OVER 20,000 ENTRIES

MEDICAL ENCYCLOPEDIC DICTIONARY

2013 EDITION

The most common diseases explained. Descriptions, preventions, diagnoses, symptoms, and treatments.

EXTRA

OVER 100 MEDICAL TESTS

MEDICAL ENCYCLOPEDIC DICTIONARY

a publication of

iMed Books, imprint of XSEBRA

Copyright

© 2013 Medica Press, Zurich - Zwitserland

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This book is designed to provide information on medical terms and a selection of diseases only. This information is provided and sold with the knowledge that the publisher and author do not offer any professional service. In the case of a need for any such expertise consult with the appropriate professional. This book does not contain all information available on the subject. This book has not been created to be specific to any individuals’ or organizations’ situation or needs. Every effort has been made to make this book as accurate as possible. However, there may be typographical and or content errors. Therefore, this book should serve only as a general guide and not as the ultimate source of subject information. This book contains information that might be dated and is intended only to guide, inform and educate. The author and publisher shall have no liability or responsibility to any person or entity regarding any loss or damage incurred, or alleged to have incurred, directly or indirectly, by the information contained in this book. You hereby agree to be bound by this disclaimer or you may return this book within the delivery terms of the bookseller. We recommend a regular medical check, even if you’re health is in order.

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This interactive medical encyclopedic dictionary offers over 20,000 entries with answers on all your medical questions. This book includes over 4,000 files and articles on most common and specific health issues, and links to nearly 200 selected websites. We have added an appendix with over 100 researches to conclude this medical guide. This is an ideal interactive ebook for medical students, professionals, and personal use.

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Medica Press, an international team of medical specialists working together for over 30 years, edits the data. Home base of Medica Press is Zurich, Switzerland. This team has served many publishers worldwide with information for medical encyclopedia, handbooks, educational material and newsletters. Now this unique content is for the first time available in ebooks. None of this content has been published online and most of the time the information is more extensive compared to free data on the web, and 100% accurate and secured. Nevertheless, always consult a professional doctor with health issues. The content of this ebook is only to be used for informational purposes.

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Contents

Navigate by shortcuts to the desired section or make use of the full tekst search option of this ebook.

A

B

C

D

E

F

G

H

I

J

K

L

M

N

O

P

Q

R

S

T

U

V

W

X

Y

Z

Extra section with over 100 Medical Tests

A

A blood type

One of for blood groups (the others being AB, B, and 0) in the AB0 blood group system for classifying human blood based on the presence or absence of antigen A and/or B on the surface of red blood cells. A person with type A blood produces antibodies against B antigens that cause the blood cells to agglutinate, or clump together.

AA

(Alcoholics Anonymous) Worldwide organization numbering over 1.5 million anonymous members, in which former alcoholics aid those suffering from alcoholism. It stresses self-help, and all involved pool their experiences or mutual encouragement.

AB blood type

One of the for blood groups (the others being A, B, and 0) in the AB0 blood group system, for classifying human blood based on the presence or absence of two antigens A and B on the surface of red blood cells.

AB0 blood group system

The most important of several systems for classifying human blood, used in blood transfusion therapy. Based on the presence or absence of two antigens A and B on the surface of red blood cells, the system classifies for groups, type A, B, AB, and 0.

Abarticulation

Dislocation of a joint, for instance a pulled-out shoulder.

Abasia

Inability to walk, generally caused by a disorder of the cerebellum.

Abc liniment

Liniment containing aconite, belladonna and chloroform. It is used for rubbing on painful muscles and joints but should not be used on broken skin.

Abdomen

The part of the body between the chest and the pelvis; the belly, including the stomach, liver, intestines, and other organs called the viscera.

Abdominal aortography

X-ray studies of the abdominal aorta and nearby blood vessels after injection of contrast medium into the aorta or using various other injection techniques.

Abdominal breathing

Breathing in which the diaphragmatic muscle action is reinforced by the abdominal muscles. Such breathing occurs more in men than in women and is commonly practiced by singers.

Abdominal delivery

Delivery of a child through an incision in the abdomen.

Abdominal hernia

Hernia in which a portion of an organ protrudes through the muscular walls of the abdomen, forming a swelling.

Abdominal migraine

Sudden stomach aches, headaches and nausea in children, which occur every few days, weeks or months.

Abdominal pregnancy

Pregnancy in which the conceptus develops in the abdominal cavity, not in the uterus; occurs in about 2 percent of ectopic pregnancies and usually results in fetal death.

Abdominalgia

Pain arising within the abdomen.

Abdominocentesis

Operation of draining the peritoneal cavity abdomen of fluid which may be due to liver disease or a growth.

Abdominohysterectomy

Removal of the uterus through an abdominal incision.

Abdominopelvic

Pertaining to the abdomen and pelvis.

Abdominoperineal resection

Surgical removal of the anus, the rectum, and the surrounding muscles of the anal canal. Because the muscles of the anal sphincter are removed, a permanent colostomy is required.

Abdominoscopy

Examination of the interior of the abdomen by means of an instrument inserted through its wall.

Abdominovaginal

Pertaining to the abdomen and vagina.

Abducens

(Abducens nerve) Sixth cranial nerve. It supplies the external rectus muscle of the eye, and paralysis of this nerve and muscle produces a squint.

Abduct

To draw away from the middle line of the body. If the arm is moved sideways from the body it is said to have been abducted. The reverse movement is called adduction.

Abduction

The act of kidnapping, of forcibly taking away. Abduction also means the movement of a part of the body away from the midline.

Abductor

Muscle producing the movement of abduction.

Abernathy’s sarcoma

A circumscribed, usually malignant, fatty tumor occurring principally on the trunk.

Aberrant

Departure from normal. Usually refers to a mental disorder or to an error of refraction in a lens.

Aberrant energy expression

The abnormal and unorganized methods of releasing energy that are found as symptoms in psychoses and neuroses.

Aberration, emotional

Any emotional response other than that which might ordinarily be expected; an emotional illness, especially one in which the manifestation and symptoms are in themselves directly emotional.

Abetalipoproteinemia

The absence in the blood of lipoproteins. As a result, the absorption of fat and fat-soluble vitamins is greatly impaired. Bowel movements contain excess fat and red blood cells, are misshapen. The central nervous system may be damaged, resulting in loss of coordination.

Although abetalipoproteinemia cannot be cured, taking massive doses of vitamin E may delay or slow the damage to the central nervous system.

Abience

Type of behavior that moves the organism away from exposure to a stimulus.

Ability

Power to perform an act, physical or mental, either before or after training. The term ‘general ability’ is used of a wide range of mental capacities or, specifically, of a general factor affecting all mental operations.

Ability test

Test to demonstrate a particular level of knowledge or skill.

Abiogenesis

Also called spontaneous generation. The doctrine that living matter may be produced by nonliving matter.

Abiotrophy

An early loss of function or vitality of cells or tissues.

Ablation

The removal of diseased or unwanted tissue from the body by surgical or other means.

Ablution

A form of hydrotherapy given for insomnia that usually brings quiet, restful sleep.

Ablutomania

A preoccupation with thoughts about washing that frequently accompanies an obsessive-compulsive neurosis.

Abnormal heart rhythm

Sequences of heartbeats that are irregular, too fast, too slow, or conducted via an abnormal electrical pathway through the heart; this disorder is called an arrhythmia. The heart rate is regulated automatically by the autonomic nervous system, which consists of the sympathetic and parasympathetic divisions. The sympathetic division increases the heart rate through a network of nerves called the sympathetic plexus. The parasympathetic division decreases the heart rate through a single nerve, the vagus nerve.

Causes

The most common cause of arrhythmia is heart disease, particularly coronary artery disease, heart valve disorders, and heart failure. Some arrhythmias are caused by anatomic abnormalities present at birth (congenital heart defect). Age-related changes in the heart’s electrical system make some arrhythmias more likely. An overactive thyroid gland, producing high levels of thyroid hormone, may cause slow arrhythmias. Sometimes no cause for an arrhythmia may be found.

Symptoms

Some people who have abnormal heartbeats may be aware of them. However, awareness of heartbeats (called palpitations) varies widely among people. Arrhythmias have consequences that range from harmless to life threatening. The seriousness of an arrhythmia may not be closely linked with the severity of the symptoms it causes. Some life-threatening arrhythmias cause no symptoms.

Diagnosis

Often, a person’s description of symptoms can help doctors make a preliminary diagnosis and determine the severity of the arrhythmia. Electrocardiography (ECG) is the main diagnostic procedure for detecting arrhythmias and determining their cause. This procedure provides a graphic representation of the electrical current producing each heartbeat. Usually, ECG records the heart rhythm for only a very short time. Because arrhythmias are often intermittent, a portable ECG monitor (Holter monitor) may be used to record heart rhythm continuously.

Treatment

Most arrhythmias neither cause symptoms nor interfere with the heart’s ability to pump blood. Antiarrhythmic drugs (see data in the table) are useful for suppressing fast arrhythmias that cause intolerable symptoms or pose a risk. Artificial pacemakers are electronic devices that act in place of the heart’s own pacemaker. The most common use of pacemakers is to treat slow arrhythmias.

Abnormality

Deviation from the norm; sickness, disease, defect, but also disturbed, disorganized, maladjustive behavior.

Abocclusion

Condition in which the upper and lower jaws do not meet when closed.

Aboiement

The uncontrollable and involuntary production of abnormal or unusual sounds. For example, some severely regressive schizophrenic patients make many animalistic noises.

Abortifacient

Something that produces an abortion.

Abortion

Termination of pregnancy; expulsion or removal of the embryo or fetus before it reaches full development and can normally be expected to be capable of independent life. Abortion may be spontaneous or induced.

Abortionist

One who induces abortions, especially illegal or unauthorized abortions.

Abortus

A dead or nonviable fetus (weighing less than 500 g (17.5 oz) at birth).

Aboulia

Inability, usually pathological, to make or to act on decisions.

Abrachia

Developmental anomaly characterized by complete absence of the arms.

Abrasio uteri

Term used for scraping off the lining of the uterus.

Abrasion

An area on the skin, or some other surface of the body, that has been damaged by scraping or rubbing.

Abreact

To release unconscious tension by talking about or reliving the events that caused it.

Abreaction

Treatment used by psychiatrists to obtain a patient’s emotional release. By administering various drugs, especially carbon dioxide inhalations, the patient is made to relive the incident causing his fear or worry.

Abreaction, motor

Living through an unconscious emotion or experience by muscular or motor expression.

Abrin

A potent toxin which is derived from the seeds of the jequirity plant and which causes red cells to stick together (a lectin).

Abruptio placentae

Premature separation of a normally implanted placenta from the uterus. All degrees from a few mm coming apart to complete detachment may occur. The cause is unknown.

Abscess

A localized accumulation of pus, usually representing one response of the body to infection by bacteria and other micro-organisms.

Absence

Brief generalized seizures (epileptic attacks) manifested by a 10- to 30-second loss of consciousness, with eye or muscle flutterings at a rate of three per second, and with or without loss of muscle tone. Patients suddenly stop any activity in which they are engaged and resume it after the attack.

Absence epilepsy

Absence epilepsy is a seizure disorder; periodic disturbance of the brain’s electrical activity, resulting in some degree of temporary brain dysfunction. Normal brain function requires an orderly, organized, coordinated discharge of electrical impulses. Electrical impulses enable the brain to communicate with the spinal cord, nerves, and muscles as well as within itself. When electrical impulses discharge abnormally, a seizure may occur.

Absence epilepsy begins in childhood, usually between the ages of 5 and 15. The seizure disorder does not produce the convulsions and other dramatic symptoms of tonic-clonic seizures. A person does not fall down, collapse, or move jerkily. Instead, the person has episodes of staring with fluttering eyelids and sometimes twitching facial muscles. The person is completely unaware of the surroundings. These episodes last 2 to 3 seconds and, rarely, 10 to 30 seconds

The person abruptly stops activity and resumes it just as abruptly, experiencing no after-effects and not knowing that a seizure has occurred.

Absence, atonic

A complex absence characterized by a loss of control of the postural muscles sufficient to cause the subject to slump to the ground.

Absence, automatic

A complex absence characterized by usually simple epileptic automatisms, for example, involuntary movements of the lips or tongue, or behavior such as rubbing the hands together or adjusting the clothes.

Absence, enuretic

A complex absence characterized by urinary incontinence. Such absences must be differentiated from partial seizures of temporal lobe origin, which may be accompanied by urinary incontinence or, more frequently, by automatisms of urination.

Absence, hypertonic

A complex absence characterized by a tensing of the postural muscles causing the head to be pulled backwards, the eyes to roll up into the head and, sometimes, the arching of the back; the latter may force subjects to walk backwards in order to keep their balance.

Absence, myoclonic

A type of hypertonic absence in which subjects walk backwards as a result of the arching of their backs due to a tensing of the muscles.

Absence, subclinical

An absence that is easily recognizable from an electro-encephalogram (EEG) but that clinically is limited to a slight decrease of alertness (or perhaps a slight loss of efficiency or of decision-making ability).

Absentmindedness

Being so absorbed in thought so as to be largely unaware of surrounding conditions.

Absintism

The damaging effects on tissues and organs caused by excessive amounts of absinth, a formerly popular French liqueur or cordial consisting of brandy flavored with wormwood. The sale and consumption of absinth are prohibited because of its harmful effects on the nervous system.

Absolute threshold

The intensity or frequency at which a stimulus becomes effective, as measured under experimental conditions.

Absorbent

The ability of something to absorb; a substance applied to a wound to staunch or arrest the flow of blood.

Absorption

In medicine term used in two different senses.

1.  Focusing attention on one object, thereby excluding other objects.

2.  Excluding reality because the focus of one’s attention is on autistic thoughts.

Abstemiousness

A way of life characterized by refraining from a free use of food and strong drinks.

Abstinence

Restraint from indulging a desire for something pleasurable, e.g. Alcohol or sexual relations.

Abstract intelligence

The ability to understand and manage abstract concepts, relationships and symbols.

Abstraction

The mental process of forming abstract ideas. An ‘abstraction experiment’ is the name given to a type of experiment in which the subject is required to respond verbally, or in action, to common features in objects or situations presented serially.

Abstruseness

The quality of being remote from ordinary minds or notions. It also means difficulty in being comprehended or understood.

Absurdities test

A type of mental test in which the subject is asked to point out what is absurd about a statement, story or picture.

Abundance motive

Desire to experience enjoyment, to obtain gratification, to seek novelty, to discover and understand, to attempt to achieve and create. This motive includes the goals of satisfaction and stimulation.

Acantha

One of the pointed bony processes of the vertebrae.

Acanthocyte

An abnormal red blood cell with irregular projections of protoplasm, giving it a spiny or thorny appearance.

Acanthocytosis

Breakdown of the thorny-cell layer of the epidermis (for instance, in the skin disorder pemphigus vulgaris).

Acanthoma

Benign tumor of the skin. Acanthoma adenoides cysticum: a cystic tumor, often familial, occurring on chest, face and in axillary regions. Tumors contain tissues resembling sweat glands and hair follicles.

Acanthosis

Overdevelopment and thickening of the prickle-cell layer of the outer skin, as in psoriasis.

Acapnia

Diminished carbon dioxide content of the blood; can be produced by hyperventilation.

Acardia

Congenital absence of the heart.

Acardiohemia

Lack of blood in the heart.

Acardionervia

Lack of nerve stimulus to the heart.

Acariasis

A skin disease caused by mites.

Acatamathesia

Inability to comprehend perceived situations, objects or language.

Acataphasia

Inability to connect words sensibly in sentences.

Accelerated coronary disease

A premature hardening of the coronary arteries, possibly leading to a heart attack and sudden death. Both genetically determined and avoidable risk factors, such a cigarette smoking, contribute to the disease and its earlier onset.

Accelerated radiation therapy

Radiation therapy that shortens the overall treatment time which theoretically could overcome possible tumor regrowth during radiation treatment.

Access

Way of approach, a sudden emotional outburst.

Accession

The attack or commencement of a disease or disorder.

Accessory nerve

The eleventh cranial nerve, associated with the pharynx and muscles in the throat, larynx, palate, neck, and back.

Accident

An unexpected happening, especially one that results in injury.

Accident prevention

Measures to be taken to prevent accidents in the house, on the road, in the factory or laboratory, during sports activities, etc.

Accident proneness

High incidence of accidents in certain individuals.

Accident-prone

Having a greater-than-average incidence of accidents.

Acclimatization

The process of adjustment that allows an individual organism to survive under changed conditions. In a hot, sunny climate, man acclimatizes by eating less, drinking more and wearing lighter clothes; furthermore, his skin may darken. At higher altitudes, he can adjust to the diminished oxygen by increased production of red blood corpuscles.

Accommodation

1.  The adjustment of the eye lens whereby it is able to focus a clear image on to the retina.

2.  The continuing process of adjusting to one’s environment.

Accoucheur

A man who acts as a midwife, attending women in childbirth.

Accretion

The growing together of parts naturally separated, such as the fingers or toes.

Acculturation

A change in the cultural behavior and thinking of an individual or group through contact with another culture.

ACE inhibitors

Angiotensin-converting enzyme inhibitors; a group of heart drugs that reduce the risk of heart attack and of death due to coronary heart disease.

Acenesthesia

Absence or lack of the feeling or perception of one’s own body.

Acephaly

The state of possessing no head.

Acerculoma

Intracranial tumor containing psammoma bodies.

Acetabuloplasty

Surgical repair of the cup-like socket of the haunch bone, into which the head of the femur fits to form the hip joint.

Acetabulum

The cavity in the pelvis that receives the head of the thigh bone.

Acetal

An organic compound formed by a combination of an aldehyde with an alcohol.

Aceto-acetic acid

A ketone body produced by metabolic disease or disturbance.

Acetone

A ketone body in blood or urine produced by metabolic disease or disturbance.

Acetonemia

An excess of ketone bodies in the blood.

Acetonuria

An excess of ketone bodies in the urine.

Acetylcholine (ach)

A substance playing an important role in the transmission of nerve impulses within the nervous system.

Acetylcysteine

A compound with mucolytic (dissolvement of mucus) properties, used as an aid in various bronchial disorders, and is invaluable in mucoviscidosis. Also given intravenously in cases of paracetamol poisoning.

Acetylsalicylic acid

Another name for aspirin.

Achalasia

A disorder in which the rhythmic contractions of the esophagus are greatly decreased and the lower esophageal sphincter fails to relax normally. The disorder results from a malfunction of the nerves controlling the rhythmic contractions of the esophagus. The cause of the nerve malfunction is not known.

The disorder may occur at any age but usually begins almost unnoticed between the ages of 20 and 60 and then progresses gradually over many months or years. The tight lower esophageal sphincter causes the part of the esophagus above it to enlarge greatly. This enlargement contributes to many of the symptoms. Difficulty swallowing both solids and liquids is the main symptom. Other symptoms may include:

•  pain

•  regurgitation of the bland, nonacid contents of the enlarged esophagus

•  coughing at night

•  feeling of globus sensation.

The aim of the treatment is to relieve symptoms by getting the lower esophageal sphincter to open more easily. Nitrates (for example, nitroglycerin placed under the tongue before meals) or calcium channel blockers may delay the need for dilation by helping to relax the sphincter.

If these treatments do not work, surgery to cut the muscular fibers in the lower esophageal sphincter (myotomy) is usually performed. Surgery can be done laparoscopically.

Ache

Pain, or continuous pain, as opposed to sudden twinges (spasmodic pain); a continuous gnawing pain as in toothache or earache.

Achievement

Performance in a standardized series of tests, usually educational.

Achievement age

The chronological age corresponding to any particular level on a scale of achievement tests.

Achievement motive

The social motive to accomplish something of value or importance, to meet standards of excellence in what one does.

Achievement quotient

The ratio of achievement age to the chronological age of the individual tested, expressed as a percentage.

Achievement test

Test for acquired ability.

Achilles heel

The point of weakness that is most vulnerable or susceptible. In the Achilles myth, it was the warrior’s only vulnerable part.

Achilles tendon

The tendon from the calf muscles to the heel bone, important in standing, walking and running.

Achilles tendon rupture

Severe injury occurring in athletes who recommence training after long periods of relative inactivity.

Achillodynia

Pain in the Achilles tendon or its bursa.

Achilloraphy

Suturing of the Achilles tendon.

Achillotomy

Subcutaneous surgical division of the Achilles tendon, sometimes performed on spastic children.

Achlorhydria

Absence of hydrochloric acid from the stomach juice, a condition found in pernicious anemia and gastric cancer.

Acholia

Lack or absence of bile secretion due to compression of the bile duct or its blockage by a stone.

Acholuria

Lack of bile pigments in the urine: an indication of a hemolytic anemia.

Achondroplasia

Defective development of cartilage causing dwarfism.

Achreocythemia

Absence of coloring in the red blood cells as a result of deficiency or lack of hemoglobin.

Achromatin

That portion of the nucleus of a cell which is unstainable.

Achromatopsia

Inability to distinguish colors, arising from some defect in the eye.

Achylia

Absence or severe deficiency of hydrochloric acid, pepsinogen, or other digestive secretions.

Acid

1.  A compound that contains hydrogen as an essential constituent and has a sour taste;

2.  (slang) the hallucinogenic drug LSD.

Acid phosphatase

An enzyme capable of catalyzing the hydrolysis of esterified phosphoric acid, with liberation of inorganic phosphate. The enzyme is secreted by the prostate gland and some other organs.

Acid reflux

Condition in which acid fluid from the stomach wells up into the esophagus, usually caused by a hiatus hernia of the diaphragm. The condition can be treated by specific drugs.

Acid suppressant

Medicine that treats indigestion by reducing the amount of acid produced by the stomach.

Acid-base balance

A normal equilibrium between the acid and base elements of the blood and body fluids.

Acidemia

Abnormal acidity of the blood, caused by poor breathing or increased lactic acid from the muscles.

Acid-fast

Not easily decolorized by acids when stained, as the tubercle bacillus.

Acidity

The quality of being acid or sour.

Acidophilic

Having the quality of being easy to stain with acid.

Acidosis

Abnormally acid condition of the blood.

Aciduria

Abnormally acid urine.

Acini

Minute sacs or alveoli, filled with secreting cells. The liver acini are the smallest functional units of the liver.

Acme

The height of a crisis of disease or mental disorder.

Acmesthesia

Sensing sharp points with touch without pain sensation.

Acne

An inflammatory disease of the sebaceous glands of the skin, usually on the face and upper body, characterized by papules, pustules, comedones (blackheads) and in severe cases by cysts, nodules and scarring.

Acne conglobata

Severe acne vulgaris with many comedones, marked by the formation of pus, cysts and scarring.

Acne rosacea

Chronic disease of the skin of the nose, forehead and cheeks, marked by flushing, red coloration due to dilatation of the capillaries, with appearance of pimples and acne-like pustules.

Acne vulgaris

Another name for acne.

Acneiform

Resembling acne, in particular acne vulgaris.

Acoria

An insatiable desire for food because the individual never feels full after eating.

Acoustic

Pertaining to the sense or organs of hearing, or to the science of sound.

Acoustic nerve

Nerve connecting ear to brain; either of the eight pair of cranial nerves, which convey impulses relating to hearing and balance from the inner ear to the brain.

Acoustic neurinoma

Tumor formed from the Schwann cells of the eighth cranial nerve that links the brain with the ear. Hearing loss and tinnitus are early symptoms.

Acoustics

The cause, nature and phenomena of the vibrations of elastic bodies that affect the organ of hearing.

Acquired characteristics

Modifications in an organism resulting from interaction with its environment. Even organisms that produce asexually can pass on acquired characteristics.

Acquired immune deficiency syndrome

The full name of AIDS.

Acquired immunity

Any form of immunity not innate but obtained during life.

Acrid

Sharp or biting to the taste or smell.

Acridine derivatives

Dyers or stains (usually yellow or orange) used for some medical tests and as antiseptic agents.

Acro-arthritis

Arthritic condition of the joints of the hands or feet, usually rheumatoid arthritis.

Acroasphyxia

Cold, pale condition of hands and feet; symptom of Raynaud’s disease.

Acrocyanosis

A persistent, painless bluish discoloration of both hands, and less commonly, of both feet, caused by unexplained spasm of the small blood vessels within the skin. The disorder usually occurs in women. The fingers and hands or toes and feet tend to feel cold and to be bluish. They sometimes sweat profusely and may swell. The disorder is not painful and does not damage the skin.

Treatment by calcium channel blockers may dilate the arteries. Usually, reassurance that the bluish skin discoloration does not indicate a serious disorder is all that is necessary.

Acrodynia

Also called erythredema and ‘pink disease.’ A disease of infants marked by pain and swelling in, and pink coloration of, the fingers and toes and by listlessness, irritability, failure to thrive and profuse perspiration. The disease is usually caused by mercury poisoning.

Acromegaly

A rare disease, associated with the overgrowing of bone, especially in the jaws, hands and feet.

Acromelalgia

Bilateral vasodilatation of the blood vessels of the hands and feet. The skin is reddened, warm, and painful. The cause is unknown.

Acromial

Pertaining to the acromion.

Acromion

The outward end of the scapula or shoulder blade where it forms the tip of the shoulder.

Acronyx

Ingrowing of a nail.

Acrophobia

A morbid fear of heights, sometimes associated with physical symptoms; often an isolated phobia in otherwise normal people.

Acrosome

A structure at the end of a sperm cell that releases enzymes to digest the cell membrane of an egg, enabling the sperm to penetrate the egg.

Acrotism

An absence or weakness of the pulse.

Acth

Adrenocorticotrop(h)in; the hormone of the anterior pituitary gland which specifically stimulates the cortex of the adrenal glands to produce corticosteroids.

Actin

A protein important in the contraction of muscles.

Acting out

Common coping mechanism; a directed expression of an unconscious wish or impulse that enables a person to avoid thinking about a painful situation or experiencing a painful emotion.

Actinism

The chemical action in cells and tissues of the body caused by the rays of light beyond the violet end of the spectrum. Actinic means producing chemical action.

Actinodermatitis

An inflammation of the skin, caused by prolonged exposure to the sun’s rays.

Actinomycete

A member of the order (Actinomycetales, which contains rod-shaped or filamentous bacteria.

Actinomycoma

A tumor produced by actinomycosis (a noncontagious ray fungus).

Actinomycosis

A chronic infection caused by Actinomyces israelii, an anaerobic bacterium on the gums, teeth, and tonsils. The thoracic form causes the following symptoms:

•  chest pain

•  fever

•  cough

•  sputum

These symptoms, however, may not appear until the lungs are severely infected. If an abscess develops in the chest, pus may drain through the skin by way of channels connecting the abscess to the chest wall.

To treat actinomycosis, doctors drain abscesses and give high doses of antibiotics such as penicillin or tetracycline. To prevent relapse, antibiotics are taken for as long as 6 to 12 months.

Actinotherapy

Treatment of disease by rays of light, especially ultraviolet or infra-red radiation.

Action system

All the glands, nerves and muscles involved in the production of a particular response.

Actionpotential

A temporary change in electrical potential that occurs between the inside and the outside of a nerve or muscle fiber when a nerve impulse is transmitted.

Activated charcoal

A general antidote used to treat some forms of acute poisoning.

Activated lymphocyte

A lymphocyte altered by passage through the thymus (T cell), that has become stimulated by contact with antigen and is therefore able to induce a cell-mediated immune reaction.

Active analysis

A technique in which the analyst in psychoanalysis takes a more dominating role in the treatment process.

Active fantasizing

A psychotherapeutic procedure involving the analysis of the patient’s spontaneous imagination. Through the analysis of fantasized images, the analyst can uncover the unconscious roots of the patient’s conflicts and help the patient to bring them into conscious awareness.

Active immunity

A form of acquired immunity in which the body produces its own antibodies against disease-causing antigens. It can occur naturally after infection or artificially after vaccination.

Active therapy

A method of psychoanalytic therapy sometimes used to break down a resistance.

Activities of daily living

The full name of ADL.

Acuity

Sharpness, clearness; for instance, visual acuity, the extent of how much you can see which is dependent on the clarity of the focus on the retina, how well your nerves are performing and on the interpretation of the stimuli by the brain.

Acumen

Quickness of perception, mental acuteness or penetration.

Acupressure

An old Japanese treatment system, comparable to acupuncture. It relies on the proper application of carefully applied pressure by the fingers or hand on specific points on the surface of the body to eliminate fatigue and to stimulate the natural curative abilities of the body.

Acupuncture

An ancient Chinese medical practice in which fine needles are inserted into the body at specific points, and is used for relieving pain and in treating a variety of conditions.

Acute

A term applied to a disease that is attended by more or less strong symptoms and comes speedily to a crisis.

Acute abdomen

Acute disorder of abdominal organs, peritoneum or abdominal wall. When no certain diagnosis can be made immediately, the best course of action may then be for the surgeon to open the abdomen and inspect the organs. This procedure is called laparotomy.

Acute adrenal failure

Sudden failure of the function of the adrenal glands and their production of hormones. This can occur as a result of a condition such as Addison’s disease. The symptoms are profound weakness, confusion and even collapse.

Acute anterior poliomyelitis

A type of poliomyelitis.

Acute atelectasis

A condition in which all or part of a lung becomes airless and contracts. Atelectasis may be an acute or chronic condition. The most common cause of atelectasis is an obstruction of a large bronchus (one of the two main branches of the trachea leading directly to the lungs). Smaller airways can also become blocked.

Acute atelectasis is a common postoperative complication, especially after chest or abdominal surgery. Acute atelectasis may also occur with an injury, usually to the chest (such as that caused by a car accident, a fall, or a stabbing).

Atelectasis following surgery or injury, sometimes described as massive, involves most alveoli in one or more regions of the lungs. In these

Circumstances, the degree of collapse among alveoli tends to be quite

Consistent and complete.

Causes

The obstruction may be caused by a plug of mucus, a tumor, or an inhaled foreign object inside the bronchus. Alternatively, the bronchus may be blocked by something pressing from the outside, such as a tumor, enlarged lymph nodes, or a significant amount of fluid (pleural effusion) of air (pneumothorax) in the pleural space.

When an airway becomes blocked, the air in the small air sacs of the lung (alveoli) beyond the blockage is absorbed into the bloodstream, causing the alveoli to shrink and retract. The collapsed lung tissue commonly fills with blood cells, serum, and mucus and becomes infected.

Symptoms

The loss of functioning lung tissue leads to shortness of breath. The persistence of blood flow through the collapsed area leads to a decrease in the blood oxygen level: the heart rate increases, and sometimes the person may look bluish (a condition called cyanosis).

Widespread atelectasis resulting from deficient or ineffective surfactant produces:

•  shortness of breath

•  rapid, shallow breathing

•  low blood oxygen level

•  fever

•  low blood pressure

Slowly developing atelectasis may cause no symptoms or only minor ones, such as shortness of breath or an increased heart rate.

Diagnosis

Doctors suspect atelectasis based on a person’s symptoms, the physical examination findings, and the setting in which the symptoms occur.

A chest X-ray that shows the airless area confirms the diagnosis.

Treatment

The primary treatment of massive atelectasis is correction of the underlying cause. Antibiotics are given for an infection. In treatment of atelectasis due to deficient or ineffective surfactant, attention is directed at treating the low blood oxygen (often with mechanical ventilation) and its effect promptly and at identifying and treating the underlying condition.

Acute brain disorder

A complex collection of symptoms resulting from temporary impairment of the functions of the brain tissue, such as disordered behavior occasionally induced by drugs.

Acute bronchitis

Acute inflammation of the tracheobronchial tree of the lungs, which will generally run its course with eventual complete healing and return of function. Although usually mild, bronchitis may be serious in already weakened patients and in those with chronic lung or heart diseases. Pneumonia is a critical complication.

Acute coryza

Another name for the common cold.

Acute gastritis

Gastritis is defined as an inflammatory process of the stomach. It is characterized by pain or tenderness, nausea, vomiting and systemic electrolyte changes if vomiting persists. The mucosal lining of the stomach may be atrophic or hypertrophic.

Acute gastritis is characterized by superficial, mucosal lesions of the corpus of the stomach that occur very rapidly in relation to various stresses. The most common provocative stresses are:

•  major burns

•  trauma with multiple injuries

•  shock

•  alcohol

•  corticosteroids

•  aspirin or other anti-inflammatory agents

•  food or drug allergens

•  toxins.

Most often there are no specific symptoms, but anorexia, nausea, vomiting and distress in the stomach region may occur. Haemorrhage (bleeding) causes the greatest concern. It occurs in about 10 per cent of the patients, is usually mild and often follows the stressful event within 6 to 7 days.

Acute gastritis may account for as much as 30 percent of all gastrointestinal bleeding episodes. Presence of haemorrhage can be the only symptom of acute gastritis, although patients are commonly very ill as a result of the underlying disorder. Prevention of haemorrhage is often possible.

Treating the underlying disorder (for instance, shock) or withdrawing the offending agent prompts the disorder to subside spontaneously. The use of antacids not only relieves pain, but may prevent haemorrhage. Their preventive use is recommended when predisposing conditions are apparent.

Acute hallucinosis

A condition in which the individual experiences hallucinations for not longer than a few weeks. Hallucinosis is typically the result of poisons in the body, and is particularly associated with acute alcoholism.

Acute histoplasmosis

An infection with the fungus Histoplasma capsulatum that occurs mainly in the lungs but sometimes spread throughout the body. The spores of Histoplasma are present in the soil. Farmers and others who work with soil are most likely to inhale the spores; severe disease can result when large numbers of spores are inhaled.

Symptoms

Most people with histoplasmosis do not have any symptoms. In acute histoplasmosis, symptoms usually appear 3 to 21 days after a person inhales the spores. The person may feel sick and have a fever and a cough. Symptoms usually disappear without treatment in 2 weeks and rarely last longer than 6 weeks. This form of histoplasmosis is rarely fatal.

Treatment

People with the acute form of histoplasmosis rarely require treatment. Those with the progressive disseminated form do need treatment and often respond well to amphoterin B given intravenously or to itreaconazole given by mouth.

In the chronic cavitary form, itraconazole or amphotericin B may eliminate the fungus, although the destruction caused by the infection leaves behind scar tissue.

Breathing problems similar to those caused by chronic obstructive pulmonary disease usually remain. Therefore, treatment should begin as soon as possible to limit lung damage.

Acute kidney failure

Rapid decline (days or weeks) in the kidney’s ability to filter metabolic waste products from the blood. Acute renal failure (acute failure of the kidneys) is the clinical condition associated with rapid, steadily increasing excess uraea in the blood, with or without oliguria, a daily urine volume of less than 500 milliliters. The causes of acute failure of the kidneys can be grouped into three diagnostic categories:

•  inadequate perfusion of the kidneys

•  obstruction

•  kidney diseases.

Acute leukemia

Usually rapidly progressing forms of leukemia characterized by replacement of normal bone marrow by blast cells of a clone arising from malign transformation of hematopoietic cells.

Acute lymphedema

A temporary condition that lasts less than 6 months in which the skin indents when touched and stays indented, but remain soft to the touch.

Acute lymphoblastic leukemia

A fast-growing type of leukemia.

Acute lymphocytic leukemia

Usually rapidly progressing forms of leukemia characterized by replacement of normal bone marrow by blast cells of a clone arising from malign transformation of hematopoietic cells.

Acute lymphocytic leukemia is primarily a childhood disease with peak incidence from ages 3 to 5 years. It is the most common childhood malignancy, occurring also during adolescence, and less commonly among adults.

Acute mastoiditis

Bacterial infection in the mastoid process (the knob of bone projecting down from the skull behind the ear) resulting in the lining of the mastoid air cells (which communicate with the middle ear) becoming inflamed.

Acute myelocytic leukemia

Usually rapidly progressing forms of leukemia characterized by replacement of normal bone marrow by blast cells of a clone arising from malign transformation of hematopoietic cells.

Acute myelocytic leukemia is the more common acute leukemia among adults; it is the form usually associated with irradiation as a causative agent and occurring as a second malignancy following cancer chemotherapy.

Acute otitis media

Also called glue ear. A bacterial or viral infection in the middle ear. It is common in young children, particularly from the age of three months to three years. Microorganisms may migrate from the nasopharynx (the region behind the nose in the throat) to the middle ear via the membrane covering the Eustachian tube.

Acute pancreatitis

Sudden inflammation of the pancreas that may be mild or life threatening but that usually subsides. In general, acute pancreatitis is a self-limited disease in 80 percent of cases associated with minimal morbidity and mortality. However, complications do increase in severity, making it important to identify high-risk patients. The diagnosis of acute pancreatitis is made on clinical grounds, by confirmation of laboratory and radiological studies.

The most common causes are:

•  gallstones

•  alcoholism

•  drugs such as furosemide and azathioprine

•  mumps

•  high blood levels of lipids, especially triglycerides

•  damage to the pancreas from surgery or endoscopy

•  damage to the pancreas from blunt or penetrating injuries

•  cancer of the pancreas

•  reduced blood supply to the pancreas, for example, from severely low blood pressure

•  hereditary pancreatitis

Diagnosis

The diagnosis is considered when patients present complaints of relatively severe pain in the middle part of the abdomen. The pain is constant and boring in nature, usually radiating to the back and associated with nausea, vomiting, and abdominal tenderness.

Analysis of the blood shows an elevation of the enzyme amylase. However, a normal amylase content of the blood does not exclude the diagnosis of pancreatitis. Special diagnostic methods such as abdominal sonography (using ultrasound) and CT-scan or MRI-scan may show the inflammatory process of the pancreas.

Treatment

Treatment of mild pancreatitis, particularly when flare-ups are recurrent, usually involves taking analgesics for pain relief and ingesting only clear liquids. Usually, normal eating can resume after 2 to days without further treatment.

Moderate to severe pancreatitis usually requires hospitalization. All people with moderate to severe acute pancreatitis must initially avoid food and liquids, because eating and drinking stimulate the pancreas to produce more enzymes.

If symptoms such as pain and nausea subsides quickly and complications such as ileus do not develop, food and liquids can be resumed through a tube.

However, if symptoms do nod subside quickly or if complications develop, fluids are given intravenously to prevent or treat dehydration and low blood pressure, which could worsen the pancreatitis.

People with severe acute pancreatitis generally are admitted to an intensive care unit, where vital signs (pulse, blood pressure, and rate of breathing) and urine production can be monitored continuously. Blood samples are repeatedly drawn to monitor various components of the blood, including hematocrit, sugar (glucose) levels, and amylase and lipase levels.

A tube may be inserted through the nose and into the stomach to remove fluid and air, particularly if nausea and vomiting persists and gastrointestinal ileus is present.

Occasionally, surgery is needed during the first few days of severe acute pancreatitis. For instance, surgery may be undertaken to clarify an uncertain diagnosis (exploratory surgery) or to relieve pancreatitis that stems from an injury. Sometimes, if a person’s condition deteriorates after the first week of the illness, surgery is performed to remove infected or dead pancreatic tissue.

Acute pericarditis

Inflammation of the pericardium that begins suddenly, is often painful and causes fluid and blood components such as fibrin, red blood cells, and white blood cells to pour into the pericardial space.

Causes

Acute pericarditis results from infection or other conditions that irritate the pericardium. Infection is usually due to a virus, but may be caused by bacteria, parasites, or fungi.

Other conditions can irritate the pericardium and thus can cause acute pericarditis. These conditions include:

•  heart attack

•  heart surgery

•  lupus erythematosus

•  rheumatoid arthritis

•  kidney failure

•  injury

•  cancer (such as leukemia)

•  rheumatic fever

•  underactive thyroid gland

•  radiation therapy

•  aortic aneurysm

Symptoms

Usually acute pericarditis causes fever and chest pain, which typically extends to the left shoulder and sometimes down the left arm. The accumulating fluid or blood in the pericardial space puts pressure on the heart, interfering with the ability to pump blood. Acute pericarditis due to a viral infection is usually painful but short-lived and has no lasting effects.

Diagnosis

Doctors can diagnose acute pericarditis based on the person’s description of the pain and the sounds heard by listening through a stethoscope on the person’s chest. A chest X-ray and echocardiography may be useful because they can usually detect too much fluid in the pericardial space. Blood tests can detect some of the conditions that cause pericarditis.

Treatment

Regardless of the cause, doctors usually hospitalize people with pericarditis, give them medicines that reduce inflammation and pain, and watch for complications, particularly cardiac tamponade. Further treatment of acute pericarditis depends on the cause. When acute pericarditis occurs within the first few hours or days of a heart attack, treatment for the heart attack, including aspirin and stronger analgesics such as morphine, can usually reduce any discomfort due to pericarditis.

Acute polyneuropathy

Another name for Guillain-Barré’s syndrome.

Acute polyradiculitis

Another name for Guillain-Barré’s syndrome.

Acute posterior ganglionitis

A complication of infection by herpes zoster.

Acute pyelonephritis

Inflammation of the kidney (pyelum) caused by bacteria. Pyelonephritis is especially likely in females during childhood or pregnancy, and after catheterization of the urethra, but is uncommon in males free from urinary tract abnormalities.

Coli bacilli (Escherichia coli) are the most common bacteria and account for about 85 per cent of uncomplicated infections. Spread via the bloodstream to the kidney may occur from any systemic infection but is commonest with staphylococci in the blood.

Those subjected to instrumentation or with catheters in place, or who become infected while in hospital, are on chronic antibiotic therapy or are being treated with corticosteroids are particularly likely to have unusual micro-organisms set up colonies in their urinary tracts.

Typically, the onset of this disease is rapid and characterized by the following signs and symptoms:

•  chills

•  fever

•  flank pain

•  nausea and vomiting.

Bladder irritation from infected urine may result in frequency and urgency. The diagnosis is established on the basis of the signs and symptoms and analysis of the urine.

Antibiotics will be instituted as soon as the doctor has established the diagnosis; thorough analysis of the urine and even a culture of a urine sample is usually necessary.

Treatment should be continued for a minimum of 10 to 14 days and, in some instances, for four weeks. Urine culture should be repeated during therapy and after its completion. If obstruction is present, surgery may be required.

Acute respiratory distress syndrome

This condition is respiratory failure with life-threatening respiratory distress and lowered oxygen-content in the blood, associated with various acute injuries to the lungs. This important and common medical emergency is precipitated by an acute illness or injury that directly affects the lungs, including such conditions as:

•  direct injury to the chest trauma;

•  prolonged or profound shock;

•  fat embolism (where a globule of fat travels through the bloodstream to block an artery in the lung);

•  massive blood transfusion;

•  oxygen toxicity;

•  sepsis;

•  hemorrhagic inflammatory process of the pancreas;

•  cardiopulmonary bypass (i.e. Heart-lungmachine).

The following signs and symptoms are indicative for this lung condition. • Twelve to 24 hours following the initial injury or illness or, more commonly, five to ten days later, following the onset of sepsis, convalescence is interrupted by progressive respiratory distress and failure. Dyspnoea (difficulty in breathing) occurs initially, accompanied by hyperventilation, grunting when breathing out and decreased content of oxygen in the blood.

•  Secondary bacterial invasion of the lung and persistent lung sepsis, the most common complications, are frequently fatal, and prompt recognition of the emergency and correct treatment are necessary to prevent sudden death.

•  Pneumothorax (air pressure from outside the chest collapsing a lung inwards) occurring late in acute respiratory distress syndrome is an ominous sign, since it is usually associated with severe lung damage and a need for high ventilatory pressures.

The survival rate is 60 to 70 percent with prompt early treatment; only 10 to 20 percent survive without treatment. Victims who respond quickly to treatment have little or no residual disturbance of lung function or disability.

Those requiring prolonged treatment, however, may develop restrictive lung disease. Despite different causes, the principles of treatment are similar. Ventilation must be improved and the underlying cause of the acute lung injury corrected.

Acute stress disorder

An anxiety disorder caused by exposure to an overwhelming traumatic event, in which the person later repeatedly re-experiences the event.

An acute stress disorder is similar to posttraumatic stress disorder, except that it begins within 4 weeks of the traumatic event and lasts only 2 days to 4 weeks.

A person with acute stress disorder has been exposed to a terrifying event. The person mentally re-experiences the traumatic event, avoids things that remind him of it, and has increased anxiety.

The person also has three or more of the following symptoms:

•  a sense of numbing or detachment

•  a lack of emotional responsiveness

•  reduced awareness of surroundings

•  a feeling that things are not real

•  a feeling that he himself is not real

•  an inability to remember an important part of the event.

The number of people with acute stress disorder is unknown. The likelihood of developing acute stress disorder is greater when traumatic events are severe.

Treatment

Many people recover from acute stress disorder once they are removed from the traumatic situation and given appropriate support in the form of understanding, empathy for their distress, and an opportunity to describe what happened and their reaction to it.

Acute transverse myelitis

Inflammation affecting both the gray and white matter in one or several adjacent segments of the spinal cord, causing sudden local back pain followed by the development over a few hours of symptoms as if the spinal cord had been severed. Corticosteroids are given to reduce the inflammation, although their effectiveness is uncertain.

Acute tubulo-interstitial nephritis

A syndrome of acute renal failure most commonly due to hypersensitivity to a drug affecting the tubules and interstitial tissue. This disorder was previously often associated with severe systemic infections, but with the advent of antibiotics, the dominant cause now is a reaction to drugs.

Among the most commonly incriminated are methicillin, anticonvulsants, penicillin, ampicillin, rifampicin and diuretics. The initial presentation may be that of acute failure of the kidney, with or without decreased urinary output.

Helpful clinical clues include a medical history of exposure to suspect drugs and signs of hypersensitivity, such as fever, skin rash and eosinophilia (abnormal increase of a certain type of white blood cell).

The urine usually contains proteins, and the kidneys are often large because of oedema. The interval between exposure to the drug and development of kidney damage varies between five days and five weeks.

If severe, prolonged oliguria (minimal urination) is present, patients are treated for acute failure of the kidneys. On withdrawal of the offending drug, they usually recover as far as the function of the kidney is concerned but some irreversible cases have been reported.

Acute-onset nausea and vomiting

Usually occur a few minutes to several hours after chemotherapy is given.

Acyanosis

Condition of the blood or blood vessels without cyanosis (a bluish tinge resulting from lack of oxygen in the blood).

Acyclovir

An antiviral drug used to treat genital herpes and cold sores. It works by interfering with viral reproduction, thereby reducing infection.

Acystia

Congenital absence of the bladder.

Adactylia

Absence of fingers or toes or both from birth.

Adamantinoma

A tumor of the jaw, especially the lower one, arising from the enamel organ. May be partly cystic, partly solid, and may reach a large size; of low-grade malignancy.

Adam’s apple

The prominence of the thyroid cartilage at the front of the throat, predominantly in men.

Adaptation

The process of modification of the form or functions of a part of an organism, to make it fit for its environment and so achieve efficiency in life and reproduction.

Adaptation syndrome

The syndrome comprises a series of phenomena arising in response to a trauma or lesion in man or in animals; the combined effect of the agents which cause this is called ‘stress.’. The three stress stages are:

1.  The alarm reaction: in grave stress, blood pressure falls, temperature rises, the blood thickens, etc.

2.  The resistance phase, in which the conditions are counteracted.

3.  The exhaustion phase, in which the symptoms of the alarm reaction recur.

Adaptive behavior

Behavior that brings the organism into adjustment with any variation in its environment.

Addict

One who is addicted to a practice or a habit, especially to narcotics.

Addiction

A condition of strong and irresistible dependence on the use of a particular substance (for instance, cocaine, alcohol) such that abrupt deprivation of the substance produces characteristic withdrawal symptoms.

Addictive behavior

Specific behavioral pattern of an addict.

Addictive drugs

Any drug that can lead to physiological dependence on the drug. These include alcohol, cocaine, marijuana, nicotine, opium, morphine, codeine, heroin (and other narcotics) and others.

Addison’s disease

A slowly and usually progressive disease resulting from insufficient function of the cortex of the adrenal glands.

Additive

A substance added in small amounts to another for improvement, as a drug added to medicine.

Adduct

To draw (one’s limb) toward the middle line of the body.

Adductor

The muscle that draws towards the middle line of the body.

Aden fever

An infectious, eruptive, usually epidemic fever of warm climates, characterized especially by severe pains in the joints and muscles.

Adenectomy

The surgical removal of a gland.

Adenine

A white, crystalline alkaloid, obtained from tea, glandular organs or uric acid.

Adenitis

Inflammation of a gland or a lymph node.

Adenoacanthoma

Adenocarcinoma in which some cells have undergone squamous metaplasia.

Adenocarcinoma

A malignant tumor that appears in the lining tissue of glands.

Adenochondroma

Adenoma with added characteristics of a chondroma.

Adenoepithelioma

Tumor consisting of glandular and epithelial cellular elements.

Adenofibroma

A benign tumor of connective tissue frequently found in the uterus.

Adenoid

A mass of lymph tissue in the nasopharynx (nasal cavity and throat).

Adenoid hypertrophy

Enlargement of adenoidal tissue due to lymphoid hyperplasia (an abnormal increase in lymph tissue). The condition occurs in children and may have a physical cause or accompany an infection or allergy.

Adenoidectomy

Surgical removal of the adenoids.

Adenolipoma

A benign tumor having glandular characteristics but composed of fat.

Adenoma

Glandular tumor arising from the mucosa of the digestive tract. It is a benign (noncancerous) lesion that is confined to the mucosa. Adenomas are premalignant lesions and over time can degenerate into an invasive tumor.

•  Adenoma, acidophil: a tumor of the pituitary gland whose cells stain with acid days.

•  Adenoma, basophil: a tumor of the pituitary gland whose cells stain with basic dyes.

•  Adenoma, chromophobe: a tumor of the pituitary gland composed of cells that do not stain readily.

•  Adenoma sebaceum: benign tumor-like growth on the face developing from epithelium of sebaceous glands which undergo fatty but never colloid metamorphosis.

•  Adenoma, tubular: an adenoma of the form of a tubular gland.

Adenoma, hepatocellular

A common noncancerous liver tumor that may be mistaken for a cancerous tumor and that in rare cases may rupture and bleed. Hepatocellular adenomas occur mainly in women of childbearing age, particularly among those who use oral contraceptives. These tumors usually cause no symptoms, so most remain undetected.

Hepatocellular adenomas caused by oral contraceptives use often disappear when the woman stops taking the drug.

Adenoma-carcinoma sequence

The process by which a benign adenoma is transformed into cancer.

Adenomatosis

The condition of multiple glandular enlargement.

Adenomyoma

The benign ingrowth of the endometrium (lining) of the uterus into its muscles. If this forms a circumscribed tumor-like nodule, it is called an adenomyoma.

Adenopathy

General term for a nonspecific disease of glands.

Adenosarcoma

A malignant growth with characteristics of adenoma and sarcoma (a type of cancer).

Adenosclerosis

Hardening of a gland, with or without swelling, usually due to replacement by fibrous tissue or calcium salts.

Adenosine

A crystalline nucleotide which, upon undergoing hydrolysis, yields adenine and ribose.

Adenosine diphosphate (ADP)

A co-enzyme, found in all living cells, important to the transfer of energy through the cell during glycolysis.

Adenosine triphosphate (ATP)

A nucleotide that occurs in all cells. It represents the reserve energy of muscle and is important in many biochemical processes that produce or require energy.

Adenosis

The enlargement of a gland, or the abnormal formation of glandular tissue.

Adenotonsillectomy

Removal of both the tonsils and adenoids by a surgical procedure.

Adenoviruses

A group of viruses causing a variety of acute disorders characterized by fever, inflammation of the mucous membranes in the breathing passages and around the eyes, and an increase of submucous and regional lymphoid tissue.

ADH

Abbreviation of antidiuretic hormone.

Adhesion

A growth of scar tissue resulting from an incision.

Adifax

A brand name for a drug that contains dexfenfluramine (a drug for weight reduction) as the active ingredient.

Adipocere

A brown, waxy substance, consisting primarily of fatty acids, that is produced by postmortem chemical changes to body fat over time as a result of prolonged immersion in water.

Adipocyte

A cell that synthesizes and stores fate.

Adipoma

A tumor consisting of fatty tissue.

Adipose

Fat stored in the cells of adipose tissue.

Adiposis

The state of excessive obesity; an abnormally large amount of fat on the body.

Adiposis dolorosa

Scattered areas of fat accumulation under the skin. The condition usually affects menopausal women.

Adiposogenital dystrophia

Retarded development of the testes or ovaries and increased sugar tolerance, usually occurring in individuals during the pre- and post-adolescent period. The condition is the result of an impairment of the pituitary gland or the hypothalamus.

Adipsin

A protein that is believed to control appetite, and so is used to treat obesity.

Aditus

An entrance or opening. An approach to an organ.

Adjuncts

Drugs that complement the chemotherapy regimen.

Adjustment

A change to a more satisfactory process, as in overcoming emotional problems.

Adjustment disorder

A maladaptive reaction to an identifiable psychosocial stressor, or stressors, that occurs within three months after onset of the stressor, and has persisted for no longer than six months.

Adjustment reaction

Mild or transient psychological disorders lasting longer than acute stress reactions which occur in individuals of any age without any apparent pre-existing mental disorder.

Adjuvant

A substance added to a prescription to aid the operation of the principal ingredient.

Adjuvant analgesics

A medicine that has a primary purpose other than treatment of pain but helps in relieving pain in some situations.

Adjuvant chemoradiation

Chemotherapy and radiation given following curative intent surgery for locally advanced gastric of CEJ carcinomas.

Adjuvant therapy

Treatment given after the primary treatment to increase the chances of a cure, and treatment to prevent the cancer from recurring.

ADL

Abbreviation of ‘Activities of Daily Living.’ ADL is a major program in the rehabilitation of disabled people. The ultimate goal for all disabled people is to return to gainful employment and the maximum of independence.

Adler, Alfred

(1870-1939) Distinguished Austrian psychiatrist who proposed a system of psychiatric theory and therapy which he named individual psychology.

Adler’s theory

An approach to psychology and psychiatry based on the hypothesis that behavior is governed by an effort to compensate for inferiority or deficiency.

Adnexa

Adjoining parts; accessory parts equalling one structure as, for instance, the ovaries and Fallopian tubes.

Adolescence

The period of life between childhood and the full development of the frame (between about 12 and 23 years of age).

Adolescent crisis

The emotional changes that occur during adolescence. The adolescent ego is confronted with new challenges: achieving independence, casting off emotional ties and developing new ones. Both physiological and psychological events, during this time, present problems for the adolescent to deal with before reaching maturity.

Adoption

The creation of a parent-child relationship where no such natural or legal relationship exists.

ADP

Acronym for adenosine diphosphate.

Adrenal

Pertaining to the adrenal glands or its secretions.

Adrenal cortex

Center of the adrenal gland.

Adrenal corticosteroid

Drug related to hydrocortisone, corticosterone or deoxycorticosterone used primarily for its ability to reduce inflammation. Also used to replace natural corticosteroids in deficient patients.

Adrenal glands

Small endocrine glands lying in the abdomen in the space behind the peritoneum, closely attached to the upper part of each kidney, but not related to the function of the kidneys. The medulla produces adrenaline and noradrenaline and the cortex corticosteroids.

Adrenal virilism

The result of adrenogenital syndrome.

Adrenalectomy

Removal of an adrenal gland.

Adrenaline

A hormone secreted by the adrenal glands, together with smaller quantities of noradrenaline. The nerve endings of the sympathetic nervous system also secrete both hormones (noradrenaline in greater quantities). They are similar chemically and in their effects.

Adrenergic

Liberated or activated by adrenaline or a similar substance.

Adrenergic blocking agents

Drugs which block the normal response of an organ or tissue to nerve impulses transmitted by the sympathetic nervous system.

Adrenergic-response rate

Personality characteristics generally indicative of high levels of adrenaline secretion, such as high blood pressure, rapid pulse and high blood sugar level.

Adrenocorticoids

Medicines that belong to the general family of steroids. Your body naturally produces certain cortisone-like hormones which are necessary to maintain good health. If your body does not produce enough, your doctor may have prescribed this medicine to help make up the difference.

Adrenocorticotrop(h)ic hormone (ACTH)

A hormone secreted by the front part of the pituitary gland which stimulates the adrenal cortex.

Adrenogenital syndrome

Any syndrome, congenital or acquired, in which excessive output of adrenal androgens (sex hormones) causes virilization, in which male characteristics become emphasized. The effects depend on the sex and age of the patient when the disease begins, and are more marked in women than in men.

Adsorption

Concentration of a substance on or near the surface of any solid or liquid. This is entirely different from absorption, which is the soaking up of a substance into the texture of a material.

ADT

Abbreviation sometimes used on a prescription to indicate to chemists that they can flavor medicine with whatever they like; the letters quite simply stand for ‘any damn thing’.

Adult rumination

The usually involuntary regurgitation of small amounts of food from the stomach (most often 15 to 30 minutes after eating), rechewing the material and, in most cases, again swallowing it. The reasons why this occurs are poorly understood.

Adulteration

Pollution. Usually means the fraudulent addition of a cheap substitute to foods or medicine instead of the full quantity of a more expensive article.

Adultery

Voluntary sexual intercourse by a married person with one who is not his or her wife or husband.

Adulthood

Period of life between 24 and 45 years of age.

Adult-onset diabetes

Older name for type 2 diabetes.

See Diabetes.

Advance directives

Legal documents that allow people to express their decisions regarding what they do and don’t want to have done during their last weeks or months in case they become unable to communicate effectively.

Advanced care directives

A legal document with specific instructions, prepared in advance, that are intended to direct a person’s medical care if he or she becomes unable to do so in the future.

Adventitia

The outer of the three layers composing the walls of blood vessels.

Adverse reaction

An unexpected or unpredictable reaction to a drug that is unrelated to the drug’s unusual effects. The cause may sometimes be an allergic reaction or a genetic disorder, such as the lack of an enzyme that normally inactivates the drug.

Adynamic ileus

Temporary absence of the normal contractile movement of the intestinal wall. Like an obstruction of the intestines, ileus prevents the passage of intestinal contents. Unlike a mechanical obstruction, though, ileus rarely leads to rupture.

Ileus commonly occurs for 24 to 72 hours after abdominal surgery. It may also be caused by an infection or a blood cloth inside the abdomen, atherosclerosis that reduces the blood supply to the intestine, or an injury to an intestinal artery or vein. Disorders outside the intestine may cause ileus, such as kidney failure or abnormal levels of blood electrolytes.

The symptoms of ileus are:

•  abdominal bloating

•  vomiting

•  severe constipation

•  loss of appetite

•  cramps.

The buildup of gas and liquid caused by ileus must be relieved. Sometimes a tube is passed through the anus into the large intestine to relieve the pressure. The person is not allowed to eat or drink anything until intestinal function normalizes. Fluids and electrolytes are given intravenously.

Aedes

A genus of mosquitoes, including approximately 500 species; some are vectors of disease, such as Aedes aegypti, a vector of yellow fever and dengue.

Aegophony

Curious noise (sometimes described as like the bleat of a goat) heard through a stethoscope when listening to the chest of someone suffering from pleurisy with effusion (inflammation of the membranes surrounding the lungs, in which fluid accumulates between lung and chest wall).

Aeremia

Presence of air in the blood. Usually a fatal condition and sometimes the cause of death in criminal abortion.

Aeroanaerobic

A term applied to bacteria capable of living both in the presence and absence of oxygen.

Aerobic organism

A microorganism that requires atmospheric oxygen in order to grow.

Aerobics

An active exercise program done to music, often in a class; exercises, e.g. Walking, jogging, bicycling, and swimming, that increase respiration and heart rates.

Aerobosis

Life in the presence of oxygen.

Aeroembolism

A condition in which nitrogen bubbles form in fluids and tissues of the body during rapid ascent to high altitudes.

Aerogenous

Gas producing; said of bacteria that produce gas in their metabolism.

Aeromedicine

The branch of medicine concerned with disorders that result from or occur during flying.

Aeroneurosis

Nervous disorder encountered among aircrew and pilots of aircraft. It was first noted during World War II in pilots who had undertaken so many battle missions that they were showing evidence of nervous breakdown and were overdue for a rest.

Aeropause

The dividing line between outer space and areas in which man and aircraft can function.

Aerophagia

Swallowing of air.

Aerosol

Atomized particles ejected into the air from a pressurized can. Some medicines are distributed in the form of an aerosol.

Afebrile

Running no temperature, without a fever.

Affect

A violent emotion, such as terror, fear or anger. ‘Affect’ is derived from the Latin word affectus diseased state of mind or body. It is no longer used in this sense and nowadays we understand affect to be an emotion or feeling attached to a mental conception or image.

Affect act

Action made without thinking and caused by a strong affect; primitive, explosive ‘short-circuit’ reaction.

Affect block

The inability to love due to a fear of love and of emotional ties. As a result of the blocking of affect, this condition involves the incapability for strong emotions and the avoidance of loving by using doubts and uncertainties.

Affectation

Feigned or unnatural behavior that is often meant to impress others.

Affective contact

Emotional relationships with others. A poor affective contact can be due to aloofness, superficialness or avoiding the emotion in an emotional atmosphere.

Affective dementia

Mental deterioration not of the intellectual powers but of the emotional life, through which a barrier is created between the sufferer and others.

Affective disorder

Psychiatric disorder in which a disturbance of affect or mood is a primary factor of the disease.

Affective experience

An emotional experience, whether pleasant or unpleasant, mild or intense.

Affective personality disorder

Personality disorder characterized by lifelong predominance of a pronounced mood which may be persistently depressive, persistently elated, or alternately one then the other.

Affective psychoses

Mental disorders, usually recurrent, in which there is a severe disturbance of mood (mostly compounded of depression and anxiety but also manifested as elation and excitement) which is accompanied by one or more of the following: delusions, perplexity, disturbed attitude to self, disorder of perception and behavior.

Affective reintegration

The reorganization of affects or emotions into harmony following their previous disintegration during an affective psychosis.

Affective transformation

The representation in consciousness of a repressed emotion usually by its opposite.

Afferent

Leading towards the center. Medically, the center is frequently the brain so that nerves carrying impulses from the outside of the body towards the brain area are called afferent nerves.

Affiliation

The settlement of the paternity of a child on its true father.

Affinity

Attraction; in biochemistry, the force that impels certain atoms to unite with certain others to form compounds.

Affliction

A state of acute pain or distress of body or mind. The term is also meant in the sense of the cause of continued pain of body or mind.

Afibrogenemia

Deficiency or absence of fibrinogen (a protein that aids in clotting) in the blood. The most common cause is concealed accidental hemorrhage.

Aflatoxin

A toxic compound produced by a mould fungus in agricultural crops, especially peanuts. It can cause hepatitis and liver cancer.

Afterbirth

The material, primarily the placenta, expelled from the mother’s body after the delivery of her child.

Aftercare

Further treatment of patients after discharge from hospital or treatment center. The term aftercare is also used for the rehabilitation of offenders leaving prison.

Aftereffect

A delayed effect, an effect occurring after the first result of a drug has disappeared.

Afterhearing

Hearing sounds after the stimulus causing the sound has stopped.

Afterimage

The image or sense impression that remains after the stimulus has disappeared.

Afterlife

A form of existence believed to continue after death; the period of someone’s life that follows a particular event.

Afternystagmus

Nystagmus is the coarse or fine movement of the eyeball and when this persists after the abrupt stopping of a rotation, it is called afternystagmus.

Afterpains

Pains not felt until some interval after the time when it was caused. The term is also used for pains following childbirth associated with the contractions of the uterus.

Aftersensation

Any sense impression, e.g. An aftertaste or afterimage, that remains after the immediate stimulus has been removed.

Aftersound

Hearing of a sound after the original cause which produced it has ceased to exist.

Aftertaste

Taste that persists long after the food has been swallowed.

After-treatment

Treatment of a convalescent patient.

Agalactia

Non-secretion or imperfect secretion of milk after childbirth.

Agammaglobulinemia

An immunological deficiency state in which there is a low level of gamma globulins in the blood, resulting in heightened susceptibility to infectious diseases. People with this condition are unable to produce immunity against infections.

Agar agar

Gelatinous substance derived from seaweed. It is used in bulk-forming laxative medicines, sometimes combined with liquid paraffin, and in certain preparations for the treatment of obesity. It fills up the stomach with bulk without producing any norishment.

Age ratio

The chronological age of a child at one testing divided by the child’s chronological age at a later testing. This ratio is a crude measure of a test’s predictive power.

Ageing

The process of growing old. Generally during aging a person’s height decreases, bone tissue diminishes, hair becomes gray and/or is thinned or lost, nose and ear lengthens, eye lenses become more rigid, and other physical changes occur.

Agenesis

Incomplete development, sterility, sexual impotence.

Agent

An active force or substance capable of producing an effect.

Ageusia

An impairment or deficiency in the sense of taste. The cause of such a disorder may be either physiological or emotional.

Agglutination

The clumping together of bacteria or other cells because of the introduction of an antibody.

Agglutinins

Antibodies found in blood plasma which cause the agglutination (sticking together) of antigens such as foreign red blood cells and bacteria.

Agglutinogen

Antigenic substance found in germs or other cells which, when injected into the bloodstream, causes the production of an antidote (agglutinin). The agglutinin then clumps together the original germs or cells, rendering them inactive and easier for the body to destroy. This process forms the basis of all the preventive inoculations against disease.

Aggravation

A feeling of exasperation or irritation, especially when caused by a continuing problem.

Aggression

Attack on another, usually but not necessarily, as a response to opposition. Aggression is defined by psychoanalysts as a manifestation, either of the will to have power over other people, or a projection of the death impulse.

Aggressive behavior

The acts of behavioral responses of an organism that display the quality of aggression.

Agitated depression

Depressive disorder marked by restlessness, anxiety and increased activity intermingled with fear and tension.

Agitated melancholia

State of deep depression with acute anxiety and agitation.

Agitation

A mental or physical disturbance, especially worry. Agitation is also used in the sense of a public disturbance on a large scale, or the process of creating it.

Agitation, psychomotor

Excessive motor activity associated with a feeling of inner tension; the activity is usually nonproductive and repetitious.

Agitographia

Compulsion to write very fast with the unconscious omission of words or whole sentences. It is the manifestation of a nervous disorder.

Agitolalia

Excessive rapidity of speech in which words, syllables and sounds are slurred, left out or distorted.

Aglaucopsia

Color-blindness, especially to green color.

Aglossia

Congenital absence of the tongue.

Aglutition

Inability to swallow.

Aglycemia

Absence of sugar in the blood. The more common name for this condition is now hypoglycemia.

Agnathia

Congenital condition in which the jaws are either absent or defectively developed.

Agnosia

Loss of the ability to associate objects with their usual role or function. Agnosia is caused by dysfunction in the parietal, temporal, or occipital lobes of the brain, where memories of the uses and importance of familiar objects, sights, and sounds are stored.

Agnosia often develops suddenly after a head injury or stroke, When one parietal lobe is damaged (usually the result of a stroke), people have difficulty identifying a familiar object, such as a key or safety pin, that is placed in the hand on the side of the body opposite the damage.

No specific treatment exists.

Agonist

A contracting muscle that is controlled by another opposing muscle. It is a term meaning to have a positive, stimulating effect. An agonist drug is one that binds to a receptor, thereby triggering or increasing a particular activity in that cell.

Agony

Intense mental or physical suffering, an intense feeling.

Agoraphobia

A phobia is a mental disorder involving persistent, unrealistic, intense anxiety and fear in response to specific external situations. People who have a phobia avoid situations that trigger their anxiety and fear, or they endure them with great distress. However, they recognize that their anxiety if excessive and there are aware that they have a problem.

Agoraphobia is characterized by anxiety or avoidance of being trapped in situations or places with no way to escape easily if anxiety or panic develops.

Agoraphobia is diagnosed in about 4% of women and 2% of men during any 12-month period. Most people with this disorder develop it in their early 20s, agoraphobia rarely develops after age 40.

If agoraphobia is not treated, it usually waxes and wanes in severity and may even disappear without formal treatment, possibly because the person has conducted some personal form of behavior therapy.

Exposure therapy, a type of behavior therapy in which the person is exposed repeatedly to the anxiety-provoking situation, is the best treatment for agoraphobia, helping more than 90% of people who practice this therapy faithfully.

Agranulocyte

One of the white blood cells which is devoid of granules.

Agranulocytosis

Condition characterized by pronounced leukopenia in which there is a great reduction in the number of polymorphonuclear leukocytes (a type of white blood cell).

Agraphia

Inability to write due to the disease of part of the brain.

Agromania

Unhealthy desire to be left alone or in solitude. It may be the reason why some people become hermits.

Ague

Malarial fever, or any other severe recurrent symptom of malarial origin.

AI

Common abbreviation for artificial insemination. A method of inducing pregnancy in which a man’s semen is introduced into a woman’s uterus by artificial means.

AID

Artificial insemination by donor. A method of inducing pregnancy in which semen from a donor other than the woman’s partner is introduced into her uterus by artificial means.

AIDS

Acquired immunodeficiency syndrome, a disease in which the body’s immune system breaks down. AIDS is caused by a virus called the human immunodeficiency virus, or HIV. A person who is infected can infect others (blood, sperm), even if no symptoms are present. People infected with HIV can develop many health problems. These can include:

•  Extreme weight loss;

•  Severe pneumonia;

•  A form of cancer;

•  Damage to the nervous system.

There is no specific cure; some drugs can alleviate the symptoms.

AIDS dementia

Early signs of dementia in patients with AIDS. This syndrome occurs in approximately one-third of AIDS patients. The onset is usually insidious, and cognitive dysfunction predominates initially.

AIDS encephalopathy

Involvement of the central nervous system as a direct consequence of neurological manifestations in patients with HIV-infection.

AIDS-related complex

A variety of chronic but nonspecific symptoms and physical findings that appear related to AIDS, which may consist of chronic generalized lymphadenopathy, recurrent fevers, weight loss, and minor infections.

AIH

Artificial insemination with sperm of the husband.

Ailment

Disease, morbid infection of the body.

Aim inhibition

A state with no conscious erotic interest in the object. A relationship is said to be aim-inhibited if the subject has no conscious interest in the object.

Air embolus

Blockage of a blood vessel by an air bubble.

Airsickness

Form of motion sickness allied to seasickness, experienced by nervous individuals when flying. The cause of airsickness lies in the effect of the movement of the aircraft on the labyrinth of the inner ear where the sense of balance is located; this cause was suggested because deaf-mutes are immune to motion sickness.

Akathisia

A condition marked by restlessness, ranging from anxiety to inability to lie or sit quietly or to sleep, as seen in toxic reactions to certain drugs (phenothiazines). The person also feels a distressing inner restlessness.

Akinesia

Marked absence of movement due to disease of the nervous system and brain.

Ala

An anatomical appendage resembling a wing.

Alactasia

A condition marked by malabsorption of lactose (milk sugar) due to deficiency of the digestive enzyme, lactase.

Alalia

Inability to speak through impairment in the organs of speech.

Alanine

A crystalline water-soluble amino acid that is a constituent of various proteins and can also be produced by humans and animals.

Alarm reaction

The release of metabolites in the affected tissues as a response to stress.

Alastrim

An infectious disease variola minor occurring especially in southern areas but also seen in Western Europe and referred to there as white pox, milk pox or kaffir pox. The skin eruptions show a strong resemblance to true smallpox variola major and the manner of infection is also the same, but alastrim is of a less serious nature.

Albedo

White crescent-like area at the base of a nail.

Albee’s operation

Surgical procedure for treating ankylosis of the hip joint.

Albers-Schönberg disease

An hereditary disease marked by abnormally dense bone, and by the common occurrence of fractures of affected bone. The condition is also called marble bones.

Albinism

Lack of body pigment; inability to produce pigment.

Albino

A person of abnormally pale, milky complexion, with light hair and pink eyes, resulting from a deficiency in pigmentation.

Albumin

Group of proteins soluble in water and in 50 percent saturated sulphate solution; present in animals and plants. Ovalbumin is the chief protein in egg white; serum albumin occurs in blood plasma, where it controls osmotic pressure.

Albuminemia

Abnormal amount of albumin in the blood.

Albuminometer

Apparatus for measuring the quantity of albumin in the blood or other body fluid.

Albuminuria

A condition in which the urine contains albumin, often indicating kidney disease.

Alcohol

1.  Any class of chemical compounds derived from hydrocarbons by replacing one or more of the hydrogen atoms with an equal number of hydroxyl radicals.

2.  Term for ethyl alcohol, the alcohol of commerce and medicine.

Alcohol dependence syndrome

A psychological state, usually also physical, resulting from taking alcohol, characterized by behavioral and other responses that always include a compulsion to take alcohol on a continuous or periodic basis in order to experience its effects, and sometimes to avoid the discomfort of its absence; tolerance may or may not be present.

Alcohol hallucinosis

Hallucinosis in which vivid and persistent hallucinations develop shortly (usually within 48 hours) after cessation of or reduction in alcohol ingestion by a person who apparently has an alcohol dependence syndrome.

Alcohol idiosyncratic intoxication

Marked Behavioral change usually to aggressiveness that is due to the recent ingestion of an amount of alcohol insufficient to induce intoxication in most people.

Alcohol intoxication

Maladaptive behavior changes due to recent ingestion of alcohol.

Alcoholic jealousy

Chronic paranoid psychosis characterized by delusional jealousy and associated with alcoholism.

Alcoholic liver disease

Hepatic disorders due to alcohol abuse. In general, a correlation exists between the severity of liver damage and the intensity of alcohol abuse as measured by duration and dose. However, the mechanisms by which alcohol actually damages the liver have not yet been adequately defined.

By providing calories without essential nutrients, decreasing appetite and causing malabsorption through its toxic effects on the gut and pancreas, alcohol promotes malnutrition. It is also a toxin to the liver cells whose metabolism then creates profound derangements of the cellular constituents.

Apparent variations in the susceptibility of individuals and the greater susceptibility of females to alcoholic liver disease suggest that other factors are also significant. The fact that alcoholic liver disease frequently runs in families means that the influence of genetic factors cannot be dismissed.

Although the data are controversial, and many abnormalities are no doubt secondary rather than primary, various immunological abnormalities in those with alcoholic liver disease suggest that a person’s immunological status may play a major role in determining susceptibility to alcohol.

The spectrum of changes associated with prolonged alcohol consumption range from the simple accumulation of neutral fat in liver cells to cirrhosis and cancer. The findings usually overlap and many present features of the entire spectrum. The key lesions may well be fibrosis around the small veins.

Fatty liver

Fatty liver appears to be the initial change associated with alcoholic liver disease and is the most common liver abnormality in hospitalized alcoholics. Hydropic change (i.e. Swelling due to excess fluid in the body) is prevalent in the early stages of alcoholic liver injury.

Although insufficiently explained, alcohol does affect the transport of certain substances through the membranes of cells, thus increasing the amount of sodium and water in the cells. It can also be associated with the accumulation of excess protein in the cells.

Cirrhosis

About 20 percent of heavy drinkers will develop cirrhosis in which the liver is finely nodular with its architecture is organized by thin fibrous septa and nodules. If drinking stops and the liver undergoes a constructive regenerative response, the picture can be that of a mixed cirrhosis.

Iron deposits

Increased amounts of iron in the liver are seen in alcoholics with normal, fatty or cirrhotic livers, but the incidence is less than 10 percent. The underlying mechanisms are obscure, but there appears to be no relationship with the amount of iron consumed in the alcohol or with the length of the drinking history.

Variations in drinking pattern, individual susceptibility to the toxic effects of alcohol and the many kinds of damage means that there is a highly variable clinical picture. For a long time, there may be no symptoms and no signs referable to the liver. In general, symptoms can be related to the amount of alcohol drunk and the overall duration of alcohol ingestion.

Thus, symptoms usually become apparent when a person is in his/her 30s and severe problems tend to appear in the 40s. Those with only a fatty liver are usually without specific symptoms, but may have an enlarged, smooth and occasionally tender liver.

In theory, the treatment of this condition is simple and straightforward; in practice, it is difficult: the person must stop drinking alcohol. However, following severe bouts of illness, major adverse social consequences and a review of the facts by a doctor who establishes rapport, many will stop drinking. It also helps to point out that much of alcoholic liver disease is reversible.

Although still controversial, it is unlikely that corticosteroids have any role to play in the treatment of alcoholic liver disease. The survival rate of those with alcoholic hepatitis, fibrosis and cirrhosis improves if drinking stops.

Alcoholic poisoning

Severe condition of chronic alcoholism, characterized by various conditions including nerve degeneration, mental deterioration, fatty degeneration of the liver, weight loss, personality changes, etc.

Alcoholic psychosis

Complete and ultimate mental deterioration that occurs in the chronic alcoholic. In one variety, Korsakow’s psychosis (or syndrome), there is complete mental, moral and social degeneration. Sufferers steal, cheat and lie to obtain alcohol, and no longer keep themselves clean or tidy.

Alcoholics anonymous

The full name of AA.

Alcoholism

A chronic, progressive and often fatal disease of major prevalence, but one that is treatable.

Alcoholization

The act or process of taking alcohol or the condition of being under the influence of alcohol.

Alcoholophilia

Pathological craving for alcohol.

Alcoholuria

Presence of alcohol in urine.

Aldosterone

A hormone secreted by the adrenal cortex that promotes the retention of salt and water by the kidneys.

Aldosteronism

Rare illness in which an over-production of the hormone aldosterone by the adrenal cortex leads to high blood pressure.

Aleppo boil

A manifestation on the skin of an infestation by Leishmania bacteria.

Alethia

Inability to forget.

Aleukemia

Blood disease in which white cells are either few or absent. It may occur in the course of leukemia.

Aleukocytosis

A diminished production of white blood cells in the peripheral blood.

Alexia

A disorder of language: the complete inability to comprehend the written word; word blindness.

Algae

The most primitive plant variety, having no true root, stem or leaf. Algae form the food for molluscs, fish and other aquatic animals. There are many thousands of varieties such as green, brown and red algae.

Algesia

Pain; increased sensitivity to pain.

Alginates

Salts of alginic acid. Certain alginates have been used for absorbable surgical dressings. They are available in solution, as foam and in specially impregnated gauze.

Alginuresis

Pain on passing urine, more commonly called dysuria.

Algolagnia

A form of sexual perversion in which the infliction or the experiencing of pain increases the pleasure of the sexual act.

Alienation

To estrange, a mental derangement. Term also used for legal insanity.

Aliment

Food; nutrient.

Alimentary canal

The canal from the mouth to the anus.

Alimentary tract

Passage from the throat to the anus.

Alimentation

The providing of food or norishment.

Alkalemia

A high alkali content in the blood.

Alkali

Chemical which is the complete opposite in its function to an acid, and neutralizes an acid to form a salt.

Alkali reserve

Total amount of available alkali in the body which can be used to buffer against acids.

Alkalinity

An excess of alkali; the concentration of alkali in a solution, measured in terms of ph.

Alkalinuria

Presence of alkali in the urine.

Alkalizers

Drugs that neutralize acidic properties of the blood and urine by making them more alkaline (or basic). Systemic alkalizers include potassium citrate and citric acid, sodium bicarbonate, sodium citrate and citric acid, and tricitrates. Urinary alkalizers include potassium citrate, potassium citrate and citric acid, potassium citrate and sodium citrate, sodium citrate and citric acid.

Alkaloids

Narcotic poisons found in certain plants and fungi. They have complex molecular structures and are usually heterocyclic nitrogen-containing bases. Many, such as atropine from deadly nightshade, are extremely poisonous. Others, such as morphine, nicotine and cocaine, can be highly addictive.

Alkalosis

A condition wherein the concentration of alkali in the body is higher than normal.

Alkaptone bodies

A class of substances, especially homogenistic acid, present in urine in alkaptonuria, a rare metabolic disease.

Alkaptonuria

Defect of the body present at birth and characterized by the excretion in the urine of a substance called homogenistic acid.

Alkylating agents

Substances that disrupt the process of cell division by affecting the DNA in the nucleus, probably by adding abnormal chemical groups to it. The chemicals are used to treat malignant diseases.

Allantois

A fetal membrane developing from the hindgut, which eventually develops into the placenta and umbilical cord.

Allele

Alternative forms of a gene. Each person possesses only two alleles for each gene, receiving one of each pair of alleles from each parent.

Allergen

-  A substance, usually a protein, which, when taken into the body, makes it hypersensitive or ‘allergic’ to it.

-  An environmental substance that causes an allergic response in a sensitive individual.

Allergic

Pertaining to or affected with allergy.

Allergic bronchopulmonary aspergillosis

Allergic bronchopulmonary aspergillosis belongs to the group of allergic lung diseases. The lungs are particularly prone to allergic reactions because they are exposed to large quantities of airborne substances that commonly cause allergic reactions, including dusts, pollens, fungi, and chemicals.

Exposure to irritating dusts or airborne substances, often when a person is at work, may increase the likelihood of an allergic respiratory reaction. Allergic reactions involving the lungs may also occur from eating a certain food or taking a certain drug.

The body reacts to an antigen by forming proteins that react with antigens (antibodies). Antibodies typically bind to an antigen (such as a fungus), thereby rendering it harmless in an immune response.

Allergic bronchopulmonary aspergillosis is an allergic lung disorder that often mimics pneumonia and is characterized by asthma, airway and lung inflammation with eosinophils (a type of white blood cell), and increased number of eosinophils in the blood.

Causes

Allergic bronchopulmonary aspergillosis is caused by an allergic reaction to a fungus, most commonly Aspergillus fumigatus. This fungus flourishes in soil, decaying vegetation, foods, dusts, and water. A person who inhales the fungus may become sensitized and develop allergic asthma.

Symptoms

The first indications of allergic bronchopulmonary aspergillosis are usually progressive symptoms of asthma, such as wheezing and shortness of breath, and a mild fever. The person usually does not feel well. Brownish flecks or plugs may appear in coughed-up sputum.

Diagnosis

Repeated chest X-rays show areas that look like pneumonia, but they move around, most often in the upper parts of the lung. With long-standing disease, chest X-rays or CT may show widened airways often plugged with mucus. Blood tests reveal high levels of eosinophils and antibodies to Aspergillus.

Treatment

Because Aspergillus appears in many places in the environment, the fungus is difficult to avoid. Antiasthmatic drugs, especially corticosteroids, are used to treat this condition.

Allergic conjunctivitis

Atopic conjunctivitis in which the membranes around the eyes become inflamed, usually part of an allergic syndrome such as hay fever, but may also occur alone through direct contact with airborne substances such as pollen, fungus spores, various dusts or flakes of animal skin.

Allergic interstitial pneumonitis

Allergic interstitial pneumonitis belongs to the group of allergic lung diseases.

The lungs are particularly prone to allergic reactions because they are exposed to large quantities of airborne substances that commonly cause allergic reactions, including dusts, pollens, fungi, and chemicals.

Exposure to irritating dusts or airborne substances, often when a person is at work, may increase the likelihood of an allergic respiratory reaction. Allergic reactions involving the lungs may also occur from eating a certain food or taking a certain drug.

The body reacts to an antigen by forming proteins that react with antigens (antibodies). Antibodies typically bind to an antigen (such as a fungus), thereby rendering it harmless in an immune response.

This disease is characterized by inflammation in and around the tiny airsacs (alveoli) and smallest airways (bronchioles) of the lung caused by an allergic reaction to inhaled organic dusts or, less commonly, chemicals.

Causes

Lung damage appears to result from a combination of immune complex reactions and cell-mediated allergic reactions. Initial exposure to the dust sensitizes lymphocytes. Some lymphocytes then help to produce antibodies that play a role in tissue damage.

Recurrent exposure to the antigen results in a chronic inflammatory response, which is manifested by a buildup of white blood cells in the walls of alveoli and small airways. The buildup leads progressively to symptoms and disease.

Symptoms

If a person has developed hypersensitivity to an organic dust, then the following symptoms appear 4 to 8 hours after re-exposure to it:

•  fever

•  cough

•  chills

•  shortness of breath

With this disease, a person repeatedly comes in contact with an allergen over months to years, and lung scarring (fibrosis) may result.

Diagnosis

The diagnosis depends in the clinical features, identification (if possible) of the dust or other substance causing the problem, and evidence of the person’s exposure to the suspected agent, as determined by the presence of antibodies on a blood test.

Prevention and treatment

The best prevention is to avoid exposure to the antigen, but this may be impractical if the person cannot change jobs. People who have an acute episode of pulmonary hypersensitivity usually recover if further contact with the substance is avoided. If the episode is severe, corticosteroids, such as prednisone, reduce symptoms and may help reduce severe inflammation.

Allergic lung disease

The lungs are particularly prone to allergic reactions because they are exposed to large quantities of airborne substances that commonly cause allergic reactions, including dusts, pollens, fungi, and chemicals.

Exposure to irritating dusts or airborne substances, often when a person is at work, may increase the likelihood of an allergic respiratory reaction. Allergic reactions involving the lungs may also occur from eating a certain food or taking a certain drug.

The body reacts to an antigen by forming proteins that react with antigens (antibodies). Antibodies typically bind to an antigen (such as a fungus), thereby rendering it harmless in an immune response.

Allergic purpura

An acute or chronic bleeding from capillaries, primarily affecting skin, joints and the gastro-intestinal and urinary systems. Skin bruises vary in appearance. The disorder is often self-limited with a good prognosis.

Allergic rhinitis

A symptom complex including hay fever and perennial allergic rhinitis, characterized by seasonal or perennial sneezing, runny nose, nasal congestion, itching and often conjunctivitis (inflamed eye membranes) and pharyngitis (sore throat).

Allergy

-  A hypersensitivity reaction to the presence of an agent (allergen) that is intrinsically harmless such as animal hairs, dust, pollen, or substances in certain foods.

-  A state of sensitivity to a particular environmental substance, or allergen. An allergic reaction is the body’s response, directed by the immune system, to exposure to an allergen.

Allocheiria

Disorder of sensation where touch or pain is felt, not at the site where it occurred, but at the corresponding point on the other side of the body.

Alloerotism

Erotic tendencies directed towards other people.

Allogenic

Denoting tissues that are distinct as far as their antigens are concerned, but are from the same species (said of tumors and transplants).

Allogenic stem cell transplantation

A treatment that uses donor stem cells to restore a patient’s bone marrow and blood cells. First, the patient is given conditioning therapy (high-dose chemotherapy or high-dose chemotherapy with total body radiation) to treat the leukemia and to turn off the patient’s immune system so that the donor stem cells will not be rejected. A type of transplant called a nonmyeloablative transplant may also be administered using lower doses of conditioning therapy.

Allogenic transplant

A transplant using another individual as the donor.

Allograft

Transfer of tissue or organ between members of the same species.

Allopathy

The standard form of medical practice in this country; a system of therapeutics based on the production of a condition incompatible with or antagonistic to the conditions being treated. This is the opposite of homeopathy.

Allorhythmia

Irregular rhythm of the heart.

All-or-none law

Principle relating to nerve fibers and muscles in which they either react to a complete degree or do not act at all.

All-or-none response

Response which is either elicited or not, and when elicited shows full intensity and no grading.

Allotopia

Displacement or malposition of an organ.

Allotransplant

Transplant between genetically different individuals; to transplant an organ or body tissue from one member of a species to a genetically different member of the same species.

Alochia

Absence of the lochia, the vaginal discharge that takes place for some days following childbirth.

Alopecia

Partial or total loss of hair from natural or abnormal causes.

Alpha rhythm

The most common electrical brain waves of the adult cerebral cortex as observed on an electroencephalogram (EEG). During rest, the oscillations are regular and smooth, occurring at a rate of 8 to 12 per second with an amplitude of 5 to 25 microvolts.

Alpha-adrenergic blocker

Member of a group of drugs used to treat hypertension. These drugs include prazosin, terazosin, doxazosin and labetalol (an alpha-adrenergic and beta-adrenergic combination drug).

Alpha-blocker

A drug used to treat high blood pressure and some other conditions. The nervous stimulation that constricts blood vessels, and hence increases blood pressure, is blocked by such drugs.

Alpha-fetoprotein

Tumor marker. Alpha-fetoprotein is normally produced by fetal liver cells; the compound is found in the blood of people with liver cancer (hepatoma). In addition, alpha-fetoprotein is often found in people with certain cancers of the ovary or testis and in children and young adults with pineal gland tumors. Testing can be useful in diagnosing cancer and in monitoring its treatment.

Alpha-receptor

A protein molecule in the membrane of a cell that specifically binds adrenaline, noradrenaline, or related substances and triggers a response, e.g. A nerve impulse, in the cell.

Alport’s syndrome

Hereditary nephritis; genetically determined nephritis of the kidneys. This condition runs in families and is characterized by:

•  blood in the urine (hematuria)

•  functional impairment of the kidneys

•  nerve deafness

•  sight abnormalities.

Most evidence supports an inheritance that is not based on the sex of the parent or child; however, males are more commonly and severely afflicted but father fewer affected sons than daughters. Thus, transmission is most often through females.

The onset of the disease may be similar to that of acute glomerulonephritis, but many have no symptoms and the disease is detected by finding blood in the urine. The blood may also contain small amounts of protein, white blood cells and casts of various types.

Afflicted females usually do not show symptoms and have little functional impairment, while most males with the disease develop evidence of insufficiency of the kidney between the ages of 20 and 30.

Nerve deafness - that is, deafness resulting from damage to the auditory nerve - is frequently present, usually perceived in the higher frequencies and more commonly found among affected males than females.

Some individuals with a family history may have nerve deafness alone without kidney disease; however, such persons are still capable of transmitting the kidney disease to a subsequent generation. Treatment is only indicated when uraemia occurs; its management is the same as in the kidney diseases.

ALS

Abbreviation of antilymphocyte serum. It diminishes the number of circulating lymphocytes, thus reducing the body’s defense mechanisms and thereby giving a transplanted organ a better chance of survival in the recipient.

Alter

One’s conception of another human being as a distinct person like oneself.

Alter ego

A very intimate friend that is considered by the individual as a second or other self.

Alternate generation

The type of inheritance among animals by which the young do not resemble their parents, but their grandparents or some remote ancestor. This characteristic is thought also to occur in some human families.

Alternative medicine

Methods of diagnosis and treatment not regularly taught in medical schools; the treatment of illness using remedies not considered part of mainstream medicine, e.g. Homeopathy or naturopathy.

Altitude sickness

A condition of lack of oxygen in the blood and tissues due to low atmospheric pressure. Night vision is impaired, followed by breathlessness, headache and faintness. At 5000 m (16,420 ft.) mental changes include indifference, euphoria and faulty judgement but complete acclimatization is possible up to this height. At very high altitudes 6000-7000 m (19,700-22,980 ft.) cyanosis, coma and death rapidly result. Treatment is by oxygen and descent. The use of pressurized cabins in aircraft prevents the occurrence of the condition.

Altruism

Consideration for the well-being of other people.

Alum

Common or potash alum is used as an astringent and to check bleeding from abrasions and minor cuts.

Aluminosis

A chronic infection of the respiratory system due to the presence of aluminum-bearing dust in the lungs.

Alveolar

Pertaining to the sockets of the teeth or the alveoli in the lungs.

Alveolar lobules

Physiologic unit of the lung consisting of a respiratory bronchiole and its branches (alveolar ducts, alveolar sacs and alveoli).

Alveoli, dental

The cavities or sockets in the jaws, in which the roots of the teeth are embedded.

Alveoli, pulmonary

Small air pockets that make up the alveolar sacs of the lungs, where oxygen and carbon dioxide are exchanged.

Alveolitis

Inflammation of alveoli.

Alymphocytosis

Gross deficiency or complete absence of lymphocytes in the blood.

Alzheimer’s diagnosis

A definite diagnosis of Alzheimer’s disease is still only possible during autopsy when the hallmark plaques and tangles can be detected. But with the tools now available, physicians and patients can count on 85 to 90 percent accuracy, according to studies in which clinical diagnosis was later confirmed by autopsy.

The following diagnostic tools are available:

Patient history

A detailed description of how and when symptoms developed; the patient’s and family’s medical history; and an assessment of the patient’s emotional status and living environment.

Physical examination and laboratory tests

Standard medical tests to help identify other possible causes of dementia.

Brain scans

Usually a computed tomography (CT) scan or magnetic resonance imaging (MRI) to detect strokes or tumours that could be causing symptoms of dementia.

Neuropsychological testing

Usually several different tests in which patients answer questions or complete tasks that measure memory, language skills, ability to do arithmetic, and other abilities related to brain functioning.

Alzheimer’s disease

A disorder that affects the brain’s thinking and reasoning ability. It is the common cause of mental breakdown in older people, responsible for over half of all nursing home admissions. Although Alzheimer’s usually begins in the elderly, it sometimes can start in the 40s and 50s. The cause and the essential nature of the disease process are not understood.

It is not infectious or contagious, it tends to be inherited but not to the extent that every descendant of every Alzheimer’s patient is afflicted. Alzheimer’s disease appears to be related to a form of degeneration of certain brain cells. Specific alterations in brain cells can be found in a particular percentage of cases.

Symptoms

Alzheimer’s patients suffer progressively increasing impairment of memory and other intellectual abilities. Although the problem may initially be manifested in such ways as forgetfulness, poor judgment, or difficulty making calculations and handling money, the cognitive losses ultimately leave the person confused, disoriented, and incapable of communicating normally.

Affected individuals undergo personality changes that may range from apathy and social withdrawal to quarrelsomeness and agitation, and frequently display various emotional reactions to their illness, such as anxiety, depression, or suspiciousness. Other symptoms such as disturbed sleep, hallucinations, delusional ideas, or a tendency to wander aimlessly, are also common.

Over time, these individuals lose the ability for their own well-being. Eventually, they may lose elementary physical abilities, such as bladder and bowel control, and become totally dependent on others to provide for their personal needs and safety.

The peculiar tragedy of Alzheimer’s disease and other related dementias is that they dissolve the mind and steal the humanity of the victim, leaving a body from which the person has largely been removed. In addition, abnormalities in the ability to communicate may occur that are not caused by disorientation but by brain abnormalities that can interfere with the ability to speak, understand speech, read or write.

There also may be a general physical showing - of movement, coordination, and reaction time - along with muscle rigidity. There may be loss of or change in appetite, such as disinterest in food or a demand for only one type of food, which can lead to malnutrition.

The individual leads an increasingly sedentary life, eventually taking to bed with its associated consequence of muscle contractures, pneumonia, and a propensity for infection, bed sores and other problems the patient may be unable to recognize or complain about in order for treatment to be undertaken in a timely way.

Caregivers face the agony of seeing their beloved ones’ minds and personalities disappear from bodies that may frequently remain otherwise healthy, and shoulder heavy physical and social burdens for their loved ones’ care, typically over prolonged periods of incapacitation averaging 6-8 years and sometimes as long as 20 years.

Treatment

Anyone suspected of having Alzheimer’s disease must see a doctor as soon as possible. Similar symptoms are caused by other treatable diseases, such as anaemia, stroke, thyroid disorders, and atherosclerosis. But these diseases all need prompt treatment in the elderly. Only when other causes are ruled out is the diagnosis of Alzheimer’s made.

The person with Alzheimer’s disease should be encouraged to continue daily routines as normally as possible. Although unable to function as well as before, even small accomplishments can improve mental outlook and pride. It is best to maintain an orderly, routine environment so the person does not have to try to learn new things. If problems with sleep or depression arise, medication can help alleviate them.

A careful exercise program under the guidance of a physical therapist can aid overall good health and self-esteem. The importance of routine, calmness, simplicity and patient human contact cannot be overestimated.

Certain drugs may improve memory functions and motor dysfunctions.

Alzheimner’s symptoms

Alzheimer’s patients suffer progressively increasing impairment of memory and other intellectual abilities. Although the problem may initially be manifested in such ways as forgetfulness, poor judgment, or difficulty making calculations and handling money, the cognitive losses ultimately leave the person confused, disoriented, and incapable of communicating normally.

Mild symptoms

• Confusion and memory loss

Alzheimer’s sufferers forget often, are unable to recall, and repeatedly ask the same question, forgetting the earlier answer. Patients may forget to pay household bills - forgetting what a bill is, why it needs to be paid - and even how to write a check or address an envelope.

• Disorientation; getting lost in familiar surroundings

Anyone can temporarily misplace car keys or glasses. A person with Alzheimer’s disease forgets often and may not be able to find belongings because they have put things in inappropriate places - an iron in the freezer, for example, or a loaf of bread in the washing machine.

People with Alzheimer’s disease may not know what year it is, where they live, who is the prime-minister or how to get to their neighbourhood grocery store. The disorientation is more than just momentary.

• Problems with routine tasks

Occasionally, everyone gets distracted and forgets - for example, a step in a process. However, people with Alzheimer’s disease may not only forget how to tie their shoes - they may not even remember to wear their shoes.

• Changes in personality and judgment

People with Alzheimer’s disease can have rapid mood swings for no apparent reason. Someone who was once calm, kind and loving may become mean, irritable and difficult. The patients may become passive and reluctant to get involved in business, social or family activities that they once enjoyed.

Someone with Alzheimer’s disease may forget to answer a ringing phone, turn off the faucet, care for a pet, or attend to any number of everyday activities that require conscientious thought. They may dress inappropriately, such as forgetting to wear a coat outdoors or wearing several shorts at a time.

Moderate symptoms

• Difficulty with activities of daily living, such as feeding and bathing

• Anxiety, suspiciousness, agitation

• Sleep disturbances

• Wandering, pacing

• Difficulty recognizing family and friends

Severe symptoms

• Loss of speech

A person with Alzheimer’s disease may have trouble finding the right words, use inappropriate words or repeatedly say the same things - making speech virtually incomprehensible. Patients may also be completely unable to initiate conversation or they may misinterpret what

Others say.

• Loss of appetite; weight loss

• Loss of bladder and bowel control

• Total dependence on caregiver

Amalgam

Soft mixture of metal and mercury used for filling teeth and may contain silver, tin, copper or various combinations of these metals.

Amastia

Absence of breast development.

Amathophobia

Fear of dust or dirt.

Amativeness

That propensity that impels to sexual passion.

Amaurosis

Blindness caused by disease in the optic nerve, without any perceptible change in the eye itself.

Amaurotic idiocy

Defective intelligence with amaurosis, and usually early death.

Ambidexterity

The ability to use both hands with equal ease.

Ambiguity

The quality of having more than one meaning or interpretation. The term is also used in the sense of an idea, statement or expression capable of being understood in more than one sense.

Ambisexual

Term used to describe secondary sexual characteristics that are common to both sexes.

Ambivalence

Emotional attitude towards an individual involving the alternation of the opposite feelings of love and hate.

Ambiversion

Type of personality, balanced or oscillating between introversion and extroversion.

Amblyopia

Dimness of vision or blindness for which there is no recognizable cause in the eye; it may be caused by toxins such as tobacco or alcohol.

Amboceptor

Double membrane receptor, the one combining with the blood cell, the other with complement.

Ambosexual

Having male and female characteristics, a hermaphrodite.

Ambulance

Vehicle fitted with suitable appliances for moving the injured and sick.

Ambulant

Ability to walk about.

Ambulatory

Pertaining to a disease or condition which can be dealt with while patients are able to walk about and not confined to their beds.

Ambulatory blood pressure monitoring

Diagnostic procedure in which blood pressure is recorded continuously for 24 hours while the person engages in normal daily activities. If the diagnosis of high blood pressure is in doubt (for example, if the measurements taken in the office vary too much), a 24-hour blood pressure monitor may be used.

Procedure

The monitor is a portable battery-operated device, worn on the hip, connected to a blood pressure cuff, worn on the arm. This monitor repeatedly records blood pressure throughout the day and night over a 24- of 48-hour-period. The readings determine not only whether high blood pressure is present but also how severe it is.

Ambulatory electrocardiography

Diagnostic procedure in which electrocardiograms are recorded continuously for 24 hours while the person engages in normal daily activities. Abnormal heart rhythms and inadequate blood flow to the heart muscle may occur only briefly and unpredictably. To detect such problems, doctors may use continuous ambulatory ECG.

Procedure

The person wears a small battery-powered device (Holter monitor) with a shoulder strap. The monitor detects the heart’s electrical activity through electrodes attached to the chest and records the ECG. While wearing the monitor, the person notes in a diary the time and type of any symptoms. Subsequently the ECG is run through a computer, which analyses the rate and rhythm of the heart, looks for changes in electrical activity that could indicate inadequate blood flow to the heart muscle, and produces a record of every heartbeat during the 24 hours. Symptoms recorded in the diary can then be correlated with changes in the ECG.

Results

Abnormal heart rhythms and inadequate blood flow to the heart may be detected in relation to certain events during normal daily activities.

Ambulatory peritoneal dialysis

Hemodialysis (blood washing) carried out by a kidney machine at home. Patients can connect themselves up in the late evening, and sleep through the night while being dialysed.

Ambulatory traction

Traction exerted by a walking-splints or braces on fractured limbs or inflamed joints while patients are up and about.

Ameba

Also spelled ameba; small parasite which, in the body, can cause disease.

Amebecide

A drug that kills amebas (single-celled microorganisms).

Amebiasis

Infection with an ameba that is pathogenic.

Amebic dysentery

Also spelled amebic dysentery; a form of amebiasis characterized by ulceration of the intestinal tract, caused by the ameba.

Amebicide

Drug used to treat infections caused by amebas, tiny micro-organisms commonly found in nature.

Ameboid

Resembling an ameba in shape or in mode of movement, said of certain types of white blood cells.

Amelia

Congenital absence of a limb or limbs.

Amelioration

Reduction of the severity of symptoms of a disease or disorder.

Ameloblastoma

Highly destructive tumor of the jaw originating from ameloblastic cells.

Amenorrhea

Abnormal stoppage or absence of the menstrual flow.

Amentia

A form of passive stupor with semi-consciousness, disorientation and an inability to speak.

American leishmaniasis

Variation of leishmaniasis, a parasite infection, that may manifest itself as localized skin ulcers resembling Oriental sore (beginning as a pimple, spreading, healing slowly, leaving a scar) or as ulcers in the mucous membranes of the nose and throat.

Ametropia

An eye condition in which there is some error of refraction, in consequence of which parallel rays, with the eye at rest, are not focused on the retina.

Amimia

A language defect, involving the inability to use significant gestures.

Amino acids

An important class of carboxylic acids containing one or more (-NH2) groups. The building blocks of the proteins, found in all living matter, are composed of about 20 amino acids, and most of them are found and synthesized in cells.

Amino-aciduria

Excessive amounts of one or more amino acids in the urine.

Aminoglutethimide

Generic name of a drug for advanced breast cancer and Cushing’s syndrome.

Aminoglycoside serum assay

A blood test done to make sure that antibiotic drugs such as gentamicin, tobramycin and amikacin are administered in dosages that maintain therapeutic blood levels.

Aminoglycosides

A family of antibiotics used for serious infections. This usefulness is limited because of relative toxicity compared to some other antibiotics. These drugs include amikacin, gentamicin, kanamycin, neomycin, netilmicin, streptomycin, tobramycin.

Amitosis

The direct method of cell division, characterized by the simple splitting of the nucleus, without formation of chromosomes.

Amitriptyline

An antidepressant drug with sedative effects, also used to treat chronic pain.

Ammonia

A substance produced by bacterial activity in the intestine. It is measured in blood to determine if the liver is functioning adequately in converting ammonia into urea, a substance excreted by the kidneys.

Ammonia nitrogen

A substance measured in urine to determine the body’s acid/base balance and nitrogen balance.

Amnesia

The total or partial inability to recall recent or remote experiences. When amnesia is caused by a psychologic rather than a physical disturbance, it is called dissociative amnesia. Amnesia may also be a symptom of other disorders, such as acute stress disorder, posttraumatic stress disorder, or somatization disorder.

Amnesia, anterograde

Loss of memory for those experiences and events following the physical or psychological trauma.

Amnesia, catathymic

Memory loss limited and confined to a certain recollection or experience.

Amnesia, circumscribed

Memory loss in which the beginning or the termination of the memory loss is fairly easily defined.

Amnesia, infantile

Loss of memory for the years from birth to about five years of age necessitated by the unacceptable nature of memories concerning the rise of the sexual life and the limits imposed upon the infant’s power.

Amnesia, retrograde

Loss of memory for those events and experiences preceding the cause of the amnesia.

Amnestic syndrome

Impairment in short- and long-term memory that is attributed to a specific organic factor.

Amniocentesis

A procedure whereby fluid is drawn from the liquid-filled amniotic sac surrounding the developing fetus while in the uterus. Cells shed from the fetus into the fluid can then be specially prepared within two to three weeks for chromosomal analysis to detect such conditions as spina bifida and Down’s syndrome.

Amniography

Method by which the amniotic fluid is made opaque by injection of radio-opaque material in order to visualize the fetal skeleton and soft tissues more clearly.

Amnion

Innermost embryonic membrane surrounding the fetus and continuing into the umbilical cord. It has no blood vessels and is smooth and transparent.

Amnion puncture

Puncture into the amnion cavity, carried out in pregnancy. Cells from the embryonic fluid may be analyzed for chromosomal and biochemical defects of the fetus.

Amniorrhea

Loss of the fluid surrounding the baby within the uterus shortly before birth. Popularly called ‘the breaking of the waters’.

Amniotic cavity

Fluid-filled cavity within which the unborn baby lies.

Amniotic fluid

Clear, watery fluid, secreted by the amnion, which fills the entire amniotic cavity and serves to protect the fetus. The amount of amniotic fluid increases with the duration of the pregnancy, and in normal circumstances at the end of the pregnancy amounts to 0.5 to 1.0 liter (18-35 fl. Oz). The fluid contains small fibers, skin cells and sebaceous fat from the fetus.

Amniotic fluid, bilirubin

A test done on amniotic fluid to detect fetal abnormalities, such as hemolytic disease, in early or late pregnancy.

Amniotic fluid, creatine

A test done on amniotic fluid to determine the age of the fetus.

Amniotic fluid, estriol

A test done on amniotic fluid to detect fetal abnormalities, such as fetoplacental disorders, in early or late pregnancy.

Amniotomy

Surgical rupture of the fetal membranes to induce labor.

Amok

A furious, reckless state, comparable to a psychotic disturbance, in which the afflicted runs about frantically, attacking everyone and everything in sight.

Amphetamines

A group of stimulant drugs, including Benzedrine and Methedrine, now in medical disfavor following widespread abuse and addiction. They counteract fatigue, suppress appetite, speed up performance (hence the slang word for them: ‘speed’) and give confidence, but pronounced depression often follows; thus psychological and then physical addiction are encouraged.

Amphimixis

The union of maternal and paternal characteristics in sexual reproduction.

Amphoric resonance

A sound similar to that produced by blowing over the neck of an empty bottle.

Amphoric respiration

A hollow blowing sound heard when a stethoscope is held over cavities in the lungs, due to the echo produced from the walls of the cavity.

Ampoule

A small container for a consecrated substance, especially oil, water, or wine.

Ampulla

Bell-like mouth of a canal such as in the tear duct of the eye and the milk ducts of the breast.

Amputate

To cut off, as a limb or other member, by a surgical operation.

Amputating ulcer

A penetrating ulcer encircling a part, such as a toe, leading ultimately to the complete loss of that part, such as is seen in yaws.

Amputation

The surgical removal of a part of the body. Usually this is one of the limbs, sometimes a whole arm or leg, but can also be a breast or other protruding organ. A doctor may be obliged to carry out an emergency amputation in a number of dire circumstances, such as injuries in industry where a limb is caught in machinery, in those trapped in mining and railway accidents or under falling masonry during earthquakes. In most of these injuries a part of the limb, usually at its end, such as a hand or foot, is irretrievably damaged, pulped or mangled.

Amputation neuroma

Small, painful and tender growth that sometimes develops at the cut end of a nerve following amputation of a limb.

Amputee

Somebody who has had a limb or part of a limb cut off.

Amsterdam criteria

Screening guidelines used to identify families with hereditary nonpolyposis colon cancer (HNPCC).

Amusia

A form of aphasia characterized by loss of the faculty of musical expression or of the recognition of simple musical tones.

Amyelia

Congenital malformation of the spinal cord.

Amyelineuria

Partial paralysis or impaired functioning of the spinal cord.

Amygdala

An almond-shaped mass of gray matter, one in each hemisphere of the brain, associated with feelings of fear and aggression and important for visual learning and memory.

Amygdalin

A white glycoside powder, obtained from bitter almonds, chiefly used medically as an expectorant.

Amylase

An enzyme secreted by the pancreas, which becomes elevated in diseases of the pancreas or salivary glands, kidney problems, and drug ingestion.

Amyloid

A protein complex of starchlike characteristics forming a hard substance in tissues during certain diseases.

Amyloid degeneration

Waxy degeneration occurring in cases of long-standing disease, such as tuberculosis, in which the tissues of the body have deposits of starch-like substances which prevent the various organs (mainly the heart, liver, kidney, spleen and intestine) from carrying out their functions, and contribute to the worsening of the patient’s condition.

Amyloid kidney

State of amyloid or waxy degeneration of the kidney seen in amyloid degeneration.

Amyloidosis

Another name for amyloid degeneration.

Amylopsin

An enzyme of the pancreatic juice, capable of converting starch into sugar.

Amylorrhea

Presence of excessive quantities of starch in the stools.

Amylose

A soluble component of starch that is an unbranched carbohydrate polymer formed of glucose units, with a tendency to form gels in aqueous solution.

Amyotonia

Extreme flaccidity and smallness of the muscles, occurring mostly in early childhood.

Amyotonia congenita

Disease of early childhood, usually congenital and sometimes running through families, characterized by the extreme flaccidity, smallness and weakness of the muscles, which are not actually paralysed.

Amyotrophic lateral sclerosis

Chronic disease in which there is degeneration of the nerve cells supplying certain muscle groups resulting in a progressive muscular atrophy (wasting) of groups of muscles.

Amyotrophy

A degeneration of the muscles caused by nerve disease.

Ana

‘In equal quantities of each’; refers to ingredients used in prescriptions.

Ana titers

A test to evaluate the immune system and to detect antinuclear antibodies (anas), substances which appear in the blood of some patients with autoimmune disease.

Anabasine

An insecticidal liquid alkaloid, related to nicotine and found in tobacco.

Anabiosis

A return to life from a state resembling death.

Anabolic steroids

Group of steroids that are derivatives of the male sex hormone testosterone.

Anabolism

The constructive process by which living cells convert simple substances into more complex compounds, especially into living matter.

Anabolite

A product of an anabolic process.

Anachlorhydria

Absence of hydrochloric acid in the gastric juice.

Anacidity

Lack of normal acidity, especially in the gastric juice.

Anaclitic

Term employed by psychoanalysts to describe one type of object-choice modeled after the first love object.

Anaclitic depression

Impaired development of an infant resulting from separation from its mother.

Anacrotic pulse

One with a ‘notch’ in the ascending part of the pulse curve when seen on sphygmograms (graphic tracings of pulse beats), especially in aortic stenosis (narrowing of the main artery from the heart).

Anacrotism

An abnormality of the blood circulation characterized by a secondary notch in the ascending part of a sphygmographic tracing of the pulse.

Anadontism

The state in which all teeth have failed to develop.

Anaemophobia

Morbid fear of wind and draughts.

Anaerobe

Any organism whose respiration does not make use of oxygen. Many bacteria and parasites are facultative anaerobes (that is, they can survive without oxygen for short or long periods), and a few are obligate anaerobes (unable to use oxygen in respiration).

Anaerobic respiration

The production of energy from foodstuffs without the presence of oxygen.

Anaerobiosis

Life in the absence of air or free oxygen.

Anagogic

Term employed by Carl Jung for the morally uplifting trends on the unconscious.

Anagogy

An elevation of mind to things celestial; the spiritual meaning or application of words.

Anal

Related to, or situated near, the anus.

Anal canal

The terminal section of the rectum.

Anal cancer

Malignant growth developing in the skin cells of the immediate area around the anus or in the lining of the transitional zone between the anus and the rectum. Unlike the rectum and the large intestine, in which cancers are almost always adenocarcinoma, cancers of the anus are primarily squamous cell carcinomas.

People with anal cancer often experience bleeding with bowel movements, pain, and sometimes itching around the anus. About 25% of people with anal cancer have no symptoms; in these instances, the cancer is found only during a routine examination.

Radiation therapy combined with chemotherapy may be used instead of or in addition to surgery. Surgery alone is avoided so as not to interfere with the functioning of the muscular ring that keeps the anus closed until the person has a bowel movement, which could lead to loss of control over bowel movements (fecal incontinence).

Anal character

Type of character neurosis inferred to be the result of fixation at the anal stage of development.

Anal eroticism

In psychoanalytical theory, concentration of interest on the anal region as a pregenital phase of sexual development.

Anal fissure

A tear or ulcer in the lining of the anus. Anal fissures may be caused by an injury from a hard or large bowel movement. Uncommonly, they may also be caused by penetration of the anus during anal sex. Fissures cause the anal sphincter to go into spasm, which prevents healing.

A stool softener or psyllium may reduce the possibility of reinjury by hard bowel movement, while lubricating and soothing the lower rectum. When these and other measures fail, surgery may be needed.

Anal fistula

Erosion of tissues caused by a spreading abscess within the anus. The fistula itself is a tiny tube leading directly from the anal canal to a pin-hole-sized opening in the skin near the anal orifice. The treatment is a minor operation.

Anal itching

Itchy skin around the anus can have many causes, including skin disorders such as psoriasis and atopic dermatitis, diseases such as diabetes or liver disease, anal disorders such as skin tags or draining fistulas, and malignant growth.

Allergic reactions such as contact dermatitis caused by anesthetic preparations, or chemicals used in soap are another cause. Infections with fungi, bacteria, or parasites (such as pinworms and, less commonly, scabies or lice) can produce anal itching. Or itching can be a side effect of antibiotics, especially tetracycline.

After bowel movements, the anal area should be cleaned with absorbent cotton or soft, plain toilet or facial tissue, which may be moistened with warm water. Corticosteroid creams, antifungal creams, or soothing suppositories may be used.

Anal sadism

Refers to sadistic fantasies that originate in the anal stage.

Anal sex

Sexual intercourse by way of the anus. The area around the anus is an important erogenous zone, stimulating to both women and men.

Anal sphincter

Ring of muscle tissue at the end of the gastrointestinal tract. Either of two sphincters, called the outer and inner sphincter.

Anal stage

Stage of psychosexual development of infants postulated by instinct theory, in which the anus and defecation are the major source of sensuous pleasure and form the center of the infant’s self-awareness; and a stage of ego development, in which mastery of the body, particularly of its sphincters, are the infant’s major preoccupation.

Anal verge

The distal margin of the anal canal comprising the muscular rim of the anus.

Analeptic

A drug that acts as a restorative, e.g. Caffeine. Most analeptics stimulate certain parts of the brain.

Analgesia

Loss of sensibility to pain.

Analgesics

Drugs used for the relief of pain. They mainly impair perception of or emotional response to pain by affecting the higher brain center. Aspirin and paracetamol are mild but effective.

Anality

An anal psychological state, stage, or quality.

Analogous

Having similar function but a different structure and origin.

Analogue

In medicine, term used in three different senses.

1.  Something that is analogous or similar to something else;

2.  An organ similar in function to an organ of another animal or plant but different in structure and origin:

3.  A chemical compound structurally similar to another but differing often by a single element of the same valence and group of the periodic table as the element it replaces.

Analogy

Functional similarity between anatomical parts without similarity of structure and origin.

Analysand

A person who is being analyzed. The word owes what little currency it has to the fact that it makes it possible to avoid calling students ‘patients’.

Analysis

In its general psychological sense, the determining of the constituents of any total or complex experience or mental process; frequently used in a special sense of psychoanalysis, and kindred procedures and theories, and even as synonymous with psychoanalysis.

Analyst

A person who analyzes or who is skilled in analysis.

Analytic psychology

A modification of psychoanalysis due to Carl Jung that adds to the concept of the personal unconscious a racial or collective unconscious, that objects to a narrowly sexual interpretation of libido, and that advocates that psychotherapy be conducted in terms of the patient’s present-day conflicts and maladjustments rather that in terms of his early psychosexual development.

Anamnesis

Recalling to mind; employed also in the medical sense of the history of an illness up to the present.

Anamnestic

1.  Of or relating to an anamnesis;

2.  Of or relating to a second rapid increased production of antibodies in response to an immunogenic substance after serum antibodies from a first response can no longer be detected in the blood.

Anamniota

A group of vertebrates that develop no amnion and that include the cyclostomes, fishes, and amphibians.

Anamorphosis

A gradually ascending progression or change of form from one type to another in the evolution of a group of animals or plants.

Ananastasia

A hysterical condition characterized by inability to stand up.

Anancasm

Stereotyped, repetitious behavior which produces anxiety if not performed.

Anancastic personality disorder

Personality disorder characterized by: feelings of personal insecurity, doubt, incompleteness leading to excessive conscientiousness, checking, stubbornness and caution.

Anangioplasia

Imperfect vascularization of an organ or tissue.

Anaphase

The stage in mitosis (cell division) in which the chromosome halves move away from each other toward the opposite ends of the cell.

Anaphoresis

Too little or defective perspiration; the movement of electropositive particles into tissues induced by the presence of an electric field.

Anaphrodisia

Diminished sexual desire or sexual impotence.

Anaphrodisiac

A substance capable of dulling sexual appetite.

Anaphylactic reaction

Severe allergic response to a substance, e.g., a drug or vaccine. Symptoms appear within a few seconds or minutes after exposure. An anaphylactic reaction is a severe medical emergency.

Anaphylactic shock

Sudden profound collapse following the injection of a foreign protein.

Anaphylactoid purpura

Another name of allergic purpura.

Anaphylaxis

An acute, often explosive, allergic reaction of the whole body, characterized by urticaria (skin rash), breathing problems and a dramatic drop in blood pressure and occasionally by vomiting and abdominal cramps.

Anaplasia

Reversion of some highly developed cells of an organ or tissue in the body to a more primitive type, accompanied by excessive tendency to multiply, such as is seen in cancer growth.

Anaplastic large B cell lymphoma

A type of intermediate grade lymphoma.

Anaplastic lung cancers

Cancers tending to grow more rapidly and to spread earlier.

Anaplastic thyroid cancer

A malignant tumor of the liver characterized by los of differentiation of liver cells. This cancer grows very quickly and usually causes a large growth in the neck. It also tends to spread throughout the body.

About 80 percent of people with anaplastic cancer die within 1 year, even with treatment. However, treatment with chemotherapy and radiation therapy before and after surgery has resulted in some cures.

Anarrhexis

Surgical operation of rebreaking a bone in order to reset it into a better position.

Anarthria

The loss of power of articulate speech.

Anaspadias

Birth deformity in which the urethra opens on the top surface of the penis.

Anastomose

To join up or provide a communication between two different hollow parts or hollow organs; joining up two arteries by a surgical means.

Anastomosis

The connection or place of connection of two or more parts of a natural branching system, e.g. Of blood vessels.

Anatomy

The branch of science that studies the physical structure of animals, plants, or other organisms.

Ancon

The upper end of the ulna or elbow.

Ancylostomiasis

Hookworm disease, caused by any of certain bloodsucking nematode worms equipped with mouth hooks, which feed off the lining of the intestine of humans and animals. The disease is characterized by severe anemia.

Androgen

Steroid hormone that produces secondary male characteristics such as facial and body hair and a deep voice.

Androgyne

Somebody who gives the impression of having both a male and a female sexual identity.

Androgynoid

A man with hermaphroditic sexual characteristics who is mistaken for a woman; a pseudohermaphrodite.

Androgyny

Female pseudohermaphroditism.

Android

Resembling a man in form and structure.

Androphobia

Fear of men, or of the male sex.

Androsterone

Androgenic steroid probably manufactured by the adrenal glands and found in the urine of both men and women.

Anelectrotonus

The lessened irritability and conductivity of a nerve in the neighborhood of the anode (positive pole).

Anemia

A disorder caused by deficiency in the number of red blood cells and/or their hemoglobin content (the red substance which binds with oxygen) or both. The clinical features include:

•  palor

•  easy fatigue

•  breathlessness on exertion

•  giddiness

•  palpitations

•  loss of appetite.

Many different disorders may cause an anemia and it may sometimes occur as a result of drug treatment.

Anemia, aplastic

A form of anemia in which the bone marrow is unable to manufacture adequate numbers of blood cells of all types red cells, white cells, and platelets.

Anemia, hemolytic

Anemia caused by a shortened lifespan of red blood cells. The body can’t manufacture new cells fast enough to replace old cells.

Anemia, iron-deficiency

Anemia caused by lack of iron. There are three main mechanisms by which a person becomes iron-deficient:

•  Nutritional insufficiency;

•  Intestinal malabsorption;

•  Blood loss. These factors may be encountered together in the same individual.

Anemia, pernicious

Anemia caused by a vitamin B12 deficiency. Symptoms include:

•  Weakness;

•  Fatigue;

•  Numbness;

•  Tingling of the hands or feet;

•  Degeneration of the central nervous system.

Anemia, sickle-cell

Anemia caused by defective hemoglobin that deprives red blood cells of oxygen, making them sickle-shaped.

Anencephaly

Absence of the brain, or of all but the brain stem and the cerebellum.

Anergy

Inability to react to specific antigens, either in the body fluids or in the cells themselves; usually refers to an inability to mount delayed-type skin reactions.

Anerotism

Avoidance of sexual relations.

Anesthesia

Loss of sensation; absence of sensation may be of three types: general, local or pathological.

Anesthesia dolorosa

Severe pain in part of the body which at the same time is insensible to touch. Seen in certain diseases of the spinal cord.

Anesthesia, General

A reversible state of drug-induced unconsciousness with muscle relaxation and suppression of reflexes; this facilitates many surgical procedures and avoids distress.

Anesthesia, Infiltration

Method of anesthesia by which the anesthetic is injected into the immediate area of the operation.

Anesthesia, local

The reversible blocking of pain impulses by the chemical action of cocaine derivatives. Large nerves are blocks for minor surgery and dentistry.

Anesthesia, nerve block

Method of anesthesia by which the anesthetic is injected into the vicinity of a nerve rendering the area supplied by it insensitive.

Anesthesia, pathological

Loss of sensation following injury or disease.

Anesthesia, spinal

Method of anesthesia by which the anesthetic is injected into the vertebral canal outside or inside the subarachnoid space of the spinal cord.

Anesthesiology

The science of administering esthetics.

Anesthetic

Substance which causes the loss or reduction of sensitivity, though functional anesthesia may be produced by hypnotic suggestion or acupuncture.

Anesthetic, general

A drug or drug combination given to produce unconsciousness before and during surgery or potentially painful investigative procedures. General anesthesia is usually induced initially by injection of a drug such as thiopentone, and maintained by inhalation of the fumes of a volatile liquid such as halothane or a gas such as nitrous oxide mixed with oxygen.

Anesthetic, local

A drug applied topically or injected to numb sensation in a small area.

Anesthetic, topical

Medicine used to relieve pain, itching, and redness of minor skin disorders. Topical esthetics deaden the nerve endings in the skin. They do not cause drowsiness or unconsciousness as general esthetics for surgery do. Benzocaine (present in many of these topical medicines) may be absorbed through the skin of young children and cause unwanted effects.

Anesthetist

A medical doctor specializing in anesthesiology.

Anethopathy

Personality disorder characterized by a lack of moral inhibitions and unethical behavior, and also including narcissistic sexual behavior and general egocentricity.

Aneuploidy

An irregular number of chromosomes (e.g., 45, 47 or 48 chromosomes in humans), caused by the loss or addition of one or more chromosomes or parts of chromosomes.

Aneurine

Vitamin B1, sometimes called thiamine. A deficiency of aneurine in the diet is the cause of beriberi.

Aneurysm

A bulge (dilation) in the wall of an artery, usually the aorta. The bulge occurs in a weak area of the artery’s wall. The pressure inside the artery forces the weak area to balloon outward. If untreated, an aneurysm may rupture, resulting in internal bleeding. A blood cloth (thrombus) often develops in the aneurysm because blood flow inside the aneurysm is sluggish.

Development

Aneurysms can develop anywhere along the aorta. Three fourth of aortic aneurysms develop in the part of the aorta that passes through the abdomen (abdominal aorta), and the rest develop in the part that passes through the chest (thoracic aorta).

Aneurysms can also develop in:

•  the arteries at the back of the knee (popliteal arteries)

•  the main arteries of the thigh (femoral arteries)

•  the arteries supplying the head (carotid arteries)

•  the arteries supplying the brain (cerebral arteries)

•  the arteries of the heart muscle (coronary arteries).

Causes

The most common cause of aortic aneurysms is atherosclerosis, which weakens the wall of the aorta. Less common causes include

•  injuries

•  hereditary connective-tissue disorders

•  Marfan syndrome

•  infectious diseases

Aneurysm, arteriovenous

Aneurysm in which an artery and a vein become connected by a saccule.

Aneurysm, fusiform

All the walls of the blood vessels dilate more or less equally, creating a tubular swelling.

Aneurysm, sacculated

Aneurysm due to the yielding of a weak patch on one side of the vessel and not involving the entire circumference; usually due to an injury.

Aneurysm, varicose

Aneurysm forming a blood-filled sac between an artery and a vein.

Aneurysmectomy

Extirpation of an aneurysm by removal of its sac.

Aneurysmorrhaphy

Surgical repair of an aneurysm.

Aneurysmotomy

Incision of the sac of an aneurysm, allowing it to heal by granulation.

Angel’s wing

Abnormal prominence of the shoulder blades. Also called winged scapula.

Anger

Primary emotion, provoked typically by frustration. Surprisingly, it is frequently confused with hate, despite the fact that it is a short-lasting emotion readily experienced towards those we love, whereas hate is a lasting sentiment.

Angiectasia

Enlarged capillaries or abnormal dilation of a vessel.

Angiedema

Local weals and a tingling redness on the skin, usually involving large fluid-filled areas.

Angiitis

Inflammation of a blood vessel or of a lymphatic.

Angina

Spasmodic pain associated with the sensation of choking or suffocation.

Angina decubitus

Temporary chest pain or a sensation of pressure that occurs while the heart muscle is not receiving enough oxygen. Angina decubitus is angina that occurs when a person is lying down (not necessarily only at night) without any apparent cause. Angina decubitus occurs because gravity redistributes fluids in the body. This redistribution makes the heart work harder.

Angina pectoris

Temporary chest pain or a sensation of pressure that occurs while the heart muscle is not receiving enough oxygen. Narrowing of the arteries due to fatty deposits or occasionally due to another abnormality may interfere with blood flow to the heart muscle and prevent it from receiving enough blood and oxygen. Angina usually first occurs during physical exertion or emotional distress, which makes the heart work harder and increases its need for oxygen. If the artery is narrowed enough (usually more than 70 per cent) angina pectoris can occur even at rest, when the demands on the heart are at their maximum.

Causes

Usually, angina results from coronary artery disease. A sudden temporary constriction of an artery may cause angina by abruptly decreasing the supply of blood and thus oxygen.

Symptoms

Most commonly, a person feels angina as pressure or an ache beneath the breastbone (sternum). Pain also may occur in either shoulder or down the inside of either arm; through the back, and in the throat, jaw, or teeth. Most people describe the feeling as discomfort or heaviness rather than pain.

Typically angina is triggered by exertion, lasts no more than a few minutes, and subsides with rest. Some people experience angina predictably with a specific degree of exertion. Often, angina is worse when exertion follows a meal. It is usually worse in cold weather.

Diagnosis

Doctors diagnose angina largely based on a person’s description of the symptoms. A physical examination and electrocardiography may detect little, if anything abnormal between and sometimes even during attacks of angina. The following procedures may help evaluate the inadequate blood

Supply to the heart muscle and determine whether coronary artery

Disease is present and how extensive it is:

•  exercise stress testing

•  radionuclide imaging

•  echocardiography

•  coronary angiography

•  continuous ECG monitoring

Treatment

Treatment begins with attempts to slow progression of coronary artery disease or to reverse it by dealing with risk factors. Treatment of stable angina is designed to prevent or reduce ischemia and to minimize symptoms. Five types of drugs are available:

•  beta-blockers

•  nitrates

•  calcium channel blockers

•  angiotensin-converting enzyme inhibitors

•  antiplatelet drugs.

Angina, nocturnal

Temporary chest pain or a sensation of pressure that occurs while the heart muscle is not receiving enough oxygen. Angina nocturnal is angina pectoris that occurs at night.

Angina, unstable

Temporary chest pain or a sensation of pressure that occurs while the heart muscle is not receiving enough oxygen. Unstable angina refers to angina pectoris in which the pattern of symptoms changes. Because the characteristics of angina in a particular person usually remains constant, any change - such as more severe pain, more frequent attacks, or attacks occurring with less exertion or during rest - is serious. Such change usually reflects a rapid progression of coronary artery disease, with an increasing narrowing of a coronary artery because an atheroma has ruptured or a clot has formed.

Angina, variant

Temporary chest pain or a sensation of pressure that occurs while the heart muscle is not receiving enough oxygen. Variant angina pectoris results from a spasm of one of the large coronary arteries on the surface of the heart. It is called variant because it is characterized by pain during rest, not during exertion, and by specific changes detected with electrocardiography (ECG) during an episode of angina pectoris.

Angiocardiography

X-ray examination of the heart and large blood vessels after the injection of radio-opaque substances into the bloodstream to outline the shape of these organs.

Angiocardiokinetic

Stimulating or that which affects movements of heart and blood vessels.

Angiocarditis

Inflammation of the heart and larger blood vessels attached to the heart.

Angiogenesis

The formation of new blood vessels, e.g. In an embryo or as a result of a tumor.

Angiogram

A series of X-ray film of a blood vessel taken in rapid sequence following the injection of a radiopacque substance into the vessel.

Angiography

Radiography of the blood vessels after introduction of a contrast medium. Intra-arterial digital subtraction angiography is a radiologic imaging technique for arteriography that uses electronic circuitry to subtract the background of bone and soft tissue from the image of the arteries, which have been injected with contrast material.

Angiography, digital subtraction

A radiologic imaging technique for arteriography that uses electronic circuitry to subtract the background of bone and soft tissue from the image of the arteries, which have been injected with contrast material. In digital subtraction angiography, images of arteries are obtained before and after a radiopaque dye is inserted and a computer subtracts one image from the other. Images of tissues other than the arteries are thus eliminated. As a result, the arteries can be seen more clearly, much less dye is required, and the procedure may be safer that standard angiography.

Angiohemophilia

Another name for Von Willebrand’s disease.

Angiolipoma

A benign tumor composed of fat tissue and vascular structures; a mixed angioma and lipoma.

Angiology

The branch of anatomy that deals with the blood vessels and lymphatics.

Angiolymphoma

A tumor composed principally of dilated lymphatics.

Angioma

A form of tumor, usually benign, consisting principally of blood or lymph vessels. Considered to be remnants of fetal tissue or undergoing disordered development.

Angioma cavernosum

An angioma that is congenital; appears as an elevated dark red tumor, ranging in size from a pea to that of the hand. Il may pulsate; commonly involves the subcutaneous or submucous tissue, It is nonmalignant and small ones may disappear without therapy.

Angioma senile

An angioma in elderly persons and consisting of a compressible mass of blood vessels.

Angioma simplex

Angioma that is congenital; made up of capillaries, nonelevated, bright red or purple-red in color; may cover a large surface. The angioma is usually found in the face; there is no satisfactory treatment.

Angioma venosum racemosum

Swelling associated with greatly enlarged superficial varicose veins.

Angioma, senile

An angioma in elderly persons and consisting of a compressible mass of small blood vessels.

Angiomyolipoma

A benign tumor composed of fat tissue, muscle cells and vascular structures.

Angiomyoma

A benign tumor composed of muscle cells and vascular structures; an angioma mixed with a myoma.

Angiomyosarcoma

A tumor composed of muscle cells, vascular structures and elements of a sarcoma.

Angionecrosis

Death of a blood vessel or part of a blood vessel.

Angioneurectomy

Surgical removal of blood vessels and nerves.

Angioneurotic edema

Condition in which loose tissues of the body, notably the face and the scrotum in the male, swell up. It may be a manifestation of an allergy or emotional disorder.

Angioplasty

An angiographic procedure for eliminating of areas of narrowing in the blood vessels, such as by inflation of a balloon within the vessel or by laser vaporization of an occlusion within a vessel. Percutaneous transluminal angioplasty is the dilatation of a blood vessel by means of a balloon catheter inserted through the skin and through the lumen of the vessel to the site of narrowing, where inflation of the balloon flattens the plaque against the vessel wall.

Procedure

A cardiologist inserts a balloon-tipped catheter into a large artery (usually the femoral artery) and threads then catheter through the connecting arteries and aorta to the narrowed or blocked coronary artery. Then the cardiologist inflates the balloon to force the atheroma against the arterial wall and thus open the artery.

Often, a collapsed tube made of wire mesh (a stent) is placed over the inflated balloon at the catheter’s tip and inserted with the catheter. When the catheter reaches the atheroma, the balloon is inflated, opening up the stent. Then the balloon-tipped catheter is removed, and the stent is left in place to help keep the artery open.

Angiosarcoma

Rare cancer originating in the blood vessels of the liver. An angiosarcoma may be caused by exposure to vinyl chloride in the workplace, such as the manufacture of polyvinyl chloride, or by exposure to arsenic. However, in most people, there is no discernible cause.

Angiosclerosis

Hardening of the walls of the vascular system.

Angioscope

A long fine surgical viewing instrument threaded into a patient’s blood vessels, to allow surgeons to observe and perform operations without large incisions.

Angiospasm

Spasmodic contraction of the muscular coats of the smaller arteries.

Angiostenosis

Narrowing of a tube or passage, especially a blood vessel (artery).

Angiostomy

Operation making an artificial fistulous opening into a blood vessel.

Angiotensin

Hormone formed from angiotensinogen (a blood plasma constituent) by certain cells in the kidney. When in contact with renin (also produced by the kidney), a substance is formed that raises blood pressure.

Angle-closure glaucoma

A disorder characterized by attacks of suddenly increased pressure within the eyeball, usually on one side with severe pain and loss of vision, caused by acute obstruction of aqueous drainage within the eye.

Angst

In existentialist philosophy, a feeling of dread arising from an awareness of free choice.

Angström unit

Unit for measuring wavelengths of ultraviolet light, X-rays or radium. The unit is equivalent to one-hundred-millionth of a centimeter.

Anguish

1.  Extreme pain or distress of either body or mind.

2.  Any keen affection of the emotions or feelings.

Anhedonia

Absence of the capacity to experience pleasure, particularly in the sense of absence of pleasure-unpleasure feeling in situations where it is normally present.

Anhydremia

Lessening or lowering of the watery constituents in the blood.

Anhydrosis

Abnormal decrease or absence of sweat.

Anileridine

A drug with analgesic and narcotic properties used before and after operations.

Aniline

An oily compound obtained from the dry distillation of coal and much used in the preparation of dyes. It is an important cause of serious industrial poisoning associated with malfunction of bone marrow as well as blood disorders.

Anilingus

The practice of stimulating the anus with the tongue or mouth.

Anima, animus

Terms of Carl Jung describing the unconscious female image in men and the unconscious male image in women.

Animal magnetism

Any force or power in certain individuals said to give them the ability to induce hypnosis.

Animalism

The state of being actuated by sensual appetites only.

Animism

The belief that anything that moves is alive.

Aniridia

Absence, complete or partial, of the iris.

Aniseikonia

A defect in the lens of one eye that results in its seeing an image that differs in size and shape from the image seen by the other eye.

Anisocoria

Inequality in the diameter of the pupils of the eye.

Anisocytosis

Unequal size of the red blood corpuscles and an indication of the presence of a blood disease.

Anisomelia

Unequal length of limbs.

Anisorhythmia

Absence of synchronism in rate of the atria and ventricles or irregular heart action.

Ankle

The joint connecting the foot and the leg.

Ankle clonus

Greatly increased ankle jerk reflex and a sign to the doctor of a disorder of the nervous system.

Ankle fracture

This may occur with or without dislocation or subluxation. Usually the foot is anchored to the ground while the momentum of the body continues forwards. The most important forces are external rotation and either abduction or adduction of the ankle. The ankle is swollen and painful and the deformity is obvious.

Conservative treatment and plaster immobilization for 6-12 weeks can be used when there is little or no placement or when there has been a very accurate reduction. The foot is placed at a right ankle to the leg and must be in a neutral position.

Surgery is required to ensure perfect reduction and to maintain it in unstable fractures, to remove soft tissues which are intervening in the fracture and to repair the ligamentous damage.

It has been pointed out that the ankle mortise depends on the correct length of the fibula and the integrity of the anterior and posterior tibiofibular ligaments. The fibula with its taut elastic attachment to the tibia takes absolute priority over the medial ankle.

Damage to the tibiofibular syndesmosis can be reduced from the level of the fracture. A fracture of the fibula at the level of the ankle or below this is never associated with a lesion of the syndesmosis. By contrast, a fracture of the fibula above this level is always associated with a lesion of either the anterior or the posterior tibiofibular ligament.

Ankle jerk

Reflex jerk of the foot produced by the calf muscles when the Achilles tendon at the back of the heel is tapped with a hammer.

Ankle sprain

Injury of the ankle. Acute capsular sprains of the ankle are probably the commonest single type of sports injury. The classic injury is one of inversion and internal rotation which results in sprain of the lateral ligament complex. In the acute injury with local pain and swelling the treatment is by strapping or plaster depending on the severity of the problem.

After 2-3 weeks the lesion resolves; more problematical is the less acute sprain which is often ignored because of the paucity of signs, the only gross physical sign being limitation of movement although careful inspection from behind shows filling of the sulcus on either side of the Achilles tendon due to backward bulging of the joint. This injury requires immobilization for it can be the precursor of a chronic sprained ankle.

Chronic sprained ankle

When a sprain has become chronic the local tender area in the capsule is demarcated and treated with ultrasound, manipulation under local or general anaesthesia and local steroid injections. The ankle may have to be rested in plaster (below-knee) for 3-4 weeks, and a raise and floaty may have to be applied to the heel of the shoe (usually 5 mm).

Ligament tears

In football, soccer and rugby the ankle is particularly vulnerable to sliding tackles or a clash of feet and the anterior fibres of the lateral ligament are torn with tenderness and swelling over the front aspect of the lateral ankle. When the opposing player’s boot comes through in a tackle from behind the posterior and middle fibres of the lateral ligament may be damaged.

There is local pain and swelling on the lateral aspect of the ankle and severe bruising may be seen extending posteriorly to the Achilles region and on the dorsum and sole of the foot. Instability may be shown by stress firms, an arthrogram (special X-ray of the joint) or CT-scan may be used in acute tears to show the extent of ligamentous damage.

Treatment may be conservative or surgery. A walking cast may be applied for 3-4 weeks. Some doctors do not advocate repair of the lateral ligament unless instability is present in two planes and an arthrogram shows major damage. At surgery the joint is cleared of clotted blood and the shredded ligaments opposed with dexon. The foot is placed in slight valgus initially to take the strain off the suture line.

A plaster is worn for 3-4 weeks and mobilization exercises should be designed to regain full inversion before competition is resumed, especially football and soccer. Surgery is recommended in cases of chronic recurrent instability.

Ankle tonus reflex

Clonic (spasmodic) contractions of the calf muscles in response to pressure against the sole of the foot.

Ankylating agents

A group of chemotherapy drugs that target the DNA of cancer cells to prevent the cells from growing or reproducing. Alkylating agents attack cancer cells in all phases and disrupt their growth. These cells are then destroyed.

Ankylocolpos

Narrowing of the vagina from adhesions.

Ankylose

To fuse together. This term is normally used when referring to joints in which the two surfaces are fused together by disease or are fixed together by surgical operation, the result being that the joint becomes solid and is no longer usable.

Ankylosing spondylitis

Inflammation of the spine and large joints, resulting in stiffness and pain. The disease is 3 times more common in men than in women, developing most commonly between the ages of 20 and 40. Its cause is not known, the disease tends to run in families, indicating that genetics plays a role.

Mild to moderate flare-ups of inflammation generally alternate with periods of almost no symptoms. The most common symptom is back pain, which varies in intensity from one episode to another and from one person to another.

Pain is often worse at night and in the morning. Early morning stiffness that is relieved by activity is also very common. Pain in the lower back and the associated muscle spasms are often relieved by bending backward.

Therefore, people often assume a stooped posture, which can lead to a permanent bent-over position. In others, the spine becomes noticeably straight and stiff.

Ankylosis

The fusion of bones of a joint, often in an abnormal position as a result of disease or injury, or intentionally through surgery.

Anlage

The initial accumulation of cells in a growing organ or part.

Ann Arbor Staging System

Used to describe the areas in the body affected by a lymphoma. It was created at a conference held in Ann Arbor, Michigan.

Annoyance

The physical or mental discomfort caused by something that angers or irritates.

Anochia

Congenital absence of a nail or nails.

Anodyne

Any medicine that allays pain.

Anomaly

Something contrary to the general rule or to what is expected.

Anomia

Optic aphasia, the inability to recognize names or to recognize objects.

Anopheles

The generic name of a group of mosquitoes, which, when infected with the organisms causing malaria, may transmit the disease to human beings by biting.

Anorchus

A male with congenital absence of testicles in the scrotum. A condition with undescended testicles may also exist.

Anorectal abscess

A pus-filled cavity caused by bacteria invading a mucus-secreting gland in the anus and rectum. An abscess may be deep in the rectum or close to the opening of the anus. An abscess develops when bacteria invade a mucus-secreting gland in the anus or rectum, where they multiply.

Antibiotics have limited value except for people who have a fever, diabetes, or an infection elsewhere in the body. Usually, treatment consists of cutting into the abscess and draining the pus after a local anesthetic has been given.

Anorectal fistula

An abnormal channel from the anus or rectum usually in the skin near the anus but occasionally to another organ, such as the vagina. The only effective treatment is surgery to remove the fistula. During surgery, sometimes the sphincter is inadvertently partially cut. If too much of the sphincter is cut, the person may have difficulty controlling bowel movements.

Anorexia

Pathological loss of appetite.

Anorexia nervosa

Eating disorder characterized by a distorted body image, an extreme fear of obesity, refusal to maintain a minimally normal body weight, and in women, the absence of menstrual periods.

About 95% of people who have anorexia nervosa are female. The disorder usually begins in adolescence, occasionally earlier, and less commonly in adulthood. Anorexia nervosa primarily affects people in middle and upper socioeconomic classes.

Symptoms

Anorexia means lack of appetite, but people who have anorexia nervosa are actually hungry and preoccupied with food. They study diets and count calories; they hoard, conceal, and deliberately waste food; they collect recipes, and they prepare elaborate meals for others.

Half of the people who have anorexia nervosa binge and then purge by vomiting or taking laxatives. The other half simply restrict the amount of food they eat. They also frequently lie about how much they have eaten and conceal their vomiting and their peculiar dietary habits, Many also take diuretics to treat perceived bloating.

Diagnosis

The disorder is usually diagnosed on the basis of severe weight loss and the characteristic psychologic symptoms. The typical person with anorexia nervosa is an adolescent girl who has lost at least 15% of the body weight, fears obesity, stops having menstrual periods, denies being sick, and otherwise appears healthy.

Treatment

Treatment has two phases: short-term intervention to restore body weight and save the person’s life and long-term therapy to improve psychologic functioning and prevent relapse.

When the person nutritional status is acceptable and stabilized, long-term therapy is begun. Treatment is aimed at establishing a calm, concerned, stable environment while encouraging the consumption of an adequate amount of food. This treatment may include individual, group, and family psychotherapy as well as drug therapy.

Anorgasmy

Absence of a climax (orgasm) in sexual relations.

Anosmia

Loss of the sense of smell.

Anovulant

A drug that prevents a woman from ovulating, e.g. A birth-control pill.

Anovulation

Cessation of egg-cell production by the ovaries.

Anoxemia

Deficiency of oxygen in the blood.

Anoxia

Lack of oxygen in blood and body tissues. Asphyxia, lung disease, paralysis of respiratory muscles and some forms of coma prevent enough oxygen reaching the blood. Disease of the heart or circulation may also lead to tissue anoxia. Irreversible brain damage follows prolonged anoxia.

Antacids

Mild alkalis or bases taken by mouth to neutralize excess stomach acidity for relief of dyspepsia, including the pain of a peptic ulcer and heartburn.

Antagonism

Opposition to the action of a substance on living cells or tissues.

Antagonist

A term meaning to have a negative effect.

1.  A drug that counteracts the action of another drug.

2.  A muscle that counteracts another muscle.

Anteflexion of the uterus

An abnormal position of the uterus, where it is sharply bent forward (anteflexed).

Antemortem

Existing or happening before death.

Antenatal

Existing or happening before birth. The period between conception and delivery of the child.

Antenatal care

Monitoring of the condition of a pregnant woman and of her unborn child. Advice is given about her diet, the bad effects of smoking, and other matters. One can obtain antenatal care from a family doctor or from a clinic.

Antepartum

Before the onset of labor.

Anterior resection

Surgical removal of the lower portion of the sigmoid colon or upper rectum that is performed through an incision in the lower abdomen.

Anterior root

Bundle of nerve fibers emerging from the front portion of the spinal cord to form a spinal nerve. Also called a motor root because it supplies the muscles with nerves.

Anterior uveitis

Inflammation of the iris or ciliary body of the eye or, more usually, inflammation of both.

Anteversion

Turning or tilting forward; displacement as in the tipping forward of an organ.

Anthelix

An elevated ridge of cartilage in the auricle, the external part of the ear.

Anthelminthic drug

Drug used to treat infections caused by helminths (worms).

Anthelmintic

A medicine that destroys parasitic intestinal worms.

Anthracosilicosis

A form of pneumoconiosis due to breathing coal dust.

Anthracosis

Black lung; the depositing of coal dust in the lungs, occurring mainly in those who work in coal mines. It causes no ill effects.

Anthracyclines

A group of chemotherapy drugs that work by deforming the DNA structure of cancer cells and terminate their biological function. They disrupt the growth of cancer cells, which are then destroyed.

Anthrax

An infection with the gram-positive bacterium Bacillus anthracis that typically involves the skin, lungs, and digestive tract. Anthrax is a potentially fatal disease that usually spreads to people from animals, especially cows, goats, and sheep. Pulmonary anthrax (woolsorter’s disease) results from inhaling the spores of the anthrax bacterium.

People at high risk of contracting anthrax, such as veterinarians, laboratory technicians, and employees of textile mills that process animal hair, can be vaccinated.

Anthrax infection is treated with a combination of antibiotics. Corticosteroids may also be used to reduce any swelling in the throat. The longer treatment is delayed, the greater the risk of death.

Anthropogenesis

The scientific study of the origin of humankind and how it has developed.

Anthropography

The branch of anthropology which studies the geographical distribution of people according to physical type, language, culture, etc.

Anthropology

The study of humans from biological, cultural and social viewpoints. There are two main disciplines, physical anthropology and cultural anthropology, the latter embracing social anthropology.

Anthropometry

The anthropological study of the physical characteristics of humans; originally restricted to measurements of parts of the body, it now includes blood-typing, biostatistics, etc. Anthropometry has contributed considerably to modern ideas of human evolution.

Anthropomorphism

The attribution of human characteristics to that which is not human. It occurs in mythology, religion, literature (especially in fables where animals are credited with human feelings) and in common phrases such as ‘the cruel sea’ and ‘the angry sky.’

Anthropopathism

The attribution of human emotions to a nonhuman thing.

Anthropophobia

A pathological fear of human companionship or of society in general.

Anthroposophy

A spiritual movement developed under Rudolf Steiner, who founded the Anthroposophical Society in 1912. It aims at higher spiritual experience and knowledge, through man’s inner powers independent of the senses. Steiner claimed his ‘spiritual science’ had practical applications, especially in education, and some schools are based on his ideas.

Antiadrenaline

Agent opposing the effects of impulses conveyed by adrenergic postganglionic fibers of the sympathetic nervous system.

Antiallergic agent

Agent that lessens or decreases allergic reactions.

Antianginals

A group of drugs used to treat angina pectoris (chest pain that comes and goes, caused by coronary artery disease).

Anti-angiogenesis agents

Drugs that attack the blood vessels to tumors.

Anti-angiogenesis treatments

Medications and other treatments that prevent cancer growth by limiting the growth of new blood vessels which provide nutrients for cancer expansion.

Antiantitoxin

An antibody that inhibits or counteracts the effects of an antitoxin.

Antianxiety drug

Drug used to treat symptoms of anxiety, feelings of apprehension or danger accompanied by restlessness.

Antiarrhythmic drug

Drug used to help regulate an unusual or abnormal heart rhythm.

Antiasthmatic drug

Drug used to treat symptoms of asthma, including difficulty in breathing and wheezing.

Antibacterial drug

Drug that is destructive to or prevents the growth of bacteria.

Antibacterial serum

Blood serum that can kill bacteria or prevent their growth.

Antibiosis

A relationship between two organisms that is harmful to one, such as in parasitism.

Antibiotics

Substances produced by micro-organisms that kill or prevent the growth of other micro-organisms; their properties are made use of in the treatment of bacterial and fungal infections.

Antibody

A substance produced by body tissue or cells as a reaction to the introduction of a foreign substance (an antigen).

Antibody therapy

The use of antibodies to treat cancer.

Anticholinergic drug

A drug that antagonizes or counteracts the effects of acetylcholine, a natural substance responsible for transmitting nerve impulses from one nerve to another or from a nerve to an organ.

Anticipatory nausea and vomiting

Learned from previous experiences with vomiting; anticipating that nausea and vomiting will occur as it did previously triggers the actual reflex.

Anticipatory reaction

Response by a subject to a stimulus other than the proper stimulus, given by a keyed-up subject, and shown by an extremely short reaction time, in some cases even of almost zero value.

Anticoagulant

Any drug that interferes with blood clotting, used to treat or to prevent thrombosis and clot embolism. The two main types are heparin, which is injected and has an immediate but short-lived effect, and the coumarins (including warfarin), which are taken by mouth and are longer-lasting. They affect different parts of the clotting mechanism, coumarins depleting certain factors made in the liver.

Anticonvulsant drug

Drug used to prevent or treat any disease associated with violent involuntary contractions such as occur in epilepsy.

Anti-D immunoglobulin

Name of a drug used to prevent sensitization to Rhesus antigen.

Antideoxyribonuclease B

An antibody that is measured in blood to diagnose diseases such as rheumatic fever or poststreptococcal glomerulonephritis.

Antidepressants

Drugs used in the treatment of depression; they are of two types: tricyclic compounds and monoamine oxidase inhibitors. Although their mode of action is obscure, they have revolutionized the treatment of depression.

Antidiabetic drugs

Drugs that can lower blood sugar levels adequately in people with type 2 diabetes (also called oral antihyperglycemic drugs). However, they are not effective in type 1 diabetes. Sufonylureas (for example, glypizide) and meglitinides (for example, repaglinide) stimulate the pancreas to produce more insulin.

Biguanides (for example, metformin) and thiazolidinediones (for example, rosiglitazone) do not affect the release of insulin but increase the body’s response to it (insulin sensitizers). A doctor may prescribe one of these drugs alone or with a sulfonulurea drug.

Another class of drug is the glucosidase inhibitors, such as acarbose, which work by delaying absorption of glucose in the intestine.

Oral hyperglycemic drugs are usually prescribed for people with type 2 diabetes if diet and exercise fail to lower the levels of sugar in the blood adequately. The drugs are sometimes taken only once a day, in the morning, although some people need two or three doses. More than one type of drug may be used if one is not adequate.

If oral antihyperglycemic drugs cannot control blood sugar levels well enough, insulin injections alone or in combination with oral drugs may be needed.

Antidiabetics, oral

Medicines taken by mouth to help reduce the amount of sugar present in the blood. They are used to treat certain types of diabetes mellitus (sugar diabetes).

Antidiarrheal drug

Drug used to treat symptoms of diarrhea.

Antidiuretic

An agent that acts to reduce excretion of urine.

Antidiuretic hormone (ADH)

Hormone produced by the posterior lobe of the pituitary gland. It acts on the kidneys and plays a large part in regulating the volume of urine.

Antidote

Drug used to counteract the adverse effects of a drug or chemical.

Antidyskinetics

Medicines used to treat Parkinson’s disease. By improving muscle control and reducing stiffness, these medicines allow more normal movements of the body as the disease symptoms are reduced.

Antiemetic drug

Drug used to control vomiting.

Antifibronyltic drugs

A group of drugs used to treat fungus infections. Those listed as systemic are taken orally or given by injection. Those listed as topical are applied directly to the skin and include liquids, powders, creams, ointments and liniments. Those listed as vaginal are used topically inside the vagina and sometimes on the vaginal lips.

Antiflatulent drug

Drug used to relieve discomfort due to excessive gas (‘wind’) in the stomach or intestines.

Antifungal

Said of an agent destructive to fungi; suppressing the growth or reproduction of fungi.

Antigalactic

Agent which dries up the supply of milk in the lactating breast.

Antigen

A substance capable of combining with antibody and causing a specific immune response by the body. Sometimes used to mean a substance that can combine with an antibody but cannot by itself elicit an immune response.

Antigenic determinant

The specific configuration on the surface of an antigen that determines its ability to react with a corresponding configuration on an antibody.

Antiglaucoma drugs

Medicines used to treat glaucoma. Those listed as systemic are taken orally or given by injection. Those listed as ophthalmic are used as eye drops.

Antiglobulin

Antibody directed against an immunoglobulin molecule.

Antigout drugs

Drugs to treat the metabolic disease called gout. Gout causes recurrent attacks of joint pain caused by deposits of uric acid in the joint.

Antihemophilic factor

A blood protein used to promote blood clotting in hemophilia.

Antihemorrhagic

Something which prevents hemorrhage or bleeding.

Antihistamine

Drug used for its ability to neutralize or antagonize the effects of histamine, a naturally occurring substance; used to relieve the symptoms of allergy. Some of the antihistamines are also used to prevent motion sickness, nausea, vomiting, and dizziness.

Antihormones

Drugs that block hormones.

Antihyperammonemias

Medications that decrease the amount of ammonia in the blood.

Antihyperlipidemic drugs

Drugs used to help control high levels of fats (cholesterol, triglycerides) in the blood.

Antihypertensive drugs

Drugs that can be used to control high blood pressure (hypertension). Those most often given are the diuretics (primarily the thiazides), which promote the natural elimination of excess fluids in the tissues and circulation.

Antiinfective

Relating to any agent used to treat an infection.

Antiinflammatory

Agent drug for reducing inflammation.

Antiinflammatory analgesic

Medicine taken by mouth to relieve some symptoms caused by arthritis or rheumatism, such as inflammation, swelling, stiffness, and joint pain. The medicines do not cure arthritis and will help you only as long as you continue to take it.

Antiinflammatory drugs, non-steroidal (NSAIDS)

A family of drugs not related to cortisone or other steroids that decrease inflammation wherever it occurs in the body. Used for treatment of pain, fever, arthritis, gout, menstrual cramps and vascular headaches.

Antiinflammatory drugs, steroidal

A family of drugs with pharmacologic characteristics similar to those of cortisone and cortisone-like drugs. They are used for many purposes to help the body deal with inflammation no matter what the cause.

Antilymphocyte serum

Full name of ALS.

Antimalarials

A group of drugs used to treat malaria. The choice depends on the precise type of malaria organisms and its developmental state.

Antimetabolite

An agent bearing a close structural resemblance to one required for normal functioning of the body, and exerting its effect by interfering with the utilization of the essential metabolite.

Antimicrobic

Agent acting against or destroying microbes (germs).

Antimigraine

Agent or drug against severe headache or migraine, such as methysergide.

Antimyasthenics

Medicines to treat myasthenia gravis, a muscle disorder (especially of the face and head) with increasing fatigue and weakness as muscles tire from use.

Antimycotic

Agent acting against or destroying fungi.

Antimydriatic

Substance which, when applied to the eye, contracts the pupil.

Antineoplastic drug

Drug used to treat neoplasms (unusual growths of tissue). Cancers are neoplastic diseases.

Antinuclear antibodies

Antibody substances measured in blood to detect a wide variety of diseases, including connective tissue disease, drug-associated disease and others involving the liver, intestines and circulatory system.

Antioxidant

Any substance that inhibits the destructive effects of oxidation, e.g. In the body or in foodstuffs.

Antiparkinsonian

Agent or drug effective in the treatment of Parkinson’s disease.

Antiperiodic

Agent or drug useful against periodic diseases such as intermittent fever.

Antiperistalsis

Peristalsis (involuntary movement of the alimentary tract) taking place in the reverse direction.

Antiphlogistic

An agent that subdues inflammation.

Antipruritic drug

Drug used to relieve itching.

Antipsychiatry

A way of treating people with psychiatric disorders that is derived from psychoanalysis and is opposed to the conventional medical mode, which uses medication.

Antipsychotic

Counteracting or alleviating the symptoms of a psychiatric disorder such as schizophrenia.

Antipsychotic drugs

Drugs used to treat the mental disease of psychosis, including such variants as schizophrenia, manic-depressive psychosis, anxiety states, severe behavior problems and others.

Antipyretic drug

Drug used to reduce fever. The most commonly used drugs are aspirin and paracetamol.

Antirheumatic drug

Drug used to treat arthritis or other rheumatic disease.

Antisepsis

Destruction of germs causing disease, fermentation or putrefaction.

Antiseptic

Substance that kills or prevents the growth of micro-organisms (particularly bacteria and fungi). They are used to avoid sepsis (infection) from contamination of body surfaces and surgical instruments.

Antiserum

Blood serum containing a specific type of antibody.

Antisocial

Aversion of being with people; hostility towards codes of conduct stemming from any organization of people.

Antisocial disorder

Personality disorder characterized by disregard for social obligations, lack of feeling for others and impetuous violence or callous unconcern.

Antispasmodic

An agent that quiets muscle spasm. The drugs reduce spasms (abnormally strong or inappropriate contraction) of the muscles of the gastrointestinal tract, airways, and blood vessels. Antispasmodic drugs are most commonly prescribed to relieve irritable bowel syndrome.

Antistreptolysin

Agent acting against streptolysis, a product of Streptococci. The quantity of antistreptolysin in the blood may be indicative of a recent infection with Strepto-cocci.

Antitetanus

Agent acting against or destroying the tetanus (lockjaw) bacillus.

Antithrombin

A substance which inhibits coagulation of blood by preventing a reaction between thrombin and fibrinogen.

Antithromboplastin

A substance which counteracts thromboplastin, thus interfering with normal blood coagulation.

Antithyroid drugs

Drugs which decrease the amount of thyroid hormones produced by the thyroid gland.

Antitoxin

Antibody produced in the body against the toxin (poison) of a bacteria. They are also formed after inoculation with a toxoid, a chemically inactivated toxin that can still confer immunity.

Antitumor antibiotics

A class of chemotherapy drugs.

Antitussive drug

Drug used to relieve cough.

Anti-ulcer drugs

A group of medicines used to treat peptic ulcer in the stomach, duodenum or the lower end of the esophagus.

Anti-urolithics

Medicines that prevent the formation of kidney stones.

Antiviral drugs

A group of drugs to treat viral infection.

Antivitamin

A substance that makes a vitamin ineffective.

Antivivisection

Opposition to experiments in laboratories conducted on living animals to reveal whether remedies are safe to be used on humans.

Antrum

A natural hollow or cavity, particularly a cavity in bone.

Anuresis

Inability to bring about the act of urination.

Anuria

Total suppression of urine.

Anus

Back passage, the terminal opening of the intestines.

Anvil

The incus, one of the three small bones in the middle ear.

Anxiety

A normal response to a threat or to psychologic stress; experienced occasionally by everyone. Normal anxiety has its root in fear and serves as important survival function. When someone is faced with a dangerous situation, anxiety induces the fight-or-flight response. With this response, a variety of physical changes, such as increased blood flow to the heart and muscles, provide the body with the necessary energy and strength to deal with life-threatening situations, such as running from an aggressive animal of fighting off an attacker.

However, when anxiety occurs at inappropriate times, occurs frequently, or is so intense and long-lasting that it interferes with a person’s normal activities, then it is considered a disorder.

Anxiety complex

Form of neurosis characterized by fear and apprehension at the outcome of any situation; a morbid attitude to personal health and a constant feeling of impending disaster.

Anxiety disorder

Mental disorder characterized by a state of distressing chronic but fluctuating nervousness that is appropriately severe for the person’s circumstances. Anxiety disorders are more common that any other category of mental health disorder and are believed to affect about 10% of adults in developed countries.

However, anxiety disorders often are not recognized by people who have them or by health care professionals and consequently are seldom treated.

Causes

The causes of an anxiety disorder are not fully known, but both physical and psychological factors are involved. Anxiety is viewed at a psychologic level as a response to environmental stresses, such as the breakup of a significant relationship or exposure to a life-threatening disaster.

When a person’s response to stresses is improper or a person is overwhelmed by events, an anxiety disorder can arise. For example, some people find speaking before a group exhilarating, while others dread it, becoming anxious with symptoms such as sweating, fear, rapid heart rate, and tremor.

Symptoms

Anxiety can arise suddenly, as in panic, and gradually over minutes, hours, or days. The anxiety itself can last for any length of time, from a few seconds to years.

Anxiety ranges in intensity from barely noticeable qualms to full-blown panic attacks, during which a person may experience the following symptoms:

•  shortness of breath

•  dizziness

•  increased heart rate.

Anxiety disorders can be so distressing and interfere so much with a person’s life that they can lead to depression. Sometimes the depression develops first and an anxiety disorder develops later.

Diagnosis

The diagnosis of an anxiety disorder is based largely on its symptoms. The ability to tolerate anxiety varies and determining what constitutes abnormal activity can be difficult. A family history of an anxiety disorder (except posttraumatic stress disorder) may help a doctor make a diagnosis.

Treatment

An anxiety disorder must be distinguished from anxiety that occurs in many other mental health disorders, for which different treatment approaches are used.

Depending on the anxiety, drug therapy (benzodiazepines, antidepressants) or psychotherapy (such as behavior therapy), alone or in combination, can significantly relieve the distress and dysfunction for most people.

Anxiety equivalent

Intense physical response or bodily disturbance such as rapid heartbeat or breathlessness which replaces conscious anxiety or fear.

Anxiety neurosis

Condition in which apprehension is objectively out of proportion to any apparent cause.

Anxiety reaction

Part of an anxiety neurosis.

Anxiety state

A psychological neurosis marked by almost continuous anxiety and apprehension with attacks of fear and panic, and characterized by palpitations, shortness of breath, nausea and other physical effects of nervous irritability of the organs.

Anxiolytics

Agents that reduce anxiety. The drugs belong to the group of benzodiazepines, such as Librium and Valium.

Aorta

The main trunk of the arterial blood circulatory system from which all arteries (except the pulmonary) branch. This large artery stems from the heart at the left ventricle.

Aorta, abdominal

That part of the aorta that passes through the abdomen. Important branches are:

•  phrenic arteries

•  celiac artery

•  inferior mesenteric artery

•  superior mesenteric artery

•  suprarenal arteries

•  renal arteries

•  ovarian arteries

•  lumbar arteries

•  middle sacral artery

•  right and left common iliac arteries

Aorta, thoracal

That part of the aorta that passes through the chest (thorax). Important branches are:

•  bronchial arteries

•  esophageal arteries

•  pericardial arteries

•  intercostal arteries

•  mediastinal arteries

•  Phrenic arteries

Aorta-arteriography

X-ray studies, using a series of films, of the circulatory system of the abdomen and a portion of the lower extremities, after injecting contrast medium through a needle or catheter into an artery or vein in the lower part of the body.

Aortalgia

Pain in the aortic artery.

Aortic aneurysm

Blood-filled sac formed by localized swelling of the aorta wall.

Aortic aneurysm, abdominal

Aneurysm that occurs in the part of the aorta that passes through the abdomen (abdominal aorta). An aneurysm is a bulge (dilation) in the wall of an artery, usually the aorta. The bulge occurs in a weak area of the artery’s wall. The pressure inside the artery forces the weak area to balloon outward. If untreated, an aneurysm may rupture, resulting in internal bleeding. A blood cloth (thrombus) often develops in the aneurysm because blood flow inside the aneurysm is sluggish.

Symptoms

People who have an abdominal aortic aneurysm often become aware of a pulsing sensation in their abdomen. The aneurysm may cause pain, typically a deep, penetrating pain mainly in the back. The pain can be severe and is usually unrelenting if the aneurysm is leaking.

When the aneurysm ruptures, the first symptom is usually excruciating pain in the lower abdomen and back and tenderness in the area over the aneurysm. If the resulting internal bleeding is severe, a person may rapidly go into shock. A ruptured abdominal aneurysm is often fatal.

Diagnosis

Pain is a useful but late clue. However, many people with aneurysms have no symptoms and are diagnosed by chance when a routine physical examination or an imaging procedure (such as X-rays or ultrasonography) is performed for another reason.

Usually ultrasonography can clearly show the size of an aneurysm. Computer tomography (CT) of the abdomen, particularly if performed after a radiopacque dye is injected intravenously, can determine the size and shape of an aneurysm more accurately than ultrasonography.

Treatment

Aneurysms that are less than 5 centimeters wide rarely rupture. The only treatment required may be antihypertensive drugs to lower blood pressure. Aneurysms that are wider than 6 centimeters rupture fairly commonly, so surgery is usually recommended. Rupture or threatened rupture of an abdominal aortic aneurysm requires emergency surgery.

Aortic aneurysm, thoracic

Aneurysm in the part of the aorta that passes through the chest (thoracic aorta). An aneurysm is a bulge (dilation) in the wall of an artery, usually the aorta. The bulge occurs in a weak area of the artery’s wall. The pressure inside the artery forces the weak area to balloon outward. If untreated, an aneurysm may rupture, resulting in internal bleeding. A blood cloth (thrombus) often develops in the aneurysm because blood flow inside the aneurysm is sluggish.

Symptoms

Thoracic aortic aneurysms may become huge without causing symptoms. Symptoms result from the pressure of the enlarging aorta against nearby structures and thus depends on where the aneurysm develops. Typical symptoms are:

•  pain (usually high in the back)

•  coughing

•  wheezing

A group of symptoms called Horner’s syndrome may result from pressure on certain nerves in the chest. Symptoms include:

•  a constricted pupil

•  drooping eyelid

•  sweating on one side of the face

Diagnosis

Doctors may diagnose a thoracic aortic aneurysm based on symptoms, or they may discover the aneurysm by chance during a routine physical examination. A chest X-ray taken for another reason may detect an aneurysm. Computed tomography (CT), magnetic resonance imaging (MRI), or transesophageal sonography is used to determine the precise size and location of the aneurysm.

Treatment

If a thoracic aneurysm is 6 centimeters wide or larger, surgical repair using a synthetic graft is usually performed, as for an abdominal aneurysm. Untreated ruptured thoracic aortic aneurysms are always fatal.

Aortic arch

The section of the largest artery (aorta) in the body that forms the curve between the ascending and descending parts.

Aortic arch syndrome

A collection of symptoms resulting from disease that obstructs one or more of the large branches of the aortic arch, commonly the innominate, the left common carotid and the left subclavian arteries.

Aortic coarctation

Narrowing of the aorta, usually just before the ductus arteriosus joins the aorta. Coarctation reduces blood flow in the lower half of the body; therefore, the blood pressure is lower in the legs and tends to be higher than normal in the arms. Coarctation can cause heart murmurs.

Coarctation is usually suspected only when a doctor notices a heart murmur or differences in pulses or blood pressures between the arms and legs when performing a physical examination. X-rays, electrocardiography, and echocardiography are usually used to confirm the diagnosis.

Treatment

Coarctation that does not cause severe symptoms should be surgically repaired in early childhood, usually when the child is about 3 to 5 years old. Infants with severe symptoms from coarctation require emergency treatment, including giving alprostadil to reopen the ductus arteriosus, other medicines to widen the narrowing. Some infants who undergo emergency surgery need more surgery when they are older. Sometimes, instead of surgery, doctors use balloon angioplasty to relieve coarctation.

Aortic dissection

An often fatal disorder in which the inner layer (lining) of the aortic wall tears. Most aortic dissections occur because the artery’s wall deteriorates. Most commonly, such deterioration is associated with high blood pressure, which is present in more than two thirds of people who have an aortic dissection.

Causes

Aortic dissection may be caused by hereditary connective-tissue disorders or birth defects of the heart and blood vessels. Other causes include arteriosclerosis and injury.

Symptoms

Virtually everyone who has an aortic dissection experiences pain - typically sudden, excruciating pain, often described as tearing or ripping. Most commonly the pain is felt across the chest but is often also felt in the back between the shoulder blades.

Diagnosis

The distinctive symptoms of an aortic dissection make the diagnosis obvious to doctors, although the disorder produces a variety of symptoms that sometimes resemble those of other disorders. In about two thirds of people with aortic dissection, pulses in the arms and legs are diminished or absent.

Chest X-rays are the first step in detecting aortic dissection; they show a widened aorta in 90 per cent of people with symptoms. Computed tomography (CT) performed after injecting a radiopacque dye can quickly and reliably detect aortic dissection and thus is useful in an emergency.

Treatment

People with an aortic dissection are admitted to intensive care units, where their vital signs (pulse, blood pressure, and rate of breathing) are closely monitored. As soon as possible, drugs, usually sodium nitroprusside plus a beta-blocker, are given intravenously to reduce the heart rate and blood pressure to the lowest level that can maintain a sufficient blood supply to the brain, heart, and kidneys. Soon after drug therapy begins, doctors must decide whether to recommend surgery.

During surgery, the surgeon removes the largest possible area of the dissected aorta, closes the false channel between the middle and outer layers of the aorta’s wall, and rebuilds the aorta with a synthetic graft. If the aortic valve is leaking, the surgeon repairs or replaces it. Removal and repair of a dissected aorta usually takes 3 to 6 hours, and the hospital stay is usually 7 to 10 days.

Aortic incompetence

Incorrect closure of the aortic valve (between the aorta and the heart), whereby blood may leak back from the aorta to the left ventricle. The most likely cause is rheumatic fever.

Aortic insufficiency

Leakage of the aortic valve each time the left ventricle relaxes. As the left ventricle relaxes to fill with blood from the left atrium, blood leaks backward from the aorta, increasing the volume and pressure of blood in the left ventricle. As a result, the amount of work the heart has to do increases. To compensate, the muscular walls of the ventricles thicken (hypertrophy), and the chambers of the ventricles enlarge (dilate).

Causes

The most common causes of severe or mild aortic valve insufficiency are:

•  weakening of the valve’s usually tough, fibrous tissue due to myxomatous degeneration

•  aortic aneurysms

•  aortic dissection

•  severe high blood pressure

•  valvular birth defect

•  infective endocarditis

Symptoms

Mild aortic valve insufficiency produces no symptoms other than a characteristic heart murmur that can be heard with a stethoscope. People with severe regurgitation may have palpitations. Eventually, heart failure with fluid accumulation in the lungs results.

Diagnosis

Doctors usually suspect the diagnosis based on the results of a physical examination and an enlarged heart seen on an X-ray. Electrocardiography may show signs of an enlarged left ventricle. Echocardiography can show the faulty valve and help cardiologists determine how severe regurgitation is and whether heart valve replacement surgery is needed.

Treatment

Heart failure due to aortic valve insufficiency can initially be treated with drugs. Unless aortic regurgitation is mild, surgery is ultimately almost always required. The damaged valve should be surgically replaced with an artificial valve before the left ventricle becomes irreversibly damaged and heart failure becomes too severe.

Aortic murmur

Symptom of a hereditary or acquired valvular disease.

Aortic regurgitation

Leakage of the aortic valve each time the left ventricle relaxes. As the left ventricle relaxes to fill with blood from the left atrium, blood leaks backward from the aorta, increasing the volume and pressure of blood in the left ventricle. As a result, the amount of work the heart has to do increases. To compensate, the muscular walls of the ventricles thicken (hypertrophy), and the chambers of the ventricles enlarge (dilate).

Causes

The most common causes of severe or mild aortic regurgitation are:

•  weakening of the valve’s usually tough, fibrous tissue due to myxomatous degeneration

•  aortic aneurysms

•  aortic dissection

•  severe high blood pressure

•  valvular birth defect

•  infective endocarditis

Symptoms

Mild aortic regurgitation produces no symptoms other than a characteristic heart murmur that can be heard with a stethoscope. People with severe regurgitation may have palpitations. Eventually, heart failure with fluid accumulation in the lungs results.

Diagnosis

Doctors usually suspect the diagnosis based on the results of a physical examination and an enlarged heart seen on an X-ray. Electrocardiography may show signs of an enlarged left ventricle. Echocardiography can show the faulty valve and help cardiologists determine how severe regurgitation is and whether heart valve replacement surgery is needed.

Treatment

Heart failure due to aortic regurgitation can initially be treated with drugs. Unless aortic regurgitation is mild, surgery is ultimately almost always required. The damaged valve should be surgically replaced with an artificial valve before the left ventricle becomes irreversibly damaged and heart failure becomes too severe.

Aortic stenosis

Narrowing of the aortic valve opening that increases resistance to blood flow from the left ventricle to the aorta. In aortic stenosis, the wall of the left ventricle usually thickens because the ventricle must work harder to pump the blood through the narrowed valve opening into the aorta.

Causes

In younger people, the most common cause is a birth defect, such as a valve with only two cusps instead of the usual three or a valve with an abnormal tunnel shape. Furthermore, aortic stenosis is mainly a disease of older people, the result of scarring and calcium accumulation in the valve cusps. In such cases, aortic stenosis begins after age 60 but does not usually produce symptoms until age 70 or 80.

Symptoms

Chest pain occurs during exertion because the blood supply to the enlarged heart muscle is inadequate. Eventually, heart failure develops, causing fatigue and shortness of breath. People who have severe aortic stenosis may faint during exertion because blood pressure may fall suddenly.

Diagnosis

Doctors usually base the diagnosis on a characteristic heart murmur heard through a stethoscope, on pulse abnormalities, and on results of electrocardiography indicating thickening of the heart wall.

Treatment

Adults who have aortic stenosis but no symptoms should see their doctor regularly and should avoid overly stressful exercises. In adults who have aortic stenosis that causes fainting, angina, or shortness of breath during exertion, the aortic valve is surgically replaced, preferably before the left ventricle is irreversibly damaged.

Aortic valve

A valve at the junction of the aorta and the left ventricle of the heart.

Aortic valve stenosis

Narrowing of the valve that opens to allow the blood to flow from the left ventricle into the aorta and then to the body. To propel blood through the narrowed aortic valve, the left ventricle must pump under very high pressures. Sometimes, not enough blood is pumped to supply the body with oxygenated blood.

Symptoms

Most children with aortic valve stenosis do not develop symptoms other than a heart murmur. In some older children, the defect causes fatigue, chest pain, shortness of breath , or fainting.

In adolescents, severe aortic valve stenosis may lead to sudden death, presumably because of an erratic rhythm caused by poor flow through the coronary arteries to the heart.

Diagnosis

A doctor suspects aortic valve stenosis after detecting a particular murmur or if the child develops symptoms. Cardiac catheterization is often used to determine the severity of the narrowing.

Treatment

For older children with severe narrowing or symptoms, the aortic valve must be replaced or widened. Usually the valve is opened surgically (using a procedure called balloon valvulotomy) or replaced with an artificial one.

Infants with heart failure must have emergency treatment, usually including drugs, and emergency surgery or balloon valvoplasty.

Aortitis

Inflammation of the aorta, either weakening the aortic wall, leading to aneurysm formation, or obstructing the aortic lumen (the cavity inside the aorta) or of the openings of major branches, leading to symptoms and signs of ischemia (a lack of blood to the tissues).

Aortography

Visualization by X-rays of the aorta and its branches after the injection of a contrast medium.

Aortolith

Calcareous deposit in the aortic wall, usually due to atherosclerosis.

Aortomalacia

Softening of the aorta’s walls.

Aortotomy

Incision of the aorta.

Apareunia

Inability to have sexual intercourse.

Apathetic

Not taking any interest in anything, or not bothering to do anything.

Apathy

Lack of feeling or emotion.

Ape hand

Deformity of the hand seen in progressive muscular atrophy and in amyotrophic lateral sclerosis.

Aperistalsis

Absence of peristalsis (involuntary muscular movement of the digestive tract).

Apex

The top of a body, organ or part.

Apex beat

The point of maximum impulse of the heart against the chest wall felt in the 5th left intercostal space. A weak apex beat nay be noted in healthy persons at rest, heart failure, pericardial effusion, emphysema, shock or collapse.

Apexcardiography

A procedure in which a transducer is applied to the apex of the heart, to identify abnormal heart sounds in such conditions as heart valve disease or tumor of the heart muscle.

Apgar score

System of scoring a newborn infant’s physical condition one and five minutes after birth; a score that is given after assessing the condition of a newborn baby in the five areas of heart rate, breathing, skin color, muscle tone, and reflex response. Each area has a maximum of two points.

Aphagia

Inability to swallow.

Aphakia

Absence of the clear lens of the eye.

Aphalangia

Congenital absence of fingers or toes.

Aphasia

Partial or complete loss of the ability to express or understand spoken or written language because of damage to the language areas of the brain. In most people, part of the left temporal lobe called Wernicke’s area and part of the frontal lobe called Broca’s area control language function. Damage to any part of these small, areas by a stroke, a tumor, or head injury or an infection interferes with at least some aspect of language function.

The variety of aphasias reflects the complex nature of language function. Aphasia may involve loss of only the ability to comprehend written words (alexia) or the ability to recall or say the names of objects (anomia).

Aphemia

Inability to utter words, due to emotion or psychoneurosis.

Aphonia

Inability to utter sounds, owing to defect or disease of the larynx.

Aphrasia

Inability to speak connected phrases, though the individual is able to utter separate words.

Aphrodisiac

Anything contributing to sexual excitement.

Aphtha

A small white ulcer occurring usually in the mouth.

Aphthongia

Inability to utter words, because of muscular spasm in the tongue.

Aphthous ulcer

White, often painful ulcer, usually appearing as clusters on the lower lip.

Apicectomy

Excision of the apex of the petrous (hard) part of the temporal bone protecting the inner ear, or the apex of a tooth.

Aplasia

Congenital absence or defective development of a tissue or organ.

Aplastic anemia

Anemia characterized by a drastic fall in the production of all blood cells in the bone marrow.

Apnea

Temporary cessation of breathing.

Apneusis

An abnormal form of breathing caused by brain damage, in which each full inhalation is held for a prolonged period.

Apocrine sweat gland

Gland exhibiting that type of secretion in which the free end of the secreting cell is cast off along with the secretory product.

Apoenzyme

The protein component of an enzyme that determines the enzyme’s specific function but has no physiological effect until it becomes attached to another component (coenzyme).

Aponeurosis

A white, very resistant membrane surrounding the voluntary muscles and large arteries, and covering the skull beneath the scalp.

Apophysis

Bony outgrowth that has never been entirely separated from the bone of which it forms a part.

Apoplexy

Another name for stroke: abolition or sudden diminution of sensation and voluntary movement, resulting from clotting in or rupture of the blood vessels of the brain.

Apoptosis

Programmed cell death; the natural process by which cells kill themselves.

Apostasy

An abandonment of what one has professed; a total desertion or departure from one’s faith or principles.

Apparatus

The system or structure in which a process occurs or an organization functions; a group or system of organs that work together to perform a particular function.

Appendectomy

Surgical excision of the vermiform appendix.

Appendicitis

Inflammation and infection of the appendix. When the appendix becomes inflamed and infected, the process can spread so rapidly that gangrene (tissue death resulting from lack of nutrition when the blood supply to the affected part is decreased or lost) and rupture may set in within a matter of hours.

The chief danger from this is that rupture of the appendix may lead to peritonitis, one of the most serious of all diseases. In the past 30 years the death rate from appendicitis has been reduced by 92-95 per cent.

The death rate could probably be reduced almost to zero by prompt recognition of an inflamed appendix and by avoiding certain hazards in treating it. Unfortunately, the infection cannot be prevented, but early diagnosis makes medical therapy and surgical removal of the organ

Possible before complications set in.

Appendicitis is most prevalent between the ages 10 and 30. However, no age is completely immune. Fortunately, appendicitis is extremely uncommon in the first two years of life.

Signs and symptoms

The three main symptoms of appendicitis are:

•  nausea

•  abdominal pain

•  mild fever in adults.

The pain starts to localize in the lower right part over the appendix area. In young children the fever may be very high, and there may also be vomiting, constipation, or diarrhea. In addition to these symptoms, the doctor looks for positive evidence of an inflamed appendix, such as tenderness over the inflamed appendix when pressure is exerted, or pain in the region of the appendix during an examination through the rectum of the male, or through the vagina in the female patient.

A laboratory test, the white blood count, is also helpful for the doctor in making the diagnosis. An increase in white blood cells can point to signs of an acute inflammation. In some cases the diagnosis may be difficult, because the appendix may be in an unusual position or the symptoms may be atypical.

Treatment

Because the risks involved in operative removal of the appendix (appendectomy) under narcosis are now so small and the dangers of a ruptured appendix are so great, in equivocal cases the physician will be more inclined to operate than risk peritonitis.

Acute appendicitis is usually treated by surgical removal of the diseased appendix. In certain cases, especially mild inflammations, the physician merely prescribes bed rest, no food, and antibiotics. Many cases treated in this way will clear up and not require surgery, but they may recur.

Chronic appendicitis (causing continuous pain for weeks or months) does not occur. Any pain of this sort is indicative of other medical or surgical problems.

One of the major dangers in appendicitis is the use of laxatives. Statistics show that when a person with appendicitis takes a laxative, his chances of dying are three times as great as they would be otherwise.

This is due to the fact that laxatives or cathartics increase intestinal activity and may also increase the pressure within the appendix. The more pressure, the more likelihood that the sac will burst. The same is true for enemas. Delay in operating also lessens the chance of a cure.

Appendicolysis

Surgical cutting of adhesions about the appendix.

Appendicular

Relating to an appendage or limb.

Appendix

Part of the intestines located in the lower right abdomen, at the junction of the small and large intestines, is a little wormlike appendage called the vermiform appendix (vermiform literally means shaped like a worm). This structure is part of the digestive system in herbivorous animals, and it is often as long as the entire large intestine. But in humans it serves no known purpose.

The appendix is a hollow tube, which, it is thought, sometimes becomes plugged by faecal matter or other material. This prevents the normal drainage from taking place, and the appendix then becomes susceptible to infection by bacteria.

One can visualize the situation as a sort of boil that will rupture into the peritoneal cavity unless the body’s defenses overcome the infection or the surgeon removes the inflamed appendix before the boil breaks and discharges its pus.

Apperception

In the original sense, clear perception, in particular where there is recognition or identification. Nowadays in the psychology of education, it is taken as the fundamental process in acquiring knowledge, and the part played by existing knowledge.

Appetite

Immediate desire, commonly associated with food, sexual feelings, etc.; used also to describe an insistent impulse, inherited or acquired and, when congenital, frequently classed as an instinctive impulse.

Appetite suppressant

Medicine used in the short-term (a few weeks) treatment of obesity. For a few weeks (6 to 12), these medicines in combination with dieting, exercise, and changes in eating habits can help patients lose weight.

Applied psychology

The branch of psychology which seeks to apply to practical problems and practical life the methods and results of pure and (especially) experimental psychology.

Appreciation

The quick grasp of a situation or set of actions; the first stage of comprehension.

Apprehension

Mental perception or understanding.

Apprehension span

The largest numbers of objects that can be remembered after a limited period of seeing them.

Approach-approach conflict

A conflict existing within a person who, with two or more desirable but mutually exclusive goals, is temporarily torn between them.

Approach-avoidance conflict

A conflict in which many incentives are at once desirable and undesirable, both positive and negative. For example, the girl likes sweets, but she does not want to get fat. The attitude toward a goal that is at the same time wanted and not wanted and disliked, is called an ambivalent attitude.

Approbation

That state or disposition of the mind in which we assent to the propriety of a thing with some degree of pleasure or satisfaction.

Apraxia

Loss of the ability to perform tasks that require remembering patterns or sequences of movements. Apraxia is usually caused by damage to the parietal or frontal lobes. In apraxia, the memory of the sequence of movements needed to complete simple skilled or complex tasks is impaired.

Some forms of apraxia affects only particular tasks. For example, a person may lose the ability to do any of the following:

•  draw a picture

•  write a note

•  button a jacket

•  tie a shoelace

•  pick up a telephone receiver

•  play a musical instrument.

Occupational therapy may help some people with apraxia to learn to compensate for their losses.

Aprosexia

Inability to maintain concentrated attention.

Apselaphesia

Disorganization of the sense of touch.

Aptitude

Natural ability to acquire relatively general or special types of knowledge or skill.

Aptitude test

A test that predicts performances not yet obtained. The items in the test consist of samples of achievements, that is, of what can be accomplished now.

Apyrexia

Absence of or intermission of fever.

Aquarobics

Aerobic exercises done to music in a swimming pool.

Aqueduct

Canal, usually said of the canal connecting the third and forth ventricles of the brain.

Aqueous humur

The watery fluid that fills the anterior and posterior chambers of the eye between the lens and the cornea.

Arachis oil

Oil expressed from ground nuts. Often used in injections, when drugs such as penicillin are added.

Arachnodactyly

An inherited disorder of connective tissue transmitted as an autosomal dominant trait, resulting in abnormalities of the eyes, circulation system and skeleton.

Arachnoid

The semi-transparent, thin middle membrane that covers the brain and spinal cord.

Arachnophobia

An abnormally strong fear of spiders.

Arbor

A treelike structure or part.

Arboviruses

Viruses that are maintained in nature through transmission between vertebrates and hematophagous arthropods (bloodsucking insects); they multiply in both the vertebrates and the arthropods. Examples of arboviruses are yellow fever and dengue, which are transmitted by mosquitoes.

Archetype

Carl Jung’s term for the content of the collective unconscious. It is used in the sense of the inherited unconscious patterns that Jung held to constitute the fundamental structure of the mind. Archetypes can be observed only through their effects, e.g. Images recurring in dreams, behavior patterns, etc.

Archiblastoma

Tumor of archiblastic tissue. Archiblast is the outer layer which surrounds the germinal vesicle.

Arcus senilis

The opaque white ring that appears in old age around the cornea of the eye because of cholesterol deposits.

ARDS

Abbreviation for ‘acute respiratory distress syndrome,’ respiratory failure with life-threatening respiratory distress and hypoxemia (too little oxygen in the blood), associated with various acute injuries to the lungs.

Arenaviruses

Lymphocytic choriomeningitis and structurally related viruses that are transmitted by rodents and can show man-to-man transmission.

Areola

A small area or space; the colored circle or halo surrounding the nipple.

Argentaffinoma

Growth containing argentaffin elastic fibers. May be located in several body sites but usually in the ileum.

Arginase

An enzyme in the liver that aids the breakdown of the amino acid arginine, producing urea for excretion.

Arginine

An amino acid that is one of the constituents of protein. It is derived from guanidine in plant and animal tissue.

Argyll Robertson pupil

One which reacts to accommodation that is, it contracts when the eyes converge on a near object but not to light. It is a diagnostic sign in syphilis.

Arithmomania

An obsessive interest in counting, and in numerical relations.

Arm

The part of the upper limb between wrist and shoulder.

Armpit

The hollow area under the arm where it joins the body.

Aromase inhibitor

Hormone-related drug used in postmenopausal women with hormone receptor positive breast cancer. Three drugs in this category have been approved for treatment of breast cancer: anastrozole, letrozole and exemestane. They work by blocking en enzyme that makes estrogen in postmenopausal women. However, they cannot stop the ovaries of premenopausal women from making estrogen, and for this reason they only work in postmenopausal women.

Aromatase inhibitors

Drugs that suppress the body’s production of estrogen by reducing production of the enzyme aromatase.

Aromatherapy

The use of oils extracted from plants to alleviate physical and psychological disorders, usually through massage or inhalation.

Arousal

The arousing of a feeling, response, or desire; waking up from sleep, unconsciousness, or a similar state.

Arrector pilli

The minute muscles arising in the skin connected to the hair follicles, which contract when stimulated by cold or fright, causing the hair to stand on end and resulting in the condition called ‘goose-flesh.’

Arrhenoblastoma

A tumor of the ovaries that results in the development of masculine physical characteristics.

Arrhythmia

Sequences of heartbeats that are irregular, too fast, too slow, or conducted via an abnormal electrical pathway through the heart. The heart rate is regulated automatically by the autonomic nervous system, which consists of the sympathetic and parasympathetic divisions. The sympathetic division increases the heart rate through a network of nerves called the sympathetic plexus. The parasympathetic division decreases the heart rate through a single nerve, the vagus nerve.

Causes

The most common cause of arrhythmia is heart disease,, particularly coronary artery disease, heart valve disorders, and heart failure. Some arrhythmias are caused by anatomic abnormalities present at birth (congenital heart defect). Age-related changes in the heart’s electrical system make some arrhythmias more likely. An overactive thyroid gland, producing high levels of thyroid hormone, may cause slow arrhythmias. Sometimes no cause for an arrhythmia may be found.

Symptoms

Some people who have abnormal heartbeats may be aware of them. However, awareness of heartbeats (called palpitations) varies widely among people. Arrhythmias have consequences that range from harmless to life threatening. The seriousness of an arrhythmia may not be closely linked with the severity of the symptoms it causes. Some life-threatening arrhythmias cause no symptoms.

Diagnosis

Often, a person’s description of symptoms can help doctors make a preliminary diagnosis and determine the severity of the arrhythmia. Electrocardiography (ECG) is the main diagnostic procedure for detecting arrhythmias and determining their cause. This procedure provides a graphic representation of the electrical current producing each heartbeat. Usually, ECG records the heart rhythm for only a very short time. Because arrhythmias are often intermittent, a portable ECG monitor (Holter monitor) may be used to record heart rhythm continuously.

Treatment

Most arrhythmias neither cause symptoms nor interfere with the heart’s ability to pump blood. Antiarrhythmic drugs (see data in the table) are useful for suppressing fast arrhythmias that cause intolerable symptoms or pose a risk. Artificial pacemakers are electronic devices that act in place of the heart’s own pacemaker. The most common use of pacemakers is to treat slow arrhythmias.

Arteriagra

Pain in an artery or along an artery.

Arterial bleeding

Blood is bright red and comes in spurts. Arrest by pressure on the proximal side of the vessel (nearest the heart).

Arterial blood gas testing

Method of measuring the levels of oxygen and carbon dioxide in the arterial blood. A sample from a vein cannot be used. Taking a sample from an artery requires skill and may cause a few minutes of discomfort for the person. Usually the sample is taken from an artery in the wrist (radial artery).

Oxygen and carbon dioxide levels are important indicators of lung function because they reflect how well the lungs are getting oxygen into the blood and getting carbon dioxide out of it.

Arterial circulation

It is maintained by the pumping of the heart, elasticity and extensibility of arterial walls, peripheral resistance in the areas of small arteries, and by the quantity of blood in the body.

Arterial varix

An enlarged and tortuous artery.

Arterialization

To change venous blood to arterial blood by oxygenation.

Arteriarctia

Stenosis of constriction of an artery.

Arteriectasis

Stretching or dilatation of an artery.

Arteriectomy

Removal of an artery or part of an artery by surgery.

Arterio-

Combining form indicating artery or arterial.

Arterioatony

Lack of tone in the muscles of the arterial walls.

Arteriogram

Recording of the arterial pulse. The term is also used to denote an X-ray picture of an artery which contains a radiopacque dye.

Arteriography

The visualization of an artery or arterial system by X-ray after the injection of a radio-opaque medium.

Arteriole

A minute artery, especially one which, at its distal end, leads into a capillary.

Arteriology

Science of arteries, usually combined with the study of other vessels.

Arteriomyomatosus

Thickening of the arterial walls due to overgrowth of muscle fibers.

Arteriopathy

Any disease of the arteries.

Arterioplasty

An operation to repair or reconstruct an artery.

Arteriosclerosis

A general term for several diseases in which the wall of an artery becomes thicker and less elastic. There are three types:

•  atherosclerosis

•  arteriosclerosis

•  Mönckeberg’s arteriosclerosis

Atherosclerosis

Atherosclerosis, the most common type, means hardening related to atheromas, which are deposits of fatty materials. It affects medium-sized and large arteries.

Arteriosclerosis

Arteriosclerosis means the hardening of the arterioles, which are small arteries. It affects primarily the inner and middle layers of the walls of the arterioles. The walls thicken, narrowing the arterioles. As a result, organs supplied by the affected arterioles do not receive enough blood. The kidneys are often affected. This disorder occurs mainly in people who have high blood pressure or diabetes. Either of these disorders may stress the walls of arterioles, resulting in thickening.

Mönckeberg’s arteriosclerosis

Mönckeberg’s arteriosclerosis, affects small to medium arteries. Calcium accumulates within the walls of the arteries, making them stiff but not narrow. This essentially harmless disorder usually affects men and women older than 50.

Arteriosclerotic dementia

Dementia attributable, because of physical signs (on examination of the central nervous system) to degenerative disease of the arteries of the brain.

Arteriostenosis

Temporary or permanent narrowing of the interior of an artery.

Arteriosympathectomy

Removal of an arterial sheath containing fibers of the sympathetic part of the autonomic nervous system.

Arteriotomy

Surgical division or opening of an artery.

Arteriovenous

Relating to the arteries and veins.

Arteriovenous fistula

An abnormal channel between an artery and a vein. Normally, blood flows from arteries into capillaries and then into veins. When an arteriovenous fistula is present, blood flows directly from an artery into a vein, bypassing the capillaries.

Causes

Congenital arteriovenous fistulas are uncommon. Acquired arteriovenous fistulas can be caused by any injury that damages an artery and a vein that lie side by side. Typically, the injury is a piercing wound, as from a knife or bullet. The fistula may appear immediately or may develop after a few hours. The area can swell quickly if blood escapes into the surrounding tissues.

Symptoms

When congenital arteriovenous fistulas are near the surface of the skin, they may appear swollen and reddish blue. If a large acquired arteriovenous fistula is not treated, a large volume of blood flows under high pressure from the artery into the venous network. The walls of the veins are not strong enough to withstand such high pressure, so the walls stretch and the veins enlarge and bulge.

Diagnosis

With a stethoscope placed over a large acquired fistula, doctors can hear a distinctive to-and-fro sound, like that of a moving machinery. This sound is called a machinery murmur. Doppler ultrasonography is used to confirm the diagnosis and to determine the extent of the problem.

Treatment

Small congenital arteriovenous fistulas can be cut out or eliminated with laser coagulation therapy. Acquired arteriovenous fistulas are corrected by a surgeon as soon as possible after diagnosis. Before the surgery, a radiopacque dye, which can be seen on X-rays, may be injected to outline the fistula more clearly in a procedure called angiography. If the surgeon cannot reach the fistula easily (for example, if it is in the brain), complex injection techniques that cause clots to form may be used to block blood flow through the fistula.

Arteriovenous malformation

Abnormal, tangled collection of dilated blood vessels that are congenitally malformed, so that the blood from arteries flows directly into veins without the usual resistance of an intervening capillary bed.

Arteriovenous malformation (av malformation)

Abnormal, tangled collection of dilated blood vessels that are congenitally malformed, so that the blood from arteries flows directly into veins without the usual resistance of an intervening capillary bed.

Arteritis

Inflammation of an artery.

Artery

Blood vessel which carries blood from the heart to the tissues.

Arthralgia

Pain, especially neuralgic pain, in a joint.

Arthrectomy

Excision (cutting out) of a joint.

Arthritis

Inflammation of one or more joints, causing pain, swelling, and restriction of movement.

Arthrodesis

Surgical fusion of a joint.

Arthrodynia

Pain in a joint.

Arthrography

The inside of a joint shown by X-rays. It is usually necessary to inject the joint with a substance opaque to X-rays.

Arthropathy

General term for any disease or disorder of a joint.

Arthroplasty

1.  Surgical repair of a joint.

2.  The making of an artificial joint.

Arthroscopy

Direct examination of the interior of a joint by means of an instrument called on arthroscope.

Arthrosis

Any disease causing degeneration of a joint.

Arthrosynovitis

Inflammation of the membrane lining of a joint.

Arthrotomy

A surgical operation that involves cutting into a joint of the body.

Arthus reaction

The development of an inflammatory lesion, which occurs when a person is injected with something to which he or she is overly sensitive (an antigen) that is then attacked by antibodies. The reaction is characterized by the area of the body becoming hard and fluid-filled, with hemorrhage and necrosis (death of tissue) within hours after the injection.

Articulation

1.  A joining or juncture, as of the bones.

2.  Distinct and clear speech.

Artifact

Term applied to products of human activity, as against the results of natural processes.

Artificial insemination

Introduction of sperm into the vagina by means other than copulation. The technique is widely used for breeding livestock as it produces many offspring from one selected male. It has a limited use in treating human impotence and sterility.

Artificial pacemaker

Electronic device that acts in place of the heart’s natural pacemaker (the sinus or sinoatrial node), that is, it generates electrical impulses that initiate each heartbeat. Pacemakers consist of a battery, an impulse generator, and wires that connect the pacemaker to the heart. Some pacemakers are placed directly into the atrium near the sinoatrial node.

Artificial respiration

A method by which air is rhythmically forced into and out of the lungs of a person whose breathing has ceased.

Artificialism

The tendency of children to attribute the occurrence of natural phenomena such as rain or sunshine to artificial causes or to the intentions of a person.

Arytenoid

Ladle-shaped; usually referring to the two cartilages of the larynx to which the vocal cords are attached.

Asbestosis

Asbestosis belongs to the group of occupational lung diseases, which are caused by harmful particles, mists, vapors or gases that are inhaled, usually while a person works. If the lung disease is due to inhaled particles, the term pneumoconiosis is often used. Asbestosis is widespread scarring of lung tissue caused by breathing asbestos dust.

Where in the airways or lungs an inhaled substance ends up and what type of lung disease develops depends on the size and kind of particles inhaled. Large particles may get trapped in the nose and large airways, but very small particles may reach the lungs. There, some particles dissolve and may be absorbed into the bloodstream; most solid particles that do not dissolve, but are removed by then body’s defenses.

Many different kinds of particles can harm the lungs. Some are organic, meaning that they are made of materials that contain carbon and are parts of the building blocks of living organisms (such as grain dusts, cotton dust, or animal dander). Some are inorganic, meaning that they are usually salts of metals (such as asbestos).

Different types of particles produce different reactions in the body. Some particles (animal dander, for example) can cause allergic reactions or a type of asthma. Other particles cause harm not by triggering allergic reactions but by being toxic to the cells of the airways and air sacs in the lung.

Causes

Asbestos is composed of fibrous mineral silicates of different chemical compositions. When inhaled, asbestos fibers settle deep in the lungs, causing scars. Asbestos inhalation also can cause the two layers of membrane covering the lungs (the pleura) to thicken; these thickenings are called pleural plaques.

Symptoms and diagnosis

Inhaling asbestos fibers can occasionally cause fluid to accumulate in the space between the two pleural layers of the lungs; this is called a noncancerous (benign) asbestos effusion.

Asbestos can also caused cancer in the pleura, called mesothelioma, or in the membranes of the abdomen, called peritoneal mesothelioma.

Asbestosis can also cause lung cancer. Lung cancer from asbestos is related in part to the level of exposure to asbestos fibers; however, among people with asbestosis, lung cancer occurs most commonly in those who also smoke cigarettes, particularly those who smoke more than a pack a day.

Prevention

Diseases caused by asbestos inhalation can be prevented by minimizing asbestos dust and fibers inn the workplace. Because industries that use asbestos have improved dust control, fewer people develop asbestosis today, but mesotheliomas are still occurring in people who were exposed as many as 40 years ago.

Treatment

Most treatments for asbestosis ease symptoms. Chemotherapy and radiation therapy do not work well, and surgical removal of the cancer does not cure the cancer.

Ascariasis

Infection with the roundworm Ascaris lumbricoides. After being taken into the body, the larvae migrate first to the lungs, then to the intestines.

Ascaricide

An agent that destroys ascarids (roundworms).

Aschoff’s node

A white mass of Purkinje fibers (a specific impulse-conducting system) found in the heart at the base of the interatrial septum and forming the beginning of the atrioventricular ‘bundle of His.’

Aschoff’s nodule

Nodule in myocardium (heart muscle) and connective tissue in rheumatoid arthritis.

Ascites

The presence of free fluid in the peritoneal cavity of the abdomen.

Ascomycete

A fungus that produces spores sexually inside a membranous, often cylindrical, spore case.

Ascorbic acid

Vitamin C.

Ascorbic acid tolerance

A test to determine the extent of ascorbic acid deficiency; blood levels are measured following the administration of a known amount of vitamin C.

Asemasia

Pathological inability to use or understand language.

Asepsis

Absence of microorganisms; prevention of sepsis.

Aseptic necrosis

The death of bone tissue due to an impaired blood supply. The disorder usually occurs in people between the ages of 30 and 60. It most commonly affects the thigh bone (femur) at the hip. In people older than 50, the bone disorder is usually caused by a hip fracture but may be caused by a disease that blocks the small blood vessels that supply blood to the ends of the long bones.

Causes

Serious injuries can cause the disorder, minor ones do not. There are a number of nontraumatic causes including:

•  alcohol abuse

•  atherosclerosis

•  Gaucher’s disease

•  high doses of corticosteroids

•  hip dislocation

•  hip fracture of the femoral neck

•  radiotherapy

•  sickle cell anemia

•  tumors

Symptoms

In some people, severe incapacitating pain starts suddenly, probably occurring when the blood supply is cut off. However, most people have this bone disorder for some time before symptoms occur. Pain is brought on by standing, walking, or moving the affected bone and generally progress when the person is resting.

Diagnosis

Because the bone disorder is often painless at first, it is often not diagnosed in its early stages, When the disease occurs because of a serious injury, the disorder cannot be detected microscopically for days to weeks and cannot be detected on X-ray until some months later. Magnetic resonance imaging (MRI) is the best test to detect this bone disorder early, so that complications can be avoided.

Treatment

Simple treatment measures include use of nonsteroidal anti-inflammatory drugs (NSIAD’s) or other analgesics for pain, and avoidance of weight-bearing or strain on affected bones and joints,

Often these treatments must be maintained for 6 months or more. Exercises to increase a joint’s range are rarely adequate and do not cure the disorder.

The simplest surgical procedure is called core depression, which involves taking a plug of bone out of the involved area. This procedure is very effective for early disease that has not yet progressed to bone collapse; it may even prevent collapse.

Another procedure is bone crafting, consisting of taking bone tissue with the blood vessels intact from elsewhere in then body and attaching the bone tissue and blood vessels near the diseased bone.

Asexual

Without sex, sexless. In biology it is used in the sense of reproduction by other than sexual action, without the union of male and female germ cells.

Asian influenza

A variant epidemic form of influenza, probably originating in China.

Asparagine

An amino acid found in many plant proteins that can also be produced by humans and animals.

Asperger’s disorder

A pervasive developmental disorder, affecting both mental health and the child’s overall development. The disorder is related to autism but is less severe.

Children with Asperger’s disorder have impaired social interactions similar to those of children with autism, as well as stereotyped or repetitive behaviors and mannerisms and non-functional rituals. However, language skills are normal, and IQ is also normal.

Aspergilloma

Fungus ball; a characteristic form of aspergillosis, which appears on chest X-rays as a dense round ball, capped by a curved sliver of air, in a cavity.

Aspergillosis

An infectious disease of the lung, with occasional spread through the blood, caused by certain fungi of the genus Aspergillus. The fungus appears after antibacterial or antifungal therapy in bronchi damaged by bronchitis, bronchiectasis or tuberculosis.

Asperity

Roughness or harshness to touch, taste, hearing or feelings.

Aspermia

Failure to produce or ejaculate sperm.

Asphyxia

The complex of symptoms due to inability to take oxygen into or excrete carbon dioxide from the lungs. The commonest causes are drowning, suffocation or strangling; inhalation of poisonous gases, obstruction of larynx, trachea or bronchi of the lungs (which can occur in severe cases of croup and asthma). Early artificial respiration is essential.

Aspirate

Fluid drawn by suction from the body for laboratory examination, or to reduce excess fluid.

Aspiration

Ambition. The term aspiration is also used in the following two senses:

1.  The pronunciation of an aspirate (such as the letter H) or the sign that marks one;

2.  The action or use of an aspirator.

Aspiration pneumonia

Pneumonia is an infection of the small sacs of the lungs (alveoli) and the tissues around them. Often, pneumonia is the final illness in people who have other serious, chronic diseases. It is the sixth most common fatal infection acquired in hospitals.

Tiny particles from the mouth frequently dribble or are inhaled (aspirated) into the airways, but usually they are cleared out by normal defense mechanisms before they can get into the lungs and cause inflammation or infection. When such particles are not cleared, they can cause aspiration pneumonia.

Causes

Pneumonia is not a single illness but rather many different ones, each caused by a different microscopic organism; whether it is a bacteria, virus or fungus.

Usually pneumonia starts after organisms are inhaled into the lungs, but sometimes the infection is carried to the lungs by the bloodstream or it migrates to the lungs directly from a nearby infection.

Pneumonia may follow surgery, or an injury (trauma), particularly a chest injury, because of the resulting shallow breasting, impaired ability to cough, and retention of mucus.

Symptoms

The most common symptom of pneumonia is a cough that produces sputum. Other common symptoms include:

•  chest pain

•  chills

•  fever

•  shortness of breath.

These symptoms may vary, however, depending on how extensive the disease is and which organisms causing it.

Diagnosis

In most cases the diagnosis of pneumonia is confirmed with a chest X-ray. For most bacterial pneumonias, the involved tissue of the lung appears on the X-ray as a dense white patch (because the X-ray beam does not get through_), compared with nearly healthy lung tissue that appears black. Viral pneumonias typically produce faint, widely scattered white streaks or patches.

Doctors culture sputum and blood specimens in an attempt to identify the organism causing pneumonia. However, despite these tests, the precise organism cannot be identified in up to half of the people who have pneumonia.

Treatment

Usually, antibiotics are started whenever bacterial pneumonia is suspected (including obstructive pneumonia), even before the bacteria is identified. The prompt use of antibiotics likely reduces the severity of pneumonia and the chance of developing complications, some of which can lead to death.

Antibiotics are not helpful for viral pneumonia. However, antibiotics are given for viral pneumonia that are likely to be followed by bacterial infections, such as those caused by respiratory syncytial virus infection in infants and sometimes those caused by the influenza virus, at least in some people which are very susceptible to pneumonia.

Aspirator

A device that uses suction to remove air, liquids or granular substances from a cavity of the body.

Aspirin

Acetylsalicylic acid, an effective painkiller, which reduces fever and inflammation and also affects blood platelets so that blood does not clot as readily.

Assay

Chemical testing carried out to determine the composition of a substance or the concentration of various components of a substance.

Assertivity training

A behavior therapy technique by which the anxiety felt by many people in interpersonal situations is overcome by encouraging them to express other spontaneously felt emotions in the actual situation.

Assessment

A judgment about something based on an understanding of the situation.

Assimilating

The tendency to distort memory in the direction of familiar objects and experiences, e.g. Reproducing a geometrical form so that the reproduction looks more like a familiar object than the original did.

Assimilation

In the general sense, becoming like, or being like.

Assisted suicide

The suicide of a patient, usually somebody who is terminally ill, that is aided by a carer or especially a doctor, by the express wish and consent of a patient.

Association

Used generally to describe the way a person may find a connection between ideas, feelings or movements in such a way that this calls them readily to mind. This principle and process has been recognized since the time of Aristotle. The laws, in accordance with which connections are established, are known as the laws of association.

Association areas

Portions of the cerebral hemispheres of the brain other than the projection areas. Because their function is unknown, the assumption is made that these areas serve some sort of integrative or associative function.

Association psychology

A pre-experimental branch of psychology, whose basic explanatory principle is the association of ideas.

Association tests

Tests, usually verbal, where the subject responds to a word with another word. Where the subject can respond with the first word that comes to mind regardless of whatever word it is, this is known as a ‘free’ or ‘chance’ test. Where the subject is instructed to respond by giving the antonym or synonym, etc. Of the presented word, this test is known as a ‘controlled association’ test.

Associationism

The name given to a psychological theory, which takes association to be the fundamental principle of mental life, in terms of which even the higher thought processes are to be explained. It is usually combined with sensationalism, and is opposed to theories emphasizing an independent activity of the mind.

Associative thinking

Relatively uncontrolled and undirected thinking as in free association, reverie and dreams.

Astasia

Unsteadiness or tremor, in the contraction of a muscle, or in maintaining a position.

Asteatosis

Any disease in which there is a loss of activity of the sebaceous glands of the skin or scantiness of their secretions.

Astereognosis

Inability to recognize by touch the form of solid objects.

Asterixis

This movement disorder belongs to the group of tremors. A tremor is an involuntary, rhythmic, shaking movement, produced when muscles repeatedly contract and relax. Factors that can make a tremor more noticeable include stress, anxiety, fatigue, alcohol withdrawal, an overactive thyroid gland, consumption of caffeine, and use of drugs that are stimulants. Asterixis is a coarse, slow, nonrhythmic movement that occurs when a person stretches out the arms and extends the hands. This tremor commonly results from liver failure and so has been called liver flap. However, it may also result from kidney failure and brain damage due to a metabolic disorder.

Asthenia

Lack or impairment of strength, as in neurasthenia or psychasthenia. The word asthenic is used to describe depressive feelings or emotions, or of a type of physical build with a small trunk and long limbs.

Asthenic personality disorder

Personality disorder characterized by passive compliance with the wishes of elders and others and a weak inadequate response to the demands of daily life. Lack of vigor may show itself in the intellectual or emotional spheres; there is little capacity for enjoyment.

Asthenic reaction

A psychoneurotic reaction characterized by chronic aches, pains, physical and mental fatigue. It usually occurs in young adults and is believed to result from sustained emotional stress which the individual cannot cope with.

Asthenopia

Weakness of the eye muscles or visual power because of fatigue.

Asthma

Asthma or bronchial asthma is a reversible obstruction of the airways not due to any other disease. Asthma is a common condition which affects up to 5 per cent of the population at some period of their lives.

In recent years there has been a more precise understanding of the underlying mechanisms of the body’s immune defense systems, which have led to more rational guidelines for effective management of the condition. Changes in the immune defense system and in the control of the diameter of the airways are probably responsible for attacks of wheezing.

Characteristics

The most important characteristic of asthma is airway obstruction. The airways of the lungs (the bronchi) are basically tubes with muscular walls. Cells lining the bronchi have microscopic structures, called receptors.

There are three main types of receptors: beta-adrenergic, cholinergic, and peptidergic. These receptors sense the presence of specific substances and stimulate the underlying muscles to contract and relax, thus altering the flow of blood.

Beta-adrenergic receptors respond to chemicals such as noradrenaline and make the muscles relax, thereby widening (dilating) the airways and increasing airflow. Cholinergic receptors respond to a chemical called acetylcholine, making the muscles contract and decreasing airflow.

Causes and stresses

When individuals with sensitive bronchi (airway tubes) are subjected to stresses of different kinds, overt asthma attacks may occur.

Among the known stresses are:

•  respiratory infections

•  certain types of exercise;

•  emotional upset;

•  changes in barometric pressure;

•  changes in temperature;

•  inhalation of cold air;

•  inhalation of such irritants as petrol fumes, fresh paint and other noxious odors;

•  inhalation of cigarette smoke;

•  exposure to specific allergens.

Psychological factors may aggravate an asthmatic attack but are not a primary cause. Persons whose asthma is precipitated by exposure to something to which they are allergic - for instance airborne pollens, molds, house dust, flakes of animal skin -are said to have allergic or extrinsic asthma, but they account for only about 10 to 20 per cent of adult asthma sufferers.

In perhaps 30 to 50 per cent of adult asthmatics, attacks appear not to be triggered by allergens, but by infection, irritants or emotional factors. These are said to have intrinsic asthma.

Symptoms and signs

Asthmatic attacks are characterized by the narrowing of the large and small airways due to spasm of the muscles of the bronchial tubes, edema (excess fluid in the tissues) and inflammation in the inner lining of the airways, and the production of mucus.

Individuals with asthma differ greatly in the frequency and degree of their symptoms. Some have only an occasional attack that is mild in degree and of brief duration, and otherwise are entirely free of symptoms.

Others have mild coughing and wheezing much of the time, punctuated by severe attacks following exposure to known allergens, infections, certain exercise or irritants. An asthma attack may begin acutely with bouts of wheezing, coughing and shortness of breath, or gradually with slowly increasing symptoms and signs of distress of the respiratory system.

In either case, the person usually first notices the onset of breathing that is difficult and becoming more rapid, coughing and tightness or pressure in the chest, and may even notice audible wheezes.

All of this may subside quickly or may persist for hours or days, and abnormalities in the function of the airways and lungs may last for weeks or months after an acute attack.

The cough during an acute attack sounds tight and is generally free of mucus. Except in young children, who rarely expectorate, sputum with mucus is produced as the attack subsides.

In severe episodes, the person may not be able to speak more than a few words at a time without having to stop for breath. Fatigue and severe distress are evident in the rapid, shallow breathing.

Diagnosis

Many children with persistent coughs, particularly at night, and wheezing episodes are regarded as suffering from bronchitis, triggered by infections of the airways. To distinguish between the two, many doctors have children blow deep breaths into a peak-flow meter; this measures the force of the breath.

Recurrent asthma, which may last over several days or even weeks, may follow a single exposure to an allergen over a short period of time with maximum falls in function of airways and lungs occurring during the night. Diagnostic tests include:

•  examination of the blood and the sputum;

•  chest X-rays, CT-scans and MRI-scans;

•  pulmonary (lung) function tests;

•  allergy skin tests;

•  exercise testing.

The diagnosis of asthma should be considered in any individual who wheezes. Asthma is the most likely diagnosis when the typical bouts of wheezing start in childhood or early adulthood and are interspersed with intervals without wheezing. In addition, more than 50 per cent of asthmatics have a family history of allergy or asthma.

Treatment

Treatment is based on two classes of antiasthmatic drugs. The first are anti-inflammatory drugs, which suppress the inflammation that triggers the airways to narrow. The second are bronchodilators, which help to relax and widen (dilate) the airways. Within each of these two classes, several drugs are available. Anti-inflammatory drugs include corticosteroids (which are inhaled, taken by mouth, or given intravenously), leukotrine modifiers and cromolyn. Bronchodilators include: beta-adrenergic agonists and theophylline.

Asthma complications

A number of complications may occur during acute and severe attacks.

Pneumothorax

Air or gas in the pleural cavity (the space between the lung and the membrane that covers it). This occurs when an over-dilated air sac in the lung ruptures, permitting communication between airways and the pleural cavity. It is first seen as a sudden worsening of the person’s respiratory distress, accompanied by sharp chest pains.

Atelectasis

The absence of air in air sacs, commonly called a collapsed lung. This condition usually involves the right middle lobe or an entire lung. Unless the collapse involves a substantial amount of lung tissue, the atelectasis is usually only diagnosed as a result of X-ray examination.

Bronchiectasis

Narrowing of the airways (bronchial tubes). This may lead to greatly limited breathing capacity and recurrent infections. Contrary to popular opinion, uncomplicated asthma rarely leads to chronic emphysema, especially in a nonsmoker. Emphysema is a gaseous distention of the air sacs.

Asthma emergencies

The most important step is the recognition that the degree of severity is notoriously difficult. A good guide is the person’s ability to speak, so that an attack may be considered severe if the person can only utter monosyllables or is completely unable to speak.

Examination of such sufferers may also show an irregular pulse or a heart rate over 130 beats per minute, cyanosis (bluish tinge of the lips, nails, face, etc.) And so on. Such signs suggest a medical emergency, and are indications that the person should immediately be admitted to hospital.

The initial treatment should be the administration of oxygen by face mask, together with an intravenous injection of a hydrocortisone preparation to reduce inflammation, followed by aminophylline that will relax the spasm of the bronchi.

Antibiotic treatment requires definite indications of a bacterial infection. In childhood, associated infections are very often caused by viruses, and are unresponsive to antibiotics, but in the older person, where the asthmatic attack may be superimposed on chronic airways obstruction, early use of an antibiotic may be valuable.

The most frequently used bronchodilator (a drug that widens the airways) is aminophylline. A useful alternative is salbutamol, which is usually given by aerosol inhalation. However, since, in an asthma emergency, the person will almost certainly be unable to use a pressurized aerosol, the doctor will give the medication by other means.

Asthma warning signs

Asthma in young children is not always easy for parents to identify - or even for doctors to diagnose - since it can masquerade as a cold or respiratory infection. Some possible red flags are:

• Wheezing

This seems like an obvious-tip-off, but two thirds of infants under 1 year old who wheeze with respiratory infections do not become asthmatic. If wheezing recurs, it may be asthma.

• Serious coughs

Coughing is an inescapable part of life, but persistent hacking - particularly accompanied by wheezing - is a clear warning. Croup can be another signal if the child has it more than once.

• Play-related problems

If exercise of playing hard typically brings on a fit of coughing, tightness in the chest or more than the usual panting, asthma may be to blame.

• Trouble breathing at night

It is not only bad dreams that spook asthmatic kids. If shortness of breath awakens them at night, suspect asthma.

• Family history

If one parent has asthma, the child is at least three times more likely to have inherited the disease. A strong family history of hay fever and eczema may be another tip-off.

Astigmatism

A malformation of the lens of the eye, such that rays of light are not brought to converge at the same point.

Astraphobia

Irrational fear of thunder and lightning.

Astringent

An agent that contracts the organic tissues and canals of the body, thereby checking or diminishing bleeding or excessive discharges.

Astrocyte

A star-shaped supporting cell in the central nervous system.

Astrocytoma

A tumor composed of astrocytes (neuroglial cells of ectodermal origin, characterized by fibrous cytoplasm); the most common type of primary brain tumor.

Some astrocytomas grow slowly and may initially cause only seizures. Others grow fast and are cancerous; they can produce various symptoms of brain dysfunction. Symptoms vary depending on the tumor’s location. Tumors in the frontal lobes (located behind the forehead) can cause weakness and personality changes. Tumors in the parietal lobes (located behind the frontal lobes) can cause loss or changes in sensation. Tumors in the temporal lobes can cause seizures and, if they develop on the dominant side, the inability to understand and use language. Tumors in the occipital lobe (toward the back of the head) can cause partial loss of vision in both eyes.

Treatment of a brain tumor depends on its location and type. When possible, the tumor is removed surgically. Most cancerous brain tumors are treated with a combination of surgery, radiation therapy, and chemotherapy.

Asylum

An institution for receiving and maintaining persons laboring under certain bodily defects or mental maladies.

Asymbolia

Inability, owing to a brain disorder, to use or understand language.

Asymmetry

When the two sides of the body do not match, particularly with respect to paired members such as the hands, but also used of vision, where one eye operates more strongly than the other in convergence.

Asymptomatic

Showing or causing no symptoms.

Asynergy

Inability, owing to a disorder of the cerebellum of the brain, to carry out complex actions depending on the coordination of different muscle groups.

Asystole

Faulty contraction of the ventricles of the heart, preventing it from performing a complete systole (contraction).

Ataractic

Term used to describe a drug or other agent that produces calm and peace of mind.

Atavism

The inheritance by an individual of characteristics not shown by its parents. Once thought to be throwbacks to an ancestral form, atavisms are now known to be primarily the result of the random reappearance of recessive traits, though they may also result from aberrations in the development of the embryo or from disease.

Ataxia

Impaired coordination of body movements resulting in unsteady gait, difficulty in fine movements and speech disorder.

Ataxia telangiectasia

A hereditary progressive disease characterized by ataxia from a disease of the cerebellum of the brain, telangiectasias (abnormally dilated small arteries and capillaries), recurrent infections and variable defects of the immune system.

Atelectasis

A condition in which all or part of a lung becomes airless and contracts. Atelectasis may be an acute or chronic condition. The most common cause of atelectasis is an obstruction of a large bronchus (one of the two main branches of the trachea leading directly to the lungs). Smaller airways can also become blocked.

Causes

The obstruction may be caused by a plug of mucus, a tumor, or an inhaled foreign object inside the bronchus. Alternatively, the bronchus may be blocked by something pressing from the outside, such as a tumor, enlarged lymph nodes, or a significant amount of fluid (pleural effusion) of air (pneumothorax) in the pleural space.

When an airway becomes blocked, the air in the small air sacs of the lung (alveoli) beyond the blockage is absorbed into the bloodstream, causing the alveoli to shrink and retract. The collapsed lung tissue commonly fills with blood cells, serum, and mucus and becomes infected.

Symptoms

The loss of functioning lung tissue leads to shortness of breath. The persistence of blood flow through the collapsed area leads to a decrease in the blood oxygen level: the heart rate increases, and sometimes the person may look bluish (a condition called cyanosis).

Widespread atelectasis resulting from deficient or ineffective surfactant produces:

•  shortness of breath

•  rapid, shallow breathing

•  low blood oxygen level

•  fever

•  low blood pressure

Slowly developing atelectasis may cause no symptoms or only minor ones, such as shortness of breath or an increased heart rate.

Diagnosis

Doctors suspect atelectasis based on a person’s symptoms, the physical examination findings, and the setting in which the symptoms occur.

A chest X-ray that shows the airless area confirms the diagnosis.

Treatment

The primary treatment of massive atelectasis is correction of the underlying cause. Antibiotics are given for an infection. In treatment of atelectasis due to deficient or ineffective surfactant, attention is directed at treating the low blood oxygen (often with mechanical ventilation) and its effect promptly and at identifying and treating the underlying condition.

Atelocardia

Congenital anomaly with incomplete development of the heart.

Athero-embolic renal disease

Clinical syndrome involving either rapid deterioration of kidney function or a more slowly progressive kidney failure, depending on the amount of atheromatous material obstructing the renal arteries.

This syndrome may occur spontaneously or as a result of vascular surgery or arteriography, when atheromatous plaque from an artery breaks off to form an embolus and travels via the bloodstream to block a renal artery.

In those with severe erosive disease of the main artery of the body - the aorta - the frequency of this disease is approximately 15 to 30 percent; in those with mild atherosclerosis, peripheral embolism (i.e. Occurring on the outer parts of the body) has an incidence of only about 1 per cent.

Emboli in the kidney occur most commonly in the elderly and the incidence increases with age. Most people with this disorder and failure of the kidney function have high blood pressure.

Signs of peripheral embolism such as painful muscle nodules or overt gangrene strongly suggest the diagnosis, but these are not often present. There are no distinctive laboratory findings or abnormalities of the urine sediment. Diagnosis is confirmed only by biopsy of the kidney.

No treatment reverses the failure of the kidney function. Those with athero-embolic renal disease and advanced insufficiency of the kidney do not regain normal kidney function even transiently. Surgical experience involving severe atherosclerosis of the aorta has shown that careful technique can minimize the likelihood of athero-embolism of the renal arteries.

Atherogenesis

The origination and formation of fatty deposits in arteries.

Atheroma

A mass or plaque of degenerated thickened arterial intima, occurring in atherosclerosis. The wall of an artery is composed or several layers. The lining or inner layer (endothelium) is usually smooth and unbroken. Atherosclerosis begins when the lining is injured or diseased. Then certain white blood cells called monocytes are activated and move out of the bloodstream and through the lining of an artery into the artery’s wall.

Inside the lining, they are transformed into foam cells, which are cells that collect fatty materials, mainly cholesterol. In time, smooth muscle cells move from the middle layer into the lining of the artery’s wall and multiply there.

Connective and elastic tissue materials also accumulate there, as may cell debris, cholesterol crystals, and calcium. This accumulation of fat-laden cells, smooth muscle cells, and other materials forms a patchy deposit called an atheroma or atherosclerotic plaque. As they grow, atheromas thicken the artery’s wall and bulge into the channel of the artery. They may narrow or block an artery, reducing or stopping blood flow.

Atheromatosis

Generalized atheromatous condition due to the development of atherosclerosis.

Atheronecrosis

Necrosis or degeneration accompanying arteriosclerosis.

Atherosclerosis

A condition in which patchy deposits of fatty material (atheromas or atherosclerotic plaques) develop in the walls of medium-sized and large arteries, leading to reduced or blocked blood flow. Atherosclerosis can affect the medium-sized and large arteries of the brain, heart, kidneys, other vital organs, and legs. Atheromas may be scattered throughout medium-sized and large arteries, but they usually form where the arteries branch; presumably because the constant turbulent blood flow at these areas injures the artery’s wall, making these areas more susceptible to atheroma formation.

Risk factors

Risk factors for atherosclerosis include:

•  smoking

•  high levels of cholesterol in the blood

•  high blood pressure

•  diabetes

•  obesity

•  physical inactivity

•  high levels of homocysteine

The above-mentioned risk factor can usually be modified. Risk factors that cannot be modified include having a family history of early atherosclerosis (that is, having a close relative who developed the disease at a young age), advancing age, and male sex. Men have a higher risk than women, although women who have coronary artery disease are more likely to die than men who have the disease.

Symptoms

Usually, atherosclerosis does not produce symptoms until it narrows the interior of an artery by more than 70 per cent. Symptoms depend on where the narrowing or blockage, which can occur almost anywhere in the body, is. If arteries supplying the heart are narrowed, chest pain can result; if they are blocked a heart attack can result. Blockage in the arteries supplying the brain can cause a stroke. Narrowing of the arteries in the legs cause leg cramps.

Typically, symptoms develop gradually, as the atheroma slowly narrows an artery. However, sometimes the first symptoms occur suddenly because the blockage occurs suddenly, for example, when a blood clot lodges in an artery narrowed by an atheroma, causing a heart attack or stroke.

Treatment

When atherosclerosis becomes severe enough to cause complications, the complications themselves must be treated. Complications include angina, heart attack, abnormal heart rhythms, heart failure, kidney failure, stroke, and leg cramps.

Atherosclerotic plaque

A mass or plaque of degenerated thickened arterial intima, occurring in atherosclerosis. The wall of an artery is composed or several layers. The lining or inner layer (endothelium) is usually smooth and unbroken. Atherosclerosis begins when the lining is injured or diseased. Then certain white blood cells called monocytes are activated and move out of the bloodstream and through the lining of an artery into the artery’s wall.

Inside the lining, they are transformed into foam cells, which are cells that collect fatty materials, mainly cholesterol. In time, smooth muscle cells move from the middle layer into the lining of the artery’s wall and multiply there.

Connective and elastic tissue materials also accumulate there, as may cell debris, cholesterol crystals, and calcium. This accumulation of fat-laden cells, smooth muscle cells, and other materials forms a patchy deposit called an atherosclerotic plaque. As they grow, atherosclerotic plaques thicken the artery’s wall and bulge into the channel of the artery. They may narrow or block an artery, reducing or stopping blood flow.

Atherosis

Fatty degeneration of arterial walls.

Athetosis

A condition in which the hands and feet continually perform involuntary, slow, irregular movements, due to brain damage.

Athlete’s foot

Ringworm of the feet, a contagious disease caused by a fungus that grows in wet or damp areas.

Athrombia

Defective clotting of the blood.

Atonic seizures

Atonic seizures or epilepsy is a seizure disorder; periodic disturbance of the brain’s electrical activity, resulting in some degree of temporary brain dysfunction. Normal brain function requires an orderly, organized, coordinated discharge of electrical impulses. Electrical impulses enable the brain to communicate with the spinal cord, nerves, and muscles as well as within itself. When electrical impulses discharge abnormally, a seizure may occur.

Atonic seizures, which occur primarily in children, are characterized by complete loss of muscle tone and consciousness. They are brief, but they cause the child to collapse to the ground, increasing the risk of injury.

Atony

Defect of muscular power. The term is also used in the sense of weakness of every organ.

Atopic dermatitis

A chronic, itching, superficial inflammation of the skin, usually occurring in individuals with a personal or family history of allergic disorders.

Atopy

An inherited tendency to develop asthma, hay fever and other allergies to things that usually provoke no immune reactions in most persons.

ATP

Acronym for adenosine triphosphate.

Atransferrinemic anemia

Anemia due to a disturbance in the movement of iron from storage sites in the body to the developing red cells.

Atresia

Closure of a normal body opening, such as anus or vagina, caused by failure of development or disease.

Atrial fibrillation

An arrhythmia of the heart which results from the continuous and chaotic re-entry of electrical impulses within the muscle of the atrium. Fibrillation is much more common than flutter, and occurs in the same diseases. In young people, the condition is most commonly the result of valvular heart disease. In older persons, atherosclerosis of the arteries of the heart is the major cause.

Arterial fibrillation may be intermittent or sustained. During this rhythm disorder, the contractions of the atria are so fast that the atrial walls quiver. As a result blood is not pumped effectively to the ventricles. During atrial fibrillation, the atrial rhythm is irregular, so the ventricular rhythm, is also irregular.

This arrhythmia of the heart may occur even when there is no other sign of heart disease. However, more often these arrhythmias are caused by such conditions as:

•  rheumatic fever

•  high blood pressure

•  coronary artery disease

•  alcohol abuse

•  overactive thyroid gland

•  birth defect of the heart.

Symptoms

The major symptoms of this condition depend on how fast the ventricles beat. A modest increase in the ventricular rate - to less than about 120 beats per minute - may produce no symptoms. Higher rates cause unpleasant palpitations or chest discomfort.

The reduced pumping ability of the heart may cause weakness, faintness, and shortness of breath. Some people, especially older people, develop heart failure or chest pain.

Symptoms suggest the diagnosis of this atrial disorder, and electrocardiography confirms it.

Treatment

Treatment of this condition is designed to control the rate at which the ventricles contract, to restore the normal rhythm of the heart, and to treat the disorder causing the arrhythmias. Various medicines may achieve these goals. Drugs to prevent the formation of clots and emboli may also be given.

Atrial flutter

An arrhythmia of the heart in which continuous electrical activity within the atrium is organized into regular cyclic waves, producing an atrial rate of between 240 and 400 (approximately 300) beats per minute. This condition may occur in any organic heart disease, but particularly in atherosclerosis, heart attack, valvular heart disease and inflammation of the atrium.

Arterial flutter may be intermittent or sustained. During this rhythm disorder, the contractions of the atria are so fast that the atrial walls quiver. As a result blood is not pumped effectively to the ventricles. During atrial flutter, the atrial rhythm is regular, and the ventricular rhythm, may be regular or irregular.

This arrhythmia of the heart may occur even when there is no other sign of heart disease. However, more often these arrhythmias are caused by such conditions as:

•  rheumatic fever

•  high blood pressure

•  coronary artery disease

•  alcohol abuse

•  overactive thyroid gland

•  birth defect of the heart.

Symptoms

The major symptoms of this condition depend on how fast the ventricles beat. A modest increase in the ventricular rate - to less than about 120 beats per minute - may produce no symptoms. Higher rates cause unpleasant palpitations or chest discomfort.

The reduced pumping ability of the heart may cause weakness, faintness, and shortness of breath. Some people, especially older people, develop heart failure or chest pain.

Symptoms suggest the diagnosis of this atrial disorder, and electrocardiography confirms it.

Treatment

Treatment of this condition is designed to control the rate at which the ventricles contract, to restore the normal rhythm of the heart, and to treat the disorder causing the arrhythmias. Various medicines may achieve these goals. Drugs to prevent the formation of clots and emboli may also be given.

Atrial septal defect

Hole in the wall (septum) that separate the upper chambers (atria) of the heart. This is the most common congenital abnormality found in adults, females especially being affected. Three types occur:

•  a foramen secundum defect, which is the most common

•  a foramen primum defect near the atrioventricular valves, often present in Down’s syndrome

•  a connection between the pulmonary veins and the right atrium in the heart.

The higher pressures on the left side of the heart and the greater compliance of the right ventricle cause a large flow of blood from the left to right and the output of the right ventricle into the pulmonary vessels may be two or three times normal. This high flow is responsible for the pulmonary systemic murmur, and for the delay in closure of the pulmonary valve producing a wide splitting of the second heart sound.

Patients with an atrial septal defect often have no symptoms before reaching 40 years. During adolescence the heart gradually increases in size and some patients develop irreversible pulmonary hypertension, which reduces or reverses the left to right shunt and so alters the physical signs.

Surgical repair of a complete atrioventricular defect should be done early to prevent fixed pulmonary vascular, clearly under age 2 year, and possibly in the second half of the first year. The indication of surgical repair should be taken in the context of the patient’s overall medical state, since many are severely retarded.

Atrioventricular block (av block)

A heart disorder characterized by the electrical impulse (which causes the heart to beat) being blocked between the muscle of the atrium and that of the ventricle, because of abnormal conduction across the atrioventricular node.

Atrioventricular bundle

A bundle of modified cardiac muscle fibers which forms a part of the impulse-conducting system of the heart. It extends from the atrioventricular node a short distance in the intraventricular septum, then divides into two branches which supply fibers to the two ventricles.

Atrium

Either of the two chambers of the heart that receive blood from outside the heart.

Atrophic gastritis

Gastritis is defined as an inflammatory process of the stomach. It is characterized by pain or tenderness, nausea, vomiting and systemic electrolyte changes if vomiting persists. The mucosal lining of the stomach may be atrophic or hypertrophic.

Atrophy or wasting of tissue is a condition more common in the aged. The cause is unknown. Associations that are not fully explained have been noted between gastritis and stomach polyps, stomach cancer, peptic ulcer of the stomach and pernicious anaemia.

No specific pattern of symptoms and/or signs have been identified. Some patients complain of nausea, pain and distress in the region of the stomach, especially after eating, but many have no symptoms at all.

Indirect evidence tends to corroborate the suggestion that there is a strong correlation between chronic gastritis and smoking. However, it is still not known whether smoking per se is a definite cause of chronic or atrophic gastritis.

Corticosteroids have been tried because some patients with atrophic gastritis have antibodies to certain glandular cells in the stomach, and patients with pernicious anaemia (a type of anaemia characterized by defective red blood cell production) may have antibodies to intrinsic factor as well. However, the results of treatment with corticosteroids have generally been disappointing and their routine use is not recommended. Antacids may relieve distress.

Atrophy

Wasting or withering away or failure to develop normally, from lack of food or use.

Atropine

A poisonous crystalline alkaloid used in medicine. Atropine is an ingredient in many gastrointestinal and ophthalmic preparations as well as being contained in plants such as jimsonweed and deadly nightshade (belladonna).

ATS

Anti-tetanus serum; serum to produce artificial passive immunity against tetanus.

Attachment

The act of attaching one thing to another; a bond of affection or friendship.

Attachment behavior

An outward expression of a young child’s need to re-establish contact and reaffirm the bond with the primary caregiver. Attachment is most often displayed when the child is confronted with unfamiliar circumstances.

Attack

A sudden episode affecting a person in apparently good health, or a sudden worsening of a chronic condition.

Attack, cataplectic

A sudden and very brief slumping of the body affecting part or all of the body’s muscles and occurring in certain narcoleptic subjects independently of any epileptic mechanism.

Attack, epileptic drop

An atonic epileptic seizure in which the muscles holding the body upright lose their strength partially or completely for a very short time.

Attention

The process of mental selection in which the individual concentrates on certain elements by considering them apart from their environment. Active attention is a voluntary reaction to outside stimuli.

Attention deficit hyperactivity disorder (ADHD)

Developmentally inappropriate degrees of inattention, impulsiveness, and hyperactivity. People with the disorder generally display some disturbance in each of these areas, but to varying degrees.

Attention span

The length of time that somebody can concentrate effectively on a particular task or activity.

Attenuated virus vaccines

Liquid products of killed germs used for injections to prevent certain diseases.

Attic

That portion of the ear lying above the tympanic cavity.

Attitude

A physical posture, either conscious or unconscious, especially while interacting with others.

Attribute

A fundamental aspect or characteristic of a sensation, with the vanishing of which the sensation vanishes; for example, all sensations must have quality, intensity and duration.

Atypical hyperplasia

A non-cancerous breast disease characterized by a growth of abnormal cells within the breast duct of lobules; can signal an increased risk of developing cancer.

Atypical somatiform disorder

Another name for hypochondriasis.

Audiogram

Graphic record of an individual’s hearing ability through the range of audibility.

Audiovisual aid

Any aid to teaching that combines sound and vision.

Auditory

Relating to hearing or to the sense or organs of hearing.

Auditory nerve

The nerve of hearing (part of the eighth cranial nerve), going from the organs of hearing and the semicircular canals of the ears to the brain.

Auditory projection area

The area in the superior temporal convolution of the cerebral cortex of the brain where the auditory nerve terminates and where hearing is perceived.

Aura

Subjective feelings preceding an attack of epilepsy or migraine. Historically, a term introduced by the 2nd-century Greek physician Galen to describe the sensation of a breath (from the Latin aura, a breath or puff of air) felt by some subjects prior to the start of an epileptic seizure.

Aural

Relating to the ear.

Aural eczematoid dermatitis

Eczema, characterized by itching, redness, discharge, descaling and even fissuring leading to secondary infection, frequently involving the pinna (outer ear) and ear canal.

Auricle

Also called the pinna: the external ear, or that part which is prominent from the head.

Auricular nerve, great

Small nerve (nervus auricularis magnus) originating from components of the second and third cervical segments. It supplies the lower portion of the auricle and the skin over the parotid gland and the angle of the mandible.

Auriscope

An instrument for examining the eardrum.

Aurotherapy

The use of gold salts in the treatment of a disease, especially rheumatic diseases.

Auscultation

Listening with a stethoscope for abnormal heart sounds. In this way one can hear the distinctive sounds caused by opening and closing of the heart valves. Abnormalities of the valves and heart structures create turbulent blood flow that causes characteristic sounds called murmurs. Turbulent blood flow typically occurs as blood moves through narrowed or leaking valves.

However, not all heart diseases cause murmurs, and not all murmurs indicate heart disease. Harmless heart murmurs are common among infants and children because of the rapid flow of blood through small structures of the heart.

As blood vessel walls, valves, and other tissues gradually stiffen in older people, blood may flow turbulently, even when no serious heart disease is present. Also the doctor may hear clicks and opening snaps when an abnormal valve opens. A gallop rhythm (a sound resembling that of a galloping horse), due to one or two extra heart sounds, is often heard in people who have heart failure.

Auscultatory percussion

Auscultation of the heart or lungs at the same time percussion is made.

Australian antigen

An antigen often found in the serum of people who have hepatitis; the blood test for this antigen is used to detect serum hepatitis (Type B), and to differentiate it from Type A hepatitis.

Autism

A disorder in which a young child cannot develop normal social relationships, uses language abnormally of not at all, behaves in compulsive and ritualistic ways, and may fail to develop normal intelligence. Autism, the most common of the pervasive developmental disorders, occurs in 5 of 10,000 children. Symptoms may appear in the first 2 years of life and always before age 3. The disorder is 2 to 4 times more common in boys than in girls.

Causes

The specific cause of autism is not fully understood, although it is clearly a biologically determined disorder. Several chromosomal abnormalities, such as fragile X syndrome, contribute to the development of autism. Prenatal infections, for example, viral infections such as rubella or cytomegalovirus, may also play a role. It is clear however, that autism is not caused by poor parenting, adverse childhood conditions, or vaccination.

Symptoms

Symptoms range from mild to severe and often keep children from functioning independently in school or society. In addition, about 20 to 40% of autistic children, particularly those with an intelligence quotient less than 50, develop seizures before reaching adolescence.

Autistic children develop symptoms in at least 3 of the following areas:

•  social relationships: for example, an autistic child does not cuddle and avoids eye contact;

•  language: about 50% of autistic children never learn to speak; those who learn do so much later than normal and use words in an unusual way;

•  behavior: autistic children are very resistant to changes, such as new food, toys, furniture arrangement, and clothing; they often become excessively attached to particular inanimate objects;

•  intelligence: about 70% of children with autism have some degree of mental retardation - an IQ less than 70.

Diagnosis

The diagnosis is made by close observation of the child in a playroom setting and careful questioning of parents and teachers. Standard tests, such as the Childhood Autism Rating Scale, may help the evaluation.

In addition to giving standardized tests, a doctor should perform certain tests to look for underlying treatable or inherited medical disorders such as diseases of metabolism.

Prognosis and treatment

The symptoms of autism generally persists throughout life. The prognosis is strongly influenced by how much usable language the child has acquired by age 7. Autistic children may benefit from certain intensive behavioral modification techniques. Children whose IQ are normal may be helped by psychotherapy aimed at correcting social difficulties. Special education is crucial and often includes speech, occupational, physical and behavioral therapy within a program equipped to manage children with autism.

Autistic thinking

Mental activity which is controlled by the wishes of the individual, as contrasted with reality thinking, controlled by the conditions imposed by the real nature of objects and events.

Autoantibody

An antibody that acts like a foreign substance (antigen) and may react against normal tissues to cause disease.

Autoantigen

Some substance within the body capable of imitating the production of auto-antibodies.

Autochthonous tumor

Tumor arising in the same host.

Autoclave

A machine that sterilizes objects and equipment using pressurized steam.

Autodigestion

Digestion of tissues or destruction of cells by their own secretions.

Autoeroticism

Refers either to a pleasurable activity in which the self is used as an object (e.g. Masturbation) or to a libidinal attitude, orientation or stage of development. In the former case, the term is used objectively to describe observable behavior; in the latter it is used to describe a hypothesis about a person’s or infant’s disregard of external objects.

Autogenous vaccine

A vaccine produced by culturing a person’s own bacteria; the hepatitis vaccine is an example of this.

Autograft

Transfer of tissue from one location to another in the same individual.

Autohemotherapy

Injecting a person with his own blood.

Autohypnosis

Selfinduced hypnosis; a process by which somebody hypnotizes himself or herself.

Autoimmune disease

A disorder characterized by an abnormal immune reaction of unknown cause. In most cases it is directed against a constituent, often protein in nature, of the person’s own body. This constituent is regarded as a foreign body by the person’s own immune and defense system which forms antibodies (auto-antibodies) against the constituent as it would against any foreign invader.

Autoinfection

Infection transferred from one part of an infected body to one or more additional parts.

Autointoxication

Intoxication or poisoning by toxins developed by one’s own body.

Autokinesis

Significant shifts of judgment or subjective modifications or interpretations of objective data, through the operation of set, attitude or frame of reference.

Autokinetic illusion

Apparent movement of a bright point when it is observed continuously in darkness.

Autologous stem cell infusion

Blood or bone marrow stem cells are taken from a patient in remission. The cells are stored and then reinfused as soon as conditioning with chemotherapy and/or radiotherapy is completed.

Autologous stem cell transplant

A transplant in which you are your own bone marrow stem cell donor.

Autolysis

Digestion or disintegration of tissue by enzymes generated in cells.

Automatism

Usually a complex act performed unconsciously, but in psychological research, sensory automatism is employed to describe the automatic functioning of the senses, which is seemingly of the nature of hallucination.

Automatism, epileptic

More or less coordinated and adapted involuntary motor activity occurring during a state of clouding of consciousness either in the course of or after an epileptic seizure, and usually followed by amnesia of the event.

Autonomic nervous system

That part of the nervous system that regulates involuntary vital functions, such as the activity of the heart and smooth muscle.

Autophobia

Morbid fear of solitude.

Autoplasty

The repairing of injured or diseased parts of the body with tissue from another part of the same body.

Autopolyploid

An individual or strain whose chromosome complement consists of more than two complete copies of the genome of a single ancestral species.

Autoprothrombin

Any of several blood factors formed in the conversion of prothrombin to thrombin.

Autopsy

Dissection and inspection of a body after death to determine the cause of death.

Autopsychosis

Mental disorder in which all ideas are centered round the self.

Autoradiograph

A photograph that reveals how radioactivity is distributed in a specimen or sample, made by exposing a photographic plate to the radiation.

Autoregulation

The maintenance of relative constancy of a physiological process by a bodily part or system under varying conditions; especially the maintenance of a constant supply of blood to an organ in spite of varying arterial pressure.

Autosadism

Sadistic tendencies defensively turned towards the self because of the anxiety and guilt associated with aggression directed towards others.

Autoscope

A device for recording or magnifying small involuntary movements of the body.

Autoscopy

Visual hallucination of an image of one’s body.

Autoserum

A serum used to treat the same patient from which it was taken.

Autosomal dominant

A pattern of inheritance in which half of the offspring will receive the mutated gene and develop the syndrome possessed by the parent.

Autosomes

Those chromosomes that are not sex chromosomes. Humans each have 22 pairs of autosomes.

Autosuggestion

Suggestion, arising from the individual himself. The process of influencing one’s conduct, or state of mind or body, by an idea which one keeps constantly in mind, e.g. To help oneself to get to sleep by telling oneself that one is sleepy.

Autotelic

A term employed to describe a type of character or character trait to indicate the predominance of aims towards self-defense, self-protection and self-development in an individual’s system of purposes.

Autotherapy

The treatment of disease using the person’s own body secretions.

Autotomy

Reflex separation of a part from the body especially in an invertebrate.

Autotopagnosia

Loss of the power to recognize or orient a bodily part due to a brain lesion.

Autotoxemia

Self-poisoning by absorption of a poisonous substance produced in the body.

Autotoxin

A poisonous substance formed within the body and acting against it.

Autotransfusion

The replacement into a person of the actual blood lost by hemorrhage, especially when it occurs into the abdominal cavity.

Autotransplantation

The action of autotransplanting; the condition of being autotransplanted.

Autotrophy

The condition of being autotrophic; the [process by which an autotrophic organism obtains energy from carbon dioxide or carbonates and inorganic substances.

Autovaccination

Vaccination of an individual by material from his own body or with a vaccine prepared from such material.

Auxiliary nurse

Nurse who did not receive formal training.

Av block

Short name for atrioventricular block.

Av malformation

Short name for arteriovenous malformation.

Avascular

Lacking of blood vessels or having a poor blood supply, said of tissues such as cartilage.

Avascular bone necrosis

The death of bone tissue due to an impaired blood supply. The disorder usually occurs in people between the ages of 30 and 60. It most commonly affects the thigh bone (femur) at the hip. In people older than 50, the bone disorder is usually caused by a hip fracture but may be caused by a disease that blocks the small blood vessels that supply blood to the ends of the long bones.

Causes

Serious injuries can cause the disorder, minor ones do not. There are a number of nontraumatic causes including:

•  alcohol abuse

•  atherosclerosis

•  Gaucher’s disease

•  high doses of corticosteroids

•  hip dislocation

•  hip fracture of the femoral neck

•  radiotherapy

•  sickle cell anemia

•  tumors

Symptoms

In some people, severe incapacitating pain starts suddenly, probably occurring when the blood supply is cut off. However, most people have this bone disorder for some time before symptoms occur. Pain is brought on by standing, walking, or moving the affected bone and generally progress when the person is resting.

Diagnosis

Because the bone disorder is often painless at first, it is often not diagnosed in its early stages, When the disease occurs because of a serious injury, the disorder cannot be detected microscopically for days to weeks and cannot be detected on X-ray until some months later. Magnetic resonance imaging (MRI) is the best test to detect this bone disorder early, so that complications can be avoided.

Treatment

Simple treatment measures include use of nonsteroidal anti-inflammatory drugs (NSIAD’s) or other analgesics for pain, and avoidance of weight-bearing or strain on affected bones and joints,

Often these treatments must be maintained for 6 months or more. Exercises to increase a joint’s range are rarely adequate and do not cure the disorder.

The simplest surgical procedure is called core depression, which involves taking a plug of bone out of the involved area. This procedure is very effective for early disease that has not yet progressed to bone collapse; it may even prevent collapse.

Another procedure is bone crafting, consisting of taking bone tissue with the blood vessels intact from elsewhere in then body and attaching the bone tissue and blood vessels near the diseased bone.

Avastin

The first successfully developed compound, actually an antibody, that blocks the growth of new blood vessels in cancers. This drug has significant activity in non-small cell lung cancer when added to standard chemotherapy.

Aversion

A feeling of repugnance toward something with a desire to avoid or turn from it; The term is also used to describe a tendency to extinguish a behavior or to avoid a thing or situation.

Aversion therapy

A method of treatment used in behavior therapy with the emphasis on deconditioning. Effective in some forms of addiction and abnormal behavior.

Avitaminosis

A disease caused by vitamin deficiency.

Avoidance-avoidance conflict

A conflict based on two unattractive alternatives. There is a strong tendency to escape the dilemma by doing something else.

Avoidant disorder

An excessive shrinking from contact with unfamiliar people that is of sufficient severity to interfere with social functioning in peer relationships.

Avoidant personality disorder

A pervasive pattern of social discomfort, fear of negative evaluation, and timidity, beginning by early adulthood and present in a variety of contexts.

Avulsion

A pulling or tearing apart or off, as by surgery or injury.

Awakening

The act or process of waking from sleep.

Awareness

Mere experience of an object or idea, sometimes equivalent to consciousness.

Axanthopia

The inability to see the color yellow.

Axilla

The armpit, the cavity under the upper part of the arm or shoulder.

Axillary lymph node dissection

Removal of lymph nodes in the armpit during the initial surgery; the nodes are then examined by a pathologist to determine if cancerous cells are present.

Axillary nerve

Nerve (nervus axillaris) originating from the fifth and sixth cervical segments; it is derived from the back cord of the brachial plexus. It passes sideward through the armpit and accompanies the posterior circumflex artery around the neck of the upper arm bone. For this reason the nerve is frequently called the circumflex nerve.

On its way to the back of the upper arm bone it sends small branches to the minor teres muscle. The major branches supply the deltoid muscle and also small sensory branches supply the skin overlying the lower portion of the deltoid muscle. The function of the nerve is tested by abduction of the arm towards the horizontal against resistance. The test is best performed when the arm is raised sideward.

Axillofemoral bypass graft

Surgical establishment of a connector between the axillary artery and the common femoral arteries. Used in patients with insufficient blood flow to the legs.

Axis

The pivotal vertebra of the neck on which the head turns.

Axon

A long, single nerve fiber that carries transmitted nerve signals away from the body of the nerve cell.

Axonotemesis

Nerve damage (as from compression or crushing) that affects axons but does not completely sever the surrounding endoneural sheath so that regeneration can take place.

Ayurveda

Naturopathic system of medicine that originated in India and is still widely practiced in Asia. The word ‘Ayurveda’ is composed of two terms, ayus meaning life and veda meaning knowledge or science. Medicine apart, various other aspects of life come within the purview of Ayurveda. In its broadest perspective, it deals with the health and treatment of diseases of man, animals and even plants.

Azathioprine

Synthetic drug that suppresses the body’s immune responses and is widely used during and after transplant surgery to prevent rejection of the transplanted organ.

Azoospermia

Absence of spermatozoa in the semen.

Azotemia

A large accumulation of urea and other nitrogenous waste in the blood resulting from a kidney malfunction.

Azoturia

An excess of urea and other nitrogenous substances in the urine.

Azygography

X-ray examination of the azygos vein (unpaired vein in the chest) after injection of contrast medium.

Azygos vein

Any of a system of three veins which drain the thoracic wall and much of the abdominal wall and which form a collateral circulation when either the inferior or superior vena cava is obstructed; especially a vein that receives blood from the right half of the thoracic and abdominal walls, ascends along the right side of the vertebral column, and empties into the superior vena cava.

B

B cell

A type of white blood cell (lymphocyte), formed in bone marrow and present in blood and lymph, that creates antibodies in response to a specific antigen.

Babcock test

Test for determining the fat content of milk and milk products.

Babesiosis

A cosmopolitan infection of animals by parasites of the genus Babesia. The disease is rare in humans. The organisms are transmitted by hard bodied ticks and produce hemolytic anemia (in which the red blood cells break up) with fever.

Babinski reflex

Also called Babinski’s sign: an abnormal reflex found in certain diseases of the nervous system in which the foot flexes upwards when the sole is stroked.

Babkin reflex

When pressure is applied to an infant’s palms and its head turns to midline.

Baby

An extremely young child; especially an infant. Each newborn is classified as either premature, full-term or post mature, depending on when in the mother’s pregnancy it was born (gestational age).

Babyhood

The period during which a child is considered to be a baby, usually from birth to two or three years.

Bacchanal

From Bacchus, the god of wine; reveling in or characterized by intemperate drinking.

Bachelor plaster

A type of double plaster, with the legs encased from groin to ankles, in full abduction and medial rotation that is, fixed so that both legs remain as far to either side as possible.

Bacillary

Related to or caused by bacilli

Bacillemia

The presence of bacilli in the blood.

Bacilluria

Presence of bacilli in the urine.

Bacillus

Straight-rod-shaped bacteria.

Back

The posterior part of the trunk; the hind part of the body in humans and the upper part in other mammals.

Back pressure-arm lift method

Artificial respiration in which the operator kneels at the head of the prone victim, compresses the chest manually by pressure on the back, and then pulls up the elbows thereby expanding the lungs.

Backache

Lower back pain; also called lumbago.

Backbone

The vertebral column; the spine.

Backing

The metal portion of a dental crown, bridge, or similar structure to which a porcelain or plastic tooth facing is attached.

Backwardness

The quality or state of being dull, not quick of apprehension.

Bacteremia

Invasion of the circulatory system by bacteria.

Bacteria

Any of numerous unicellular (one-celled) micro-organisms of the class Schizo-mycetes, occurring in a wide variety of forms, existing either as free-living organisms or as parasites, and having a wide range of biochemical, often pathological, properties.

Bacterial

Pertaining to or caused by bacteria.

Bacterial endocarditis

Infection of the lining of the heart (endocardium) and usually also of the heart valves. Infective endocarditis affects twice as many men as women of all ages but 8 times as many older men as older women. It has become more common among older people.

Causes

Bacteria are the main cause of infective endocarditis. Although bacteria are not normally found in the blood, an injury to the skin, lining of the mouth, or gums can allow a small number of bacteria to enter the bloodstream. Certain surgical, dental, and medical procedures may also introduce bacteria into the bloodstream. In people with normal heart valves, usually no harm is done, and the body’s white blood cells rapidly destroy these bacteria. However, damaged heart valves may trap the bacteria, which can then lodge on the endocardium and start to multiply. When the number of bacteria in the bloodstream is large enough, endocarditis can develop, even in people who have normal heart valves.

Symptoms

Acute bacterial endocarditis usually begins suddenly with a high fever, fast heart rate, fatigue, and rapid and extensive heart valve damage.

Subacute bacterial endocarditis may produce such symptoms as fatigue, mild fever, a moderately fast heart rate, weight loss, sweating, and a low red blood cell count. These symptoms may occur for months before the endocarditis results in blockage of an artery or damages heart valves and thus makes the diagnosis clear to doctors.

Diagnosis

Because many of the symptoms are vague and general, doctors may have difficulty making a diagnosis. Usually, people suspected of having acute or subacute infective endocarditis are hospitalized promptly for diagnosis as well as treatment. Development of a heart murmur or a change in a pre-existing heart murmur supports the diagnosis. A blood sample is drawn to test for the presence of bacteria. Detecting bacteria in the blood helps doctors make the diagnosis.

Echocardiography, which uses ultrasound waves, can produce images showing heart valve vegetation’s and damage to the heart.

Treatment

Treatment usually consists of at least two weeks and often up to 6 weeks of antibiotics given intravenously in high doses. Antibiotic therapy is almost always started in the hospital but may be finished at home with the help of a home nurse.

Antibiotics alone do not always cure an infection, particularly if the valve is artificial. Heart surgery may be needed to repair or replace damaged valves and remove vegetation’s.

Bacterial sensitivity test

A laboratory procedure to determine which antibiotic drug will be most effectively counteract a specific infection.

Bacterial vaccine

An emulsion of killed, living or attenuated (weakened) bacteria, used for raising the immunity of a person suffering from infection by the same germ.

Bactericidal

Destructive to bacteria; term used to describe a drug that kills bacteria.

Bacteriologist

One who studies and is skilled in the science of bacteriology.

Bacteriology

Study of bacteria, viruses and fungi that cause disease.

Bacteriolysins

Antibodies that dissolve bacteria when complement is present. Complement is a normal body protein needed for antigen-antibody reaction.

Bacteriolysis

The process of dissolving or destruction of bacteria.

Bacteriophage

A submicroscopic, usually viral, organism that destroys bacteria.

Bacteriophobia

A morbid fear of bacteria and other microbes.

Bacteriostasis

An arrest or retardation of growth of the bacteria.

Bacteriostat

A substance that restricts the growth and activity of bacteria without killing them.

Bacteriostatic

A term used to describe a drug that stops the growth or multiplication of bacteria.

Bacteriotherapy

Treatment of a disease or disorder by introduction of bacteria into the bloodstream.

Bacteriotropic

Directed toward bacteria or affecting them in a specific way.

Bacteriuria

The presence of bacteria in the urine.

Bacteroidaceae

A family of extremely varied gram-negative bacteria that usually live in the alimentary canal or on mucous surfaces and are sometimes associated with acute infective processes.

Bag of waters

The double-walled fluid-filled sac that encloses and protects the fetus in the mother’s womb and that breaks releasing its fluid during the birth process.

Bagasse

Plant residue (as of sugarcane or grapes) left after a product (as juice) has been extracted.

Bagassosis

A chronic inflammatory lung disorder induced by the dust of bagasse derived from sugar cane and used in board-making.

Bainbridge reflex

A homeostatic reflex mechanism that causes acceleration of heartbeat following the stimulation of local muscle spindles when blood pressure in the venae cavae and right atrium is increased.

Baker’s cyst

Tiny sac filled with joint (synovial) fluid that forms in an extension of the joint capsule behind the knee. Such a cyst results from an accumulation of trapped joint fluid, which bulges from the joint capsule behind the knee as a protruding sac.

Causes of the joint fluid accumulation include:

•  rheumatoid arthritis

•  osteoarthritis

•  overuse of the knees.

The cysts produce discomfort at the back of the knee. They may enlarge and extend downward into the calf muscles.

A rapid increase in the amount and pressure of fluid within the cyst can cause it to rupture. The fluid released from the cyst can cause the surrounding tissues to become inflamed, resulting in symptoms that may mimic those of thrombophlebitis.

If the cyst has ruptured, the pain is treated with a nonsteroidal anti-inflammatory drug. If the ruptured cyst causes thrombophlebitis in the popliteal vein, this is treated with bed rest, elevation of the leg, compresses and anticoagulants. Occasionally, antibiotics are also needed.

Baker’s itch

Form of dermatitis caused by handling yeast and dough.

Balance

In general sense, maintenance of equilibrium or posture; in the field of esthetics, used to describe the equivalence of value or weight, on the right and left sides of a picture.

Balanitis

Inflammation of the head of the penis (glans penis), usually caused by an infection.

Balanus

Bulbous tip of the penis, the glans of the penis.

Baldness

(Alopecia) Loss of hair, usually from the scalp, due to disease of hair follicles. ‘Male-pattern baldness’ is an inherited tendency, often starting when a man is in his 20s. Alopecia areata is a disease of unknown cause producing patchy baldness.

Balkan beam

Wooden beam attached to a hospital bed whereby a Thomas’s bed splint can be slung up, with pulleys and weights attached.

Ball-and-field test

One of the tests in the Binet-Simon series, in which subjects are asked to show the track they would pursue to find a ball lost in a circular field.

Ballism

Violent, flinging limb movements caused by injury in the area of the subthalamic nucleus of the brain, usually a small stroke. The head is sometimes also affected. The repeated violent movements incapacitate and may exhaust the sufferer.

Ballistocardiograph

Mechanism of measuring the impact by the discharge of blood from the heart at each beat and resulting recoil.

Balloon catheter

A catheter that has two lumens and an inflatable tip which can be expanded by the passage of gas, water, or a radiopaque medium through one of the lumens and that is used to measure blood pressure in a blood vessel or to expand a partly closed or obstructed bodily passage or tube (as a coronary artery).

Ballottement

Diagnostic sign of pregnancy elicited by the doctor placing a finger in the vagina just below the cervix and giving the presenting part of the fetus a slight push, so that it floats away and returns to touch the examining finger.

Balneotherapy

Treatment of disease by medicinal baths, the standard treatment offered at various spas.

Balsam

Mixture of oils and resins derived from certain plants and trees.

Balsam of Peru

A viscous aromatic liquid from the trunks of Central American trees. Used with zinc ointment, it is a mild antiseptic for bedsores.

Band keratopathy

Calcium deposition in Bowman’s membrane and the stroma of the cornea that appears as an opaque gray streak and occurs in hypercalcemia and various chronic inflammatory conditions of the eye.

Bandage

Piece of material used to bind up wounds, hold dressings in place or support injured limbs. Variously shaped pieces of sterilized crêpe, muslin, gauze, cotton, linen or elastic fabric are used.

Bankhart’s operation

Operative procedure for recurrent dislocation of the shoulder joint, in which the defect of the glenoid cavity is repaired.

Banting

A method of dieting for obesity by avoiding sweets and carbohydrates.

Banti’s syndrome

Clinical syndrome characterized by gastrointestinal bleeding, anemia, leukopenia (a great increase of white cells in the blood) and thrombocytopenia (few or no platelets in the blood).

Barber’s itch

Any rash or skin eruption on the face and neck, especially around the beard, caused by a fungal infection.

Barbiturates