CHAPTER 23 INDEXING PRINCIPLES FOR CATEGORY C (DISEASES) 23.1 Category C is the MeSH category for disease terms. The terms are arranged in two ways: by type of disease (e.g., infections, neoplasms, congenital diseases) and by system (e.g., cardiovascular diseases, gastrointestinal diseases, endocrine diseases). 23.2 The Tree Structure given below shows the specific coverage of diseases in Category C. C1 BACTERIAL AND FUNGAL DISEASES C2 VIRUS DISEASES C3 PARASITIC DISEASES C4 NEOPLASMS C5 MUSCULOSKELETAL DISEASES C6 DIGESTIVE SYSTEM DISEASES C7 STOMATOGNATHIC DISEASES C8 RESPIRATORY TRACT DISEASES C9 OTORHINOLARYNGOLOGIC DISEASES C10 NERVOUS SYSTEM DISEASES C11 EYE DISEASES C12 UROLOGIC AND MALE GENITAL DISEASES C13 FEMALE GENITAL DISEASES AND PREGNANCY COMPLICATIONS C14 CARDIOVASCULAR DISEASES C15 HEMIC AND LYMPHATIC DISEASES C16 NEONATAL DISEASES AND ABNORMALITIES C17 SKIN DISEASES C18 NUTRITIONAL AND METABOLIC DISEASES C19 ENDOCRINE DISEASES C20 IMMUNOLOGIC DISEASES C21 INJURY, OCCUPATIONAL DISEASES, POISONING C22 ANIMAL DISEASES C23 SYMPTOMS AND GENERAL PATHOLOGY 23.3 The subheadings available for use with Category C terms are: /blood /microbiology /blood supply (C4 only) /mortality /cerebrospinal fluid /nursing /chemically induced /parasitology /chemistry (C4 only) /pathology /classification /physiopathology /complications /prevention & control /congenital /psychology /diagnosis /radiography /diet therapy /radionuclide imaging /drug therapy /radiotherapy /economics /rehabilitation /embryology /secondary (C4 only) /enzymology /secretion (C4 only) /epidemiology /surgery /ethnology /therapy /etiology /transmission (C1-3 only) /genetics /ultrasonography /history /ultrastructure (C4 only) /immunology /urine /metabolism /veterinary /virology 23.3.1 A few "tissue-oriented" subheadings have been assigned only to Category C4, the tree containing neoplasms (tumors, cancers and cysts); neoplasms can be viewed as tissue in addition to being thought of as diseases, so the additional subheadings are permitted. See Chapter 24 for a discussion of neoplasms. 23.3.2 The subheading /transmission is an AQ only for Categories C1-3 (the infectious diseases). It is reserved for transmission of diseases caused by microorganisms or parasitic organisms; genetic transmission is covered instead by the subheading /genetics. See section 23.22+. 23.3.3 Each subheading is discussed specifically in Chapter 19, so the correct use of every subheading allowed with disease terms will not be covered in this chapter. 23.4 The categorization of "disease" in MeSH is very broad, including not only what are generally thought of as "diseases" or "disorders", but also such concepts as "abnormalities", "injuries", "poisoning" and "addiction", and many pathologic descriptions such as "hypertrophy", "metaplasia" and "necrosis". 23.4.1 The word "lesion" is often used by authors and can mean many things depending on the article. An indexer must not consider the word synonymous with "injury" or "cancer" unless proven to be so in the article; usually a "lesion" will be indexed as a "disease" or as the /pathology of the involved organ. 23.5 The main heading DISEASE exists in MeSH but its use is restricted to articles on the disease process in general as opposed to health. Use the heading DISEASE for articles such as: "The stages of illness" or "Disease, the physician and society". 23.5.1 Few subheadings are permitted with the general heading DISEASE (only /classification, /ethnology, /etiology, /psychology, and /transmission). For any article which seems to require another subheading on the term DISEASE, index only any other aspect studied; users of Index Medicus will be looking at their particular aspect of interest, not at DISEASE. Adaptation to disease. DISEASE / * psychol * ADAPTATION, PSYCHOLOGICAL But: Blood hormone levels in disease. HORMONES / * blood (Not: * DISEASE) 23.5.2 If an indexer wants to use one of the following Category C subheadings with the general term DISEASE, its main heading equivalent should be used instead. DISEASE / diag =DIAGNOSIS DISEASE / diet ther =DIET THERAPY DISEASE / drug ther =DRUG THERAPY DISEASE / econ =ECONOMICS, MEDICAL DISEASE / epidemiol =MORBIDITY or EPIDEMIOLOGY DISEASE / genet =HEREDITARY DISEASES DISEASE / immunol =IMMUNITY or IMMUNOLOGY DISEASE / mortal =MORTALITY DISEASE / nurs =NURSING CARE DISEASE / pathol =PATHOLOGY DISEASE / prev =PREVENTIVE MEDICINE DISEASE / radiogr =RADIOGRAPHY DISEASE / radionuclide =RADIONUCLIDE IMAGING DISEASE / radiother =RADIOTHERAPY DISEASE / rehabil =REHABILITATION DISEASE / surg =SURGICAL PROCEDURES, OPERATIVE DISEASE / ther =THERAPEUTICS or a specific DISEASE / ultrasonogr =ULTRASONOGRAPHY DISEASE / vet =ANIMAL DISEASES or VETERINARY MEDICINE 23.6 MeSH has some headings which are annotated to allow their use either for a specialty or for diseases within its province; these terms usually include the word MEDICINE. For instance, AVIATION MEDICINE can mean the specialty or the medical aspects of aviation. Other specialty terms, such as MILITARY MEDICINE, are to be used only for the specialty itself; the indexer must check the annotation before using a specialty heading for a disease. 23.7 The many types of disease terms available in MeSH are shown below. Pre-coordinated organ-diseases terms: BRAIN DISEASES STOMACH DISEASES Infection terms: Pre-coordinated general terms: BACTERIAL INFECTIONS VIRUS DISEASES Pre-coordinated specific terms: STREPTOCOCCAL INFECTIONS ADENOVIRUS INFECTIONS Historical or classical terms: PLAGUE BOTULISM YELLOW FEVER Terms in which the organism is inherent: TUBERCULOSIS for Mycobacterium tuberculosis infection TRYPANOSOMIASIS for Trypanosoma infection Terms in which the organism and organ are inherent: TUBERCULOSIS, PULMONARY AMEBIASIS, HEPATIC STAPHYLOCOCCAL SCALDED SKIN SYNDROME Neoplasm terms: Pre-coordinated organ-neoplasms terms: BRAIN NEOPLASMS STOMACH NEOPLASMS Histological types of neoplasms: ASTROCYTOMA ADENOCARCINOMA Inflammatory disease terms (usually end in -ITIS): ENCEPHALITIS GASTRITIS PNEUMONIA Terms for specific diseases: ENCEPHALOMALACIA PYLORIC STENOSIS Syndromes: Eponymous syndromes: BASSEN-KORNZWEIG SYNDROME LAURENCE-MOON-BIEDL SYNDROME Descriptive syndromes: NAIL-PATELLA SYNDROME SEA-BLUE HISTIOCYTE SYNDROME Animal diseases: Pre-coordinated animal-diseases: CAT DISEASES DOG DISEASES Species-specific diseases: MASTITIS, BOVINE NAIROBI SHEEP DISEASE 23.8 Index a disease as specifically as possible. An article on coronary disease is indexed as CORONARY DISEASE, not HEART DISEASES. An article on lung cancer is indexed as LUNG NEOPLASMS, not RESPIRATORY TRACT NEOPLASMS nor LUNG DISEASES. 23.8.1 When many diseases are discussed in an article, however, it may not be possible to index each without using too much depth. The "rule of three" permits the indexing of up to three related terms; if more than three related terms are to be indexed, they should usually be covered by a single, more general term which is chosen by consulting the Trees. For example, in an article about the drug therapy of celiac disease, lactose intolerance, intestinal lipodystrophy, short bowel syndrome, and Crohn disease, the indexer may need to index several drugs as well as the diseases, and possibly also the complications caused by the diseases and the drugs. If each disease and each drug were indexed as well as all the complications, too many terms would be used, so the indexer must group in the following manner: CELIAC DISEASE, LACTOSE INTOLERANCE, SHORT BOWEL SYNDROME and LIPODYSTROPHY, INTESTINAL are treed under MALABSORPTION SYNDROMES, so that term can be used instead of indexing four terms. If for some reason there is still too much depth (as in a priority 3 journal), MALABSORPTION SYNDROMES and CROHN DISEASE can be grouped with the still more general term INTESTINAL DISEASES. 23.8.2 Even when there are not too many terms, there may be too many IM terms. In general, we do not make more than five terms IM if a grouping procedure can be followed to choose an IM term which covers three or more related main concepts. The specific terms may still be indexed NIM if there is not too much depth. ATPase levels in heart mitochondria in congestive cardiomyopathy, aortic subvalvular stenosis, endomyocardial fibrosis, and myocarditis. MITOCHONDRIA, HEART / * enzymol ATPASE / * anal CARDIOMYOPATHY, CONGESTIVE / enzymol AORTIC SUBVALVULAR STENOSIS / enzymol ENDOMYOCARDIAL FIBROSIS / enzymol MYOCARDITIS / enzymol MYOCARDIAL DISEASES / * enzymol Note that MYOCARDIAL DISEASES is the most specific term which groups all the related concepts; HEART DISEASES is also available but is less specific. 23.9 Always use the most specific pre-coordinated disease term available rather than combining two terms. Index SALMONELLA INFECTIONS, not SALMONELLA + INFECTIONS not SALMONELLA + BACTERIAL INFECTIONS Index AORTIC ANEURYSM, not AORTA + ANEURYSM not AORTIC DISEASES + ANEURYSM 23.10 MeSH contains many terms which refer to systemic diseases. When indexing an article about one of those diseases in a specific organ, coordinate the systemic disease term (IM) with the pre-coordinated organ-diseases term (IM), not the organ term. Use the same subheading(s) on both terms. Immunology of pulmonary amyloidosis. AMYLOIDOSIS / * immunol LUNG DISEASES / * immunol 23.10.1 Similarly, when indexing any disease in which the article is about a more specific organ or location than indicated by the disease term, the disease term for the specific organ or location should be added as a coordinate. Both terms should be made IM, and the same subheading(s) should be used on both. Epidemiology of spinal osteoporosis. OSTEOPOROSIS / * epidemiol SPINAL DISEASES / * epidemiol Complications of colonic hemorrhage. GASTROINTESTINAL HEMORRHAGE / * compl COLONIC DISEASES / * compl 23.11 When a pre-coordinated organ-diseases concept does not exist in MeSH, index the organ (IM) and add the most specific corresponding Category C term available, but make it NIM. "Cystic duct diseases" is indexed as * CYSTIC DUCT BILE DUCT DISEASES MeSH does not have a term to cover "cystic duct diseases", so * CYSTIC DUCT must be indexed. Then the indexer must check the Trees to see what term CYSTIC DUCT is indented under; in this case BILE DUCTS. Since MeSH has the term BILE DUCT DISEASES, that term is added NIM. (If BILE DUCT DISEASES had not been available, the Trees would have been consulted for the term under which BILE DUCTS is treed, and the corresponding disease term for that anatomical part would have been used as the NIM coordinate.) 23.11.1 Since AQs are different for organs and diseases, it may not be possible to use a subheading on the organ when a pre-coordinated organ-diseases term does not exist for it; however, if a subheading applies to the organ and is an AQ, it should be used. Radiography of cystic duct diseases. CYSTIC DUCT / * radiogr BILE DUCT DISEASES / radiogr Drug therapy of cystic duct diseases. * CYSTIC DUCT BILE DUCT DISEASES / drug ther Ultrasonography of the pancreatic ducts in cystic duct diseases. (No imaging of the cystic duct) * CYSTIC DUCT BILE DUCT DISEASES / ultrasonogr PANCREATIC DUCTS / * ultrasonogr 23.11.2 If an article is about a specific disease for which a MeSH term exists as an indention under the general organ-diseases term, that specific disease term should be indexed IM in coordination with the term for the more specific organ, and the general organ-diseases term should not be indexed at all. Cystic duct cholangitis. * CYSTIC DUCT * CHOLANGITIS Not: BILE DUCT DISEASES 23.11.3 There are some locational terms which MeSH has annotated "coord NIM with (a disease term) IM"; the decision has been made that these specific sites are relatively unimportant. When indexing a disease in such a location, do not follow the rule given in 23.11 but use the instructions in the annotation, making the location NIM with the disease term IM. Radiography in diseases of the internal carotid artery. CAROTID ARTERY DISEASES / * radiogr CAROTID ARTERY, INTERNAL / radiogr 23.11.4 If a pre-coordinated organ-diseases heading does not exist in MeSH, do not attempt to achieve the concept of "disease" by using the subheadings /pathology or /physiopathology on the organ. These subheadings are not synonymous with "disease"; /pathology is a description of non-normal tissue and /physiopathology is descriptive of non-normal function (see sections 19.8.52 and 19.8.55). To index a "disease" concept when the specific term is not available, follow the instructions given above. The previous sections discussed indexing policies for diseases in general. The rest of Chapter 23 will be devoted to policies for specific concepts. The brief Table of Contents below shows the coverage in individual sections of the chapter. 23.12 Infections 23.13 Inflammation 23.14 Pathological processes 23.15 /pathology 23.16 Acute and chronic disease 23.17 Pain 23.18 Postoperative complications 23.19 Fistulas 23.20 Abnormalities 23.21 Congenital diseases 23.22 Hereditary diseases and /genetics 23.23 Injuries 23.24 Drug hypersensitivity 23.25 Deficiency diseases 23.26 Syndromes 23.27 Physiological processes vs. disease 23.28 /physiopathology vs. /blood 23.29 Hematology 23.30 Serology 23.31 Enzymes 23.32 /etiology 23.33 Veterinary diseases 23.34 Pregnancy complications 23.12 An infection is a disease caused by an organism. Infections are among the most common diseases we index. Authors sometimes use the term "infectious disease"; this may mean INFECTION in general, a specific infection, or COMMUNICABLE DISEASES. Check the text of the article itself for the meaning in a given instance. 23.12.1 MeSH has many infection terms in Categories C1-C3; section 23.7 shows the types of infection terms available. 23.12.2 For the rules on how to index infections, see sections 22.12 through 22.18. 23.12.3 When an infection occurs in a specific organ, the pre-coordinated organ-diseases term must be indexed as well as the term for the infection itself. The subheading /microbiology or /parasitology on the organ-diseases term shows the origin of the disease. Any other subheading required for the subject of the article will probably be used on both the infection term and the organ- diseases term. Systemic Staphylococcus epidermidis infection. * STAPHYLOCOCCUS EPIDERMIDIS * STAPHYLOCOCCAL INFECTIONS Staphylococcus epidermidis infection of the adrenal glands. * STAPHYLOCOCCUS EPIDERMIDIS * STAPHYLOCOCCAL INFECTIONS ADRENAL GLAND DISEASES / * microbiol Drug therapy of Staphylococcus epidermidis infection of the adrenal glands. * STAPHYLOCOCCUS EPIDERMIDIS STAPHYLOCCAL INFECTIONS / * drug ther ADRENAL GLAND DISEASES / * drug ther / microbiol 23.12.4 If the infection occurs in an organ for which there is no pre- coordinated organ-diseases term available, the rules given in section 23.11 should be followed. Again the subheadings /microbiology or /parasitology can be used. Klebsiella pneumoniae infection of the cystic duct. * KLEBSIELLA PNEUMONIAE * KLEBSIELLA INFECTIONS CYSTIC DUCT / * microbiol BILE DUCT DISEASES / microbiol (note: NIM) 23.12.5 MeSH contains the following pre-coordinated general "system- infection" terms. EYE INFECTIONS, BACTERIAL (also FUNGAL, PARASITIC, and VIRAL) INTESTINAL DISEASES, PARASITIC When indexing an infection caused by a specific organism in an organ located in one of these systems, if the infection term is not indented under one of the general terms, the general term should be added as a coordinate to the specific infection and specific organ-diseases term. This saves the searcher who wants articles on any infection anywhere in the system from having to search for all possible infections and specific organ-diseases. Epidemiology of enterovirus infections of the uvea. ENTEROVIRUS INFECTIONS / * epidemiol UVEAL DISEASES / * epidemiol / microbiol EYE INFECTIONS, VIRAL / * epidemiol 23.13 The term INFLAMMATION is used for general articles on the inflammatory process. MeSH contains many terms for inflammations of specific organs, usually expressed by a Greek root for the organ with the suffix -ITIS. Each organ for which there is an inflammation term available is annotated with that information at the organ term. If no inflammation term exists for the organ being studied, index IM the pre-coordinated organ-diseases term (or the organ itself if no disease term exists) and add INFLAMMATION as an NIM coordinate. Stomach inflammation = * GASTRITIS Inflammation of the mouth = * STOMATITIS Cecitis = * CECAL DISEASES INFLAMMATION (No inflammation term is is available for the cecum 23.13.1 Many inflammatory diseases are caused by an infection of the organ; in such cases index the inflammation term with the subheading /microbiology or /parasitology, coordinated with the pre-coordinated organism-infections term. Do not use the subheading /complications on the organism-infections term, because the inflammation is not really a complication; it is a symptom of the infection occurring in that organ and thus is merely a more specific term than the organ- diseases term which would be used otherwise. (Do not assume that an infection in an organ is inflammatory unless stated so in the article; use the pre- coordinated organ-diseases term rather than an -ITIS term unless there is proof of inflammation.) Staphylococcal pancreatitis. PANCREATITIS / * microbiol * STAPHYLOCOCCAL INFECTIONS (Not: STAPHYLOCOCCAL INFECTIONS / * compl) 23.13.2 If an inflammation is caused by tuberculosis, coordinate the -ITIS term with the most specific pre-coordinated TUBERCULOSIS term available. Tuberculous endocarditis. * TUBERCULOSIS, CARDIOVASCULAR ENDOCARDITIS, BACTERIAL / * microbiol Tuberculous duodenitis. * TUBERCULOSIS, GASTROINTESTINAL DUODENITIS / * microbiol 23.14 MeSH contains many terms in Category C23 treed under PATHOLOGICAL PROCESSES (NON MESH); these are descriptive of what an organ or tissue looks like. Each of the terms is annotated with the correct indexing, since different terms have different coordinations. In the sections below, examples are given of each type of indexing. 23.14.1 TORSION and ULCER are two of the terms annotated to be indexed NIM in coordination with the pre-coordinated organ-diseases term (IM). However, the annotation for TORSION says to use no qualifiers, while the annotation for ULCER does not have this restriction. Surgery for uterine torsion. UTERINE DISEASES / * surg TORSION 23.14.2 INFARCTION and NEOVASCULARIZATION are two of the terms annotated to be indexed in coordination with the organ / * blood supply, not a pre- coordinated organ-disease term. However, NEOVASCULARIZATION is annotated that it can be IM or NIM, depending on the article, whereas INFARCTION must be IM. Therapy of liver infarction. LIVER / * blood supply INFARCTION / * ther (Not: LIVER DISEASES / * ther) 23.14.3 NECROSIS and HYPERPLASIA are two of the terms annotated to be indexed NIM in coordination with the organ / * pathology rather than a pre- coordinated organ-diseases term. However, the annotation for NECROSIS says to use no qualifiers, while the annotation for HYPERPLASIA does not have this restriction. Detection of focal nodular hyperplasia of the liver. LIVER / * pathol HYPERPLASIA / diag (Not: LIVER DISEASES / * diag) 23.15 For any article discussing the pathology of an organ in a disease, index the organ even if it is the organ normally affected by the disease. Do not, however, index the organ merely because it is inherent in the disease if it is not discussed. Lung pathology in pulmonary tuberculosis. LUNG / * pathol TUBERCULOSIS, PULMONARY / * pathol Pathology of pulmonary tuberculosis. TUBERCULOSIS, PULMONARY / * pathol (Not: LUNG / pathol, either IM or NIM, unless the lung is especially discussed; the author may discuss many organs affected by the disease) 23.16 ACUTE DISEASE and CHRONIC DISEASE are MeSH terms used primarily as NIM coordinates with a specific disease term indexed IM. 23.16.1 Index ACUTE DISEASE or CHRONIC DISEASE as IM concepts only when the general concept of acuteness or chronicity is the point of the article, irrespective of any specific disease. When either of these terms is made IM, the following subheadings may be used with it: /classification, /economics, /epidemiology, /mortality, /nursing, /psychology, /rehabilitation, /therapy. The psychology of chronic disease. CHRONIC DISEASE / * psychol 23.16.2 An article on a specific acute or chronic disease should be indexed as the specific disease, coordinated with ACUTE DISEASE or CHRONIC DISEASE. In such a case (far more common than the general article shown in 23.16.1), the coordinate term must be NIM and no qualifier may be used with it. Therapy of acute pancreatitis. PANCREATITIS / * ther ACUTE DISEASE 23.16.3 Do not attempt to qualify every disease as acute or chronic; the acuteness or chronicity must be the point of the article (and even then, the terms must be NIM in reference to a specific disease). 23.16.4 The term CRITICAL ILLNESS is also available, and should be indexed in the same manner as ACUTE DISEASE and CHRONIC DISEASE (IM for general articles with the same limited set of subheadings allowed, NIM as a coordinate with no qualifiers). However, it is far less likely that a specific disease will be discussed as "critical", so this term will not be used as frequently as the others. It may well be that the term will be used primarily for general articles on critical illness, irrespective of any specific disease. 23.17 Articles on pain in general will be indexed as PAIN (IM) with any subheadings required. Such articles will probably discuss the physiopathological mechanisms of pain, its psychology, etc. irrespective of an organ. 23.17.1 If the pain process in a specific disease is especially discussed, PAIN may be indexed but will probably be NIM. The subheading on the specific disease may be /complications, but /physiopathology is probably better if the pain process is discussed. 23.18 POSTOPERATIVE COMPLICATIONS and its indentions are conditions affecting patients who have undergone surgery; they may or may not be directly related to the surgery. INTRAOPERATIVE COMPLICATIONS is also available in MeSH and should be indexed by the same rules as POSTOPERATIVE COMPLICATIONS, but intraoperative complications are seen less frequently so the following examples all refer to postoperative complications. 23.18.1 If a complication follows surgery but is unrelated to the specific surgical procedure, index the complication (IM), add POSTOPERATIVE COMPLICATIONS (IM), and add the type of surgery, but do not use /adverse effects on the surgical procedure. Postoperative pneumonia. PNEUMONIA / * etiol * POSTOPERATIVE COMPLICATIONS Postoperative pneumonia in cholecystectomy. PNEUMONIA / * etiol * POSTOPERATIVE COMPLICATIONS * CHOLECYSTECTOMY If the complication term is indented under POSTOPERATIVE COMPLICATIONS, the more general term should not be indexed. Epidemiology of postoperative surgical shock in hepatectomy. SHOCK, SURGICAL / * epidemiol * HEPATECTOMY 23.18.2 If a postoperative complication is a direct result of a surgical procedure, and the procedure is a MeSH term, index the procedure with the subheading / * adverse effects and do not add POSTOPERATIVE COMPLICATIONS. Postoperative hepatic coma in portacaval anastomosis. HEPATIC COMA / * etiol PORTACAVAL ANASTOMOSIS / * adv eff Many postoperative complications which are direct results of specific procedures are available in MeSH as indentions under POSTOPERATIVE COMPLICATIONS. These should be indexed without adding the procedure as well, unless the procedure is discussed. Etiology of postgastrectomy syndromes. POSTGASTRECTOMY SYNDROMES / * etiol But: A new gastrectomy technique to prevent postgastrectomy syndromes. GASTRECTOMY / * methods POSTGASTRECTOMY SYNDROMES / * prev 23.18.3 If a postoperative complication is a direct result of a surgical procedure but no MeSH heading exists for the procedure, index POSTOPERATIVE COMPLICATIONS (IM) in coordination with the complication (unless, of course, it is an indention under POSTOPERATIVE COMPLICATIONS). Postoperative cerebral hemorrhage in brain surgery. CEREBRAL HEMORRHAGE / * etiol * POSTOPERATIVE COMPLICATIONS BRAIN / * surg 23.18.4 If a postoperative complication is a direct result of a surgical procedure, and the procedure is a MeSH term but no term exists for the complication, POSTOPERATIVE COMPLICATIONS may be indexed if subheadings are needed for the complication, but it must be made NIM because / * adverse effects has been used with the specific procedure. (This is similar to the policy on main heading-subheading duplicates, section 19.7.4.) Ultrasound and radiographic imaging of bile leaks caused by cholecystectomy. CHOLECYSTECTOMY / * adv eff * BILE POSTOPERATIVE COMPLICATIONS / ultrasonogr / radiogr 23.18.5 If a complication is a direct result of a surgical procedure, and the procedure is a MeSH term, but the intraoperative appearance of the complication is being discussed as well as the postoperative appearance, INTRAOPERATIVE COMPLICATIONS and POSTOPERATIVE COMPLICATIONS may be added but again should be made NIM because / * adverse effects has been used with the procedure. Intraoperative and postoperative arrhythmias in heart surgery. HEART SURGERY / * adv eff ARRHYTHMIA / * etiol POSTOPERATIVE COMPLICATIONS INTRAOPERATIVE COMPLICATIONS 23.19 A fistula is an abnormal passage between two or more internal organs or from an internal organ to the body surface. Fistulas are of various origins: congenital, traumatic, post-infection. There are many pre-coordinated specific organ-fistula and general system-fistula headings available in MeSH. 23.19.1 If the fistula can be adequately indexed by one of the pre- coordinated specific organ-fistula headings, use that. Stomach fistula = * GASTRIC FISTULA Vaginal fistula = * VAGINAL FISTULA 23.19.2 If no pre-coordinated organ-fistula term exists for the specific organ, but there is a more general system-fistula term available, index it and coordinate with the pre-coordinated organ-diseases term for the specific organ, making both IM. Renal fistula = * URINARY FISTULA * KIDNEY DISEASES Parotid fistula = * PAROTID DISEASES * SALIVARY GLAND FISTULA 23.19.3 If no pre-coordinated organ-fistula term is available for the specific organ, and no general system-fistula term exists either, index the pre-coordinated organ-diseases term and coordinate with FISTULA, making both IM. Tracheal fistula = * TRACHEAL DISEASES * FISTULA Ovarian fistula = * OVARIAN DISEASES * FISTULA 23.19.4 If no pre-coordinated organ-fistula or system-fistula term is available for the specific organ or area, and no pre-coordinated organ-diseases term is available either, index the organ or area and coordinate with FISTULA, making both IM. If a more general system-diseases term is available, it should be added NIM, following the rules given in section 23.11. Perineal fistula = * PERINEUM * FISTULA Scrotal fistula = * SCROTUM * FISTULA GENITAL DISEASES, MALE (NIM) 23.19.5 When indexing a fistula, each element must be covered in turn, independently. Do not use /complications on the elements of a fistula. Surgery of a gastroduodenocolonic fistula. GASTRIC FISTULA / * surg INTESTINAL FISTULA / * surg DUODENAL DISEASES / * surg COLONIC DISEASES / * surg 23.19.6 An ARTERIOVENOUS FISTULA (also called arteriovenous aneurysm) or an ARTERIO-ARTERIAL FISTULA should be indexed in coordination with with the terms for the specific vessels involved (IM). As with organs, if a pre-coordinated vessel-diseases term exists in MeSH, use it rather than just the term for the vessel. Congenital aortocaval fistula. AORTIC DISEASES / * congen VENAE CAVAE / * abnorm ARTERIOVENOUS FISTULA / * congen Radiography of a pulmonary arteriovenous aneurysm. PULMONARY ARTERY / * radiogr PULMONARY VEINS / * radiogr ARTERIOVENOUS FISTULA / * radiogr 23.19.6.1 If a heading does not exist for the specific blood vessel, or if the vessel is not specified by the author, index the term for the organ or area with the subheading / * blood supply and add the appropriate FISTULA term. Arterioarterial fistulas of the leg. LEG / * blood supply * ARTERIO-ARTERIAL FISTULA 23.19.6.2 There are two headings which must be distinguished from the term ARTERIOVENOUS FISTULA. ARTERIOVENOUS ANASTOMOSIS is a Category A term referring to the normal anatomical connection between an artery and a vein. An ARTERIOVENOUS SHUNT, SURGICAL (sometimes called a surgical anastomosis) is created surgically; it should be coordinated with /surgery on the specific artery and vein. 23.19.7 Sometimes a fistula is created artificially in order to study the physiology of an organ. If the fistula is discussed, index the organ with the subheading / * physiology, add the same organ with / surgery (NIM) and add FISTULA or an indention (NIM only with no subheading, since the article is not about the disease concept). In most cases, such a technique is third-tier and need not be indexed. 23.20 The concept of "abnormality" in MeSH refers to an inborn structural anomaly of a body part. Category C16 contains many terms for abnormalities; the abnormalities terms in this tree fall into two groups: pre-coordinated organ- abnormalities terms (MOUTH ABNORMALITIES, CORONARY VESSEL ANOMALIES, etc.) and specific abnormality terms (CLEFT PALATE, SPINA BIFIDA, etc.). 23.20.1 If a MeSH term does not exist for the specific abnormality discussed in an article, index the organ or area with the subheading /abnormalities (see section 19.8.1). If the article requires a subheading which cannot be used on the organ or area, the term ABNORMALITIES or a specific may be indexed with the subheading desired, but must be made NIM (see section 19.7.4). Surgery of uterine abnormalities. UTERUS / * surg / * abnorm Epidemiology of abnormalities of the uterus. UTERUS / * abnorm ABNORMALITIES / epidemiol 23.20.2 ABNORMALITIES, MULTIPLE should be indexed when an article discusses the existence of more than one abnormality in a patient. Do not routinely use the subheading /complications on each abnormality; the addition of the term ABNORMALITIES, MULTIPLE indicates that the abnormalities coexist, so only the subheadings required to cover the subject of the article need to be indexed. Different subheadings may be used on different terms. If a subheading applies to more than one of the abnormalities, it may also be used with the term ABNORMALITIES, MULTIPLE. Surgery of esophageal atresia and intestinal anomalies in a child with a radiographically demonstrated heart deformity. ESOPHAGEAL ATRESIA / * surg INTESTINES / * surg / * abnorm ABNORMALITIES, MULTIPLE / * surg HEART DEFECTS, CONGENITAL / * radiogr 23.20.2.1 Some recurring groupings of multiple abnormalities have been given SYNDROME names (see section 23.26+). When indexing an article about such a grouping called a syndrome by the author, use the term for the syndrome if in MeSH and do not add ABNORMALITIES, MULTIPLE if the term is indented under it. If no MeSH term exists for the syndrome, index the abnormalities and add both SYNDROME (NIM) and ABNORMALITIES, MULTIPLE (IM), since there are many syndromes which are not comprised of abnormalities, and many groupings of abnormalities which have not been designated as syndromes. 23.20.3 ABNORMALITIES, DRUG-INDUCED are deformities in offspring caused by chemical compounds taken by or given to the mother when she was pregnant. Index drug- or chemically-induced abnormalities using the abnormality term with the subheading / * chemically induced, the term for the compound with the subheading / * adverse effects, and * ABNORMALITIES, DRUG-INDUCED. Cleft palate from anticonvulsant therapy during pregnancy. ANTICONVULSANTS / * adv eff CLEFT PALATE / * chem ind * ABNORMALITIES, DRUG-INDUCED EPILEPSY / * drug ther PREGNANCY COMPLICATIONS / * drug ther 23.20.3.1 The term TERATOGENS is also available in MeSH, but is used primarily for toxicology studies in which the ability of a chemical to act as a teratogen is studied prospectively; retrospective studies looking at deformities which resulted from therapeutic or diagnostic techniques will probably be indexed as ABNORMALITIES, DRUG-INDUCED. Studies of the teratogenic effect of hydrocortisone in rats. HYDROCORTISONE / * tox TERATOGENS / * tox RATS (check tag) ANIMAL (check tag) 23.20.4 ABNORMALITIES, RADIATION-INDUCED are abnormalities in offspring caused by prenatal irradiation. Index a radiation-induced abnormality using the term for the abnormality with the subheading / * etiology, the specific type of radiation (unless x-rays; see section 19.8.60) with the subheading / * adverse effects (if allowed), and * ABNORMALITIES, RADIATION-INDUCED. Microcephaly caused by background radiation. MICROCEPHALY / * etiol BACKGROUND RADIATION / * adv eff * ABNORMALITIES, RADIATION-INDUCED 23.20.5 When an article discusses an abnormality in a newborn infant, the check tag INFANT, NEWBORN must be checked. If the article is about an abnormality in an older patient, the check tag INFANT, NEWBORN should not be checked, only the age at which the patient is seen. 23.20.6 Do not confuse abnormalities with congenital diseases. Although it is true that all abnormalities are congenital by MeSH definition, the subheading /abnormalities and the terms indented under ABNORMALITIES in Category C16 refer to morphological deviations from normal structure. When a title says "congenital", check to see whether the article is about a congenital disease, or whether a structural "abnormality" is meant. 23.21 Index congenital diseases using one of the disease terms indented under INFANT, NEWBORN, DISEASES. If the term used is not indented there, index it with the subheading /congenital (see 19.8.18). 23.21.1 When an article discusses a congenital disease in a newborn infant, the check tag INFANT, NEWBORN must be checked even if the disease is indented under INFANT, NEWBORN, DISEASES. If the article is about a congenital disease in an older patient, do not check INFANT, NEWBORN, only the age at which the patient is seen. 23.21.2 Do not confuse diseases of neonates with congenital diseases. It is possible for an infant to develop a disease within the first month of life (the limits of the check tag INFANT, NEWBORN) without having been born with the disease. "Congenital" means "existing at birth" or acquired at birth. It is not necessarily a synonym for "neonatal". When a title says "neonatal", check to see if the disease was indeed present at birth before indexing it as /congenital. Neonatal staph infections from contamination in hospital nurseries. STAPHYLOCOCCAL INFECTIONS / * transm CROSS INFECTION / * transm * NURSERIES, HOSPITAL INFANT, NEWBORN (check tag) 23.21.3 When a newborn infant develops signs of a disease which were not visible at birth, but the disease itself is unlikely to have developed in the brief period after birth, it is correct to index the disease as having been congenital. Intestinal obstruction in a 5-day-old infant resulting from an undisclosed peritoneal tumor. PERITONEAL NEOPLASMS / * congen / compl INTESTINAL OBSTRUCTION / * etiol INFANT, NEWBORN (check tag) 23.21.4 When indexing articles about congenital diseases, abnormalities, or other diseases in the neonatal period, do not add the term INFANT, NEWBORN, DISEASES as a coordinate, merely check the tag INFANT, NEWBORN. The term INFANT, NEWBORN, DISEASES is annotated "GEN only", so it should be reserved for articles on unspecified diseases in the neonatal period. Since diseases in premature infants are more unusual and devastating, the term INFANT, PREMATURE, DISEASES is annotated to be an IM concept. Use it as a coordinate for any disease in a premature infant (except those indented under it), making it IM with the same subheadings. Add the term INFANT, PREMATURE (NIM with no subheading). 23.22 Index familial (hereditary) diseases using the disease term with the subheading /genetics (see 19.8.34). Ultrastructure of the X chromosome in X-linked muscular dystrophy. X CHROMOSOME / * ultrastruct MUSCULAR DYSTROPHY / * genet * LINKAGE Familial platelet disorders. BLOOD PLATELET DISORDERS / * genet 23.22.1 Familial diseases which are not hereditary should be indexed with the term FAMILY HEALTH (NIM for articles on a specific disease in a family, as opposed to the concept in general). A family with measles from sleeping in the same room. MEASLES / * transm * HOUSING FAMILY HEALTH 23.22.2 There is a main heading HEREDITARY DISEASES, but it is reserved for general articles on hereditary or familial diseases. Do not use it as a coordinate for a disease indexed with the subheading /genetics. Gout as a hereditary disease. GOUT / * genet (Not: * HEREDITARY DISEASES) Incidence of hereditary diseases in the United States. HEREDITARY DISEASES / * epidemiol INCIDENCE UNITED STATES / epidemiol 23.22.3 Do not confuse /genetics with /congenital. A congenital disease may or may not be hereditary. Conversely, a hereditary disease need not necessarily be present at birth; Huntington chorea is hereditary, but the disease does not develop until adulthood. 23.22.4 An additional use of the subheading /genetics is for studies of the genetic aspects of any disease, whether or not hereditary. Chromosome aberrations in various types of leukemia. LEUKEMIA / * genet * CHROMOSOME ABERRATIONS 23.23 MeSH contains many terms for various wounds and injuries in Category C21. If, however, the term for the specific injury is not available, index the term for the organ or area with the subheading /injuries (see 19.8.38). Surgery of arm injuries. ARM INJURIES / * surg Surgery of kidney trauma. KIDNEY / * inj / * surg 23.23.1 When indexing an organ or area with the subheading /injuries, if the injury requires a subheading which cannot be used on the organ or area, WOUNDS AND INJURIES or an indention may be added with the subheadings desired but must be made NIM (see 19.7.4). Preventing injuries to the fibula. FIBULA / * inj LEG INJURIES / prev (Not: WOUNDS AND INJURIES / prev) But: Radiography of fibular injuries. FIBULA / * inj / * radiogr (Not: LEG INJURIES / radiogr) 23.23.2 Many of the terms in Category C21 should be coordinated with the specific organ/injuries or pre-coordinated organ-injuries term. Incidence of fractures of the finger. FRACTURES / * epidemiol FINGER INJURIES / * epidemiol INCIDENCE Radiographic diagnosis of an elbow dislocation. DISLOCATIONS / * radiogr ELBOW JOINT / * inj / * radiogr 23.24 The MeSH term DRUG HYPERSENSITIVITY means "drug allergy"; do not use it for "sensitivity" meaning how well a patient responds to a drug, or whether side effects develop. Allergy to the calcium channel blocker nifedipine. NIFEDIPINE / * adv eff CALCIUM CHANNEL BLOCKERS / * adv eff DRUG HYPERSENSITIVITY / * etiol But: Overdose from extreme sensitivity to nifedipine. NIFEDIPINE / * pois CALCIUM CHANNEL BLOCKERS / * pois OVERDOSE / etiol (Not: DRUG HYPERSENSITIVITY / * compl) 23.24.1 Do not use DRUG HYPERSENSITIVITY for allergies to all terms from Category D; save it for allergy to "drugs" in the conventional sense (penicillin, aspirin, etc.). Allergies to various metals and other non-drug substances in Category D like DENTIFRICES, CELLOPHANE, SILICONES, etc. should be indexed merely as HYPERSENSITIVITY or a specific, with the subheading /etiology. Pulmonary allergic response to the glycopeptide vancomycin. VANCOMYCIN / * adv eff ANTIBIOTICS, GLYCOPEPTIDE / * adv eff DRUG HYPERSENSITIVITY / * etiol RESPIRATORY HYPERSENSITIVITY / * chem ind Formaldehyde hypersensitivity in people living in houses with certain types of wood paneling. FORMALDEHYDE / * adv eff CONSTRUCTION MATERIALS / * adv eff HYPERSENSITIVITY / * etiol 23.24.2 Other terms available for use when indexing allergies to compounds from Category D include: ANAPHYLAXIS: a severe immediate hypersensitivity reaction caused by exposure to an antigen (such as a drug or biological product) in a previously sensitized individual. If caused by a drug, index ANAPHYLAXIS/chemically induced and coordinate with DRUG HYPERSENSITIVITY, but not if caused by a vaccine, toxin or other biological product. DRUG ERUPTIONS: any skin disease (not necessarily inflammatory) caused by a drug administered internally or externally. If the latter, coordinate with DERMATITIS, ALLERGIC CONTACT. DERMATITIS, ALLERGIC CONTACT: any allergic skin disease (not necessarily inflammatory) caused by a drug, any other Category D term, or factor such as plants or insects, coming in contact with the skin. If caused by a cutaneously administered drug, coordinate with DRUG ERUPTIONS. DERMATITIS, OCCUPATIONAL: any skin disease (not necessarily inflammatory) caused by any allergen or irritant in a work environment. If discussed, coordinate with DERMATITIS, ALLERGIC CONTACT or DERMATITIS, IRRITANT. MULTIPLE CHEMICAL SENSITIVITY: a type of hypersensitivity usually to occupational or environmental chemicals and often affecting multiple organs. The specific chemicals are seldom at issue. If discussed, consider adding an appropriate occupational or environmental term such as ENVIRONMENTAL (or OCCUPATIONAL) EXPOSURE or OCCUPATIONAL DISEASES. If a specific chemical is discussed, index it IM or NIM. 23.25 The term DEFICIENCY DISEASES is available in MeSH but should be made IM only when indexing articles on deficiency diseases in general, irrespective of any specific substance. Occurrence of deficiency diseases in Calcutta. DEFICIENCY DISEASES / * epidemiol INDIA / epidemiol Deficiency of a specific dietary substance or endogenous compound should be indexed with a pre-coordinated substance-deficiency term if one is available in MeSH, or with the subheading /deficiency on the term for the substance (see 19.8.21). However, if a disease subheading is needed when /defic is indexed with a specific dietary substance, DEFICIENCY DISEASES may be added with the subheading desired, NIM only (see section 19.7.4). Diagnosis of potassium deficiency. POTASSIUM DEFICIENCY / * diag Selenium deficiency. SELENIUM / * defic Diagnosis of selenium deficiency. SELENIUM / * defic DEFICIENCY DISEASES / diag Since DEFICIENCY DISEASES is treed under NUTRITION DISORDERS, do not add DEFICIENCY DISEASES as a coordinate when indexing /defic with an endogenous substance. Although DEFICIENCY DISEASES is restricted to dietary deficiencies, deficiencies of many endogenous compounds result in specific diseases which are available in MeSH. Sections 23.25.1 to 23.25.3.1 discuss some types of diseases resulting from deficiencies of various endogenous compounds. 23.25.1 Deficiencies of many enzymes result in inborn errors of metabolism, so a specific heading treed under METABOLISM, INBORN ERRORS may be applicable. Whether to index only the enzyme with the subheading /defic, only the inborn error of metabolism which results, or both, depends upon the slant of the article. If the article is only about the fact that there is an enzyme deficiency, index only the enzyme with the subheading /defic; if the article is only about the disease which results, index only the disease; if the article is about both aspects, index both. Detecting iduronidase deficiency as a confirmatory test in patients with suspected Scheie's syndrome. IDURONIDASE / * defic SCHEIE'S SYNDROME / * diag * ENZYME TESTS 23.25.2 Deficiency of any of the immunologic components of the blood often results in a disease treed under IMMUNOLOGIC DEFICIENCY SYNDROMES, and deficiency of one of the blood coagulation factors usually results in one of the BLOOD COAGULATION DISORDERS or a disease treed under EMBOLISM AND THROMBOSIS (NON MESH). Therapy of IgM deficiency. IGM / * defic DYSGAMMAGLOBULINEMIA / * ther Hereditary deficiency of antithrombin III. (The author describes how the patient suffers recurring thromboembolism.) ANTITHROMBIN III / * defic THROMBOEMBOLISM / * genet RECURRENCE 23.25.3 Deficiency of hormones usually results in endocrine disorders, most of which are available in Category C19. As with enzymes, the indexer must make the determination whether the disease is relevant or whether the article really is just about the deficiency. For example, although THYROID HORMONES / * defic is allowable in MeSH, the indexer should check carefully to see if HYPOTHYROIDISM might not be a better way to cover the substance of the article. 23.25.3.1 A specific disease caused by a hormone deficiency is DIABETES MELLITUS, caused by a deficiency of or resistance to the hormone insulin. MeSH contains many terms for specific types of diabetes and its complications. When indexing one of the types of complications, it is not necessary to use /etiology on the pre-coordinated term, as the term itself implies that it results from diabetes. It also is not necessary to add DIABETES MELLITUS/complications, just any specific type of diabetes. Incidence of paresthesias in insulin-dependent diabetes. DIABETES MELLITUS, INSULIN-DEPENDENT / * compl PARESTHESIA / * epidemiol / etiol DIABETIC NEUROPATHIES / * epidemiol INCIDENCE (Not: DIABETIC NEUROPATHIES / etiol) Incidence of diabetic foot. DIABETIC FOOT / * epidemiol INCIDENCE (Not: DIABETIC FOOT / etiol) (Not: DIABETES MELLITUS / compl) 23.26 Syndromes are characteristic groupings of diseases. Dorland's Illustrated Medical Dictionary defines a syndrome as "a set of symptoms which occur together; ... a symptom complex". MeSH contains two types of syndrome terms, the eponymous syndromes (those containing a personal name, like CUSHING'S SYNDROME) and the descriptive syndromes (in which the name of the syndrome describes its characteristics, like PRUNE BELLY SYNDROME). 23.26.1 To index a syndrome, always look for the term in MeSH first. Check the text carefully; the same syndrome may be called different names by different authors. In addition, the same author (or another with the same last name) may have identified more than one syndrome, so be sure that if a syndrome term is available in MeSH, it refers to the syndrome being described in the article. For example, MeSH has the term BERNARD-SOULIER SYNDROME (a platelet disorder), and also BERNARD'S SYNDROME see HORNER'S SYNDROME (caused by paralysis of the cervical sympathetic nerves). 23.26.2 When no MeSH term exists for the specific syndrome described in an article, index the dominant features of the syndrome as described by the author (usually no more than three or so), and add the heading SYNDROME (NIM with no subheading). 23.26.2.1 To decide which component(s) of the syndrome to make IM, favor the specialty of the journal or the author; if the syndrome has renal elements and the article is in a nephrology journal, the kidney aspects will usually be IM and the others NIM. 23.26.2.2 Do not routinely add the subheading /complications to each of the components of a syndrome, since the addition of the term SYNDROME shows that the diseases indexed are part of the constellation of symptoms making up the syndrome. Index only the subheadings needed to cover the subject of the article (/surgery, /pathology, etc.). Different subheadings may be used on different components. 23.26.2.3 A convenient tool for the indexing of syndromes which are not available as MeSH terms is Jablonski's Dictionary of Syndromes & Eponymic Diseases, 2nd Edition, by Stanley Jablonski. 23.26.3 The term SYNDROME should only be indexed IM for articles about syndromes in general, such as "Nomenclature for syndromes". 23.26.4 On occasion an author uses the word "syndrome" in a facetious, literary, pseudo-medical or humorous context: "the only child syndrome", "the holier-than-thou syndrome", etc. Sometimes such articles are out of scope and should not be indexed at all, and sometimes they should be indexed as WIT AND HUMOR, but there may be medical elements described; if the MeSH concept of "syndrome" applies, the term SYNDROME may be indexed. 23.27 MeSH contains many terms for physiologic states, with corresponding disease terms available for extreme variants of more or less permanent nature. For example, BODY TEMPERATURE is available, but so are HYPERTHERMIA and HYPOTHERMIA. 23.27.1 When an author uses a term which corresponds to one of the disease headings, the indexer must examine the text to determine if a disease state actually exists; if not, the term for the physiologic process should be indexed instead of the disease. The hypertensive effects of angiotensin in rats. (The author is studying the pharmacology of the drug.) ANGIOTENSIN / * pharmacol BLOOD PRESSURE / * drug eff STIMULATION, CHEMICAL Hypertension as a side effect of sympathomimetic therapy. SYMPATHOMIMETICS / * adv eff HYPERTENSION / * chem ind 23.27.2 In many articles on a disease state, the researchers also study the physiologic process (perhaps to see if treatment is being effective). Whether or not to index both aspects depends upon how important both are. Heart rate changes in procainamide treatment of tachycardia. TACHYCARDIA / * drug ther / physiopathol PROCAINAMIDE / * ther use / pharmacol ANTI-ARRHYTHMIA AGENTS / * ther use / pharmacol HEART RATE / * drug eff Procainamide treatment of tachycardia. (Heart rate studied as a method of seeing effectiveness.) TACHYCARDIA / * drug ther PROCAINAMIDE / * ther use ANTI-ARRHYTHMIA AGENTS / * ther use 23.28 Terms such as HEMODYNAMICS, BLOOD PRESSURE, BLOOD CIRCULATION, etc. refer to the movement of blood through the blood vessels, caused by the pumping action of the heart. They have nothing to do with blood as a substance, so each of these terms has been annotated to tell the indexer to use /physiopathology rather than /blood on any disease in which these concepts are studied. 23.29 The hematologic aspects of a disease, however, should be coordinated with the subheading /blood on the disease; such concepts include substances in the blood, the physical chemistry of the blood (such as BLOOD VISCOSITY), blood cells, blood coagulation, etc. Terms in this area about which an indexer might be unsure have been annotated to use /blood on the disease. 23.30 Serology (despite its name, which sounds as though it would mean /blood) usually refers to some aspect of immunology, so the serological aspects of disease in addition to the immunological aspects should be indexed as the /immunology of the disease. 23.30.1 Serodiagnosis, however, refers to diagnosis of a disease by the measurement of some immune compound such as an antibody; the correct subheading on the disease will be /diagnosis. 23.30.2 Seroepidemiology refers to the study of the epidemiology of a disease by determining the number of people who have antibodies to it. The correct subheading on the disease will be /epidemiology, and a common coordinate term will be SEROEPIDEMIOLOGIC METHODS (NIM with the specific disease IM). 23.31 Enzyme activities are often studied in disease states. Index such articles as the /metabolism of the enzyme, coordinated with the /enzymology of the organ and disease. If the enzyme activity is measured in a specific body fluid such as the blood, use that more specific subheading with the enzyme term, but still use /enzymology with the disease, not the body fluid subheading. Liver catalase activity in gout. GOUT / * enzymol LIVER / * enzymol CATALASE / * metab Blood catalase activity in gout. GOUT / * enzymol CATALASE / * blood 23.32 Various aspects of the /etiology of a disease can be indexed more specifically (see the Subheading Trees, Figure 19.5). 23.32.1 The microbial, viral or parasitic etiology of a disease should be indexed as the /microbiology, /virology, or /parasitology of the disease, respectively. (These subheadings are also used for studies of microorganisms or parasites in a disease when the organisms do not cause the disease.) Enterovirus-induced myocarditis. MYOCARDITIS / * virol * ENTEROVIRUS INFECTIONS Demonstration of Toxoplasma gondii in the liver of patients with AIDS. AIDS / * parasitol LIVER / * parasitol TOXOPLASMA GONDII / * isol 23.32.2 A disease caused by a drug or chemical should be indexed with the subheading /chemically induced; the subheading on the chemical will usually be /adverse effects, / poisoning, or /toxicity. As discussed in section 25.11.2, however, when the disease is deliberately induced as an experimental model, no subheading is used on the chemical, and the chemical is usually an NIM concept. 23.32.3 Studies of the prenatal factors leading to the development of a disease should be indexed as the /embryology of the disease. Quite frequently, this aspect is studied in patients with abnormalities. The embryonal origin of cleft palate. CLEFT PALATE / * embryol 23.32.3.1 When a pregnant woman is exposed to chemicals, microorganisms, radiation, etc. resulting in a disease or any other effects in the offspring (not necessarily visible at birth), the term PRENATAL EXPOSURE DELAYED EFFECTS should be used; whether the subheading /embryology is also used with the disease depends upon the amount of discussion devoted to the embryologic period. Cognition disorders in adolescents caused by maternal treatment with anticonvulsants during pregnancy. (No discussion of the embryologic period) COGNITION DISORDERS / * chem ind * PRENATAL EXPOSURE DELAYED EFFECTS ANTICONVULSANTS / * adv eff EPILEPSY / * drug ther PREGNANCY COMPLICATIONS / * drug ther ADOLESCENT (check tag) FEMALE (check tag) HUMAN (check tag) PREGNANCY (check tag) As discussed in section 23.20.3, any inborn structural anomaly caused by a drug or chemical should be indexed as ABNORMALITIES, DRUG-INDUCED, not PRENATAL EXPOSURE DELAYED EFFECTS. 23.32.4 An etiologic subheading restricted to use with infections is /transmission. It thus refers strictly to transmission by organisms, not hereditary transmission (see section 23.22+). Transmission of leishmaniasis from a bite by Phlebotomus. LEISHMANIASIS / * transm INSECT BITES / * compl * INSECT VECTORS * PHLEBOTOMUS 23.32.5 The hereditary etiology of a disease should be indexed with the subheading /genetics. See section 23.22+. 23.33 Index veterinary diseases (not animal models) with all of the following: the disease term with the subheading /veterinary (IM), the pre- coordinated animal-diseases heading if in MeSH (IM), the animal term (NIM or a check tag), and the check tag ANIMAL. Liver diseases in cattle. LIVER DISEASES / * vet * CATTLE DISEASES CATTLE (check tag) ANIMAL (check tag) 23.33.1 In most cases, some aspect of the veterinary disease will be discussed; the subheading needed for that aspect is made IM on the pre- coordinated animal-diseases term, but must be NIM on the term for the disease itself, since /veterinary is always made IM. Liver metabolism in bovine liver diseases. LIVER DISEASES / * vet / metab CATTLE DISEASES / * metab LIVER / * metab CATTLE (check tag) ANIMAL (check tag) 23.33.2 If no pre-coordinated animal-diseases term exists for the specific animal, make the animal itself IM, using a subheading if one is applicable to the article and is an AQ for animal terms. Fluid therapy of kidney diseases in minks. KIDNEY DISEASES / * vet / ther * MINK FLUID THERAPY / * vet ANIMAL (check tag) Microbiology of kidney diseases in minks. KIDNEY DISEASES / * vet / microbiol MINK / * microbiol ANIMAL (check tag) 23.33.3 Do not use /veterinary with any term from Category C22, as these are the ANIMAL DISEASES. When indexing any heading from this category treed under a specific pre-coordinated animal-diseases term, the animal-diseases term should not be indexed, only the term for the animal (NIM or as a check tag). Epidemiology of bovine mastitis. MASTITIS, BOVINE / * epidemiol CATTLE (check tag) ANIMAL (check tag) FEMALE (check tag) (Not: CATTLE DISEASES / * epidemiol, because MASTITIS, BOVINE is an indention under it) 23.33.4 Do not use /complications on any general animal-diseases term (such as SHEEP DISEASES). Since a complication of a sheep disease (or a coexisting sheep disease) is another sheep disease, MeSH has not allowed /complications as an AQ for any such term. Coexisting muscle and joint diseases in race horses. MUSCULAR DISEASES / * vet / compl JOINT DISEASES / * vet / compl * HORSE DISEASES HORSES (NIM) ANIMAL (check tag) (Not: HORSE DISEASES / * compl) 23.33.5 The subheadings /injuries and /abnormalities are AQs for higher animals in Category B2. When indexing a veterinary abnormality or injury that is available as a MeSH heading, use /veterinary on the heading and coordinate with /inj or /abnorm on the animal rather than using the pre-coordinated animal- diseases term. Femoral fractures in four foals. FEMORAL FRACTURES / * vet HORSES / * inj ANIMAL (check tag) (Not: * HORSE DISEASES) 23.33.5.1 However, if an injury or abnormality causes a disease, the animal- diseases term must be added as a coordinate for that disease. Syncope in cattle with Arnold-Chiari deformities. ARNOLD-CHIARI DEFORMITY / * vet / compl CATTLE / * abnorm SYNCOPE / * vet / etiol CATTLE DISEASES / * etiol ANIMAL (check tag) 23.33.6 Another AQ for higher animals in Category B2 is /surgery, which is also, of course, an AQ for the pre-coordinated animal-diseases terms. Most of the articles we see are on surgery for disease, and in these instances /surg should be used on the animal-diseases term, with no qualifier on the animal term added NIM or as a check tag. Surgical treatment of infertility in a ewe. INFERTILITY, FEMALE / * vet / surg SHEEP DISEASES / * surg SHEEP (NIM, no subheading) ANIMAL (check tag) FEMALE (check tag) CASE REPORT (check tag) Use /surg on the animal term in the following instances: 23.33.6.1 Surgery in healthy animals: New methods for spaying cats. CASTRATION, FEMALE / * vet / methods CATS / * surg FEMALE (check tag) ANIMAL (check tag) 23.33.6.2 Surgery where no animal disease is especially discussed: Spinal fusion in dogs. DOGS / * surg SPINAL FUSION / * vet ANIMAL (check tag) 23.33.6.3 Surgery for abnormalities or injuries: Surgical correction of congenital heart defects in cattle. HEART DEFECTS, CONGENITAL / * vet / surg CATTLE / * abnorm / * surg ANIMAL (check tag) 23.33.6.4 Surgery where there is no specific pre-coordinated animal-diseases term available in MeSH so the animal is added IM too: Surgical treatment of a liver abscess in a rhesus monkey. LIVER ABSCESS / * vet / surg MONKEY, RHESUS / * surg MONKEY DISEASES / * surg ANIMAL (check tag) CASE REPORT (check tag) 23.33.7 Other subheadings which are AQs for animals in Category B2 but also for animal-diseases terms are: /blood, /csf, /embryol, /genet, /immunol, /metab, /microbiol, /parasitol, /psychol, and /urine, and /virol. As with /surg, these should be used on the animal term for articles on studies in normal animals, where no disease is discussed, in animals with abnormalities or injuries, and where MeSH has provided no pre-coordinated specific animal- diseases term. In all other cases, use the subheading on the animal-diseases term. Changes in erythrocyte deformability in heart enlargement in broiler chickens. * ERYTHROCYTE DEFORMABILITY HEART ENLARGEMENT / * vet / blood CHICKENS / * blood POULTRY DISEASES / * blood ANIMAL (check tag) Genetic eye defects in the dog. EYE ABNORMALITIES / * vet / genet DOGS / * abnorm / * genet ANIMAL (check tag) But: Lipid metabolism in Sarcocystis infection in swine. SARCOCYSTOSIS / * vet / metab SWINE DISEASES / * metab SWINE (NIM, no subheading) ANIMAL (check tag) 23.33.8 It may be hard to determine whether a disease in an animal is a veterinary disease or is being viewed as a model, in which case the veterinary aspects are ignored. Pregnant sheep, for example, may be used as models of human pregnancy, so an article on intrauterine growth retardation in sheep may or may not require the subheading /veterinary and the addition of SHEEP DISEASES. The indexer must read the introduction carefully to see the author's emphasis. The author's affiliation may also be a guide; in the article mentioned above, if the author were from a department of veterinary medicine the emphasis might be on the sheep as sheep, whereas if the author were from a department of obstetrics, the sheep might be models. 23.33.9 Do not consider as a disease the infection or infestation of an animal lower than vertebrates in the evolutionary scale. Use only the term for the animal, not a disease term. Nematode infestations of grasshoppers. GRASSHOPPERS / * parasitol * NEMATODES (Not: NEMATODE INFECTIONS / * vet) 23.34 PREGNANCY COMPLICATIONS and its indentions are used for articles on disease states occurring during pregnancy. The diseases do not have to be caused by the pregnancy; many articles discuss the care of women who have pre- existing conditions but become pregnant. 23.34.1 For any article about a disease in a pregnant woman, index the disease (IM) and coordinate with the term PREGNANCY COMPLICATIONS (IM). Use the same subheading on both terms, if allowed. Do NOT use /compl on the disease, because /compl is used for two coexisting diseases and pregnancy itself is not considered a disease. (If, however, the woman has two diseases, /compl may be used for the coexistence of the diseases.) Check the tags FEMALE and PREGNANCY (for indexers working online, the computer will automatically add these check tags when the term PREGNANCY COMPLICATIONS is indexed). Treatment options for Graves' disease complicating pregnancy. GRAVES' DISEASE / * ther PREGNANCY COMPLICATIONS / * ther HUMAN (check tag) FEMALE (check tag) PREGNANCY (check tag) 23.34.2 If MeSH contains a term for the disease which is indented under the term PREGNANCY COMPLICATIONS, index it and do not add the more general term. Pregnancy in phenylketonuria; dietary treatment aimed at normalizing maternal plasma phenylalanine concentrations. PHENYLKETONURIA, MATERNAL / * diet ther / * blood PHENYLALANINE / * blood HUMAN (check tag) FEMALE (check tag) PREGNANCY (check tag) Not: PREGNANCY COMPLICATIONS / * diet ther / * blood 23.34.3 Indented under the term PREGNANCY COMPLICATIONS are five more specific, but still relatively general, types of complications: PREGNANCY COMPLICATIONS, CARDIOVASCULAR PREGNANCY COMPLICATIONS, HEMATOLOGIC PREGNANCY COMPLICATIONS, INFECTIOUS PREGNANCY COMPLICATIONS, NEOPLASTIC PREGNANCY COMPLICATIONS, PARASITIC If the disease being indexed is a cardiovascular, hematologic, infectious, neoplastic, or parasitic disease, index the disease and coordinate it with one of these more specific terms rather than the general term PREGNANCY COMPLICATIONS. The function of the hemostatic system in pregnant women with iron deficiency anemia. PREGNANCY COMPLICATIONS, HEMATOLOGIC / * blood ANEMIA, IRON-DEFICIENCY / * blood * HEMOSTASIS HUMAN (check tag) FEMALE (check tag) PREGNANCY (check tag) 23.34.4 The MeSH heading ABORTION is also indented under PREGNANCY COMPLICATIONS. It should be reserved for articles on so-called "spontaneous abortion" or "miscarriage", not the deliberately-induced procedure. Long-term psychological sequelae of spontaneous abortion. ABORTION / * psychol 23.34.4.1 Articles on abortion procedures are indexed as ABORTION, INDUCED or an indention, or as ABORTION, CRIMINAL. Do not use ABORTION. Psychological responses to various abortion procedures. ABORTION, INDUCED / * psychol / methods 23.34.4.2 ABORTION, HABITUAL (frequently referred to as "recurrent abortion") is an indention under ABORTION and thus must not be used for "repeat abortions" as a method of birth control. The latter must be indexed as one of the abortion procedure terms in Category E. 23.34.5 At times an indexer must index an article on a disease in a pregnant woman which causes an abnormality or disease in her fetus or baby. In such cases, index the pregnancy complication aspects as above, probably with no subheading. (Do not use /compl, which should be reserved for complications in the same person.) Add the term for the disease or abnormality in the baby, using the subheading /embryol (which is indented under /etiol and is defined as "embryologic factors contributing to postnatal disorders"). Maternal diabetes leading to microcephaly in the infant. * PREGNANCY IN DIABETES MICROCEPHALY / * embryol PREGNANCY (check tag) HUMAN (check tag) FEMALE (check tag) INFANT, NEWBORN (check tag) 23.34.6 LABOR COMPLICATIONS and its indentions are indexed in the same way as PREGNANCY COMPLICATIONS. Pneumomediastinum in labor. * PNEUMOMEDIASTINUM * LABOR COMPLICATIONS HUMAN (check tag) FEMALE (check tag) PREGNANCY (check tag) Prevention of uterine rupture in labor. UTERINE RUPTURE / * prev HUMAN (check tag) FEMALE (check tag) PREGNANCY (check tag) Not: LABOR COMPLICATIONS / * prev because UTERINE RUPTURE is treed under LABOR COMPLICATIONS 23.34.7 PUERPERAL DISORDERS and its indentions are diseases occurring in the postpartum period. They are indexed the same way as PREGNANCY COMPLICATIONS, but since the woman is no longer pregnant, the check tag PREGNANCY should not be indexed and will not be added automatically by the computer. Prevalence of puerperal psychoses. PSYCHOSES / * epidemiol PUERPERAL DISORDERS / * epidemiol PREVALENCE HUMAN (check tag) FEMALE (check tag) Not: PREGNANCY (check tag) 23.34.8 FETAL DISEASES and its indentions are diseases which occur in the unborn baby as opposed to the pregnant mother. FETAL DISEASES is indexed like PREGNANCY COMPLICATIONS (in coordination with the disease, using the same subheadings), but the check tags for the mother should not be indexed unless something about the mother is discussed enough to be indexed. For indexers working online, the computer will not automatically check FEMALE and PREGNANCY when FETAL DISEASES is indexed. The two examples below show the types of articles in which the maternal aspects do not need to be indexed or checked versus those in which they should be indexed and checked. Atrial natriuretic factor blood concentrations in anemic fetuses. ATRIAL NATRIURETIC FACTOR / * blood ANEMIA / * blood FETAL DISEASES / * blood HUMAN (check tag) Not: FEMALE (check tag) Not: PREGNANCY (check tag) Streptococcus group B infections in pregnant women and their unborn babies. * STREPTOCOCCUS GROUP B * STREPTOCOCCAL INFECTIONS * PREGNANCY COMPLICATIONS, INFECTIOUS * FETAL DISEASES HUMAN (check tag) FEMALE (check tag) PREGNANCY (check tag) 23.34.8.1 The term PRENATAL DIAGNOSIS is available as well. Not all articles indexed with PRENATAL DIAGNOSIS also need the term FETAL DISEASES; index FETAL DISEASES only if the article discusses the fetal aspect (for example, diagnosing the disease during the fetal period so that treatment can occur prior to birth). If the emphasis of the article is really what happens after the baby is born, do not add FETAL DISEASES. Diagnosis and surgical management of fetal neuroblastoma. FETAL DISEASES / * diag / * surg NEUROBLASTOMA / * diag / * surg * PRENATAL DIAGNOSIS HUMAN (check tag) Maternal serum inhibin levels in the prenatal diagnosis of Down syndrome. INHIBIN / * blood PRENATAL DIAGNOSIS / * methods DOWN SYNDROME / * diag HUMAN (check tag) FEMALE (check tag) PREGNANCY (check tag) Not: FETAL DISEASES / * diag