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Raynaud's phenomenon (by history or observed) definition: WHAT: Raynaud's phenomenon. Raynaud's Phenomenon: the paroxysmal constriction of the small arteries and arterioles of the hands or feet, usually precipitated by cold or emotional upset, resulting in pallor and cyanosis of the fingers or toes following a characteristic pattern. WHY: Raynaud's phenomenon may occur in mixed connective tissue disease, systemic lupus erythematosus, progressive systemic sclerosis, poly- myositis/dermatomyositis, and rheumatoid arthritis associated with Sjogren's syndrome. HOW: In Raynaud's phenomenon there are three classic color changes of the fingers or toes. First, vasoconstriction results in a white blanching of the fingertips. Second, vasodilatation with sludging of vascular flow follows and results in blue, cyanotic digits. Finally, with recovery, there is increased blood flow with resulting erythema of the fingers. With observation of two of the three color changes, Raynaud's phenomenon is considered present. Local body cooling (by placing the hands in ice cold water) may demonstrate Raynaud's phenomenon, but some cases require general body cooling before the characteristic color phases occur. Permanent tissue damage can be induced by this testing, which therefore must be done only when absolutely necessary. If the digits show persistent cyanosis or there is evidence of pre-existing necrosis, performing this test is especially hazardous. One or more digits may be involved in Raynaud's phenomenon, and this involvement may be unilateral. REFS: 1) Spittell, JA: "Raynaud's phenomenon and allied vasospastic disorders". In Juergens, JL et al. (eds.): Peripheral Vascular Diseases, pp. 555-83. Philadelphia: W.B. Saunders Co., 1980. 2) Porter, JM; Snider, RL; Bardana, EJ; Rosch, J and Eidemiller, LR: The diagnosis and treatment of Raynaud's phenomenon. Surgery 77:11, 1975. DN19300-3.
Raynauds Phenomenon definition: Intermittent bilateral attacks of ischemia of the fingers or toes and sometimes of the ears or nose, marked by severe pallor, and often accompanied by paresthesia and pain.
Raynaud's Syndrome definition: A set of symptoms characteristic of peripheral vascular disease, namely caused by an inappropriate response of the peripheral arteries in reaction to environmental stimuli, usually to the cold. The term is used when an underlying disease (mostly connective tissue/autoimmune disorders such as lupus, scleroderma, rheumatoid arthritis, etc.) is primarily causative and a range of symptoms including the peripheral vascular spasm is secondary. The term does not refer to the primary Raynauds or Raynauds disease.
Penile lesion, by history or observed definition: Penile Lesion, Observed: any erosion, scar, ulcer, or hyper- keratotic lesion observed by the physician on the glans or shaft of the penis.
No-Observed-Adverse-Effect Level definition: The highest dosage administered that does not produce toxic effects. The NOAEL will depend on how closely dosages are spaced (lowest-observed-adverse-effect level and no-observed-effect level) and the number of animals examined. The ultimate objective is usually to determine not the "safe" dosage in laboratory animals but the "safe" dosage for humans. Therefore, the extrapolation most often required of toxicologists is from high-dosage studies in laboratory animals to low doses in humans. (Casarett and Doull's Toxicology: The Basic Science of Poisons, 4th ed)
Directly Observed Therapy definition: A treatment method in which patients are under direct observation when they take their medication or receive their treatment. This method is designed to reduce the risk of treatment interruption and to ensure patient compliance.
Observed definition: Ascertained or determined through monitoring or observation.

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