Night Sweats: A Medical Dictionary, Bibliography, And Annotated Research Guide To Internet References

IGHT WEATS 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., 1960Night Sweats: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References / James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary, and index. ISBN: 0-597-84129-2 1. Night Sweats-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 night sweats. 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 NIGHT SWEATS ......................................................................................... 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Night Sweats................................................................................. 5 The National Library of Medicine: PubMed .................................................................................. 8 CHAPTER 2. BOOKS ON NIGHT SWEATS ......................................................................................... 15 Overview...................................................................................................................................... 15 Book Summaries: Online Booksellers........................................................................................... 15 Chapters on Night Sweats............................................................................................................ 15 CHAPTER 3. MULTIMEDIA ON NIGHT SWEATS............................................................................... 19 Overview...................................................................................................................................... 19 Video Recordings ......................................................................................................................... 19 CHAPTER 4. PERIODICALS AND NEWS ON NIGHT SWEATS............................................................ 23 Overview...................................................................................................................................... 23 News Services and Press Releases................................................................................................ 23 Academic Periodicals covering Night Sweats .............................................................................. 24 CHAPTER 5. RESEARCHING MEDICATIONS .................................................................................... 27 Overview...................................................................................................................................... 27 U.S. Pharmacopeia....................................................................................................................... 27 Commercial Databases ................................................................................................................. 28 APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 31 Overview...................................................................................................................................... 31 NIH Guidelines............................................................................................................................ 31 NIH Databases............................................................................................................................. 33 Other Commercial Databases....................................................................................................... 36 APPENDIX B. PATIENT RESOURCES ................................................................................................. 37 Overview...................................................................................................................................... 37 Patient Guideline Sources............................................................................................................ 37 Finding Associations.................................................................................................................... 43 APPENDIX C. FINDING MEDICAL LIBRARIES .................................................................................. 45 Overview...................................................................................................................................... 45 Preparation................................................................................................................................... 45 Finding a Local Medical Library.................................................................................................. 45 Medical Libraries in the U.S. and Canada ................................................................................... 45 ONLINE GLOSSARIES.................................................................................................................. 51 Online Dictionary Directories ..................................................................................................... 51 NIGHT SWEATS DICTIONARY ................................................................................................. 53 INDEX ................................................................................................................................................ 75

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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 night sweats 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 night sweats, 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 night sweats, 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 night sweats. 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 night sweats, 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 night sweats. 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 NIGHT SWEATS Overview In this chapter, we will show you how to locate peer-reviewed references and studies on night sweats.

The Combined Health Information Database The Combined Health Information Database summarizes studies across numerous federal agencies. To limit your investigation to research studies and night sweats, 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 “night sweats” (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: •

Physiology, Medical Management and Oral Implications of Menopause Source: JADA. Journal of the American Dental Association. 133(1): 73-81. January 2002. Contact: Available from American Dental Association. ADA Publishing Co, Inc., 211 East Chicago Avenue, Chicago, IL 60611. (312) 440-2867. Website: www.ada.org. Summary: Approximately 36 million women in the United States are in the postmenopausal phase of life. The physiological changes associated with spontaneous or surgical menopause (after surgical removal of both ovaries) cause some women to experience uncomfortable symptoms such as hot flashes, night sweats, and vaginal dryness. In addition, estrogen deprivation arising from menopause in association with age-related factors disproportionately increases the risk of developing cardiovascular disease, osteoporosis, Alzheimer disease, and oral disease. Hormone replacement

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therapy (HRT, featuring estrogen or estrogen and progestin) often is prescribed on a short term basis to alleviate the uncomfortable symptoms associated with estrogen deficiency and on a long term basis to prevent some of the chronic illnesses common to postmenopausal women. This article reviews the physiology, medical management, and oral implications of menopause. Dentists who treat women entering menopause need to consider the stressful phase of life their patients are experiencing. Clinical findings of postmenopausal problems on dental examination may include a lack of saliva, increased dental caries (cavities), dysesthesia (reduced or altered sense of feeling), taste alterations, atrophic gingivitis (inflammation of the gums), periodontitis, and osteoporotic jaws unsuitable for conventional prosthetic devices or dental implants. Panoramic dental radiographs may reveal calcified carotid artery atheromas. The author stresses that dentists have an opportunity to refer women who are not under the care of a gynecologist for an evaluation to determine the appropriateness of HRT for its systemic and oral health benefits. 1 figure. 111 references. •

Cranial Arteritis: A Medical Emergency With Orofacial Manifestations Source: Journal of the American Dental Association. JADA. 130(8): 1203-1209. August 1999. Summary: Cranial arteritis (CA), a vascular disease affecting mostly elderly people, may result in permanent blindness if untreated. Since it frequently mimics temporomandibular joint, myofascial or odontogenic pain, dentists must be familiar with this condition. In this article, the authors present reports of two patients who had signs and symptoms of CA, some of which were suggestive of other head and neck pain disorders. In both cases, the diagnosis of CA was confirmed by temporal artery biopsy, and treatment with systemic steroids resulted in rapid resolution of symptoms. The clinical manifestations of CA include a wide variety of local and systemic signs and symptoms. The disease may begin with a gradual onset of symptoms such as fatigue, anorexia, weight loss, mental confusion, or depression. One study indicated that up to 50 percent of CA cases are associated with polymyalgia rheumatica, a clinical syndrome that involves pain and stiffness of the shoulders and pelvic girdle, often accompanied by fever, night sweats, malaise, anorexia, and weight loss. The two syndromes frequently coexist and may be related. However, CA can lead to blindness, while polymyalgia rheumatica alone does not. The classic description of CA includes temporal headaches, scalp tenderness, and jaw claudication (muscle pain associated with function). Jaw claudication has been shown to be the strongest predictor of CA, and this diagnosis should be suspected in any elderly patient who complains of masticatory muscle pain during eating. 33 references.

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Hormone Replacement: More Than Just Estrogen Source: Diabetes Self-Management. 15(2): 58, 60-62. March-April 1998. Contact: Available from R.A. Rapaport Publishing, Inc. 150 West 22nd Street, New York, NY 10011. (800) 234-0923. Summary: This article focuses on the use of hormone replacement therapy following menopause to reduce the risk of heart disease in women, particularly women with diabetes. It describes the normal body changes that occur during menopause. Early signs of menopause include irregular periods, hot flashes, and night sweats. Menopause can also weaken the muscles and tissues of the vagina and the base of the bladder. The article identifies the potential benefits of hormone replacement therapy, including reducing the risk of heart disease and preventing osteoporosis. It highlights potential

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concerns about hormone replacement therapy, including impairing blood glucose control, affecting blood pressure, and increasing the risk of developing blood clots and breast and endometrial cancer. The article discusses the available choices for hormone replacement and stresses the need for women with diabetes to talk with a doctor about hormone replacement therapy. It also includes a list of organizations and books that provide information about menopause and the pros and cons of hormone replacement therapy. •

Nephrotoxicity Associated with Olsalazine Source: American Journal of Medicine. 100(2): 238-240. February 1996. Summary: This article reports the first recognized case of nephrotoxicity associated with the azodisalicylate preparation olsalazine. Mesalazine and olsalazine were developed to treat inflammatory bowel disease (IBD) because of adverse reactions to sulfasalazine. Nevertheless, these new 5-aminosalicylic acid (5-ASA) preparations had other types of drug toxicity, including nephrotoxicity associated with the mesalazine preparations. The case involved a 71-year-old white man with a 19-year history of Crohn's colitis who presented with fever, night sweats, and a 15-pound weight loss. The patient's colitis had been managed by episodic treatment of active disease with corticosteroids because of a remote unspecified adverse reaction to sulfasalazine. The authors describe the various diagnostic tests undertaken, noting that finally percutaneous renal biopsy revealed severe interstitial nephritis. Since the renal biopsy findings were consistent with a druginduced interstitial nephritis, the patient's olsalazine was discontinued (on the 18th hospital day). The patient quickly became afebrile. In addition, his ocular symptoms became less frequent and completely resolved 2 days after discontinuation of the olsalazine. One year after discharge, the patient remains asymptomatic, free of constitutional or visual symptoms, and with normal BUN and creatinine of 1.9 mg per dL. The authors conclude that the findings in this patient were similar to NSAID (nonsteroidal anti-inflammatory drugs) nephrotoxicity, but data from the literature are incomplete and fail to prove a common pathogenesis. 26 references. (AA-M).

Federally Funded Research on Night Sweats The U.S. Government supports a variety of research studies relating to night sweats. 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 night sweats. 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

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

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animals or simulated models to explore night sweats. The following is typical of the type of information found when searching the CRISP database for night sweats: •

Project Title: ALTERNATIVE THERAPIES FOR MENOPAUSE: A RANDOMIZED TRIAL Principal Investigator & Institution: Newton, Katherine M.; Associate Investigator; Center for Health Studies Seattle, Wa 98101 Timing: Fiscal Year 2002; Project Start 01-JUL-2000; Project End 30-NOV-2004 Summary: (Adapted from Investigator's Abstract) Hormone replacement therapy (HRT: estrogen and progestin) remains the treatment of choice for women with vasomotor symptoms, and long-term HRT has been recommended for prevention purposes. The demand for alternatives to HRT, and the availability and use of over-the-counter products including dietary phytoestrogen supplements and naturopathic medicines, has grown dramatically. Few of these products have faced the rigors of randomized trials and none have been tested to evaluate their effects on long-term outcomes. The purpose of this four-year randomized controlled trial is to evaluate the efficacy and safety of three alternative approaches utilizing phytoestrogens to treat vasomotor symptoms in peri- and postmenopausal women. The treatments were chosen because of the scientific evidence supporting a possible benefit, the availability of products with adequate quality control their frequency of use in naturopathic medicine, and our ability to blind participants to the intervention. The five proposed treatment arms are as follow: 1) esterified estrogen and micronized progesterone: 9) a single herbal product, black cohosh; 3) a multibotanical preparation; 4) a combination regimen that includes the same multibotanical preparation plus soy diet counseling; and 5) placebo. The primary aim is to compare the effects of three alternative treatments, HRT, and placebo on the frequency and intensity of vasomotor symptoms measured by The Wiklund Menopause Symptom Checklist and a daily Vasomotor Symptom Diary. The secondary aims are to compare the effects of three alternative treatments, HRT, and placebo on the following: 1) vaginal cytology (vaginal maturation index); 2) serum lipids (total cholesterol, HDL and LDL cholesterol, triglycerides); 3) bone mineral density (hip and spine dual energy x-ray absorptiometry scan); 4) glucose metabolism (insulin, fasting blood glucose); and 5) coagulation factors (fibrinogen, PAI-1). The hypotheses are that compared to placebo the three alternative treatments tested in this study will have the following effects: reduce frequency of hot flashes and night sweats, improve vaginal maturation and decrease vagina atrophy as measured by maturation index, lower total cholesterol and LDL with no effect on HDL, reduce the rate of decline in bone mineral density (BMD), and have no effect on glucose metabolism or clotting factors. To accomplish the specific aims the investigators propose to do the following: 1) recruit and randomize 400 periand post-menopausal women to one of five treatment arms for one year; 2) collect measurements of primary and secondary outcomes at baseline, three, six, and 12 months; and 3) compare changes in outcomes in the groups taking alternative treatments to those in the HRT and placebo groups. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: INFLUENCE OF SOY CONSUMPTION ON MENOPAUSE IN JAPAN Principal Investigator & Institution: Melby, Melissa K.; Anthropology; Emory University 1784 North Decatur Road Atlanta, Ga 30322 Timing: Fiscal Year 2002; Project Start 01-AUG-2002

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Summary: (provided by applicant): For two decades, anthropologists have been aware that the experience and symptoms of menopause (i.e., hot flashes, night sweats) may not be universal. Several researchers have hypothesized that dietary factors such as phytoestrogens (plant estrogenic chemicals) in soy, which is consumed in great quantities by the Japanese, may play a role in their lower rate of menopausal symptoms. This dissertation project will test a biocultural, reproductive ecology model of whether and how soy consumption affects the menopausal transition (konenki) in Japan. Specifically, we hypothesize that: (1) Women with higher phytoestrogen exposure/intake will have less frequent or severe midlife symptoms; and (2) Variance in gonadotropins (FSH and LH) will be negatively correlated with phytoestrogen exposure. Two populations of Japanese women, aged 45-55, from the Tohoku and Kinki regions of Japan (which have the highest and lowest soy consumption respectively, providing a natural experiment in phytoestrogen exposure) will be sampled longitudinally for levels of E2, FSH, LH, SHBG, and the phoytoestrogens genistein and diadzein. This study will characterize the menopausal transition in Japan from multiple perspectives: (1) endocrinological/physiological; (2) ecological (diet), and (3) experimental. By combining new assays for measurement of phytoestrogens with our well-validated finger prick blood spot methods, this project will provide a biocultural characterization of menopause in Japan. These data are sorely needed to model crosscultural variation at the end of the reproductive lifespan, and the influence of the environment on endocrinology and experience over the menopausal transition. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: MELATONIN FOR SLEEP DISTURBANCES DURING MENOPAUSE Principal Investigator & Institution: Suhner, Andrea G.; Scripps Research Institute Tpc7 La Jolla, Ca 92037 Timing: Fiscal Year 2001; Project Start 30-SEP-2001; Project End 16-MAR-2003 Summary: Up to half of all women going through menopause report significant sleep disturbance. A number of factors contribute to these sleep problems, with hormonal imbalance and hot flashes being the most important. Estrogen replacement therapy can alleviate these symptoms, yet side effects and contraindications make the use of this hormone replacement therapy (HRT) problematic in many women. As such, alternatives to traditional HRT are needed. Previous work in our lab has indicated that not only low levels of sex steroids but also the marked increase of gonadotropins observed during the menopause transition may play an important role in disturbed sleep experienced by peri- and postmenopausal women. In particular, our studies have shown that elevated levels of luteinizing hormone (LH) or a high ratio of LH-to-estradiol were associated with low sleep- efficiency in postmenopausal women. Hormonal imbalance also induces changes in the thermoregulatory system. The result is hot flashes and sweats, which can adversely affect night-time sleep quality The proposed study will test the hypothesis that exogenous melatonin decreases LH levels and in so doing, increases sleep quality. Furthermore, we hypothesize that melatonin will reduce severity and number of hot flashes by virtue of its temperature-lowering effect. As a consequence, the number of awakenings due to nocturnal hot flashes and night sweats will be reduced, leading to improved sleep quality. To test these hypotheses, twelve symptomatic peri- or postmenopausal women between the ages of 45-55 will ingest a daily dose of 3 mg melatonin or placebo every evening at bedtime over a period of 14 days. Each subject will undergo both conditions. At the end of each treatment session, subjects will spend two consecutive nights in the sleep laboratory. Polysomnographic sleep variables and core body temperature will be recorded continuously on both nights. Hot flashes will be

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objectively identified by measuring distal skin temperature and proximal skin resistance. Over-night urine samples will be collected to assess LH levels. Sleep parameters, temperature data, number of hot flashes and LH levels will be compared across active and control condition. The current project is an important first step to identify and assess a promising alternative for sleep disturbances in menopause. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: MENOPAUSAL SYMPTOMS STUDY Principal Investigator & Institution: Woods, Margo N.; New England Medical Center Hospitals 750 Washington St Boston, Ma 021111533 Timing: Fiscal Year 2001 Summary: This study aims to identify a safe and effective alternative to hormone replacement therapy to treat menopausal symptoms in women at increased risk for breast cancer. Women at high risk for breast cancer with frequent menopausal symptoms will be recruited to investigate the effect of a soy dietary supplement bar on their menopausal symptoms and serum hormone levels. Women with frequent hot flashes or night sweats will be randomized using a double-blind, cross-over study design to receive either a placebo bar or a soy dietary supplement bar. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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

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A simple clinical staging system that predicts progression to AIDS using CD4 count, oral thrush, and night sweats. Author(s): Rabeneck L, Crane MM, Risser JM, Lacke CE, Wray NP. Source: Journal of General Internal Medicine : Official Journal of the Society for Research and Education in Primary Care Internal Medicine. 1993 January; 8(1): 5-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8093485&dopt=Abstract

PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM) at the National Institutes of Health (NIH). The PubMed database was developed in conjunction with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text journal articles at Web sites of participating publishers. Publishers that participate in PubMed supply NLM with their citations electronically prior to or at the time of publication.

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Are night sweats a sign of esophageal reflux? Author(s): Reynolds WA. Source: Journal of Clinical Gastroenterology. 1989 October; 11(5): 590-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2794443&dopt=Abstract

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Benztropine for venlafaxine-induced night sweats. Author(s): Pierre JM, Guze BH. Source: Journal of Clinical Psychopharmacology. 2000 April; 20(2): 269. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10770471&dopt=Abstract

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Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 1-2003. A 43-year-old man with fever and night sweats. Author(s): Tanoue LT, Mark EJ. Source: The New England Journal of Medicine. 2003 January 9; 348(2): 151-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12519926&dopt=Abstract

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Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 23-2002. A 73-year-old man with leg pains, occipital headaches, and night sweats. Author(s): Docken WP, Mark EJ. Source: The New England Journal of Medicine. 2002 July 25; 347(4): 272-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12140304&dopt=Abstract

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Common causes of night sweats in various populations. Author(s): Taylor RD. Source: American Family Physician. 2003 October 1; 68(7): 1264. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14567481&dopt=Abstract

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Descriptive epidemiology of night sweats upon admission to a university hospital. Author(s): Lea MJ, Aber RC. Source: Southern Medical Journal. 1985 September; 78(9): 1065-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4035433&dopt=Abstract

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Diabetes mellitus, AIDS, and night sweats. Author(s): Silbert PL. Source: Lancet. 1989 November 25; 2(8674): 1285. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2573805&dopt=Abstract

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Diagnosing night sweats requires clear definition. Author(s): Mold JW. Source: American Family Physician. 2003 October 1; 68(7): 1264, 1266; Author Reply 1266. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14567482&dopt=Abstract

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Diagnosing night sweats. Author(s): Viera AJ, Bond MM, Yates SW. Source: American Family Physician. 2003 March 1; 67(5): 1019-24. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12643362&dopt=Abstract

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Fever, weight loss, and night sweats: infection or malignancy? Author(s): Winter AJ, Wiselka MJ, Wilde JT, Radcliffe KW. Source: Sexually Transmitted Infections. 1998 December; 74(6): 439-44. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10195055&dopt=Abstract

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Flushes, night sweats and palpitations need to be treated seriously. Author(s): Maartens R, MacDonald H, van der Westhuizen A. Source: South African Medical Journal. Suid-Afrikaanse Tydskrif Vir Geneeskunde. 1996 February; 86(2): 186-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8619161&dopt=Abstract

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Frequently asked questions from clinical practice. What is the appropriate diagnostic approach for patients who complain of night sweats? Author(s): Chambliss ML. Source: Archives of Family Medicine. 1999 March-April; 8(2): 168-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10101988&dopt=Abstract

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Mediastinal mass with fever and night sweats in a young farmer--potential pitfalls in the diagnostic work-up and treatment. Author(s): Joss RA, Gebbers JO. Source: Annals of Oncology : Official Journal of the European Society for Medical Oncology / Esmo. 1993 November; 4(9): 781-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7506571&dopt=Abstract

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Night sweats and swollen glands. Author(s): McCluskey DR, Buckley MR, McCluggage WG. Source: Lancet. 1998 March 7; 351(9104): 722. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9504518&dopt=Abstract

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Night sweats in Hodgkin's disease. A manifestation of preceding minor febrile pulses. Author(s): Gobbi PG, Pieresca C, Ricciardi L, Vacchi S, Bertoloni D, Rossi A, Grignani G, Rutigliano L, Ascari E. Source: Cancer. 1990 May 1; 65(9): 2074-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2372772&dopt=Abstract

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Night sweats in prostatic cancer. Author(s): Moore CB. Source: Jama : the Journal of the American Medical Association. 1969 April 7; 208(1): 155. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5818506&dopt=Abstract

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Night sweats redux. Author(s): Stuart LA. Source: Hosp Pract (Off Ed). 1993 November 15; 28(11): 23. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8227245&dopt=Abstract

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Night sweats redux. Author(s): Bozymski EM. Source: Hosp Pract (Off Ed). 1993 November 15; 28(11): 23. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8227244&dopt=Abstract

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Night sweats. Author(s): Geiderman JM. Source: Annals of Emergency Medicine. 1997 August; 30(2): 237-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9250655&dopt=Abstract

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Night sweats. Author(s): Cowley DM. Source: Hosp Pract (Off Ed). 1993 September 30; 28(9A): 16. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8408355&dopt=Abstract

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Night sweats. Author(s): Fred HL. Source: Hosp Pract (Off Ed). 1993 August 15; 28(8): 88. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8340435&dopt=Abstract

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Night sweats. A dominant symptom in diabetes insipidus. Author(s): Raff SB, Gershberg H. Source: Jama : the Journal of the American Medical Association. 1975 December 22; 234(12): 1252-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1242752&dopt=Abstract

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Night sweats: two other causes. Author(s): Gordon DS. Source: Jama : the Journal of the American Medical Association. 1994 May 25; 271(20): 1577. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8182807&dopt=Abstract

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Night sweats: two other causes. Author(s): Duhon DR. Source: Jama : the Journal of the American Medical Association. 1994 May 25; 271(20): 1577. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8182806&dopt=Abstract

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Night sweats--presentation of an often forgotten diagnosis. Author(s): Morris GC, Thomas TP. Source: Br J Clin Pract. 1991 Summer; 45(2): 145. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1793701&dopt=Abstract

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Nonproductive cough, dyspnea, malaise, and night sweats in a 47-year-old woman. Author(s): Adlakha A, Kang E, Adlakha K, Ryu JH. Source: Chest. 1996 May; 109(5): 1385-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8625694&dopt=Abstract

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Pathologic quiz case: a 43-year-old man with fatigue and night sweats. Author(s): O'Quinn K. Source: Archives of Pathology & Laboratory Medicine. 2001 June; 125(6): 838-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11371247&dopt=Abstract

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Prevalence of night sweats in primary care patients: an OKPRN and TAFP-Net collaborative study. Author(s): Mold JW, Mathew MK, Belgore S, DeHaven M. Source: The Journal of Family Practice. 2002 May; 51(5): 452-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12019054&dopt=Abstract

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Sertraline-related night sweats. Author(s): Ahmed A. Source: The American Journal of Geriatric Psychiatry : Official Journal of the American Association for Geriatric Psychiatry. 2002 July-August; 10(4): 484. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12095910&dopt=Abstract

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Sertraline-related night sweats. Author(s): Babbott SF, Pearson VE. Source: Annals of Internal Medicine. 1999 February 2; 130(3): 242-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10049212&dopt=Abstract

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Significance of night sweats. Author(s): McWhinney IR. Source: The Journal of Family Practice. 2002 May; 51(5): 457-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12019055&dopt=Abstract

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Thalidomide for distressing night sweats in advanced malignant disease. Author(s): Deaner P. Source: Palliative Medicine. 1998 May; 12(3): 208-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9743843&dopt=Abstract

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Thalidomide for night sweats in patients with advanced cancer. Author(s): Calder K, Bruera E. Source: Palliative Medicine. 2000 January; 14(1): 77-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10717731&dopt=Abstract

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The haemodialysis patient with night sweats, ascites, and increased CA 125. Author(s): Sessler R, Konyar H, Hasche G, Olbricht CJ. Source: Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association. 2001 January; 16(1): 175-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11209018&dopt=Abstract

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CHAPTER 2. BOOKS ON NIGHT SWEATS Overview This chapter provides bibliographic book references relating to night sweats. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on night sweats 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 “night sweats” at online booksellers’ Web sites, you may discover non-medical books that use the generic term “night sweats” (or a synonym) in their titles. The following is indicative of the results you might find when searching for “night sweats” (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): •

Night Sweats by Thom Gunn; ISBN: 0941150607; http://www.amazon.com/exec/obidos/ASIN/0941150607/icongroupinterna

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Night Sweats [DOWNLOAD: MICROSOFT READER] by Victoria Manley (2003); ISBN: B00009M9IN; http://www.amazon.com/exec/obidos/ASIN/B00009M9IN/icongroupinterna

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The Man With Night Sweats by Thom Gunn; ISBN: 0374523819; http://www.amazon.com/exec/obidos/ASIN/0374523819/icongroupinterna

Chapters on Night Sweats In order to find chapters that specifically relate to night sweats, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search

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to book chapters and night sweats 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 “night sweats” (or synonyms) into the “For these words:” box. The following is a typical result when searching for book chapters on night sweats: •

Common Side Effects of Insulin Source: in Carlisle, B.A.; Kroon, L.A.; Koda-Kimble, M.A. 101 Medication Tips for People with Diabetes. Alexandria, VA: American Diabetes Association. 1999. p. 62-65. Contact: Available from American Diabetes Association (ADA). Order Fulfillment Department, P.O. Box 930850, Atlanta, GA 31193-0850. (800) 232-6733. Fax (770) 4429742. Website: www.diabetes.org. PRICE: $14.95 plus shipping and handling. ISBN: 1580400329. Order number 483301. Summary: This chapter identifies the common side effects of insulin, including weight gain, hypoglycemia, and lumps at the injection site. Although most people who use insulin will gain weight, it can be minimized by properly adjusting the dose to just the right amount a person needs to keep blood glucose levels within the target range without causing too many lows. People who experience night sweats and morning headaches may be injecting too much insulin in relation to their evening meal or too much of the wrong type of insulin. Testing blood glucose at 3:00 a.m. and again first thing in the morning for several days may help determine whether a change needs to be made to the insulin regimen. Lumps and fat pads, which are not dangerous, occur when insulin is repeatedly injected into the same place. If injection sites are carefully rotated, a person should not have to use the same site more than once every 2 weeks.

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Chapter 21-C: Vasculitides: Giant Cell Arteritis, Polymyalgia Rheumatica, and Takayasu's Arteritis Source: in Klippel, J.H., et al., eds. Primer on the Rheumatic Diseases. 12th ed. Atlanta, GA: Arthritis Foundation. 2001. p. 397-405. Contact: Available from Arthritis Foundation. P.O. Box 1616, Alpharetta, GA 300091616. (800) 207-8633. Fax (credit card orders only) (770) 442-9742. Website: www.arthritis.org. PRICE: $69.95 plus shipping and handling. ISBN: 0912423293. Summary: This chapter provides health professionals with information on the epidemiology, etiology, pathogenesis, clinical features, diagnosis, and treatment of giant cell arteritis (GCA), polymyalgia rheumatica (PMR), and Takayasu's arteritis (TA). GCA, also known as temporal arteritis, occurs more frequently in women than in men and is most likely to occur in people older than 50 years. The prevalence is highest in Scandinavian countries and in regions settled by people of northern European descent. This suggests an inherited risk. GCA presents with two major symptomatic complexes: signs of vascular insufficiency resulting from impaired blood flow and signs of systemic inflammation. The extracranial branches of the carotid arteries are most often affected. The predominant histologic feature of GCA is a mononuclear cell infiltrate dominated by T lymphocytes and macrophages that penetrate all layers of the wall of a mid sized artery. There is no pathognomonic laboratory test for GCA, and specific autoantibodies have not been identified. Diagnosis is based on clinical features and arterial biopsy results. Corticosteroids are effective in suppressing the symptoms. No other immunosuppressive agent used to manage other rheumatic diseases has proved useful in treating GCA. Vision loss, the most feared complication of GCA, can be prevented

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with early diagnosis and prompt treatment. PMR, a syndrome of muscle pain and stiffness in the neck, shoulders, and hips, can accompany, precede, or follow GCA, but it may also occur independently. The disease appears more frequently in women than in men and is more prevalent in Scandinavians and people of northern European descent. The cause of PMR is unknown. Most pathogenic abnormalities in people who have PMR are similar to those of GCA, supporting the emerging concept that PMR is a GCA variant characterized by dominance of the systemic inflammatory syndrome over the vascular component. The onset of PMR is abrupt and the myalgias are symmetrical and initially affect the shoulders. Malaise, weight loss, sweats, and low grade fever are common. The diagnosis of PMR is a clinical one. The differential diagnosis includes arthropathies, shoulder disorders, inflammatory myopathies, hypothyroidism, Parkinson's disease, malignancies, and infections. Although PMR is responsive to corticosteroid therapy, a critical issue in treating the disease is the dosage required for successful suppression of symptoms because the steroid requirements may differ markedly among patients. PMR is self limiting in most patients. TA is a rare granulomatous polyarteritis of the large elastic arteries, but it also may affect the coronary and pulmonary arteries. The disease affects primarily adolescent girls and young women. Incidence rates are highest in Asia. Although the etiology of TA is unknown, microbial infections have been implicated; however, no conclusive evidence for infectious organisms has been found. Clinical manifestations include fever, night sweats, malaise, anorexia, weight loss, diffuse myalgias, neurologic and ophthalmologic symptoms, and cardiac disease. Diagnosis is made by characteristic findings on vascular imaging. Corticosteroids are the therapy of choice for TA. Early diagnosis, immunosuppression, and aggressive surgical management have led to improved prognosis. 4 figures and 21 references. •

Week Two: Nutrition Basics Source: in Green, W.F. First Year: Hepatitis B. New York, NY: Marlowe and Company. 2002. p. 87-98. Contact: Available from Marlowe and Company. 161 William Street, 16th Floor, New York, NY 10038. PRICE: $15.95 plus shipping and handling. ISBN: 1569245339. Summary: Viral hepatitis B (liver infection) is one of the most preventable medical conditions due to the availability of a hepatitis B vaccine, yet an estimated 100,000 people in the United States are infected each year, and 6,000 die from complications. When the author of this book was diagnosed in 1993, he decided to be proactive in his quest to understand and manage his illness. In this chapter, the author focuses on what readers can expect to experience during the second week after they receive their diagnosis of hepatitis B virus HBV) infection, discussing the issue of nutrition. The chapter is in two parts: first, a focus on the psychosocial aspects that the reader might experience, followed by a section of instructional material. In nontechnical language, the author reviews the basic building blocks of nutrition (including proteins, fats, carbohydrates, vitamins, minerals, antioxidants, supplements), and the role of the liver in processing those nutrients. The second section outlines other symptoms that may be due to HBV (beyond fatigue, which was discussed in a previous chapter). These can include liver pain or discomfort, joint pain, gastrointestinal symptoms, varicose veins, night sweats, rashes, and itching.

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CHAPTER 3. MULTIMEDIA ON NIGHT SWEATS Overview In this chapter, we show you how to keep current on multimedia sources of information on night sweats. We start with sources that have been summarized by federal agencies, and then show you how to find bibliographic information catalogued by the National Library of Medicine.

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

AIDS: Profile of an Epidemic, Update Contact: Indiana University, Audio - Visual Center, Bloomington, IN, 47405, (812) 3358087. Summary: This video presents all known aspects of AIDS, bringing together both noted personalities (such as Ed Asner who introduces the topic) and experts from related fields--physicians, biochemists immunologists--to discuss cause, transmission, and signs and symptoms. Since the disease was first described in 1981, 60,000 people have contracted it. Of this number, 72 percent are homosexual or bisexual men. Infection in the remaining cases has been through contaminated transfused blood or contaminated needles used by intravenous drug addicts. Several AIDS patients and their physicians are interviewed and describe physical symptoms and emotional responses to the disease. Symptoms include unexplained fever for longer than a week, weight loss, swollen glands, night sweats, mood changes, shortness of breath, and diarrhea. The cause is a human retrovirus. Now, meticulous screening of blood products has virtually eliminated that as a source of infection. Extensive research is also under way to develop

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vaccines to prevent AIDS and new drugs to combat the disease once it has been identified in individuals. Most AIDS patients receive emotional support and counseling from physicians, psychologists, and nurses. The content included in this video adds immeasurably to our knowledge about AIDS. Audience: general public, health care professionals and students, and all those who care for AIDS patients. (Producer's abstract). •

Now That You Know: Living Healthy With HIV; Part 4 - Understanding Treatment Contact: Kaiser Permanente, National Video Communications, 825 Colorado Blvd Ste 301, Los Angeles, CA, 90041, (323) 259-4776, http://www.kaiserpermanente.org/locations/index.html. Summary: This videorecording tells persons with Human immunodeficiency virus (HIV) infection about symptoms, opportunistic infections, and available treatment. Narrators Bob Goen and Susan Campos introduce the material by saying that infected persons need to take control of their own health, become educated, and become informed. The main portion of the videorecording opens with a segment on azidothymidine (AZT). It discusses early intervention and when it is appropriate to begin treatment. A model demonstrates how antiviral treatment, such as AZT intervention, slows the rate of growth. Viewers are warned that being on antiviral therapy does not prevent them from being infectious. Possible side effects of the medication are discussed. After turning to general background information on opportunistic infections, that videorecording takes a detailed look at some of the most common. It classifies symptoms into infections that do not lead to an AIDS diagnosis, such as candida, shingles, and weight loss; nonspecific symptoms, such as fatigue, fever, and night sweats; and opportunistic infections that lead to an AIDS diagnosis. Of those, it takes the most detailed looks at Pneumocystis carinii pneumonia (PCP), cytomegalovirus retinitis (CMV) infection, toxoplasmosis, and mycobacterium avium intracellulare (MAI). Holistic therapies are considered briefly at the conclusion of the videorecording.

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Talking About AIDS: One Man's Story Contact: Northwestern Michigan College, Student Health Services, 1701 E Front St, Traverse City, MI, 49684, (616) 922-1255. Summary: This videotape highlights the life and death of Tom Judd, an artist and AIDS patient who worked with high school students and community groups to educate people about the ravages of the disease and the dangers of high-risk behavior. The tape contains interviews with Mr. Judd, his family members and friends, and uses old photographs and home video recordings to chronicle his life and illustrate the pain he endured during his last few years. Mr. Judd's goal was to reach high school and college students and convince this segment of the population that they are at very high risk of becoming HIV-positive, and that they must aggressively alter the trend of high-risk, unsafe sex practices. The audience will see Mr. Judd progress from a man who appears outwardly healthy through the final days of chronic diarrhea and exhaustion to Kaposis sarcoma to night sweats and dangerously high fevers. Mr. Judd also addresses the psychological and social issues surrounding AIDS patients, including potential isolation, boredom, loneliness and abandonment.

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Facing AIDS: Teens Ask a Young Man What It's Like Contact: New York Department of Health, Corning Tower Rm 1084, Empire State Plz, Albany, NY, 12237, (518) 474-5370. Summary: Using a question-and-answer format, this videorecording presents a group of teenagers and a young man with Acquired immunodeficiency syndrome (AIDS) discussing the impact the disease has made on his life. Peer pressure, drugs, and alcohol are discussed as factors contributing to human immunodeficiency virus (HIV) transmission. High-risk individuals and risky behaviors are identified. Symptoms of the disease are mentioned, including night sweats, fever, and swollen lymph nodes. Psychosocial factors are enumerated, with particular emphasis on isolation, thoughts of suicide, fear, and the need for hope.

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CHAPTER 4. PERIODICALS AND NEWS ON NIGHT SWEATS Overview In this chapter, we suggest a number of news sources and present various periodicals that cover night sweats.

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

Night sweats common among adult primary care patients Source: Reuters Medical News Date: June 03, 2002

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The NIH Within MEDLINEplus, the NIH has made an agreement with the New York Times Syndicate, the AP News Service, and Reuters to deliver news that can be browsed by the public. Search news releases at http://www.nlm.nih.gov/medlineplus/alphanews_a.html. MEDLINEplus allows you to browse across an alphabetical index. Or you can search by date at the following Web page: http://www.nlm.nih.gov/medlineplus/newsbydate.html. Often, news items are indexed by MEDLINEplus within its search engine. Business Wire Business Wire is similar to PR Newswire. To access this archive, simply go to http://www.businesswire.com/. You can scan the news by industry category or company name. Market Wire Market Wire is more focused on technology than the other wires. To browse the latest press releases by topic, such as alternative medicine, biotechnology, fitness, healthcare, legal, nutrition, and pharmaceuticals, access Market Wire’s Medical/Health channel at http://www.marketwire.com/mw/release_index?channel=MedicalHealth. Or simply go to Market Wire’s home page at http://www.marketwire.com/mw/home, type “night sweats” (or synonyms) into the search box, and click on “Search News.” As this service is technology oriented, you may wish to use it when searching for press releases covering diagnostic procedures or tests. Search Engines Medical news is also available in the news sections of commercial Internet search engines. See the health news page at Yahoo (http://dir.yahoo.com/Health/News_and_Media/), or you can use this Web site’s general news search page at http://news.yahoo.com/. Type in “night sweats” (or synonyms). If you know the name of a company that is relevant to night sweats, you can go to any stock trading Web site (such as http://www.etrade.com/) and search for the company name there. News items across various news sources are reported on indicated hyperlinks. Google offers a similar service at http://news.google.com/. BBC Covering news from a more European perspective, the British Broadcasting Corporation (BBC) allows the public free access to their news archive located at http://www.bbc.co.uk/. Search by “night sweats” (or synonyms).

Academic Periodicals covering Night Sweats Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to night sweats. In addition to

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

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CHAPTER 5. RESEARCHING MEDICATIONS Overview While a number of hard copy or CD-ROM resources are available for researching medications, a more flexible method is to use Internet-based databases. Broadly speaking, there are two sources of information on approved medications: public sources and private sources. We will emphasize free-to-use public sources.

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

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following drugs have been mentioned in the Pharmacopeia and other sources as being potentially applicable to night sweats: Rifabutin •

Systemic - U.S. Brands: Mycobutin http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202683.html

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

Mosby’s Drug Consult Mosby’s Drug Consult database (also available on CD-ROM and book format) covers 45,000 drug products including generics and international brands. It provides prescribing information, drug interactions, and patient information. Subscription information is available at the following hyperlink: http://www.mosbysdrugconsult.com/. PDRhealth The PDRhealth database is a free-to-use, drug information search engine that has been written for the public in layman’s terms. It contains FDA-approved drug information adapted from the Physicians’ Desk Reference (PDR) database. PDRhealth can be searched by brand name, generic name, or indication. It features multiple drug interactions reports. Search PDRhealth at http://www.pdrhealth.com/drug_info/index.html. Other Web Sites Drugs.com (www.drugs.com) reproduces the information in the Pharmacopeia as well as commercial information. You may also want to consider the Web site of the Medical Letter, Inc. (http://www.medletter.com/) which allows users to download articles on various drugs and therapeutics for a nominal fee. If you have any questions about a medical treatment, the FDA may have an office near you. Look for their number in the blue pages of the phone book. You can also contact the FDA through its toll-free number, 1-888-INFO-FDA (1-888-463-6332), or on the World Wide Web at www.fda.gov.

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APPENDICES

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

NIH Guidelines Commonly referred to as “clinical” or “professional” guidelines, the National Institutes of Health publish physician guidelines for the most common diseases. Publications are available at the following by relevant Institute4: •

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

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

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

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

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

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

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

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

4

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

5 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.

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

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

A comprehensive source of information on clinical guidelines written for professionals is the Combined Health Information Database. You will need to limit your search to one of the following: Brochure/Pamphlet, Fact Sheet, or Information Package, and “night sweats” using the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find associations, use the drop boxes at the bottom of the search page where “You may refine your search by.” For the publication date, select “All Years.” Select your preferred language and the format option “Fact Sheet.” Type “night sweats” (or synonyms) into the “For these words:” box. The following is a sample result: •

Testimony on Acupuncture As A Treatment for AIDS. Testimony Presented to the New York City Council by Michael O. Smith, M.D., May 13, 1988 Contact: Lincoln Hospital, 349 E 140th St, Bronx, NY, 10454, (212) 579-5000. Summary: The use of acupuncture to relieve HIV-related symptoms (night sweats, fatigue, diarrhea, and acute skin reactions) and as a detoxifying and stress-relieving procedure is described. On the theory that acupuncture enhances the immune system, it is claimed that Acquired immunodeficiency syndrome (AIDS) patients treated during early stages of Kaposi's sarcoma were symptom-free 3 years later and that acupuncture used on substance abusers reduced their craving and relieved stress.

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Tuberculosis Awareness Contact: Coastal Training Technologies Corporation, 500 Studio Dr, Virgina Beach, VA, 23542, (800) 725-3418, http://www.coastal.com. Summary: This brochure for employees and employers provides general information about tuberculosis (TB). TB is an infection/disease that has been on the rise since 1985. TB spreads through the air when a person infected with TB coughs, speaks, sings, sneezes, or spits. It usually takes multiple exposures to someone with TB for the infection to occur. There are two forms of TB: active TB and TB infection. Persons with TB infection have TB bacilii in their bodies, but are not contagious and exhibit no symptoms. Preventive therapy can help keep persons with TB infection from developing active TB. Active TB may develop when the immune system is weakened, in times of high stress, or from poor nutrition, substance abuse, or sickness. The symptoms of the active, contagious form of TB are coughing, fever, fatigue, night sweats, and weight loss. TB can be detected by a physician or a clinic using the Mantoux PPD skin test. Persons diagnosed with active TB should adhere to their prescribed medical regimens to prevent the development of the multidrug-resistant TB (MDRTB), which is harder to treat. High-risk groups include immunocompromised persons, persons in depressed socio-economic conditions, foreign-born persons from countries with high TB rates, anyone living with someone who has active TB, or anyone in regular contact with a member of the high-risk groups. Immunocompromised persons, such as those with the human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS),

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are most vulnerable to TB as their immune systems cannot effectively fight the infection. MDRTB poses a particular threat to immunocompromised persons because they may succumb to the disease before effective medication is found. At the end of this brochure there is a quiz that tests the readers' knowledge of TB.

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 “night sweats” (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 497 7 977 81 0 1562

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 “night sweats” (or synonyms) at the following Web site: http://text.nlm.nih.gov.

7

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

8

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 11

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

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

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Coffee Break: Tutorials for 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: •

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

•

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

12 Adapted 13

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.

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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 night sweats can appear at any moment and be published by a number of sources, the best approach to finding guidelines is to systematically scan the Internet-based services that post them.

Patient Guideline Sources The remainder of this chapter directs you to sources which either publish or can help you find additional guidelines on topics related to night sweats. 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 night sweats. 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 “night sweats”:

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Other guides Hormone Replacement Therapy http://www.nlm.nih.gov/medlineplus/hormonereplacementtherapy.html Menopause http://www.nlm.nih.gov/medlineplus/menopause.html Sleep Disorders http://www.nlm.nih.gov/medlineplus/sleepdisorders.html Tuberculosis http://www.nlm.nih.gov/medlineplus/tuberculosis.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 Combined Health Information Database (CHID) CHID Online is a reference tool that maintains a database directory of thousands of journal articles and patient education guidelines on night sweats. CHID offers summaries that describe the guidelines available, including contact information and pricing. CHID’s general Web site is http://chid.nih.gov/. To search this database, go to http://chid.nih.gov/detail/detail.html. In particular, you can use the advanced search options to look up pamphlets, reports, brochures, and information kits. The following was recently posted in this archive: •

What You Need to Know About AIDS Contact: Washington County Department of Health and Human Services, 155 N 1st Ave MS-5, Hillsboro, OR, 97124-3072, (503) 693-4402, http://www.co.washington.or.us/deptmts/hhs/hhsmain.htm. Summary: This brochure discusses Acquired immunodeficiency syndrome (AIDS), its transmission, who gets the disease, tests for the virus, its symptoms, and how it can be prevented. Three high-risk situations are described: Sexual contact with a person infected with human immunodeficiency virus (HIV); sharing of needles in intravenous drug use; and pregnancy of an HIV-infected woman. Symptoms of AIDS include unexplained weight loss, persistent cough, severe night sweats, long-term diarrhea, chronic weakness and fatigue, fevers, swollen lymph glands, and fungal infections of the mouth.

•

You Can Prevent MAC (Disseminated Mycobacterium Avium Complex Disease): A Guide for People With HIV Infection Contact: CDC National Prevention Information Network, PO Box 6003, Rockville, MD, 20849-6003, (800) 458-5231, http://www.cdcnpin.org. Summary: This brochure presents information about the symptoms, diagnosis, and treatment of mycobacterium avium complex (MAC), a group of organisms that can

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infect people living with HIV/AIDS. Adults with HIV usually do not get MAC disease until their T-cell count drops below 50, and most people with HIV have already been diagnosed with AIDS before they get MAC. Children who get MAC disease usually do so before their T-cell count falls to 50. MAC spreads quickly through the bloodstream and is characterized by fever, night sweats, weight loss, abdominal pain, tiredness, and diarrhea. MAC disease is diagnosed by laboratory tests that can identify the MAC organisms in samples of blood, bone marrow, or tissue. MAC disease is spread through normal contact with air, food, and water, and therefore is difficult to avoid. However, there are drugs that can prevent MAC organisms from causing the disease: clarithromycin, azithromycin, and rifabutin. Individuals who have had MAC disease should continue to take drugs to treat and prevent further MAC disease. Additional sources for locating referrals, materials, and information on HIV/AIDS treatment, clinical trials, and social security benefits are provided. •

Getting TB, Getting Rid of TB Contact: World Health Organization, Joint United Nations Programme on HIV/AIDS, 20 Avenue Appia, CH-1211 Geneva, http://www.unaids.org. Summary: This brochure presents the basic facts and statistics about tuberculosis (TB). It begins with an explanation of TB exposure and transmission, and defines the multidrug resistant TB strains. Nearly 5 million people who are infected with TB are also infected with HIV. The symptoms of TB, such as coughing, exhaustion, night sweats, weight loss, and chest pain are described. The death rate and high contagion rate are also addressed. The brochure also highlights international efforts to eradicate TB. These efforts include prevention, monitoring, treatment, diagnosis, program organization, and financial support to governments committed to long-term TB control. The role of the World Health Organization in these efforts is explained.

•

TB and HIV Contact: Chinese-American Planning Council Incorporated, 150 Elizabeth St, New York, NY, 10012-4603, (212) 941-0030, http://www.chinatownweb.com/cpc. Summary: This brochure provides Chinese Americans with information about tuberculosis (TB) and how it relates to the human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS). TB is an infection/disease that usually attacks the lungs but may affect other parts of the body. TB, which is an airborne virus, is spread by infected persons through coughing, sneezing, talking, singing, or spitting. The symptoms of TB include coughing, which may last for weeks and contain bloody sputum, night sweats, chest pain, fever, and weight loss. If left untreated, half of all persons with TB will die within five years. The majority of those who live longer than five year will be seriously debilitated. People can be infected with TB although they may not appear to be ill. Person with the human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) have a greater risk of becoming ill with TB (i.e., having active TB) because their immune systems are weakened and cannot fight off infections as easily as that of a healthy individual. Person who are HIV-positive should get a TB skin test to determine if they have TB; if they do have TB, these persons should undergo medical treatment immediately and remain on their medication for the duration of their treatment. Children are at a higher risk than most adults for contracting TB and, therefore, should receive a skin test if they are HIV-positive or have been in contact with a person who has active TB. Hotline telephone numbers for HIV/AIDS and TB information services in New York City are provided.

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HIV/AIDS : What's It Going to Cost You? Contact: Health Edco, Division of WRS Group, Inc., PO Box 21207, Waco, TX, 767021207, (254) 776-6461. Summary: This brochure provides general information about the human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS). HIV is a virus that weakens the immune system and allows diseases that usually do not cause many problems in a healthy individual to be deadly to infected persons. Persons exhibiting symptoms of HIV/AIDS should get tested immediately. Testing can be either confidential or anonymous. Antibodies usually develop within six months of infection; testing before antibodies develop will show a negative result even though a person is infected. Symptoms of HIV/AIDS include extreme weight loss, Kaposi's sarcoma (KS), pneumocystis carinii pneumonia (PCP), night sweats, diarrhea, dementia, and fatigue. Women may experience chronic vaginal infection, cancer of the sex organs, and abnormal Pap smear. HIV can be transmitted through risky sexual behavior; from a mother to her infant before, during, or after birth; and through direct contact with infected blood. Individuals can reduce their risks for HIV by practicing sexual abstinence, forming a monogamous relationship with a partner, practicing safer sex with condoms during each sexual encounter, and avoiding substance abuse. While there is no known cure for HIV/AIDS, medical treatment can slow the amount of damage done to the immune system by HIV. HIV/AIDS can be deadly, may cause friends and family members to distance themselves from infected individuals because they do not know about or are afraid of the disease, and can have a negative financial impact. The brochure provides contact information for services from which individuals can learn more about HIV/AIDS.

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Protect Yourself From HIV Contact: Washington Department of Social and Health Services, Office of Disease Prevention and Control, Office on AIDS, Airdustrial Pk, Olympia, WA, 98504-0095, (360) 586-3887. Summary: This brochure, for the general public, discusses the facts about the human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS). HIV is a virus that causes AIDS and is commonly asymptomatic. The brochure discusses (1) symptoms including fever, fatigue, rapid weight loss, night sweats, diarrhea, dry cough, spots on the skin, and/or white patches in the mouth; (2) HIV transmission through unprotected sex, through needle sharing with infected individuals, and perinatally from HIV-positive pregnant women to their infants; (3) prevention methods such as avoiding substance abuse, not sharing needles, properly cleaning injection drug needles before and after use, and practicing safer sex with condoms; and (4) HIV testing. The brochure provides contact information for services and hotlines in Washington State where individuals can learn more about HIV/AIDS.

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Women and AIDS : Basic Facts About AIDS and HIV Contact: Immunization Action Coalition, 1573 Selby Ave Ste 234, St Paul, MN, 55104, (651) 647-9009, http://www.immunize.org. Summary: This brochure, written for female government employees, discusses the facts about the human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS). HIV is a virus that attacks the immune system, weakening over a period of time, leading to the development of AIDS. Individuals should keep fluids such as blood, semen, and vaginal fluids from open cuts or cracked skin. Other areas that

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should be kept clear of these fluids are listed. Whether in the work place or at home, individuals should use latex barriers such as gloves or condoms to keep the aforementioned fluids away from skin. The symptoms of HIV-infection include a lowgrade fever, fatigue, weight loss not resulting from dieting, skin rashes, and night sweats. Women specifically may experience a series of yeast infections that never seem to clear up even with treatment. HIV is relatively difficult to transmit in the workplace, unless there are situations in which individuals are exposed to blood or other infectious body fluids. Women who are pregnant can help to prevent the spread of HIV to their infants by taking a virus-reducing medicine. Parents are encouraged to discuss sexuality and HIV/AIDS with their children and adolescents to help them to prevent HIV. Women who are caregivers to HIV-positive individuals are instructed to observe the body fluid safety precautions and seek support and free time from this stressful task. •

TB Can Be Cured! Contact: Solidarity Health Publications, PO Box 260, Eikenhof, (011) 900-1754. Summary: This comic book addresses a variety of issues related to tuberculosis (TB) and HIV/AIDS. A doctor and a nurse at a clinic in South Africa decide that something must be done to reduce the transmission of TB in the area. With the help of a soccer player named John, they decide to organize a soccer team to raise awareness about TB. At the clinic, the doctor and the nurse explain that persons with TB might have a persistent cough, loss of appetite, night sweats, pain in the chest, and breathlessness. The doctor and the nurse also provide a brief explanation of how TB is spread, how it is treated, and how to prevent its spread. When John begins to feel severe fatigue at soccer practice, he gets tested for TB, and tests positive. He receives proper treatment and recovers quickly. John's grandfather is also hospitalized with TB. The comic book also explains that people with AIDS are at great risk for TB because they have no natural immune system. It stresses the fact that TB can be cured, but that there is no cure for AIDS.

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Inflammatory Bowel Disease: Clinical Features and Comparison to the Functional Bowel Disorders Source: Milwaukee, WI: International Foundation for Functional Gastrointestinal Disorders (IFFGD). 1996. 2 p. Contact: Available from International Foundation for Functional Gastrointestinal Disorders (IFFGD). P.O. Box 170864, Milwaukee, WI 53217. (888) 964-2001 or (414) 9641799. Fax (414) 964-7176. E-mail: [email protected]. Website: www.iffgd.org. PRICE: Single copy free; bulk copies available. Summary: This fact sheet summarizes the clinical features of inflammatory bowel disease (IBD) and compares IBD to the functional bowel disorders. The inflammatory bowel diseases cause the traditional gastrointestinal symptoms, but may also cause fever, chills, night sweats, weight loss, and inflammation within various organs of the body (oral cavity, eye, skin, liver, joints, ileum, and colon). The author describes the symptoms associated with ulcerative colitis (UC) and Crohn's disease and current treatment options. The fact sheet gives the toll free telephone number of the Crohn's and Colitis Foundation of America (800-932-2423).

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Mycaobacterium Avium Complex (MAC) Contact: National AIDS Treatment Information Project, Beth Israel Deaconess Medical Center, Beth Israel Hospital, 330 Brookline Ave Libby Bldg 317, Boston, MA, 02215, (617) 667-5520, http://www.natip.org. Summary: This fact sheet, for individuals with the human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS), discusses the opportunistic infection, mycobacterium avium complex (MAC). MAC is a name for a group of closely related bacteria that grow in many places in the environment, including water and soil. Most individuals become infected with MAC by consuming food or drink or breathing in air contaminated with it. In persons with advanced HIV and weakened immune systems, MAC can spread throughout the blood stream and cause tissue damage and disease. The symptoms of MAC include high fever, night sweats, tiredness, diarrhea, weight loss, loss of appetite, abdominal pain, enlargement of the spleen and liver, and anemia. MAC is often diagnosed through a blood culture, a bone marrow aspiration, endoscopy, or bronchoscopy. MAC in individuals with HIV can be successfully treated using a combination of medications such as clarithromycin, azithromycin, ciprofloxacin, ethambutol, and rifabutin. The possible side effects of these drugs are identified. MAC cannot be easily prevented because the organisms are so common in the environment; however the risk for developing disseminated MAC can be reduced by taking prophylactic medications such as clarithromycin and azithromycin.

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Learn About Tuberculosis Infection Contact: US Department of Health and Human Services, Public Health Service, National Institutes of Health, National Institute of Allergy and Infectious Diseases, Division of Microbiology and Infectious Diseases, 6700-B Rockledge Dr, Bethesda, MD, 20892-7630, (301) 496-1884, http://www.niaid.nih.gov/dmid. Summary: This pamphlet provides information for persons who have tuberculosis (TB) infection, not active TB disease. If an individual's skin test (PPD test) is positive, but the chest x-ray does not have spots or shadows, that individual is said to have TB infection or latent TB infection. This means that the germ that causes TB disease is in the body, but is not active. That individual cannot spread the germ to others. Individuals with TB infection may not look or feel sick, but the germ may become active at any time and make them sick. Then they can spread the germ to others. A doctor or local health department may give them medicines, called antibiotics, for their TB infection. However, it is important that individuals with TB take all of their medicines for the required length of time. If they stop taking the medicines, the infection will not go away, and they may become even sicker. Individuals with TB should eat well and get lots of rest while taking their medications. Their PPD tests will always be positive, so there is no need to take another PPD test. They will only need a chest x-ray if they have symptoms of TB disease, such as fever, cough, or night sweats.

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HIV Antibody Testing Form Contact: Salina/Saline County Health Department, 125 W Elm St, Salina, KS, 674012315, (785) 826-6600, http://www.saline.org/services.html. Summary: This testing form on Human immunodeficiency virus (HIV) seeks responses on identified risk factors, date of onset of current symptoms and pre-counseling given. The Salina-Saline County Health Department screens for risk factors such as gay and bisexual males, sexual partner diagnosed with Acquired immunodeficiency syndrome (AIDS), hemophiliacs, blood transfusions, AIDS symptoms, veni-injections of street

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drugs and number of partners. A check list of current symptoms includes diarrhea, appetite loss, weight loss, severe fatigue, lymphodenopathy, night sweats, persistent cough, and skin lesions. 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 night sweats. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html. Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •

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

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

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

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

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

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

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

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

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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 “night sweats” (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 “night sweats”. 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 “night sweats” (or synonyms) into the “For these words:” box. You should check back periodically with this database since it is updated every three months. The National Organization for Rare Disorders, Inc. The National Organization for Rare Disorders, Inc. has prepared a Web site that provides, at no charge, lists of associations organized by health topic. You can access this database at the following Web site: http://www.rarediseases.org/search/orgsearch.html. Type “night sweats” (or a synonym) into the search box, and click “Submit Query.”

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

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

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

•

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

•

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

•

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

•

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

•

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

•

California: Gateway Health Library (Sutter Gould Medical Foundation)

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

16

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

Finding Medical Libraries

47

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

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•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

Finding Medical Libraries

49

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

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•

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

•

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

•

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

•

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

51

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

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

•

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

•

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

•

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

•

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

•

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

•

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

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

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

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

•

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

•

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

•

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

53

NIGHT SWEATS DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Abdominal: Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs. [NIH] Abdominal Pain: Sensation of discomfort, distress, or agony in the abdominal region. [NIH] Adrenal Cortex: The outer layer of the adrenal gland. It secretes mineralocorticoids, androgens, and glucocorticoids. [NIH] Adverse Effect: An unwanted side effect of treatment. [NIH] Aerobic: In biochemistry, reactions that need oxygen to happen or happen when oxygen is present. [NIH] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] 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] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] 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] Ankle: That part of the lower limb directly above the foot. [NIH] Anorexia: Lack or loss of appetite for food. Appetite is psychologic, dependent on memory and associations. Anorexia can be brought about by unattractive food, surroundings, or company. [NIH] Antiallergic: Counteracting allergy or allergic conditions. [EU] Antibiotic: A drug used to treat infections caused by bacteria and other microorganisms. [NIH]

Antibodies: Immunoglobulin molecules having a specific amino acid sequence by virtue of

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which they interact only with the antigen that induced their synthesis in cells of the lymphoid series (especially plasma cells), or with an antigen closely related to it. [NIH] Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Antidepressant: A drug used to treat depression. [NIH] Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Anti-inflammatory: Having to do with reducing inflammation. [NIH] Anti-Inflammatory Agents: Substances that reduce or suppress inflammation. [NIH] Antimicrobial: Killing microorganisms, or suppressing their multiplication or growth. [EU] Antineoplastic: Inhibiting or preventing the development of neoplasms, checking the maturation and proliferation of malignant cells. [EU] Antioxidants: Naturally occurring or synthetic substances that inhibit or retard the oxidation of a substance to which it is added. They counteract the harmful and damaging effects of oxidation in animal tissues. [NIH] Antiviral: Destroying viruses or suppressing their replication. [EU] Aqueous: Having to do with water. [NIH] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Arteritis: Inflammation of an artery. [NIH] Ascites: Accumulation or retention of free fluid within the peritoneal cavity. [NIH] Aspiration: The act of inhaling. [NIH] Asymptomatic: Having no signs or symptoms of disease. [NIH] ATP: ATP an abbreviation for adenosine triphosphate, a compound which serves as a carrier of energy for cells. [NIH] Atrophy: Decrease in the size of a cell, tissue, organ, or multiple organs, associated with a variety of pathological conditions such as abnormal cellular changes, ischemia, malnutrition, or hormonal changes. [NIH] 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] Azithromycin: A semi-synthetic macrolide antibiotic structurally related to erythromycin. It has been used in the treatment of Mycobacterium avium intracellulare infections, toxoplasmosis, and cryptosporidiosis. [NIH] Bacillus: A genus of Bacillaceae that are spore-forming, rod-shaped cells. Most species are saprophytic soil forms with only a few species being pathogenic. [NIH]

Dictionary 55

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] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU] Bewilderment: Impairment or loss of will power. [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] Biopsy: Removal and pathologic examination of specimens in the form of small pieces of tissue from the living body. [NIH] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Bladder: The organ that stores urine. [NIH] Blood Glucose: Glucose in blood. [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 transfusion: The administration of blood or blood products into a blood vessel. [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] Bone Marrow: The soft tissue filling the cavities of bones. Bone marrow exists in two types, yellow and red. Yellow marrow is found in the large cavities of large bones and consists mostly of fat cells and a few primitive blood cells. Red marrow is a hematopoietic tissue and is the site of production of erythrocytes and granular leukocytes. Bone marrow is made up of a framework of connective tissue containing branching fibers with the frame being filled with marrow cells. [NIH] Bone marrow aspiration: The removal of a small sample of bone marrow (usually from the hip) through a needle for examination under a microscope. [NIH] Bowel: The long tube-shaped organ in the abdomen that completes the process of digestion. There is both a small and a large bowel. Also called the intestine. [NIH] Branch: Most commonly used for branches of nerves, but applied also to other structures. [NIH]

Broad-spectrum: Effective against a wide range of microorganisms; said of an antibiotic. [EU] Bronchi: The larger air passages of the lungs arising from the terminal bifurcation of the trachea. [NIH]

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Bronchoscopy: Endoscopic examination, therapy or surgery of the bronchi. [NIH] Carbohydrate: An aldehyde or ketone derivative of a polyhydric alcohol, particularly of the pentahydric and hexahydric alcohols. They are so named because the hydrogen and oxygen are usually in the proportion to form water, (CH2O)n. The most important carbohydrates are the starches, sugars, celluloses, and gums. They are classified into mono-, di-, tri-, polyand heterosaccharides. [EU] Carcinogenic: Producing carcinoma. [EU] Cardiac: Having to do with the heart. [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] Carotid Arteries: Either of the two principal arteries on both sides of the neck that supply blood to the head and neck; each divides into two branches, the internal carotid artery and the external carotid artery. [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 Count: A count of the number of cells of a specific kind, usually measured per unit volume of sample. [NIH] Cell Division: The fission of a cell. [NIH] Cellulose: A polysaccharide with glucose units linked as in cellobiose. It is the chief constituent of plant fibers, cotton being the purest natural form of the substance. As a raw material, it forms the basis for many derivatives used in chromatography, ion exchange materials, explosives manufacturing, and pharmaceutical preparations. [NIH] Cerebrovascular: Pertaining to the blood vessels of the cerebrum, or brain. [EU] Cervical: Relating to the neck, or to the neck of any organ or structure. Cervical lymph nodes are located in the neck; cervical cancer refers to cancer of the uterine cervix, which is the lower, narrow end (the "neck") of the uterus. [NIH] Chest Pain: Pressure, burning, or numbness in the chest. [NIH] Cholesterol: The principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils. [NIH] Chromosomal: Pertaining to chromosomes. [EU] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Ciprofloxacin: A carboxyfluoroquinoline antimicrobial agent that is effective against a wide range of microorganisms. It has been successfully and safely used in the treatment of resistant respiratory, skin, bone, joint, gastrointestinal, urinary, and genital infections. [NIH] Clarithromycin: A semisynthetic macrolide antibiotic derived from erythromycin that is active against a variety of microorganisms. It can inhibit protein synthesis in bacteria by reversibly binding to the 50S ribosomal subunits. This inhibits the translocation of aminoacyl transfer-RNA and prevents peptide chain elongation. [NIH] Claudication: Limping or lameness. [EU] 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]

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Cloning: The production of a number of genetically identical individuals; in genetic engineering, a process for the efficient replication of a great number of identical DNA molecules. [NIH] Coagulation: 1. The process of clot formation. 2. In colloid chemistry, the solidification of a sol into a gelatinous mass; an alteration of a disperse phase or of a dissolved solid which causes the separation of the system into a liquid phase and an insoluble mass called the clot or curd. Coagulation is usually irreversible. 3. In surgery, the disruption of tissue by physical means to form an amorphous residuum, as in electrocoagulation and photocoagulation. [EU] Colitis: Inflammation of the colon. [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] Condoms: A sheath that is worn over the penis during sexual behavior in order to prevent pregnancy or spread of sexually transmitted disease. [NIH] Confusion: A mental state characterized by bewilderment, emotional disturbance, lack of clear thinking, and perceptual disorientation. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Consciousness: Sense of awareness of self and of the environment. [NIH] Constitutional: 1. Affecting the whole constitution of the body; not local. 2. Pertaining to the constitution. [EU] Consumption: Pulmonary tuberculosis. [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] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary heart disease: A type of heart disease caused by narrowing of the coronary arteries that feed the heart, which needs a constant supply of oxygen and nutrients carried by the blood in the coronary arteries. When the coronary arteries become narrowed or clogged by fat and cholesterol deposits and cannot supply enough blood to the heart, CHD results. [NIH] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Corpus: The body of the uterus. [NIH] Corpus Luteum: The yellow glandular mass formed in the ovary by an ovarian follicle that has ruptured and discharged its ovum. [NIH] Cortex: The outer layer of an organ or other body structure, as distinguished from the internal substance. [EU] Corticosteroid: Any of the steroids elaborated by the adrenal cortex (excluding the sex hormones of adrenal origin) in response to the release of corticotrophin (adrenocorticotropic

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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] Creatinine: A compound that is excreted from the body in urine. Creatinine levels are measured to monitor kidney function. [NIH] Cryptosporidiosis: Parasitic intestinal infection with severe diarrhea caused by a protozoan, Cryptosporidium. It occurs in both animals and humans. [NIH] Curative: Tending to overcome disease and promote recovery. [EU] Cytomegalovirus: A genus of the family Herpesviridae, subfamily Betaherpesvirinae, infecting the salivary glands, liver, spleen, lungs, eyes, and other organs, in which they produce characteristically enlarged cells with intranuclear inclusions. Infection with Cytomegalovirus is also seen as an opportunistic infection in AIDS. [NIH] Cytomegalovirus Retinitis: Infection of the retina by cytomegalovirus characterized by retinal necrosis, hemorrhage, vessel sheathing, and retinal edema. Cytomegalovirus retinitis is a major opportunistic infection in AIDS patients and can cause blindness. [NIH] Databases, Bibliographic: Extensive collections, reputedly complete, of references and citations to books, articles, publications, etc., generally on a single subject or specialized subject area. Databases can operate through automated files, libraries, or computer disks. The concept should be differentiated from factual databases which is used for collections of data and facts apart from bibliographic references to them. [NIH] Degenerative: Undergoing degeneration : tending to degenerate; having the character of or involving degeneration; causing or tending to cause degeneration. [EU] Dementia: An acquired organic mental disorder with loss of intellectual abilities of sufficient severity to interfere with social or occupational functioning. The dysfunction is multifaceted and involves memory, behavior, personality, judgment, attention, spatial relations, language, abstract thought, and other executive functions. The intellectual decline is usually progressive, and initially spares the level of consciousness. [NIH] Density: The logarithm to the base 10 of the opacity of an exposed and processed film. [NIH] Dental Caries: Localized destruction of the tooth surface initiated by decalcification of the enamel followed by enzymatic lysis of organic structures and leading to cavity formation. If left unchecked, the cavity may penetrate the enamel and dentin and reach the pulp. The three most prominent theories used to explain the etiology of the disase are that acids produced by bacteria lead to decalcification; that micro-organisms destroy the enamel protein; or that keratolytic micro-organisms produce chelates that lead to decalcification. [NIH]

Dental implant: A small metal pin placed inside the jawbone to mimic the root of a tooth. Dental implants can be used to help anchor a false tooth or teeth, or a crown or bridge. [NIH] Dentists: Individuals licensed to practice dentistry. [NIH] Deprivation: Loss or absence of parts, organs, powers, or things that are needed. [EU] 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

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gravity urine and great thirst. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Diarrhea: Passage of excessively liquid or excessively frequent stools. [NIH] Diffusion: The tendency of a gas or solute to pass from a point of higher pressure or concentration to a point of lower pressure or concentration and to distribute itself throughout the available space; a major mechanism of biological transport. [NIH] Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Disorientation: The loss of proper bearings, or a state of mental confusion as to time, place, or identity. [EU] Distal: Remote; farther from any point of reference; opposed to proximal. In dentistry, used to designate a position on the dental arch farther from the median line of the jaw. [EU] DNA Topoisomerase: An enzyme catalyzing ATP-independent breakage of single-stranded DNA, followed by passage and rejoining of another single-stranded DNA. This enzyme class brings about the conversion of one topological isomer of DNA into another, e.g., the relaxation of superhelical turns in DNA, the interconversion of simple and knotted rings of single-stranded DNA, and the intertwisting of single-stranded rings of complementary sequences. (From Enzyme Nomenclature, 1992) EC 5.99.1.2. [NIH] Dominance: In genetics, the full phenotypic expression of a gene in both heterozygotes and homozygotes. [EU] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Drug Toxicity: Manifestations of the adverse effects of drugs administered therapeutically or in the course of diagnostic techniques. It does not include accidental or intentional poisoning for which specific headings are available. [NIH] Dyspnea: Difficult or labored breathing. [NIH] Edema: Excessive amount of watery fluid accumulated in the intercellular spaces, most commonly present in subcutaneous tissue. [NIH] Efficacy: The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control trial. [NIH] Ejaculation: The release of semen through the penis during orgasm. [NIH] Electrocoagulation: Electrosurgical procedures used to treat hemorrhage (e.g., bleeding ulcers) and to ablate tumors, mucosal lesions, and refractory arrhythmias. [NIH] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] 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] Enamel: A very hard whitish substance which covers the dentine of the anatomical crown of a tooth. [NIH] Endocrine System: The system of glands that release their secretions (hormones) directly

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into the circulatory system. In addition to the endocrine glands, included are the chromaffin system and the neurosecretory systems. [NIH] Endocrinology: A subspecialty of internal medicine concerned with the metabolism, physiology, and disorders of the endocrine system. [NIH] Endometrial: Having to do with the endometrium (the layer of tissue that lines the uterus). [NIH]

Endometrium: The layer of tissue that lines the uterus. [NIH] Endoscopy: Endoscopic examination, therapy or surgery performed on interior parts of the body. [NIH] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]

Enzymatic: Phase where enzyme cuts the precursor protein. [NIH] Enzymes: Biological molecules that possess catalytic activity. They may occur naturally or be synthetically created. Enzymes are usually proteins, however catalytic RNA and catalytic DNA molecules have also been identified. [NIH] Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH] Erythromycin: A bacteriostatic antibiotic substance produced by Streptomyces erythreus. Erythromycin A is considered its major active component. In sensitive organisms, it inhibits protein synthesis by binding to 50S ribosomal subunits. This binding process inhibits peptidyl transferase activity and interferes with translocation of amino acids during translation and assembly of proteins. [NIH] Esophageal: Having to do with the esophagus, the muscular tube through which food passes from the throat to the stomach. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]

Estradiol: The most potent mammalian estrogenic hormone. It is produced in the ovary, placenta, testis, and possibly the adrenal cortex. [NIH] Estrogen: One of the two female sex hormones. [NIH] Exhaustion: The feeling of weariness of mind and body. [NIH] Exogenous: Developed or originating outside the organism, as exogenous disease. [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] Fatigue: The state of weariness following a period of exertion, mental or physical, characterized by a decreased capacity for work and reduced efficiency to respond to stimuli. [NIH]

Febrile: Pertaining to or characterized by fever. [EU] 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] Forearm: The part between the elbow and the wrist. [NIH]

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Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] Gastrin: A hormone released after eating. Gastrin causes the stomach to produce more acid. [NIH]

Gastrointestinal: Refers to 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]

Genetics: The biological science that deals with the phenomena and mechanisms of heredity. [NIH] Genistein: An isoflavonoid derived from soy products. It inhibits protein-tyrosine kinase and topoisomerase-ii (dna topoisomerase (atp-hydrolysing)) activity and is used as an antineoplastic and antitumor agent. Experimentally, it has been shown to induce G2 phase arrest in human and murine cell lines. [NIH] Genital: Pertaining to the genitalia. [EU] Gland: An organ that produces and releases one or more substances for use in the body. Some glands produce fluids that affect tissues or organs. Others produce hormones or participate in blood production. [NIH] Glomerulus: A tiny set of looping blood vessels in the nephron where blood is filtered in the kidney. [NIH] Glucocorticoids: A group of corticosteroids that affect carbohydrate metabolism (gluconeogenesis, liver glycogen deposition, elevation of blood sugar), inhibit corticotropin secretion, and possess pronounced anti-inflammatory activity. They also play a role in fat and protein metabolism, maintenance of arterial blood pressure, alteration of the connective tissue response to injury, reduction in the number of circulating lymphocytes, and functioning of the central nervous system. [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] Glycoprotein: A protein that has sugar molecules attached to it. [NIH] Gonadal: Pertaining to a gonad. [EU] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Grade: The grade of a tumor depends on how abnormal the cancer cells look under a microscope and how quickly the tumor is likely to grow and spread. Grading systems are different for each type of cancer. [NIH] Gram-positive: Retaining the stain or resisting decolorization by alcohol in Gram's method of staining, a primary characteristic of bacteria whose cell wall is composed of a thick layer of peptidologlycan with attached teichoic acids. [EU] Growth: The progressive development of a living being or part of an organism from its earliest stage to maturity. [NIH] Habitat: An area considered in terms of its environment, particularly as this determines the type and quality of the vegetation the area can carry. [NIH] Haemodialysis: The removal of certain elements from the blood by virtue of the difference in the rates of their diffusion through a semipermeable membrane, e.g., by means of a haemodialyzer. [EU]

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Heart attack: A seizure of weak or abnormal functioning of the heart. [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] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hepatitis: Inflammation of the liver and liver disease involving degenerative or necrotic alterations of hepatocytes. [NIH] Hepatocytes: The main structural component of the liver. They are specialized epithelial cells that are organized into interconnected plates called lobules. [NIH] Heterozygotes: Having unlike alleles at one or more corresponding loci on homologous chromosomes. [NIH] Homozygotes: An individual having a homozygous gene pair. [NIH] Hormonal: Pertaining to or of the nature of a hormone. [EU] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] Hormone Replacement Therapy: Therapeutic use of hormones to alleviate the effects of hormone deficiency. [NIH] Host: Any animal that receives a transplanted graft. [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] 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] Hypothyroidism: Deficiency of thyroid activity. In adults, it is most common in women and is characterized by decrease in basal metabolic rate, tiredness and lethargy, sensitivity to cold, and menstrual disturbances. If untreated, it progresses to full-blown myxoedema. In infants, severe hypothyroidism leads to cretinism. In juveniles, the manifestations are intermediate, with less severe mental and developmental retardation and only mild symptoms of the adult form. When due to pituitary deficiency of thyrotropin secretion it is called secondary hypothyroidism. [EU] Id: The part of the personality structure which harbors the unconscious instinctive desires and strivings of the individual. [NIH] Ileum: The lower end of the small intestine. [NIH] Immune response: The activity of the immune system against foreign substances (antigens). [NIH]

Immune system: The organs, cells, and molecules responsible for the recognition and

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disposal of foreign ("non-self") material which enters the body. [NIH] Immunocompromised: Having a weakened immune system caused by certain diseases or treatments. [NIH] Immunodeficiency: The decreased ability of the body to fight infection and disease. [NIH] Immunodeficiency syndrome: The inability of the body to produce an immune response. [NIH]

Immunosuppressive: Describes the ability to lower immune system responses. [NIH] Indicative: That indicates; that points out more or less exactly; that reveals fairly clearly. [EU] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]

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] Inflammatory bowel disease: A general term that refers to the inflammation of the colon and rectum. Inflammatory bowel disease includes ulcerative colitis and Crohn's disease. [NIH]

Insulin: A protein hormone secreted by beta cells of the pancreas. Insulin plays a major role in the regulation of glucose metabolism, generally promoting the cellular utilization of glucose. It is also an important regulator of protein and lipid metabolism. Insulin is used as a drug to control insulin-dependent diabetes mellitus. [NIH] Insulin-dependent diabetes mellitus: A disease characterized by high levels of blood glucose resulting from defects in insulin secretion, insulin action, or both. Autoimmune, genetic, and environmental factors are involved in the development of type I diabetes. [NIH] Internal Medicine: A medical specialty concerned with the diagnosis and treatment of diseases of the internal organ systems of adults. [NIH] Interstitial: Pertaining to or situated between parts or in the interspaces of a tissue. [EU] Intestine: A long, tube-shaped organ in the abdomen that completes the process of digestion. There is both a large intestine and a small intestine. Also called the bowel. [NIH] Intracellular: Inside a cell. [NIH] Intravenous: IV. Into a vein. [NIH] Involuntary: Reaction occurring without intention or volition. [NIH] Ions: An atom or group of atoms that have a positive or negative electric charge due to a gain (negative charge) or loss (positive charge) of one or more electrons. Atoms with a positive charge are known as cations; those with a negative charge are anions. [NIH] Ischemia: Deficiency of blood in a part, due to functional constriction or actual obstruction of a blood vessel. [EU] Joint: The point of contact between elements of an animal skeleton with the parts that

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surround and support it. [NIH] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Keratolytic: An agent that promotes keratolysis. [EU] Latent: Phoria which occurs at one distance or another and which usually has no troublesome effect. [NIH] Lethargy: Abnormal drowsiness or stupor; a condition of indifference. [EU] Leukocytes: White blood cells. These include granular leukocytes (basophils, eosinophils, and neutrophils) as well as non-granular leukocytes (lymphocytes and monocytes). [NIH] Library Services: Services offered to the library user. They include reference and circulation. [NIH]

Ligaments: Shiny, flexible bands of fibrous tissue connecting together articular extremities of bones. They are pliant, tough, and inextensile. [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] Localized: Cancer which has not metastasized yet. [NIH] Loneliness: The state of feeling sad or dejected as a result of lack of companionship or being separated from others. [NIH] Lymph: The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. [NIH] Lymph node: A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Also known as a lymph gland. Lymph nodes are spread out along lymphatic vessels and contain many lymphocytes, which filter the lymphatic fluid (lymph). [NIH]

Lymphadenitis: Inflammation of the lymph nodes. [NIH] Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. [NIH] Lymphatic system: The tissues and organs that produce, store, and carry white blood cells that fight infection and other diseases. This system includes the bone marrow, spleen, thymus, lymph nodes and a network of thin tubes that carry lymph and white blood cells. These tubes branch, like blood vessels, into all the tissues of the body. [NIH] Lymphoid: Referring to lymphocytes, a type of white blood cell. Also refers to tissue in which lymphocytes develop. [NIH] Malaise: A vague feeling of bodily discomfort. [EU] Malignancy: A cancerous tumor that can invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malnutrition: A condition caused by not eating enough food or not eating a balanced diet. [NIH]

MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Memory: Complex mental function having four distinct phases: (1) memorizing or learning,

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(2) retention, (3) recall, and (4) recognition. Clinically, it is usually subdivided into immediate, recent, and remote memory. [NIH] Menopause: Permanent cessation of menstruation. [NIH] Menstrual Cycle: The period of the regularly recurring physiologic changes in the endometrium occurring during the reproductive period in human females and some primates and culminating in partial sloughing of the endometrium (menstruation). [NIH] Menstruation: The normal physiologic discharge through the vagina of blood and mucosal tissues from the nonpregnant uterus. [NIH] 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] Micro-organism: An organism which cannot be observed with the naked eye; e. g. unicellular animals, lower algae, lower fungi, bacteria. [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] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] Monitor: An apparatus which automatically records such physiological signs as respiration, pulse, and blood pressure in an anesthetized patient or one undergoing surgical or other procedures. [NIH] Mononuclear: A cell with one nucleus. [NIH] Mucins: A secretion containing mucopolysaccharides and protein that is the chief constituent of mucus. [NIH] Mucus: The viscous secretion of mucous membranes. It contains mucin, white blood cells, water, inorganic salts, and exfoliated cells. [NIH] Mycobacteriosis: Any disease caused by Mycobacterium other than M. tuberculosis, M. bovis, and M. avium. [NIH] Mycobacterium: A genus of gram-positive, aerobic bacteria. Most species are free-living in soil and water, but the major habitat for some is the diseased tissue of warm-blooded hosts. [NIH]

Mycobacterium avium: A bacterium causing tuberculosis in domestic fowl and other birds. In pigs, it may cause localized and sometimes disseminated disease. The organism occurs occasionally in sheep and cattle. It should be distinguished from the M. avium complex, which infects primarily humans. [NIH] Mycobacterium avium Complex: A complex that includes several strains of M. avium. M. intracellulare is not easily distinguished from M. avium and therefore is included in the complex. These organisms are most frequently found in pulmonary secretions from persons with a tuberculous-like mycobacteriosis. Strains of this complex have also been associated with childhood lymphadenitis and AIDS. M. avium alone causes tuberculosis in a variety of

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birds and other animals, including pigs. [NIH] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Neck Pain: Discomfort or more intense forms of pain that are localized to the cervical region. This term generally refers to pain in the posterior or lateral regions of the neck. [NIH] Necrosis: A pathological process caused by the progressive degradative action of enzymes that is generally associated with severe cellular trauma. It is characterized by mitochondrial swelling, nuclear flocculation, uncontrolled cell lysis, and ultimately cell death. [NIH] Need: A state of tension or dissatisfaction felt by an individual that impels him to action toward a goal he believes will satisfy the impulse. [NIH] Needle Sharing: Usage of a single needle among two or more people for injecting drugs. Needle sharing is a high-risk behavior for contracting infectious disease. [NIH] Neoplasm: A new growth of benign or malignant tissue. [NIH] Nephritis: Inflammation of the kidney; a focal or diffuse proliferative or destructive process which may involve the glomerulus, tubule, or interstitial renal tissue. [EU] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Neurologic: Having to do with nerves or the nervous system. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Ocular: 1. Of, pertaining to, or affecting the eye. 2. Eyepiece. [EU] Opacity: Degree of density (area most dense taken for reading). [NIH] Ophthalmologic: Pertaining to ophthalmology (= the branch of medicine dealing with the eye). [EU] Ophthalmology: A surgical specialty concerned with the structure and function of the eye and the medical and surgical treatment of its defects and diseases. [NIH] Opportunistic Infections: An infection caused by an organism which becomes pathogenic under certain conditions, e.g., during immunosuppression. [NIH] Oral Health: The optimal state of the mouth and normal functioning of the organs of the mouth without evidence of disease. [NIH] Osteoporosis: Reduction of bone mass without alteration in the composition of bone, leading to fractures. Primary osteoporosis can be of two major types: postmenopausal osteoporosis and age-related (or senile) osteoporosis. [NIH] Ovaries: The pair of female reproductive glands in which the ova, or eggs, are formed. The ovaries are located in the pelvis, one on each side of the uterus. [NIH] Ovary: Either of the paired glands in the female that produce the female germ cells and secrete some of the female sex hormones. [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]

Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU]

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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] 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] Patient Education: The teaching or training of patients concerning their own health needs. [NIH]

Pelvic: Pertaining to the pelvis. [EU] Penis: The external reproductive organ of males. It is composed of a mass of erectile tissue enclosed in three cylindrical fibrous compartments. Two of the three compartments, the corpus cavernosa, are placed side-by-side along the upper part of the organ. The third compartment below, the corpus spongiosum, houses the urethra. [NIH] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Peptide Chain Elongation: The process whereby an amino acid is joined through a substituted amide linkage to a chain of peptides. [NIH] Percutaneous: Performed through the skin, as injection of radiopacque material in radiological examination, or the removal of tissue for biopsy accomplished by a needle. [EU] Periodontitis: Inflammation of the periodontal membrane; also called periodontitis simplex. [NIH]

Peritoneal: Having to do with the peritoneum (the tissue that lines the abdominal wall and covers most of the organs in the abdomen). [NIH] Peritoneal Cavity: The space enclosed by the peritoneum. It is divided into two portions, the greater sac and the lesser sac or omental bursa, which lies behind the stomach. The two sacs are connected by the foramen of Winslow, or epiploic foramen. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Phospholipids: Lipids containing one or more phosphate groups, particularly those derived from either glycerol (phosphoglycerides; glycerophospholipids) or sphingosine (sphingolipids). They are polar lipids that are of great importance for the structure and function of cell membranes and are the most abundant of membrane lipids, although not stored in large amounts in the system. [NIH] Photocoagulation: Using a special strong beam of light (laser) to seal off bleeding blood vessels such as in the eye. The laser can also burn away blood vessels that should not have grown in the eye. This is the main treatment for diabetic retinopathy. [NIH] Physiology: The science that deals with the life processes and functions of organismus, their cells, tissues, and organs. [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

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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] Poisoning: A condition or physical state produced by the ingestion, injection or inhalation of, or exposure to a deleterious agent. [NIH] Polymyalgia Rheumatica: A syndrome in the elderly characterized by proximal joint and muscle pain, high erythrocyte sedimentation rate, and a self-limiting course. Pain is usually accompanied by evidence of an inflammatory reaction. Women are affected twice as commonly as men and Caucasians more frequently than other groups. The condition is frequently associated with temporal arteritis and some theories pose the possibility that the two diseases arise from a single etiology or even that they are the same entity. [NIH] Polypeptide: A peptide which on hydrolysis yields more than two amino acids; called tripeptides, tetrapeptides, etc. according to the number of amino acids contained. [EU] Posterior: Situated in back of, or in the back part of, or affecting the back or dorsal surface of the body. In lower animals, it refers to the caudal end of the body. [EU] Postmenopausal: Refers to the time after menopause. Menopause is the time in a woman's life when menstrual periods stop permanently; also called "change of life." [NIH] 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] 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] Progesterone: Pregn-4-ene-3,20-dione. The principal progestational hormone of the body, secreted by the corpus luteum, adrenal cortex, and placenta. Its chief function is to prepare the uterus for the reception and development of the fertilized ovum. It acts as an antiovulatory agent when administered on days 5-25 of the menstrual cycle. [NIH] Progression: Increase in the size of a tumor or spread of cancer in the body. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Prophylaxis: An attempt to prevent disease. [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] Protein-Tyrosine Kinase: An enzyme that catalyzes the phosphorylation of tyrosine residues in proteins with ATP or other nucleotides as phosphate donors. EC 2.7.1.112. [NIH] Proteolytic: 1. Pertaining to, characterized by, or promoting proteolysis. 2. An enzyme that

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promotes proteolysis (= the splitting of proteins by hydrolysis of the peptide bonds with formation of smaller polypeptides). [EU] Proximal: Nearest; closer to any point of reference; opposed to distal. [EU] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] 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] Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the waves/rays themselves; a stream of electromagnetic particles (electrons, neutrons, protons, alpha particles) or a mixture of these. The most common source is the sun. [NIH] Radiological: Pertaining to radiodiagnostic and radiotherapeutic procedures, and interventional radiology or other planning and guiding medical radiology. [NIH] Randomized: Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments. [NIH] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Redux: Appetite suppressant. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Reflux: The term used when liquid backs up into the esophagus from the stomach. [NIH] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Retina: The ten-layered nervous tissue membrane of the eye. It is continuous with the optic nerve and receives images of external objects and transmits visual impulses to the brain. Its outer surface is in contact with the choroid and the inner surface with the vitreous body. The outer-most layer is pigmented, whereas the inner nine layers are transparent. [NIH] Retinal: 1. Pertaining to the retina. 2. The aldehyde of retinol, derived by the oxidative enzymatic splitting of absorbed dietary carotene, and having vitamin A activity. In the retina, retinal combines with opsins to form visual pigments. One isomer, 11-cis retinal combines with opsin in the rods (scotopsin) to form rhodopsin, or visual purple. Another, all-trans retinal (trans-r.); visual yellow; xanthopsin) results from the bleaching of rhodopsin by light, in which the 11-cis form is converted to the all-trans form. Retinal also combines with opsins in the cones (photopsins) to form the three pigments responsible for colour vision. Called also retinal, and retinene1. [EU] Retinitis: Inflammation of the retina. It is rarely limited to the retina, but is commonly associated with diseases of the choroid (chorioretinitis) and of the optic nerve (neuroretinitis). The disease may be confined to one eye, but since it is generally dependent on a constitutional factor, it is almost always bilateral. It may be acute in course, but as a rule it lasts many weeks or even several months. [NIH] Retrovirus: A member of a group of RNA viruses, the RNA of which is copied during viral replication into DNA by reverse transcriptase. The viral DNA is then able to be integrated into the host chromosomal DNA. [NIH] Rheumatic Diseases: Disorders of connective tissue, especially the joints and related structures, characterized by inflammation, degeneration, or metabolic derangement. [NIH] Rifabutin: A broad-spectrum antibiotic that is being used as prophylaxis against disseminated Mycobacterium avium complex infection in HIV-positive patients. [NIH] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of

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developing a disease. [NIH] Saline: A solution of salt and water. [NIH] Saliva: The clear, viscous fluid secreted by the salivary glands and mucous glands of the mouth. It contains mucins, water, organic salts, and ptylin. [NIH] Salivary: The duct that convey saliva to the mouth. [NIH] Salivary glands: Glands in the mouth that produce saliva. [NIH] Saponins: Sapogenin glycosides. A type of glycoside widely distributed in plants. Each consists of a sapogenin as the aglycon moiety, and a sugar. The sapogenin may be a steroid or a triterpene and the sugar may be glucose, galactose, a pentose, or a methylpentose. Sapogenins are poisonous towards the lower forms of life and are powerful hemolytics when injected into the blood stream able to dissolve red blood cells at even extreme dilutions. [NIH] Sarcoma: A connective tissue neoplasm formed by proliferation of mesodermal cells; it is usually highly malignant. [NIH] 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] Semen: The thick, yellowish-white, viscid fluid secretion of male reproductive organs discharged upon ejaculation. In addition to reproductive organ secretions, it contains spermatozoa and their nutrient plasma. [NIH] Semisynthetic: Produced by chemical manipulation of naturally occurring substances. [EU] Senile: Relating or belonging to old age; characteristic of old age; resulting from infirmity of old age. [NIH] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] Sexual Abstinence: Refraining from sexual intercourse. [NIH] Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Signs and Symptoms: Clinical manifestations that can be either objective when observed by a physician, or subjective when perceived by the patient. [NIH] Skeleton: The framework that supports the soft tissues of vertebrate animals and protects many of their internal organs. The skeletons of vertebrates are made of bone and/or cartilage. [NIH] Skull: The skeleton of the head including the bones of the face and the bones enclosing the brain. [NIH] Small intestine: The part of the digestive tract that is located between the stomach and the large intestine. [NIH] Sneezing: Sudden, forceful, involuntary expulsion of air from the nose and mouth caused by irritation to the mucous membranes of the upper respiratory tract. [NIH] Soft tissue: Refers to muscle, fat, fibrous tissue, blood vessels, or other supporting tissue of the body. [NIH] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a

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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] Spermatozoa: Mature male germ cells that develop in the seminiferous tubules of the testes. Each consists of a head, a body, and a tail that provides propulsion. The head consists mainly of chromatin. [NIH] 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] Sputum: The material expelled from the respiratory passages by coughing or clearing the throat. [NIH] Staging: Performing exams and tests to learn the extent of the cancer within the body, especially whether the disease has spread from the original site to other parts of the body. [NIH]

Sterile: Unable to produce children. [NIH] Steroid: A group name for lipids that contain a hydrogenated cyclopentanoperhydrophenanthrene ring system. Some of the substances included in this group are progesterone, adrenocortical hormones, the gonadal hormones, cardiac aglycones, bile acids, sterols (such as cholesterol), toad poisons, saponins, and some of the carcinogenic hydrocarbons. [EU] 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] Street Drugs: Drugs obtained and often manufactured illegally for the subjective effects they are said to produce. They are often distributed in urban areas, but are also available in suburban and rural areas, and tend to be grossly impure and may cause unexpected toxicity. [NIH]

Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Stroke: Sudden loss of function of part of the brain because of loss of blood flow. Stroke may be caused by a clot (thrombosis) or rupture (hemorrhage) of a blood vessel to the brain. [NIH] Subacute: Somewhat acute; between acute and chronic. [EU] Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU] 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] Temporal: One of the two irregular bones forming part of the lateral surfaces and base of the skull, and containing the organs of hearing. [NIH] Testis: Either of the paired male reproductive glands that produce the male germ cells and the male hormones. [NIH]

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Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Thrombin: An enzyme formed from prothrombin that converts fibrinogen to fibrin. (Dorland, 27th ed) EC 3.4.21.5. [NIH] Thyroid: A gland located near the windpipe (trachea) that produces thyroid hormone, which helps regulate growth and metabolism. [NIH] Thyrotropin: A peptide hormone secreted by the anterior pituitary. It promotes the growth of the thyroid gland and stimulates the synthesis of thyroid hormones and the release of thyroxine by the thyroid gland. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxins: Specific, characterizable, poisonous chemicals, often proteins, with specific biological properties, including immunogenicity, produced by microbes, higher plants, or animals. [NIH] Toxoplasmosis: The acquired form of infection by Toxoplasma gondii in animals and man. [NIH]

Transcriptase: An enzyme which catalyses the synthesis of a complementary mRNA molecule from a DNA template in the presence of a mixture of the four ribonucleotides (ATP, UTP, GTP and CTP). [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Transfusion: The infusion of components of blood or whole blood into the bloodstream. The blood may be donated from another person, or it may have been taken from the person earlier and stored until needed. [NIH] Translocation: The movement of material in solution inside the body of the plant. [NIH] Tubercle: A rounded elevation on a bone or other structure. [NIH] Tuberculin: A sterile liquid containing the growth products of, or specific substances extracted from, the tubercle bacillus; used in various forms in the diagnosis of tuberculosis. [NIH]

Tuberculosis: Any of the infectious diseases of man and other animals caused by species of Mycobacterium. [NIH] Ulcer: A localized necrotic lesion of the skin or a mucous surface. [NIH] Ulcerative colitis: Chronic inflammation of the colon that produces ulcers in its lining. This condition is marked by abdominal pain, cramps, and loose discharges of pus, blood, and mucus from the bowel. [NIH] Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [NIH] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]

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Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [NIH] Urine: Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra. [NIH] 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] Vaccine: A substance or group of substances meant to cause the immune system to respond to a tumor or to microorganisms, such as bacteria or viruses. [NIH] Vagina: The muscular canal extending from the uterus to the exterior of the body. Also called the birth canal. [NIH] Vaginal: Of or having to do with the vagina, the birth canal. [NIH] Varicose: The common ulcer in the lower third of the leg or near the ankle. [NIH] Varicose vein: An abnormal swelling and tortuosity especially of the superficial veins of the legs. [EU] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vasomotor: 1. Affecting the calibre of a vessel, especially of a blood vessel. 2. Any element or agent that effects the calibre of a blood vessel. [EU] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Venlafaxine: An antidepressant drug that is being evaluated for the treatment of hot flashes in women who have breast cancer. [NIH] 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] 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] Weight Gain: Increase in body weight over existing weight. [NIH] X-ray: High-energy radiation used in low doses to diagnose diseases and in high doses to treat cancer. [NIH]

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INDEX A Abdominal, 39, 42, 53, 67, 72 Abdominal Pain, 39, 42, 53, 72 Adrenal Cortex, 53, 57, 60, 68 Adverse Effect, 53, 59, 70 Aerobic, 53, 65 Algorithms, 53, 55 Alternative medicine, 24, 53 Amino Acid Sequence, 53 Amino Acids, 53, 60, 67, 68 Androgens, 53, 58 Anemia, 42, 53 Ankle, 53, 73 Anorexia, 4, 17, 53 Antiallergic, 53, 58 Antibiotic, 53, 54, 55, 56, 60, 69 Antibodies, 40, 53, 54, 68 Antibody, 42, 54, 63 Antidepressant, 54, 73 Antigen, 54, 63 Anti-inflammatory, 5, 54, 58, 61 Anti-Inflammatory Agents, 54, 58 Antimicrobial, 54, 56 Antineoplastic, 54, 58, 61 Antioxidants, 17, 54 Antiviral, 20, 54 Aqueous, 54, 55 Arterial, 16, 54, 61, 62, 68 Arteries, 17, 54, 55, 56, 57, 65 Arteritis, 4, 16, 54, 68 Ascites, 13, 54 Aspiration, 54 Asymptomatic, 5, 40, 54 ATP, 54, 59, 61, 68, 72 Atrophy, 6, 54 Autoantibodies, 16, 54 Autoantigens, 54 Azithromycin, 39, 42, 54 B Bacillus, 54, 72 Bacteria, 42, 53, 54, 55, 56, 58, 61, 65, 73 Bacterium, 55, 65 Base, 4, 55, 58, 64, 71 Bewilderment, 55, 57 Bile, 55, 61, 64, 71 Biopsy, 4, 5, 16, 55, 67 Biotechnology, 8, 24, 33, 55 Bladder, 4, 55, 72, 73

Blood Glucose, 5, 6, 16, 55, 62, 63 Blood pressure, 5, 55, 56, 61, 62, 65 Blood transfusion, 42, 55 Blood vessel, 55, 56, 61, 63, 64, 67, 70, 71, 73 Body Fluids, 41, 55 Bone Marrow, 39, 42, 55, 64 Bone marrow aspiration, 42, 55 Bowel, 41, 55, 63, 72 Branch, 49, 55, 64, 66, 67, 70, 72 Broad-spectrum, 55, 69 Bronchi, 55, 56 Bronchoscopy, 42, 56 C Carbohydrate, 56, 58, 61 Carcinogenic, 56, 71 Cardiac, 17, 56, 66, 71 Cardiovascular, 3, 56 Cardiovascular disease, 3, 56 Carotid Arteries, 16, 56 Cell, 16, 39, 54, 55, 56, 61, 63, 64, 65, 66, 67, 68 Cell Count, 39, 56 Cell Division, 55, 56, 68 Cellulose, 56, 68 Cerebrovascular, 56 Cervical, 56, 66 Chest Pain, 39, 56 Cholesterol, 6, 55, 56, 57, 71 Chromosomal, 56, 69 Chronic, 4, 20, 38, 40, 56, 58, 63, 71, 72 Ciprofloxacin, 42, 56 Clarithromycin, 39, 42, 56 Claudication, 4, 56 Clinical trial, 5, 33, 39, 56, 69 Cloning, 55, 57 Coagulation, 6, 57 Colitis, 5, 41, 57 Computational Biology, 33, 57 Condoms, 40, 41, 57 Confusion, 4, 57, 59 Connective Tissue, 55, 57, 61, 64, 69, 70 Consciousness, 57, 58 Constitutional, 5, 57, 69 Consumption, 7, 57 Contraindications, ii, 7, 57 Coronary, 17, 56, 57, 65 Coronary heart disease, 56, 57

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Coronary Thrombosis, 57, 65 Corpus, 57, 67, 68 Corpus Luteum, 57, 68 Cortex, 57 Corticosteroid, 17, 57 Creatinine, 5, 58 Cryptosporidiosis, 54, 58 Curative, 58, 72 Cytomegalovirus, 20, 58 Cytomegalovirus Retinitis, 20, 58 D Databases, Bibliographic, 33, 58 Degenerative, 58, 62 Dementia, 40, 58 Density, 6, 58, 66 Dental Caries, 4, 58 Dental implant, 4, 58 Dentists, 4, 58 Deprivation, 3, 58 Diabetes Insipidus, 11, 58 Diagnostic procedure, 24, 59 Diarrhea, 19, 20, 34, 38, 39, 40, 42, 43, 58, 59 Diffusion, 59, 61 Digestion, 55, 59, 63, 64, 71 Direct, iii, 27, 40, 59, 69 Disorientation, 57, 59 Distal, 8, 59, 69 DNA Topoisomerase, 59, 61 Dominance, 17, 59 Drug Interactions, 28, 59 Drug Toxicity, 5, 59 Dyspnea, 12, 59 E Edema, 58, 59 Efficacy, 6, 59 Ejaculation, 59, 70 Electrocoagulation, 57, 59 Electrolyte, 58, 59, 65 Electrons, 55, 59, 63, 66, 69 Enamel, 58, 59 Endocrine System, 59, 60 Endocrinology, 7, 60 Endometrial, 5, 60 Endometrium, 60, 65 Endoscopy, 42, 60 Environmental Health, 32, 34, 60 Enzymatic, 58, 60, 69 Enzymes, 60, 66, 67 Erythrocytes, 53, 55, 60 Erythromycin, 54, 56, 60 Esophageal, 9, 60

Esophagus, 60, 69, 71 Estradiol, 7, 60 Estrogen, 3, 4, 6, 7, 60 Exhaustion, 20, 39, 60 Exogenous, 7, 60 F Family Planning, 33, 60 Fat, 16, 55, 57, 58, 60, 61, 64, 70 Fatigue, 4, 12, 17, 20, 34, 38, 40, 41, 43, 60 Febrile, 11, 60 Fibrinogen, 6, 60, 72 Forearm, 55, 60 G Gallbladder, 53, 61 Gastrin, 61, 62 Gastrointestinal, 17, 41, 56, 61 Gene, 55, 59, 61, 62 Genetics, 59, 61 Genistein, 7, 61 Genital, 56, 61 Gland, 53, 61, 64, 67, 70, 72 Glomerulus, 61, 66 Glucocorticoids, 53, 58, 61 Glucose, 6, 16, 55, 56, 61, 62, 63, 70 Glycoprotein, 60, 61 Gonadal, 61, 71 Governing Board, 61, 68 Grade, 17, 41, 61 Gram-positive, 61, 65 Growth, 20, 53, 54, 61, 64, 66, 68, 72 H Habitat, 61, 65 Haemodialysis, 13, 61 Heart attack, 56, 62 Hemoglobin, 53, 60, 62 Hemorrhage, 58, 59, 62, 71 Hepatitis, 17, 62 Hepatocytes, 62 Heterozygotes, 59, 62 Homozygotes, 59, 62 Hormonal, 7, 54, 58, 62 Hormone, 3, 4, 6, 7, 8, 38, 58, 60, 61, 62, 63, 68, 72 Hormone Replacement Therapy, 4, 7, 8, 38, 62 Host, 62, 69 Hydrogen, 55, 56, 62, 65, 66 Hypertension, 56, 62 Hypoglycemia, 16, 62 Hypothyroidism, 17, 62 I Id, 43, 48, 50, 62

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Ileum, 41, 62 Immune response, 54, 58, 62, 63, 73 Immune system, 34, 39, 40, 41, 42, 62, 63, 73 Immunocompromised, 34, 63 Immunodeficiency, 20, 21, 34, 38, 39, 40, 42, 63 Immunodeficiency syndrome, 21, 34, 38, 42, 63 Immunosuppressive, 16, 63 Indicative, 15, 63, 67, 73 Infarction, 57, 63, 65 Infection, 10, 17, 19, 20, 34, 38, 39, 40, 41, 42, 58, 63, 64, 66, 69, 71, 72 Inflammation, 4, 16, 41, 54, 57, 62, 63, 64, 66, 67, 69, 72 Inflammatory bowel disease, 5, 41, 63 Insulin, 6, 16, 63 Insulin-dependent diabetes mellitus, 63 Internal Medicine, 8, 13, 60, 63 Interstitial, 5, 63, 66 Intestine, 55, 63, 69, 70 Intracellular, 63 Intravenous, 19, 38, 63 Involuntary, 63, 66, 70 Ions, 55, 59, 62, 63 Ischemia, 54, 63 J Joint, 4, 17, 39, 56, 63, 68 K Kb, 32, 64 Keratolytic, 58, 64 L Latent, 42, 64 Lethargy, 62, 64 Leukocytes, 55, 64 Library Services, 48, 64 Ligaments, 57, 64 Lipid, 63, 64 Liver, 17, 41, 42, 53, 55, 58, 61, 62, 64 Localized, 58, 63, 64, 65, 66, 68, 72 Loneliness, 20, 64 Lymph, 21, 38, 56, 64 Lymph node, 21, 56, 64 Lymphadenitis, 64, 65 Lymphatic, 63, 64, 71 Lymphatic system, 64, 71 Lymphoid, 54, 64 M Malaise, 4, 12, 17, 64 Malignancy, 10, 64 Malignant, 13, 54, 64, 66, 70

Malnutrition, 54, 64 MEDLINE, 33, 64 Membrane, 61, 64, 67, 69 Memory, 53, 58, 64 Menopause, 3, 4, 6, 7, 38, 65, 68 Menstrual Cycle, 65, 68 Menstruation, 65 Metabolic disorder, 58, 65 MI, 20, 51, 65 Micro-organism, 58, 65 Mineralocorticoids, 53, 58, 65 Molecular, 33, 36, 55, 57, 60, 65 Molecule, 54, 55, 65, 66, 72 Monitor, 58, 65 Mononuclear, 16, 65 Mucins, 65, 70 Mucus, 65, 72 Mycobacteriosis, 65 Mycobacterium, 20, 38, 42, 54, 65, 69, 72 Mycobacterium avium, 20, 38, 42, 54, 65, 69 Mycobacterium avium Complex, 38, 42, 65 Myocardium, 65, 66 N Neck Pain, 4, 66 Necrosis, 58, 63, 65, 66 Need, 3, 4, 5, 10, 15, 19, 20, 21, 34, 38, 42, 44, 53, 66 Needle Sharing, 40, 66 Neoplasm, 66, 70 Nephritis, 5, 66 Nervous System, 61, 66 Neurologic, 17, 66 Nucleus, 65, 66 O Ocular, 5, 66 Opacity, 58, 66 Ophthalmologic, 17, 66 Ophthalmology, 66 Opportunistic Infections, 20, 66 Oral Health, 4, 66 Osteoporosis, 3, 4, 66 Ovaries, 3, 66 Ovary, 57, 60, 66 Ovum, 57, 66, 68 Oxidation, 54, 66 P Palliative, 13, 66, 72 Pancreas, 53, 63, 67 Pathogenesis, 5, 16, 67 Pathologic, 12, 55, 57, 67

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Night Sweats

Patient Education, 38, 46, 48, 51, 67 Pelvic, 4, 67 Penis, 57, 59, 67 Peptide, 56, 67, 68, 69, 72 Peptide Chain Elongation, 56, 67 Percutaneous, 5, 67 Periodontitis, 4, 67 Peritoneal, 54, 67 Peritoneal Cavity, 54, 67 Pharmacologic, 67, 72 Phospholipids, 60, 67 Photocoagulation, 57, 67 Physiology, 3, 4, 60, 67 Pituitary Gland, 58, 67 Placenta, 60, 67, 68 Plants, 61, 67, 70, 72 Plasma, 54, 60, 62, 65, 68, 70 Plasma cells, 54, 68 Poisoning, 59, 68 Polymyalgia Rheumatica, 4, 16, 68 Polypeptide, 53, 60, 68 Posterior, 66, 67, 68 Postmenopausal, 3, 6, 7, 66, 68 Practice Guidelines, 35, 68 Prevalence, 12, 16, 68 Progesterone, 6, 68, 71 Progression, 8, 68 Progressive, 58, 61, 66, 68 Prophylaxis, 68, 69 Protein S, 55, 56, 60, 68 Proteins, 17, 53, 54, 60, 65, 67, 68, 69, 70, 72 Protein-Tyrosine Kinase, 61, 68 Proteolytic, 60, 68 Proximal, 8, 59, 68, 69 Public Policy, 33, 69 Pulmonary, 17, 55, 57, 65, 69 Pulmonary Artery, 55, 69 R Radiation, 69, 73 Radiological, 67, 69 Randomized, 6, 8, 59, 69 Rectum, 63, 69 Redux, 11, 69 Refer, 1, 4, 69 Reflux, 9, 69 Regimen, 6, 16, 59, 69 Retina, 58, 69 Retinal, 58, 69 Retinitis, 58, 69 Retrovirus, 19, 69 Rheumatic Diseases, 16, 69 Rifabutin, 28, 39, 42, 69

Risk factor, 42, 69 S Saline, 42, 70 Saliva, 4, 70 Salivary, 58, 70 Salivary glands, 58, 70 Saponins, 70, 71 Sarcoma, 20, 34, 40, 70 Screening, 19, 56, 70 Secretion, 58, 61, 62, 63, 65, 70 Semen, 40, 59, 70 Semisynthetic, 56, 70 Senile, 66, 70 Serum, 6, 8, 65, 70 Sexual Abstinence, 40, 70 Side effect, 7, 16, 20, 27, 42, 53, 70, 72 Signs and Symptoms, 4, 19, 70 Skeleton, 63, 70 Skull, 70, 71 Small intestine, 62, 63, 70 Sneezing, 39, 70 Soft tissue, 55, 70 Specialist, 43, 70 Species, 54, 65, 70, 72 Spermatozoa, 70, 71 Spinal cord, 56, 66, 71 Spleen, 42, 58, 64, 71 Sputum, 39, 71 Staging, 8, 71 Sterile, 71, 72 Steroid, 17, 70, 71 Stomach, 53, 60, 61, 62, 67, 69, 70, 71 Street Drugs, 43, 71 Stress, 34, 71 Stroke, 32, 56, 71 Subacute, 63, 71 Subclinical, 63, 71 Suppression, 17, 58, 71 Symptomatic, 7, 16, 71 Systemic, 4, 16, 28, 55, 63, 71 T Temporal, 4, 16, 68, 71 Testis, 60, 71 Therapeutics, 28, 72 Thrombin, 60, 72 Thyroid, 62, 72 Thyrotropin, 62, 72 Tissue, 39, 42, 54, 55, 57, 59, 60, 63, 64, 65, 66, 67, 69, 70, 72 Toxic, iv, 72 Toxicity, 59, 71, 72 Toxicology, 34, 72

Index 79

Toxins, 54, 63, 72 Toxoplasmosis, 20, 54, 72 Transcriptase, 69, 72 Transfection, 55, 72 Transfusion, 72 Translocation, 56, 60, 72 Tubercle, 72 Tuberculin, 72 Tuberculosis, 34, 38, 39, 41, 42, 57, 65, 72 U Ulcer, 72, 73 Ulcerative colitis, 41, 63, 72 Unconscious, 62, 72 Urethra, 67, 72, 73 Urinary, 56, 73 Urine, 8, 55, 58, 59, 72, 73 Uterus, 56, 57, 60, 65, 66, 68, 73

V Vaccine, 17, 73 Vagina, 4, 6, 65, 73 Vaginal, 3, 6, 40, 73 Varicose, 17, 73 Varicose vein, 17, 73 Vascular, 4, 16, 63, 67, 73 Vasomotor, 6, 73 Vein, 63, 73 Venlafaxine, 9, 73 Veterinary Medicine, 33, 73 Viral, 17, 69, 73 Virus, 17, 20, 21, 34, 38, 39, 40, 42, 73 W Weight Gain, 16, 73 X X-ray, 6, 42, 73

80

Night Sweats