Clinical Information System: From 1 Different Sources
An information system that collects, stores and transmits information that is used to support clinical applications (e.g. transmission of laboratory test results, radiology results, prescription drug orders). Electronic medical records are one method by which clinical information systems can be created.
A collective term for the brain, spinal cord, their nerves, and the sensory end organs. More broadly, this can even include the neurotransmitting hormones instigated by the CNS that control the chemical nervous system, the endocrine glands.... central nervous system
A controlled research study of the safety and effectiveness of drugs, devices or techniques that occurs in four phases, starting with the enrolment of a small number of people, to the later stages in which thousands of people are involved prior to approval by the licensing authorities (for example, the Food and Drug Administration).... clinical trial
A functional, not physical, system in the brain, generally considered to mediate emotions with metabolism.... limbic system
See IMMUNITY.
Age Disease and mode of administration
3 days BCG (Bacille Calmette-Guerin) by injection if tuberculosis in family in past 6 months.
2 months Poliomyelitis (oral); adsorbed diphtheria, whooping-cough (pertussis)1 and tetanus2 (triple vaccine given by injection); HiB injection.3
3 months Poliomyelitis (oral); diphtheria, whooping-cough (pertussis)1 and tetanus2 (triple vaccine given by injection); HiB injection.3
4 months Poliomyelitis (oral); diphtheria, whooping-cough (pertussis)1 and tetanus2 (triple vaccine given by injection); HiB injection.3
12–18 months Measles, mumps, and rubella (German measles)4 (given together live by injection).
(SCHOOL ENTRY)
4–5 years Poliomyelitis (oral); adsorbed diphtheria and tetanus (given together by injection); give MMR vaccine if not already given at 12–18 months.
10–14 females Rubella (by injection) if they have missed MMR.
10–14 BCG (Bacille Calmette-Guerin) by injection to tuberculin-negative children to prevent tuberculosis.
15–18 Poliomyelitis single booster dose (oral); tetanus (by injection).
1 Pertussis may be excluded in certain susceptible individuals.
2 Known as DPT or triple vaccine.
3 Haemophilus in?uenzae immunisation (type B) is being introduced to be given at same time, but di?erent limb.
4 Known as MMR vaccine. (Some parents are asking to have their infants immunised with single-constituent vaccines because of controversy over possible side-effects – yet to be con?rmed scienti?cally – of the combined MMR vaccine.)
Recommended immunisation schedules in the United Kingdom... immune system
All the organs and tissues associated with the act of RESPIRATION or breathing. The term includes the nasal cavity (see NOSE) and PHARYNX, along with the LARYNX, TRACHEA, bronchi (see BRONCHUS), BRONCHIOLES and LUNGS. The DIAPHRAGM and other muscles, such as those between the RIBS, are also part of the respiratory system which is responsible for oxygenating the blood and removing carbon dioxide from it.... respiratory system
This extensive, complex and ?nely tuned network of billions of specialised cells called neurones (see NEURON(E)) is responsible for maintaining the body’s contacts with and responses to the outside world. The network also provides internal communication links – in concert with HORMONES, the body’s chemical messengers – between the body’s diverse organs and tissues, and, importantly, the BRAIN stores relevant information as memory. Each neurone has a ?lamentous process of varying length called an AXON along which passes messages in the form of electrochemically generated impulses. Axons are bundled together to form nerves (see NERVE).
The nervous system can be likened to a computer. The central processing unit – which receives, processes and stores information and initiates instructions for bodily activities – is called the central nervous system: this is made up of the brain and SPINAL CORD. The peripheral nervous system – synonymous with the cables that transmit information to and from a computer’s processing unit – has two parts: sensory and motor. The former collects information from the body’s many sense organs. These respond to touch, temperature, pain, position, smells, sounds and visual images and the information is signalled to the brain via the sensory nerves. When information has been processed centrally, the brain and spinal cord send instructions for action via motor nerves to the ‘voluntary’ muscles controlling movements and speech, to the ‘involuntary’ muscles that operate the internal organs such as the heart and intestines, and to the various glands, including the sweat glands in the skin. (Details of the 12 pairs of cranial nerves and the 31 pairs of nerves emanating from the spinal cord are given in respective texts on brain and spinal cord.)
Functional divisions of nervous system As well as the nervous system’s anatomical divisions, the system is divided functionally, into autonomic and somatic parts. The autonomic nervous system, which is split into sympathetic and parasympathetic divisions, deals with the automatic or unconscious control of internal bodily activities such as heartbeat, muscular status of blood vessels, digestion and glandular functions. The somatic system is responsible for the skeletal (voluntary) muscles (see MUSCLE) which carry out intended movements initiated by the brain – for example, the activation of limbs, tongue, vocal cords (speech), anal muscles (defaecation), urethral sphincters (urination) or vaginal muscles (childbirth). In addition, many survival responses – the most powerfully instinctive animal drives, which range from avoiding danger and pain to shivering when cold or sweating when hot – are initiated unconsciously and automatically by the nervous system using the appropriate neural pathways to achieve the particular survival reaction required.
The complex functions of the nervous system include the ability to experience emotions, such as excitement and pleasure, anxiety and frustration, and to undertake intellectual activities. For these experiences an individual can utilise many built-in neurological programmes and he or she can enhance performance through learning – a vital human function that depends on MEMORY, a three stage-process in the brain of registration, storage and recall. The various anatomical and functional divisions of the nervous system that have been unravelled as science has strived to explain how it works may seem confusing. In practical terms, the nervous system works mainly by using automatic or relex reactions (see REFLEX ACTION) to various stimuli (described above), supplemented by voluntary actions triggered by the activity of the conscious (higher) areas of the brain. Some higher functions crucial to human activity – for example, visual perception, thought, memory and speech – are complex and subtle, and the mechanisms are not yet fully understood. But all these complex activities rest on the foundation of relatively simple electrochemical transmissions of impulses through the massive network of billions of specialised cells, the neurones.... nervous system
Involving the whole body or organism, and not just individual parts.... systemic
Part of the nervous system which regulates the bodily functions that are not under conscious control: these include the heartbeat, intestinal movements, salivation, sweating, etc. The autonomic nervous system consists of two main divisions – the SYMPATHETIC NERVOUS SYSTEM and the PARASYMPATHETIC NERVOUS SYSTEM. The smooth muscles, heart and most glands are connected to nerve ?bres from both systems and their proper functioning depends on the balance between these two. (See also NERVES; NERVOUS SYSTEM.)... autonomic nervous system
A framework through which health organizations are accountable for continuously improving the quality of their services and safeguarding high standards of care.... clinical governance
See NERVOUS SYSTEM.... peripheral nervous system
A network of interdependent components that work together to attain the goals of the complex whole.... system
Part of the AUTONOMIC NERVOUS SYSTEM. It consists of scattered collections of grey matter known as ganglia, united by an irregular network of nerve-?bres; those portions where the ganglia are placed most closely and where the network of ?bres is especially dense being known as plexuses. The chief part of the sympathetic system consists of two ganglionated cords that run through the neck, chest, and abdomen, lying close in front of the spine. In conjunction with the other part of the autonomic nervous system – the parasympathetic – this part controls many of the body’s involuntary activities involving glands, organs and other tissues. (For further details, see NERVOUS SYSTEM.)... sympathetic nervous system
Lymph is the same fluid which oozes from a cut when bleeding stops. It surrounds every living cell. Lymph conveys to the blood the final products of digestion of food. It also receives from the blood waste products of metabolism. This is a two-way traffic.
Lymph fluid, loaded with waste, excess protein, etc, is sucked into the lymph tubes to be filtered by the spleen and the lymph nodes. The tubes are filled with countless one-way valves referred to collectively as the lymphatic pump, which propels the flow of lymph forwards. Lymph ultimately is collected in the main thoracic duct rising upwards in front of the spine to enter the bloodstream at the base of the neck.
A number of disorders may arise when the fluid becomes over-burdened by toxaemia, poor drainage and enlarged nodes (glands). Such un-eliminated wastes form cellulite – unwanted tissue formation and swelling. Thus, the soil may be prepared for various chronic illnesses from glandular disorders to arthritis. If the lymph is circulating freely it is almost impossible to become sick.
This system is capable of ingesting foreign particles and building up an immunity against future infection. Some herbal Lymphatics are also antimicrobials, natural alternatives to conventional antibiotics.
Treatment. Clivers is particularly relative to glandular swellings of neck and axillae.
For active inflammation: Echinacea, Goldenseal, Ginseng (Panax).
Alternatives. Teas: Clivers, Red Clover, Agnus Castus herb, Bladderwrack, Violet leaves, Marigold petals.
Decoctions: Blue Flag, Echinacea, Fenugreek seeds, Saw Palmetto.
Tablets/capsules. Agnus Castus, Echinacea, Bladderwrack, Red Clover, Thuja, Poke root, Fenugreek. Formula No 1. Echinacea 2; Clivers 1; Burdock 1; Poke root half. Dose: Liquid Extracts: one 5ml teaspoon. Tinctures: two 5ml teaspoons. Powders: 500mg (two 00 capsules or one-third teaspoon). Thrice daily.
Formula No 2. Equal parts: Blue Flag root, Poke root, Senna. Dose: as above.
Topical. Poultices: Slippery Elm, Fenugreek seeds, Marshmallow. Horsechestnut (Aesculus) ointment. ... lymphatic system
This refers to the whole circulatory system: the heart, the systemic circulation (the arteries and veins of the body) and the pulmonary circulation (the arteries and veins of the lungs). Blood circulates throughout the cardiovascular system bringing oxygen and nutrients to the tissues and removing carbon dioxide and other waste products.... cardiovascular system
A MEDICAL AUDIT carried out by health professionals.... clinical audit
A vein or collection of veins which ?nish at both ends in a bed of capillary blood vessels. An important example is the hepatic portal system, comprising the portal vein and its tributaries. Blood from the stomach, pancreas, spleen and intestines drains into the veins that join up to comprise the portal vein into the liver, where it branches into sinusoids.... portal system
A collective term for all the organs involved in sexual reproduction. In the female these are the OVARIES, FALLOPIAN TUBES, UTERUS, VAGINA and VULVA. In the male these are the testes (see TESTICLE), VAS DEFERENS, SEMINAL VESICLES, URETHRA and PENIS.... reproductive system
That part of the AUTONOMIC NERVOUS SYSTEM which is connected with the BRAIN and SPINAL CORD through certain nerve centres in the midbrain, medulla, and lower end of the cord. The nerves from these centres are carried in the third, seventh, ninth and tenth cranial nerves and the second, third and fourth sacral nerves. The action of the parasympathetic system is usually antagonistic to that of the sympathetic system. Thus it inhibits the action of the HEART and augments the action of the INTESTINE; whereas the sympathetic augments the action of the heart and inhibits that of the intestine. (See diagram of sympathetic and parasympathetic nervous systems under NERVOUS SYSTEM.)... parasympathetic nervous system
See separate dictionary entry.... systemic lupus erythematosus (sle)
A system in which prices for health services and payment methods are the same, regardless of who is paying. For instance, in an all payer system, federal or state government, a private insurer, a self-insured employer plan, an individual, or any other payer could pay the same rates. The uniform fee bars health care providers from shifting costs from one payer to another. See “cost shifting”.... all payer system
A complete system of theory and practices that has evolved independently of, and often prior to, the conventional biological approach. Many are traditional systems of medicine that are practised by individual cultures throughout the world. Traditional Oriental medicine and Ayurveda, India’s traditional system of medicine, are two examples.... alternative medical system
A system for planning of appointments between resources such as clinicians and facilities and patients. It is used in order to minimize waiting times, prioritize appointments and optimize the utilization of resources.... appointment scheduling system
A structured process developed to ensure that assessment is relevant, consistent, fair and valid. The system requires rules of operation, a regular review process and competent assessors.... assessment system
The several blood factors that enable the acid waste products of metabolism to be carried in the alkaline blood without disrupting its chemistry. These include carbolic acid, carbonates, phosphates, electrolytes, blood proteins, and erythrocyte membranes.... buffering system
The course of the circulation is as follows: the veins pour their blood, coming from the head, trunk, limbs and abdominal organs, into the right atrium of the HEART. This contracts and drives the blood into the right ventricle, which then forces the blood into the LUNGS by way of the pulmonary artery. Here it is contained in thin-walled capillaries, over which the air plays freely, and through which gases pass readily out and in. The blood gives o? carbon dioxide (CO2) and takes up oxygen (see RESPIRATION), and passes on by the pulmonary veins to the left atrium of the heart. The left atrium expels it into the left ventricle, which forces it on into the aorta, by which it is distributed all over the body. Passing through capillaries in the various tissues, it enters venules, then veins, which ultimately unite into two great veins, the superior and the inferior vena cava, these emptying into the right atrium. This complete circle is accomplished by any particular drop of blood in about half a minute.
In one part of the body there is a further complication. The veins coming from the bowels, charged with food material and other products, split up, and their blood undergoes a second capillary circulation through the liver. Here it is relieved of some food material and puri?ed, and then passes into the inferior vena cava, and so to the right atrium. This is known as the portal circulation.
The circle is maintained always in one direction by four valves, situated one at the outlet from each cavity of the heart.
The blood in the arteries going to the body generally is bright red, that in the veins dull red in colour, owing to the former being charged with oxygen and the latter with carbon dioxide (see RESPIRATION). For the same reason the blood in the pulmonary artery is dark, that in the pulmonary veins is bright. There is no direct communication between the right and left sides of the heart, the blood passing from the right ventricle to the left atrium through the lungs.
In the embryo, before birth, the course of circulation is somewhat di?erent, owing to the fact that no nourishment comes from the bowels nor air into the lungs. Accordingly, two large arteries pass out of the navel, and convey blood to be changed by contact with maternal blood (see PLACENTA), while a large vein brings this blood back again. There are also communications between the right and left atria, and between pulmonary artery and aorta. The latter is known as the ductus arteriosus. At birth all these extra vessels and connections close and rapidly shrivel up.... circulatory system of the blood
Clinical means literally ‘belonging to a bed’, but the word is used to denote anything associated with the practical study or observation of sick people – as in clinical medicine, clinical thermometers.... clinical
Professional specialized or therapeutic care that requires ongoing assessment, planning, intervention and evaluation by health care professionals.... clinical care
A diagnosis (e.g. myocardial infarct) or a patient state that may be associated with more than one diagnosis (such as paraplegia) or that may be as yet undiagnosed (such as low back pain).... clinical condition
Cleavers tea has been used for centuries, even in ancient Greece. It is considered probably the best tonic for the lymphatic system available. Discover all of its benefits and learn how to make the most of this type of tea.
Description of Cleavers tea
Cleavers is an annual green plant that grows mostly in Britain, North America and Eurasia regions. The green to white flowers look like small balls and they are very sticky, similar to the leaves.
Scientifically named gallium aparine, cleavers is also called bedstraw, barweed, catchweed, grip grass. The entire cleavers plant is used in herbal medicine and is harvested just before it blooms in early summer.
The active constituents of cleavers tea are chlorophyll, citric acide, rubichloric acid, galiosin and tannins. To benefit the most from these constituents, you can consume cleavers, usually found in the form of tea, extracts, capsule, or fresh for many cooking recipes. The roasted seeds are used as a coffee substitute and the young leaves can be eaten like spinach.
Cleavers tea has a slightly bitter taste and no odor.
Cleavers tea brew
For a tasty Cleavers tea, take 2 to 3 teaspoons of the dried above-ground parts of the plant and infuse them in a 250 mg cup of hot water for 10 or 15 minutes. You may add sugar or honey to improve its taste and drink up to three times per day.
Cleavers tea Benefits
Cleavers tea is a strong detoxifying for the lymphatic system. It is diuretic, thus treating most of urinary tract infections.
It cleans the blood, the liver and kidneys. The tea can be used together with Uva Ursi or Echinacea for best results.
Applied topically, Cleavers tea helps in the treatment of many skin conditions like acne, eczema, psoriasis, dandruff, itchy scalp, sunburns or even wounds.
Cleavers tea can be used as a facial tonner because it helps clear the complexion.
Cleavers tea Side effects
Cleavers tea has no known side effects. Though it is widely safe, children, pregnant or nursing women should drink it with precaution.
Cleavers tea can surely be included in a healthy lifestyle. As long as you don’t exaggerate with it, you can enjoy the benefits of this tea and even use the plant to prepare many tasty recipes and salads.... cleavers tea - best tonic for the lymphatic system available in nature
Services provided to patients (history-taking, physical examination, preventive care, tests, procedures, drugs, advice) or information on clinical condition or on patient state used as a patient outcome.... clinical event
Systematically developed statements which assist clinicians and patients to decide on appropriate treatments for speci?c conditions. The guidelines are attractive to health managers and patients because they are potentially able to reduce variation in clinical practice. This helps to ensure that patients receive the right treatment of an acceptable standard. In England and Wales, the NATIONAL INSTITUTE FOR CLINICAL EXCELLENCE (NICE) is developing national guidelines with advice from health-care professionals and patients to improve clinical e?ectiveness of NHS care. Some doctors have reservations about guidelines because (1) health-care managers might use them primarily to contain costs; (2) in?exibility would discourage clinical innovations; (3) they could encourage litigation by patients. (See also HEALTH CARE COMMISSION; MEDICAL LITIGATION.)... clinical guidelines
Clinical information, excluding information about treatment and intervention. Clinical information that does not record an intervention is by nature a clinical observation. The observer may be the patient or related person (information about symptoms, family history, occupation or lifestyle) or a health care professional (information about physical signs, measurements, properties observed or diagnoses). While information about the nature of a planned or performed treatment is excluded by the definition, clinical observations may be recorded on the results of a treatment, on progress during the course of a treatment, or on the result of a treatment.... clinical observation
A multidisciplinary set of daily prescriptions and outcome targets for managing the overall care of a specific type of patient, e.g. from pre-admission to post-discharge for patients receiving inpatient care. Clinical pathways are often intended to maintain or improve quality of care and decrease costs for patients in particular diagnosis-related groups.... clinical pathway
An instrument that estimates the extent to which a health care provider delivers clinical services that are appropriate for each patient’s condition; provides them safely, competently and in an appropriate time-frame; and achieves desired outcomes in terms of those aspects of patient health and patient satisfaction that can be affected by clinical services.... clinical performance measure
A systematically developed statement to assist practitioner and patient decisions about appropriate health care for one or more specific clinical circumstances.... clinical practice guideline
A conclusion that an intervention has an effect that is of practical meaning to older persons and health care providers. Even though an intervention is found to have a statistically significant effect, this effect may not be clinically significant. In a trial with a large number of participants, a small difference between treatment and control groups may be statistically significant, but clinically unimportant. In a trial with few participants, an important clinical difference may be observed that does not achieve statistical significance. (A larger trial may be needed to confirm that this is a statistically significant difference).... clinical significance
The physical manifestations of an illness elicited by a doctor when examining a patient – for example, a rash, lump, swelling, fever or altered physical function such as re?exes.... clinical signs
Initially driven by anxiety about the possibility of medical negligence cases, clinical risk management has evolved into the study of IATROGENIC DISEASE. The ?rst priority of risk managers is to ensure that all therapies in medicine are as safe as possible. Allied to this is a recognition that errors may occur even when error-prevention strategies are in place. Lastly, any accidents that occur are analysed, allowing a broader understanding of their cause. Risk management is generally centred on single adverse events. The threat of litigation is taken as an opportunity to expose unsafe conditions of practice and to put pressure on those with the authority to implement change. These might include senior clinicians, hospital management, the purchasing authorities, and even the Secretary of State for Health. Attention is focused on organisational factors rather than on the individuals involved in a speci?c case.... clinical risk management
The experiences of a patient as communicated to a doctor, for example, pain, weakness, cough. They may or may not be accompanied by con?rmatory CLINICAL SIGNS.... clinical symptoms
An integrated collection of computer and telecommunication capabilities that permit multiple providers, payers, employers and related health care entities within a geographic area to share and communicate client, clinical and payment information.... community health information network (chin)
This is part of the body’s defence mechanism that comprises a series of 20 serum peptides (see PEPTIDE). These are sequentially activated to produce three signi?cant effects: ?rstly, the release of small peptides which provoke in?ammation and attract phagocytes (see PHAGOCYTE); secondly, the deposition of a substance (component C3b) on the membranes of invading bacteria or viruses, attracting phagocytes to destroy the microbes; thirdly, the activation of substances that damage cell membranes – called lytic components – which hasten the destruction of ‘foreign’ cells. (See IMMUNOLOGY.)... complement system
A health system that includes all the elements required to meet all the health needs of the population.... comprehensive health system
See “decision analysis”.... decision support system
See “health system”.... health care delivery system
The generation and the use of appropriate health information to support decision-making, health care delivery and management of health services at national and subnational level.... health information system
Services, facilities, institutions, personnel or establishments, organizations and those operating them for the delivery of a variety of health programmes.... health system infrastructure
Research dealing with the entire health system or only part of it, the object being to ensure that the system is optimally planned and organized and that programmes are carried out by the health system infrastructure efficiently and effectively and with appropriate technology.... health systems research
A designated site or contact for locating needed services or care for older adults.... information and referral service
Decision processes oriented towards the creation or acquisition of information and knowledge, the design of information storage and flow, and the allocation and utilization of information in organizational work processes. See also “health information system”.... information management
The advent of computing has had widespread effects in all areas of society, with medicine no exception. Computer systems are vital – as they are in any modern enterprise – for the administration of hospitals, general practices and health authorities, supporting payroll, ?nance, stock ordering and billing, resource and bed management, word-processing correspondence, laboratory-result reporting, appointment and record systems, and management audit.
The imaging systems of COMPUTED TOMOGRAPHY (CT) and magnetic resonance imaging (see MRI) have powerful computer techniques underlying them.
Computerised statistical analysis of study data, population databases and disease registries is now routine, leading to enhanced understanding of the interplay between diseases and the population. And the results of research, available on computerised indexes such as MEDLINE, can be obtained in searches that take only seconds, compared with the hours or days necessary to accomplish the same task with its paper incarnation, Index Medicus.
Medical informatics The direct computerisation of those activities which are uniquely medical – history-taking, examination, diagnosis and treatment – has proved an elusive goal, although one hotly pursued by doctors, engineers and scientists working in the discipline of medical informatics. Computer techniques have scored some successes: patients are, for example, more willing to be honest about taboo areas, such as their drug or alcohol consumption, or their sexual proclivities, with a computer than face to face with a clinician; however, the practice of taking a history remains the cornerstone of clinical practice. The examination of the patient is unlikely to be supplanted by technological means in the foreseeable future; visual and tactile recognition systems are still in their infancy. Skilled interpretation of the result by machine rather than the human mind seems equally as remote. Working its way slowly outwards from its starting point in mathematical logic, ARTIFICIAL INTELLIGENCE that in any way mimics its natural counterpart seems a distant prospect. Although there have been successes in computer-supported diagnosis in some specialised areas, such as the diagnosis of abdominal pain, workable systems that could supplant the mind of the generalist are still the dream of the many developers pursuing this goal, rather than a reality available to doctors in their consulting rooms now.
In therapeutics, computerised prescribing systems still require the doctor to make the decision about treatment, but facilitate the process of writing, issuing, and recording the prescription. In so doing, the system can provide automated checks, warning if necessary about allergies, potential drug interactions, or dosing errors. The built-in safety that this process o?ers is enhanced by the superior legibility of the script that ensues, reducing the potential for error when the medicine is dispensed by the nurse or the pharmacist.
Success in these individual applications continues to drive development, although the process has its critics, who are not slow to point to the lengthier consultations that arise when a computer is present in the consulting room and its distracting e?ect on communication with the patient.
Underlying these many software applications lies the ubiquitous personal computer – more powerful today than its mainframe predecessor of only 20 years ago – combined with networking technology that enables interconnection and the sharing of data. As in essence the doctor’s role involves the acquisition, manipulation and application of information – from the individual patient, and from the body of medical knowledge – great excitement surrounds the development of open systems that allow di?erent software and hardware platforms to interact. Many problems remain to be solved, not least the fact that for such systems to work, the whole organisation, and not just a few specialised individuals, must become computer literate. Such systems must be easy to learn to use, which requires an intuitive interface between user(s) and system(s) that is predictable and logical in its ordering and presentation of information.
Many other issues stand in the way of the development towards computerisation: standard systems of nomenclature for medical concepts have proved surprisingly di?cult to develop, but are crucial for successful information-sharing between users. Sharing information between existing legacy systems is a major challenge, often requiring customised software and extensive human intervention to enable the previous investments that an organisation has made in individual systems (e.g. laboratory-result reporting) to be integrated with newer technology. The beginnings of a global solution to this substantial obstacle to networking progress is in sight: the technology that enables the Internet – an international network of telephonically linked personal computers – also enables the establishment of intranets, in which individual servers (computers dedicated to serving information to other computers) act as repositories of ‘published’ data, which other users on the network may ‘browse’ as necessary in a client-server environment.
Systems that support this process are still in early stages of development, but the key conceptualisations are in place. Developments over the next 5–10 years will centre on the electronic patient record available to the clinician on an integrated clinical workstation. The clinical workstation – in essence a personal computer networked to the hospital or practice system – will enable the clinician to record clinical data and diagnoses, automate the ordering of investigations and the collection of the results, and facilitate referral and communication between the many professionals and departments involved in any individual patient’s care.
Once data is digitised – and that includes text, statistical tables, graphs, illustrations and radiological images, etc. – it may be as freely networked globally as locally. Consultations in which live video and sound transmissions are the bonds of the doctor-patient relationship (the techniques of telemedicine) are already reality, and have proved particularly convenient and cost-e?ective in linking the patient and the generalist to specialists in remote areas with low population density.
As with written personal medical records, con?dentiality of personal medical information on computers is essential. Computerised data are covered by the Data Protection Act 1984. This stipulates that data must:
be obtained and processed fairly and lawfully.
be held only for speci?ed lawful purposes.
•not be used in a manner incompatible with those purposes.
•only be recorded where necessary for these purposes.
be accurate and up to date.
not be stored longer than necessary.
be made available to the patient on request.
be protected by appropriate security and backup procedures. As these problems are solved, concerns about
privacy and con?dentiality arise. While paper records were often only con?dential by default, the potential for breaches of security in computerised networks is much graver. External breaches of the system by hackers are one serious concern, but internal breaches by authorised users making unauthorised use of the data are a much greater risk in practice. Governing network security so that clinical users have access on a need-to-know basis is a di?cult business: the software tools to enable this – encryption, and anonymisation (ensuring that clinical information about patients is anonymous to prevent con?dential information about them leaking out) of data collected for management and research processes – exist in the technical domain but remain a complex conundrum for solution in the real world.
The mushroom growth of websites covering myriad subjects has, of course, included health information. This ranges from clinical details on individual diseases to facts about medical organisations and institutes, patient support groups, etc. Some of this information contains comments and advice from orthodox and unorthodox practitioners. This open access to health information has been of great bene?t to patients and health professionals. But web browsers should be aware that not all the medical information, including suggested treatments, has been subject to PEER REVIEW, as is the case with most medical articles in recognised medical journals.... information technology in medicine
(See EVIDENCE-BASED MEDICINE.) Clinical trials aim to evaluate the relative effects of di?erent health-care interventions. They are based on the idea that there must a fair comparison of the alternatives in order to know which is better. Threats to a fair comparison include the play of chance and bias, both of which can cause people to draw the wrong conclusions about how e?ective a treatment or procedure is.
An appreciation of the need to account for chance and bias has led to development of methods where new treatments are compared to either a PLACEBO or to the standard treatment (or both) in a controlled, randomised clinical trial. ‘Controlled’ means that there is a comparison group of patients not receiving the test intervention, and ‘randomised’ implies that patients have been assigned to one or other treatment group entirely by chance and not because of their doctor’s preference. If possible, trials are ‘double-blind’ – that is, neither the patient nor the investigator knows who is receiving which intervention until after the trial is over. All such trials must follow proper ethical standards with the procedure fully explained to patients and their consent obtained.
The conduct, e?ectiveness and duplication of clinical trials have long been subjects of debate. Apart from occasional discoveries of deliberately fraudulent research (see RESEARCH FRAUD AND MISCONDUCT), the structure of some trials are unsatisfactory, statistical analyses are sometimes disputed and major problems have been the – usually unwitting – duplication of trials and non-publication of some trials, restricting access to their ?ndings. Duplication occurs because no formal international mechanism exists to enable research workers to discover whether a clinical trial they are planning is already underway elsewhere or has been completed but never published, perhaps because the results were negative, or no journal was willing to publish it, or the authors or funding authorities decided not to submit it for publication.
In the mid 1980s a proposal was made for an international register of clinical trials. In 1991 the NHS launched a research and development initiative and, liaising with the COCHRANE COLLABORATION, set out to collect systematically data from published randomised clinical trials. In 1994 the NHS set up a Centre for Reviews and Dissemination which, among other responsibilities, maintains a database of research reviews to provide NHS sta? with relevant information.
These e?orts are hampered by availability of information about trials in progress and unpublished completed trials. With a view to improving accessibility of relevant information, the publishers of Current Science, in 1998, launched an online metaregister of ongoing randomised controlled trials.
Subsequently, in October 1999, the editors of the British Medical Journal and the Lancet argued that the case for an international register of all clinical trials prior to their launch was unanswerable. ‘The public’, they said, ‘has the right to know what research is being funded. Researchers and research funders don’t want to waste resources repeating trials already underway.’ Given the widening recognition of the importance to patients and doctors of the practice of EVIDENCE-BASED MEDICINE, the easy availability of information on planned, ongoing and completed clinical trials is vital. The register was ?nally set up in 2005.... clinical trials
A network of organizations, usually including hospitals and medical practitioner groups, that provides or arranges to provide a coordinated continuum of services to a defined population and is held both clinically and financially accountable for the outcomes in the populations served.... integrated delivery system / integrated services network (isn)
A system of databases designed to process and exchange information to support decision-making as well as implementation, monitoring and evaluation of programmes, activities and projects. See also “health information system”.... management information system
The following conditions are discussed under their individual headings: APHASIA; BRAIN, DISEASES OF; CATALEPSY; CHOREA; CRAMP; EPILEPSY; HYSTERIA; LEARNING DISABILITY; MEMORY; MENTAL ILLNESS; MULTIPLE SCLEROSIS (MS); NERVES, INJURIES TO; NEURALGIA; NEURITIS; PARALYSIS; PSYCHOSOMATIC DISEASES; SPINE AND SPINAL CORD, DISEASES AND INJURIES OF; STROKE; TABES.... nervous system, disorders of
See “integrated delivery system”.... organized delivery system
The people, institutions and resources, arranged together in accordance with established policies, to improve the health of the population they serve, while responding to people’s legitimate expectations and protecting them against the cost of ill-health through a variety of activities, the primary intent of which is to improve health. Health systems fulfil three main functions: health care delivery, fair treatment of all, and meeting non-health expectations of the population. These functions are performed in the pursuit of three goals: health, responsiveness and fair financing. A health system is usually organized at various levels, starting at the community level or the primary level of health care and proceeding through the intermediate (district, regional or provincial) to the central level.... health system
A system that is based on incorporating divergent provider modalities (e.g. public, private, non-profit, etc.).... pluralistic system
A system whereby reimbursement rates are set for a given period of time prior to the circumstances giving rise to actual reimbursement claims.... prospective payment system
This consists of highly specialised cells scattered throughout the body, but found mainly in the SPLEEN, BONE MARROW, LIVER, and LYMPH nodes or glands. Their main function is the ingestion of red blood cells and the conversion of HAEMOGLOBIN to BILIRUBIN. They are also able to ingest bacteria and foreign colloidal particles.... reticulo-endothelial system
Major government schemes to ensure adequate health services to substantial sectors of the community through direct provision of services.... state medicine (health care systems)
A review of studies in which evidence has been systematically searched for, studied, assessed and summarized according to predetermined criteria.... systematic review
A school of thought evolving from earlier systems analysis theory and propounding that virtually all outcomes are the result of systems rather than individuals. In practice, the systems approach is characterized by attempts to improve the quality and/or efficiency of a process through improvements to the system.... systems approach
An error that is not the result of an individual’s actions, but the predictable outcome of a series of actions and factors that comprise a diagnostic or treatment process.... systems error
The use of digital imaging systems to replace conventional X-ray pictures and other imaging techniques. Though expensive to operate, digital imaging and storage systems o?er promising possibilities for transmission of clinical images within and between hospitals and community health-care units, providing fast access and remote working that will bene?t patients and health-care sta? alike. When security and con?dentiality are assured, images could be transferred via the Internet and teleradiology. In future, hospitals might be able to eliminate the costly physical transfer and storage of X-ray ?lms. The integration of PACS with hospital information systems in the NHS will (hopefully) facilitate the introduction of electronic radiology.... picture archiving and communications system (pacs)
Stevia Tea is made from a green plant native to Paraguay with nutritious leaves up to 30 times sweeter than cane sugar. Stevia Tea contains numerous vitamins and nutrients and it has no calories, but its sweet taste reduces the craving for sweets and aids in the weight loss process. It does not adversely affect the blood sugar level and it can be enjoyed by both diabetics and obese people.
Stevia Tea Brewing
Stevia Tea can be added to other teas as a replacement for artificial sweetners. Pour one cup of unboiled hot water or other type of beverage over the Stevia Tea bag and let it steep for about three to five minutes. You can serve it hot or iced.
If you use Stevia leaves to prepare your Stevia Tea cup, all you need to do is pour hot water over a couple of leaves and it will be ready in only a few minutes. There is no need to add sugar or honey because of its natural sweetness which serves as the perfect substitute.
Stevia Tea Health Benefits
Stevia, also called “honeyleaf” or “sweet herb”, is considered a miracle plant due to its health restoring benefits. Its leaves contain numerous beneficial minerals which include calcium, zinc, potassium and carbohydrates, as well as A and C vitamins. Stevia Tea can be used as an aid in the treatment of diabetes, high blood pressure and heartburn. Other health benefits of Stevia Tea include the improvement of digestion, oral health and hygene. The water based stevia concentrate has alo been used for treating skin conditions such as acnea. It is beneficial in skin care, having a smoothing and softening effect.
Stevia Tea Side Effects
The reportedside effects of Stevia Tea include dizziness, nausea and bloating, numbness and mild muscle pain, but none of them were long-lasting. Stevia may interfere with the blood sugar level, potentially lowering it, but caution is advisable among people with diabetes. Patients who already have a low blood pressure should avoid it because another effect of Stevia Tea is lowering the blood pressure. Although there are no long-term side effects, it is recommended that pregnant and nursing women avoid it also until more conclusive research is conducted.
Sweetening your tea with stevia will bring your cup a delighful taste, without any unpleasant aftertaste. Enjoy a nice sweet cup of Stevia Tea and benefit from its nutritional value and extraordinarily valuable health effects!... stevia tea information
White tea is a fruity low-caffeine beverage with a delicate aroma and a sweet or bittersweet taste. Despite its name, it has a pale yellow colour. White tea originated in the Fujian province of China sometime in the 18th century. Green tea and black tea are made from the leaves of the tea plant, whereas white tea is prepared from its white fuzzy buds. White tea is minimally processed, withered in natural sunlight and only slightly oxidized.
White Tea Brewing
White tea brewing is a quite easy procedure. When preparing white tea, preferably use water heated at a below boiling temperature of approximately 80 degrees Celsius and steep it for three to five minutes. White tea should be enjoyed plain because milk might neutralize its beneficial properties.
White Tea Health Benefits
White tea consumption offers your body numerous health benefits by boosting the immune system and strengthening its power to fight against viruses and bacteria. The beverage is also effective in the prevention of dental plaque, one of the main causes of tooth decay, and it may also have a beneficial effect for people afflicted with osteoporosis or arthritis.
Research shows that some white tea compounds protect against cancer, reduce the cholesterol level and improve artery function, thus lowering the risk of cardiovascular disease. The antioxidants in white tea protect the skin and make it appear healthy and radiant.
Regular consumption of white tea may also prevent obesity and aid in the weight-loss process. White tea increases metabolism, encouraging the burning of fat.
White Tea Side Effects
Although white tea has low caffeine content, some people may still experience unpleasant side effects which include anxiety, sleeping difficulties, nausea, faster heart rate, tremors or gastrointestinal problems.
Enjoy the pleasant aroma ofwhite tea and its health benefits at any time of the day. You have a wide range of white teas you can choose from and you can drink as many as four cups a day. White tea is definitely one of nature’s great gifts!... white tea - health benefits, information
Environmental medicine. Treatment of allergies by natural medicines. The science that endeavours to bridge physics and chemistry; including such disciplines as homoeopathy, acupuncture, herbalism, etc. ... clinical ecology
Your immune system consists of a series of antibodies and other microorganisms whose main purpose is to defend your system against external attacks.
When we have a cold or flu, the main thing that keeps us alive is this line of defense that keeps all bacteria, infections and microbes away from us.
Unfortunately, our immune system is not strong enough to fight all causes, so we need to enhance its power by taking a treatment.
How a Tea for Immune System Works
A Tea for Immune System must contain enough active constituents to fight a wide range of diseases. First of all, it must contain minerals, manganese, magnesium, iron, volatile oils, acids, tannins, nutrients and enzymes.
These teas can be taken as cures for a short amount of time (1 or 2 weeks) to enhance your body strength, so you mustn’t exaggerate when taking it.
Efficient Tea for Immune System
A Tea for Immune System must contain a lot of active constituents and it must be very effective. If you don’t know which teas to choose from, here’s a list to guide you on:
- Garlic Tea – can be found almost anywhere on the globe and it has a wide range of uses, from cuisine to pharmaceutical purposes. Also a great cure for diarrhea, this Tea for Immune System has a rather unpleasant taste and smell. Feel free to add honey, lemon, ginger or mint in order to make it more adequate.
- Green Tea – probably the most important tea in the world, Green Tea contains all the ingredients necessary to promote a healthy life, full of great benefits. However, don’t take it in case you suffer from menstrual and menopausal pains in order to avoid stomach and uterus irritations.
- Yerba Mate Tea – the South American tea has a series of health advantages and it’s been named by the scientific society “the new green tea”. Drink it from a traditional bombilla or straight from a normal glass, but make sure you know which the risks are and that you’re taking this treatment under supervision.
- Ginseng Tea – this wonderful Chinese Tea is used as a main ingredient in the Asian cuisine, but also as a great adjuvant in cases of nausea, vomiting and auto-immune deficiencies. However, make sure that you’re using the right amount of herbs when preparing this decoction in order to avoid developing a acid foods and drinks intolerance!
Tea for Immune System Side Effects
When taken properly, these teas are generally safe. However, drinking more tea than it’s recommended may lead to constipation, upset stomach or even death. Talk to your doctor before starting any kind of herbal treatment and find out which are the risks.
Don’t take a treatment based on a Tea for Immune System if you’re pregnant, breastfeeding, on anti coagulants, blood thinners or preparing for a surgery. Also, children must be kept away from these teas since there’s no study to prove how safe it is for them.
When in doubt, always ask your doctor. If he says there’s nothing that could interfere with your treatment, choose a tea that fits you best and enjoy its health benefits!... tea for immune system
See lupus erythematosus.... systemic lupus erythematosus
A test on human volunteers of the effectiveness and safety of a drug. A trial can also involve systematic comparison of alternative forms of medical or surgical treatment for a particular disorder. Patients involved in clinical trials have to give their consent, and the trials are approved and supervised by an ethics committee.... trial, clinical
See urinary tract.... urinary system
see blood group.... abo system
acute physiological and chronic health evaluation: a tool used to assess the severity of illness in a critically ill patient and to estimate mortality. The assessment uses information from 12 physiological measurements, including temperature, blood pressure, arterial pH, and certain blood results.... apache scoring system
(CCGs) self-governing bodies set up by the Health and Social Care Act 2012, following the abolition of *primary care trusts and *strategic health authorities, to commission most NHS services in England. CCGs are formed of all GP practices within a given geographical area, and all GP practices must belong to a clinical commissioning group. All CCGs have their own constitution and governing body, which (in addition to GPs) must include at least one registered nurse and at least one secondary care specialist doctor. There are currently 195 CCGs in England.... clinical commissioning groups
The nervous system is responsible for almost any reaction that comes from your body.
From eyes to muscles and even hair, your body is a very complex electric system directed by your brain.
Most of the problems that a person has in a lifetime are related to a nervous system failure.
In order to treat this kind of problems or prevent them from happening, you may want to try a tea instead of all those traditional pills.
How a Tea for Nervous System Works
A Tea for Nervous System is indeed helpful if it contains an important amount of nutrients, enzymes, tannins, volatile oils and minerals (sodium, iron, magnesium and manganese).
You may want to avoid a tea that has an elevated acids level since it may cause you even more damages.
A Tea for Nervous System will make your body send all the active constituents to the affected areas and heal the damaged tissue.
Efficient Tea for Nervous System
In order to work properly, a Tea for Nervous System must show results in a short time period and be one hundred percent safe (you don’t want any more complications than you already have).
However, before starting any kind of herbal treatment, remember to take the indicated dose and never surpass it in order to avoid other health problems. If you don’t know which teas could be helpful for you, here’s a list for guidance:
- Oolong Tea – contains half the amount of caffeine that other teas have so it’s best for your health to give it a try every once in a while.
This Tea for Nervous System will also strengthen your entire organism and rejuvenate the aspect of your skin. However, don’t drink more than 2 cups per day.
- Green Tea – as the scientists have proved, this decoction contains all the ingredients necessary to sustain life, so it’s good for a number of other health complaints, such as infertility, headaches, nausea, loss of appetite, anemia and asthenia.
Just make sure you avoid it at all costs in case you’re experiencing some menstrual or menopausal symptoms (it may cause uterine contractions and internal bleedings).
- Black Tea – some say that it does more damages than good for your nervous system and some others think that this tea is worth a try. Having an elevated level of caffeine, this tea is highly addictive.
In right amount, it can treat infertility, erectile dysfunctions, sore throats and colds. However, ask an herbalist before starting a treatment based on this Tea for Nervous System in order to find out which are the risks.
Tea for Nervous System Side Effects
When taken according to specifications, these teas are generally safe. However, exceeding the number of cups recommended per day may lead to other health complaints, such as nausea, diarrhea, uterine contractions, internal bleedings and headaches.
If you’ve tried one of these teas and something doesn’t feel quite right, talk to your doctor as soon as possible! Don’t take a Tea for Nervous System if you’re pregnant, breastfeeding, on blood thinners or anticoagulants.
The same advice if you’re preparing for a surgery (some of the active compounds in these teas may interfere with your anesthetic and cause death).
But if you have the green light from your doctor, choose a tea that fits best your requirements and enjoy its wonderful health benefits!... tea for nervous system
consideration of the moral issues attendant upon, and questions arising from, clinical practice, as distinct from research. In North America, it is common for hospitals to employ a clinical ethicist or provide a formal clinical ethics consultation service. In the UK, clinical *ethics committees are increasingly common in the NHS.... clinical ethics
see community health.... clinical medical officer
the branch of medicine dealing with the study of actual patients and the diagnosis and treatment of disease at the bedside, as opposed to the study of disease by *pathology or other laboratory work.... clinical medicine
The group of organs responsible for digestion. It consists of the digestive tract (also known as the alimentary tract or canal) and various associated organs. The digestive tract consists of the mouth, pharynx, oesophagus, stomach, intestines, and the anus. The intestines are the small intestine (comprising the duodenum, jejunum, and ileum) and the large intestine (comprising the caecum, colon, and rectum). The associated organs, such as the salivary glands, liver, and pancreas, secrete digestive juices that break down food as it goes through the tract.
Food and the products of digestion are moved from the throat to the rectum by peristalsis (waves of muscular contractions of the intestinal wall).
Food is broken down into simpler substances before being absorbed into the bloodstream.Physical breakdown is performed by the teeth, which cut and chew, and the stomach, which churns the food. The chemical breakdown of food is performed by the action of enzymes, acids, and salts.
Carbohydrates are broken down into simple sugars. Proteins are broken down into polypeptides, peptides, and amino acids. Fats are broken down into glycerol, glycerides, and fatty acids.
In the mouth, saliva lubricates food and contains enzymes that begin to break down carbohydrates. The tongue moulds food into balls (called boli) for easy swallowing. The food then passes into the pharynx. From here, it is pushed into the oesophagus and squeezed down into the stomach, where it is mixed with hydrochloric acid and pepsin. Produced by the stomach lining, these substances help break down proteins. When the food has been converted to a semi-liquid consistency, it passes into the duodenum where bile salts and acids (produced by the liver) help to break down fats. Digestive juices released by the pancreas into the duodenum contain enzymes that further break down food. Breakdown ends in the small intestine, carried out by enzymes produced by glands in the intestinal lining. Nutrients are absorbed in the small intestine. The residue enters the large intestine, where water is absorbed. Undigested matter is expelled via the rectum and anus as faeces.... digestive system
(EWS) a system to detect deteriorating patients on the ward. Certain physical parameters are accorded scores: the higher the scores for individual patients, the greater the deterioration in their condition. Parameters scored include blood pressure, respiratory rate, pulse rate, blood oxygen saturation, and level of consciousness. Adjustments can be made for increased age.... early warning system
a continuous compression bandage consisting of four layers that are applied and left in situ for up to seven days to treat venous leg ulcers, increasing the chance of healing by up to 30%. Thorough assessment of the patient’s status must be undertaken before the application.... four-layer system
one of the cylindrical units of which compact *bone is made. A Haversian canal forms a central tube, around which are alternate layers of bone matrix (lamellae) and lacunae containing bone cells. The lacunae are linked by minute channels (canaliculi).... haversian system
(HSCIC) formerly, an executive nondepartmental public body set up in April 2013 to collect, analyse, and publish UK national health data and supply IT systems and services to health-care providers nationwide. It was rebranded as *NHS Digital in August 2016.... health and social care information centre
(House–Brackmann score, House–Brackmann scale, House–Brackmann facial weakness scale) a six-point grading system for patients with *Bell’s palsy or other forms of facial nerve palsy. Grade I is normal function; grade VI is a total palsy. [J. W. House and D. E. Brackmann (21st century), US otorhinolarygologists]... house–brackmann facial nerve grading system
(CGI) rating scales commonly used by clinicians to measure symptom severity and treatment response in treatment studies of patients with psychiatric illnesses. Many researchers consider them to be a good tool to measure the clinical utility or relevance of a given treatment. The Clinical Global Impression–Severity scale (CGI-S) is used to rate the severity of the patient’s symptoms relative to the clinician’s past experience with patients who have the same diagnosis. Scores range from 1 (normal) to 7 (extremely ill). The Clinical Global Impression–Improvement scale (CGI-I) measures change in the patient’s presentation from baseline. Scores range from 1 (very much improved) to 7 (very much worse). A score of 4 indicates no change.... clinical global impression
a process that enables patients to voice concerns about the standard of care they receive. In the UK, any complaints should be raised as soon as possible, in the first instance locally with the NHS provider involved. Various statutory and voluntary advice and advocacy services are available to assist in this. If a patient is not satisfied with the outcome of local resolution, the matter can be referred to the *Parliamentary and Health Service Ombudsman. Legal action cannot usually proceed at the same time and only a small proportion of complaints proceed to law. Disciplinary procedures are separate from the complaints procedure although complaints may prompt or inform disciplinary action.... complaints system
see HLA system.... human leucocyte antigen system
(loop system) a device for helping people with some types of *hearing aid or *cochlear implant to hear more effectively in certain situations. Electrical signals from a television, sound system, or microphone are passed through an amplifier to a wire that is positioned in a loop encompassing the desired listening area. This creates an electromagnetic field that can be picked up by a coil within the hearing aid or cochlear implant. Induction loops are installed in such places as public buildings, lecture theatres, classrooms, and churches. See also assistive listening device.... induction loop system
the person in charge of the independent public agency set up to regulate the use and storage of personal data under the Data Protection Act 1998 (see data protection). The office of the Information Commissioner both regulates the use of data under the Act and takes any enforcement action required as a result of noncompliance with the principles of the statute. The Information Commissioner’s office also promotes public access to official information under the Freedom of Information Act 2000.... information commissioner
(injury severity scale, ISS) a system used, particularly in *triage, for grading the severity of an injury. See also abbreviated injury scale.... injury scoring system
see IUS.... intrauterine system
see induction loop system.... loop system
(MSA) a condition that results from degeneration of cells in the *basal ganglia (resulting in *parkinsonism), the *cerebellum (resulting in *ataxia), the *pyramidal system, and the *autonomic nervous system (resulting in symptoms of autonomic failure, such as postural hypotension).... multiple system atrophy
(NCAS) see Practitioner Performance Advice.... national clinical assessment service
the system of dual control of certain activities of the body by means of both nerves and circulating hormones. The functioning of the autonomic nervous system is particularly closely linked to that of the pituitary and adrenal glands. The system can give rise to neuroendocrine tumours (NETs), which have special structural features and often produce active hormones. See also neurohormone; neurosecretion.... neuroendocrine system
see PACS.... picture archiving and communication system
a collection of nerve fibres in the central nervous system that extend from the *motor cortex in the brain to the spinal cord and are responsible for initiating movement. In the medulla oblongata the fibres form a *pyramid (hence the name), within which they cross from one side of the brain to the opposite side of the spinal cord; this is called the decussation of the pyramids. Damage to the pyramidal system manifests in a specific pattern of weakness in the face, arms, and legs, abnormally brisk reflexes, and an extensor *plantar reflex (Babinski response).... pyramidal system
(NSF, nephrogenic fibrosing dermopathy) a rare condition, first reported in 1997, that occurs exclusively in patients with chronic kidney disease (CKD), who develop large areas of hardened skin with fibrotic nodules and plaques. Flexion contractures with an accompanying limitation of range of motion can also occur. Exposure to gadolinium, used as a contrast agent in magnetic resonance imaging, has been identified as a causative factor, but many patients with severe CKD have been exposed to gadolinium without consequence. Linear gadolinium preparations (Omniscan, OptiMARK) appear to carry the highest risk of NSF. There is no cure for the condition.... nephrogenic systemic fibrosis
(OSCE) a type of examination used increasingly in the health sciences (medicine, dentistry, nursing, physiotherapy, pharmacy) to assess clinical skills in examination, communication, medical procedures, and interpretation of results. The examination usually takes the form of a circuit of stations around which each candidate moves after a specified time interval (5–10 minutes) at each station. Stations are a mixture of interactive and noninteractive tasks. Some have an examiner and a simulated patient, either an actor for assessment of communication or history-taking skills or a manikin of a specific part of the body (e.g. to demonstrate how to use an auriscope). Other stations have investigation results with a list of questions that are to be completed on computer-marked examination papers. Each station has a different examiner and the stations are standardized with specific marking criteria, thus enabling fairer comparison with peers.... objective structured clinical examination
(RIS) a computer database used to keep details of all the patients attending a clinical radiology department. It records patient demographics, imaging procedures done, medications given and dosage, person performing the imaging, and time and place of examination. Radiologist reports interpreting the images will also feature here. The RIS is vital to the functioning of a picture archiving and communications system (see PACS) and the electronic medical record system.... radiology information system
the system of nerve pathways in the brain concerned with the level of consciousness – from the states of sleep, drowsiness, and relaxation to full alertness and attention. The system integrates information from all of the senses and from the cerebrum and cerebellum and determines the overall activity of the brain and the autonomic nervous system and patterns of behaviour during waking and sleeping.... reticular activating system
(RES) a community of cells – *phagocytes – spread throughout the body. It includes *macrophages and *monocytes. The RES is concerned with defence against microbial infection and with the removal of worn-out blood cells from the bloodstream. See also spleen.... reticuloendothelial system
any of various methods in which the application of an agreed numerical scale is used as a means of estimating the degree of a clinical situation, e.g. the severity of an injury, the degree of patient recovery, or the extent of malignancy. Examples include the *Glasgow Coma Scale (or scoring system) and the *injury scoring system.... scoring system
a type of health-care system in which there is only one purchaser of health-care services, usually the government. The NHS is a single-payer system.... single-payer system
the system of blood vessels that supplies all parts of the body except the lungs. It consists of the aorta and all its branches, carrying oxygenated blood to the tissues, and all the veins draining deoxygenated blood into the vena cava. Compare pulmonary circulation.... systemic circulation
see shock.... systemic inflammatory response
see cardiovascular system.... vascular system
those parts of the body involved in balance. The peripheral vestibular system, or *vestibular apparatus, is in the inner ear. The central vestibular system comprises those parts of the brain that are involved in balance. The central vestibular system receives other inputs as well as from the ear, in particular inputs from the eyes and proprioceptors.... vestibular system
Amenorrhoea/lack of menstruation (M,B):
French basil, carrot seed, celery seed, cinnamon leaf, dill, sweet fennel, hops, hyssop, juniper, laurel, lovage, sweet marjoram, myrrh, parsley, rose (cabbage & damask), sage (clary & Spanish), tarragon, yarrow.
Dysmenorrhoea/cramp, painful or difficult menstruation (M,C,B):
Melissa, French basil, carrot seed, chamomile (German & Roman), cypress, frankincense, hops, jasmine, juniper, lavandin, lavender (spike & true), lovage, sweet marjoram, rose (cabbage & damask), rosemary, sage (clary & Spanish), tarragon, yarrow.
Cystitis (C,B,D):
Canadian balsam, copaiba balsam, bergamot, cedarwood (Atlas, Texas & Virginian), celery seed, chamomile (German & Roman), cubebs, eucalyptus blue gum, frankincense, juniper, lavandin, lavender (spike & true), lovage, mastic, niaouli, parsley, Scotch pine, sandalwood, tea tree, thyme, turpentine, yarrow.
Frigidity (M,S,B,V):
Cassie, cinnamon leaf, jasmine, neroli, nutmeg, parsley, patchouli, black pepper, cabbage rose, rosewood, clary sage, sandalwood, ylang ylang.
Lack of nursing milk (M):
Celery seed, dill, sweet fennel, hops.
Labour pain & childbirth aid (M,C,B):
Cinnamon leaf, jasmine, true lavender, nutmeg, parsley, rose (cabbage & damask), clary sage.
Leucorrhoea/white discharge from the vagina (B,D):
Bergamot, cedarwood (Atlas, Texas & Virginian), cinnamon leaf, cubebs, eucalyptus blue gum, frankincense, hyssop, lavandin, lavender (spike & true), sweet marjoram, mastic, myrrh, rosemary, clary sage, sandalwood, tea tree, turpentine.
Menopausal problems (M,B,V):
Cypress, sweet fennel, geranium, jasmine, rose (cabbage & damask).
Menorrhagia/excessive menstruation (M,B):
Chamomile (German & Roman), cypress, rose (cabbage & damask).
Premenstrual tension/PMT (M,B,V):
Carrot seed, chamomile (German & Roman), geranium, true lavender, sweet marjoram, neroli, tarragon.
Pruritis/itching (D):
Bergamot, Atlas cedarwood, juniper, lavender, myrrh, tea tree.
Sexual overactivity (M,B):
Hops, sweet marjoram.
Thrush/candida (B,D):
Bergamot, geranium, myrrh, tea tree.
Urethritis (B,D):
Bergamot, cubebs, mastic, tea tree, turpentine.
Immune System
Chickenpox (C,S,B):
Bergamot, chamomile (German & Roman), eucalyptus (blue gum & lemon), true lavender, tea tree.
Colds/’flu (M,B,V,I):
Angelica, star anise, aniseed, copaiba balsam, Peru balsam, French basil, West Indian bay, bergamot, borneol, cabreuva, cajeput, camphor (white), caraway, cinnamon leaf, citronella, clove bud, coriander, eucalyptus (blue gum, lemon & peppermint), silver fir, frankincense, ginger, grapefruit, immortelle, juniper, laurel, lemon, lime, sweet marjoram, mastic, mint (peppermint & spearmint), myrtle, niaouli, orange (bitter & sweet), pine (longleaf & Scotch), rosemary, rosewood, Spanish sage, hemlock spruce, tea tree, thyme, turpentine, yarrow.
Fever (C,B):
French basil, bergamot, borneol, camphor (white), eucalyptus (blue gum, lemon & peppermint), silver fir, ginger, immortelle, juniper, lemon, lemongrass, lime, mint (peppermint & spearmint), myrtle, niaouli, rosemary, rosewood, Spanish sage, hemlock spruce, tea tree, thyme, yarrow.
Measles (S,B,I,V):
Bergamot, eucalyptus blue gum, lavender (spike & true), tea tree.... genito-urinary and endocrine systems
Health Encyclopedia