Gilbert's Syndrome: A Medical Dictionary, Bibliography, And Annotated Research Guide To Internet References

GILBERT’S SYNDROME A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES J...

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GILBERT’S SYNDROME A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES

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

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

Publisher, Health Care: Philip Parker, Ph.D. Editor(s): James Parker, M.D., Philip Parker, Ph.D. Publisher's note: The ideas, procedures, and suggestions contained in this book are not intended for the diagnosis or treatment of a health problem. As new medical or scientific information becomes available from academic and clinical research, recommended treatments and drug therapies may undergo changes. The authors, editors, and publisher have attempted to make the information in this book up to date and accurate in accord with accepted standards at the time of publication. The authors, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of this book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised to always check product information (package inserts) for changes and new information regarding dosage and contraindications before prescribing any drug or pharmacological product. Caution is especially urged when using new or infrequently ordered drugs, herbal remedies, vitamins and supplements, alternative therapies, complementary therapies and medicines, and integrative medical treatments. Cataloging-in-Publication Data Parker, James N., 1961Parker, Philip M., 1960Gilbert’s Syndrome: 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: 0-497-00479-8 1. Gilbert’s Syndrome-Popular works. I. Title.

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

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

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

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

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

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Table of Contents FORWARD .......................................................................................................................................... 1 CHAPTER 1. STUDIES ON GILBERT’S SYNDROME .............................................................................. 3 Overview........................................................................................................................................ 3 Federally Funded Research on Gilbert’s Syndrome ....................................................................... 3 E-Journals: PubMed Central ......................................................................................................... 5 The National Library of Medicine: PubMed .................................................................................. 5 CHAPTER 2. ALTERNATIVE MEDICINE AND GILBERT’S SYNDROME .............................................. 35 Overview...................................................................................................................................... 35 National Center for Complementary and Alternative Medicine.................................................. 35 Additional Web Resources ........................................................................................................... 37 General References ....................................................................................................................... 37 CHAPTER 3. PERIODICALS AND NEWS ON GILBERT’S SYNDROME ................................................. 39 Overview...................................................................................................................................... 39 News Services and Press Releases................................................................................................ 39 Academic Periodicals covering Gilbert’s Syndrome .................................................................... 41 CHAPTER 4. RESEARCHING MEDICATIONS .................................................................................... 43 Overview...................................................................................................................................... 43 U.S. Pharmacopeia....................................................................................................................... 43 Commercial Databases ................................................................................................................. 44 Researching Orphan Drugs ......................................................................................................... 44 APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 49 Overview...................................................................................................................................... 49 NIH Guidelines............................................................................................................................ 49 NIH Databases............................................................................................................................. 51 Other Commercial Databases....................................................................................................... 53 APPENDIX B. PATIENT RESOURCES ................................................................................................. 55 Overview...................................................................................................................................... 55 Patient Guideline Sources............................................................................................................ 55 Finding Associations.................................................................................................................... 57 APPENDIX C. FINDING MEDICAL LIBRARIES .................................................................................. 59 Overview...................................................................................................................................... 59 Preparation................................................................................................................................... 59 Finding a Local Medical Library.................................................................................................. 59 Medical Libraries in the U.S. and Canada ................................................................................... 59 ONLINE GLOSSARIES.................................................................................................................. 65 Online Dictionary Directories ..................................................................................................... 66 GILBERT’S SYNDROME DICTIONARY................................................................................... 67 INDEX ................................................................................................................................................ 87

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FORWARD In March 2001, the National Institutes of Health issued the following warning: "The number of Web sites offering health-related resources grows every day. Many sites provide valuable information, while others may have information that is unreliable or misleading."1 Furthermore, because of the rapid increase in Internet-based information, many hours can be wasted searching, selecting, and printing. Since only the smallest fraction of information dealing with Gilbert’s syndrome 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 Gilbert’s syndrome, 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 Gilbert’s syndrome, 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 Gilbert’s syndrome. 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 Gilbert’s syndrome, 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 Gilbert’s syndrome. The Editors

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

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CHAPTER 1. STUDIES ON GILBERT’S SYNDROME Overview In this chapter, we will show you how to locate peer-reviewed references and studies on Gilbert’s syndrome.

Federally Funded Research on Gilbert’s Syndrome The U.S. Government supports a variety of research studies relating to Gilbert’s syndrome. 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 Gilbert’s syndrome. 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 Gilbert’s syndrome. The following is typical of the type of information found when searching the CRISP database for Gilbert’s syndrome: •

Project Title: PHASE I CLINICAL TRIALS OF ANTICANCER AGENTS Principal Investigator & Institution: Ratain, Mark J.; Professor of Medicine and Chairman; Medicine; University of Chicago 5801 S Ellis Ave Chicago, Il 60637 Timing: Fiscal Year 2002; Project Start 10-MAY-1995; Project End 28-FEB-2003 Summary: (Applicant's Description) The overall objective of this proposal is to conduct phase I and pharmacological studies of new anticancer agents. These studies will aim to

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

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define the recommended phase II dose, toxicities, pharmacokinetics, and pharmacodynamics of such agents. Some of these trials may incorporate pharmacokinetics or pharmacodynamic modulators. Five new s t udies are proposed. These include 1)evaluation of genotyping for abnormalities in the UGT*1.1 promoters region (known to cause Gilbert's syndrome) and phenotyping with buprenorphine (a known substrate for UGI*1.1) as potential predictors of CPT-11 toxicity (diarrhea) and SN-38 glucuronidation (known to be a substrate for UGT*1.1); 2) evaluation of [O]6benzylguanine (BG) pharmacodynamics in patients with colorectal cancer or sarcoma undergoing surgical resections; 3)evaluation of BG in combination with temozolomide; 4)evaluation of ketoconazole (a potent inhibitor of CYP3A4 on carboxyanidoimadzole (a substrate for CYP3A4) pharmacokinetics and toxicity; and 5)evaluation of UCN-01 on biweekly (24 hr infusion) schedule. All studies will include both pharmacokinetics and correlative laboratory studies. The project total accrual is 375 patients, or 75 patients per year. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: REGULATED PROPERTIES OF THE HUMAN UGT1A1 GENE. Principal Investigator & Institution: Tukey, Robert H.; Professor; Pharmacology; University of California San Diego La Jolla, Ca 920930934 Timing: Fiscal Year 2003; Project Start 01-APR-1994; Project End 30-NOV-2006 Summary: (provided by applicant): Human UDP-glucuronosyltransferase 1A1 is involved in the metabolism of endogenous agents such as bilirubin in addition to many clinically used therapeutics. The wide tissue distribution of UGT1A1 indicates it plays an important role in metabolism and homeostasis. This has recently been illustrated with deficiencies in the expression of UGT1A1, as observed in Gilbert's syndrome, which have been linked to a number of severe toxicological episodes. Thus, understanding the events involved in the regulation and expression of UGT1A1 is important and is the focus of this application. We will show from recent experiments conducted in our laboratory as well as others that the UGT1A1 gene can be regulated by a host of agents, all of which have been shown to regulate other important drug metabolizing genes. Agents which induce UGTIA1 such as TCDD, rifampicin, tertbutylhydroquinone, [3-napthoflavone, phenobarbital and chrysin modulate gene transcription through one of the following nuclear receptors; the aryl hydrocarbon receptor (AhR), the pregnane X receptor (PXR), the constitutive androstane receptor (CAR) as well as Nrf2 through antioxidant (ARE) dependant pathways. To our knowledge, this may represent the first example of a gene that can be regulated by most of the major classes of inducing agents. Experiments are outlined that will characterize the regulatory regions as well as cellular signaling events associated with activation of the UGT1A1 gene. These investigations will be complemented by analyzing expression of human UGT1A1 in transgenic mice that have "knocked-out" important regulators of gene expression such as Nrf2, PXR, NF-rd3 and the AhR. The development of these tools to examine UGT1A1 expression will also allow us to determine if differences exist in the inducibility and regulation of the UGT1A1 gene in promoter deficient Gilbert's syndromes. Identifying the mechanisms that underlie expression of UGT1A1 may provide us with important clues toward improving expression of this gene and avoiding potential toxicities because of inadequate gene expression. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

Studies

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

Unconjugated Bilirubin and an Increased Proportion of Bilirubin Monoconjugates in the Bile of Patients with Gilbert's Syndrome and Crigler-Najjar Disease. by Fevery J, Blanckaert N, Heirwegh KP.; 1977 Nov; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=372448

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 Gilbert’s syndrome, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “Gilbert’s syndrome” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for Gilbert’s syndrome (hyperlinks lead to article summaries): •

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(TA)8 allele in the UGT1A1 gene promoter of a Caucasian with Gilbert's syndrome. Author(s): Iolascon A, Faienza MF, Centra M, Storelli S, Zelante L, Savoia A. Source: Haematologica. 1999 February; 84(2): 106-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10091406

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

With PubMed Central, NCBI is taking the lead in preservation and maintenance of open access to electronic literature, just as NLM has done for decades with printed biomedical literature. PubMed Central aims to become a world-class library of the digital age. 5 The value of PubMed Central, in addition to its role as an archive, lies in the availability of data from diverse sources stored in a common format in a single repository. Many journals already have online publishing operations, and there is a growing tendency to publish material online only, to the exclusion of print. 6 PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM) at the National Institutes of Health (NIH). The PubMed database was developed in conjunction with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text journal articles at Web sites of participating publishers. Publishers that participate in PubMed supply NLM with their citations electronically prior to or at the time of publication.

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A case of congenital dyserythropoietic anemia type II, Gilbert's syndrome and malleolar trophic ulcers. Author(s): Bordi B, Rosaria D'Amico M, Guariglia R, Capobianco G, Bordi E, Tirelli A. Source: Hematology (Amsterdam, Netherlands). 2002 June; 7(3): 197-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12243985

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A case of Gilbert's syndrome combined with macroamylasemia. Author(s): Inoue H, Adachi Y, Yamashita M, Nanno T, Katoh H, Enomoto M, Suwa M, Yamamoto T. Source: Gastroenterol Jpn. 1989 June; 24(3): 320-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2472995

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A Caucasian boy with Gilbert's syndrome heterozygous for the (TA)(8) allele. Author(s): Tsezou A, Tzetis M, Kitsiou S, Kavazarakis E, Galla A, Kanavakis E. Source: Haematologica. 2000 March; 85(3): 319. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10702824

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A modeling study of the effect of fasting on bilirubin kinetics in Gilbert's syndrome. Author(s): Okolicsanyi L, Orlando R, Venuti M, Dal Brun G, Cobelli C, Ruggeri A, Salvan A. Source: The American Journal of Physiology. 1981 May; 240(5): R266-71. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7235043

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Abnormal hepatic transport of indocyanine green in Gilbert's syndrome. Author(s): Martin JF, Vierling JM, Wolkoff AW, Scharschmidt BF, Vergalla J, Waggoner JG, Berk PD. Source: Gastroenterology. 1976 March; 70(3): 385-91. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=814028

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Abnormal hepatic uptake of low doses of sulfobromophthalein in Gilbert's syndrome: the role of reduced affinity of the plasma membrane carrier of organic anions. Author(s): Gentile S, Persico M, Tiribelli C. Source: Hepatology (Baltimore, Md.). 1990 August; 12(2): 213-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2391064

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Acute appendicitis in patients with Gilbert's syndrome. Author(s): Lotveit T. Source: Acta Chir Scand. 1985; 151(8): 701-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4096175

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Agenesis of the gallbladder associated with Gilbert's syndrome. Author(s): Orlando R, Candiani F, Lirussi F. Source: Surgical Endoscopy. 2001 July; 15(7): 757. Epub 2001 May 02. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11591986

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Alkaptonuria and Gilbert's syndrome. Report of two affected siblings and hepatic ultrastructure in one sibling. Author(s): Brown NK, Smuckler EA. Source: The American Journal of Medicine. 1970 June; 48(6): 759-65. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5420562

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Alteration of drug metabolism in Gilbert's syndrome. Author(s): Carulli N, Ponz de Leon M, Mauro E, Manenti F, Ferrari A. Source: Gut. 1976 August; 17(8): 581-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=976795

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An assay of bilirubin UDP-glucuronyl transferase on needle-biopsies applied to Gilbert's syndrome. Author(s): Bellet H, Raynaud A. Source: Clinica Chimica Acta; International Journal of Clinical Chemistry. 1974 May 31; 53(1): 51-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4210385

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An assessment of red cell survival in idiopathic unconjugated hyperbilirubinaemia (Gilbert's syndrome) by the use of radioactive diisopropylfluorophosphate and chromium. Author(s): Powell LW, Billing BH, Williams HS. Source: Australas Ann Med. 1967 August; 16(3): 221-5. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6056611

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An evaluation of bilirubin kinetics with respect to the diagnosis of Gilbert's syndrome. Author(s): Okolicsanyi L, Ghidini O, Orlando R, Cortelazzo S, Benedetti G, Naccarato R, Manitto P. Source: Clin Sci Mol Med. 1978 May; 54(5): 539-47. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=750155

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An expanded model of bilirubin kinetics: effect of feeding, fasting, and phenobarbital in Gilbert's syndrome. Author(s): Kirshenbaum G, Shames DM, Schmid R. Source: Journal of Pharmacokinetics and Biopharmaceutics. 1976 April; 4(2): 115-55. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=950587

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Anaesthesia and Gilbert's syndrome. Author(s): Hargreaves J. Source: Anaesthesia. 1985 June; 40(6): 595-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4025758

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Analysis of bilirubins in biological fluids by extraction and thin-layer chromatography of the intact tetrapyrroles: application to bile of patients with Gilbert's syndrome, hemolysis, or cholelithiasis. Author(s): Fevery J, Blanckaert N, Leroy P, Michiels R, Heirwegh KP. Source: Hepatology (Baltimore, Md.). 1983 March-April; 3(2): 177-83. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6832709

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Analysis of genes for bilirubin UDP-glucuronosyltransferase in Gilbert's syndrome. Author(s): Aono S, Adachi Y, Uyama E, Yamada Y, Keino H, Nanno T, Koiwai O, Sato H. Source: Lancet. 1995 April 15; 345(8955): 958-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7715297

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Antipyrine clearance in patients with Gilbert's syndrome. Author(s): Ishizaki T, Chiba K, Sasaki T. Source: European Journal of Clinical Pharmacology. 1984; 27(3): 297-302. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6510457

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Are Gilbert's syndrome and liver involvement genetically linked in infectious mononucleosis? Author(s): Guala A, Campra D, Marinelli I, Gaidano G, Pagani L. Source: The Pediatric Infectious Disease Journal. 2003 December; 22(12): 1110-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14688581

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Bile salt measurements in Gilbert's syndrome. Author(s): Douglas JG, Beckett GJ, Nimmo IA, Finlayson ND, Percy-Robb IW. Source: European Journal of Clinical Investigation. 1981 December; 11(6): 421-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6800816

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Bilirubin and paranitrophenol glucuronyl transferase activities of the liver in patients with Gilbert's syndrome An attempt at a biochemical breakdown of the Gilbert's syndrome. Author(s): Auclair C, Hakim J, Boivin P, Troube H, Boucherot J. Source: Enzyme. 1976; 21(2): 97-107. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=816648

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Bilirubin levels in the acute hemolytic crisis of G6PD deficiency are related to Gilbert's syndrome. Author(s): Iolascon A, Faienza MF, Giordani L, Perrotta S, Ruggiu G, Meloni GF, del Giudice EM. Source: European Journal of Haematology. 1999 May; 62(5): 307-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10359058

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Bright yellow--the extended spectrum of Gilbert's syndrome. Author(s): June CH, Benjamin SB. Source: The American Journal of Gastroenterology. 1984 June; 79(6): 482-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6731424

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Bromsulfophthalein clearance and aminopyrine test in patients with Gilbert's syndrome. Author(s): Bar-Meir S, Bar-Tal L, Papa MZ, Peled Y. Source: Isr J Med Sci. 1986 May; 22(5): 376-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3744786

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Can the liver with Gilbert's syndrome be used as graft of living-related liver transplantation? Author(s): Miyake H, Tashiro S, Yogita S, Ishikawa M, Fukuda Y, Harada M, Wada D, Ito S, Yasuda M. Source: J Med Invest. 1998 February; 44(3-4): 219-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9597813

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Cholelithiasis and Gilbert's syndrome in homozygous beta-thalassaemia. Author(s): Galanello R, Piras S, Barella S, Leoni GB, Cipollina MD, Perseu L, Cao A. Source: British Journal of Haematology. 2001 December; 115(4): 926-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11843828

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Coexisting Gilbert's syndrome and sickle cell disease. Author(s): Borker A, Udall J, Warrier R. Source: Southern Medical Journal. 2002 August; 95(8): 939-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12190239

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Co-inheritance of Gilbert's syndrome and sickle cell anemia. Author(s): Agbemadzo B, Koduri PR. Source: American Journal of Hematology. 2002 January; 69(1): 86-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11835342

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Co-inherited Gilbert's syndrome: a factor determining hyperbilirubinemia in homozygous beta-thalassemia. Author(s): Galanello R, Cipollina MD, Dessi C, Giagu N, Lai E, Cao A. Source: Haematologica. 1999 February; 84(2): 103-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10091405

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Combined polymorphisms in UDP-glucuronosyltransferases 1A1 and 1A6: implications for patients with Gilbert's syndrome. Author(s): Peters WH, te Morsche RH, Roelofs HM. Source: Journal of Hepatology. 2003 January; 38(1): 3-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12480553

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Comparison of in-vivo and in-vitro drug metabolism in patients with Gilbert's syndrome. Author(s): Narang AP, Datta DV. Source: J Assoc Physicians India. 1982 June; 30(6): 357-9. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6763035

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Comparison of nicotinic acid- and caloric restriction-induced hyperbilirubinaemia in the diagnosis of Gilbert's syndrome. Author(s): Gentile S, Orzes N, Persico M, Marmo R, Bronzino P, Tiribelli C. Source: Journal of Hepatology. 1985; 1(5): 537-43. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4056354

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Compensated hemolytic anemia associated with Gilbert's syndrome: a case report. Author(s): Stone GM. Source: Aerosp Med. 1971 July; 42(7): 785-6. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5162447

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Concomitant Gilbert's syndrome and thalassemia trait. Author(s): Singh G, Agarwal MP. Source: J Assoc Physicians India. 2003 March; 51: 316-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12839364

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Constitutional hepatic dysfunction (Gilbert's syndrome). A new definition based on kinetic studies with unconjugated radiobilirubin. Author(s): Berk PD, Bloomer JR, Howe RB, Berlin NI. Source: The American Journal of Medicine. 1970 September; 49(3): 296-305. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5455561

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Contribution of two missense mutations (G71R and Y486D) of the bilirubin UDP glycosyltransferase (UGT1A1) gene to phenotypes of Gilbert's syndrome and CriglerNajjar syndrome type II. Author(s): Yamamoto K, Sato H, Fujiyama Y, Doida Y, Bamba T. Source: Biochimica Et Biophysica Acta. 1998 April 28; 1406(3): 267-73. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9630669

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Co-occurrence of three different mutations in the bilirubin UDPglucuronosyltransferase gene in a Chinese family with Crigler-Najjar syndrome type I and Gilbert's syndrome. Author(s): Maruo Y, Poon KK, Ito M, Iwai M, Takahashi H, Mori A, Sato H, Takeuchi Y. Source: Clinical Genetics. 2003 November; 64(5): 420-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14616765

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Correlation of mutational analysis to clinical features in Taiwanese patients with Gilbert's syndrome. Author(s): Hsieh SY, Wu YH, Lin DY, Chu CM, Wu M, Liaw YF. Source: The American Journal of Gastroenterology. 2001 April; 96(4): 1188-93. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11316168

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Decreased glucuronidation and increased bioactivation of acetaminophen in Gilbert's syndrome. Author(s): de Morais SM, Uetrecht JP, Wells PG. Source: Gastroenterology. 1992 February; 102(2): 577-86. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1732127

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Defective bromosulfophthalein clearance in patients with constitutional hepatic dysfunction (Gilbert's syndrome). Author(s): Berk PD, Blaschke TF, Waggoner JG. Source: Gastroenterology. 1972 September; 63(3): 472-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5071284

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Definition of a conjugation of dysfunction in Gilbert's syndrome: studies of the handling of bilirubin loads and of the pattern of bilirubin conjugates secreted in bile. Author(s): Goresky CA, Gordon ER, Shaffer EA, Pare P, Carassavas D, Aronoff A. Source: Clin Sci Mol Med. 1978 July; 55(1): 63-71. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=668269

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Delayed gastric emptying in subjects with Gilbert's syndrome. Author(s): Mendez-Sanchez N, Gonzalez V, Flores A, Martinez M, Graef A, Uribe M. Source: Hepatogastroenterology. 2001 July-August; 48(40): 1183-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11490829

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Detection of Gilbert's syndrome in patients with hemolysis. A method using radioactive chromium. Author(s): Berk PD, Blaschke TF. Source: Annals of Internal Medicine. 1972 October; 77(4): 527-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4642732

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Diagnosis of Gilbert's syndrome. Reliability of the caloric restriction and phenobarbital stimulation tests. Author(s): Thomsen HF, Hardt F, Juhl E. Source: Scandinavian Journal of Gastroenterology. 1981; 16(5): 699-703. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7323703

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Diagnosis of Gilbert's syndrome: role of reduced caloric intake test. Author(s): Owens D, Sherlock S. Source: British Medical Journal. 1973 September 15; 3(5880): 559-63. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4726927

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Disposition of lorazepam in Gilbert's syndrome: effects of fasting, feeding, and enterohepatic circulation. Author(s): Herman RJ, Chaudhary A, Szakacs CB. Source: Journal of Clinical Pharmacology. 1994 October; 34(10): 978-84. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7836548

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Disposition of propafenone in a poor metabolizer of CYP2D6 with Gilbert's syndrome. Author(s): Dilger K, Meisel P, Hofmann U, Eichelbaum M. Source: Therapeutic Drug Monitoring. 2000 June; 22(3): 366-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10850406

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Dissociation between vascular and metabolic effects of nicotinic acid in Gilbert's syndrome. Author(s): Gentile S, Marmo R, Persico M, Faccenda F, Orlando C, Rubba P. Source: Clinical Physiology (Oxford, England). 1990 March; 10(2): 171-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2318027

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Donor liver uridine diphosphate (UDP)-glucuronosyltransferase-1A1 deficiency causing Gilbert's syndrome in liver transplant recipients. Author(s): Te HS, Schiano TD, Das S, Kuan SF, DasGupta K, Conjeevaram HS, Baker AL. Source: Transplantation. 2000 May 15; 69(9): 1882-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10830226

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Dose dependence of nicotinic acid-induced hyperbilirubinemia and its dissociation from hemolysis in Gilbert's syndrome. Author(s): Gentile S, Tiribelli C, Persico M, Bronzino P, Marmo R, Orzes N, Orlando C, Rubba P, Coltorti M. Source: The Journal of Laboratory and Clinical Medicine. 1986 February; 107(2): 166-71. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3944496

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Doxorubicin dosage guidelines in a patient with hyperbilirubinemia of Gilbert's syndrome. Author(s): Cupp MJ, Higa GM. Source: The Annals of Pharmacotherapy. 1998 October; 32(10): 1026-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9793595

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Drug treatment of hypercholesterolaemia in a patient with Gilbert's syndrome. Author(s): Cummings MH, Watts GF. Source: Annals of Clinical Biochemistry. 1994 July; 31 ( Pt 4): 383-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7979108

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Effect of changes in dietary components on the serum bilirubin in Gilbert's syndrome. Author(s): Felsher BF. Source: The American Journal of Clinical Nutrition. 1976 July; 29(7): 705-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=937224

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Effect of cimetidine on the metabolism of cholephilic dyes in Gilbert's syndrome. Author(s): Kutz K, Deres M. Source: European Journal of Clinical Pharmacology. 1984; 27(2): 227-32. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6499902

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Effect of clofibrate on the metabolism of bilirubin, bromosulphophthalein and indocyanine green and on the biliary lipid composition in Gilbert's syndrome. Author(s): Kutz K, Kandler H, Gugler R, Fevery J. Source: Clinical Science (London, England : 1979). 1984 April; 66(4): 389-97. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6697662

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Effect of dietary composition on the unconjugated hyperbilirubinaemia of Gilbert's syndrome. Author(s): Gollan JL, Bateman C, Billing BH. Source: Gut. 1976 May; 17(5): 335-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1278716

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Effect of different doses of S-adenosyl-L-methionine (SAMe) on nicotinic acidinduced hyperbilirubinaemia in Gilbert's syndrome. Author(s): Gentile S, Persico M, Orlando C, Le Grazie C, Di Padova C, Coltorti M. Source: Scandinavian Journal of Clinical and Laboratory Investigation. 1988 October; 48(6): 525-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3217756

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Effect of low caloric diet on endogenous carbon monoxide production: normal adults and Gilbert's syndrome. Author(s): Bensinger TA, Maisels MJ, Carlson DE, Conrad ME. Source: Proceedings of the Society for Experimental Biology and Medicine. Society for Experimental Biology and Medicine (New York, N. Y.). 1973 November; 144(2): 417-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4746911

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Effect of splenectomy of hepatic bilirubin clearance in patients with hereditary spherocytosis. Implications for the diagnosis of Gilbert's syndrome. Author(s): Berk PD, Berman MD, Blitzer BL, Chretien P, Martin JF, Scharschmidt BF, Vierling JM, Wolkoff AW, Vergalla J, Waggoner JG. Source: The Journal of Laboratory and Clinical Medicine. 1981 July; 98(1): 37-45. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7252326

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Effects of corticosteroids on bilirubin metabolism in patients with Gilbert's syndrome. Author(s): Ohkubo H, Okuda K, Iida S. Source: Hepatology (Baltimore, Md.). 1981 March-April; 1(2): 168-72. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7286896

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Effects of phenobarbital on unconjugated bilirubin clearance, gammaglutamyltranspeptidase and urinary d-glucaric acid in patients with Gilbert's syndrome. Author(s): Kawasaki H, Murawaki Y, Kimura N, Hirayama C. Source: Hepatogastroenterology. 1982 December; 29(6): 252-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6130037

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Epirubicin in a breast cancer patient with Gilbert's syndrome: apparent lack of major pharmacokinetic alterations. Author(s): Riggi M, Poggesi I, Regazzi MB, Grasso S, Fittipaldo A, Seematter RJ. Source: Annals of Oncology : Official Journal of the European Society for Medical Oncology / Esmo. 1999 March; 10(3): 360-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10355585

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Evaluation of tests for Gilbert's syndrome. Author(s): Olsson R, Lindstedt G. Source: Acta Med Scand. 1980; 207(5): 425-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7386236

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Excess lipofuscin accumulation in constitutional hepatic dysfunction (Gilbert's syndrome). Light and electron microscopic observations. Author(s): Barth RF, Grimley PM, Berk PD, Bloomer JR, Howe RB. Source: Arch Pathol. 1971 January; 91(1): 41-7. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5538621

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Extreme hyperbilirubinemia in a patient with hereditary spherocytosis, Gilbert's syndrome, and obstructive jaundice. Author(s): Katz ME, Weinstein IM. Source: The American Journal of the Medical Sciences. 1978 May-June; 275(3): 373-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=686044

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Familial increased serum intestinal alkaline phosphatase: a new variant associated with Gilbert's syndrome. Author(s): Lieverse AG, van Essen GG, Beukeveld GJ, Gazendam J, Dompeling EC, ten Kate LP, van Belle SA, Weits J. Source: Journal of Clinical Pathology. 1990 February; 43(2): 125-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2318988

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Frequency of Gilbert's syndrome associated with UGTA1 (TA)(7) polymorphism in Southern Italy. Author(s): Iolascon A, Perrotta S, Coppola B, Carbone R, Miraglia Del Giudice E. Source: Haematologica. 2000 March; 85(3): 335-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10702836

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Frequent co-occurrence of the TATA box mutation associated with Gilbert's syndrome (UGT1A1*28) with other polymorphisms of the UDPglucuronosyltransferase-1 locus (UGT1A6*2 and UGT1A7*3) in Caucasians and Egyptians. Author(s): Kohle C, Mohrle B, Munzel PA, Schwab M, Wernet D, Badary OA, Bock KW. Source: Biochemical Pharmacology. 2003 May 1; 65(9): 1521-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12732365

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Genetic inheritance of Gilbert's syndrome. Author(s): Bosma P, Chowdhury JR, Jansen PH. Source: Lancet. 1995 July 29; 346(8970): 314-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7630272

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Genetic interactions in the pathogenesis of neonatal hyperbilirubinemia: Gilbert's Syndrome and glucose-6-phosphate dehydrogenase deficiency. Author(s): Kaplan M. Source: Journal of Perinatology : Official Journal of the California Perinatal Association. 2001 December; 21 Suppl 1: S30-4; Discussion S35-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11803413

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Genetic testing for Gilbert's syndrome. Author(s): Koduri PR. Source: Int J Clin Pract. 2001 September; 55(7): 495. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11594267

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Genetic testing for Gilbert's syndrome: how useful is it in determining the cause of jaundice? Author(s): Rudenski AS, Halsall DJ. Source: Clinical Chemistry. 1998 August; 44(8 Pt 1): 1604-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9702945

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Genetic variation in bilirubin UPD-glucuronosyltransferase gene promoter and Gilbert's syndrome. Author(s): Monaghan G, Ryan M, Seddon R, Hume R, Burchell B. Source: Lancet. 1996 March 2; 347(9001): 578-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8596320

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Gilbert's syndrome (Criggler-Najjar type) with Hansen's disease of the dimorphous type. Author(s): Banerjee K. Source: International Journal of Leprosy and Other Mycobacterial Diseases : Official Organ of the International Leprosy Association. 1982 December; 50(4): 509. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6892026

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Gilbert's syndrome accounts for the phenotypic variability of congenital dyserythropoietic anemia type II (CDA-II). Author(s): Perrotta S, del Giudice EM, Carbone R, Servedio V, Schettini F Jr, Nobili B, Iolascon A. Source: The Journal of Pediatrics. 2000 April; 136(4): 556-9. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10753261

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Gilbert's syndrome and chronic fatigue syndrome. Author(s): Valesini G, Conti F, Priori R, Balsano F. Source: Lancet. 1993 May 1; 341(8853): 1162-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8097856

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Gilbert's syndrome and drug metabolism. Author(s): Macklon AF, Savage RL, Rawlins MD. Source: Clinical Pharmacokinetics. 1979 May-June; 4(3): 223-32. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=383356

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Gilbert's syndrome and HL-A. Preliminary report. Author(s): Penner E, Mayr WR, Pacher M, Djawan S, Seyfried H, Pantucek F. Source: Z Immunitatsforsch Exp Klin Immunol. 1975 August; 150(1): 90-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=127467

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Gilbert's syndrome and hyperbilirubinaemia in ABO-incompatible neonates. Author(s): Kaplan M, Hammerman C, Renbaum P, Klein G, Levy-Lahad E. Source: Lancet. 2000 August 19; 356(9230): 652-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10968441

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Gilbert's syndrome and jaundice in glucose-6-phosphate dehydrogenase deficient neonates. Author(s): Kaplan M. Source: Haematologica. 2000; 85(E-Letters): E01. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11114816

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Gilbert's syndrome and jaundice in glucose-6-phosphate dehydrogenase deficient neonates. Author(s): Iolascon A, Faienza MF, Perrotta S, Meloni GF, Ruggiu G, del Giudice EM. Source: Haematologica. 1999 February; 84(2): 99-102. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10091404

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Gilbert's syndrome and Ramadan: exacerbation of unconjugated hyperbilirubinemia by religious fasting. Author(s): Ashraf W, van Someren N, Quigley EM, Saboor SA, Farrow LJ. Source: Journal of Clinical Gastroenterology. 1994 September; 19(2): 122-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7963357

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Gilbert's syndrome as a cause of postoperative jaundice. Author(s): Taylor S. Source: Anaesthesia. 1984 December; 39(12): 1222-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6517249

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Gilbert's syndrome associated with glucose-6-phosphate dehydrogenase deficiency. Author(s): Panich V, Sungnate T, Pootrakul P. Source: J Med Assoc Thai. 1972 August; 55(8): 483-91. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5081185

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Gilbert's syndrome co-existing with and masking hereditary spherocytosis. Author(s): Sharma S, Vukelja SJ, Kadakia S. Source: Annals of Hematology. 1997 June; 74(6): 287-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9236515

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Gilbert's syndrome during medical residency training. Author(s): Poveda F, Sanchez JF, Martinez PL, Camacho J. Source: Journal of Accident & Emergency Medicine. 1994 December; 11(4): 265-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7894821

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Gilbert's syndrome in children: report of two cases in the same family. Author(s): Laosombat V, Thakerngpol K, Stitnimankarn T. Source: J Med Assoc Thai. 1981 December; 64(12): 640-7. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6153033

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Gilbert's syndrome in identical twins. Author(s): Graham JR. Source: The Medical Journal of Australia. 1987 November 16; 147(10): 524. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3683272

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Gilbert's syndrome in patients with gallbladder stones. Author(s): Peel AL, Ritchie HD. Source: Annals of the Royal College of Surgeons of England. 1974 October; 55(4): 184-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4420293

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Gilbert's syndrome is a contributory factor in prolonged unconjugated hyperbilirubinemia of the newborn. Author(s): Monaghan G, McLellan A, McGeehan A, Li Volti S, Mollica F, Salemi I, Din Z, Cassidy A, Hume R, Burchell B. Source: The Journal of Pediatrics. 1999 April; 134(4): 441-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10190918

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Gilbert's syndrome is caused by a heterozygous missense mutation in the gene for bilirubin UDP-glucuronosyltransferase. Author(s): Koiwai O, Nishizawa M, Hasada K, Aono S, Adachi Y, Mamiya N, Sato H. Source: Human Molecular Genetics. 1995 July; 4(7): 1183-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8528206

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Gilbert's syndrome is not associated with HELLP syndrome. Author(s): Zusterzeel PL, te Morsche R, Raijmakers MT, Peters WH, Steegers EA. Source: Bjog : an International Journal of Obstetrics and Gynaecology. 2001 September; 108(9): 1003-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11563452

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Gilbert's syndrome unmasked as a cause of recurrent jaundice following porta-caval shunt surgery. Author(s): Ghosh P, Kochhar R, Mehta SK, Levi S. Source: Br J Clin Pract. 1990 December; 44(12): 793-4. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2102254

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Gilbert's syndrome. Author(s): Avasthi R, Agarwal S, Ram BK. Source: J Indian Med Assoc. 1995 October; 93(10): 403. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9053431

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Gilbert's syndrome. Author(s): Watson KJ, Gollan JL. Source: Baillieres Clin Gastroenterol. 1989 April; 3(2): 337-55. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2655758

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Gilbert's syndrome. Author(s): Arias IM. Source: British Medical Journal. 1968 June 15; 2(606): 702. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5658426

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Gilbert's syndrome: a possible cause of hyperbilirubinemia after orthotopic liver transplantation. Author(s): Lachaux A, Aboufadel A, Chambon M, Boillot O, Le Gall C, Gille D, Hermier M. Source: Transplantation Proceedings. 1996 October; 28(5): 2846. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8908094

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Gilbert's syndrome: analytical subcellular fractionation of liver biopsy specimens. Enzyme activities, organelle pathology and evidence for subpopulations of the syndrome. Author(s): Dawson J, Seymour CA, Peters TJ. Source: Clinical Science (London, England : 1979). 1979 December; 57(6): 491-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=391473

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Gilbert's syndrome: diagnosis by typical serum bilirubin pattern. Author(s): Sieg A, Stiehl A, Raedsch R, Ullrich D, Messmer B, Kommerell B. Source: Clinica Chimica Acta; International Journal of Clinical Chemistry. 1986 January 15; 154(1): 41-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3943223

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Gilbert's syndrome: evidence of morphological heterogeneity. Author(s): Dawson J, Carr-Locke DL, Talbot IC, Rosenthal FD. Source: Gut. 1979 October; 20(10): 848-53. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=533695

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Gilbert's syndrome: report of a case and review of literature. Author(s): Cowsill LJ. Source: J Am Osteopath Assoc. 1979 May; 78(9): 631-6. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=376493

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Gilbert's syndrome--a legitimate genetic anomaly? Author(s): Schmid R. Source: The New England Journal of Medicine. 1995 November 2; 333(18): 1217-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7565981

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Gilbert's syndrome--a possible cause of hyperbilirubinemia after orthotopic liver transplantation. Author(s): Arnold JC, Otto G, Kraus T, Kommerell B, Theilmann L. Source: Journal of Hepatology. 1992 March; 14(2-3): 404. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1500702

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Gilbert's syndrome--clinical and pharmacological implications. Author(s): Radu P, Atsmon J. Source: Isr Med Assoc J. 2001 August; 3(8): 593-8. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11519385

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Gilbert's syndrome--does it exist? A study of the prevalence of symptoms in Gilbert's syndrome. Author(s): Olsson R, Bliding A, Jagenburg R, Lapidus L, Larsson B, Svardsudd K, Wittboldt S. Source: Acta Med Scand. 1988; 224(5): 485-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3264448

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Gilbert's syndrome--report of six cases. Author(s): Roy PK, Ali Z, Hasan M, Khan AK. Source: Bangladesh Med Res Counc Bull. 1985 December; 11(2): 51-4. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3837663

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Hemolysis in Gilbert's syndrome. Author(s): Ostrow JD. Source: Hepatology (Baltimore, Md.). 2002 September; 36(3): 764; Author Reply 764-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12198673

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Hepatic bilirubin glucuronidation in Gilbert's syndrome. Author(s): Felsher BF, Craig JR, Carpio N. Source: The Journal of Laboratory and Clinical Medicine. 1973 June; 81(6): 829-37. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4710368

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Hepatic bilirubin udp-glucuronyl transferase activity in liver disease and gilbert's syndrome. Author(s): Black M, Billing BH. Source: The New England Journal of Medicine. 1969 June 5; 280(23): 1266-71. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5770050

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Hepatic uptake of organic anions affects the plasma bilirubin level in subjects with Gilbert's syndrome mutations in UGT1A1. Author(s): Persico M, Persico E, Bakker CT, Rigato I, Amoroso A, Torella R, Bosma PJ, Tiribelli C, Ostrow JD. Source: Hepatology (Baltimore, Md.). 2001 March; 33(3): 627-32. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11230743

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Heterogeneity of bilirubin in familial unconjugated hyperbilirubinemia, Gilbert's syndrome. Author(s): Kakajima O, Nakatani S, Kadowaki S, Fukada H, Ishihara K. Source: Jinrui Idengaku Zasshi. 1974 December; 19(3): 203-16. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4478007

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Heterogeneity of paracetamol metabolism in Gilbert's syndrome. Author(s): Esteban A, Perez-Mateo M. Source: Eur J Drug Metab Pharmacokinet. 1999 January-March; 24(1): 9-13. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10412886

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Hyperbilirubinaemia in heterozygous beta-thalassaemia is related to co-inherited Gilbert's syndrome. Author(s): Galanello R, Perseu L, Melis MA, Cipollina L, Barella S, Giagu N, Turco MP, Maccioni O, Cao A. Source: British Journal of Haematology. 1997 November; 99(2): 433-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9375768

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Hyperbilirubinemia, glucose-6-phosphate-dehydrogenase deficiency and Gilbert's syndrome. Author(s): Galanello R, Cipollina MD, Carboni G, Perseu L, Barella S, Corrias A, Cao A. Source: European Journal of Pediatrics. 1999 November; 158(11): 914-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10541948

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Hypersideremic and hyperbilirubinemic effect of nicotinic acid in patients with Gilbert's syndrome. Author(s): Gentile S, Gentile F. Source: Hepatogastroenterology. 1987 August; 34(4): 152-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3666665

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Ichthyosis vulgaris associated with Gilbert's syndrome. Author(s): Schueller WA, Carson WE, Izuno GT. Source: Southern Medical Journal. 1973 May; 66(5): 575-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4698767

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Icteric plasma suggests Gilbert's syndrome in the blood donor. Author(s): Naiman JL, Sugasawara EJ, Benkosky SL, Mailhot EA. Source: Transfusion. 1996 November-December; 36(11-12): 974-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8937407

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Idiopathic unconjugated hyperbilirubinemia (Gilbert's syndrome) and concurrent psychotropic drug administration. Author(s): Durst R, Jabotinsky-Rubin K, Dorevitch A, Kikinzon L, Tur-Kaspa R. Source: Pharmacopsychiatry. 1993 March; 26(2): 49-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8378413

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Idiopathic unconjugated hyperbilirubinemia (Gilbert's syndrome). A study of 42 families. Author(s): Powell LW, Hemingway E, Billing BH, Sherlock S. Source: The New England Journal of Medicine. 1967 November 23; 277(21): 1108-12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6054997

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Idiopathic unconjugated hyperbilirubinemia (Gilbert's syndrome). Report of 2 cases in the same family. Author(s): Klunklin K, Kammerdsuphapol S. Source: J Med Assoc Thai. 1971 October; 54(10): 767-72. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5124031

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Impaired plasma clearance of nicotinic acid and rifamycin-SV in Gilbert's syndrome: evidence of a functional heterogeneity. Author(s): Gentile S, Marmo R, Persico M, Bronzino P, Coltorti M. Source: Hepatogastroenterology. 1985 June; 32(3): 113-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4018705

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Improvement of the nicotinic acid test in the diagnosis of Gilbert's syndrome by pretreatment with indomethacin. Author(s): Gentile S, Rubba P, Persico M, Bronzino P, Marmo R, Faccenda F. Source: Hepatogastroenterology. 1985 December; 32(6): 267-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4093124

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'In vitro' assay of bilirubin-UDP glucuronyl transferase activity in the liver of patients with Gilbert's syndrome and a variety of hepatic disorders. Author(s): Black M, Billing BH. Source: Gut. 1968 December; 9(6): 728-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5717986

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Interleukin-2-induced reversible hyperbilirubinemia and cholestasis in a patient with Gilbert's syndrome. Author(s): Engin H, Oksuzoglu CB, Altundag K. Source: Journal of Gastroenterology. 2002; 37(2): 145-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11871767

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Isotretinoin-associated normalization of hyperbilirubinemia in patients with Gilbert's syndrome. Author(s): Wang JI, Jackson TL Jr, Kaplan DL. Source: Journal of the American Academy of Dermatology. 1995 January; 32(1): 136-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7822509

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Liver resection in patients with Gilbert's syndrome. Author(s): Arita J, Sugawara Y, Hashimoto T, Kaneko J, Kokudo N, Makuuchi M, Maruo Y. Source: Surgery. 2003 November; 134(5): 835-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14639364

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Liver ultrastructure in Gilbert's syndrome. Author(s): McGee JO, Allan JG, Russell RI, Patrick RS. Source: Gut. 1975 March; 16(3): 220-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1123177

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Localization of bilirubin pools in the non-jaundiced rat, with a note on bilirubin dynamics in normal human adults and in Gilbert's syndrome. Author(s): Brodersen R. Source: Scandinavian Journal of Clinical and Laboratory Investigation. 1972 September; 30(1): 95-106. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5073096

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Manifestation of Gilbert's syndrome after orthotopic liver transplantation: rare cause of postoperative hyperbilirubinemia. Author(s): Henne-Bruns D, Kremer B. Source: Clin Transpl. 1989; : 309. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2487585

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Medical Grand Rounds from Touro Infirmary: A jaundiced eye: Gilbert's syndrome. Author(s): Jacobs S. Source: J La State Med Soc. 1974 July; 126(7): 253-7. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4846784

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Molecular diagnosis of a familial nonhemolytic hyperbilirubinemia (Gilbert's syndrome) in healthy subjects. Author(s): Borlak J, Thum T, Landt O, Erb K, Hermann R. Source: Hepatology (Baltimore, Md.). 2000 October; 32(4 Pt 1): 792-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11003624

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Molecular genetic basis of Gilbert's syndrome. Author(s): Burchell B, Hume R. Source: Journal of Gastroenterology and Hepatology. 1999 October; 14(10): 960-6. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10530490

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N-acetylation and debrisoquine hydroxylation polymorphisms in patients with Gilbert's syndrome. Author(s): Siegmund W, Fengler JD, Franke G, Zschiesche M, Eike O, Eike E, Meisel P, Wulkow R. Source: British Journal of Clinical Pharmacology. 1991 October; 32(4): 467-72. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1958441

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Neonatal hyperbilirubinemia and Gilbert's syndrome. Author(s): Laforgia N, Faienza MF, Rinaldi A, D'Amato G, Rinaldi G, Iolascon A. Source: Journal of Perinatal Medicine. 2002; 30(2): 166-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12012638

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Nicotinic acid test in the diagnosis of Gilbert's syndrome: correlation with bilirubin clearance. Author(s): Rollinghoff W, Paumgartner G, Preisig R. Source: Gut. 1981 August; 22(8): 663-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7286783

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No association between Gilbert's syndrome, the ABO blood groups and the haptoglobin phenotypes. Author(s): Platzer R, Bircher J. Source: Experientia. 1977 September 15; 33(9): 1142-3. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=891855

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No effect of endurance exercise on serum bilirubin in healthy athletes and with congenital hyperbilirubinemia (Gilbert's syndrome). Author(s): Floreani A, Corsi N, Martines D, Varnier M, Naccarato R. Source: The Journal of Sports Medicine and Physical Fitness. 1993 March; 33(1): 79-82. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8350612

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Normal fasting-state levels of serum cholyl-conjugated bile acids in Gilbert's syndrome: an aid to the diagnosis. Author(s): Vierling JM, Berk PD, Hofmann AF, Martin JF, Wolkoff AW, Scharschmidt BF. Source: Hepatology (Baltimore, Md.). 1982 May-June; 2(3): 340-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7076117

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Normal pathways for glucuronidation, sulphation and oxidation of paracetamol in Gilbert's syndrome. Author(s): Ullrich D, Sieg A, Blume R, Bock KW, Schroter W, Bircher J. Source: European Journal of Clinical Investigation. 1987 June; 17(3): 237-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3113968

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Novel missense mutation of the UGT1A1 gene in Thai siblings with Gilbert's syndrome. Author(s): Sutomo R, Laosombat V, Sadewa AH, Yokoyama N, Nakamura H, Matsuo M, Nishio H. Source: Pediatrics International : Official Journal of the Japan Pediatric Society. 2002 August; 44(4): 427-32. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12139570

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Olanzapine toxicity in unconjugated hyperbilirubinaemia (Gilbert's syndrome). Author(s): Martin-Escudero JC, Duenas-Laita A, Perez-Castrillon JL, HerrerosFernandez V. Source: The British Journal of Psychiatry; the Journal of Mental Science. 2003 March; 182: 267. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12611795

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Oral cholecystography in Gilbert's syndrome and diagnostics of jaundice. Author(s): Bloch HS, Johnson EA. Source: Jama : the Journal of the American Medical Association. 1971 November 22; 218(8): 1302. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5171185

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Pathogenesis of Gilbert's syndrome. Author(s): Fevery J. Source: European Journal of Clinical Investigation. 1981 December; 11(6): 417-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6800815

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Pharmacokinetics of Josamycin in patients with liver cirrhosis and Gilbert's syndrome after repeated doses. Author(s): Okolicsanyi L, Venuti M, Strazzabosco M, Biral A, Orlando R, Iemmolo RM, Nassuato G, Muraca M, Padrini G, Miglioli PA, et al. Source: Int J Clin Pharmacol Ther Toxicol. 1985 August; 23(8): 434-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4044077

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Pharmacokinetics of morphine are not altered in subjects with Gilbert's syndrome. Author(s): Skarke C, Schmidt H, Geisslinger G, Darimont J, Lotsch J. Source: British Journal of Clinical Pharmacology. 2003 August; 56(2): 228-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12895198

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Phosphofructokinase deficiency (Tarui disease) associated with hepatic glucuronyltransferase deficiency (Gilbert's syndrome): a case and family study. Author(s): Fogelfeld L, Sarova-Pinchas I, Meytes D, Barash V, Brok-Simoni F, Feigl D. Source: Isr J Med Sci. 1990 June; 26(6): 328-33. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2380035

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Plasma clearance of nicotinic acid and rifamycin-SV, and their interaction in Gilbert's syndrome: application of a compartmental model. Author(s): Gentile S, Marmo R, Persico M, Bronzino P, Coltorti M. Source: Hepatogastroenterology. 1984 April; 31(2): 72-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6724499

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Plasma sulfobromophthalein disappearance in Gilbert's syndrome. Author(s): Serra MA, Aparisi L, Garcia F, Del Olmo JA, Gilabert MS, Rodriguez F, Escudero A, Wassel A, Rodrigo JM. Source: Hepatogastroenterology. 1997 January-February; 44(13): 210-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9058146

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Platelet serotonin (5-HT) content is decreased in patients with alcoholic liver cirrhosis, but elevated in Gilbert's syndrome. Author(s): Borcsiczky D, Szalay F, Tekes K, Tarcali J, Magyar K, de Chatel R. Source: Journal of Hepatology. 1996 November; 25(5): 781-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8938562

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Polymorphic acetylation and aminopyrine demethylation in Gilbert's syndrome. Author(s): Platzer R, Kupfer A, Bircher J, Preisig R. Source: European Journal of Clinical Investigation. 1978 August; 8(4): 219-23. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=100326

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Polymorphism in the promoter region of the bilirubin UDP-glucuronosyltransferase (Gilbert's syndrome) in healthy Dutch subjects. Author(s): Te Morsche RH, Zusterzeel PL, Raijmakers MT, Roes EM, Steegers EA, Peters WH. Source: Hepatology (Baltimore, Md.). 2001 March; 33(3): 765. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11230763

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Population studies on Gilbert's syndrome. Author(s): Owens D, Evans J. Source: Journal of Medical Genetics. 1975 June; 12(2): 152-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1142378

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Porphyrin metabolism and haem biosynthesis in Gilbert's syndrome. Author(s): McColl KE, Thompson GG, el Omar E, Moore MR, Goldberg A. Source: Gut. 1987 February; 28(2): 125-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3557184

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Predicted homozygous mis-sense mutation in Gilbert's syndrome. Author(s): Soeda Y, Yamamoto K, Adachi Y, Hori T, Aono S, Koiwai O, Sato H. Source: Lancet. 1995 December 2; 346(8988): 1494. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7491021

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Predicting the risk of sporadic elevated bilirubin levels and diagnosing Gilbert's syndrome by genotyping UGT1A1*28 promoter polymorphism. Author(s): Rauchschwalbe SK, Zuhlsdorf MT, Schuhly U, Kuhlmann J. Source: Int J Clin Pharmacol Ther. 2002 June; 40(6): 233-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12078936

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Pregnancy, oral contraceptives, and chronic familial jaundice with predominantly conjugated hyperbilirubinemia (Dubin-Johnson syndrome). Author(s): Cohen L, Lewis C, Arias IM. Source: Gastroenterology. 1972 June; 62(6): 1182-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5050316

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Primary shunt hyperbilirubinemia associated with Gilbert's syndrome. Author(s): Cofrancesco E, Salvatore M, Fenu MP, Pogliani EM. Source: American Journal of Clinical Pathology. 1983 May; 79(5): 627-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6837527

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Proceedings: The fasting and nicotinic acid provocation tests in the diagnosis of Gilbert's syndrome. Author(s): Davidson AR, Rojas-Bueno A, Williams R. Source: Gut. 1973 October; 14(10): 820. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4758672

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Red blood cell survival and hyperbilirubinaemia in the Gilbert's syndrome. Author(s): Cartei G, Chisesi T, Cazzavillan M, Barbui T, Battista R, Vianello Dri A, Dini E. Source: Folia Haematol Int Mag Klin Morphol Blutforsch. 1976; 103(1): 93-100. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=58824

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Reduced caloric intake and nicontinic acid provocation tests in the diagnosis of Gilbert's syndrome. Author(s): Davidson AR, Rojas-Bueno A, Thompson RP, Williams R. Source: British Medical Journal. 1975 May 31; 2(5969): 480. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1148663

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Relationships between serum bilirubins and production and conjugation of bilirubin. Studies in Gilbert's syndrome, Crigler-Najjar disease, hemolytic disorders, and rat models. Author(s): Muraca M, Fevery J, Blanckaert N. Source: Gastroenterology. 1987 February; 92(2): 309-17. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3792767

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Rifampicin test in the diagnosis of Gilbert's syndrome. Author(s): Erdil A, Kadayifci A, Ates Y, Bagci S, Uygun A, Dagalp K. Source: Int J Clin Pract. 2001 March; 55(2): 81-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11321865

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Role of bilirubin overproduction in revealing Gilbert's syndrome: is dyserythropoiesis an important factor? Author(s): Metreau JM, Yvart J, Dhumeaux D, Berthelot P. Source: Gut. 1978 September; 19(9): 838-43. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=101425

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Schizophrenia-associated idiopathic unconjugated hyperbilirubinemia (Gilbert's syndrome). Author(s): Miyaoka T, Seno H, Itoga M, Iijima M, Inagaki T, Horiguchi J. Source: The Journal of Clinical Psychiatry. 2000 November; 61(11): 868-71. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11105741

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Schizophrenia-associated idiopathic unconjugated hyperbilirubinemia (Gilbert's syndrome): 3 case reports. Author(s): Miyaoka T, Seno H, Maeda T, Itoga M, Horiguchi J. Source: The Journal of Clinical Psychiatry. 2000 April; 61(4): 299-300. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10830152

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Serum bile acids in Gilbert's syndrome after oral load of chenodeoxycholic acid. Author(s): Foberg U, Fryden A, Kagedal B, Tobiasson P. Source: Scandinavian Journal of Gastroenterology. 1985 April; 20(3): 325-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4001842

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Serum bile acids in Gilbert's syndrome before and after reduced caloric intake. Author(s): Briheim G, Fryden A, Tobiasson P. Source: Scandinavian Journal of Gastroenterology. 1982 October; 17(7): 877-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7156881

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Serum free fatty acids and bilirubin concentration during fasting in patients with Gilbert's syndrome and normal controls. Author(s): Orzes N, Tamaro G, Parco S, Baldini G, Lunazzi GC, Sottocasa GL, Mangiarotti MA, Tiribelli C. Source: Ric Clin Lab. 1987 January-March; 17(1): 61-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3589403

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Serum primary bile acids in Gilbert's syndrome. Author(s): Roda A, Roda E, Sama C, Festi D, Aldini R, Morselli AM, Mazzella G, Barbara L. Source: Gastroenterology. 1982 January; 82(1): 77-83. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7053338

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Sex differences of nicotinate-induced hyperbilirubinemia in Gilbert's syndrome. Implication of bilitranslocase function. Author(s): Gentile S, Tiribelli C, Baldini G, Lunazzi G, Sottocasa GL. Source: Journal of Hepatology. 1985; 1(4): 417-29. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3840503

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Sex distribution in Gilbert's syndrome. Author(s): Kaplan M, Levy-Lahad E, Hammerman C, Renbaum P, Halevy J. Source: Isr Med Assoc J. 2001 December; 3(12): 989. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11794939

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Structural brain changes in schizophrenia associated with idiopathic unconjugated hyperbilirubinemia (Gilbert's syndrome): a planimetric CT study. Author(s): Miyaoka T, Seno H, Itoga M, Inagaki T, Horiguchi J. Source: Schizophrenia Research. 2001 December 1; 52(3): 291-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11705723

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TATA-box mutant in the promoter of the uridine diphosphate glucuronosyltransferase gene in Italian patients with Gilbert's syndrome. Author(s): Sampietro M, Lupica L, Perrero L, Romano R, Molteni V, Fiorelli G. Source: Ital J Gastroenterol Hepatol. 1998 April; 30(2): 194-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9675658

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The diagnosis of Gilbert's syndrome: role of the reduced caloric intake test. Author(s): Owens D, Sherlock S. Source: Gut. 1972 October; 13(10): 853. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5087116

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The genetic basis of Gilbert's syndrome. Author(s): Mathew P. Source: The New England Journal of Medicine. 1996 March 21; 334(12): 802-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8592567

Studies

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•

The genetic basis of Gilbert's syndrome. Author(s): Sato H, Adachi Y, Koiwai O. Source: Lancet. 1996 March 2; 347(9001): 557-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8596313

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The genetic basis of the reduced expression of bilirubin UDPglucuronosyltransferase 1 in Gilbert's syndrome. Author(s): Bosma PJ, Chowdhury JR, Bakker C, Gantla S, de Boer A, Oostra BA, Lindhout D, Tytgat GN, Jansen PL, Oude Elferink RP, et al. Source: The New England Journal of Medicine. 1995 November 2; 333(18): 1171-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7565971

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The implication of bilitranslocase function in the impaired rifamycin SV metabolism in Gilbert's syndrome. Author(s): Gentile S, Persico M, Baldini G, Lunazzi G, Tiribelli C, Sottocasa GL. Source: Clinical Science (London, England : 1979). 1985 June; 68(6): 675-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2485269

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The interaction between Gilbert's syndrome and G6PD deficiency influences bilirubin levels. Author(s): Cappellini MD, Martinez di Montemuros F, Sampietro M, Tavazzi D, Fiorelli G. Source: British Journal of Haematology. 1999 March; 104(4): 928-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10192462

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The pharmacokinetics of lamotrigine (BW430C) in healthy subjects with unconjugated hyperbilirubinaemia (Gilbert's syndrome). Author(s): Posner J, Cohen AF, Land G, Winton C, Peck AW. Source: British Journal of Clinical Pharmacology. 1989 July; 28(1): 117-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2775610

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The prevalence of isolated unconjugated hyperbilirubinaemia (Gilbert's syndrome) in subjects attending a health screening programme in Singapore. Author(s): Gwee KA, Koay ES, Kang JY. Source: Singapore Med J. 1992 December; 33(6): 588-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1488666

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The reciprocal relation between caloric intake and the degree of hyperbilirubinemia in Gilbert's syndrome. Author(s): Felsher BF, Rickard D, Redeker AG. Source: The New England Journal of Medicine. 1970 July 23; 283(4): 170-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5424007

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The utility of rifampin in diagnosing Gilbert's syndrome. Author(s): Murthy GD, Byron D, Shoemaker D, Visweswaraiah H, Pasquale D. Source: The American Journal of Gastroenterology. 2001 April; 96(4): 1150-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11316162

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Treatment of Gilbert's syndrome with phenobarbitone. Author(s): Black M, Sherlock S. Source: Lancet. 1970 June 27; 1(7661): 1359-61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4195058

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Two easy-to-perform diagnostic tests for Gilbert's syndrome. Author(s): Chen YC, Chiou TJ, Yang MH, Yu IT. Source: Zhonghua Yi Xue Za Zhi (Taipei). 2002 May; 65(5): 231-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12166768

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UDP-glucuronosyltransferase in Gilbert's syndrome. Author(s): Debinski HS, Lee CS, Dhillon AP, Mackenzie P, Rhode J, Desmond PV. Source: Pathology. 1996 August; 28(3): 238-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8912353

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Unconjugated bilirubin and an increased proportion of bilirubin monoconjugates in the bile of patients with Gilbert's syndrome and Crigler-Najjar disease. Author(s): Fevery J, Blanckaert N, Heirwegh KP, Preaux AM, Berthelot P. Source: The Journal of Clinical Investigation. 1977 November; 60(5): 970-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=409736

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Unconjugated hyperbilirubinemia (Gilbert's syndrome). Author(s): Bitar J. Source: J Med Liban. 1970; 23(5): 485-9. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5504259

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Use of double gradient denaturing gradient gel electrophoresis to detect (AT)n polymorphisms in the UDP-glucuronosyltransferase 1 gene promoter associated with Gilbert's syndrome. Author(s): Gurtler V, Parkin JD, Mayall BC. Source: Electrophoresis. 1999 October; 20(14): 2841-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10546817

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Variation in UGT1A1 activity in Gilbert's syndrome. Author(s): Ostrow JD, Tiribelli C. Source: Journal of Hepatology. 2001 April; 34(4): 636-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11394668

Studies

•

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Zinc sulfate inhibits the enterohepatic cycling of unconjugated bilirubin in subjects with Gilbert's syndrome. Author(s): Mendez-Sanchez N, Martinez M, Gonzalez V, Roldan-Valadez E, Flores MA, Uribe M. Source: Ann Hepatol. 2002 January-March; 1(1): 40-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15114295

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CHAPTER 2. ALTERNATIVE MEDICINE AND GILBERT’S SYNDROME Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to Gilbert’s syndrome. 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 Gilbert’s syndrome 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 “Gilbert’s syndrome” (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 Gilbert’s syndrome: •

Clinical and laboratory manifestations of congenital dyserythropoietic anemia type I in young adults. Author(s): Shalev H, Kapleushnik Y, Haeskelzon L, Degani O, Kransnov T, Sphilberg O, Moser A, Yaniv I, Tamary H. Source: European Journal of Haematology. 2002 March; 68(3): 170-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12068798

•

Combination of oxaliplatin plus irinotecan in patients with gastrointestinal tumors: results of two independent phase I studies with pharmacokinetics. Author(s): Wasserman E, Cuvier C, Lokiec F, Goldwasser F, Kalla S, Mery-Mignard D, Ouldkaci M, Besmaine A, Dupont-Andre G, Mahjoubi M, Marty M, Misset JL, Cvitkovic E.

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Source: Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology. 1999 June; 17(6): 1751-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10561212 •

Expression and inducibility of the human bilirubin UDP-glucuronosyltransferase UGT1A1 in liver and cultured primary hepatocytes: evidence for both genetic and environmental influences. Author(s): Ritter JK, Kessler FK, Thompson MT, Grove AD, Auyeung DJ, Fisher RA. Source: Hepatology (Baltimore, Md.). 1999 August; 30(2): 476-84. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10421657

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Genetic predisposition to the metabolism of irinotecan (CPT-11). Role of uridine diphosphate glucuronosyltransferase isoform 1A1 in the glucuronidation of its active metabolite (SN-38) in human liver microsomes. Author(s): Iyer L, King CD, Whitington PF, Green MD, Roy SK, Tephly TR, Coffman BL, Ratain MJ. Source: The Journal of Clinical Investigation. 1998 February 15; 101(4): 847-54. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9466980

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Gilbert's syndrome and fluorouracil toxicity in colorectal cancer patients: which correlation? Author(s): Mandala M, Cremonesi M, Cazzaniga M, Rezzani C, Ghilardi M, Mary C, Ferretti G, Barni S. Source: Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland. 2004 March; 6(2): 129-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15008914

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Irinotecan treatment in cancer patients with UGT1A1 polymorphisms. Author(s): Innocenti F, Ratain MJ. Source: Oncology (Huntingt). 2003 May; 17(5 Suppl 5): 52-5. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12800608

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Pharmacogenetics of anticancer agents: lessons from amonafide and irinotecan. Author(s): Innocenti F, Iyer L, Ratain MJ. Source: Drug Metabolism and Disposition: the Biological Fate of Chemicals. 2001 April; 29(4 Pt 2): 596-600. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11259359

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Pharmacogenetics: a tool for individualizing antineoplastic therapy. Author(s): Innocenti F, Iyer L, Ratain MJ. Source: Clinical Pharmacokinetics. 2000 November; 39(5): 315-25. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11108431

Alternative Medicine 37

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Phenotype-genotype correlation of in vitro SN-38 (active metabolite of irinotecan) and bilirubin glucuronidation in human liver tissue with UGT1A1 promoter polymorphism. Author(s): Iyer L, Hall D, Das S, Mortell MA, Ramirez J, Kim S, Di Rienzo A, Ratain MJ. Source: Clinical Pharmacology and Therapeutics. 1999 May; 65(5): 576-82. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10340924

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Severe CPT-11 toxicity in patients with Gilbert's syndrome: two case reports. Author(s): Wasserman E, Myara A, Lokiec F, Goldwasser F, Trivin F, Mahjoubi M, Misset JL, Cvitkovic E. Source: Annals of Oncology : Official Journal of the European Society for Medical Oncology / Esmo. 1997 October; 8(10): 1049-51. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9402181

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/

•

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

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

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

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

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

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

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

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

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

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

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

•

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

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.

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This Web site provides a general overview of various topics and can lead to a number of general sources.

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CHAPTER 3. PERIODICALS AND NEWS ON GILBERT’S SYNDROME Overview In this chapter, we suggest a number of news sources and present various periodicals that cover Gilbert’s syndrome.

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

New Insights Regarding The Pathogenesis Of Gilbert's Syndrome Published Source: Reuters Medical News Date: November 02, 1995

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The NIH Within MEDLINEplus, the NIH has made an agreement with the New York Times Syndicate, the AP News Service, and Reuters to deliver news that can be browsed by the public. Search news releases at http://www.nlm.nih.gov/medlineplus/alphanews_a.html. MEDLINEplus allows you to browse across an alphabetical index. Or you can search by date at the following Web page: http://www.nlm.nih.gov/medlineplus/newsbydate.html. Often, news items are indexed by MEDLINEplus within its search engine. Business Wire Business Wire is similar to PR Newswire. To access this archive, simply go to http://www.businesswire.com/. You can scan the news by industry category or company name. Market Wire Market Wire is more focused on technology than the other wires. To browse the latest press releases by topic, such as alternative medicine, biotechnology, fitness, healthcare, legal, nutrition, and pharmaceuticals, access Market Wire’s Medical/Health channel at http://www.marketwire.com/mw/release_index?channel=MedicalHealth. Or simply go to Market Wire’s home page at http://www.marketwire.com/mw/home, type “Gilbert’s syndrome” (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 “Gilbert’s syndrome” (or synonyms). If you know the name of a company that is relevant to Gilbert’s syndrome, 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 “Gilbert’s syndrome” (or synonyms).

Periodicals and News

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

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CHAPTER 4. RESEARCHING MEDICATIONS Overview While a number of hard copy or CD-ROM resources are available for researching medications, a more flexible method is to use Internet-based databases. Broadly speaking, there are two sources of information on approved medications: public sources and private sources. We will emphasize free-to-use public sources.

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

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

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

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

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

Researching Medications

45

marketing, information on side effects can be found on the product’s label. If the product is not approved, you may need to contact the sponsor. The following is a list of orphan drugs currently listed in the NORD Orphan Drug Designation Database for Gilbert’s syndrome: •

Flumecinol (trade name: Zixoryn) http://www.rarediseases.org/nord/search/nodd_full?code=706

If you have any questions about a medical treatment, the FDA may have an office near you. Look for their number in the blue pages of the phone book. You can also contact the FDA through its toll-free number, 1-888-INFO-FDA (1-888-463-6332), or on the World Wide Web at www.fda.gov.

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APPENDICES

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

NIH Guidelines Commonly referred to as “clinical” or “professional” guidelines, the National Institutes of Health publish physician guidelines for the most common diseases. Publications are available at the following by relevant Institute7: •

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

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

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

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

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

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

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

•

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

7

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

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•

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.8 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:9 •

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

8

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

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•

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

•

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

The NLM Gateway10 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.11 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “Gilbert’s syndrome” (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 674 2 763 2 7 1448

HSTAT12 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.13 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.14 Simply search by “Gilbert’s syndrome” (or synonyms) at the following Web site: http://text.nlm.nih.gov.

10

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

11

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). 12 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 13 14

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

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

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Coffee Break: Tutorials for Biologists15 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.16 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.17 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/.

15 Adapted 16

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. 17 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.

55

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 Gilbert’s syndrome can appear at any moment and be published by a number of sources, the best approach to finding guidelines is to systematically scan the Internetbased 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 Gilbert’s syndrome. 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 Gilbert’s syndrome. 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 “Gilbert’s syndrome”:

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Alzheimer's Caregivers http://www.nlm.nih.gov/medlineplus/alzheimerscaregivers.html Alzheimer's Disease http://www.nlm.nih.gov/medlineplus/alzheimersdisease.html Bile Duct Diseases http://www.nlm.nih.gov/medlineplus/bileductdiseases.html Cirrhosis http://www.nlm.nih.gov/medlineplus/cirrhosis.html Facial Injuries and Disorders http://www.nlm.nih.gov/medlineplus/facialinjuriesanddisorders.html Genetic Brain Disorders http://www.nlm.nih.gov/medlineplus/geneticbraindisorders.html Head and Brain Malformations http://www.nlm.nih.gov/medlineplus/headandbrainmalformations.html Hepatitis http://www.nlm.nih.gov/medlineplus/hepatitis.html Hepatitis C http://www.nlm.nih.gov/medlineplus/hepatitisc.html Infant and Toddler Health http://www.nlm.nih.gov/medlineplus/infantandtoddlerhealth.html Liver Diseases http://www.nlm.nih.gov/medlineplus/liverdiseases.html Lymphoma http://www.nlm.nih.gov/medlineplus/lymphoma.html Metabolic Disorders http://www.nlm.nih.gov/medlineplus/metabolicdisorders.html Metabolic Syndrome X http://www.nlm.nih.gov/medlineplus/metabolicsyndromex.html Pancreatic Diseases http://www.nlm.nih.gov/medlineplus/pancreaticdiseases.html Parkinson's Disease http://www.nlm.nih.gov/medlineplus/parkinsonsdisease.html Porphyria http://www.nlm.nih.gov/medlineplus/porphyria.html Sjogren's Syndrome http://www.nlm.nih.gov/medlineplus/sjogrenssyndrome.html Stem Cells and Stem Cell Transplantation http://www.nlm.nih.gov/medlineplus/stemcellsandstemcelltransplantation.html Wilson's Disease http://www.nlm.nih.gov/medlineplus/wilsonsdisease.html You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the

Patient Resources

57

search box and click “Search.” This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system (mostly patient-oriented information). It also has the disadvantage of generating unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search. The 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 Gilbert’s syndrome. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html. Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •

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

•

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

•

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

•

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

•

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

•

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 Gilbert’s syndrome. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with Gilbert’s syndrome. 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 Gilbert’s syndrome. 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.

58


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

59

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.18

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

18

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

60


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)19: •

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/

19

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

Finding Medical Libraries

61

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

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•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

Finding Medical Libraries

63

•

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/

64


•

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

65

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 Gilbert’s syndrome: •

Basic Guidelines for Gilbert’s Syndrome Gilbert's syndrome Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000301.htm

•

Signs & Symptoms for Gilbert’s Syndrome Abdominal pain Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003120.htm Fatigue Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003088.htm Jaundice Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003243.htm Nausea Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003117.htm

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Stress Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003211.htm •

Diagnostics and Tests for Gilbert’s Syndrome Bilirubin Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003479.htm Indirect bilirubin Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003479.htm

•

Background Topics for Gilbert’s Syndrome Benign Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002236.htm

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

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

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

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

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

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GILBERT’S SYNDROME DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. 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] Acetaminophen: Analgesic antipyretic derivative of acetanilide. It has weak antiinflammatory properties and is used as a common analgesic, but may cause liver, blood cell, and kidney damage. [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] Adaptability: Ability to develop some form of tolerance to conditions extremely different from those under which a living organism evolved. [NIH] Adverse Effect: An unwanted side effect of treatment. [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] 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] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alkaline: Having the reactions of an alkali. [EU] Alkaline Phosphatase: An enzyme that catalyzes the conversion of an orthophosphoric monoester and water to an alcohol and orthophosphate. EC 3.1.3.1. [NIH] Alkaloid: A member of a large group of chemicals that are made by plants and have nitrogen in them. Some alkaloids have been shown to work against cancer. [NIH] Alkylating Agents: Highly reactive chemicals that introduce alkyl radicals into biologically active molecules and thereby prevent their proper functioning. Many are used as antineoplastic agents, but most are very toxic, with carcinogenic, mutagenic, teratogenic, and immunosuppressant actions. They have also been used as components in poison gases. [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,

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magnet therapy, spiritual healing, and meditation. [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] Ampulla: A sac-like enlargement of a canal or duct. [NIH] 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] Anemia: A reduction in the number of circulating erythrocytes or in the quantity of hemoglobin. [NIH] Anions: Negatively charged atoms, radicals or groups of atoms which travel to the anode or positive pole during electrolysis. [NIH] Anode: Electrode held at a positive potential with respect to a cathode. [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] Anticonvulsant: An agent that prevents or relieves convulsions. [EU] Antifungal: Destructive to fungi, or suppressing their reproduction or growth; effective against fungal infections. [EU] 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] Anti-inflammatory: Having to do with reducing inflammation. [NIH] 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

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split to give products that have unpaired electrons. This process is called oxidation. [NIH] Antipyretic: An agent that relieves or reduces fever. Called also antifebrile, antithermic and febrifuge. [EU] Anxiety: Persistent feeling of dread, apprehension, and impending disaster. [NIH] Appendicitis: Acute inflammation of the vermiform appendix. [NIH] Arteries: The vessels carrying blood away from the heart. [NIH] Assay: Determination of the amount of a particular constituent of a mixture, or of the biological or pharmacological potency of a drug. [EU] Asymptomatic: Having no signs or symptoms of disease. [NIH] Atypical: Irregular; not conformable to the type; in microbiology, applied specifically to strains of unusual type. [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] Bacterium: Microscopic organism which may have a spherical, rod-like, or spiral unicellular or non-cellular body. Bacteria usually reproduce through asexual processes. [NIH] Beta-Thalassemia: A disorder characterized by reduced synthesis of the beta chains of hemoglobin. There is retardation of hemoglobin A synthesis in the heterozygous form (thalassemia minor), which is asymptomatic, while in the homozygous form (thalassemia major, Cooley's anemia, Mediterranean anemia, erythroblastic anemia), which can result in severe complications and even death, hemoglobin A synthesis is absent. [NIH] Bile: An emulsifying agent produced in the liver and secreted into the duodenum. Its composition includes bile acids and salts, cholesterol, and electrolytes. It aids digestion of fats in the duodenum. [NIH] Bile Acids: Acids made by the liver that work with bile to break down fats. [NIH] Bile Acids and Salts: Steroid acids and salts. The primary bile acids are derived from cholesterol in the liver and usually conjugated with glycine or taurine. The secondary bile acids are further modified by bacteria in the intestine. They play an important role in the digestion and absorption of fat. They have also been used pharmacologically, especially in the treatment of gallstones. [NIH] Bile duct: A tube through which bile passes in and out of the liver. [NIH] Bile Pigments: Pigments that give a characteristic color to bile including: bilirubin, biliverdine, and bilicyanin. [NIH] Biliary: Having to do with the liver, bile ducts, and/or gallbladder. [NIH] Bilirubin: A bile pigment that is a degradation product of heme. [NIH] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biopsy: Removal and pathologic examination of specimens in the form of small pieces of tissue from the living body. [NIH] Biopsy specimen: Tissue removed from the body and examined under a microscope to determine whether disease is present. [NIH] Biosynthesis: The building up of a chemical compound in the physiologic processes of a living organism. [EU] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and

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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] Blood Groups: The classification systems (or schemes) of the different antigens located on erythrocytes.The antigens are the phenotypic expression of the genetic differences characteristic of specific blood groups. [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 vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Blood Volume: Volume of circulating blood. It is the sum of the plasma volume and erythrocyte volume. [NIH] Buprenorphine: A derivative of the opioid alkaloid thebaine that is a more potent and longer lasting analgesic than morphine. It appears to act as a partial agonist at mu and kappa opioid receptors and as an antagonist at delta receptors. The lack of delta-agonist activity has been suggested to account for the observation that buprenorphine tolerance may not develop with chronic use. [NIH] Caloric intake: Refers to the number of calories (energy content) consumed. [NIH] Camptothecin: An alkaloid isolated from the stem wood of the Chinese tree, Camptotheca acuminata. This compound selectively inhibits the nuclear enzyme DNA topoisomerase. Several semisynthetic analogs of camptothecin have demonstrated antitumor activity. [NIH] Carbon Dioxide: A colorless, odorless gas that can be formed by the body and is necessary for the respiration cycle of plants and animals. [NIH] Carcinogenic: Producing carcinoma. [EU] Carcinogens: Substances that increase the risk of neoplasms in humans or animals. Both genotoxic chemicals, which affect DNA directly, and nongenotoxic chemicals, which induce neoplasms by other mechanism, are included. [NIH] Cardiac: Having to do with the heart. [NIH] Cardiac Output: The volume of blood passing through the heart per unit of time. It is usually expressed as liters (volume) per minute so as not to be confused with stroke volume (volume per beat). [NIH] Cardiovascular: Having to do with the heart and blood vessels. [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] Causal: Pertaining to a cause; directed against a cause. [EU] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Cell Survival: The span of viability of a cell characterized by the capacity to perform certain functions such as metabolism, growth, reproduction, some form of responsiveness, and adaptability. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Cerebrospinal: Pertaining to the brain and spinal cord. [EU]

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Cerebrospinal fluid: CSF. The fluid flowing around the brain and spinal cord. Cerebrospinal fluid is produced in the ventricles in the brain. [NIH] Ceroid: A naturally occurring lipid pigment with histochemical characteristics similar to lipofuscin. It accumulates in various tissues in certain experimental and pathological conditions. [NIH] Chenodeoxycholic Acid: A bile acid, usually conjugated with either glycine or taurine. It acts as a detergent to solubilize fats for intestinal absorption and is reabsorbed by the small intestine. It is used as cholagogue, a choleretic laxative, and to prevent or dissolve gallstones. [NIH] Cholecystography: Radiography of the gallbladder after ingestion of a contrast medium. [NIH]

Cholelithiasis: Presence or formation of gallstones. [NIH] Choleretic: A choleretic agent. [EU] Cholestasis: Impairment of biliary flow at any level from the hepatocyte to Vater's ampulla. [NIH]

Cholesterol: The principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils. [NIH] Chromium: A trace element that plays a role in glucose metabolism. It has the atomic symbol Cr, atomic number 24, and atomic weight 52. According to the Fourth Annual Report on Carcinogens (NTP85-002,1985), chromium and some of its compounds have been listed as known carcinogens. [NIH] 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 Fatigue Syndrome: Fatigue caused by the combined effects of different types of prolonged fatigue. [NIH] Cirrhosis: A type of chronic, progressive liver disease. [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] 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] 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

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classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix 'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Complementary and alternative medicine: CAM. Forms of treatment that are used in addition to (complementary) or instead of (alternative) standard treatments. These practices are not considered standard medical approaches. CAM includes dietary supplements, megadose vitamins, herbal preparations, special teas, massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complementary medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used to enhance or complement the standard treatments. Complementary medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Conjugated: Acting or operating as if joined; simultaneous. [EU] Conjugation: 1. The act of joining together or the state of being conjugated. 2. A sexual process seen in bacteria, ciliate protozoa, and certain fungi in which nuclear material is exchanged during the temporary fusion of two cells (conjugants). In bacterial genetics a form of sexual reproduction in which a donor bacterium (male) contributes some, or all, of its DNA (in the form of a replicated set) to a recipient (female) which then incorporates differing genetic information into its own chromosome by recombination and passes the recombined set on to its progeny by replication. In ciliate protozoa, two conjugants of separate mating types exchange micronuclear material and then separate, each now being a fertilized cell. In certain fungi, the process involves fusion of two gametes, resulting in union of their nuclei and formation of a zygote. 3. In chemistry, the joining together of two compounds to produce another compound, such as the combination of a toxic product with some substance in the body to form a detoxified product, which is then eliminated. [EU] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH]

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Consciousness: Sense of awareness of self and of the environment. [NIH] Constitutional: 1. Affecting the whole constitution of the body; not local. 2. Pertaining to the constitution. [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 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] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Curative: Tending to overcome disease and promote recovery. [EU] Degenerative: Undergoing degeneration : tending to degenerate; having the character of or involving degeneration; causing or tending to cause degeneration. [EU] Demethylation: Process that releases substantial amounts of carbon dioxide in the liver. [NIH]

Diagnostic procedure: A method used to identify a disease. [NIH] Diarrhea: Passage of excessively liquid or excessively frequent stools. [NIH] Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] 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] Dissociative Disorders: Sudden temporary alterations in the normally integrative functions of consciousness. [NIH] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Duodenum: The first part of the small intestine. [NIH] Dyes: Chemical substances that are used to stain and color other materials. The coloring may or may not be permanent. Dyes can also be used as therapeutic agents and test reagents in medicine and scientific research. [NIH] Electrolysis: Destruction by passage of a galvanic electric current, as in disintegration of a chemical compound in solution. [NIH] Electrolytes: Substances that break up into ions (electrically charged particles) when they are dissolved in body fluids or water. Some examples are sodium, potassium, chloride, and calcium. Electrolytes are primarily responsible for the movement of nutrients into cells, and the movement of wastes out of cells. [NIH]

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Electrons: Stable elementary particles having the smallest known negative charge, present in all elements; also called negatrons. Positively charged electrons are called positrons. The numbers, energies and arrangement of electrons around atomic nuclei determine the chemical identities of elements. Beams of electrons are called cathode rays or beta rays, the latter being a high-energy biproduct of nuclear decay. [NIH] Electrophoresis: An electrochemical process in which macromolecules or colloidal particles with a net electric charge migrate in a solution under the influence of an electric current. [NIH]

Endemic: Present or usually prevalent in a population or geographical area at all times; said of a disease or agent. Called also endemial. [EU] Endogenous: Produced inside an organism or cell. The opposite is external (exogenous) production. [NIH] Enterohepatic: Of or involving the intestine and liver. [EU] Enterohepatic Circulation: Recycling through liver by excretion in bile, reabsorption from intestines into portal circulation, passage back into liver, and re-excretion in bile. [NIH] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]

Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Epidemic: Occurring suddenly in numbers clearly in excess of normal expectancy; said especially of infectious diseases but applied also to any disease, injury, or other healthrelated event occurring in such outbreaks. [EU] 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] Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH] Evacuation: An emptying, as of the bowels. [EU] Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] Extraction: The process or act of pulling or drawing out. [EU] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fatigue: The state of weariness following a period of exertion, mental or physical, characterized by a decreased capacity for work and reduced efficiency to respond to stimuli. [NIH]

Fats: One of the three main classes of food and a source of energy in the body. Bile dissolves fats, and enzymes break them down. This process moves fats into cells. [NIH] 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] Fractionation: Dividing the total dose of radiation therapy into several smaller, equal doses delivered over a period of several days. [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]

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Fungi: A kingdom of eukaryotic, heterotrophic organisms that live as saprobes or parasites, including mushrooms, yeasts, smuts, molds, etc. They reproduce either sexually or asexually, and have life cycles that range from simple to complex. Filamentous fungi refer to those that grow as multicelluar colonies (mushrooms and molds). [NIH] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] Gastric: Having to do with the stomach. [NIH] Gastric Emptying: The evacuation of food from the stomach into the duodenum. [NIH] Gastrointestinal: Refers to the stomach and intestines. [NIH] Gastrointestinal tract: The stomach and intestines. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]

Gene Expression: The phenotypic manifestation of a gene or genes by the processes of gene action. [NIH] Genetics: The biological science that deals with the phenomena and mechanisms of heredity. [NIH] Genotype: The genetic constitution of the individual; the characterization of the genes. [NIH] Glucaric Acid: A sugar acid derived from D-glucose in which both the aldehydic carbon atom and the carbon atom bearing the primary hydroxyl group are oxidized to carboxylic acid groups. [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] Glucuronosyltransferase: A family of enzymes accepting a wide range of substrates, including phenols, alcohols, amines, and fatty acids. They function as drug-metabolizing enzymes that catalyze the conjugation of UDPglucuronic acid to a variety of endogenous and exogenous compounds. EC 2.4.1.17. [NIH] Glutamate: Excitatory neurotransmitter of the brain. [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] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Graft: Healthy skin, bone, or other tissue taken from one part of the body and used to replace diseased or injured tissue removed from another part of the body. [NIH] Hair follicles: Shafts or openings on the surface of the skin through which hair grows. [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] Heme: The color-furnishing portion of hemoglobin. It is found free in tissues and as the prosthetic group in many hemeproteins. [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

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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] Hemolysis: The destruction of erythrocytes by many different causal agents such as antibodies, bacteria, chemicals, temperature, and changes in tonicity. [NIH] Hemolytic: A disease that affects the blood and blood vessels. It destroys red blood cells, cells that cause the blood to clot, and the lining of blood vessels. HUS is often caused by the Escherichia coli bacterium in contaminated food. People with HUS may develop acute renal failure. [NIH] Hemostasis: The process which spontaneously arrests the flow of blood from vessels carrying blood under pressure. It is accomplished by contraction of the vessels, adhesion and aggregation of formed blood elements, and the process of blood or plasma coagulation. [NIH]

Hepatic: Refers to the liver. [NIH] Hepatitis: Inflammation of the liver and liver disease involving degenerative or necrotic alterations of hepatocytes. [NIH] Hepatocyte: A liver cell. [NIH] Hepatomegaly: Enlargement of the liver. [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]

Homeostasis: The processes whereby the internal environment of an organism tends to remain balanced and stable. [NIH] Hydrogen: The first chemical element in the periodic table. It has the atomic symbol H, atomic number 1, and atomic weight 1. It exists, under normal conditions, as a colorless, odorless, tasteless, diatomic gas. Hydrogen ions are protons. Besides the common H1 isotope, hydrogen exists as the stable isotope deuterium and the unstable, radioactive isotope tritium. [NIH] Hydroxylation: Hydroxylate, to introduce hydroxyl into (a compound or radical) usually by replacement of hydrogen. [EU] Hyperbilirubinemia: Pathologic process consisting of an abnormal increase in the amount of bilirubin in the circulating blood, which may result in jaundice. [NIH] Hypnotic: A drug that acts to induce sleep. [EU] Idiopathic: Describes a disease of unknown cause. [NIH] Immunology: The study of the body's immune system. [NIH] Immunosuppressant: An agent capable of suppressing immune responses. [EU] 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] Indocyanine Green: A tricarbocyanine dye that is used diagnostically in liver function tests

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and to determine blood volume and cardiac output. [NIH] Indomethacin: A non-steroidal anti-inflammatory agent (NSAID) that inhibits the enzyme cyclooxygenase necessary for the formation of prostaglandins and other autacoids. It also inhibits the motility of polymorphonuclear leukocytes. [NIH] 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]

Infectious Mononucleosis: A common, acute infection usually caused by the Epstein-Barr virus (Human herpesvirus 4). There is an increase in mononuclear white blood cells and other atypical lymphocytes, generalized lymphadenopathy, splenomegaly, and occasionally hepatomegaly with hepatitis. [NIH] Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Infusion: A method of putting fluids, including drugs, into the bloodstream. Also called intravenous infusion. [NIH] Ingestion: Taking into the body by mouth [NIH] Intestinal: Having to do with the intestines. [NIH] Intestine: A long, tube-shaped organ in the abdomen that completes the process of digestion. There is both a large intestine and a small intestine. Also called the bowel. [NIH] Intravenous: IV. Into a vein. [NIH] Intrinsic: Situated entirely within or pertaining exclusively to a part. [EU] 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] Irinotecan: An anticancer drug that belongs to a family of anticancer drugs called topoisomerase inhibitors. It is a camptothecin analogue. Also called CPT 11. [NIH] Jaundice: A clinical manifestation of hyperbilirubinemia, consisting of deposition of bile pigments in the skin, resulting in a yellowish staining of the skin and mucous membranes. [NIH]

Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Ketoconazole: Broad spectrum antifungal agent used for long periods at high doses, especially in immunosuppressed patients. [NIH] Kinetic: Pertaining to or producing motion. [EU] Large Intestine: The part of the intestine that goes from the cecum to the rectum. The large intestine absorbs water from stool and changes it from a liquid to a solid form. The large intestine is 5 feet long and includes the appendix, cecum, colon, and rectum. Also called

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colon. [NIH] Latent: Phoria which occurs at one distance or another and which usually has no troublesome effect. [NIH] Laxative: An agent that acts to promote evacuation of the bowel; a cathartic or purgative. [EU]

Leukocytes: White blood cells. These include granular leukocytes (basophils, eosinophils, and neutrophils) as well as non-granular leukocytes (lymphocytes and monocytes). [NIH] Lipid: Fat. [NIH] Lipofuscin: A naturally occurring lipid pigment with histochemical characteristics similar to ceroid. It accumulates in various normal tissues and apparently increases in quantity with age. [NIH] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Liver Cirrhosis: Liver disease in which the normal microcirculation, the gross vascular anatomy, and the hepatic architecture have been variably destroyed and altered with fibrous septa surrounding regenerated or regenerating parenchymal nodules. [NIH] Liver Transplantation: The transference of a part of or an entire liver from one human or animal to another. [NIH] Lorazepam: An anti-anxiety agent with few side effects. It also has hypnotic, anticonvulsant, and considerable sedative properties and has been proposed as a preanesthetic agent. [NIH] Lymph: The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. [NIH] Lymphadenopathy: Disease or swelling of the lymph nodes. [NIH] Lymphocytes: White blood cells formed in the body's lymphoid tissue. The nucleus is round or ovoid with coarse, irregularly clumped chromatin while the cytoplasm is typically pale blue with azurophilic (if any) granules. Most lymphocytes can be classified as either T or B (with subpopulations of each); those with characteristics of neither major class are called null cells. [NIH] Lymphoid: Referring to lymphocytes, a type of white blood cell. Also refers to tissue in which lymphocytes develop. [NIH] Lymphoma: A general term for various neoplastic diseases of the lymphoid tissue. [NIH] Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] Mediator: An object or substance by which something is mediated, such as (1) a structure of the nervous system that transmits impulses eliciting a specific response; (2) a chemical substance (transmitter substance) that induces activity in an excitable tissue, such as nerve or muscle; or (3) a substance released from cells as the result of the interaction of antigen with antibody or by the action of antigen with a sensitized lymphocyte. [EU] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Mental: Pertaining to the mind; psychic. 2. (L. mentum chin) pertaining to the chin. [EU] Mental Processes: Conceptual functions or thinking in all its forms. [NIH] Metabolite: Any substance produced by metabolism or by a metabolic process. [EU] Methionine: A sulfur containing essential amino acid that is important in many body

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functions. It is a chelating agent for heavy metals. [NIH] MI: Myocardial infarction. Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Microbe: An organism which cannot be observed with the naked eye; e. g. unicellular animals, lower algae, lower fungi, bacteria. [NIH] Microcirculation: The vascular network lying between the arterioles and venules; includes capillaries, metarterioles and arteriovenous anastomoses. Also, the flow of blood through this network. [NIH] 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] Modeling: A treatment procedure whereby the therapist presents the target behavior which the learner is to imitate and make part of his repertoire. [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] Mononuclear: A cell with one nucleus. [NIH] Morphine: The principal alkaloid in opium and the prototype opiate analgesic and narcotic. Morphine has widespread effects in the central nervous system and on smooth muscle. [NIH] Morphological: Relating to the configuration or the structure of live organs. [NIH] Motility: The ability to move spontaneously. [EU] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Narcotic: 1. Pertaining to or producing narcosis. 2. An agent that produces insensibility or stupor, applied especially to the opioids, i.e. to any natural or synthetic drug that has morphine-like actions. [EU] Necrosis: A pathological process caused by the progressive degradative action of enzymes that is generally associated with severe cellular trauma. It is characterized by mitochondrial swelling, nuclear flocculation, uncontrolled cell lysis, and ultimately cell death. [NIH] Neonatal: Pertaining to the first four weeks after birth. [EU] Neoplasm: A new growth of benign or malignant tissue. [NIH] Neoplastic: Pertaining to or like a neoplasm (= any new and abnormal growth); pertaining to neoplasia (= the formation of a neoplasm). [EU] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Nuclear: A test of the structure, blood flow, and function of the kidneys. The doctor injects a mildly radioactive solution into an arm vein and uses x-rays to monitor its progress through the kidneys. [NIH] Nuclei: A body of specialized protoplasm found in nearly all cells and containing the

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chromosomes. [NIH] Opiate: A remedy containing or derived from opium; also any drug that induces sleep. [EU] Opium: The air-dried exudate from the unripe seed capsule of the opium poppy, Papaver somniferum, or its variant, P. album. It contains a number of alkaloids, but only a few morphine, codeine, and papaverine - have clinical significance. Opium has been used as an analgesic, antitussive, antidiarrheal, and antispasmodic. [NIH] Oxaliplatin: An anticancer drug that belongs to the family of drugs called platinum compounds. [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]

Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [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] 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] Pharmacodynamic: Is concerned with the response of living tissues to chemical stimuli, that is, the action of drugs on the living organism in the absence of disease. [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] Phenobarbital: A barbituric acid derivative that acts as a nonselective central nervous system depressant. It promotes binding to inhibitory GABA subtype receptors, and modulates chloride currents through receptor channels. It also inhibits glutamate induced depolarizations. [NIH] Phenolphthalein: An acid-base indicator which is colorless in acid solution, but turns pink to red as the solution becomes alkaline. It is used medicinally as a cathartic. [NIH] Phenotypes: An organism as observed, i. e. as judged by its visually perceptible characters resulting from the interaction of its genotype with the environment. [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]

Pigment: A substance that gives color to tissue. Pigments are responsible for the color of skin, eyes, and hair. [NIH] Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized 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]

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Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Platinum: Platinum. A heavy, soft, whitish metal, resembling tin, atomic number 78, atomic weight 195.09, symbol Pt. (From Dorland, 28th ed) It is used in manufacturing equipment for laboratory and industrial use. It occurs as a black powder (platinum black) and as a spongy substance (spongy platinum) and may have been known in Pliny's time as "alutiae". [NIH]

Platinum Compounds: Inorganic compounds which contain platinum as the central atom. [NIH]

Pneumonia: Inflammation of the lungs. [NIH] Polymorphism: The occurrence together of two or more distinct forms in the same population. [NIH] Polypeptide: A peptide which on hydrolysis yields more than two amino acids; called tripeptides, tetrapeptides, etc. according to the number of amino acids contained. [EU] Polyposis: The development of numerous polyps (growths that protrude from a mucous membrane). [NIH] Porphyria: A group of disorders characterized by the excessive production of porphyrins or their precursors that arises from abnormalities in the regulation of the porphyrin-heme pathway. The porphyrias are usually divided into three broad groups, erythropoietic, hepatic, and erythrohepatic, according to the major sites of abnormal porphyrin synthesis. [NIH]

Porphyrins: A group of compounds containing the porphin structure, four pyrrole rings connected by methine bridges in a cyclic configuration to which a variety of side chains are attached. The nature of the side chain is indicated by a prefix, as uroporphyrin, hematoporphyrin, etc. The porphyrins, in combination with iron, form the heme component in biologically significant compounds such as hemoglobin and myoglobin. [NIH] Postoperative: After surgery. [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] Predisposition: A latent susceptibility to disease which may be activated under certain conditions, as by stress. [EU] Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from incidence, which refers to the number of new cases in the population at a given time. [NIH] Progeny: The offspring produced in any generation. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Promoter: A chemical substance that increases the activity of a carcinogenic process. [NIH] Propafenone: An antiarrhythmia agent that is particularly effective in ventricular arrhythmias. It also has weak beta-blocking activity. The drug is generally well tolerated. [NIH]

Prostaglandins: A group of compounds derived from unsaturated 20-carbon fatty acids, primarily arachidonic acid, via the cyclooxygenase pathway. They are extremely potent

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mediators of a diverse group of physiological processes. [NIH] Prostaglandins A: (13E,15S)-15-Hydroxy-9-oxoprosta-10,13-dien-1-oic acid (PGA(1)); (5Z,13E,15S)-15-hydroxy-9-oxoprosta-5,10,13-trien-1-oic acid (PGA(2)); (5Z,13E,15S,17Z)-15hydroxy-9-oxoprosta-5,10,13,17-tetraen-1-oic acid (PGA(3)). A group of naturally occurring secondary prostaglandins derived from PGE. PGA(1) and PGA(2) as well as their 19hydroxy derivatives are found in many organs and tissues. [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 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] Protozoa: A subkingdom consisting of unicellular organisms that are the simplest in the animal kingdom. Most are free living. They range in size from submicroscopic to macroscopic. Protozoa are divided into seven phyla: Sarcomastigophora, Labyrinthomorpha, Apicomplexa, Microspora, Ascetospora, Myxozoa, and Ciliophora. [NIH] Psychology: The science dealing with the study of mental processes and behavior in man and animals. [NIH] Psychotropic: Exerting an effect upon the mind; capable of modifying mental activity; usually applied to drugs that effect the mental state. [EU] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Publishing: "The business or profession of the commercial production and issuance of literature" (Webster's 3d). It includes the publisher, publication processes, editing and editors. Production may be by conventional printing methods or by electronic publishing. [NIH]

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] Radiation therapy: The use of high-energy radiation from x-rays, gamma rays, neutrons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body in the area near cancer cells (internal radiation therapy, implant radiation, or brachytherapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. Also called radiotherapy. [NIH] Radioactive: Giving off radiation. [NIH] Reabsorption: 1. The act or process of absorbing again, as the selective absorption by the kidneys of substances (glucose, proteins, sodium, etc.) already secreted into the renal tubules, and their return to the circulating blood. 2. Resorption. [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] Receptors, Serotonin: Cell-surface proteins that bind serotonin and trigger intracellular changes which influence the behavior of cells. Several types of serotonin receptors have been recognized which differ in their pharmacology, molecular biology, and mode of action. [NIH]

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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] Red blood cells: RBCs. Cells that carry oxygen to all parts of the body. Also called erythrocytes. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Refraction: A test to determine the best eyeglasses or contact lenses to correct a refractive error (myopia, hyperopia, or astigmatism). [NIH] Resection: Removal of tissue or part or all of an organ by surgery. [NIH] Sarcoma: A connective tissue neoplasm formed by proliferation of mesodermal cells; it is usually highly malignant. [NIH] Schizophrenia: A mental disorder characterized by a special type of disintegration of the personality. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Sebaceous: Gland that secretes sebum. [NIH] Sedative: 1. Allaying activity and excitement. 2. An agent that allays excitement. [EU] 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] Shunt: A surgically created diversion of fluid (e.g., blood or cerebrospinal fluid) from one area of the body to another area of the body. [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] 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]

Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] 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] Spherocytes: Small, abnormal spherical red blood cells with more than the normal amount of hemoglobin. [NIH] Spherocytosis: A condition in which there are abnormally thick, almost spherical, red blood

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cells or spherocytes in the blood. [NIH] Spleen: An organ that is part of the lymphatic system. The spleen produces lymphocytes, filters the blood, stores blood cells, and destroys old blood cells. It is located on the left side of the abdomen near the stomach. [NIH] Splenectomy: An operation to remove the spleen. [NIH] Splenomegaly: Enlargement of the spleen. [NIH] Sporadic: Neither endemic nor epidemic; occurring occasionally in a random or isolated manner. [EU] 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] 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] Sulfobromophthalein: A phenolphthalein that is used as a diagnostic aid in heptatic function determination. [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] Taurine: 2-Aminoethanesulfonic acid. A conditionally essential nutrient, important during mammalian development. It is present in milk but is isolated mostly from ox bile and strongly conjugates bile acids. [NIH] Temozolomide: An anticancer drug that belongs to the family of drugs called alkylating agents. [NIH] Thalassemia: A group of hereditary hemolytic anemias in which there is decreased synthesis of one or more hemoglobin polypeptide chains. There are several genetic types with clinical pictures ranging from barely detectable hematologic abnormality to severe and fatal anemia. [NIH] 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] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tissue Distribution: Accumulation of a drug or chemical substance in various organs (including those not relevant to its pharmacologic or therapeutic action). This distribution depends on the blood flow or perfusion rate of the organ, the ability of the drug to penetrate organ membranes, tissue specificity, protein binding. The distribution is usually expressed as tissue to plasma ratios. [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]

Dictionary 85

Topoisomerase inhibitors: A family of anticancer drugs. The topoisomerase enzymes are responsible for the arrangement and rearrangement of DNA in the cell and for cell growth and replication. Inhibiting these enzymes may kill cancer cells or stop their growth. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Trace element: Substance or element essential to plant or animal life, but present in extremely small amounts. [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Trophic: Of or pertaining to nutrition. [EU] Tryptophan: An essential amino acid that is necessary for normal growth in infants and for nitrogen balance in adults. It is a precursor serotonin and niacin. [NIH] Uracil: An anticancer drug that belongs to the family of drugs called alkylating agents. [NIH] Uridine Diphosphate: A uracil nucleotide containing a pyrophosphate group esterified to C5 of the sugar moiety. [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] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Ventricular: Pertaining to a ventricle. [EU] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Virulence: The degree of pathogenicity within a group or species of microorganisms or viruses as indicated by case fatality rates and/or the ability of the organism to invade the tissues of the host. [NIH] Virus: Submicroscopic organism that causes infectious disease. In cancer therapy, some viruses may be made into vaccines that help the body build an immune response to, and kill, tumor cells. [NIH] 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] Vulgaris: An affection of the skin, especially of the face, the back and the chest, due to chronic inflammation of the sebaceous glands and the hair follicles. [NIH] 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]

X-ray: High-energy radiation used in low doses to diagnose diseases and in high doses to

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treat cancer. [NIH] Zygote: The fertilized ovum. [NIH]

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INDEX A Acceptor, 67, 80 Acetaminophen, 11, 67 Acute renal, 67, 76 Adaptability, 67, 70 Adverse Effect, 67, 83 Affinity, 6, 67 Agonist, 67, 70 Algorithms, 67, 70 Alkaline, 15, 67, 80 Alkaline Phosphatase, 15, 67 Alkaloid, 67, 70, 79 Alkylating Agents, 67, 84, 85 Alternative medicine, 40, 67 Amino acid, 68, 75, 78, 81, 82, 83, 84, 85 Ampulla, 68, 71 Analgesic, 67, 68, 70, 79, 80 Analog, 68, 74 Anemia, 6, 9, 10, 16, 35, 68, 69, 84 Anions, 6, 21, 68, 77 Anode, 68 Antibacterial, 68, 83 Antibiotic, 68, 83 Antibodies, 68, 75, 76 Antibody, 67, 68, 71, 75, 77, 78, 82, 83 Anticonvulsant, 68, 78 Antifungal, 68, 77 Antigen, 67, 68, 72, 77, 78 Anti-inflammatory, 67, 68, 77 Antimetabolite, 68, 74 Antineoplastic, 36, 67, 68, 74 Antioxidant, 4, 68 Antipyretic, 67, 69 Anxiety, 69, 78 Appendicitis, 6, 69 Arteries, 69, 70, 73, 79 Assay, 7, 23, 69 Asymptomatic, 69 Atypical, 69, 77 B Bacteria, 68, 69, 72, 76, 79, 83 Bacterium, 69, 72, 76 Beta-Thalassemia, 10, 69 Bile, 5, 8, 11, 25, 29, 30, 32, 56, 69, 71, 74, 75, 77, 78, 84 Bile Acids, 25, 29, 30, 69, 84 Bile Acids and Salts, 69 Bile duct, 69

Bile Pigments, 69, 77 Biliary, 13, 69, 71 Biochemical, 8, 15, 68, 69, 83 Biopsy, 19, 69 Biopsy specimen, 19, 69 Biosynthesis, 27, 69 Biotechnology, 5, 40, 51, 69 Blood Groups, 25, 70 Blood Platelets, 70, 83 Blood vessel, 70, 76, 80, 83, 85 Blood Volume, 70, 77 Buprenorphine, 4, 70 C Caloric intake, 12, 28, 29, 30, 31, 70 Camptothecin, 70, 77 Carbon Dioxide, 70, 73 Carcinogenic, 67, 70, 81 Carcinogens, 70, 71 Cardiac, 70, 77, 79 Cardiac Output, 70, 77 Cardiovascular, 70, 83 Case report, 10, 29, 37, 70 Causal, 70, 76 Cell, 7, 9, 28, 56, 67, 69, 70, 71, 72, 74, 76, 79, 80, 82, 85 Cell Survival, 7, 28, 70 Central Nervous System, 70, 79, 80, 83 Cerebrospinal, 70, 71, 83 Cerebrospinal fluid, 71, 83 Ceroid, 71, 78 Chenodeoxycholic Acid, 29, 71 Cholecystography, 26, 71 Cholelithiasis, 8, 9, 71 Choleretic, 71 Cholestasis, 23, 71 Cholesterol, 69, 71 Chromium, 7, 12, 71 Chromosome, 71, 72 Chronic, 16, 28, 70, 71, 77, 85 Chronic Fatigue Syndrome, 16, 71 Cirrhosis, 56, 71 Clinical trial, 3, 51, 71 Cloning, 70, 71 Colloidal, 71, 74 Colon, 71, 77 Colorectal, 4, 36, 71 Colorectal Cancer, 4, 36, 71 Complement, 71, 72

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Gilbert S Syndrome

Complementary and alternative medicine, 35, 37, 72 Complementary medicine, 35, 72 Computational Biology, 51, 72 Conjugated, 25, 28, 69, 71, 72 Conjugation, 11, 28, 72, 75 Connective Tissue, 72, 83 Consciousness, 68, 73 Constitutional, 10, 11, 15, 73 Contraindications, ii, 73 Contrast medium, 71, 73 Coronary, 73, 79 Coronary Thrombosis, 73, 79 Curative, 73, 84 D Degenerative, 73, 76 Demethylation, 27, 73 Diagnostic procedure, 40, 73 Diarrhea, 4, 73 Digestion, 69, 73, 77, 78, 84 Direct, iii, 73, 83 Dissociation, 12, 13, 67, 73 Dissociative Disorders, 73 Drug Interactions, 44, 73 Duodenum, 69, 73, 75, 84 Dyes, 13, 73 E Electrolysis, 68, 73 Electrolytes, 69, 73 Electrons, 69, 74, 77, 80, 82 Electrophoresis, 32, 74 Endemic, 74, 84 Endogenous, 4, 14, 74, 75, 82 Enterohepatic, 12, 33, 74 Enterohepatic Circulation, 12, 74 Environmental Health, 50, 52, 74 Enzyme, 8, 19, 67, 70, 74, 77, 84, 85 Epidemic, 74, 84 Epithelial, 74 Epithelial Cells, 74 Erythrocytes, 68, 70, 74, 76, 83 Evacuation, 74, 75, 78 Exogenous, 74, 75, 82 Extraction, 8, 74 F Family Planning, 51, 74 Fatigue, 65, 71, 74 Fats, 69, 71, 74 Fluorouracil, 36, 74 Fractionation, 19, 74 Free Radicals, 68, 73, 74 Fungi, 68, 72, 75, 79

G Gallbladder, 7, 18, 69, 71, 75 Gastric, 11, 75 Gastric Emptying, 11, 75 Gastrointestinal, 35, 75, 83, 84 Gastrointestinal tract, 75, 83 Gene, 4, 5, 11, 16, 18, 25, 30, 32, 70, 75 Gene Expression, 4, 75 Genetics, 11, 18, 27, 72, 75 Genotype, 37, 75, 80 Glucaric Acid, 14, 75 Glucose, 16, 17, 22, 71, 75, 82 Glucuronosyltransferase, 4, 8, 11, 12, 15, 16, 18, 27, 30, 31, 32, 36, 75 Glutamate, 75, 80 Glycine, 68, 69, 71, 75 Governing Board, 75, 81 Graft, 9, 75 H Hair follicles, 75, 85 Haptens, 67, 75 Heme, 69, 75, 81 Hemoglobin, 68, 69, 74, 75, 81, 83, 84 Hemolysis, 8, 12, 13, 21, 76 Hemolytic, 9, 10, 28, 76, 84 Hemostasis, 76, 83 Hepatic, 6, 7, 10, 11, 14, 15, 21, 23, 26, 76, 78, 81 Hepatitis, 56, 76, 77 Hepatocyte, 71, 76 Hepatomegaly, 76, 77 Hereditary, 14, 15, 18, 76, 84 Heredity, 75, 76 Heterogeneity, 20, 21, 23, 67, 76 Homeostasis, 4, 76 Hydrogen, 67, 76, 79, 80 Hydroxylation, 24, 76 Hyperbilirubinemia, 10, 13, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 28, 29, 30, 31, 32, 76, 77 Hypnotic, 76, 78 I Idiopathic, 7, 22, 23, 29, 30, 76 Immunology, 67, 76 Immunosuppressant, 67, 74, 76 In vitro, 23, 37, 76 In vivo, 76 Indocyanine Green, 6, 13, 76 Indomethacin, 23, 77 Infarction, 73, 77, 79 Infection, 77, 78, 85 Infectious Mononucleosis, 8, 77

89

Inflammation, 68, 69, 76, 77, 81, 85 Infusion, 4, 77 Ingestion, 71, 77 Intestinal, 15, 71, 77 Intestine, 69, 71, 74, 77 Intravenous, 77 Intrinsic, 67, 77 Ions, 73, 76, 77 Irinotecan, 35, 36, 37, 77 J Jaundice, 15, 16, 17, 19, 26, 28, 65, 76, 77 K Kb, 50, 77 Ketoconazole, 4, 77 Kinetic, 10, 77 L Large Intestine, 71, 77, 83 Latent, 78, 81 Laxative, 71, 78 Leukocytes, 77, 78 Lipid, 13, 71, 78 Lipofuscin, 15, 71, 78 Liver, 8, 9, 12, 19, 20, 21, 23, 24, 26, 27, 36, 37, 56, 67, 69, 71, 73, 74, 75, 76, 78 Liver Cirrhosis, 26, 27, 78 Liver Transplantation, 9, 19, 20, 24, 78 Lorazepam, 12, 78 Lymph, 77, 78 Lymphadenopathy, 77, 78 Lymphocytes, 68, 77, 78, 84, 85 Lymphoid, 68, 78 Lymphoma, 56, 78 M Malignant, 68, 78, 79, 83 Mediator, 78, 83 MEDLINE, 51, 78 Membrane, 6, 72, 78, 81 Mental, iv, 3, 26, 50, 52, 73, 74, 78, 82, 83 Mental Processes, 73, 78, 82 Metabolite, 36, 37, 78 Methionine, 14, 78, 84 MI, 66, 79 Microbe, 79, 85 Microcirculation, 78, 79 Microorganism, 79, 85 Modeling, 6, 79 Molecular, 18, 24, 51, 53, 70, 72, 79, 82 Molecule, 68, 72, 73, 79, 80, 82 Monitor, 79 Mononuclear, 77, 79 Morphine, 26, 70, 79, 80 Morphological, 20, 79

Motility, 77, 79, 83 Myocardium, 79 N Narcotic, 79 Necrosis, 77, 79 Neonatal, 16, 25, 79 Neoplasm, 79, 83 Neoplastic, 78, 79 Nervous System, 70, 78, 79, 84 Nuclear, 4, 70, 72, 74, 79 Nuclei, 72, 74, 79 O Opiate, 79, 80 Opium, 79, 80 Oxaliplatin, 35, 80 Oxidation, 25, 67, 69, 80 P Palliative, 80, 84 Pathogenesis, 16, 26, 39, 80 Pathologic, 69, 73, 76, 80 Perfusion, 80, 84 Pharmacodynamic, 4, 80 Pharmacokinetic, 14, 80 Pharmacologic, 80, 84, 85 Phenobarbital, 4, 7, 12, 14, 80 Phenolphthalein, 80, 84 Phenotypes, 11, 25, 80 Physiologic, 67, 69, 80, 82 Pigment, 69, 71, 78, 80 Plants, 67, 70, 75, 80 Plasma, 6, 21, 22, 23, 26, 27, 68, 70, 75, 76, 81, 84 Platinum, 80, 81 Platinum Compounds, 80, 81 Pneumonia, 73, 81 Polymorphism, 15, 27, 28, 37, 81 Polypeptide, 68, 81, 84 Polyposis, 71, 81 Porphyria, 56, 81 Porphyrins, 81 Postoperative, 17, 24, 81 Practice Guidelines, 52, 81 Predisposition, 36, 81 Prevalence, 20, 31, 81 Progeny, 72, 81 Progressive, 71, 79, 81 Promoter, 4, 5, 16, 27, 28, 30, 32, 37, 81 Propafenone, 12, 81 Prostaglandins, 77, 81, 82 Prostaglandins A, 77, 82 Protein Binding, 82, 84 Protein S, 70, 82

90

Gilbert S Syndrome

Proteins, 68, 71, 79, 81, 82, 83 Protozoa, 72, 79, 82 Psychology, 73, 82 Psychotropic, 22, 82 Public Policy, 51, 82 Publishing, 5, 82 R Radiation, 74, 82, 85 Radiation therapy, 74, 82 Radioactive, 7, 12, 76, 79, 82 Reabsorption, 74, 82 Receptor, 4, 68, 80, 82, 83 Receptors, Serotonin, 82, 83 Recombination, 72, 83 Rectum, 71, 77, 83 Red blood cells, 74, 76, 83, 84 Refer, 1, 71, 75, 83 Refraction, 83 Resection, 23, 83 S Sarcoma, 4, 83 Schizophrenia, 29, 30, 83 Screening, 31, 71, 83 Sebaceous, 83, 85 Sedative, 78, 83 Serotonin, 27, 82, 83, 85 Serum, 13, 15, 20, 25, 28, 29, 30, 71, 83 Shunt, 19, 28, 83 Side effect, 43, 45, 67, 78, 83, 85 Small intestine, 71, 73, 77, 83 Smooth muscle, 79, 83, 84 Specialist, 57, 83 Specificity, 67, 83, 84 Spectrum, 9, 77, 83 Spherocytes, 83, 84 Spherocytosis, 14, 15, 18, 83 Spleen, 84 Splenectomy, 14, 84 Splenomegaly, 77, 84 Sporadic, 28, 84 Stomach, 75, 83, 84 Stress, 66, 81, 84 Substance P, 78, 84

Substrate, 4, 84 Sulfobromophthalein, 6, 27, 84 Sulfur, 78, 84 T Taurine, 69, 71, 84 Temozolomide, 4, 84 Thalassemia, 10, 69, 84 Therapeutics, 4, 37, 44, 84 Thermal, 73, 84 Tissue, 4, 37, 68, 69, 72, 74, 75, 78, 79, 80, 83, 84 Tissue Distribution, 4, 84 Tolerance, 67, 70, 84 Tonicity, 76, 84 Topoisomerase inhibitors, 77, 85 Toxic, iv, 67, 72, 85 Toxicity, 4, 26, 36, 37, 73, 85 Toxicology, 52, 85 Trace element, 71, 85 Transfection, 70, 85 Trophic, 6, 85 Tryptophan, 83, 85 U Uracil, 85 Uridine Diphosphate, 12, 30, 36, 85 Urinary, 14, 85 Urine, 85 V Vascular, 12, 77, 78, 79, 85 Vein, 77, 79, 85 Ventricular, 81, 85 Veterinary Medicine, 51, 85 Virulence, 85 Virus, 77, 85 Vitro, 10, 85 Vivo, 10, 85 Vulgaris, 22, 85 W White blood cell, 68, 77, 78, 85 X X-ray, 73, 79, 82, 85 Z Zygote, 72, 86

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Gilbert S Syndrome

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