CHAPTER 19 QUALIFIERS (SUBHEADINGS)
19.1 DEFINITION AND PURPOSE
19.1.1 Subheadings provide a convenient method of grouping constantly
recurring aspects of a concept. Material on various subjects appears to fall
into large natural groups. Studies on organs tend to be about anatomy,
physiology, pathology, etc., whereas drug studies tend to cover metabolism,
therapeutic use, etc.
These natural categories or frequently discussed aspects of a subject or of main
headings are grouped under what MeSH calls subheadings or qualifiers. A
subheading is attached directly to the main heading which it qualifies,
separated from it by a slash ( / ) and spaces in the indexing operation. For
form see sections 9.2.2 and 9.2.3.
BRAIN / pathol SODIUM / metab
COMA / etiol VACCINATION / hist
A subheading will always answer the question "What aspect of this main heading
is the author writing about or discussing?"
19.1.2 When an indexer has decided upon the main headings which best
describe the article, the next step in indexing is to consider the standpoint
from which the author treats each subject. This narrowing down of a main
heading generally involves indexing one of the subheadings available for the
main heading. In this way, if a searcher is not interested in all aspects of a
drug, for example, but only in its metabolism, the search need refer only to the
subheading /metabolism with the drug, thus eliminating articles indexed under
the subheadings /therapeutic use, /toxicity, etc.
19.1.3 It is the responsibility of the indexer to index the article where
it most faithfully reflects the slant and meaning of the discussion, first by
choosing the correct main headings and second by pinpointing the slant of each
main heading in the form of the correct subheading.
19.1.4 Often the article needs more than one subheading on a single main
heading. An article on the pathology and metabolism of the liver is indexed as
LIVER/pathology and LIVER/metabolism; an article on the diagnosis, complications
and therapy of hepatitis is indexed as HEPATITIS/diagnosis,
HEPATITIS/complications and HEPATITIS/therapy.
The permissible number of subheadings with the same main heading, and the number
which may be made IM, is discussed in sections 19.5 and 19.6.
19.1.5 Occasionally the slant of an article does not fit comfortably into
the subheadings available to the main heading. In such cases the indexer is not
obliged to force the use of a subheading.
NO subheading is preferable to a WRONG one or a MISLEADING one.
19.2 ASSIGNMENT OF SUBHEADINGS
19.2.1 There are currently 82 subheadings available for indexing and
searching; however, not every subheading makes sense with every MeSH heading.
For example, an article can discuss the /ultrastructure of an organ but not of a
therapeutic technique, the /pharmacology of a drug but not of an instrument,
/drug effects on an organ but not on hospitals, etc.
MeSH has therefore limited the subheadings that can be assigned to any given
term. This limitation is created by a field known as the AQ field in the MeSH
record for each main heading (AQ stands for "allowable qualifiers"). A
subheading, or qualifier, cannot be used with any heading unless it is an AQ for
that term; any other subheading will be rejected by the computer.
While the use of an AQ field in theory allows complete individualization of the
allowable subheadings for each MeSH term, in practice it would be impossible for
the MeSH Section to evaluate each of the more than 14,000 MeSH heading records
to decide which subheadings could apply to each term. Therefore, using the fact
that terms are assigned to MeSH tree categories based on their similarities to
other MeSH terms in the same tree, MeSH has created arbitrary groupings which
contain the AQs most likely to be applicable to terms within that grouping. For
example, the general D list of AQs contains the subheadings most likely to apply
to Category D terms (chemicals) in general. In addition, subgroupings exist
within D; the ENZYMES list more specifically contains AQs for the enzymes
within the D8 tree. The subheading /genetics is not allowed with general
Category D terms, because most chemicals are not endogenous, but it is allowed
with terms from the ENZYMES list.
Once subheadings have been assigned generically within these groups, MeSH can
"fine-tune" the AQs for individual terms as the need arises. For instance,
SNAKE VENOMS is assigned to subcategory D24 only, for which the subheading
/enzymology is not an AQ; however, /enzymology is an AQ for SNAKE VENOMS.
19.2.2 Prior to 1990, the system for assigning subheadings to terms was far
less flexible. Almost all subheadings were assigned by category only, and there
were only approximately 20 possible groupings. Except for a very few terms for
which "extended subheadings" were created, if the subheading desired for a given
term did not seem reasonable with most other terms from the same category,
chances were slim that the subheading would ever be permitted with the category.
Now, the subheading need only be added as an AQ to any terms with which it is
reasonable.
19.2.3 Since the computer is programmed to accept a subheading with a main
heading only if so assigned, a combination of a main heading and a subheading
NOT legitimately assigned will be rejected by the computer. The combination
must then be corrected and re-input.
19.3 INVALID MAIN HEADING/SUBHEADING COMBINATIONS
19.3.1 There are many MAIN HEADING/subheading combinations which are
invalid because MeSH has provided a specific pre-coordinated term for the
combination; if an indexer attempts to index the concept using the MAIN
HEADING/subheading it will be rejected.
Here are a few examples from the several hundred programmed for rejection:
Invalid Correct
ARM / injuries ARM INJURIES
ACCIDENTS / prevention & control ACCIDENT PREVENTION
HISTOLOGY / methods HISTOLOGICAL TECHNIQUES
BURNS / chemically induced BURNS, CHEMICAL
GLUCOSE / blood BLOOD GLUCOSE
Each main heading which has one of these pre-coordinated terms available has
been annotated to warn indexers not to index the
MAIN HEADING/subheading combination.
19.3.2 MeSH also provides annotations on other forbidden combinations which
involve a conflict with established indexing rules. For example, HEART, "the
pump," has one set of allowable subheadings and MYOCARDIUM, the heart as tissue,
has another set, even though the same array of subheadings is available to both
HEART and MYOCARDIUM in the list of Category A qualifiers.
19.3.3 When a subheading is needed with a term for which it is not an AQ,
index the main heading without a subheading as IM and use a main heading
duplicate or near-duplicate of the subheading as an NIM coordinate, if available
(see section 19.7).
An article on copying machines is indexed as
* COPYING PROCESSES
EQUIPMENT AND SUPPLIES
since /instrumentation is not an AQ for COPYING PROCESSES.
Since main headings tend to have the most commonly used subheadings as AQs, the
principle above is not needed very often.
19.4 RULES ON THE USE OF SUBHEADINGS
19.4.1 The section entitled INDEXING OPERATION defines indexing as "the
process of assigning to an article the headings from MEDICAL SUBJECT HEADINGS
(MeSH) ... which best describe the content and substance as written by the
author" (section 4.1).
Depth indexing (section 5.1) requires the indexer to use as many headings as are
needed to cover major and minor aspects of an article.
Section 6, INDEX MEDICUS HEADINGS AND NON-INDEX MEDICUS HEADINGS, discusses the
process by which an indexer must decide which headings are the point of the
article and will be printed in INDEX MEDICUS (the IM headings) and which are
discussed but not the main point and so will be stored in the computer (the NIM
headings).
The practice of qualifying a main heading with a subheading does not modify the
principles of multiple headings given above. The indexer will cover all aspects
of any article, using as many headings as needed to describe the article
faithfully and making a judgment as to which concepts are to be IM and which
NIM. But in addition each main heading must, if possible, be qualified by the
correct subheading.
19.4.2 Since the subheading is designed to answer the question, "Given a
main heading, what aspects of it is the author discussing?", the indexer must
ask and answer this question for every main heading used.
If an article is about the metabolism of the liver in arthritis as well as the
effect of aspirin therapy on the metabolic function, the indexer must consider
the following questions:
1. What aspect of LIVER?
2. What aspect of ARTHRITIS?
3. What aspect of ASPIRIN?
The answers in the same order are:
1a. the metabolic aspect of the LIVER
1b. drug effects on the LIVER
2a. the metabolic aspect of ARTHRITIS
2b. the drug therapy of ARTHRITIS
3a. the effect of ASPIRIN
3b. the therapeutic aspect of ASPIRIN
The article will then be indexed accordingly, using the appropriate subheadings:
1a. LIVER / metabolism
1b. LIVER / drug effects
2a. ARTHRITIS / metabolism
2b. ARTHRITIS / drug therapy
3a. ASPIRIN / pharmacology
3b. ASPIRIN / therapeutic use
19.5 MULTIPLE SUBHEADINGS AND TREEING OF SUBHEADINGS
19.5.1 Just as MeSH terms are treed according to their relationship with
other similar terms, and are arranged hierarchically by their level of
specificity, MeSH subheadings may also be treed (see Figure 19.5). Indexers
should use the subheading trees in the same way they use the trees for main
headings, i.e., at all times indexing the most specific subheading available to
cover the concept needed for a given article, but using the trees to group
related concepts.
For example, if an article is only about the radiography of brain tumors, the
correct indexing is
BRAIN NEOPLASMS / * radiogr
However, if the article is on the radiography, radionuclide imaging, and
ultrasonography of the brain neoplasms, the indexer may index each of these
concepts NIM but needs a way to group them for the IM; by looking at Figure 19.5
it can be seen that the correct indexing for the IM is
BRAIN NEOPLASMS / * diag
In addition, if BRAIN NEOPLASMS is just one of many terms to be indexed for the
article, or if the article is in a priority 3 journal, the indexer will probably
not want to index it with three subheadings at all; by using the subheading
trees the decision can be made to cover the 3 related concepts with one
subheading
BRAIN NEOPLASMS / diag (IM or NIM depending on the article)
19.5.2 Indexers should not use more than three subheadings with any main
heading except in very rare circumstances. For any article in which more
than three subheadings seem to be needed with one main heading, the indexer
should use the subheading trees in an attempt to reduce the number of
subheadings required.
For example, if an article is about many aspects of a disease and substantively
discusses diagnosis, epidemiology, genetic aspects, and therapy, each of these
subheadings may be indexed because they have no relationship with one another in
the subheading trees.
If, however, the article discusses diagnosis, therapy, epidemiology, and
mortality of the disease, the last subheading should not be indexed because it
is a subset of /epidemiology in the subheading trees.
19.5.3 The following subheadings were not assigned by MeSH to any part of
the subheading tree:
/class /inj /psychol
/drug eff /instrum /rad eff
/educ /methods /vet
/hist /pathogen
SUBHEADING TREES, used to group related concepts.
/adv eff
/pois
/tox
/anal
/blood
/csf
/isol
/urine
/anat
/blood supply
/cytol
/pathol
/ultrastruct
/embryol
/abnorm
/innerv
/chem
/agon
/analogs
/antag
/chem syn
/compl
/second
/cytol
/pathol
/ultrastruct
/diag
/pathol
/radiogr
/radionuclide
/ultrasonogr
/embryol
/abnorm
/epidemiol
/ethnol
/mortal
/etiol
/chem ind
/compl
/second
/congen
/embryol
/genet
/immunol
/microbiol
/virol
/parasitol
/transm
/metab
/biosyn
/blood
/csf
/defic
/enzymol
/pharmacokin
/urine
/microbiol
/virol
/organ
/econ
/legis
/man
/stand
/supply
/trends
/util
/pharmacol
/admin
/adv eff
/pois
/tox
/agon
/antag
/contra
/diag use
/pharmacokin
/physiol
/genet
/growth
/immunol
/metab
/biosyn
/blood
/csf
/defic
/enzymol
/pharmacokin
/urine
/physiopathol
/secret
/statist
/epidemiol
/ethnol
/mortal
/surg
/transpl
/ther use
/admin
/adv eff
/contra
/pois
/ther
/diet ther
/drug ther
/nurs
/prev
/radiother
/rehabil
/surg
/transpl
Figure 19.5
19.6 NUMBER OF SUBHEADINGS IM
19.6.1 In general it is indexing policy to make only one subheading IM with
any given term indexed, but the rule is not absolute. If two subheading
concepts are both the main point of the article, if they cannot be treed (either
one under the other or both under a more general subheading as in Figure 19.5),
if they are discussed to the same extent in the article, and if neither is the
subject of the journal as a whole, then both may be made IM. However, in most
cases there is some reason to choose one of the two to be the IM subheading.
Diagnosis and therapy of hemolytic anemia.
(This title is from a journal on general internal medicine; diagnosis and
therapy are each discussed for approximately 2 pages).
Since /diag and /ther are not in the same subheading tree, this article should
be indexed as
ANEMIA, HEMOLYTIC / * diag / * ther
Diagnosis and therapy of hemolytic anemia.
(This title is from the same journal, but diagnosis is discussed for the first 3
pages of the article and therapy for just 1 page).
The article should be indexed as
ANEMIA, HEMOLYTIC / * diag / ther
Radiographic and radionuclide imaging of brain disorders.
/radiogr and /radionuclide are both treed under /diag in the subheading trees,
so the article should be indexed as
BRAIN DISEASES / * diag
(Either or both /radiogr and /radionuclide may be added NIM depending on the
length of the article, how much each aspect is discussed, the number of other
concepts to be indexed, priority of the journal, etc.)
Pathology and therapy of liver diseases.
(This title is from a journal published by a pathology society; pathology and
therapy are discussed equally).
It should be indexed as
LIVER DISEASES / * pathol / ther
Pathology and therapy of liver diseases.
(This title is from the same pathology society journal, but therapy is discussed
for 3 pages, and pathology for just 1 page).
It should be indexed as
LIVER DISEASES / * ther / pathol
19.6.2 Indexers should not make three or more subheadings IM with the same
MeSH heading. If that many subheadings seem to be the main point, are discussed
equally, etc., the subheading trees (Figure 19.5) should be consulted; in all
likelihood at least two of the subheadings can be treed so that the number of IM
subheadings needed is fewer.
Diagnosis, ultrasonographic imaging, and epidemiology of kidney
diseases.
(This title is from a general medicine journal and all 3 concepts are discussed
equally).
Since /ultrasonogr is treed under /diag in the subheading trees, both concepts
can be covered by /*diag; /*diag is thus approximately two-thirds of the
article, so the article should be indexed as
KIDNEY DISEASES / * diag / epidemiol
(/ultrasonogr may also be added NIM depending on the priority of the journal,
number of other concepts to cover, etc.)
19.6.3 If, however, there is no relationship among the 3 subheadings in the
subheading trees and none of them is the subject of the journal as a whole, then
the MeSH term should be made IM "up front" and the subheadings should be indexed
NIM.
Epidemiology, diagnosis and therapy of toxoplasmosis.
* TOXOPLASMOSIS / epidemiol / diag / ther
19.7 MAIN HEADING-SUBHEADING DUPLICATES
For many subheadings in MeSH, there are also main headings which are identical
or very similar.
19.7.1 Identical main headings:
ABNORMALITIES
BLOOD
CEREBROSPINAL FLUID
CHEMISTRY
CLASSIFICATION
CYTOLOGY
DIAGNOSIS
DIET THERAPY
DRUG THERAPY
ECONOMICS
EDUCATION
EMBRYOLOGY
EPIDEMIOLOGY
ETHNOLOGY
GENETICS
HISTORY
IMMUNOLOGY
METABOLISM
METHODS
MICROBIOLOGY
MORTALITY
ORGANIZATION AND ADMINISTRATION
PARASITOLOGY
PATHOLOGY
PHARMACOKINETICS
PHARMACOLOGY
PHYSIOLOGY
POISONING
PSYCHOLOGY
RADIATION EFFECTS
RADIOGRAPHY
RADIONUCLIDE IMAGING
RADIOTHERAPY
REHABILITATION
SURGERY
TRANSPLANTATION
ULTRASONOGRAPHY
URINE
VIROLOGY
19.7.2 Near-identical main headings:
ANATOMY /anat HISTOLOGY /anat
BLOOD VESSELS /blood supply JURISPRUDENCE /legis
CHEMISTRY, ANALYTICAL /anal LEGISLATION /legis
DEFICIENCY DISEASES /defic NERVOUS SYSTEM /innerv
DISEASE TRANSMISSION /transm PREVENTIVE MEDICINE /prev
DRUG ANTAGONISM /antag STATISTICS /statist
ENZYMES /enzymology THERAPEUTICS /ther
EQUIPMENT AND SUPPLIES /instrum TOXICOLOGY /tox
GROWTH /growth VETERINARY MEDICINE /vet
HEALTH MANPOWER /man WOUNDS AND INJURIES /inj
19.7.3 In general the main headings given in both lists above are reserved
for general articles only or for articles on the concept as a discipline or a
specialty.
Surgery in the 21st century.
SURGERY / * trends
FUTUROLOGY
Toxicology for nursing students.
TOXICOLOGY / * educ
* EDUCATION, NURSING
Occurrence of childhood poisoning in the United States.
POISONING / * epidemiol
UNITED STATES / epidemiol
HUMAN (check tag)
CHILD (check tag)
19.7.4 Occasionally an indexer needs to cover a concept which cannot be
fully indexed by a single MAIN HEADING/subheading coordination; the subheading
seems to need a qualifier also. Since our system does not have secondary
subheadings, in these cases indexers may add the main heading equivalent of the
subheading NIM, qualifying it with the additional subheading needed.
Urine cytology in bladder neoplasms.
BLADDER NEOPLASMS / * urine
URINE / cytol
Adverse effects of radiotherapy for breast neoplasms.
BREAST NEOPLASMS / * radiother
RADIOTHERAPY / adv eff
19.7.5 The additional main heading added for complete indexing must not be
made IM, as it is very general. All main headings which have equivalent
subheadings are annotated to say "GEN only; prefer /(the subheading)"; for any
of these terms to be made IM, the article must deal with the concept in general.
When the secondary concept is discussed in general, it may be made IM also, but
this will be rare.
A new instrument for use in radiotherapy of breast cancer and a
study of its use in the treatment of other diseases.
BREAST NEOPLASMS / * radiother
RADIOTHERAPY / * instrum
19.7.6 If the secondary concept can be covered by applying a second
subheading to the original main heading, it should be indexed that way, rather
than by adding the general MeSH main heading for the secondary aspect.
Surgery of liver abnormalities.
LIVER / * abnorm / * surg
But: Epidemiology of liver abnormalities.
LIVER / * abnorm
ABNORMALITIES / epidemiol
In these examples, /surg is an AQ for LIVER but /epidemiol is not, so the two
articles cannot be indexed in the same way.
19.7.7 If there is another main heading which is more specific than the
general subheading equivalent, it should be used rather than the more general
term, but still must be made NIM.
Methods in pulmonary arteriography.
PULMONARY ARTERY / * radiogr
ARTERIOGRAPHY / methods
(not RADIOGRAPHY / methods)
19.8 SCOPE AND APPLICATION OF SUBHEADINGS
The following pages give the subheadings in alphabetical order for easy
reference. Each subheading is accompanied by its official MeSH definition and
the forms used in indexing and searching.
The examples given with each subheading are hypothetical titles which may
sometimes appear over-simple to the practiced medical eye; they were intended
to illustrate indexing practices only. To avoid distractions, check tags are
not always indicated even if appropriate.
ALPHABETIC LIST OF SUBHEADINGS WITH ABBREVIATIONS
Subheading Form for Form for Searching or
Indexing Indexing Online
abnormalities.................abnorm......................AB
administration & dosage.......admin.......................AD
adverse effects...............adv eff.....................AE
agonists......................agon........................AG
analogs & derivatives.........analogs.....................AA
analysis......................anal........................AN
anatomy & histology...........anat........................AH
antagonists & inhibitors......antag.......................AI
biosynthesis..................biosyn......................BI
blood.........................blood.......................BL
blood supply..................blood supply................BS
cerebrospinal fluid...........csf.........................CF
chemical synthesis............chem syn....................CS
chemically induced............chem ind....................CI
chemistry.....................chem........................CH
classification................class.......................CL
complications.................compl.......................CO
congenital....................congen......................CN
contraindications.............contra......................CT
cytology......................cytol.......................CY
deficiency....................defic.......................DF
diagnosis.....................diag........................DI
diagnostic use................diag use....................DU
diet therapy..................diet ther...................DH
drug effects..................drug eff....................DE
drug therapy..................drug ther...................DT
economics.....................econ........................EC
education.....................educ........................ED
embryology....................embryol.....................EM
enzymology....................enzymol.....................EN
epidemiology..................epidemiol...................EP
ethnology.....................ethnol......................EH
etiology......................etiol.......................ET
genetics......................genet.......................GE
growth & development..........growth......................GD
history.......................hist........................HI
immunology....................immunol.....................IM
injuries......................inj.........................IN
innervation...................innerv......................IR
instrumentation...............instrum.....................IS
isolation & purification......isol........................IP
legislation & jurisprudence...legis.......................LJ
manpower......................man.........................MA
metabolism....................metab.......................ME
methods.......................methods.....................MT
microbiology..................microbiol...................MI
mortality.....................mortal......................MO
nursing.......................nurs........................NU
organization & administration.organ.......................OG
parasitology..................parasitol...................PS
pathogenicity.................pathogen....................PY
pathology.....................pathol......................PA
pharmacokinetics..............pharmacokin.................PK
pharmacology..................pharmacol...................PD
physiology....................physiol.....................PH
physiopathology...............physiopathol................PP
poisoning.....................pois........................PO
prevention & control..........prev........................PC
psychology....................psychol.....................PX
radiation effects.............rad eff.....................RE
radiography...................radiogr.....................RA
radionuclide imaging..........radionuclide................RI
radiotherapy..................radiother...................RT
rehabilitation................rehabil.....................RH
secondary.....................second......................SC
secretion.....................secret......................SE
standards.....................stand.......................ST
statistics & numerical data...statist.....................SN
supply & distribution.........supply......................SD
surgery.......................surg........................SU
therapeutic use...............ther use....................TU
therapy.......................ther........................TH
toxicity......................tox.........................TO
transmission..................transm......................TM
transplantation...............transpl.....................TR
trends........................trends......................TD
ultrasonography...............ultrasonogr.................US
ultrastructure................ultrastruct.................UL
urine.........................urine.......................UR
utilization...................util........................UT
veterinary....................vet.........................VE
virology......................virol.......................VI
Figure 19.8
19.8.1 /abnormalities /AB, /abnorm
Used with organs for congenital defects producing changes in the morphology of
the organ. It is used also for abnormalities in animals.
This subheading is to be used for articles on inborn structural abnormalities
only, not for those on abnormal functions or structural anomalies resulting from
disease, injuries, etc. Common terms seen in the literature to be indexed with
/abnorm are: agenesis, anomaly, aplasia, atresia, deformity, ectopy,
hypoplasia, malformation, teratology, duplication (of a single organ), etc.
Hepatic agenesis.
LIVER / * abnorm
Abnormalities of the iliac artery.
ILIAC ARTERY / * abnorm
Imperforate urethra in a calf.
CATTLE / * abnorm
URETHRA / * abnorm
There are many abnormality headings in Category C16, some of which should be
coordinated with a specific organ/abnorm. Check the annotation for each to see
if such a coordinate is needed.
Jejunal atresia.
* INTESTINAL ATRESIA
JEJUNUM / * abnorm
A drug-induced abnormality of the bile ducts.
* ABNORMALITIES, DRUG-INDUCED
BILE DUCTS / * abnorm
By MeSH definition, /abnorm must be reserved for congenital abnormalities;
structural changes in an organ caused by a drug given or disease occurring after
birth cannot be indexed as /abnorm.
Structural abnormalities of the liver in kidney diseases.
LIVER / * pathol
KIDNEY DISEASES / * pathol
For further discussion of the indexing principles for abnormalities, see
sections 21.34 and 23.20+.
See also section 19.8.18 for a discussion of the use of the subheading
/congenital with disease headings.
19.8.2 /administration & dosage /AD, /admin
Used with drugs for dosage forms, routes of administration, frequency and
duration of administration, quantity of medication, and the effects of these
factors.
This subheading needs to be differentiated from /therapeutic use and
/pharmacology. Authors may use the word "administration" but not discuss how
the drug is administered. In addition, the route of administration or dosage
form of the drug may be in the title but not the main point. In these cases,
the main point is probably /*ther use or /*pharmacol, with /admin added NIM if
at all.
Duration of administration of oral ampicillin in the treatment of
gonorrhea.
AMPICILLIN / * admin / ther use
ADMINISTRATION, ORAL
GONORRHEA / * drug ther
DRUG ADMINISTRATION SCHEDULE
Subcutaneous vitamin D injections.
VITAMIN D / * admin
INJECTIONS, SUBCUTANEOUS
A new sustained-release tablet form of meperidine compared with
conventional tablets.
MEPERIDINE / * admin
TABLETS
SUSTAINED-RELEASE PREPARATIONS
COMPARATIVE STUDY (check tag)
But: Effects of cocaine administration on respiration in rats.
COCAINE / * pharmacol
RESPIRATION / * drug eff
Treatment of diabetes with new oral antidiabetics.
(This article is about new antidiabetics which, unlike
insulin, need not be injected; the point is studying whether the drugs are
effective in treatment.)
DIABETES MELLITUS / * drug ther
ANTIDIABETICS / * ther use (/ admin)
(ADMINISTRATION, ORAL)
(Concepts in parentheses to be indexed only if discussed.)
19.8.3 /adverse effects /AE, /adv eff
Used with drugs, chemicals, or biological agents in accepted dosage - or with
physical agents or manufactured products in normal usage - when intended for
diagnostic, therapeutic, prophylactic, or anesthetic purposes. It is used also
for adverse effects or complications of diagnostic, therapeutic, prophylactic,
anesthetic, surgical, or other procedures, but excludes contraindications for
which "contraindications" is used.
The subheading /adv eff is used for "side effects" or "complications" of a drug,
chemical, or procedure.
Do not confuse with the following:
/contraindications: Used with drugs and procedures for conditions in which
the drug should not be given or the procedure performed.
/poisoning: Used for the serious condition known as "poisoning", "overdose", or
"intoxication".
/toxicity: Used only for experimental studies to determine whether a compound
is toxic, or under what conditions it becomes toxic.
For a full comparison, including examples, of /adv eff, /contra, /pois, and
/tox, see section 19.9.
19.8.4 /agonists /AG, /agon
Used with chemicals, drugs, and endogenous substances to indicate substances or
agents that have affinity for a receptor and intrinsic activity at that
receptor. (From Textbook of Pharmacology, 1991, p.16).
It is not usually hard to decide that the subheading /agon should be indexed for
an article, since the author will use the term "agonist", but the indexer must
be careful to use the subheading on the correct chemical. The chemical which is
acting as an agonist is indexed with the subheading /pharmacology, while the
chemical or receptor to which it is an agonist receives the subheading /agon.
Effects on discrimination learning of the low efficacy mu agonist
nalbuphine.
NALBUPHINE / * pharmacol
RECEPTORS, OPIOID, MU / * agon
DISCRIMINATION LEARNING / * drug eff
Leuprolide, an agonist of luteinizing hormone releasing hormone.
LEUPROLIDE / * pharmacol
LUTEINIZING HORMONE-RELEASING HORMONE / * agon
MeSH contains many pre-coordinated AGONIST terms, which should be used instead
of the subheading /agon if available.
Effects of serotonin agonists on heart rate.
SEROTONIN AGONISTS / * pharmacol
HEART RATE / * drug eff
Beta-agonists in the treatment of asthma.
ASTHMA / * drug ther
ADRENERGIC BETA-AGONISTS / * ther use
Be very careful to distinguish the word agonist from the word antagonist
(covered by the subheading /antagonists & inhibitors, section 19.8.8).
19.8.5 /analogs & derivatives /AA, /analogs
Used with drugs and chemicals for substances that share the same parent molecule
or have similar electronic structure but differ by the addition or substitution
of other atoms or molecules. It is used when the specific chemical heading is
not available and no appropriate group heading exists.
This subheading has a very restricted use by indexers; only with singular MeSH
chemicals for articles on groups of their derivatives. Single analogs must be
indexed individually; check MeSH and the Chemical Tool for the specific analog,
and if it is not in either place, flag it for the chemical specialists. (They
may map the term using /analogs on a MeSH term, but the indexer does not).
Synthesis of a series of hydrochlorothiazide derivatives in an
attempt to increase pharmacological activity.
HYDROCHLOROTHIAZIDE / * analogs / chem syn / pharmacol
But: A new analog of hydrochlorothiazide with increased
pharmacological activity.
(This article is about a specific compound, which although not named in the
title will almost certainly be named chemically in the article. The specific
chemical should be identified, and if MeSH or the Chemical Tool contains the
term, it may be indexed. If not, it must be flagged for the chemical
specialists; no attempt should be made by the indexer to index the compound
chemically if it is not in MeSH or the Chemical Tool.)
The subheading /analogs cannot be used with any plural MeSH chemical term. The
plural terminology implies a group of chemicals, so any similar chemicals can be
indexed merely by using the plural term.
Pharmacology of a new group of morphinan derivatives.
MORPHINANS / * pharmacol
In addition, /analogs cannot be used as a subheading on terms from the Chemical
Tool. Since each of the terms in the Tool maps to a plural MeSH term or as
/analogs already, /analogs is illegal. An article on a group of derivatives of
a compound in the Chemical Tool should be indexed using only the term for the
compound; the computer will automatically map the indexing to a plural term or
as /analogs.
Pharmacokinetics of a series of sedative pyrithyldione analogs.
pyrithyldione / * pharmacokin
HYPNOTICS AND SEDATIVES / * pharmacokin
(The computer maps the first term to PYRIDONES, a plural term.)
19.8.6 /analysis /AN, /anal
Used for the identification or quantitative determination of a substance or its
constituents and metabolites; includes the analysis of air, water, or other
environmental carrier. It excludes the chemical analysis of tissues, tumors,
body fluids, organisms, and plants for which "chemistry" is used. The concept
applies to both methodology and results. For analysis of substances in blood,
cerebrospinal fluid, and urine the specific subheading designating the fluid is
used.
The subheading /anal is used with Category D terms (chemicals) for determination
of their levels.
Do not confuse with the following:
/chemistry: Used with Category A and B terms (organs, tissues, microorganisms,
parasites and plants) and tumors for their chemical content or composition, and
with Category D terms for their chemical composition, structure,
characterization and properties.
/isolation & purification: Used with Category B terms (microorganisms and
parasites) for the obtaining of pure strains or for demonstration of their
presence, and with Category D terms for their isolation or purification.
/metabolism: Used with Category D terms for changes in levels of endogenous
compounds or for changes in the molecular structure of all compounds. Used with
Categories A, B, and C for changes in chemical constituents or as a coordinate
when /metab or /pharmacokin is used on a Category D term.
/pharmacokinetics: Used with exogenous chemicals for studies of their
movement through the body.
For a full comparison, including examples, of /anal, /chem, /isol, /metab, and
/pharmacokin, see section 19.10.
19.8.7 /anatomy & histology /AH, /anat
Used with organs, regions, and tissues for normal descriptive anatomy and
histology, and for the normal anatomy and structure of animals and plants.
/anat is used for articles on either gross anatomy or tissue histology. It
should be interpreted as "anatomy or histology"; the "&" does not mean that the
article must discuss both.
Pancreatic histology.
PANCREAS / * anat
Morphology of the canine liver.
LIVER / * anat
DOGS / * anat
Structure of the basement membrane.
BASEMENT MEMBRANE / * anat
Measurement of the uterus during the first trimester ofpregnancy.
UTERUS / * anat
* PREGNANCY TRIMESTER, FIRST
Weight of the human pituitary.
PITUITARY GLAND / * anat
ORGAN WEIGHT
/anat is used to describe normal organs or normal tissue. If a diseased state
or pathological condition exists, the proper subheading for a description of the
organ or tissue is /pathology instead.
Structure of the lung in emphysema.
LUNG / * pathol
PULMONARY EMPHYSEMA / * pathol
The subheading covers organs and tissues but not cells or subcellular
structures. For these, use /cytology or /ultrastructure, respectively.
Structure of the hepatocyte.
LIVER / * cytol
Structure of muscle mitochondria.
MITOCHONDRIA, MUSCLE / * ultrastruct
19.8.8 /antagonists & inhibitors /AI, /antag
Used with chemicals, drugs, and endogenous substances to indicate substances or
agents which counteract their biological effects by any mechanism.
In using this subheading, the indexer must be careful to pair it with the right
drug or chemical; it is often confused. The drug which is doing the
antagonizing is indexed with the subheading /pharmacology, while the compound
which is being antagonized is indexed with /antag.
Reserpine antagonism of acetylcholine.
ACETYLCHOLINE / * antag
RESERPINE / * pharmacol
Chlorpromazine inhibition of norepinephrine.
NOREPINEPHRINE / * antag
CHLORPROMAZINE / * pharmacol
Blockade of the NMDA receptor by MK-801.
RECEPTORS, N-METHYL-D-ASPARTATE / * antag
MK-801 / * pharmacol
The term DRUG ANTAGONISM exists in MeSH, but it should be reserved for general
articles only.
Drug antagonism as a cause of drug resistance.
* DRUG ANTAGONISM
* DRUG RESISTANCE
Be very careful to distinguish the word antagonist from the word agonist
(covered by the subheading /agonists, section 19.8.4).
19.8.9 /biosynthesis /BI, /biosyn
Used for the anabolic formation of chemical substances in organisms, in living
cells, or by subcellular fractions.
Since this subheading is restricted to anabolic formation (constructive
metabolic processes) only, it will be used only with naturally-occurring
chemicals which are synthesized by the conversion of small molecules to large.
The formation of chemicals resulting from the breakdown of other compounds,
whether endogenous or exogenous, cannot be indexed with /biosyn on the resultant
compound.
Amino acid synthesis in the liver in gout.
AMINO ACIDS / * biosyn
LIVER / * metab
GOUT / * metab
Streptomycin production by Actinomyces.
STREPTOMYCIN / * biosyn
ACTINOMYCES / * metab
But: Formation of N-demethylcarbachol from carbachol in the liver.
N-demethylcarbachol / * metab
CARBACHOL / * metab
DEALKYLATION
(not N-demethylcarbachol / * biosyn)
Acetaldehyde is reduced to ethanol by alcohol dehydrogenase.
ETHANOL / * metab
ACETALDEHYDE / * metab
ALCOHOL DEHYDROGENASE / * metab
OXIDATION-REDUCTION
(not ETHANOL / * biosyn)
19.8.10 /blood /BL, /blood
Used for the presence or analysis of substances in the blood; also for
examination of, or changes in, the blood in disease states. It excludes
serodiagnosis, for which the subheading "diagnosis" is used, and serology, for
which "immunology" is used.
/blood should be used for in vivo or in vitro studies of substances in the
blood, blood cells (including their metabolism), and physical properties of the
blood (such as its viscosity, coagulability, etc.).
Blood serotonin levels in schizophrenia.
SEROTONIN / * blood
SCHIZOPHRENIA / * blood
Transportation of sodium in erythrocytes from pregnant women.
SODIUM / * blood
ERYTHROCYTES / * metab
PREGNANCY / * blood
BIOLOGICAL TRANSPORT / physiol
Blood viscosity in hypertension.
HYPERTENSION / * blood
* BLOOD VISCOSITY
Do not use /blood for studies on the hemodynamics of blood, such as its flow,
circulation, pressure, etc. These do not usually result from the properties of
the fluid itself, but the dynamics of the cardiovascular system which propels
it, and thus should be indexed with the subheading /physiology, or
/physiopathology in a disease.
Blood pressure in labor.
LABOR / * physiol
* BLOOD PRESSURE
Blood volume in migraine.
MIGRAINE / * physiopathol
* BLOOD VOLUME
The subheading /blood is not an AQ for Category D terms normally found in the
blood, so /analysis or /metabolism (as appropriate) should be used instead.
Changes in blood fibrin levels in liver disease.
FIBRIN / * metab
LIVER DISEASES / * blood
(not FIBRIN / * blood)
19.8.11 /blood supply /BS, /blood supply
Used for arterial, capillary, and venous systems of an organ or region whenever
the specific heading for the vessel does not exist. It includes blood flow
through the organ.
When indexing an organ with /*blood supply, add (NIM) the specific type of
vessel or flow studied: ARTERIES, MICROCIRCULATION, etc.
Since this subheading is used on an organ when a heading for a vessel does not
exist in MeSH, do not index a larger vessel from which it arose, even if a term
for that larger vessel is available.
Vasculature of the kidney.
KIDNEY / * blood supply
Surgery of the testicular artery.
TESTIS / * blood supply
ARTERIES / surg
(not AORTA, ABDOMINAL / * surg even though the testicular artery
arises from the abdominal aorta.)
/*blood supply is indexed with REGIONAL BLOOD FLOW (NIM) for studies of the
circulation within an organ, unless a specific pre-coordinated CIRCULATION term
exists in MeSH. The CIRCULATION terms must only be used for the process of
circulation; articles on the anatomy of the vessels within an organ are indexed
as the organ / * blood supply.
Blood circulation in the stomach.
STOMACH / * blood supply
REGIONAL BLOOD FLOW
Renal circulation.
* RENAL CIRCULATION
Ultrastructure of capillaries in the liver.
LIVER / * blood supply
CAPILLARIES / ultrastruct
(not * LIVER CIRCULATION)
/blood supply is also permitted with tumor site and histologic terms.
Vasculature of uterine fibromas.
UTERINE NEOPLASMS / * blood supply
LEIOMYOMA / * blood supply
See also sections 21.4 through 21.6 for a discussion of /blood supply.
19.8.12 /cerebrospinal fluid /CF, /csf
Used for the presence or analysis of substances in the cerebrospinal fluid;
also for examination of or changes in cerebrospinal fluid in disease states.
Cerebrospinal fluid lithium in patients with major depression as
related to response to treatment.
DEPRESSIVE DISORDER / * csf / * drug ther
LITHIUM / * csf / * ther use
The cerebrospinal fluid in neurosyphilis.
NEUROSYPHILIS / * csf
Analysis of cerebrospinal fluid amyloid protein in multiple
sclerosis.
MULTIPLE SCLEROSIS / * csf
CEREBROSPINAL FLUID PROTEINS / * anal
AMYLOID / * csf
Cerebrospinal fluid leukocyte count in viral meningitis.
MENINGITIS, VIRAL / * csf
* LEUKOCYTE COUNT
CEREBROSPINAL FLUID / cytol
19.8.13 /chemical synthesis /CS, /chem syn
Used for the chemical preparation of molecules in vitro. For the formation of
chemical substances in organisms, living cells, or subcellular fractions,
"biosynthesis" is used.
/chem syn must be distinguished from /biosynthesis in that the former will take
place in vitro, in the absence of any living biological system; the latter will
take place in vivo or in the presence of a living biological system in vitro.
When enzymes are used in an industrial context to synthesize chemicals, the
subheading used on the resultant chemical should be /biosyn (if clearly an
anabolic process) or /metabolism (if a catabolic process or if no indication is
given; see section 19.8.9). Do not use the subheading /chem syn for synthesis
using enzymes.
Pitfalls in the large-scale synthesis of hydrocortisone.
HYDROCORTISONE / * chem syn
But: Use of immobilized enzymes in the large-scale production of
hydrocortisone.
ENZYMES, IMMOBILIZED / * metab
HYDROCORTISONE / * biosyn
Hydrocortisone synthesis in the adrenal cortex.
ADRENAL CORTEX / * metab
HYDROCORTISONE / * biosyn
Distinguish also between the chemical synthesis of a substance and its chemistry
or its chemical analysis. An article on the chemical structure of a compound
(/chemistry) or on its chemical analysis or determination (/analysis) is not
necessarily on its chemical synthesis.
The chemistry of hydrocortisone.
HYDROCORTISONE / * chem
Chemical analysis of hydrocortisone.
HYDROCORTISONE / * anal
19.8.14 /chemically induced /CI, /chem ind
Used for diseases, syndromes, congenital abnormalities, or symptoms caused by
chemical compounds in man or animals.
When the subheading /chem ind is indexed with a disease, the subheading used
with the drug or chemical involved will be /adverse effects, /poisoning, or
/toxicity.
Indomethacin-induced peptic ulcer.
PEPTIC ULCER / * chem ind
INDOMETHACIN / * adv eff
Studies in rats to determine if oxazepam causes cortical necrosis in
the kidney.
OXAZEPAM / * tox
KIDNEY CORTEX NECROSIS / * chem ind
RATS (check tag)
Acute renal failure caused by attempted suicide with haloperidol.
HALOPERIDOL / * pois
KIDNEY FAILURE, ACUTE / * chem ind
* SUICIDE, ATTEMPTED
Any disease main heading containing the word TOXIC refers to a chemically-
induced or drug-induced disease. The term PSYCHOSES, TOXIC means chemically-
induced or drug-induced psychosis; HEPATITIS, TOXIC means chemically- or drug-
induced hepatitis. When indexing such a precoordinated TOXIC disease term, it
is not possible to use the subheading /chem ind; since it would be redundant,
MeSH has not allowed /chem ind as an AQ with any of these terms.
Chloroquine-induced psychosis.
CHLOROQUINE / * adv eff
PSYCHOSES, TOXIC / * etiol
not PSYCHOSES, TOXIC / * chem ind)
In experimental studies, diseases are often deliberately induced by drugs in
order to study some aspect of the disease. In these cases, the drug itself is
not being studied, so no subheading is used on it. See section 25.11.2.
Metabolism in experimental liver neoplasms induced by
2-acetylaminofluorene.
LIVER NEOPLASMS, EXPERIMENTAL / * metab / chem ind
2-ACETYLAMINOFLUORENE
19.8.15 /chemistry /CH, /chem
Used with chemicals, biological, and non-biological substances for their
composition, structure, characterization, and properties; also used for the
chemical composition or content of organs, tissue, tumors, body fluids,
organisms, and plants. Excludes chemical analysis and determination of
substances for which "analysis" is used; excludes synthesis for which "chemical
synthesis" is used; excludes isolation and purification of substances for which
"isolation & purification" is used.
The subheading /chem is used with Category A and B terms (organs and tissues,
microorganisms, parasites and plants) and tumors in Category C4 for their
chemical content or composition, and with Category D terms for their chemical
characterization, composition, structure, and properties.
Do not confuse with the following:
/analysis: Used with Category D terms (chemicals) for determination of their
levels.
/isolation & purification: Used with Category B terms (microorganisms and
parasites) for the obtaining of pure strains or for demonstration of their
presence, and with Category D terms for their isolation or purification.
/metabolism: Used with Category D terms for changes in levels of endogenous
compounds or for changes in the molecular structure of all compounds. Used with
Categories A, B, and C for changes in chemical constituents or as a coordinate
when /metab or /pharmacokin is used on a Category D term.
/pharmacokinetics: Used with exogenous chemicals for studies of their
movement through the body.
For a full comparison, including examples, of /anal, /chem, /isol, /metab, and
/pharmacokin, see section 19.10.
19.8.16 /classification /CL, /class
Used for taxonomic or other systematic or hierarchical classification systems.
This is the most widely assigned subheading; it may be used with terms from all
categories except Z (geography). Despite its being an AQ for many terms,
however, /class is not used very frequently by most indexers. The titles below
are representative of articles indexers may encounter in which /class is
appropriate.
Taxonomy of vertebrates.
VERTEBRATES / * class
Characteristics of the various types of anemia.
ANEMIA / * class
Classification of amino acids.
AMINO ACIDS / * class
Salmonella serotyping in outbreaks of food poisoning.
SALMONELLA FOOD POISONING / * microbiol / * epidemiol
SALMONELLA / * class
* DISEASE OUTBREAKS
SEROTYPING
Subtypes of antigen-presenting cells.
ANTIGEN-PRESENTING CELLS / * class
19.8.17 /complications /CO, /compl
Used with diseases to indicate conditions that co-exist or follow, i.e., co-
existing diseases, complications, or sequelae.
This subheading is used for two concepts: (1) one disease causing another; and
(2) the co-existence of two or more diseases for which no causal relationship
can be determined.
If disease A causes disease B, this will be indexed as
DISEASE A / * compl
DISEASE B / * etiol
If it is not known whether disease A causes disease B or disease B causes
disease A, the article will be indexed as
DISEASE A / * compl
DISEASE B / * compl
Do not confuse /compl with /etiol. Be careful to index /compl on the cause and
/etiol on the effect. Remember that it is possible for a headache to be caused
by vomiting or for a headache to cause vomiting. The first instance is indexed
as
HEADACHE / * etiol
VOMITING / * compl
The second instance is indexed as
HEADACHE / * compl
VOMITING / * etiol
Headache and vomiting may also be co-existent without any discussion of one
causing the other, and in that case the article is indexed as
HEADACHE / * compl
VOMITING / * compl
More examples of the use of /compl and /etiol:
Complications of trachoma.
TRACHOMA / * compl
Trachoma complicated by ocular toxoplasmosis.
TRACHOMA / * compl
TOXOPLASMOSIS, OCULAR / * compl
Blindness caused by systemic lupus erythematosus.
BLINDNESS / * etiol
LUPUS ERYTHEMATOSUS, SYSTEMIC / * compl
Systemic lupus erythematosus causing blindness.
BLINDNESS / * etiol
LUPUS ERYTHEMATOSUS, SYSTEMIC / * compl
19.8.18 /congenital /CN, /congen
Used with disease headings to indicate those conditions existing at, and usually
before, birth. It excludes morphologic abnormalities and birth injuries, for
which "abnormalities" and "injuries" are used.
Do not confuse the subheading /congen with /abnormalities or with /genetics.
/congen means a disease "existing at birth"; it need not be either a structural
abnormality (indexed as the organ/*abnorm) or a familial or hereditary condition
(indexed as the disease/*genet). For example, a child may be born with
hepatitis (HEPATITIS/*congen) but the hepatitis need have nothing to do with the
structure of the liver nor have affected any other member of the family.
Authors generally use the term "congenital" in articles where the subheading is
appropriate. However, there are some instances in which the indexer should use
the subheading /congen even when the author does not. When a disease is not
noticed at birth, but is detected in the newborn period and is unlikely to have
arisen in the short period after birth, the subheading /congen should be used
(for instance, a tumor).
Do not check the tag INFANT, NEWBORN for every congenital disease unless the
article actually discusses the newborn infant; frequently congenital disease
conditions do not come to the attention of physicians until long after the
neonatal period.
On the other hand, not every disease in a newborn infant is necessarily
"congenital"; it may have been acquired several days or more after birth (for
example, hospital infections).
Do not use the subheading /congen with diseases known to be congenital by
definition (e.g., INTESTINAL ATRESIA and EPISPADIAS) or known to be diseases of
newborn infants (e.g., JAUNDICE, NEONATAL and HYDROCEPHALUS). MeSH has been
annotated to warn the indexer away from the use of /congen with specific
headings. In general, Category C16 terms (neonatal diseases and abnormalities)
do not have /congen as an AQ.
Congenital deafness.
DEAFNESS / * congen
Congenital cataract.
CATARACT / * congen
Teratoma in a week-old infant.
TERATOMA / * congen
INFANT, NEWBORN (check tag)
CASE REPORT (check tag)
Vesico-ureteral reflux in a newborn caused by urethral valves.
VESICO-URETERAL REFLUX / * congen
URETHRA / * abnorm
INFANT, NEWBORN (check tag)
CASE REPORT (check tag)
But: Congenitally hypoplastic kidney.
KIDNEY / * abnorm
(not KIDNEY DISEASES / * congen)
Hereditary kidney diseases.
KIDNEY DISEASES / * genet
(not KIDNEY DISEASES / * congen)
19.8.19 /contraindications /CT, /contra
Used with drugs, chemicals, and biological and physical agents in any disease or
physical state that might render their use improper, undesirable, or
inadvisable. Used also with contraindicated diagnostic, therapeutic,
prophylactic, anesthetic, surgical, or other procedures.
The subheading /contra is used with drugs and procedures for conditions in which
the drug should not be given or the procedure performed.
Do not confuse with the following:
/adverse effects:
Used for "side effects" or "complications" of a drug, chemical, or procedure.
/poisoning: Used for the serious condition known as "poisoning", "overdose", or
"intoxication".
/toxicity: Used only for experimental studies to determine whether a compound
is toxic, or under what conditions it becomes toxic.
For a full comparison, including examples, of /adv eff, /contra, /pois, and
/tox, see section 19.9.
19.8.20 /cytology /CY, /cytol
Used for normal cellular morphology of unicellular and multicellular organisms.
/cytol is used only for the normal cytology of organs. The cytology of an organ
in a disease state is indexed as /pathology.
Uterine cytology during menstruation.
UTERUS / * cytol
* MENSTRUATION
But: Uterine cytology in fallopian tube diseases.
UTERUS / * pathol
FALLOPIAN TUBE DISEASES / * pathol
/cytol is used with cell terms at the cellular level. If a subheading is needed
for a subcellular element, /ultrastructure is used instead.
Structure of the mitochondria in uterine muscle.
MITOCHONDRIA, MUSCLE / * ultrastruct
MYOMETRIUM / * ultrastruct
/cytol is an AQ for some Category B terms (organisms). It is not permitted with
vertebrates, because authors do not discuss the cytology of animals but rather
of specific organs within an animal. However, /cytol is permitted with
invertebrates, bacteria, and fungi. Since viruses are not cellular organisms,
/cytol by definition is not allowed with them; /ultrastructure should be used
instead.
Structure of atypical mycobacteria.
MYCOBACTERIUM, ATYPICAL / * cytol
Insect cytology.
INSECTS / * cytol
Protozoan morphology.
PROTOZOA / * cytol
But: Cytology of the dog pancreas.
PANCREAS / * cytol
DOGS / * anat
(not DOGS / * cytol)
Structure of the poliovirus.
POLIOVIRUS / * ultrastruct
(not POLIOVIRUS / * cytol)
19.8.21 /deficiency /DF, /defic
Used with endogenous and exogenous substances which are absent or in diminished
amount relative to the normal requirement of an organism or a biologic system.
The key to the correct use of this subheading lies in the definition: "the
normal requirement." /defic is only permitted with compounds which are normally
required by the body, such as nutrients or enzymes. An article on a patient
resistant to the analgesic effects of aspirin because of an inadequate dose
cannot be indexed ASPIRIN/*defic.
Urea excretion in essential amino acid deficiency.
UREA / * urine
AMINO ACIDS, ESSENTIAL / * defic
Pyruvate kinase deficiency in hemolytic anemia.
PYRUVATE KINASE / * defic
ANEMIA, HEMOLYTIC / * enzymol
MeSH has provided many pre-coordinated terms containing the word DEFICIENCY for
common deficiency diseases (VITAMIN A DEFICIENCY, etc.). Check before indexing
any compound with the subheading /defic to see if such a term exists.
Effect of protein deficiency on the metabolism of warfarin.
PROTEIN DEFICIENCY / * metab
WARFARIN / * metab
Although the MeSH definition refers only to the "normal requirement of an
organism", restrict the use of /defic to higher organisms. Do not use it for
articles on culturing microorganisms in "deficient" media; use /physiology or
/metabolism on the "deficient" compound instead.
Growth of Salmonella in leucine-deficient media.
(Author is studying leucine's role in the growth of Salmonella by omitting it
from the culture media to see if growth stops.)
SALMONELLA / * growth
LEUCINE / * physiol
CULTURE MEDIA
(not LEUCINE / * defic)
For a further discussion of the indexing of /defic and various DEFICIENCY
DISEASES, see section 23.25+.
19.8.22 /diagnosis /DI, /diag
Used with diseases for all aspects of diagnosis, including examination,
differential diagnosis, and prognosis; excludes mass screening for which
"prevention & control" is used. Excludes radiographic diagnosis for which
"radiography" is used; excludes scintigraphic diagnosis for which "radionuclide
imaging" is used; excludes ultrasonic diagnosis for which "ultrasonography" is
used.
With the exception of checking for one of the specific diagnostic subheadings
listed above and/or indented under /diag in the subheading trees (Figure 19.5),
this subheading should pose few problems for an indexer, as the author usually
uses the word "diagnosis".
Diagnosis of gout.
GOUT / * diag
Differential diagnosis of gout.
GOUT / * diag
DIAGNOSIS, DIFFERENTIAL
Gout simulating arthritis.
GOUT / * diag
ARTHRITIS / * diag
DIAGNOSIS, DIFFERENTIAL
Arthritis simulating gout.
ARTHRITIS / * diag
GOUT / * diag
DIAGNOSIS, DIFFERENTIAL
Electroencephalographic diagnosis of epilepsy.
EPILEPSY / * diag
* ELECTROENCEPHALOGRAPHY
But: Diagnosis of liver neoplasms by needle biopsy of the liver.
LIVER NEOPLASMS /* pathol
LIVER / * pathol
BIOPSY, NEEDLE
Use of ultrasonography in diagnosing liver abscess.
LIVER ABSCESS / * ultrasonogr
For a discussion of diagnostic techniques, see 26.4+ through 26.14.
19.8.23 /diagnostic use /DU, /diag use
Used with chemical compounds, drugs, and physical agents when these substances
are used for studies of clinical function of an organ, or for the diagnosis of
human or animal diseases.
/diag use is indexed on exogenous chemicals administered to perform various
function tests, as contrast media, or as tracers.
Diatrizoate in renal arteriography.
DIATRIZOATE / * diag use
RENAL ARTERY / * radiogr
Indocyanine green in liver function studies.
* LIVER FUNCTION TESTS
INDOCYANINE GREEN / * diag use
/diag use may also be used with physical agents.
Cold effects on blood flow to the fingers in the diagnosis of
Raynaud's disease.
COLD / * diag use
RAYNAUD'S DISEASE / * diag
FINGERS / * blood supply
REGIONAL BLOOD FLOW / physiol
Save /diag use for administered compounds; stains, monoclonal antibodies, etc.
used ex vivo should be indexed with no subheading.
Methylene blue staining of inclusion bodies in the pathologic
diagnosis of cytomegalovirus infection.
* METHYLENE BLUE
INCLUSION BODIES, VIRAL / * ultrastruct
CYTOMEGALIC INCLUSION DISEASE / * pathol
/diag use cannot be used with an endogenous chemical when its levels are
measured to diagnose a disease; the subheading is reserved for exogenous
compounds. However, either BIOLOGICAL MARKERS (NIM) or TUMOR MARKERS,
BIOLOGICAL (IM) may be added in such a study.
Beta-HCG blood levels in the detection of ectopic pregnancy.
BETA HCG / * blood
PREGNANCY, ECTOPIC / * diag
BIOLOGICAL MARKERS / blood
19.8.24 /diet therapy /DH, /diet ther
Used with disease headings for dietary and nutritional management of the
disease. The concept does not include vitamin or mineral supplements, for which
"drug therapy" may be used.
This subheading is relatively easy to use, because the dietary aspect is usually
obvious. However, as indicated by the MeSH definition, vitamin and mineral
supplements should be indexed as /drug therapy, not /diet ther. Also, tube
"feeding" should be indexed as /therapy, not /diet ther.
Peptic ulcer diets.
PEPTIC ULCER / * diet ther
An easily absorbed protein diet for malabsorption syndromes.
MALABSORPTION SYNDROMES / * diet ther
DIETARY PROTEINS / * admin / * pharmacokin
* INTESTINAL ABSORPTION
But: Vitamin A supplements in the treatment of vitamin A
deficiency.
VITAMIN A / * ther use
VITAMIN A DEFICIENCY / * drug ther
Enteral feeding in patients with Crohn's disease.
CROHN DISEASE / * ther
* ENTERAL FEEDING
19.8.25 /drug effects /DE, /drug eff
Used with organs, regions, tissues, or organisms and physiological and
psychological processes for the effects of drugs and chemicals.
When using this subheading on an organ, organism, physiological or psychological
term, the subheading used on the drug or chemical producing the effect will
usually be /pharmacology. Indexers should have no problem in indexing the /drug
eff--/pharmacol coordination. Occasionally, one of the subheadings indented
under /pharmacol in the Subheading Trees (Figure 19.5) will be the coordination
for /drug eff.
Effect of penicillin G on the heart.
HEART / * drug eff
PENICILLIN G / * pharmacol
Effect of penicillin G on the fetus.
FETUS / * drug eff
PENICILLIN G / * pharmacol
Response of Treponema pallidum to penicillin G.
TREPONEMA PALLIDUM / * drug eff
PENICILLIN G / * pharmacol
Effect of promazine on learning.
LEARNING / * drug eff
PROMAZINE / * pharmacol
Effects of the amobarbital test on memory and the EEG in epileptic
patients.
AMOBARBITAL / * diag use
MEMORY / * drug eff
EEG / * drug eff
EPILEPSY / * physiopathol
/drug eff is also an AQ for enzymes, proteins, and nucleic acids.
Effects of cycloheximide on DNA, C5a peptidase, and proteins in
Streptococcus pyogenes.
CYCLOHEXIMIDE / * pharmacol
STREPTOCOCCUS PYOGENES / * drug eff / genet / enzymol
DNA, BACTERIAL / * drug eff
BACTERIAL PROTEINS / * drug eff
C5a peptidase / * drug eff
19.8.26 /drug therapy /DT, /drug ther
Used with disease headings for the treatment of disease by the administration of
drugs, chemicals, and antibiotics. For diet therapy and radiotherapy, use
specific subheadings. The concept excludes immunotherapy and treatment with
biologicals for which "therapy" is used.
/drug ther is not restricted to the treatment of disease in humans. It is
permitted with veterinary diseases and experimental diseases in animals. If the
study concerns the effect of a drug on a disease for the purpose of treating the
disease, /drug ther is the correct subheading for clinical or experimental
therapy.
When using the subheading /drug ther on a disease, the correct coordination will
be /therapeutic use on the drug given.
Colchicine therapy of gout.
GOUT / * drug ther
COLCHICINE / * ther use
Various trypanocidal drugs in the treatment of bovine
trypanosomiasis.
TRYPANOSOMIASIS, BOVINE / * drug ther
TRYPANOCIDAL AGENTS / * ther use
CATTLE (check tag)
Therapeutic effects of neomycin in experimental staph infections in
mice.
NEOMYCIN / * ther use
STAPHYLOCOCCAL INFECTIONS / * drug ther
MICE (check tag)
By definition, /drug ther cannot be used when diseases are treated with so-
called "biological products" such as vaccines, sera, antitoxins, etc.; use the
subheading /therapy instead.
Vaccine therapy of tularemia.
TULAREMIA / * ther
* VACCINE THERAPY
Antitoxin therapy of snake bites.
SNAKE BITES / * ther
ANTITOXINS / * ther use
19.8.27 /economics /EC, /econ
Used for the economic aspects of any subject, as well as for all aspects of
financial management. It includes the raising or providing of funds.
A method of analyzing the costs of hemophilia therapy.
HEMOPHILIA / * econ / * ther
COSTS AND COST ANALYSIS / methods
The economics of fluoridation.
FLUORIDATION / * econ
May hospital-shared laundry services qualify for tax exemption?
LAUNDRY SERVICE, HOSPITAL / * econ
HOSPITAL SHARED SERVICES / * econ
* TAXES
Salaries in community health nursing.
COMMUNITY HEALTH NURSING / * econ
* SALARIES AND FRINGE BENEFITS
The cost-effectiveness of chloramphenicol in the treatment of
typhoid.
CHLORAMPHENICOL / * econ / * ther use
TYPHOID / * econ / * drug ther
COST EFFECTIVENESS
These terms have been available in MeSH for many years: ECONOMICS; ECONOMICS,
MEDICAL; ECONOMICS, DENTAL; ECONOMICS, HOSPITAL; ECONOMICS, NURSING. Reserve
these headings for general articles only; do not use them as coordinates for
headings indexable with /econ.
The free enterprise system in medicine.
* ECONOMICS, MEDICAL
Effects of Medicare on U.S. hospitals.
* ECONOMICS, HOSPITAL
* MEDICARE
UNITED STATES
Income tax savings for nurses.
* ECONOMICS, NURSING
* INCOME TAX
Although /econ is allowed with many terms, it is sometimes needed with a term
for which it is not an AQ. In such a case, index the specific subject (IM) and
add ECONOMICS or one of the pre-coordinated ECONOMICS terms such as ECONOMICS,
MEDICAL (NIM).
The economic implications of the metric system.
* METRIC SYSTEM
ECONOMICS
If the economic aspect needed is a specific concept for which we have a main
heading, index the specific subject (IM) and coordinate with the specific
economic aspect (IM or NIM depending upon the article); do not add ECONOMICS or
ECONOMICS, MEDICAL, etc.
Taxing the automobile driver.
* AUTOMOBILE DRIVING
* TAXES
(not ECONOMICS)
When indexing an article on the economic aspects of several subjects, use /econ
with main headings for which it is an AQ, but add ECONOMICS or one of the pre-
coordinated ECONOMICS terms NIM as a coordinate for headings which do not have
/econ as an AQ.
Economic aspects of efficiency in libraries.
LIBRARIES / * econ
* EFFICIENCY
ECONOMICS
19.8.28 /education /ED, /educ
Used for education, training programs, and courses in various fields and
disciplines, and for training groups of persons.
When indexing a specialty or discipline with the subheading /educ, coordinate it
with the specific type of education or education-related concept (e.g.,
CURRICULUM) from Tree I2. Both are IM.
/educ is assumed to be the training of a specialist in that specialty. That is,
SOCIOLOGY/*educ is assumed to be the training of sociologists in sociology. For
the training of other professionals in sociology, coordinate SOCIOLOGY/*educ
with the specific type of professional training (*EDUCATION, MEDICAL, etc.).
Training in urology.
UROLOGY / * educ
Urology in the medical school curriculum.
UROLOGY / * educ
* EDUCATION, MEDICAL, UNDERGRADUATE
* CURRICULUM
A refresher course in urology for the pediatrician.
UROLOGY / * educ
* EDUCATION, MEDICAL, CONTINUING
PEDIATRICS / * educ
Residencies in obstetrics.
OBSTETRICS / * educ
* INTERNSHIP AND RESIDENCY
Clinical psychology for medical record administrators.
MEDICAL RECORD ADMINISTRATORS / * educ
PSYCHOLOGY, CLINICAL / * educ
Clinical psychology for psychiatrists.
PSYCHOLOGY, CLINICAL / * educ
PSYCHIATRY / * educ
Methods of teaching urology to nursing students.
UROLOGY / * educ
TEACHING / * methods
* EDUCATION, NURSING
19.8.29 /embryology /EM, /embryol
Used with organs, regions, and animal headings for embryologic and fetal
development. It is used also with diseases for embryologic factors contributing
to postnatal disorders.
Pancreas embryology.
PANCREAS / * embryol
Cat embryology.
CATS / * embryol
Embryonic factors in drug-induced abnormalities.
ABNORMALITIES, DRUG-INDUCED / * embryol
The embryo in cystic fibrosis.
CYSTIC FIBROSIS / * embryol
The MeSH definition of /embryol includes the fetus, but since the name of the
subheading might imply that it refers only to the embryo, the indexer should add
the fetal aspect NIM (if relevant), as a coordinate for /*embryol on a specific
organ and/or animal.
NOTE: The fetal terms should be reserved for articles on mammals only, and made
IM only for studies on the fetus as a whole, not in relation to any specific
organ for which the indexer has used /*embryol.
Anatomy and development of the human fetus.
FETUS / * anat
* FETAL DEVELOPMENT
HUMAN (check tag)
Anatomy of the fetal pancreas.
PANCREAS / * embryol
FETUS / anat
Development of the fetal pancreas.
PANCREAS / * embryol
FETAL DEVELOPMENT
Development of the Japanese quail embryo.
COTURNIX / * embryo
EMBRYO, NON-MAMMALIAN / growth
(not EMBRYO DEVELOPMENT see FETAL DEVELOPMENT)
19.8.30 /enzymology /EN, /enzymol
Used with organisms, except vertebrates, and with organs and tissues. It is also
used with diseases for enzymes during the course of the disease, but excludes
diagnostic enzyme tests, for which "diagnosis" is used.
Brain enzymology.
BRAIN / * enzymol
Determination of aldolase in the brain.
BRAIN / * enzymol
ALDOLASE / * anal
Aldolase activity in the brain in encephalomyelitis.
BRAIN / * enzymol
ALDOLASE / * metab
ENCEPHALOMYELITIS / * enzymol
Note the difference in the subheading used on the enzyme in the two examples
given above; see section 19.10 for a discussion of the differences between
/analysis and /metabolism.
Blood catalase activity in alcoholism.
ALCOHOLISM / * enzymol CATALASE / * blood
Esterase distribution in the spider-mite.
MITES / * enzymol
ESTERASES / * anal
Peroxidase activity of Mycobacterium tuberculosis.
MYCOBACTERIUM TUBERCULOSIS / * enzymol
PEROXIDASES / * metab
Based on the MeSH definition, /enzymol should not be used for diagnostic enzyme
tests. See the example below and also sections 25.19.4 and 26.8+ for further
discussion of ENZYME TESTS.
Urinary amylase in the diagnosis of acute pancreatitis.
PANCREATITIS / * diag
AMYLASE / * urine
* ENZYME TESTS
ACUTE DISEASE
19.8.31 /epidemiology /EP, /epidemiol
Used with human and veterinary diseases for the distribution of disease, factors
which cause disease, and the attributes of disease in defined populations;
includes incidence, frequency, prevalence, endemic and epidemic outbreaks; also
surveys and estimates of morbidity in geographic areas and in specified
populations. Used also with geographical headings for the location of
epidemiologic aspects of a disease. Excludes mortality for which "mortality" is
used.
Note the concepts included under epidemiology above. Many of these are MeSH
main headings and are indexed NIM as coordinates for /epidemiol on a disease.
These terms are an exception to the rule of indexing only what is discussed.
Any mention of an epidemiologic method requires that the method be indexed NIM;
see section 26.27+.
In addition, when indexing in this field, always consider indexing a geographic
term with /epidemiol if relevant; see section 36.6. (The geography may not
always be relevant and then should not be added even though it can be
ascertained. For example, an incidence study performed in a Wisconsin hospital
may not necessarily be about the incidence only in Wisconsin or even in the
United States.)
NOTE: Geographic terms can never be made IM, so when /epidemiol is used with a
geographic term, it cannot be an IM concept.
The incidence of pneumonia in Italy.
PNEUMONIA / * epidemiol
ITALY / epidemiol
INCIDENCE
Longitudinal studies of pneumonia.
PNEUMONIA / * epidemiol
LONGITUDINAL STUDIES
An outbreak of measles in Maryland.
MEASLES / * epidemiol
* DISEASE OUTBREAKS
MARYLAND / epidemiol
Since /ethnology is indented under /epidemiol in the Subheading Trees (Figure
19.5), /epidemiol does not need to be used on a disease for a study of its
epidemiology in ethnic or racial groups; use only /ethnology. See next page
for example.
19.8.32 /ethnology /EH, /ethnol
Used with diseases and selected terms for ethnic, cultural, anthropological, or
racial aspects, and with geographic headings to indicate the place of origin of
a group of people.
This subheading is used with diseases for articles on either ethnic or racial
aspects. Do not add /genetics for articles on race unless genetics is also
discussed. When /ethnol is indexed, do not add the general terms RACIAL STOCKS
or ETHNIC GROUPS, but if a specific ethnic or racial group is discussed, it
should be indexed (usually IM).
Frequency of Hodgkin's disease in Caucasians.
HODGKIN'S DISEASE / * ethnol
* CAUCASOID RACE
Colon cancer as related to life style in various ethnic groups.
COLONIC NEOPLASMS / * ethnol
* LIFE STYLE
(not ETHNIC GROUPS (IM or NIM))
Since /ethnol is indented under /epidemiology in the Subheading Trees (Figure
19.5), /epidemiology does not need to be used in addition to /ethnol on a
disease for a study of its epidemiology in ethnic or racial groups.
Occurrence of neuroses in the Aborigines of Australia.
NEUROTIC DISORDERS / * ethnol
ABORIGINES / * psychol
AUSTRALIA / epidemiol
(not AUSTRALIA / ethnol (see next page))
But: The frequency of type 2 diabetes in the United States.
(Article has a section devoted to its frequency among various native
American groups.)
DIABETES MELLITUS, TYPE 2 / * epidemiol / ethnol
UNITED STATES / epidemiol
INDIANS, NORTH AMERICAN / statist
Here the main point is /epidemiology in general, with the ethnic aspects merely
one section of the article, so both subheadings are needed.
/ethnol is also an AQ for various other terms, such as indentions under
PREGNANCY and SOCIAL PROBLEMS. If an article seems to be about the ethnic or
racial aspects of a concept, check the list of AQs to see if /ethnol is allowed.
Labor patterns in Hispanic Americans.
LABOR / * ethnol
* HISPANIC AMERICANS
PREGNANCY (check tag)
HUMAN (check tag)
FEMALE (check tag)
Crime rates among Hispanic Americans.
CRIME / * ethnol
HISPANIC AMERICANS / * statist
UNITED STATES
In addition, /ethnol is indexed with a geographic term to mean an ethnic
group from that area but living somewhere else. For example, Puerto Ricans as
an ethnic group living elsewhere are indexed PUERTO RICO/ethnol. Puerto Ricans
living in Puerto Rico are indexed simply as PUERTO RICO.
NOTE: Geographic terms can never be made IM, so when /ethnol is used with a
geographic term, it cannot be an IM concept even if the point of the article is
the ethnic group.
Incidence of AIDS in Haitians living in New York City.
AIDS / * ethnol
NEW YORK CITY / epidemiol
HAITI / ethnol
INCIDENCE
How frequent is colitis in Yemenite Jews in Israel?
COLITIS / * ethnol
* JEWS
YEMEN / ethnol
ISRAEL / epidemiol
Note the use of /epidemiol and /ethnol on the geographic terms in the two
examples above; /ethnol is used only on the area of origin.
19.8.33 /etiology /ET, /etiol
Used with diseases for causative agents including microorganisms and includes
environmental and social factors and personal habits as contributing factors.
It includes pathogenesis.
In general, when the subheading /etiol is used, the etiological factor is
indexed with the subheading /adverse effects. When one disease causes another,
the primary disease is indexed with the subheading /complications, the secondary
disease with /etiol.
Heat in the etiology of acne.
ACNE / * etiol
HEAT / * adv eff
The pathogenesis of gout.
GOUT / * etiol
Gout causing iritis.
GOUT / * compl
IRITIS / * etiol
Joint diseases caused by hemochromatosis.
HEMOCHROMATOSIS / * compl
JOINT DISEASES / * etiol
The Subheading Trees (Figure 19.5) give more specific subheadings under /etiol;
the specific subheading should be used when appropriate.
Fluorides causing acne
ACNE / * chem ind
FLUORIDES / * adv eff
Peptic ulcer caused by Helicobacter pylori infections.
* HELICOBACTER PYLORI
HELICOBACTER INFECTIONS / * compl
PEPTIC ULCER / * microbiol
19.8.34 /genetics /GE, /genet
Used for mechanisms of heredity and the genetics of organisms, for the genetic
basis of normal and pathologic states, and for the genetic aspects of endogenous
chemicals. It includes biochemical and molecular influence on genetic material.
This subheading can be used with organisms, endogenous compounds, physiological
processes, and diseases, for their genetic and hereditary aspects.
A simple method of karyotyping for use with horses.
HORSES / * genet
KARYOTYPING / * vet / methods
Disorders of muscle contraction in hereditary muscular dystrophies.
MUSCLE CONTRACTION / * genet
MUSCULAR DYSTROPHY / * physiopathol / * genet
Esterase polymorphism.
ESTERASES / * genet
* POLYMORPHISM
/genet is also used to index the concept of "familial", meaning "hereditary",
disease when no pre-coordinated term exists for the concept. Non-hereditary
familial diseases should, however, be indexed with the term FAMILY HEALTH.
The hereditary aspects of gout.
GOUT / * genet
Familial Behcet's disease.
BEHCET'S SYNDROME / * genet
But: Familial hypercholesterolemia.
* HYPERCHOLESTEROLEMIA, FAMILIAL
Spread of the common cold in families caused by sharing eating utensils.
COMMON COLD / * transm
* COOKING AND EATING UTENSILS
FAMILY HEALTH
EQUIPMENT CONTAMINATION
Do not confuse familial or hereditary diseases with congenital diseases. A
congenital (occurring at birth) disease may or may not be hereditary, and a
hereditary disease may not manifest itself for many years after birth. An
article may, of course, discuss the genetics of a congenital disease.
Genetic predisposition in congenital hip dislocation.
HIP DISLOCATION, CONGENITAL / * genet
Do not use /genet merely because a genetic disease is presented in the article
unless discussion is devoted to the genetic aspects.
The pathology of Turner's syndrome.
TURNER'S SYNDROME / * pathol
But: Turner's syndrome with ring X chromosomes.
TURNER'S SYNDROME / * genet
* X CHROMOSOME
* RING CHROMOSOMES
When an article discusses the genetics of an organism involved in an infection,
the subheading /genet is used on the organism, but the correct subheading on the
infection is /microbiology, /virology, or /parasitology; save /genet for the
genetics of the patient.
Genetic characteristics of Salmonella typhi in typhoid patients.
SALMONELLA TYPHI / * genet
TYPHOID / * microbiol
(not TYPHOID / * genet)
19.8.35 /growth & development /GD, /growth
Used with microorganisms, plants, and the postnatal period of animals for growth
and development. It includes also the postnatal growth or development of organs
or anatomical parts.
Development of the femur in congenital hip dislocation.
HIP DISLOCATION, CONGENITAL / * physiopathol
FEMUR / * growth
Vertical growth of the nose.
NOSE / * growth
Growth of Salmonella and the effects of various culture media.
SALMONELLA / * growth / * drug eff
CULTURE MEDIA / * pharmacol
Effect of dietary proteins on the growth of puppies.
DOGS / * growth
DIETARY PROTEINS / * pharmacol
Since this subheading is defined in terms of postnatal growth, prenatal
development should be indexed with the subheading /embryology instead.
Development of the fetal lung.
LUNG / * embryol
FETAL DEVELOPMENT
19.8.36 /history /HI, /hist
Used for the historical aspects of any subject. It includes brief historical
notes but excludes case histories.
When the subheading /hist is used, the appropriate historical publication
type(s) and check tag(s) must be added. For detailed indexing instructions, see
sections 17.42 and 32.15+ (HISTORICAL ARTICLE), 17.13 and 32.16+ ( BIOGRAPHY),
and 32.17 (Chronologic Tags).
The use of curare by ancient Indian groups in Brazil.
CURARE / * hist
INDIANS, SOUTH AMERICAN / * hist
BRAZIL
HISTORICAL ARTICLE (PT)
ANCIENT (check tag)
If an article is on the history of a topic for which a second subheading is also
applicable, make /*hist the only IM subheading.
A history of the treatment of epilepsy.
EPILEPSY / * hist / ther
HISTORICAL ARTICLE (PT)
centuries as given in the article
/hist should be reserved for terms of actual historical significance. For
example, although an article on the discovery of vitamin C can be indexed as
VITAMIN C/*hist, an article on the "history" of a drug which is only 15 years
old is not really a historical article.
The history of the synthesis of zidovudine in our laboratory.
ZIDOVUDINE / * chem syn
(not ZIDOVUDINE / * hist)
If /hist is not an AQ for the MeSH heading to which it applies, merely index the
main heading without a subheading and add any historical check tags and
publication types which apply.
Alchemy in the Middle Ages.
* ALCHEMY
HISTORICAL ARTICLE (PT)
MIDDLE AGES (check tag)
19.8.37 /immunology /IM, /immunol
Used for immunologic studies of tissues, organs, microorganisms, fungi, viruses,
and animals. It includes immunologic aspects of diseases but not immunologic
procedures used for diagnostic, preventive, or therapeutic purposes, for which
"diagnosis", "prevention & control", or "therapy" are used. The concept is also
used for chemicals as antigens or haptens.
When the subheading /immunol is used, it is usually coordinated with one of the
many headings in MeSH referring to antigens, antibodies, other immune compounds,
and immune activities.
Isolation of antigens from Staphylococcus aureus.
STAPHYLOCOCCUS AUREUS / * immunol
ANTIGENS, BACTERIAL / * isol
Antigenic determinants of plasma proteins.
BLOOD PROTEINS / * immunol
* ANTIGENIC DETERMINANTS
Antibody formation in mouse models of gout.
GOUT / * immunol
ANTIBODY FORMATION
MICE (check tag)
Localization of Coxsackie A16 viral antigens in various organs of mice.
COXSACKIE A VIRUSES / * immunol
ANTIGENS, VIRAL / * anal
MICE (check tag)
Immunochemical techniques are not indexed as /immunol but as /anal, /chem, or
/metab (or an indention). But if the compound being studied is an immune
compound, /immunol is used on the tissue or disease.
Radioimmunoassay of cortisol in blood.
CORTISOL / * blood
RADIOIMMUNOASSAY
Immunoperoxidase demonstration of IgG in the kidney.
IGG / * anal
KIDNEY / * immunol
IMMUNOPEROXIDASE TECHNIQUES
By MeSH definition, immunologic diagnosis, therapy, or prevention should be
indexed as /diagnosis, /therapy, or /prevention & control, respectively, rather
than as /immunol.
The serodiagnosis of gout.
GOUT / * diag
SERODIAGNOSIS
Immunotherapy of leukemia.
LEUKEMIA / * ther
* IMMUNOTHERAPY
Frequency of measles vaccination in developing countries.
MEASLES / * prev
VACCINATION / * util
* DEVELOPING COUNTRIES
Although mice were merely experimental animals in some of the previous examples,
there are occasions in which the type of animal causing the immune reaction,
and/or the type of animal in which the response occurs, are the main point of
the article. In such cases, index the animal(s) IM with the subheading
/*immunol.
Antibody formation to porcine versus beef insulin in patients with insulin-
dependent diabetes.
INSULIN / * immunol
INSULIN ANTIBODIES / * biosyn
DIABETES MELLITUS, INSULIN-DEPENDENT / * immunol
CATTLE / * immunol
SWINE / * immunol
SPECIES SPECIFICITY
ANIMAL (check tag)
HUMAN (check tag)
COMPARATIVE STUDY (check tag)
Do Balb/c mice develop antibodies to HIV-1?
HIV-1 / * immunol
HIV ANTIBODIES / * biosyn
MICE, INBRED BALB C / * immunol
ANIMAL (check tag)
MICE (check tag)
19.8.38 /injuries /IN, /inj
Used with anatomic headings, animals, and sports for wounds and injuries.
Excludes cell damage, for which "pathology" is used.
The concept of "injury" includes unspecified wounds, blunt or penetrating
wounds, contusions, fractures, dislocations, sprains, burns, etc. Many specific
injury types are found in Category C21, especially pre-coordinated organ-
injuries and bone-fractures terms.
Liver injuries.
LIVER / * inj
Penetrating wounds of the liver.
LIVER / * inj
* WOUNDS, PENETRATING
Surgical treatment of leg fractures.
LEG INJURIES / * surg
FRACTURES / * surg
Radiographic diagnosis of tibial fractures in the horse.
TIBIAL FRACTURES / * vet / radiogr
HORSES / * inj / radiogr
Occurrence of knee and elbow joint injuries in football players.
ELBOW JOINT / * inj
KNEE INJURIES / * epidemiol
FOOTBALL / * inj
/inj should be reserved for physical injuries only. Tissue "injuries", for
example those caused by a chemical, will probably be indexed as the /pathology
of the tissue (and in this case possibly also /drug effects). RADIATION
INJURIES should be coordinated with the subheading /radiation effects on the
organ affected by the radiation.
Radiation injuries of the lung during radiotherapy.
RADIOTHERAPY / * adv eff
* RADIATION INJURIES
LUNG / * rad eff
(not LUNG / * inj)
19.8.39 /innervation /IR, /innerv
Used with organs, regions, or tissues for their nerve supply.
This subheading is to be used when a specific nerve heading is not available in
MeSH. Do not attempt to index the nerve by tracing its pathway in a reference
book and using the MeSH term for the part of the nervous system from which it
arose; merely index the organ with the subheading / innerv.
When indexing the subheading /innerv, coordinate IM or NIM with the specific
type of innervation (AUTONOMIC NERVOUS SYSTEM, SYMPATHETIC NERVOUS SYSTEM,
AFFERENT FIBERS, etc.) if stated by the author.
Innervation of the pancreas.
PANCREAS / * innerv
Parasympathetic innervation of the pancreas.
PANCREAS / * innerv
* PARASYMPATHETIC NERVOUS SYSTEM
Preganglionic fibers of the corpora cavernosa.
PENIS / * innerv
* AUTONOMIC FIBERS, PREGANGLIONIC
The palatine nerve.
PALATE / * innerv
Anatomy of the gastric nerve.
STOMACH / * innerv
(not VAGUS NERVE / * anat although the gastric nerve arises from the vagus
nerve)
For further discussion of the use of /innerv, see section 21.7.
19.8.40 /instrumentation /IS, /instrum
Used with diagnostic or therapeutic procedures, analytic techniques, and
specialties or disciplines, for the development or modification of apparatus,
instruments, or equipment.
This subheading refers exclusively to "apparatus, instruments, or equipment."
Authors occasionally call a test or questionnaire an "instrument", but that
wording should not be covered by /instrum; /methods is probably better.
A gas-holding apparatus for use in gas chromatography.
CHROMATOGRAPHY, GAS / * instrum
A platinum EEG electrode.
ELECTROENCEPHALOGRAPHY / * instrum
* ELECTRODES
* PLATINUM
Development of a new film-holder for taking chest x-rays.
THORACIC RADIOGRAPHY / * instrum
EQUIPMENT DESIGN
A new surgical stapler for use in jejunoileal bypass.
* SURGICAL STAPLERS
JEJUNOILEAL BYPASS / * instrum
Sterilization of dairy equipment.
DAIRYING / * instrum
* STERILIZATION
A portable sterilizer for sterilization of dairy equipment.
DAIRYING / * instrum
STERILIZATION / * instrum
But: A psychological instrument for assessing personality.
(The "instrument" was a questionnaire, not a piece of equipment.)
PERSONALITY ASSESSMENT / * methods
QUESTIONNAIRES
For a further discussion of equipment and the subheading /instrum, see section
26.24+.
19.8.41 /isolation & purification /IP, /isol
Used with bacteria, viruses, fungi, protozoa, and helminths for the obtaining of
pure strains or for the demonstration of the presence of or identification of
organisms by DNA analyses, immunologic, or other methods, including culture
techniques. It is used also with biological substances and chemicals for the
isolation and purification of the constituents.
The subheading /isol is used with Category B terms (microorganisms and
parasites) for obtaining pure strains or for demonstrating their presence, and
with Category D terms for their isolation or purification.
Do not confuse with the following:
/analysis:
Used with Category D terms (chemicals) for determination of their levels.
/chemistry:
Used with Category A and B terms (organs, tissues, microorganisms, parasites,
and plants) and tumors for their chemical content or composition, and with
Category D terms for their chemical composition, structure, characterization and
properties.
/metabolism:
Used with Category D terms for changes in levels of endogenous compounds or for
changes in the molecular structure of all compounds. Used with Categories A, B,
and C for changes in chemical constituents or as a coordinate when /metab or
/pharmacokin is used on a Category D term.
/pharmacokinetics:
Used with exogenous chemicals for studies of their movement through the body.
For a full comparison, including examples, of /anal, /chem, /isol, /metab, and
/pharmacokin, see section 19.10.
19.8.42 /legislation & jurisprudence /LJ, /legis
Used for laws, statutes, ordinances, or government regulations, as well as for
legal controversy and court decisions.
Like all double subheadings (e.g. /prevention & control), /legislation &
jurisprudence is used for "legislation OR jurisprudence."
Legislation examples:
The new Florida Rape Law.
RAPE / * legis
FLORIDA
Nursing home legislation in Maryland.
NURSING HOMES / * legis
MARYLAND
Jurisprudence examples:
Expert testimony in sex offenses.
SEX OFFENSES / * legis
* EXPERT TESTIMONY
The discharged hospital employee sues in Virginia Commonwealth Court.
PERSONNEL, HOSPITAL / * legis
EMPLOYEE GRIEVANCES / * legis
VIRGINIA
Several of these examples specify the country or the state. It is indexing
policy to add a geographic term when indexing laws or court cases; see section
36.7. As with epidemiologic terms which are added whether or not discussed, the
geographic terms added for legal or judicial articles need not be discussed but
only mentioned.
Many general terms are available in MeSH: JURISPRUDENCE; LEGISLATION;
LEGISLATION, DENTAL; LEGISLATION, DRUG; LEGISLATION, HOSPITAL; LEGISLATION,
MEDICAL; LEGISLATION, NURSING; LEGISLATION, PHARMACY; LEGISLATION,
VETERINARY. Reserve these headings for general articles only; for specific
topics use the subheading /legis.
New dental legislation.
* LEGISLATION, DENTAL
Pending federal medical legislation.
* LEGISLATION, MEDICAL
UNITED STATES
When an article discusses legal or judicial aspects of a term for which /legis
is not an AQ, coordinate the specific subject (IM) with LEGISLATION (NIM) for
legislative aspects or with JURISPRUDENCE (NIM) for judicial aspects.
Laws on tattooing.
* TATTOOING
LEGISLATION
Court cases involving vaccines.
* VACCINES
JURISPRUDENCE
If the legal or judicial concept needed is a specific aspect for which we have a
heading, index the specific subject (IM) and the specific law or jurisprudence
aspect (IM) but do not add LEGISLATION or JURISPRUDENCE.
Expert testimony in occupational disease cases.
* OCCUPATIONAL DISEASES
* EXPERT TESTIMONY
New legislation on over-the-counter drugs.
* OVER-THE-COUNTER DRUGS
* LEGISLATION, DRUG
In an article on multiple topics, /legis is used with main headings for which it
is an AQ, but a LEGISLATION or JURISPRUDENCE term is added for headings with
which the subheading cannot be used.
The rise in divorce and paternity suits.
DIVORCE / * legis
* PATERNITY
JURISPRUDENCE
Laws on architectural accessibility in museums.
ARCHITECTURAL ACCESSIBILITY / * legis
* MUSEUMS
LEGISLATION
19.8.43 /manpower /MA, /man
Used with disciplines and programs for the demand, supply, distribution,
recruitment, and use of personnel.
/man is a statistical concept referring to the number of personnel available in
a given field. For example, DENTISTRY/*man means all personnel in the field of
dentistry, not necessarily DENTISTS only; manpower in dentistry is also dental
technicians, dental hygienists, dental assistants, hospital dental staff, etc.
Manpower in medical technology.
TECHNOLOGY, MEDICAL / * man
Nursing manpower.
NURSING / * man
Are emergency rooms understaffed?
HOSPITAL EMERGENCY SERVICE / * man
The shortage of surgeons in Nigeria.
SURGERY / * man
NIGERIA
See also sections 19.8.69 and 35.2.5 for a discussion of the use of /man versus
/supply & distribution, which is used with terms from Category M (named groups).
19.8.44 /metabolism /ME, /metab
Used with organs, cells and subcellular fractions, organisms and diseases for
biochemical changes and metabolism. It is used also with drugs and chemicals
for catabolic changes (breakdown of complex molecules into simpler ones). For
anabolic processes (conversion of small molecules into large), biosynthesis is
used. For enzymology, pharmacokinetics, and secretion use the specific
subheadings.
The subheading /metab is used with Category D terms for changes in levels of
endogenous compounds or for changes in the molecular structure of all compounds.
It is used with Categories A, B, and C for changes in chemical constituents or
as a coordinate when /metab or /pharmacokin is used on a Category D term.
Do not confuse with the following:
/analysis:
Used with Category D terms (chemicals) for determination of their levels.
/chemistry:
Used with Category A and B terms (organs, tissues, microorganisms, parasites and
plants) and tumors for their chemical content or composition, and with Category
D terms for their chemical composition, structure, characterization and
properties.
/isolation & purification:
Used with Category B terms (microorganisms and parasites) for the obtaining of
pure strains or for demonstration of their presence, and with Category D terms
for their isolation or purification.
/pharmacokinetics:
Used with exogenous chemicals for studies of their movement through the body.
For a full comparison, including examples, of /anal, /chem, /isol, /metab, and
/pharmacokin, see section 19.10.
19.8.45 /methods /MT, /methods
Used with techniques, procedures, and programs for methods.
Do not confuse this subheading with /instrumentation, which refers only to
equipment used in various specialties or with various techniques. Many articles
discussing methods refer to the instrumentation used and many articles
discussing instruments relate them to techniques employing the instruments.
Whether /methods, /instrum or both is indexed depends upon the amount of text
devoted to the discussion of each. In many articles both the method and the
instrumentation are routine and are mentioned merely in passing; in such cases
they should not be indexed at all.
Enlargement techniques in diagnostic radiology.
RADIOGRAPHIC MAGNIFICATION / * methods
Hemilaryngectomy.
LARYNGECTOMY / * methods
Do not use /methods with any MeSH term containing the word "technique" or
"techniques". Since the concept of "method" is inherent in the term, MeSH has
not allowed /methods as an AQ for any such term.
A new enzyme immunoassay technique.
* IMMUNOENZYME TECHNIQUES
(not IMMUNOENZYME TECHNIQUES / * methods)
When the method or technique is important in the article but there is no term to
index with the subheading /methods, add the main heading METHODS (NIM).
However, remember that a main heading equivalent of a subheading (or another
general term) may be added NIM with the subheading /methods (see 19.7.4 and
19.7.7).
A method for stripping varicose veins.
VARICOSE VEINS / * surg
VASCULAR SURGERY / methods
not METHODS (NIM))
(not SURGICAL PROCEDURES, OPERATIVE / methods)
When indexing an article on the methodologic aspects of several subjects, use
/methods with main headings for which it is an AQ, but add METHODS (NIM) as a
coordinate for other headings, if there is no general term to be added NIM with
the subheading /methods .
19.8.46 /microbiology /MI, /microbiol
Used with organs, animals and higher plants and with diseases for microbiologic
studies. For parasites, "parasitology" is used; for viruses, "virology" is
used.
Use this subheading with reference to organisms in Categories B3 (bacteria and
rickettsiae) and B5 (fungi). Organisms in Category B1 (the invertebrates)
should be indexed as /parasitology, while those in Category B4 (the viruses)
should be indexed as /virology. (Since /virol is treed under /microbiol in the
Subheading Trees, /microbiol may be used to group the subheadings if viruses are
merely studied along with other microorganisms; see Figure 19.5.)
Isolation of Mycoplasma from the intestinal tract of a cow.
MYCOPLASMA / * isol
INTESTINES / * microbiol
CATTLE / * microbiol
Sputum levels of Mycobacterium tuberculosis in pulmonary tuberculosis.
TUBERCULOSIS, PULMONARY / * microbiol
SPUTUM / * microbiol
MYCOBACTERIUM TUBERCULOSIS / * isol
But: Rotavirus gastroenteritis.
GASTROENTERITIS / * virol
* ROTAVIRUS INFECTIONS
The MeSH definition of /microbiol permits its use with disease headings for
discussions of microbes in a disease whether the microbe is the causative agent
or not.
Classification of strains of Staphylococcus in staphylococcal mastitis in
cattle.
MASTITIS, BOVINE / * microbiol
STAPHYLOCOCCAL INFECTIONS / * vet / microbiol
STAPHYLOCOCCUS / * class
CATTLE (check tag)
ANIMAL (check tag)
FEMALE (check tag)
Demonstration of Pneumocystis carinii in the liver of AIDS patients.
AIDS / * microbiol
LIVER / * microbiol
PNEUMOCYSTIS CARINII / * isol
It should be noted that the use of /microbiol is merely a statement of the
presence of a microbe; it does not necessarily mean that an infection is
present. Although clinically the presence of a microorganism is likely to
indicate an infection, remember that articles or discussions concerning a
microbe are not necessarily about infections.
Demonstration of the presence of Proteus mirabilis in the kidney.
PROTEUS MIRABILIS / * isol
KIDNEY / * microbiol
(not PROTEUS INFECTIONS, KIDNEY DISEASES, or NEPHRITIS unless discussed that way
in the article)
Do not use /microbiol on an organ to index a microbial infection if there is no
pre-coordinated infections term in MeSH; use instead a pre-coordinated organ-
diseases term.
Bacterial infections of the biliary tract.
BILIARY TRACT DISEASES / * microbiol
* BACTERIAL INFECTIONS
(not BILIARY TRACT / * microbiol)
When an article discusses the genetics of a microorganism involved in an
infection, use /genet on the organism but /microbiol on the infection. Save
/genet with diseases for articles on the genetics of the patients.
Genetic variants among strains of Streptococcus group A isolated from recent
cases of necrotizing fasciitis.
STREPTOCOCCUS GROUP A / * genet / isol
* VARIATION (GENETICS)
STREPTOCOCCAL INFECTIONS / * microbiol / pathol
FASCIITIS / * microbiol / pathol
NECROSIS
(not STREPTOCOCCAL INFECTIONS / * genet)
(not FASCIITIS / * genet)
19.8.47 /mortality /MO, /mortal
Used with human and veterinary diseases for mortality statistics. For deaths
resulting from various procedures statistically but for a death resulting in a
specific case, use FATAL OUTCOME, not /mortality.
Since /mortal is statistical, it should be used on diseases and procedures only
for studies of the mortality of groups of patients.
Mortality in liver cirrhosis.
LIVER CIRRHOSIS / * mortal
Mortality in spinal anesthesia.
ANESTHESIA, SPINAL / * mortal
Case reports on individual fatalities (frequently seen with titles such as "A
fatal case of ...." or similar expressions) are covered by indexing the term
FATAL OUTCOME. This term is to be used only for articles on fatal outcomes in
individual cases; the check tag CASE REPORT must be checked. No subheading
should be used on the disease or procedure as a coordinate for FATAL OUTCOME
(but a subheading may of course be used to cover any other important aspect of
the case, such as diagnosis or treatment.)
Death of a patient after a routine cholecystectomy.
* CHOLECYSTECTOMY
FATAL OUTCOME
CASE REPORT (check tag)
(not: CHOLECYSTECTOMY / * mortal)
Needle thoracostomy fails to detect a fatal tension pneumothorax.
THORACOSTOMY / * methods
PNEUMOTHORAX / * diag
FATAL OUTCOME
CASE REPORT (check tag)
Since /mortal is a subset of /epidemiology in the Subheading Trees (Figure
19.5), the rules used for indexing epidemiologic studies apply to this
subheading also. The method used for determining the mortality should be
indexed even if merely mentioned. In addition, the geographic location studied
should be indexed if relevant, whether or not discussed, and the subheading
/epidemiol should be used on the geographic term.
Longitudinal studies of mortality in pulmonary hypertension.
HYPERTENSION, PULMONARY / * mortal
LONGITUDINAL STUDIES
Heart attack survival rates in Finland versus France.
MYOCARDIAL INFARCTION / * mortal
SURVIVAL RATE
FINLAND / epidemiol
FRANCE / epidemiol
COMPARATIVE STUDY (check tag)
SURVIVAL RATE and SURVIVAL ANALYSIS are two epidemiologic methods which are
frequently used to study mortality. Keep in mind, however, that these may
really be measures of treatment effectiveness (especially in diseases such as
neoplasms which would be fatal without treatment) and, if so, the subheading
/mortal may not be needed even when one of these terms is indexed.
A phase II trial of taxol in ovarian neoplasms.
(Disease-free and mortality-free survival rates are measured.)
OVARIAN NEOPLASMS / * drug ther
TAXOL / * ther use
SURVIVAL RATE
CLINICAL TRIAL, PHASE II (PT)
HUMAN (check tag)
FEMALE (check tag)
(not OVARIAN NEOPLASMS / mortal since this is not an
epidemiology study)
Although the MeSH definition of /mortal refers only to human and veterinary
diseases, the subheading may also be used when indexing an experimental animal
study if the author discusses it as a model of the mortality of the disease in
humans.
A mouse model for disseminated paracoccidioidomycosis: the first animal model
with mortality rates similar to those seen in humans.
PARACOCCIDIOIDOMYCOSIS / * mortal
* DISEASE MODELS, ANIMAL
MICE (check tag)
ANIMAL (check tag)
19.8.48 /nursing /NU, /nurs
Used with diseases for nursing care and techniques in their management. It
includes the nursing role in diagnostic, therapeutic, and preventive procedures.
The subheading /nurs includes nursing care given by both professional nurses and
non-professionals, such as family members.
A common coordination with a disease or procedure qualified by /nurs is one of
the specific nursing terms in MeSH.
Nursing care in gout.
GOUT / * nurs
Nursing care during cerebral ventriculography.
CEREBRAL VENTRICULOGRAPHY / * nurs
Private duty nursing in paraplegia.
PARAPLEGIA / * nurs
* NURSING, PRIVATE DUTY
Home nursing in parkinsonism.
PARKINSON DISEASE / * nurs
* HOME NURSING
19.8.49 /organization & administration /OG, /organ
Used for administrative structure and management.
The role of transfusion service directors.
BLOOD BANKS / * organ
* ADMINISTRATIVE PERSONNEL
Organization of a facility devoted to the treatment of breast cancer.
BREAST NEOPLASMS / * ther
CANCER CARE FACILITIES / * organ
Scheduling radiology department visits.
RADIOLOGY DEPARTMENT, HOSPITAL / * organ
* APPOINTMENTS AND SCHEDULES
When the concept of organization, administration, or management is needed with a
main heading for which /organ is not an AQ, index the main heading (IM) and add
ORGANIZATION AND ADMINISTRATION (NIM).
The organization of pilot projects.
* PILOT PROJECTS
ORGANIZATION AND ADMINISTRATION
If the organizational aspect is a specific heading available in MeSH, index the
subject of the article (IM) and add the heading for the organizational aspect
(also IM) but do not add ORGANIZATION AND ADMINISTRATION.
Personnel management in transportation fields.
* TRANSPORTATION
* PERSONNEL MANAGEMENT
When indexing an article on the organizational aspects of several subjects, use
/organ with main headings for which it is an AQ, but add ORGANIZATION AND
ADMINISTRATION as an NIM coordinate for headings which do not have /organ as an
AQ.
Management of blood banks and organ transplantation programs.
BLOOD BANKS / * organ
* ORGAN TRANSPLANTATION
ORGANIZATION AND ADMINISTRATION
19.8.50 /parasitology /PS, /parasitol
Used with animals, higher plants, organs, and diseases for parasitic factors.
In diseases, it is not used if the parasitic involvement is implicit in the
diagnosis.
The subheading /parasitol should be used with organs, diseases, animals and
plants for articles on their parasites. The most common parasites we index are
helminths and protozoa, but /parasitol should be used for articles on any
organism from Category B1 (the invertebrates) discussed as a parasite.
The numbers of Giardia in the feces of infected children.
GIARDIASIS / * parasitol
GIARDIA / * isol
FECES / * parasitol
Tick infestations of cats.
CAT DISEASES / * parasitol
TICK INFESTATIONS / * vet
As with the subheadings /microbiology and /virology, /parasitol may be used with
a disease heading for any discussion of parasites in the disease, whether or not
the parasites cause the disease. Also, an article may discuss a parasite in an
organ without being about an infection of that organ.
Isolation of Dioctophyma in heartworm disease of dogs.
DIOCTOPHYMA / * isol
HEARTWORM DISEASE / * vet / parasitol
DOG DISEASES / * parasitol
DOGS (check tag)
Demonstration of parasites in the lungs of healthy cats.
LUNG / * parasitol
CATS / * parasitol
(not LUNG DISEASES, PARASITIC / * vet)
(not CAT DISEASES / * parasitol)
Do not use /parasitol on an organ to index a parasitic infection if there is no
precoordinated organ-infections term in MeSH; use instead a pre-coordinated
organ-diseases term.
Helminth infections of the kidney.
* HELMINTHIASIS
KIDNEY DISEASES / * parasitol
(not KIDNEY / * parasitol)
Although /parasitol is an AQ for organisms in Category B1, it is not to be used
for articles on them as parasites, but rather for studies of their parasites.
Relations of Schistosoma mansoni to its host Biomphalaria.
BIOMPHALARIA / * parasitol
SCHISTOSOMA MANSONI / * physiol
HOST-PARASITE RELATIONS
(not SCHISTOSOMA MANSONI / * parasitol)
(not SCHISTOSOMIASIS MANSONI / * vet; see section 23.33.9 for parasites
in invertebrates)
Studies on nematodes in South American cestodes.
NEMATODA / * isol
CESTODA / * parasitol
SOUTH AMERICA
When an article discusses the genetics of a parasite involved in a disease, use
/genet on the parasite, but /parasitol on the disease; save /genet on diseases
for studies of the genetics of the patients.
Genes coding for ribosomal proteins in Leishmania infantum isolated from
infected patients.
LEISHMANIA INFANTUM / * genet / isol
RIBOSOMAL PROTEINS / * genet
PROTOZOAN PROTEINS / * genet
* GENES, PROTOZOAN
LEISHMANIASIS, VISCERAL / * parasitol
(not LEISHMANIASIS, VISCERAL / * genet)
19.8.51 /pathogenicity /PY, /pathogen
Used with microorganisms, viruses, and parasites for studies of their ability to
cause disease in man or animals.
This subheading should be reserved for discussions of an organisms's ability or
inability to cause disease (its "virulence" or "pathogenicity"). The studies
may be performed in vitro.
Fatal Streptococcal infections caused by a new strain of Streptococcus group A;
how has the organism's virulence changed in the last 10 years?
STREPTOCOCCAL INFECTIONS / * microbiol / mortal
STREPTOCOCCUS GROUP A / * pathogen
VIRULENCE
Studies to determine if Mycobacterium bovis isolated from cases of bovine
tuberculosis is pathogenic to humans.
MYCOBACTERIUM BOVIS / * pathogen / isol
TUBERCULOSIS, BOVINE / * microbiol
CATTLE (check tag)
ANIMAL (check tag)
HUMAN (check tag)
Do not index /pathogen merely because the word "pathogenic" is used to cover the
concept that an infection exists in a patient or animal. If there is no
discussion of the ability of the organism to cause the infection, all that
should be indexed is the organism-infection term.
Epidemiology of pathogenic Escherichia coli in Poland.
(No discussion of the organism itself, just the infection.)
ESCHERICHIA COLI INFECTIONS / * epidemiol
POLAND / epidemiol
(not ESCHERICHIA COLI / * pathogen)
/pathogen should not be used to cover an infection when there is no specific
pre-coordinated organism-infection term in MeSH; instead, index the organism IM
with no subheading and add the next most specific organism-infection term
available in MeSH, also IM.
Gardnerella infections.
* GARDNERELLA
* BACTERIAL INFECTIONS
(not GARDNERELLA / * pathogen)
19.8.52 /pathology /PA, /pathol
Used for organ, tissue, or cell structure in disease states.
The subheading /pathol is used to index deviations from the normal structure of
organs, tissues and cells; /anatomy & histology is used for the normal
structure of organs and tissues, and /cytology is used for normal cells.
The normal and pathological liver cell.
LIVER / * cytol
LIVER / * pathol
Connective tissue pathology.
CONNECTIVE TISSUE / * pathol
When indexing /pathol on a disease, any organ discussed must also be indexed
even if it is the organ affected by the disease; /pathol used on the disease
term does not imply any particular organ.
Conversely, the indexer must not assume that an organ with the subheading
/pathol must be indexed merely because /pathol has been used on a disease of
that organ. An author may discuss the general pathology of a disease without
emphasizing one organ in particular. See the first and second examples below;
even though hepatitis is a liver disease, the liver should be indexed only if it
is especially discussed.
The pathology of hepatitis.
HEPATITIS / * pathol
(not LIVER / * pathol)
Liver pathology in hepatitis.
LIVER / * pathol
HEPATITIS / * pathol
Kidney pathology in hepatitis.
KIDNEY / * pathol
HEPATITIS / * pathol
Liver pathology in the diagnosis of hepatitis.
LIVER / * pathol
HEPATITIS / * pathol
(not: HEPATITIS / * diag, because of Subheading Trees)
/ultrastructure (for the subcellular structure of organs and tissues) is
different from /anat and /cytol; it can be used for either normal or
pathological states. However, it is not an AQ for Category C terms (except for
neoplasms) and therefore the correct coordinate is /pathol on the disease.
Submitochondrial particles of the muscle in muscular dystrophy.
MUSCULAR DYSTROPHY / * pathol
MITOCHONDRIA, MUSCLE / * ultrastruct
SUBMITOCHONDRIAL PARTICLES / * ultrastruct
Do not use /pathol to index "disease" when MeSH does not provide an organ-
diseases term. /pathol refers only to the structure of tissue and is not meant
to be a substitute for "disease". Always restrict /pathol to a description of
the appearance of an organ, tissue or cell.
Diseases of the ciliary body.
* CILIARY BODY
UVEAL DISEASES
(not CILIARY BODY / * pathol)
Likewise, authors sometimes use the word "pathology" as a substitute for
"disease"; indexers should not use the subheading /pathol in these instances,
but save it for studies of structure.
Epidemiology of lung pathology in coal miners.
* COAL MINING
LUNG DISEASES / * epidemiol
OCCUPATIONAL DISEASES / * epidemiol
(not LUNG / * pathol unless the appearance of the lung is
discussed)
19.8.53 /pharmacokinetics /PK, /pharmacokin
Used for the mechanism, dynamics and kinetics of exogenous chemical and drug
absorption, biotransformation, distribution, release, transport, uptake, and
elimination as a function of dosage, extent, and rate of metabolic processes.
The subheading /pharmacokin is used with exogenous chemicals for studies of
their movement through the body.
Do not confuse with the following:
/analysis:
Used with Category D term (chemicals) for determination of their levels.
/chemistry:
Used with Category A and B terms (organs, tissues, microorganisms, parasites and
plants) and tumors for their chemical content or composition, and with Category
D terms for their chemical composition, structure, characterization and
properties.
/isolation & purification:
Used with Category B terms (microorganisms and parasites) for obtaining pure
strains or for demonstration of their presence, and with Category D terms for
their isolation or purification.
/metabolism:
Used with Category D terms for changes in levels of endogenous compounds or for
changes in the molecular structure of all compounds. Used with Categories A, B,
and C for changes in chemical constituents or as a coordinate when /metab or
/pharmacokin is used on a Category D term.
For a full comparison, including examples, of /anal, /chem, /isol, /metab, and
/pharmacokin, see section 19.10.
19.8.54 /pharmacology /PD, /pharmacol
Used with drugs and exogenously administered chemical substances for their
effects on living tissues and organisms. It includes acceleration and
inhibition of physiological and biochemical processes and other pharmacologic
mechanisms of action.
/pharmacol is used with Category D terms exclusively. The corresponding
subheading coordinate is almost always /drug effects on an organ, organism, or
physiological or psychological process.
Mechanism of action of cephalosporins on Bacillus cereus.
BACILLUS CEREUS / * drug eff
CEPHALOSPORINS / * pharmacol
Effect of mannitol on coronary ultrastructure.
MANNITOL / * pharmacol
CORONARY VESSELS / * drug eff / * ultrastruct
Suppression of lactation by diethylstilbestrol.
LACTATION / * drug eff
DIETHYLSTILBESTROL / * pharmacol
DEPRESSION, CHEMICAL
Antagonism of morphine by naloxone.
MORPHINE / * antag
NALOXONE / * pharmacol
Sometimes "The effect of" a Category D term should not be indexed as its
/pharmacol. "The effect of" an endogenous substance may be its /physiology;
see section 19.8.55. "The effect of" a drug on a disease is probably its
/therapeutic use, not /pharmacol unless only about the effects of the drug on
some aspect of the disease process.
Effect of penicillin on experimental hepatitis in dogs.
HEPATITIS, ANIMAL / * drug ther
PENICILLINS / * ther use
DOGS (check tag)
Effect of a single dose of propranolol on heart rate in patients with
hypertension.
PROPRANOLOL / * pharmacol
HEART RATE / * drug eff
HYPERTENSION / * physiopathol
19.8.55 /physiology /PH, /physiol
Used with organs, tissues, and cells of unicellular and multicellular organisms
for normal function. It is used also with biochemical substances, endogenously
produced, for their physiologic role.
This subheading is restricted to articles on normal function. For disordered
function, use /physiopathology; see section 19.8.56.
Liver function.
LIVER / * physiol
Effect of pregnancy on the liver.
LIVER / * physiol
PREGNANCY / * physiol
Changes in cerebral metabolism during mental tasks.
BRAIN / * metab
MENTAL PROCESSES / * physiol
Role of insulin in body weight regulation.
BODY WEIGHT / * physiol
INSULIN / * physiol
Effects of endogenous serotonin in labor.
SEROTONIN / * physiol
LABOR / * physiol
Note that in the last two examples the Category D terms are endogenous compounds
which have /physiol as an AQ. Remember that /physiol is to be reserved for the
role of the compound in the body. The clue to correct indexing of /physiol with
Category D terms will be words like "function of", "physiology of", "role in",
"endogenous", etc.
Substances for which /physiol is an AQ can also be used as drugs and can
affect physiological processes. In these cases, the drug should be indexed with
/pharmacology (not /physiol) and the physiological process should be indexed
with /drug effects; see section 19.8.54.
Effects of intravenous serotonin on heart rate in labor.
SEROTONIN / * pharmacol / admin
HEART RATE / * drug eff
LABOR / * drug eff / physiol
INJECTIONS, INTRAVENOUS
19.8.56 /physiopathology /PP, /physiopathol
Used with organs and diseases for disordered function in disease states.
This subheading is used with an organ for its disordered function in a disease,
or with a disease for disordered physiology caused by the disease.
Liver function in hepatitis.
LIVER / * physiopathol
HEPATITIS / * physiopathol
Heart function in normal pregnancy and pregnancy in patients with mitral valve
prolapse.
HEART / * physiol
HEART / * physiopathol
PREGNANCY / * physiol
PREGN COMPL CARDIOVASCULAR / * physiopathol
MITRAL VALVE PROLAPSE / * physiopathol
Brain function in schizophrenia.
SCHIZOPHRENIA / * physiopathol
BRAIN / * physiopathol
The normal function of an organ in an unrelated disease is indexed as the
/physiology of the organ.
Normal lung function in heart diseases.
LUNG / * physiol
HEART DISEASES / * physiopathol
Occasionally an author uses a phrase such as "liver physiopathology" in a title.
In such instances, the text will determine whether the correct indexing is
LIVER/*physiopathol or LIVER DISEASES.
Do not use /physiopathol on an organ to cover "disease" in the absence of a pre-
coordinated organ-diseases heading; save it for studies of disordered function.
Diseases of the cystic duct.
* CYSTIC DUCT
BILE DUCT DISEASES
(not CYSTIC DUCT / * physiopathol)
19.8.57 /poisoning /PO, /pois
Used with drugs, chemicals, and industrial materials for human or animal
poisoning, acute or chronic, whether the poisoning is accidental, occupational,
suicidal, by medication error, or by environmental exposure.
The subheading /pois is used for the serious condition known as "poisoning",
"overdose", or "intoxication".
Do not confuse with the following:
/adverse effects:
Used for "side effects" or "complications" of a drug, chemical, or procedure.
/contraindications:
Used with drugs and procedures for conditions in which the drug should not be
given or the procedure performed.
/toxicity:
Used only for experimental studies to determine whether a compound is toxic, or
under what conditions it becomes toxic.
For a full comparison, including examples, of /adv eff, /contra, /pois, and
/tox, see section 19.9.
19.8.58 /prevention & control /PC, /prev
Used with disease headings for increasing human or animal resistance against
disease, (e.g., immunization), for control of transmission agents, for
prevention and control of environmental hazards, or for prevention and control
of social factors leading to disease. It includes preventive measures in
individual cases.
This subheading, like other two-part subheadings (e.g., /legislation &
jurisprudence), may be used for articles on either prevention or control of
diseases and environmental hazards; an article does not need to discuss both
prevention and control.
The first half of the subheading rarely poses difficulties for indexers, who
realize that /prev should be indexed not only when the word "prevention" is
used, but also when words or phrases like "reducing the risk of", "prophylaxis",
"immunization against", etc. appear. As can be seen from the scope note above,
/prev may be used for case reports discussing prevention.
Methods used to reduce the high occurrence of syphilis.
SYPHILIS / * prev
Prevention of measles by passive immunization.
MEASLES / * prev
* IMMUNIZATION, PASSIVE
Prevention of air and water pollution.
AIR POLLUTION / * prev
WATER POLLUTION / * prev
Ergotamine prevention of migraine recurrence in a 46-year-old woman.
MIGRAINE / * prev
ERGOTAMINE / * ther use
RECURRENCE
HUMAN (check tag)
MID AGE (check tag)
FEMALE (check tag)
CASE REPORT (check tag)
Articles on the "control" of disease in a public health context should also be
indexed with the subheading /prev. The subheading should not, however, be used
for "control" of disease in individual patients. In most cases, "control" of a
physiologic dysfunction in a patient with a disease is part of the overall
management of that disease, and therefore /therapy or a more specific
therapeutic subheading should be used rather than /prev.
Controlling malaria by spraying for mosquitoes.
MALARIA / * prev
MOSQUITO CONTROL / * methods
But: Use of an insulin infusion system to control blood glucose in a patient
with type 1 diabetes.
* INSULIN INFUSION SYSTEMS
BLOOD GLUCOSE / * drug eff
DIABETES MELLITUS, TYPE 1 / * drug ther / blood
HUMAN (check tag)
CASE REPORT (check tag)
(not: DIABETES MELLITUS, TYPE 1 / * prev)
19.8.59 /psychology /PX, /psychol
Used with non-psychiatric diseases, techniques, and named groups for
psychologic, psychiatric, psychosomatic, psychosocial, behavioral, and emotional
aspects, and with psychiatric disease for psychologic aspects; used also with
animal terms for animal behavior and psychology.
/psychol may be used for articles on the psychological aspects of diseases,
procedures, groups of people, and higher animals. It may also be used instead
of /complications or /adverse effects for psychological diseases resulting from
other diseases or procedures.
The ulcer personality.
PEPTIC ULCER / * psychol
* PERSONALITY
Alcoholic memory disorders.
ALCOHOLISM / * psychol
MEMORY DISORDERS / * etiol
Aggressiveness of pit bulldogs.
DOGS / * psychol
* AGGRESSION
Psychological adaptation of the patient to colostomy.
COLOSTOMY / * psychol
* ADAPTATION, PSYCHOLOGICAL
Post-mastectomy depression.
DEPRESSION / * etiol
MASTECTOMY / * psychol
If an article is on the psychology of a subject for which /psychol is not an AQ,
index the subject (IM) and add PSYCHOLOGY (NIM), or any specific psychological
term (IM).
The psychological response to long periods of rain.
* RAIN
PSYCHOLOGY
Motivation to use seat belts.
* SEAT BELTS
* MOTIVATION
19.8.60 /radiation effects /RE, /rad eff
Used for effects of ionizing and nonionizing radiation upon living organisms,
organs and tissues, and their constituents, and upon physiologic processes. It
includes the effect of irradiation on drugs and chemicals.
When indexing /rad eff, assume it refers to x-rays unless otherwise specified
and do not add X-RAYS as a coordinate unless the x-rays are compared with other
radiation. Except for x-rays, always specify the type of ray if given (a term
indented under RADIATION in Category H or RADIOISOTOPES in Category D1), making
it IM if it is the point of the article. Do not index RADIATION, IONIZING or
RADIATION, NON-IONIZING unless the article is very general and the specific type
of ray is not specified; when one of these terms is indexed, it will seldom be
IM.
Effect of x-rays on the pancreas.
PANCREAS / * rad eff
Effect of ultraviolet rays on Salmonella.
SALMONELLA / * rad eff
* ULTRAVIOLET RAYS
Effect of ionizing radiation on plants.
PLANTS / * rad eff
RADIATION, IONIZING
Radiation injuries to the ovary.
OVARY / * rad eff
* RADIATION INJURIES
Stability of aspirin stored in light-permeable versus light- resistant
containers.
ASPIRIN / * rad eff
* LIGHT
* DRUG CONTAINERS AND CLOSURES
DRUG STABILITY
COMPARATIVE STUDY (check tag)
For a further discussion of the indexing of radiation and the use of /rad eff,
see sections 28.11 through 28.13.
19.8.61 /radiography /RA, /radiogr
Used with organs, regions, and diseases for x-ray examinations. It does not
include radionuclide imaging for which "radionuclide imaging" is used.
/radiogr is used for articles on the "x-ray image of organs" and "the x-ray
diagnosis of disease". Radioisotope scanning does not go here; use instead the
subheading /radionuclide imaging.
X-raying the pancreas.
PANCREAS / * radiogr
Radiography of the lung.
LUNG / * radiogr
X-ray diagnosis of pulmonary tuberculosis.
TUBERCULOSIS, PULMONARY / * radiogr
MeSH contains terms for many specific types of radiographic studies; some of
these terms should be indexed as coordinations for /radiogr on an organ and/or
disease, while others are pre-coordinated terms for the radiography of a
specific organ. Every organ for which a pre-coordinated radiography term is
available has a warning in MeSH not to index the organ/radiogr but rather the
pre-coordinated term.
Cholecystographic diagnosis of cholelithiasis.
CHOLELITHIASIS / * radiogr
* CHOLECYSTOGRAPHY
Cineradiography of the lung in patients with emphysema.
LUNG / * radiogr
* CINERADIOGRAPHY
PULMONARY EMPHYSEMA / * radiogr
Computed tomography of the brain in the diagnosis of tumors.
BRAIN / * radiogr
* TOMOGRAPHY, X-RAY COMPUTED
BRAIN NEOPLASMS / * radiogr
Radiography of the cerebral arteries.
* CEREBRAL ANGIOGRAPHY
(not CEREBRAL ARTERIES / * radiogr)
19.8.62 /radionuclide imaging /RI, /radionuclide
Used for radionuclide imaging of any anatomical structure, or for the diagnosis
of disease.
/radionuclide is used for studies in which an image of an organ is obtained with
radioisotopes; the radioisotope used in performing the scan is indexed with the
subheading /diagnostic use. Common concepts which should be indexed as
/radionuclide include "scintigraphy" and "isotope scanning". When x-rays are
used to obtain the image of the organ, /radiography should be indexed instead;
"CAT scans" are performed with x-rays and should therefore be indexed as
/radiogr.
Brain scintigraphy.
BRAIN / * radionuclide
Thallium-201 for myocardial imaging.
HEART / * radionuclide
THALLIUM RADIOISOTOPES / * diag use
Early radionuclide diagnosis of acute osteomyelitis.
OSTEOMYELITIS / * radionuclide
ACUTE DISEASE
TIME FACTORS
Radioisotopes used in ORL diagnostic scans.
OTORHINOLARYNGOLOGICAL DISEASES / * radionuclide
RADIOISOTOPES / * diag use
Radionuclide cystography in detecting vesicoureteral reflux.
BLADDER / * radionuclide
VESICO-URETERAL REFLUX / * radionuclide
Comparison of x-rays and scanning in bone tumors.
BONE NEOPLASMS / * radiogr / * radionuclide
COMPARATIVE STUDY (check tag)
19.8.63 /radiotherapy /RT, /radiother
Used with disease headings for the therapeutic use of ionizing and nonionizing
radiation. It includes the use of radioisotope therapy.
While /radiography is restricted to x-ray imaging techniques, /radiother
includes the therapeutic use of other radiations such as radioisotopes.
However, /radiother will be presumed to be x-ray therapy unless otherwise
specified, and X-RAY THERAPY should be indexed only when compared with other
types of radiotherapy. When any other type of radiotherapy is studied, it
should be added as an IM coordinate for /*radiother.
/radiother is not restricted to the treatment of human diseases. It is
permitted for the treatment of disease in experimental or veterinary animals.
Radiotherapy of skin cancer.
SKIN NEOPLASMS / * radiother
X-ray therapy of skin cancer.
SKIN NEOPLASMS / * radiother
Cobalt teletherapy of brain tumors.
BRAIN NEOPLASMS / * radiother
COBALT RADIOISOTOPES / * ther use
* RADIOISOTOPE TELETHERAPY
Ultraviolet therapy of eczema.
ECZEMA / * radiother
* ULTRAVIOLET THERAPY
Radiotherapy of experimental skin neoplasms in the rat.
SKIN NEOPLASMS / * radiother
RATS (check tag)
19.8.64 /rehabilitation /RH, /rehabil
Used with diseases and surgical procedures for restoration of function of the
individual.
/rehabil is used with diseases and surgical procedures for articles where the
intent is to get the patient out of bed and into the normal activities of life
whether cured or not. The subheading is used for physical procedures only, such
as exercise therapy, splinting, use of self-help devices, etc.; restoration of
function by surgical means should be indexed as /surgery instead.
Braces to assist walking after leg fractures.
FRACTURES / * rehabil
LEG INJURIES / * rehabil
* BRACES
Rehabilitation after coronary bypass.
CORONARY ARTERY BYPASS / * rehabil
Early mobilization after spinal injuries.
SPINAL INJURIES / * rehabil
* EARLY MOBILIZATION
Vocational rehabilitation for psychiatric patients.
MENTAL DISORDERS / * rehabil
* REHABILITATION, VOCATIONAL
But: Reconstruction of the breast after mastectomy.
* MASTECTOMY
* BREAST RECONSTRUCTION
REOPERATION
(not MASTECTOMY / * rehabil)
19.8.65 /secondary /SC, /second
Used with neoplasms to indicate the secondary location to which the neoplastic
process has metastasized.
Metastasis means the movement of a neoplasm from one organ to another not
directly connected with it; the histological type is the same in both organs.
The subheading /second is used on the site to which the tumor has gone (an
organ-neoplasms term), and also on the histologic type term (since the histology
is the same in both the primary and secondary locations). The subheading
/pathology should be used on the organ-neoplasms term indicating the original
site, if the original site is relevant to the article and must be indexed.
Pulmonary metastases of bone cancer.
BONE NEOPLASMS / * pathol
LUNG NEOPLASMS / * second
Metastasis of thyroid papillary adenocarcinoma to the lung.
THYROID NEOPLASMS / * pathol
LUNG NEOPLASMS / * second
ADENOCARCINOMA, PAPILLARY / * second
Surgery of Wilms' tumor metastatic to the orbit.
ORBITAL NEOPLASMS / * second / * surg
NEPHROBLASTOMA / * second / * surg
(KIDNEY NEOPLASMS / pathol only if discussed)
The term NEOPLASM METASTASIS exists in MeSH, but it should be reserved for
articles in which there is neither a secondary site (organ-neoplasms term) nor a
histologic type term with which to use /second. Such articles are very rare!
Metastatic breast cancer.
(The cancer arose elsewhere and went to the breast.)
BREAST NEOPLASMS / * second
Metastatic breast cancer.
(The cancer arose in the breast and went to other organs, but no histologic
type is given and no metastatic site is discussed.)
BREAST NEOPLASMS / * pathol
NEOPLASM METASTASIS
Metastatic breast squamous cell carcinoma. (The squamous cell carcinoma arose
elsewhere and went to the breast, but the site of the original neoplasm is not
given.) BREAST NEOPLASMS / *
second
CARCINOMA, SQUAMOUS CELL / * second
Metastatic breast squamous cell carcinoma.
(The squamous cell carcinoma arose in the breast and went elsewhere, but no
particular site of the metastasis is discussed.)
BREAST NEOPLASMS / * pathol
CARCINOMA, SQUAMOUS CELL / * second
For a further discussion of the subheading /second and NEOPLASM METASTASIS, see
sections 24.3.1 and 24.4.1.3+.
Terms which should also be considered before indexing the subheading /second
include:
LYMPHATIC METASTASIS (section 24.4.1.4)
NEOPLASM INVASIVENESS (24.4.1.1+)
NEOPLASM RECURRENCE, LOCAL (24.4.1.5)
NEOPLASM SEEDING (24.4.1.11)
NEOPLASMS, MULTIPLE PRIMARY (24.4.1.6)
NEOPLASMS, SECOND PRIMARY (24.4.1.7)
NEOPLASMS, UNKNOWN PRIMARY (24.4.1.8)
19.8.66 /secretion /SE, /secret
Used for the discharge across the cell membrane, into the intracellular space or
ducts, of endogenous substances resulting from the activity of intact cells of
glands, tissues, or organs.
/secret is allowed with organs (Category A) and endogenous substances (Category
D). In addition, it is an AQ for most neoplasm terms, since neoplasms may be
viewed as tissue; it is not an AQ, however, for leukemias or lymphomas, which
are not solid tumors.
Insulin secretion by the islands of Langerhans.
INSULIN / * secret
ISLANDS OF LANGERHANS / * secret
Effect of reserpine on adrenal gland secretions.
ADRENAL GLANDS / * drug eff / * secret
RESERPINE / * pharmacol
Sympathetic control of glucagon release from the pancreas.
GLUCAGON / * secret
ISLANDS OF LANGERHANS / * secret
SYMPATHETIC NERVOUS SYSTEM / * physiol
An HCG-secreting intracranial teratoma.
GONADOTROPINS, CHORIONIC / * secret
BRAIN NEOPLASMS / * secret
TERATOMA / * secret
/secret is restricted to use with endogenous substances. Frequently authors use
the word "secretion" when they mean "excretion" with reference to exogenous
substances.
Liver secretion of warfarin into the bile.
LIVER / * metab
WARFARIN / * metab
BILE / * metab
(not LIVER / * secret)
(not WARFARIN / * secret)
19.8.67 /standards /ST, /stand
Used with facilities, personnel, and program headings for the development,
testing, and application of standards of adequacy or acceptable performance and
with chemicals and drugs for standards of identification, quality, and potency.
It includes health or safety standards in industries and occupations.
The subheading /stand is used for articles not only on "standards" but also on
quality and quality control.
The international standard for penicillins.
PENICILLINS / * stand
Preparation of a hemoglobin reference standard.
HEMOGLOBINS / * stand
REFERENCE STANDARDS
Nursing school standards in Ghana.
SCHOOLS, NURSING / * stand
GHANA
Procedures for assuring the quality of hospital emergency services in teaching
hospitals.
HOSPITAL EMERGENCY SERVICE / * stand
HOSPITALS, TEACHING / * stand
* QUALITY ASSURANCE, HEALTH CARE
Impact of PSRO on community mental health centers.
* PROFESSIONAL REVIEW ORGANIZATIONS
COMMUNITY MENTAL HEALTH CENTERS / * stand
Do not use /stand for articles evaluating the effectiveness of procedures or
programs.
Is MRI of value in patients with low back pain?
* MRI
LOW BACK PAIN / * pathol
(not MRI / * stand)
19.8.68 /statistics & numerical data /SN, /statist
Used with non-disease headings for the expression of numerical values which
describe particular sets or groups of data. It excludes manpower distribution
for which "manpower" is used and excludes supply or demand for which "supply &
distribution" is used.
This subheading, like all other two-part subheadings (e.g., /prevention &
control), may be used for articles presenting either statistics or numerical
data; both concepts do not need to be present for /statist to be indexed.
Social security beneficiaries 1980-1988.
SOCIAL SECURITY / * statist
UNITED STATES
Estimating bed occupancy in nursing homes.
BED OCCUPANCY / * statist
NURSING HOMES / * util
Although /statist is an AQ for many terms, a more specific subheading should be
used if possible. By MeSH definition, statistics on manpower or supply are
indexed as /manpower or /supply & distribution, respectively. In addition, the
Subheading Trees (Figure 19.5) show that statistical aspects of diseases are
indexed with the subheadings /epidemiology, /ethnology, or /mortality.
Statistics on the supply of pacemakers in Switzerland.
PACEMAKER, ARTIFICIAL / * supply
SWITZERLAND
Statistics on survival in multiple trauma.
MULTIPLE TRAUMA / * mortal
SURVIVAL RATE
Data on the availability of nurses in Great Britain.
NURSES / * supply
GREAT BRITAIN
Data on nursing personnel in Great Britain.
NURSING / * man
GREAT BRITAIN
Some concepts such as /economics or /utilization are often discussed from a
statistical standpoint. In these cases, index the specific subheading needed
(/econ, /util, etc.); if the statistics are especially important, /statist
should be added (NIM) as a second subheading, since MeSH has not defined these
concepts or treed them as specific aspects of /statist.
Statistics on the utilization of pacemakers in Switzerland.
PACEMAKER, ARTIFICIAL / * util / statist
SWITZERLAND
When /statist is needed with a main heading for which it is not an AQ, add the
term STATISTICS (NIM).
Statistics on the presence of pollutants in the environment.
* ENVIRONMENTAL POLLUTANTS
STATISTICS
19.8.69 /supply & distribution /SD, /supply
Used for the quantitative availability and distribution of material,
equipment, health services, and facilities. It excludes food supply and water
supply in industries and occupations.
Availability of antibiotics in developing countries.
ANTIBIOTICS / * supply
* DEVELOPING COUNTRIES
Distribution of community health services in the United States.
COMMUNITY HEALTH SERVICES / * supply
UNITED STATES
The shortage of hospital libraries.
LIBRARIES, HOSPITAL / * supply
The dwindling number of minority group nurses.
NURSES / * supply
* MINORITY GROUPS
/supply is sometimes confused with /manpower. It is easy to confuse
the subheadings because they both can be used for personnel; /man is defined
exclusively in terms of personnel, and /supply includes the availability of
personnel as well as services, equipment, and facilities. The difference is
that /man is used with fields and disciplines for studies on the numbers of any
personnel in that field, while /supply is used with "people" terms for the
numbers of just those people.
Compare these examples:
NURSING / man vs NURSES / supply
PHARMACY / man vs PHARMACISTS / supply
DENTISTRY / man vs DENTISTS / supply
In each of these examples, /man can refer to any personnel within the
field (for example, the field of dentistry includes dental technicians, etc.,
not just DENTISTS), but /supply refers only to the named group of people.
For further discussion of /man and /supply, see sections 19.8.43 and
35.2.5.
19.8.70 /surgery /SU, /surg
Used for operative procedures on organs, regions, or tissues in the
treatment of diseases, including tissue section by lasers. It excludes
transplantation, for which "transplantation" is used.
This subheading may be used on organs, diseases, and animal terms.
Surgery of the liver in liver diseases.
LIVER / * surg
LIVER DISEASES / * surg
Hepatectomy in cancer of the liver.
LIVER NEOPLASMS / * surg
* HEPATECTOMY
Cryosurgery of facial dermatitis.
FACIAL DERMATOSES / * surg
* CRYOSURGERY
Adaptation of microsurgical instruments for use with cattle.
MICROSURGERY / * vet / instrum
CATTLE / * surg
EQUIPMENT DESIGN
/surg is used for all articles on surgical treatment of a disease, even if
the organ operated upon is only indirectly involved in the disease.
Thymectomy in the treatment of myasthenia gravis.
* THYMECTOMY
MYASTHENIA GRAVIS / * surg
Ovariectomy in breast cancer.
BREAST NEOPLASMS / * surg
* OVARIECTOMY
FEMALE (check tag)
HUMAN (check tag)
When surgery is performed in a patient with an unrelated disease, however,
/surg cannot be used on the disease not being treated.
The surgical risk in hemophilia.
* HEMOPHILIA
* SURGICAL PROCEDURES, OPERATIVE
RISK
(not HEMOPHILIA / * surg)
Surgery for liver diseases in obese patients.
LIVER DISEASES / * surg / compl
OBESITY / * compl
(not OBESITY / * surg)
Although the MeSH definition for /surg states that it excludes
transplantation because the subheading /transplantation exists, /transpl is an
AQ only for organs, not diseases. Therefore, the subheading on the disease
being treated by transplantation is /surg.
Adrenal gland transplantation in the treatment of parkinsonism.
ADRENAL GLANDS / * transpl
PARKINSON DISEASE / * surg
For a further discussion of /surg and various surgical procedures, see
sections 26.15+ through 26.20+.
19.8.71 /therapeutic use /TU, /ther use
Used with drugs, biological preparations, and physical agents for their use in
the prophylaxis and treatment of disease. It includes veterinary use.
This subheading seldom poses problems, as most articles clearly indicate that
the drug or physical agent is being used in treatment. The MeSH definition
allows its use with veterinary animals but it is used also for experimental
diseases in animals. If the drug or physical agent is studied to learn its
effectiveness in treating a disease, whether clinical or experimental, /ther use
is the correct subheading.
Hydralazine therapy of hypertension.
HYPERTENSION / * drug ther
HYDRALAZINE / * ther use
Effect of indomethacin therapy on experimental nephritis in rats.
INDOMETHACIN / * ther use
NEPHRITIS / * drug ther
RATS (check tag)
Erythromycin treatment of a streptococcal infection in a beagle.
STREPTOCOCCAL INFECTIONS / * vet
/ drug ther
ERYTHROMYCIN / * ther use
DOG DISEASES / * drug ther
DOGS (check tag)
CASE REPORT (check tag)
Vidarabine in the treatment of herpesvirus laryngitis.
HERPESVIRUS INFECTIONS / * drug ther
LARYNGITIS / * drug ther / virol
VIDARABINE / * ther use
Local cooling in the treatment of burns.
BURNS / * ther
COLD / * ther use
19.8.72 /therapy /TH, /ther
Used with diseases for therapeutic interventions except drug therapy, diet
therapy, radiotherapy, and surgery, for which specific subheadings exist. The
concept is also used for articles and books dealing with multiple therapies.
The treatment of gout.
GOUT / * ther
Immunotherapy of autoimmune diseases.
AUTOIMMUNE DISEASES / * ther
* IMMUNOTHERAPY
Psychotherapy of peptic ulcer.
PEPTIC ULCER / * ther
* PSYCHOTHERAPY
Successive heat and cold for experimental contusions in rats.
CONTUSIONS / * ther
COLD / * ther use
HEAT / * ther use
COMBINED MODALITY THERAPY
RATS (check tag)
/ther (not /drug therapy) is the correct subheading with disease terms
when a biological product is used in treatment. The correct subheading with the
biological product is /therapeutic use.
Intensive antitoxin therapy of tetanus.
TETANUS / * ther
TETANUS ANTITOXIN / * ther use
As listed in the definition and shown in the Subheading Trees (Figure
19.5), MeSH has many subheadings for specific types of therapy; a more specific
subheading should be used whenever possible.
Therapy of herpes simplex with amantadine.
HERPES SIMPLEX / * drug ther
AMANTADINE / * ther use
Radiocobalt therapy of lung cancer.
LUNG NEOPLASMS / * radiother
COBALT RADIOISOTOPES / * ther use
19.8.73 /toxicity /TO, /tox
Used with drugs and chemicals for experimental human and animal studies of
their ill effects. It includes studies to determine the margin of safety or the
reactions accompanying administration at various dose levels. It is used also
for experimental studies of exposure to environmental agents.
The subheading /tox is used only for experimental studies to determine
whether a compound is toxic, or under what conditions it becomes toxic.
Do not confuse with the following:
/adverse effects:
Used for "side effects" or "complications" of a drug, chemical, or procedure.
/contraindications:
Used with drugs and procedures for conditions in which the drug should not be
given or the procedure performed.
/poisoning:
Used for the serious condition known as "poisoning", "overdose", or
"intoxication".
For a full comparison, including examples, of /adv eff, /contra, /pois,
and /tox, see section 19.9.
19.8.74 /transmission /TM, /transm
Used with diseases for studies of the modes of transmission.
This subheading is used for transmission of infectious diseases only.
Variability of modes of spread in venereal diseases.
SEXUALLY TRANSMITTED DISEASES / * transm
The mobility explosion and communicable diseases.
COMMUNICABLE DISEASES / * transm
* TRAVEL
The type of housing in the spread of the common cold.
COMMON COLD / * transm
* HOUSING
Transmission of infectious mononucleosis.
INFECTIOUS MONONUCLEOSIS / * transm
Zoonotic shigellosis in a zookeeper resulting from exposure to the feces of an
infected spider monkey.
MONKEY DISEASES / * transm
SHIGELLOSIS / * transm / * vet
OCCUPATIONAL DISEASES / * microbiol
ANIMALS, ZOO / * microbiol
SPIDER MONKEY / * microbiol
FECES / microbiol
ZOONOSES
Note: Although /*vet must be the only IM subheading on a veterinary
disease (see 19.8.81), in this case /*transm may also be made IM on SHIGELLOSIS
for the human disease.
Genetic transmission should be indexed with the subheading /genetics, not
/transm; see section 19.8.34.
A study of the transmission of Huntington disease in 5 generations of a family.
HUNTINGTON'S DISEASE / * genet
(not: HUNTINGTON'S DISEASE / * transm)
19.8.75 /transplantation /TR, /transpl
Used with organs, tissues, or cells for transplantation from one site to
another within the same subject, or from one subject to another of the same
species or different species.
Transplantation is not restricted to whole organs. The subheading
/transpl or a TRANSPLANTATION term may be used when a part of an organ is
transplanted, but the organ or part, tissue, or cell must be moved from one site
to another, with no portion attached in its original position. Therefore,
partial detachment and repositioning of organs (in various bypass procedures or
urinary diversion, for example) does not fall within the definition of /transpl.
MeSH has many pre-coordinated organ-transplantation and blood cell
transfusion terms, so the subheading /transpl is not needed often. The terms
TRANSPLANTATION, ORGAN TRANSPLANTATION, TISSUE TRANSPLANTATION, CELL
TRANSPLANTATION and BLOOD COMPONENT TRANSFUSION are also available but are to be
used for general articles only; in most articles a specific organ, tissue, or
cell is discussed and should be indexed with the subheading /transpl or as one
of the specific pre-coordinated terms available.
The following are the transplantation types available in MeSH:
TRANSPLANTATION, AUTOLOGOUS--within the same subject.
TRANSPLANTATION, HETEROLOGOUS--between different species.
TRANSPLANTATION, HETEROTOPIC--to a site different from the
normal anatomic location of the organ.
TRANSPLANTATION, HOMOLOGOUS--between the same species.
TRANSPLANTATION, ISOGENEIC--between genetically identical
subjects.
Since most visceral transplants are homologous and most skin grafts are
autologous, etc., index the AUTOLOGOUS, HOMOLOGOUS and ISOGENEIC transplantation
terms only if particularly discussed and only NIM as coordinates for
transplantation of a specific organ or tissue. It is not necessary to index
them just because the author mentions them in the title with no further
discussion of their significance. HETEROLOGOUS and HETEROTOPIC transplantation
are rare enough to be indexed as routine coordinates, and indeed are usually
made IM.
The subheading used on the disease being treated by organ transplantation
is /surgery, since /transpl is an AQ only for organs. However, the disease
coordinate for BONE MARROW TRANSPLANTATION and BLOOD COMPONENT TRANSFUSION (and
its indentions) is /therapy, not /surgery, since these are not surgical
techniques.
REPLANTATION is the return of organs removed traumatically, and less
frequently surgically, to their original location. Do not consider this
/transpl; use /surg as the qualifier on the organ.
Reimplantation of a partially amputated thumb.
AMPUTATION, TRAUMATIC / * surg
THUMB / * surg / * inj
* REPLANTATION
The following are some examples of the use of pre-coordinated
TRANSPLANTATION and TRANSFUSION terms, and the subheading /transpl.
Transplantation of one lobe of an adult liver in infants with biliary atresia.
BILIARY ATRESIA / * surg
LIVER TRANSPLANTATION / * methods
INFANT (check tag)
ADULT (check tag)
Platelet transfusion for refractory thrombopenia.
THROMBOPENIA / * ther
* PLATELET TRANSFUSION
Pathology of the islets after homologous transplantation in rats.
ISLETS OF LANGERHANS TRANSPLANTATION / * pathol
RATS (check tag)
(not: TRANSPLANTATION, HOMOLOGOUS)
Heterograft tracheal transplants in animals.
TRACHEA / * transpl
* TRANSPLANTATION, HETEROLOGOUS
ANIMAL (check tag)
Osteoblast transplantation for ununited fractures.
FRACTURES, UNUNITED / * surg
OSTEOBLASTS / * transpl
(not: CELL TRANSPLANTATION)
Experimental transplantation of liver cells in rats.
* CELL TRANSPLANTATION
LIVER / * cytol
RATS (check tag)
(not: * LIVER TRANSPLANTATION)
19.8.76 /trends /TD, /trends
Used for the manner in which a subject changes, qualitatively or
quantitatively, with time, whether past, present, or future. It excludes
discussions of the course of disease in particular patients.
The word "trends" appears frequently in titles and when seen will probably
be correctly indexed with the subheading /trends (provided, of course, that
/trends is an AQ for the term used). In addition, /trends will probably be the
correct subheading for titles containing words and phrases such as these:
anticipating the impact looking ahead
changing nature outlook
declining perspectives in 19--
emerging planning for
expanded role projection to 19--
faces tomorrow prospects for
forecast shifts in demand
future since 19--
growth then...now...
in transition where are we going?
Many articles are written on trends on a nationwide or national level. Tend to
index such articles with a geographic term.
The changing nature of psychotherapy.
PSYCHOTHERAPY / * trends
The U.S. labor market is still in a vertical climb.
EMPLOYMENT / * trends
UNITED STATES
Pediatric emergency services of the future.
EMERGENCY MEDICAL SERVICES / * trends
CHILD HEALTH SERVICES / * trends
FUTUROLOGY
Trends in medical education in Great Britain.
EDUCATION, MEDICAL / * trends
GREAT BRITAIN
The definition of /trends includes reference to "past, present or future."
This does not mean that the subheading is a substitute for the main heading
FORECASTING.
Whether the indexer adds FORECASTING as a coordinate for /trends to
designate the future depends in general on the time span. The immediate future
usually falls within the scope of "trends"; the remote future falls within the
definition of FORECASTING, especially if there is a discussion on extrapolation
or interpretation beyond the facts.
A rule of thumb on the use of FORECASTING is this: use only the
subheading /trends for the immediate future but add FORECASTING for about ten or
more years in the future.
Specialty hospitals, under pressure, face an uncertain future in the next few
years.
HOSPITALS, SPECIAL / * trends
Rehabilitation in the 1990s.
REHABILITATION / * trends
But: Nursing care in the 21st century.
NURSING CARE / * trends
FORECASTING
Note! The term FORECASTING is in the SOCIAL SCIENCES tree and should
therefore be restricted to uses such as these, not used for "forecasting" or
"predicting" the course of a disease in a patient.
Can measurements of blood serotonin predict the response to treatment in
patients with depressive disorders?
SEROTONIN / * blood
DEPRESSIVE DISORDERS / * blood / * ther
(not FORECASTING)
There is no way to index the concept of "trends" if /trends is not an AQ
for the main heading in question. The title of the citation will have to show
the "trend" slant for the searcher.
Changes in the use of germ-free animals over the last ten years.
* GERM-FREE LIFE
19.8.77 /ultrasonography /US, /ultrasonogr
Used with organs and regions for ultrasonic imaging and with diseases for
ultrasonic diagnosis. Does not include ultrasonic therapy.
This subheading is to be used with organs and diseases for ultrasonic
imaging and ultrasonic diagnosis. When the specific ultrasonographic technique
exists as a main heading in MeSH, it should be added as a coordinate.
Ultrasonography of the lung.
LUNG / * ultrasonogr
Ultrasonic diagnosis of ectopic pregnancy.
PREGNANCY, ECTOPIC / * ultrasonogr
* ULTRASONOGRAPHY, PRENATAL
Ultrasonic differentiation of pancreatic neoplasms and cysts.
PANCREATIC NEOPLASMS / * ultrasonogr
PANCREATIC CYST / * ultrasonogr
DIAGNOSIS, DIFFERENTIAL
Diagnosis of mitral valve stenosis using color Doppler echocardiography.
MITRAL VALVE STENOSIS / * ultrasonogr
* ECHOCARDIOGRAPHY, DOPPLER, COLOR
19.8.78 /ultrastructure /UL, /ultrastruct
Used with tissues and cells (including neoplasms) and microorganisms for
microanatomic structures, generally below the size visible by light microscopy.
Unlike the subheadings /anatomy & histology and /cytology, which are
reserved for normal structure with /pathology being used for abnormal structure,
/ultrastruct is used for both normal and pathological subcellular structure.
When /ultrastruct is indexed for pathological ultrastructure, it is not
necessary to add /pathol as a second subheading. However, /ultrastruct is not
an AQ for any diseases except neoplasms, so the subheading used on any non-
neoplastic disease is /pathol.
Nucleolar structure in plants.
PLANTS / * ultrastruct
CELL NUCLEOLUS / * ultrastruct
Ultrastructure of staphylococci and HIV-1 in the kidney.
KIDNEY / * microbiol / virol
STAPHYLOCOCCUS / * ultrastruct
HIV-1 / * ultrastruct
Liver lysosomes in hepatitis and liver neoplasms.
LIVER / * ultrastruct
LYSOSOMES / * ultrastruct
HEPATITIS / * pathol
LIVER NEOPLASMS / * ultrastruct
/ultrastruct is not an AQ for vertebrates (Category B2), although it is
allowed with other Category B organisms.
Ultrastructure of the feline seminiferous tubule.
SEMINIFEROUS TUBULES / * ultrastruct
CATS / * anat
(not CATS / * ultrastruct)
/ultrastruct is used with proteins, enzymes, and nucleic acids for studies
of their gross structure performed using electron microscopy.
Electron microscopy studies of DNA.
DNA / * ultrastruct
MICROSCOPY, ELECTRON
19.8.79 /urine /UR, /urine
Used for the presence or analysis of substances in the urine, and also for
the examination of, or changes in, the urine in disease.
Urinary urea in lactating cows.
CATTLE / * urine
UREA / * urine
LACTATION / * urine
Urinary estrogen excretion in pregnant mares.
HORSES / * urine
ESTROGENS / * urine
PREGNANCY, ANIMAL / * urine
Urinary excretion of corticosteroids in breast cancer.
BREAST NEOPLASMS / * urine
CORTICOSTEROIDS / * urine
Chromatography of urinary 17-ketosteroids.
17-KETOSTEROIDS / * urine
CHROMATOGRAPHY
Urine cytology in kidney tumors.
KIDNEY NEOPLASMS / * urine
URINE / cytol
19.8.80 /utilization /UT, /util
Used with equipment, facilities, programs, services, and health personnel
for discussions, usually with data, of how much they are used. It includes
discussions of overuse and underuse.
This subheading is indexed primarily for articles on health care and
health services which discuss the degree of use; i.e., is a piece of equipment
or a given service or specific personnel used at all? used much? used seldom?
used under certain conditions? The subheading is not to be used with a Category
E heading for articles on how the equipment or technique is to be used, but
rather on how much it is used. "The use of ECG to diagnose heart disease" is
not within the scope of /util. However, /util would correctly apply to this
concept: "Is ECG used much in outland areas of Sumatra?"
Who uses Medicare?
MEDICARE / * util
UNITED STATES
Use of dental technicians in special hospitals.
DENTAL TECHNICIANS / * util
HOSPITALS, SPECIAL / * man
Non-users of health services.
HEALTH SERVICES / * util
Effective use of hospitals and hospital medical staffs.
HOSPITALS / * util
HOSPITAL MEDICAL STAFF / * util
How frequently are cesarean sections performed in the United States versus
France?
CESAREAN SECTION / * util
UNITED STATES
FRANCE
COMPARATIVE STUDY (check tag)
HUMAN (check tag)
FEMALE (check tag)
PREGNANCY (check tag)
As can be seen in some of the examples given above, a common coordinate
for articles indexed with /util is one of the geographic headings from Category
Z.
19.8.81 /veterinary /VE, /vet
Used for naturally occurring diseases in animals, or for diagnostic,
preventive, or therapeutic procedures used in veterinary medicine.
/vet is used with disease terms for articles on veterinary diseases (i.e.,
not laboratory models of human disease). When /*vet is used on a disease, a
pre-coordinated animal-diseases term should be added IM to indicate the species
in which the disease is occurring, and the animal name should be added NIM as a
main heading or a check tag.
Brucellosis in dogs.
BRUCELLOSIS / * vet
* DOG DISEASES
DOGS (check tag)
ANIMAL (check tag)
If an IM subheading is used on the animal-diseases term, it should be
added to the term for the disease type but should be made NIM; the IM
subheading for a veterinary article should always be /*vet.
Thiabendazole therapy of intestinal parasites in sheep.
INTESTINAL DISEASES, PARASITIC / * vet / drug ther
SHEEP DISEASES / * drug ther
THIABENDAZOLE / * ther use
SHEEP
ANIMAL (check tag)
When the Category C term indexed with /vet is a MeSH heading for an
abnormality or injury rather than a disease, the coordination should be the name
of the animal with /*abnorm or /*inj rather than a pre-coordinated animal-
diseases term.
Occurrence of diaphragmatic eventration in pigs.
DIAPHRAGMATIC EVENTRATION / * vet / epidemiol
SWINE / * abnorm
ANIMAL (check tag)
(not SWINE DISEASES / * epidemiol)
Spinal injuries in horses.
SPINAL INJURIES / * vet
HORSES / * inj
ANIMAL (check tag)
(not * HORSE DISEASES)
/vet is not an AQ for any term in Category C22, a tree devoted exclusively
to animal diseases; when a term is indexed from Category C22, the veterinary
aspect is inherent.
Nairobi sheep disease.
* NAIROBI SHEEP DISEASE
SHEEP
ANIMAL (check tag)
Antibiotic treatment of Salmonella infections in horses.
SALMONELLA INFECTIONS, ANIMAL / * drug ther
ANTIBIOTICS / * ther use
HORSE DISEASES / * drug ther
HORSES
ANIMAL (check tag)
If no pre-coordinated animal-diseases term exists for the particular
animal studied, the animal name itself should be indexed IM.
Dermatitis in minks.
DERMATITIS / * vet
* MINK
ANIMAL (check tag)
The other use of /vet is with diagnostic and therapeutic procedures
performed on veterinary animals. Again, when the procedures are being tested in
laboratory animals as a model of human use, the subheading /vet should not be
used.
Amputation of the hindlimb of a German shepherd.
DOGS / * surg
AMPUTATION / * vet
HINDLIMB / * surg
ANIMAL (check tag)
CASE REPORT (check tag)
A new surgical retractor for use in surgery on large zoo animals.
ANIMALS, ZOO / * surg
SURGICAL INSTRUMENTS / * vet
ANIMAL (check tag)
For a further discussion of veterinary diseases, see section 23.33+.
19.8.82 /virology /VI, /virol
Used with organs, animals, and higher plants and with diseases for
virologic studies. For bacteria, rickettsia, and fungi, "microbiology" is used;
for parasites, "parasitology" is used.
This subheading is used like the subheading /microbiology (section
19.8.46), of which it is a subset. When viruses are studied in organs, animals,
plants, or diseases (even if they are not the cause of the disease), the
subheading /virol should be used.
Use of PCR to demonstrate the presence of human papillomavirus 16 as a cause of
cervical intraepithelial neoplasia.
PAPILLOMAVIRUS, HUMAN / * isol / genet
PAPOVAVIRIDAE INFECTIONS / * diag / compl
TUMOR VIRUS INFECTIONS / * diag / compl
CERVICAL INTRAEPITHELIAL NEOPLASIA / * virol
CERVIX NEOPLASMS / * virol
DNA, VIRAL / anal
POLYMERASE CHAIN REACTION
HUMAN (check tag)
FEMALE (check tag)
Isolation of cowpea mosaic virus from various legumes.
COWPEA MOSAIC VIRUSES / * isol
LEGUMES / * virol
When an article discusses the genetics of a virus involved in an
infection, use /genetics on the virus but /virol on the infection. Save /genet
with infections for the genetics of the patients.
Complete nucleotide sequence of a hepatitis B virus DNA derived from a patient
with hepatitis B.
HEPATITIS B VIRUS / * genet
DNA, VIRAL / * chem
HEPATITIS B / * virol
BASE SEQUENCE
MOLECULAR SEQUENCE DATA
(not HEPATITIS B / * genet)
Since /virol is indented under /microbiol in the Subheading Trees (Figure
19.5), /microbiol may be used for grouping purposes if an article discusses
viruses along with other microorganisms.
Demonstration of Ureaplasma urealyticum, Malassezia furfur and cytomegaloviruses
on the skin of preterm neonates.
UREAPLASMA UREALYTICUM / * isol
MALASSEZIA / * isol
CYTOMEGALOVIRUS / * isol
SKIN / * microbiol / virol
INFANT, PREMATURE / * microbiol / virol
HUMAN (check tag)
INFANT, NEWBORN (check tag)
Although not listed in the scope note, /virol is an AQ for organisms in
Categories B1 (the invertebrates), B3 (bacteria), and B5 (algae and fungi) as
well as for higher animals and plants. Bacteriophages, which are bacterial
viruses, are therefore indexed using the subheading /virol on the bacterium
infected.
Streptococcus pneumoniae bacteriophages share an extremely conserved DNA
fragment.
STREPTOCOCCUS PHAGES / * genet
STREPTOCOCCUS PNEUMONIAE / virol
DNA, VIRAL / * chem
* CONSERVED SEQUENCE
BASE SEQUENCE
(MOLECULAR SEQUENCE DATA if a sequence of 9 or more bases is shown)
19.9 COMPARISON OF /ADV EFF, /CONTRA, /POIS, /TOX
The subheadings /adverse effects, /contraindications, /poisoning,
and /toxicity can be very difficult for an indexer to differentiate. They must,
however, be used according to indexing policies and their MeSH definitions, not
necessarily the words of the author. The following discussion compares the four
subheadings.
19.9.1 /adv eff (See also section 19.8.3 for its MeSH definition):
This subheading is used for articles on "side effects" or "complications"
of diagnostic or therapeutic procedures. It may also be used for "side effects"
of drugs and chemicals, when they are administered deliberately (for
therapeutic, pharmacologic, or diagnostic purposes) but unintended harmful
effects occur in the patient or animal.
An additional use of /adv eff is with environmental pollutants when
exposure to relatively low levels (including occupational exposure) causes
disease or other harmful effects.
19.9.2 /contra (See also section 19.8.19 for its MeSH definition):
This subheading should not be as difficult as the others to use correctly,
because authors tend to use the word "contraindication" or some variant of it
when the subheading applies. It describes conditions when a drug should not be
given, or a diagnostic or therapeutic procedure should not be performed.
19.9.3 /pois (See also section 19.8.57 for its MeSH definition):
This subheading is used for articles on the serious condition known as
"poisoning", "overdose", or "intoxication" in animals or humans. It may be used
for articles about exposure to environmental or occupational pollutants, but the
feature distinguishing it from /adv eff in these situations is the degree (very
high levels of exposure rather than low levels). Authors will often use the
actual word "poisoning" when environmental poisoning occurs.
Be careful when using /pois since there are many pre-coordinated terms
available in MeSH (CADMIUM POISONING, MERCURY POISONING, etc.).
19.9.4 /tox (See also section 19.8.73 for its MeSH definition):
This subheading is for experimental studies in humans or animals only (not
microorganisms), where the point is to see whether a compound is toxic, or under
what circumstances it becomes toxic (for example, at what dose level).
Experimental studies of therapy, in which unintended harmful effects occur,
should be indexed as /adv eff; for /tox to be used the intention of the study
from the start must be to determine toxicity. The subheading thus will rarely
be used for human studies (although volunteers are sometimes recruited for such
studies and Phase I studies of drugs may meet the criteria).
Even when an author uses the word "toxicity" or a word with "toxicity" as
a suffix (nephrotoxicity, etc.), the subheading /tox must not be used except in
these experimental circumstances.
19.9.5 When /adv eff, /pois, or /tox is used with a drug or chemical term,
the usual coordinate on any disease produced is /chem ind; when /adv eff is
used with a procedure, the usual coordinate on any disease produced is /etiol.
Examples of the correct use of the 4 subheadings:
19.9.6 /adv eff
Hepatotoxicity of acetaminophen given for fever.
ACETAMINOPHEN / * adv eff / ther use
LIVER DISEASES / * chem ind
FEVER / * drug ther
(not ACETAMINOPHEN / * tox)
Complications of cryosurgery.
CRYOSURGERY / * adv eff
Peripheral neuropathy in chemical workers in relation to levels of vinyl
chloride in the air.
VINYL CHLORIDE / * adv eff
AIR POLLUTANTS, OCCUPATIONAL / * adv eff
PERIPHERAL NERVE DISEASES / * chem ind
OCCUPATIONAL DISEASES / * chem ind
* CHEMICAL INDUSTRY
19.9.7 /contra
Phenytoin should not be used to treat epilepsy in pregnant women.
PHENYTOIN / * contra / ther use
EPILEPSY / * drug ther
PREGNANCY COMPLICATIONS / * drug ther
PREGNANCY (check tag)
FEMALE (check tag)
Knee prosthesis surgery is contraindicated in the morbidly obese.
KNEE PROSTHESIS / * contra
* OBESITY, MORBID
19.9.8 /pois
Drug treatment of digoxin overdose.
DIGOXIN / * pois
OVERDOSE / drug ther
Fatalities in two workers exposed to high levels of methane gas.
METHANE / * pois
AIR POLLUTANTS, OCCUPATIONAL / * pois
FATAL OUTCOME
CASE REPORT (check tag)
19.9.9 /tox
LD50 of cocaine in rats.
COCAINE / * tox
LETHAL DOSE 50
RATS (check tag)
Studies to determine if acetaminophen causes hepatotoxicity in guinea pigs.
ACETAMINOPHEN / * tox
LIVER DISEASES / * chem ind
GUINEA PIGS (check tag)
Tolerability of ascending intravenous doses of granisetron, a novel serotonin
antagonist, in healthy human subjects.
GRANISETRON / * tox / admin
INJECTIONS, INTRAVENOUS
HUMAN (check tag)
19.10 COMPARISON OF /ANAL, /CHEM, /ISOL, /METAB, /PHARMACOKIN
The subheadings /analysis, /chemistry, /isolation & purification,
/metabolism, and /pharmacokinetics can be very difficult for an indexer to
differentiate. The following discussion compares the five subheadings.
19.10.1 /anal (See also section 19.8.6 for its MeSH definition):
This subheading is used only with Category D terms (chemicals), for
determination of their levels or demonstration of their presence.
For endogenous compounds, /anal is used for one-time assays, where the
concept of changes in levels is not an issue. Changes in levels, often
discussed as having been influenced by drugs, diseases, or physiologic
processes, should be indexed as /metab.
For exogenous chemicals, /anal is usually reserved for articles where the
techniques of performing the analysis are the main point; most studies of the
"levels" of these compounds in the body are concerned with their movement to
various organs and should be indexed as /pharmacokin.
Analysis of compounds in the blood, cerebrospinal fluid, or urine should
be covered by the appropriate specific subheading (/blood, /csf, or /urine).
Studies on the chemical content of organs and tissues (Category A),
microorganisms, parasites and plants (Categories B1 and B3-B6) and neoplasms
(Category C4) are indexed with /chem on the Category A, B, or C4 term,
coordinated with /anal on the chemicals studied.
19.10.2 /chem (See also section 19.8.15 for its MeSH definition):
This subheading can be applied to terms from Categories A, B (except B2),
C4 and D, but it has a different meaning for Categories A, B and C4 than for
Category D.
With Categories A (organs and tissues), B (microorganisms, parasites, and
plants) and C4 (neoplasms), /chem refers to the natural chemical content or
composition of the organ, organism, tissue, or neoplasm; the Category D term
being studied is indexed with the subheading /anal. (The content of enzymes or
immune compounds, however, should be indexed as /enzymol or /immunol,
respectively, on the organ, organism, tissue, or neoplasm. The content of
nucleic acids should be indexed as /genet on the organism or neoplasm and on any
Category A term for which it is an AQ; use /chem if /genet is not allowed.) A
study of the "content" of an exogenous drug is probably about its
pharmacokinetics and should be indexed as /metab on the organ, organism, tissue,
or neoplasm. Changes in the content of endogenous chemicals as affected by
drugs, disease, or natural physiological processes should also be indexed as the
/metab of the organ, organism, tissue, or neoplasm.
With Category D terms (chemicals), /chem refers to studies of their
chemical characterization, composition, structure and properties. Concepts which
will correctly be indexed as /chem include: molecular weight and structure,
solubility and other physical chemistry properties, chemical reactions, etc.
Although the "characterization" of a compound is to be indexed as /chem,
"characterization" of an enzyme usually refers to a study of its activity and
should be indexed as /metab; "characterization" of an antigen could be a study
of its immunology or genetics and would be indexed as /immunol or /genet in
those instances. Studies of the structure of proteins and nucleic acids which
are performed with electron microscopy should be indexed as their /ultrastruct
rather than /chem. Chemical synthesis of a compound should be indexed as
/chemical synthesis.
19.10.3 /isol (See also section 19.8.41 for its MeSH definition):
This subheading can be applied to Category B terms (microorganisms and
parasites) as well as to Category D terms (chemicals), but its use is different
for Category B than for Category D.
For microorganisms and parasites, /isol is obviously used for studies
where the organisms are isolated; however, it can also be used when the
presence of the organism is demonstrated by genetic or immune techniques but the
organism is not actually isolated.
For chemicals, the compound must actually be isolated or purified for
/isol to be used; mere demonstration of the presence of the compound should be
indexed as /anal.
19.10.4 /metab (See also section 19.8.44 for its MeSH definition):
For Category D terms, this is the most frequently used of the 5 related
subheadings. It should be used for articles on changes in levels of endogenous
compounds (often discussed as affected by diseases, drugs, or physiological
processes) and metabolic changes in structure of all Category D terms. For
exogenous chemicals, the following concepts should be indexed as /metab:
anabolism, assimilation, binding, catabolism, conversion, degradation,
incorporation, mobilization, metabolic pathways, splitting, turnover,
utilization. Studies of the movement of exogenous chemicals through the body,
without any metabolic changes in the molecule of the compound, should instead be
indexed as /pharmacokin.
Specific aspects of metabolism such as biosynthesis, deficiency,
enzymology, and metabolism in the blood, cerebrospinal fluid or urine should be
covered by the appropriate specific subheading (/biosyn, /defic, /enzymol,
/blood, /csf, or /urine).
19.10.5 /pharmacokin (See also section 19.8.53 for its MeSH definition):
This subheading is to be used for exogenous compounds only, for studies of
their movement through the body of the patient or higher animal to which they
are administered. The following concepts should be indexed as /pharmacokin for
exogenous chemicals in humans or higher animals (not microorganisms):
absorption, adsorption, clearance, distribution, kinetics, permeation, release,
transport, uptake.
Since /pharmacokin is restricted to exogenous compounds, the "tissue
distribution" of an endogenous compound cannot be indexed with this subheading;
the article is probably a study of the tissues in which the compound naturally
occurs, and as such is indexed as /anal of the compound. The other concepts
listed above, (absorption, transport, etc.), should be indexed as /metab when
the article is about endogenous compounds or exogenous compounds in
microorganisms, since /pharmacokin cannot be used.
When /pharmacokin is used, the subheading on any organ, tissue, animal, or
disease in which the compound is studied is /metab.
19.10.6 Examples of the correct use of the 5 subheadings:
Levels of endogenous testosterone in the testis.
TESTOSTERONE / * anal
TESTIS / * chem
Levels of beta-lactam antibiotics in the kidney in relation to their ability to
treat urinary tract infections.
ANTIBIOTICS, LACTAM / * pharmacokin / * ther use
KIDNEY / * metab
URINARY TRACT INFECTIONS / * drug ther / * metab
Determination of lipids in bacteria.
BACTERIA / * chem
LIPIDS / * anal
An enzyme-linked immunosorbent assay for analyzing digoxin.
DIGOXIN / * anal
ENZYME-LINKED IMMUNOSORBENT ASSAY
Radioimmunoassay in the analysis of digoxin blood levels.
DIGOXIN / * blood
RADIOIMMUNOASSAY
Natural sodium content of the kidney.
KIDNEY / * chem
SODIUM / * anal
Determining estrogen receptors in breast neoplasms.
RECEPTORS, ESTROGEN / * anal
BREAST NEOPLASMS / * chem
Levels of ATPase in the liver.
LIVER / * enzymol
ATPASE / * anal
Activity of ATPase in the liver.
LIVER / * enzymol
ATPASE / * metab
Analysis of DNA in HIV-1.
HIV-1 / * genet
DNA, VIRAL / * anal
Mitochondrial DNA in the muscles of patients with the MERRF syndrome.
MITOCHONDRIA, MUSCLE / * genet
MERRF SYNDROME / * genet
DNA, MITOCHONDRIAL / * metab
Determination of IgG in the kidney.
KIDNEY / * immunol
IGG / * anal
Molecular weight and structure of verapamil.
VERAPAMIL / * chem
MOLECULAR WEIGHT
MOLECULAR STRUCTURE
Mathematical models of oxidation reactions of morphine derivatives.
MORPHINE DERIVATIVES / * chem
MODELS, CHEMICAL
OXIDATION-REDUCTION
Phase transitions of glycosaminoglycans.
GLYCOSAMINOGLYCANS / * chem
THERMODYNAMICS
Analysis of adenine in DNA.
ADENINE / * anal
DNA / * chem
Determination of proline in eye proteins.
PROLINE / * anal
EYE PROTEINS / * chem
Amino acid sequence of tubulin.
TUBULIN / * chem
AMINO ACID SEQUENCE
Structure of tubulin polymers in microtubules determined by
electron microscopy.
TUBULIN / * ultrastruct
BIOPOLYMERS
MICROTUBULES / * ultrastruct
MICROSCOPY, ELECTRON
Diagnosis of tuberculosis by isolation of Mycobacterium tuberculosis from
bronchoalveolar lavage fluid.
BRONCHOALVEOLAR LAVAGE FLUID / * microbiol
MYCOBACTERIUM TUBERCULOSIS / * isol
TUBERCULOSIS, PULMONARY / * diag
Detection of viral DNA for the demonstration of human papillomavirus 16 in
condylomata acuminata.
CONDYLOMATA ACUMINATA / * virol
DNA, VIRAL / * anal
PAPILLOMAVIRUS, HUMAN / * isol
(/genet may be added as a second subheading on PAPILLOMAVIRUS, HUMAN if
the DNA is actually studied in addition to being used to show the presence of
the virus.)
Purification of various glycosides from Papaver.
GLYCOSIDES / * isol
PAPAVER / * chem
Demonstration of the presence of various glycosides in Papaver.
GLYCOSIDES / * anal
PAPAVER / * chem
Transport of pituitary gonadotropins is delayed in obesity.
GONADOTROPINS, PITUITARY / * metab
OBESITY / * metab
BIOLOGICAL TRANSPORT / physiol
Transport of aspirin to the brain in relation to the rate of pain relief.
ASPIRIN / * pharmacokin / * ther use
PAIN / * drug ther / * metab
BRAIN / * metab
BIOLOGICAL TRANSPORT / physiol
Transport of calcium in platelets.
CALCIUM / * blood
PLATELETS / * metab
BIOLOGICAL TRANSPORT / physiol
19.11 COMMON SUBHEADING COORDINATIONS
The groups below show the most common subheading coordinations, although
they cannot always be followed. NOTE: It is possible to make one subheading IM
without also making its coordinate IM.
When more than one subheading is listed as an option, the choice depends
on the article; in most cases, only one of the options will be correct for the
article being indexed.
DISEASE A / compl....(When it is known that DISEASE A DISEASE
B / etiol causes DISEASE B)
DISEASE A / compl....(Diseases are associated but
DISEASE B / compl cause-effect not established)
DISEASE / chem ind
DRUG / adv eff
DISEASE / diag
DRUG / diag use
DISEASE / pathol
ORGAN / pathol
RADIOISOTOPE / diag use
DISEASE / radionuclide
ORGAN / radionuclide
ORGAN / drug eff
DRUG / pharmacol
ORGANISM / drug eff
DRUG / pharmacol
ORGAN / metab
DRUG / metab or / pharmacokin
ORGAN / chem
CHEMICAL / anal
DISEASE / etiol
TECHNIQUE / adv eff
DISEASE / ultrasonogr
ORGAN / ultrasonogr
DISEASE / radiogr
ORGAN / radiogr
DISEASE / physiopathol
ORGAN / physiopathol
PHYSIOLOGIC PROCESS / drug eff
DRUG / pharmacol
PSYCHOLOGIC PROCESS / drug eff
DRUG / pharmacol
ORGANISM / metab
DRUG / metab
ORGAN / metab
DISEASE / metab
RADIOISOTOPE / ther use
DISEASE / radiother
DISEASE / drug ther
DRUG / ther use
ORGAN / surg
DISEASE / surg
ORGAN / transpl
DISEASE / surg
In the columns below and on the next page, common coordinations used when
indexing infectious diseases are paired with those used when indexing other
diseases. The reason for the differences is that the compounds analyzed
represent different concepts. Analysis of an endogenous compound shows what is
happening in the patient's body during the disease studied; in contrast, the
presence of a compound from a microorganism or parasite is an indication that
the organism is also present in the disease and/or organ studied (i.e., it is an
indirect indicator for the organism.)
INFECTIOUS DISEASE OTHER DISEASE
DISEASE / microbiol+
ORGAN / microbiol+
ORGANISM / isol
When an immune compound is analyzed
ORGANISM'S IMMUNE CPD / anal++ PATIENT'S IMMUNE CPD / anal++
ORGAN / microbiol+ ORGAN / immunol
ORGAN-DISEASE / microbiol+ or DISEASE / immunol/ diag
INFECTION / microbiol+ or / diag
ORGANISM / isol or / immunol
+options include /microbiol, /parasitol, or /virol
++options include /anal, /biosyn, /blood, /csf, /isol, /genet, /metab, and
/urine
INFECTIOUS DISEASE OTHER DISEASE
When DNA or RNA is analyzed
ORGANISM'S NUCLEIC ACID/anal++ PATIENT'S NUCLEIC ACID /anal++
ORGAN / microbiol+ ORGAN / chem or /genet
ORGAN-DISEASE / microbiol+ or DISEASE / genet
/ diag
INFECTION / microbiol+ or /diag
ORGANISM / isol or / genet
When an enzyme is studied
ORGANISM'S ENZYME / metab++ PATIENT'S ENZYME / metab++
ORGAN / microbiol+ ORGAN / enzymol
ORGAN-DISEASE / microbiol+ or DISEASE / enzymol
/ diag
INFECTION / microbiol+ or /diag
ORGANISM / enzymol
+options include /microbiol, /parasitol, or /virol
++options include /anal, /biosyn, /blood, /csf, /isol, /genet, /metab, and
/urine