, and air sickness. [NIH] Mucosa: A mucous membrane, or tunica mucosa. [EU] Multicenter study: A clinical trial that is carried out at more than one medical institution.

198


[NIH]

Multiple Myeloma: A malignant tumor of plasma cells usually arising in the bone marrow; characterized by diffuse involvement of the skeletal system, hyperglobulinemia, Bence-Jones proteinuria, and anemia. [NIH] Muscle Fibers: Large single cells, either cylindrical or prismatic in shape, that form the basic unit of muscle tissue. They consist of a soft contractile substance enclosed in a tubular sheath. [NIH] Muscle tension: A force in a material tending to produce extension; the state of being stretched. [NIH] Mycophenolate mofetil: A drug that is being studied for its effectiveness in preventing graft-versus-host disease and autoimmune disorders. [NIH] Myocardial infarction: Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Myocardial Ischemia: A disorder of cardiac function caused by insufficient blood flow to the muscle tissue of the heart. The decreased blood flow may be due to narrowing of the coronary arteries (coronary arteriosclerosis), to obstruction by a thrombus (coronary thrombosis), or less commonly, to diffuse narrowing of arterioles and other small vessels within the heart. Severe interruption of the blood supply to the myocardial tissue may result in necrosis of cardiac muscle (myocardial infarction). [NIH] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Myosin: Chief protein in muscle and the main constituent of the thick filaments of muscle fibers. In conjunction with actin, it is responsible for the contraction and relaxation of muscles. [NIH] Nasogastric: The process of passing a small, flexible plastic tube through the nose or mouth into the stomach or small intestine. [NIH] Natriuresis: The excretion of abnormal amounts of sodium in the urine. [EU] Nausea: An unpleasant sensation in the stomach usually accompanied by the urge to vomit. Common causes are early pregnancy, sea and motion sickness, emotional stress, intense pain, food poisoning, and various enteroviruses. [NIH] NCI: National Cancer Institute. NCI, part of the National Institutes of Health of the United States Department of Health and Human Services, is the federal government's principal agency for cancer research. NCI conducts, coordinates, and funds cancer research, training, health information dissemination, and other programs with respect to the cause, diagnosis, prevention, and treatment of cancer. Access the NCI Web site at http://cancer.gov. [NIH] Nebramycin: A complex of antibiotic substances produced by Streptomyces tenebrarius. [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] Neoplasms: New abnormal growth of tissue. Malignant neoplasms show a greater degree of anaplasia and have the properties of invasion and metastasis, compared to benign neoplasms. [NIH] Nephrectomy: Surgery to remove a kidney. Radical nephrectomy removes the kidney, the adrenal gland, nearby lymph nodes, and other surrounding tissue. Simple nephrectomy removes only the kidney. Partial nephrectomy removes the tumor but not the entire kidney. [NIH]

Dictionary 199

Nephritis: Inflammation of the kidney; a focal or diffuse proliferative or destructive process which may involve the glomerulus, tubule, or interstitial renal tissue. [EU] Nephrolithiasis: Kidney stones. [NIH] Nephrologist: A doctor who treats patients with kidney problems or hypertension. [NIH] Nephrology: A subspecialty of internal medicine concerned with the anatomy, physiology, and pathology of the kidney. [NIH] Nephropathy: Disease of the kidneys. [EU] Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Netilmicin: Semisynthetic 1-N-ethyl derivative of sisomycin, an aminoglycoside antibiotic with action similar to gentamicin, but less ear and kidney toxicity. [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] Neurogenic: Loss of bladder control caused by damage to the nerves controlling the bladder. [NIH] Neuromuscular: Pertaining to muscles and nerves. [EU] Neurons: The basic cellular units of nervous tissue. Each neuron consists of a body, an axon, and dendrites. Their purpose is to receive, conduct, and transmit impulses in the nervous system. [NIH] Neuropathy: A problem in any part of the nervous system except the brain and spinal cord. Neuropathies can be caused by infection, toxic substances, or disease. [NIH] Neurotoxicity: The tendency of some treatments to cause damage to the nervous system. [NIH]

Neurotransmitter: Any of a group of substances that are released on excitation from the axon terminal of a presynaptic neuron of the central or peripheral nervous system and travel across the synaptic cleft to either excite or inhibit the target cell. Among the many substances that have the properties of a neurotransmitter are acetylcholine, norepinephrine, epinephrine, dopamine, glycine, y-aminobutyrate, glutamic acid, substance P, enkephalins, endorphins, and serotonin. [EU] Nitric Oxide: A free radical gas produced endogenously by a variety of mammalian cells. It is synthesized from arginine by a complex reaction, catalyzed by nitric oxide synthase. Nitric oxide is endothelium-derived relaxing factor. It is released by the vascular endothelium and mediates the relaxation induced by some vasodilators such as acetylcholine and bradykinin. It also inhibits platelet aggregation, induces disaggregation of aggregated platelets, and inhibits platelet adhesion to the vascular endothelium. Nitric oxide activates cytosolic guanylate cyclase and thus elevates intracellular levels of cyclic GMP. [NIH]

Nitrogen: An element with the atomic symbol N, atomic number 7, and atomic weight 14. Nitrogen exists as a diatomic gas and makes up about 78% of the earth's atmosphere by volume. It is a constituent of proteins and nucleic acids and found in all living cells. [NIH] Nosocomial: Pertaining to or originating in the hospital, said of an infection not present or incubating prior to admittance to the hospital, but generally occurring 72 hours after admittance; the term is usually used to refer to patient disease, but hospital personnel may also acquire nosocomial infection. [EU]

200


Nuclear: A test of the structure, blood flow, and function of the kidneys. The doctor injects a mildly radioactive solution into an arm vein and uses x-rays to monitor its progress through the kidneys. [NIH] Nuclear Family: A family composed of spouses and their children. [NIH] Nuclei: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nucleic acid: Either of two types of macromolecule (DNA or RNA) formed by polymerization of nucleotides. Nucleic acids are found in all living cells and contain the information (genetic code) for the transfer of genetic information from one generation to the next. [NIH] Nursing Care: Care given to patients by nursing service personnel. [NIH] Nutrition Assessment: Evaluation and measurement of nutritional variables in order to assess the level of nutrition or the nutritional status of the individual. Nutrition surveys may be used in making the assessment. [NIH] Nutritional Status: State of the body in relation to the consumption and utilization of nutrients. [NIH] Observational study: An epidemiologic study that does not involve any intervention, experimental or otherwise. Such a study may be one in which nature is allowed to take its course, with changes in one characteristic being studied in relation to changes in other characteristics. Analytical epidemiologic methods, such as case-control and cohort study designs, are properly called observational epidemiology because the investigator is observing without intervention other than to record, classify, count, and statistically analyze results. [NIH] Odds Ratio: The ratio of two odds. The exposure-odds ratio for case control data is the ratio of the odds in favor of exposure among cases to the odds in favor of exposure among noncases. The disease-odds ratio for a cohort or cross section is the ratio of the odds in favor of disease among the exposed to the odds in favor of disease among the unexposed. The prevalence-odds ratio refers to an odds ratio derived cross-sectionally from studies of prevalent cases. [NIH] Odour: A volatile emanation that is perceived by the sense of smell. [EU] Oliguria: Clinical manifestation of the urinary system consisting of a decrease in the amount of urine secreted. [NIH] Oncogene: A gene that normally directs cell growth. If altered, an oncogene can promote or allow the uncontrolled growth of cancer. Alterations can be inherited or caused by an environmental exposure to carcinogens. [NIH] Opacity: Degree of density (area most dense taken for reading). [NIH] Optic Chiasm: The X-shaped structure formed by the meeting of the two optic nerves. At the optic chiasm the fibers from the medial part of each retina cross to project to the other side of the brain while the lateral retinal fibers continue on the same side. As a result each half of the brain receives information about the contralateral visual field from both eyes. [NIH]

Organ Procurement: The administrative procedures involved with acquiring organs for transplantation through various programs, systems, or organizations. It includes obtaining consent and arranging for transportation of donor organs, after tissue harvesting, to the hospital for processing and transplant. [NIH] Organ Transplantation: Transference of an organ between individuals of the same species or between individuals of different species. [NIH]

Dictionary 201

Osmosis: Tendency of fluids (e.g., water) to move from the less concentrated to the more concentrated side of a semipermeable membrane. [NIH] Osmotic: Pertaining to or of the nature of osmosis (= the passage of pure solvent from a solution of lesser to one of greater solute concentration when the two solutions are separated by a membrane which selectively prevents the passage of solute molecules, but is permeable to the solvent). [EU] Osteoarthritis: A progressive, degenerative joint disease, the most common form of arthritis, especially in older persons. The disease is thought to result not from the aging process but from biochemical changes and biomechanical stresses affecting articular cartilage. In the foreign literature it is often called osteoarthrosis deformans. [NIH] Osteodystrophy: Defective bone formation. [EU] Osteomalacia: A condition marked by softening of the bones (due to impaired mineralization, with excess accumulation of osteoid), with pain, tenderness, muscular weakness, anorexia, and loss of weight, resulting from deficiency of vitamin D and calcium. [EU]

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] Ovum: A female germ cell extruded from the ovary at ovulation. [NIH] Oxidants: Oxidizing agents or electron-accepting molecules in chemical reactions in which electrons are transferred from one molecule to another (oxidation-reduction). In vivo, it appears that phagocyte-generated oxidants function as tumor promoters or cocarcinogens rather than as complete carcinogens perhaps because of the high levels of endogenous antioxidant defenses. It is also thought that oxidative damage in joints may trigger the autoimmune response that characterizes the persistence of the rheumatoid disease process. [NIH]

Oxidation: The act of oxidizing or state of being oxidized. Chemically it consists in the increase of positive charges on an atom or the loss of negative charges. Most biological oxidations are accomplished by the removal of a pair of hydrogen atoms (dehydrogenation) from a molecule. Such oxidations must be accompanied by reduction of an acceptor molecule. Univalent o. indicates loss of one electron; divalent o., the loss of two electrons. [EU]

Oxidation-Reduction: A chemical reaction in which an electron is transferred from one molecule to another. The electron-donating molecule is the reducing agent or reductant; the electron-accepting molecule is the oxidizing agent or oxidant. Reducing and oxidizing agents function as conjugate reductant-oxidant pairs or redox pairs (Lehninger, Principles of Biochemistry, 1982, p471). [NIH] Oxidative Stress: A disturbance in the prooxidant-antioxidant balance in favor of the former, leading to potential damage. Indicators of oxidative stress include damaged DNA bases, protein oxidation products, and lipid peroxidation products (Sies, Oxidative Stress, 1991, pxv-xvi). [NIH] Oxygen Consumption: The oxygen consumption is determined by calculating the difference between the amount of oxygen inhaled and exhaled. [NIH] Oxygenation: The process of supplying, treating, or mixing with oxygen. No:1245 oxygenation the process of supplying, treating, or mixing with oxygen. [EU] 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

202


gland that secretes digestive enzymes. [NIH] Pancreas Transplant: A surgical procedure that involves replacing the pancreas of a person who has diabetes with a healthy pancreas that can make insulin. The healthy pancreas comes from a donor who has just died or from a living relative. A person can donate half a pancreas and still live normally. [NIH] Pancreas Transplantation: The transference of a pancreas from one human or animal to another. [NIH] Pancreatic: Having to do with the pancreas. [NIH] Pancreatitis: Acute or chronic inflammation of the pancreas, which may be asymptomatic or symptomatic, and which is due to autodigestion of a pancreatic tissue by its own enzymes. It is caused most often by alcoholism or biliary tract disease; less commonly it may be associated with hyperlipaemia, hyperparathyroidism, abdominal trauma (accidental or operative injury), vasculitis, or uraemia. [EU] Parathyroid: 1. Situated beside the thyroid gland. 2. One of the parathyroid glands. 3. A sterile preparation of the water-soluble principle(s) of the parathyroid glands, ad-ministered parenterally as an antihypocalcaemic, especially in the treatment of acute hypoparathyroidism with tetany. [EU] Parathyroid Glands: Two small paired endocrine glands in the region of the thyroid gland. They secrete parathyroid hormone and are concerned with the metabolism of calcium and phosphorus. [NIH] Parathyroid hormone: A substance made by the parathyroid gland that helps the body store and use calcium. Also called parathormone, parathyrin, or PTH. [NIH] Parathyroidectomy: Excision of one or both of the parathyroid glands. [NIH] Parenteral: Not through the alimentary canal but rather by injection through some other route, as subcutaneous, intramuscular, intraorbital, intracapsular, intraspinal, intrasternal, intravenous, etc. [EU] Parenteral Nutrition: The administering of nutrients for assimilation and utilization by a patient who cannot maintain adequate nutrition by enteral feeding alone. Nutrients are administered by a route other than the alimentary canal (e.g., intravenously, subcutaneously). [NIH] Parietal: 1. Of or pertaining to the walls of a cavity. 2. Pertaining to or located near the parietal bone, as the parietal lobe. [EU] Paroxysmal: Recurring in paroxysms (= spasms or seizures). [EU] Pathogen: Any disease-producing microorganism. [EU] Pathogenesis: The cellular events and reactions that occur in the development of disease. [NIH]

Pathologic: 1. Indicative of or caused by a morbid condition. 2. Pertaining to pathology (= branch of medicine that treats the essential nature of the disease, especially the structural and functional changes in tissues and organs of the body caused by the disease). [EU] Pathophysiology: Altered functions in an individual or an organ due to disease. [NIH] Patient Care Management: Generating, planning, organizing, and administering medical and nursing care and services for patients. [NIH] Patient Compliance: Voluntary cooperation of the patient in following a prescribed regimen. [NIH] Patient Education: The teaching or training of patients concerning their own health needs. [NIH]

Dictionary 203

Patient Satisfaction: The degree to which the individual regards the health care service or product or the manner in which it is delivered by the provider as useful, effective, or beneficial. [NIH] Patient Selection: Criteria and standards used for the determination of the appropriateness of the inclusion of patients with specific conditions in proposed treatment plans and the criteria used for the inclusion of subjects in various clinical trials and other research protocols. [NIH] Pediatrics: A medical specialty concerned with maintaining health and providing medical care to children from birth to adolescence. [NIH] Pelvic: Pertaining to the pelvis. [EU] Penicillin: An antibiotic drug used to treat infection. [NIH] Penicillinase: A beta-lactamase preferentially cleaving penicillins. (Dorland, 28th ed) EC 3.5.2.-. [NIH] Pentosephosphate Pathway: A pathway of hexose oxidation in which glucose-6-phosphate undergoes two successive oxidations by NADP, the final one being an oxidative decarboxylation to form a pentose phosphate. [NIH] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Perception: The ability quickly and accurately to recognize similarities and differences among presented objects, whether these be pairs of words, pairs of number series, or multiple sets of these or other symbols such as geometric figures. [NIH] Percutaneous: Performed through the skin, as injection of radiopacque material in radiological examination, or the removal of tissue for biopsy accomplished by a needle. [EU] Perfusion: Bathing an organ or tissue with a fluid. In regional perfusion, a specific area of the body (usually an arm or a leg) receives high doses of anticancer drugs through a blood vessel. Such a procedure is performed to treat cancer that has not spread. [NIH] Pericardium: The fibroserous sac surrounding the heart and the roots of the great vessels. [NIH]

Periodontitis: Inflammation of the periodontal membrane; also called periodontitis simplex. [NIH]

Peripheral Neuropathy: Nerve damage, usually affecting the feet and legs; causing pain, numbness, or a tingling feeling. Also called "somatic neuropathy" or "distal sensory polyneuropathy." [NIH] Peripheral Vascular Disease: Disease in the large blood vessels of the arms, legs, and feet. People who have had diabetes for a long time may get this because major blood vessels in their arms, legs, and feet are blocked and these limbs do not receive enough blood. The signs of PVD are aching pains in the arms, legs, and feet (especially when walking) and foot sores that heal slowly. Although people with diabetes cannot always avoid PVD, doctors say they have a better chance of avoiding it if they take good care of their feet, do not smoke, and keep both their blood pressure and diabetes under good control. [NIH] Peritoneal: Having to do with the peritoneum (the tissue that lines the abdominal wall and covers most of the organs in the abdomen). [NIH] Peritoneal Cavity: The space enclosed by the peritoneum. It is divided into two portions, the greater sac and the lesser sac or omental bursa, which lies behind the stomach. The two sacs are connected by the foramen of Winslow, or epiploic foramen. [NIH] Peritoneal Dialysis: Dialysis fluid being introduced into and removed from the peritoneal cavity as either a continuous or an intermittent procedure. [NIH]

204


Peritoneum: Endothelial lining of the abdominal cavity, the parietal peritoneum covering the inside of the abdominal wall and the visceral peritoneum covering the bowel, the mesentery, and certain of the organs. The portion that covers the bowel becomes the serosal layer of the bowel wall. [NIH] Peritonitis: Inflammation of the peritoneum; a condition marked by exudations in the peritoneum of serum, fibrin, cells, and pus. It is attended by abdominal pain and tenderness, constipation, vomiting, and moderate fever. [EU] Phagocyte: An immune system cell that can surround and kill microorganisms and remove dead cells. Phagocytes include macrophages. [NIH] Pharmaceutical Preparations: Drugs intended for human or veterinary use, presented in their finished dosage form. Included here are materials used in the preparation and/or formulation of the finished dosage form. [NIH] Pharmacokinetic: The mathematical analysis of the time courses of absorption, distribution, and elimination of drugs. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] 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] Phosphorylates: Attached to a phosphate group. [NIH] Photocoagulation: Using a special strong beam of light (laser) to seal off bleeding blood vessels such as in the eye. The laser can also burn away blood vessels that should not have grown in the eye. This is the main treatment for diabetic retinopathy. [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] Piperacillin: Semisynthetic, broad-spectrum, ampicillin-derived ureidopenicillin antibiotic proposed for pseudomonas infections. It is also used in combination with other antibiotics. [NIH]

Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Plaque: A clear zone in a bacterial culture grown on an agar plate caused by localized destruction of bacterial cells by a bacteriophage. The concentration of infective virus in a fluid can be estimated by applying the fluid to a culture and counting the number of. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Plasma cells: A type of white blood cell that produces antibodies. [NIH] Plasma protein: One of the hundreds of different proteins present in blood plasma,

Dictionary 205

including carrier proteins ( such albumin, transferrin, and haptoglobin), fibrinogen and other coagulation factors, complement components, immunoglobulins, enzyme inhibitors, precursors of substances such as angiotension and bradykinin, and many other types of proteins. [EU] Plasmid: An autonomously replicating, extra-chromosomal DNA molecule found in many bacteria. Plasmids are widely used as carriers of cloned genes. [NIH] Plasmin: A product of the lysis of plasminogen (profibrinolysin) by plasminogen activators. It is composed of two polypeptide chains, light (B) and heavy (A), with a molecular weight of 75,000. It is the major proteolytic enzyme involved in blood clot retraction or the lysis of fibrin and quickly inactivated by antiplasmins. EC 3.4.21.7. [NIH] Platelet Aggregation: The attachment of platelets to one another. This clumping together can be induced by a number of agents (e.g., thrombin, collagen) and is part of the mechanism leading to the formation of a thrombus. [NIH] Platelets: A type of blood cell that helps prevent bleeding by causing blood clots to form. Also called thrombocytes. [NIH] Pneumonia: Inflammation of the lungs. [NIH] Poisoning: A condition or physical state produced by the ingestion, injection or inhalation of, or exposure to a deleterious agent. [NIH] Polycystic: An inherited disorder characterized by many grape-like clusters of fluid-filled cysts that make both kidneys larger over time. These cysts take over and destroy working kidney tissue. PKD may cause chronic renal failure and end-stage renal disease. [NIH] Polymorphism: The occurrence together of two or more distinct forms in the same population. [NIH] Polyposis: The development of numerous polyps (growths that protrude from a mucous membrane). [NIH] Polysaccharide: A type of carbohydrate. It contains sugar molecules that are linked together chemically. [NIH] Posterior: Situated in back of, or in the back part of, or affecting the back or dorsal surface of the body. In lower animals, it refers to the caudal end of the body. [EU] Postmenopausal: Refers to the time after menopause. Menopause is the time in a woman's life when menstrual periods stop permanently; also called "change of life." [NIH] Postoperative: After surgery. [NIH] Potassium: An element that is in the alkali group of metals. It has an atomic symbol K, atomic number 19, and atomic weight 39.10. It is the chief cation in the intracellular fluid of muscle and other cells. Potassium ion is a strong electrolyte and it plays a significant role in the regulation of fluid volume and maintenance of the water-electrolyte balance. [NIH] Potentiating: A degree of synergism which causes the exposure of the organism to a harmful substance to worsen a disease already contracted. [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

206


symptom that heralds another. [EU] Pre-eclamptic: A syndrome characterized by hypertension, albuminuria, and generalized oedema, occurring only in pregnancy. [NIH] Prekallikrein: A plasma protein which is the precursor of kallikrein. Plasma that is deficient in prekallikrein has been found to be abnormal in thromboplastin formation, kinin generation, evolution of a permeability globulin, and plasmin formation. The absence of prekallikrein in plasma leads to Fletcher factor deficiency, a congenital disease. [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] Primary Prevention: Prevention of disease or mental disorders in susceptible individuals or populations through promotion of health, including mental health, and specific protection, as in immunization, as distinguished from the prevention of complications or after-effects of existing disease. [NIH] 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] 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] Prognostic factor: A situation or condition, or a characteristic of a patient, that can be used to estimate the chance of recovery from a disease, or the chance of the disease recurring (coming back). [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] Progressive disease: Cancer that is increasing in scope or severity. [NIH] Projection: A defense mechanism, operating unconsciously, whereby that which is emotionally unacceptable in the self is rejected and attributed (projected) to others. [NIH] Promoter: A chemical substance that increases the activity of a carcinogenic process. [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] Prostaglandin: Any of a group of components derived from unsaturated 20-carbon fatty acids, primarily arachidonic acid, via the cyclooxygenase pathway that are extremely potent mediators of a diverse group of physiologic processes. The abbreviation for prostaglandin is PG; specific compounds are designated by adding one of the letters A through I to indicate the type of substituents found on the hydrocarbon skeleton and a subscript (1, 2 or 3) to indicate the number of double bonds in the hydrocarbon skeleton e.g., PGE2. The predominant naturally occurring prostaglandins all have two double bonds and are synthesized from arachidonic acid (5,8,11,14-eicosatetraenoic acid) by the pathway shown in the illustration. The 1 series and 3 series are produced by the same pathway with fatty acids having one fewer double bond (8,11,14-eicosatrienoic acid or one more double bond (5,8,11,14,17-eicosapentaenoic acid) than arachidonic acid. The subscript a or ß indicates the configuration at C-9 (a denotes a substituent below the plane of the ring, ß, above the plane).

Dictionary 207

The naturally occurring PGF's have the a configuration, e.g., PGF2a. All of the prostaglandins act by binding to specific cell-surface receptors causing an increase in the level of the intracellular second messenger cyclic AMP (and in some cases cyclic GMP also). The effect produced by the cyclic AMP increase depends on the specific cell type. In some cases there is also a positive feedback effect. Increased cyclic AMP increases prostaglandin synthesis leading to further increases in cyclic AMP. [EU] Prostate: A gland in males that surrounds the neck of the bladder and the urethra. It secretes a substance that liquifies coagulated semen. It is situated in the pelvic cavity behind the lower part of the pubic symphysis, above the deep layer of the triangular ligament, and rests upon the rectum. [NIH] Protein Binding: The process in which substances, either endogenous or exogenous, bind to proteins, peptides, enzymes, protein precursors, or allied compounds. Specific proteinbinding measures are often used as assays in diagnostic assessments. [NIH] Protein C: A vitamin-K dependent zymogen present in the blood, which, upon activation by thrombin and thrombomodulin exerts anticoagulant properties by inactivating factors Va and VIIIa at the rate-limiting steps of thrombin formation. [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] Proteinuria: The presence of protein in the urine, indicating that the kidneys are not working properly. [NIH] Proteolytic: 1. Pertaining to, characterized by, or promoting proteolysis. 2. An enzyme that promotes proteolysis (= the splitting of proteins by hydrolysis of the peptide bonds with formation of smaller polypeptides). [EU] Protocol: The detailed plan for a clinical trial that states the trial's rationale, purpose, drug or vaccine dosages, length of study, routes of administration, who may participate, and other aspects of trial design. [NIH] Proximal: Nearest; closer to any point of reference; opposed to distal. [EU] Pruritus: An intense itching sensation that produces the urge to rub or scratch the skin to obtain relief. [NIH] Pseudomonas: A genus of gram-negative, aerobic, rod-shaped bacteria widely distributed in nature. Some species are pathogenic for humans, animals, and plants. [NIH] Pseudomonas Infections: Infections with bacteria of the genus Pseudomonas. [NIH] Psychic: Pertaining to the psyche or to the mind; mental. [EU] Psychology: The science dealing with the study of mental processes and behavior in man and animals. [NIH] 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] 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]

208


Pulmonary Edema: An accumulation of an excessive amount of watery fluid in the lungs, may be caused by acute exposure to dangerous concentrations of irritant gasses. [NIH] Pulse: The rhythmical expansion and contraction of an artery produced by waves of pressure caused by the ejection of blood from the left ventricle of the heart as it contracts. [NIH]

Putrefaction: The process of decomposition of animal and vegetable matter by living organisms. [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] Racemic: Optically inactive but resolvable in the way of all racemic compounds. [NIH] Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the waves/rays themselves; a stream of electromagnetic particles (electrons, neutrons, protons, alpha particles) or a mixture of these. The most common source is the sun. [NIH] Radioactive: Giving off radiation. [NIH] Radiography: Examination of any part of the body for diagnostic purposes by means of roentgen rays, recording the image on a sensitized surface (such as photographic film). [NIH] Radioimmunotherapy: Radiotherapy where cytotoxic radionuclides are linked to antibodies in order to deliver toxins directly to tumor targets. Therapy with targeted radiation rather than antibody-targeted toxins (immunotoxins) has the advantage that adjacent tumor cells, which lack the appropriate antigenic determinants, can be destroyed by radiation cross-fire. Radioimmunotherapy is sometimes called targeted radiotherapy, but this latter term can also refer to radionuclides linked to non-immune molecules (radiotherapy). [NIH] Radiological: Pertaining to radiodiagnostic and radiotherapeutic procedures, and interventional radiology or other planning and guiding medical radiology. [NIH] Radiotherapy: The use of ionizing radiation to treat malignant neoplasms and other benign conditions. The most common forms of ionizing radiation used as therapy are x-rays, gamma rays, and electrons. A special form of radiotherapy, targeted radiotherapy, links a cytotoxic radionuclide to a molecule that targets the tumor. When this molecule is an antibody or other immunologic molecule, the technique is called radioimmunotherapy. [NIH] Randomized: Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments. [NIH] Randomized clinical trial: A study in which the participants are assigned by chance to separate groups that compare different treatments; neither the researchers nor the participants can choose which group. Using chance to assign people to groups means that the groups will be similar and that the treatments they receive can be compared objectively. At the time of the trial, it is not known which treatment is best. It is the patient's choice to be in a randomized trial. [NIH] Reactivation: The restoration of activity to something that has been inactivated. [EU] Reactive Oxygen Species: Reactive intermediate oxygen species including both radicals and non-radicals. These substances are constantly formed in the human body and have been shown to kill bacteria and inactivate proteins, and have been implicated in a number of diseases. Scientific data exist that link the reactive oxygen species produced by inflammatory phagocytes to cancer development. [NIH] Reagent: A substance employed to produce a chemical reaction so as to detect, measure,

Dictionary 209

produce, etc., other substances. [EU] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Recombinant: A cell or an individual with a new combination of genes not found together in either parent; usually applied to linked genes. [EU] Recombination: The formation of new combinations of genes as a result of segregation in crosses between genetically different parents; also the rearrangement of linked genes due to crossing-over. [NIH] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Recurrence: The return of a sign, symptom, or disease after a remission. [NIH] Red blood cells: RBCs. Cells that carry oxygen to all parts of the body. Also called erythrocytes. [NIH] Reductase: Enzyme converting testosterone to dihydrotestosterone. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Reflux: The term used when liquid backs up into the esophagus from the stomach. [NIH] Refractory: Not readily yielding to treatment. [EU] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Registries: The systems and processes involved in the establishment, support, management, and operation of registers, e.g., disease registers. [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] Relative risk: The ratio of the incidence rate of a disease among individuals exposed to a specific risk factor to the incidence rate among unexposed individuals; synonymous with risk ratio. Alternatively, the ratio of the cumulative incidence rate in the exposed to the cumulative incidence rate in the unexposed (cumulative incidence ratio). The term relative risk has also been used synonymously with odds ratio. This is because the odds ratio and relative risk approach each other if the disease is rare ( 5 percent of population) and the number of subjects is large. [NIH] Remission: A decrease in or disappearance of signs and symptoms of cancer. In partial remission, some, but not all, signs and symptoms of cancer have disappeared. In complete remission, all signs and symptoms of cancer have disappeared, although there still may be cancer in the body. [NIH] Renal cell carcinoma: A type of kidney cancer. [NIH] Renal failure: Progressive renal insufficiency and uremia, due to irreversible and progressive renal glomerular tubular or interstitial disease. [NIH] Renal Osteodystrophy: Decalcification of bone due to hyperparathyroidism secondary to chronic kidney disease. [NIH] Renal pelvis: The area at the center of the kidney. Urine collects here and is funneled into the ureter, the tube that connects the kidney to the bladder. [NIH] Renin: An enzyme which is secreted by the kidney and is formed from prorenin in plasma and kidney. The enzyme cleaves the Leu-Leu bond in angiotensinogen to generate angiotensin I. EC 3.4.23.15. (Formerly EC 3.4.99.19). [NIH] Renin-Angiotensin System: A system consisting of renin, angiotensin-converting enzyme,

210


and angiotensin II. Renin, an enzyme produced in the kidney, acts on angiotensinogen, an alpha-2 globulin produced by the liver, forming angiotensin I. The converting enzyme contained in the lung acts on angiotensin I in the plasma converting it to angiotensin II, the most powerful directly pressor substance known. It causes contraction of the arteriolar smooth muscle and has other indirect actions mediated through the adrenal cortex. [NIH] Renovascular: Of or pertaining to the blood vessels of the kidneys. [EU] Resolving: The ability of the eye or of a lens to make small objects that are close together, separately visible; thus revealing the structure of an object. [NIH] Resorption: The loss of substance through physiologic or pathologic means, such as loss of dentin and cementum of a tooth, or of the alveolar process of the mandible or maxilla. [EU] Restoration: Broad term applied to any inlay, crown, bridge or complete denture which restores or replaces loss of teeth or oral tissues. [NIH] Retina: The ten-layered nervous tissue membrane of the eye. It is continuous with the optic nerve and receives images of external objects and transmits visual impulses to the brain. Its outer surface is in contact with the choroid and the inner surface with the vitreous body. The outer-most layer is pigmented, whereas the inner nine layers are transparent. [NIH] Retinal: 1. Pertaining to the retina. 2. The aldehyde of retinol, derived by the oxidative enzymatic splitting of absorbed dietary carotene, and having vitamin A activity. In the retina, retinal combines with opsins to form visual pigments. One isomer, 11-cis retinal combines with opsin in the rods (scotopsin) to form rhodopsin, or visual purple. Another, all-trans retinal (trans-r.); visual yellow; xanthopsin) results from the bleaching of rhodopsin by light, in which the 11-cis form is converted to the all-trans form. Retinal also combines with opsins in the cones (photopsins) to form the three pigments responsible for colour vision. Called also retinal, and retinene1. [EU] Retinitis: Inflammation of the retina. It is rarely limited to the retina, but is commonly associated with diseases of the choroid (chorioretinitis) and of the optic nerve (neuroretinitis). The disease may be confined to one eye, but since it is generally dependent on a constitutional factor, it is almost always bilateral. It may be acute in course, but as a rule it lasts many weeks or even several months. [NIH] Retrospective: Looking back at events that have already taken place. [NIH] Retrospective study: A study that looks backward in time, usually using medical records and interviews with patients who already have or had a disease. [NIH] Retroviral vector: RNA from a virus that is used to insert genetic material into cells. [NIH] Rheumatic Diseases: Disorders of connective tissue, especially the joints and related structures, characterized by inflammation, degeneration, or metabolic derangement. [NIH] Rheumatoid: Resembling rheumatism. [EU] Ribavirin: 1-beta-D-Ribofuranosyl-1H-1,2,4-triazole-3-carboxamide. A nucleoside antimetabolite antiviral agent that blocks nucleic acid synthesis and is used against both RNA and DNA viruses. [NIH] Ribonuclease: RNA-digesting enzyme. [NIH] Ribose: A pentose active in biological systems usually in its D-form. [NIH] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Risk patient: Patient who is at risk, because of his/her behaviour or because of the type of person he/she is. [EU] Ristocetin: An antibiotic mixture of two components, A and B, obtained from Nocardia

Dictionary 211

lurida (or the same substance produced by any other means). It is no longer used clinically because of its toxicity. It causes platelet agglutination and blood coagulation and is used to assay those functions in vitro. [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] Saphenous: Applied to certain structures in the leg, e. g. nerve vein. [NIH] Saphenous Vein: The vein which drains the foot and leg. [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] Satellite: Applied to a vein which closely accompanies an artery for some distance; in cytogenetics, a chromosomal agent separated by a secondary constriction from the main body of the chromosome. [NIH] Saturated fat: A type of fat found in greatest amounts in foods from animals, such as fatty cuts of meat, poultry with the skin, whole-milk dairy products, lard, and in some vegetable oils, including coconut, palm kernel, and palm oils. Saturated fat raises blood cholesterol more than anything else eaten. On a Step I Diet, no more than 8 to 10 percent of total calories should come from saturated fat, and in the Step II Diet, less than 7 percent of the day's total calories should come from saturated fat. [NIH] Scleroderma: A chronic disorder marked by hardening and thickening of the skin. Scleroderma can be localized or it can affect the entire body (systemic). [NIH] Sclerosis: A pathological process consisting of hardening or fibrosis of an anatomical structure, often a vessel or a nerve. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] 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] Segmental: Describing or pertaining to a structure which is repeated in similar form in successive segments of an organism, or which is undergoing segmentation. [NIH] Segmentation: The process by which muscles in the intestines move food and wastes through the body. [NIH] Seizures: Clinical or subclinical disturbances of cortical function due to a sudden, abnormal, excessive, and disorganized discharge of brain cells. Clinical manifestations include abnormal motor, sensory and psychic phenomena. Recurrent seizures are usually referred to as epilepsy or "seizure disorder." [NIH] Self Care: Performance of activities or tasks traditionally performed by professional health care providers. The concept includes care of oneself or one's family and friends. [NIH] Semen: The thick, yellowish-white, viscid fluid secretion of male reproductive organs discharged upon ejaculation. In addition to reproductive organ secretions, it contains spermatozoa and their nutrient plasma. [NIH] Semisynthetic: Produced by chemical manipulation of naturally occurring substances. [EU]

212


Serologic: Analysis of a person's serum, especially specific immune or lytic serums. [NIH] Serotonin: A biochemical messenger and regulator, synthesized from the essential amino acid L-tryptophan. In humans it is found primarily in the central nervous system, gastrointestinal tract, and blood platelets. Serotonin mediates several important physiological functions including neurotransmission, gastrointestinal motility, hemostasis, and cardiovascular integrity. Multiple receptor families (receptors, serotonin) explain the broad physiological actions and distribution of this biochemical mediator. [NIH] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] Serum Albumin: A major plasma protein that serves in maintaining the plasma colloidal osmotic pressure and transporting large organic anions. [NIH] Shock: The general bodily disturbance following a severe injury; an emotional or moral upset occasioned by some disturbing or unexpected experience; disruption of the circulation, which can upset all body functions: sometimes referred to as circulatory shock. [NIH]

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] Sirolimus: A macrolide compound obtained from Streptomyces hygroscopicus that acts by selectively blocking the transcriptional activation of cytokines thereby inhibiting cytokine production. It is bioactive only when bound to immunophilins. Sirolimus is a potent immunosuppressant and possesses both antifungal and antineoplastic properties. [NIH] 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] 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] Social Support: Support systems that provide assistance and encouragement to individuals

Dictionary 213

with physical or emotional disabilities in order that they may better cope. Informal social support is usually provided by friends, relatives, or peers, while formal assistance is provided by churches, groups, etc. [NIH] Social Work: The use of community resources, individual case work, or group work to promote the adaptive capacities of individuals in relation to their social and economic environments. It includes social service agencies. [NIH] Sodium: An element that is a member of the alkali group of metals. It has the atomic symbol Na, atomic number 11, and atomic weight 23. With a valence of 1, it has a strong affinity for oxygen and other nonmetallic elements. Sodium provides the chief cation of the extracellular body fluids. Its salts are the most widely used in medicine. (From Dorland, 27th ed) Physiologically the sodium ion plays a major role in blood pressure regulation, maintenance of fluid volume, and electrolyte balance. [NIH] Soft tissue: Refers to muscle, fat, fibrous tissue, blood vessels, or other supporting tissue of the body. [NIH] Solvent: 1. Dissolving; effecting a solution. 2. A liquid that dissolves or that is capable of dissolving; the component of a solution that is present in greater amount. [EU] Somatic: 1. Pertaining to or characteristic of the soma or body. 2. Pertaining to the body wall in contrast to the viscera. [EU] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] 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] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] Spleen: An organ that is part of the lymphatic system. The spleen produces lymphocytes, filters the blood, stores blood cells, and destroys old blood cells. It is located on the left side of the abdomen near the stomach. [NIH] Stem cell transplantation: A method of replacing immature blood-forming cells that were destroyed by cancer treatment. The stem cells are given to the person after treatment to help the bone marrow recover and continue producing healthy blood cells. [NIH] Stem Cells: Relatively undifferentiated cells of the same lineage (family type) that retain the ability to divide and cycle throughout postnatal life to provide cells that can become specialized and take the place of those that die or are lost. [NIH] Stenosis: Narrowing or stricture of a duct or canal. [EU] Sterile: Unable to produce children. [NIH] Steroid:

A

group

name

for

lipids

that

contain

a

hydrogenated

214


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] Steroid therapy: Treatment with corticosteroid drugs to reduce swelling, pain, and other symptoms of inflammation. [NIH] 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] Stricture: The abnormal narrowing of a body opening. Also called stenosis. [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] Stromal: Large, veil-like cell in the bone marrow. [NIH] Stromal Cells: Connective tissue cells of an organ found in the loose connective tissue. These are most often associated with the uterine mucosa and the ovary as well as the hematopoietic system and elsewhere. [NIH] Subacute: Somewhat acute; between acute and chronic. [EU] Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU] Subcutaneous: Beneath the skin. [NIH] Subspecies: A category intermediate in rank between species and variety, based on a smaller number of correlated characters than are used to differentiate species and generally conditioned by geographical and/or ecological occurrence. [NIH] Substance P: An eleven-amino acid neurotransmitter that appears in both the central and peripheral nervous systems. It is involved in transmission of pain, causes rapid contractions of the gastrointestinal smooth muscle, and modulates inflammatory and immune responses. [NIH]

Substrate: A substance upon which an enzyme acts. [EU] Substrate Specificity: A characteristic feature of enzyme activity in relation to the kind of substrate on which the enzyme or catalytic molecule reacts. [NIH] Sulbactam: A beta-lactamase inhibitor with very weak antibacterial action. The compound prevents antibiotic destruction of beta-lactam antibiotics by inhibiting beta-lactamases, thus extending their spectrum activity. Combinations of sulbactam with beta-lactam antibiotics have been used successfully for the therapy of infections caused by organisms resistant to the antibiotic alone. [NIH] Sulfur: An element that is a member of the chalcogen family. It has an atomic symbol S, atomic number 16, and atomic weight 32.066. It is found in the amino acids cysteine and methionine. [NIH]

Dictionary 215

Supplementation: Adding nutrients to the diet. [NIH] Support group: A group of people with similar disease who meet to discuss how better to cope with their cancer and treatment. [NIH] Suppression: A conscious exclusion of disapproved desire contrary with repression, in which the process of exclusion is not conscious. [NIH] Survival Rate: The proportion of survivors in a group, e.g., of patients, studied and followed over a period, or the proportion of persons in a specified group alive at the beginning of a time interval who survive to the end of the interval. It is often studied using life table methods. [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] Symphysis: A secondary cartilaginous joint. [NIH] Symptomatic: Having to do with symptoms, which are signs of a condition or disease. [NIH] Systemic: Affecting the entire body. [NIH] Systemic lupus erythematosus: SLE. A chronic inflammatory connective tissue disease marked by skin rashes, joint pain and swelling, inflammation of the kidneys, inflammation of the fibrous tissue surrounding the heart (i.e., the pericardium), as well as other problems. Not all affected individuals display all of these problems. May be referred to as lupus. [NIH] Systolic: Indicating the maximum arterial pressure during contraction of the left ventricle of the heart. [EU] Tachycardia: Excessive rapidity in the action of the heart, usually with a heart rate above 100 beats per minute. [NIH] Teaching Materials: Instructional materials used in teaching. [NIH] Teratogenic: Tending to produce anomalies of formation, or teratism (= anomaly of formation or development : condition of a monster). [EU] Testis: Either of the paired male reproductive glands that produce the male germ cells and the male hormones. [NIH] Testosterone: A hormone that promotes the development and maintenance of male sex characteristics. [NIH] Tetany: 1. Hyperexcitability of nerves and muscles due to decrease in concentration of extracellular ionized calcium, which may be associated with such conditions as parathyroid hypofunction, vitamin D deficiency, and alkalosis or result from ingestion of alkaline salts; it is characterized by carpopedal spasm, muscular twitching and cramps, laryngospasm with inspiratory stridor, hyperreflexia and choreiform movements. 2. Tetanus. [EU] Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Thermal: Pertaining to or characterized by heat. [EU] Thigh: A leg; in anatomy, any elongated process or part of a structure more or less comparable to a leg. [NIH] Third Ventricle: A narrow cleft inferior to the corpus callosum, within the diencephalon, between the paired thalami. Its floor is formed by the hypothalamus, its anterior wall by the lamina terminalis, and its roof by ependyma. It communicates with the fourth ventricle by

216


the cerebral aqueduct, and with the lateral ventricles by the interventricular foramina. [NIH] Threshold: For a specified sensory modality (e. g. light, sound, vibration), the lowest level (absolute threshold) or smallest difference (difference threshold, difference limen) or intensity of the stimulus discernible in prescribed conditions of stimulation. [NIH] Thrombin: An enzyme formed from prothrombin that converts fibrinogen to fibrin. (Dorland, 27th ed) EC 3.4.21.5. [NIH] Thrombocytopenia: A decrease in the number of blood platelets. [NIH] Thrombomodulin: A cell surface glycoprotein of endothelial cells that binds thrombin and serves as a cofactor in the activation of protein C and its regulation of blood coagulation. [NIH]

Thromboplastin: Constituent composed of protein and phospholipid that is widely distributed in many tissues. It serves as a cofactor with factor VIIa to activate factor X in the extrinsic pathway of blood coagulation. [NIH] Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] Thyroid: A gland located near the windpipe (trachea) that produces thyroid hormone, which helps regulate growth and metabolism. [NIH] Thyroid Gland: A highly vascular endocrine gland consisting of two lobes, one on either side of the trachea, joined by a narrow isthmus; it produces the thyroid hormones which are concerned in regulating the metabolic rate of the body. [NIH] Thyroxine: An amino acid of the thyroid gland which exerts a stimulating effect on thyroid metabolism. [NIH] Tin: A trace element that is required in bone formation. It has the atomic symbol Sn, atomic number 50, and atomic weight 118.71. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tissue Harvesting: The removal of organs or tissue for reuse, for example, for transplantation. [NIH] Tobramycin: An aminoglycoside, broad-spectrum antibiotic produced by Streptomyces tenebrarius. It is effective against gram-negative bacteria, especially the Pseudomonas species. It is a 10% component of the antibiotic complex, nebramycin, produced by the same species. [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] Tonicity: The normal state of muscular tension. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxin: A poison; frequently used to refer specifically to a protein produced by some higher plants, certain animals, and pathogenic bacteria, which is highly toxic for other living organisms. Such substances are differentiated from the simple chemical poisons and the vegetable alkaloids by their high molecular weight and antigenicity. [EU]

Dictionary 217

Transcriptase: An enzyme which catalyses the synthesis of a complementary mRNA molecule from a DNA template in the presence of a mixture of the four ribonucleotides (ATP, UTP, GTP and CTP). [NIH] Transcription Factors: Endogenous substances, usually proteins, which are effective in the initiation, stimulation, or termination of the genetic transcription process. [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Transketolase: An enzyme of the transferase class that catalyzes the conversion of sedoheptulose 7-phosphate and D-glyceraldehyde 3-phosphate to D-ribose 5-phosphate and D-xylulose 5-phosphate in the pentosephosphate pathway. (Dorland, 27th ed) EC 2.2.1.1. [NIH]

Translation: The process whereby the genetic information present in the linear sequence of ribonucleotides in mRNA is converted into a corresponding sequence of amino acids in a protein. It occurs on the ribosome and is unidirectional. [NIH] Transmitter: A chemical substance which effects the passage of nerve impulses from one cell to the other at the synapse. [NIH] Transplantation: Transference of a tissue or organ, alive or dead, within an individual, between individuals of the same species, or between individuals of different species. [NIH] Trauma: Any injury, wound, or shock, must frequently physical or structural shock, producing a disturbance. [NIH] Tropomyosin: A protein found in the thin filaments of muscle fibers. It inhibits contraction of the muscle unless its position is modified by troponin. [NIH] Troponin: One of the minor protein components of skeletal muscle. Its function is to serve as the calcium-binding component in the troponin-tropomyosin B-actin-myosin complex by conferring calcium sensitivity to the cross-linked actin and myosin filaments. [NIH] 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] Type 2 diabetes: Usually characterized by a gradual onset with minimal or no symptoms of metabolic disturbance and no requirement for exogenous insulin. The peak age of onset is 50 to 60 years. Obesity and possibly a genetic factor are usually present. [NIH] Ubiquitin: A highly conserved 76 amino acid-protein found in all eukaryotic cells. [NIH] Ultrafiltration: The separation of particles from a suspension by passage through a filter with very fine pores. In ultrafiltration the separation is accomplished by convective transport; in dialysis separation relies instead upon differential diffusion. Ultrafiltration occurs naturally and is a laboratory procedure. Artificial ultrafiltration of the blood is referred to as hemofiltration or hemodiafiltration (if combined with hemodialysis). [NIH] Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [NIH] Uraemia: 1. An excess in the blood of urea, creatinine, and other nitrogenous end products of protein and amino acids metabolism; more correctly referred to as azotemia. 2. In current usage the entire constellation of signs and symptoms of chronic renal failure, including nausea, vomiting anorexia, a metallic taste in the mouth, a uraemic odour of the breath, pruritus, uraemic frost on the skin, neuromuscular disorders, pain and twitching in the muscles, hypertension, edema, mental confusion, and acid-base and electrolyte imbalances. [EU]

Urea: A compound (CO(NH2)2), formed in the liver from ammonia produced by the deamination of amino acids. It is the principal end product of protein catabolism and

218


constitutes about one half of the total urinary solids. [NIH] Uremia: The illness associated with the buildup of urea in the blood because the kidneys are not working effectively. Symptoms include nausea, vomiting, loss of appetite, weakness, and mental confusion. [NIH] Ureters: Tubes that carry urine from the kidneys to the bladder. [NIH] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]

Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [NIH] Urine: Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra. [NIH] Urolithiasis: Stones in the urinary system. [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] Vancomycin: Antibacterial obtained from Streptomyces orientalis. It is a glycopeptide related to ristocetin that inhibits bacterial cell wall assembly and is toxic to kidneys and the inner ear. [NIH] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vascular Resistance: An expression of the resistance offered by the systemic arterioles, and to a lesser extent by the capillaries, to the flow of blood. [NIH] Vasculitis: Inflammation of a blood vessel. [NIH] Vasoconstriction: Narrowing of the blood vessels without anatomic change, for which constriction, pathologic is used. [NIH] Vasodilation: Physiological dilation of the blood vessels without anatomic change. For dilation with anatomic change, dilatation, pathologic or aneurysm (or specific aneurysm) is used. [NIH] Vasodilators: Any nerve or agent which induces dilatation of the blood vessels. [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] 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] Ventricular: Pertaining to a ventricle. [EU] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Viral: Pertaining to, caused by, or of the nature of virus. [EU] Virulence: The degree of pathogenicity within a group or species of microorganisms or viruses as indicated by case fatality rates and/or the ability of the organism to invade the tissues of the host. [NIH] Virus: Submicroscopic organism that causes infectious disease. In cancer therapy, some viruses may be made into vaccines that help the body build an immune response to, and

Dictionary 219

kill, tumor cells. [NIH] Visceral: , from viscus a viscus) pertaining to a viscus. [EU] Vitro: Descriptive of an event or enzyme reaction under experimental investigation occurring outside a living organism. Parts of an organism or microorganism are used together with artificial substrates and/or conditions. [NIH] Vivo: Outside of or removed from the body of a living organism. [NIH] War: Hostile conflict between organized groups of people. [NIH] Weight Gain: Increase in body weight over existing weight. [NIH] Weight Lifting: A sport in which weights are lifted competitively or as an exercise. [NIH] White blood cell: A type of cell in the immune system that helps the body fight infection and disease. White blood cells include lymphocytes, granulocytes, macrophages, and others. [NIH]

Xenograft: The cells of one species transplanted to another species. [NIH] X-ray: High-energy radiation used in low doses to diagnose diseases and in high doses to treat cancer. [NIH] Xylulose: A 5-carbon keto sugar. [NIH] Zalcitabine: A dideoxynucleoside compound in which the 3'-hydroxy group on the sugar moiety has been replaced by a hydrogen. This modification prevents the formation of phosphodiester linkages which are needed for the completion of nucleic acid chains. The compound is a potent inhibitor of HIV replication at low concentrations, acting as a chainterminator of viral DNA by binding to reverse transcriptase. Its principal toxic side effect is axonal degeneration resulting in peripheral neuropathy. [NIH] Zymogen: Inactive form of an enzyme which can then be converted to the active form, usually by excision of a polypeptide, e. g. trypsinogen is the zymogen of trypsin. [NIH]

221

INDEX A Abdominal, 45, 100, 165, 192, 193, 196, 201, 202, 203, 204 Abdominal Pain, 45, 165, 204 Absolute risk, 7, 165 Acceptor, 165, 194, 201 Acetylcholine, 165, 199 Actin, 165, 198, 217 Activities of Daily Living, 18, 165 Acute renal, 78, 120, 165 Acyl, 115, 165 Adenosine, 165, 204 Adipocytes, 165, 194 Adjustment, 9, 12, 17, 18, 104, 165 Adolescence, 165, 203 Adrenal Cortex, 165, 166, 178, 206, 210 Adrenal Glands, 165, 167 Adverse Effect, 165, 212 Aerobic, 15, 165, 183, 197, 207 Afferent, 34, 165, 166, 194 Afferent Pathways, 34, 166 Affinity, 116, 166, 213 Age of Onset, 166, 217 Agonist, 166, 181 Albumin, 132, 166, 205 Albuminuria, 123, 166, 206 Aldosterone, 58, 71, 166 Alertness, 162, 166 Algorithms, 114, 120, 166, 171 Alimentary, 166, 182, 202 Alkaline, 166, 167, 173, 215 Alkaloid, 166, 175 Allogeneic, 166, 187 Allograft, 7, 64, 166 Alternative medicine, 133, 166 Aluminum, 23, 88, 167 Ameliorating, 33, 116, 167 Amino acid, 65, 75, 90, 167, 168, 169, 187, 194, 203, 207, 212, 214, 216, 217 Amino Acid Sequence, 167, 168 Ammonia, 167, 217 Amphetamines, 167, 176 Ampicillin, 38, 167, 204 Amyloidosis, 49, 52, 61, 101, 149, 167 Anaemia, 56, 57, 167, 196 Anaesthesia, 167, 191 Analgesic, 23, 149, 167 Analog, 167, 185, 193

Anatomical, 167, 170, 175, 191, 211 Anemic, 8, 167 Anesthesia, 167, 170, 182 Angina, 5, 7, 168 Angina Pectoris, 7, 168 Angioplasty, 7, 168, 170 Angiotensin-Converting Enzyme Inhibitors, 71, 168 Angiotensinogen, 79, 113, 168, 209, 210 Animal model, 33, 134, 168 Anions, 166, 168, 193, 212 Anorexia, 88, 96, 134, 136, 167, 168, 201, 217 Anoxia, 168, 188 Antagonism, 168, 180 Antibacterial, 168, 213, 214, 218 Antibiotic, 167, 168, 172, 198, 199, 203, 204, 210, 213, 214, 216 Antibodies, 20, 108, 112, 168, 183, 188, 195, 197, 204, 208 Antibody, 42, 50, 57, 137, 166, 168, 169, 176, 188, 189, 191, 196, 197, 208, 213 Anticoagulant, 168, 207 Antifungal, 168, 212 Antigen, 77, 166, 168, 169, 176, 183, 189, 191, 196, 197 Antihypertensive, 27, 30, 169 Antimetabolite, 169, 185, 210 Antineoplastic, 169, 178, 185, 196, 212 Antioxidant, 19, 34, 169, 201 Antiviral, 169, 192, 210 Anuria, 169, 193 Anxiety, 15, 169 Aorta, 169, 178, 218 Apolipoproteins, 169, 194 Aqueous, 169, 170, 194 Arginine, 67, 169, 199 Arterial, 15, 41, 65, 69, 169, 175, 190, 207, 215 Arteries, 169, 171, 178, 194, 197, 198 Arteriolar, 169, 172, 210 Arterioles, 169, 171, 173, 198, 218 Arteriolosclerosis, 15, 169 Arteriosclerosis, 15, 169, 190, 198 Arteriovenous, 8, 31, 41, 120, 169 Arteriovenous Fistula, 8, 31, 41, 120, 169 Artery, 7, 45, 47, 49, 67, 70, 78, 83, 90, 129, 134, 168, 169, 178, 182, 208, 211

222


Articular, 169, 201 Assay, 112, 169, 211 Asymptomatic, 7, 170, 202 Atherectomy, 46, 170, 182 Atrium, 170, 197, 218 Atrophy, 15, 170 Autodigestion, 170, 202 Autologous, 61, 170 Autonomic, 124, 165, 170, 215 Autonomic Neuropathy, 124, 170 Azotemia, 170, 217 B Bacteria, 165, 168, 169, 170, 182, 184, 187, 189, 197, 205, 207, 208, 213, 216, 218 Base, 50, 89, 170, 179, 188, 193, 217 Basement Membrane, 170, 184 Behavioral Medicine, 76, 170 Benign, 169, 170, 198, 208 Benzene, 170, 193 Beta-Lactamases, 170, 214 Bilateral, 42, 67, 71, 171, 210 Bile, 171, 185, 194, 214 Biliary, 171, 202 Biliary Tract, 171, 202 Bilirubin, 166, 171 Binding agent, 14, 51, 171 Biochemical, 14, 126, 169, 171, 193, 201, 212 Biological response modifier, 171, 192 Biopsy, 13, 15, 20, 171, 203 Biotechnology, 37, 38, 133, 143, 171 Bladder, 62, 170, 171, 177, 199, 207, 209, 218 Blood Cell Count, 171, 188 Blood Coagulation, 171, 173, 211, 216 Blood Glucose, 126, 171, 188, 192 Blood Platelets, 171, 196, 212, 216 Blood vessel, 171, 173, 174, 175, 182, 186, 188, 193, 196, 203, 204, 210, 212, 213, 214, 216, 218 Body Composition, 42, 171 Body Fluids, 112, 171, 181, 213 Body Mass Index, 7, 171 Bolus, 82, 171 Bolus infusion, 171 Bone Marrow, 113, 170, 172, 183, 186, 187, 191, 195, 196, 198, 213, 214 Bone Marrow Cells, 113, 172, 196 Bone Marrow Transplantation, 113, 172 Bowel, 172, 180, 192, 204 Bowel Movement, 172, 180 Bradykinin, 172, 199, 205

Branch, 159, 172, 179, 202, 207, 213, 215 Broad-spectrum, 167, 172, 173, 174, 204, 216 Buccal, 172, 195 Buffers, 172, 188 C Cadaver, 123, 172 Calcifediol, 172 Calcification, 41, 45, 47, 50, 70, 84, 169, 172 Calcineurin, 107, 172 Calcitriol, 14, 88, 97, 133, 172 Calcium, 14, 91, 96, 124, 125, 136, 172, 173, 176, 180, 190, 197, 201, 202, 212, 215, 217 Calmodulin, 172, 173 Caloric intake, 92, 173 Capillary, 172, 173, 186 Capsules, 173, 186 Carbenicillin, 37, 173 Carbohydrates, 173, 174, 188 Carcinogen, 173, 196 Carcinogenic, 170, 173, 192, 206, 214 Carcinoma, 173 Cardiac, 6, 7, 8, 17, 71, 73, 84, 88, 89, 132, 173, 181, 182, 188, 198, 214 Cardiomyopathy, 17, 173 Cardiotonic, 173, 181 Cardiovascular disease, 6, 7, 8, 14, 18, 19, 30, 34, 39, 62, 68, 91, 124, 173 Cardiovascular System, 170, 173 Carnitine, 114, 115, 124, 173 Case report, 73, 173, 175 Catabolism, 54, 173 Catecholamine, 174, 181 Catheter, 8, 170, 174, 182 Catheterization, 168, 174 Cations, 174, 188, 193 Caudal, 174, 180, 190, 205 Causal, 18, 174 Cause of Death, 6, 34, 174, 179 Cefoperazone, 38, 174 Cell membrane, 174, 193, 204 Cell motility, 174, 189 Cell proliferation, 169, 174, 212 Cell Respiration, 174, 197 Cell Transplantation, 174 Cellobiose, 174 Cellulose, 89, 173, 174, 204 Central Nervous System, 34, 165, 167, 170, 172, 174, 175, 182, 187, 212 Centrifugation, 174, 188 Cerebral, 45, 89, 174, 178, 216 Cerebrovascular, 11, 173, 174

Index 223

Cerebrum, 174 Character, 168, 175, 179 Chemotherapeutic agent, 175, 180 Chemotherapy, 79, 113, 175 Chin, 15, 79, 175, 196 Cholesterol, 15, 19, 43, 72, 98, 134, 171, 175, 178, 181, 190, 194, 211, 214 Cholesterol Esters, 175, 194 Chromosomal, 175, 205, 211 Chromosome, 68, 175, 194, 211 Chronic, 5, 7, 10, 11, 12, 13, 14, 17, 20, 23, 24, 28, 30, 31, 33, 34, 38, 39, 41, 46, 53, 59, 69, 71, 73, 75, 78, 79, 84, 89, 90, 91, 98, 105, 113, 115, 119, 120, 124, 126, 127, 136, 150, 151, 164, 175, 180, 182, 191, 193, 202, 205, 209, 211, 214, 215, 217 Chronic Disease, 11, 113, 175 Chylomicrons, 175, 194 Cirrhosis, 20, 175 Clinical study, 175, 177 Clinical trial, 32, 34, 107, 108, 125, 143, 175, 177, 181, 197, 203, 207, 208 Cloning, 113, 171, 175 Coagulation, 43, 125, 171, 175, 205 Coca, 175 Cocaine, 9, 22, 175 Cofactor, 176, 207, 216 Collagen, 167, 170, 176, 186, 205 Colloidal, 166, 176, 212 Colon, 176, 194 Colorectal, 21, 176 Colorectal Cancer, 21, 176 Comorbidity, 11, 13, 27, 176 Complement, 176, 177, 195, 205 Complementary and alternative medicine, 95, 101, 176 Complementary medicine, 95, 177 Compliance, 9, 30, 33, 66, 75, 89, 103, 104, 105, 177 Computational Biology, 143, 177 Computer Simulation, 21, 177 Concentric, 72, 169, 177 Conception, 177, 184 Concomitant, 37, 177 Congestive heart failure, 7, 177 Connective Tissue, 172, 176, 177, 185, 186, 195, 210, 214, 215 Consciousness, 167, 177, 180, 181 Constipation, 177, 204 Constriction, 177, 193, 211, 218 Consumption, 134, 177, 179, 200, 201 Contraception, 55, 177

Contractility, 168, 177 Contraindications, ii, 177 Contrast Media, 54, 177 Contrast medium, 177, 178 Control group, 35, 177 Controlled clinical trial, 17, 27, 177 Convulsions, 178, 181 Coronary, 7, 11, 40, 45, 46, 47, 49, 70, 73, 83, 129, 134, 168, 173, 178, 190, 197, 198 Coronary Angiography, 7, 178 Coronary Artery Bypass, 7, 73, 178 Coronary Circulation, 168, 178 Coronary heart disease, 11, 173, 178 Coronary Thrombosis, 178, 197, 198 Cortex, 178 Cortical, 178, 211 Corticosteroid, 178, 214 Cortisol, 166, 178 Cost Savings, 28, 178 Creatinine, 15, 27, 68, 163, 178, 193, 217 Creatinine clearance, 68, 163, 178 Curative, 178, 215 Cutaneous, 45, 83, 100, 178, 195 Cyclic, 173, 179, 187, 199, 207 Cystathionine beta-Synthase, 179, 190 Cytogenetics, 179, 211 Cytokine, 33, 179, 212 Cytomegalovirus, 42, 179 Cytomegalovirus Retinitis, 42, 179 Cytotoxic, 179, 208, 212 D Dairy Products, 179, 211 Data Collection, 25, 127, 179 De novo, 18, 179 Deamination, 179, 217 Death Certificates, 45, 179 Decision Making, 3, 28, 29, 59, 135, 179 Degenerative, 179, 189, 201 Density, 19, 23, 36, 72, 171, 174, 179, 181, 194, 200 Deprivation, 134, 179 Dermatosis, 44, 45, 179 Developing Countries, 52, 179 Diagnostic procedure, 111, 133, 179 Dialysate, 34, 35, 120, 179, 180 Dialysis Solutions, 24, 34, 180 Dialyzer, 19, 50, 150, 180, 188 Diastole, 180 Diastolic, 17, 60, 180, 190 Diencephalon, 180, 190, 215 Dietetics, 123, 124, 180 Dietitian, 120, 134, 180

224


Digestion, 166, 171, 172, 180, 192, 194, 214 Digestive system, 109, 180 Digestive tract, 170, 180, 212 Dihydrotestosterone, 180, 209 Dilatation, 6, 17, 168, 180, 206, 218 Dilate, 78, 180 Dilation, 170, 172, 180, 218 Diltiazem, 80, 180 Dipyridamole, 7, 180 Direct, iii, 5, 25, 34, 180, 181, 197, 209 Discrimination, 4, 180 Disease Progression, 6, 180 Dissociation, 34, 166, 180 Dissociative Disorders, 180, 181 Distal, 178, 181, 203, 207 Distention, 45, 181 Dobutamine, 7, 83, 181 Dopamine, 176, 181, 199 Dorsal, 181, 205 Double-blind, 27, 34, 80, 181 Double-blinded, 34, 181 Dreams, 16, 181 Drug Interactions, 181 Drug Monitoring, 38, 50, 181 Drug Tolerance, 181, 216 Duct, 174, 181, 184, 211, 213 Dyslipidemia, 63, 96, 137, 181 Dyspnoea, 39, 181 E Echocardiography, 7, 17, 50, 83, 181 Eclampsia, 48, 181 Edema, 40, 60, 179, 181, 217 Efferent, 34, 182 Efficacy, 22, 29, 33, 34, 35, 50, 51, 78, 107, 125, 182 Elasticity, 169, 182 Elastin, 70, 176, 182 Electrocoagulation, 175, 182 Electrolyte, 54, 68, 99, 137, 164, 166, 178, 182, 188, 193, 205, 213, 217 Emboli, 45, 182 Embryo, 182, 191 Empirical, 25, 182 Endarterectomy, 168, 170, 182 Endocarditis, 115, 182 Endocardium, 182 Endogenous, 181, 182, 201, 207, 217 Endothelium, 182, 199 Endothelium-derived, 182, 199 Endotoxic, 182, 194 Energy balance, 182, 194 Enteral Nutrition, 64, 120, 182

Environmental Health, 142, 144, 183 Enzymatic, 167, 172, 173, 176, 183, 185, 196, 210 Enzyme, 26, 41, 42, 79, 116, 179, 183, 186, 187, 205, 207, 209, 210, 212, 214, 216, 217, 219 Enzyme Inhibitors, 41, 183, 205 Epidemic, 4, 10, 30, 183 Epidemiological, 77, 79, 123, 183 Epidermal, 183, 197 Epigastric, 183, 201 Epithelial, 183, 189 Epithelial Cells, 183, 189 Epitopes, 112, 183 Epoetin alfa, 125, 183 Ergometer, 22, 183 Erythroblasts, 183 Erythrocytes, 113, 116, 167, 171, 172, 183, 209 Erythroid Progenitor Cells, 113, 183 Erythropoiesis, 41, 112, 113, 183 Erythropoietin, 6, 8, 15, 19, 25, 28, 33, 43, 56, 57, 60, 64, 113, 124, 125, 126, 163, 183 Esophagus, 180, 183, 209, 214 Eukaryotic Cells, 183, 217 Excrete, 169, 183, 193 Exercise Test, 22, 183, 184 Exercise Tolerance, 125, 184 Exocrine, 184, 201 Exogenous, 14, 33, 182, 184, 207, 217 Extracellular, 33, 46, 177, 184, 197, 213, 215 Extracellular Matrix, 33, 177, 184 Extracellular Space, 184, 197 Extremity, 69, 184 F Family Characteristics, 119, 184 Family Planning, 143, 184 Family Relations, 3, 184 Fat, 124, 134, 165, 171, 172, 178, 182, 184, 194, 196, 211, 213 Fatigue, 40, 96, 124, 162, 184, 188 Fatty acids, 166, 184, 206 Feces, 114, 177, 184 Femoral, 71, 184, 189 Femoral Neck Fractures, 71, 184, 189 Femur, 184, 189 Fenfluramine, 61, 97, 184 Ferritin, 34, 184 Fetal Hemoglobin, 64, 184 Fetus, 183, 184 Fibrin, 171, 184, 185, 204, 205, 216 Fibrinogen, 97, 184, 185, 205, 216

Index 225

Fibrinolytic, 43, 185 Fibrosis, 15, 33, 36, 185, 211 Fluorouracil, 180, 185 Folate, 19, 91, 95, 99, 185 Fold, 20, 21, 26, 185 Folic Acid, 78, 98, 185 Follicles, 185 Food Preferences, 16, 40, 88, 96, 134, 185 Foramen, 175, 185, 203 Forearm, 171, 185 Free Radicals, 169, 180, 185 G Gadolinium, 91, 185 Gallbladder, 165, 171, 180, 185 Gamma Rays, 185, 208 Gangrene, 77, 83, 100, 185 Gas, 167, 185, 190, 199 Gastric, 170, 173, 185 Gastrin, 185, 189 Gastrointestinal, 33, 49, 57, 172, 182, 185, 186, 212, 214 Gastrostomy, 182, 186 Gelatin, 186, 187 Gene, 33, 39, 58, 91, 116, 171, 186, 189, 200 Gene Expression, 186 Gene Therapy, 33, 186 Genital, 170, 186 Germ Cells, 186, 215 Gland, 14, 165, 178, 186, 195, 198, 201, 202, 207, 211, 214, 216 Glomerular, 15, 29, 36, 123, 186, 192, 193, 209 Glomerular Filtration Rate, 15, 29, 123, 186, 193 Glomeruli, 15, 186 Glomerulonephritis, 5, 23, 26, 52, 186, 195 Glomerulosclerosis, 15, 56, 112, 186 Glomerulus, 186, 199 Glucose, 43, 58, 126, 171, 174, 179, 186, 187, 188, 192, 203, 211 Glucose Intolerance, 179, 186 Glucuronic Acid, 186, 189 Glutamic Acid, 185, 187, 199 Glyceraldehyde 3-Phosphate, 116, 187, 217 Glycine, 84, 92, 167, 187, 199 Glycolysis, 116, 187 Glycoprotein, 42, 112, 183, 185, 187, 216 Gonadal, 187, 214 Gonads, 187, 190 Governing Board, 187, 205 Grade, 22, 187

Graft, 8, 10, 26, 108, 137, 187, 189, 198 Graft Rejection, 108, 187 Graft Survival, 10, 26, 108, 137, 187 Grafting, 7, 73, 178, 187 Graft-versus-host disease, 187, 198 Gram-negative, 182, 187, 207, 216 Grasses, 185, 187 Guanylate Cyclase, 187, 199 H Haemodialysis, 60, 79, 82, 89, 98, 187 Hair follicles, 43, 187 Haplotypes, 63, 187 Haptens, 166, 188 Health Education, 188 Health Fairs, 20, 188 Heart attack, 5, 173, 188 Heart failure, 8, 17, 35, 168, 188 Hematocrit, 6, 171, 188 Hematopoietic tissue, 113, 172, 188 Hemodialysis Solutions, 34, 188 Hemodialyzer, 127, 188 Hemofiltration, 39, 188, 217 Hemoglobin, 60, 167, 171, 183, 184, 188, 194 Hemoglobin H, 184, 188 Hemoglobinopathies, 186, 188 Hemorheology, 95, 188 Hemorrhage, 179, 182, 189, 214 Heparin, 60, 69, 189 Hepatic, 57, 166, 189 Hepatitis, 13, 20, 60, 71, 77, 189 Hepatocyte, 33, 60, 189 Hepatocyte Growth Factor, 33, 189 Hereditary, 26, 189 Heredity, 186, 189 Heterogeneity, 68, 166, 189 Hip Fractures, 184, 189 Histology, 15, 189 Holidays, 16, 189 Homeostasis, 23, 189 Homogeneous, 169, 189 Homologous, 186, 189 Hormonal, 170, 178, 189 Hormone, 59, 90, 166, 173, 178, 183, 185, 189, 192, 194, 206, 212, 215, 216 Host, 187, 189, 191, 218 Human growth hormone, 90, 189 Humoral, 187, 189 Hydration, 72, 137, 189 Hydrogen, 165, 170, 172, 173, 189, 190, 194, 197, 201, 219 Hydrophilic, 113, 114, 190

226


Hydrophobic, 190, 194 Hydroxylation, 172, 190 Hydroxyproline, 167, 176, 190 Hypercalcemia, 92, 190 Hypercholesterolemia, 7, 19, 36, 63, 181, 190 Hyperglycemia, 12, 19, 190 Hyperhomocysteinemia, 19, 62, 65, 78, 84, 91, 92, 98, 179, 190 Hyperlipidemia, 37, 181, 190 Hypertriglyceridemia, 181, 190 Hypertrophy, 6, 8, 17, 19, 36, 47, 48, 72, 88, 190 Hypoglycemia, 132, 190 Hypogonadism, 23, 190 Hypotension, 17, 24, 178, 190 Hypothalamic, 35, 190 Hypothalamus, 35, 180, 190, 215 Hypovolemia, 24, 190 Hypoxemia, 72, 190 Hypoxia, 113, 167, 190 I Id, 93, 100, 113, 148, 152, 153, 158, 160, 190 Immune response, 169, 178, 187, 188, 190, 191, 195, 214, 218 Immune system, 190, 191, 195, 204, 218, 219 Immunization, 191, 206 Immunodeficiency, 22, 38, 62, 79, 82, 191 Immunofluorescence, 15, 191, 197 Immunogenic, 191, 194 Immunoglobulin, 74, 112, 168, 191, 197 Immunologic, 112, 191, 208 Immunology, 166, 191 Immunophilin, 172, 191 Immunosuppressant, 185, 191, 212 Immunosuppressive, 121, 137, 172, 191 Impairment, 130, 191, 196 In vitro, 186, 191, 211 In vivo, 33, 37, 186, 189, 191, 197, 201 Indicative, 121, 191, 202, 218 Induction, 36, 64, 191 Infarction, 6, 191 Infection Control, 20, 191 Infiltration, 186, 191 Infusion, 34, 192 Ingestion, 23, 192, 205, 215 Initiation, 29, 76, 113, 192, 217 Inner ear, 192, 218 Inorganic, 65, 90, 192 Insight, 119, 192 Insulin, 21, 26, 29, 65, 89, 126, 192, 202, 217

Insulin-dependent diabetes mellitus, 21, 26, 192 Interferon, 13, 192 Interferon-alpha, 192 Intermittent, 29, 192, 203 Internal Medicine, 26, 33, 88, 89, 91, 127, 192, 199 Interstitial, 15, 26, 60, 184, 192, 199, 209 Intestinal, 28, 173, 192 Intestine, 172, 176, 192, 194 Intoxication, 50, 192 Intracellular, 191, 192, 199, 205, 207, 212 Intramuscular, 192, 202 Intraperitoneal, 82, 89, 90, 126, 192 Intravenous, 7, 19, 22, 29, 33, 57, 61, 65, 88, 97, 114, 115, 192, 202 Intrinsic, 3, 166, 170, 192 Inulin, 186, 192 Involuntary, 192, 198 Ionizing, 193, 208 Ions, 170, 172, 173, 180, 182, 190, 193 Ischemia, 170, 193 Isoflavones, 79, 98, 193 Isotonic, 15, 193 J Jejunostomy, 182, 193 Joint, 30, 169, 193, 201, 215 K Kb, 142, 193 Keto, 193, 219 Kidney Failure, 4, 10, 13, 26, 36, 115, 122, 136, 148, 149, 150, 182, 186, 188, 193 Kidney Failure, Acute, 193 Kidney Failure, Chronic, 115, 193 Kidney stone, 5, 193, 199 Kidney Transplantation, 20, 29, 52, 76, 114, 123, 124, 137, 148, 193 Kinetic, 99, 193 L Lag, 34, 193 Lamivudine, 38, 79, 193 Large Intestine, 176, 180, 192, 194, 209, 212 Lens, 194, 210 Leptin, 56, 194 Leucine, 115, 194 Leukemia, 184, 186, 194 Leukocytes, 171, 172, 192, 194 Library Services, 158, 194 Life cycle, 30, 194 Life Expectancy, 19, 21, 194 Ligament, 194, 207 Linkage, 33, 58, 68, 174, 194

Index 227

Lipid, 19, 68, 169, 192, 193, 194, 201 Lipid A, 19, 194 Lipid Peroxidation, 194, 201 Lipopolysaccharides, 194 Lipoprotein, 36, 69, 72, 181, 187, 194 Living Donors, 108, 194 Lobe, 189, 194, 202 Localized, 167, 191, 194, 204, 211 Low-density lipoprotein, 63, 181, 194 Lung Transplantation, 74, 195 Lupus, 26, 81, 150, 195, 215 Lupus Nephritis, 81, 195 Lymph, 182, 195, 198 Lymph node, 195, 198 Lymphatic, 182, 191, 195, 213 Lymphocyte, 169, 195, 196 Lymphoid, 168, 195 Lytic, 195, 212 M Macrophage, 36, 195 Maintenance therapy, 108, 195 Major Histocompatibility Complex, 188, 195 Malaise, 124, 195 Malignancy, 22, 30, 195 Malignant, 169, 195, 198, 208 Malignant tumor, 195, 198 Malnutrition, 17, 19, 22, 70, 88, 124, 134, 136, 166, 170, 188, 195 Mammary, 178, 195 Mammogram, 172, 195, 197 Mandible, 175, 195, 210 Meat, 115, 195, 211 Medial, 169, 196, 200 Mediator, 25, 196, 212 Medical Records, 20, 196, 210 Medical Staff, 181, 196 MEDLINE, 143, 196 Mefloquine, 38, 196 Megakaryocytes, 172, 196 Megaloblastic, 185, 196 Melphalan, 61, 196 Memory, 105, 168, 196 Meninges, 174, 196 Menopause, 196, 205 Mental, iv, 13, 32, 109, 142, 144, 175, 180, 184, 196, 206, 207, 217, 218 Mental Disorders, 109, 196, 206 Mental Health, iv, 32, 109, 142, 144, 196, 206, 207 Mental Processes, 180, 196, 207 Mesentery, 196, 204

Meta-Analysis, 29, 196 Metabolite, 19, 172, 196 Methylmalonic Acid, 84, 92, 99, 196 MI, 37, 164, 196 Microbe, 197, 216 Microcalcifications, 172, 197 Microdialysis, 35, 197 Microorganism, 176, 197, 202, 219 Microscopy, 15, 170, 197 Mineralization, 197, 201 Mitochondria, 115, 197 Mitral Valve, 45, 197 Mixed Connective Tissue Disease, 115, 197 Modification, 24, 70, 167, 197, 208, 219 Molecular, 33, 60, 69, 115, 143, 145, 171, 172, 173, 177, 179, 180, 185, 189, 197, 205, 216 Molecule, 112, 169, 170, 176, 180, 182, 188, 197, 201, 205, 208, 209, 212, 214, 217, 218 Monitor, 178, 197, 200 Monoclonal, 112, 197 Monoclonal antibodies, 112, 197 Motion Sickness, 197, 198 Mucosa, 195, 197, 214 Multicenter study, 57, 197 Multiple Myeloma, 64, 198 Muscle Fibers, 15, 198, 217 Muscle tension, 15, 198 Mycophenolate mofetil, 81, 92, 137, 198 Myocardial infarction, 5, 7, 42, 61, 70, 178, 181, 196, 198 Myocardial Ischemia, 168, 198 Myocardium, 82, 168, 196, 198 Myosin, 172, 198, 217 N Nasogastric, 182, 198 Natriuresis, 168, 198 Nausea, 136, 162, 163, 198, 217, 218 NCI, 1, 109, 141, 198 Nebramycin, 198, 216 Neoplasms, 169, 198, 208 Nephrectomy, 67, 198 Nephritis, 38, 78, 199 Nephrolithiasis, 5, 199 Nephrologist, 9, 16, 18, 132, 199 Nerve, 166, 167, 175, 182, 196, 199, 203, 210, 211, 214, 217, 218 Nervous System, 166, 174, 196, 199, 214, 215 Netilmicin, 37, 199 Neural, 165, 189, 199

228


Neurogenic, 35, 199 Neuromuscular, 165, 199, 217 Neurons, 176, 199, 215 Neuropathy, 116, 170, 199, 203 Neurotoxicity, 83, 199 Neurotransmitter, 165, 167, 172, 181, 187, 199, 212, 214 Nitric Oxide, 19, 35, 43, 58, 67, 199 Nitrogen, 166, 193, 196, 199, 217 Nosocomial, 13, 72, 199 Nuclear, 183, 184, 185, 197, 200 Nuclear Family, 184, 200 Nuclei, 186, 200 Nucleic acid, 199, 200, 210, 219 Nursing Care, 200, 202 Nutrition Assessment, 120, 137, 200 Nutritional Status, 18, 65, 90, 125, 134, 136, 200 O Observational study, 41, 200 Odds Ratio, 26, 200, 209 Odour, 200, 217 Oliguria, 193, 200 Oncogene, 189, 200 Opacity, 179, 200 Optic Chiasm, 190, 200 Organ Procurement, 137, 152, 200 Organ Transplantation, 119, 200 Osmosis, 201 Osmotic, 126, 166, 201, 212 Osteoarthritis, 115, 201 Osteodystrophy, 23, 201 Osteomalacia, 23, 172, 201 Outpatient, 8, 201 Ovum, 194, 201, 206 Oxidants, 35, 201 Oxidation, 37, 63, 90, 165, 169, 194, 201, 203 Oxidation-Reduction, 201 Oxidative Stress, 19, 34, 65, 96, 201 Oxygen Consumption, 183, 201 Oxygenation, 190, 201 P Palliative, 201, 215 Pancreas, 9, 10, 63, 76, 81, 121, 165, 180, 192, 201, 202 Pancreas Transplant, 81, 121, 202 Pancreas Transplantation, 81, 121, 202 Pancreatic, 173, 202 Pancreatitis, 61, 202 Parathyroid, 14, 91, 151, 172, 202, 215 Parathyroid Glands, 202

Parathyroid hormone, 14, 172, 202 Parathyroidectomy, 14, 202 Parenteral, 33, 64, 98, 120, 202 Parenteral Nutrition, 120, 202 Parietal, 202, 204 Paroxysmal, 168, 202 Pathogen, 20, 202 Pathogenesis, 8, 32, 33, 34, 36, 91, 202 Pathologic, 171, 178, 202, 210, 218 Pathophysiology, 8, 88, 96, 202 Patient Care Management, 124, 202 Patient Compliance, 4, 9, 29, 202 Patient Education, 16, 28, 35, 156, 158, 164, 202 Patient Satisfaction, 9, 203 Patient Selection, 124, 127, 203 Pediatrics, 31, 41, 49, 51, 75, 90, 91, 92, 203 Pelvic, 203, 207 Penicillin, 167, 168, 173, 203 Penicillinase, 173, 203 Pentosephosphate Pathway, 203, 217 Peptide, 167, 194, 203, 207 Perception, 9, 13, 18, 125, 203 Percutaneous, 7, 46, 67, 203 Perfusion, 190, 203 Pericardium, 203, 215 Periodontitis, 73, 203 Peripheral Neuropathy, 39, 203, 219 Peripheral Vascular Disease, 5, 7, 11, 45, 203 Peritoneal Cavity, 192, 203 Peritoneum, 127, 196, 203, 204 Peritonitis, 82, 101, 126, 204 Phagocyte, 201, 204 Pharmaceutical Preparations, 174, 186, 204 Pharmacokinetic, 125, 204 Pharmacologic, 25, 167, 204, 216 Phospholipids, 184, 194, 204 Phosphorus, 124, 125, 134, 136, 173, 202, 204 Phosphorylates, 116, 204 Photocoagulation, 175, 204 Physiologic, 126, 166, 192, 193, 204, 206, 209, 210 Physiology, 75, 199, 204 Piperacillin, 37, 204 Plants, 166, 175, 186, 192, 204, 207, 211, 216 Plaque, 168, 170, 204 Plasma cells, 168, 198, 204 Plasma protein, 166, 204, 206, 212

Index 229

Plasmid, 33, 205, 218 Plasmin, 205, 206 Platelet Aggregation, 199, 205 Platelets, 199, 205 Pneumonia, 177, 205 Poisoning, 192, 198, 205 Polycystic, 5, 205 Polymorphism, 79, 91, 205 Polyposis, 176, 205 Polysaccharide, 169, 174, 205 Posterior, 35, 181, 201, 205 Postmenopausal, 54, 205 Postoperative, 121, 205 Potassium, 24, 50, 58, 124, 125, 134, 136, 166, 205 Potentiating, 113, 205 Practice Guidelines, 56, 144, 205 Precursor, 168, 181, 183, 205, 206, 217 Pre-eclamptic, 181, 206 Prekallikrein, 58, 206 Prevalence, 7, 11, 14, 17, 19, 20, 23, 30, 31, 32, 61, 97, 152, 200, 206 Primary Prevention, 25, 51, 206 Probe, 197, 206 Progesterone, 206, 214 Prognostic factor, 79, 206 Progression, 6, 11, 14, 15, 20, 24, 25, 34, 56, 85, 89, 134, 137, 168, 206 Progressive, 5, 6, 29, 33, 36, 53, 114, 123, 124, 169, 175, 181, 187, 193, 201, 206, 209 Progressive disease, 36, 206 Projection, 12, 206 Promoter, 36, 206 Prospective study, 69, 206 Prostaglandin, 168, 206 Prostate, 21, 207 Protein Binding, 115, 207 Protein C, 9, 137, 166, 167, 169, 184, 194, 207, 217 Protein S, 92, 171, 189, 207 Proteins, 43, 69, 112, 116, 167, 169, 174, 176, 197, 199, 203, 204, 207, 208, 212, 217 Proteinuria, 15, 75, 91, 98, 123, 186, 198, 207 Proteolytic, 176, 185, 205, 207 Protocol, 83, 207 Proximal, 36, 181, 207 Pruritus, 163, 207, 217 Pseudomonas, 174, 204, 207, 216 Pseudomonas Infections, 204, 207 Psychic, 196, 207, 211 Psychology, 76, 92, 180, 207

Public Health, 12, 45, 144, 207 Public Policy, 143, 207 Pulmonary, 89, 115, 171, 177, 183, 188, 193, 207, 208, 218 Pulmonary Artery, 171, 207, 218 Pulmonary Edema, 89, 193, 208 Pulse, 41, 197, 208 Putrefaction, 185, 208 Q Quality of Life, 13, 17, 40, 42, 71, 96, 104, 125, 136, 208 R Race, 9, 11, 12, 20, 21, 22, 27, 123, 196, 208 Racemic, 196, 208 Radiation, 168, 185, 193, 208, 219 Radioactive, 190, 197, 200, 208 Radiography, 177, 178, 208 Radioimmunotherapy, 208 Radiological, 203, 208 Radiotherapy, 113, 208 Randomized, 7, 14, 27, 30, 34, 35, 40, 51, 80, 96, 182, 208 Randomized clinical trial, 7, 30, 208 Reactivation, 125, 208 Reactive Oxygen Species, 35, 208 Reagent, 112, 208 Receptor, 35, 36, 41, 79, 88, 113, 169, 181, 189, 209, 212 Recombinant, 6, 28, 43, 56, 57, 64, 90, 126, 209, 218 Recombination, 186, 209 Rectum, 172, 176, 180, 185, 194, 207, 209 Recurrence, 56, 209 Red blood cells, 6, 183, 209, 211 Reductase, 91, 209 Refer, 1, 172, 176, 199, 208, 209, 216 Reflux, 51, 84, 132, 209 Refractory, 7, 77, 182, 209 Regimen, 105, 182, 202, 209 Registries, 97, 123, 209 Regurgitation, 61, 97, 209 Relative risk, 6, 7, 18, 165, 209 Remission, 195, 209 Renal cell carcinoma, 82, 209 Renal failure, 4, 5, 8, 12, 14, 23, 34, 49, 68, 69, 78, 89, 113, 114, 120, 124, 126, 127, 129, 136, 205, 209, 217 Renal Osteodystrophy, 14, 23, 91, 120, 137, 150, 209 Renal pelvis, 193, 209 Renin, 34, 58, 68, 71, 168, 209 Renin-Angiotensin System, 34, 168, 209

230


Renovascular, 10, 23, 35, 210 Resolving, 127, 210 Resorption, 173, 210 Restoration, 208, 210 Retina, 179, 194, 200, 210 Retinal, 179, 200, 210 Retinitis, 179, 210 Retrospective, 61, 210 Retrospective study, 61, 210 Retroviral vector, 186, 210 Rheumatic Diseases, 26, 210 Rheumatoid, 201, 210 Ribavirin, 13, 210 Ribonuclease, 197, 210 Ribose, 116, 165, 210, 217 Risk factor, 5, 7, 9, 14, 15, 17, 19, 22, 25, 31, 44, 56, 61, 72, 78, 80, 91, 134, 190, 206, 209, 210 Risk patient, 4, 210 Ristocetin, 210, 218 S Saliva, 211 Salivary, 48, 179, 180, 211 Salivary glands, 179, 180, 211 Saphenous, 178, 211 Saphenous Vein, 178, 211 Saponins, 211, 214 Satellite, 8, 211 Saturated fat, 134, 211 Scleroderma, 115, 169, 197, 211 Sclerosis, 15, 169, 211 Screening, 4, 12, 20, 21, 175, 211 Secretion, 50, 113, 178, 192, 211 Segmental, 46, 56, 186, 211 Segmentation, 211 Seizures, 125, 163, 202, 211 Self Care, 8, 136, 165, 211 Semen, 207, 211 Semisynthetic, 173, 174, 199, 204, 211 Serologic, 15, 212 Serotonin, 184, 199, 212, 217 Serum, 9, 15, 27, 34, 56, 79, 85, 98, 99, 166, 176, 193, 194, 197, 204, 212 Serum Albumin, 9, 212 Shock, 190, 212, 217 Side effect, 8, 29, 108, 165, 196, 212, 216, 219 Signal Transduction, 172, 212 Signs and Symptoms, 209, 212, 217 Sirolimus, 108, 212 Skeletal, 14, 198, 212, 217 Skeleton, 165, 184, 193, 206, 212

Small intestine, 175, 189, 192, 198, 212 Smooth muscle, 167, 210, 212, 214 Social Environment, 208, 212 Social Support, 9, 17, 80, 212 Social Work, 30, 135, 213 Sodium, 124, 125, 136, 166, 198, 213 Soft tissue, 172, 212, 213 Solvent, 113, 114, 170, 201, 213 Somatic, 165, 189, 203, 213 Specialist, 132, 153, 180, 213 Species, 35, 166, 174, 197, 200, 207, 208, 213, 214, 216, 217, 218, 219 Specificity, 166, 213 Spectrum, 213, 214 Sperm, 175, 213 Spinal cord, 174, 175, 196, 199, 213, 215 Spleen, 167, 179, 195, 213 Stem cell transplantation, 61, 213 Stem Cells, 183, 187, 213 Stenosis, 17, 31, 78, 213, 214 Sterile, 202, 213 Steroid, 108, 178, 211, 213, 214 Steroid therapy, 108, 214 Stimulant, 181, 214 Stimulus, 177, 193, 214, 216 Stomach, 165, 170, 180, 183, 185, 186, 189, 198, 203, 209, 212, 213, 214 Stress, 4, 5, 15, 16, 19, 25, 28, 34, 74, 83, 91, 104, 115, 163, 174, 178, 198, 201, 214 Stricture, 213, 214 Stroke, 7, 11, 61, 109, 129, 142, 173, 214 Stromal, 172, 214 Stromal Cells, 172, 214 Subacute, 191, 214 Subclinical, 191, 211, 214 Subcutaneous, 165, 182, 202, 214 Subspecies, 213, 214 Substance P, 196, 211, 214 Substrate, 116, 183, 214 Substrate Specificity, 116, 214 Sulbactam, 38, 214 Sulfur, 193, 214 Supplementation, 33, 78, 85, 97, 98, 99, 100, 126, 215 Support group, 11, 164, 215 Suppression, 14, 178, 215 Survival Rate, 7, 10, 12, 31, 215 Sympathetic Nervous System, 168, 215 Symphysis, 175, 207, 215 Symptomatic, 6, 7, 202, 215 Systemic, 26, 42, 53, 78, 167, 169, 171, 191, 195, 197, 211, 215, 218

Index 231

Systemic lupus erythematosus, 26, 42, 78, 195, 197, 215 Systolic, 17, 190, 215 T Tachycardia, 181, 215 Teaching Materials, 16, 215 Teratogenic, 180, 215 Testis, 116, 187, 215 Testosterone, 209, 215 Tetany, 202, 215 Therapeutics, 48, 89, 215 Thermal, 180, 215 Thigh, 184, 215 Third Ventricle, 190, 215 Threshold, 180, 190, 216 Thrombin, 184, 185, 205, 207, 216 Thrombocytopenia, 60, 216 Thrombomodulin, 207, 216 Thromboplastin, 206, 216 Thrombosis, 31, 42, 61, 207, 214, 216 Thyroid, 202, 216 Thyroid Gland, 202, 216 Thyroxine, 166, 216 Tin, 203, 216 Tissue Harvesting, 200, 216 Tobramycin, 37, 216 Tolerance, 64, 81, 92, 186, 216 Tonicity, 193, 216 Toxic, iv, 170, 187, 188, 196, 199, 216, 218, 219 Toxicity, 33, 69, 134, 181, 199, 211, 216 Toxicology, 144, 216 Toxin, 182, 216 Transcriptase, 193, 217, 219 Transcription Factors, 115, 217 Transfection, 171, 186, 217 Transketolase, 116, 217 Translation, 167, 217 Transmitter, 165, 181, 196, 217 Trauma, 202, 217 Tropomyosin, 217 Troponin, 85, 132, 217 Tryptophan, 176, 187, 212, 217 Type 2 diabetes, 12, 19, 27, 32, 69, 98, 217 U Ubiquitin, 71, 217 Ultrafiltration, 188, 217

Unconscious, 190, 217 Uraemia, 46, 202, 217 Urea, 120, 170, 193, 217, 218 Uremia, 17, 82, 114, 116, 193, 209, 218 Ureters, 193, 218 Urethra, 207, 218 Urinary, 200, 218 Urine, 15, 112, 123, 162, 163, 166, 169, 171, 178, 193, 198, 200, 207, 209, 218 Urolithiasis, 120, 218 V Vaccine, 207, 218 Vancomycin, 46, 218 Vascular, 4, 5, 6, 8, 12, 15, 19, 31, 47, 61, 65, 77, 84, 178, 182, 190, 191, 199, 216, 218 Vascular Resistance, 15, 218 Vasculitis, 26, 81, 92, 202, 218 Vasoconstriction, 181, 218 Vasodilation, 168, 218 Vasodilators, 199, 218 Vector, 33, 218 Vein, 169, 192, 200, 211, 218 Venous, 31, 169, 171, 207, 218 Ventricle, 35, 197, 207, 208, 215, 218 Ventricular, 6, 8, 17, 19, 47, 48, 60, 64, 68, 88, 218 Veterinary Medicine, 143, 218 Viral, 22, 218, 219 Virulence, 216, 218 Virus, 13, 20, 38, 62, 71, 77, 79, 82, 192, 204, 210, 218 Visceral, 92, 170, 204, 219 Vitro, 189, 219 Vivo, 219 W War, 67, 219 Weight Gain, 137, 219 Weight Lifting, 15, 219 White blood cell, 168, 194, 195, 204, 219 X Xenograft, 168, 219 X-ray, 177, 185, 195, 200, 208, 219 Xylulose, 116, 217, 219 Z Zalcitabine, 193, 219 Zymogen, 207, 219

232


End-Stage Renal Disease - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Renal Failure - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Chronic Renal Failure - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Foot and Mouth Disease - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Canavan Disease: A Medical Dictionary, Bibliography, And Annotated Research Guide To Internet References

Parkinson's Disease - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Degenerative Joint Disease - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Hirschsprung's Disease - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Peyronie's Disease - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Chagas Disease - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Pelvic Inflammatory Disease - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Alzheimer's Disease: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Gastroesophageal Reflux Disease - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Periodontal Disease - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Batten Disease: A Medical Dictionary, Bibliography, And Annotated Research Guide To Internet References

Tay-Sachs Disease - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Cushing's Disease - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Huntington Disease - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Gallbladder Disease - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Huntington's Disease - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Lung Disease - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Creutzfeldt-Jakob Disease - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Colon Disease - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Degenerative Disc Disease: A Medical Dictionary, Bibliography, And Annotated Research Guide To Internet References

Raynaud's Disease - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Wilson's Disease - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Chronic Obstructive Pulmonary Disease - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Addison's Disease - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Gum Disease - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Graves' Disease - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

End-Stage Renal Disease - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Renal Failure - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Chronic Renal Failure - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Foot and Mouth Disease - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Canavan Disease: A Medical Dictionary, Bibliography, And Annotated Research Guide To Internet References

Parkinson's Disease - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Degenerative Joint Disease - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Hirschsprung's Disease - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Peyronie's Disease - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Chagas Disease - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Pelvic Inflammatory Disease - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Alzheimer's Disease: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Gastroesophageal Reflux Disease - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Periodontal Disease - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Batten Disease: A Medical Dictionary, Bibliography, And Annotated Research Guide To Internet References

Tay-Sachs Disease - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Cushing's Disease - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Huntington Disease - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Gallbladder Disease - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Huntington's Disease - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Lung Disease - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Creutzfeldt-Jakob Disease - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Colon Disease - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Degenerative Disc Disease: A Medical Dictionary, Bibliography, And Annotated Research Guide To Internet References

Raynaud's Disease - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Wilson's Disease - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Chronic Obstructive Pulmonary Disease - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Addison's Disease - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Gum Disease - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Graves' Disease - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

Recommend Documents