HELLP Syndrome - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

HELLP SYNDROME A 3-IN-1 MEDICAL REFERENCE Medical Dictionary Bibliography & Annotated Research Guide TO I NTERNET R EFE...

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HELLP SYNDROME A 3-IN-1 MEDICAL REFERENCE Medical Dictionary Bibliography & Annotated Research Guide TO I NTERNET

R EFERENCES

HELLP

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., 1960HELLP 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: 0-497-00522-0 1. HELLP 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 HELLP 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 HELLP SYNDROME .................................................................................. 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on HELLP Syndrome......................................................................... 4 The National Library of Medicine: PubMed .................................................................................. 4 CHAPTER 2. BOOKS ON HELLP SYNDROME .................................................................................. 43 Overview...................................................................................................................................... 43 Book Summaries: Online Booksellers........................................................................................... 43 Chapters on HELLP Syndrome.................................................................................................... 43 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 HELLP SYNDROME DICTIONARY ........................................................................................... 67 INDEX ................................................................................................................................................ 93

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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 HELLP 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 HELLP 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 HELLP 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 HELLP 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 HELLP 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 HELLP 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 HELLP SYNDROME Overview In this chapter, we will show you how to locate peer-reviewed references and studies on HELLP syndrome.

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

HELLP Syndrome: Hemolysis, Elevated Liver Enzymes, and Low Platelets Source: JAMA. Journal of the American Medical Association. 280(6): 559-562. August 12, 1998. Summary: This article presents a detailed case study and discussion of HELLP syndrome, which consists of hemolysis, elevated liver enzymes, and low platelets. The HELLP syndrome is one of the hypertensive disorders of pregnancy, which also include preeclampsia and eclampsia. The multi-organ dysfunction in HELLP can lead to acute tubular necrosis and renal failure. Preeclampsia is associated with glomerular endotheliosis, whose pathologic hallmark is a thickening of the basement membranes; a similar renal lesion may account for the proteinuria in HELLP. With proper supportive care, most patients fully recover kidney function. The author emphasizes that all

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HELLP Syndrome

physicians should know that a cardinal symptom of the HELLP syndrome is right upper quadrant pain. Clinicians examining pregnant women in a primary care or subspecialty setting should have a low threshold for ordering a complete blood count, urinalysis, and liver function tests, even if the patients complaints are nonspecific. Finally, pregnant women need regular, accurate blood pressure measurement. A blood pressure of 140 over 90 mm Hg, normal in most nonpregnant patients, may indicate serious disease in pregnant women. 28 references.

Federally Funded Research on HELLP Syndrome The U.S. Government supports a variety of research studies relating to HELLP 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 HELLP 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 HELLP syndrome.

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

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). 3 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. 2

Studies

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31P magnetic resonance spectroscopy of the liver in HELLP syndrome. Author(s): Magee LA, Dixon RM, Kemp GJ, Redman CW, Styles P. Source: British Journal of Obstetrics and Gynaecology. 1999 June; 106(6): 582-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10426617

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A case of HELLP syndrome at 23 weeks' gestation. Author(s): Neuhaus W, Crombach G, Hamm W, Bolte A. Source: Archives of Gynecology and Obstetrics. 1994; 255(4): 217-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7695370

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A case of mild ocular manifestations in pregnancy induced hypertension with HELLP syndrome. Author(s): Wenzel M, Lehnen H. Source: Acta Ophthalmol (Copenh). 1994 June; 72(3): 391-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7976276

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A case of partial mole and atypical type I triploidy associated with severe HELLP syndrome at 18 weeks' gestation. Author(s): Stefos T, Plachouras N, Mari G, Cosmi E, Lolis D. Source: Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology. 2002 October; 20(4): 403-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12383328

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A comparison of severe pre-eclampsia/eclampsia in patients with and without HELLP syndrome. Author(s): Zuberi NF, Arif K, Khan FM, Pal JA. Source: J Pak Med Assoc. 1998 February; 48(2): 29-32. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9610088

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A model for the HELLP syndrome: the maternal experience. Author(s): Kidner MC, Flanders-Stepans MB. Source: Journal of Obstetric, Gynecologic, and Neonatal Nursing : Jognn / Naacog. 2004 January-February; 33(1): 44-53. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14971552

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A review of HELLP syndrome. Author(s): Curtin WM, Weinstein L. Source: Journal of Perinatology : Official Journal of the California Perinatal Association. 1999 March; 19(2): 138-43. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10642976

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A variant of HELLP syndrome. Author(s): Steer R. Source: Aust Fam Physician. 1991 May; 20(5): 692-3. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1854309

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Absence of seasonal variation on the frequency of HELLP syndrome. Author(s): Magann EF, Chauhan SP, Morrison JC, Martin JN Jr. Source: Southern Medical Journal. 1998 August; 91(8): 731-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9715217

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Acute fatty liver and HELLP syndrome: two distinct pregnancy disorders. Author(s): Vigil-De Gracia P. Source: International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics. 2001 June; 73(3): 215-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11376667

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Acute liver necrosis in the HELLP syndrome: successful outcome after orthotopic liver transplantation. A case report. Author(s): Erhard J, Lange R, Niebel W, Scherer R, Kox WJ, Philipp T, Eigler FW. Source: Transplant International : Official Journal of the European Society for Organ Transplantation. 1993 May; 6(3): 179-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8499073

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Acute onset of blindness during labor: report of a case of transient cortical blindness in association with HELLP syndrome. Author(s): Ebert AD, Hopp HS, Entezami M, Runkel S, Weitzel HK. Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology. 1999 May; 84(1): 111-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10413240

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Acute pancreatitis and deep vein thrombosis associated with HELLP syndrome. Author(s): Paternoster DM, Rodi J, Santarossa C, Vanin M, Simioni P, Girolami A. Source: Minerva Ginecol. 1999 January-February; 51(1-2): 31-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10230242

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Acute renal failure complicating HELLP syndrome, SLE and anti-phospholipid syndrome: successful outcome using plasma exchange therapy. Author(s): Roberts G, Gordon MM, Porter D, Jardine AG, Gibson IW. Source: Lupus. 2003; 12(4): 251-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12729047

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Acute renal failure in a patient with HELLP syndrome--an unusual complication of eclampsia. Author(s): Ghosh AK, Vashisht K, Varma S, Khullar D, Sakhuja V. Source: Renal Failure. 1994; 16(2): 295-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8041968

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Adrenomedullin, calcitonin gene-related peptide and their receptors: evidence for a decreased placental mRNA content in preeclampsia and HELLP syndrome. Author(s): Knerr I, Dachert C, Beinder E, Metzler M, Dotsch J, Repp R, Rascher W. Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology. 2002 February 10; 101(1): 47-53. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11905404

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Aggressive management of HELLP syndrome and eclampsia. Author(s): Poole JH. Source: Aacn Clinical Issues. 1997 November; 8(4): 524-38; Quiz 646-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9392709

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Altered lipid metabolism in preeclampsia and HELLP syndrome: links to enhanced platelet reactivity and fetal growth. Author(s): Wetzka B, Winkler K, Kinner M, Friedrich I, Marz W, Zahradnik HP. Source: Seminars in Thrombosis and Hemostasis. 1999; 25(5): 455-62. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10625202

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An association between refractory HELLP syndrome and antiphospholipid antibodies during pregnancy; a report of 2 cases. Author(s): Ornstein MH, Rand JH. Source: The Journal of Rheumatology. 1994 July; 21(7): 1360-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7966086

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Anaphylactoid reaction to hydroxyethylstarch during cesarean delivery in a patient with HELLP syndrome. Author(s): Vercauteren MP, Coppejans HC, Sermeus L. Source: Anesthesia and Analgesia. 2003 March; 96(3): 859-61, Table of Contents. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12598274

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Anesthesia in pregnant women with HELLP syndrome. Author(s): Vigil-De Gracia P, Silva S, Montufar C, Carrol I, De Los Rios S. Source: International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics. 2001 July; 74(1): 23-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11430937

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Antepartum reversal of hematologic abnormalities associated with the HELLP syndrome. A report of three cases. Author(s): Clark SL, Phelan JR, Allen SH, Golde SR. Source: J Reprod Med. 1986 January; 31(1): 70-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3950889

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Association of a decrease in antithrombin III activity with a perinatal elevation in aspartate aminotransferase in women with twin pregnancies: relevance to the HELLP syndrome. Author(s): Minakami H, Watanabe T, Izumi A, Matsubara S, Koike T, Sayama M, Moriyama I, Sato I. Source: Journal of Hepatology. 1999 April; 30(4): 603-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10207801

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Association of HELLP syndrome with autoimmune antibodies and glucose intolerance. Author(s): Weitgasser R, Spitzer D, Kartnig I, Zajc M, Staudach A, Sandhofer F. Source: Diabetes Care. 2000 June; 23(6): 786-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10840997

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Association of maternal and/or fetal factor V Leiden and G20210A prothrombin mutation with HELLP syndrome and intrauterine growth restriction. Author(s): Schlembach D, Beinder E, Zingsem J, Wunsiedler U, Beckmann MW, Fischer T. Source: Clinical Science (London, England : 1979). 2003 September; 105(3): 279-85. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12725641

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Bilateral bullous retinal detachment as a complication of the HELLP syndrome. Author(s): Gupta LY, Mansour SE. Source: Can J Ophthalmol. 1994 October; 29(5): 242-5. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7859180

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Bilateral serous retinal detachment as a complication of HELLP syndrome. Author(s): Tranos PG, Wickremasinghe SS, Hundal KS, Foster PJ, Jagger J. Source: Eye (London, England). 2002 July; 16(4): 491-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12101460

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Bioactive tumour necrosis factor alpha in pre-eclamptic patients with and without the HELLP syndrome. Author(s): Visser W, Beckmann I, Bremer HA, Lim HL, Wallenburg HC. Source: British Journal of Obstetrics and Gynaecology. 1994 December; 101(12): 1081-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7826964

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Bone marrow necrosis and refractory HELLP syndrome in a patient with catastrophic antiphospholipid antibody syndrome. Author(s): Sinha J, Chowdhry I, Sedan S, Barland P. Source: The Journal of Rheumatology. 2002 January; 29(1): 195-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11824961

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Cardiopulmonary morbidity as a complication of severe preeclampsia HELLP syndrome. Author(s): Terrone DA, Isler CM, May WL, Magann EF, Norman PF, Martin JN Jr. Source: Journal of Perinatology : Official Journal of the California Perinatal Association. 2000 March; 20(2): 78-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10785880

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Care of the pregnancy complicated by HELLP syndrome. Author(s): Barton JR, Sibai BM. Source: Gastroenterology Clinics of North America. 1992 December; 21(4): 937-50. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1478745

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Care of the pregnancy complicated by HELLP syndrome. Author(s): Barton JR, Sibai BM. Source: Obstetrics and Gynecology Clinics of North America. 1991 June; 18(2): 165-79. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1945249

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Central retinal vein occlusion and HELLP syndrome. Author(s): Gonzalvo FJ, Abecia E, Pinilla I, Izaguirre LB, Olivan JM, Honrubia FM. Source: Acta Ophthalmologica Scandinavica. 2000 October; 78(5): 596-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11037923

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Cerebral haemodynamic pathologies in HELLP syndrome. Author(s): Knopp U, Kehler U, Rickmann H, Arnold H, Gliemroth J. Source: Clinical Neurology and Neurosurgery. 2003 September; 105(4): 256-61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12954542

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Characteristic magnetic resonance imaging for neurological assessment in HELLP syndrome with eclampsia: a case report. Author(s): Fukuhara S, Migita K, Iida K, Okabayashi K, Inoue T, Iwasaki Y, Wada S, Yamanoue T, Ohtani M. Source: Hiroshima J Med Sci. 2001 March; 50(1): 37-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11314857

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Clinical and haemostatic parameters in the HELLP syndrome: relevance of plasminogen activator inhibitors. Author(s): Gilabert J, Estelles A, Ridocci F, Espana F, Aznar J, Galbis M. Source: Gynecologic and Obstetric Investigation. 1990; 30(2): 81-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2147163

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Clinical use of human hepatocyte growth factor in the early detection of HELLP syndrome. Author(s): Iioka H. Source: Gynecologic and Obstetric Investigation. 1996; 41(2): 103-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8838969

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Coagulation and plasma fibronectin parameters in HELLP syndrome. Author(s): Paternoster DM, Stella A, Simioni P, Mussap M, Plebani M. Source: International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics. 1995 September; 50(3): 263-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8543109

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Continuous renal replacement therapy in patients with HELLP syndrome. Author(s): Piccinni P, Dan M, Marafon S, Zamperetti N, Irone M, Digito A, Lieta E, Ronco C. Source: Minerva Anestesiol. 1999 June; 65(6): 433-6. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10394815

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Correlation of platelet count changes with liver cell destruction in HELLP syndrome. Author(s): Rychel V, Williams KP. Source: Hypertension in Pregnancy : Official Journal of the International Society for the Study of Hypertension in Pregnancy. 2003; 22(1): 57-62. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12648443

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Corticosteroid therapy for conservative management in marginally-viable pregnancy complicated by HELLP syndrome. Author(s): Dreyfus M, Tissier I, Ndocko MA, Denoual I, Baldauf JJ, Ritter J. Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology. 1999 August; 85(2): 233-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10584642

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Corticosteroid-induced arrest of HELLP syndrome progression in a marginally-viable pregnancy. Author(s): Magann EF, Washburne JF, Sullivan CA, Chauhan SP, Morrison JC, Martin JN Jr. Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology. 1995 April; 59(2): 217-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7657019

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Corticosteroids for enhanced fetal lung maturation in patients with HELLP syndrome: impact on neonates. Author(s): Magann EF, Graves GR, Roberts WE, Blake PG, Morrison JC, Martin JN Jr. Source: The Australian & New Zealand Journal of Obstetrics & Gynaecology. 1993 May; 33(2): 131-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8216108

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Corticosteroids for HELLP syndrome in pregnancy. Author(s): Matchaba P, Moodley J. Source: Cochrane Database Syst Rev. 2004; (1): Cd002076. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14973983

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Corticosteroids for the enhancement of fetal lung maturity: impact on the gravida with preeclampsia and the HELLP syndrome. Author(s): Magann EF, Martin RW, Isaacs JD, Blake PG, Morrison JC, Martin JN Jr. Source: The Australian & New Zealand Journal of Obstetrics & Gynaecology. 1993 May; 33(2): 127-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8216107

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Critical care of HELLP syndrome with corticosteroids. Author(s): Magann EF, Martin JN Jr. Source: American Journal of Perinatology. 2000; 17(8): 417-22. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11142392

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CT demonstration of resolution of hepatic lesions in HELLP syndrome: a case report. Author(s): Muchnok C, Hogg JP, Granke DS. Source: W V Med J. 1998 January-February; 94(1): 18-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9505565

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D-dimer test for early detection of HELLP syndrome. Author(s): Neiger R, Trofatter MO, Trofatter KF Jr. Source: Southern Medical Journal. 1995 April; 88(4): 416-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7716593

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HELLP Syndrome

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D-dimer test for HELLP syndrome. Author(s): McClincy MS, Vandenburg HL, Kiser WR. Source: Southern Medical Journal. 1995 November; 88(11): 1182-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7482002

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Dexamethasone compared with betamethasone for glucocorticoid treatment of postpartum HELLP syndrome. Author(s): Isler CM, Magann EF, Rinehart BK, Terrone DA, Bass JD, Martin JN Jr. Source: International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics. 2003 March; 80(3): 291-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12628531

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Dexamethasone in the post-partum treatment of HELLP syndrome. Author(s): Vigil-De Gracia P, Garcia-Caceres E. Source: International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics. 1997 December; 59(3): 217-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9486510

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Distribution of ABO and Rh blood groups in patients with HELLP syndrome. Author(s): Sezik M, Toyran H, Yapar EG. Source: Archives of Gynecology and Obstetrics. 2002 November; 267(1): 33-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12410371

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Doppler sonographic findings for hypertension in pregnancy and HELLP syndrome. Author(s): Joern H, Funk A, Rath W. Source: Journal of Perinatal Medicine. 1999; 27(5): 388-94. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10642960

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Doppler velocimetry of hepatic blood flow in postpartum patients with HELLP syndrome (hemolysis, elevated liver enzymes, and low platelets) Author(s): Kurzel RB, Au AH, Rooholamini SA. Source: American Journal of Obstetrics and Gynecology. 1996 December; 175(6): 1677-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8987963

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Early development of HELLP syndrome associated with eclampsia: a case report. Author(s): Gurel SA, Gurel H. Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology. 1998 February; 76(2): 241-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9481583

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Early development of HELLP syndrome: a case report. Author(s): Georgiew DB, Skortcheva I, Abadjiew V. Source: Gynecologic and Obstetric Investigation. 1990; 30(2): 127-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2245950

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Early onset, severe pre-eclampsia and HELLP syndrome: sex ratio of infants. Author(s): Hall DR. Source: Journal of Obstetrics and Gynaecology : the Journal of the Institute of Obstetrics and Gynaecology. 2002 November; 22(6): 636. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12554252

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Effect of corticosteroids on HELLP syndrome: a case report. Author(s): Schlembach D, Munz W, Fischer T. Source: Journal of Perinatal Medicine. 2000; 28(6): 502-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11155438

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Effect of the HELLP syndrome on maternal immune function. Author(s): Cunningham DS, Christie TL, Evans EE, McCaul JF. Source: J Reprod Med. 1993 June; 38(6): 459-64. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8331625

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Effects of postpartum corticosteroids in patients with HELLP syndrome. Author(s): Yalcin OT, Sener T, Hassa H, Ozalp S, Okur A. Source: International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics. 1998 May; 61(2): 141-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9639218

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Elevated serum levels of the c-erbB-2 encoded oncoprotein fragment in cases of pure preeclampsia and HELLP syndrome. Author(s): Meden H, Mielke S, Wuttke W, Kuhn W. Source: The Journal of Obstetrics and Gynaecology Research. 1997 April; 23(2): 213-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9158311

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Elevations of serum interleukin-12 concentrations in women with severe preeclampsia and HELLP syndrome. Author(s): Dudley DJ, Hunter C, Mitchell MD, Varner MW, Gately M. Source: Journal of Reproductive Immunology. 1996 August; 31(1-2): 97-107. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8887125

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HELLP Syndrome

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Embryonal sarcoma of the liver in pregnancy, associated with HELLP syndrome. Author(s): Akerboom-Straberger BM, Lotgering FK. Source: American Journal of Obstetrics and Gynecology. 2004 February; 190(2): 556-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14981406

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Enhancement of hepatic artery resistance to blood flow in preeclampsia in presence or absence of HELLP syndrome (hemolysis, elevated liver enzymes, and low platelets) Author(s): Oosterhof H, Voorhoeve PG, Aarnoudse JG. Source: American Journal of Obstetrics and Gynecology. 1994 August; 171(2): 526-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8059835

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Epoprostenol and plasmapheresis in complicated HELLP syndrome with pancreatitis. Author(s): Huber W, Schweigart U, Classen M. Source: Lancet. 1994 April 2; 343(8901): 848. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7908087

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Ethnic variation in the incidence of HELLP syndrome in a hypertensive pregnant population. Author(s): Williams KP, Wilson S. Source: Journal of Perinatal Medicine. 1997; 25(6): 498-501. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9494922

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Extensive hepatic infarction caused by thrombosis of right portal vein branches and arterial vasospasm in HELLP syndrome associated with homozygous factor V Leiden. Author(s): Seige M, Schweigart U, Moessmer G, Schneider KT, Classen M. Source: The American Journal of Gastroenterology. 1998 March; 93(3): 473-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9517665

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Extensive reversible brain magnetic resonance lesions in a patient with HELLP syndrome. Author(s): Feske SK, Sperling RA, Schwartz RB. Source: Journal of Neuroimaging : Official Journal of the American Society of Neuroimaging. 1997 October; 7(4): 247-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9344010

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Factor V Leiden and factor II G20210A in preeclampsia and HELLP syndrome. Author(s): Benedetto C, Marozio L, Salton L, Maula V, Chieppa G, Massobrio M. Source: Acta Obstetricia Et Gynecologica Scandinavica. 2002 December; 81(12): 1095-100. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12519104

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Familial thrombotic thrombocytopenic purpura imitating HELLP syndrome (hemolysis, elevated liver enzymes, and low platelets) in two sisters during pregnancy. Author(s): Uslu M, Guzelmeric K, Asut I. Source: American Journal of Obstetrics and Gynecology. 1994 February; 170(2): 699-700. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8116734

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Gestational thrombocytopenia and pregnancy-induced antithrombin deficiency: progenitors to the development of the HELLP syndrome and acute fatty liver of pregnancy. Author(s): Minakami H, Yamada H, Suzuki S. Source: Seminars in Thrombosis and Hemostasis. 2002 December; 28(6): 515-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12536342

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Getting perspective on HELLP syndrome. Author(s): Poole JH. Source: Mcn. the American Journal of Maternal Child Nursing. 1988 NovemberDecember; 13(6): 432-7. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3148805

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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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Glutathione S-transferase alpha as marker for hepatocellular damage in preeclampsia and HELLP syndrome. Author(s): Steegers EA, Mulder TP, Bisseling JG, Delemarre FM, Peters WH. Source: Lancet. 1995 June 17; 345(8964): 1571-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7791457

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Haptoglobin and its association with the HELLP syndrome. Author(s): Raijmakers MT, Roes EM, te Morsche RH, Steegers EA, Peters WH. Source: Journal of Medical Genetics. 2003 March; 40(3): 214-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12624142

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Haptoglobin helps diagnose the HELLP syndrome. Author(s): Poldre PA. Source: American Journal of Obstetrics and Gynecology. 1987 November; 157(5): 1267. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3688086

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HELLP syndrome (hemolysis, elevated liver enzymes, and low platelets) pathophysiology and anesthetic considerations. Author(s): Portis R, Jacobs MA, Skerman JH, Skerman EB. Source: Aana Journal. 1997 February; 65(1): 37-47. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9223938

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HELLP syndrome (hemolysis, elevated liver enzymes, and low platelets) presenting as generalized malaise. Author(s): Tomsen TR. Source: American Journal of Obstetrics and Gynecology. 1995 June; 172(6): 1876-8; Discussion 1878-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7778647

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HELLP syndrome after the improvement of coagulation and fibrinolysis parameters in severe preeclampsia. Author(s): Furuhashi M, Oda H, Imai N. Source: International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics. 1996 March; 52(3): 279-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8775684

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HELLP syndrome and cholecystitis: case report and review of the literature. Author(s): Bramwell KJ, Chacon SR, Alanis-Amezcua JM, Roberts DL, Resnik R, Rosen P. Source: The Journal of Emergency Medicine. 1997 November-December; 15(6): 821-6. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9404799

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HELLP syndrome and coagulopathies of pregnancy. Author(s): Poole J. Source: Critical Care Nursing Clinics of North America. 1993 September; 5(3): 475-87. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8217043

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HELLP syndrome and factor V Leiden. Author(s): Bozzo M, Carpani G, Leo L, Marcozzi S, Sacchi E, Moroni G, Pardi G. Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology. 2001 March; 95(1): 55-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11267721

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HELLP syndrome and postpartum corticosteroids. Author(s): Varol F, Aydin T, Gucer F. Source: International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics. 2001 May; 73(2): 157-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11336737

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HELLP syndrome and the anaesthetist. Author(s): Duffy BL. Source: Anaesthesia. 1988 March; 43(3): 223-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3364641

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HELLP syndrome associated with factor V R506Q mutation. Author(s): Brenner B, Lanir N, Thaler I. Source: British Journal of Haematology. 1996 March; 92(4): 999-1001. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8616100

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HELLP syndrome complicated by visual loss. Author(s): Tara PN, Byrne H, Francis PJ, Shennan A. Source: Journal of Obstetrics and Gynaecology : the Journal of the Institute of Obstetrics and Gynaecology. 2003 September; 23(5): 562-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12963522

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HELLP syndrome in a pregnant patient with a past history of splenectomy for idiopathic thrombocytopenic purpura. Case report. Author(s): Yamamoto H, Yamazaki K, Nishikawa S, Hayashi T, Hayakawa O, Kudo R. Source: Archives of Gynecology and Obstetrics. 1997; 259(2): 105-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9059752

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HELLP syndrome in primigravida related to disturbances in fatty acid oxidation in foetus. Author(s): Sikorska K, Witczak-Malinowska K. Source: Medical Science Monitor : International Medical Journal of Experimental and Clinical Research. 2001 May; 7 Suppl 1: 277-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12211736

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HELLP syndrome in the 18th week of gestation in association with elevated angiotensin AT(1)-receptor autoantibodies. Author(s): Fischer T, Wallukat G, Schneider MP, Schlembach D, Munz W, Homuth V. Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology. 2001 August; 97(2): 255-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11451561

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HELLP syndrome leading to a diagnosis of pregnancy. Author(s): Kathula SK, Bolla SR, Magann EF. Source: Southern Medical Journal. 2002 August; 95(8): 934-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12190237

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HELLP syndrome with antepartum pulmonary edema--a case report. Author(s): Chang HC, Cherng YG, Lee TS, Lin CJ, Tai YT, Chen TG, Chen TL. Source: Acta Anaesthesiol Sin. 1999 March; 37(1): 41-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10407527

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HELLP syndrome with haemaglobin vasospasm. Author(s): Gliemroth J, Knopp U, Kehler U, Felberbaum R, Nowak G. Source: Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia. 2000 January; 7(1): 59-62. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10847654

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HELLP syndrome with reversible posterior leukoencephalopathy. Author(s): Marano E, Scuteri N, Vacca G, Orefice G. Source: Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology. 2003 June; 24(2): 82-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12827545

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HELLP syndrome without hypertension. Author(s): Blereau RP. Source: Southern Medical Journal. 1987 August; 80(8): 1068-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3616719

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HELLP syndrome, multifactorial thrombophilia and postpartum myocardial infarction. Author(s): Brandenburg VM, Frank RD, Heintz B, Rath W, Bartz C. Source: Journal of Perinatal Medicine. 2004; 32(2): 181-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15085897

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HELLP syndrome. Author(s): Rath W, Faridi A, Dudenhausen JW. Source: Journal of Perinatal Medicine. 2000; 28(4): 249-60. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11031696

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HELLP syndrome. Author(s): Parmar VM, Patil AN, Deshpande AK. Source: J Assoc Physicians India. 1999 October; 47(10): 1025-6. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10778703

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HELLP syndrome. Author(s): Egerman RS, Sibai BM. Source: Clinical Obstetrics and Gynecology. 1999 June; 42(2): 381-9. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10370856

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HELLP syndrome. Author(s): Buist NR, Winter SC. Source: Jama : the Journal of the American Medical Association. 1999 February 24; 281(8): 704-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10052438

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HELLP syndrome. Author(s): Minakami H, Sato I. Source: Jama : the Journal of the American Medical Association. 1999 February 24; 281(8): 703-4; Author Reply 704-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10052437

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HELLP syndrome. Author(s): Gerace JR. Source: American Journal of Obstetrics and Gynecology. 1987 October; 157(4 Pt 1): 10156. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3674150

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HELLP syndrome. Author(s): Erkkola R, Ekblad U, Kero P, Kanto J, Maenpaa J. Source: Ann Chir Gynaecol Suppl. 1987; 202: 26-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3477984

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HELLP syndrome. A case report. Author(s): Sosa RR, Moore PJ, Dommisse J. Source: South African Medical Journal. Suid-Afrikaanse Tydskrif Vir Geneeskunde. 1988 May 7; 73(9): 543-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3375948

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HELLP syndrome. Managing a pregnancy complication. Author(s): Shannon DM. Source: Nursing. 1995 October; 25(10): 32W-32Aa. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7566720

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HELLP syndrome: a case report with guidelines for diagnosis and management. Author(s): Patterson KW, O'Toole DP. Source: British Journal of Anaesthesia. 1991 April; 66(4): 513-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2025482

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HELLP syndrome: a condition of varied presentation. Author(s): Gleeson R, Farrell J, Doyle M, Walshe JJ. Source: Ir J Med Sci. 1996 October-December; 165(4): 265-7. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8990651

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HELLP syndrome: a severe consequence of pregnancy-induced hypertension. Author(s): Shannon DM. Source: Journal of Obstetric, Gynecologic, and Neonatal Nursing : Jognn / Naacog. 1987 November-December; 16(6): 395-402. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3694307

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HELLP syndrome: a variant of severe preeclampsia. Author(s): Smith CV. Source: Nebr Med J. 1994 March; 79(3): 86-7. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8196820

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HELLP syndrome: an often unrecognized complication of preeclampsia. Author(s): Lim BH, Barry CL, Brown GH. Source: The Australian & New Zealand Journal of Obstetrics & Gynaecology. 1991 February; 31(1): 20-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1872766

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HELLP syndrome: CT evaluation. Author(s): Minakami H, Sugimoto H, Manaka C, Takahashi T, Sato I, Tamada T. Source: Gynecologic and Obstetric Investigation. 1994; 38(1): 28-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7959322

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HELLP syndrome: hemolysis, elevated liver enzymes, and low platelets. Author(s): Stone JH. Source: Jama : the Journal of the American Medical Association. 1998 August 12; 280(6): 559-62. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9707148

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Hellp syndrome: incidence and maternal-fetal outcome--a prospective study. Author(s): Abroug F, Boujdaria R, Nouira S, Abroug S, Souissi M, Najjar MF, Secourgeon JF, Bouchoucha S. Source: Intensive Care Medicine. 1992; 18(5): 274-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1527257

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HELLP syndrome: laboratory parameters and clinical course in four patients treated with plasma exchange. Author(s): Julius CJ, Dunn ZL, Blazina JF. Source: Journal of Clinical Apheresis. 1994; 9(4): 228-35. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7759467

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HELLP syndrome: mechanisms and management. Author(s): Ellison J, Sattar N, Greer I. Source: Hosp Med. 1999 April; 60(4): 243-9. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10396428

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HELLP syndrome: pathologic entity or technical inadequacy? Author(s): Greer IA, Cameron AD, Walker JJ. Source: American Journal of Obstetrics and Gynecology. 1985 May 1; 152(1): 113-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3993707

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HELLP syndrome: recognition and perinatal management. Author(s): Padden MO. Source: American Family Physician. 1999 September 1; 60(3): 829-36, 839. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10498110

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HELLP syndrome: undiagnosed in a case of impending rupture of uterus. A case report. Author(s): Khan-Ghori SN, el-Bakry KA, Samarkandi AH. Source: Middle East J Anesthesiol. 1998 October; 14(6): 459-67. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9859107

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HELLP syndrome? Author(s): Ludington M. Source: Anaesthesia and Intensive Care. 1990 May; 18(2): 275. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2368914

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HELLP syndrome--a serious complication of hypertension in pregnancy. Author(s): Oian P, Maltau JM, Abyholm T. Source: Acta Obstetricia Et Gynecologica Scandinavica. 1984; 63(8): 727-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6543087

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HELLP syndrome--a syndrome of hemolysis, elevated liver enzymes and low platelet count--complicating preeclampsia-eclampsia. Author(s): Reubinoff BE, Schenker JG. Source: International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics. 1991 October; 36(2): 95-102. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1683323

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HELLP! A cry for laboratory assistance: a comprehensive review of the HELLP syndrome highlighting the role of the laboratory. Author(s): Jones SL. Source: Hematopathol Mol Hematol. 1998; 11(3-4): 147-71. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9844823

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Hemodialysis rescued the mother in a case of severe chronic renal failure accompanied by perirenal hematoma due to HELLP syndrome. Author(s): Katsuragawa H, Yoshida M, Miyamoto U. Source: Acta Obstetricia Et Gynecologica Scandinavica. 1991; 70(4-5): 367-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1746264

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Hemolysis, elevated liver enzymes and low platelet count. The HELLP syndrome. Author(s): Bertakis KD, Hufford DB. Source: The Western Journal of Medicine. 1986 January; 144(1): 81-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3953075

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Hemolysis, elevated liver enzymes, and low platelets in pregnancy (HELLP syndrome). A case report and literature review. Author(s): Schorr-Lesnick B, Dworkin B, Rosenthal WS. Source: Digestive Diseases and Sciences. 1991 November; 36(11): 1649-52. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1935505

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Hepatic enzymes and the HELLP syndrome: a long-standing error? Author(s): McMahon LP, O'Coigligh S, Redman CW. Source: British Journal of Obstetrics and Gynaecology. 1993 July; 100(7): 693-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8103674

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Hepatic hemorrhage and the HELLP syndrome: a surgeon's perspective. Author(s): Stevenson JT, Graham DJ. Source: The American Surgeon. 1995 September; 61(9): 756-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7661469

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Hepatic histopathologic characteristics in HELLP syndrome (hemolysis, elevated liver enzymes, and low platelet count) Author(s): Minakami H, Tamada T. Source: American Journal of Obstetrics and Gynecology. 1993 November; 169(5): 1357-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8238206

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Hepatic histopathologic condition does not correlate with laboratory abnormalities in HELLP syndrome (hemolysis, elevated liver enzymes, and low platelet count) Author(s): Barton JR, Riely CA, Adamec TA, Shanklin DR, Khoury AD, Sibai BM. Source: American Journal of Obstetrics and Gynecology. 1992 December; 167(6): 1538-43. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1471661

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Hepatic imaging in HELLP syndrome (hemolysis, elevated liver enzymes, and low platelet count). Author(s): Barton JR, Sibai BM. Source: American Journal of Obstetrics and Gynecology. 1996 June; 174(6): 1820-5; Discussion 1825-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8678146

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Hepatic infarction in preeclampsia as part of the HELLP syndrome: CT appearance. Author(s): Zissin R, Yaffe D, Fejgin M, Olsfanger D, Shapiro-Feinberg M. Source: Abdominal Imaging. 1999 November-December; 24(6): 594-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10525815

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Hepatic infarctions during pregnancy are associated with the antiphospholipid syndrome and in addition with complete or incomplete HELLP syndrome. Author(s): Pauzner R, Dulitzky M, Carp H, Mayan H, Kenett R, Farfel Z, Many A. Source: Journal of Thrombosis and Haemostasis : Jth. 2003 August; 1(8): 1758-63. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12911590

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Hepatobiliary scintigraphy in the evaluation of preeclampsia and HELLP syndrome. Author(s): Rosen JM, Luhmann KC, Tank RA. Source: Clinical Nuclear Medicine. 1994 August; 19(8): 740-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7955759

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Heterozygosity for the common LCHAD mutation (1528g>C) is not a major cause of HELLP syndrome and the prevalence of the mutation in the Dutch population is low. Author(s): den Boer ME, Ijlst L, Wijburg FA, Oostheim W, van Werkhoven MA, van Pampus MG, Heymans HS, Wanders RJ. Source: Pediatric Research. 2000 August; 48(2): 151-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10926288

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High-order multiple pregnancies complicated by HELLP syndrome. A report of four cases with corticosteroid therapy to prolong gestation. Author(s): Heller CS, Elliott JP. Source: J Reprod Med. 1997 November; 42(11): 743-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9408876

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Hyperkalaemic periodic paralysis and HELLP syndrome: an unusual combination. Author(s): Johnstone FD, Greer IA. Source: Scott Med J. 1989 October; 34(5): 530-1. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2587981

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Imaging of subcapsular hepatic and renal hematomas in pregnancy complicated by preeclampsia and the HELLP syndrome. Author(s): Chan AD, Gerscovich EO. Source: Journal of Clinical Ultrasound : Jcu. 1999 January; 27(1): 35-40. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9888097

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Imitators of preeclampsia and HELLP syndrome. Author(s): Martin JN Jr, Stedman CM. Source: Obstetrics and Gynecology Clinics of North America. 1991 June; 18(2): 181-98. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1945250

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Immunohistological study in cases of HELLP syndrome (hemolysis, elevated liver enzymes and low platelets) and acute fatty liver of pregnancy. Author(s): Halim A, Kanayama N, El Maradny E, Maehara K, Takahashi A, Nosaka K, Fukuo S, Amamiya A, Kobayashi T, Terao T. Source: Gynecologic and Obstetric Investigation. 1996; 41(2): 106-12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8838970

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Inability to detect cell free fetal DNA in the urine of normal pregnant women nor in those affected by preeclampsia associated HELLP syndrome. Author(s): Li Y, Zhong XY, Kang A, Troeger C, Holzgreve W, Hahn S. Source: Journal of the Society for Gynecologic Investigation. 2003 December; 10(8): 5038. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14662164

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Increasing maternal weight: a risk factor for preeclampsia/eclampsia but apparently not for HELLP syndrome. Author(s): Martin JN Jr, May WL, Rinehart BK, Martin RW, Magann EF. Source: Southern Medical Journal. 2000 July; 93(7): 686-91. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10923957

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Induction of HELLP syndrome-like biochemical parameters by stimulation of the celiac ganglion in rats. Author(s): Kanayama N, She L, Maehara K, Kajiwara Y, Terao T. Source: Journal of Hypertension. 1996 April; 14(4): 453-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8761894

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Infants of mothers with HELLP syndrome compensate intrauterine growth retardation faster than unaffected premature infants: does HELLP change fetal programming? Author(s): Brune T, Baytar-Dagly B, Hentschel R, Harms E, Louwen F. Source: Biology of the Neonate. 2002; 82(3): 174-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12373068

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Intensive care management of the HELLP syndrome. Author(s): McBrien ME, Coppel DL. Source: Ulster Med J. 1995 October; 64(2): 173-7. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8533184

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Intensive-care management of a patient with HELLP syndrome--case report. Author(s): Kulpinski D, Kolak R, Jovanovic N, Komarcevic M. Source: Med Pregl. 1999 March-May; 52(3-5): 173-8. English, Croatian. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10518406

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Intracranial subdural hematoma following dural puncture in a parturient with HELLP syndrome. Author(s): Ezri T, Abouleish E, Lee C, Evron S. Source: Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. 2002 October; 49(8): 820-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12374711

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Intrahepatic cholangiocarcinoma masquerading as the HELLP syndrome (hemolysis, elevated liver enzymes, and low platelet count) in pregnancy: case report. Author(s): Balderston KD, Tewari K, Azizi F, Yu JK. Source: American Journal of Obstetrics and Gynecology. 1998 September; 179(3 Pt 1): 823-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9758000

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Intravenous immunoglobulins in postpartum, persistently severe HELLP syndrome: a safe alternative to plasma exchange? Author(s): Pourrat O, Ducroz B, Magnin G. Source: American Journal of Obstetrics and Gynecology. 1992 February; 166(2): 766. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1536261

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Is conservative treatment of HELLP syndrome safe? Author(s): Tsatsaris V, Carbonne B, Dupre La Tour M, Cabrol D, Milliez J. Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology. 1998 October; 80(2): 139-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9846656

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Is the HELLP syndrome due to inherited factors? Report of two cases. Author(s): Berti P, Contino L, Pesando P, Demicheli M, Santi R, Inverardi D, Dallavalle FM, Canevari A. Source: Haematologica. 1994 March-April; 79(2): 170-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8063266

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Lactate dehydrogenase isoenzymes in serum of patients with preeclampsia/eclampsia complicated by the HELLP syndrome. Author(s): Beyer C. Source: Clinica Chimica Acta; International Journal of Clinical Chemistry. 1991 October 14; 202(1-2): 119-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1807867

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Late occurrence of diffuse cerebral swelling after intracerebral hemorrhage in a patient with the HELLP syndrome--Case report. Author(s): Hashiguchi K, Inamura T, Irita K, Abe M, Noda E, Yanai S, Takahashi S, Fukui M. Source: Neurol Med Chir (Tokyo). 2001 March; 41(3): 144-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11372559

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Leukocytosis is proportional to HELLP syndrome severity: evidence for an inflammatory form of preeclampsia. Author(s): Terrone DA, Rinehart BK, May WL, Moore A, Magann EF, Martin JN Jr. Source: Southern Medical Journal. 2000 August; 93(8): 768-71. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10963506

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Liver dysfunction in late pregnancy: cytomegalovirus-induced hepatitis or the HELLP syndrome? Author(s): Ohkuchi A, Minakami H, Suzuki I, Ayustawati, Izumi A, Sato I. Source: The Journal of Obstetrics and Gynaecology Research. 2001 December; 27(6): 31923. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11794817

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Liver function following pregnancy complicated by the HELLP syndrome. Author(s): Knapen MF, van Altena AM, Peters WH, Merkus HM, Jansen JB, Steegers EA. Source: British Journal of Obstetrics and Gynaecology. 1998 November; 105(11): 1208-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9853772

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Liver rupture postpartum associated with preeclampsia and HELLP syndrome. Author(s): Risseeuw JJ, de Vries JE, van Eyck J, Arabin B. Source: The Journal of Maternal-Fetal Medicine. 1999 January-February; 8(1): 32-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10052844

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Liver transplantation using an organ donor with HELLP syndrome. Author(s): Briceno PJ, Ortiz JA, Manzarbeitia C, Jeon H, Munoz SJ, Rothstein KD, Araya V, Gala I, Reich DJ. Source: Transplantation. 2004 January 15; 77(1): 137-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14724450

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Lupus anticoagulant and HELLP syndrome complicated by placental abruption, hepatic, dermal and adrenal infarction. Author(s): Ilbery M, Jones AR, Sampson J. Source: The Australian & New Zealand Journal of Obstetrics & Gynaecology. 1995 May; 35(2): 215-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7677696

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Magnetic resonance evaluation of brainstem dysfunction in eclampsia and the HELLP syndrome. Author(s): Imaizumi H, Nara S, Kaneko M, Chiba S, Tamakawa M. Source: The Journal of Emergency Medicine. 1995 March-April; 13(2): 191-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7775789

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Marker for liver damage in neonates born to mothers with HELLP syndrome. Author(s): Knapen M, van Schaijk F, Mulder T, Peters W, Steegers E. Source: Lancet. 1997 May 24; 349(9064): 1519-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9167466

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Massive hepatic necrosis in the HELLP syndrome: CT correlation. Author(s): Chiang KS, Athey PA, Lamki N. Source: Journal of Computer Assisted Tomography. 1991 September-October; 15(5): 8457. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1885809

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Maternal and neonatal outcome of pregnancies complicated with maternal HELLP syndrome. Author(s): Raval DS, Co S, Reid MA, Pildes R. Source: Journal of Perinatology : Official Journal of the California Perinatal Association. 1997 July-August; 17(4): 266-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9280089

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Maternal and perinatal outcome after expectant management of the HELLP syndrome compared with pre-eclampsia without HELLP syndrome. Author(s): van Pampus MG, Wolf H, Westenberg SM, van der Post JA, Bonsel GJ, Treffers PE. Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology. 1998 January; 76(1): 31-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9481543

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Maternal benefit of high-dose intravenous corticosteroid therapy for HELLP syndrome. Author(s): Martin JN Jr, Thigpen BD, Rose CH, Cushman J, Moore A, May WL. Source: American Journal of Obstetrics and Gynecology. 2003 September; 189(3): 830-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14526324

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Maternal death associated with Eisenmenger's syndrome complicated with HELLP syndrome. Author(s): Ding DC, Chu TW, Liu JY. Source: International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics. 2003 November; 83(2): 189-91. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14550595

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Maternal death caused by HELLP syndrome (with hypoglycemia) complicating mild pregnancy-induced hypertension in a twin gestation. Author(s): Neuman M, Ron-El R, Langer R, Bukovsky I, Caspi E. Source: American Journal of Obstetrics and Gynecology. 1990 February; 162(2): 372-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2309817

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Maternal death due to the HELLP syndrome. Author(s): Cardwell MS. Source: J Tenn Med Assoc. 1987 August; 80(8): 473-4. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3657140

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Maternal death in pregnancy from HELLP syndrome. A report of three medico-legal autopsy cases with special reference to distinctive histopathological alterations. Author(s): Tsokos M, Longauer F, Kardosova V, Gavel A, Anders S, Schulz F. Source: International Journal of Legal Medicine. 2002 February; 116(1): 50-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11924711

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Maternal middle cerebral artery velocity changes in HELLP syndrome versus preeclampsia. Author(s): Williams KP, Wilson S. Source: Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology. 1998 March; 11(3): 195-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9589143

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Maternal morbidity and mortality in 442 pregnancies with hemolysis, elevated liver enzymes, and low platelets (HELLP syndrome) Author(s): Sibai BM, Ramadan MK, Usta I, Salama M, Mercer BM, Friedman SA. Source: American Journal of Obstetrics and Gynecology. 1993 October; 169(4): 1000-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8238109

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Methylenetetrahydrofolate reductase polymorphisms in preeclampsia and the HELLP syndrome. Author(s): Zusterzeel PL, Visser W, Blom HJ, Peters WH, Heil SG, Steegers EA. Source: Hypertension in Pregnancy : Official Journal of the International Society for the Study of Hypertension in Pregnancy. 2000; 19(3): 299-307. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11118403

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Midtrimester triple test levels in women with severe preeclampsia and HELLP syndrome. Author(s): Shenhav S, Gemer O, Volodarsky M, Zohav E, Segal S. Source: Acta Obstetricia Et Gynecologica Scandinavica. 2003 October; 82(10): 912-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12956840

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Neonatal lupus erythematosus and maternal lupus erythematosus mimicking HELLP syndrome. Author(s): Paton S, Wiss K, Lyon N, Baden L, Gellis SE. Source: Pediatric Dermatology. 1993 June; 10(2): 177-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8346116

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Neonatal morbidity and mortality associated with maternal HELLP syndrome. Author(s): Aliefendioglu D, Yurdakok M, Oran O, Erdem G, Tekinalp G, Onderoglu L. Source: Turk J Pediatr. 2000 October-December; 42(4): 308-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11196748

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Neonatal salvage by week's gestation in pregnancies complicated by HELLP syndrome. Author(s): Magann EF, Perry KG Jr, Chauhan SP, Graves GR, Blake PG, Martin JN Jr. Source: Journal of the Society for Gynecologic Investigation. 1994 July-September; 1(3): 206-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9419772

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Neutrophil oxygen radical production in pre-eclampsia with HELLP syndrome. Author(s): Zusterzeel PL, Wanten GJ, Peters WH, Merkus HM, Steegers EA. Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology. 2001 December 1; 99(2): 213-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11788174

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New issues for nosografic setting of "HELLP syndrome". Author(s): Vegna G, Leone S, Sorrentino M, Lentini G, Guglielmo L, Mercadante S. Source: Acta Eur Fertil. 1989 March-April; 20(2): 99-100. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2800936

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Obstetrical anaesthesia for a parturient with preeclampsia, HELLP syndrome and acute cortical blindness. Author(s): Crosby ET, Preston R. Source: Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. 1998 May; 45(5 Pt 1): 452-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9598260

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Obstetrical anaesthesia for patients with HELLP syndrome. Author(s): Collins PD. Source: Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. 1992 January; 39(1): 95-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1733544

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Orthotopic liver transplantation for complicated HELLP syndrome. Case report and review of the literature. Author(s): Strate T, Broering DC, Bloechle C, Henschen S, Pothmann W, Hoffmann S, Izbicki JR, Rogiers X. Source: Archives of Gynecology and Obstetrics. 2000 September; 264(2): 108-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11045337

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Outcome of pregnancies with HELLP syndrome complicated by acute renal failure (1989-1999). Author(s): Selcuk NY, Odabas AR, Cetinkaya R, Tonbul HZ, San A. Source: Renal Failure. 2000 May; 22(3): 319-27. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10843242

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Paroxysmal nocturnal haemoglobinuria in pregnancy--not to be confused with preeclampsia or HELLP syndrome. Case report and literature review. Author(s): Higgins SP, McMahon LP, Brennecke SP. Source: Journal of Obstetrics and Gynaecology : the Journal of the Institute of Obstetrics and Gynaecology. 2004 January; 24(1): 83-5. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14675991

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Pathogenesis of acute renal failure associated with the HELLP syndrome: a case report and review of the literature. Author(s): Abraham KA, Kennelly M, Dorman AM, Walshe JJ. Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology. 2003 May 1; 108(1): 99-102. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12694980

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Pathology case of the month. Abdominal pain in pregnancy. HELLP syndrome with subcapsular hematoma of the liver. Author(s): Shukla D, Veillon DM, Scott LK, Heldmann M, Lewis DF, Cotelingam JD. Source: J La State Med Soc. 2003 March-April; 155(2): 77-9. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12778989

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Pemphigoid gestationis occurring in a patient with HELLP syndrome. Author(s): Lowe PM, Fryer J, Shumack S. Source: The Australasian Journal of Dermatology. 1996 May; 37(2): 89-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8687334

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Plasma exchange for preeclampsia. I. Postpartum use for persistently severe preeclampsia-eclampsia with HELLP syndrome. Author(s): Martin JN Jr, Files JC, Blake PG, Norman PH, Martin RW, Hess LW, Morrison JC, Wiser WL. Source: American Journal of Obstetrics and Gynecology. 1990 January; 162(1): 126-37. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2301481

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Plasma exchange for preeclampsia: II. Unsuccessful antepartum utilization for severe preeclampsia with or without HELLP syndrome. Author(s): Martin JN Jr, Perry KG Jr, Roberts WE, Norman PF, Files JC, Blake PG, Morrison JC, Wiser WL. Source: Journal of Clinical Apheresis. 1994; 9(3): 155-61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7706195

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Plasma exchange for preeclampsia: III. Immediate peripartal utilization for selected patients with HELLP syndrome. Author(s): Martin JN Jr, Perry KG Jr, Roberts WE, Files JC, Norman PF, Morrison JC, Blake PG. Source: Journal of Clinical Apheresis. 1994; 9(3): 162-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7706196

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Plasma exchange in a patient with postpartum HELLP syndrome. Author(s): Hamada S, Takishita Y, Tamura T, Naka O, Higuchi K, Takahashi H. Source: The Journal of Obstetrics and Gynaecology Research. 1996 August; 22(4): 371-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8870421

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Plasma exchange in severe postpartum HELLP syndrome. Author(s): Forster JG, Peltonen S, Kaaja R, Lampinen K, Pettila V. Source: Acta Anaesthesiologica Scandinavica. 2002 September; 46(8): 955-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12190795

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Postpartum HELLP syndrome after a normotensive pregnancy. Author(s): Esan K, Moneim T, Page IJ. Source: The British Journal of General Practice : the Journal of the Royal College of General Practitioners. 1997 July; 47(420): 441-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9281873

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Postpartum HELLP syndrome. Author(s): Yilmazturk A, Schluter W. Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology. 1992 February 28; 43(3): 243-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1563576

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Pre-eclampsia and HELLP syndrome. Author(s): Liaw ST. Source: Aust Fam Physician. 1991 September; 20(9): 1384-5. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1953487

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Pre-eclampsia and the HELLP syndrome still cause maternal mortality in The Netherlands and other developed countries; can we reduce it? Author(s): Onrust S, Santema JG, Aarnoudse JG. Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology. 1999 January; 82(1): 41-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10192483

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Pre-eclampsia and the HELLP syndrome. Author(s): Liaw ST. Source: Aust Fam Physician. 1989 May; 18(5): 485, 487, 490. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2751505

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Pregnancies complicated by HELLP syndrome (hemolysis, elevated liver enzymes, and low platelets): subsequent pregnancy outcome and long-term prognosis. Author(s): Sibai BM, Ramadan MK, Chari RS, Friedman SA. Source: American Journal of Obstetrics and Gynecology. 1995 January; 172(1 Pt 1): 125-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7847520

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Pregnancy complicated by pre-eclampsia-eclampsia with HELLP syndrome. Author(s): Vigil-De Gracia P. Source: International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics. 2001 January; 72(1): 17-23. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11146072

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Pregnancy-induced hypertension: understanding severe preeclampsia and the HELLP syndrome. Author(s): Sauer PM, Harvey CJ. Source: Critical Care Nursing Clinics of North America. 1992 December; 4(4): 703-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1288594

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ProC Global assay in the evaluation of women with history of severe preeclampsia or HELLP syndrome. Author(s): Heilmann L, von Tempelhoff GF, Pollow K. Source: Clinical and Applied Thrombosis/Hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis. 2002 October; 8(4): 319-24. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12518722

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Progression of hepatic damage during cold storage after procurement in a liver and kidney donor with HELLP syndrome. Author(s): Woodside KJ, Knisely AS, Strauss AW, Gugliuzza KK, Daller JA. Source: Transplantation. 2001 December 27; 72(12): 1990-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11773901

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Pulmonary artery thrombus and subcapsular liver hematoma in a patient with HELLP syndrome: a therapeutic conundrum. Author(s): Calderon EG, Khawar S, Cunningham JA, Russell LD, Alpert MA. Source: The American Journal of the Medical Sciences. 2002 March; 323(3): 151-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11908860

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Recurrence of microangiopathic hemolytic anemia after apparent recovery from the HELLP syndrome. A case report. Author(s): Lombano F, Kidder MY, Lilly M, Gollin YG, Block BS. Source: J Reprod Med. 2002 October; 47(10): 875-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12418076

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Relation between gestational thrombocytopenia and the syndrome of hemolysis, elevated liver enzymes, and low platelet count (HELLP syndrome). Author(s): Minakami H, Kohmura Y, Izumi A, Watanabe T, Matsubara S, Sato I. Source: Gynecologic and Obstetric Investigation. 1998; 46(1): 41-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9692341

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Results of the pregnancies with HELLP syndrome. Author(s): Celik C, Gezginc K, Altintepe L, Tonbul HZ, Yaman ST, Akyurek C, Turk S. Source: Renal Failure. 2003 July; 25(4): 613-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12911166

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Ruptured subcapsular hepatic haematoma secondary to "HELLP syndrome". Author(s): Majerus B, Desnault H, Jault T, Parc R. Source: Acta Chir Belg. 1995 November-December; 95(6): 251-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8571714

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Severe EPH gestosis accompanied by HELLP syndrome and acute renal failure. Author(s): Zakut H, Adler M. Source: Gynecologic and Obstetric Investigation. 1988; 25(2): 141-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3371762

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Severe folate deficiency mimicking HELLP syndrome--report of two cases. Author(s): Gupta RS, Rajaram S, Goel N, Singh KC. Source: J Indian Med Assoc. 2003 January; 101(1): 32-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12841505

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Severe HELLP syndrome presenting with acute gum bleeding following toothbrushing at 38 weeks' gestation. Author(s): Jones KA, Abramowicz JS, Anissi D, Mirwald MA, Sherer DM. Source: American Journal of Critical Care : an Official Publication, American Association of Critical-Care Nurses. 1993 September; 2(5): 395-6. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8220671

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Severe HELLP syndrome remote from term. Author(s): Gardeil F, Gaffney G, Morrison JJ. Source: Ir Med J. 2001 February; 94(2): 54. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11321175

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Severe hypoglycemia associated with HELLP syndrome. Author(s): Egley CC, Gutliph J, Bowes WA Jr. Source: American Journal of Obstetrics and Gynecology. 1985 July 1; 152(5): 576-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4014352

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Severe hypoglycemia associated with the HELLP syndrome. Author(s): Mabie BC, Sibai BM. Source: American Journal of Obstetrics and Gynecology. 1986 January; 154(1): 211-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3946496

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Short-term outcome in infants with birth weights less than 1750 g born to mothers with HELLP syndrome. Author(s): Gortner L, Pohlandt F, Bartmann P, Terinde R, Versmold H, Dorigo O. Source: Journal of Perinatal Medicine. 1992; 20(1): 25-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1608020

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Significant decrease of maternal serum serotonin levels in singleton pregnancies complicated by the HELLP syndrome. Author(s): Backe J, Bussen S, Steck T. Source: Gynecological Endocrinology : the Official Journal of the International Society of Gynecological Endocrinology. 1997 December; 11(6): 405-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9476090

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Spontaneous intrahepatic hemorrhage and hepatic rupture in the HELLP syndrome: four cases and a review. Author(s): Sheikh RA, Yasmeen S, Pauly MP, Riegler JL. Source: Journal of Clinical Gastroenterology. 1999 June; 28(4): 323-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10372929

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Spontaneous liver hematoma and a hepatic rupture in HELLP syndrome: report of two cases. Author(s): Aldemir M, Bac B, Tacyildiz I, Yagmur Y, Keles C. Source: Surgery Today. 2002; 32(5): 450-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12061700

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Spontaneous resolution of HELLP syndrome in a primigravida presenting at 31 weeks' gestation. Author(s): Brewster JA, Speck EH, Lindow SW. Source: Journal of Obstetrics and Gynaecology : the Journal of the Institute of Obstetrics and Gynaecology. 2003 March; 23(2): 206-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12751520

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Standard parameters of preeclampsia: can the clinician depend upon them to reliably identify the patient with the HELLP syndrome? Author(s): Magann EF, Chauhan SP, Naef RW, Blake PG, Morrison JC, Martin JN Jr. Source: The Australian & New Zealand Journal of Obstetrics & Gynaecology. 1993 May; 33(2): 122-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8216106

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Subcapsular hepatic hematoma without rupture, due to severe preeclampsia and the HELLP syndrome. Author(s): Morgan GH, Gammill SL. Source: J Tenn Med Assoc. 1987 December; 80(12): 736-7. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3695470

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Subcapsular liver hematoma in HELLP syndrome: Evaluation of diagnostic and therapeutic options--a unicenter study. Author(s): Wicke C, Pereira PL, Neeser E, Flesch I, Rodegerdts EA, Becker HD. Source: American Journal of Obstetrics and Gynecology. 2004 January; 190(1): 106-12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14749644

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Subsequent pregnancy outcome in women with a history of HELLP syndrome at < or = 28 weeks of gestation. Author(s): Chames MC, Haddad B, Barton JR, Livingston JC, Sibai BM. Source: American Journal of Obstetrics and Gynecology. 2003 June; 188(6): 1504-7; Discussion 1507-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12824985

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Successful liver transplantation from an eclamptic donor complicated by the HELLP syndrome. Author(s): Nardo B, Montalti R, Beltempo P, Bertelli R, Cavallari A. Source: Transplantation. 2003 July 27; 76(2): 440-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12883214

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Successful transplantation of kidneys from a donor with HELLP syndrome-related death. Author(s): Flynn MF, Power RE, Murphy DM, Dorman A, Abraham KA, Walshe JJ, Hickey DP. Source: Transplant International : Official Journal of the European Society for Organ Transplantation. 2001; 14(2): 108-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11370163

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Successful use of recombinant factor VIIa for massive bleeding after caesarean section due to HELLP syndrome. Author(s): Zupancic Salek S, Sokolic V, Viskovic T, Sanjug J, Simic M, Kastelan M. Source: Acta Haematologica. 2002; 108(3): 162-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12373090

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Surgical treatment of HELLP syndrome-associated liver rupture -- an update. Author(s): Reck T, Bussenius-Kammerer M, Ott R, Muller V, Beinder E, Hohenberger W. Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology. 2001 November; 99(1): 57-65. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11604187

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Syncytin, a novel human endogenous retroviral gene in human placenta: evidence for its dysregulation in preeclampsia and HELLP syndrome. Author(s): Knerr I, Beinder E, Rascher W. Source: American Journal of Obstetrics and Gynecology. 2002 February; 186(2): 210-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11854637

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Temporising management of severe pre-eclampsia with and without the HELLP syndrome. Author(s): Visser W, Wallenburg HC. Source: British Journal of Obstetrics and Gynaecology. 1995 February; 102(2): 111-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7756201

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The evaluation of maternal parameters at diagnosis may predict HELLP syndrome severity. Author(s): Carpani G, Bozzo M, Ferrazzi E, D'Amato B, Pizzotti D, Radaelli T, Moroni G, Pardi G. Source: J Matern Fetal Neonatal Med. 2003 March;13(3):147-51. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12820835

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The HELLP syndrome (hemolysis, elevated liver enzymes, and low platelets): much ado about nothing? Author(s): Sibai BM. Source: American Journal of Obstetrics and Gynecology. 1990 February; 162(2): 311-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2309811

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The HELLP syndrome associated wiht fetal medium-chain acyl-CoA dehydrogenase deficiency. Author(s): Nelson J, Lewis B, Walters B. Source: Journal of Inherited Metabolic Disease. 2000 July; 23(5): 518-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10947209

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The HELLP syndrome at 16 weeks gestation: possible association with the antiphospholipid syndrome. Author(s): McMahon LP, Smith J. Source: The Australian & New Zealand Journal of Obstetrics & Gynaecology. 1997 August; 37(3): 313-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9325513

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The HELLP syndrome mimics cholecystitis. Author(s): Duffy BL, Watson RI. Source: The Medical Journal of Australia. 1988 May 2; 148(9): 473-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3362080

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The HELLP syndrome, a prospective study. Author(s): Abraham KA, Connolly G, Farrell J, Walshe JJ. Source: Renal Failure. 2001 September; 23(5): 705-13. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11725917

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The HELLP syndrome. Author(s): Donner A, Ullrich R, Kneifel W, Urak G, Hartmann T, Zimpfer M, Germann P. Source: Acta Anaesthesiologica Scandinavica. Supplementum. 1997; 111: 165-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9420998

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The HELLP syndrome. Author(s): Geary M. Source: British Journal of Obstetrics and Gynaecology. 1997 August; 104(8): 887-91. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9255078

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The HELLP syndrome: a serious complication of pregnancy with hemolysis, elevated levels of liver enzymes, and low platelet count. Author(s): Baca L, Gibbons RB. Source: The American Journal of Medicine. 1988 October; 85(4): 590-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3177422

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The HELLP syndrome: case report and review of the literature. Author(s): Fish R. Source: The Journal of Emergency Medicine. 1993 March-April; 11(2): 169-74. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8505522

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The HELLP syndrome: its association with unexplained elevation of MSAFP and MShCG in the second trimester. Author(s): Morssink LP, Heringa MP, Beekhuis JR, De Wolf BT, Mantingh A. Source: Prenatal Diagnosis. 1997 July; 17(7): 601-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9249859

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The HELLP syndrome: maternal and perinatal outcome. Author(s): Murray D, O'Riordan M, Geary M, Phillips R, Clarke T, McKenna P. Source: Ir Med J. 2001 January; 94(1): 16-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11322219

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The impact of parity on the incidence of HELLP syndrome and small for gestational age infants in hypertensive pregnant women. Author(s): Williams KP, Wilson S. Source: J Obstet Gynaecol Can. 2002 June; 24(6): 485-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12196855

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The importance of early laboratory screening methods for maternal and fetal outcome in cases of HELLP syndrome. Author(s): Rath W, Loos W, Kuhn W, Graeff H. Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology. 1990 July-August; 36(1-2): 43-51. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2365128

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The importance of parity to major maternal morbidity in the eclamptic mother with HELLP syndrome. Author(s): Isler CM, Rinehart BK, Terrone DA, May WL, Magann EF, Martin JN Jr. Source: Hypertension in Pregnancy : Official Journal of the International Society for the Study of Hypertension in Pregnancy. 2003; 22(3): 287-94. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14572365

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The interrelationship of eclampsia, HELLP syndrome, and prematurity: cofactors for significant maternal and perinatal risk. Author(s): Martin JN Jr, Perry KG Jr, Miles JF Jr, Blake PG, Magann EF, Roberts WE, Martin RW. Source: British Journal of Obstetrics and Gynaecology. 1993 December; 100(12): 1095100. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8297842

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The natural history of HELLP syndrome: patterns of disease progression and regression. Author(s): Martin JN Jr, Blake PG, Perry KG Jr, McCaul JF, Hess LW, Martin RW. Source: American Journal of Obstetrics and Gynecology. 1991 June; 164(6 Pt 1): 1500-9; Discussion 1509-13. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2048596

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The role of labetalol and propofol in the management of HELLP syndrome--a case report. Author(s): Chu YL, Lin SY, Lee PC, Wang YP, Lee LH, Liu CC. Source: Acta Anaesthesiol Sin. 1996 March; 34(1): 43-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9084519

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Thrombelastography reveals two causes of haemorrhage in HELLP syndrome. Author(s): Whitta RK, Cox DJ, Mallett SV. Source: British Journal of Anaesthesia. 1995 April; 74(4): 464-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7537514

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Thrombocytopenia in preeclampsia: an earlier detector of HELLP syndrome. Author(s): Jaleel A, Baseer A. Source: J Pak Med Assoc. 1997 September; 47(9): 230-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9361486

x

Thrombocytopenia in the HELLP syndrome is not due to platelet-associated IgG (PAIgG). Author(s): Marzusch K, Dietl J, Korte K, Schnaidt M. Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology. 1992 July 3; 45(2): 107-12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1499844

x

Thrombocytopenia with the HELLP syndrome. Report of two cases with reversal in normotensive and nonproteinuric gravidas. Author(s): Segal S, Shenhav S, Gemer O. Source: J Reprod Med. 1998 March; 43(3): 227-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9564652

Studies

41

x

Time course of recovery and complications of HELLP syndrome with two different treatments: heparin or dexamethasone. Author(s): Mecacci F, Carignani L, Cioni R, Parretti E, Mignosa M, Piccioli A, Scarselli G, Mello G. Source: Thrombosis Research. 2001 April 15; 102(2): 99-105. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11323019

x

Toward the early diagnosis of the HELLP syndrome in the community hospital. Author(s): Kelch BP, Nowak ML. Source: J Am Osteopath Assoc. 1987 June; 87(6): 431-6. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3610686

x

Transient postpartum diabetes insipidus in twin pregnancy associated with HELLP syndrome. Author(s): Yamanaka Y, Takeuchi K, Konda E, Samoto T, Satou A, Mizudori M, Maruo T. Source: Journal of Perinatal Medicine. 2002; 30(3): 273-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12122912

x

Transient proteinuria in an infant born to a mother with HELLP syndrome. Author(s): Gunes T, Akcakus M, Dusunsel R, Cetin N, Poyrazoglu H. Source: European Journal of Pediatrics. 2002 November; 161(11): 614-5. Epub 2002 September 10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12424588

x

Treatment of HELLP syndrome with nitric oxide donor. Author(s): de Belder A, Lees C, Martin J, Moncada S, Campbell S. Source: Lancet. 1995 January 14; 345(8942): 124-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7815862

x

Treatment of persistent postpartum HELLP syndrome with plasmapheresis. Author(s): Katz VL, Watson WJ, Thorp JM Jr, Hansen W, Bowes WA Jr. Source: American Journal of Perinatology. 1992 March; 9(2): 120-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1590866

x

Triplet pregnancy complicated by a gradual decline in antithrombin-III activity and HELLP syndrome: a case report. Author(s): Izumi A, Minakami H, Matsubara S, Sato I. Source: The Journal of Obstetrics and Gynaecology Research. 1998 August; 24(4): 275-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9798357

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x

Twelve steps to optimal management of HELLP syndrome. Author(s): Magann EF, Martin JN Jr. Source: Clinical Obstetrics and Gynecology. 1999 September; 42(3): 532-50. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10451769

x

Two patients with postpartum HELLP syndrome after a normotensive twin pregnancy. Author(s): Tilstra JH. Source: International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics. 1994 October; 47(1): 49-51. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7813751

x

Type 1 diabetes mellitus developing during HELLP syndrome. Author(s): Weitgasser R, Schnoll F, Haidbauer R. Source: Acta Diabetologica. 1993; 30(3): 173-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8111079

x

Unusual presentation of mesangial proliferative glomerulonephritis in HELLP syndrome associated with acute renal failure. Author(s): Fang JT, Chen YC, Huang CC. Source: Renal Failure. 2000; 22(5): 641-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11041296

x

Vasospasms are characteristic in cases with eclampsia/preeclampsia and HELLP syndrome: proposal of an angiospastic syndrome of pregnancy. Author(s): Kobayashi T, Tokunaga N, Isoda H, Kanayama N, Terao T. Source: Seminars in Thrombosis and Hemostasis. 2001; 27(2): 131-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11372766

x

Vitreous haemorrhage as a complication of HELLP syndrome. Author(s): Leff SR, Yarian DL, Masciulli L, Green SN, Baldomero RE. Source: The British Journal of Ophthalmology. 1990 August; 74(8): 498. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2390528

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CHAPTER 2. BOOKS ON HELLP SYNDROME Overview This chapter provides bibliographic book references relating to HELLP syndrome. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on HELLP syndrome include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.

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

The Silent Cries of a HELLP Syndrome Baby by With Norma Jean Lutz John & Rebecca Knox (Author); ISBN: 0970207700; http://www.amazon.com/exec/obidos/ASIN/0970207700/icongroupinterna

Chapters on HELLP Syndrome In order to find chapters that specifically relate to HELLP syndrome, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and HELLP syndrome using the “Detailed Search” option. Go to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find book chapters, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Book Chapter.” Type “HELLP

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syndrome” (or synonyms) into the “For these words:” box. The following is a typical result when searching for book chapters on HELLP syndrome: x

Pregnant Patient with Liver Disease Source: in Brandt, L., et al., eds. Clinical Practice of Gastroenterology. Volume Two. Philadelphia, PA: Current Medicine. 1999. p. 961-969. Contact: Available from W.B. Saunders Company. Order Fulfillment, 6277 Sea Harbor Drive, Orlando, FL 32887. (800) 545-2522. Fax (800) 874-6418 or (407) 352-3445. Website: www.wbsaunders.com. PRICE: $235.00 plus shipping and handling. ISBN: 0443065209 (two volume set); 0443065217 (volume 1); 0443065225 (volume 2). Summary: Liver diseases encountered in pregnant patients include those present before conception, those that occur coincident with pregnancy, and those that are unique to pregnancy. This chapter on the pregnant patient with liver disease is from a lengthy textbook that brings practitioners up to date on the complexities of gastroenterology practice, focusing on the essentials of patient care. The author describes the features of liver diseases unique to pregnancy and briefly discusses the pregnant patient with viral hepatitis. Evaluation of pregnant patients with abnormal liver test results is similar to that of nonpregnant patients suspected of having liver disease; however, attention to the stage of pregnancy and the obstetric history is important. Diseases discussed include hyperemesis gravidarum, intrahepatic cholestasis of pregnancy, pregnancy induced hypertension (high blood pressure, previously called preeclampsia), HELLP syndrome (hemolysis, elevated liver enzymes, and low platelets), acute fatty liver of pregnancy, hepatic rupture, and viral hepatitis. In each section, the author reviews the epidemiology and risk factors, the pathogenesis, the clinical features, maternal and fetal outcome, and patient care management. 2 figures. 7 tables. 17 references.

x

Liver in Pregnancy Source: in Sherlock, S.; Dooley, J. Diseases of the Liver and Biliary System. Malden, MA: Blackwell Science, Inc. 2002. p.471-479. Contact: Available from Blackwell Science, Inc. 350 Main Street, Commerce Place, Malden, MA 02148. (800) 215-1000 or (617) 388-8250. Fax (617) 388-8270. E-mail: [email protected]. Website: www.blackwell-science.com. PRICE: $178.95. ISBN: 0632055820. Summary: This chapter on the liver in pregnancy is from a textbook that presents a comprehensive and up-to-date account of diseases of the liver and biliary system. The chapter covers normal pregnancy; liver disease in pregnancy, including hyperemesis gravidarum; liver diseases of late pregnancy, including acute fatty liver of pregnancy, pregnancy toxemias, the HELLP syndrome, toxemia and the HELLP syndrome, hepatic hemorrhage, cholestasis of pregnancy, and Budd-Chiari syndrome; intercurrent jaundice, due to viral hepatitis or biliary tract disease; hepatotoxic (damaging to the liver) drugs and the pregnant woman; the effect of pregnancy on pre-existing chronic liver disease; and pregnancy in liver transplant recipients. 6 figures. 5 tables. 54 references.

x

Liver Disease in Pregnancy Source: in Carlson, K.J. et al. Primary Care of Women. St. Louis, MO: Mosby-Year Book, Inc. 1995. p. 360-368.

Books

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Contact: Available from Mosby-Year Book, Inc. 11830 Westline Industrial Drive, St. Louis, MO 63146. (800) 325-4177 or (314) 872-8370. Fax (314) 432-1380. PRICE: $69.95 (as of 1995). ISBN: 0801676770. Summary: This chapter, from a medical text on the primary care of women, discusses liver disease in pregnancy. Topics include epidemiology; classification of hepatic disorders in pregnancy; liver function test results during pregnancy; a recommended approach to the pregnant patient with abnormal liver function test results; and liver disorders specific to pregnancy, including hyperemesis gravidarum, intrahepatic cholestasis of pregnancy, acute fatty liver of pregnancy (AFLP), preeclampsia/eclampsia, HELLP syndrome, and hepatic rupture. The authors note that hepatic disorders diagnosed before pregnancy may be unaffected or exacerbated by the pregnant state. 9 tables. 37 references.

47

APPENDICES

49

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 Institute4: x

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

x

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

x

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

x

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

x

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

x

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

x

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

x

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

4

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

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HELLP Syndrome

x

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

x

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

x

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

x

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

x

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

x

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

x

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

x

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

x

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

x

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

x

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

x

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

x

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

x

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

x

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

x

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

x

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

x

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.5 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:6 x

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

x

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

x

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

x

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/

x

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

x

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

x

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/

x

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

x

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

x

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

x

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

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). 6 See http://www.nlm.nih.gov/databases/databases.html. 5

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x

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

x

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 Gateway7 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.8 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “HELLP 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 1073 3 191 1 4 1272

HSTAT9 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.10 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.11 Simply search by “HELLP syndrome” (or synonyms) at the following Web site: http://text.nlm.nih.gov.

Adapted from NLM: http://gateway.nlm.nih.gov/gw/Cmd?Overview.x. The NLM Gateway is currently being developed by the Lister Hill National Center for Biomedical Communications (LHNCBC) at the National Library of Medicine (NLM) of the National Institutes of Health (NIH). 9 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 10 The HSTAT URL is http://hstat.nlm.nih.gov/. 11 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. 7 8

Physician Resources

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Coffee Break: Tutorials for Biologists12 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.13 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.14 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: x

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

x

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

Adapted 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. 14 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. 12 13

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APPENDIX B. PATIENT RESOURCES Overview Official agencies, as well as federally funded institutions supported by national grants, frequently publish a variety of guidelines written with the patient in mind. These are typically called “Fact Sheets” or “Guidelines.” They can take the form of a brochure, information kit, pamphlet, or flyer. Often they are only a few pages in length. Since new guidelines on HELLP 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 HELLP 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 HELLP 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 “HELLP syndrome”:

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Down Syndrome http://www.nlm.nih.gov/medlineplus/downsyndrome.html High Risk Pregnancy http://www.nlm.nih.gov/medlineplus/highriskpregnancy.html Metabolic Syndrome X http://www.nlm.nih.gov/medlineplus/metabolicsyndromex.html Preeclampsia http://www.nlm.nih.gov/medlineplus/preeclampsia.html Turner's Syndrome http://www.nlm.nih.gov/medlineplus/turnerssyndrome.html You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the search box and click “Search.” This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system (mostly patient-oriented information). It also has the disadvantage of generating unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search.

The 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 HELLP 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: x

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

x

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

x

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

x

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

x

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

x

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

x

WebMDHealth: http://my.webmd.com/health_topics

Patient Resources

57

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

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 “HELLP 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 “HELLP 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 “HELLP syndrome” (or synonyms) into the “For these words:” box. You should check back periodically with this database since it is updated every three months.

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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 “HELLP 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.15

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

15

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

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libraries recommended by the National Library of Medicine (sorted alphabetically by name of the U.S. state or Canadian province where the library is located)16: x

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

x

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

x

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

x

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

x

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

x

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

x

California: Gateway Health Library (Sutter Gould Medical Foundation)

x

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

x

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

x

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

x

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

x

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

x

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

x

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

x

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

x

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

x

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

x

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

16

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

Finding Medical Libraries

61

x

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

x

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

x

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

x

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

x

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

x

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

x

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

x

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

x

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

x

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

x

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

x

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

x

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

x

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

x

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

x

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

x

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

x

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

x

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

x

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

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x

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

x

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

x

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

x

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

x

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

x

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

x

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

x

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

x

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

x

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

x

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

x

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

x

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

x

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

x

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

x

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

x

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

x

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/

x

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

Finding Medical Libraries

63

x

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

x

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

x

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

x

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

x

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

x

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

x

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

x

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

x

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

x

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

x

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

x

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

x

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

x

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

x

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

x

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

x

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

x

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

x

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

x

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

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x

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

x

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

x

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

x

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: x

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

x

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

x

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

x

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

x

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

x

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

x

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 HELLP syndrome: x

Basic Guidelines for HELLP Syndrome HELLP Syndrome Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000890.htm

x

Signs & Symptoms for HELLP Syndrome Abdominal pain Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003120.htm Abdominal tenderness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003120.htm Headache Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003024.htm Nausea and vomiting Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003117.htm

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Vomiting Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003117.htm x

Diagnostics and Tests for HELLP Syndrome Blood pressure Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003398.htm Liver function tests Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003436.htm Platelet count Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003647.htm

x

Background Topics for HELLP Syndrome Enzyme Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002353.htm

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

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

x

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

x

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

x

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

67

HELLP SYNDROME DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Abdominal: Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs. [NIH] Abortion: 1. The premature expulsion from the uterus of the products of conception - of the embryo, or of a nonviable fetus. The four classic symptoms, usually present in each type of abortion, are uterine contractions, uterine haemorrhage, softening and dilatation of the cervix, and presentation or expulsion of all or part of the products of conception. 2. Premature stoppage of a natural or a pathological process. [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] Acetylcholine: A neurotransmitter. Acetylcholine in vertebrates is the major transmitter at neuromuscular junctions, autonomic ganglia, parasympathetic effector junctions, a subset of sympathetic effector junctions, and at many sites in the central nervous system. It is generally not used as an administered drug because it is broken down very rapidly by cholinesterases, but it is useful in some ophthalmological applications. [NIH] Acute renal: A condition in which the kidneys suddenly stop working. In most cases, kidneys can recover from almost complete loss of function. [NIH] Acyl: Chemical signal used by bacteria to communicate. [NIH] Adrenal Cortex: The outer layer of the adrenal gland. It secretes mineralocorticoids, androgens, and glucocorticoids. [NIH] Albuminuria: More than normal amounts of a protein called albumin in the urine. Albuminuria may be a sign of kidney disease. [NIH] Amino acid: Any organic compound containing an amino (-NH2 and a carboxyl (- COOH) group. The 20 a-amino acids listed in the accompanying table are the amino acids from which proteins are synthesized by formation of peptide bonds during ribosomal translation of messenger RNA; all except glycine, which is not optically active, have the L configuration. Other amino acids occurring in proteins, such as hydroxyproline in collagen, are formed by posttranslational enzymatic modification of amino acids residues in polypeptide chains. There are also several important amino acids, such as the neurotransmitter y-aminobutyric acid, that have no relation to proteins. Abbreviated AA. [EU] Amino Acid Sequence: The order of amino acids as they occur in a polypeptide chain. This is referred to as the primary structure of proteins. It is of fundamental importance in determining protein conformation. [NIH] Amniotic Fluid: Amniotic cavity fluid which is produced by the amnion and fetal lungs and kidneys. [NIH] Ampulla: A sac-like enlargement of a canal or duct. [NIH] Anaesthesia: Loss of feeling or sensation. Although the term is used for loss of tactile sensibility, or of any of the other senses, it is applied especially to loss of the sensation of pain, as it is induced to permit performance of surgery or other painful procedures. [EU]

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Androgens: A class of sex hormones associated with the development and maintenance of the secondary male sex characteristics, sperm induction, and sexual differentiation. In addition to increasing virility and libido, they also increase nitrogen and water retention and stimulate skeletal growth. [NIH] Anemia: A reduction in the number of circulating erythrocytes or in the quantity of hemoglobin. [NIH] Antiallergic: Counteracting allergy or allergic conditions. [EU] 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] Antibodies, Anticardiolipin: Antiphospholipid antibodies found in association with systemic lupus erythematosus (lupus erythematosus, systemic), antiphospholipid syndrome, and in a variety of other diseases as well as in healthy individuals. The antibodies are detected by solid-phase immunoassay employing the purified phospholipid antigen cardiolipin. [NIH] Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Anticoagulant: A drug that helps prevent blood clots from forming. Also called a blood thinner. [NIH] 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] Anti-Inflammatory Agents: Substances that reduce or suppress inflammation. [NIH] Antineoplastic: Inhibiting or preventing the development of neoplasms, checking the maturation and proliferation of malignant cells. [EU] Antiphospholipid Syndrome: The presence of antibodies directed against phospholipids (antibodies, antiphospholipid). The condition is associated with a variety of diseases, notably systemic lupus erythematosus and other connective tissue diseases, thrombopenia, and arterial or venous thromboses. In pregnancy it can cause abortion. Of the phospholipids, the cardiolipins show markedly elevated levels of anticardiolipin antibodies (antibodies, anticardiolipin). Present also are high levels of lupus anticoagulant (lupus coagulation inhibitor). [NIH] Aphakia: Absence of crystalline lens totally or partially from field of vision, from any cause except after cataract extraction. Aphakia is mainly congenital or as result of lens dislocation and subluxation. [NIH] Aponeurosis: Tendinous expansion consisting of a fibrous or membranous sheath which serves as a fascia to enclose or bind a group of muscles. [NIH] Arginine: An essential amino acid that is physiologically active in the L-form. [NIH] Arterial: Pertaining to an artery or to the arteries. [EU]

Dictionary 69

Arteries: The vessels carrying blood away from the heart. [NIH] Arteriosclerosis: Thickening and loss of elasticity of arterial walls. Atherosclerosis is the most common form of arteriosclerosis and involves lipid deposition and thickening of the intimal cell layers within arteries. Additional forms of arteriosclerosis involve calcification of the media of muscular arteries (Monkeberg medial calcific sclerosis) and thickening of the walls of small arteries or arterioles due to cell proliferation or hyaline deposition (arteriolosclerosis). [NIH] Artery: Vessel-carrying blood from the heart to various parts of the body. [NIH] Aspartate: A synthetic amino acid. [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] Autoantibodies: Antibodies that react with self-antigens (autoantigens) of the organism that produced them. [NIH] Autoantigens: Endogenous tissue constituents that have the ability to interact with autoantibodies and cause an immune response. [NIH] Autodigestion: Autolysis; a condition found in disease of the stomach: the stomach wall is digested by the gastric juice. [NIH] Autopsy: Postmortem examination of the body. [NIH] Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH] Bacterium: Microscopic organism which may have a spherical, rod-like, or spiral unicellular or non-cellular body. Bacteria usually reproduce through asexual processes. [NIH] Bacteriuria: The presence of bacteria in the urine with or without consequent urinary tract infection. Since bacteriuria is a clinical entity, the term does not preclude the use of urine/microbiology for technical discussions on the isolation and segregation of bacteria in the urine. [NIH] Basal Ganglia: Large subcortical nuclear masses derived from the telencephalon and located in the basal regions of the cerebral hemispheres. [NIH] Basement Membrane: Ubiquitous supportive tissue adjacent to epithelium and around smooth and striated muscle cells. This tissue contains intrinsic macromolecular components such as collagen, laminin, and sulfated proteoglycans. As seen by light microscopy one of its subdivisions is the basal (basement) lamina. [NIH] Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]

Bile: An emulsifying agent produced in the liver and secreted into the duodenum. Its composition includes bile acids and salts, cholesterol, and electrolytes. It aids digestion of fats in the duodenum. [NIH] Bile 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]

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Biliary Tract: The gallbladder and its ducts. [NIH] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Bladder: The organ that stores urine. [NIH] Blastocyst: The mammalian embryo in the post-morula stage in which a fluid-filled cavity, enclosed primarily by trophoblast, contains an inner cell mass which becomes the embryonic disc. [NIH] 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 pressure: The pressure of blood against the walls of a blood vessel or heart chamber. Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Body Fluids: Liquid components of living organisms. [NIH] Bradykinin: A nonapeptide messenger that is enzymatically produced from kallidin in the blood where it is a potent but short-lived agent of arteriolar dilation and increased capillary permeability. Bradykinin is also released from mast cells during asthma attacks, from gut walls as a gastrointestinal vasodilator, from damaged tissues as a pain signal, and may be a neurotransmitter. [NIH] Buccal: Pertaining to or directed toward the cheek. In dental anatomy, used to refer to the buccal surface of a tooth. [EU] Bullous: Pertaining to or characterized by bullae. [EU] Caesarean section: A surgical incision through the abdominal and uterine walls in order to deliver a baby. [NIH] Calcitonin: A peptide hormone that lowers calcium concentration in the blood. In humans, it is released by thyroid cells and acts to decrease the formation and absorptive activity of osteoclasts. Its role in regulating plasma calcium is much greater in children and in certain diseases than in normal adults. [NIH] Calcitonin Gene-Related Peptide: Calcitonin gene-related peptide. A 37-amino acid peptide derived from the calcitonin gene. It occurs as a result of alternative processing of mRNA from the calcitonin gene. The neuropeptide is widely distributed in neural tissue of the brain, gut, perivascular nerves, and other tissue. The peptide produces multiple biological effects and has both circulatory and neurotransmitter modes of action. In particular, it is a potent endogenous vasodilator. [NIH] Calcium: A basic element found in nearly all organized tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. [NIH] Carbohydrate: An aldehyde or ketone derivative of a polyhydric alcohol, particularly of the

Dictionary 71

pentahydric and hexahydric alcohols. They are so named because the hydrogen and oxygen are usually in the proportion to form water, (CH2O)n. The most important carbohydrates are the starches, sugars, celluloses, and gums. They are classified into mono-, di-, tri-, polyand heterosaccharides. [EU] 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] Cardiolipins: Acidic phospholipids composed of two molecules of phosphatidic acid covalently linked to a molecule of glycerol. They occur primarily in mitochondrial inner membranes and in bacterial plasma membranes. They are the main antigenic components of the Wassermann-type antigen that is used in nontreponemal syphilis serodiagnosis. [NIH] Cardiovascular: Having to do with the heart and blood vessels. [NIH] Cardiovascular disease: Any abnormal condition characterized by dysfunction of the heart and blood vessels. CVD includes atherosclerosis (especially coronary heart disease, which can lead to heart attacks), cerebrovascular disease (e.g., stroke), and hypertension (high blood pressure). [NIH] Carotene: The general name for a group of pigments found in green, yellow, and leafy vegetables, and yellow fruits. The pigments are fat-soluble, unsaturated aliphatic hydrocarbons functioning as provitamins and are converted to vitamin A through enzymatic processes in the intestinal wall. [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] Cataract: An opacity, partial or complete, of one or both eyes, on or in the lens or capsule, especially an opacity impairing vision or causing blindness. The many kinds of cataract are classified by their morphology (size, shape, location) or etiology (cause and time of occurrence). [EU] Caudal: Denoting a position more toward the cauda, or tail, than some specified point of reference; same as inferior, in human anatomy. [EU] Causal: Pertaining to a cause; directed against a cause. [EU] Cavernous Sinus: An irregularly shaped venous space in the dura mater at either side of the sphenoid bone. [NIH] Celiac Artery: The arterial trunk that arises from the abdominal aorta and after a short course divides into the left gastric, common hepatic and splenic arteries. [NIH] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Cell motility: The ability of a cell to move. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] Cerebral Arteries: The arteries supplying the cerebral cortex. [NIH] Cerebrum: The largest part of the brain. It is divided into two hemispheres, or halves, called the cerebral hemispheres. The cerebrum controls muscle functions of the body and also controls speech, emotions, reading, writing, and learning. [NIH] Cholecystitis: Inflammation of the gallbladder. [NIH] Cholestasis: Impairment of biliary flow at any level from the hepatocyte to Vater's ampulla. [NIH]

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Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Chronic renal: Slow and progressive loss of kidney function over several years, often resulting in end-stage renal disease. People with end-stage renal disease need dialysis or transplantation to replace the work of the kidneys. [NIH] CIS: Cancer Information Service. The CIS is the National Cancer Institute's link to the public, interpreting and explaining research findings in a clear and understandable manner, and providing personalized responses to specific questions about cancer. Access the CIS by calling 1-800-4-CANCER, or by using the Web site at http://cis.nci.nih.gov. [NIH] 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] Collagen: A polypeptide substance comprising about one third of the total protein in mammalian organisms. It is the main constituent of skin, connective tissue, and the organic substance of bones and teeth. Different forms of collagen are produced in the body but all consist of three alpha-polypeptide chains arranged in a triple helix. Collagen is differentiated from other fibrous proteins, such as elastin, by the content of proline, hydroxyproline, and hydroxylysine; by the absence of tryptophan; and particularly by the high content of polar groups which are responsible for its swelling properties. [NIH] 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] Conception: The onset of pregnancy, marked by implantation of the blastocyst; the formation of a viable zygote. [EU] Cones: One type of specialized light-sensitive cells (photoreceptors) in the retina that provide sharp central vision and color vision. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue Diseases: A heterogeneous group of disorders, some hereditary, others acquired, characterized by abnormal structure or function of one or more of the elements of connective tissue, i.e., collagen, elastin, or the mucopolysaccharides. [NIH] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Convulsions: A general term referring to sudden and often violent motor activity of cerebral or brainstem origin. Convulsions may also occur in the absence of an electrical cerebral discharge (e.g., in response to hypotension). [NIH] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Cortex: The outer layer of an organ or other body structure, as distinguished from the internal substance. [EU]

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Cortical: Pertaining to or of the nature of a cortex or bark. [EU] Cortical Blindness: The inability to understand or interpret what is seen due to a disturbance in the cerebral associational areas, the retina, the sensory pathways, and the striate area being intact. [NIH] Corticosteroid: Any of the steroids elaborated by the adrenal cortex (excluding the sex hormones of adrenal origin) in response to the release of corticotrophin (adrenocorticotropic hormone) by the pituitary gland, to any of the synthetic equivalents of these steroids, or to angiotensin II. They are divided, according to their predominant biological activity, into three major groups: glucocorticoids, chiefly influencing carbohydrate, fat, and protein metabolism; mineralocorticoids, affecting the regulation of electrolyte and water balance; and C19 androgens. Some corticosteroids exhibit both types of activity in varying degrees, and others exert only one type of effect. The corticosteroids are used clinically for hormonal replacement therapy, for suppression of ACTH secretion by the anterior pituitary, as antineoplastic, antiallergic, and anti-inflammatory agents, and to suppress the immune response. Called also adrenocortical hormone and corticoid. [EU] Cortisone: A natural steroid hormone produced in the adrenal gland. It can also be made in the laboratory. Cortisone reduces swelling and can suppress immune responses. [NIH] Cutaneous: Having to do with the skin. [NIH] Cyclic: Pertaining to or occurring in a cycle or cycles; the term is applied to chemical compounds that contain a ring of atoms in the nucleus. [EU] Cytokine: Small but highly potent protein that modulates the activity of many cell types, including T and B cells. [NIH] Cytomegalovirus: A genus of the family Herpesviridae, subfamily Betaherpesvirinae, infecting the salivary glands, liver, spleen, lungs, eyes, and other organs, in which they produce characteristically enlarged cells with intranuclear inclusions. Infection with Cytomegalovirus is also seen as an opportunistic infection in AIDS. [NIH] Decidua: The epithelial lining of the endometrium that is formed before the fertilized ovum reaches the uterus. The fertilized ovum embeds in the decidua. If the ovum is not fertilized, the decidua is shed during menstruation. [NIH] Degenerative: Undergoing degeneration : tending to degenerate; having the character of or involving degeneration; causing or tending to cause degeneration. [EU] Dermal: Pertaining to or coming from the skin. [NIH] Developed Countries: Countries that have reached a level of economic achievement through an increase of production, per capita income and consumption, and utilization of natural and human resources. [NIH] Dexamethasone: (11 beta,16 alpha)-9-Fluoro-11,17,21-trihydroxy-16-methylpregna-1,4diene-3,20-dione. An anti-inflammatory glucocorticoid used either in the free alcohol or esterified form in treatment of conditions that respond generally to cortisone. [NIH] Diabetes Insipidus: A metabolic disorder due to disorders in the production or release of vasopressin. It is characterized by the chronic excretion of large amounts of low specific gravity urine and great thirst. [NIH] Diabetes Mellitus: A heterogeneous group of disorders that share glucose intolerance in common. [NIH] Diastolic: Of or pertaining to the diastole. [EU] Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Digestive system: The organs that take in food and turn it into products that the body can

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use to stay healthy. Waste products the body cannot use leave the body through bowel movements. The digestive system includes the salivary glands, mouth, esophagus, stomach, liver, pancreas, gallbladder, small and large intestines, and rectum. [NIH] Dihydrotestosterone: Anabolic agent. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Dorsal: 1. Pertaining to the back or to any dorsum. 2. Denoting a position more toward the back surface than some other object of reference; same as posterior in human anatomy; superior in the anatomy of quadrupeds. [EU] Dorsum: A plate of bone which forms the posterior boundary of the sella turcica. [NIH] Duodenum: The first part of the small intestine. [NIH] Eclampsia: Onset of convulsions or coma in a previously diagnosed pre-eclamptic patient. [NIH]

Edema: Excessive amount of watery fluid accumulated in the intercellular spaces, most commonly present in subcutaneous tissue. [NIH] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Electrons: Stable elementary particles having the smallest known negative charge, present in all elements; also called negatrons. Positively charged electrons are called positrons. The numbers, energies and arrangement of electrons around atomic nuclei determine the chemical identities of elements. Beams of electrons are called cathode rays or beta rays, the latter being a high-energy biproduct of nuclear decay. [NIH] Elementary Particles: Individual components of atoms, usually subatomic; subnuclear particles are usually detected only when the atomic nucleus decays and then only transiently, as most of them are unstable, often yielding pure energy without substance, i.e., radiation. [NIH] Embolus: Bit of foreign matter which enters the blood stream at one point and is carried until it is lodged or impacted in an artery and obstructs it. It may be a blood clot, an air bubble, fat or other tissue, or clumps of bacteria. [NIH] Embryo: The prenatal stage of mammalian development characterized by rapid morphological changes and the differentiation of basic structures. [NIH] Embryo Transfer: Removal of a mammalian embryo from one environment and replacement in the same or a new environment. The embryo is usually in the pre-nidation phase, i.e., a blastocyst. The process includes embryo or blastocyst transplantation or transfer after in vitro fertilization and transfer of the inner cell mass of the blastocyst. It is not used for transfer of differentiated embryonic tissue, e.g., germ layer cells. [NIH] Endogenous: Produced inside an organism or cell. The opposite is external (exogenous) production. [NIH] Endothelium: A layer of epithelium that lines the heart, blood vessels (endothelium, vascular), lymph vessels (endothelium, lymphatic), and the serous cavities of the body. [NIH] Endothelium-derived: Small molecule that diffuses to the adjacent muscle layer and relaxes it. [NIH] End-stage renal: Total chronic kidney failure. When the kidneys fail, the body retains fluid and harmful wastes build up. A person with ESRD needs treatment to replace the work of the failed kidneys. [NIH] Environmental Health: The science of controlling or modifying those conditions, influences,

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or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]

Enzymatic: Phase where enzyme cuts the precursor protein. [NIH] Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Epidermis: Nonvascular layer of the skin. It is made up, from within outward, of five layers: 1) basal layer (stratum basale epidermidis); 2) spinous layer (stratum spinosum epidermidis); 3) granular layer (stratum granulosum epidermidis); 4) clear layer (stratum lucidum epidermidis); and 5) horny layer (stratum corneum epidermidis). [NIH] Epithelial: Refers to the cells that line the internal and external surfaces of the body. [NIH] Epithelial Cells: Cells that line the inner and outer surfaces of the body. [NIH] Epithelium: One or more layers of epithelial cells, supported by the basal lamina, which covers the inner or outer surfaces of the body. [NIH] Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]

Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] Extraction: The process or act of pulling or drawing out. [EU] Extravasation: A discharge or escape, as of blood, from a vessel into the tissues. [EU] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fat: Total lipids including phospholipids. [NIH] Fatty Liver: The buildup of fat in liver cells. The most common cause is alcoholism. Other causes include obesity, diabetes, and pregnancy. Also called steatosis. [NIH] Fertilization in Vitro: Fertilization of an egg outside the body when the egg is normally fertilized in the body. [NIH] Fetus: The developing offspring from 7 to 8 weeks after conception until birth. [NIH] Fibrinogen: Plasma glycoprotein clotted by thrombin, composed of a dimer of three nonidentical pairs of polypeptide chains (alpha, beta, gamma) held together by disulfide bonds. Fibrinogen clotting is a sol-gel change involving complex molecular arrangements: whereas fibrinogen is cleaved by thrombin to form polypeptides A and B, the proteolytic action of other enzymes yields different fibrinogen degradation products. [NIH] Fibrinolysis: The natural enzymatic dissolution of fibrin. [NIH] Fibronectin: An adhesive glycoprotein. One form circulates in plasma, acting as an opsonin; another is a cell-surface protein which mediates cellular adhesive interactions. [NIH] Folate: A B-complex vitamin that is being studied as a cancer prevention agent. Also called folic acid. [NIH] Folic Acid: N-(4-(((2-Amino-1,4-dihydro-4-oxo-6-pteridinyl)methyl)amino)benzoyl)-Lglutamic acid. A member of the vitamin B family that stimulates the hematopoietic system. It is present in the liver and kidney and is found in mushrooms, spinach, yeast, green leaves, and grasses. Folic acid is used in the treatment and prevention of folate deficiencies and megaloblastic anemia. [NIH] Forearm: The part between the elbow and the wrist. [NIH] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH]

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Ganglion: 1. A knot, or knotlike mass. 2. A general term for a group of nerve cell bodies located outside the central nervous system; occasionally applied to certain nuclear groups within the brain or spinal cord, e.g. basal ganglia. 3. A benign cystic tumour occurring on a aponeurosis or tendon, as in the wrist or dorsum of the foot; it consists of a thin fibrous capsule enclosing a clear mucinous fluid. [EU] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body through the rectum (flatus) or the mouth (burp). [NIH] Gastroenterology: A subspecialty of internal medicine concerned with the study of the physiology and diseases of the digestive system and related structures (esophagus, liver, gallbladder, and pancreas). [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]

Gestation: The period of development of the young in viviparous animals, from the time of fertilization of the ovum until birth. [EU] Gestational: Psychosis attributable to or occurring during pregnancy. [NIH] Gestational Age: Age of the conceptus. In humans, this may be assessed by medical history, physical examination, early immunologic pregnancy tests, radiography, ultrasonography, and amniotic fluid analysis. [NIH] Glomerular: Pertaining to or of the nature of a glomerulus, especially a renal glomerulus. [EU]

Glomeruli: Plural of glomerulus. [NIH] Glomerulonephritis: Glomerular disease characterized by an inflammatory reaction, with leukocyte infiltration and cellular proliferation of the glomeruli, or that appears to be the result of immune glomerular injury. [NIH] Glomerulus: A tiny set of looping blood vessels in the nephron where blood is filtered in the kidney. [NIH] Glucocorticoid: A compound that belongs to the family of compounds called corticosteroids (steroids). Glucocorticoids affect metabolism and have anti-inflammatory and immunosuppressive effects. They may be naturally produced (hormones) or synthetic (drugs). [NIH] Glucose: D-Glucose. A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. [NIH] Glucose Intolerance: A pathological state in which the fasting plasma glucose level is less than 140 mg per deciliter and the 30-, 60-, or 90-minute plasma glucose concentration following a glucose tolerance test exceeds 200 mg per deciliter. This condition is seen frequently in diabetes mellitus but also occurs with other diseases. [NIH] Glucose tolerance: The power of the normal liver to absorb and store large quantities of glucose and the effectiveness of intestinal absorption of glucose. The glucose tolerance test is a metabolic test of carbohydrate tolerance that measures active insulin, a hepatic function based on the ability of the liver to absorb glucose. The test consists of ingesting 100 grams of glucose into a fasting stomach; blood sugar should return to normal in 2 to 21 hours after ingestion. [NIH] Glucose Tolerance Test: Determination of whole blood or plasma sugar in a fasting state

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before and at prescribed intervals (usually 1/2 hr, 1 hr, 3 hr, 4 hr) after taking a specified amount (usually 100 gm orally) of glucose. [NIH] Glucuronic Acid: Derivatives of uronic acid found throughout the plant and animal kingdoms. They detoxify drugs and toxins by conjugating with them to form glucuronides in the liver which are more water-soluble metabolites that can be easily eliminated from the body. [NIH] Glycoprotein: A protein that has sugar molecules attached to it. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Gravidity: Pregnancy; the condition of being pregnant, without regard to the outcome. [EU] Guanylate Cyclase: An enzyme that catalyzes the conversion of GTP to 3',5'-cyclic GMP and pyrophosphate. It also acts on ITP and dGTP. (From Enzyme Nomenclature, 1992) EC 4.6.1.2. [NIH] Haematoma: A localized collection of blood, usually clotted, in an organ, space, or tissue, due to a break in the wall of a blood vessel. [EU] Haemorrhage: The escape of blood from the vessels; bleeding. Small haemorrhages are classified according to size as petechiae (very small), purpura (up to 1 cm), and ecchymoses (larger). The massive accumulation of blood within a tissue is called a haematoma. [EU] Hematoma: An extravasation of blood localized in an organ, space, or tissue. [NIH] Hemoglobin: One of the fractions of glycosylated hemoglobin A1c. Glycosylated hemoglobin is formed when linkages of glucose and related monosaccharides bind to hemoglobin A and its concentration represents the average blood glucose level over the previous several weeks. HbA1c levels are used as a measure of long-term control of plasma glucose (normal, 4 to 6 percent). In controlled diabetes mellitus, the concentration of glycosylated hemoglobin A is within the normal range, but in uncontrolled cases the level may be 3 to 4 times the normal conentration. Generally, complications are substantially lower among patients with Hb levels of 7 percent or less than in patients with HbA1c levels of 9 percent or more. [NIH] 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] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hemostasis: The process which spontaneously arrests the flow of blood from vessels carrying blood under pressure. It is accomplished by contraction of the vessels, adhesion and aggregation of formed blood elements, and the process of blood or plasma coagulation. [NIH]

Heparin: Heparinic acid. A highly acidic mucopolysaccharide formed of equal parts of sulfated D-glucosamine and D-glucuronic acid with sulfaminic bridges. The molecular weight ranges from six to twenty thousand. Heparin occurs in and is obtained from liver, lung, mast cells, etc., of vertebrates. Its function is unknown, but it is used to prevent blood clotting in vivo and vitro, in the form of many different salts. [NIH] Hepatic: Refers to the liver. [NIH] Hepatic Artery: A branch of the celiac artery that distributes to the stomach, pancreas, duodenum, liver, gallbladder, and greater omentum. [NIH]

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Hepatitis: Inflammation of the liver and liver disease involving degenerative or necrotic alterations of hepatocytes. [NIH] Hepatocellular: Pertaining to or affecting liver cells. [EU] Hepatocyte: A liver cell. [NIH] Hepatocyte Growth Factor: Multifunctional growth factor which regulates both cell growth and cell motility. It exerts a strong mitogenic effect on hepatocytes and primary epithelial cells. Its receptor is proto-oncogene protein C-met. [NIH] Hepatotoxic: Toxic to liver cells. [EU] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Hormonal: Pertaining to or of the nature of a hormone. [EU] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] Hydrogen: The first chemical element in the periodic table. It has the atomic symbol H, atomic number 1, and atomic weight 1. It exists, under normal conditions, as a colorless, odorless, tasteless, diatomic gas. Hydrogen ions are protons. Besides the common H1 isotope, hydrogen exists as the stable isotope deuterium and the unstable, radioactive isotope tritium. [NIH] Hyperbilirubinemia: Pathologic process consisting of an abnormal increase in the amount of bilirubin in the circulating blood, which may result in jaundice. [NIH] Hyperemesis: Excessive vomiting. [EU] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Hypoglycemia: Abnormally low blood sugar [NIH] Idiopathic: Describes a disease of unknown cause. [NIH] Immune function: Production and action of cells that fight disease or infection. [NIH] Immune response: The activity of the immune system against foreign substances (antigens). [NIH]

Immunoglobulins: Glycoproteins present in the blood (antibodies) and in other tissue. They are classified by structure and activity into five classes (IgA, IgD, IgE, IgG, IgM). [NIH] Immunologic: The ability of the antibody-forming system to recall a previous experience with an antigen and to respond to a second exposure with the prompt production of large amounts of antibody. [NIH] Immunosuppressive: Describes the ability to lower immune system responses. [NIH] Implantation: The insertion or grafting into the body of biological, living, inert, or radioactive material. [EU] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Incision: A cut made in the body during surgery. [NIH] 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,

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intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]

Infiltration: The diffusion or accumulation in a tissue or cells of substances not normal to it or in amounts of the normal. Also, the material so accumulated. [EU] 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] Initiator: A chemically reactive substance which may cause cell changes if ingested, inhaled or absorbed into the body; the substance may thus initiate a carcinogenic process. [NIH] Interferon: A biological response modifier (a substance that can improve the body's natural response to disease). Interferons interfere with the division of cancer cells and can slow tumor growth. There are several types of interferons, including interferon-alpha, -beta, and gamma. These substances are normally produced by the body. They are also made in the laboratory for use in treating cancer and other diseases. [NIH] Interleukin-1: A soluble factor produced by monocytes, macrophages, and other cells which activates T-lymphocytes and potentiates their response to mitogens or antigens. IL-1 consists of two distinct forms, IL-1 alpha and IL-1 beta which perform the same functions but are distinct proteins. The biological effects of IL-1 include the ability to replace macrophage requirements for T-cell activation. The factor is distinct from interleukin-2. [NIH] Interleukin-12: A heterodimeric cytokine that stimulates the production of interferon gamma from T-cells and natural killer cells, and also induces differentiation of Th1 helper cells. It is an initiator of cell-mediated immunity. [NIH] Interleukin-2: Chemical mediator produced by activated T lymphocytes and which regulates the proliferation of T cells, as well as playing a role in the regulation of NK cell activity. [NIH] Interstitial: Pertaining to or situated between parts or in the interspaces of a tissue. [EU] Intoxication: Poisoning, the state of being poisoned. [EU] Intracellular: Inside a cell. [NIH] Intrahepatic: Within the liver. [NIH] Intravenous: IV. Into a vein. [NIH] Intrinsic: Situated entirely within or pertaining exclusively to a part. [EU] Invasive: 1. Having the quality of invasiveness. 2. Involving puncture or incision of the skin or insertion of an instrument or foreign material into the body; said of diagnostic techniques. [EU]

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] Isoenzymes: One of various structurally related forms of an enzyme, each having the same mechanism but with differing chemical, physical, or immunological characteristics. [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]

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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] Laminin: Large, noncollagenous glycoprotein with antigenic properties. It is localized in the basement membrane lamina lucida and functions to bind epithelial cells to the basement membrane. Evidence suggests that the protein plays a role in tumor invasion. [NIH] Lesion: An area of abnormal tissue change. [NIH] Leukoencephalopathy: A condition with spongy holes in the brain's white matter. [NIH] Lipid: Fat. [NIH] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Liver Transplantation: The transference of a part of or an entire liver from one human or animal to another. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Lupus: A form of cutaneous tuberculosis. It is seen predominantly in women and typically involves the nasal, buccal, and conjunctival mucosa. [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] Macrophage: A type of white blood cell that surrounds and kills microorganisms, removes dead cells, and stimulates the action of other immune system cells. [NIH] Magnetic Resonance Imaging: Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques. [NIH] Magnetic Resonance Spectroscopy: Spectroscopic method of measuring the magnetic moment of elementary particles such as atomic nuclei, protons or electrons. It is employed in clinical applications such as NMR Tomography (magnetic resonance imaging). [NIH] Malaise: A vague feeling of bodily discomfort. [EU] Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] Maternal Mortality: Maternal deaths resulting from complications of pregnancy and childbirth in a given population. [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] Membranes: Thin layers of tissue which cover parts of the body, separate adjacent cavities, or connect adjacent structures. [NIH]

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Metabolic disorder: A condition in which normal metabolic processes are disrupted, usually because of a missing enzyme. [NIH] MI: Myocardial infarction. Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Microbiology: The study of microorganisms such as fungi, bacteria, algae, archaea, and viruses. [NIH] Middle Cerebral Artery: The largest and most complex of the cerebral arteries. Branches of the middle cerebral artery supply the insular region, motor and premotor areas, and large regions of the association cortex. [NIH] Mineralocorticoids: A group of corticosteroids primarily associated with the regulation of water and electrolyte balance. This is accomplished through the effect on ion transport in renal tubules, resulting in retention of sodium and loss of potassium. Mineralocorticoid secretion is itself regulated by plasma volume, serum potassium, and angiotensin II. [NIH] Mitochondrial Swelling: Increase in volume of mitochondria due to an influx of fluid; it occurs in hypotonic solutions due to osmotic pressure and in isotonic solutions as a result of altered permeability of the membranes of respiring mitochondria. [NIH] 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] Monocytes: Large, phagocytic mononuclear leukocytes produced in the vertebrate bone marrow and released into the blood; contain a large, oval or somewhat indented nucleus surrounded by voluminous cytoplasm and numerous organelles. [NIH] Motility: The ability to move spontaneously. [EU] Mucinous: Containing or resembling mucin, the main compound in mucus. [NIH] Mucosa: A mucous membrane, or tunica mucosa. [EU] Myocardial infarction: Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Myopia: That error of refraction in which rays of light entering the eye parallel to the optic axis are brought to a focus in front of the retina, as a result of the eyeball being too long from front to back (axial m.) or of an increased strength in refractive power of the media of the eye (index m.). Called also nearsightedness, because the near point is less distant than it is in emmetropia with an equal amplitude of accommodation. [EU] Natural killer cells: NK cells. A type of white blood cell that contains granules with enzymes that can kill tumor cells or microbial cells. Also called large granular lymphocytes (LGL). [NIH] 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]

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Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] Neural: 1. Pertaining to a nerve or to the nerves. 2. Situated in the region of the spinal axis, as the neutral arch. [EU] Neuropeptide: A member of a class of protein-like molecules made in the brain. Neuropeptides consist of short chains of amino acids, with some functioning as neurotransmitters and some functioning as hormones. [NIH] Neurotransmitter: Any of a group of substances that are released on excitation from the axon terminal of a presynaptic neuron of the central or peripheral nervous system and travel across the synaptic cleft to either excite or inhibit the target cell. Among the many substances that have the properties of a neurotransmitter are acetylcholine, norepinephrine, epinephrine, dopamine, glycine, y-aminobutyrate, glutamic acid, substance P, enkephalins, endorphins, and serotonin. [EU] Nitric Oxide: A free radical gas produced endogenously by a variety of mammalian cells. It is synthesized from arginine by a complex reaction, catalyzed by nitric oxide synthase. Nitric oxide is endothelium-derived relaxing factor. It is released by the vascular endothelium and mediates the relaxation induced by some vasodilators such as acetylcholine and bradykinin. It also inhibits platelet aggregation, induces disaggregation of aggregated platelets, and inhibits platelet adhesion to the vascular endothelium. Nitric oxide activates cytosolic guanylate cyclase and thus elevates intracellular levels of cyclic GMP. [NIH]

Normotensive: 1. Characterized by normal tone, tension, or pressure, as by normal blood pressure. 2. A person with normal blood pressure. [EU] Nuclear: A test of the structure, blood flow, and function of the kidneys. The doctor injects a mildly radioactive solution into an arm vein and uses x-rays to monitor its progress through the kidneys. [NIH] Nuclei: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nursing Care: Care given to patients by nursing service personnel. [NIH] Ocular: 1. Of, pertaining to, or affecting the eye. 2. Eyepiece. [EU] Oedema: The presence of abnormally large amounts of fluid in the intercellular tissue spaces of the body; usually applied to demonstrable accumulation of excessive fluid in the subcutaneous tissues. Edema may be localized, due to venous or lymphatic obstruction or to increased vascular permeability, or it may be systemic due to heart failure or renal disease. Collections of edema fluid are designated according to the site, e.g. ascites (peritoneal cavity), hydrothorax (pleural cavity), and hydropericardium (pericardial sac). Massive generalized edema is called anasarca. [EU] Omentum: A fold of the peritoneum (the thin tissue that lines the abdomen) that surrounds the stomach and other organs in the abdomen. [NIH] Oncogene: A gene that normally directs cell growth. If altered, an oncogene can promote or allow the uncontrolled growth of cancer. Alterations can be inherited or caused by an environmental exposure to carcinogens. [NIH] Ophthalmic: Pertaining to the eye. [EU] Opsin: A protein formed, together with retinene, by the chemical breakdown of metarhodopsin. [NIH] Optic Nerve: The 2nd cranial nerve. The optic nerve conveys visual information from the retina to the brain. The nerve carries the axons of the retinal ganglion cells which sort at the

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optic chiasm and continue via the optic tracts to the brain. The largest projection is to the lateral geniculate nuclei; other important targets include the superior colliculi and the suprachiasmatic nuclei. Though known as the second cranial nerve, it is considered part of the central nervous system. [NIH] Osteoclasts: A large multinuclear cell associated with the absorption and removal of bone. An odontoclast, also called cementoclast, is cytomorphologically the same as an osteoclast and is involved in cementum resorption. [NIH] Ovum: A female germ cell extruded from the ovary at ovulation. [NIH] Oxidation: The act of oxidizing or state of being oxidized. Chemically it consists in the increase of positive charges on an atom or the loss of negative charges. Most biological oxidations are accomplished by the removal of a pair of hydrogen atoms (dehydrogenation) from a molecule. Such oxidations must be accompanied by reduction of an acceptor molecule. Univalent o. indicates loss of one electron; divalent o., the loss of two electrons. [EU]

Pancreas: A mixed exocrine and endocrine gland situated transversely across the posterior abdominal wall in the epigastric and hypochondriac regions. The endocrine portion is comprised of the Islets of Langerhans, while the exocrine portion is a compound acinar gland that secretes digestive enzymes. [NIH] Pancreatic: Having to do with the pancreas. [NIH] Pancreatitis: Acute or chronic inflammation of the pancreas, which may be asymptomatic or symptomatic, and which is due to autodigestion of a pancreatic tissue by its own enzymes. It is caused most often by alcoholism or biliary tract disease; less commonly it may be associated with hyperlipaemia, hyperparathyroidism, abdominal trauma (accidental or operative injury), vasculitis, or uraemia. [EU] Paralysis: Loss of ability to move all or part of the body. [NIH] Parity: The number of offspring a female has borne. It is contrasted with gravidity, which refers to the number of pregnancies, regardless of outcome. [NIH] 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] Pathologies: The study of abnormality, especially the study of diseases. [NIH] Pathophysiology: Altered functions in an individual or an organ due to disease. [NIH] Patient Care Management: Generating, planning, organizing, and administering medical and nursing care and services for patients. [NIH] Pelvis: The lower part of the abdomen, located between the hip bones. [NIH] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Perinatal: Pertaining to or occurring in the period shortly before and after birth; variously defined as beginning with completion of the twentieth to twenty-eighth week of gestation and ending 7 to 28 days after birth. [EU] Perivascular: Situated around a vessel. [EU] Petechiae: Pinpoint, unraised, round red spots under the skin caused by bleeding. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Phospholipids: Lipids containing one or more phosphate groups, particularly those derived

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from either glycerol (phosphoglycerides; glycerophospholipids) or sphingosine (sphingolipids). They are polar lipids that are of great importance for the structure and function of cell membranes and are the most abundant of membrane lipids, although not stored in large amounts in the system. [NIH] Physical Examination: Systematic and thorough inspection of the patient for physical signs of disease or abnormality. [NIH] Physiologic: Having to do with the functions of the body. When used in the phrase "physiologic age," it refers to an age assigned by general health, as opposed to calendar age. [NIH]

Physiology: The science that deals with the life processes and functions of organismus, their cells, tissues, and organs. [NIH] Pigment: A substance that gives color to tissue. Pigments are responsible for the color of skin, eyes, and hair. [NIH] Pituitary Gland: A small, unpaired gland situated in the sella turcica tissue. It is connected to the hypothalamus by a short stalk. [NIH] Placenta: A highly vascular fetal organ through which the fetus absorbs oxygen and other nutrients and excretes carbon dioxide and other wastes. It begins to form about the eighth day of gestation when the blastocyst adheres to the decidua. [NIH] Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Plasma cells: A type of white blood cell that produces antibodies. [NIH] Plasma protein: One of the hundreds of different proteins present in blood plasma, including carrier proteins ( such albumin, transferrin, and haptoglobin), fibrinogen and other coagulation factors, complement components, immunoglobulins, enzyme inhibitors, precursors of substances such as angiotension and bradykinin, and many other types of proteins. [EU] Plasmapheresis: Procedure whereby plasma is separated and extracted from anticoagulated whole blood and the red cells retransfused to the donor. Plasmapheresis is also employed for therapeutic use. [NIH] Plasmin: A product of the lysis of plasminogen (profibrinolysin) by plasminogen activators. It is composed of two polypeptide chains, light (B) and heavy (A), with a molecular weight of 75,000. It is the major proteolytic enzyme involved in blood clot retraction or the lysis of fibrin and quickly inactivated by antiplasmins. EC 3.4.21.7. [NIH] Plasminogen: Precursor of fibrinolysin (plasmin). It is a single-chain beta-globulin of molecular weight 80-90,000 found mostly in association with fibrinogen in plasma; plasminogen activators change it to fibrinolysin. It is used in wound debriding and has been investigated as a thrombolytic agent. [NIH] Plasminogen Activators: A heterogeneous group of proteolytic enzymes that convert plasminogen to plasmin. They are concentrated in the lysosomes of most cells and in the vascular endothelium, particularly in the vessels of the microcirculation. EC 3.4.21.-. [NIH] Platelet Aggregation: The attachment of platelets to one another. This clumping together can be induced by a number of agents (e.g., thrombin, collagen) and is part of the

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mechanism leading to the formation of a thrombus. [NIH] Platelet Count: A count of the number of platelets per unit volume in a sample of venous blood. [NIH] Platelets: A type of blood cell that helps prevent bleeding by causing blood clots to form. Also called thrombocytes. [NIH] Pneumonia: Inflammation of the lungs. [NIH] Posterior: Situated in back of, or in the back part of, or affecting the back or dorsal surface of the body. In lower animals, it refers to the caudal end of the body. [EU] Potentiates: A degree of synergism which causes the exposure of the organism to a harmful substance to worsen a disease already contracted. [NIH] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Precursor: Something that precedes. In biological processes, a substance from which another, usually more active or mature substance is formed. In clinical medicine, a sign or symptom that heralds another. [EU] Preeclampsia: A toxaemia of late pregnancy characterized by hypertension, edema, and proteinuria, when convulsions and coma are associated, it is called eclampsia. [EU] Pre-Eclampsia: Development of hypertension with proteinuria, edema, or both, due to pregnancy or the influence of a recent pregnancy. It occurs after the 20th week of gestation, but it may develop before this time in the presence of trophoblastic disease. [NIH] Pre-eclamptic: A syndrome characterized by hypertension, albuminuria, and generalized oedema, occurring only in pregnancy. [NIH] Pregnancy Outcome: Results of conception and ensuing pregnancy, including live birth, stillbirth, spontaneous abortion, induced abortion. The outcome may follow natural or artificial insemination or any of the various reproduction techniques, such as embryo transfer or fertilization in vitro. [NIH] Pregnancy Tests: Tests to determine whether or not an individual is pregnant. [NIH] Pregnancy Toxemias: Pregnancy-induced hypertensive states, including EPH gestosis when edema and proteinuria accompany hypertension. Other hypertensive disorders that develop during pregnancy or the puerperium are pre-eclampsia and eclampsia, either of which may be superimposed upon chronic hypertensive vascular or renal disease. [NIH] Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from incidence, which refers to the number of new cases in the population at a given time. [NIH] Progression: Increase in the size of a tumor or spread of cancer in the body. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Propofol: A widely used anesthetic. [NIH] Prospective study: An epidemiologic study in which a group of individuals (a cohort), all free of a particular disease and varying in their exposure to a possible risk factor, is followed over a specific amount of time to determine the incidence rates of the disease in the exposed and unexposed groups. [NIH]

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Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] Proteinuria: The presence of protein in the urine, indicating that the kidneys are not working properly. [NIH] Proteoglycans: Glycoproteins which have a very high polysaccharide content. [NIH] Prothrombin: A plasma protein that is the inactive precursor of thrombin. It is converted to thrombin by a prothrombin activator complex consisting of factor Xa, factor V, phospholipid, and calcium ions. Deficiency of prothrombin leads to hypoprothrombinemia. [NIH]

Protons: Stable elementary particles having the smallest known positive charge, found in the nuclei of all elements. The proton mass is less than that of a neutron. A proton is the nucleus of the light hydrogen atom, i.e., the hydrogen ion. [NIH] 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] Puerperium: Period from delivery of the placenta until return of the reproductive organs to their normal nonpregnant morphologic state. In humans, the puerperium generally lasts for six to eight weeks. [NIH] Pulmonary: Relating to the lungs. [NIH] Pulmonary Artery: The short wide vessel arising from the conus arteriosus of the right ventricle and conveying unaerated blood to the lungs. [NIH] Pulmonary Edema: An accumulation of an excessive amount of watery fluid in the lungs, may be caused by acute exposure to dangerous concentrations of irritant gasses. [NIH] Purpura: Purplish or brownish red discoloration, easily visible through the epidermis, caused by hemorrhage into the tissues. [NIH] Quality of Life: A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral and social environment. [NIH] Radiography: Examination of any part of the body for diagnostic purposes by means of roentgen rays, recording the image on a sensitized surface (such as photographic film). [NIH] 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] Recombinant: A cell or an individual with a new combination of genes not found together in either parent; usually applied to linked genes. [EU] Red blood cells: RBCs. Cells that carry oxygen to all parts of the body. Also called erythrocytes. [NIH] Reductase: Enzyme converting testosterone to dihydrotestosterone. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Refractory: Not readily yielding to treatment. [EU] Renal failure: Progressive renal insufficiency and uremia, due to irreversible and progressive renal glomerular tubular or interstitial disease. [NIH] Renal Replacement Therapy: Procedures which temporarily or permanently remedy insufficient cleansing of body fluids by the kidneys. [NIH] Reproduction Techniques: Methods pertaining to the generation of new individuals. [NIH]

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Retina: The ten-layered nervous tissue membrane of the eye. It is continuous with the optic nerve and receives images of external objects and transmits visual impulses to the brain. Its outer surface is in contact with the choroid and the inner surface with the vitreous body. The outer-most layer is pigmented, whereas the inner nine layers are transparent. [NIH] Retinal: 1. Pertaining to the retina. 2. The aldehyde of retinol, derived by the oxidative enzymatic splitting of absorbed dietary carotene, and having vitamin A activity. In the retina, retinal combines with opsins to form visual pigments. One isomer, 11-cis retinal combines with opsin in the rods (scotopsin) to form rhodopsin, or visual purple. Another, all-trans retinal (trans-r.); visual yellow; xanthopsin) results from the bleaching of rhodopsin by light, in which the 11-cis form is converted to the all-trans form. Retinal also combines with opsins in the cones (photopsins) to form the three pigments responsible for colour vision. Called also retinal, and retinene1. [EU] Retinal Detachment: Separation of the inner layers of the retina (neural retina) from the pigment epithelium. Retinal detachment occurs more commonly in men than in women, in eyes with degenerative myopia, in aging and in aphakia. It may occur after an uncomplicated cataract extraction, but it is seen more often if vitreous humor has been lost during surgery. (Dorland, 27th ed; Newell, Ophthalmology: Principles and Concepts, 7th ed, p310-12). [NIH] Retinal Vein: Central retinal vein and its tributaries. It runs a short course within the optic nerve and then leaves and empties into the superior ophthalmic vein or cavernous sinus. [NIH]

Retinal Vein Occlusion: Occlusion of the retinal vein. Those at high risk for this condition include patients with hypertension, diabetes mellitus, arteriosclerosis, and other cardiovascular diseases. [NIH] Retinol: Vitamin A. It is essential for proper vision and healthy skin and mucous membranes. Retinol is being studied for cancer prevention; it belongs to the family of drugs called retinoids. [NIH] Rhodopsin: A photoreceptor protein found in retinal rods. It is a complex formed by the binding of retinal, the oxidized form of retinol, to the protein opsin and undergoes a series of complex reactions in response to visible light resulting in the transmission of nerve impulses to the brain. [NIH] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Rods: One type of specialized light-sensitive cells (photoreceptors) in the retina that provide side vision and the ability to see objects in dim light (night vision). [NIH] Salivary: The duct that convey saliva to the mouth. [NIH] Salivary glands: Glands in the mouth that produce saliva. [NIH] Sarcoma: A connective tissue neoplasm formed by proliferation of mesodermal cells; it is usually highly malignant. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Secretion: 1. The process of elaborating a specific product as a result of the activity of a gland; this activity may range from separating a specific substance of the blood to the elaboration of a new chemical substance. 2. Any substance produced by secretion. [EU] Sediment: A precipitate, especially one that is formed spontaneously. [EU] Sensibility: The ability to receive, feel and appreciate sensations and impressions; the quality of being sensitive; the extend to which a method gives results that are free from false negatives. [NIH]

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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] Serous: Having to do with serum, the clear liquid part of blood. [NIH] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] Sex Ratio: The number of males per 100 females. [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] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] Spleen: An organ that is part of the lymphatic system. The spleen produces lymphocytes, filters the blood, stores blood cells, and destroys old blood cells. It is located on the left side of the abdomen near the stomach. [NIH] Splenectomy: An operation to remove the spleen. [NIH] Spontaneous Abortion: The non-induced birth of an embryo or of fetus prior to the stage of viability at about 20 weeks of gestation. [NIH] Steatosis: Fatty degeneration. [EU] Steroids: Drugs used to relieve swelling and inflammation. [NIH] Stillbirth: The birth of a dead fetus or baby. [NIH] Stimulus: That which can elicit or evoke action (response) in a muscle, nerve, gland or other excitable issue, or cause an augmenting action upon any function or metabolic process. [NIH] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Striate: Recurrent branch of the anterior cerebral artery which supplies the anterior limb of the internal capsule. [NIH] Subcapsular: Situated below a capsule. [EU] Supportive care: Treatment given to prevent, control, or relieve complications and side effects and to improve the comfort and quality of life of people who have cancer. [NIH] Suppression: A conscious exclusion of disapproved desire contrary with repression, in which the process of exclusion is not conscious. [NIH] Symptomatic: Having to do with symptoms, which are signs of a condition or disease. [NIH] Systemic: Affecting the entire body. [NIH] Systemic lupus erythematosus: SLE. A chronic inflammatory connective tissue disease marked by skin rashes, joint pain and swelling, inflammation of the kidneys, inflammation

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of the fibrous tissue surrounding the heart (i.e., the pericardium), as well as other problems. Not all affected individuals display all of these problems. May be referred to as lupus. [NIH] Systolic: Indicating the maximum arterial pressure during contraction of the left ventricle of the heart. [EU] Tendon: A discrete band of connective tissue mainly composed of parallel bundles of collagenous fibers by which muscles are attached, or two muscles bellies joined. [NIH] Testosterone: A hormone that promotes the development and maintenance of male sex characteristics. [NIH] Threshold: For a specified sensory modality (e. g. light, sound, vibration), the lowest level (absolute threshold) or smallest difference (difference threshold, difference limen) or intensity of the stimulus discernible in prescribed conditions of stimulation. [NIH] Thrombin: An enzyme formed from prothrombin that converts fibrinogen to fibrin. (Dorland, 27th ed) EC 3.4.21.5. [NIH] Thrombocytes: Blood cells that help prevent bleeding by causing blood clots to form. Also called platelets. [NIH] Thrombocytopenia: A decrease in the number of blood platelets. [NIH] Thrombolytic: 1. Dissolving or splitting up a thrombus. 2. A thrombolytic agent. [EU] Thrombopenia: Reduction in the number of platelets in the blood. [NIH] Thrombophilia: A disorder of hemostasis in which there is a tendency for the occurrence of thrombosis. [NIH] Thromboses: The formation or presence of a blood clot within a blood vessel during life. [NIH]

Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] Thrombus: An aggregation of blood factors, primarily platelets and fibrin with entrapment of cellular elements, frequently causing vascular obstruction at the point of its formation. Some authorities thus differentiate thrombus formation from simple coagulation or clot formation. [EU] Thyroid: A gland located near the windpipe (trachea) that produces thyroid hormone, which helps regulate growth and metabolism. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tone: 1. The normal degree of vigour and tension; in muscle, the resistance to passive elongation or stretch; tonus. 2. A particular quality of sound or of voice. 3. To make permanent, or to change, the colour of silver stain by chemical treatment, usually with a heavy metal. [EU] Tonicity: The normal state of muscular tension. [NIH] Torsion: A twisting or rotation of a bodily part or member on its axis. [NIH] Toxaemia: 1. The condition resulting from the spread of bacterial products (toxins) by the bloodstream. 2. A condition resulting from metabolic disturbances, e.g. toxaemia of pregnancy. [EU] Toxemia: A generalized intoxication produced by toxins and other substances elaborated by an infectious agent. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicology: The science concerned with the detection, chemical composition, and

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pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxins: Specific, characterizable, poisonous chemicals, often proteins, with specific biological properties, including immunogenicity, produced by microbes, higher plants, or animals. [NIH] Transplantation: Transference of a tissue or organ, alive or dead, within an individual, between individuals of the same species, or between individuals of different species. [NIH] Trauma: Any injury, wound, or shock, must frequently physical or structural shock, producing a disturbance. [NIH] 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] Tuberculosis: Any of the infectious diseases of man and other animals caused by species of Mycobacterium. [NIH] Tumour: 1. Swelling, one of the cardinal signs of inflammations; morbid enlargement. 2. A new growth of tissue in which the multiplication of cells is uncontrolled and progressive; called also neoplasm. [EU] Ultrasonography: The visualization of deep structures of the body by recording the reflections of echoes of pulses of ultrasonic waves directed into the tissues. Use of ultrasound for imaging or diagnostic purposes employs frequencies ranging from 1.6 to 10 megahertz. [NIH] Uraemia: 1. An excess in the blood of urea, creatinine, and other nitrogenous end products of protein and amino acids metabolism; more correctly referred to as azotemia. 2. In current usage the entire constellation of signs and symptoms of chronic renal failure, including nausea, vomiting anorexia, a metallic taste in the mouth, a uraemic odour of the breath, pruritus, uraemic frost on the skin, neuromuscular disorders, pain and twitching in the muscles, hypertension, edema, mental confusion, and acid-base and electrolyte imbalances. [EU]

Uremia: The illness associated with the buildup of urea in the blood because the kidneys are not working effectively. Symptoms include nausea, vomiting, loss of appetite, weakness, and mental confusion. [NIH] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]

Urinalysis: Examination of urine by chemical, physical, or microscopic means. Routine urinalysis usually includes performing chemical screening tests, determining specific gravity, observing any unusual color or odor, screening for bacteriuria, and examining the sediment microscopically. [NIH] Urine: Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra. [NIH] Uterus: The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in which a fetus develops. Also called the womb. [NIH] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vasculitis: Inflammation of a blood vessel. [NIH] Vasodilator: An agent that widens blood vessels. [NIH] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Venous: Of or pertaining to the veins. [EU] Venous blood: Blood that has given up its oxygen to the tissues and carries carbon dioxide

Dictionary 91

back for gas exchange. [NIH] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Viral: Pertaining to, caused by, or of the nature of virus. [EU] Viral Hepatitis: Hepatitis caused by a virus. Five different viruses (A, B, C, D, and E) most commonly cause this form of hepatitis. Other rare viruses may also cause hepatitis. [NIH] 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] Vitreous: Glasslike or hyaline; often used alone to designate the vitreous body of the eye (corpus vitreum). [EU] Vitreous Humor: The transparent, colorless mass of gel that lies behind the lens and in front of the retina and fills the center of the eyeball. [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] 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]

Womb: A hollow, thick-walled, muscular organ in which the impregnated ovum is developed into a child. [NIH] Zygote: The fertilized ovum. [NIH]

93

INDEX A Abdominal, 23, 31, 65, 67, 70, 71, 83 Abortion, 67, 68, 85 Acceptor, 67, 83 Acetylcholine, 67, 82 Acute renal, 6, 7, 30, 31, 34, 42, 67, 77 Acyl, 38, 67 Adrenal Cortex, 67, 73 Albuminuria, 67, 85 Amino acid, 67, 68, 69, 70, 82, 83, 86, 88, 90 Amino Acid Sequence, 67, 68 Amniotic Fluid, 67, 76 Ampulla, 67, 71 Anaesthesia, 17, 19, 21, 25, 30, 40, 67 Androgens, 67, 68, 73 Anemia, 34, 68, 75 Antiallergic, 68, 73 Antibodies, 7, 8, 68, 69, 77, 78, 84 Antibodies, Anticardiolipin, 68 Antibody, 9, 68, 78, 79, 80 Anticoagulant, 27, 68 Antigen, 68, 71, 78, 79, 80 Anti-inflammatory, 68, 73, 76 Anti-Inflammatory Agents, 68, 73 Antineoplastic, 68, 73 Antiphospholipid Syndrome, 23, 38, 68 Aphakia, 68, 87 Aponeurosis, 68, 76 Arginine, 68, 82 Arterial, 14, 68, 69, 71, 78, 89 Arteries, 68, 69, 70, 71, 72, 81 Arteriosclerosis, 69, 87 Artery, 33, 68, 69, 72, 74, 81, 88 Aspartate, 8, 69 Assay, 33, 69 Asymptomatic, 69, 83 Atypical, 5, 69 Autoantibodies, 17, 69 Autoantigens, 69 Autodigestion, 69, 83 Autopsy, 29, 69 B Bacteria, 67, 68, 69, 74, 77, 81 Bacterium, 69, 77 Bacteriuria, 69, 90 Basal Ganglia, 69, 76 Basement Membrane, 3, 69, 80 Benign, 69, 76, 81

Bile, 69, 75, 79, 80 Bile duct, 69 Bile Pigments, 69, 79 Biliary, 44, 69, 70, 71, 83 Biliary Tract, 44, 70, 83 Biochemical, 25, 70, 88 Bladder, 70, 90 Blastocyst, 70, 72, 74, 84 Blood Groups, 12, 70 Blood Platelets, 70, 88, 89 Blood pressure, 4, 44, 66, 70, 71, 78, 82 Blood vessel, 70, 71, 74, 76, 77, 89, 90 Body Fluids, 70, 86 Bradykinin, 70, 82, 84 Buccal, 70, 80 Bullous, 8, 70 C Caesarean section, 37, 70 Calcitonin, 7, 70 Calcitonin Gene-Related Peptide, 7, 70 Calcium, 70, 86 Carbohydrate, 70, 73, 76 Carbon Dioxide, 71, 84, 90 Cardiolipins, 68, 71 Cardiovascular, 71, 87, 88 Cardiovascular disease, 71, 87 Carotene, 71, 87 Case report, 6, 9, 11, 12, 13, 16, 17, 18, 19, 21, 22, 25, 26, 30, 31, 34, 39, 40, 41, 71 Cataract, 68, 71, 87 Caudal, 71, 85 Causal, 71, 77 Cavernous Sinus, 71, 87 Celiac Artery, 71, 77 Cell, 10, 24, 69, 70, 71, 73, 74, 75, 76, 78, 79, 81, 82, 83, 84, 85, 86, 91 Cell motility, 71, 78 Central Nervous System, 67, 71, 76, 83, 88 Cerebral, 9, 26, 69, 71, 72, 73, 81, 88 Cerebral Arteries, 71, 81 Cerebrum, 71 Cholecystitis, 16, 38, 71 Cholestasis, 44, 45, 71 Chronic, 22, 44, 72, 73, 74, 79, 83, 85, 88, 90 Chronic renal, 22, 72, 90 CIS, 72, 87 Clinical trial, 4, 51, 72 Collagen, 67, 69, 72, 84

94

HELLP Syndrome

Computational Biology, 51, 72 Conception, 44, 67, 72, 75, 85 Cones, 72, 87 Connective Tissue, 68, 72, 87, 88, 89 Connective Tissue Diseases, 68, 72 Contraindications, ii, 72 Convulsions, 72, 74, 85 Coronary, 71, 72, 81 Coronary Thrombosis, 72, 81 Cortex, 71, 72, 73, 81 Cortical, 6, 30, 73 Cortical Blindness, 6, 30, 73 Corticosteroid, 10, 11, 24, 28, 73 Cortisone, 73 Cutaneous, 73, 80 Cyclic, 73, 77, 82 Cytokine, 73, 79 Cytomegalovirus, 26, 73 D Decidua, 73, 84 Degenerative, 73, 78, 87 Dermal, 27, 73 Developed Countries, 32, 73 Dexamethasone, 12, 41, 73 Diabetes Insipidus, 41, 73 Diabetes Mellitus, 42, 73, 76, 77, 87 Diastolic, 73, 78 Digestion, 69, 73, 80, 88 Digestive system, 73, 76 Dihydrotestosterone, 74, 86 Direct, iii, 74, 86 Dorsal, 74, 85 Dorsum, 74, 76 Duodenum, 69, 74, 77, 88 E Eclampsia, 3, 5, 7, 9, 12, 22, 24, 26, 27, 31, 32, 33, 40, 42, 45, 74, 85 Edema, 74, 82, 85, 90 Electrolyte, 73, 74, 81, 90 Electrons, 74, 79, 80, 83 Elementary Particles, 74, 80, 86 Embolus, 74, 78 Embryo, 67, 70, 74, 85, 88 Embryo Transfer, 74, 85 Endogenous, 37, 69, 70, 74 Endothelium, 74, 82, 84 Endothelium-derived, 74, 82 End-stage renal, 72, 74 Environmental Health, 50, 52, 74 Enzymatic, 67, 70, 71, 75, 87 Enzyme, 66, 75, 77, 79, 81, 84, 86, 89, 91 Epidermis, 75, 86

Epithelial, 73, 75, 78, 80 Epithelial Cells, 75, 78, 80 Epithelium, 69, 74, 75, 87 Erythrocytes, 68, 70, 75, 77, 86 Esophagus, 74, 75, 76, 88 Exogenous, 74, 75 Extraction, 68, 75, 87 Extravasation, 75, 77 F Family Planning, 51, 75 Fat, 71, 73, 74, 75, 80 Fatty Liver, 6, 15, 24, 44, 45, 75 Fertilization in Vitro, 75, 85 Fetus, 67, 75, 84, 88, 90 Fibrinogen, 75, 84, 89 Fibrinolysis, 16, 75 Fibronectin, 10, 75 Folate, 34, 75 Folic Acid, 75 Forearm, 70, 75 G Gallbladder, 67, 69, 70, 71, 74, 75, 76, 77 Ganglion, 25, 76, 82 Gas, 71, 76, 78, 82, 91 Gastroenterology, 9, 14, 35, 44, 76 Gastrointestinal, 70, 76, 88 Gastrointestinal tract, 76, 88 Gene, 37, 70, 76, 82 Gestation, 5, 17, 24, 28, 30, 34, 36, 38, 76, 83, 84, 85, 88 Gestational, 15, 34, 39, 76 Gestational Age, 39, 76 Glomerular, 3, 76, 86 Glomeruli, 76 Glomerulonephritis, 42, 76 Glomerulus, 76 Glucocorticoid, 12, 73, 76 Glucose, 8, 73, 76, 77 Glucose Intolerance, 8, 73, 76 Glucose tolerance, 76 Glucose Tolerance Test, 76 Glucuronic Acid, 77 Glycoprotein, 75, 77, 80 Governing Board, 77, 85 Gravidity, 77, 83 Guanylate Cyclase, 77, 82 H Haematoma, 34, 77 Haemorrhage, 40, 42, 67, 77 Hematoma, 22, 25, 31, 33, 35, 36, 77 Hemoglobin, 68, 75, 77

95

Hemolysis, 3, 12, 14, 15, 16, 20, 22, 23, 24, 25, 29, 33, 34, 38, 39, 44, 77 Hemolytic, 34, 77 Hemorrhage, 22, 26, 35, 44, 77, 86 Hemostasis, 7, 15, 33, 42, 77, 88, 89 Heparin, 41, 77 Hepatic, 11, 12, 14, 22, 23, 24, 27, 33, 34, 35, 36, 44, 45, 71, 76, 77 Hepatic Artery, 14, 77 Hepatitis, 26, 44, 78, 91 Hepatocellular, 15, 78 Hepatocyte, 10, 71, 78 Hepatocyte Growth Factor, 10, 78 Hepatotoxic, 44, 78 Heredity, 76, 78 Hormonal, 73, 78 Hormone, 70, 73, 78, 89 Hydrogen, 67, 71, 78, 81, 83, 86 Hyperbilirubinemia, 78, 79 Hyperemesis, 44, 45, 78 Hypertension, 5, 10, 12, 18, 20, 21, 25, 28, 29, 33, 39, 44, 71, 78, 85, 87, 90 Hypoglycemia, 28, 35, 78 I Idiopathic, 17, 78 Immune function, 13, 78 Immune response, 68, 69, 73, 78, 91 Immunoglobulins, 25, 78, 84 Immunologic, 76, 78 Immunosuppressive, 76, 78 Implantation, 72, 78 In vivo, 77, 78 Incision, 70, 78, 79 Infarction, 14, 23, 27, 78 Infection, 69, 73, 78, 91 Infiltration, 76, 79 Inflammation, 68, 71, 78, 79, 83, 85, 88, 90 Initiator, 79 Interferon, 79 Interleukin-1, 13, 79 Interleukin-12, 13, 79 Interleukin-2, 79 Interstitial, 79, 86 Intoxication, 79, 89 Intracellular, 79, 82, 86 Intrahepatic, 25, 35, 44, 45, 79 Intravenous, 25, 28, 79 Intrinsic, 69, 79 Invasive, 79, 80 Ions, 74, 78, 79, 86 Isoenzymes, 26, 79

J Jaundice, 44, 78, 79 K Kb, 50, 80 L Laminin, 69, 80 Lesion, 3, 80 Leukoencephalopathy, 18, 80 Lipid, 7, 69, 80 Liver Transplantation, 6, 30, 36, 80 Localized, 77, 79, 80, 82, 84 Lupus, 6, 27, 29, 68, 80, 89 Lymphocytes, 68, 79, 80, 81, 88, 91 Lymphoid, 68, 80 M Macrophage, 79, 80 Magnetic Resonance Imaging, 9, 80 Magnetic Resonance Spectroscopy, 5, 80 Malaise, 16, 80 Malignant, 68, 80, 81, 87 Maternal Mortality, 32, 80 Mediator, 79, 80, 88 MEDLINE, 51, 80 Membranes, 71, 79, 80, 81, 84, 87 Metabolic disorder, 73, 81 MI, 66, 81 Microbiology, 69, 81 Middle Cerebral Artery, 29, 81 Mineralocorticoids, 67, 73, 81 Mitochondrial Swelling, 81 Molecular, 51, 53, 72, 75, 77, 81, 84, 86 Molecule, 68, 71, 74, 81, 83, 86 Monocytes, 79, 81 Motility, 81, 88 Mucinous, 76, 81 Mucosa, 80, 81 Myocardial infarction, 18, 72, 81 Myocardium, 81 Myopia, 81, 87 N Natural killer cells, 79, 81 Necrosis, 3, 6, 8, 9, 27, 78, 81 Neonatal, 5, 20, 28, 29, 30, 37, 81 Neoplasm, 81, 87, 90 Nerve, 76, 80, 82, 87, 88 Neural, 70, 82, 87 Neuropeptide, 70, 82 Neurotransmitter, 67, 70, 82 Nitric Oxide, 41, 82 Normotensive, 32, 40, 42, 82 Nuclear, 23, 69, 74, 76, 81, 82 Nuclei, 74, 80, 82, 83, 86

96

HELLP Syndrome

Nursing Care, 82, 83 O Ocular, 5, 82 Oedema, 82, 85 Omentum, 77, 82 Oncogene, 78, 82 Ophthalmic, 82, 87 Opsin, 82, 87 Optic Nerve, 82, 87 Osteoclasts, 70, 83 Ovum, 73, 76, 83, 91 Oxidation, 17, 67, 83 P Pancreas, 67, 74, 76, 77, 83 Pancreatic, 83 Pancreatitis, 6, 14, 83 Paralysis, 24, 83 Parity, 39, 83 Pathogenesis, 31, 44, 83 Pathologic, 3, 21, 72, 78, 83 Pathologies, 9, 83 Pathophysiology, 16, 83 Patient Care Management, 44, 83 Pelvis, 83, 90 Peptide, 67, 70, 83, 86 Perinatal, 5, 8, 9, 12, 13, 14, 18, 21, 28, 35, 39, 40, 41, 83 Perivascular, 70, 83 Petechiae, 77, 83 Pharmacologic, 83, 90 Phospholipids, 68, 71, 75, 83 Physical Examination, 76, 84 Physiologic, 84, 86 Physiology, 76, 84 Pigment, 84, 87 Pituitary Gland, 73, 84 Placenta, 37, 84, 86 Plants, 71, 76, 84, 90 Plasma, 6, 10, 21, 25, 31, 32, 68, 70, 71, 75, 76, 77, 81, 84, 86 Plasma cells, 68, 84 Plasma protein, 84, 86 Plasmapheresis, 14, 41, 84 Plasmin, 84 Plasminogen, 10, 84 Plasminogen Activators, 84 Platelet Aggregation, 82, 84 Platelet Count, 10, 22, 23, 25, 34, 39, 85 Platelets, 3, 12, 14, 15, 16, 20, 22, 24, 29, 33, 38, 44, 82, 84, 85, 89 Pneumonia, 72, 85 Posterior, 18, 74, 83, 85

Potentiates, 79, 85 Practice Guidelines, 52, 85 Precursor, 75, 84, 85, 86, 90 Preeclampsia, 3, 7, 9, 11, 13, 14, 16, 20, 22, 23, 24, 26, 27, 29, 30, 31, 32, 33, 36, 37, 40, 42, 44, 45, 56, 85 Pre-Eclampsia, 5, 13, 15, 28, 29, 30, 31, 33, 37, 85 Pre-eclamptic, 8, 74, 85 Pregnancy Outcome, 33, 36, 85 Pregnancy Tests, 76, 85 Pregnancy Toxemias, 44, 85 Prevalence, 23, 85 Progression, 11, 33, 40, 85 Progressive, 72, 81, 85, 86, 90 Propofol, 40, 85 Prospective study, 20, 38, 85 Proteins, 67, 68, 72, 79, 81, 83, 84, 86, 88, 90 Proteinuria, 3, 41, 85, 86 Proteoglycans, 69, 86 Prothrombin, 8, 86, 89 Protons, 78, 80, 86 Public Policy, 51, 86 Puerperium, 85, 86 Pulmonary, 18, 33, 70, 86 Pulmonary Artery, 70, 86 Pulmonary Edema, 18, 86 Purpura, 15, 17, 77, 86 Q Quality of Life, 86, 88 R Radiography, 76, 86 Receptor, 17, 68, 78, 86, 88 Receptors, Serotonin, 86, 88 Recombinant, 37, 86 Red blood cells, 75, 77, 86 Reductase, 29, 86 Refer, 1, 70, 86 Refractory, 7, 9, 86 Renal failure, 3, 86 Renal Replacement Therapy, 10, 86 Reproduction Techniques, 85, 86 Retina, 72, 73, 81, 82, 87, 91 Retinal, 8, 9, 82, 87 Retinal Detachment, 8, 87 Retinal Vein, 9, 87 Retinal Vein Occlusion, 9, 87 Retinol, 87 Rhodopsin, 82, 87 Risk factor, 24, 44, 85, 87 Rods, 87

97

S Salivary, 73, 74, 87 Salivary glands, 73, 74, 87 Sarcoma, 14, 87 Screening, 39, 72, 87, 90 Secretion, 73, 81, 87 Sediment, 87, 90 Sensibility, 67, 87 Serotonin, 35, 82, 86, 88, 90 Serous, 8, 74, 88 Serum, 13, 26, 35, 81, 88 Sex Ratio, 13, 88 Side effect, 88, 89 Specialist, 57, 88 Species, 88, 90 Spinal cord, 71, 76, 88 Spleen, 73, 88 Splenectomy, 17, 88 Spontaneous Abortion, 85, 88 Steatosis, 75, 88 Steroids, 73, 76, 88 Stillbirth, 85, 88 Stimulus, 88, 89 Stomach, 67, 69, 74, 75, 76, 77, 78, 82, 88 Striate, 73, 88 Subcapsular, 24, 31, 33, 34, 36, 88 Supportive care, 3, 88 Suppression, 73, 88 Symptomatic, 83, 88 Systemic, 68, 70, 79, 82, 88 Systemic lupus erythematosus, 68, 88 Systolic, 78, 89 T Tendon, 76, 89 Testosterone, 86, 89 Threshold, 4, 78, 89 Thrombin, 75, 84, 86, 89 Thrombocytes, 85, 89 Thrombocytopenia, 15, 34, 40, 89 Thrombolytic, 84, 89 Thrombopenia, 68, 89 Thrombophilia, 18, 89 Thromboses, 68, 89 Thrombosis, 6, 7, 14, 15, 23, 33, 41, 42, 89

Thrombus, 33, 72, 78, 85, 89 Thyroid, 70, 89 Tissue, 68, 69, 70, 72, 74, 77, 78, 79, 80, 81, 82, 83, 84, 87, 88, 89, 90 Tone, 82, 89 Tonicity, 77, 89 Torsion, 78, 89 Toxaemia, 85, 89 Toxemia, 44, 89 Toxic, iv, 78, 89, 90 Toxicology, 52, 89 Toxins, 68, 77, 78, 89, 90 Transplantation, 6, 27, 33, 36, 37, 72, 74, 90 Trauma, 81, 83, 90 Tryptophan, 72, 88, 90 Tuberculosis, 80, 90 Tumour, 8, 76, 90 U Ultrasonography, 76, 90 Uraemia, 83, 90 Uremia, 86, 90 Urethra, 90 Urinalysis, 4, 90 Urine, 24, 67, 69, 70, 73, 86, 90 Uterus, 21, 67, 73, 90 V Vascular, 74, 78, 79, 82, 84, 85, 89, 90 Vasculitis, 83, 90 Vasodilator, 70, 90 Vein, 6, 14, 79, 82, 87, 90 Venous, 68, 71, 82, 85, 90 Venous blood, 85, 90 Veterinary Medicine, 51, 91 Viral, 44, 91 Viral Hepatitis, 44, 91 Virus, 91 Vitreous, 42, 87, 91 Vitreous Humor, 87, 91 Vitro, 74, 77, 78, 91 W White blood cell, 68, 80, 81, 84, 91 Womb, 90, 91 Z Zygote, 72, 91

98

HELLP Syndrome

99

100

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