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.
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