Urine Tests - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

RINE ESTS A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES J AMES N. ...

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RINE ESTS A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES

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

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

Publisher, Health Care: Philip Parker, Ph.D. Editor(s): James Parker, M.D., Philip Parker, Ph.D. Publisher's note: The ideas, procedures, and suggestions contained in this book are not intended for the diagnosis or treatment of a health problem. As new medical or scientific information becomes available from academic and clinical research, recommended treatments and drug therapies may undergo changes. The authors, editors, and publisher have attempted to make the information in this book up to date and accurate in accord with accepted standards at the time of publication. The authors, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of this book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised to always check product information (package inserts) for changes and new information regarding dosage and contraindications before prescribing any drug or pharmacological product. Caution is especially urged when using new or infrequently ordered drugs, herbal remedies, vitamins and supplements, alternative therapies, complementary therapies and medicines, and integrative medical treatments. Cataloging-in-Publication Data Parker, James N., 1961Parker, Philip M., 1960Urine Tests: 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: 0-597-84113-6 1. Urine Tests-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 urine tests. 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 URINE TESTS ............................................................................................. 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Urine Tests.................................................................................... 5 The National Library of Medicine: PubMed ................................................................................ 15 CHAPTER 2. ALTERNATIVE MEDICINE AND URINE TESTS ............................................................. 31 Overview...................................................................................................................................... 31 National Center for Complementary and Alternative Medicine.................................................. 31 Additional Web Resources ........................................................................................................... 38 General References ....................................................................................................................... 40 CHAPTER 3. BOOKS ON URINE TESTS ............................................................................................. 41 Overview...................................................................................................................................... 41 Book Summaries: Federal Agencies.............................................................................................. 41 Book Summaries: Online Booksellers........................................................................................... 43 Chapters on Urine Tests .............................................................................................................. 43 CHAPTER 4. MULTIMEDIA ON URINE TESTS ................................................................................... 45 Overview...................................................................................................................................... 45 Video Recordings ......................................................................................................................... 45 Bibliography: Multimedia on Urine Tests ................................................................................... 46 CHAPTER 5. PERIODICALS AND NEWS ON URINE TESTS ................................................................ 47 Overview...................................................................................................................................... 47 News Services and Press Releases................................................................................................ 47 Newsletter Articles ...................................................................................................................... 51 Academic Periodicals covering Urine Tests................................................................................. 52 APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 57 Overview...................................................................................................................................... 57 NIH Guidelines............................................................................................................................ 57 NIH Databases............................................................................................................................. 59 Other Commercial Databases....................................................................................................... 61 APPENDIX B. PATIENT RESOURCES ................................................................................................. 63 Overview...................................................................................................................................... 63 Patient Guideline Sources............................................................................................................ 63 Finding Associations.................................................................................................................... 69 APPENDIX C. FINDING MEDICAL LIBRARIES .................................................................................. 71 Overview...................................................................................................................................... 71 Preparation................................................................................................................................... 71 Finding a Local Medical Library.................................................................................................. 71 Medical Libraries in the U.S. and Canada ................................................................................... 71 ONLINE GLOSSARIES.................................................................................................................. 77 Online Dictionary Directories ..................................................................................................... 77 URINE TESTS DICTIONARY....................................................................................................... 79 INDEX .............................................................................................................................................. 119

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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 urine tests 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 urine tests, 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 urine tests, 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 urine tests. 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 urine tests, 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 urine tests. 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 URINE TESTS Overview In this chapter, we will show you how to locate peer-reviewed references and studies on urine tests.

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

Comparison of Questionnaire, Breath Carbon Monoxide and Urine Cotinine in Assessing the Smoking Habits of Type 2 Diabetic Patients Source: Diabetic Medicine. 17(2): 119-123. 2000. Contact: Available from John Wiley and Sons, Inc. Life and Medical Sciences, 605 Third Avenue, New York, NY 10518-0012. (800) US-WILEY. Fax (212) 850-8888. Summary: This article describes a study that examined the value of urinary cotinine and breath carbon monoxide (CO) in assessing the accuracy of self reported smoking habits in a large group of patients who had type 2 diabetes to assess whether reporting of smoking in this older age group may be more accurate. The study population consisted of 299 type 2 diabetic patients. All were interviewed about smoking habits using a standard questionnaire, 298 had breath CO analyzed, and 193 had urine tested for

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cotinine. Direct questioning suggested that 77 of the participants were smokers. Fiftyeight of the 298 patients tested had a breath CO level of greater than 8 parts per million, suggesting current active smoking. Of the 77 admitted smokers, 55 had a raised breath CO level. Out of 221 admitted nonsmokers, three had raised breath CO level. Forty-six of the 193 patients tested had a urinary cotinine creatinine ratio greater than 1.0 milligram (mg) per mg, suggesting current smoking. Among the 77 admitted smokers, 52 had urine samples for cotinine level tested. Forty-four of these had a raised urine cotinine-creatinine ratio, and eight had a level less than 1.0 mg, suggesting nonsmoking status. Among 222 nonsmokers, 141 had urine tests for cotinine, and only two had a raised urine cotinine-creatinine ratio. Assuming urinary cotinine-creatinine as the gold standard, the sensitivity, specificity, and positive predictive values for questionnaires were 97 percent, 95 percent, and 85 percent, respectively. For breath CO, these values were 74 percent, 98 percent, and 93 percent. The article concludes that, at least in this population of type 2 diabetic patients, a structured smoking history appeared to identify current smokers with good accuracy. 1 figure. 1 table. 23 references. (AA-M). •

Diagnostic Procedures and Laboratory Tests in IBD Source: Foundation Focus. July 1990. Contact: Available from Crohn's and Colitis Foundation of America, Inc. 386 Park Avenue South, 17th Floor, New York, NY 10016-8804. (800) 343-3637 or (800) 932-2423 or (212) 685-3440. Summary: This article describes the procedures and laboratory tests used to confirm a diagnosis of inflammatory bowel disease. Blood and urine tests determine the patient's nutritional status and general health, liver and kidney function, and electrolytes; coagulation tests reveal the patient's ability to clot blood and to control bleeding from the bowel lining. B-12 deficiency is measured by the Schilling test. Other tests search for evidence of active or past infection by parasites. The urinalysis looks for bacteria, and white and red blood cells. Stool examinations help to identify inflammation, diseasecausing organisms, and parasites. Radiologic procedures include the barium enema, upper GI and small bowel follow-through examinations, diagnostic ultrasound, abdominal CT scans, and intravenous pyelogram examinations. These help to identify inflammation, obstruction, gallstones, and abscesses. Endoscopic procedures examine the inside of the bowel for inflammation and include the taking of biopsies. Some precautions in ordering tests are noted.

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Magnificant Seven Source: Diabetes Forecast. 47(1): 37-39. January 1994. Contact: Available from American Diabetes Association. 1701 North Beauregard Street, Alexandria, VA 22311. (800) 232-3472. Website: www.diabetes.org. Summary: This article emphasizes the importance of regular medical check ups and diagnostic tests in order to become aware of diabetes complications while they can still be treated. The author describes seven tests and exams and gives general guidelines on each one. The seven consist of a general physical exam; blood and urine tests to check for signs of kidney diseases; blood test for glycosylated hemoglobin (HbA1C); eye exam by an eye doctor; blood tests to check lipid levels; check-ups because of specific problems, including impotence, numbness or tingling in the legs, stomach distress, swelling of the legs, blurred vision, chest pain, or foot sores; and blood pressure checks.

Studies

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Medical Tests Explained: A Guide to Routine Lab Work Source: Diabetes Self-Management. 15(2): 6-7, 9-10, 12-13. March-April 1998. Contact: Available from R.A. Rapaport Publishing, Inc. 150 West 22nd Street, New York, NY 10011. (800) 234-0923. Summary: This article explains some of the common medical tests that a doctor may order to help evaluate the state of health of a person with diabetes. The doctor may order tests to evaluate average blood glucose control, including tests to measure fasting blood glucose levels and glycated hemoglobin A1c, tests that help assess cardiovascular health, including tests that measure cholesterol and triglyceride levels in the blood, and tests that measure the ability of the kidneys to excrete the body's waste products, including those that check urine albumin levels, blood urea nitrogen levels, and creatinine levels. Functioning of the kidneys, adrenal glands, and pituitary gland is assessed through tests that measure sodium, potassium, calcium, phosphate, and bicarbonate levels in the blood. The complete blood count is a group of tests that measure the cells floating in the bloodstream. These tests include the red blood cell count, the red blood cell indices, the white blood cell count, and the platelet count. Thyroid function tests include those that measure the level of thyroid-stimulating hormone and thyroxine in the blood. Liver function tests are not routine, but they may be needed to evaluate patients with a history of liver problems or those who are taking certain medications. These tests measure serum glutamic oxaloacetic transaminase, serum glutamic-pyruvic transaminase, gamma glutamyl transpeptidase, and bilirubin. Other tests include prostate screening and routine urine tests. The article also includes a sample printout that shows laboratory results for a 52-year-old man with diabetes.

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Psychosocial Correlates of Glycemic Control: The Pittsburgh Epidemiology of Diabetes Complications (EDC) Study Source: Diabetes Research and Clinical Practice. 21(2,3): 187-195. 1993. Summary: This article reports on a study in which the psychosocial correlates of glycemic control were examined in an incident cohort of persons with childhood onset insulin-dependent diabetes, aged 18 years or older at the time of the study (n=592). Glycosylated hemoglobin (GHb) was measured at the beginning of the study, and questionnaires on diabetes self-care activity, barriers to regimen adherence, and social support were completed. Demographic information was also collected. Results demonstrated that GHb was correlated with age, income and educational attainment, suggesting that older, more educated and wealthier patients have better glycemic control. GHb was also inversely associated with the degree of self-care activity, in particular administering injections at the recommended times and the frequency of performing blood/urine tests. Factors related to self-care behavior were identified. They included degree of social support and patients' reports of difficulties adhering to their self-care regimens. The authors conclude that psychosocial factors (e.g., low income and education) may have an important effect on glycemic control in adults and also (e.g. social support and adherence difficulties) seem particularly important in influencing the performance of self-care. 1 figure. 4 tables. 42 references. (AA-M).

Federally Funded Research on Urine Tests The U.S. Government supports a variety of research studies relating to urine tests. These studies are tracked by the Office of Extramural Research at the National Institutes of

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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 urine tests. 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 urine tests. The following is typical of the type of information found when searching the CRISP database for urine tests: •

Project Title: COMPREHENSIVE HBP CARE FOR YOUNG URBAN BLACK MEN Principal Investigator & Institution: Bone, Lee R.; Johns Hopkins University 3400 N Charles St Baltimore, Md 21218 Timing: Fiscal Year 2001 Summary: The primary objective of this clinical trial is to compare the differential reduction in BP in 309 inner city underserved hypertensive black men, 21-54 years of age; the age/sex/race group with HBP which continues to be the most poorly diagnosed, treated and studied and which suffers disproptionally from premature hypertension related complications. The 2 arm trial tests the effectiveness of a comprehensive educational, behavioral, and treatment HBP control program provided by a nurse practitioner and community health worker compared to usual medical care available in the community. The intervention lasts 24 months. All men will be seen at baseline, and 12, 24, 36 months for interviews, BP measurement and blood and urine tests (as well as cardiac assessment per ancillary study protocol: W. Post, PI). Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: DO URINE TESTS INCREASE CHLAMYDIA SCREENING IN TEENS Principal Investigator & Institution: Shafer, Mary-Ann B.; Pediatrics; University of California San Francisco 500 Parnassus Ave San Francisco, Ca 94122 Timing: Fiscal Year 2001; Project Start 30-SEP-1999; Project End 29-SEP-2003 Summary: Sexually transmitted diseases (STDs) remain epidemic among sexually active adolescents. Addressing the problem within a primary care setting has been hindered by a number of barriers including the lack of screening for sexual activity and STD risk by the physician and by the lack of an accurate non-invasive screening test for C. trachomatis (CT) and N.gonorrhoeae (GC) and. Recently the nucleic acid amplification tests (NAATs) for CT and GC have been successfully applied to first void urines thereby obviating the need for traditional invasive screening (pelvic exam in females, urethral swab in males), yet the adoption of this technique for screening has been slow. To determine whether a "systems-level" intervention based on the Precede-Proceed model and targeting and training designated intake clinic nurses (intervention) results in an increased rate of urine-based screening for CT and GC in asymptomatic sexually active adolescents attending general HMO pediatric practice clinics compared to the

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

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traditional physician initiated screening model (control). Pediatric clinics caring for teens in a large regional HMO will be the target. In this quasi-experimental design, 10 clinics (500 teens in each clinic) will be grouped into the 2 conditions: 5 into the intervention and 5 into the control. Intervention: A designated nurse/medical assistant (nurse/MA) in each clinic will receive 4 hours of training to properly ask teens about sexual activity and subsequently to obtain urines for STD screening among the sexually active. The nurse/MA will have ongoing supervision and support. Physicians in the same condition will receive 1.5 hour workshop on the importance of urine screening using the new NAATs in the sexually active teen to increase support of the nurse/MA role. Control: These clinics will remain in the traditional "physician initiated" STD screening model. Physicians will receive a 1 hour didactic lecture on STDs in teens and the technology of the new NAATs for screening for CT and GC. No other staff will be included. NAATs for CT and GC will be available to all clinics. Data sources will include number and percent of sexually active teens screened with urines in each clinic, and demographic data obtained from a central patient information computer data bank. Analysis will focus on a comparison of urine screening among sexually active teens in the control and intervention clinics adjusting for potential teen and clinic differences. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: DRUG COURT OFFENDERS IN OUTPATIENT TREATMENT Principal Investigator & Institution: Pottieger, Anne E.; None; University of Delaware Newark, De 19716 Timing: Fiscal Year 2001; Project Start 01-JUN-1999; Project End 31-MAY-2004 Summary: The overall goal of the project is increased understanding of the influence that drug courts have in motivating treatment retention and post-treatment success when they divert or sentence offenders to outpatient substance abuse treatment. The specific aims are: (1) assessment of 12-month and 24-month post-treatment outcomes for drug court offenders sent to outpatient substance abuse treatment, by examining multiple outcome indicators for diverted and sentenced drug court offenders as well as comparable volunteer treatment clients; (2) examination of the impact of drug court sentencing on retention in outpatient substance abuse treatment; and (3) analysis of variations in treatment treatment motivations, program retention, and post-treatment outcomes for drug court offenders sent to outpatient substance abuse treatment, through hypothesis testing and exploratory study of how those variations are related to addiction careers, treatment careers, and concurrent life problems. In a proposed 5-year study, the project will interview 720 adult offenders sent to outpatient substance abuse treatment by the Delaware Drug Court in Wilmington (New Castle County): 180 offenders referred to each of three programs: diversion to drug education, diversion to outpatient therapy, and sentencing to intensive outpatient treatment. A fourth sample will be 180 volunteer clients with similar drug and crime backgrounds who are also in intensive outpatient treatment at the same treatment agency. Treatment program data will be used to indicate retention, treatment motivation at entry, and substance use before treatment. Treatment outcome indicators for 12 and 24 months after leaving treatment will be official arrest data, urine tests for drug use, and self-reported substance use, crime, employment, family relationships, and health. Analysis will include both hypothesis testing and exploratory analysis, combining outcome assessment of outpatient programs for drug court offenders with specification, testing, and exploration of a theory about how treatment effects are modified by addiction career stages and consequent life problems. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: EFFECTIVENESS OF ASSERTIVE AFTERCARE FOR YOUTH Principal Investigator & Institution: Godley, Mark D.; Chestnut Health Systems 1003 Martin Luther King Dr Bloomington, Il 61701 Timing: Fiscal Year 2001; Project Start 01-JUN-1997; Project End 31-MAY-2002 Summary: APPLICANT'S ABSTRACT: The majority of adolescents entering residential treatment programs already have chronic and relapsing problems with alcohol abuse and dependence as well as multiple comorbid problems that complicate treatment. Two thirds relapse to alcohol use within 90 days after discharge from residential programs, a fifth returning to weekly use. While all are referred to an outpatient program at discharge, in some counties as many as 60% never get any treatment and only a fraction of these stay in aftercare treatment for even four sessions. The primary goal of this research is to evaluate the effectiveness of an Assertive Aftercare Protocol (AAP) in increasing successful transfer and decreasing relapse and other problems relative to the current system's Status Quo (SQ) level of aftercare. AAP is designed to ensure a specified quantity and quality of aftercare services are provided including assessment, aftercare planning, frequent community-based contacts, linkages between systems, relapse prevention, problem solving, social skill building; family/social support and other forms of case management. The specific aims are to evaluate two core hypotheses: Hl. Following discharge from residential treatment, clients randomly assigned to the experimental assertive aftercare protocol will have improved intermediate outcomes (treatment participation, self-efficacy We will test these hypotheses for both immediate and long-term effects in a blocked randomized field experiment. Over a 3-year period approximately 250 clients will be interviewed at intake to residential care, discharge from residential care, and then quarterly post-discharge for a year. At the point of discharge from residential services, half the clients will be randomly assigned to the experimental Assertive Aftercare Protocol (AAP) and the other half to receive the current Status Quo aftercare. Data will include self-reports, collateral reports, service records, and urine tests for alcohol, marijuana and cocaine. Additional comparisons will be possible with a pre-experimental baseline group of another 80 clients and a separate state-wide study we are currently conducting with 38 treatment units serving approximately 7200 clients per year. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: GENETIC EPIDEMIOLOGY OBSTRUCTIVE PULMONARY DISEASE

OF

EARLY

ONSET

CHRONIC

Principal Investigator & Institution: Speizer, Frank E.; Edward H Kass Professor; Brigham and Women's Hospital 75 Francis Street Boston, Ma 02115 Timing: Fiscal Year 2001 Summary: The purpose of this study is to determine the genetic and environmental factors which contribute to the development of early-onset chronic obstructive pulmonary disease (COPD). These factors will be determined by studying individuals with early-onset COPD and their relatives using a series of blood and urine tests. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: HIV PREVENTION PROGRAM AMONG SUBSTANCE ABUSING SMI Principal Investigator & Institution: Blank, Michael B.; Psychiatry; University of Pennsylvania 3451 Walnut Street Philadelphia, Pa 19104

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Timing: Fiscal Year 2003; Project Start 01-SEP-2003; Project End 30-JUN-2008 Summary: (provided by applicant): Persons with serious mental illness (SMI) are at increased risk for HIV/AIDS. The relative risk of HIV/AIDS is at least five times greater in SMI as the general Medicaid population in Philadelphia and over seven times for those also treated for substance abuse. SMI persons reported more transmissions through heterosexual contact, injection drug use (IDU), and women have more sex with men who have sex with men (MSM) than in the general population. A cost study showed that SMI with HIV had much higher health care costs than non-SMI persons with HIV and non-HIV persons with SMI. We will implement a prevention program for persons with SMI who also abuse substances. A comprehensive pilot study demonstrated convincingly that SMI participants were able to learn from case managers teaching HIV prevention skills. Preventing AIDS through Health (PATH) is a translation of two HIV prevention programs proven effective in the general population and among substance users. The RESPECT program was developed by CDC and is the first HIV prevention program to show one-on-one counseling can reduce at-risk sexual behavior in a multi-site demonstration. The NIDA Community-Based Outreach Model (CBOM) was designed to reduce the risk of HIV and other blood-borne infections in drug users. Both are highly structured, manualized interventions. PATH uses case managers (CMs) to draw on features of both interventions depending on individual consumer risk profiles. CMs have specialized expertise in providing services to this population. We believe that this expertise, prior relationships with these persons, and an ability to reinforce regularly the intervention will result in significantly reduced risk. Blood testing will identify those who are HIV positive at baseline. Breathalyzer and urine testing will supplement clinical interviews and other measures to identify substance abuse co-morbidity. Using a longitudinal experimental and control group design, we will randomly assign case managers to deliver the intervention to consenting participants in their caseloads who meet inclusion criteria. Participants will be in treatment at a large CMHC in Philadelphia. Independent interviews will be conducted with case managers and consumers before the intervention, and again at 3, 6 and 12months post intervention and focus on changes in risk behaviors, fidelity of translation of the intervention, cost and outcomes. Breathalyzer and urine tests at 12-months will supplement self-reports of use of alcohol, cocaine, marijuana, benzodiazapines, and opiates. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: HIV RISK REDUCTION AMONG YOUNG INCARCERATED FEMALES Principal Investigator & Institution: Robertson, Angela A.; None; Mississippi State University P. O. Box 6156 Mississippi State, Ms 39762 Timing: Fiscal Year 2003; Project Start 30-SEP-2003; Project End 30-JUN-2008 Summary: (provided by applicant): This study is a longitudinal analysis of STD/HIV exposure among adolescent female offenders in Mississippi, a population that is disproportionately African American, and at higher risk than adolescents in general due to their propensity to engage in a variety of risk-taking behaviors, earlier onset of sexual behaviors, and the greater prevalence of mental disorders, substance abuse disorders, maltreatment, and family dysfunction. Based on social cognitive theory and Fisher and Fisher's (1992) IMB (Information, Motivation, and Behavioral skills) model, we request funding to evaluate a drug abuse related HIV risk reduction intervention and to compare outcomes against a STD/HIV information and health education control condition. Approximately 400 females committed to the state reformatory/training

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school for girls will be recruited for participation. The research design will consist of alternating cohort/waves of about 36 subjects each. One treatment condition will be administered at a time with a washout period between cohort/waves. Over a three-year period, one half of subjects will get 18 hours of HIV prevention and one half will get 18 hours of Health Education. Before and after the intervention, subjects' social competency skills and health knowledge will be measured. Before intervention and at 6-month and 12-month follow-up, self-report measures of alcohol and drug use, sexual risk behaviors, and impulsivity will be collected. Measures of condom attitudes, self-efficacy, sexual decision-making, and attitudes towards HIV prevention will be collected four times. Urine tests for the detection of 2 STDs (chlamydia and gonorrhea) will also be performed before intervention and at 6-month and 12- month follow-up. Multivariate data analyses will compare the experimental program against the Health Education control condition to evaluate the impact of the prevention program on lowering sexual risk behavior. It is hypothesized that the HIV prevention intervention will produce more favorable attitudes towards condoms and HIV prevention, more consistent use of condoms, and lower risk behavior post intervention and through the one-year follow-up period than the Health Education control condition. It is also hypothesized that the incidence of chlamydia and gonorrhea infection during the follow-up period will be lower for participants of HIV prevention than participants in the control group. The results will be useful to juvenile justice administrators and others that work with this high-risk population. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: INCENTIVES TO IMPROVE TREATMENT OUTCOME IN HIV AND IDUS Principal Investigator & Institution: Batki, Steven L.; Professor and Director of Research; University of California San Francisco 500 Parnassus Ave San Francisco, Ca 94122 Timing: Fiscal Year 2002 Summary: (Applicant?s Abstract) The overall goal of the proposed research study is to improve treatment outcomes for drug use and medical care among human immunodeficiency virus (HIV) infected injection drug users (IDUs) undergoing methadone treatment. Methadone maintenance treatment (MMT) is a widely applied and highly effective treatment available for IDUs who are opioid dependent, yet it has limitations. For example, while methadone treatment significantly reduces the use of heroin, it does not completely eliminate opiate use in all patients. Furthermore, the use of non-opiates such as stimulants, alcohol, and other drugs is not as robustly reduced in MMT patients as is the use of opiates. Continued drug use by HIV-infected IDUs increase the risk for other infectious diseases. Drug use may also cause problems with HIV health care by interfering with appointment keeping and adherence to medical regimens. It is therefore essential to find ways to improve the effectiveness of MMT with respect to both drug use and medical care in HIV-infected persons. The proposed study will consist of a six month randomized trial to test the efficacy of incentives in the form of contingent vouchers designed to improve the treatment outcome of HIV-infected MMT patients in the domains of drug use and HIV medical care. 150 HIV-infected MMT patients will be randomized to one of three treatment conditions: 1) a Drug Voucher group that will be given incentives to reinforce drug-free urine tests, 2) a Drug plus Medical Voucher group that will be given incentives to reinforce both drug-free urines and HIV "Medical Care Management" appointment keeping, and 3) a No Voucher control group that will receive no incentives. Participants in the study will be able to exchange vouchers for goods and services of their choice. The main outcomes will

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consist of drug use, medical appointment keeping, HIV and drug-related medical morbidity, and HIV and drug-related health care costs. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: MECHANISMS OF BLADDER CANCER PROGRESSION Principal Investigator & Institution: Lokeshwar, Vinata B.; Urology; University of Miami-Medical Box 248293 Coral Gables, Fl 33124 Timing: Fiscal Year 2003; Project Start 01-JAN-1997; Project End 31-MAY-2007 Summary: (provided by applicant): Identification of "molecular determinants" that regulate bladder cancer (BCa) progression could improve treatment and recurrence monitoring for BCa patients. Hyaluronic acid (HA) is a glycosaminoglycan that promotes tumor metastasis. Hyaluronidase (HAase) is an enzyme that degrades HA into angiogenic fragments. HYAL1 is the major HAase expressed in bladder tumor (BT) cells. It regulates BCa growth and invasion both in vitro and in BT xenografts. While HYAL1 wild type (wt) is enzymatically active and is exclusively expressed in highgrade BCa, 5 HYAL1 variants are enzymatically inactive and expressed in normal and low-grade BCa tissues. In BT tissues, both tumor cells and the stroma produce HA, however, HAS1 type HA-synthase is exclusively expressed in BT cells. The measurement of urinary HA and HAase levels (HA-HAase test) has high accuracy in detecting BCa. This proposal is designed to investigate the therapeutic and prognostic potentials of HYAL1, HYAL1 splice variants, and HAS1 in BCa progression. Furthermore, in a multi-center trial whether the HA-HAase test, either alone or in combination with other urine tests, can be used for monitoring BCa recurrence will be evaluated. To define HYAL1 function(s) in BCa growth and progression, the efficacy of anti-HAase therapy will be tested in BT xenografts, following delivery of HYAL1antisense cDNA using a viral system or by treatment with a HAase inhibitor. The mechanism of HYAL1 action will be examined by analyzing alterations in cell cycle regulators, matrix degrading enzymes, and angiogenic factors (Aim 1). A possible neutralizing effect of HYAL1 variants on BCa growth and invasion will be examined by cDNA transfection of HYAL1wt expressing BT cells with HYAL1 splice variant cDNAs. Differential expression of HYAL1 variants in BT tissues will be correlated with BT prognosis (Aim 2). HAS1 function in BT growth and progression will be evaluated by transfecting BCa cells which either express or are blocked in HYAL1 production, using HAS1-sense and HAS1-antisense constructs. Expression of HAS1 and its variant (HAS1v) in BT tissues will be correlated with BCa prognosis (Aim 3). In a multi-center trial, the utility of the HA-HAase test, urine cytology, BTA-Stat, NMP22 tests, individually and in combination, will be examined for precision to monitor tumor recurrence in 100 to 150 BCa patients. The results will be compared to clinical findings (Aim 4). The proposed study will reveal the function, therapeutic and/or prognostic potentials of the HA, HYAL1 and related molecules in BT progression. Furthermore, it will establish whether the HA-HAase test or its combination with other tests can precisely monitor BCa recurrence. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: PROTEOMIC CHARACTERIZATION OF IC BLADDER Principal Investigator & Institution: De Miguel, Fernando; Urology; University of Pittsburgh at Pittsburgh 350 Thackeray Hall Pittsburgh, Pa 15260 Timing: Fiscal Year 2003; Project Start 30-SEP-2003; Project End 31-JUL-2007

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Summary: (provided by applicant): Interstitial cystitis (IC) is a painful bladder syndrome of unknown etiology, characterized by chronic pelvic pain, urinary frequency and urgency. It affects an estimated 700,000 to one million people in the United States; approximately 90% of the reported sufferers are women. Diagnosis of IC is primarily based on symptoms, as there are no currently available blood or urine tests due to the lack of demonstrated biological markers. The nuclear matrix is the structural scaffolding of the cell nucleus and plays a central role in the regulation of important cellular processes. Specific nuclear matrix proteins (NMPs) have been identified as unique to certain cell types or states. Although the estimated number of different proteins in a cell might outnumber the estimated number of genes in the same cell, proteins are the functional players in cell pathophysiology. Therefore, we propose to use a proteomic approach to identify specific new markers related to chronic cystitis. Several agents, such as Nerve Growth Factor (NGF), nitric oxide (NO) and proinflammatory mediators, have been shown to exert an effect in bladder afferent pathways that could be related to frequent voiding and nociceptive responses in chronic cystitis. Thus, two hypotheses will be tested: 1) Alterations in NMPs are characteristic of the bladder with chronic irritation and can be developed into diagnostic markers and/or treatment targets for painful bladder syndrome such as IC. 2) Functional improvement of chronic cystitis after intervention on NGF, NO, and inflammatory pathways, is associated with changes in NMPs. To address these hypotheses, we propose the following Specific Aims: 1) to perform a comprehensive analysis of the nuclear matrix protein composition of the bladder with chronic irritation in comparison to normal controls to identify specific proteins associated with the disease. 2) to characterize and sequence specific nuclear matrix proteins associated with bladders with chronic irritation and to raise antibodies against these markers and to develop diagnostics tests in this regard. 3) to analyze the effect of several modulators of the bladder afferent pathway, NGF, NO and IPD-1151 T, on specific NMPs associated with the pathogenesis of chronic cystitic bladder. The longterm objectives of this research project are to identify new markers that can be used in sensitive, specific test/screens for IC and may prove of immense value in the accurate diagnosis, and even early prediction, of disease. The results of this research project could also identify new molecular targets of drug therapy for chronic bladder and/or pelvic pain associated with painful bladder syndromes, offering a better outcome for patients with IC. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: PROTEOMICS APPROACHES TO INTERSTITIAL CYSTITIS. Principal Investigator & Institution: Liu, Brian C.; Assistant Professor; Brigham and Women's Hospital 75 Francis Street Boston, Ma 02115 Timing: Fiscal Year 2003; Project Start 30-SEP-2003; Project End 31-JUL-2007 Summary: (provided by applicant): This application is in response to a Request for Applications (RFA): DK-03-010, Basic Research in Interstitial Cystitis. Diagnosis of interstitial cystitis (IC) is primarily based on symptoms, as there are no currently available blood or urine tests due to the lack of demonstrated biological markers. In addition, there are currently no consistently effective treatments for IC, and a precise etiology has not been demonstrated. Thus, one area of critical need is to identify disease markers for IC. Markers that can be used in sensitive, specific tests/screens for IC may have immense value in the accurate diagnosis of disease, as well as elucidating potential pathobiological pathways that may translate into a mode of action for the treatment of IC. The identification of disease signatures is one of the research areas of special interest, and anticipated goals of this RFA. Therefore, to fulfill this goal, we will: 1) generate

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disease-associated urinary protein profiles of clinically annotated interstitial cystitis specimens with surface enhanced laser desorption ionization time-of-flight (SELDI-TOF) mass spectrometry; 2) characterize potential disease-associated proteins, based on results obtained from SELDI-TOF, by 2-0 difference gel electrophoresis (2-D QIGE) and tandem mass spectrometry (msims)-based sequence identification; 3) compare relative expression levels of low- abundance urinary proteins in clinically annotated IC specimens with isotope-coded affinity tag (ICAT) and mass spectrometry; 4) mine proteomics data and to create predictive bioinformatics models (i.e., hierarchical cluster analysis and K-means methods, canonical correlations, discriminant analysis, Bayesian statistics, self-organizing maps and neural networks) that can stratify samples according to clinical information and/or outcome; 5) develop a biorepository consisting of urine, serum, and plasma specimens as a resource for future assays, including the creation of resources in the form of frozen urine, serum, and plasma protein arrays, as well as resources for global metabolomics studies. Through these specific aims, our goal is to fulfill the need to develop reliable predictive and diagnostic tools for IC, which is deemed to be a high-priority by the NIDDK Bladder Research Progress Group. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: SEX HORMONES, STRESS, AND PAIN IN FIBROMYALGIA Principal Investigator & Institution: Okifuji, Akiko; Associate Professor; Anesthesiology; University of Utah Salt Lake City, Ut 84102 Timing: Fiscal Year 2001; Project Start 11-SEP-2000; Project End 31-JUL-2005 Summary: Many chronic pain disorders are more prevalent in women. Women also exhibit greater sensitivity to experimentally induced pain. Research has suggested that sex hormones exert multiple impacts upon human CNS, including the sympathoadrenal and serotonergic functions. The primary purpose of this proposal is to test several components of a conceptual model hypothesizing how the hormonal and stress factors are related to fibromyalgia syndrome (FMS), a chronic musculoskeletal pain disorder, predominantly seen in women. We will use both laboratory and field study approaches to evaluate the effects of sex hormones in pain sensitivity, stress reactivity, and symptom perception across a menstrual cycle in women with FMS, in comparisons to healthy pain-free females (PFF) and males (PFM). Specifically, we will test sex steroid production in FMS, estrogenic effects on the sympathoadrenal functions in response to stressors, estrogenic effects on pain sensitivity, involvement of sex hormones in perimenstrual and FMS symptoms across menstrual cycle, and sleep and stress as predictors of pain, fatigue, distressed mood in FMS. A total of 300 subjects (100 each in FMS, PFF, PFM) will undergo home urine tests, daily symptom monitoring, blood and saliva sampling, and experimentally induced stress and pain testing. The laboratory testing will be repeated on 3 separate days: once during the mid-luteal phase (high estrogen E + high progesterone P), once during the perimenstrual phase (low E + low P), and once during the late-follicular phase (high E + low P). Male subjects will be scheduled using a "yoked-cycle" to female subjects. Each subject will be randomly assigned to one of the two experimental conditions ("stress-priming" vs "non-stresspriming" tasks just prior to pain testing). Blood pressure and salivary cortisol will be sampled multiple times throughout the laboratory sessions. The findings from this project are expected to promote better understanding of the role of female sex hormones in noxious sensory processing in chronic pain disorders. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: UTILIZATION AND COST EFFECTIVENESS OF NEW HIV TESTS Principal Investigator & Institution: Phillips, Katheryn A.; Associate Professor of Health Economics; Medicine; University of California San Francisco 500 Parnassus Ave San Francisco, Ca 94122 Timing: Fiscal Year 2001; Project Start 01-JUL-1999; Project End 31-AUG-2003 Summary: Aim #1 is to examine the factors associated with people's decisions on where to be tested, particularly whether they choose to be tested at home, doctors' offices, or public clinics. After 10 years of debate, the FDA approved the first home collection HIV test in 1996. Previous surveys found that a large percentage of the U.S. population could be likely to use home collection tests, including those who had not been tested and who were at high risk. We now have the unique opportunity to examine who is actually using home collection tests and how users' characteristics compare to individuals tested elsewhere, using data from nationally representative surveys and other sources. We will also collect new data and analyze existing data on individuals' preferences for different testing sites and methods, examine trends over time in how many people are tested and where they are tested, and compare te actual rates of use of home collection tests to how many people stated that they would use these tests before they were available. Aim # 2 is to examine the cost-effectiveness of a range of testing sites and methods, including home collection tests. The approval of home collection HIV tests opens the door to new testing technologies that promise to dramatically change the nature of HIV testing, including rapid tests, oral fluids tests, urine tests, and self- testing ("true" home tests with instant results). New HIV tests may change the cost effectiveness of testing programs and policies by changing the willingness of individuals to be tested, the number of persons found to be HIV- positive, and the cost of testing. We will therefore conduct a cost-effectiveness analysis of testing alternatives which incorporates the unique data obtained from the first aim of the proposed study. We will examine the policy implications of our findings, including how new testing methods can facilitate the early identification of HIV -infected persons and their entry into care; the implications for individuals, providers, and policymakers of the shifting of costs and benefits as a result of new tests; and the economic, social, and ethical issues that will arise because of new testing technologies. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: VOGLIBOSE IN TYPE II DIABETES Principal Investigator & Institution: Feinglos, Mark N.; Duke University Durham, Nc 27706 Timing: Fiscal Year 2001 Summary: PURPOSE: The purpose of this study is to compare the safety and efficacy of orally administered voglibose (AO-128) 2 mg three times daily or 3 mg twice daily with placebo. Type II diabetes is characterized by fasting hyperglycemia and glucose intolerance, manifested by a steep increase in post-prandial blood glucose concentration and insulin secretion. The goal in treatment of type II diabetes is to achieve normoglycemia, usually through use of diet and exercise therapy or with oral agents such as sulfonylureas (e.g., glipizide), biguanides (metformin), and, most recently, alpha-glucosidase inhibitors (acarbose). Voglibose, an N- substituted derivative of valiolamine, is also an alpha-glucosidase inhibitor. The compounds in this class delay digestion of disaccharides and complex carbohydrates by reversible inhibition of alphaglucosidases in the brush border of the small intestine. The inhibitory activity of voglibose is about 190-270 times more potent than acarbose, which has already received

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FDA approval. Because it favors inhibition of maltase and sucrase, voglibose is considered to be a selective disaccharidase inhibitor. METHODS: This is a phase III, 36 week, placebo- controlled, double-blind comparative trial. A total of 324 patients with type II diabetes will be randomized in order to obtain 276 evalable patients in the USA. Half of the subjects will be randomized to receive either voglibose (2mg tid or 3mg bid) or placebo for a period of 26 weeks. Patients who successfully complete this trial may be eligible for a one-year, open-label protocol extension (D-103). During the screening visit, patients will undergo a history and physical, blood and urine tests, an EKG, and retinal photos. Patients will be given placebo during a 6-8 week single-blind lead-in period when the pre-study oral agent(s) will be discontinued and baseline values will be determined. At the end of the lead-in period, eligible patients will be randomly assigned to 26 weeks of double-blind treatment with either voglibose or placebo. Group 1 patients will receive voglibose 1mg qd with breakfast for 2 weeks, then 2mg with breakfast plus 1mg with dinner for 2 weeks, then 3mg with breakfast and dinner for the remaining 22 weeks. Group 2 patients will receive 1mg with breakfast for 2 weeks, then 1mg with breakfast, lunch, and dinner for 2 weeks, and finally 2mg with breakfast, lunch, and dinner for the remaining 22 weeks. Group 3 patients will receive placebo with breakfast, lunch, and dinner for the entire 26 weeks. A follow-up visit will occur 1-2 weeks following the treatment period. Patients will return for clinic visits at 2 week to 2 month intervals, during which blood and urine samples will be collected and physical exams will be performed. A glucose tolerance test will be conducted prior to and at the end of the treatment period, during which patients will be asked to drink a "glucola" beverage and timed samples measuring glycemic and insulin response will be taken. The fundus photos and EKG will be repeated at the end of study participation. RESULTS AND CONCLUSIONS: The study was completed at our site in February 1998. This was a pharmaceutical-sponsored multicenter study and results have not been provided for us to date. SIGNIFICANCE OF THE STUDY AND FUTURE PLANS: As mentioned previously, animal studies have indicated that the inhibitory activity of voglibose is 190 - 270 times more potent than acarbose (a currently marketed alpha glucosidase inhibitor). Also, human studies (368 volunteers and 1635 patients treated with voglibose) to date have indicated that voglibose significantly reduces the postprandial peak and area under the curve of blood glucose and insulin in a dose-dependent manner. Interim analysis of a placebo-controlled European study in 259 patients with type II diabetes indicates a dose-dependent decrease in glycated HbA1c. The results of this study and D-103 will provide the basis for future studies. 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

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

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

A bedside urine test for human choriogonadotropin (hCG) as sensitive as serum radioimmunoassays. Author(s): Buck RH, Joubert SM, Norman RJ. Source: Clinical Chemistry. 1986 August; 32(8): 1596. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3731469&dopt=Abstract

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A comparative analysis of rapid urine tests for the diagnosis of upper urinary tract malignancy. Author(s): Siemens DR, Morales A, Johnston B, Emerson L. Source: Can J Urol. 2003 February; 10(1): 1754-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12625854&dopt=Abstract

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A comparison of serial quantitative serum and urine tests in early pregnancy. Author(s): Corson SL, Batzer FR, Schlaff S. Source: J Reprod Med. 1981 December; 26(12): 611-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6172585&dopt=Abstract

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A controlled study of the clinical effectiveness of urine test results in a methadone maintenance program. Author(s): Grevert P, Weinberg A. Source: Proc Natl Conf Methadone Treat. 1973; 2: 1052-9. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4808247&dopt=Abstract

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A marvel of colors and ingredients. The story of urine test strip. Author(s): Voswinckel P. Source: Kidney International. Supplement. 1994 November; 47: S3-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7869669&dopt=Abstract

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A sensitive bedside urine test for human chorionic gonadotrophin in suspected ectopic pregnancy. Author(s): Hofmeyr GJ, Rodrigues FA, Koll PC. Source: South African Medical Journal. Suid-Afrikaanse Tydskrif Vir Geneeskunde. 1989 January 21; 75(2): 49-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2464197&dopt=Abstract

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A simple, inexpensive urine test of smoking. Author(s): Peach H, Morris RW, Ellard GA, Jenner PJ. Source: Iarc Sci Publ. 1986; (74): 183-93. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3623668&dopt=Abstract

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A simple, inexpensive urine test of smoking. Author(s): Peach H, Ellard GA, Jenner PJ, Morris RW. Source: Thorax. 1985 May; 40(5): 351-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4023989&dopt=Abstract

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A urine test for control of ingestion of ethionamide. Author(s): Eidus L, Harnanansingh AM. Source: Am Rev Respir Dis. 1968 August; 98(2): 315-6. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5667761&dopt=Abstract

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A urine test system for HIV-1 antibodies. Author(s): Gottfried TD, Sturge JC, Urnovitz HB. Source: Am Clin Lab. 1999 January-February; 18(1): 4. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10351123&dopt=Abstract

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Adult diabetes: reporting urine test results: switch from + to %. Author(s): Lundin DV. Source: The American Journal of Nursing. 1978 May; 78(5): 878-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=247908&dopt=Abstract

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An evaluation of a rapid urine test for the diagnosis of Helicobacter pylori infection in the Chinese population. Author(s): Wong WM, Wong BC, Xia HH, Tang VS, Lai KC, Hu WH, Yuen MF, Chan CK, Lam SK. Source: Alimentary Pharmacology & Therapeutics. 2002 April; 16(4): 813-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11929401&dopt=Abstract

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Application of a leukocyte and nitrite urine test strip to the management of children with neurogenic bladder. Author(s): Anderson JD, Chambers GK, Johnson HW. Source: Diagnostic Microbiology and Infectious Disease. 1993 July; 17(1): 29-33. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8359003&dopt=Abstract

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Bedside application of an ultrasensitive urine test for HCG in patients with suspected ectopic pregnancy. Author(s): Buck RH, Pather N, Moodley J, Joubert SM, Norman RJ. Source: Annals of Clinical Biochemistry. 1987 May; 24 ( Pt 3): 268-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3606011&dopt=Abstract

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Blood and urine tests for diagnosis and monitoring of diabetes. Author(s): Higgins C. Source: British Journal of Nursing (Mark Allen Publishing). 1994 September 22-October 12; 3(17): 886, 888-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7994134&dopt=Abstract

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Blood tests or urine tests in diabetes management? Author(s): Smith RB. Source: N Z Med J. 1982 June 9; 95(709): 383. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6955657&dopt=Abstract

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BTA TRAK urine test increases the efficacy of cytology in the diagnosis of low-grade transitional cell carcinoma of the bladder. Author(s): Gibanel R, Ribal MJ, Filella X, Ballesta AM, Molina R, Alcaraz A, Alcover JB. Source: Anticancer Res. 2002 March-April; 22(2B): 1157-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12168917&dopt=Abstract

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Can a two-glass urine test or leucocyte esterase test of first-void urine improve syndromic management of male urethritis in southern Thailand? Author(s): Chandeying V, Skov S, Tabrizi SN, Kemapunmanus M, Garland S. Source: International Journal of Std & Aids. 2000 April; 11(4): 235-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10772086&dopt=Abstract

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Choice of urine tests for detection of glycosuria. Author(s): Paulshock BZ. Source: Del Med J. 1968 March; 40(3): 89-90. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5644832&dopt=Abstract

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Clinical evaluation of two urine tests for the early diagnosis of pregnancy. Author(s): Filstein M, Knee G, Polfliet M, Strauss JF 3rd. Source: J Reprod Med. 1984 April; 29(4): 242-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6716366&dopt=Abstract

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Comparing self-reported cocaine use with repeated urine tests in outpatient cocaine abusers. Author(s): Ehrman RN, Robbins SJ, Cornish JW. Source: Experimental and Clinical Psychopharmacology. 1997 May; 5(2): 150-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9234052&dopt=Abstract

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Comparison of Chemstrip uG, Clinitest, and Diastix urine test methods in diabetic children. Author(s): Sobel DO, Balsam M. Source: Diabetes Care. 1984 May-June; 7(3): 265-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6734396&dopt=Abstract

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Cost of a toxicology laboratory facility. Development expenses and cost per urine test using thin layer chromatographic techniques in a drug abuse urine screening program. Author(s): Kaistha KK, Jaffe JH. Source: Int J Addict. 1972; 7(3): 585-92. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5085286&dopt=Abstract

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Desipramine and amantadine causing false-positive urine test for amphetamine. Author(s): Merigian KS, Browning RG. Source: Annals of Emergency Medicine. 1993 December; 22(12): 1927-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8239121&dopt=Abstract

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Detection of Chlamydia trachomatis cervical infection by urine tests among adolescents clinics. Author(s): Beck-Sague CM, Farshy CE, Jackson TK, Guillory L, Edelkind D, Bullard JC, Urdez EA, Jones B, Francis K, Sievert A, Morse SA, Black CM. Source: The Journal of Adolescent Health : Official Publication of the Society for Adolescent Medicine. 1998 March; 22(3): 197-204. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9502006&dopt=Abstract

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Detection of the time of ovulation in clomiphene stimulated cycles with an easily applicable urine test. Author(s): Lehmann-Willenbrock E, Riedel HH, Langenbucher H, Grillo M. Source: Zentralblatt Fur Gynakologie. 1990; 112(5): 279-83. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2353551&dopt=Abstract

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Developmental risk factors in postpartum women with urine tests positive for cocaine. Author(s): Fritz P, Galanter M, Lifshutz H, Egelko S. Source: The American Journal of Drug and Alcohol Abuse. 1993; 19(2): 187-97. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7683450&dopt=Abstract

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Diagnosis of Helicobacter pylori infection in children: is the 15N urine test more reliable than the 13C breath test? Author(s): Krumbiegel P, Herbarth O, Kiess W, Muller DM, Richter T. Source: Scandinavian Journal of Gastroenterology. 2000 April; 35(4): 353-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10831257&dopt=Abstract

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Diagnostic value of various urine tests in the Jordanian population with urinary tract infection. Author(s): Al-Daghistani HI, Abdel-Dayem M. Source: Clinical Chemistry and Laboratory Medicine : Cclm / Fescc. 2002 October; 40(10): 1048-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12476947&dopt=Abstract

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Distribution of isoniazid inactivators determined in Eskimos and Canadian college students by a urine test. Author(s): Eidus L, Hodgkin MM, Schaefer O, Jessamine AG. Source: Rev Can Biol. 1974 June; 33(2): 117-23. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4851412&dopt=Abstract

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Doxepin causing false-positive urine test for amphetamine. Author(s): Merigian KS, Browning R, Kellerman A. Source: Annals of Emergency Medicine. 1993 August; 22(8): 1370. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8333649&dopt=Abstract

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Early detection of pregnancy by new beta-hCG monoclonal urine test. Author(s): Spona J, Dancoine F, Lorenz U, Valente D, Wasley GD. Source: Gynecologic and Obstetric Investigation. 1985; 19(1): 6-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2580762&dopt=Abstract

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Elevated tissue expression of hyaluronic acid and hyaluronidase validates the HAHAase urine test for bladder cancer. Author(s): Hautmann SH, Lokeshwar VB, Schroeder GL, Civantos F, Duncan RC, Gnann R, Friedrich MG, Soloway MS. Source: The Journal of Urology. 2001 June; 165(6 Pt 1): 2068-74. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11371930&dopt=Abstract

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Estimating the population consuming isoniazid by urine test. Author(s): Narain R, Rao MS, Naganna K, Bagga AS. Source: Am Rev Respir Dis. 1971 July; 104(1): 122-5. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4933670&dopt=Abstract

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Evaluation of a simple, random urine test for prospective analysis of proteinuria in Type 2 diabetes: a six year follow-up study. Author(s): Viswanathan V, Chamukuttan S, Kuniyil S, Ambady R. Source: Diabetes Research and Clinical Practice. 2000 August; 49(2-3): 143-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10963826&dopt=Abstract

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Evaluation of an office-based urine test for detecting Helicobacter pylori: a Prospective Pilot Study. Author(s): Wu DC, Kuo CH, Lu CY, Su YC, Yu FJ, Lee YC, Lin SR, Liu CS, Jan CM, Wang WM. Source: Hepatogastroenterology. 2001 May-June; 48(39): 614-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11462887&dopt=Abstract

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Evaluation of Aution Max AX-4280 automated urine test-strip analyser. Author(s): Zaman Z, Roggeman S, Cappelletti P, Ferrai G, Buxeda M, Barba N. Source: Clinical Chemistry and Laboratory Medicine : Cclm / Fescc. 2001 July; 39(7): 649-57. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11522115&dopt=Abstract

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Evaluation of new serum and urine tests in cases of suspected pathologic early pregnancy. Author(s): Steier JA, Myking OL. Source: Acta Obstetricia Et Gynecologica Scandinavica. 1986; 65(5): 463-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3776490&dopt=Abstract

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Evaluation of reagent strips in urine tests for detection of Schistosoma haematobium infection: a comparative study in Ghana and Zambia. Author(s): Mott KE, Dixon H, Osei-Tutu E, England EC, Ekue K, Tekle A. Source: Bulletin of the World Health Organization. 1985; 63(1): 125-33. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3872731&dopt=Abstract

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Falsely increased urinary caffeine attributable to contamination by urine test strips. Author(s): Van Acker JT, Verstraete AG, Van Hamme MA, Delanghe JR. Source: Clinical Chemistry. 1999 August; 45(8 Pt 1): 1315-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10430810&dopt=Abstract

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False-positive benzodiazepine urine test due to oxaprozin. Author(s): Pulini M. Source: Jama : the Journal of the American Medical Association. 1995 June 28; 273(24): 1905-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7783293&dopt=Abstract

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Follow-up of compliance with tuberculosis treatment in children: monitoring by urine tests. Author(s): Palanduz A, Gultekin D, Kayaalp N. Source: Pediatric Pulmonology. 2003 July; 36(1): 55-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12772224&dopt=Abstract

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HA-HAase urine test. A sensitive and specific method for detecting bladder cancer and evaluating its grade. Author(s): Lokeshwar VB, Block NL. Source: The Urologic Clinics of North America. 2000 February; 27(1): 53-61. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10696245&dopt=Abstract

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Hemp oil ingestion causes positive urine tests for delta 9-tetrahydrocannabinol carboxylic acid. Author(s): Costantino A, Schwartz RH, Kaplan P. Source: Journal of Analytical Toxicology. 1997 October; 21(6): 482-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9323529&dopt=Abstract

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I.V. Tetracycline and “dip-stick” urine tests. Author(s): Kristensen KA. Source: The New England Journal of Medicine. 1970 September 17; 283(12): 660. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5450650&dopt=Abstract

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In vivo adulteration: excess fluid ingestion causes false-negative marijuana and cocaine urine test results. Author(s): Cone EJ, Lange R, Darwin WD. Source: Journal of Analytical Toxicology. 1998 October; 22(6): 460-73. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9788521&dopt=Abstract

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Investigation of interference by nonsteroidal anti-inflammatory drugs in urine tests for abused drugs. Author(s): Rollins DE, Jennison TA, Jones G. Source: Clinical Chemistry. 1990 April; 36(4): 602-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2323039&dopt=Abstract

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Low level of compliance with tuberculosis treatment in children: monitoring by urine tests. Author(s): Palanduz A, Gultekin D, Erdem E, Kayaalp N. Source: Annals of Tropical Paediatrics. 2003 March; 23(1): 47-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12648324&dopt=Abstract

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Marijuana-positive urine test results from consumption of hemp seeds in food products. Author(s): Fortner N, Fogerson R, Lindman D, Iversen T, Armbruster D. Source: Journal of Analytical Toxicology. 1997 October; 21(6): 476-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9323528&dopt=Abstract

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Mesna and other free-sulfhydryl compounds produce false-positive results in a urine test strip method for ascorbic acid. Author(s): Csako G. Source: Clinical Chemistry. 1999 December; 45(12): 2295-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10585377&dopt=Abstract

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Methadone dosage levels, positive urine tests and length of time in a methadone treatment program. Author(s): Langley M, Norris B, Parker L. Source: Proc Natl Conf Methadone Treat. 1973; 2: 963-71. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4808327&dopt=Abstract

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Methaqualone (Mandrax) abuse, urine testing, and identification: clinical correlation between a new mass urinalysis test and a military drug abuse program. Author(s): Rock NL, Moore RJ. Source: Int J Addict. 1976; 11(2): 237-44. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1262091&dopt=Abstract

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Misleading urine tests after Hexabrix IVU. Author(s): Shanahan JC, Palmer C, Egginton J. Source: The British Journal of Radiology. 1985 April; 58(688): 389. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4063686&dopt=Abstract

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Misleading urine tests after using contrast media. Author(s): Dawson P, Howell M. Source: The British Journal of Radiology. 1985 August; 58(692): 785. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3842288&dopt=Abstract

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Monitoring regularity of drug intake in tuberculous patients by means of simple urine tests. Author(s): Burkhardt KR, Nel EE. Source: South African Medical Journal. Suid-Afrikaanse Tydskrif Vir Geneeskunde. 1980 June 14; 57(24): 981-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7404075&dopt=Abstract

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Multi-centre evaluation of the urine test strip analyser Rapimat. Author(s): Haeckel R, Bonini P, Ceriotti G, Kutter D, Vonderschmitt DJ. Source: J Clin Chem Clin Biochem. 1985 August; 23(8): 473-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4056663&dopt=Abstract

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Nalline and urine tests in narcotics detection: a critical overview. Author(s): Lewis VS, Pollack S, Petersen DM, Geis G. Source: Int J Addict. 1973; 8(1): 163-71. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4713700&dopt=Abstract

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New uses for old urine tests. Author(s): Savolainen H. Source: Br J Ind Med. 1989 June; 46(6): 361-3. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2684262&dopt=Abstract

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Ophthalmic use of cocaine and the urine test for benzoylecgonine. Author(s): Bralliar BB, Skarf B, Owens JB. Source: The New England Journal of Medicine. 1989 June 29; 320(26): 1757-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2733741&dopt=Abstract

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Pancreolauryl and NBT-PABA tests. Are serum tests more practicable alternatives to urine tests in the diagnosis of exocrine pancreatic insufficiency? Author(s): Lankisch PG, Brauneis J, Otto J, Goke B. Source: Gastroenterology. 1986 February; 90(2): 350-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3484456&dopt=Abstract

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Phenistix urine test-strip and desferioxamine. Author(s): Finlay HV. Source: British Medical Journal. 1978 July 29; 2(6133): 356. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=567510&dopt=Abstract

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Prospective evaluation of the effect of ionizing radiation on the bladder tumorassociated (BTA) urine test. Author(s): Crane CH, Clark MM, Bissonette EA, Theodorescu D. Source: International Journal of Radiation Oncology, Biology, Physics. 1999 January 1; 43(1): 73-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9989516&dopt=Abstract

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Quality specifications for ordinal scale measurements with multiproperty (multiple) urine test strips. Author(s): Kouri T, Laippala P, Kutter D, Gant V, Hallander H, Guder WG. Source: Scandinavian Journal of Clinical and Laboratory Investigation. 1999 November; 59(7): 523-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10667691&dopt=Abstract

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Random urine tests in the assessment of thyroid function. Author(s): Finucane JF. Source: Ir J Med Sci. 1976 June; 145(6): 195-200. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=939683&dopt=Abstract

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Rapid miniaturized tests for bacteriuria: Microstix and bacturcult urine tests. Author(s): Winter CC. Source: The Journal of Urology. 1975 November; 114(5): 755-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1102732&dopt=Abstract

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Rapid one step urine test for human chorionic gonadotrophin in evaluating suspected complications of early pregnancy. Author(s): Kingdom JC, Kelly T, MacLean AB, McAllister EJ. Source: Bmj (Clinical Research Ed.). 1991 June 1; 302(6788): 1308-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2059687&dopt=Abstract

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Rapid one step urine tests in early pregnancy. Author(s): Dalton ME, Price L. Source: Bmj (Clinical Research Ed.). 1991 September 28; 303(6805): 786. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1932954&dopt=Abstract

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Results of a baseline urine test predict levels of cocaine use during treatment. Author(s): Ehrman RN, Robbins SJ, Cornish JW. Source: Drug and Alcohol Dependence. 2001 March 1; 62(1): 1-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11173162&dopt=Abstract

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Routine urine tests in general practice. Author(s): Macleod M. Source: Lancet. 1970 May 30; 1(7657): 1167-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4192112&dopt=Abstract

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Screening women in jails for chlamydial and gonococcal infection using urine tests: feasibility, acceptability, prevalence, and treatment rates. Author(s): Mertz KJ, Schwebke JR, Gaydos CA, Beidinger HA, Tulloch SD, Levine WC. Source: Sexually Transmitted Diseases. 2002 May; 29(5): 271-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11984443&dopt=Abstract

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Sensitive urine tests and human chorionic gonadotrophin secreted during ectopic pregnancy. Author(s): Norman RJ, Reddi K, Kemp M, Joubert SM, Patel F. Source: British Medical Journal (Clinical Research Ed.). 1986 March 1; 292(6520): 590-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3081181&dopt=Abstract

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Set of simple side-room urine tests for detection of inborn errors of metabolism. Author(s): Buist NR. Source: British Medical Journal. 1968 June 22; 2(607): 745-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4231911&dopt=Abstract

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Simple urine tests for screennng for inborn errors of metabolism. Author(s): Verma IC. Source: Indian J Pediatr. 1970 September; 37(272): 487-91. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5515467&dopt=Abstract

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Spot urine test for quantitative estimation of proteinuria. Author(s): Rathi DP, Bansal RC, Malhotra KK. Source: J Assoc Physicians India. 1985 December; 33(12): 781, 783. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3837001&dopt=Abstract

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Studies on 13C-phenacetin metabolism. II. A combination of breath test and urine test of in vivo metabolites in the diagnosis of liver disease. Author(s): Kajiwara M, Okazaki T, Iida K, Narumi S, Hirose M, Ijichi M, Abel T, Hirano S, Iinuma M. Source: Chemical & Pharmaceutical Bulletin. 1996 June; 44(6): 1258-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8814956&dopt=Abstract

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TAC topical anesthesia produces positive urine tests for cocaine. Author(s): Altieri M, Bogema S, Schwartz RH. Source: Annals of Emergency Medicine. 1990 May; 19(5): 577-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2184707&dopt=Abstract

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The “Kumasi modified” two glass urine test and urinary schistosomiasis. Author(s): Adu-Sarkodie Y. Source: Genitourinary Medicine. 1996 October; 72(5): 383-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8976862&dopt=Abstract

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The abandoning of the 2-glass urine test for urethritis: a flawed concept that is based on misunderstanding. Author(s): Markos AR. Source: International Journal of Std & Aids. 2002 June; 13(6): 432. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12015024&dopt=Abstract

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The application of urine tests to monitor the regularity of dapsone selfadministration. Author(s): Ellard GA, Gammon PT, Harris JM. Source: Lepr Rev. 1974 September; 45(3): 224-34. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4437270&dopt=Abstract

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The influence of renal threshold on the interpretation of urine tests for glucose in diabetic patients. Author(s): Walford S, Page MM, Allison SP. Source: Diabetes Care. 1980 November-December; 3(6): 672-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7449599&dopt=Abstract

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The molybdate urine test in determination of the activity of rheumatoid arthritis. Author(s): Krzymien H. Source: Pol Med Sci Hist Bull. 1970 October; 13(4): 154-7. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5489788&dopt=Abstract

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The urine test strip of the future. Author(s): Kutter D. Source: Clinica Chimica Acta; International Journal of Clinical Chemistry. 2000 July; 297(1-2): 297-304. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10841930&dopt=Abstract

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The use of semi-quantitative urine test-strip (Micral Test) for microalbuminuria screening in patients with diabetes mellitus. Author(s): Leong SO, Lui KF, Ng WY, Thai AC. Source: Singapore Med J. 1998 March; 39(3): 101-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9632966&dopt=Abstract

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Three highly sensitive “bedside” serum and urine tests for pregnancy compared. Author(s): Christensen H, Thyssen HH, Schebye O, Berget A. Source: Clinical Chemistry. 1990 September; 36(9): 1686-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2208712&dopt=Abstract

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Trace contamination of over-the-counter androstenedione and positive urine test results for a nandrolone metabolite. Author(s): Catlin DH, Leder BZ, Ahrens B, Starcevic B, Hatton CK, Green GA, Finkelstein JS. Source: Jama : the Journal of the American Medical Association. 2000 November 22-29; 284(20): 2618-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11086369&dopt=Abstract

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Twelve months' experience of a quality assessment scheme for urine tests using reagent strips. Author(s): White G. Source: Annals of Clinical Biochemistry. 1995 November; 32 ( Pt 6): 589-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8579293&dopt=Abstract

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Urinary sulfated bile acids: a new simple urine test for cholestasis in infants and children. Author(s): Obatake M, Muraji T, Satoh S, Nishijima E, Tsugawa C. Source: Journal of Pediatric Surgery. 2002 December; 37(12): 1707-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12483636&dopt=Abstract

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Urine test as a potential aid in testing for patient compliance with methyldopa therapy. Author(s): Vlasses PH, Hockensmith JW, Gennaro AR, Amadio P Jr. Source: Am J Hosp Pharm. 1979 August; 36(8): 1046, 1050. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=484562&dopt=Abstract

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Urine test for adenylosuccinase deficiency in autistic children. Author(s): Maddocks J, Reed T. Source: Lancet. 1989 January 21; 1(8630): 158-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2563072&dopt=Abstract

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Urine test for bladder cancer. Author(s): Burton A. Source: The Lancet Oncology. 2002 September; 3(9): 522. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12217780&dopt=Abstract

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Urine test for L-dopa consumption. Author(s): Wolcott GJ, Hackett TN Jr. Source: Lancet. 1969 November 29; 2(7631): 1201. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4187234&dopt=Abstract

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Urine test for phenotyping isoniazid inactivators. Author(s): Eidus L, Harnanansingh AM, Jessamine AG. Source: Am Rev Respir Dis. 1971 October; 104(4): 587-91. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5094058&dopt=Abstract

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Urine test for the assessment of smoking status. Author(s): Chambers KL, Ellard GA, Hewson AT, Smith RF. Source: British Journal of Biomedical Science. 2001; 58(2): 61-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11440208&dopt=Abstract

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Urine test in SNE. Author(s): Pincus JH, Cooper JR, Turner VL, Piros K. Source: Neurology. 1979 March; 29(3): 424-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=571998&dopt=Abstract

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Urine test strips: reliability of semi-quantitative findings under tropical conditions. Author(s): Kaiser C, Bergel F, Doehring-Schwerdtfeger E, Feldmeier H, Ehrich JH. Source: Pediatric Nephrology (Berlin, Germany). 1992 March; 6(2): 145-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1571210&dopt=Abstract

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Urine tests for morphine. Author(s): Mani GC. Source: The New England Journal of Medicine. 1972 April 20; 286(16): 895. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5061085&dopt=Abstract

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Urine tests for phenotyping slow and fast acetylators. Author(s): Jessamine AG, Hodgkin MM, Eidus L. Source: Canadian Journal of Public Health. Revue Canadienne De Sante Publique. 1974 March-April; 65(2): 119-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4826016&dopt=Abstract

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Urine tests to monitor the self-administration of dapsone by leprosy patients. Author(s): Ellard GA, Gammon PT, Helmy HS, Rees RJ. Source: The American Journal of Tropical Medicine and Hygiene. 1974 May; 23(3): 46470. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4823797&dopt=Abstract

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Use of Clinitest urine test for indirect estimation of blood glucose levels in the critically ill. Author(s): Angaran DM, Smith DF, Birnbaum ML. Source: Am J Hosp Pharm. 1980 July; 37(7): 950-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7395888&dopt=Abstract

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Use of hair analysis for confirmation of self-reported cocaine use in users with negative urine tests. Author(s): Ursitti F, Klein J, Sellers E, Koren G. Source: Journal of Toxicology. Clinical Toxicology. 2001; 39(4): 361-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11527230&dopt=Abstract

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CHAPTER 2. ALTERNATIVE MEDICINE AND URINE TESTS Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to urine tests. 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 urine tests 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 “urine tests” (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 urine tests: •

1H NMR urine analysis as an effective tool to detect creatine supplementation. Author(s): Cartigny B, Azaroual N, Mille-Hamard L, Imbenotte M, Kintz P, Vermeersch G, Lhermitte M. Source: Journal of Analytical Toxicology. 2002 September; 26(6): 355-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12220017&dopt=Abstract

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9-nitrocamptothecin liposome aerosol: lack of subacute toxicity in dogs. Author(s): Gilbert BE, Seryshev A, Knight V, Brayton C. Source: Inhalation Toxicology. 2002 February; 14(2): 185-97. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12122579&dopt=Abstract

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A long-term study on the efficacy of a herbal plant, Orthosiphon grandiflorus, and sodium potassium citrate in renal calculi treatment. Author(s): Premgamone A, Sriboonlue P, Disatapornjaroen W, Maskasem S, Sinsupan N, Apinives C.

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Source: Southeast Asian J Trop Med Public Health. 2001 September; 32(3): 654-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11944733&dopt=Abstract •

Acupuncture for the treatment of cocaine addiction: a randomized controlled trial. Author(s): Margolin A, Kleber HD, Avants SK, Konefal J, Gawin F, Stark E, Sorensen J, Midkiff E, Wells E, Jackson TR, Bullock M, Culliton PD, Boles S, Vaughan R. Source: Jama : the Journal of the American Medical Association. 2002 January 2; 287(1): 55-63. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11754709&dopt=Abstract

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Acupuncture treatment in the prevention of uncomplicated recurrent lower urinary tract infections in adult women. Author(s): Alraek T, Soedal LI, Fagerheim SU, Digranes A, Baerheim A. Source: American Journal of Public Health. 2002 October; 92(10): 1609-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12356607&dopt=Abstract

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Acute psychosis due to the interaction of legal compounds--ephedra alkaloids in 'vigueur fit' tablets, caffeine in 'red bull' and alcohol. Author(s): Tormey WP, Bruzzi A. Source: Med Sci Law. 2001 October; 41(4): 331-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11693229&dopt=Abstract

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Adolescent heroin use: a review. Author(s): Schwartz RH. Source: Pediatrics. 1998 December; 102(6): 1461-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9832585&dopt=Abstract

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Analysis of urinary metabolites of tea catechins by liquid chromatography/electrospray ionization mass spectrometry. Author(s): Li C, Meng X, Winnik B, Lee MJ, Lu H, Sheng S, Buckley B, Yang CS. Source: Chemical Research in Toxicology. 2001 June; 14(6): 702-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11409941&dopt=Abstract

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Assessing the accuracy of a food frequency questionnaire for estimating usual intake of phytoestrogens. Author(s): Huang MH, Harrison GG, Mohamed MM, Gornbein JA, Henning SM, Go VL, Greendale GA. Source: Nutrition and Cancer. 2000; 37(2): 145-54. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11142086&dopt=Abstract

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Blackberry anthocyanins are slightly bioavailable in rats. Author(s): Felgines C, Texier O, Besson C, Fraisse D, Lamaison JL, Remesy C.

Alternative Medicine 33

Source: The Journal of Nutrition. 2002 June; 132(6): 1249-53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12042441&dopt=Abstract •

Bladder tissue pharmacokinetics of intravesical taxol. Author(s): Song D, Wientjes MG, Au JL. Source: Cancer Chemotherapy and Pharmacology. 1997; 40(4): 285-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9225946&dopt=Abstract

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Clinical pathology of the domestic rabbit. Acquisition and interpretation of samples. Author(s): Benson KG, Paul-Murphy J. Source: Veterinary Clin North Am Exot Anim Pract. 1999 September; 2(3): 539-51, V. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11229042&dopt=Abstract

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Comparison of expressed prostatic secretions with urine after prostatic massage--a means to diagnose chronic prostatitis/inflammatory chronic pelvic pain syndrome. Author(s): Ludwig M, Schroeder-Printzen I, Ludecke G, Weidner W. Source: Urology. 2000 February; 55(2): 175-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10688073&dopt=Abstract

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Cranberry juice consumption may reduce biofilms on uroepithelial cells: pilot study in spinal cord injured patients. Author(s): Reid G, Hsiehl J, Potter P, Mighton J, Lam D, Warren D, Stephenson J. Source: Spinal Cord : the Official Journal of the International Medical Society of Paraplegia. 2001 January; 39(1): 26-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11224011&dopt=Abstract

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Cyclical changes in emotional information processing in sleep and dreams. Author(s): Severino SK, Bucci W, Creelman ML. Source: The Journal of the American Academy of Psychoanalysis. 1989 Winter; 17(4): 555-77. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2695504&dopt=Abstract

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Determining metabolizable energy content in commercial pet foods. Author(s): Laflamme DP. Source: Journal of Animal Physiology and Animal Nutrition. 2001 August; 85(7-8): 22230. Erratum In: J Anim Physiol Anim Nutr (Berl) 2001 December; 85(11-12): 431. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11686793&dopt=Abstract

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Diabetic control and the effect of changing a diabetic clinic to modern management. Author(s): Barnett AH.

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Source: Diabetic Medicine : a Journal of the British Diabetic Association. 1985 January; 2(1): 57-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2951068&dopt=Abstract •

Dietary phytate reduction improves zinc absorption in Malawian children recovering from tuberculosis but not in well children. Author(s): Manary MJ, Hotz C, Krebs NF, Gibson RS, Westcott JE, Arnold T, Broadhead RL, Hambidge KM. Source: The Journal of Nutrition. 2000 December; 130(12): 2959-64. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11110854&dopt=Abstract

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Dietary supplementation with L-arginine ameliorates the progression of renal disease in rats with subtotal nephrectomy. Author(s): Reyes AA, Purkerson ML, Karl I, Klahr S. Source: American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation. 1992 August; 20(2): 168-76. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1496971&dopt=Abstract

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Effect of blackcurrant-, cranberry- and plum juice consumption on risk factors associated with kidney stone formation. Author(s): Kessler T, Jansen B, Hesse A. Source: European Journal of Clinical Nutrition. 2002 October; 56(10): 1020-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12373623&dopt=Abstract

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Effect of oral creatine supplementation on random urine creatinine, pH, and specific gravity measurements. Author(s): Ropero-Miller JD, Paget-Wilkes H, Doering PL, Goldberger BA. Source: Clinical Chemistry. 2000 February; 46(2): 295-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10657393&dopt=Abstract

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Effects of an extract of Serenoa repens on dogs with hyperplasia of the prostate gland. Author(s): Barsanti JA, Finco DR, Mahaffey MM, Fayrer-Hosken RA, Crowell WA, Thompson FN Jr, Shotts EB. Source: Am J Vet Res. 2000 August; 61(8): 880-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10951976&dopt=Abstract

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Effects of dietary iron and folate supplementation on the physiological changes produced in weanling rats by sodium saccharin exposure. Author(s): Garland EM, Shapiro R, Wehner JM, Johnson LS, Mattson BJ, Khachab M, Asamoto M, Cohen SM.


Source: Food and Chemical Toxicology : an International Journal Published for the British Industrial Biological Research Association. 1993 October; 31(10): 689-99. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8225126&dopt=Abstract •

Effects of dietary medium-chain triacylglycerols on serum lipoproteins and biochemical parameters in healthy men. Author(s): Nosaka N, Kasai M, Nakamura M, Takahashi I, Itakura M, Takeuchi H, Aoyama T, Tsuji H, Okazaki M, Kondo K. Source: Bioscience, Biotechnology, and Biochemistry. 2002 August; 66(8): 1713-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12353632&dopt=Abstract

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Four-week feeding studies with differently processed dehulled faba bean (Vicia faba L. minor) products in rats. Author(s): Schmandke H, Plass R, Lewerenz HJ, Bleyl DW. Source: Die Nahrung. 2000 April; 44(2): 133-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10795584&dopt=Abstract

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From the Food and Drug Administration. Author(s): Henney JE. Source: Jama : the Journal of the American Medical Association. 1999 October 6; 282(13): 1218. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10517411&dopt=Abstract

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General practice care of non-insulin-dependent diabetes with fasting blood glucose measurements. Author(s): Muir A, Howe-Davies SA, Turner RC. Source: The American Journal of Medicine. 1982 November; 73(5): 637-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7137201&dopt=Abstract

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Hemp oil ingestion causes positive urine tests for delta 9-tetrahydrocannabinol carboxylic acid. Author(s): Costantino A, Schwartz RH, Kaplan P. Source: Journal of Analytical Toxicology. 1997 October; 21(6): 482-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9323529&dopt=Abstract

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Home monitoring of the diabetic pet. Author(s): Mathes MA. Source: Clin Tech Small Anim Pract. 2002 May; 17(2): 86-95. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12219722&dopt=Abstract

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Human nutritional supplements in the horse. Dehydroepiandrosterone versus androstenedione: comparative effects on the androgen profile and consequences for

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doping analysis. Author(s): Dehennin L, Bonnaire Y, Plou P. Source: Journal of Analytical Toxicology. 2001 November-December; 25(8): 685-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11765025&dopt=Abstract •

In vivo studies on the metabolism of the monoterpenes S-(+)- and R-(-)-carvone in humans using the metabolism of ingestion-correlated amounts (MICA) approach. Author(s): Engel W. Source: Journal of Agricultural and Food Chemistry. 2001 August; 49(8): 4069-75. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11513712&dopt=Abstract

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Lead exposure and accumulation in healthy Thais: assessed by lead levels, EDTA mobilization and heme synthesis-related parameters. Author(s): Wananukul W, Sirivarasai J, Sriapha C, Chanatara V, Chunvimaluang N, Keanpoompuang A, Boriboon W, Pumala K, Kaojarern S. Source: J Med Assoc Thai. 1998 February; 81(2): 110-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9529840&dopt=Abstract

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Low calcium diet in dogs causes a greater increase in parathyroid function measured with an intact hormone than with a carboxylterminal assay. Author(s): Cloutier M, D'Amour P, Gascon-Barre M, Hamel L. Source: Bone Miner. 1990 June; 9(3): 179-88. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2114188&dopt=Abstract

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Mercury exposure: current concepts, controversies, and a clinic's experience. Author(s): Kales SN, Goldman RH. Source: Journal of Occupational and Environmental Medicine / American College of Occupational and Environmental Medicine. 2002 February; 44(2): 143-54. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11851215&dopt=Abstract

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Metabolic emergencies. Author(s): Sirridge WT. Source: Compr Ther. 1981 September; 7(9): 68-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6796326&dopt=Abstract

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Metabolism of [6]-gingerol in rats. Author(s): Nakazawa T, Ohsawa K. Source: Life Sciences. 2002 March 22; 70(18): 2165-75. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12002808&dopt=Abstract

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Miniature pigs. Author(s): Van Metre DC, Angelos SM.


Source: Veterinary Clin North Am Exot Anim Pract. 1999 September; 2(3): 519-37, V. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11229041&dopt=Abstract •

Molybdenum supplementation in phenylketonuria diets: adequate in early infancy? Author(s): Sievers E, Arpe T, Schleyerbach U, Schaub J. Source: Journal of Pediatric Gastroenterology and Nutrition. 2000 July; 31(1): 57-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10896072&dopt=Abstract

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Pellagra may be a rare secondary complication of anorexia nervosa: a systematic review of the literature. Author(s): Prousky JE. Source: Alternative Medicine Review : a Journal of Clinical Therapeutic. 2003 May; 8(2): 180-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12777163&dopt=Abstract

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Plant poisonings from herbal medication admitted to a Tunisian toxicologic intensive care unit, 1983-1998. Author(s): Hamouda C, Amamou M, Thabet H, Yacoub M, Hedhili A, Bescharnia F, Ben Salah N, Zhioua M, Abdelmoumen S, El Mekki Ben Brahim N. Source: Vet Hum Toxicol. 2000 June; 42(3): 137-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10839315&dopt=Abstract

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Plasma kinetics and urinary excretion of the flavanones naringenin and hesperetin in humans after ingestion of orange juice and grapefruit juice. Author(s): Erlund I, Meririnne E, Alfthan G, Aro A. Source: The Journal of Nutrition. 2001 February; 131(2): 235-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11160539&dopt=Abstract

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Pycnogenol does not impact the antioxidant or vitamin C status of healthy young adults. Author(s): Silliman K, Parry J, Kirk LL, Prior RL. Source: Journal of the American Dietetic Association. 2003 January; 103(1): 67-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12525796&dopt=Abstract

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Quantification of proteins extracted from calcium oxalate and calcium phosphate crystals induced in vitro in the urine of healthy controls and stone-forming patients. Author(s): Atmani F, Khan SR. Source: Urologia Internationalis. 2002; 68(1): 54-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11803269&dopt=Abstract

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Quantitative capillary electrophoresis/ion spray tandem mass spectrometry determination of EDTA in human plasma and urine. Author(s): Sheppard RL, Henion J. Source: Analytical Chemistry. 1997 August 1; 69(15): 2901-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9253243&dopt=Abstract

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Quantitative urine levels of abusable drugs for clinical purposes. Author(s): Tennant F. Source: Clin Lab Med. 1990 June; 10(2): 301-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2372998&dopt=Abstract

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Reduction of bacteriuria and pyuria after ingestion of cranberry juice. Author(s): Avorn J, Monane M, Gurwitz JH, Glynn RJ, Choodnovskiy I, Lipsitz LA. Source: Jama : the Journal of the American Medical Association. 1994 March 9; 271(10): 751-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8093138&dopt=Abstract

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Reduction of bacteriuria and pyuria using cranberry juice. Author(s): Goodfriend R. Source: Jama : the Journal of the American Medical Association. 1994 August 24-31; 272(8): 588; Author Reply 589-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8057503&dopt=Abstract

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Responses of lactating dairy cows to copper source, supplementation rate, and dietary antagonist (iron). Author(s): Chase CR, Beede DK, Van Horn HH, Shearer JK, Wilcox TCJ, Donovan GA. Source: Journal of Dairy Science. 2000 August; 83(8): 1845-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10984161&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/

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

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

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

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

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

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


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

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

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

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

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

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

The following is a specific Web list relating to urine tests; 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 Anaphylaxis Source: Integrative Medicine Communications; www.drkoop.com Angioedema Source: Integrative Medicine Communications; www.drkoop.com Appendicitis Source: Integrative Medicine Communications; www.drkoop.com Chronic Fatigue Syndrome Source: Integrative Medicine Communications; www.drkoop.com Diabetes Mellitus Source: Integrative Medicine Communications; www.drkoop.com Edema Source: Integrative Medicine Communications; www.drkoop.com Histoplasmosis Source: Integrative Medicine Communications; www.drkoop.com Photodermatitis Source: Integrative Medicine Communications; www.drkoop.com Pulmonary Edema Source: Integrative Medicine Communications; www.drkoop.com Rheumatoid Arthritis Source: Integrative Medicine Communications; www.drkoop.com Serum Sickness Source: Integrative Medicine Communications; www.drkoop.com

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Sunburn Source: Integrative Medicine Communications; www.drkoop.com Urinary Incontinence Source: Integrative Medicine Communications; www.drkoop.com Water Retention Source: Integrative Medicine Communications; www.drkoop.com

The following is a specific Web list relating to urine tests; 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: •

Minerals Carnitine Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10012,00.html

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

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

Everything You Need to Know About Medical Tests Source: Springhouse, PA: Springhouse Corporation. 1996. 691 p. Contact: Available from Springhouse Publishing. Attention: Trade and Textbook Department, 1111 Bethlehem Pike, P.O. Box 908, Springhouse, PA 19477-0908. (800) 3313170 or (215) 646-4670 or (215) 646-4671. Fax (215) 646-8716. PRICE: $24.95 (as of 1995). ISBN: 0874348234. Summary: This consumer reference guide provides information on over 400 diagnostic tests. For each test, the book covers the reasons the test is performed; what patients

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should know before the test; what to expect during and after the test; risk factors associated with the test; the normal results; and what abnormal results mean. Tests are categorized in 16 chapters: x-rays; CT and MRI (magnetic resonance imaging) scans; nuclear medicine scans; ultrasound scans; heart and brain monitoring; endoscopy; biopsies; vision and hearing tests; special function tests; blood cell and clotting tests; blood element tests; hormone tests; immune system tests; urine tests; cultures; and fluid analysis. The book also provides numerous sidebars giving readers insight into anatomy, physiology, preventive measures, and self-care behaviors. A subject index concludes the volume. •

Healing Handbook for Persons with Diabetes Source: Worcester, MA: University of Massachusetts Medical School. 1998. [141 p.]. Contact: Available from University of Massachusetts Medical School Bookstore. 55 Lake Avenue, Worcester, MA 01655. (508) 856-3213. Website: http://www.umassmed.edu/diabeteshandbook/. PRICE: $14.95 plus $5.00 for shipping and handling. Summary: This handbook, available in both English and Spanish, provides people who have diabetes with an overview of the disease. Chapter one defines diabetes and provides information on the causes and history of the disease, as well as an overview of insulin, the pancreas, and kidney functioning. Chapter two offers practical advice for accepting diabetes and living with it day to day. Topics include psychological and social aspects, coping skills, life and health insurance, diabetes identification, legal rights, treatment plans, regular assessments, and continuing education. Chapters three and four describe type 1 and type 2 diabetes, respectively. Topics include goals and management. Chapter five focuses on blood glucose monitoring. Topics include self monitoring of blood glucose (SMBG), equipment for SMBG, glycosylated hemoglobin, and urine tests for ketones and glucose. Chapter six deals with diet, focusing on basic nutrition, meal planning at home or when dining out, and exchange lists. Chapter seven offers advice on exercise programs for people who have diabetes. Topics include aerobic exercise options, exercise for the overweight person with type 2 diabetes, exercise for the person with type 1 diabetes, food exchanges for exercise, easy exercises for beginners, and blood glucose monitoring during exercise. Chapter eight provides an overview of insulin, focusing on types of insulin, how to buy and store insulin, how to inject insulin, and how to avoid and treat insulin reactions. Chapter nine describes oral medications that are used to treat type 2 diabetes, including sulfonylurea compounds, biguanides, thiazolidinediones, and alpha glucosidase inhibitors. Chapter 10 serves as a guide to diabetes management during an illness. Chapter 11 offers tips for preventing some common skin and foot problems experienced by people who have diabetes. Chapter 12 describes complications associated with diabetes and provides advice on how to avoid them. Complications discussed include those affecting the eyes, kidneys, nerves, blood vessels, feet, and teeth. Chapter 13 addresses special concerns of families coping with diabetes. Sections discuss the special needs of women with diabetes during pregnancy, provide advice for parents of children with diabetes, and offer information for school personnel who have contact with students who have diabetes. Chapter 14 offers tips that help ensure safe, healthy travel for people who have diabetes. Chapter 15 highlights current research activities into the causes and prevention of and potential treatments for diabetes. Some chapters end with a series of questions and answers that may help clarify information about the chapter. Several chapters list products for people with diabetes or refer to other publications on diabetes. A glossary of diabetes related terms is included at the end of the handbook.

Books

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Type II Diabetes Sourcebook Source: Los Angeles, CA: Lowell House, and Chicago, IL: Contemporary Books. 1997. 336 p. Contact: Available from Contemporary Books, Inc. 2 Prudential Plaza, Suite 1200, Chicago, IL 60601. Also available from Lowell House, 2020 Avenue of the Stars, Suite 300, Los Angeles, CA 90067. (310) 552-7555. Fax (310) 552-7573. PRICE: $25.00 (cloth). ISBN: 1565656466. Summary: This sourcebook provides people with diabetes a comprehensive manual of self care for noninsulin-dependent diabetes mellitus (NIDDM, or Type II). The authors stress the importance of active patient participation and self management in caring for diabetes and in preventing complications. Sixteen chapters cover an introduction to diabetes, self empowerment, the patient care team and elements of a good treatment plan, the biology of diabetes and the role of insulin, stress management, blood glucose and its monitoring, food and nutrition, exercise, medications, laboratory tests and why each is important, daily hygiene and self care steps to prevent complications, pregnancy, the social and psychological aspects of diabetes, financial considerations, complications, and research being undertaken in this area. The chapter on laboratory tests covers blood pressure, hemoglobin A1C testing, lipid profile, urine tests, oral glucose tolerance test (OGTT), and the fructosamine assay. The chapter on mental health covers family problems, social support, communication skills, professional counseling, support groups, and diabetes burnout. The book includes two appendices: a listing of resources and a glossary of common terms. A subject index concludes the volume.

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

Steal This Urine Test by Abbie Hoffman, Jonathan Silvers (Contributor); ISBN: 0140104003; http://www.amazon.com/exec/obidos/ASIN/0140104003/icongroupinterna

Chapters on Urine Tests In order to find chapters that specifically relate to urine tests, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and urine tests 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 “urine tests” (or

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synonyms) into the “For these words:” box. The following is a typical result when searching for book chapters on urine tests: •

Urine Tests Source: in Carlson, K.J.; Eisenstat, S.A.; Ziporyn, T. Harvard Guide to Women's Health. Cambridge, MA: Harvard University Press. 1996. p. 620. Contact: Available from Harvard University Press. Customer Service Department, 79 Garden Street, Cambridge, MA 02138. (800) 448-2242. Fax (800) 962-4983. PRICE: $24.95 (paperback). ISBN: 0674367693 (paperback). Summary: This brief chapter on urine tests is from a consumer handbook on women's health. Topics include the indications for urine testing, urine testing as a standard part of prenatal care, a description of how urine testing is performed, and the risks and complications associated with urine testing. The chapter concludes with a list of other chapters in the book that may be related. The authors emphasize the emotional and social issues that may impact women's health. They also discuss how common diseases and their treatments are different for women than for men.

•

Urine Tests: Examining the Body's Excess Fluids Source: in Shaw, M., et al., eds. Everything You Need to Know About Medical Tests. Springhouse, PA: Springhouse Corporation. 1996. p. 549-616. Contact: Available from Springhouse Publishing. Attention: Trade and Textbook Department, 1111 Bethlehem Pike, P.O. Box 908, Springhouse, PA 19477-0908. (800) 3313170 or (215) 646-4670 or (215) 646-4671. Fax (215) 646-8716. PRICE: $24.95 (as of 1995). ISBN: 0874348234. Summary: This lengthy chapter, from a consumer handbook about medical practice and disease, presents information on urine tests used for diagnosis. Written in a question and answer format, the chapter discusses urine tests for these functions, diseases, and substances: kidney stones, kidney function, phosphate reabsorption by the kidneys, amylase, arysulfatase A, lysozyme, aldosterone, Cushing's syndrome, epinephrine, norepinephrine, dopamine, estrogens, pregnancy, placental estriol, pregnanetriol, vanillylmandelic acid, homovanillic acid, hydroxyindoleacetic acid, pregnanediol, proteins, Bence Jones protein, amino acid disorders, creatinine, creatinine clearance by the kidneys, urea clearance by the kidneys, uric acid, hemoglobin, myoglobin, porphyrins, delta-aminolevulinic acid, bilirubin, urobilinogen, sugar, glucose, ketones, vitamin B6, vitamin C, sodium, chloride, potassium, calcium, phosphates, magnesium, and iron. For each test discussed, the authors provide information about why the test is done, how the test is performed, what to do before the test, and what the results indicate.

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CHAPTER 4. MULTIMEDIA ON URINE TESTS Overview In this chapter, we show you how to keep current on multimedia sources of information on urine tests. We start with sources that have been summarized by federal agencies, and then show you how to find bibliographic information catalogued by the National Library of Medicine.

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

Gestational Diabetes: Your Questions Answered Source: Madison, WI: University of Wisconsin Hospitals and Clinics, Department of Outreach Education. 1996. (videocassette). Contact: Available from University of Wisconsin Hospital and Clinics. Picture of Health, 702 North Blackhawk Avenue, Suite 215, Madison, WI 53705-3357. (800) 757-4354 or (608) 263-6510. Fax (608) 262-7172. PRICE: $19.95 plus shipping and handling; bulk copies available. Order number 093096B. Summary: This videotape answers frequently asked questions about gestational diabetes. A moderator asks an obstetrician-gynecologist and a dietitian about various aspects of gestational diabetes. Topics include what gestational diabetes is and what causes it, how it differs from other kinds of diabetes, and how it will affect a baby. Gestational diabetes, which usually develops between 24 to 26 weeks of gestation, is caused when the placenta produces chemicals that interfere with insulin and the mother's body cannot compensate for this change. Risk factors for gestational diabetes

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include being over 30 years old and overweight, having a family history of diabetes, and having had a baby over 9.5 pounds or a stillborn infant. Most women have no symptoms so blood tests are usually performed between 24 and 28 weeks of gestation. Many women who have gestational diabetes can manage the disease with diet and exercise. However, some women may need insulin to manage their diabetes. If a woman needs insulin, she needs to self monitor her blood glucose levels, give herself insulin injections, have her pregnancy monitored more closely, do urine tests to monitor ketones, and have tests to make sure the baby is developing properly. Participants also answer questions about the effect of gestational diabetes on the baby, the impact of gestational diabetes on delivery, and other pregnancy complications. The videotape concludes by identifying sources of additional information.

Bibliography: Multimedia on Urine Tests The National Library of Medicine is a rich source of information on healthcare-related multimedia productions including slides, computer software, and databases. To access the multimedia database, go to the following Web site: http://locatorplus.gov/. Select “Search LOCATORplus.” Once in the search area, simply type in urine tests (or synonyms). Then, in the option box provided below the search box, select “Audiovisuals and Computer Files.” From there, you can choose to sort results by publication date, author, or relevance. The following multimedia has been indexed on urine tests: •

Urine testing [videorecording] Source: School of Nursing, University of Minnesota; Year: 1975; Format: Videorecording; Minneapolis: The University, [1975]

•

Urine testing for diabetic control [videorecording] Source: [Comm-Sales, inc., Minnesota Association of Health Care Facilities]; Year: 1974; Format: Videorecording; Los Angeles: Professional Research, 1974

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CHAPTER 5. PERIODICALS AND NEWS ON URINE TESTS Overview In this chapter, we suggest a number of news sources and present various periodicals that cover urine tests.

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

Urine test for cervical virus seen as promising Source: Reuters Health eLine Date: August 25, 2003

•

HPV urine testing may be option when cervical exam not feasible Source: Reuters Industry Breifing Date: August 25, 2003

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•

Simple urine test can monitor compliance with tuberculosis drug Source: Reuters Medical News Date: April 01, 2003

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HIV urine tests useful in high-risk communities Source: Reuters Health eLine Date: December 26, 2002

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Urine test may predict long-term memory loss Source: Reuters Health eLine Date: November 25, 2002

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Routine urine tests not advised for diabetic women Source: Reuters Health eLine Date: November 13, 2002

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Rapid urine test highly accurate in detecting pneumococcal infection in children Source: Reuters Industry Breifing Date: November 01, 2002

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Urine test promising for ID'ing rare brain ailment Source: Reuters Health eLine Date: October 24, 2002

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Calypte Biomedical to meet with FDA on rapid HIV urine test protocol Source: Reuters Industry Breifing Date: August 27, 2002

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Urine test may catch bladder cancer early Source: Reuters Health eLine Date: July 17, 2002

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Urine test may identify increased Alzheimer's risk Source: Reuters Health eLine Date: June 18, 2002

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Urine test for prion disease shows promise Source: Reuters Medical News Date: July 02, 2001

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Urine test predicts heart disease in some women Source: Reuters Health eLine Date: June 25, 2001

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Urine test detects kidney-transplant rejection Source: Reuters Health eLine Date: March 28, 2001

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Urine test spots early signs of bladder cancer Source: Reuters Health eLine Date: March 21, 2001

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Urine test might help monitor progression in MS patients Source: Reuters Industry Breifing Date: February 06, 2001

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Cheap, quick urine test may detect bladder cancer Source: Reuters Health eLine Date: January 16, 2001

Periodicals and News

•

Random spot urine test predicts left ventricle hypertrophy in African-American me Source: Reuters Medical News Date: December 25, 2000

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Urine test may detect heart disorder in black me Source: Reuters Health eLine Date: November 28, 2000

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Urine test helps detect bladder cancers early Source: Reuters Health eLine Date: November 20, 2000

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Urine test helps detect bladder cancer recurrence Source: Reuters Medical News Date: November 20, 2000

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FDA approves Beckman Coulter's urine test for Ecstasy Source: Reuters Industry Breifing Date: October 23, 2000

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New HIV/STD urine test available to physicians soon Source: Reuters Medical News Date: January 25, 2000

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Urine test may help diagnose bladder cancer Source: Reuters Health eLine Date: December 30, 1999

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Urine test may help diagnose cancers in epithelial-lined internal organs Source: Reuters Medical News Date: November 01, 1999

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FDA approves urine test for pneumonia bacteria Source: Reuters Health eLine Date: August 31, 1999

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Urine test for Alzheimer's disease under development Source: Reuters Medical News Date: August 03, 1999

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Urine test diagnoses newborn cerebral palsy Source: Reuters Health eLine Date: July 28, 1999

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Urine test detects urinary tract transitional cell cancer Source: Reuters Medical News Date: April 28, 1999

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Urine test detects bladder cancer Source: Reuters Health eLine Date: April 27, 1999

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New urine test may detect cancer Source: Reuters Health eLine Date: April 07, 1999

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Urine test detects cancer on the basis of pteridine levels Source: Reuters Medical News Date: April 06, 1999

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•

Urine tests detect STDs in teens Source: Reuters Health eLine Date: February 18, 1999

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China may adopt Calypte's HIV urine test system Source: Reuters Medical News Date: October 23, 1998

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HIV-1 urine test used by life insurance companies Source: Reuters Medical News Date: August 27, 1998

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FDA approves HIV-1 Western lot urine test Source: Reuters Medical News Date: June 02, 1998

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FDA approves HIV urine test Source: Reuters Health eLine Date: June 02, 1998

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LCR assay of swabs may be alternative to urine tests for Chlamydia Source: Reuters Medical News Date: May 18, 1998

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Urine Test More Sensitive Than Cytology For Bladder Cancer Diagnosis Source: Reuters Medical News Date: March 26, 1998

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Urine Test Strips Can Miss Bacteria Source: Reuters Health eLine Date: February 06, 1998

•

Urine Tests Trace Those At Risk For STD Source: Reuters Health eLine Date: January 30, 1998

•

Dual Serum And Urine Testing Increases HIV-1 Antibody Detection Source: Reuters Medical News Date: October 30, 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.


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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 “urine tests” (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 “urine tests” (or synonyms). If you know the name of a company that is relevant to urine tests, 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 “urine tests” (or synonyms).

Newsletter Articles Use the Combined Health Information Database, and limit your search criteria to “newsletter articles.” Again, you will need to use the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. Go to the bottom of the search page where “You may refine your search by.” Select the dates and language that you prefer. For the format option, select “Newsletter Article.” Type “urine tests” (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 urine tests: •

American College of Physicians Home Medical Guide to Diabetes Source: New York, NY: Dorling Kindersley Publishing, Inc. 2000. 96 p. Contact: Available from Dorling Kindersley Publishing, Inc. 95 Madison Avenue, New York, NY 10016. (212) 213-4800. Fax (212) 213-5240. E-mail: [email protected]. Website: www.dk.com. PRICE: $6.95 plus shipping and handling. ISBN: 0789452006. Summary: This illustrated guide provides people who have diabetes with expert advice on understanding and living with this chronic disease. The guide begins with a section that explains what diabetes is and what causes it. Known causes include heredity, infection, and environmental factors. The next section focuses on tests used to diagnosis

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diabetes, including the oral glucose tolerance test and urine tests. This is followed by sections that discuss the treatment of diabetes with diet and medications such as sulfonylureas, benzoic acid derivatives, biguanides, acarbose, thiazolidinediones, and insulin. The next section is devoted to monitoring blood glucose levels through blood and urine tests. Hypoglycemia is the focus of the next section. Topics include preventing and treating this acute complication. This is followed by a section that discusses exercising, socializing, traveling, coping with illness, and having a baby. The next section deals with issues related to children who have diabetes, including home monitoring, hypoglycemia, food difficulties, family reactions, and behavioral issues. The topic of the next section is complications of diabetes, including diabetic retinopathy, diabetic nephropathy, diabetic neuropathy, erectile dysfunction, skin problems, cardiovascular problems, and foot problems. This is followed by a section that explains the medical procedures and information that a person who has diabetes should expect from his or her health care professional. The final section addresses the issues of preventing, curing, and treating diabetes in the future. In addition, the guide presents answers to some common questions about diabetes and provides information on useful resources and online sites. 12 figures. •

Laboratory Testing in Scleroderma Source: Scleroderma Foundation Newsline. 2(3): 2,16-17,27. Summer-Fall 1999. Contact: Available from Scleroderma Foundation. 12 Kent Way, Suite 101, Byfield, MA 01922. (800) 722-4673 or (978) 463-5843. Fax (978) 463-5809. E-mail: [email protected]. Website: www.scleroderma.org. Summary: This newsletter article provides people who have scleroderma with information on the role of laboratory testing in diagnosing and following its course. Laboratory tests used to evaluate the status of scleroderma include those that assess blood count, hemoglobin and hematocrit, muscle enzymes, creatinine, blood urea nitrogen, urine tests, bilirubin, and alkaline phosphatase 5' nucleotidase. People who have scleroderma often have unique antibodies in their blood that can react with normal cell components. These antibodies are known as antinuclear antibodies (ANA). The ANA test is commonly used to assist in the diagnosis of scleroderma. Some autoantibodies have prognostic significance because they tend to be associated with milder or more severe forms of scleroderma. For example, antibodies to centromere proteins are associated with a limited form of scleroderma, but antibodies to topoisomerase 1 usually occur in people who have more widespread skin disease. Although certain autoantibodies have predictive value, ANA tests do have limitations. First, there is no correlation between the amount of autoantibodies in a given volume of blood and disease severity. Second, some patients occasionally change their antibodies completely. Third, scleroderma patients typically have more than one autoantibody. Research has attempted to determine whether autoantibodies hold clues to the etiology of scleroderma, but further research is still needed. 2 tables.

Academic Periodicals covering Urine Tests Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to urine tests. In addition to these sources, you can search for articles covering urine tests that have been published by any of the periodicals listed in previous chapters. To find the latest studies published, go to


53

http://www.ncbi.nlm.nih.gov/pubmed, type the name of the periodical into the search box, and click “Go.” If you want complete details about the historical contents of a journal, you can also visit the following Web site: http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi. Here, type in the name of the journal or its abbreviation, and you will receive an index of published articles. At http://locatorplus.gov/, you can retrieve more indexing information on medical periodicals (e.g. the name of the publisher). Select the button “Search LOCATORplus.” Then type in the name of the journal and select the advanced search option “Journal Title Search.”

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APPENDICES

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

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

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

•

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

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

•

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

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

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

•

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/

4

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

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•

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

•

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

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

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

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

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

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

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

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

•

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

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

•

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

•

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

•

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

•

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

Physician Resources

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NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.5 Physician-oriented resources provide a wide variety of information related to the biomedical and health sciences, both past and present. The format of these resources varies. Searchable databases, bibliographic citations, full-text articles (when available), archival collections, and images are all available. The following are referenced by the National Library of Medicine:6 •

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

•

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

5 Remember, for the general public, the National Library of Medicine recommends the databases referenced in MEDLINEplus (http://medlineplus.gov/ or http://www.nlm.nih.gov/medlineplus/databases.html). 6 See http://www.nlm.nih.gov/databases/databases.html.

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•

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

•

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

The NLM Gateway7 The NLM (National Library of Medicine) Gateway is a Web-based system that lets users search simultaneously in multiple retrieval systems at the U.S. National Library of Medicine (NLM). It allows users of NLM services to initiate searches from one Web interface, providing one-stop searching for many of NLM’s information resources or databases.8 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “urine tests” (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 1836 132 1265 33 38 3304

HSTAT9 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.10 These documents include clinical practice guidelines, quickreference guides for clinicians, consumer health brochures, evidence reports and technology assessments from the Agency for Healthcare Research and Quality (AHRQ), as well as AHRQ’s Put Prevention Into Practice.11 Simply search by “urine tests” (or synonyms) at the following Web site: http://text.nlm.nih.gov.

7

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

8

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

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

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

Physician Resources

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Coffee Break: Tutorials for Biologists12 Coffee Break is a general healthcare site that takes a scientific view of the news and covers recent breakthroughs in biology that may one day assist physicians in developing treatments. Here you will find a collection of short reports on recent biological discoveries. Each report incorporates interactive tutorials that demonstrate how bioinformatics tools are used as a part of the research process. Currently, all Coffee Breaks are written by NCBI staff.13 Each report is about 400 words and is usually based on a discovery reported in one or more articles from recently published, peer-reviewed literature.14 This site has new articles every few weeks, so it can be considered an online magazine of sorts. It is intended for general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/.

Other Commercial Databases In addition to resources maintained by official agencies, other databases exist that are commercial ventures addressing medical professionals. Here are some examples that may interest you: •

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

•

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

12 Adapted 13

from http://www.ncbi.nlm.nih.gov/Coffeebreak/Archive/FAQ.html.

The figure that accompanies each article is frequently supplied by an expert external to NCBI, in which case the source of the figure is cited. The result is an interactive tutorial that tells a biological story. 14 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process.

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

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•

Other guides Bladder Diseases http://www.nlm.nih.gov/medlineplus/bladderdiseases.html Cancer http://www.nlm.nih.gov/medlineplus/cancer.html Children's Health http://www.nlm.nih.gov/medlineplus/childrenshealth.html Hormones http://www.nlm.nih.gov/medlineplus/hormones.html Kidney Diseases http://www.nlm.nih.gov/medlineplus/kidneydiseases.html Laboratory Tests http://www.nlm.nih.gov/medlineplus/laboratorytests.html Urinary Tract Infections http://www.nlm.nih.gov/medlineplus/urinarytractinfections.html

Within the health topic page dedicated to urine tests, the following was listed: •

General/Overviews Lab Tests Source: Center for Devices and Radiological Health http://www.fda.gov/cdrh/oivd/consumer-lab.html Lab Tests Online Source: American Association for Clinical Chemistry http://www.labtestsonline.org/ Pathologist Is. Source: American Society for Clinical Pathology http://www.ascp.org/general/pub_resources/pathologist.asp Understanding Your Tests Source: American Association for Clinical Chemistry http://www.labtestsonline.org/understanding/index.html Why Doctors Order Laboratory Tests Source: Nemours Foundation http://kidshealth.org/parent/general/sick/labtest2.html

•

Diagnosis/Symptoms Interpreting Laboratory Test Results Source: National Cancer Institute http://cis.nci.nih.gov/fact/5_27.htm

Patient Resources

•

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Specific Conditions/Aspects Blood Culture Source: Nemours Foundation http://kidshealth.org/parent/general/sick/labtest3.html Blood Cultures Source: American Association for Clinical Chemistry http://labtestsonline.org/understanding/analytes/blood_culture/test.html Blood Gas Tests Source: American Association for Clinical Chemistry http://www.labtestsonline.org/understanding/analytes/blood_gases/test.html Buying Diagnostic Tests from the Internet: Buyer Beware! Source: Center for Devices and Radiological Health http://www.fda.gov/cdrh/consumer/buyerbeware.html Helping You Identify Quality Laboratory Services Source: Joint Commission on Accreditation of Healthcare Organizations http://www.jcaho.org/general%2Bpublic/making%2Bbetter%2Bchoices/helping% 2Byou%2Bchoose/lab.htm Home Tests Source: American Association for Clinical Chemistry http://www.labtestsonline.org/understanding/analytes/home_testing.html Home-Use Tests Source: Center for Devices and Radiological Health http://www.fda.gov/cdrh/oivd/consumer-homeuse.html Screening Tests for Adults (Ages 30-49) Source: American Association for Clinical Chemistry http://www.labtestsonline.org/understanding/wellness/d_adult.html Screening Tests for Young Adults (Ages 18-29) Source: American Association for Clinical Chemistry http://www.labtestsonline.org/understanding/wellness/c_youngadult1.html White Blood Cell Count Source: American Association for Clinical Chemistry http://www.labtestsonline.org/understanding/analytes/wbc/test.html

•

Children I Had a Lab Test! Source: American Society for Clinical Pathology http://www.ascp.org/general/pub_resources/labtest/ Screening Tests for Children (Ages 2-12) Source: American Association for Clinical Chemistry http://www.labtestsonline.org/understanding/wellness/b_children.html Screening Tests for Newborns and Infants Source: American Association for Clinical Chemistry http://www.labtestsonline.org/understanding/wellness/a_newborn.html

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•

Latest News Better Diagnostic Tests Needed to Identify SARS, Researchers Find Source: 12/02/2003, Canadian Press http://www.nlm.nih.gov//www.nlm.nih.gov/medlineplus/news/fullstory_14941 .html Elderly Women May Not Need Some Cancer Tests Source: 12/02/2003, Reuters Health http://www.nlm.nih.gov//www.nlm.nih.gov/medlineplus/news/fullstory_14925 .html Firm Will Sell Gene Test to Breast Cancer Patients Source: 12/07/2003, New York Times Syndicate http://www.nlm.nih.gov//www.nlm.nih.gov/medlineplus/news/fullstory_15009 .html

•

Men hCG Test Source: American Association for Clinical Chemistry http://www.labtestsonline.org/understanding/analytes/hcg/test.html

•

Prevention/Screening 24-Hour Urine Collection Source: National Institutes of Health, Clinical Center http://www.cc.nih.gov/ccc/patient_education/procdiag/24hr.pdf ACTH StimulationTest Source: National Institutes of Health, Clinical Center http://www.cc.nih.gov/ccc/patient_education/procdiag/acth.pdf Allergy Test (RAST Test) Source: American Association for Clinical Chemistry http://www.labtestsonline.org/understanding/analytes/allergy/test.html Antinuclear Antibody Test Source: American Association for Clinical Chemistry http://www.labtestsonline.org/understanding/analytes/ana/test.html Basic Metabolic Panel Source: American Association for Clinical Chemistry http://www.labtestsonline.org/understanding/analytes/bmp/bmp.html Blood Sedimentation Rate Test Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=HO00025 Calcium Pentagastrin Test Source: National Institutes of Health, Clinical Center http://www.cc.nih.gov/ccc/patient_education/procdiag/calciumpentagastri.pdf Chloride Test Source: American Association for Clinical Chemistry http://www.labtestsonline.org/understanding/analytes/chloride/test.html

Patient Resources

Clonidine Stimulation Test Source: National Institutes of Health, Clinical Center http://www.cc.nih.gov/ccc/patient_education/procdiag/clonidine.pdf CO2 Test Source: American Association for Clinical Chemistry http://www.labtestsonline.org/understanding/analytes/co2/test.html Complete Blood Count Source: Nemours Foundation http://kidshealth.org/parent/general/sick/labtest4.html Comprehensive Metabolic Panel Source: American Association for Clinical Chemistry http://www.labtestsonline.org/understanding/analytes/cmp/cmp.html CRH Stimulation Test Source: National Institutes of Health, Clinical Center http://www.cc.nih.gov/ccc/patient_education/procdiag/crh.pdf Electrolytes Source: Nemours Foundation http://kidshealth.org/parent/general/sick/labtest5.html Electromyography and Nerve Conduction Velocities Source: Muscular Dystrophy Association http://www.mdausa.org/publications/Quest/q75ss.html Glomerular Filtration Rate (GFR) Source: National Institutes of Health, Clinical Center http://www.cc.nih.gov/ccc/patient_education/procdiag/glomerular.pdf Glucose Tests Source: American Association for Clinical Chemistry http://www.labtestsonline.org/understanding/analytes/glucose/test.html Liver Function Tests Source: Nemours Foundation http://kidshealth.org/parent/general/sick/labtest6.html Lumbar Puncture (Spinal Tap) Source: Nemours Foundation http://kidshealth.org/parent/general/sick/lumbar_puncture.html Oral Glucose Tolerance Test Source: National Institutes of Health, Clinical Center http://www.cc.nih.gov/ccc/patient_education/procdiag/oralglu.pdf Potassium Test Source: American Association for Clinical Chemistry http://www.labtestsonline.org/understanding/analytes/potassium/test.html Preparing for a Needle Aspiration Biopsy Source: National Institutes of Health, Clinical Center http://www.cc.nih.gov/ccc/patient_education/pepubs/needle.html Secretin Test Source: National Institutes of Health, Clinical Center http://www.cc.nih.gov/ccc/patient_education/procdiag/secretin.pdf

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Sodium Test Source: American Association for Clinical Chemistry http://www.labtestsonline.org/understanding/analytes/sodium/test.html Stool Tests Source: Nemours Foundation http://kidshealth.org/parent/general/sick/labtest8.html Strep Screen/Throat Culture Source: Nemours Foundation http://kidshealth.org/PageManager.jsp?dn=nemours&article_set=22876&lic=16&c at_id=128 Swallowing Test Source: National Institutes of Health, Clinical Center http://www.cc.nih.gov/ccc/patient_education/procdiag/swallowing.pdf Therapeutic Drug Monitoring Source: American Association for Clinical Chemistry http://www.labtestsonline.org/understanding/analytes/thdm/glance.html Total Protein Test Source: American Association for Clinical Chemistry http://www.labtestsonline.org/understanding/analytes/tp/test.html Tumor Markers Source: National Cancer Institute http://cis.nci.nih.gov/fact/5_18.htm Understanding Your Complete Blood Count Source: National Institutes of Health, Clinical Center http://www.cc.nih.gov/ccc/patient_education/pepubs/cbc97.pdf Urine Tests Source: Nemours Foundation http://kidshealth.org/parent/general/sick/labtest7.html •

Teenagers Screening Tests for Teens Source: American Association for Clinical Chemistry http://www.labtestsonline.org/understanding/wellness/c_youngadult.html

•

Women hCG Test Source: American Association for Clinical Chemistry http://www.labtestsonline.org/understanding/analytes/hcg/test.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.

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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 urine tests. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html. Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •

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

•

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

•

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

•

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

•

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

•

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

•

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

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

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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 “urine tests” (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 “urine tests”. Type the following hyperlink into your Web browser: http://chid.nih.gov/detail/detail.html. To find associations, use the drop boxes at the bottom of the search page where “You may refine your search by.” For publication date, select “All Years.” Then, select your preferred language and the format option “Organization Resource Sheet.” Type “urine tests” (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 “urine tests” (or a synonym) into the search box, and click “Submit Query.”

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

Preparation Your local public library and medical libraries have interlibrary loan programs with the National Library of Medicine (NLM), one of the largest medical collections in the world. According to the NLM, most of the literature in the general and historical collections of the National Library of Medicine is available on interlibrary loan to any library. If you would like to access NLM medical literature, then visit a library in your area that can request the publications for you.15

Finding a Local Medical Library The quickest method to locate medical libraries is to use the Internet-based directory published by the National Network of Libraries of Medicine (NN/LM). This network includes 4626 members and affiliates that provide many services to librarians, health professionals, and the public. To find a library in your area, simply visit http://nnlm.gov/members/adv.html or call 1-800-338-7657.

Medical Libraries in the U.S. and Canada In addition to the NN/LM, the National Library of Medicine (NLM) lists a number of libraries with reference facilities that are open to the public. The following is the NLM’s list and includes hyperlinks to each library’s Web site. These Web pages can provide information on hours of operation and other restrictions. The list below is a small sample of

15

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

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

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

•

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

•

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

•

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

•

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

•

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

•

California: Gateway Health Library (Sutter Gould Medical Foundation)

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

16

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

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•

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/

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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

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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

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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

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

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

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

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URINE TESTS 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] Acceptor: A substance which, while normally not oxidized by oxygen or reduced by hydrogen, can be oxidized or reduced in presence of a substance which is itself undergoing oxidation or reduction. [NIH] Acetylcholine: A neurotransmitter. Acetylcholine in vertebrates is the major transmitter at neuromuscular junctions, autonomic ganglia, parasympathetic effector junctions, a subset of sympathetic effector junctions, and at many sites in the central nervous system. It is generally not used as an administered drug because it is broken down very rapidly by cholinesterases, but it is useful in some ophthalmological applications. [NIH] ACTH: Adrenocorticotropic hormone. [EU] Adenosine: A nucleoside that is composed of adenine and d-ribose. Adenosine or adenosine derivatives play many important biological roles in addition to being components of DNA and RNA. Adenosine itself is a neurotransmitter. [NIH] Adrenal Cortex: The outer layer of the adrenal gland. It secretes mineralocorticoids, androgens, and glucocorticoids. [NIH] Adrenal Glands: Paired glands situated in the retroperitoneal tissues at the superior pole of each kidney. [NIH] Adrenal Medulla: The inner part of the adrenal gland; it synthesizes, stores and releases catecholamines. [NIH] Adrenergic: Activated by, characteristic of, or secreting epinephrine or substances with similar activity; the term is applied to those nerve fibres that liberate norepinephrine at a synapse when a nerve impulse passes, i.e., the sympathetic fibres. [EU] Adverse Effect: An unwanted side effect of treatment. [NIH] Aerobic: In biochemistry, reactions that need oxygen to happen or happen when oxygen is present. [NIH] Aerobic Exercise: A type of physical activity that includes walking, jogging, running, and dancing. Aerobic training improves the efficiency of the aerobic energy-producing systems that can improve cardiorespiratory endurance. [NIH] Aerosol: A solution of a drug which can be atomized into a fine mist for inhalation therapy. [EU]

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

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stereochemical compatibility between them), most accurately applied to interactions among simple, uniform antigenic determinants such as haptens. Expressed as the association constant (K litres mole -1), which, owing to the heterogeneity of affinities in a population of antibody molecules of a given specificity, actually represents an average value (mean intrinsic association constant). 6. The reciprocal of the dissociation constant. [EU] Age of Onset: The age or period of life at which a disease or the initial symptoms or manifestations of a disease appear in an individual. [NIH] Agonist: In anatomy, a prime mover. In pharmacology, a drug that has affinity for and stimulates physiologic activity at cell receptors normally stimulated by naturally occurring substances. [EU] Albumin: 1. Any protein that is soluble in water and moderately concentrated salt solutions and is coagulable by heat. 2. Serum albumin; the major plasma protein (approximately 60 per cent of the total), which is responsible for much of the plasma colloidal osmotic pressure and serves as a transport protein carrying large organic anions, such as fatty acids, bilirubin, and many drugs, and also carrying certain hormones, such as cortisol and thyroxine, when their specific binding globulins are saturated. Albumin is synthesized in the liver. Low serum levels occur in protein malnutrition, active inflammation and serious hepatic and renal disease. [EU] Aldosterone: (11 beta)-11,21-Dihydroxy-3,20-dioxopregn-4-en-18-al. A hormone secreted by the adrenal cortex that functions in the regulation of electrolyte and water balance by increasing the renal retention of sodium and the excretion of potassium. [NIH] Alertness: A state of readiness to detect and respond to certain specified small changes occurring at random intervals in the environment. [NIH] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alkaline: Having the reactions of an alkali. [EU] Alkaline Phosphatase: An enzyme that catalyzes the conversion of an orthophosphoric monoester and water to an alcohol and orthophosphate. EC 3.1.3.1. [NIH] Alkaloid: A member of a large group of chemicals that are made by plants and have nitrogen in them. Some alkaloids have been shown to work against cancer. [NIH] Alpha Particles: Positively charged particles composed of two protons and two neutrons, i.e., helium nuclei, emitted during disintegration of very heavy isotopes; a beam of alpha particles or an alpha ray has very strong ionizing power, but weak penetrability. [NIH] Alpha-1: A protein with the property of inactivating proteolytic enzymes such as leucocyte collagenase and elastase. [NIH] Alpha-Glucosidases: Enzymes that catalyze the exohydrolysis of 1,4-alpha-glucosidic linkages with release of alpha-glucose. Deficiency of alpha-1,4-glucosidase may cause glycogen storage disease type II. EC 3.2.1.20. [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] Amantadine: An antiviral that is used in the prophylactic or symptomatic treatment of Influenza A. It is also used as an antiparkinsonian agent, to treat extrapyramidal reactions, and for postherpetic neuralgia. The mechanisms of its effects in movement disorders are not well understood but probably reflect an increase in synthesis and release of dopamine, with

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perhaps some inhibition of dopamine uptake. [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] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Aminolevulinic Acid: A compound produced from succinyl-CoA and glycine as an intermediate in heme synthesis. [NIH] Ammonia: A colorless alkaline gas. It is formed in the body during decomposition of organic materials during a large number of metabolically important reactions. [NIH] Amphetamine: A powerful central nervous system stimulant and sympathomimetic. Amphetamine has multiple mechanisms of action including blocking uptake of adrenergics and dopamine, stimulation of release of monamines, and inhibiting monoamine oxidase. Amphetamine is also a drug of abuse and a psychotomimetic. The l- and the d,l-forms are included here. The l-form has less central nervous system activity but stronger cardiovascular effects. The d-form is dextroamphetamine. [NIH] Amplification: The production of additional copies of a chromosomal DNA sequence, found as either intrachromosomal or extrachromosomal DNA. [NIH] Ampulla: A sac-like enlargement of a canal or duct. [NIH] Amylase: An enzyme that helps the body digest starches. [NIH] Anal: Having to do with the anus, which is the posterior opening of the large bowel. [NIH] Analgesic: An agent that alleviates pain without causing loss of consciousness. [EU] Analogous: Resembling or similar in some respects, as in function or appearance, but not in origin or development;. [EU] Analytes: A component of a test sample the presence of which has to be demonstrated. The term "analyte" includes where appropriate formed from the analyte during the analyses. [NIH]

Androgenic: Producing masculine characteristics. [EU] Androstenedione: A steroid with androgenic properties that is produced in the testis, ovary, and adrenal cortex. It is a precursor to testosterone and other androgenic hormones. [NIH] Anemia: A reduction in the number of circulating erythrocytes or in the quantity of hemoglobin. [NIH] Anesthesia: A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures. [NIH] Anesthetics: Agents that are capable of inducing a total or partial loss of sensation, especially tactile sensation and pain. They may act to induce general anesthesia, in which an unconscious state is achieved, or may act locally to induce numbness or lack of sensation at a targeted site. [NIH] Anions: Negatively charged atoms, radicals or groups of atoms which travel to the anode or

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positive pole during electrolysis. [NIH] Anorexia: Lack or loss of appetite for food. Appetite is psychologic, dependent on memory and associations. Anorexia can be brought about by unattractive food, surroundings, or company. [NIH] Anorexia Nervosa: The chief symptoms are inability to eat, weight loss, and amenorrhea. [NIH]

Antagonism: Interference with, or inhibition of, the growth of a living organism by another living organism, due either to creation of unfavorable conditions (e. g. exhaustion of food supplies) or to production of a specific antibiotic substance (e. g. penicillin). [NIH] Anthocyanins: Glycosidic pigments in blue, red, and purple flowers and also found as metabolic byproducts in blood and urine. [NIH] Antibiotics: Substances produced by microorganisms that can inhibit or suppress the growth of other microorganisms. [NIH] Antibodies: Immunoglobulin molecules having a specific amino acid sequence by virtue of which they interact only with the antigen that induced their synthesis in cells of the lymphoid series (especially plasma cells), or with an antigen closely related to it. [NIH] Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Anticoagulant: A drug that helps prevent blood clots from forming. Also called a blood thinner. [NIH] 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] Antihypertensive: An agent that reduces high blood pressure. [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] Antiviral: Destroying viruses or suppressing their replication. [EU] Anus: The opening of the rectum to the outside of the body. [NIH] Aorta: The main trunk of the systemic arteries. [NIH] Aqueous: Having to do with water. [NIH] Arginine: An essential amino acid that is physiologically active in the L-form. [NIH] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Arterioles: The smallest divisions of the arteries located between the muscular arteries and the capillaries. [NIH]

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Ascorbic Acid: A six carbon compound related to glucose. It is found naturally in citrus fruits and many vegetables. Ascorbic acid is an essential nutrient in human diets, and necessary to maintain connective tissue and bone. Its biologically active form, vitamin C, functions as a reducing agent and coenzyme in several metabolic pathways. Vitamin C is considered an antioxidant. [NIH] Assay: Determination of the amount of a particular constituent of a mixture, or of the biological or pharmacological potency of a drug. [EU] Asymptomatic: Having no signs or symptoms of disease. [NIH] Atrium: A chamber; used in anatomical nomenclature to designate a chamber affording entrance to another structure or organ. Usually used alone to designate an atrium of the heart. [EU] Autoantibodies: Antibodies that react with self-antigens (autoantigens) of the organism that produced them. [NIH] Autoantigens: Endogenous tissue constituents that have the ability to interact with autoantibodies and cause an immune response. [NIH] Autonomic: Self-controlling; functionally independent. [EU] Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH] Bacterium: Microscopic organism which may have a spherical, rod-like, or spiral unicellular or non-cellular body. Bacteria usually reproduce through asexual processes. [NIH] Bacteriuria: The presence of bacteria in the urine with or without consequent urinary tract infection. Since bacteriuria is a clinical entity, the term does not preclude the use of urine/microbiology for technical discussions on the isolation and segregation of bacteria in the urine. [NIH] Barium: An element of the alkaline earth group of metals. It has an atomic symbol Ba, atomic number 56, and atomic weight 138. All of its acid-soluble salts are poisonous. [NIH] Barium enema: A procedure in which a liquid with barium in it is put into the rectum and colon by way of the anus. Barium is a silver-white metallic compound that helps to show the image of the lower gastrointestinal tract on an x-ray. [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] Benzoic Acid: A fungistatic compound that is widely used as a food preservative. It is conjugated to glycine in the liver and excreted as hippuric acid. [NIH] Bile: An emulsifying agent produced in the liver and secreted into the duodenum. Its composition includes bile acids and salts, cholesterol, and electrolytes. It aids digestion of fats in the duodenum. [NIH] Bile Acids: Acids made by the liver that work with bile to break down fats. [NIH] Bile Acids and Salts: Steroid acids and salts. The primary bile acids are derived from cholesterol in the liver and usually conjugated with glycine or taurine. The secondary bile acids are further modified by bacteria in the intestine. They play an important role in the digestion and absorption of fat. They have also been used pharmacologically, especially in the treatment of gallstones. [NIH] Bile Ducts: Tubes that carry bile from the liver to the gallbladder for storage and to the

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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] Bioavailable: The ability of a drug or other substance to be absorbed and used by the body. Orally bioavailable means that a drug or other substance that is taken by mouth can be absorbed and used by the body. [NIH] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biofilms: Films of bacteria or other microbial organisms, usually embedded in extracellular polymers such as implanted medical devices, which adhere to surfaces submerged in, or subjected to, aquatic environments (From Singleton & Sainsbury, Dictionary of Microbiology and Molecular Biology, 2d ed). Biofilms consist of multilayers of microbial cells glued together to form microbial communities which are highly resistant to both phagocytes and antibiotics. [NIH] Biological Markers: Measurable and quantifiable biological parameters (e.g., specific enzyme concentration, specific hormone concentration, specific gene phenotype distribution in a population, presence of biological substances) which serve as indices for health- and physiology-related assessments, such as disease risk, psychiatric disorders, environmental exposure and its effects, disease diagnosis, metabolic processes, substance abuse, pregnancy, cell line development, epidemiologic studies, etc. [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] Blastocyst: The mammalian embryo in the post-morula stage in which a fluid-filled cavity, enclosed primarily by trophoblast, contains an inner cell mass which becomes the embryonic disc. [NIH] Blood Cell Count: A count of the number of leukocytes and erythrocytes per unit volume in a sample of venous blood. A complete blood count (CBC) also includes measurement of the hemoglobin, hematocrit, and erythrocyte indices. [NIH] Blood Coagulation: The process of the interaction of blood coagulation factors that results in an insoluble fibrin clot. [NIH] Blood Glucose: Glucose in blood. [NIH] Blood 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]

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Blood urea: A waste product in the blood that comes from the breakdown of food protein. The kidneys filter blood to remove urea. As kidney function decreases, the BUN level increases. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Body Fluids: Liquid components of living organisms. [NIH] Body Mass Index: One of the anthropometric measures of body mass; it has the highest correlation with skinfold thickness or body density. [NIH] Bone scan: A technique to create images of bones on a computer screen or on film. A small amount of radioactive material is injected into a blood vessel and travels through the bloodstream; it collects in the bones and is detected by a scanner. [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] Bradykinin: A nonapeptide messenger that is enzymatically produced from kallidin in the blood where it is a potent but short-lived agent of arteriolar dilation and increased capillary permeability. Bradykinin is also released from mast cells during asthma attacks, from gut walls as a gastrointestinal vasodilator, from damaged tissues as a pain signal, and may be a neurotransmitter. [NIH] Branch: Most commonly used for branches of nerves, but applied also to other structures. [NIH]

Breakdown: A physical, metal, or nervous collapse. [NIH] Bronchi: The larger air passages of the lungs arising from the terminal bifurcation of the trachea. [NIH] Bronchitis: Inflammation (swelling and reddening) of the bronchi. [NIH] Caffeine: A methylxanthine naturally occurring in some beverages and also used as a pharmacological agent. Caffeine's most notable pharmacological effect is as a central nervous system stimulant, increasing alertness and producing agitation. It also relaxes smooth muscle, stimulates cardiac muscle, stimulates diuresis, and appears to be useful in the treatment of some types of headache. Several cellular actions of caffeine have been observed, but it is not entirely clear how each contributes to its pharmacological profile. Among the most important are inhibition of cyclic nucleotide phosphodiesterases, antagonism of adenosine receptors, and modulation of intracellular calcium handling. [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] Calcium Oxalate: The calcium salt of oxalic acid, occurring in the urine as crystals and in certain calculi. [NIH] Calculi: An abnormal concretion occurring mostly in the urinary and biliary tracts, usually composed of mineral salts. Also called stones. [NIH] Canonical: A particular nucleotide sequence in which each position represents the base more often found when many actual sequences of a given class of genetic elements are compared. [NIH] Capillary: Any one of the minute vessels that connect the arterioles and venules, forming a network in nearly all parts of the body. Their walls act as semipermeable membranes for the

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interchange of various substances, including fluids, between the blood and tissue fluid; called also vas capillare. [EU] 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] Carbon Dioxide: A colorless, odorless gas that can be formed by the body and is necessary for the respiration cycle of plants and animals. [NIH] Carcinogenic: Producing carcinoma. [EU] Carcinoma: Cancer that begins in the skin or in tissues that line or cover internal organs. [NIH]

Cardiac: Having to do with the heart. [NIH] Cardiorespiratory: Relating to the heart and lungs and their function. [EU] Cardiovascular: Having to do with the heart and blood vessels. [NIH] Carotene: The general name for a group of pigments found in green, yellow, and leafy vegetables, and yellow fruits. The pigments are fat-soluble, unsaturated aliphatic hydrocarbons functioning as provitamins and are converted to vitamin A through enzymatic processes in the intestinal wall. [NIH] Carrier Proteins: Transport proteins that carry specific substances in the blood or across cell membranes. [NIH] Catalyse: To speed up a chemical reaction. [EU] Catecholamine: A group of chemical substances manufactured by the adrenal medulla and secreted during physiological stress. [NIH] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Cell Cycle: The complex series of phenomena, occurring between the end of one cell division and the end of the next, by which cellular material is divided between daughter cells. [NIH] Cell Division: The fission of a cell. [NIH] Cellulose: A polysaccharide with glucose units linked as in cellobiose. It is the chief constituent of plant fibers, cotton being the purest natural form of the substance. As a raw material, it forms the basis for many derivatives used in chromatography, ion exchange materials, explosives manufacturing, and pharmaceutical preparations. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Centrifugation: A method of separating organelles or large molecules that relies upon differential sedimentation through a preformed density gradient under the influence of a gravitational field generated in a centrifuge. [NIH] Centromere: The clear constricted portion of the chromosome at which the chromatids are joined and by which the chromosome is attached to the spindle during cell division. [NIH] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] Cerebral Palsy: Refers to a motor disability caused by a brain dysfunction. [NIH] Cerebrum: The largest part of the brain. It is divided into two hemispheres, or halves, called the cerebral hemispheres. The cerebrum controls muscle functions of the body and also

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controls speech, emotions, reading, writing, and learning. [NIH] Cervical: Relating to the neck, or to the neck of any organ or structure. Cervical lymph nodes are located in the neck; cervical cancer refers to cancer of the uterine cervix, which is the lower, narrow end (the "neck") of the uterus. [NIH] Cervix: The lower, narrow end of the uterus that forms a canal between the uterus and vagina. [NIH] Check-up: A general physical examination. [NIH] Chest Pain: Pressure, burning, or numbness in the chest. [NIH] Chlamydia: A genus of the family Chlamydiaceae whose species cause a variety of diseases in vertebrates including humans, mice, and swine. Chlamydia species are gram-negative and produce glycogen. The type species is Chlamydia trachomatis. [NIH] Cholestasis: Impairment of biliary flow at any level from the hepatocyte to Vater's ampulla. [NIH]

Cholesterol: The principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils. [NIH] Chromatin: The material of chromosomes. It is a complex of DNA, histones, and nonhistone proteins (chromosomal proteins, non-histone) found within the nucleus of a cell. [NIH] Chromosomal: Pertaining to chromosomes. [EU] Chromosome: Part of a cell that contains genetic information. Except for sperm and eggs, all human cells contain 46 chromosomes. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Chronic Disease: Disease or ailment of long duration. [NIH] Chronic Obstructive Pulmonary Disease: Collective term for chronic bronchitis and emphysema. [NIH] Chronic prostatitis: Inflammation of the prostate gland, developing slowly and lasting a long time. [NIH] CIS: Cancer Information Service. The CIS is the National Cancer Institute's link to the public, interpreting and explaining research findings in a clear and understandable manner, and providing personalized responses to specific questions about cancer. Access the CIS by calling 1-800-4-CANCER, or by using the Web site at http://cis.nci.nih.gov. [NIH] Citrus: Any tree or shrub of the Rue family or the fruit of these plants. [NIH] Clear cell carcinoma: A rare type of tumor of the female genital tract in which the inside of the cells looks clear when viewed under a microscope. [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] Clomiphene: A stilbene derivative that functions both as a partial estrogen agonist and complete estrogen antagonist depending on the target tissue. It antagonizes the estrogen receptor thereby initiating or augmenting ovulation in anovulatory women. [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] Cluster Analysis: A set of statistical methods used to group variables or observations into strongly inter-related subgroups. In epidemiology, it may be used to analyze a closely grouped series of events or cases of disease or other health-related phenomenon with well-

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defined distribution patterns in relation to time or place or both. [NIH] Coagulation: 1. The process of clot formation. 2. In colloid chemistry, the solidification of a sol into a gelatinous mass; an alteration of a disperse phase or of a dissolved solid which causes the separation of the system into a liquid phase and an insoluble mass called the clot or curd. Coagulation is usually irreversible. 3. In surgery, the disruption of tissue by physical means to form an amorphous residuum, as in electrocoagulation and photocoagulation. [EU] Coca: Any of several South American shrubs of the Erythroxylon genus (and family) that yield cocaine; the leaves are chewed with alum for CNS stimulation. [NIH] Cocaine: An alkaloid ester extracted from the leaves of plants including coca. It is a local anesthetic and vasoconstrictor and is clinically used for that purpose, particularly in the eye, ear, nose, and throat. It also has powerful central nervous system effects similar to the amphetamines and is a drug of abuse. Cocaine, like amphetamines, acts by multiple mechanisms on brain catecholaminergic neurons; the mechanism of its reinforcing effects is thought to involve inhibition of dopamine uptake. [NIH] Codons: Any triplet of nucleotides (coding unit) in DNA or RNA (if RNA is the carrier of primary genetic information as in some viruses) that codes for particular amino acid or signals the beginning or end of the message. [NIH] Coenzyme: An organic nonprotein molecule, frequently a phosphorylated derivative of a water-soluble vitamin, that binds with the protein molecule (apoenzyme) to form the active enzyme (holoenzyme). [EU] Cognitive restructuring: A method of identifying and replacing fear-promoting, irrational beliefs with more realistic and functional ones. [NIH] Colitis: Inflammation of the colon. [NIH] Colloidal: Of the nature of a colloid. [EU] Competency: The capacity of the bacterium to take up DNA from its surroundings. [NIH] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix 'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU]

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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] Computed tomography: CT scan. A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called computerized tomography and computerized axial tomography (CAT) scan. [NIH] Computerized axial tomography: A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called CAT scan, computed tomography (CT scan), or computerized tomography. [NIH] Conception: The onset of pregnancy, marked by implantation of the blastocyst; the formation of a viable zygote. [EU] Concretion: Minute, hard, yellow masses found in the palpebral conjunctivae of elderly people or following chronic conjunctivitis, composed of the products of cellular degeneration retained in the depressions and tubular recesses in the conjunctiva. [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] Cones: One type of specialized light-sensitive cells (photoreceptors) in the retina that provide sharp central vision and color vision. [NIH] Conjugated: Acting or operating as if joined; simultaneous. [EU] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Consciousness: Sense of awareness of self and of the environment. [NIH] Consumption: Pulmonary tuberculosis. [NIH] Contamination: The soiling or pollution by inferior material, as by the introduction of organisms into a wound, or sewage into a stream. [EU] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Contrast Media: Substances used in radiography that allow visualization of certain tissues. [NIH]

Control group: In a clinical trial, the group that does not receive the new treatment being

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studied. This group is compared to the group that receives the new treatment, to see if the new treatment works. [NIH] Controlled study: An experiment or clinical trial that includes a comparison (control) group. [NIH]

Cornea: The transparent part of the eye that covers the iris and the pupil and allows light to enter the inside. [NIH] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Corpus: The body of the uterus. [NIH] Corpus Luteum: The yellow glandular mass formed in the ovary by an ovarian follicle that has ruptured and discharged its ovum. [NIH] Cortisol: A steroid hormone secreted by the adrenal cortex as part of the body's response to stress. [NIH] Cotinine: 1-Methyl-5-(3-pyridyl)-2-pyrrolidinone antidepressant. Synonym: Scotine. [NIH]

fumarate.

Stimulant

proposed

as

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]

Creatinine: A compound that is excreted from the body in urine. Creatinine levels are measured to monitor kidney function. [NIH] Creatinine clearance: A test that measures how efficiently the kidneys remove creatinine and other wastes from the blood. Low creatinine clearance indicates impaired kidney function. [NIH] Curative: Tending to overcome disease and promote recovery. [EU] Cyclic: Pertaining to or occurring in a cycle or cycles; the term is applied to chemical compounds that contain a ring of atoms in the nucleus. [EU] Cystitis: Inflammation of the urinary bladder. [EU] 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] Deamination: The removal of an amino group (NH2) from a chemical compound. [NIH] Decarboxylation: The removal of a carboxyl group, usually in the form of carbon dioxide, from a chemical compound. [NIH] Decidua: The epithelial lining of the endometrium that is formed before the fertilized ovum reaches the uterus. The fertilized ovum embeds in the decidua. If the ovum is not fertilized, the decidua is shed during menstruation. [NIH] Delivery of Health Care: The concept concerned with all aspects of providing and distributing health services to a patient population. [NIH] Delusions: A false belief regarding the self or persons or objects outside the self that persists despite the facts, and is not considered tenable by one's associates. [NIH]

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DES: Diethylstilbestrol. A synthetic hormone that was prescribed from the early 1940s until 1971 to help women with complications of pregnancy. DES has been linked to an increased risk of clear cell carcinoma of the vagina in daughters of women who used DES. DES may also increase the risk of breast cancer in women who used DES. [NIH] Dextroamphetamine: The d-form of amphetamine. It is a central nervous system stimulant and a sympathomimetic. It has also been used in the treatment of narcolepsy and of attention deficit disorders and hyperactivity in children. Dextroamphetamine has multiple mechanisms of action including blocking uptake of adrenergics and dopamine, stimulating release of monamines, and inhibiting monoamine oxidase. It is also a drug of abuse and a psychotomimetic. [NIH] Diabetes Mellitus: A heterogeneous group of disorders that share glucose intolerance in common. [NIH] Diabetic Retinopathy: Retinopathy associated with diabetes mellitus, which may be of the background type, progressively characterized by microaneurysms, interretinal punctuate macular edema, or of the proliferative type, characterized by neovascularization of the retina and optic disk, which may project into the vitreous, proliferation of fibrous tissue, vitreous hemorrhage, and retinal detachment. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Diastolic: Of or pertaining to the diastole. [EU] Dietitian: An expert in nutrition who helps people plan what and how much food to eat. [NIH]

Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Digestive tract: The organs through which food passes when food is eaten. These organs are the mouth, esophagus, stomach, small and large intestines, and rectum. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Disaccharides: Sugars composed of two monosaccharides linked by glycoside bonds. [NIH] Discriminant Analysis: A statistical analytic technique used with discrete dependent variables, concerned with separating sets of observed values and allocating new values. It is sometimes used instead of regression analysis. [NIH] Dissociation: 1. The act of separating or state of being separated. 2. The separation of a molecule into two or more fragments (atoms, molecules, ions, or free radicals) produced by the absorption of light or thermal energy or by solvation. 3. In psychology, a defense mechanism in which a group of mental processes are segregated from the rest of a person's mental activity in order to avoid emotional distress, as in the dissociative disorders (q.v.), or in which an idea or object is segregated from its emotional significance; in the first sense it is roughly equivalent to splitting, in the second, to isolation. 4. A defect of mental integration in which one or more groups of mental processes become separated off from normal consciousness and, thus separated, function as a unitary whole. [EU] Diuresis: Increased excretion of urine. [EU] Diuretic: A drug that increases the production of urine. [NIH] Dopa: The racemic or DL form of DOPA, an amino acid found in various legumes. The dextro form has little physiologic activity but the levo form (levodopa) is a very important physiologic mediator and precursor and pharmacological agent. [NIH] Dopamine: An endogenous catecholamine and prominent neurotransmitter in several systems of the brain. In the synthesis of catecholamines from tyrosine, it is the immediate precursor to norepinephrine and epinephrine. Dopamine is a major transmitter in the

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extrapyramidal system of the brain, and important in regulating movement. A family of dopaminergic receptor subtypes mediate its action. Dopamine is used pharmacologically for its direct (beta adrenergic agonist) and indirect (adrenergic releasing) sympathomimetic effects including its actions as an inotropic agent and as a renal vasodilator. [NIH] Doping: The action of administering a drug to someone before a sports event (originally to a horse before a race); the substance thus administered. [EU] Dose-dependent: Refers to the effects of treatment with a drug. If the effects change when the dose of the drug is changed, the effects are said to be dose dependent. [NIH] Dreams: A series of thoughts, images, or emotions occurring during sleep which are dissociated from the usual stream of consciousness of the waking state. [NIH] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Duct: A tube through which body fluids pass. [NIH] Duodenum: The first part of the small intestine. [NIH] Ectopic: Pertaining to or characterized by ectopia. [EU] Ectopic Pregnancy: The pregnancy occurring elsewhere than in the cavity of the uterus. [NIH]

Edema: Excessive amount of watery fluid accumulated in the intercellular spaces, most commonly present in subcutaneous tissue. [NIH] Efficacy: The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control trial. [NIH] Electrocoagulation: Electrosurgical procedures used to treat hemorrhage (e.g., bleeding ulcers) and to ablate tumors, mucosal lesions, and refractory arrhythmias. [NIH] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Electrons: Stable elementary particles having the smallest known negative charge, present in all elements; also called negatrons. Positively charged electrons are called positrons. The numbers, energies and arrangement of electrons around atomic nuclei determine the chemical identities of elements. Beams of electrons are called cathode rays or beta rays, the latter being a high-energy biproduct of nuclear decay. [NIH] Electrophoresis: An electrochemical process in which macromolecules or colloidal particles with a net electric charge migrate in a solution under the influence of an electric current. [NIH]

Emphysema: A pathological accumulation of air in tissues or organs. [NIH] Endometrium: The layer of tissue that lines the uterus. [NIH] Endoscopy: Endoscopic examination, therapy or surgery performed on interior parts of the body. [NIH] Endothelium: A layer of epithelium that lines the heart, blood vessels (endothelium, vascular), lymph vessels (endothelium, lymphatic), and the serous cavities of the body. [NIH] Endothelium-derived: Small molecule that diffuses to the adjacent muscle layer and relaxes it. [NIH] Enema: The injection of a liquid through the anus into the large bowel. [NIH] Environmental Exposure: The exposure to potentially harmful chemical, physical, or biological agents in the environment or to environmental factors that may include ionizing

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

Enzymatic: Phase where enzyme cuts the precursor protein. [NIH] Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Enzyme Inhibitors: Compounds or agents that combine with an enzyme in such a manner as to prevent the normal substrate-enzyme combination and the catalytic reaction. [NIH] Epidemic: Occurring suddenly in numbers clearly in excess of normal expectancy; said especially of infectious diseases but applied also to any disease, injury, or other healthrelated event occurring in such outbreaks. [EU] Epidemiologic Studies: Studies designed to examine associations, commonly, hypothesized causal relations. They are usually concerned with identifying or measuring the effects of risk factors or exposures. The common types of analytic study are case-control studies, cohort studies, and cross-sectional studies. [NIH] Epigastric: Having to do with the upper middle area of the abdomen. [NIH] Epinephrine: The active sympathomimetic hormone from the adrenal medulla in most species. It stimulates both the alpha- and beta- adrenergic systems, causes systemic vasoconstriction and gastrointestinal relaxation, stimulates the heart, and dilates bronchi and cerebral vessels. It is used in asthma and cardiac failure and to delay absorption of local anesthetics. [NIH] Epithelial: Refers to the cells that line the internal and external surfaces of the body. [NIH] Erectile: The inability to get or maintain an erection for satisfactory sexual intercourse. Also called impotence. [NIH] Erection: The condition of being made rigid and elevated; as erectile tissue when filled with blood. [EU] Erythrocyte Indices: Quantification of size and cell hemoglobin content or concentration of the erythrocyte, usually derived from erythrocyte count, blood hemoglobin concentration, and hematocrit. Includes the mean cell volume (MCV), mean cell hemoglobin (MCH), and mean cell hemoglobin concentration (MCHC). Use also for cell diameter and thickness. [NIH] Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]

Estradiol: The most potent mammalian estrogenic hormone. It is produced in the ovary, placenta, testis, and possibly the adrenal cortex. [NIH] Estriol: (16 alpha,17 beta)-Estra-1,3,5(10)-triene-3,16,17-triol. A metabolite of estradiol and usually the predominant estrogenic metabolite in urine. During pregnancy, large amounts of estriol are produced by the placenta. It has also been obtained from plant sources. The 16 beta-isomer has also been isolated from the urine of pregnant women. [NIH] Estrogen: One of the two female sex hormones. [NIH] Estrogen receptor: ER. Protein found on some cancer cells to which estrogen will attach. [NIH]

Excrete: To get rid of waste from the body. [NIH] Exercise Therapy: Motion of the body or its parts to relieve symptoms or to improve function, leading to physical fitness, but not physical education and training. [NIH]

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Exocrine: Secreting outwardly, via a duct. [EU] Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] Expectorant: 1. Promoting the ejection, by spitting, of mucus or other fluids from the lungs and trachea. 2. An agent that promotes the ejection of mucus or exudate from the lungs, bronchi, and trachea; sometimes extended to all remedies that quiet cough (antitussives). [EU]

Extracellular: Outside a cell or cells. [EU] Extrapyramidal: Outside of the pyramidal tracts. [EU] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Family Relations: Behavioral, psychological, and social relations among various members of the nuclear family and the extended family. [NIH] Fat: Total lipids including phospholipids. [NIH] Fatigue: The state of weariness following a period of exertion, mental or physical, characterized by a decreased capacity for work and reduced efficiency to respond to stimuli. [NIH]

Fatty acids: A major component of fats that are used by the body for energy and tissue development. [NIH] Feces: The excrement discharged from the intestines, consisting of bacteria, cells exfoliated from the intestines, secretions, chiefly of the liver, and a small amount of food residue. [EU] Fetus: The developing offspring from 7 to 8 weeks after conception until birth. [NIH] Fibrinogen: Plasma glycoprotein clotted by thrombin, composed of a dimer of three nonidentical pairs of polypeptide chains (alpha, beta, gamma) held together by disulfide bonds. Fibrinogen clotting is a sol-gel change involving complex molecular arrangements: whereas fibrinogen is cleaved by thrombin to form polypeptides A and B, the proteolytic action of other enzymes yields different fibrinogen degradation products. [NIH] Folate: A B-complex vitamin that is being studied as a cancer prevention agent. Also called folic acid. [NIH] Folic Acid: N-(4-(((2-Amino-1,4-dihydro-4-oxo-6-pteridinyl)methyl)amino)benzoyl)-Lglutamic acid. A member of the vitamin B family that stimulates the hematopoietic system. It is present in the liver and kidney and is found in mushrooms, spinach, yeast, green leaves, and grasses. Folic acid is used in the treatment and prevention of folate deficiencies and megaloblastic anemia. [NIH] Follicular Phase: The period of the menstrual cycle that begins with menstruation and ends with ovulation. [NIH] Food Exchange: See: Exchange lists. [NIH] Forearm: The part between the elbow and the wrist. [NIH] Fructosamine: An amino sugar formed when glucose non-enzymatically reacts with the Nterminal amino group of proteins. The fructose moiety is dervied from glucose by the "classical" Amadori rearrangement. [NIH] Fructose: A type of sugar found in many fruits and vegetables and in honey. Fructose is used to sweeten some diet foods. It is considered a nutritive sweetener because it has calories. [NIH] Fundus: The larger part of a hollow organ that is farthest away from the organ's opening. The bladder, gallbladder, stomach, uterus, eye, and cavity of the middle ear all have a fundus. [NIH]

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Fungistatic: Inhibiting the growth of fungi. [EU] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] Gallstones: The solid masses or stones made of cholesterol or bilirubin that form in the gallbladder or bile ducts. [NIH] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body through the rectum (flatus) or the mouth (burp). [NIH] Gastrin: A hormone released after eating. Gastrin causes the stomach to produce more acid. [NIH]

Gastrointestinal: Refers to the stomach and intestines. [NIH] Gastrointestinal tract: The stomach and intestines. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]

Genetic Code: The specifications for how information, stored in nucleic acid sequence (base sequence), is translated into protein sequence (amino acid sequence). The start, stop, and order of amino acids of a protein is specified by consecutive triplets of nucleotides called codons (codon). [NIH] Gestation: The period of development of the young in viviparous animals, from the time of fertilization of the ovum until birth. [EU] Gestational: Psychosis attributable to or occurring during pregnancy. [NIH] 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] Glipizide: An oral hypoglycemic agent which is rapidly absorbed and completely metabolized. [NIH] Glomerular: Pertaining to or of the nature of a glomerulus, especially a renal glomerulus. [EU]

Glomerulus: A tiny set of looping blood vessels in the nephron where blood is filtered in the kidney. [NIH] Glucose: D-Glucose. A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. [NIH] Glucose Intolerance: A pathological state in which the fasting plasma glucose level is less than 140 mg per deciliter and the 30-, 60-, or 90-minute plasma glucose concentration following a glucose tolerance test exceeds 200 mg per deciliter. This condition is seen frequently in diabetes mellitus but also occurs with other diseases. [NIH] Glucose tolerance: The power of the normal liver to absorb and store large quantities of glucose and the effectiveness of intestinal absorption of glucose. The glucose tolerance test is a metabolic test of carbohydrate tolerance that measures active insulin, a hepatic function based on the ability of the liver to absorb glucose. The test consists of ingesting 100 grams of glucose into a fasting stomach; blood sugar should return to normal in 2 to 21 hours after ingestion. [NIH] Glucose Tolerance Test: Determination of whole blood or plasma sugar in a fasting state before and at prescribed intervals (usually 1/2 hr, 1 hr, 3 hr, 4 hr) after taking a specified amount (usually 100 gm orally) of glucose. [NIH]

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Glycine: A non-essential amino acid. It is found primarily in gelatin and silk fibroin and used therapeutically as a nutrient. It is also a fast inhibitory neurotransmitter. [NIH] 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] Glycogen Storage Disease: A group of inherited metabolic disorders involving the enzymes responsible for the synthesis and degradation of glycogen. In some patients, prominent liver involvement is presented. In others, more generalized storage of glycogen occurs, sometimes with prominent cardiac involvement. [NIH] Glycosaminoglycan: A type of long, unbranched polysaccharide molecule. Glycosaminoglycans are major structural components of cartilage and are also found in the cornea of the eye. [NIH] Glycoside: Any compound that contains a carbohydrate molecule (sugar), particularly any such natural product in plants, convertible, by hydrolytic cleavage, into sugar and a nonsugar component (aglycone), and named specifically for the sugar contained, as glucoside (glucose), pentoside (pentose), fructoside (fructose) etc. [EU] Glycosuria: The presence of glucose in the urine; especially the excretion of an abnormally large amount of sugar (glucose) in the urine, i.e., more than 1 gm. in 24 hours. [EU] Gonadal: Pertaining to a gonad. [EU] Gonorrhea: Acute infectious disease characterized by primary invasion of the urogenital tract. The etiologic agent, Neisseria gonorrhoeae, was isolated by Neisser in 1879. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Grade: The grade of a tumor depends on how abnormal the cancer cells look under a microscope and how quickly the tumor is likely to grow and spread. Grading systems are different for each type of cancer. [NIH] Gram-negative: Losing the stain or decolorized by alcohol in Gram's method of staining, a primary characteristic of bacteria having a cell wall composed of a thin layer of peptidoglycan covered by an outer membrane of lipoprotein and lipopolysaccharide. [EU] Granulocytes: Leukocytes with abundant granules in the cytoplasm. They are divided into three groups: neutrophils, eosinophils, and basophils. [NIH] Growth: The progressive development of a living being or part of an organism from its earliest stage to maturity. [NIH] Guanylate Cyclase: An enzyme that catalyzes the conversion of GTP to 3',5'-cyclic GMP and pyrophosphate. It also acts on ITP and dGTP. (From Enzyme Nomenclature, 1992) EC 4.6.1.2. [NIH] Haptens: Small antigenic determinants capable of eliciting an immune response only when coupled to a carrier. Haptens bind to antibodies but by themselves cannot elicit an antibody response. [NIH] Headache: Pain in the cranial region that may occur as an isolated and benign symptom or as a manifestation of a wide variety of conditions including subarachnoid hemorrhage; craniocerebral trauma; central nervous system infections; intracranial hypertension; and other disorders. In general, recurrent headaches that are not associated with a primary disease process are referred to as headache disorders (e.g., migraine). [NIH] Health Care Costs: The actual costs of providing services related to the delivery of health care, including the costs of procedures, therapies, and medications. It is differentiated from health expenditures, which refers to the amount of money paid for the services, and from

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fees, which refers to the amount charged, regardless of cost. [NIH] Health Education: Education that increases the awareness and favorably influences the attitudes and knowledge relating to the improvement of health on a personal or community basis. [NIH] Health Expenditures: The amounts spent by individuals, groups, nations, or private or public organizations for total health care and/or its various components. These amounts may or may not be equivalent to the actual costs (health care costs) and may or may not be shared among the patient, insurers, and/or employers. [NIH] Hematocrit: Measurement of the volume of packed red cells in a blood specimen by centrifugation. The procedure is performed using a tube with graduated markings or with automated blood cell counters. It is used as an indicator of erythrocyte status in disease. For example, anemia shows a low hematocrit, polycythemia, high values. [NIH] Heme: The color-furnishing portion of hemoglobin. It is found free in tissues and as the prosthetic group in many hemeproteins. [NIH] Hemoglobin: One of the fractions of glycosylated hemoglobin A1c. Glycosylated hemoglobin is formed when linkages of glucose and related monosaccharides bind to hemoglobin A and its concentration represents the average blood glucose level over the previous several weeks. HbA1c levels are used as a measure of long-term control of plasma glucose (normal, 4 to 6 percent). In controlled diabetes mellitus, the concentration of glycosylated hemoglobin A is within the normal range, but in uncontrolled cases the level may be 3 to 4 times the normal conentration. Generally, complications are substantially lower among patients with Hb levels of 7 percent or less than in patients with HbA1c levels of 9 percent or more. [NIH] Hemoglobin A: Normal adult human hemoglobin. The globin moiety consists of two alpha and two beta chains. [NIH] Hepatic: Refers to the liver. [NIH] Hepatocyte: A liver cell. [NIH] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Heterogeneity: The property of one or more samples or populations which implies that they are not identical in respect of some or all of their parameters, e. g. heterogeneity of variance. [NIH]

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] Hyaluronidase: An enzyme that splits hyaluronic acid and thus lowers the viscosity of the acid and facilitates the spreading of fluids through tissues either advantageously or disadvantageously. [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] Hyperglycemia: Abnormally high blood sugar. [NIH] Hyperplasia: An increase in the number of cells in a tissue or organ, not due to tumor formation. It differs from hypertrophy, which is an increase in bulk without an increase in

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the number of cells. [NIH] Hypersensitivity: Altered reactivity to an antigen, which can result in pathologic reactions upon subsequent exposure to that particular antigen. [NIH] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Hypertrophy: General increase in bulk of a part or organ, not due to tumor formation, nor to an increase in the number of cells. [NIH] Hypoglycemia: Abnormally low blood sugar [NIH] Hypoglycemic: An orally active drug that produces a fall in blood glucose concentration. [NIH]

Hypothalamus: Ventral part of the diencephalon extending from the region of the optic chiasm to the caudal border of the mammillary bodies and forming the inferior and lateral walls of the third ventricle. [NIH] Id: The part of the personality structure which harbors the unconscious instinctive desires and strivings of the individual. [NIH] Immune response: The activity of the immune system against foreign substances (antigens). [NIH]

Immune system: The organs, cells, and molecules responsible for the recognition and disposal of foreign ("non-self") material which enters the body. [NIH] Immunodeficiency: The decreased ability of the body to fight infection and disease. [NIH] Immunoglobulin: A protein that acts as an antibody. [NIH] Immunology: The study of the body's immune system. [NIH] Impairment: In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function. [NIH] Impotence: The inability to perform sexual intercourse. [NIH] In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Incision: A cut made in the body during surgery. [NIH] Indicative: That indicates; that points out more or less exactly; that reveals fairly clearly. [EU] Infancy: The period of complete dependency prior to the acquisition of competence in walking, talking, and self-feeding. [NIH] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]

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]

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

Ingestion: Taking into the body by mouth [NIH] Inhalation: The drawing of air or other substances into the lungs. [EU] Inotropic: Affecting the force or energy of muscular contractions. [EU] Insight: The capacity to understand one's own motives, to be aware of one's own psychodynamics, to appreciate the meaning of symbolic behavior. [NIH] Insulin: A protein hormone secreted by beta cells of the pancreas. Insulin plays a major role in the regulation of glucose metabolism, generally promoting the cellular utilization of glucose. It is also an important regulator of protein and lipid metabolism. Insulin is used as a drug to control insulin-dependent diabetes mellitus. [NIH] Insulin-dependent diabetes mellitus: A disease characterized by high levels of blood glucose resulting from defects in insulin secretion, insulin action, or both. Autoimmune, genetic, and environmental factors are involved in the development of type I diabetes. [NIH] Intensive Care: Advanced and highly specialized care provided to medical or surgical patients whose conditions are life-threatening and require comprehensive care and constant monitoring. It is usually administered in specially equipped units of a health care facility. [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] Intravenous pyelogram: IVP. A series of x-rays of the kidneys, ureters, and bladder. The xrays are taken after a dye is injected into a blood vessel. The dye is concentrated in the urine, which outlines the kidneys, ureters, and bladder on the x-rays. [NIH] Intravesical: Within the bladder. [NIH] Intrinsic: Situated entirely within or pertaining exclusively to a part. [EU] Introns: Non-coding, intervening sequences of DNA that are transcribed, but are removed from within the primary gene transcript and rapidly degraded during maturation of messenger RNA. Most genes in the nuclei of eukaryotes contain introns, as do mitochondrial and chloroplast genes. [NIH] Invasive: 1. Having the quality of invasiveness. 2. Involving puncture or incision of the skin or insertion of an instrument or foreign material into the body; said of diagnostic techniques. [EU]

Ionization: 1. Any process by which a neutral atom gains or loses electrons, thus acquiring a net charge, as the dissociation of a substance in solution into ions or ion production by the passage of radioactive particles. 2. Iontophoresis. [EU] Ionizing: Radiation comprising charged particles, e. g. electrons, protons, alpha-particles, etc., having sufficient kinetic energy to produce ionization by collision. [NIH] Ions: An atom or group of atoms that have a positive or negative electric charge due to a gain (negative charge) or loss (positive charge) of one or more electrons. Atoms with a positive charge are known as cations; those with a negative charge are anions. [NIH]

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Isoniazid: Antibacterial agent used primarily as a tuberculostatic. It remains the treatment of choice for tuberculosis. [NIH] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Keto: It consists of 8 carbon atoms and within the endotoxins, it connects poysaccharide and lipid A. [NIH] Kidney Disease: Any one of several chronic conditions that are caused by damage to the cells of the kidney. People who have had diabetes for a long time may have kidney damage. Also called nephropathy. [NIH] Kidney stone: A stone that develops from crystals that form in urine and build up on the inner surfaces of the kidney, in the renal pelvis, or in the ureters. [NIH] Kinetic: Pertaining to or producing motion. [EU] Large Intestine: The part of the intestine that goes from the cecum to the rectum. The large intestine absorbs water from stool and changes it from a liquid to a solid form. The large intestine is 5 feet long and includes the appendix, cecum, colon, and rectum. Also called colon. [NIH] Leprosy: A chronic granulomatous infection caused by Mycobacterium leprae. The granulomatous lesions are manifested in the skin, the mucous membranes, and the peripheral nerves. Two polar or principal types are lepromatous and tuberculoid. [NIH] Leucocyte: All the white cells of the blood and their precursors (myeloid cell series, lymphoid cell series) but commonly used to indicate granulocytes exclusive of lymphocytes. [NIH]

Leukocytes: White blood cells. These include granular leukocytes (basophils, eosinophils, and neutrophils) as well as non-granular leukocytes (lymphocytes and monocytes). [NIH] Levo: It is an experimental treatment for heroin addiction that was developed by German scientists around 1948 as an analgesic. Like methadone, it binds with opioid receptors, but it is longer acting. [NIH] Levodopa: The naturally occurring form of dopa and the immediate precursor of dopamine. Unlike dopamine itself, it can be taken orally and crosses the blood-brain barrier. It is rapidly taken up by dopaminergic neurons and converted to dopamine. It is used for the treatment of parkinsonism and is usually given with agents that inhibit its conversion to dopamine outside of the central nervous system. [NIH] 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] Linkages: The tendency of two or more genes in the same chromosome to remain together from one generation to the next more frequently than expected according to the law of independent assortment. [NIH] Lipid: Fat. [NIH] Liposome: A spherical particle in an aqueous medium, formed by a lipid bilayer enclosing an aqueous compartment. [EU] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Liver scan: An image of the liver created on a computer screen or on film. A radioactive substance is injected into a blood vessel and travels through the bloodstream. It collects in

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the liver, especially in abnormal areas, and can be detected by the scanner. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Lumbar: Pertaining to the loins, the part of the back between the thorax and the pelvis. [EU] Luteal Phase: The period of the menstrual cycle that begins with ovulation and ends with menstruation. [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] Lymphoid: Referring to lymphocytes, a type of white blood cell. Also refers to tissue in which lymphocytes develop. [NIH] Magnetic Resonance Imaging: Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques. [NIH] Malignancy: A cancerous tumor that can invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malnutrition: A condition caused by not eating enough food or not eating a balanced diet. [NIH]

Manic: Affected with mania. [EU] Manic-depressive psychosis: One of a group of psychotic reactions, fundamentally marked by severe mood swings and a tendency to remission and recurrence. [NIH] Mediate: Indirect; accomplished by the aid of an intervening medium. [EU] Mediator: An object or substance by which something is mediated, such as (1) a structure of the nervous system that transmits impulses eliciting a specific response; (2) a chemical substance (transmitter substance) that induces activity in an excitable tissue, such as nerve or muscle; or (3) a substance released from cells as the result of the interaction of antigen with antibody or by the action of antigen with a sensitized lymphocyte. [EU] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Membranes: Thin layers of tissue which cover parts of the body, separate adjacent cavities, or connect adjacent structures. [NIH] 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] Menstrual Cycle: The period of the regularly recurring physiologic changes in the endometrium occurring during the reproductive period in human females and some primates and culminating in partial sloughing of the endometrium (menstruation). [NIH] Menstruation: The normal physiologic discharge through the vagina of blood and mucosal tissues from the nonpregnant uterus. [NIH] Mental Disorders: Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior

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producing either distress or impairment of function. [NIH] Mental Health: The state wherein the person is well adjusted. [NIH] Metabolite: Any substance produced by metabolism or by a metabolic process. [EU] Metastasis: The spread of cancer from one part of the body to another. Tumors formed from cells that have spread are called "secondary tumors" and contain cells that are like those in the original (primary) tumor. The plural is metastases. [NIH] Methyldopa: An alpha-2 adrenergic agonist that has both central and peripheral nervous system effects. Its primary clinical use is as an antihypertensive agent. Before its alphaadrenergic actions became clear, methyldopa was thought to act by inhibiting decarboxylation of DOPA leading to depletion of norepinephrine or by conversion to and release as the false transmitter alpha-methylnorepinephrine. [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] Milligram: A measure of weight. A milligram is approximately 450,000-times smaller than a pound and 28,000-times smaller than an ounce. [NIH] Mobilization: The process of making a fixed part or stored substance mobile, as by separating a part from surrounding structures to make it accessible for an operative procedure or by causing release into the circulation for body use of a substance stored in the body. [EU] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] Monitor: An apparatus which automatically records such physiological signs as respiration, pulse, and blood pressure in an anesthetized patient or one undergoing surgical or other procedures. [NIH] Monoamine: Enzyme that breaks down dopamine in the astrocytes and microglia. [NIH] Monoclonal: An antibody produced by culturing a single type of cell. It therefore consists of a single species of immunoglobulin molecules. [NIH] Morphine: The principal alkaloid in opium and the prototype opiate analgesic and narcotic. Morphine has widespread effects in the central nervous system and on smooth muscle. [NIH] Motivations: The most compelling inner determinants of human behavior; also called drives, urges, impulses, needs, wants, tensions, and willful cravings. [NIH] Mucins: A secretion containing mucopolysaccharides and protein that is the chief constituent of mucus. [NIH] Multicenter study: A clinical trial that is carried out at more than one medical institution. [NIH]

Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH]

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Myoglobin: A conjugated protein which is the oxygen-transporting pigment of muscle. It is made up of one globin polypeptide chain and one heme group. [NIH] Narcotic: 1. Pertaining to or producing narcosis. 2. An agent that produces insensibility or stupor, applied especially to the opioids, i.e. to any natural or synthetic drug that has morphine-like actions. [EU] NCI: National Cancer Institute. NCI, part of the National Institutes of Health of the United States Department of Health and Human Services, is the federal government's principal agency for cancer research. NCI conducts, coordinates, and funds cancer research, training, health information dissemination, and other programs with respect to the cause, diagnosis, prevention, and treatment of cancer. Access the NCI Web site at http://cancer.gov. [NIH] 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] Nephrectomy: Surgery to remove a kidney. Radical nephrectomy removes the kidney, the adrenal gland, nearby lymph nodes, and other surrounding tissue. Simple nephrectomy removes only the kidney. Partial nephrectomy removes the tumor but not the entire kidney. [NIH]

Nephropathy: Disease of the kidneys. [EU] Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Networks: Pertaining to a nerve or to the nerves, a meshlike structure of interlocking fibers or strands. [NIH] Neural: 1. Pertaining to a nerve or to the nerves. 2. Situated in the region of the spinal axis, as the neutral arch. [EU] Neurogenic: Loss of bladder control caused by damage to the nerves controlling the bladder. [NIH] Neurons: The basic cellular units of nervous tissue. Each neuron consists of a body, an axon, and dendrites. Their purpose is to receive, conduct, and transmit impulses in the nervous system. [NIH] Neuropathy: A problem in any part of the nervous system except the brain and spinal cord. Neuropathies can be caused by infection, toxic substances, or disease. [NIH] Neutrons: Electrically neutral elementary particles found in all atomic nuclei except light hydrogen; the mass is equal to that of the proton and electron combined and they are unstable when isolated from the nucleus, undergoing beta decay. Slow, thermal, epithermal, and fast neutrons refer to the energy levels with which the neutrons are ejected from heavier nuclei during their decay. [NIH] Nitric Oxide: A free radical gas produced endogenously by a variety of mammalian cells. It is synthesized from arginine by a complex reaction, catalyzed by nitric oxide synthase. Nitric oxide is endothelium-derived relaxing factor. It is released by the vascular endothelium and mediates the relaxation induced by some vasodilators such as acetylcholine and bradykinin. It also inhibits platelet aggregation, induces disaggregation of aggregated platelets, and inhibits platelet adhesion to the vascular endothelium. Nitric oxide activates cytosolic guanylate cyclase and thus elevates intracellular levels of cyclic GMP.

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[NIH]

Nitrocamptothecin: An alkaloid drug belonging to a class of anticancer agents called topoisomerase inhibitors. [NIH] Nitrogen: An element with the atomic symbol N, atomic number 7, and atomic weight 14. Nitrogen exists as a diatomic gas and makes up about 78% of the earth's atmosphere by volume. It is a constituent of proteins and nucleic acids and found in all living cells. [NIH] Norepinephrine: Precursor of epinephrine that is secreted by the adrenal medulla and is a widespread central and autonomic neurotransmitter. Norepinephrine is the principal transmitter of most postganglionic sympathetic fibers and of the diffuse projection system in the brain arising from the locus ceruleus. It is also found in plants and is used pharmacologically as a sympathomimetic. [NIH] Nuclear: A test of the structure, blood flow, and function of the kidneys. The doctor injects a mildly radioactive solution into an arm vein and uses x-rays to monitor its progress through the kidneys. [NIH] Nuclear Family: A family composed of spouses and their children. [NIH] Nuclear Matrix: The fibrogranular network of residual structural elements within which are immersed both chromatin and ribonucleoproteins. It extends throughout the nuclear interior from the nucleolus to the nuclear pore complexes along the nuclear periphery. [NIH] Nuclear Medicine: A specialty field of radiology concerned with diagnostic, therapeutic, and investigative use of radioactive compounds in a pharmaceutical form. [NIH] Nuclear Pore: An opening through the nuclear envelope formed by the nuclear pore complex which transports nuclear proteins or RNA into or out of the cell nucleus and which, under some conditions, acts as an ion channel. [NIH] Nuclei: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nucleic acid: Either of two types of macromolecule (DNA or RNA) formed by polymerization of nucleotides. Nucleic acids are found in all living cells and contain the information (genetic code) for the transfer of genetic information from one generation to the next. [NIH] Nucleolus: A small dense body (sub organelle) within the nucleus of eukaryotic cells, visible by phase contrast and interference microscopy in live cells throughout interphase. Contains RNA and protein and is the site of synthesis of ribosomal RNA. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nutritional Status: State of the body in relation to the consumption and utilization of nutrients. [NIH] Odds Ratio: The ratio of two odds. The exposure-odds ratio for case control data is the ratio of the odds in favor of exposure among cases to the odds in favor of exposure among noncases. The disease-odds ratio for a cohort or cross section is the ratio of the odds in favor of disease among the exposed to the odds in favor of disease among the unexposed. The prevalence-odds ratio refers to an odds ratio derived cross-sectionally from studies of prevalent cases. [NIH] Opium: The air-dried exudate from the unripe seed capsule of the opium poppy, Papaver somniferum, or its variant, P. album. It contains a number of alkaloids, but only a few morphine, codeine, and papaverine - have clinical significance. Opium has been used as an analgesic, antitussive, antidiarrheal, and antispasmodic. [NIH] Opsin: A protein formed, together with retinene, by the chemical breakdown of meta-

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rhodopsin. [NIH] Optic Disk: The portion of the optic nerve seen in the fundus with the ophthalmoscope. It is formed by the meeting of all the retinal ganglion cell axons as they enter the optic nerve. [NIH]

Osmotic: Pertaining to or of the nature of osmosis (= the passage of pure solvent from a solution of lesser to one of greater solute concentration when the two solutions are separated by a membrane which selectively prevents the passage of solute molecules, but is permeable to the solvent). [EU] Outpatient: A patient who is not an inmate of a hospital but receives diagnosis or treatment in a clinic or dispensary connected with the hospital. [NIH] Ovary: Either of the paired glands in the female that produce the female germ cells and secrete some of the female sex hormones. [NIH] Overweight: An excess of body weight but not necessarily body fat; a body mass index of 25 to 29.9 kg/m2. [NIH] Ovulation: The discharge of a secondary oocyte from a ruptured graafian follicle. [NIH] Ovum: A female germ cell extruded from the ovary at ovulation. [NIH] Oxalic Acid: A strong dicarboxylic acid occurring in many plants and vegetables. It is produced in the body by metabolism of glyoxylic acid or ascorbic acid. It is not metabolized but excreted in the urine. It is used as an analytical reagent and general reducing agent. [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]

Painful bladder syndrome: Another name for interstitial cystitis. [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] Pancreatic Insufficiency: Absence of or reduced pancreatic exocrine secretion into the duodenum and resultant poor digestion of lipids, vitamins, nitrogen, and carbohydrates. [NIH]

Parathyroid: 1. Situated beside the thyroid gland. 2. One of the parathyroid glands. 3. A sterile preparation of the water-soluble principle(s) of the parathyroid glands, ad-ministered parenterally as an antihypocalcaemic, especially in the treatment of acute hypoparathyroidism with tetany. [EU] Parathyroid Glands: Two small paired endocrine glands in the region of the thyroid gland. They secrete parathyroid hormone and are concerned with the metabolism of calcium and phosphorus. [NIH] Particle: A tiny mass of material. [EU] Pathogenesis: The cellular events and reactions that occur in the development of disease. [NIH]

Pathologic: 1. Indicative of or caused by a morbid condition. 2. Pertaining to pathology (=

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branch of medicine that treats the essential nature of the disease, especially the structural and functional changes in tissues and organs of the body caused by the disease). [EU] Pathophysiology: Altered functions in an individual or an organ due to disease. [NIH] Patient Care Team: Care of patients by a multidisciplinary team usually organized under the leadership of a physician; each member of the team has specific responsibilities and the whole team contributes to the care of the patient. [NIH] Patient Compliance: Voluntary cooperation of the patient in following a prescribed regimen. [NIH] Patient Participation: Patient involvement in the decision-making process in matters pertaining to health. [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] Pepsin: An enzyme made in the stomach that breaks down proteins. [NIH] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Perception: The ability quickly and accurately to recognize similarities and differences among presented objects, whether these be pairs of words, pairs of number series, or multiple sets of these or other symbols such as geometric figures. [NIH] Peripheral Nerves: The nerves outside of the brain and spinal cord, including the autonomic, cranial, and spinal nerves. Peripheral nerves contain non-neuronal cells and connective tissue as well as axons. The connective tissue layers include, from the outside to the inside, the epineurium, the perineurium, and the endoneurium. [NIH] Peripheral Nervous System: The nervous system outside of the brain and spinal cord. The peripheral nervous system has autonomic and somatic divisions. The autonomic nervous system includes the enteric, parasympathetic, and sympathetic subdivisions. The somatic nervous system includes the cranial and spinal nerves and their ganglia and the peripheral sensory receptors. [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] Phenotype: The outward appearance of the individual. It is the product of interactions between genes and between the genotype and the environment. This includes the killer phenotype, characteristic of yeasts. [NIH] Phosphates: Inorganic salts of phosphoric acid. [NIH] Phosphorus: A non-metallic element that is found in the blood, muscles, nevers, bones, and teeth, and is a component of adenosine triphosphate (ATP; the primary energy source for the body's cells.) [NIH] Photocoagulation: Using a special strong beam of light (laser) to seal off bleeding blood vessels such as in the eye. The laser can also burn away blood vessels that should not have grown in the eye. This is the main treatment for diabetic retinopathy. [NIH] Physical Examination: Systematic and thorough inspection of the patient for physical signs of disease or abnormality. [NIH] Physical Fitness: A state of well-being in which performance is optimal, often as a result of

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physical conditioning which may be prescribed for disease therapy. [NIH] Physiologic: Having to do with the functions of the body. When used in the phrase "physiologic age," it refers to an age assigned by general health, as opposed to calendar age. [NIH]

Physiology: The science that deals with the life processes and functions of organismus, their cells, tissues, and organs. [NIH] Pigment: A substance that gives color to tissue. Pigments are responsible for the color of skin, eyes, and hair. [NIH] Pilot study: The initial study examining a new method or treatment. [NIH] Pituitary Gland: A small, unpaired gland situated in the sella turcica tissue. It is connected to the hypothalamus by a short stalk. [NIH] Placenta: A highly vascular fetal organ through which the fetus absorbs oxygen and other nutrients and excretes carbon dioxide and other wastes. It begins to form about the eighth day of gestation when the blastocyst adheres to the decidua. [NIH] Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Plasma cells: A type of white blood cell that produces antibodies. [NIH] Plasma protein: One of the hundreds of different proteins present in blood plasma, including carrier proteins ( such albumin, transferrin, and haptoglobin), fibrinogen and other coagulation factors, complement components, immunoglobulins, enzyme inhibitors, precursors of substances such as angiotension and bradykinin, and many other types of proteins. [EU] Platelet Aggregation: The attachment of platelets to one another. This clumping together can be induced by a number of agents (e.g., thrombin, collagen) and is part of the mechanism leading to the formation of a thrombus. [NIH] Platelet Count: A count of the number of platelets per unit volume in a sample of venous blood. [NIH] Platelets: A type of blood cell that helps prevent bleeding by causing blood clots to form. Also called thrombocytes. [NIH] Polymers: Compounds formed by the joining of smaller, usually repeating, units linked by covalent bonds. These compounds often form large macromolecules (e.g., polypeptides, proteins, plastics). [NIH] Polypeptide: A peptide which on hydrolysis yields more than two amino acids; called tripeptides, tetrapeptides, etc. according to the number of amino acids contained. [EU] Polysaccharide: A type of carbohydrate. It contains sugar molecules that are linked together chemically. [NIH] Porphyrins: A group of compounds containing the porphin structure, four pyrrole rings connected by methine bridges in a cyclic configuration to which a variety of side chains are attached. The nature of the side chain is indicated by a prefix, as uroporphyrin, hematoporphyrin, etc. The porphyrins, in combination with iron, form the heme component in biologically significant compounds such as hemoglobin and myoglobin. [NIH]

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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] Postherpetic Neuralgia: Variety of neuralgia associated with migraine in which pain is felt in or behind the eye. [NIH] Postprandial: Occurring after dinner, or after a meal; postcibal. [EU] 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] Potassium Citrate: A powder that dissolves in water, which is administered orally, and is used as a diuretic, expectorant, systemic alkalizer, and electrolyte replenisher. [NIH] Practicability: A non-standard characteristic of an analytical procedure. It is dependent on the scope of the method and is determined by requirements such as sample throughout and costs. [NIH] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Precursor: Something that precedes. In biological processes, a substance from which another, usually more active or mature substance is formed. In clinical medicine, a sign or symptom that heralds another. [EU] Pregnancy Complications: The co-occurrence of pregnancy and a disease. The disease may precede or follow conception and it may or may not have a deleterious effect on the pregnant woman or fetus. [NIH] Prenatal: Existing or occurring before birth, with reference to the fetus. [EU] Prenatal Care: Care provided the pregnant woman in order to prevent complications, and decrease the incidence of maternal and prenatal mortality. [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] Prion: Small proteinaceous infectious particles that resist inactivation by procedures modifying nucleic acids and contain an abnormal isoform of a cellular protein which is a major and necessary component. [NIH] Problem Solving: A learning situation involving more than one alternative from which a selection is made in order to attain a specific goal. [NIH] Progesterone: Pregn-4-ene-3,20-dione. The principal progestational hormone of the body, secreted by the corpus luteum, adrenal cortex, and placenta. Its chief function is to prepare the uterus for the reception and development of the fertilized ovum. It acts as an antiovulatory agent when administered on days 5-25 of the menstrual cycle. [NIH] Progression: Increase in the size of a tumor or spread of cancer in the body. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Projection: A defense mechanism, operating unconsciously, whereby that which is emotionally unacceptable in the self is rejected and attributed (projected) to others. [NIH]

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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] Prostate gland: A gland in the male reproductive system just below the bladder. It surrounds part of the urethra, the canal that empties the bladder, and produces a fluid that forms part of semen. [NIH] Prostatitis: Inflammation of the prostate. [EU] Protein C: A vitamin-K dependent zymogen present in the blood, which, upon activation by thrombin and thrombomodulin exerts anticoagulant properties by inactivating factors Va and VIIIa at the rate-limiting steps of thrombin formation. [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] Proteinuria: The presence of protein in the urine, indicating that the kidneys are not working properly. [NIH] Protocol: The detailed plan for a clinical trial that states the trial's rationale, purpose, drug or vaccine dosages, length of study, routes of administration, who may participate, and other aspects of trial design. [NIH] Protons: Stable elementary particles having the smallest known positive charge, found in the nuclei of all elements. The proton mass is less than that of a neutron. A proton is the nucleus of the light hydrogen atom, i.e., the hydrogen ion. [NIH] Psychiatric: Pertaining to or within the purview of psychiatry. [EU] Psychosis: A mental disorder characterized by gross impairment in reality testing as evidenced by delusions, hallucinations, markedly incoherent speech, or disorganized and agitated behaviour without apparent awareness on the part of the patient of the incomprehensibility of his behaviour; the term is also used in a more general sense to refer to mental disorders in which mental functioning is sufficiently impaired as to interfere grossly with the patient's capacity to meet the ordinary demands of life. Historically, the term has been applied to many conditions, e.g. manic-depressive psychosis, that were first described in psychotic patients, although many patients with the disorder are not judged psychotic. [EU] Psychotomimetic: Psychosis miming. [NIH] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Pulmonary: Relating to the lungs. [NIH] Pulmonary Artery: The short wide vessel arising from the conus arteriosus of the right ventricle and conveying unaerated blood to the lungs. [NIH] Pulse: The rhythmical expansion and contraction of an artery produced by waves of pressure caused by the ejection of blood from the left ventricle of the heart as it contracts. [NIH]

Pyridoxal: 3-Hydroxy-5-(hydroxymethyl)-2-methyl-4- pyridinecarboxaldehyde. [NIH] Race: A population within a species which exhibits general similarities within itself, but is both discontinuous and distinct from other populations of that species, though not

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sufficiently so as to achieve the status of a taxon. [NIH] Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the waves/rays themselves; a stream of electromagnetic particles (electrons, neutrons, protons, alpha particles) or a mixture of these. The most common source is the sun. [NIH] Radioactive: Giving off radiation. [NIH] Radiography: Examination of any part of the body for diagnostic purposes by means of roentgen rays, recording the image on a sensitized surface (such as photographic film). [NIH] Radiology: A specialty concerned with the use of x-ray and other forms of radiant energy in the diagnosis and treatment of disease. [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] Reabsorption: 1. The act or process of absorbing again, as the selective absorption by the kidneys of substances (glucose, proteins, sodium, etc.) already secreted into the renal tubules, and their return to the circulating blood. 2. Resorption. [EU] Reagent: A substance employed to produce a chemical reaction so as to detect, measure, produce, etc., other substances. [EU] Reality Testing: The individual's objective evaluation of the external world and the ability to differentiate adequately between it and the internal world; considered to be a primary ego function. [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] Recurrence: The return of a sign, symptom, or disease after a remission. [NIH] Red blood cells: RBCs. Cells that carry oxygen to all parts of the body. Also called erythrocytes. [NIH] 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] Regression Analysis: Procedures for finding the mathematical function which best describes the relationship between a dependent variable and one or more independent variables. In linear regression (see linear models) the relationship is constrained to be a straight line and least-squares analysis is used to determine the best fit. In logistic regression (see logistic models) the dependent variable is qualitative rather than continuously variable and likelihood functions are used to find the best relationship. In multiple regression the dependent variable is considered to depend on more than a single independent variable. [NIH]

Relapse: The return of signs and symptoms of cancer after a period of improvement. [NIH] Relative risk: The ratio of the incidence rate of a disease among individuals exposed to a specific risk factor to the incidence rate among unexposed individuals; synonymous with risk ratio. Alternatively, the ratio of the cumulative incidence rate in the exposed to the cumulative incidence rate in the unexposed (cumulative incidence ratio). The term relative risk has also been used synonymously with odds ratio. This is because the odds ratio and relative risk approach each other if the disease is rare ( 5 percent of population) and the number of subjects is large. [NIH] Reliability: Used technically, in a statistical sense, of consistency of a test with itself, i. e. the extent to which we can assume that it will yield the same result if repeated a second time.

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[NIH]

Remission: A decrease in or disappearance of signs and symptoms of cancer. In partial remission, some, but not all, signs and symptoms of cancer have disappeared. In complete remission, all signs and symptoms of cancer have disappeared, although there still may be cancer in the body. [NIH] Renal pelvis: The area at the center of the kidney. Urine collects here and is funneled into the ureter, the tube that connects the kidney to the bladder. [NIH] Reproductive system: In women, this system includes the ovaries, the fallopian tubes, the uterus (womb), the cervix, and the vagina (birth canal). The reproductive system in men includes the prostate, the testes, and the penis. [NIH] Research Design: A plan for collecting and utilizing data so that desired information can be obtained with sufficient precision or so that an hypothesis can be tested properly. [NIH] Respiration: The act of breathing with the lungs, consisting of inspiration, or the taking into the lungs of the ambient air, and of expiration, or the expelling of the modified air which contains more carbon dioxide than the air taken in (Blakiston's Gould Medical Dictionary, 4th ed.). This does not include tissue respiration (= oxygen consumption) or cell respiration (= cell respiration). [NIH] Retina: The ten-layered nervous tissue membrane of the eye. It is continuous with the optic nerve and receives images of external objects and transmits visual impulses to the brain. Its outer surface is in contact with the choroid and the inner surface with the vitreous body. The outer-most layer is pigmented, whereas the inner nine layers are transparent. [NIH] Retinal: 1. Pertaining to the retina. 2. The aldehyde of retinol, derived by the oxidative enzymatic splitting of absorbed dietary carotene, and having vitamin A activity. In the retina, retinal combines with opsins to form visual pigments. One isomer, 11-cis retinal combines with opsin in the rods (scotopsin) to form rhodopsin, or visual purple. Another, all-trans retinal (trans-r.); visual yellow; xanthopsin) results from the bleaching of rhodopsin by light, in which the 11-cis form is converted to the all-trans form. Retinal also combines with opsins in the cones (photopsins) to form the three pigments responsible for colour vision. Called also retinal, and retinene1. [EU] Retinol: Vitamin A. It is essential for proper vision and healthy skin and mucous membranes. Retinol is being studied for cancer prevention; it belongs to the family of drugs called retinoids. [NIH] Retroperitoneal: Having to do with the area outside or behind the peritoneum (the tissue that lines the abdominal wall and covers most of the organs in the abdomen). [NIH] Rheumatism: A group of disorders marked by inflammation or pain in the connective tissue structures of the body. These structures include bone, cartilage, and fat. [NIH] Rheumatoid: Resembling rheumatism. [EU] Rheumatoid arthritis: A form of arthritis, the cause of which is unknown, although infection, hypersensitivity, hormone imbalance and psychologic stress have been suggested as possible causes. [NIH] Ribonucleoproteins: Proteins conjugated with ribonucleic acids (RNA) or specific RNA. Many viruses are ribonucleoproteins. [NIH] Ribosome: A granule of protein and RNA, synthesized in the nucleolus and found in the cytoplasm of cells. Ribosomes are the main sites of protein synthesis. Messenger RNA attaches to them and there receives molecules of transfer RNA bearing amino acids. [NIH] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH]

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Risk-Taking: Undertaking a task involving a challenge for achievement or a desirable goal in which there is a lack of certainty or a fear of failure. It may also include the exhibiting of certain behaviors whose outcomes may present a risk to the individual or to those associated with him or her. [NIH] Rods: One type of specialized light-sensitive cells (photoreceptors) in the retina that provide side vision and the ability to see objects in dim light (night vision). [NIH] Saccharin: Flavoring agent and non-nutritive sweetener. [NIH] Saliva: The clear, viscous fluid secreted by the salivary glands and mucous glands of the mouth. It contains mucins, water, organic salts, and ptylin. [NIH] Salivary: The duct that convey saliva to the mouth. [NIH] Salivary glands: Glands in the mouth that produce saliva. [NIH] Saponins: Sapogenin glycosides. A type of glycoside widely distributed in plants. Each consists of a sapogenin as the aglycon moiety, and a sugar. The sapogenin may be a steroid or a triterpene and the sugar may be glucose, galactose, a pentose, or a methylpentose. Sapogenins are poisonous towards the lower forms of life and are powerful hemolytics when injected into the blood stream able to dissolve red blood cells at even extreme dilutions. [NIH] Scans: Pictures of structures inside the body. Scans often used in diagnosing, staging, and monitoring disease include liver scans, bone scans, and computed tomography (CT) or computerized axial tomography (CAT) scans and magnetic resonance imaging (MRI) scans. In liver scanning and bone scanning, radioactive substances that are injected into the bloodstream collect in these organs. A scanner that detects the radiation is used to create pictures. In CT scanning, an x-ray machine linked to a computer is used to produce detailed pictures of organs inside the body. MRI scans use a large magnet connected to a computer to create pictures of areas inside the body. [NIH] Scleroderma: A chronic disorder marked by hardening and thickening of the skin. Scleroderma can be localized or it can affect the entire body (systemic). [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Secondary tumor: Cancer that has spread from the organ in which it first appeared to another organ. For example, breast cancer cells may spread (metastasize) to the lungs and cause the growth of a new tumor. When this happens, the disease is called metastatic breast cancer, and the tumor in the lungs is called a secondary tumor. Also called secondary cancer. [NIH] Secretin: A hormone made in the duodenum. Causes the stomach to make pepsin, the liver to make bile, and the pancreas to make a digestive juice. [NIH] Secretion: 1. The process of elaborating a specific product as a result of the activity of a gland; this activity may range from separating a specific substance of the blood to the elaboration of a new chemical substance. 2. Any substance produced by secretion. [EU] Sediment: A precipitate, especially one that is formed spontaneously. [EU] Segregation: The separation in meiotic cell division of homologous chromosome pairs and their contained allelomorphic gene pairs. [NIH] Self Care: Performance of activities or tasks traditionally performed by professional health care providers. The concept includes care of oneself or one's family and friends. [NIH] Sella: A deep depression in the shape of a Turkish saddle in the upper surface of the body of the sphenoid bone in the deepest part of which is lodged the hypophysis cerebri. [NIH] Semen: The thick, yellowish-white, viscid fluid secretion of male reproductive organs

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discharged upon ejaculation. In addition to reproductive organ secretions, it contains spermatozoa and their nutrient plasma. [NIH] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Signs and Symptoms: Clinical manifestations that can be either objective when observed by a physician, or subjective when perceived by the patient. [NIH] Small intestine: The part of the digestive tract that is located between the stomach and the large intestine. [NIH] Smooth muscle: Muscle that performs automatic tasks, such as constricting blood vessels. [NIH]

Social Support: Support systems that provide assistance and encouragement to individuals with physical or emotional disabilities in order that they may better cope. Informal social support is usually provided by friends, relatives, or peers, while formal assistance is provided by churches, groups, etc. [NIH] 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] 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] 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] Staging: Performing exams and tests to learn the extent of the cancer within the body, especially whether the disease has spread from the original site to other parts of the body. [NIH]

Sterile: Unable to produce children. [NIH] Steroid: A group name for lipids that contain a hydrogenated cyclopentanoperhydrophenanthrene ring system. Some of the substances included in this group are progesterone, adrenocortical hormones, the gonadal hormones, cardiac aglycones, bile acids, sterols (such as cholesterol), toad poisons, saponins, and some of the carcinogenic hydrocarbons. [EU] Stimulant: 1. Producing stimulation; especially producing stimulation by causing tension on muscle fibre through the nervous tissue. 2. An agent or remedy that produces stimulation. [EU]

Stimulus: That which can elicit or evoke action (response) in a muscle, nerve, gland or other

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excitable issue, or cause an augmenting action upon any function or metabolic process. [NIH] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Stress management: A set of techniques used to help an individual cope more effectively with difficult situations in order to feel better emotionally, improve behavioral skills, and often to enhance feelings of control. Stress management may include relaxation exercises, assertiveness training, cognitive restructuring, time management, and social support. It can be delivered either on a one-to-one basis or in a group format. [NIH] Stroma: The middle, thickest layer of tissue in the cornea. [NIH] Subacute: Somewhat acute; between acute and chronic. [EU] Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU] Substance P: An eleven-amino acid neurotransmitter that appears in both the central and peripheral nervous systems. It is involved in transmission of pain, causes rapid contractions of the gastrointestinal smooth muscle, and modulates inflammatory and immune responses. [NIH]

Sulfhydryl Compounds: Compounds containing the -SH radical. [NIH] Supplementation: Adding nutrients to the diet. [NIH] Support group: A group of people with similar disease who meet to discuss how better to cope with their cancer and treatment. [NIH] Sympathomimetic: 1. Mimicking the effects of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. 2. An agent that produces effects similar to those of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. Called also adrenergic. [EU] Symphysis: A secondary cartilaginous joint. [NIH] Symptomatic: Having to do with symptoms, which are signs of a condition or disease. [NIH] Symptomatic treatment: Therapy that eases symptoms without addressing the cause of disease. [NIH] Systemic: Affecting the entire body. [NIH] Systolic: Indicating the maximum arterial pressure during contraction of the left ventricle of the heart. [EU] Testis: Either of the paired male reproductive glands that produce the male germ cells and the male hormones. [NIH] Testosterone: A hormone that promotes the development and maintenance of male sex characteristics. [NIH] Tetany: 1. Hyperexcitability of nerves and muscles due to decrease in concentration of extracellular ionized calcium, which may be associated with such conditions as parathyroid hypofunction, vitamin D deficiency, and alkalosis or result from ingestion of alkaline salts; it is characterized by carpopedal spasm, muscular twitching and cramps, laryngospasm with inspiratory stridor, hyperreflexia and choreiform movements. 2. Tetanus. [EU] Tetrahydrocannabinol: A psychoactive compound extracted from the resin of Cannabis

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sativa (marihuana, hashish). The isomer delta-9-tetrahydrocannabinol (THC) is considered the most active form, producing characteristic mood and perceptual changes associated with this compound. Dronabinol is a synthetic form of delta-9-THC. [NIH] Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Thorax: A part of the trunk between the neck and the abdomen; the chest. [NIH] Threshold: For a specified sensory modality (e. g. light, sound, vibration), the lowest level (absolute threshold) or smallest difference (difference threshold, difference limen) or intensity of the stimulus discernible in prescribed conditions of stimulation. [NIH] Thrombin: An enzyme formed from prothrombin that converts fibrinogen to fibrin. (Dorland, 27th ed) EC 3.4.21.5. [NIH] Thrombomodulin: A cell surface glycoprotein of endothelial cells that binds thrombin and serves as a cofactor in the activation of protein C and its regulation of blood coagulation. [NIH]

Thyroid: A gland located near the windpipe (trachea) that produces thyroid hormone, which helps regulate growth and metabolism. [NIH] Thyroid Gland: A highly vascular endocrine gland consisting of two lobes, one on either side of the trachea, joined by a narrow isthmus; it produces the thyroid hormones which are concerned in regulating the metabolic rate of the body. [NIH] Thyroxine: An amino acid of the thyroid gland which exerts a stimulating effect on thyroid metabolism. [NIH] Time Management: Planning and control of time to improve efficiency and effectiveness. [NIH]

Tin: A trace element that is required in bone formation. It has the atomic symbol Sn, atomic number 50, and atomic weight 118.71. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tolerance: 1. The ability to endure unusually large doses of a drug or toxin. 2. Acquired drug tolerance; a decreasing response to repeated constant doses of a drug or the need for increasing doses to maintain a constant response. [EU] Topical: On the surface of the body. [NIH] Topoisomerase inhibitors: A family of anticancer drugs. The topoisomerase enzymes are responsible for the arrangement and rearrangement of DNA in the cell and for cell growth and replication. Inhibiting these enzymes may kill cancer cells or stop their growth. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicokinetics: Study of the absorption, distribution, metabolism, and excretion of test substances. [NIH] Toxicologic: Pertaining to toxicology. [EU] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxins: Specific, characterizable, poisonous chemicals, often proteins, with specific biological properties, including immunogenicity, produced by microbes, higher plants, or

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animals. [NIH] Trace element: Substance or element essential to plant or animal life, but present in extremely small amounts. [NIH] Trachea: The cartilaginous and membranous tube descending from the larynx and branching into the right and left main bronchi. [NIH] Transaminase: Aminotransferase (= a subclass of enzymes of the transferase class that catalyse the transfer of an amino group from a donor (generally an amino acid) to an acceptor (generally 2-keto acid). Most of these enzymes are pyridoxal-phosphate-proteins. [EU]

Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Transitional cell carcinoma: A type of cancer that develops in the lining of the bladder, ureter, or renal pelvis. [NIH] Translation: The process whereby the genetic information present in the linear sequence of ribonucleotides in mRNA is converted into a corresponding sequence of amino acids in a protein. It occurs on the ribosome and is unidirectional. [NIH] Transmitter: A chemical substance which effects the passage of nerve impulses from one cell to the other at the synapse. [NIH] Treatment Outcome: Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, practicability, etc., of these interventions in individual cases or series. [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] Tuberculosis: Any of the infectious diseases of man and other animals caused by species of Mycobacterium. [NIH] Tuberculostatic: Inhibiting the growth of Mycobacterium tuberculosis. [EU] Type 2 diabetes: Usually characterized by a gradual onset with minimal or no symptoms of metabolic disturbance and no requirement for exogenous insulin. The peak age of onset is 50 to 60 years. Obesity and possibly a genetic factor are usually present. [NIH] Tyrosine: A non-essential amino acid. In animals it is synthesized from phenylalanine. It is also the precursor of epinephrine, thyroid hormones, and melanin. [NIH] Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [NIH] Urea: A compound (CO(NH2)2), formed in the liver from ammonia produced by the deamination of amino acids. It is the principal end product of protein catabolism and constitutes about one half of the total urinary solids. [NIH] 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]

Urethritis: Inflammation of the urethra. [EU] Uric: A kidney stone that may result from a diet high in animal protein. When the body breaks down this protein, uric acid levels rise and can form stones. [NIH] Urinalysis: Examination of urine by chemical, physical, or microscopic means. Routine

Dictionary 117

urinalysis usually includes performing chemical screening tests, determining specific gravity, observing any unusual color or odor, screening for bacteriuria, and examining the sediment microscopically. [NIH] Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [NIH] Urinary tract: The organs of the body that produce and discharge urine. These include the kidneys, ureters, bladder, and urethra. [NIH] Urinary tract infection: An illness caused by harmful bacteria growing in the urinary tract. [NIH]

Urinate: To release urine from the bladder to the outside. [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] Urine Testing: Checking urine to see if it contains glucose (sugar) and ketones. Special strips of paper or tablets (called reagents) are put into a small amount of urine or urine plus water. Changes in the color of the strip show the amount of glucose or ketones in the urine. Urine testing is the only way to check for the presence of ketones, a sign of serious illness. However, urine testing is less desirable then blood testing for monitoring the level of glucose in the body. [NIH] Urobilinogen: A colorless compound formed in the intestines by the reduction of bilirubin. Some is excreted in the feces where it is oxidized to urobilin. Some is reabsorbed and reexcreted in the bile as bilirubin. At times, it is re-excreted in the urine, where it may be later oxidized to urobilin. [NIH] Urogenital: Pertaining to the urinary and genital apparatus; genitourinary. [EU] Uterus: The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in which a fetus develops. Also called the womb. [NIH] Vaccine: A substance or group of substances meant to cause the immune system to respond to a tumor or to microorganisms, such as bacteria or viruses. [NIH] Vagina: The muscular canal extending from the uterus to the exterior of the body. Also called the birth canal. [NIH] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vasoconstriction: Narrowing of the blood vessels without anatomic change, for which constriction, pathologic is used. [NIH] Vasodilator: An agent that widens blood vessels. [NIH] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Venous: Of or pertaining to the veins. [EU] Venous blood: Blood that has given up its oxygen to the tissues and carries carbon dioxide back for gas exchange. [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] Venules: The minute vessels that collect blood from the capillary plexuses and join together to form veins. [NIH] Vertebrae: A bony unit of the segmented spinal column. [NIH] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and

118 Urine tests

treatment of diseases in animals. [NIH] Viral: Pertaining to, caused by, or of the nature of virus. [EU] Virulence: The degree of pathogenicity within a group or species of microorganisms or viruses as indicated by case fatality rates and/or the ability of the organism to invade the tissues of the host. [NIH] Virus: Submicroscopic organism that causes infectious disease. In cancer therapy, some viruses may be made into vaccines that help the body build an immune response to, and kill, tumor cells. [NIH] Viscosity: A physical property of fluids that determines the internal resistance to shear forces. [EU] Vitreous Hemorrhage: Hemorrhage into the vitreous body. [NIH] Vitro: Descriptive of an event or enzyme reaction under experimental investigation occurring outside a living organism. Parts of an organism or microorganism are used together with artificial substrates and/or conditions. [NIH] Vivo: Outside of or removed from the body of a living organism. [NIH] Void: To urinate, empty the bladder. [NIH] White blood cell: A type of cell in the immune system that helps the body fight infection and disease. White blood cells include lymphocytes, granulocytes, macrophages, and others. [NIH]

Windpipe: A rigid tube, 10 cm long, extending from the cricoid cartilage to the upper border of the fifth thoracic vertebra. [NIH] X-ray: High-energy radiation used in low doses to diagnose diseases and in high doses to treat cancer. [NIH] Zymogen: Inactive form of an enzyme which can then be converted to the active form, usually by excision of a polypeptide, e. g. trypsinogen is the zymogen of trypsin. [NIH]

119

INDEX A Abdominal, 4, 79, 105, 111 Acceptor, 79, 105, 116 Acetylcholine, 79, 103 ACTH, 66, 79 Adenosine, 79, 85, 106 Adrenal Cortex, 79, 80, 81, 90, 93, 108 Adrenal Glands, 5, 79 Adrenal Medulla, 79, 86, 93, 104 Adrenergic, 79, 92, 93, 102, 114 Adverse Effect, 79, 113 Aerobic, 42, 79 Aerobic Exercise, 42, 79 Aerosol, 31, 79 Afferent, 12, 79 Affinity, 13, 79, 80, 113 Age of Onset, 80, 116 Agonist, 80, 87, 92, 102 Albumin, 5, 80, 107 Aldosterone, 44, 80 Alertness, 80, 85 Algorithms, 80, 84 Alkaline, 52, 80, 81, 83, 85, 114 Alkaline Phosphatase, 52, 80 Alkaloid, 80, 88, 102, 104 Alpha Particles, 80, 110 Alpha-1, 80 Alpha-Glucosidases, 14, 80 Alternative medicine, 31, 40, 51, 80, 89 Amantadine, 19, 80 Amenorrhea, 81, 82 Amino Acid Sequence, 81, 82, 95 Amino Acids, 81, 95, 106, 107, 109, 111, 116 Aminolevulinic Acid, 44, 81 Ammonia, 81, 116 Amphetamine, 19, 20, 81, 91 Amplification, 6, 81 Ampulla, 81, 87 Amylase, 44, 81 Anal, 81, 91, 93 Analgesic, 81, 100, 102, 104 Analogous, 81, 116 Analytes, 65, 66, 67, 68, 81 Androgenic, 81 Androstenedione, 28, 35, 81 Anemia, 81, 94, 97 Anesthesia, 26, 81

Anesthetics, 81, 93 Anions, 80, 81, 99 Anorexia, 37, 82 Anorexia Nervosa, 37, 82 Antagonism, 82, 85 Anthocyanins, 32, 82 Antibiotics, 82, 84 Antibodies, 12, 17, 52, 82, 83, 96, 107 Antibody, 50, 66, 80, 82, 88, 96, 98, 101, 102, 113 Anticoagulant, 82, 109 Antidepressant, 82, 90 Antigen, 79, 82, 88, 98, 101 Antihypertensive, 82, 102 Anti-inflammatory, 22, 82 Antioxidant, 37, 82, 83 Antiviral, 80, 82 Anus, 81, 82, 83, 92 Aorta, 82, 117 Aqueous, 82, 83, 100 Arginine, 34, 82, 103 Arterial, 82, 98, 109, 114 Arteries, 82, 84, 85, 90, 102 Arterioles, 82, 85 Ascorbic Acid, 23, 83, 105 Assay, 36, 43, 50, 83 Asymptomatic, 6, 83 Atrium, 83, 117 Autoantibodies, 52, 83 Autoantigens, 83 Autonomic, 79, 83, 104, 106 B Bacteria, 4, 49, 50, 82, 83, 84, 94, 96, 102, 117 Bacterium, 83, 88 Bacteriuria, 25, 38, 83, 117 Barium, 4, 83 Barium enema, 4, 83 Base, 83, 85, 95, 100 Benzoic Acid, 52, 83 Bile, 28, 83, 84, 95, 100, 112, 113, 117 Bile Acids, 28, 83, 113 Bile Acids and Salts, 83 Bile Ducts, 83, 84, 95 Biliary, 84, 85, 87 Biliary Tract, 84, 85 Bilirubin, 5, 44, 52, 80, 84, 95, 117 Bioavailable, 32, 84

120 Urine tests

Biochemical, 35, 84 Biofilms, 33, 84 Biological Markers, 12, 84 Biotechnology, 15, 35, 51, 59, 84 Biotransformation, 84 Blastocyst, 84, 89, 107 Blood Cell Count, 5, 65, 84, 97 Blood Coagulation, 84, 85, 115 Blood Glucose, 5, 14, 30, 35, 42, 43, 46, 52, 84, 97, 98, 99 Blood pressure, 4, 13, 43, 82, 84, 98, 102, 113 Blood urea, 5, 52, 85 Blood vessel, 42, 84, 85, 86, 92, 95, 99, 100, 106, 113, 117 Body Fluids, 85, 92, 113 Body Mass Index, 85, 105 Bone scan, 85, 112 Bowel, 4, 81, 85, 92, 99 Bradykinin, 85, 103, 107 Branch, 75, 85, 106, 113, 115 Breakdown, 85, 91, 95, 104 Bronchi, 85, 93, 94, 116 Bronchitis, 85, 87 C Caffeine, 21, 32, 85 Calcium, 5, 36, 37, 44, 66, 85, 88, 105, 114 Calcium Oxalate, 37, 85 Calculi, 31, 85 Canonical, 13, 85 Capillary, 38, 85, 117 Carbohydrate, 86, 95, 96, 107 Carbon Dioxide, 86, 90, 107, 111, 117 Carcinogenic, 86, 113 Carcinoma, 18, 86, 87, 91, 116 Cardiac, 6, 85, 86, 93, 96, 102, 113 Cardiorespiratory, 79, 86 Cardiovascular, 5, 52, 81, 86 Carotene, 86, 111 Carrier Proteins, 86, 107 Catalyse, 86, 116 Catecholamine, 86, 91 Cell Cycle, 11, 86 Cell Division, 83, 86, 107, 112 Cellulose, 86, 107 Central Nervous System, 79, 81, 85, 86, 88, 91, 96, 100, 102 Centrifugation, 86, 97 Centromere, 52, 86 Cerebral, 49, 86, 93 Cerebral Palsy, 49, 86 Cerebrum, 86

Cervical, 19, 47, 87 Cervix, 87, 111 Check-up, 4, 87 Chest Pain, 4, 87 Chlamydia, 10, 19, 50, 87 Cholestasis, 28, 87 Cholesterol, 5, 83, 87, 95, 113 Chromatin, 87, 104 Chromosomal, 81, 87 Chromosome, 86, 87, 100, 112 Chronic, 8, 12, 13, 33, 39, 51, 87, 89, 98, 100, 112, 114 Chronic Disease, 51, 87 Chronic Obstructive Pulmonary Disease, 8, 87 Chronic prostatitis, 33, 87 CIS, 64, 68, 87, 111 Citrus, 83, 87 Clear cell carcinoma, 87, 91 Clinical trial, 6, 59, 87, 89, 90, 102, 109, 110 Clomiphene, 19, 87 Cloning, 84, 87 Cluster Analysis, 13, 87 Coagulation, 4, 84, 85, 88, 107, 115 Coca, 88 Cocaine, 8, 9, 19, 22, 24, 25, 26, 30, 32, 88 Codons, 88, 95 Coenzyme, 83, 88 Cognitive restructuring, 88, 114 Colitis, 4, 88, 99 Colloidal, 80, 88, 92 Competency, 10, 88 Complement, 88, 89, 107 Complementary and alternative medicine, 31, 40, 89 Complementary medicine, 31, 89 Computational Biology, 59, 89 Computed tomography, 89, 112 Computerized axial tomography, 89, 112 Conception, 89, 94, 108 Concretion, 85, 89 Condoms, 10, 89 Cones, 89, 111 Conjugated, 83, 89, 103, 111 Connective Tissue, 83, 89, 101, 106, 111 Consciousness, 81, 89, 91, 92 Consumption, 23, 29, 33, 34, 89, 104, 111 Contamination, 21, 28, 89 Contraindications, ii, 89 Contrast Media, 23, 89 Control group, 9, 10, 89 Controlled study, 16, 90

Index 121

Cornea, 90, 96, 114 Coronary, 90, 102 Coronary Thrombosis, 90, 102 Corpus, 90, 106, 108 Corpus Luteum, 90, 108 Cortisol, 13, 80, 90 Cotinine, 3, 90 Creatine, 31, 34, 90 Creatinine, 4, 5, 34, 44, 52, 90 Creatinine clearance, 44, 90 Curative, 90, 115 Cyclic, 85, 90, 96, 103, 107 Cystitis, 12, 90, 105 D Databases, Bibliographic, 59, 90 Deamination, 90, 116 Decarboxylation, 90, 102 Decidua, 90, 107 Delivery of Health Care, 90, 96 Delusions, 90, 109 DES, 13, 91 Dextroamphetamine, 81, 91 Diabetes Mellitus, 27, 39, 43, 91, 95, 97, 99 Diabetic Retinopathy, 52, 91, 106 Diagnostic procedure, 51, 91 Diastolic, 91, 98 Dietitian, 45, 91 Digestion, 14, 83, 84, 85, 91, 99, 100, 105, 114 Digestive tract, 91, 113 Direct, iii, 4, 91, 92, 110 Disaccharides, 14, 91 Discriminant Analysis, 13, 91 Dissociation, 79, 91, 99 Diuresis, 85, 91 Diuretic, 91, 108 Dopa, 29, 91, 100 Dopamine, 44, 80, 81, 88, 91, 100, 102 Doping, 36, 92 Dose-dependent, 15, 92 Dreams, 33, 92 Drug Interactions, 92 Duct, 81, 92, 94, 112 Duodenum, 83, 92, 105, 112, 114 E Ectopic, 16, 18, 26, 92 Ectopic Pregnancy, 16, 18, 26, 92 Edema, 39, 91, 92 Efficacy, 8, 10, 11, 14, 18, 31, 92, 116 Electrocoagulation, 88, 92 Electrolyte, 80, 92, 108, 113 Electrons, 82, 83, 92, 99, 105, 110

Electrophoresis, 13, 38, 92 Emphysema, 87, 92 Endometrium, 90, 92, 101 Endoscopy, 42, 92 Endothelium, 92, 103 Endothelium-derived, 92, 103 Enema, 4, 83, 92 Environmental Exposure, 84, 92 Environmental Health, 58, 60, 93 Enzymatic, 85, 86, 88, 93, 111 Enzyme, 11, 80, 81, 84, 88, 93, 96, 97, 102, 106, 107, 115, 118 Enzyme Inhibitors, 93, 107 Epidemic, 6, 93 Epidemiologic Studies, 84, 93 Epigastric, 93, 105 Epinephrine, 44, 79, 91, 93, 104, 116 Epithelial, 49, 90, 93 Erectile, 52, 93, 106 Erection, 93 Erythrocyte Indices, 84, 93 Erythrocytes, 81, 84, 93, 110 Esophagus, 91, 93, 114 Estradiol, 93 Estriol, 44, 93 Estrogen, 13, 87, 93 Estrogen receptor, 87, 93 Excrete, 5, 93 Exercise Therapy, 14, 93 Exocrine, 24, 94, 105 Exogenous, 84, 94, 116 Expectorant, 94, 108 Extracellular, 84, 89, 94, 113, 114 Extrapyramidal, 80, 92, 94 F Family Planning, 59, 94 Family Relations, 7, 94 Fat, 83, 86, 94, 100, 105, 111, 116 Fatigue, 13, 39, 94 Fatty acids, 80, 94 Feces, 94, 117 Fetus, 94, 107, 108, 117 Fibrinogen, 94, 107, 115 Folate, 34, 94 Folic Acid, 94 Follicular Phase, 13, 94 Food Exchange, 42, 94 Forearm, 84, 94 Fructosamine, 43, 94 Fructose, 94, 96 Fundus, 15, 94, 105 Fungistatic, 83, 95

122 Urine tests

G Gallbladder, 79, 83, 84, 94, 95 Gallstones, 4, 83, 95 Gas, 65, 81, 86, 95, 97, 103, 104, 117 Gastrin, 95, 97 Gastrointestinal, 83, 85, 93, 95, 114 Gastrointestinal tract, 83, 95 Gene, 66, 84, 95, 99, 112 Genetic Code, 95, 104 Gestation, 45, 95, 107 Gestational, 45, 95 Gland, 5, 34, 79, 87, 95, 101, 103, 105, 107, 109, 112, 113, 115 Glipizide, 14, 95 Glomerular, 67, 95 Glomerulus, 95 Glucose Intolerance, 14, 91, 95 Glucose tolerance, 15, 43, 52, 95 Glucose Tolerance Test, 15, 43, 52, 67, 95 Glycine, 81, 83, 96 Glycogen, 80, 87, 96 Glycogen Storage Disease, 80, 96 Glycosaminoglycan, 11, 96 Glycoside, 91, 96, 112 Glycosuria, 18, 96 Gonadal, 96, 113 Gonorrhea, 10, 96 Governing Board, 96, 108 Grade, 11, 18, 22, 96 Gram-negative, 87, 96 Granulocytes, 96, 100, 118 Growth, 11, 12, 82, 95, 96, 107, 112, 115, 116 Guanylate Cyclase, 96, 103 H Haptens, 80, 96 Headache, 85, 96 Health Care Costs, 9, 11, 96, 97 Health Education, 9, 97 Health Expenditures, 96, 97 Hematocrit, 52, 84, 93, 97 Heme, 36, 81, 84, 97, 103, 107 Hemoglobin, 4, 5, 42, 43, 44, 52, 81, 84, 93, 97, 107 Hemoglobin A, 52, 97, 107 Hepatic, 80, 95, 97 Hepatocyte, 87, 97 Heredity, 51, 95, 97 Heterogeneity, 80, 97 Hormonal, 13, 97 Hormone, 5, 36, 42, 79, 80, 84, 90, 91, 93, 95, 97, 99, 105, 108, 111, 112, 114, 115

Hyaluronidase, 11, 20, 97 Hydrogen, 79, 83, 86, 97, 102, 103, 105, 109 Hyperglycemia, 14, 97 Hyperplasia, 34, 97 Hypersensitivity, 98, 111 Hypertension, 6, 96, 98 Hypertrophy, 49, 97, 98 Hypoglycemia, 52, 98 Hypoglycemic, 95, 98 Hypothalamus, 98, 107 I Id, 38, 66, 68, 69, 74, 76, 98 Immune response, 82, 83, 96, 98, 114, 118 Immune system, 42, 98, 117, 118 Immunodeficiency, 10, 98 Immunoglobulin, 82, 98, 102 Immunology, 79, 98 Impairment, 87, 98, 102, 109 Impotence, 4, 93, 98 In vitro, 11, 37, 98 In vivo, 22, 26, 36, 98 Incision, 98, 99 Indicative, 43, 98, 105, 117 Infancy, 37, 98 Infarction, 90, 98, 102 Infection, 4, 10, 17, 19, 20, 21, 26, 48, 51, 83, 98, 100, 101, 103, 111, 114, 117, 118 Inflammation, 4, 80, 82, 85, 87, 88, 90, 98, 99, 109, 111, 116 Inflammatory bowel disease, 4, 99 Ingestion, 17, 22, 35, 36, 37, 38, 95, 99, 114 Inhalation, 31, 79, 99 Inotropic, 92, 99 Insight, 42, 99 Insulin, 5, 14, 35, 42, 43, 45, 52, 95, 99, 116 Insulin-dependent diabetes mellitus, 99 Intensive Care, 37, 99 Interstitial, 12, 99, 105 Intestinal, 86, 95, 99 Intestine, 14, 83, 84, 85, 92, 97, 99, 100, 110, 113 Intracellular, 85, 98, 99, 103, 108 Intravenous, 4, 99 Intravenous pyelogram, 4, 99 Intravesical, 33, 99 Intrinsic, 80, 99 Introns, 99 Invasive, 6, 99, 101 Ionization, 13, 32, 99 Ionizing, 24, 80, 92, 99 Ions, 83, 91, 92, 97, 99 Isoniazid, 20, 29, 100

Index 123

K Kb, 58, 100 Keto, 100, 116 Kidney Disease, 4, 34, 58, 64, 100 Kidney stone, 34, 44, 100, 116 Kinetic, 99, 100 L Large Intestine, 91, 99, 100, 110, 113 Leprosy, 29, 100 Leucocyte, 18, 80, 100 Leukocytes, 84, 96, 100 Levo, 91, 100 Levodopa, 91, 100 Library Services, 74, 100 Ligament, 100, 109 Linkages, 8, 80, 97, 100 Lipid, 4, 43, 99, 100, 116 Liposome, 31, 100 Liver, 4, 5, 26, 67, 79, 80, 83, 84, 94, 95, 96, 97, 100, 112, 116 Liver scan, 100, 112 Localized, 98, 101, 107, 112 Lumbar, 67, 101 Luteal Phase, 13, 101 Lymph, 87, 92, 101, 103 Lymph node, 87, 101, 103 Lymphatic, 92, 98, 101 Lymphoid, 82, 100, 101 M Magnetic Resonance Imaging, 42, 101, 112 Malignancy, 16, 101 Malnutrition, 80, 101 Manic, 101, 109 Manic-depressive psychosis, 101, 109 Mediate, 92, 101 Mediator, 91, 101 MEDLINE, 59, 101 Membranes, 85, 86, 100, 101, 111 Memory, 48, 82, 101 Menstrual Cycle, 13, 94, 101, 108 Menstruation, 81, 90, 94, 101 Mental Disorders, 9, 101, 109 Mental Health, iv, 6, 43, 58, 60, 102 Metabolite, 28, 84, 93, 102 Metastasis, 11, 102 Methyldopa, 28, 102 MI, 77, 102 Microbe, 102, 115 Microbiology, 17, 83, 84, 102 Milligram, 4, 102 Mobilization, 36, 102 Molecular, 11, 12, 59, 61, 84, 89, 94, 102

Molecule, 82, 83, 88, 91, 92, 96, 102, 105, 110 Monitor, 11, 27, 29, 46, 48, 90, 102, 104 Monoamine, 81, 91, 102 Monoclonal, 20, 102 Morphine, 29, 102, 103, 104 Motivations, 7, 102 Mucins, 102, 112 Multicenter study, 15, 102 Myocardium, 102 Myoglobin, 44, 103, 107 N Narcotic, 102, 103 NCI, 1, 57, 64, 68, 87, 103 Necrosis, 98, 102, 103 Need, 3, 6, 12, 41, 43, 44, 45, 46, 51, 66, 70, 79, 96, 103, 115 Nephrectomy, 34, 103 Nephropathy, 52, 100, 103 Nerve, 12, 67, 79, 81, 101, 103, 105, 111, 113, 116 Nervous System, 79, 81, 85, 86, 88, 91, 96, 100, 101, 102, 103, 106, 114 Networks, 13, 103 Neural, 13, 79, 103 Neurogenic, 17, 103 Neurons, 88, 100, 103 Neuropathy, 52, 103 Neutrons, 80, 103, 110 Nitric Oxide, 12, 103 Nitrocamptothecin, 31, 104 Nitrogen, 5, 52, 80, 104, 105 Norepinephrine, 44, 79, 91, 102, 104 Nuclear, 12, 42, 92, 94, 103, 104 Nuclear Family, 94, 104 Nuclear Matrix, 12, 104 Nuclear Medicine, 42, 104 Nuclear Pore, 104 Nuclei, 80, 92, 99, 101, 103, 104, 109 Nucleic acid, 6, 95, 104, 108 Nucleolus, 104, 111 Nucleus, 12, 87, 90, 103, 104, 109 Nutritional Status, 4, 104 O Odds Ratio, 104, 110 Opium, 102, 104 Opsin, 104, 111 Optic Disk, 91, 105 Osmotic, 80, 105 Outpatient, 7, 8, 19, 105 Ovary, 81, 90, 93, 105 Overweight, 42, 46, 105

124 Urine tests

Ovulation, 19, 87, 94, 101, 105 Ovum, 90, 95, 105, 108 Oxalic Acid, 85, 105 Oxidation, 79, 82, 84, 105 P Painful bladder syndrome, 12, 105 Palliative, 105, 115 Pancreas, 42, 79, 99, 105, 112 Pancreatic, 24, 105 Pancreatic Insufficiency, 24, 105 Parathyroid, 36, 105, 114 Parathyroid Glands, 105 Particle, 100, 105 Pathogenesis, 12, 105 Pathologic, 21, 90, 98, 105, 117 Pathophysiology, 12, 106 Patient Care Team, 43, 106 Patient Compliance, 28, 106 Patient Participation, 43, 106 Pelvic, 6, 12, 33, 106, 109 Penis, 89, 106, 111 Pepsin, 106, 112 Peptide, 106, 107, 109 Perception, 13, 106 Peripheral Nerves, 100, 106 Peripheral Nervous System, 102, 106, 114 Pharmacokinetic, 106 Pharmacologic, 81, 106, 115 Phenotype, 84, 106 Phosphates, 44, 106 Phosphorus, 85, 105, 106 Photocoagulation, 88, 106 Physical Examination, 87, 106 Physical Fitness, 93, 106 Physiologic, 80, 91, 101, 107, 110 Physiology, 33, 42, 84, 107 Pigment, 84, 103, 107 Pilot study, 9, 33, 107 Pituitary Gland, 5, 107 Placenta, 45, 93, 107, 108 Plants, 80, 86, 87, 88, 95, 96, 104, 105, 107, 112, 115 Plasma, 13, 37, 38, 80, 82, 94, 95, 97, 107, 113 Plasma cells, 82, 107 Plasma protein, 13, 80, 107 Platelet Aggregation, 103, 107 Platelet Count, 5, 107 Platelets, 103, 107 Polymers, 84, 107, 109 Polypeptide, 81, 94, 103, 107, 118 Polysaccharide, 82, 86, 96, 107

Porphyrins, 44, 107 Posterior, 81, 105, 108 Postherpetic Neuralgia, 80, 108 Postprandial, 15, 108 Potassium, 5, 31, 44, 67, 80, 108 Potassium Citrate, 31, 108 Practicability, 108, 116 Practice Guidelines, 60, 108 Precursor, 81, 91, 93, 100, 104, 108, 116 Pregnancy Complications, 46, 108 Prenatal, 44, 108 Prenatal Care, 44, 108 Prevalence, 9, 26, 104, 108 Prion, 48, 108 Problem Solving, 8, 108 Progesterone, 13, 108, 113 Progression, 11, 34, 48, 108 Progressive, 96, 103, 108 Projection, 104, 108 Prostate, 5, 34, 87, 109, 111 Prostate gland, 34, 87, 109 Prostatitis, 33, 87, 109 Protein C, 12, 80, 81, 109, 116 Protein S, 84, 95, 109, 111 Proteinuria, 21, 26, 109 Protocol, 6, 8, 15, 48, 109 Protons, 80, 97, 99, 109, 110 Psychiatric, 84, 101, 109 Psychosis, 32, 95, 101, 109 Psychotomimetic, 81, 91, 109 Public Policy, 59, 109 Pulmonary, 8, 39, 84, 87, 89, 109, 117 Pulmonary Artery, 84, 109, 117 Pulse, 102, 109 Pyridoxal, 109, 116 R Race, 6, 28, 91, 92, 109 Radiation, 24, 93, 99, 110, 112, 118 Radioactive, 85, 97, 99, 100, 104, 110, 112 Radiography, 89, 110 Radiology, 23, 104, 110 Randomized, 8, 10, 15, 32, 92, 110 Reabsorption, 44, 110 Reagent, 21, 28, 105, 110 Reality Testing, 109, 110 Receptor, 82, 87, 92, 93, 110 Rectum, 82, 83, 91, 95, 99, 100, 109, 110 Recurrence, 11, 49, 101, 110 Red blood cells, 4, 93, 110, 112 Refer, 1, 42, 88, 103, 109, 110 Regimen, 5, 92, 106, 110 Regression Analysis, 91, 110

Index 125

Relapse, 8, 110 Relative risk, 9, 110 Reliability, 29, 110 Remission, 101, 110, 111 Renal pelvis, 100, 111, 116 Reproductive system, 109, 111 Research Design, 10, 111 Respiration, 86, 102, 111 Retina, 89, 91, 111, 112 Retinal, 15, 91, 105, 111 Retinol, 111 Retroperitoneal, 79, 111 Rheumatism, 111 Rheumatoid, 27, 39, 111 Rheumatoid arthritis, 27, 111 Ribonucleoproteins, 104, 111 Ribosome, 111, 116 Risk factor, 19, 34, 42, 45, 93, 110, 111 Risk-Taking, 9, 112 Rods, 111, 112 S Saccharin, 34, 112 Saliva, 13, 112 Salivary, 13, 112 Salivary glands, 112 Saponins, 112, 113 Scans, 4, 42, 112 Scleroderma, 52, 112 Screening, 5, 6, 15, 19, 26, 27, 65, 68, 87, 112, 117 Secondary tumor, 102, 112 Secretin, 67, 112 Secretion, 14, 99, 102, 105, 112 Sediment, 112, 117 Segregation, 83, 112 Self Care, 43, 112 Sella, 107, 112 Semen, 109, 112 Serum, 5, 13, 16, 21, 24, 28, 35, 39, 50, 80, 88, 113 Side effect, 79, 113, 115 Signs and Symptoms, 110, 111, 113 Small intestine, 14, 84, 92, 97, 99, 113 Smooth muscle, 85, 102, 113, 114 Social Support, 5, 8, 43, 113, 114 Sodium, 5, 31, 34, 44, 68, 80, 110, 113 Specialist, 69, 113 Species, 87, 93, 102, 109, 113, 116, 118 Specificity, 4, 80, 113 Spinal cord, 33, 86, 87, 103, 106, 113 Staging, 112, 113 Sterile, 105, 113

Steroid, 13, 81, 83, 90, 112, 113 Stimulant, 81, 85, 90, 91, 113 Stimulus, 113, 115 Stomach, 4, 79, 91, 93, 94, 95, 97, 106, 112, 113, 114 Stress, 13, 43, 86, 90, 111, 114 Stress management, 43, 114 Stroma, 11, 114 Subacute, 31, 98, 114 Subclinical, 98, 114 Substance P, 102, 112, 114 Sulfhydryl Compounds, 23, 114 Supplementation, 31, 34, 37, 38, 114 Support group, 43, 114 Sympathomimetic, 81, 91, 92, 93, 104, 114 Symphysis, 109, 114 Symptomatic, 80, 114 Symptomatic treatment, 80, 114 Systemic, 82, 84, 93, 98, 108, 112, 114 Systolic, 98, 114 T Testis, 81, 93, 114 Testosterone, 81, 114 Tetany, 105, 114 Tetrahydrocannabinol, 22, 35, 114 Therapeutics, 17, 115 Thorax, 17, 101, 115 Threshold, 27, 98, 115 Thrombin, 94, 107, 109, 115 Thrombomodulin, 109, 115 Thyroid, 5, 25, 105, 115, 116 Thyroid Gland, 105, 115 Thyroxine, 5, 80, 115 Time Management, 114, 115 Tin, 4, 115 Tolerance, 15, 43, 52, 67, 95, 115 Topical, 26, 115 Topoisomerase inhibitors, 104, 115 Toxic, iv, 93, 103, 115 Toxicity, 31, 92, 115 Toxicokinetics, 115 Toxicologic, 37, 115 Toxicology, 19, 22, 23, 30, 31, 32, 35, 36, 60, 115 Toxins, 82, 98, 115 Trace element, 115, 116 Trachea, 85, 94, 115, 116 Transaminase, 5, 116 Transfection, 11, 84, 116 Transitional cell carcinoma, 18, 116 Translation, 9, 116 Transmitter, 79, 91, 101, 102, 104, 116

126 Urine tests

Treatment Outcome, 7, 10, 116 Triglyceride, 5, 116 Tuberculosis, 22, 34, 48, 89, 100, 116 Tuberculostatic, 100, 116 Type 2 diabetes, 3, 21, 42, 116 Tyrosine, 91, 116 U Unconscious, 81, 98, 116 Urea, 5, 44, 52, 85, 116 Ureter, 111, 116 Urethra, 106, 109, 116, 117 Urethritis, 18, 27, 116 Uric, 44, 116 Urinalysis, 4, 23, 116 Urinary, 3, 11, 12, 13, 16, 20, 21, 27, 28, 32, 37, 40, 49, 64, 83, 85, 90, 116, 117 Urinary tract, 16, 20, 32, 49, 83, 117 Urinary tract infection, 20, 32, 83, 117 Urinate, 117, 118 Urine Testing, 9, 23, 44, 47, 50, 117 Urobilinogen, 44, 117 Urogenital, 96, 117 Uterus, 87, 90, 92, 94, 101, 108, 111, 117 V Vaccine, 109, 117 Vagina, 87, 91, 101, 111, 117

Vascular, 92, 98, 103, 107, 115, 117 Vasoconstriction, 93, 117 Vasodilator, 85, 92, 117 Vein, 99, 104, 117 Venous, 84, 107, 109, 117 Venous blood, 84, 107, 117 Ventricle, 49, 98, 109, 114, 117 Venules, 85, 117 Vertebrae, 113, 117 Veterinary Medicine, 59, 117 Viral, 11, 118 Virulence, 115, 118 Virus, 10, 47, 118 Viscosity, 97, 118 Vitreous Hemorrhage, 91, 118 Vitro, 11, 37, 98, 118 Vivo, 22, 26, 36, 98, 118 Void, 6, 18, 118 W White blood cell, 5, 82, 100, 101, 107, 118 Windpipe, 115, 118 X X-ray, 42, 83, 89, 99, 104, 110, 112, 118 Z Zymogen, 109, 118

Index 127

128 Urine tests

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