Rapid Weight Loss: A Medical Dictionary, Bibliography, And Annotated Research Guide To Internet References

RAPID WEIGHT LOSS A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R EFERENCES J A...

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RAPID WEIGHT LOSS A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R EFERENCES

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., 1960Rapid Weight Loss: 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: 0-597-84060-1 1. Rapid Weight Loss-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 rapid weight loss. 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 RAPID WEIGHT LOSS ................................................................................ 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Rapid Weight Loss ........................................................................ 4 The National Library of Medicine: PubMed .................................................................................. 6 CHAPTER 2. NUTRITION AND RAPID WEIGHT LOSS ...................................................................... 13 Overview...................................................................................................................................... 13 Finding Nutrition Studies on Rapid Weight Loss ....................................................................... 13 Federal Resources on Nutrition ................................................................................................... 15 Additional Web Resources ........................................................................................................... 15 CHAPTER 3. ALTERNATIVE MEDICINE AND RAPID WEIGHT LOSS ................................................ 17 Overview...................................................................................................................................... 17 National Center for Complementary and Alternative Medicine.................................................. 17 Additional Web Resources ........................................................................................................... 22 General References ....................................................................................................................... 23 CHAPTER 4. DISSERTATIONS ON RAPID WEIGHT LOSS .................................................................. 25 Overview...................................................................................................................................... 25 Dissertations on Rapid Weight Loss ............................................................................................ 25 Keeping Current .......................................................................................................................... 26 CHAPTER 5. BOOKS ON RAPID WEIGHT LOSS................................................................................. 27 Overview...................................................................................................................................... 27 Book Summaries: Online Booksellers........................................................................................... 27 Chapters on Rapid Weight Loss ................................................................................................... 28 CHAPTER 6. PERIODICALS AND NEWS ON RAPID WEIGHT LOSS ................................................... 29 Overview...................................................................................................................................... 29 News Services and Press Releases................................................................................................ 29 Newsletter Articles ...................................................................................................................... 31 Academic Periodicals covering Rapid Weight Loss...................................................................... 31 CHAPTER 7. RESEARCHING MEDICATIONS ..................................................................................... 33 Overview...................................................................................................................................... 33 U.S. Pharmacopeia....................................................................................................................... 33 Commercial Databases ................................................................................................................. 34 APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 37 Overview...................................................................................................................................... 37 NIH Guidelines............................................................................................................................ 37 NIH Databases............................................................................................................................. 39 Other Commercial Databases....................................................................................................... 41 APPENDIX B. PATIENT RESOURCES ................................................................................................. 43 Overview...................................................................................................................................... 43 Patient Guideline Sources............................................................................................................ 43 Finding Associations.................................................................................................................... 47 APPENDIX C. FINDING MEDICAL LIBRARIES .................................................................................. 49 Overview...................................................................................................................................... 49 Preparation................................................................................................................................... 49 Finding a Local Medical Library.................................................................................................. 49 Medical Libraries in the U.S. and Canada ................................................................................... 49 ONLINE GLOSSARIES.................................................................................................................. 55 Online Dictionary Directories ..................................................................................................... 55

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RAPID WEIGHT LOSS DICTIONARY ...................................................................................... 57 INDEX ................................................................................................................................................ 77

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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 rapid weight loss 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 rapid weight loss, 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 rapid weight loss, 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 rapid weight loss. 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 rapid weight loss, 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 rapid weight loss. 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 RAPID WEIGHT LOSS Overview In this chapter, we will show you how to locate peer-reviewed references and studies on rapid weight loss.

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

Rapid Weight Loss Involves Risk Source: Healthy Weight Journal. p.56-58. July/August 2000. Contact: B.C. Decker, Inc. 4 Hughson St. South, O.O. Box 620, LCD1, Hamilton, Ontario L8N 3K7, Canada. 800-568-7281. 905-522-7017. [email protected]. Summary: This article reviews the risks and consequences of rapid weight loss that occurs among athletes competing in sports that have weight classifications. By competing in the lowest possible weight class, the athletes aim for a strength and leverage advantage over their smaller opponents. Many resort to drastic measures to drop weight temporarily and quickly before each competition. This up-and-down weight cycle is repeated before each competition and may occur more than 10 times in a season. The article describes the potential negative effects of weight cutting on an

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athlete's health and performance, including dehydration and depleted energy reserves and lean body mass. Rapid weight loss may also alter hormonal status, impede normal growth and development, slow resting metabolic rate, affect psychological state and cognitive function, impair academic performance, and have more severe consequences such as pulmonary emboli, pancreatitis, and reduced immune function. The article also reviews the American College of Sports Medicine (ACSM) recommendations to limit damaging weight-cutting practices in wrestling. Suggestions for maximizing recovery in athletes who participate in rapid weight loss practices are discussed. The article concludes that the negative health and performance effects associated with rapid weight loss can be reduced with expert advice on an athlete's minimal competition weight, reasonable guidelines for achieving this weight goal, and practical tips for maximizing recovery between the weigh-in and competition.

Federally Funded Research on Rapid Weight Loss The U.S. Government supports a variety of research studies relating to rapid weight loss. 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 rapid weight loss. For most of the studies, the agencies reporting into CRISP provide summaries or abstracts. As opposed to clinical trial research using patients, many federally funded studies use animals or simulated models to explore rapid weight loss. The following is typical of the type of information found when searching the CRISP database for rapid weight loss: •

Project Title: BARIATRIC SURGERY RESEARCH CONSORTIUM Principal Investigator & Institution: Flum, David R.; Surgery; University of Washington Seattle, Wa 98195 Timing: Fiscal Year 2003; Project Start 30-SEP-2003; Project End 31-AUG-2008 Summary: (provided by applicant): Bariatric procedures offer sustained and significant weight reduction with the potential to effect general patient health, comorbid conditions, quality of life and the healthcare system. A Bariatric Surgery Clinical Research Consortium (BSCRC) wilt provide important prospective information about the true impact of the procedure on patients and opportunities to better explore the physiologic mechanisms that result in post-surgical weight loss. The BSCRC will prospectively collect clinical, demographic, epidemiological, laboratory and histological information. In addition to this database the BSCRC will complete the following studies: 1. A cross-sectional examination of the epidemiology of non-alcoholic steatohepatitis (NASH) in patients undergoing bariatric surgery and a prospective evaluation of the effect of surgically induced weight loss on the severity NASH and cellular markers of

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

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cytotoxic activity. There is a need for epidemiologic information about the prevalence, risk factors for, and impact of fatty liver disease in patients undergoing bariatric surgery. We propose a study to evaluate liver histology in a large group of patients undergoing bariatric procedures. Patients with evidence of NASH by biopsy will undergo subsequent liver biopsy at one year to determine if NASH improves with rapid weight loss. Patients with NASH who improve after weight loss represent an important model for evaluating the cellular mechanisms that are involved in the development of NASH. This study will evaluate markers of oxidative stress and hepatic mitochondrial structure to determine their relationship to NASH during and after rapid, surgical weight loss. 2. A prospective evaluation of the relationship between ghrelin, PYY3-36, appetite and weight loss outcomes after gastric bypass. Ghrelin and PYY3-36 are gutderived peptides that are involved in energy homeostasis principally through their effect on appetite. We propose a prospective study to determine the relationship of ghrelin and weight loss after gastric bypass and to determine if the degree of ghrelin suppression is correlated to hunger suppression and/or the amount of weight lost. This study will determine if inclusion of ghrelin producing cells in the gastric pouch is correlated to worsened weight loss outcomes. Lastly the study will begin to evaluate the relationship of PYY3-36 and ghrelin and determine if it is altered by or in response to the physiologic changes associated with gastric bypass. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: BENEFITS & HAZARDS OF KETOGENIC LOW CARBOHYDRATE DIETS Principal Investigator & Institution: Karanja, Njeri; Medicine; Oregon Health & Science University Portland, or 972393098 Timing: Fiscal Year 2001; Project Start 01-MAY-2001; Project End 31-MAR-2003 Summary: (APPLICANT'S ABSTRACT): Low-carbohydrate, high-fat, high-protein diets promoted by books, the Internet and other media are among the most enduring weightloss diets in the US and Europe. The public favors these diets because they include popular energy-rich foods like meat and cheese while at the same time promising to produce rapid weight loss. Without an evidence-based understanding the consequences of these diets, health care providers may find it difficult to evaluate these diets in advising clients who are choosing to use them to reduce weight in large numbers. The goal of this pilot project is to establish methodology for studying these diets in a clinical trial setting. A group of 24 overweight participants with BMIs between 27 and 39.9 Kg/m~ will be studied in a parallel group design for six weeks of controlled feeding and six weeks of follow-up. After screening, participants will be allocated to either a low-carbohydrate diet similar to the one marketed by Dr. Robert Atkins, or to an energy-matched, high carbohydrate, low fat diet similar to the combination diet used in the DASH study for six weeks. Participants will receive all foods and beverages in the General Clinical Research Center at Oregon Health Sciences University during the controlled feeding phase. Participants will first consume a standard American diet for one week to stabilize their energy requirements and acclimate to the demands of the study. This run-in week will be followed by a six-week period when participants consume either the Atkins diet or the DASH diet. Follow-up consists of following these same diets in the home setting for an additional six weeks. Measures of interest include markers of oxidative damage, cardiovascular disease (CVD) risk (lipids, blood pressure insulin, glucose), bone health, energy expenditure, substrate utilization and body composition. We will also conduct focus groups and individual interviews during the period when participants follow these diets at home to gain an understanding of how

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these diets affect the quality of their lives. This study will provide us with many tools to evaluate a variety of ways that low-carbohydrate weight-loss diets affect adherence, body weight and body composition, energy metabolism, and several markers of chronic diseases which may be affected by the altered nutrient intake. It will provide insights as to the nature of these changes, the time course of the changes, and variability of these measures. We will use information gained in this pilot study to design more comprehensive studies that evaluate these alternative diets in a more rigorous fashion. 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 rapid weight loss, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “rapid weight loss” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for rapid weight loss (hyperlinks lead to article summaries): •

A multicenter, placebo-controlled, randomized, double-blind, prospective trial of prophylactic ursodiol for the prevention of gallstone formation following gastricbypass-induced rapid weight loss. Author(s): Sugerman HJ, Brewer WH, Shiffman ML, Brolin RE, Fobi MA, Linner JH, MacDonald KG, MacGregor AM, Martin LF, Oram-Smith JC, et al. Source: American Journal of Surgery. 1995 January; 169(1): 91-6; Discussion 96-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7818005&dopt=Abstract

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Acute superior mesenteric artery syndrome due to rapid weight loss following massive small bowel resection. Author(s): Bapat VN, Rastogi S, Moorthy K, Kulgod S, Supe A. Source: Indian J Gastroenterol. 1996 October; 15(4): 154. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8916586&dopt=Abstract

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Adipose tissue distribution changes during rapid weight loss in obese adults. Author(s): Ross R, Leger L, Marliss EB, Morris DV, Gougeon R. Source: Int J Obes. 1991 November; 15(11): 733-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1778658&dopt=Abstract

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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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BP changes in obese hypertensive subjects during rapid weight loss. Comparison of restricted v unchanged salt intake. Author(s): Maxwell MH, Kushiro T, Dornfeld LP, Tuck ML, Waks AU. Source: Archives of Internal Medicine. 1984 August; 144(8): 1581-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6466017&dopt=Abstract

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Changes in abdominal subcutaneous fat water content with rapid weight loss and long-term weight maintenance in abdominally obese men and women. Author(s): Laaksonen DE, Nuutinen J, Lahtinen T, Rissanen A, Niskanen LK. Source: International Journal of Obesity and Related Metabolic Disorders : Journal of the International Association for the Study of Obesity. 2003 June; 27(6): 677-83. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12833111&dopt=Abstract

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Changes in body composition and resting energy expenditure after rapid weight loss: is there an energy-metabolism adaptation in obese patients? Author(s): Valtuena S, Blanch S, Barenys M, Sola R, Salas-Salvado J. Source: International Journal of Obesity and Related Metabolic Disorders : Journal of the International Association for the Study of Obesity. 1995 February; 19(2): 119-25. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7735338&dopt=Abstract

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Circadian variation and blood pressure: response to rapid weight loss by hypocaloric hyponatraemic diet in obesity. Author(s): DasGupta P, Brigden G, Ramhamdany E, Lahiri A, Baird IM, Raftery EB. Source: Journal of Hypertension. 1991 May; 9(5): 441-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1649864&dopt=Abstract

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Decrease in resting metabolic rate during rapid weight loss is reversed by low dose thyroid hormone treatment. Author(s): Welle SL, Campbell RG. Source: Metabolism: Clinical and Experimental. 1986 April; 35(4): 289-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3959900&dopt=Abstract

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Effect of rapid weight loss on metabolism and isokinetic performance capacity. A case study of two well trained wrestlers. Author(s): Oopik V, Paasuke M, Sikku T, Timpmann S, Medijainen L, Ereline J, Smirnova T, Gapejeva E. Source: The Journal of Sports Medicine and Physical Fitness. 1996 June; 36(2): 127-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8898520&dopt=Abstract

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Effect of rapid weight loss with supplemented fasting on liver tests. Author(s): Friis R, Vaziri ND, Akbarpour F, Afrasiabi A. Source: Journal of Clinical Gastroenterology. 1987 April; 9(2): 204-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3571895&dopt=Abstract

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Effect of rapid weight loss with supplemented fasting on serum electrolytes, lipids, and blood pressure. Author(s): Pahl MV, Vaziri ND, Akbarpour F, Afrasiabi A, Friis R. Source: Journal of the National Medical Association. 1988 July; 80(7): 803-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3404561&dopt=Abstract

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Effects of rapid weight loss and wrestling on muscle glycogen concentration. Author(s): Tarnopolsky MA, Cipriano N, Woodcroft C, Pulkkinen WJ, Robinson DC, Henderson JM, MacDougall JD. Source: Clinical Journal of Sport Medicine : Official Journal of the Canadian Academy of Sport Medicine. 1996 April; 6(2): 78-84. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8673580&dopt=Abstract

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Effects of rapid weight loss on mood and performance among amateur boxers. Author(s): Hall CJ, Lane AM. Source: British Journal of Sports Medicine. 2001 December; 35(6): 390-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11726472&dopt=Abstract

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Gallstone formation after rapid weight loss: a prospective study in patients undergoing gastric bypass surgery for treatment of morbid obesity. Author(s): Shiffman ML, Sugerman HJ, Kellum JM, Brewer WH, Moore EW. Source: The American Journal of Gastroenterology. 1991 August; 86(8): 1000-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1858735&dopt=Abstract

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Gallstone formation and rapid weight loss: pounds for stones? Author(s): Lipsky H, Barkin JS. Source: The American Journal of Gastroenterology. 1993 July; 88(7): 1128-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8317422&dopt=Abstract

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Gradual and rapid weight loss: effects on nutrition and performance in male athletes. Author(s): Fogelholm GM, Koskinen R, Laakso J, Rankinen T, Ruokonen I. Source: Medicine and Science in Sports and Exercise. 1993 March; 25(3): 371-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8455453&dopt=Abstract

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Hair loss with rapid weight loss. Author(s): Blackburn GL, Bistrian BR, Hoag C. Source: Archives of Dermatology. 1977 February; 113(2): 234. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=836699&dopt=Abstract

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Impact of rapid weight loss on cognitive function in collegiate wrestlers. Author(s): Choma CW, Sforzo GA, Keller BA. Source: Medicine and Science in Sports and Exercise. 1998 May; 30(5): 746-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9588618&dopt=Abstract

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Improvement in left ventricular function after rapid weight loss in obesity. Author(s): DasGupta P, Ramhanmdany E, Brigden G, Lahiri A, Baird IM, Raftery EB. Source: European Heart Journal. 1992 August; 13(8): 1060-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1505555&dopt=Abstract

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Increased saliva cotinine concentrations in smokers during rapid weight loss. Author(s): Niaura R, Clark MM, Raciti MA, Pera V, Abrams DB. Source: Journal of Consulting and Clinical Psychology. 1992 December; 60(6): 985-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1460162&dopt=Abstract

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Letter: Hair loss with rapid weight loss. Author(s): Blackburn GL, Bistrian BR, Hoag C. Source: Jama : the Journal of the American Medical Association. 1976 July 19; 236(3): 252. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=947023&dopt=Abstract

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Lipids and apolipoproteins A-I, B and C-II and different rapid weight loss programs (weight lifters, wrestlers, boxers and judokas). Author(s): Jauhiainen M, Laitinen M, Penttila I, Nousiainen U, Ahonen E. Source: Int J Biochem. 1985; 17(2): 167-74. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3924676&dopt=Abstract

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Loss of total body potassium during rapid weight loss does not depend on the decrease of potassium concentration in muscles. Different methods to evaluate body composition during a low energy diet. Author(s): Krotkiewski M, Landin K, Mellstrom D, Tolli J. Source: International Journal of Obesity and Related Metabolic Disorders : Journal of the International Association for the Study of Obesity. 2000 January; 24(1): 101-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10702758&dopt=Abstract

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Normal dexamethasone suppression in obese binge and nonbinge eaters with rapid weight loss. Author(s): Yanovski SZ, Yanovski JA, Gwirtsman HE, Bernat A, Gold PW, Chrousos GP. Source: The Journal of Clinical Endocrinology and Metabolism. 1993 March; 76(3): 675-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8445025&dopt=Abstract

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Prevention of gallstone formation in morbidly obese patients undergoing rapid weight loss: results of a randomized controlled pilot study. Author(s): Wudel LJ Jr, Wright JK, Debelak JP, Allos TM, Shyr Y, Chapman WC. Source: The Journal of Surgical Research. 2002 January; 102(1): 50-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11792152&dopt=Abstract

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Prolonged QT interval--ventricular tachycardia syndrome from massive rapid weight loss utilizing the liquid-protein-modified-fast diet: sudden death with sinus node ganglionitis and neuritis. Author(s): Siegel RJ, Cabeen WR Jr, Roberts WC. Source: American Heart Journal. 1981 July; 102(1): 121-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7246398&dopt=Abstract

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Rapid weight loss and lean tissue: evidence for comparable body composition and metabolic rate in differing rates of weight loss. Author(s): Coxon A, Kreitzman S, Brodie D, Howard A. Source: Int J Obes. 1989; 13 Suppl 2: 179-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2613421&dopt=Abstract

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Rapid weight loss in children. Author(s): Brook CG, Lloyd JK, Wolff OH. Source: British Medical Journal. 1974 July 6; 2(922): 44-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4835478&dopt=Abstract

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Resting metabolic rates of obese women after rapid weight loss. Author(s): Welle SL, Amatruda JM, Forbes GB, Lockwood DH. Source: The Journal of Clinical Endocrinology and Metabolism. 1984 July; 59(1): 41-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6725523&dopt=Abstract

•

Reversible anorexia and rapid weight loss associated with neuroleptic administration in Alzheimer's disease. Author(s): Rohrbaugh RM, Siegal AP. Source: Journal of Geriatric Psychiatry and Neurology. 1989 January-March; 2(1): 45-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2568117&dopt=Abstract

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Superior mesenteric artery syndrome in an intravenous drug abuser after rapid weight loss. Author(s): Barnes JB, Lee M. Source: Southern Medical Journal. 1996 March; 89(3): 331-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8604467&dopt=Abstract

Studies

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The effect of rapid weight loss due to jejunoileal bypass on total cholesterol and high-density lipoprotein. Author(s): Dobrea GM, Wieland RG, Johnson MW. Source: The American Journal of Clinical Nutrition. 1981 October; 34(10): 1994-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7293931&dopt=Abstract

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The effect of ursodeoxycholic acid therapy on gallstone formation in the morbidly obese during rapid weight loss. Author(s): Worobetz LJ, Inglis FG, Shaffer EA. Source: The American Journal of Gastroenterology. 1993 October; 88(10): 1705-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8213711&dopt=Abstract

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The effects of rapid weight loss and rehydratation on a wrestling performance test. Author(s): Klinzing JE, Karpowicz W. Source: The Journal of Sports Medicine and Physical Fitness. 1986 June; 26(2): 149-56. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3747480&dopt=Abstract

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The role of gallbladder emptying in gallstone formation during diet-induced rapid weight loss. Author(s): Gebhard RL, Prigge WF, Ansel HJ, Schlasner L, Ketover SR, Sande D, Holtmeier K, Peterson FJ. Source: Hepatology (Baltimore, Md.). 1996 September; 24(3): 544-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8781321&dopt=Abstract

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CHAPTER 2. NUTRITION AND RAPID WEIGHT LOSS Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and rapid weight loss.

Finding Nutrition Studies on Rapid Weight Loss The National Institutes of Health’s Office of Dietary Supplements (ODS) offers a searchable bibliographic database called the IBIDS (International Bibliographic Information on Dietary Supplements; National Institutes of Health, Building 31, Room 1B29, 31 Center Drive, MSC 2086, Bethesda, Maryland 20892-2086, Tel: 301-435-2920, Fax: 301-480-1845, E-mail: [email protected]). The IBIDS contains over 460,000 scientific citations and summaries about dietary supplements and nutrition as well as references to published international, scientific literature on dietary supplements such as vitamins, minerals, and botanicals.4 The IBIDS includes references and citations to both human and animal research studies. As a service of the ODS, access to the IBIDS database is available free of charge at the following Web address: http://ods.od.nih.gov/databases/ibids.html. After entering the search area, you have three choices: (1) IBIDS Consumer Database, (2) Full IBIDS Database, or (3) Peer Reviewed Citations Only. Now that you have selected a database, click on the “Advanced” tab. An advanced search allows you to retrieve up to 100 fully explained references in a comprehensive format. Type “rapid weight loss” (or synonyms) into the search box, and click “Go.” To narrow the search, you can also select the “Title” field.

4

Adapted from http://ods.od.nih.gov. IBIDS is produced by the Office of Dietary Supplements (ODS) at the National Institutes of Health to assist the public, healthcare providers, educators, and researchers in locating credible, scientific information on dietary supplements. IBIDS was developed and will be maintained through an interagency partnership with the Food and Nutrition Information Center of the National Agricultural Library, U.S. Department of Agriculture.

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Rapid Weight Loss

The following information is typical of that found when using the “Full IBIDS Database” to search for “rapid weight loss” (or a synonym): •

Decrease in resting metabolic rate during rapid weight loss is reversed by low dose thyroid hormone treatment. Source: Welle, S.L. Campbell, R.G. Metab-Clin-Exp. Orlando, Fla. : Grune & Stratton. April 1986. volume 35 (4) page 289-291. 0026-0495

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Effect of dietary protein quality and fatty acid composition on plasma lipoprotein concentrations and hepatic triglyceride fatty acid synthesis in obese cats undergoing rapid weight loss. Author(s): Multidisciplinary Nutritional Sciences Program, College of Allied Health Professions, University of Kentucky, Lexington 40506-0003, USA. Source: Ibrahim, W H Szabo, J Sunvold, G D Kelleher, J K Bruckner, G G Am-J-Vet-Res. 2000 May; 61(5): 566-72 0002-9645

•

Effects of rapid weight loss on mood and performance among amateur boxers. Author(s): Department of Sports Sciences, Brunel University, UK. Source: Hall, C J Lane, A M Br-J-Sports-Med. 2001 December; 35(6): 390-5 0306-3674

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Impact of rapid weight loss on cognitive function in collegiate wrestlers. Author(s): Department of Exercise & Sport Sciences, Ithaca College, NY 14850, USA. Source: Choma, C W Sforzo, G A Keller, B A Med-Sci-Sports-Exerc. 1998 May; 30(5): 7469 0195-9131

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Improvement in left ventricular function after rapid weight loss in obesity. Author(s): Department of Cardiology, Northwick Park Hospital, Harrow, Middlesex, U.K. Source: DasGupta, P Ramhanmdany, E Brigden, G Lahiri, A Baird, I M Raftery, E B EurHeart-J. 1992 August; 13(8): 1060-6 0195-668X

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Loss of total body potassium during rapid weight loss does not depend on the decrease of potassium concentration in muscles. Different methods to evaluate body composition during a low energy diet. Author(s): Department of Rehabilitation Medicine, Sahlgrenska University Hospital, Goteborg. [email protected] Source: Krotkiewski, M Landin, K Mellstrom, D Tolli, J Int-J-Obes-Relat-Metab-Disord. 2000 January; 24(1): 101-7 0307-0565

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Prevention of gallstone formation in morbidly obese patients undergoing rapid weight loss: results of a randomized controlled pilot study. Author(s): Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee 37232-4753, USA. Source: Wudel, L James Jr Wright, J Kelly Debelak, Jacob P Allos, Tara M Shyr, Yu Chapman, William C J-Surg-Res. 2002 January; 102(1): 50-6 0022-4804

•

Reversible anorexia and rapid weight loss associated with neuroleptic administration in Alzheimer's disease. Author(s): Department of Psychiatry, Yale University, New Haven, Connecticut. Source: Rohrbaugh, R M Siegal, A P J-Geriatr-Psychiatry-Neurol. 1989 Jan-March; 2(1): 45-7 0891-9887

Nutrition

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

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

•

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

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

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

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

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

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

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

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

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

•

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

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

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

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

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

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

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

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CHAPTER 3. ALTERNATIVE MEDICINE AND RAPID WEIGHT LOSS Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to rapid weight loss. At the conclusion of this chapter, we will provide additional sources.

National Center for Complementary and Alternative Medicine The National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health (http://nccam.nih.gov/) has created a link to the National Library of Medicine’s databases to facilitate research for articles that specifically relate to rapid weight loss and complementary medicine. To search the database, go to the following Web site: http://www.nlm.nih.gov/nccam/camonpubmed.html. Select “CAM on PubMed.” Enter “rapid weight loss” (or synonyms) into the search box. Click “Go.” The following references provide information on particular aspects of complementary and alternative medicine that are related to rapid weight loss: •

9-Aminocamptothecin: a topoisomerase I inhibitor with preclinical activity in prostate cancer. Author(s): de Souza PL, Cooper MR, Imondi AR, Myers CE. Source: Clinical Cancer Research : an Official Journal of the American Association for Cancer Research. 1997 February; 3(2): 287-94. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9815685&dopt=Abstract

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A practical guide to fad diets. Author(s): Porcello LA. Source: Clinics in Sports Medicine. 1984 July; 3(3): 723-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6571242&dopt=Abstract

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A randomized study of nutritional support in patients with colorectal and gastric cancer. Author(s): Persson CR, Johansson BB, Sjoden PO, Glimelius BL. Source: Nutrition and Cancer. 2002; 42(1): 48-58. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12235650&dopt=Abstract

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Activity of datelliptium acetate (NSC 311152; SR 95156A) against solid tumors of mice. Author(s): Mucci-LoRusso P, Polin L, Biernat LA, Valeriote FA, Corbett TH. Source: Investigational New Drugs. 1990 August; 8(3): 253-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2177044&dopt=Abstract

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Advances in dietary management of obesity in dogs and cats. Author(s): Butterwick RF, Hawthorne AJ. Source: The Journal of Nutrition. 1998 December; 128(12 Suppl): 2771S-2775S. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9868263&dopt=Abstract

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An analysis of excessive running in the development of activity anorexia. Author(s): Beneke WM, Schulte SE, vander Tuig JG. Source: Physiology & Behavior. 1995 September; 58(3): 451-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8587951&dopt=Abstract

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Biliary cholesterol saturation and weight reduction--effects of fasting and low calorie diet. Author(s): Schlierf G, Schellenberg B, Stiehl A, Czygan P, Oster P. Source: Digestion. 1981; 21(1): 44-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7227666&dopt=Abstract

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Consequences of modified fasting in obese pediatric and adolescent patients. I. Protein-sparing modified fast. Author(s): Merritt RJ, Bistrian BR, Blackburn GL, Suskind RM. Source: The Journal of Pediatrics. 1980 January; 96(1): 13-19. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7350293&dopt=Abstract

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Diabetes incidence in Pima indians: contributions of obesity and parental diabetes. Author(s): Knowler WC, Pettitt DJ, Savage PJ, Bennett PH. Source: American Journal of Epidemiology. 1981 February; 113(2): 144-56. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7468572&dopt=Abstract

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Differential effects of sauna-, diuretic-, and exercise-induced hypohydration. Author(s): Caldwell JE, Ahonen E, Nousiainen U.

Alternative Medicine 19

Source: Journal of Applied Physiology (Bethesda, Md. : 1985). 1984 October; 57(4): 101823. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6501022&dopt=Abstract •

Effect of creatine supplementation during rapid body mass reduction on metabolism and isokinetic muscle performance capacity. Author(s): Oopik V, Paasuke M, Timpmann S, Medijainen L, Ereline J, Smirnova T. Source: European Journal of Applied Physiology and Occupational Physiology. 1998 June; 78(1): 83-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9660161&dopt=Abstract

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Effect of dietary protein quality and fatty acid composition on plasma lipoprotein concentrations and hepatic triglyceride fatty acid synthesis in obese cats undergoing rapid weight loss. Author(s): Ibrahim WH, Szabo J, Sunvold GD, Kelleher JK, Bruckner GG. Source: Am J Vet Res. 2000 May; 61(5): 566-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10803654&dopt=Abstract

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Effect of fasting, refeeding, and dietary fat restriction on plasma leptin levels. Author(s): Weigle DS, Duell PB, Connor WE, Steiner RA, Soules MR, Kuijper JL. Source: The Journal of Clinical Endocrinology and Metabolism. 1997 February; 82(2): 561-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9024254&dopt=Abstract

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Effect of rapid weight loss with supplemented fasting on liver tests. Author(s): Friis R, Vaziri ND, Akbarpour F, Afrasiabi A. Source: Journal of Clinical Gastroenterology. 1987 April; 9(2): 204-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3571895&dopt=Abstract

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Effectiveness of a low-fat vegetarian diet in altering serum lipids in healthy premenopausal women. Author(s): Barnard ND, Scialli AR, Bertron P, Hurlock D, Edmonds K, Talev L. Source: The American Journal of Cardiology. 2000 April 15; 85(8): 969-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10760336&dopt=Abstract

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Effects of creatine supplementation during recovery from rapid body mass reduction on metabolism and muscle performance capacity in well-trained wrestlers. Author(s): Oopik V, Paasuke M, Timpmann S, Medijainen L, Ereline J, Gapejeva J. Source: The Journal of Sports Medicine and Physical Fitness. 2002 September; 42(3): 3309. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12094124&dopt=Abstract

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Effects of fasting and refeeding on blood pressure are determined by nutritional state, not by body weight change. Author(s): Ernsberger P, Nelson DO. Source: American Journal of Hypertension : Journal of the American Society of Hypertension. 1988 July; 1(3 Pt 3): 153S-157S. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3415792&dopt=Abstract

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Effects of protein, lipid, or carbohydrate supplementation on hepatic lipid accumulation during rapid weight loss in obese cats. Author(s): Biourge VC, Massat B, Groff JM, Morris JG, Rogers QR. Source: Am J Vet Res. 1994 October; 55(10): 1406-15. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7998698&dopt=Abstract

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Fish oil (n-3) polyunsaturated fatty acids beneficially affect biliary cholesterol nucleation time in obese women losing weight. Author(s): Mendez-Sanchez N, Gonzalez V, Aguayo P, Sanchez JM, Tanimoto MA, Elizondo J, Uribe M. Source: The Journal of Nutrition. 2001 September; 131(9): 2300-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11533270&dopt=Abstract

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Influence of dietary protein and lipid on weight loss in obese ovariohysterectomized cats. Author(s): Szabo J, Ibrahim WH, Sunvold GD, Dickey KM, Rodgers JB, Toth IE, Boissonneault GA, Bruckner GG. Source: Am J Vet Res. 2000 May; 61(5): 559-65. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10803653&dopt=Abstract

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Lack of effect of eicosapentaenoic acid in preventing cancer cachexia and inhibiting tumor growth. Author(s): Costelli P, Llovera M, Lopez-Soriano J, Carbo N, Tessitore L, Lopez-Soriano FJ, Baccino FM, Argiles JM. Source: Cancer Letters. 1995 October 20; 97(1): 25-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7585474&dopt=Abstract

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Oral zinc supplementation in anorexia nervosa. Author(s): Safai-Kutti S. Source: Acta Psychiatrica Scandinavica. Supplementum. 1990; 361: 14-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2291418&dopt=Abstract

•

Pandemic obesity and the contagion of nutritional nonsense. Author(s): Katz DL.


Source: Public Health Rev. 2003; 31(1): 33-44. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14656042&dopt=Abstract •

Primary and secondary prevention of gallstone disease: implications for patient management and research priorities. Author(s): Hofmann AF. Source: American Journal of Surgery. 1993 April; 165(4): 541-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8386910&dopt=Abstract

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Prolonged pseudoaldosteronism induced by glycyrrhizin. Author(s): Takeda R, Morimoto S, Uchida K, Nakai T, Miyamoto M, Hashiba T, Yoshimitsu K, Kim KS, Miwa U. Source: Endocrinol Jpn. 1979 October; 26(5): 541-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=393503&dopt=Abstract

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Rapid hypotensive response to fasting in spontaneously hypertensive rats. Author(s): Fitzgerald SM, Hall JE, Brands MW. Source: American Journal of Hypertension : Journal of the American Society of Hypertension. 2001 November; 14(11 Pt 1): 1123-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11724211&dopt=Abstract

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Rapid reduction of serum cholesterol and blood pressure by a twelve-day, very low fat, strictly vegetarian diet. Author(s): McDougall J, Litzau K, Haver E, Saunders V, Spiller GA. Source: Journal of the American College of Nutrition. 1995 October; 14(5): 491-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8522729&dopt=Abstract

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Rapidly progressive interstitial renal fibrosis in young women: association with slimming regimen including Chinese herbs. Author(s): Vanherweghem JL, Depierreux M, Tielemans C, Abramowicz D, Dratwa M, Jadoul M, Richard C, Vandervelde D, Verbeelen D, Vanhaelen-Fastre R, et al. Source: Lancet. 1993 February 13; 341(8842): 387-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8094166&dopt=Abstract

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Reduced adipose 18:3 omega 3 with weight loss by very low calorie dieting. Author(s): Phinney SD, Tang AB, Johnson SB, Holman RT. Source: Lipids. 1990 December; 25(12): 798-806. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2093141&dopt=Abstract

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Solid-state characterization of paclitaxel. Author(s): Liggins RT, Hunter WL, Burt HM.

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Source: Journal of Pharmaceutical Sciences. 1997 December; 86(12): 1458-63. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9423162&dopt=Abstract •

The clinical and metabolic effects of rapid weight loss in obese pet cats and the influence of supplemental oral L-carnitine. Author(s): Center SA, Harte J, Watrous D, Reynolds A, Watson TD, Markwell PJ, Millington DS, Wood PA, Yeager AE, Erb HN. Source: J Vet Intern Med. 2000 November-December; 14(6): 598-608. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11110381&dopt=Abstract

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The current status of treatment for obesity in adults. Author(s): Stunkard AJ. Source: Res Publ Assoc Res Nerv Ment Dis. 1984; 62: 157-73. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6695112&dopt=Abstract

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The pharmacokinetics and toxicity of murine monoclonal antibodies and of gelonin conjugates of these antibodies. Author(s): Scott CF Jr, Lambert JM, Goldmacher VS, Blatter WA, Sobel R, Schlossman SF, Benacerraf B. Source: International Journal of Immunopharmacology. 1987; 9(2): 211-25. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3495503&dopt=Abstract

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Time course of fungal removal of lipophilic extractives from Eucalyptus globulus wood. Author(s): Martinez-Inigo MJ, Gutierrez A, del Rio JC, Martinez MJ, Martinez AT. Source: Journal of Biotechnology. 2001 November 30; 84(2): 119-26. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11090683&dopt=Abstract

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

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

•


•

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

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

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

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

•

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


•

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

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

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

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

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

•

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

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

General Overview Gallstones Source: Healthnotes, Inc.; www.healthnotes.com Gout Source: Integrative Medicine Communications; www.drkoop.com

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

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CHAPTER 4. DISSERTATIONS ON RAPID WEIGHT LOSS Overview In this chapter, we will give you a bibliography on recent dissertations relating to rapid weight loss. We will also provide you with information on how to use the Internet to stay current on dissertations. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical dissertations that use the generic term “rapid weight loss” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on rapid weight loss, we have not necessarily excluded non-medical dissertations in this bibliography.

Dissertations on Rapid Weight Loss ProQuest Digital Dissertations, the largest archive of academic dissertations available, is located at the following Web address: http://wwwlib.umi.com/dissertations. From this archive, we have compiled the following list covering dissertations devoted to rapid weight loss. You will see that the information provided includes the dissertation’s title, its author, and the institution with which the author is associated. The following covers recent dissertations found when using this search procedure: •

Effects of Rapid Weight Loss by Dehydration and Starvation on Performance of Heat Acclimatized Subjects under Heat Stress (110 Degrees F.) As Determined by Selected Psychomotor, Strength, Mental, and Physiological Parameters by Williams, William Redden, PhD from University of North Carolina at Chapel Hill, 1967, 182 pages http://wwwlib.umi.com/dissertations/fullcit/6802252

•

The Physiological Effects of Rapid Weight Loss among Wrestlers by Elfenbaum, Louis, PhD from Ohio State University, 1966, 121 pages http://wwwlib.umi.com/dissertations/fullcit/6702436

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

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CHAPTER 5. BOOKS ON RAPID WEIGHT LOSS Overview This chapter provides bibliographic book references relating to rapid weight loss. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on rapid weight loss 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 “rapid weight loss” at online booksellers’ Web sites, you may discover non-medical books that use the generic term “rapid weight loss” (or a synonym) in their titles. The following is indicative of the results you might find when searching for “rapid weight loss” (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): •

Beyond Pritikin : A Total Nutrition Program For Rapid Weight Loss, Longevity, & Good Health by Ann Louise Gittleman (Author); ISBN: 0553574000; http://www.amazon.com/exec/obidos/ASIN/0553574000/icongroupinterna

•

Lauri's Low-Carb Cookbook: Rapid Weight Loss with Satisfying Meals! (2nd Edition) by Lauri Ann Randolph; ISBN: 0966796314; http://www.amazon.com/exec/obidos/ASIN/0966796314/icongroupinterna

•

The Lite Lifestyle: 150 Ultra Low Calorie Recipes for Rapid Weight Loss! by Laura Creavalle; ISBN: 0966916883; http://www.amazon.com/exec/obidos/ASIN/0966916883/icongroupinterna

•

The super 500 rapid weight loss program by Ronald R. Romano; ISBN: 0138759308; http://www.amazon.com/exec/obidos/ASIN/0138759308/icongroupinterna

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•

The Two-Day Diet : A Metabolic and Motivational Approach to Rapid Weight Loss by M.D. Glenn Cooper (Author); ISBN: 0394565770; http://www.amazon.com/exec/obidos/ASIN/0394565770/icongroupinterna

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

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CHAPTER 6. PERIODICALS AND NEWS ON RAPID WEIGHT LOSS Overview In this chapter, we suggest a number of news sources and present various periodicals that cover rapid weight loss.

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

Vasopressin antagonist induces rapid weight loss in decompensated CHF Source: Reuters Medical News Date: November 11, 2003

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•

Breastfeeding Prompts Rapid Weight Loss Source: Reuters Health eLine Date: November 11, 1997 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 “rapid weight loss” (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 “rapid weight loss” (or synonyms). If you know the name of a company that is relevant to rapid weight loss, 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 “rapid weight loss” (or synonyms).

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31

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

When Your Toddler is a Celiac: A Mom's View Source: CDF Newsletter. 9(1): 12. Winter 1999. Contact: Available from Celiac Disease Foundation. 13251 Ventura Blvd., Suite 1, Studio City, CA 91604-1838. (818) 990-2354. Fax (818) 990-2379. E-mail: [email protected]. Website: www.celiac.org. Summary: In this brief newsletter article, the mother of a toddler diagnosed with celiac disease (CD) at 16 months of age describes their first year of learning about and living with CD. The child had been sick for three months with all of the classic symptoms of CD, including rapid weight loss, bloated belly, muscle wasting, and constant vomiting. The mother describes the emotional ups and downs that followed the accurate CD diagnosis, from guilt because the child had to live a different lifestyle to relief that the child could be healthy if she followed a gluten free diet. The author notes that a difference between being a parent of a celiac child and being a celiac adult is that the parents must make the choices for the child, and they must be the correct ones, or the child will pay the price (in discomfort and potential long term complications). The author also encourages the celiac community to be its own advocate and to use a stronger voice in that advocacy.

•

Deflating a Spare Tire Source: Running and FitNews. September 1998. Contact: American Running and Fitness Association, 4405 East West Highway, Suite 405, Bethesda, MD 20814. (800) 776-ARFA (2732). Summary: This article discusses the role of exercise in weight control. According to the author, exercise alone will not assist in weight loss. A combination of exercise and diet, mainly reduction of fat intake, is required to produce weight loss. More importantly, according to the author, exercise can prevent weight gain. The author describes a possible weight-loss program, and cautions against rapid weight loss.

Academic Periodicals covering Rapid Weight Loss Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to rapid weight loss. In addition to these sources, you can search for articles covering rapid weight loss 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.”

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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 7. 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 rapid weight loss. 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 rapid weight loss. 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.).

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The following drugs have been mentioned in the Pharmacopeia and other sources as being potentially applicable to rapid weight loss: Ursodiol •

Systemic - U.S. Brands: Actigall http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202587.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

37

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 Institute5: •

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

5

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

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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.6 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:7 •

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

6

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

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•

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

•

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

The NLM Gateway8 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.9 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “rapid weight loss” (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 853 4 963 27 0 1847

HSTAT10 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.11 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.12 Simply search by “rapid weight loss” (or synonyms) at the following Web site: http://text.nlm.nih.gov.

8

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

9

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). 10 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 11 12

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 Biologists13 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.14 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.15 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/.

13 Adapted 14

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. 15 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 rapid weight loss 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 rapid weight loss. 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 rapid weight loss. 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 “rapid weight loss”:

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•

Other guides Health Fraud http://www.nlm.nih.gov/medlineplus/healthfraud.html Osteoporosis http://www.nlm.nih.gov/medlineplus/osteoporosis.html Preventing Disease and Staying Healthy http://www.nlm.nih.gov/medlineplus/preventingdiseaseandstayinghealthy.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 rapid weight loss. 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: •

AIDS/HIV & the African - American Community Contact: Texas Department of Health, Division of AIDS and STD Control, 1100 W 49th St, Austin, TX, 78756, (512) 458-7207. Summary: This brochure provides basic information about the impact of HIV/AIDS on African Americans, especially adolescents and young adults. The brochure lists a number of high-risk behaviors and discourages the use of drugs and alcohol. Persons with recurring fevers, rapid weight loss, swollen glands, a dry cough, or a white coating on the tongue are urged to see a doctor. The brochure also encourages persons practicing high-risk behavior to get tested for HIV. Toll-free telephone numbers are provided for more information.

•

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

Patient Resources

45

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. •

Know the Facts About HIV and AIDS Contact: American Academy of Pediatrics, Committee on School Health, PO Box 927, Elk Grove Village, IL, 60009, (847) 228-5005, http://www.aap.org. Summary: This brochure, written for parents, provides general information about the human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) and discusses how to teach children and adolescents about HIV/AIDS. HIV is spread from person to person by vaginal, anal, and oral intercourse; through contact with blood by sharing syringes or needles for drug use or other activities such as tattooing or body piercing; from mother to child during pregnancy, childbirth, or breastfeeding; and through blood transfusions or blood products. HIV is not transmitted through shaking hands, hugging, sitting next to someone, sharing bathrooms, eating food prepared by an HIV-positive person, breathing air, getting bit by an insect, giving blood, or swimming in pools. Parents are advised to teach young children that they should not touch anyone else's open sores, that they should never touch a syringe or a needle, that they should tell an adult when a syringe or needle is found, and that they cannot contract HIV from other infected children. The brochure recommends that parents educate preteens and teenagers about the advantages of sexual abstinence over safer sex in HIV prevention, safer sex, and the relationship between drug use, particularly injection drug use, and HIV/AIDS. The brochure identifies the symptoms of HIV/AIDS. These may include persistent fevers, loss of appetite, frequent diarrhea, poor weight gain or rapid weight loss, chronic lymph node swelling, persistent tiredness of lethargy, white spots in the mouth, and reoccurring or unusual infections. Individuals involved in risk behaviors should be tested for HIV.

•

Skinny on Dieting Source: Washington, DC: FTC, 1997. Contact: Bureau of Consumer Protection, Office of Consumer and Business Education, (202) 326-3650. Summary: This fact sheet explains why so many of the claims made by diet-product companies are false. Some of these include: weight loss while sleeping, rapid weight loss, claims of other individuals' weight loss, low cost meal programs, and so-called `medical miracles.' The fact sheet concludes with suggestions for safe weight loss, such as consulting a physician, following good nutrition guidelines, and setting realistic goals.

•

Gallstones Source: New York, NY: Nidus Information Services, Inc. 1996. 8 p. Contact: Available from Nidus Information Services, Inc. 175 Fifth Avenue, Suite 2338, New York, NY 10010. (800) 334-9355 or (212) 260-4268. Fax (212) 529-2349. E-mail: [email protected]. PRICE: $5.95; discounts available for orders of 15 or more reports. Summary: This report educates readers about gallstones. Topics include the different types of gallstones, such as cholesterol stones, and pigment stones; the symptoms and

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types of gallstone disease including biliary pain, chronic cholecystitis, acute cholecystitis, and common bile duct stones (choledocholilithiasis); other diseases that produce symptoms similar to gallstones; complications or gallstone-related problems, including gallbladder cancer, complications in the gallbladder or bile duct, and pancreatitis; risk factors, including age and gender, obesity and rapid weight loss, cholesterol levels or use of cholesterol-lowering drugs, and risk factors for pigment gallstones; how to prevent gallstone disease; diagnostic tests used to confirm gallstone disease, including physical examination, laboratory tests, ultrasound, cholescintigraphy, and oral cholecystography; and treatment options for gallstones, notably expectant management, surgical removal of the gallbladder, and nonsurgical therapy such as oral dissolution therapy, contact dissolution therapy, and extracorporeal shock wave lithotripsy. The report concludes with the contact information for the National Digestive Diseases Information Clearinghouse and the American Liver Foundation. •

Your Gallstones: Diagnosis and Treatment Source: Washington, DC: Digestive Disease National Coalition. 1991. 4 p. Contact: Available from Digestive Disease National Coalition. 711 Second Street, NE, Suite 2. Washington, DC 20002. (202) 544-7497. PRICE: Single copy free. Summary: Written in a question and answer format, this brochure reviews the diagnosis and treatment of common gallstones. Topics include the role of the gallbladder, the occurrence of gallstones, how rapid weight loss affects the formation of gallstones, the symptoms of gallstones, how gallstones are diagnosed, how gallstones typically progress, traditional surgical treatment of gallstones, laparoscopic removal of the gallbladder, oral medication used for dissolving cholesterol gallstones, and shock wave lithotripsy used to fragment the stones. The brochure stresses the importance of learning about all the options available to treat gallstones, in order to make an informed decision about treatment. 4 figures. 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 rapid weight loss. 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: •


•

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

Patient Resources

•

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

•

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

•

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

•

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

•

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

47

Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to rapid weight loss. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with rapid weight loss. 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 rapid weight loss. For more information, see the NHIC’s Web site at http://www.health.gov/NHIC/ or contact an information specialist by calling 1-800-336-4797. Directory of Health Organizations The Directory of Health Organizations, provided by the National Library of Medicine Specialized Information Services, is a comprehensive source of information on associations. The Directory of Health Organizations database can be accessed via the Internet at http://www.sis.nlm.nih.gov/Dir/DirMain.html. It is composed of two parts: DIRLINE and Health Hotlines. The DIRLINE database comprises some 10,000 records of organizations, research centers, and government institutes and associations that primarily focus on health and biomedicine. To access DIRLINE directly, go to the following Web site: http://dirline.nlm.nih.gov/. Simply type in “rapid weight loss” (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 “rapid weight loss”. Type the following hyperlink into

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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 “rapid weight loss” (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 “rapid weight loss” (or a synonym) into the search box, and click “Submit Query.”

49

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.16

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

16

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)17: •

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/

17

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

Finding Medical Libraries

51

•

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

53

•

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

55

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

57

RAPID WEIGHT LOSS 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] Adaptation: 1. The adjustment of an organism to its environment, or the process by which it enhances such fitness. 2. The normal ability of the eye to adjust itself to variations in the intensity of light; the adjustment to such variations. 3. The decline in the frequency of firing of a neuron, particularly of a receptor, under conditions of constant stimulation. 4. In dentistry, (a) the proper fitting of a denture, (b) the degree of proximity and interlocking of restorative material to a tooth preparation, (c) the exact adjustment of bands to teeth. 5. In microbiology, the adjustment of bacterial physiology to a new environment. [EU] Adipocytes: Fat-storing cells found mostly in the abdominal cavity and subcutaneous tissue. Fat is usually stored in the form of tryglycerides. [NIH] Adjustment: The dynamic process wherein the thoughts, feelings, behavior, and biophysiological mechanisms of the individual continually change to adjust to the environment. [NIH] Adverse Effect: An unwanted side effect of treatment. [NIH] Afferent: Concerned with the transmission of neural impulse toward the central part of the nervous system. [NIH] Affinity: 1. Inherent likeness or relationship. 2. A special attraction for a specific element, organ, or structure. 3. Chemical affinity; the force that binds atoms in molecules; the tendency of substances to combine by chemical reaction. 4. The strength of noncovalent chemical binding between two substances as measured by the dissociation constant of the complex. 5. In immunology, a thermodynamic expression of the strength of interaction between a single antigen-binding site and a single antigenic determinant (and thus of the stereochemical compatibility between them), most accurately applied to interactions among simple, uniform antigenic determinants such as haptens. Expressed as the association constant (K litres mole -1), which, owing to the heterogeneity of affinities in a population of antibody molecules of a given specificity, actually represents an average value (mean intrinsic association constant). 6. The reciprocal of the dissociation constant. [EU] 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] Amenorrhea: Absence of menstruation. [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] Anal: Having to do with the anus, which is the posterior opening of the large bowel. [NIH]

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Anastomosis: A procedure to connect healthy sections of tubular structures in the body after the diseased portion has been surgically removed. [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] Anorexia Nervosa: The chief symptoms are inability to eat, weight loss, and amenorrhea. [NIH]

Antibodies: Immunoglobulin molecules having a specific amino acid sequence by virtue of which they interact only with the antigen that induced their synthesis in cells of the lymphoid series (especially plasma cells), or with an antigen closely related to it. [NIH] Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] 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] Antioxidant: A substance that prevents damage caused by free radicals. Free radicals are highly reactive chemicals that often contain oxygen. They are produced when molecules are split to give products that have unpaired electrons. This process is called oxidation. [NIH] Antipsychotic: Effective in the treatment of psychosis. Antipsychotic drugs (called also neuroleptic drugs and major tranquilizers) are a chemically diverse (including phenothiazines, thioxanthenes, butyrophenones, dibenzoxazepines, dibenzodiazepines, and diphenylbutylpiperidines) but pharmacologically similar class of drugs used to treat schizophrenic, paranoid, schizoaffective, and other psychotic disorders; acute delirium and dementia, and manic episodes (during induction of lithium therapy); to control the movement disorders associated with Huntington's chorea, Gilles de la Tourette's syndrome, and ballismus; and to treat intractable hiccups and severe nausea and vomiting. Antipsychotic agents bind to dopamine, histamine, muscarinic cholinergic, a-adrenergic, and serotonin receptors. Blockade of dopaminergic transmission in various areas is thought to be responsible for their major effects : antipsychotic action by blockade in the mesolimbic and mesocortical areas; extrapyramidal side effects (dystonia, akathisia, parkinsonism, and tardive dyskinesia) by blockade in the basal ganglia; and antiemetic effects by blockade in the chemoreceptor trigger zone of the medulla. Sedation and autonomic side effects (orthostatic hypotension, blurred vision, dry mouth, nasal congestion and constipation) are caused by blockade of histamine, cholinergic, and adrenergic receptors. [EU] Anus: The opening of the rectum to the outside of the body. [NIH] Apathy: Lack of feeling or emotion; indifference. [EU] Apolipoproteins: The protein components of lipoproteins which remain after the lipids to which the proteins are bound have been removed. They play an important role in lipid transport and metabolism. [NIH]

Dictionary 59

Arteries: The vessels carrying blood away from the heart. [NIH] Asymptomatic: Having no signs or symptoms of disease. [NIH] Autodigestion: Autolysis; a condition found in disease of the stomach: the stomach wall is digested by the gastric juice. [NIH] Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH] Bacterial Physiology: Physiological processes and activities of bacteria. [NIH] 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] Bile: An emulsifying agent produced in the liver and secreted into the duodenum. Its composition includes bile acids and salts, cholesterol, and electrolytes. It aids digestion of fats in the duodenum. [NIH] Bile Acids: Acids made by the liver that work with bile to break down fats. [NIH] Bile Acids and Salts: Steroid acids and salts. The primary bile acids are derived from cholesterol in the liver and usually conjugated with glycine or taurine. The secondary bile acids are further modified by bacteria in the intestine. They play an important role in the digestion and absorption of fat. They have also been used pharmacologically, especially in the treatment of gallstones. [NIH] Bile Ducts: Tubes that carry bile from the liver to the gallbladder for storage and to the small intestine for use in digestion. [NIH] Biliary: Having to do with the liver, bile ducts, and/or gallbladder. [NIH] Biliary Tract: The gallbladder and its ducts. [NIH] Bilirubin: A bile pigment that is a degradation product of heme. [NIH] 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] Biotransformation: The chemical alteration of an exogenous substance by or in a biological system. The alteration may inactivate the compound or it may result in the production of an active metabolite of an inactive parent compound. The alteration may be either nonsynthetic (oxidation-reduction, hydrolysis) or synthetic (glucuronide formation, sulfate conjugation, acetylation, methylation). This also includes metabolic detoxication and clearance. [NIH] Bladder: The organ that stores urine. [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]

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Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Body Composition: The relative amounts of various components in the body, such as percent body fat. [NIH] Body Fluids: Liquid components of living organisms. [NIH] Body Mass Index: One of the anthropometric measures of body mass; it has the highest correlation with skinfold thickness or body density. [NIH] 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] 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]

Bypass: A surgical procedure in which the doctor creates a new pathway for the flow of body fluids. [NIH] Cachexia: General ill health, malnutrition, and weight loss, usually associated with chronic disease. [NIH] Calcium: A basic element found in nearly all organized tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. [NIH] Carbohydrate: An aldehyde or ketone derivative of a polyhydric alcohol, particularly of the 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] 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] Carnitine: Constituent of striated muscle and liver. It is used therapeutically to stimulate gastric and pancreatic secretions and in the treatment of hyperlipoproteinemias. [NIH] Celiac Disease: A disease characterized by intestinal malabsorption and precipitated by gluten-containing foods. The intestinal mucosa shows loss of villous structure. [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] Cerebrovascular: Pertaining to the blood vessels of the cerebrum, or brain. [EU] Character: In current usage, approximately equivalent to personality. The sum of the relatively fixed personality traits and habitual modes of response of an individual. [NIH]

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Chenodeoxycholic Acid: A bile acid, usually conjugated with either glycine or taurine. It acts as a detergent to solubilize fats for intestinal absorption and is reabsorbed by the small intestine. It is used as cholagogue, a choleretic laxative, and to prevent or dissolve gallstones. [NIH] Cholecystitis: Inflammation of the gallbladder. [NIH] Cholecystography: Radiography of the gallbladder after ingestion of a contrast medium. [NIH]

Choleretic: A choleretic agent. [EU] Cholesterol: The principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils. [NIH] Cholesterol Esters: Fatty acid esters of cholesterol which constitute about two-thirds of the cholesterol in the plasma. The accumulation of cholesterol esters in the arterial intima is a characteristic feature of atherosclerosis. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Chronic Disease: Disease or ailment of long duration. [NIH] Chylomicrons: A class of lipoproteins that carry dietary cholesterol and triglycerides from the small intestines to the tissues. [NIH] Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] Cloning: The production of a number of genetically identical individuals; in genetic engineering, a process for the efficient replication of a great number of identical DNA molecules. [NIH] Cognition: Intellectual or mental process whereby an organism becomes aware of or obtains knowledge. [NIH] Colorectal: Having to do with the colon or the rectum. [NIH] Common Bile Duct: The largest biliary duct. It is formed by the junction of the cystic duct and the hepatic duct. [NIH] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix 'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in

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the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Complementary and alternative medicine: CAM. Forms of treatment that are used in addition to (complementary) or instead of (alternative) standard treatments. These practices are not considered standard medical approaches. CAM includes dietary supplements, megadose vitamins, herbal preparations, special teas, massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complementary medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used to enhance or complement the standard treatments. Complementary medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] 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] 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] Cortisone: A natural steroid hormone produced in the adrenal gland. It can also be made in the laboratory. Cortisone reduces swelling and can suppress immune responses. [NIH] Cotinine: 1-Methyl-5-(3-pyridyl)-2-pyrrolidinone antidepressant. Synonym: Scotine. [NIH]

fumarate.

Stimulant

proposed

as

Cranial: Pertaining to the cranium, or to the anterior (in animals) or superior (in humans) end of the body. [EU] Creatine: An amino acid that occurs in vertebrate tissues and in urine. In muscle tissue, creatine generally occurs as phosphocreatine. Creatine is excreted as creatinine in the urine. [NIH]

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Creatinine: A compound that is excreted from the body in urine. Creatinine levels are measured to monitor kidney function. [NIH] Curative: Tending to overcome disease and promote recovery. [EU] Cystic Duct: The tube that carries bile from the gallbladder into the common bile duct and the small intestine. [NIH] Cytotoxic: Cell-killing. [NIH] Data Collection: Systematic gathering of data for a particular purpose from various sources, including questionnaires, interviews, observation, existing records, and electronic devices. The process is usually preliminary to statistical analysis of the data. [NIH] 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] Dehydration: The condition that results from excessive loss of body water. [NIH] Density: The logarithm to the base 10 of the opacity of an exposed and processed film. [NIH] Dexamethasone: (11 beta,16 alpha)-9-Fluoro-11,17,21-trihydroxy-16-methylpregna-1,4diene-3,20-dione. An anti-inflammatory glucocorticoid used either in the free alcohol or esterified form in treatment of conditions that respond generally to cortisone. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Diarrhea: Passage of excessively liquid or excessively frequent stools. [NIH] Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] 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] Diuretic: A drug that increases the production of urine. [NIH] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Duct: A tube through which body fluids pass. [NIH] Duodenum: The first part of the small intestine. [NIH] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Electrophysiological: Pertaining to electrophysiology, that is a branch of physiology that is concerned with the electric phenomena associated with living bodies and involved in their functional activity. [EU] Emboli: Bit of foreign matter which enters the blood stream at one point and is carried until it is lodged or impacted in an artery and obstructs it. It may be a blood clot, an air bubble, fat or other tissue, or clumps of bacteria. [NIH] Endotoxic: Of, relating to, or acting as an endotoxin (= a heat-stable toxin, associated with the outer membranes of certain gram-negative bacteria. Endotoxins are not secreted and are released only when the cells are disrupted). [EU] Energy balance: Energy is the capacity of a body or a physical system for doing work. Energy balance is the state in which the total energy intake equals total energy needs. [NIH]

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Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]

Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Epidemiological: Relating to, or involving epidemiology. [EU] Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] Extracorporeal: Situated or occurring outside the body. [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]

Fatty Liver: The buildup of fat in liver cells. The most common cause is alcoholism. Other causes include obesity, diabetes, and pregnancy. Also called steatosis. [NIH] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH] Fluid Therapy: Therapy whose basic objective is to restore the volume and composition of the body fluids to normal with respect to water-electrolyte balance. Fluids may be administered intravenously, orally, by intermittent gavage, or by hypodermoclysis. [NIH] Focus Groups: A method of data collection and a qualitative research tool in which a small group of individuals are brought together and allowed to interact in a discussion of their opinions about topics, issues, or questions. [NIH] Fold: A plication or doubling of various parts of the body. [NIH] Forearm: The part between the elbow and the wrist. [NIH] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] Gallbladder Emptying: A process whereby bile is delivered from the gallbladder into the duodenum. The emptying is caused by both contraction of the gallbladder and relaxation of the sphincter mechanism at the choledochal terminus. [NIH] Gallstones: The solid masses or stones made of cholesterol or bilirubin that form in the gallbladder or bile ducts. [NIH] Gastric: Having to do with the stomach. [NIH] Gastric Bypass: Surgical procedure in which the stomach is transected high on the body. The resulting proximal remnant is joined to a loop of the jejunum in an end-to-side anastomosis. This procedure is used frequently in the treatment of morbid obesity. [NIH] Gastrin: A hormone released after eating. Gastrin causes the stomach to produce more acid. [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]

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] Glucocorticoid: A compound that belongs to the family of compounds called corticosteroids

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(steroids). Glucocorticoids affect metabolism and have anti-inflammatory and immunosuppressive effects. They may be naturally produced (hormones) or synthetic (drugs). [NIH] Glucose: D-Glucose. A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. [NIH] Gluten: The protein of wheat and other grains which gives to the dough its tough elastic character. [EU] Glycogen: A sugar stored in the liver and muscles. It releases glucose into the blood when cells need it for energy. Glycogen is the chief source of stored fuel in the body. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Growth: The progressive development of a living being or part of an organism from its earliest stage to maturity. [NIH] Heart attack: A seizure of weak or abnormal functioning of the heart. [NIH] Heartbeat: One complete contraction of the heart. [NIH] Hepatic: Refers to the liver. [NIH] Histology: The study of tissues and cells under a microscope. [NIH] Homeostasis: The processes whereby the internal environment of an organism tends to remain balanced and stable. [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] 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] Hydrophobic: Not readily absorbing water, or being adversely affected by water, as a hydrophobic colloid. [EU] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Hypesthesia: Absent or reduced sensitivity to cutaneous stimulation. [NIH] Hypotensive: Characterized by or causing diminished tension or pressure, as abnormally low blood pressure. [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 function: Production and action of cells that fight disease or infection. [NIH] Immune response: The activity of the immune system against foreign substances (antigens). [NIH]

Immune system: The organs, cells, and molecules responsible for the recognition and disposal of foreign ("non-self") material which enters the body. [NIH]

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Immunodeficiency: The decreased ability of the body to fight infection and disease. [NIH] Immunogenic: Producing immunity; evoking an immune response. [EU] Immunoglobulin: A protein that acts as an antibody. [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] Ingestion: Taking into the body by mouth [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] Interstitial: Pertaining to or situated between parts or in the interspaces of a tissue. [EU] Intestinal: Having to do with the intestines. [NIH] Intestine: A long, tube-shaped organ in the abdomen that completes the process of digestion. There is both a large intestine and a small intestine. Also called the bowel. [NIH] Intracellular: Inside a cell. [NIH] Intravenous: IV. Into a vein. [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] Jejunoileal Bypass: A surgical procedure consisting of the anastomosis of the proximal part of the jejunum to the distal portion of the ileum, so as to bypass the nutrient-absorptive segment of the small intestine, to treat morbid obesity. [NIH] Jejunum: That portion of the small intestine which extends from the duodenum to the ileum; called also intestinum jejunum. [EU] 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] Kinetic: Pertaining to or producing motion. [EU] Leptin: A 16-kD peptide hormone secreted from white adipocytes and implicated in the regulation of food intake and energy balance. Leptin provides the key afferent signal from

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fat cells in the feedback system that controls body fat stores. [NIH] Lethargy: Abnormal drowsiness or stupor; a condition of indifference. [EU] Library Services: Services offered to the library user. They include reference and circulation. [NIH]

Ligament: A band of fibrous tissue that connects bones or cartilages, serving to support and strengthen joints. [EU] Lipid: Fat. [NIH] Lipid A: Lipid A is the biologically active component of lipopolysaccharides. It shows strong endotoxic activity and exhibits immunogenic properties. [NIH] Lipid Peroxidation: Peroxidase catalyzed oxidation of lipids using hydrogen peroxide as an electron acceptor. [NIH] Lipophilic: Having an affinity for fat; pertaining to or characterized by lipophilia. [EU] Lipopolysaccharides: Substance consisting of polysaccaride and lipid. [NIH] Lipoprotein: Any of the lipid-protein complexes in which lipids are transported in the blood; lipoprotein particles consist of a spherical hydrophobic core of triglycerides or cholesterol esters surrounded by an amphipathic monolayer of phospholipids, cholesterol, and apolipoproteins; the four principal classes are high-density, low-density, and very-lowdensity lipoproteins and chylomicrons. [EU] Lithotripsy: The destruction of a calculus of the kidney, ureter, bladder, or gallbladder by physical forces, including crushing with a lithotriptor through a catheter. Focused percutaneous ultrasound and focused hydraulic shock waves may be used without surgery. Lithotripsy does not include the dissolving of stones by acids or litholysis. Lithotripsy by laser is laser lithotripsy. [NIH] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Loop: A wire usually of platinum bent at one end into a small loop (usually 4 mm inside diameter) and used in transferring microorganisms. [NIH] Low-density lipoprotein: Lipoprotein that contains most of the cholesterol in the blood. LDL carries cholesterol to the tissues of the body, including the arteries. A high level of LDL increases the risk of heart disease. LDL typically contains 60 to 70 percent of the total serum cholesterol and both are directly correlated with CHD risk. [NIH] Lymph: The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. [NIH] Lymph node: A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Also known as a lymph gland. Lymph nodes are spread out along lymphatic vessels and contain many lymphocytes, which filter the lymphatic fluid (lymph). [NIH]

Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. [NIH] 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] Malabsorption: Impaired intestinal absorption of nutrients. [EU]

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

Meat: The edible portions of any animal used for food including domestic mammals (the major ones being cattle, swine, and sheep) along with poultry, fish, shellfish, and game. [NIH]

MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Membranes: Thin layers of tissue which cover parts of the body, separate adjacent cavities, or connect adjacent structures. [NIH] Memory: Complex mental function having four distinct phases: (1) memorizing or learning, (2) retention, (3) recall, and (4) recognition. Clinically, it is usually subdivided into immediate, recent, and remote memory. [NIH] Menopause: Permanent cessation of menstruation. [NIH] Mesenteric: Pertaining to the mesentery : a membranous fold attaching various organs to the body wall. [EU] Mesentery: A layer of the peritoneum which attaches the abdominal viscera to the abdominal wall and conveys their blood vessels and nerves. [NIH] MI: Myocardial infarction. Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Microbe: An organism which cannot be observed with the naked eye; e. g. unicellular animals, lower algae, lower fungi, bacteria. [NIH] Microbiology: The study of microorganisms such as fungi, bacteria, algae, archaea, and viruses. [NIH] Microtubules: Slender, cylindrical filaments found in the cytoskeleton of plant and animal cells. They are composed of the protein tubulin. [NIH] Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Monoclonal: An antibody produced by culturing a single type of cell. It therefore consists of a single species of immunoglobulin molecules. [NIH] Monoclonal antibodies: Laboratory-produced substances that can locate and bind to cancer cells wherever they are in the body. Many monoclonal antibodies are used in cancer detection or therapy; each one recognizes a different protein on certain cancer cells. Monoclonal antibodies can be used alone, or they can be used to deliver drugs, toxins, or radioactive material directly to a tumor. [NIH] Mucins: A secretion containing mucopolysaccharides and protein that is the chief constituent of mucus. [NIH] Mucosa: A mucous membrane, or tunica mucosa. [EU] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [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]

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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] Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] Neuritis: A general term indicating inflammation of a peripheral or cranial nerve. Clinical manifestation may include pain; paresthesias; paresis; or hypesthesia. [NIH] Neuroleptic: A term coined to refer to the effects on cognition and behaviour of antipsychotic drugs, which produce a state of apathy, lack of initiative, and limited range of emotion and in psychotic patients cause a reduction in confusion and agitation and normalization of psychomotor activity. [EU] Nutritional Support: The administration of nutrients for assimilation and utilization by a patient by means other than normal eating. It does not include fluid therapy which normalizes body fluids to restore water-electrolyte balance. [NIH] Opacity: Degree of density (area most dense taken for reading). [NIH] Oral Dissolution Therapy: A method of dissolving cholesterol gallstones. The patient takes the oral medications chenodiol (KEE-noh-DY-awl) (Chenix) and ursodiol (ERS-oh-DY-awl) (Actigall). These medicines are most often used for people who cannot have an operation. [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] Overweight: An excess of body weight but not necessarily body fat; a body mass index of 25 to 29.9 kg/m2. [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]

Oxidative Stress: A disturbance in the prooxidant-antioxidant balance in favor of the former, leading to potential damage. Indicators of oxidative stress include damaged DNA bases, protein oxidation products, and lipid peroxidation products (Sies, Oxidative Stress, 1991, pxv-xvi). [NIH] Paclitaxel: Antineoplastic agent isolated from the bark of the Pacific yew tree, Taxus brevifolia. Paclitaxel stabilizes microtubules in their polymerized form and thus mimics the action of the proto-oncogene proteins c-mos. [NIH] Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU] Pancreas: A mixed exocrine and endocrine gland situated transversely across the posterior abdominal wall in the epigastric and hypochondriac regions. The endocrine portion is comprised of the Islets of Langerhans, while the exocrine portion is a compound acinar gland that secretes digestive enzymes. [NIH] Pancreatic: Having to do with the pancreas. [NIH] Pancreatitis: Acute or chronic inflammation of the pancreas, which may be asymptomatic or symptomatic, and which is due to autodigestion of a pancreatic tissue by its own enzymes. It is caused most often by alcoholism or biliary tract disease; less commonly it may be associated with hyperlipaemia, hyperparathyroidism, abdominal trauma (accidental or operative injury), vasculitis, or uraemia. [EU]

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Paresis: A general term referring to a mild to moderate degree of muscular weakness, occasionally used as a synonym for paralysis (severe or complete loss of motor function). In the older literature, paresis often referred specifically to paretic neurosyphilis. "General paresis" and "general paralysis" may still carry that connotation. Bilateral lower extremity paresis is referred to as paraparesis. [NIH] Paresthesias: Abnormal touch sensations, such as burning or prickling, that occur without an outside stimulus. [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] Percutaneous: Performed through the skin, as injection of radiopacque material in radiological examination, or the removal of tissue for biopsy accomplished by a needle. [EU] Perfusion: Bathing an organ or tissue with a fluid. In regional perfusion, a specific area of the body (usually an arm or a leg) receives high doses of anticancer drugs through a blood vessel. Such a procedure is performed to treat cancer that has not spread. [NIH] Pharmacokinetic: The mathematical analysis of the time courses of absorption, distribution, and elimination of drugs. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Phospholipids: Lipids containing one or more phosphate groups, particularly those derived from either glycerol (phosphoglycerides; glycerophospholipids) or sphingosine (sphingolipids). They are polar lipids that are of great importance for the structure and function of cell membranes and are the most abundant of membrane lipids, although not stored in large amounts in the system. [NIH] Physical Examination: Systematic and thorough inspection of the patient for physical signs of disease or abnormality. [NIH] Physiologic: Having to do with the functions of the body. When used in the phrase "physiologic age," it refers to an age assigned by general health, as opposed to calendar age. [NIH]

Pigment: A substance that gives color to tissue. Pigments are responsible for the color of skin, eyes, and hair. [NIH] Pilot study: The initial study examining a new method or treatment. [NIH] Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH]

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Plasma cells: A type of white blood cell that produces antibodies. [NIH] Polyunsaturated fat: An unsaturated fat found in greatest amounts in foods derived from plants, including safflower, sunflower, corn, and soybean oils. [NIH] Posterior: Situated in back of, or in the back part of, or affecting the back or dorsal surface of the body. In lower animals, it refers to the caudal end of the body. [EU] Postmenopausal: Refers to the time after menopause. Menopause is the time in a woman's life when menstrual periods stop permanently; also called "change of life." [NIH] Potassium: An element that is in the alkali group of metals. It has an atomic symbol K, atomic number 19, and atomic weight 39.10. It is the chief cation in the intracellular fluid of muscle and other cells. Potassium ion is a strong electrolyte and it plays a significant role in the regulation of fluid volume and maintenance of the water-electrolyte balance. [NIH] 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] Preclinical: Before a disease becomes clinically recognizable. [EU] Precursor: Something that precedes. In biological processes, a substance from which another, usually more active or mature substance is formed. In clinical medicine, a sign or symptom that heralds another. [EU] Premenopausal: Refers to the time before menopause. Menopause is the time of life when a women's menstrual periods stop permanently; also called "change of life." [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] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Prospective study: An epidemiologic study in which a group of individuals (a cohort), all free of a particular disease and varying in their exposure to a possible risk factor, is followed over a specific amount of time to determine the incidence rates of the disease in the exposed and unexposed groups. [NIH] Prostate: A gland in males that surrounds the neck of the bladder and the urethra. It secretes a substance that liquifies coagulated semen. It is situated in the pelvic cavity behind the lower part of the pubic symphysis, above the deep layer of the triangular ligament, and rests upon the rectum. [NIH] Protein Binding: The process in which substances, either endogenous or exogenous, bind to proteins, peptides, enzymes, protein precursors, or allied compounds. Specific proteinbinding measures are often used as assays in diagnostic assessments. [NIH] Protein C: A vitamin-K dependent zymogen present in the blood, which, upon activation by thrombin and thrombomodulin exerts anticoagulant properties by inactivating factors Va and VIIIa at the rate-limiting steps of thrombin formation. [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino

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acids determines the shape and function of the protein. [NIH] Proto-Oncogene Proteins: Products of proto-oncogenes. Normally they do not have oncogenic or transforming properties, but are involved in the regulation or differentiation of cell growth. They often have protein kinase activity. [NIH] Proto-Oncogene Proteins c-mos: Cellular proteins encoded by the c-mos genes. They function in the cell cycle to maintain maturation promoting factor in the active state and have protein-serine/threonine kinase activity. Oncogenic transformation can take place when c-mos proteins are expressed at the wrong time. [NIH] Proximal: Nearest; closer to any point of reference; opposed to distal. [EU] Psychomotor: Pertaining to motor effects of cerebral or psychic activity. [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] Quality of Life: A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral and social environment. [NIH] Radioactive: Giving off radiation. [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] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Resection: Removal of tissue or part or all of an organ by surgery. [NIH] Resting metabolic rate: RMR accounts for 65 to 75 percent of daily energy expenditure and represents the minimum energy needed to maintain all physiological cell functions in the resting state. The principal determinant of RMR is lean body mass (LBM). Obese subjects have a higher RMR in absolute terms than lean individuals, an equivalent RMR when corrected for LBM and per unit surface area, and a lower RMR when expressed per kilogram of body weight. Obese persons require more energy for any given activity because of a larger mass, but they tend to be more sedentary than lean subjects. [NIH] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [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] Screening: Checking for disease when there are no symptoms. [NIH] Sedentary: 1. Sitting habitually; of inactive habits. 2. Pertaining to a sitting posture. [EU] Semen: The thick, yellowish-white, viscid fluid secretion of male reproductive organs discharged upon ejaculation. In addition to reproductive organ secretions, it contains

Dictionary 73

spermatozoa and their nutrient plasma. [NIH] 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] Shock: The general bodily disturbance following a severe injury; an emotional or moral upset occasioned by some disturbing or unexpected experience; disruption of the circulation, which can upset all body functions: sometimes referred to as circulatory shock. [NIH]

Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Small intestine: The part of the digestive tract that is located between the stomach and the large intestine. [NIH] Social Environment: The aggregate of social and cultural institutions, forms, patterns, and processes that influence the life of an individual or community. [NIH] Sodium: An element that is a member of the alkali group of metals. It has the atomic symbol Na, atomic number 11, and atomic weight 23. With a valence of 1, it has a strong affinity for oxygen and other nonmetallic elements. Sodium provides the chief cation of the extracellular body fluids. Its salts are the most widely used in medicine. (From Dorland, 27th ed) Physiologically the sodium ion plays a major role in blood pressure regulation, maintenance of fluid volume, and electrolyte balance. [NIH] Solid tumor: Cancer of body tissues other than blood, bone marrow, or the lymphatic system. [NIH] Soybean Oil: Oil from soybean or soybean plant. [NIH] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Specificity: Degree of selectivity shown by an antibody with respect to the number and types of antigens with which the antibody combines, as well as with respect to the rates and the extents of these reactions. [NIH] Sphincter: A ringlike band of muscle fibres that constricts a passage or closes a natural orifice; called also musculus sphincter. [EU] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] Steatosis: Fatty degeneration. [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] 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] Stupor: Partial or nearly complete unconsciousness, manifested by the subject's responding only to vigorous stimulation. Also, in psychiatry, a disorder marked by reduced

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responsiveness. [EU] Subcutaneous: Beneath the skin. [NIH] Substrate: A substance upon which an enzyme acts. [EU] Sudden death: Cardiac arrest caused by an irregular heartbeat. The term "death" is somewhat misleading, because some patients survive. [NIH] Superior Mesenteric Artery Syndrome: Duodenal obstruction caused by compression of the third part of the duodenum by the root of the intestinal mesentery which contains the superior mesenteric artery, vein, and nerve. [NIH] Supplementation: Adding nutrients to the diet. [NIH] Suppression: A conscious exclusion of disapproved desire contrary with repression, in which the process of exclusion is not conscious. [NIH] Symphysis: A secondary cartilaginous joint. [NIH] Symptomatic: Having to do with symptoms, which are signs of a condition or disease. [NIH] Systemic: Affecting the entire body. [NIH] Tachycardia: Excessive rapidity in the action of the heart, usually with a heart rate above 100 beats per minute. [NIH] Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Thyroid: A gland located near the windpipe (trachea) that produces thyroid hormone, which helps regulate growth and metabolism. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tissue Distribution: Accumulation of a drug or chemical substance in various organs (including those not relevant to its pharmacologic or therapeutic action). This distribution depends on the blood flow or perfusion rate of the organ, the ability of the drug to penetrate organ membranes, tissue specificity, protein binding. The distribution is usually expressed as tissue to plasma ratios. [NIH] Tooth Preparation: Procedures carried out with regard to the teeth or tooth structures preparatory to specified dental therapeutic and surgical measures. [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] Toxicokinetics: Study of the absorption, distribution, metabolism, and excretion of test substances. [NIH] 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] Trachea: The cartilaginous and membranous tube descending from the larynx and branching into the right and left main bronchi. [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH]

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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] Trauma: Any injury, wound, or shock, must frequently physical or structural shock, producing a disturbance. [NIH] Triglyceride: A lipid carried through the blood stream to tissues. Most of the body's fat tissue is in the form of triglycerides, stored for use as energy. Triglycerides are obtained primarily from fat in foods. [NIH] Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [NIH] Uraemia: 1. An excess in the blood of urea, creatinine, and other nitrogenous end products of protein and amino acids metabolism; more correctly referred to as azotemia. 2. In current usage the entire constellation of signs and symptoms of chronic renal failure, including nausea, vomiting anorexia, a metallic taste in the mouth, a uraemic odour of the breath, pruritus, uraemic frost on the skin, neuromuscular disorders, pain and twitching in the muscles, hypertension, edema, mental confusion, and acid-base and electrolyte imbalances. [EU]

Ureter: One of a pair of thick-walled tubes that transports urine from the kidney pelvis to the bladder. [NIH] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [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] Ursodeoxycholic Acid: An epimer of chenodeoxycholic acid. It is a mammalian bile acid found first in the bear and is apparently either a precursor or a product of chenodeoxycholate. Its administration changes the composition of bile and may dissolve gallstones. It is used as a cholagogue and choleretic. [NIH] Vaccines: Suspensions of killed or attenuated microorganisms (bacteria, viruses, fungi, protozoa, or rickettsiae), antigenic proteins derived from them, or synthetic constructs, administered for the prevention, amelioration, or treatment of infectious and other diseases. [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] Vasculitis: Inflammation of a blood vessel. [NIH] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Ventricle: One of the two pumping chambers of the heart. The right ventricle receives oxygen-poor blood from the right atrium and pumps it to the lungs through the pulmonary artery. The left ventricle receives oxygen-rich blood from the left atrium and pumps it to the body through the aorta. [NIH] Ventricular: Pertaining to a ventricle. [EU] Ventricular Function: The hemodynamic and electrophysiological action of the ventricles. [NIH]

Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Villous: Of a surface, covered with villi. [NIH]

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Virulence: The degree of pathogenicity within a group or species of microorganisms or viruses as indicated by case fatality rates and/or the ability of the organism to invade the tissues of the host. [NIH] Virus: Submicroscopic organism that causes infectious disease. In cancer therapy, some viruses may be made into vaccines that help the body build an immune response to, and kill, tumor cells. [NIH] Weight Gain: Increase in body weight over existing weight. [NIH] Windpipe: A rigid tube, 10 cm long, extending from the cricoid cartilage to the upper border of the fifth thoracic vertebra. [NIH]

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INDEX A Abdominal, 7, 57, 68, 69 Adaptation, 7, 57 Adipocytes, 57, 66 Adjustment, 57 Adverse Effect, 57, 73 Afferent, 57, 66 Affinity, 57, 67, 73 Algorithms, 57, 59 Alternative medicine, 30, 57 Amenorrhea, 57, 58 Amino Acid Sequence, 57, 58 Anal, 45, 57 Anastomosis, 58, 64, 66 Anorexia, 10, 14, 18, 20, 58, 75 Anorexia Nervosa, 20, 58 Antibodies, 22, 58, 68, 71 Antibody, 57, 58, 61, 66, 68, 73 Antidepressant, 58, 62 Antigen, 57, 58, 61, 66 Anti-inflammatory, 58, 63, 65 Antioxidant, 58, 69 Antipsychotic, 58, 69 Anus, 57, 58 Apathy, 58, 69 Apolipoproteins, 9, 58, 67 Arteries, 59, 60, 62, 67, 68 Asymptomatic, 44, 59, 69 Autodigestion, 59, 69 B Bacteria, 58, 59, 63, 68, 75 Bacterial Physiology, 57, 59 Base, 59, 63, 66, 75 Bile, 46, 59, 61, 63, 64, 67, 75 Bile Acids, 59 Bile Acids and Salts, 59 Bile Ducts, 59, 64 Biliary, 18, 20, 46, 59, 61, 69 Biliary Tract, 59, 69 Bilirubin, 59, 64 Biopsy, 5, 59, 70 Biotechnology, 6, 22, 30, 39, 59 Biotransformation, 59 Bladder, 59, 67, 71, 75 Blood pressure, 5, 7, 8, 20, 21, 59, 60, 65, 73 Blood transfusion, 45, 59 Blood vessel, 59, 60, 67, 68, 70, 73, 75 Body Composition, 5, 7, 9, 10, 14, 60

Body Fluids, 60, 63, 64, 69, 73 Body Mass Index, 60, 69 Bone Marrow, 60, 67, 73 Bowel, 6, 57, 60, 66 Branch, 53, 60, 63, 67, 70, 73, 74 Bypass, 5, 6, 60, 66 C Cachexia, 20, 60 Calcium, 60, 61 Carbohydrate, 5, 20, 60 Cardiovascular, 5, 60 Cardiovascular disease, 5, 60 Carnitine, 22, 60 Celiac Disease, 31, 60 Cell, 59, 60, 61, 63, 66, 67, 68, 70, 71, 72 Cerebrovascular, 60 Character, 60, 65 Chenodeoxycholic Acid, 61, 75 Cholecystitis, 46, 61 Cholecystography, 46, 61 Choleretic, 61, 75 Cholesterol, 11, 18, 20, 21, 45, 46, 59, 61, 62, 64, 67, 69 Cholesterol Esters, 61, 67 Chronic, 6, 45, 46, 60, 61, 66, 69, 75 Chronic Disease, 6, 60, 61 Chylomicrons, 61, 67 Clinical trial, 4, 5, 39, 61, 72 Cloning, 59, 61 Cognition, 61, 69 Colorectal, 18, 61 Common Bile Duct, 46, 61, 63 Complement, 61, 62 Complementary and alternative medicine, 17, 23, 62 Complementary medicine, 17, 62 Computational Biology, 39, 62 Condoms, 45, 62 Confusion, 62, 69, 75 Connective Tissue, 60, 62, 64, 67 Contraindications, ii, 62 Coronary, 60, 62, 68 Coronary heart disease, 60, 62 Coronary Thrombosis, 62, 68 Cortisone, 62, 63 Cotinine, 9, 62 Cranial, 62, 69 Creatine, 19, 62

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Creatinine, 62, 63, 75 Curative, 63, 74 Cystic Duct, 61, 63 Cytotoxic, 5, 63 D Data Collection, 63, 64 Databases, Bibliographic, 39, 63 Dehydration, 4, 25, 63 Density, 11, 60, 63, 67, 69 Dexamethasone, 9, 63 Diagnostic procedure, 30, 63 Diarrhea, 44, 45, 63 Digestion, 18, 59, 60, 63, 66, 67, 73 Direct, iii, 33, 63, 72 Distal, 63, 66, 72 Diuretic, 18, 63 Drug Interactions, 34, 63 Duct, 46, 61, 63, 72 Duodenum, 59, 63, 64, 66, 73, 74 E Electrolyte, 63, 64, 69, 71, 73, 75 Electrophysiological, 63, 75 Emboli, 4, 63 Endotoxic, 63, 67 Energy balance, 63, 66 Environmental Health, 38, 40, 64 Enzyme, 64, 74 Epidemiological, 4, 64 Exogenous, 59, 64, 71 Extracorporeal, 46, 64 F Family Planning, 39, 64 Fat, 5, 7, 19, 21, 31, 57, 59, 60, 62, 63, 64, 67, 69, 71, 75 Fatigue, 44, 64 Fatty Liver, 5, 64 Fibrosis, 21, 64 Fluid Therapy, 64, 69 Focus Groups, 5, 64 Fold, 64, 68 Forearm, 59, 64 G Gallbladder, 11, 46, 57, 59, 61, 63, 64, 67 Gallbladder Emptying, 11, 64 Gallstones, 23, 45, 46, 59, 61, 64, 69, 75 Gastric, 5, 6, 8, 18, 59, 60, 64 Gastric Bypass, 5, 8, 64 Gastrin, 64, 65 Gene, 59, 64 Gland, 62, 64, 67, 69, 71, 74 Glucocorticoid, 63, 64 Glucose, 5, 65, 66

Gluten, 31, 60, 65 Glycogen, 8, 65 Governing Board, 65, 71 Growth, 4, 20, 65, 70, 72, 74 H Heart attack, 60, 65 Heartbeat, 65, 74 Hepatic, 5, 14, 19, 20, 61, 65 Histology, 5, 65 Homeostasis, 5, 65 Hormonal, 4, 65 Hormone, 7, 14, 62, 64, 65, 66, 74 Hydrogen, 59, 60, 65, 67, 69 Hydrophobic, 65, 67 Hypertension, 7, 20, 21, 60, 65, 75 Hypesthesia, 65, 69 Hypotensive, 21, 65 I Id, 15, 22, 46, 52, 54, 65 Ileum, 65, 66 Immune function, 4, 65 Immune response, 58, 62, 65, 66, 76 Immune system, 65 Immunodeficiency, 44, 45, 66 Immunogenic, 66, 67 Immunoglobulin, 58, 66, 68 Indicative, 27, 66, 70 Infarction, 62, 66, 68 Infection, 65, 66, 67 Inflammation, 58, 61, 64, 66, 69, 75 Ingestion, 61, 66 Insulin, 5, 66 Insulin-dependent diabetes mellitus, 66 Interstitial, 21, 66 Intestinal, 60, 61, 66, 67, 74 Intestine, 59, 60, 66, 72, 73 Intracellular, 66, 71 Intravenous, 10, 66 Ions, 59, 63, 65, 66 J Jejunoileal Bypass, 11, 66 Jejunum, 64, 66 K Kb, 38, 66 Kinetic, 66 L Leptin, 19, 66 Lethargy, 45, 67 Library Services, 52, 67 Ligament, 67, 71 Lipid, 20, 58, 66, 67, 69, 75 Lipid A, 20, 67

Index 79

Lipid Peroxidation, 67, 69 Lipophilic, 22, 67 Lipopolysaccharides, 67 Lipoprotein, 11, 14, 19, 67 Lithotripsy, 46, 67 Liver, 5, 7, 19, 46, 57, 59, 60, 64, 65, 67 Loop, 64, 67 Low-density lipoprotein, 67 Lymph, 45, 67 Lymph node, 45, 67 Lymphatic, 66, 67, 73 Lymphatic system, 67, 73 Lymphoid, 58, 67 M Malabsorption, 60, 67 Malnutrition, 60, 68 Meat, 5, 68 MEDLINE, 39, 68 Membranes, 63, 68, 70, 74 Memory, 58, 68 Menopause, 68, 71 Mesenteric, 10, 68, 74 Mesentery, 68, 74 MI, 55, 68 Microbe, 68, 74 Microbiology, 57, 68 Microtubules, 68, 69 Modification, 68, 72 Molecular, 39, 41, 59, 62, 68 Monoclonal, 22, 68 Monoclonal antibodies, 22, 68 Mucins, 68, 72 Mucosa, 60, 68 Myocardium, 68 N Necrosis, 66, 68 Need, 3, 5, 28, 31, 47, 65, 68 Needle Sharing, 44, 69 Nerve, 69, 74 Neuritis, 10, 69 Neuroleptic, 10, 14, 58, 69 Nutritional Support, 18, 69 O Opacity, 63, 69 Oral Dissolution Therapy, 46, 69 Osteoporosis, 44, 69 Overweight, 5, 15, 69 Oxidation, 58, 59, 67, 69 Oxidative Stress, 5, 69 P Paclitaxel, 21, 69 Palliative, 69, 74

Pancreas, 57, 66, 69 Pancreatic, 60, 69 Pancreatitis, 4, 46, 69 Paresis, 69, 70 Paresthesias, 69, 70 Pathologic, 59, 62, 70 Patient Education, 44, 50, 52, 55, 70 Pelvic, 70, 71 Penis, 62, 70 Peptide, 66, 70, 71 Percutaneous, 67, 70 Perfusion, 70, 74 Pharmacokinetic, 70 Pharmacologic, 70, 74 Phospholipids, 64, 67, 70 Physical Examination, 46, 70 Physiologic, 4, 70, 72 Pigment, 45, 59, 70 Pilot study, 6, 10, 14, 70 Plants, 65, 70, 71, 74 Plasma, 14, 19, 58, 61, 70, 71, 73, 74 Plasma cells, 58, 71 Polyunsaturated fat, 20, 71 Posterior, 57, 69, 71 Postmenopausal, 69, 71 Potassium, 9, 14, 71 Practice Guidelines, 40, 71 Preclinical, 17, 71 Precursor, 71, 75 Premenopausal, 19, 71 Prevalence, 5, 71 Progressive, 21, 65, 68, 71 Prospective study, 5, 8, 71 Prostate, 17, 71 Protein Binding, 71, 74 Protein C, 57, 58, 67, 71 Protein S, 59, 71 Proteins, 57, 58, 61, 70, 71, 72, 73, 74, 75 Proto-Oncogene Proteins, 69, 72 Proto-Oncogene Proteins c-mos, 69, 72 Proximal, 63, 64, 66, 72 Psychomotor, 25, 69, 72 Public Policy, 39, 72 Pulmonary, 4, 59, 72, 75 Pulmonary Artery, 59, 72, 75 Q Quality of Life, 4, 72 R Radioactive, 65, 68, 72 Randomized, 6, 10, 14, 18, 72 Receptor, 57, 58, 72 Rectum, 58, 61, 71, 72

80

Rapid Weight Loss

Refer, 1, 61, 69, 72 Regimen, 21, 72 Resection, 6, 72 Resting metabolic rate, 4, 7, 10, 14, 72 Risk factor, 5, 46, 71, 72 S Saliva, 9, 72 Salivary, 72 Salivary glands, 72 Screening, 5, 61, 72 Sedentary, 72 Semen, 71, 72 Senile, 69, 73 Serum, 8, 19, 21, 61, 67, 73 Sexual Abstinence, 45, 73 Shock, 46, 67, 73, 75 Side effect, 33, 57, 58, 73, 74 Small intestine, 59, 61, 63, 65, 66, 73 Social Environment, 72, 73 Sodium, 73 Solid tumor, 18, 73 Soybean Oil, 71, 73 Specialist, 47, 73 Species, 68, 73, 76 Specificity, 57, 73, 74 Sphincter, 64, 73 Spinal cord, 61, 73 Steatosis, 64, 73 Stomach, 57, 59, 64, 65, 73 Stroke, 38, 60, 73 Stupor, 67, 73 Subcutaneous, 7, 57, 74 Substrate, 5, 74 Sudden death, 10, 74 Superior Mesenteric Artery Syndrome, 6, 74 Supplementation, 19, 20, 74 Suppression, 5, 9, 74 Symphysis, 71, 74 Symptomatic, 69, 74 Systemic, 34, 59, 66, 74

T Tachycardia, 10, 74 Therapeutics, 34, 74 Thyroid, 7, 14, 74 Tissue, 6, 10, 57, 58, 59, 60, 62, 63, 66, 67, 68, 69, 70, 72, 73, 74, 75 Tissue Distribution, 6, 74 Tooth Preparation, 57, 74 Toxic, iv, 74 Toxicity, 22, 63, 74 Toxicokinetics, 74 Toxicology, 40, 74 Toxins, 58, 66, 68, 74 Trachea, 74 Transfection, 59, 74 Transfusion, 75 Trauma, 68, 69, 75 Triglyceride, 14, 19, 75 U Unconscious, 65, 75 Uraemia, 69, 75 Ureter, 67, 75 Urethra, 70, 71, 75 Urine, 59, 62, 63, 75 Ursodeoxycholic Acid, 11, 75 V Vaccines, 75, 76 Vagina, 75 Vaginal, 45, 75 Vasculitis, 69, 75 Vein, 66, 74, 75 Ventricle, 72, 75 Ventricular, 9, 10, 14, 75 Ventricular Function, 9, 14, 75 Veterinary Medicine, 39, 75 Villous, 60, 75 Virulence, 74, 76 Virus, 44, 45, 76 W Weight Gain, 31, 45, 76 Windpipe, 74, 76

Index 81

82

Rapid Weight Loss

Index 83

84

Rapid Weight Loss

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