Thursday, May 1, 2008
Rocky Mountain spotted fever (RMSF)
Rocky Mountain spotted fever (RMSF): An acute febrile (feverish) disease initially recognized in the Rocky Mountain states, caused by Rickettsia rickettsii transmitted by hard-shelled (ixodid) ticks. Occurs only in the Western Hemisphere. Anyone frequenting tick-infested areas is at risk for RMSF. The onset of symptoms is abrupt with headache, high fever, chills, muscle pain. and then a rash. The rickettsiae grow within damaged cells lining blood vessels which may become blocked by clots. Blood vessel inflammation (vasculitis) is widespread. Early recognition of RMSF and prompt antibiotic treatment is important in reducing mortality. The first person to describe the disease was an ear, nose and throat specialist, Edward Ernest Maxey. Maxey reported the disease in 1899. Seven years later, a pathologist named Howard Taylor Ricketts showed that it was transmitted by a tick bite. The agent that causes the disease was named for him -- Rickettsia rickettsii. Rocky Mountain spotted fever is also called spotted fever, tick fever, and tick typhus.Common Misspellings: rocky mountain spotted feaver (rmsf)
Cancer, lymphoma, non-Hodgkin
Cancer, lymphoma, non-Hodgkin: A lymphoma is a cancer that develops in the lymphatic system. The most common symptom of non-Hodgkin lymphomas is a painless swelling in the lymph nodes in the neck, underarm, or groin. Non-Hodgkin lymphomas are diagnosed with a biopsy of an enlarged lymph node. Follow-up examinations are important after lymphoma treatment. Most relapses occur in the first 2 years after therapy.
Licensed clinical social worker
Licensed clinical social worker: A social worker trained in psychotherapy who helps individuals deal with a variety of mental health and daily living problems to improve overall functioning. A social worker usually has a master's degree in social work and has studied sociology, growth and development, mental health theory and practice, human behavior/social environment, psychology, research methods. Abbreviated L.C.S.W.Common Misspellings: licensed clinincal social worker
Labial sounds
Labial sounds: The lips are not only anatomic features of note, they are organs of speech essential to certain articulations. A sound requiring the participation of one or both lips is a labial (labium in Latin means lip) sound or, simply, a labial. All labials are consonants. There are bilabial sounds such as "p" which involve both lips and labiodental sounds such as "v" which involve the upper teeth and lower lip.
CAT scan, helical
CAT scan, helical: A conventional computerized axial tomography scan (CAT scan or CT scan) is an x-ray procedure which combines many x-ray images with the aid of a computer to generate cross-sectional views and, if needed, three-dimensional images of the internal organs and structures of the body. A CAT scan is used to define normal and abnormal structures in the body and/or assist in procedures by helping to accurately guide the placement of instruments or treatments. A helical CAT scan is a new specialized CAT scan technique that involves continuous movement of the patient through the scanner with the ability to scan faster and with higher definition of internal structures. Helical CAT scanning can permit greater visualization of blood vessels and internal tissues, such as those within the chest cavity. This form of scanner may be particularly helpful in the rapid evaluation of severe trauma injuries, such as those sustained in automobile accidents. A helical CAT scan is also referred to as spiral CAT scan.
Plaque, skin
Plaque, skin: A plaque is a broad, raised area on the skin. Because it is raised, it can be felt (palpated). By definition, a skin plaque has a greater surface than its elevation above the skin surface: it is broader than it is high.
Ophthalmic artery
Ophthalmic artery: The ophthalmic artery supplies blood to the eye and adjacent structures of the face. It arises from the internal carotid artery that courses up deep within the front of the neck.
Disease, sickle cell
Disease, sickle cell: A genetic blood disease due to the presence of an abnormal form of hemoglobin, namely hemoglobin S. Hemoglobin is the molecule in red blood cells that transports oxygen from the lungs to the farthest reaches of the body. Sickle cell disease, also known as sickle cell anemia, affects millions of people throughout the world. It is particularly common among people whose ancestors came from sub-Saharan Africa; Spanish-speaking regions (South America, Cuba, Central America); Saudi Arabia; India; and Mediterranean countries, such as Turkey, Greece, and Italy. In the USA, sickle cell disease occurs in about 1 in every 500 African-American births and 1 in every 1,000-1,400 Hispanic-American births. Sickle cell anemia is caused by an error in a gene that makes the beta globin chain of hemoglobin. The resultant abnormal hemoglobin (sickle hemoglobin) deforms the red blood cells when they are under low oxygen conditions. Children who inherit 2 copies of the sickle gene, one from each parent, have sickle cell anemia. Children who inherit the sickle gene from only one parent do not have the disease, but will carry the sickle cell trait. Individuals with sickle cell trait generally have no symptoms. About 2 million Americans (or 1 in 12 African-Americans) carry the sickle gene. The sickle mutation occurred thousands of years ago. The sickle gene became common in malarious areas because it affords a selective advantage against malaria. In the U.S., Canada, and many other countries where malaria is rare today, the sickle gene can no longer use its anti-malarial advantage. Instead, the sickle gene may be a serious threat to the carrier's children, who may inherit two abnormal sickle hemoglobin genes and have sickle cell anemia. In sickle cell anemia, the hemoglobin molecules tend to aggregate after unloading oxygen. They form long, rod-like structures that force the red cells to assume a sickle shape. Unlike normal red cells, which are usually smooth and deformable, the sickle red cells cannot squeeze through small blood vessels. The sickle cells block little vessels depriving the organs of blood and oxygen. This leads to the periodic episodes of pain and damages the vital organs. Whereas normal red blood cells last about 120 days in the bloodstream, sickle red cells die after only about 10 to 20 days. Because they cannot be replaced fast enough, the blood is chronically short of red blood cells causing anemia -- sickle cell anemia.
Tinea capitis
Tinea capitis: A superficial fungus infection of the skin, affecting the scalp. Also known as ringworm. This disorder occurs most commonly in children, especially those in late childhood and adolescence. It can spread in schools. Tinea capitis appears as scalp scaling that is associated with bald spots (in contrast to seborrhea or dandruff, for instance, which do not cause hair loss).
Macular pucker
Macular pucker: Scar tissue in the macula, the area of the retina responsible for sharp central vision. The scar can blur and distort vision and make straight lines appear wavy. Macular pucker is due most often to age-related shrinkage of the vitreous which pulls away from the retina, causing the retina to scar and wrinkle. Other causes of macular pucker include trauma (from surgery or an eye injury), retinal detachment, inflammation, and problems with the retinal blood vessels. The only treatment is surgery which consists of a vitrectomy (removal of the vitreous) combined with peeling away of the scar tissue. Most patients recover about half of their lost vision, and distortion is significantly reduced. The most common complication of vitrectomy is an increase in the rate of cataract development. Also called epiretinal membrane, retinal wrinkling, premacular fibrosis, and cellophane maculopathy.
Diastrophic dysplasia
Diastrophic dysplasia: An inherited skeletal disorder involving significantly short stature (dwarfism). Characteristic features at birth include short birth length with short limbs (short-limbed dwarfism), "hitchhiker thumb", and clubfeet. Palatal malformations such as cleft palate or submucous cleft of the palate are present in 50% of patients. There is swelling of the ears in the first days to weeks of life in 80% of children; the swelling then spontaneously subsides but later the ears have a "cauliflower" appearance. Fingers are short and broad and show ulnar deviation (are inclined away from the thumb). The thumb itself has a hitch-hiker-type appearance. There is increased death rate in infancy due to problems breathing, but thereafter people with diastrophic dysplasia have a normal life span. Orthopedic problems are common. The joints can be dislocated, especially the shoulder, elbows, hips, and patellae (knee caps). Flexion contractures of the knees and shoulders are common. Scoliosis (sideways curvature of the spine) is not present at birth but often develops and is progresses particularly in the early teen years. Treatment of the scoliosis includes bracing and occasionally, spinal fusion. Progressive kyphosis (forward bending of the spine) can also occur with what is called subluxation (slippage) which can result in compression of the spinal cord. The average length of babies with diastrophic dysplasia at birth is 16 1/2 inches (42 cms). The average adult height is slightly under 4 feet -- 46-47 inches (118 cms) to be exact. The final adult height is influenced by the presence of scoliosis, hip contractures and knee contractures, and foot deformities. Diastrophic dysplasia is inherited as an autosomal recessive condition meaning that the gene for diastrophic dysplasia is on one of the nonsex chromosomes and average-sized parents have a 1 in 4 (25%) chance of having additional children with diastrophic dysplasia. The gene for diastrophic dysplasia is on chromosome 5q32-q33.1 and is called "diastrophic dysplasia sulfate transporter" (DTDST). Prenatal diagnosis has been performed for diastrophic dysplasia by ultrasound and by molecular DNA diagnosis to detect DTDST. Diastrophic dysplasia was first clearly delineated by Maroteaux and Lamy in France in 1960. The term "diastrophic" was borrowed by Lamy and Maroteaux from geology: diastrophism is the process of bending of the earth's crust by which mountains, continents, ocean basins, etc., are formed. Dysplasia means abnormal in form. Common Misspellings: diastrophic displasia, diastrophic diplasia
Hepatitis, viral
Hepatitis, viral: Liver inflammation caused by viruses. Specific hepatitis viruses have been labeled A, B, C, D, E, F, and G. While other viruses, such as the mononucleosis (Epstein-Barr) virus and cytomegalovirus, can also cause hepatitis, the liver is not their primary target.
TIPS
TIPS: TIPS stands for "transjugular, intrahepatic, portosystemic shunt." It is a shunt (tube) placed between the portal vein which carries blood from the intestines to the liver and the hepatic vein which carries blood from the liver back to the heart. It is used primarily (but not exclusively) in patients with cirrhosis in which the scar tissue within the liver has blocked the flow of blood passing through the liver from the portal vein to the hepatic vein. The blockage increases the pressure in the portal vein leading to an increase in pressure in the portal vein (portal hypertension). As a result of the increase in pressure, blood flows around the liver via small, unimportant veins that connect the portal vein with other veins within the abdomen. These veins enlarge and are referred to as varices. Unfortunately, one of the places varices form is in the stomach and lower esophagus, and these varices have a tendency to bleed massively, frequently causing death from exsanguination. By providing an artificial path for blood traveling from the intestines, through the liver, and back to the heart, TIPS reduces the pressure in the varices and prevents them from rupturing and bleeding. There are several types of shunts that are placed surgically. TIPS is a non-surgical way of placing a portosystemic shunt. The shunt is passed down the jugular vein in the neck by a radiologist using x-ray guidance. The shunt then is inserted between the portal and hepatic veins within the liver.
Staph infection
Our Staph infection Main Article provides a comprehensive look at the who, what, when and how of Staph infection Staph infection: A staph infection is an infection with a Staphylococcal bacteria.
Ligament
Ligament: A ligament is a tough band of connective tissue that connects various structures such as two bones. "Ligament" is a fitting term; it comes from the Latin "ligare" meaning "to bind or tie."Common Misspellings: legiment
Tuberculous meningitis
Tuberculous meningitis: Meningitis due to tuberculosis. Tuberculous meningitis is the most severe form of tuberculosis. It causes severe neurologic deficits or death in more than half of cases. The pattern of tuberculous meningitis in the population is different in different areas of the world. In areas with much tuberculosis, tuberculous meningitis usually affects young children. It develops typically 3 to 6 months after the primary tuberculosis infection. By contrast, in areas with less tuberculosis, tuberculous meningitis tends to strike adults. It may follow a primary infection but, more frequently, is due to reactivation of an old focus of tuberculosis that had been dormant, sometimes for many years. Tuberculois meningitis begins insidiously with a gradual fluctuating fever, fatigue, weight loss, behavior changes, headache, and vomiting. This early phase is followed by neurologic deficits, loss of consciousness, or convulsions. A dense gelatinous exudate (outpouring) forms and envelops the brain arteries and cranial nerves. It creates a bottleneck in the flow of the cerebrospinal fluid, which leads to hydrocephalus. The development of arteritis and infarctions of the brain can cause hemiplegia or quadriplegia. A high index of suspicion is essential to diagnose the disease because early diagnosis is the key to a satisfactory outcome. If tuberculous meningitis is seriously suspected, treatment should start immediately. Treatment involves chemotherapy to control and eradicate the infection, management of hydrocephalus and elevated intracranial pressure, and immunomodulation with corticosteroids (cortisone-like drugs such as prednisone). The World Health Organization (WHO) recommends a two-month intensive course of isoniazid, rifampin, pyrazinamide, and ethambutol followed by 4 months of isoniazid and rifampin. Elevated intracranial pressure can be life-threatening. The hydrocephalus may require placement of a ventriculoperitoneal shunt. The use of the corticosteroid dexamethasone improves survival in patients over 14 years of age but probably does not prevent severe disability.Common Misspellings: tuberculous menigitis, tuberculous meninengitis, tuberculous menegitis, tuberculous menengitis, tuberculous merengitis, tuberculous meninigitis, tuberculous meningitus
Positive clinical trial
Positive clinical trial: A clinical trial that shows that the new treatment has a large beneficial effect and is superior to standard treatment. See: Clinical trials. See also: Inconclusive clinical trial; Negative clinical trial; Non-inferior clinical trial. Common Misspellings: positive clinincal trial
Giant cell pneumonia
Giant cell pneumonia: Also known as Hecht's pneumonia, this is a deadly but fortunately rare complication of measles. It tends to strike children who are immunodeficient as from leukemia or HIV/AIDS. The postmortem examination (autopsy) shows multinucleated giant cells lining the alveoli (air sacs) of the lungs. Named for the early 20th-century Austrian pathologist Victor Hecht. Common Misspellings: giant cell peumonia, giant cell pnemonia, giant cell pnuemonia, giant cell pnumonia
Epizootic
Epizootic: An epidemic outbreak of disease in an animal population, often with the implication that it may extend to humans. For example, Rift Valley fever (RVF) primarily affects livestock and can cause disease in a large number of domestic animals -- an "epizootic" -- and the presence of an RVF epizootic can lead to an epidemic among humans who are exposed to diseased animals. The word "epizootic" is pronounced ep�i-zo-ot�ik. It has Greek roots: epi- meaning "on" among other things, + zoon, "animal."
Alternative Medicine, National Center for Compleme
Alternative Medicine, National Center for Complementary &: See: National Center for Complementary & Alternative Medicine.
Laminopathy
Laminopathy: A disease due to mutation of the lamin A/C gene. The laminopathies include: Emery-Dreifuss muscular dystrophy type 2, familial partial lipodystrophy, limb girdle muscular dystrophy type 1B, dilated cardiomyopathy, familial partial lipodystrophy, Charcot-Marie-Tooth disorder type 2B1, mandibuloacral dysplasia, childhood progeria syndrome (Hutchinson-Gilford syndrome) and a subset of Werner syndrome. See also: Lamin A/C.
Litho-
Litho-: Prefix meaning stone. A lithotomy is an operation to remove a stone. Lithotripsy involves crushing a stone. The stone may be in the gallbladder or in the urinary tract.
Bloody sputum
Bloody sputum: Coughed up blood or bloody mucus. Bloody sputum can be caused by infection in the lungs and airways, such as acute bronchitis or pneumonia and by cancer. Whenever bloody sputum is present and cannot be attributed to a curable infectious condition, a complete lung evaluation is warranted, including bronchoscopy, to be certain cancer is not present. Also known as hemoptysis.
Bipolar II disorder
Bipolar II disorder: Bipolar disorder in someone who has experienced depression and at least one episode of hypomania but not severe mania. Hypomanic episodes characteristically do not cause significant distress or greatly impair one's work, family, or social life. Bipolar II disorder is distinct from bipolar I disorder in which a person has had at least one episode of severe mania. Severe mania characteristically causes significant distress or greatly impairs one's work, family, or social life. See also: Bipolar disorder; Depression; Hypomania; Mania.
Melittin
Melittin: The principal toxic component in bee venom. Melittin is a relatively short peptide consisting of 26 amino acids. It is a powerful cell lytic agent and binds rapidly to red blood cells causing the release of hemoglobin in the blood plasma. Lysis of these cells occurs when the organization of a lipid bilayer is perturbed.
Clinical
Clinical: 1. Having to do with the examination and treatment of patients. 2. Applicable to patients. A laboratory test may be of clinical value (of use to patients). The term comes through the French "clinique" from the Greek "kline" (a couch or bed). Clinical medicine was (and is) practiced at the bedside. Common Misspellings: clinincal
Nails, white spots on the
Nails, white spots on the: Very small semi-circular white spots on the nails. These spots may be found on the fingernails and, particularly, the toenails. The white spots on the nails reflect injury to the base (matrix) of the nail. The matrix is the part under the visible nail where the nail cells and the nail itself are produced. The injury to the nail matrix responsible for the white spots is often gotten during exercising in poorly fitting shoes. Jogging in badly fitting shoes is notorious. It causes this condition so often it is known as "jogger's nails." Jogger's nails are no cause for concern. They eventually grow out. However, they are a useful sign, that shoes that fit right are in order.
Oral glucose tolerance test
Oral glucose tolerance test: A test to determine the body's ability to handle glucose . In the test, a person fasts overnight (at least 8 but not more than 16 hours). Then first, the fasting plasma glucose is tested. After this test, the person receives 75 grams of glucose (100 grams for pregnant women). Usually, the glucose is in a sweet-tasting liquid that the person drinks. Blood samples are taken up to four times to measure the blood glucose. For the test to give reliable results, the person must be in good health (not have any other illnesses, not even a cold). Also, the person should be normally active (not lying down, for example, as an inpatient in a hospital) and the person should not be taking medicines that could affect the blood glucose. For 3 days before the test, the person should have eaten a diet high in carbohydrates (150-200 grams per day). The morning of the test, the person should not smoke or drink coffee. The oral glucose tolerance test measures blood glucose levels 5 times over a period of 3 hours. In a person without diabetes, the glucose levels rise and then fall quickly. In someone with diabetes, glucose levels rise higher than normal and fail to come back down as fast. People with glucose levels between normal and diabetic have what is termed "impaired glucose tolerance" (IGT). People with IGT do not have diabetes. Each year, only 1-5% of people whose test results show IGT actually develop diabetes. And with retesting, as many as half of the people with IGT have normal oral glucose tolerance test results. Weight loss and exercise may help people with IGT return their glucose levels to normal. Oral glucose tolerance depends on a number of factors including the ability of the intestine to absorb glucose, the power of the liver to take up and store glucose, the capacity of the pancreas to produce insulin, the amount of "active" insulin it produces, and the sensitivity of the cells in the body to the action of insulin. The outcome of the test may show: Normal glucose tolerance Abnormal glucose tolerance Depressed glucose tolerance -- in which the blood glucose peaks sharply before declining slower then usual to normal levels -- as in: Diabetes mellitus Hemochromatosis (iron overload disease) Cushing syndrome (too much cortisol ["cortisone"] hormone) Pheochromocytoma (adrenaline-producing tumor) Central nervous system lesions Increased glucose tolerance -- in which the blood glucose levels peak at lower than normal levels -- as in the: Malabsorption syndrome Insulinoma (an insulin-producing tumor) Addison disease (adrenocortical insufficiency) Hypopituitarism (underactivity of the pituitary gland) Hypothyroidism (underactivity of the thyroid gland)
Nuchal translucency test
Nuchal translucency test: A measurement of the size of the translucent space behind the neck of the fetus using ultrasound at between 10 and 14 weeks of pregnancy, reflecting the amount of fluid that has accumulated under the skin of the fetus. Nuchal translucency tends to be increased in chromosome disorders such as Turner syndrome and Down syndrome. This is strictly a screening test. It gives no concrete answers, only statistics. Also called the nuchal fold scan.
Trichobezoar
Trichobezoar: A wad of swallowed hair. Also called a hairball. Trichobezoars can sometimes be found to cause blockage of the digestive system, especially at the exit of the stomach. Interestingly, in the Far East culture, trichobezoars are felt to have medicinal properties!
Hepatic-
Hepatic-: A combining form used before a vowel to indicate a relationship to a hepatic duct or the liver. From the Greek hepar meaning liver.
Peanut allergy
Peanut allergy: An allergic reaction to peanuts, the leading cause of anaphylaxis, the most severe and potentially life threatening allergic reaction, and the leading cause of death from food allergy in the US and other Western nations. The prevalence of peanut allergy is increasing. This increase may be due to the exposure of infants with rashes to products such as skin preparations containing peanut oils, sensitizing the children to peanuts. Peanuts contain the same major allergenic proteins (called Ara h 1, 2, and 3) as tree nuts such as walnuts, cashews, and pistachios. About a third of persons with peanut allergy therefore have subsequent allergic reactions to tree nuts. To prevent allergic reactions, one should avoid all nuts and foods containing nuts. This is easier said than done. Food labels should be scrutinized and dishes of unknown origin should be avoided. Despite such precautions, people with peanut allergy average a reaction every 3 to 5 years from inadvertent exposure. A Medic Alert bracelet is advised. Patients and parents of children with peanut allergy should learn the early signs of an allergic reaction such as hives, tongue swelling, throat tightening, and vomiting. They must also carry appropriate medications, including liquid diphenhydramine (Benadryl) and, most importantly, have self-injectable epinephrine (Adrenaline) on hand at all times. It there is accidental peanut exposure, these medications should be used immediately. Then the patient should go to an emergency room as soon as possible for further treatment and for observation because of the risk of a second delayed (biphasic) reaction. The patient's IgE (immunoglobulin E) is integral to peanut allergy. IgE binds to mast cells and triggers the production and release of histamine and other molecules that mediate the allergic reaction. Antibodies directed against IgE can prevent IgE from binding to mast cells. Regular injection of a monoclonal anti-IgE antibody raises the threshold of tolerance in patients with peanut allergy. (Instead of reacting to half a peanut, people had no reactions until they ate on the average 9 peanuts.) Anti-IgE provides some protection against inadvertent exposure to peanuts, an everpresent danger. Common Misspellings: peanut alergy
HIV
HIV: Acronym for the Human Immunodeficiency Virus, the cause of AIDS (acquired immunodeficiency syndrome). HIV has also been called the human lymphotropic virus type III, the lymphadenopathy-associated virus and the lymphadenopathy virus. No matter what name is applied, it is a retrovirus. (A retrovirus has an RNA genome and a reverse transcriptase enzyme. Using the reverse transcriptase, the virus uses its RNA as a template for making complementary DNA which can integrate into the DNA of the host organism). Although the American research Robert Gallo at the National Institutes of Health (NIH) believed he was the first to find HIV, it is now generally accepted that the French physician Luc Montagnier (1932-) and his team at the Pasteur Institute discovered HIV in 1983-84.
Subacute spongiform encephalopathy
Subacute spongiform encephalopathy: See: Gerstmann-Str�ussler-Scheinker syndrome.
Wednesday, April 30, 2008
Biopsy
Biopsy: The removal of a sample of tissue for purposes of diagnosis. (Many definitions of "biopsy" stipulate that the sample of tissue is removed for examination under a microscope. This may or may not be the case. The diagnosis may be achieved by other means such as by analysis of chromosomes or genes.) A biopsy may be done, for example, because of concern about cancer. The physical exam, imaging, endoscopy, and laboratory tests may indicate that something is abnormal, but a biopsy may be the only sure way to know whether the problem is, in fact, cancer. In a biopsy, the doctor removes a sample of tissue from the abnormal area or may remove the whole tumor. A specialist trained to examine such tissues is called a pathologist. A pathologist examines the tissue under a microscope. If cancer is present, the pathologist can usually tell what kind of cancer it is and may be able to judge whether the cells are likely to grow slowly or quickly.
Thyroid stimulating immunoglobulin (TSI)
Thyroid stimulating immunoglobulin (TSI): A form of immunoglobulin G (IgG) that can bind to thyrotropin (TSH) receptors on the thyroid gland. TSIs mimic the action of TSH, causing excess secretion of thyroxine and triiodothyronine. The TSI level is abnormally high in persons with hyperthyroidism due to Graves' disease.Common Misspellings: thyriod stimulating immunoglobulin (tsi), athyroid stimulating immunoglobulin (tsi), throid stimulating immunoglobulin (tsi)
Arterial blood gas (ABG)
Arterial blood gas (ABG): The sampling of the blood levels of oxygen and carbon dioxide within the arteries, as opposed to the levels of oxygen and carbon dioxide in venous blood. Typically the acidity, or pH, of the blood is measured simultaneously with the gas levels in ABG sampling. Common Misspellings: arterial blod gas (abg)
SPECT scan
SPECT scan: Single Photon Emission Computed Tomography, a nuclear medicine procedure in which a gamma camera rotates around the patient and takes pictures from many angles, which a computer then uses to form a tomographic (cross-sectional) image. The calculation process in SPECT is similar to that in CT (X-ray computed tomography) and in PET (positron emission computed tomography).
Desmoplasia
Desmoplasia: This term refers to the growth of fibrous or connective tissue. Some tumors elicit a desmoplastic reaction, the pervasive growth of dense fibrous tissue around the tumor. Scar tissue (adhesion) within the abdomen after abdominal surgery is another type of desmoplastic reaction. "Desmo-" comes from the Greek "desmos" meaning "a fetter or band" and "-plastic" is also borrowed from the Greek, from "plassein" meaning "to form" = to form a band or fetter.
D (drug caution code)
D (drug caution code): Abbreviation on a medication that indicates caution because the medication may cause drowsiness. While not a part of the historical heritage of ancient prescription abbreviations, drug caution codes provide very valuable warnings. If you see a caution code on a prescription, talk to your pharmacist about it before using the medicine. In the United States and some other countries, a system of stickers with pictographs is also used to warn of side effects such as drowsiness.
Zygote
Zygote: The cell formed by the union of a male sex cell (a sperm) and a female sex cell (an ovum). The zygote develops into the embryo following the instruction encoded in its genetic material, the DNA. The unification of a sperm and an ovum to form a zygote constitutes fertilization.
Induced disease by proxy
Induced disease by proxy: See: Munchhausen syndrome by proxy. Common Misspellings: induced diease by proxy, induced desease by proxy
Congenital vaccinia
Congenital vaccinia: Infection of the fetus in the last trimester of pregnancy due to bloodborne dissemination of the vaccinia virus in the pregnant woman after she has received a smallpox vaccination. The affected infant is often premature. The skin lesions in the newborn infant are like a fresh vaccination but often confluent and extensive. Death almost always occurs before birth or shortly thereafter. To prevent this dire disorder, it is recommended that pregnant women not be vaccinated unless special circumstances may call for it (e.g., they have been exposed to a smallpox patient or are a household member of a smallpox case).
Tongue cancer
Tongue cancer: Malignancy of the tongue; squamous cell carcinoma of the tongue. Risk factors include smoking tobacco, smokeless tobacco, heavy alcohol intake, and dentures. Tongue cancer usually occurs after the age of 40, with men affected more than women. Tongue cancer is divided into that on the anterior tongue and that at the base of the tongue. The anterior tongue is the front two-thirds while the base is the back third of the tongue. The anterior tongue is the site of two-thirds of all tongue cancers. Three-quarters of these tumors are small and can be effectively treated by surgery or radiation. The risk of metastasis is quite small but if metastases do occur, usually to the neck, they require prompt therapy. The prognosis (outlook) is generally good. The base of the tongue is the site of only one-third of all tongue cancers but these tumors tend to be far more advanced and aggressive than those on the front of the tongue. Symptoms of tongue base tumors may be odynophagia (pain on swallowing food or fluid), otalgia (pain in the ear), or a mass in the neck. The mass is usually due to metastases that can be felt in three-quarters of cases at the time of the diagnosis. Treatment may involve a combination of methods (surgery, radiation, chemotherapy) and may need to be aggressive. The prognosis is more guarded than with anterior tongue tumors. Common Misspellings: tongue canser, tounge cancer, tounge canser, toungue cancer, toungue canser, tonge cancer, tonge canser
Tomo-
Tomo-: Or tom- before a vowel. A combining form meaning a cut, section, or layer, as might be achieved by cutting or slicing. Used in the formation of compound words such tomography. From the Greek tomos (a cutting).
Rickets, vitamin D resistant
Rickets, vitamin D resistant: A rickets-like condition caused by an inborn defect of metabolism, usually in males. Vitamin D cannot be absorbed, and so does not work to treat the illness.
Coarctation of the aorta
Coarctation of the aorta: A congenital constriction of the aorta, impeding the flow of blood below the level of the constriction and increasing blood pressure above the constriction. Symptoms may not be evident at birth but may develop as soon as the first week after birth with congestive heart failure or high blood pressure that call for early surgery. The surgery otherwise can be delayed. The outlook after surgery is favorable. Some cases have been treated by balloon angioplasty. The word "coarctation" comes from the Latin "coartare" meaning :to press together." The sides of the aorta at the point of a coarctation appear pressed together.
Pneumonoultramicroscopicsilicovolcanosconiosis
Pneumonoultramicroscopicsilicovolcanosconiosis: Allegedly, "a lung disease caused by the inhalation of very fine silicate or quartz dust." The word was invented by compounding pneumo-(lung) + ultramicroscopic + silicon + volcano + coniosis, from the Greek konis (dust). In fact, pneumonoultramicroscopicsilicovolcanosconiosis means nothing. It is a factitious and fictitious word that was created as a spoof of the many long run-on terms found in medicine. Pneumonoultramicroscopicsilicovolcanosconiosis is the epitome of the sesquipedalian words with which medicine is, unfortunately, rife. See also: Sesquipedalian.
Percutaneous transhepatic cholangiography
Percutaneous transhepatic cholangiography: See: Cholangiography, percutaneous transhepatic.
Intervening sequence
Intervening sequence: Part of a gene that is initially transcribed from the DNA into the primary RNA transcript but then is excised (removed) from it when the so-called exxon sequences on either side of it are spliced together. Intervening sequences, which are also called introns, are genetic sequences that intervene between the exxons. The DNA of a gene is thereby made up of an alternation of introns and exxons.
Histoplasma
Histoplasma: Full name: histoplasma capsulatum. A microscopic fungus that causes the disease histoplasmosis. The fungus is found throughout the world in river valleys and soil where bird or bat droppings accumulate. The spores of the fungus are released into the air when contaminated soil is disturbed (for example, by plowing fields, sweeping chicken coops, or digging holes) and the airborne spores can then be inhaled into the lungs, the primary site of infection. In the US, the fungus is so common that in parts of Kentucky and Tennessee nearly 90% of adults show evidence of exposure by a positive histoplasma skin test. The fungus can be transferred by organ transplantation.
Step therapy
Step therapy: The practice of beginning drug therapy for a medical condition with the most cost-effective and safest drug therapy and progressing to other more costly or risky therapy, only if necessary. The aims are to control costs and minimize risks. Also called step protocol. Common Misspellings: step therpy
Acid, nucleic
Acid, nucleic: One of the molecules in the chromosomes of living cells and viruses that plays a central role in the storage and replication of hereditary information and in the expression of this information through protein synthesis. The two chief types of nucleic acids are: DNA (deoxyribonucleic acid) which contains the hereditary information in humans and RNA (ribonucleic acid) which delivers the instructions coded in this information to the cell's protein manufacturing sites. History: In 1869 Friedrich Miescher developed ways of isolating intact nuclei from cells and analyzing their chemical content. From the nuclei he extracted substances rich in phosphorus and nitrogen. They came to be known as "nucleic acids." Miescher predicted that they would someday be considered as important as proteins. The substances turned out to be deoxyribonucleic acid (DNA) which was found by Avery, MacLeod and McCarty in 1944 to be the genetic material. They proved this clearly by using bacterial DNA to change (transform) the genetic material of other bacteria.
Breast aplasia
Breast aplasia: A rare condition wherein the normal growth of the breast or nipple never takes place. They are congenitally absent. There is no sign whatsoever of the breast tissue, areola or nipple. There is nothing there. Breast aplasia (also called, amastia) is frequently not alone as the only problem. Unilateral amastia (amastia just on one side) is often associated with absence of the pectoral muscles (the muscles of the front of the chest). Bilateral amastia (with absence of both breasts) is associated in 40% of cases with multiple congenital anomalies (birth defects) involving other parts of the body as well. Amastia is thought to be described in the Bible: "We have a little sister, and she hath no breasts" (Song of Solomon VIII:8). Amastia can be distinguished from amazia -- wherein breast tissue is absent, but the nipple is present -- a condition that typically is a result of radiation or surgery.Common Misspellings: breast apalasia
Nitrous oxide (laughing gas)
Nitrous oxide (laughing gas): A gas that can cause general anesthesia. Nitrous oxide is sometimes given in the company of other anesthetic agents but it is not used today as the only anesthetic agent because the concentration of nitrous oxide needed to produce anesthesia is close to the concentration that seriously lowers the blood oxygen level and creates a hazardous hypoxic state. Nitrous oxide figured in the history of anesthesiology. In 1840 a dentist named Horace Wells had the idea that, with the recently discovered "exhilarating or laughing gas", teeth might be extracted without pain. Under its influence he had one of his own teeth pulled in 1844 and afterwards frequently used it in his practice. Before a class at the Massachusetts General Hospital, Wells gave a demonstration with a patient. Things did not go too well. The patient suffered great pain. Wells became depressed, addicted (to chloroform, another anesthetic agent) and in 1848 committed suicide.
Syndactyly, bony
Syndactyly, bony: A condition in which the bones of fingers or toes are joined together. Bony syndactyly is the opposite of cutaneous syndactyly, in which the bones are normal but skin between the digits is webbed.
Weil syndrome
Weil syndrome: A severe form of leptospirosis with liver disease. See: Leptospirosis. Common Misspellings: weil syndrone
Exon
Exon: The region of a gene that contains the code for producing protein. Each exon codes for a specific portion of the complete protein. Exons are separated by introns, long regions of DNA that have no apparent function. Exons are also called coding DNA.
Crime scene investigation
Crime scene investigation: The use of physical evidence at the scene of the crime and the use of deductive and inductive reasoning to gain knowledge of the events surrounding the crime. Crime scene investigation is multidisciplinary and involves a systematic search of the crime scene; meticulous observation and documentation of the scene; photography and sketching of the scene; the identification, processing and collection of physical evidence such as fingerprints, footwear impressions, hair, fibers, biological fluids, and materials for DNA analysis; and. perhaps most important, the application of careful reasoning to the facts.
TVS
TVS: Abbreviation for "transvaginal ultrasound," a technique in which sound waves are sent out by an ultrasound probe that has been inserted in the vagina. The waves go through the vaginal wall and bounce off the ovaries, and a computer uses the ultrasound echoes to create a picture (a sonogram). TVS has been reported to be effective as a screening tool to detect ovarian cancer while it is still in an early, curable stage.
Nose job
Nose job: Slang for plastic surgery on the nose, known medically as a rhinoplasty. This is a facial cosmetic procedure, often performed to enhance the appearance of the nose. During rhinoplasty, the nasal cartilages and bones are modified, or tissue is added. The aim is to improve the visual appeal of the nose. Rhinoplasty is also frequently performed to repair nasal fractures. When rhinoplasty is used to repair nasal fractures, the goal is to restore pre-injury appearance of the nose. As noted, the term "nose job" is slang so it is not in most standard medical dictionaries although it is in very common use.
Uncertainty
Uncertainty: You may be uncertain why "uncertainty" deserves a place in a medical dictionary but some would say that uncertainty is a key element in medicine. "The core predicament of medicine -- the thing that makes being a patient so wrenching, being a doctor so difficult and being a part of a society that pays the bills they run up so vexing -- is uncertainty," observed the surgeon Atul Gawande. "Medicine's ground state is uncertainty. And wisdom -- for both patients and doctors -- is defined by how one copes with it." Source: Complications: A Surgeon's Notes on an Imperfect Science. By Atul Gawande. Metropolitan Books/Henry Holt & Co., New York, 2002.
Congenital rubella syndrome
Congenital rubella syndrome: The constellation of abnormalities caused by infection with the rubella (German measles) virus before birth. The syndrome is characterized by multiple congenital malformations (birth defects) and mental retardation. The individual features of the syndrome include growth retardation, microcephaly (abnormally small head), cataracts, glaucoma, microphthalmia (abnormally small eyes), cardiovascular malformations, hearing loss, and mental retardation. Deafness is common. After birth the child may develop diabetes due to gradual destruction of the pancreas by the rubella virus. The child has a 50% risk of being born with the congenital rubella syndrome, if the mother is infected with rubella in the first trimester (the first third) of pregnancy. Risks still exist with infection in the second trimester The discovery of the congenital rubella syndrome by the Australian ophthalmologist (eye doctor) NM Gregg in 1941 is of historic importance. It provided the first evidence that the placental barrier between the mother and the fetus does not fully protect the fetus from teratogens (agents that can cause birth defects). The rubella epidemic of 1963-1965 resulted in 1,800,000 infected individuals, approximately 20,000 fetal deaths and about 30,000 infants born with congenital rubella syndrome. Since the introduction of the rubella vaccine in 1969 there are less than 120 cases of congenital rubella syndrome reported each year. The condition also goes by the name of fetal rubella effects. Common Misspellings: congenital rubella syndrone
Clinophobia
Clinophobia: An abnormal and persistent fear of going to bed. Sufferers from clinophobia experience anxiety even though they realize that going to bed normally should not threaten their well-being. However, because they worry about having nightmares or wetting the bed, they often remain awake and develop insomnia. Insomnia then can become a real threat to their well-being. "Clinophobia" is derived from the Greek "klinein" (to bend, slope or incline, as one does during sleep) and "phobos" (fear). Another medical term containing "clino-"is "clinodactyly" meaning a finger that is curved to the side.
Placental dystocia
Placental dystocia: Difficulty delivering the placenta (the afterbirth). Dystocia comes from the Greek "dys" meaning "difficult, painful, disordered, abnormal" + "tokos" meaning "birth."
Sequence tagged site (STS)
Sequence tagged site (STS): A short (200 to 500 base pair) DNA sequence that occurs but once in the genome and whose location and base sequence are known. STSs are detectable by polymerase chain reaction (PCR), are useful for localizing and orienting the mapping and sequence data, and serve as landmarks on the physical map of a genome. Expressed sequence tags (ESTs) are STSs derived from cDNAs (complementary DNAs).
Robotripping
Robotripping: Street name for the high produced by abuse of the cough syrup Robitussin which contains dextromethorphan.
Sensitivity
Sensitivity: 1. In psychology, the quality of being sensitive. As, for example, sensitivity training, training in small groups to develop a sensitive awareness and understanding of oneself and of ones relationships with others. 2. In disease epidemiology, the ability of a system to detect epidemics and other changes in disease occurrence. 3. In screening for a disease, the proportion of persons with the disease who are correctly identified by a screening test. 4. In the definition of a disease, the proportion of persons with the disease who are correctly identified by defined criteria.
PFT
PFT: Pulmonary function test, a test designed to measure how well the lungs are working. PFTs gauge how the lungs are doing their jobs -- of expanding and contracting (when a person inhales and exhales) and of exchanging oxygen and carbon dioxide efficiently between the air (or other gases) within the lungs and the blood. For example, one PFT calls for the patient to breathe into a machine called a spirometer. It is a mechanical device that records the changes in lung size as air is inhaled and exhaled and the time it takes for the patient to do this task.
Akinetic mutism
Akinetic mutism: A state in which a person is unspeaking (mute) and unmoving (akinetic). A textbook on clinical neurology observes that a person with akinetic mutism has "sleep-waking cycles but, when apparently awake, with eyes open, lies mute. immobile and unresponsive." Akinetic mutism is often due to damage to the frontal lobes of the brain. The disorder was the subject of a front-page story in The New York Times on Aug. 30, 1998. The story concerned a 14-year-old girl in Worcester, Mass. named Audrey Santo, bedridden for 11 years, "inert and unspeaking, the legacy of an accidental fall into a backyard swimming pool" in 1987. "She has had a steady stream of visitors to her home," according to the Times, "including priests and some people who claim that they were miraculously healed by her." According to Audrey's pediatrician, Dr. John W. Harding, "She kind of gives you the impression at various times that she sees, hears, and knows who you are."
Pulmonary medicine
Pulmonary medicine: The branch of medicine that deals with the causes, diagnosis, prevention and treatment of diseases affecting the lungs. Pulmonary medicine deals with many diseases and conditions, including: ARDS (acute respiratory distress syndrome), asthma, COPD (chronic obstructive pulmonary disease), cystic fibrosis, interstitial lung disease, lung cancer, lung transplants, occupational lung disease, pulmonary hypertension, pulmonary tuberculosis, sarcoidosis of the lungs, and SARS (severe acute respiratory syndrome). Pulmonary medicine is also sometimes called pulmonology which is the science concerned with the anatomy, physiology, and pathology of the lungs. Common Misspellings: pulmanary medicine, pulmenary medicine
Urine hemoglobin
Urine hemoglobin: The presence of free hemoglobin in the urine, an abnormal finding, that may make the urine look dark. Hemoglobin in the urine is termed hemoglobinuria. Hemoglobin is the protein in the red blood cells which carries oxygen from the lungs to the tissues of the body and returns carbon dioxide from the tissues to the lungs. The iron contained in hemoglobin gives red blood cells their characteristic color. Red blood cells are normally taken out of circulation after approximately 4 months; they are trapped and disassembled in the spleen, bone marrow, and liver. If, however, red cells hemolyze (break down) within the vascular system, the components are set free in the blood stream. Free hemoglobin is bound by haptoglobin (another protein) and reprocessed. But if the level of hemoglobin in the blood rises above the ability of haptoglobin to reclaim it, hemoglobin begins to appear in the urine -- there is hemoglobinuria. Normally, there is no hemoglobin in the urine. Hemoglobinuria is a sign of a number of conditions including: acute nephritis (acute glomerulonephritis), burns, kidney cancer, malaria, paroxysmal nocturnal hemoglobinuria (dark urine in the morning that lightens up during the day), the hemolytic-uremic syndrome (HUS), pyelonephritis, sickle cell anemia (or any other type of hemolytic anemia), a transfusion reaction (due to an immune response against transfused red blood cells), thrombotic thrombocytic purpura (TTP), and tuberculosis of the urinary tract. Common Misspellings: urine hgb, urine haemoglobin, urin hemoglobin, urin hgb, urin haemoglobin
Renal stone
Renal stone: A stone in the kidney (or lower down in the urinary tract). Also called a kidney stone. Renal stones are a common cause of blood in the urine and pain in the abdomen, flank, or groin. Kidney stones occur in 1 in 20 people at some time in their life. The development of the stones is related to decreased urine volume or increased excretion of stone-forming components such as calcium, oxalate, urate, cystine, xanthine, and phosphate. The stones form in the urine collecting area (the pelvis) of the kidney and may range in size from tiny to staghorn stones the size of the renal pelvis itself. The cystine stones (below) compared in size to a quarter (a U.S. $0.25 coin) were obtained from the kidney of a young woman by percutaneous nephrolithotripsy (PNL), a procedure for crushing and removing the dense stubborn stones characteristic of cystinuria. The pain with kidney stones is usually of sudden onset, very severe and colicky (intermittent), not improved by changes in position, radiating from the back, down the flank, and into the groin. Nausea and vomiting are common. Factors predisposing to kidney stones include recent reduction in fluid intake, increased exercise with dehydration, medications that cause hyperuricemia (high uric acid) and a history of gout. Treatment includes relief of pain, hydration and, if there is concurrent urinary infection, antibiotics. The majority of stones pass spontaneously within 48 hours. However, some stones may not. There are several factors which influence the ability to pass a stone. These include the size of the person, prior stone passage, prostate enlargement, pregnancy, and the size of the stone. A 4 mm stone has an 80% chance of passage while a 5 mm stone has a 20% chance. If a stone does not pass, certain procedures (usually done by a urology specialist) may be needed. The process of stone formation is called nephrolithiasis or urolithiasis. "Nephrolithiasis" is derived from the Greek nephros- (kidney) lithos (stone) = kidney stone "Urolithiasis" is from the French word "urine" which, in turn, stems from the Latin "urina" and the Greek "ouron" meaning urine = urine stone. The stones themselves are called renal caluli. The word "calculus" (plural: calculi) is the Latin word for pebble.
Bipolar disorder
Our Bipolar disorder Main Article provides a comprehensive look at the who, what, when and how of Bipolar disorder Bipolar disorder: A mood disorder sometimes called manic-depressive illness or manic-depression that characteristically involves cycles of depression and elation or mania. Sometimes the mood switches from high to low and back again are dramatic and rapid, but more often they are gradual and slow, and intervals of normal mood may occur between the high (manic) and low (depressive) phases of the condition. The symptoms of both the depressive and manic cycles may be severe and often lead to impaired functioning. Both phases of the disease are deleterious. Mania affects thinking, judgment, and social behavior in ways that may cause serious problems and embarrassment. For example, unwise business or financial decisions may be made when an individual is in a manic phase. Depression can also affect thinking, judgment, and social behavior in ways that may cause grave problems. For example, it elevates the risk of suicide. About 5.7 million American adults, or about 2.6 percent of the population aged 18 and older, have bipolar disorder. Although bipolar disorder often worsens over time if untreated, most people with bipolar disorder can achieve stabilization of their mood swings and reduction of symptoms with proper treatment. Treatment usually consists of medications known as �mood stabilizers.� See also: Manic-depression. Common Misspellings: bipola disorder, bipoler disorder, bi-polar disorder, bi polar
Excessive daytime sleepiness
Excessive daytime sleepiness: A neurological disorder in which there is a sudden recurrent uncontrollable compulsion to sleep. Excessive daytime sleepiness is also known as narcolepsy. The condition is often associated with: Cataplexy -- a sudden loss of muscle tone and paralysis of voluntary muscles associated with a strong emotion Sleep paralysis -- immobility of the body that occurs in the transition from sleep to wakefulness Hypnagogic hallucinations -- pre-sleep dreams Automatic behaviors -- such as, for example, doing something "automatically" and not remembering afterwards how you did it. More than 100,000 Americans have excessive daytime sleepiness (narcolepsy). It strikes both males and females and affects people of all races. The symptoms most commonly appear in a person's teens and early twenties. The disease can vary in severity. Some persons with it have mild sleepiness or rare cataplexy (less than one episode per week). Other persons may have moderate sleepiness or infrequent cataplexy (less than one episode a day). Still other persons with the disorder may experience severe sleepiness or have severe cataplexy (with one or more episodes of cataplexy per day). The basic cause of narcolepsy is not known. It is not a fatal disorder in itself but it can lead to fatalities. For example, a narcoleptic may fall asleep while driving. Narcolepsy is usually treated with a medication to improve alertness and an anti-depressant that helps control cataplexy. The US Food and Drug Administration (the FDA) in 1998 approved Provigil (modafinil), a non-amphetamine drug for treating the excessive sleepiness of narcolepsy. Other names for the condition include hypnolepsy, sleeping disease, paroxysmal sleep, and Gelineau syndrome. Common Misspellings: excessive daytime sleepness, exessive daytime sleepiness, exessive daytime sleepness
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