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Some Diseases



AIDS


in full acquired immunodeficiency syndrome

Fatal transmissible disorder caused by HIV.

AIDS, the last stage of HIV infection, is defined by the appearance of potentially lethal opportunistic infections. The first AIDS cases were identified in 1981, HIV was isolated in 1983, and blood tests were developed by 1985. In 2002 approximately 40,000,000 people worldwide were living with HIV, and more than 25,000,000 had died of AIDS. In the U.S. some 2,000,000 people had been infected with HIV, 800,000 had been diagnosed with AIDS, and 450,000 had died. Sub-Saharan Africa remains the focus of infection, but the number of cases in South and Southeast Asia and elsewhere continues to mount at an alarming rate as well. An initial acute illness usually resolves within weeks. Infected persons then generally have few or no symptoms for about 10 years. As the immune system deteriorates, they develop diseases such as Pneumocystis carinii pneumonia, cytomegalovirus (CMV), lymphoma, or Kaposi sarcoma.



hepatitis


Inflammation of the liver.

There are seven known types of viral hepatitis (A-G). Types A, spread mainly through food contaminated with feces, and B, transmitted sexually or by injection, cause jaundice and flulike symptoms. The hepatitis C virus spreads mostly by shared needles in intravenous drug use and can cause liver cirrhosis and cancer after a long latent period. Until recently there was no test to detect it in blood, and many people were exposed through blood transfusions. Hepatitis D becomes active only in the presence of type B; it causes severe chronic liver disease. Type E, like Type A, is transmitted by contaminated food or water; its symptoms are more severe than Type A's and can result in death. The hepatitis F virus (HFV), which was first reported in 1994, is spread like Type A and E. The hepatitis G virus (HGV), isolated in 1996, is believed to be responsible for many sexually transmitted and bloodborne cases of hepatitis. Vaccines exist for types A and B (the second also prevents type D). Drug treatment for B and C is not always effective. The other types may not need drug treatment. Chronic active hepatitis causes spidery and striated skin markings, acne, and abnormal hair growth. It results in liver tissue death (necrosis) progressing to cirrhosis. Alcoholic hepatitis, from long-term overconsumption of alcohol, can be reversed and cirrhosis prevented by early treatment including quitting or sharply reducing drinking. Other drugs can also cause noninfectious hepatitis. An autoimmune hepatitis affects mainly young women and is treated with corticosteroids to relieve symptoms.


cholera


Acute bacterial infection with Vibrio cholerae, causing massive diarrhea with severe depletion of body fluids and salts.

(See bacterial disease.) Cholera often occurs in epidemics, spreading in contaminated water or food. The bacteria secrete a toxin that causes the diarrhea, which along with vomiting leads to dehydration, with severe muscle cramps and intense thirst. Stupor and coma may precede death by shock. With fluid and salt replacement, the disease passes in two to seven days, sooner if antibiotics are taken the first day. Prevention requires good sanitation, especially clean drinking water.

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hog cholera


or swine fever

Often fatal viral disease of swine in Europe, North America, and Africa, transmitted by vehicles used to carry pigs, people dealing with them, and uncooked garbage in feed.

Fever progresses to symptoms that include appetite loss; affected eyes and digestive tract; respiratory difficulty; rash; and inflamed mouth and throat. The pig moves reluctantly and staggers; later it cannot rise; coma follows. Antiserum is rarely effective. Survivors become chronically ill and can spread the virus. Illness must be reported, infected animals slaughtered, and quarantine instituted. A vaccine can control it. The African strain causes death sooner and has no effective prevention or treatment.

Constipation

Infrequent (and frequently incomplete) bowel movements. The opposite of diarrhea, constipation is commonly caused by irritable bowel syndrome, diverticulosis, and medications (constipation can paradoxically be caused by overuse of laxatives). Colon cancer can narrow the colon and thereby cause constipation. The large bowel (colon) can be visualized by barium enema x-rays, sigmoidoscopy, and colonoscopy. Barring a condition such as cancer, high-fiber diets can frequently relieve the constipation.

Contusion

Another name for a bruise. What is a bruise ? A bruise, or contusion, is caused when blood vessels are damaged or broken as the result of a blow to the skin (be it bumping against something or hitting yourself with a hammer). The raised area of a bump or bruise results from blood leaking from these injured blood vessels into the tissues as well as from the body’s response to the injury. A purplish, flat bruise that occurs when blood leaks out into the top layers of skin is referred to as an ecchymosis.

Coronary artery bypass graft (CABG)

Coronary artery disease develops because of hardening of the arteries (atherosclerosis) that supply blood to the heart muscle. Diagnostic tests include EKG, stress test, echocardiography, and coronary angiography. CABG surgery is advised for selected groups of patients with significant narrowings and blockages of the heart arteries (coronary artery disease) to create new routes around narrowed and blocked arteries, permitting increased blood flow to deliver oxygen and nutrients to the heart muscles. The bypass graft for a CABG can be a vein from the leg or an inner chest wall artery. CABG surgery is performed about 350,000 times annually in the United States, making it one of the most commonly performed major operations.

Costochondritis

Costochondritis is the result of inflammation of the cartilage of the chest wall, usually involving that which surrounds the breast bone (sternum). It causes local pain and tenderness of the chest around the sternum.

CPR

Cardiopulmonary resusitation. CPR involves breathing for the victim and applying external chest compression to make the heart pump. In the case of an early heart attack, death can often be avoided if a bystander starts CPR promptly (within 5 minutes of the onset of ventricular fibrillation). When paramedics arrive, medications and/or electrical shock (cardioversion) to the heart can be administered to convert ventricular fibrillation to a normal heart rhythm. Therefore, prompt CPR and rapid paramedic respronse can improve the survival chances from a heart attack.

Cracked tooth syndrome

A toothache caused by a broken tooth (tooth fracture) without associated cavity or advanced gum disease. Biting on the area of tooth fracture can cause severe sharp pains. These fractures are usually due to chewing or biting hard objects such as hard candies, pencils, nuts, etc. Sometimes, the fracture can be seen by painting a special dye on the cracked tooth. Treatment usually is to protect the tooth with a crown. However, if placing a crown does not relieve pain symptoms, a root canal procedure may be necessary.

Cranial arteritis

A serious disease characterized by inflammation of the walls of the blood vessels (vasculitis). The vessels affected by inflammation are the arteries (hence the name "arteritis"). The age of affected patients is usually over 50 years of age. Cranial arteritis is also known as temporal arteritis and as giant cell arteritis. It can lead to blindness and/or stroke. The disease is detected by a biopsy of an artery. It is treated with high dose cortisone-related medications.


Cranial dystonia

A term used to describe dystonia that affects the muscles of the head, face, and neck. Oromandibular dystonia affects the muscles of the jaw, lips, and tongue. The jaw may be pulled either open or shut, and speech and swallowing can be difficult. Spasmodic dysphonia involves the muscles of the throat that control speech. Also called spastic dysphonia or laryngeal dystonia, it causes strained and difficult speaking or breathy and effortful speech. Meige’s syndrome is the combination of blepharospasm and oromandibular dystonia and sometimes spasmodic dysphonia. Spasmodic torticollis can be classified as a type of cranial dystonia.



Creutzfeldt-Jakob disease (CJD)

A dementing disease of the brain. It is believed due to an unconventional (not a bacteria or virus), transmissible agent called a prion. Symptoms of CJD include forgetfulness, nervousness, jerky trembling hand movements, unsteady gait, muscle spasms, chronic dementia, balance disorder, and loss of facial expression. CJD is classified as a spongiform encephalopathy. Most cases occur randomly (sporadically), but inherited forms exist. There is neither treatment nor cure for CJD. Other names for CJD include Creutzfeldt-Jakob syndrome, Jakob-Creutzfeldt disease, and spastic pseuodoparalysis.


Crib death

The sudden and unexpected death of a baby with no known illness, typically affecting infants from 2 weeks to 6 months of age while sleeping. Crib death is now called Sudden Infant Death Syndrome (SIDS). Babies at an increased risk for SIDS include those with a brother or sister who died of SIDS; children whose mothers smoked or used heroin, methadone, or cocaine during pregnancy; infants born weighing less than 4.4 pounds (2000 grams); children with an abnormal breathing pattern with long periods without taking a breath (apnea); and babies who sleep on their stomachs. Since babies who sleep on their stomachs are at least 3 times more likely to die of SIDS than babies who sleep on their backs, children’s health authorities such as the American Academy of Pediatrics recommend always placing infants on their backs to sleep.


Crohn’s disease

A chronic inflammatory disease of the intestine primarily in the small and large intestines but which can occur anywhere in the digestive system between the mouth and the anus. Named after Burrill Crohn who described the disease in 1932. The disease usually affects persons in their teens or early twenties. It tends to be a chronic, recurrent condition with periods of remission and exacerbation. In the early stages, Crohn’s disease causes small scattered shallow crater-like areas (erosions) called apthous ulcers in the inner surface of the bowel. With time, deeper and larger ulcers develop, causing scarring and stiffness of the bowel and the bowel becomes increasingly narrowed, leading to obstruction. Deep ulcers can puncture holes in the bowel wall, leading to infection in the abdominal cavity (peritonitis) and in adjacent organs.When only the large intestine (colon) is involved, the condition is called Crohn’s colitis. When only the small intestine is involved, the condition is called Crohn’s enteritis. When only the end of the small intestine (the terminal ileum) is involved, it is termed terminal ileitis. When both the small intestine and the large intestine are involved, the condition is called Crohn’s enterocolitis (or ileocolitis). Abdominal pain, diarrhea, vomiting, fever, and weight loss can be symptoms. Crohn’s disease can be associated with reddish tender skin nodules, and inflammation of the joints, spine, eyes, and liver. Diagnosis is by barium enema, barium x-ray of the small bowel, and colonoscopy. Treatment includes medications for inflammation, immune suppression, antibiotics, or surgery. (The disease is also called granulomatous enteritis or regional enteritis).


Croup

An infection of the larynx, trachea, and the bronchial tubes, mainly in children. Caused usually by viruses, less often by bacteria. Symptoms include a cough that sounds like a barking seal and a harsh crowing sound during inhaling. Treatment can include moist air, salt water nose drops, decongestants and cough suppressants, pain medication, fluids, and occasionally antibiotics. The major concern in croup is breathing difficulty as the air passages narrow. Close monitoring of the breathing of a child with croup is important, especially at night. While most children recover from croup without hospitalization, some children can develop life-threatening breathing difficulties. Therefore, close contact with the doctor during this illness is important.


Cushing’s syndrome

The constellation of symptoms and signs caused by an excess of cortisol hormone. Cushing syndrome is an extremely complex hormonal condition that involves many areas of the body. Common symptoms are thinning of the skin, weakness, weight gain, bruising, hypertension, diabetes, thin weak bones (osteoporosis), facial puffiness, and in women cessation of periods. Ironically, one of the commonest causes of Cushing’s syndrome is the administration of "cortisol-like medications" for the treatment of diverse diseases. All other cases of Cushing’s syndrome are due to excess production of cortisol by the adrenal gland including 1) an abnormal growth of the pituitary gland, which stimulates the adrenal gland, 2) a benign or malignant growth within the adrenal gland itself, which produces cortisol and 3) production within another part of the body (ectopic production) of a hormone that directly or indirectly stimulates the adrenal gland to make cortisol. Neurosurgeon Harvey Cushing (1869-1939) described hyperadrenocorticism (excessive production of cortisol by the adrenal gland) due quite specifically to an ACTH-secreting pituitary adenoma, a benign pituitary tumor that puts out ACTH (AdrenoCorticoTropic Hormone) which, in turn, drives (or overdrives) the adrenal gland to overproduce cortisol.


Cuts

Severed skin. Washing a cut or scrape with soap and water and keeping it clean and dry is all that is required to care for most wounds. Putting alcohol hydrogen peroxide, and iodine into a wound can delay healing and should be avoided. Seek medical care early if you think that you might need stitches. Any delay can increase the rate of wound infection. Any puncture wound through tennis shoes has a high risk of infection and should be seen by your healthcare professional. Any redness, swelling, increased pain, or pus draining from the wound may indicate an infection that requires professional care.



Cystic fibrosis (CF)

One of the most common serious genetic (inherited) diseases. The CF gene is carried by 1/20 persons (in Caucasian populations) and 1 in 400 couples is at risk for having children with CF. CF is characterized by the production of abnormal secretions leading to mucous build-up. which can impair the pancreas (and, secondarily, the intestine). CF mucous build-up in lungs can impair respiration. Without treatment, CF results in death for 95% of children before age 5. Early diagnosis of CF is of great importance. Early and continuing treatment of CF is valuable.



Cystitis, interstitial (IC)

Disease that involves inflammation or irritation of the bladder wall. This inflammation can lead to scarring and stiffening of the bladder, and even ulcerations and bleeding. Diagnosis is based on symptoms, findings on cystoscopy and biopsy, and eliminating other treatable causes such as infection. Because doctors do not know what causes IC, treatments are aimed at relieving symptoms. Most people are helped for variable periods of time by one or a combination of treatments.


Death rate

The number of deaths in the population divided by the average population (or the population at midyear) is the crude death rate. In 1994, for example, the crude death rate per 1,000 population was 8.8 in the United States, 7.1 in Australia, etc. A death rate can also be tabulated according to age or cause.



Decongestants

Drugs that shrink the swollen membranes in the nose and make it easier to breath. Decongestants can be taken orally or by nasal spray. Decongestant nasal spray should not be used for more than five days without the doctor"s advice, and if so, usually only when accompanied by a nasal steroid. Many decongestant nasal sprays often cause a rebound effect if taken too long. A rebound effect is the worsening of symptoms when a drug is discontinued. This is a result of a tissue dependence on the medication. Decongestants should not be used by patients with high blood pressure (hypertension) unless under doctor’s supervision.



Defect, enzyme

An abnormality in the protein (enzyme) important in catalyzing a normal biochemical reaction in the body. Disorders result from a deficiency (or functional abnormality) of an enzyme. Archibald Garrod in 1902 was the first to attribute a disease to an enzyme defect: an inborn error of metabolism. Today, newborns are routinely screened for certain enzyme defects such as phenylketonuria (PKU) and galactosemia, an error in the handling (metabolism) of the sugar galactose.


Deficiency dermatitis and diarrhea, zinc

A genetic disease called acrodermatitis enteropathica is characterized by the simultaneous occurrence of skin inflammation (dermatitis) and diarrhea. The skin on the cheeks, elbows and knees and tissue about the mouth and anus are inflammed. There is also balding of the scalp, eyebrows and lashes, delayed wound healing and recurrent bacterial and fungal infections due to immune deficiency. The key laboratory finding is an abnormally low blood zinc level reflecting impaired zinc uptake. Oral treatment with zinc is curative.



Deficiency, alpha-1 antitrypsin

An inherited disease with little or no production of an important protein, alpha-1 antitrypsin. The lack of this protein leads to damage of various organs, mainly the lung and liver. The disease may become apparent at a very early age or in adulthood, as shortness of breath or liver-related symptoms (jaundice, fatigue, fluid in the abdomen, mental changes, or gastrointestinal bleeding). There are several options for treatment of the lung disease, including replacement of the missing protein. Treatment of the liver disease is a well-timed liver transplant.



Deficiency, calcium

A low blood calcium (hypocalcemia). Hypocalcemia makes the nervous system highly irritable with tetany (spasms of the hands and feet, muscle cramps, abdominal cramps, overly active reflexes, etc.). Chronic calcium deficiency contributes to poor mineralization of bones, soft bones (osteomalacia) and osteoporosis; and, in children, rickets and impaired growth. Food sources of calcium include dairy foods, some leafy green vegetables such as broccoli and collards, canned salmon, clams, oysters, calcium-fortified foods, and tofu. According to the National Academy of Sciences, adequate intake of calcium is 1 gram daily for both men and women. The upper limit for calcium intake is 2.5 grams daily.



Deficiency, glucocerebrosidase

Causes Gaucher’s disease (type 1), a progressive genetic disease, due to an enzyme defect. The enzyme, glucocerebrosidase, is needed to break down the chemical glucocerebroside. The enzyme defect in persons with Gaucher’s disease (GD) leads to the accumulation of glucocerebroside in the spleen, liver, and lymph nodes. The most common early sign is enlargement of the spleen (located in the upper left abdomen). Other signs include low red blood cell counts (anemia), a decrease in blood clotting cells (platelets), increased pigmentation of the skin, and a yellow fatty spot on the white of the eye (a pinguecula). Severe bone involvement can lead to pain and collapse of the bone of the hips, shoulders, and spine. The GD gene is on chromosome 1. The disease is a recessive trait. Both parents carry a GD gene and transmit it for their child with the disease. The parents’ risk of a child with the disease is 1 in 4 with each pregnancy. This type of Gaucher’s disease (noncerebral juvenile Gaucher’s disease) is most common in Ashkenazi Jews (of European origin) and is the most common genetic disease among Jews in the United States.



Deficiency, iron

Deficiency of iron results in anemia because iron is necessary to make hemoglobin, the key molecule in red blood cells responsible for the transport of oxygen. In iron deficiency anemia, the red cells are unusally small (microcytic) and pale (hypochromic). Characteristic features of iron deficiency anemia in children include failure to thrive (grow) and increased infections. The treatment of iron deficiency anemia , whether it be in children or adults, is with iron and iron-containing foods. Food sources of iron include meat, poultry, eggs, vegetables and cereals (especially those fortified with iron). According to the National Academy of Sciences, the Recommended Dietary Allowances of iron are 15 milligrams per day for women and 10 milligrams per day for men.


Deficiency, magnesium

Can occur due to inadequate intake or impaired intestinal absorption of magnesium. Low magnesium (hypomagnesemia) is often associated with low calcium (hypocalcemia) and potassium (hypokalemia) levels. Deficiency of magnesium causes increased irritability of the nervous system with tetany (spasms of the hands and feet, muscular twitching and cramps, spasm of the larynx, etc.). According to the National Academy of Sciences, the Recommended Dietary Allowances of magnesium are 420milligrams per day for men and 320 milligrams per day for women. The upperlimit of magnesium as supplements is 350 milligrams daily, in addition to the magnesium from food and water.



Deficiency, selenium

Deficiency of the essential mineral selenium causes Keshan disease, a fatal form of cardiomyopathy (disease of the heart muscle) first observed in Keshan province in China and since found elsewhere. According to the National Academy of Sciences, the Recommended Dietary Allowances of selenium are 70 milligrams per day for men and 55 milligrams per day for women. Food sources of selenium include seafoods, some meats such as kidney and liver, and some grains and seeds.


Dehydration

Excessive loss of body water. Diseases of the gastrointestinal tract may lead to dehydration. One clue to dehydration is a rapid drop in weight. A loss of over 10% (15 pounds in a person weighing 150 pounds) is considered severe. Symptoms include increasing thirst, dry mouth, weakness or lightheadedness (particularly if worsening on standing), or a darkening/decrease in urination are suggestive. Severe dehydration can lead to changes in the body’s chemistry, kidney failure, and become life-threatening. The best way to treat dehydration is to prevent it from occurring. If one suspects fluid loss is excessive, notify a physician. Intravenous or oral fluid replacement may be needed.



Dental braces (orthodontics)

The use of devices to move teeth or adjust underlying bone. The ideal age for starting orthodontic treatment is between ages 3 to 12 years. Temporomandibular joint (TMJ) problems can be corrected with splinting or dental braces. Teeth can be moved by removable appliances or by fixed braces. Crowding of teeth can require extraction of teeth. Retainers may be necessary long after dental braces are placed, especially with orthodontic treatment of adults.



Dental pain (toothache)

The most common cause of a toothache is a dental cavity. The second most common is gum disease. Toothache can be caused by a problem that does not originate from a tooth or the jaw.
Deoxyribonucleic acid (DNA)

The molecule that encodes the genetic information. DNA is a double-stranded molecule that is held together by weak bonds between base pairs of nucleotides to form a double helix. The four nucleotides in DNA contain the bases: adenine (A), guanine (G), cytosine ©, and thymine(T). Base pairs form naturally only between A and T and between G and C so the base sequence of each single strand of DNA can be simply deduced from that of its partner strand. The code is in triplets such as ATG. The base sequence of that triplet in the partner strand is therefore TAC.


Depression

Low spirits; dejection. Symptoms of depression include apathy, anorexia, lack of emotional expression (flat affect), social withdrawal and fatigue. Prevalent types of depression are major depression, dysthymia, and bipolar disorder. Some types of depression run in families. The first step to getting appropriate treatment is a complete physical and psychological evaluation to determine whether one, in fact, has a depressive illness.


Depression, bipolar

Formerly called manic- depressive illness. Not nearly as prevalent as other forms of depressive disorders, bipolar disorder involves cycles of depression and elation or mania. Sometimes the mood switches are dramatic and rapid, but most often they are gradual. When in the depressed cycle, you can have any or all of the symptoms of a depressive disorder. When in the manic cycle, any or all symptoms listed under mania may be experienced. Mania often affects thinking, judgment, and social behavior in ways that cause serious problems and embarrassment. For example, unwise business or financial decisions may be made when an individual is in a manic phase. Bipolar disorder is often a chronic recurring condition.



Desensitization, allergy

Stimulation of the immune system with gradually increasing doses of the substances to which a person is allergic, the aim being to modify or stop the allergy "war" (by reducing the strength of the IgE and its effect on the mast cells). This form of treatment is very effective for allergies to pollen, mites, cats, and especially stinging insects (eg, bees, hornets, yellowjackets, wasps, velvet ants, fire ants). Allergy immunotherapy usually takes 6 months to a year to become effective and shots (injections) are usually required for 3-5 years.



Diabetes mellitus

A chronic condition associated with abnormally high levels of sugar (glucose) in the blood.. Absence or insufficient production of insulin (which is produced by the pancreas and lowers blood glucose) causes diabetes. The two types of diabetes are referred to as insulin dependent (type I) and non-insulin dependent (type II). Symptoms of diabetes include increased urine output and appetite as well as fatigue. Diabetes mellitus is diagnosed by blood sugar (glucose) testing. The major complications of diabetes mellitus include dangerously elevated blood sugar, abnormally low blood sugar due to diabetes medications, and disease of the blood vessels which can damage the eye, kidneys, nerves, and heart. Treatment depends on the type of the diabetes.


Dialysis

The process of cleansing the blood by passing it through a special machine. Dialysis is necessary when the kidneys are not able to filter the blood. Dialysis allows patients with kidney failure a chance to live productive lives. There are two types of dialysis: hemodialysis and peritoneal dialysis. Each type of dialysis has advantages and disadvantages. Patients can often choose the type of long term dialysis that best matches their needs.


Dialysis, peritoneal

Technique that uses the patient’s own body tissues inside of the belly (abdominal cavity) to act as a filter. The intestines lie in the abdominal cavity, the space between the abdominal wall and the spine. A plastic tube called a "dialysis catheter" is placed through the abdominal wall into the abdominal cavity. A special fluid is then flushed into the abdominal cavity and washes around the intestines. The intestinal walls act as a filter between this fluid and the blood stream. By using different types of solutions, waste products and excess water can be removed from the body through this process.



Diaphragmatic hernia

Passage of a loop of bowel through the diaphragm muscle. This type of hernia occurs as the bowel from the abdomen "herniates" upward through the diaphragm into the chest (thoracic) cavity.


Diarrhea, antibiotic-induced

A bacterium called Clostridium difficile (C.difficile), one of the most common causes of infection of the large bowel (colon). Patients taking antibiotics are at particular risk of becoming infected with C. difficile. Antibiotics disrupt the normal bacteria of the bowel, allowing C. difficile bacteria (and other bacteria) to become established and overgrow the colon. Many persons infected with C. difficile bacteria have no symptoms but can become carriers of the bacteria and infect others. In other people, a toxin produced by C. difficile causes diarrhea, abdominal pain, severe inflammation of the colon (colitis), fever, an elevated white blood count, vomiting and dehydration. In severely affected patients, the inner lining of the colon becomes severely inflamed (a condition called pseudomembranous colitis). Rarely, the walls of the colon wear away and holes develop (colon perforation), which can lead to a life-threatening infection of the abdomen.



Diffuse idiopathic skeletal hyperostosis (DISH)

A form of degenerative arthritis characteristically associated with flowing calcification along the sides of the vertebrae of the spine and commonly with inflammation (tendinitis) and calcification of the tendons at their attachments points to bone. Because areas of the spine and tendons can become inflamed, antiinflammatory medications (NSAIDs), such ibuprofen, can be helpful in both relieving pain and inflammation. Also called Forestier’s disease.



Ear cleaning (yourself)

Never put anything smaller than your elbow in your ear! Wax is not formed in the deep part of the ear canal near the eardrum, but only in the outer part of the canal. So when a patient has wax pushed up against the eardrum, it is often because he has been probing his ear with such things as cotton-tipped swabs (such as Q-Tips), bobby pins, or twisted napkin corners. Such objects only serve as ramrods to push the wax in deeper. Also, the skin of the ear canal and the eardrum is very thin, fragile and easily injured. The ear canal is more prone to infection after it has been whipped clean of the "good" coating type wax. In addition, we have seen many perforated eardrums as a result of these efforts.

Ear cleaning (yourself)

Never put anything smaller than your elbow in your ear! Wax is not formed in the deep part of the ear canal near the eardrum, but only in the outer part of the canal. So when a patient has wax pushed up against the eardrum, it is often because he has been probing his ear with such things as cotton-tipped swabs (such as Q-Tips), bobby pins, or twisted napkin corners. Such objects only serve as ramrods to push the wax in deeper. Also, the skin of the ear canal and the eardrum is very thin, fragile and easily injured. The ear canal is more prone to infection after it has been whipped clean of the "good" coating type wax. In addition, we have seen many perforated eardrums as a result of these efforts.



malaria


A serious relapsing infection caused by protozoa of the genus Plasmodium (see plasmodium), transmitted by the bite of the Anopheles mosquito.

Known since before the 5th century BC, it occurs in tropical and subtropical regions near swamps. The roles of the mosquito and the parasite were proved in the early 20th century. Annual cases worldwide are estimated at 250 million and deaths at 2 million. Malaria from different Plasmodium species differs in severity, mortality, and geographic distribution. The parasites have an extremely complex life cycle; in one stage they develop synchronously inside red blood cells. Their mass fissions at 48-or 72-hour intervals cause attacks lasting 4–10 hours. Shaking and chills are followed by fever of up to 105 °F (40.6 °C), with severe headache and then profuse sweating as temperature returns to normal. Patients often have anemia, spleen enlargement, and general weakness. Complications can be fatal. Malaria is diagnosed by detecting the parasites in blood. Quinine was long used to alleviate the fevers. Synthetic drugs, such as chloroquine, destroy the parasites in blood cells, but many strains are now resistant. Carriers of a gene for a hemoglobinopathy have natural resistance. Malaria prevention requires preventing mosquito bites: eliminating mosquito breeding places and using insecticides or natural predators, window screens, netting, and insect repellent. See also protozoal disease.



Jaundice

Jaundice is a yellowish staining of the skin and white of the eyes (sclerae) with pigment of bile. Jaundice can be an indicator of liver or gallbladder disease or result from red blood cells rupturing (hemolysis).



hepatitis


Inflammation of the liver.

There are seven known types of viral hepatitis (A-G). Types A, spread mainly through food contaminated with feces, and B, transmitted sexually or by injection, cause jaundice and flulike symptoms. The hepatitis C virus spreads mostly by shared needles in intravenous drug use and can cause liver cirrhosis and cancer after a long latent period. Until recently there was no test to detect it in blood, and many people were exposed through blood transfusions. Hepatitis D becomes active only in the presence of type B; it causes severe chronic liver disease. Type E, like Type A, is transmitted by contaminated food or water; its symptoms are more severe than Type A's and can result in death. The hepatitis F virus (HFV), which was first reported in 1994, is spread like Type A and E. The hepatitis G virus (HGV), isolated in 1996, is believed to be responsible for many sexually transmitted and bloodborne cases of hepatitis. Vaccines exist for types A and B (the second also prevents type D). Drug treatment for B and C is not always effective. The other types may not need drug treatment. Chronic active hepatitis causes spidery and striated skin markings, acne, and abnormal hair growth. It results in liver tissue death (necrosis) progressing to cirrhosis. Alcoholic hepatitis, from long-term overconsumption of alcohol, can be reversed and cirrhosis prevented by early treatment including quitting or sharply reducing drinking. Other drugs can also cause noninfectious hepatitis. An autoimmune hepatitis affects mainly young women and is treated with corticosteroids to relieve symptoms.


cancer


Uncontrolled multiplication of abnormal cells.

Cancerous cells and tissues have abnormal growth rates, shapes, sizes, and functioning. Cancer may progress in stages from a localized tumour (confined to the site of origin) to direct extension (spread into nearby tissue or lymph nodes) and metastasis (spread to more distant sites via the blood or lymphatic system). This malignant growth pattern distinguishes cancerous tumours from benign ones. Cancer is also classified by grade, the extent to which cell characteristics remain specific to their tissue of origin. Both stage and grade affect the chances of survival. Genetic factors and immune status affect susceptibility. Triggers include hormones, viruses, smoking, diet, and radiation. Cancer can begin in almost any tissue, including blood (see leukemia) and lymph (see lymphoma). When it metastasizes, it remains a cancer of its tissue of origin. Early diagnosis and treatment increase the chance of cure. Treatment may include chemotherapy, surgery, and radiation therapy. See also bladder cancer; breast cancer; carcinogen; colorectal cancer; Kaposi sarcoma; laryngeal cancer; lung cancer; ovarian cancer; pancreatic cancer; prostate cancer; skin cancer; stomach cancer; uterine cancer.


Cancer

Also called malignancy. Cancer refers to a abnormal growths which have a tendency to grow uncontrolled and metastasize. It can involve any tissue of the body and can have many different forms in each body area. Cancer is a group of more than 100 different diseases. Benign tumors are not cancer; malignant tumors are cancer. Most cancers are named for the type of cell or the organ in which they begin. When cancer spreads (metastasizes), the new tumor has the same name as the original (primary) tumor. Skin cancer is the most common type of cancer for both men and women. The second most common cancer in men is prostate cancer, in women it is breast cancer. Lung cancer is the leading cause of death from cancer for both men and women in the U.S. Cancer is NOT contagious.


rabies


Acute, usually fatal infectious disease of warm-blooded animals that attacks the central nervous system.

It is spread by contact with an infected animal's saliva, usually from a bite. The rhabdovirus that causes it spreads along nerve tissue from the wound to the brain. Symptoms usually appear four to six weeks later, often beginning with irritability and aggressiveness. Wild animals lose their fear of humans and are easily provoked to bite, as are pets. Depression and paralysis soon follow. Death usually comes three to five days after symptoms begin. In humans, death can result from a seizure in the early phase even before symptoms of central nervous system depression develop. One name for rabies, hydrophobia ("fear of water"), comes from painful throat contraction on trying to swallow. If not treated in time (within a day or two) with a serum containing antibodies and then a series of vaccinations, rabies in humans is almost always fatal. Immediate cleansing of animal bites with soap and water can remove much of the virus.


Rabies

Virus disease of warmblooded animals transmitted to people by a bite (or other means). Animals capable of carrying rabies include dogs, bats, cats, racoons and skunks. In Latin, rabies means madness or rage.


insomnia


Inability to sleep adequately.

The causes may include poor sleeping conditions, circulatory or brain disorders, breathing disorders (e.g., sleep apnea), mental distress (e.g., tension or depression), or physical discomfort. Mild insomnia may be treated by improving sleeping conditions or through traditional remedies such as warm baths, milk, or systematic relaxation. Apnea and its associated insomnia may be treated surgically or mechanically with breathing apparatus. Severe or chronic insomnia may necessitate the temporary use of barbiturates or tranquilizers, but such drugs are often addictive and may be decreasingly effective as the body builds up tolerance. Other methods of treatment include psychotherapy and hypnosis.



scurvy


or vitamin C deficiency

Nutritional disorder caused by deficiency of vitamin C.

Deficiency interferes with tissue synthesis, causing swollen, bleeding gums; loose teeth; sore, stiff joints and legs; bleeding under the skin and in deep tissues; slow wound healing; and anemia. The scourge of sailors on long sea voyages, scurvy was recognized as diet-related in 1753, when James Lind showed that drinking citrus juice could cure and prevent it, leading to the concept of deficiency diseases. Full-blown scurvy is now rare, and adequate vitamin C usually cures even severe cases in days.



pneumonia


Inflammation and solidification of lung tissue caused by infection, foreign particle inhalation, or irradiation but usually by bacteria.

Mycoplasma pneumoniae is the most common cause in healthy individuals. The bronchi and alveoli may be inflamed. Coughing becomes severe and may bring up flecks of blood. It can be serious but is rarely fatal. Streptococcus pneumoniae is more common and generally more severe but usually affects only those with low resistance, especially in hospitals. A highly lethal form caused by Klebsiella pneumoniae is almost always confined to hospitalized patients with low immunity. Other bacterial pneumonias include Pneumocystis carinii pneumonia (rare except in AIDS) and Legionnaire disease. Most respond to antibiotic treatment. Viruses set the stage for bacterial pneumonia by weakening the individual's immune system more often than they cause pneumonia directly. Fungal pneumonia usually occurs in hospitalized persons with low resistance, but contaminated dusts can cause it in healthy individuals. It can develop rapidly and may be fatal. X-ray treatment (see radiation therapy) of structures in the chest may cause temporary lung inflammation.