Inter- Health Dictionary

An antiviral chemical secreted by an infected cell which strengthens the defence of nearby cells not yet infected.... interferon

A short period of intensive rehabilitation and treatment to enable people to return home following hospitalization or to prevent admission to hospital or residential care.... intermediate care

A condition occurring in middle-aged and elderly people, which is characterised by pain in the legs after walking a certain distance. The pain is relieved by resting for a short time. It is due to arteriosclerosis (see ARTERIES, DISEASES OF) of the arteries to the leg, which results in inadequate blood supply to the muscles. Drugs usually have little e?ect in easing the pain, but useful preventive measures are to stop smoking, reduce weight (if overweight), and to take as much exercise as possible within the limits imposed by the pain.... intermittent claudication

In?ammation between two skin surfaces in contact, typically in the toe clefts, axillae, under the breasts or in the anogenital folds. Heat, friction and obesity are aggravating factors. Secondary fungal or bacterial infection with CANDIDA or bacteria is common.

Interventional Radiology

The use of radiology (see X-RAYS) to enable doctors to carry out diagnostic or treatment procedures under direct radiological vision. This X-ray procedure is used in MINIMALLY INVASIVE SURGERY (MIS) – for example, ANGIOPLASTY, the removal of stones from the kidney (see KIDNEYS, DISEASES OF), and the observation of obstructions in the bile ducts (percutaneous CHOLANGIOGRAPHY). (See also magnetic resonance imaging – MRI.)... intertrigo

The ?brous disc that acts as a cushion between the bony vertebrae (see SPINAL COLUMN), enabling them to rotate and bend one on another. The disc tends to degenerate with age and may get ruptured and displaced – prolapsed or slipped disc – as a result of sudden strenuous action. Prolapsed disc occurs mainly in the lower back; it is more common in men than in women, and in the 30–40 age group.... intervertebral disc

A range of values for a variable of interest, e.g. a rate, constructed so that this range has a specified probability of including the true value of the variable. The specified probability is called the confidence level, and the end points of the confidence interval are called the confidence limits.... confidence interval

The term applied to the nerves, vessels and muscles that lie between the ribs, as well as to diseases affecting these structures.... intercostal

Consists of members who work together interdependently to develop goals and a common treatment plan, although they maintain distinct professional responsibilities and individual assignments. In contrast to multidisciplinary teams, leadership functions are shared.... interdisciplinary team

A substance produced by T-lymphocytes that stimulates activated T-lymphocytes and some activated B-Lymphocytes to proliferate. Also known as T-Cell growth factor.... interleukin-2

A regularly recurring fever... intermittent fever

An American term for a doctor-in-training who carries out his or her duties and learns in hospital, usually spending some of his/her time living there. The terms preferred in the UK are house o?cer or senior house o?cer (SHO).... intern

Generally, that branch of medicine concerned with diseases that do not require surgery, specifically the study and treatment of internal organs and body systems; it encompasses many subspecialties.... internal medicine

The length of the AXON (of a nerve cell) that is covered with a MYELIN sheath. The nodes of Ranvier, which have no myelin sheath, separate the internodes. (See also NERVE.)... internode

Interstitial is a term applied to indi?erent tissue set among the proper active tissue of an organ. It is generally of a supporting character and formed of ?brous tissue. The term is also applied to the ?uid always present in this in a small amount, and to diseases which specially affect this tissue, such as interstitial keratitis.... interstitial

Also called Leydig cells, these cells are scattered between the SEMINIFEROUS TUBULES of the testis (see TESTICLE). LUTEINISING HORMONE from the anterior PITUITARY GLAND stimulates the interstitial cells to produce androgens, or male hormones.... interstitial cells

Comparison of outcomes between two or more groups of patients who have been intentionally given di?erent treatments or preventative measures, for example, diets. The subjects in the trial should be randomly allocated to the groups, with patients in one group – called controls – receiving no active treatment. If possible, neither patients nor doctors participating in a study should know which patients are receiving what treatment (double blind study/trial). Furthermore, groups should exchange treatments after a prearranged time (crossover study/trial). (See CLINICAL TRIALS; RANDOMISED CONTROLLED TRIAL.)... intervention study

A temporary restoration of consciousness after a person has been rendered unconscious from a blow to the head. The victim subsequently relapses into COMA. This is a sign of raised INTRACRANIAL PRESSURE from arterial bleeding and indicates that surgery may be required to control the intracranial haemorrhage. (See also GLASGOW COMA SCALE.)... lucid interval

The SPINAL COLUMN is built up of a series of bones, known as vertebrae, placed one upon the other. Between these vertebrae lies a series of thick discs of ?bro-cartilage known as intervertebral discs. Each disc consists of an outer portion known as the anulus ?brosus, and an inner core known as the nucleus pulposus. The function of these discs is to give ?exibility and resiliency to the spinal column and to act as bu?ers against undue jarring. In other words, they are most e?cient shock-absorbers. They may, however, PROLAPSE, or protrude, between the two adjacent vertebrae. If this should happen they press on the neighbouring spinal nerve and cause pain. As the most common sites of protrusion are between the last two lumbar vertebrae and between the last lumbar vertebra and the sacrum, this means that the pain occurs in the back, causing LUMBAGO, or down the course of the sciatic nerve causing SCIATICA. The prolapse is most likely to occur in middle age, which suggests that it may be associated with degeneration of the disc involved, but it can occur in early adult life as well. It usually occurs when the individual is performing some form of exercise which involves bending or twisting, as in gardening. The onset of pain may be acute and sudden, or gradual and more chronic in intensity. (See also INTERVERTEBRAL DISC.)

Treatment varies, depending (amongst other things) on the severity of the condition. In the acute phase, rest in bed is advisable, along with ANALGESICS. Later, exercise and physiotherapy are helpful, and in some cases manipulation of the spine brings relief by allowing the herniated, or prolapsed, disc to slip back into position. The injection of a local anaesthetic into the spine (epidural ANAESTHESIA) is yet another measure that often helps the more chronic cases. If those measures fail, surgery to remove the prolapsed disc may be necessary, but the patient’s condition should be carefully reviewed before surgery is considered since success is not certain. An alternative form of treatment is the injection into the disc of chymopapain, an ENZYME obtained from the paw-paw, which dissolves the disc.... prolapsed intervertebral disc

The interval in an ELECTROCARDIOGRAM (ECG) that registers the electrical activity generated during ventricular contraction of the HEART.... q-t interval

A method of contraception (see contraception, withdrawal method of) in which the male partner withdraws his penis from the vagina before ejaculation occurs. Coitus interruptus is unreliable because sperm can be released before orgasm occurs, and it may cause psychosexual dysfunction in men and women.... coitus interruptus

A group of abnormalities in which the affected person has ambiguous genitalia (abnormal external sex organs) or external genitalia that have the opposite appearance to the chromosomal sex of the individual (see sex determination).... intersex

The difference between the lower and upper limits of a class.... class interval

Many patients are on several prescribed drugs, and numerous medicines are available over the counter, so the potential for drug interaction is large. A drug may interact with another by inhibiting its action, potentiating its action, or by simple summation of effects.

The interaction may take place:

(1) Prior to absorption or administration – for example, antacids bind tetracycline in the gut and prevent absorption.

(2) By interfering with protein binding – one drug may displace another from binding sites on plasma proteins. The action of the displaced drug will be increased because more drug is now available; for example, anticoagulants are displaced by analgesics.

(3) During metabolism or excretion of the drug – some drugs increase or decrease the activity of liver enzymes which metabolise drugs, thus affecting their rate of destruction; for example, barbiturates, nicotine, and alcohol all activate hepatic enzymes. Altering the pH of urine will affect the excretion of drugs via the kidney.

(4) At the drug receptor – one drug may displace another at the receptor, affecting its e?cacy or duration of action.... drug interactions

Action at an early stage of a disease or social process.... early intervention

D. Don.

Family: Orchidaceae.

Habitat: The Himalayan region. Found in Ranikhet.

Ayurvedic: Riddhi, Vriddhi. (Substitute: Dioscorea bulbifera.)

Action: Nervine and cardiac tonic.... habenaria intermedia

Links between generations which often involve exchanges of support.... intergenerational relations / contract

Care provided in geriatric centres and acute hospitals to older persons who are in need of limited medical care and who are awaiting nursing home placement.... interim nursing home care

Interleukins are lymphokines – that is, polypeptides produced by activated lymphocytes. They are involved in signalling between cells of the immune system (see IMMUNITY) and are released by several cell types, including lymphocytes. They interact to control the immune response of cells and also participate in HAEMOPOIESIS. There are seven varieties, interleukins 1 to 7. For example, interleukin 1 is produced as a result of in?ammation and stimulates the proliferation of T and B lymphocytes, enhancing the immune response by stimulating other lymphocytes and activating dormant T cells. Interleukin 2 has anti-cancer effects as it is able to activate T lymphocytes to become killer cells which destroy foreign antigens (see ANTIGEN) such as cancer cells, and this anti-cancer e?ect is being developed for clinical use. The remaining interleukins have a range of properties in cell growth and di?erentiation.... interleukins

An institution which is licensed to provide, on a regular basis, health-related care and services to individuals who do not require the degree of care or treatment which a hospital or skilled nursing facility is designed to provide.... intermediate care facility (icf)

An animal or human host where the juvenile stages of the parasite undergo an asexual reproductive phase of development but not reaching adult stage.... intermediate host

A term applied to fevers which continue for a time, subside completely and then return again. The name is also used in connection with a pulse in which occasional heartbeats are not felt, in consequence of irregular action of the heart.... intermittent

The simplest form of intermittent positive-pressure ventilation is mouth-to-mouth resuscitation (see APPENDIX 1: BASIC FIRST AID) where an individual blows his or her own expired gases into the lungs of a non-breathing person via the mouth or nose. Similarly gas may be blown into the lungs via a face mask (or down an endotracheal tube) and a self-in?ating bag or an anaesthetic circuit containing a bag which is in?ated by the ?ow of fresh gas from an anaesthetic machine, gas cylinder, or piped supply. In all these examples expiration is passive.

For more prolonged arti?cial ventilation it is usual to use a specially designed machine or ventilator to perform the task. The ventilators used in operating theatres when patients are anaesthetised and paralysed are relatively simple devices.They often consist of bellows which ?ll with fresh gas and which are then mechanically emptied (by means of a weight, piston, or compressed gas) via a circuit or tubes attached to an endotracheal tube into the patient’s lungs. Adjustments can be made to the volume of fresh gas given with each breath and to the length of inspiration and expiration. Expiration is usually passive back to the atmosphere of the room via a scavenging system to avoid pollution.

In intensive-care units, where patients are not usually paralysed, the ventilators are more complex. They have electronic controls which allow the user to programme a variety of pressure waveforms for inspiration and expiration. There are also programmes that allow the patient to breathe between ventilated breaths or to trigger ventilated breaths, or inhibit ventilation when the patient is breathing.

Indications for arti?cial ventilation are when patients are unable to achieve adequate respiratory function even if they can still breathe on their own. This may be due to injury or disease of the central nervous, cardiovascular, or respiratory systems, or to drug overdose. Arti?cial ventilation is performed to allow time for healing and recovery. Sometimes the patient is able to breathe but it is considered advisable to control ventilation – for example, in severe head injury. Some operations require the patient to be paralysed for better or safer surgical access and this may require ventilation. With lung operations or very unwell patients, ventilation is also indicated.

Arti?cial ventilation usually bypasses the physiological mechanisms for humidi?cation of inspired air, so care must be taken to humidify inspired gases. It is important to monitor the e?cacy of ventilation – for example, by using blood gas measurement, pulse oximetry, and tidal carbon dioxide, and airways pressures.

Arti?cial ventilation is not without its hazards. The use of positive pressure raises the mean intrathoracic pressure. This can decrease venous return to the heart and cause a fall in CARDIAC OUTPUT and blood pressure. Positive-pressure ventilation may also cause PNEUMOTHORAX, but this is rare. While patients are ventilated, they are unable to breathe and so accidental disconnection from the ventilator may cause HYPOXIA and death.

Negative-pressure ventilation is seldom used nowadays. The chest or whole body, apart from the head, is placed inside an airtight box. A vacuum lowers the pressure within the box, causing the chest to expand. Air is drawn into the lungs through the mouth and nose. At the end of inspiration the vacuum is stopped, the pressure in the box returns to atmospheric, and the patient exhales passively. This is the principle of the ‘iron lung’ which saved many lives during the polio epidemics of the 1950s. These machines are cumbersome and make access to the patient di?cult. In addition, complex manipulation of ventilation is impossible.

Jet ventilation is a relatively modern form of ventilation which utilises very small tidal volumes (see LUNGS) from a high-pressure source at high frequencies (20–200/min). First developed by physiologists to produce low stable intrathoracic pressures whilst studying CAROTID BODY re?exes, it is sometimes now used in intensive-therapy units for patients who do not achieve adequate gas exchange with conventional ventilation. Its advantages are lower intrathoracic pressures (and therefore less risk of pneumothorax and impaired venous return) and better gas mixing within the lungs.... intermittent positive pressure (ipp)

A technique in which a patient (of either sex) inserts a disposable catheter (see CATHETERS) through the URETHRA into the bladder to empty it of urine. It is increasingly used to manage patients with chronic retention of urine, or whose bladders do not empty properly

– usually the result of neurological disorder affecting the bladder (neuropathic bladder). (See URINARY BLADDER, DISEASES OF.)... intermittent self-catheterisation

See “benchmark”.... internal benchmark

See “validity”.... internal validity

A World Health Organisation classi?cation of all known diseases and syndromes. The diseases are divided according to system (respiratory, renal, cardiac, etc.) or type (accidents, malignant growth, etc.). Each of them is given a three-digit number to facilitate computerisation. This classi?cation allows mortality and morbidity rates to be compared nationally and regionally. A revised ICD is published every ten years; a similar classi?cation is being developed for impairments, disabilities and handicaps.... international classification of disease (icd)

Classification of health and health-related domains that describe body functions and structures, activities and participation. The domains are classified from body, individual and societal perspectives. Since an individual’s functioning and disability occurs in a context, this classification includes a list of environmental factors.... international classification of functioning, disability and health (icf) a

A classification of diseases, conditions and other reasons for attendance for primary care. This classification is an adaptation of the ICD but makes allowance for the diagnostic uncertainty that prevails in primary care.... international classification of health problems in primary care (ichppc)

A systematic taxonomy of the consequences of injury and disease. See “disability”; “handicap”; “impairment”.... international classification of impairments, disabilities and handicaps (icidh)

The official classification of the World Organisation of Family Doctors. It includes three elements of the doctor-patient encounter: the reason for the encounter; the diagnosis; and the treatment or other action or intervention.... international classification of primary care (icpc)

A list of diagnoses and identifying codes used by medical practitioners and other health care providers. The coding and terminology provide a uniform language that permits consistent communication on claim forms. Data from earlier time periods were coded using the appropriate revision of the ICD for that time period. Changes in classification of causes of death in successive revisions of the ICD may introduce discontinuities in cause of death statistics over time.... international statistical classification of diseases and related health problems, tenth revision (icd-10)

Access to medical information via the Internet is widespread in some populations, often serving more patients than doctors. In addition to the huge variety of information available, patients can share experiences via electronic discussion groups, or obtain e-mail advice on a fee-for-service basis. Some professional organisations and journals provide free access to information, and the Internet can be a useful resource for medical practitioners and researchers. Concerns have arisen about the growth in electronic medical information: some believe that patients who have unlimited access to information via the Internet will be less likely to tolerate health-care rationing or will demand treatments that may be inappropriate in their individual circumstances. Other criticisms relate to the quality and accuracy of the information provided, potential breaches of patient CONFIDENTIALITY, and the risk of increased accusations of medical negligence (see also ETHICS).... internet

See “physician”.... internist

The central portion of a distribution, calculated as the difference between the third quartile and the first quartile; this range includes about one half of the observations in the set, leaving one quarter of the observations on each side.... interquartile range

A recognized relationship between part or parts of different sectors of society which has been formed to take action on an issue to achieve health outcomes or intermediate health outcomes in a way which is more effective, efficient or sustainable than might be achieved by the health sector acting alone. For practical purposes, intersectoral action and multisectoral action are synonymous terms, the former perhaps emphasizing the element of coordination, the latter the contribution of a number of sectors.... intersectoral action / multisectoral action

Intersexuality is a state of indeterminate sexuality of an individual, and may present in many di?erent forms. A characteristic is that only one type of gonad – testis or ovary – is present; in a HERMAPHRODITE both types are present. Intersexuality may be due to a fault in the genetic mechanism of sex determination as early as conception, or to later errors in sexual di?erentiation of the embryo and fetus, or after birth. Some cases may result from abnormal metabolism of the sex hormones, or may be drug-induced (for example, women given androgens [see ANDROGEN] or PROGESTERONE for repeated miscarriages may give birth to girls with some genital VIRILISATION). Abnormalities of the sex chromosomes may be associated with delayed (or failure of) sexual development, so that the individual shows some of the characteristics (often underdeveloped) of both sexes. Some of the more common presentations of the condition include HYPOGONADISM, CRYPTORCHIDISM, and primary AMENORRHOEA.

Intersexuality inevitably leads to considerable psychological disturbance as the child grows up. It is therefore important to reach an early decision as to the child’s sex – or at least, the sex that he or she is to be brought up as. Surgical or hormonal means should then be employed, when appropriate, to develop the attributes of that sex and diminish those of the other, together with psychological counselling.... intersexuality

The hydrogel that surrounds cells in soft tissues. It is a mucopolysaccaride starch gel, and the serum that leaves the blood capillaries flows through this gel, some to return to the exiting venous blood, some to enter the lymph system. There is an old medical axiom: the blood feeds the lymph, and the lymph feeds the cells. Interstitial fluid that flows through the starch colloid is this lymph.... interstitial fluid

Time between paroxysms in malaria.... interval

See “measurement scale”.... interval scale

An activity or set of activities aimed at modifying a process, course of action or sequence of events in order to change one or several of their characteristics, such as performance or expected outcome. For example, it is used in public health to describe a programme or policy designed to have an impact on an illness or disease.... intervention / intervention strategy

The precisely designed set of questions used in an interview.... interview schedule

Health promotion and disease prevention initiatives which do not require the direct involvement of the individual (e.g. fluoridation programmes) are termed “passive”.... passive intervention

The provision of immediate advice or help by a variety of agencies such as social services departments to people with acute personal or sociomedical problems.... crisis intervention

A flat, circular, plate-like structure containing cartilage that lines the joints between adjacent vertebrae (bones) in the spine. Each intervertebral disc is composed of a fibrous outer layer and a soft gelatinous core. It acts as a shock absorber to cushion the vertebrae during movements of the spine. With increasing age, intervertebral discs become less supple and more susceptible to damage from injury.

Fibrous covering disclosing agents Dyes that make the plaque deposits on teeth more visible so that they can be seen and removed. discoid lupus erythematosus A form of the chronic autoimmune disorder lupus erythematosus.... disc, intervertebral

 Pain along a sensory nerve serving the chest, without loss of sensation and power of movement. Differs from neuritis in which nerves are inflamed.

Causes: all kinds of infective diseases. Rheumatism, bad teeth, bony spinal lesions, gall stone, liver disorder, thickening of pleura, fractured ribs, shingles – see: SHINGLES. In simple cases a cup of Chamomile tea may suffice. Persistent cases require one of the following alternatives.

Alternatives. Decoction. Combine equal parts: Black Cohosh, Jamaica Dogwood (or White Willow), Pleurisy root. 1 heaped teaspoon to each cup water gently simmered 20 minutes. Half-1 cup thrice daily. Formula. Cramp bark 2; Black Cohosh 1; Valerian 1. Pinch of Cayenne or few drops Tincture Capsicum. Dose: Liquid Extracts: 1 teaspoon. Tinctures: 2 teaspoons. Powders: 500mg (two 00 capsules or one- third teaspoon). Thrice daily.

Neuralgia associated with bronchi and lung: Formula: Cramp bark 2; Pleurisy root 2; Liquorice half. Dose: as above.

Practitioner. Tincture Gelsemium BPC (1973). 0.3ml (5 drops) in water as necessary.

Dr Finlay Ellingwood. Tincture Pleurisy root (Asclepias). 20 drops, every 2 hours.

Topical. Poultice: Chamomile, Hops, Linseed or Bran. Acute cases (cold), chronic cases (hot). Grated or bruised Horseradish root. Evening Primrose oil. Hot Cider vinegar. Tincture Arnica or Hypericum. Aromatherapy. 2 drops each: Juniper, Lavender, Chamomile, to 2 teaspoons vegetable oil. Massage. Diet, vitamins, minerals. Same as for general neuralgia. Cold water packs. ... neuralgia, intercostal

The effect of a drug when it is taken in combination with other drugs or with substances such as alcohol.... drug interaction

Pain during sexual intercourse, known medically as dyspareunia, which can affect both men and women. Pain may be superficial (around the external genitals) or deep (within the pelvis).

In men, superficial pain may be due to anatomical abnormalities such as chordee (bowed erection) or phimosis (tight foreskin). Prostatitis may cause a widespread pelvic ache, a burning sensation in the penis, or pain on ejaculation.

Scarring (after childbirth, for example) and lack of vaginal lubrication, especially after the menopause, may cause painful intercourse in women. Psychosexual dysfunction may also cause pain during intercourse. Vaginismus, a condition in which the muscles of the vagina go into spasm, is usually psychological in origin. Deep pain is frequently caused by pelvic disorders (such as fibroids, endometriosis, ectopic pregnancy, or pelvic inflammatory disease due to sexually transmitted infections), disorders of the ovary (such as ovarian cysts), and disorders of the cervix. Other causes are cystitis and urinary tract infections.Treatment is directed at the underlying cause of the pain.

If the discomfort is psychological in origin, special counselling may be needed (see sex therapy).... intercourse, painful

Scarring of lung tissue mainly involving the alveoli. There are a number of causes, including occupational exposure to dusts and fibrosing alveolitis, which is an autoimmune disorder.... interstitial pulmonary fibrosis

Treatment of a cancerous tumour by inserting radioactive material into the growth or into neighbouring tissue. Using this method, also called brachytherapy, radiation can be targeted at the diseased area.

Radioactive material (usually artificial radioisotopes) contained in wires, small tubes, or seeds is then implanted into or near the diseased tissue under general anaesthesia. The material is left in place for variable amounts of time depending on the radioactive substance and the tumour being treated. (See also intracavitary therapy; radiotherapy.)... interstitial radiotherapy

A term sometimes used to describe a variety of sexual activities, but which specifically refers to the insertion of the penis into the vagina.... sexual intercourse

(in Britain) any of the groups that work with NHS foundation trusts to represent the views of patients and other interested parties in setting the strategic direction of the trust. They are often formed around specific disease categories or patient groups (e.g. deaf patients, children in care).... community interest group

(GPwSI, GPSI) see general practitioner.... general practitioner with special interest

adj. describing structures, tissues, etc., that are inserted or situated between other structures.... intercalated

adj. situated or occurring between cells.... intercellular

muscles that occupy the spaces between the ribs and are responsible for controlling some of the movements of the ribs. The superficial external intercostals lift the ribs during inspiration; the deep internal intercostals draw the ribs together during expiration.... intercostal muscles

adj. going on at the same time: applied to an infection contracted by a patient who is already suffering from an infection or other disease.... intercurrent

n. 1. the resting stage between the two divisions of *meiosis. 2. see interphase.... interkinesis

a legal and ethical standard in medical care and treatment. A doctor has both an ethical and a legal obligation to maximize a patient’s welfare or wellbeing. When cases have gone to court, the judiciary has been clear that the concept of best interests extends beyond the purely medical. The principle of *autonomy requires that a patient with *capacity is in the best position to determine what is in his or her best interests. Where a patient lacks capacity, health-care professionals must act in his or her best interests. Under the Mental Capacity Act 2005, a doctor must take account of the patient’s wishes and try to determine what he or she would have wanted, possibly with reference to an advance directive (see advance directive, decision, or statement), an appointed proxy, or an *independent mental capacity advocacy service. The interests of children are especially important, and doctors must be particularly vigilant where there is a potential conflict of interests, as when reporting cases of suspected child abuse or recruiting for paediatric research.... best interests

(in medical ethics) the situation in which a health professional is subject to potential or actual pressures that may conflict with his or her obligation to promote the *best interests of the patient over and above all else. A conflict of interest arises from a particular context or situation and may threaten a doctor’s integrity and undermine trust between professional and patient. For example, a drug company may encourage a doctor to prescribe a particular medicine, which may not be the treatment of choice for a patient, or contractual financial disincentives may discourage a doctor from providing a more expensive treatment of choice for a patient. In medical research, there is always a potential conflict between protecting the individual and benefiting society. Particular problems of this kind occur in randomized controlled trials (see equipoise; intervention study). Doctors will always experience competing pressures and it is important for them to be able to recognize and then, where possible, disclose, resolve, or mitigate morally problematic conflicts.... conflict of interest

bleeding arising from the genital tract in a woman with a regular menstrual cycle, not occurring at menstruation or following sexual intercourse.... intermenstrual bleeding

n. a *lower urinary tract symptom in which the flow of urine is not continuous but stops and starts.... intermittency

a method of fetal monitoring in *labour, with *auscultation of the fetal heart for one minute through a uterine contraction every 15 minutes during the first stage, and after every other contraction, or every 5 minutes, in the second stage of labour.... intermittent auscultation

a technique to prevent thrombosis in bedridden patients. It uses an inflatable device that squeezes the calf when it inflates, preventing pools of blood forming behind the valves in the veins, thus mimicking the effects of walking.... intermittent pneumatic compression

(clean intermittent self-catheterization, ISC, CISC) a procedure in which the patient periodically passes a disposable catheter through the urethra into the bladder for the purpose of emptying it of urine. It is increasingly used in the management of patients of both sexes (including children) with chronic *retention and large residual urine volumes, often due to *neuropathic bladder. ISC may prevent back pressure and dilatation of the upper urinary tract with consequent infection and incontinence.... intermittent self-catheterization

(ICD) a list of all known diseases and syndromes, including mental and behavioural disorders, published by the *World Health Organization every ten years (approximately). Over the years the classification has moved from being disease-orientated to include a wider framework of illness and other health problems. The version in current use, ICD-10, was published in 1992 and employs alphanumeric coding. It is used in many countries as the principal means of classifying both mortality and morbidity experience and allows comparison of morbidity and mortality rates nationally and internationally. The clinical utility of the ICD is a matter of some controversy, especially in the field of psychiatry. ICD-11 was published in June 2018 and is intended to come into use from 2022. It includes about 55,000 codes for injuries, diseases, and causes of death, which is three times more than its predecessor. It also differs substantially from ICD-10 as each disease entry includes descriptions and guidance as to what is covered by the term, rather than the term alone. For the first time it includes specific sections on sexual health and traditional medicine. A parallel list, the International Classification of Functioning, Disabilities and Health (ICF), has also been compiled and is being used alongside the ICD. See also handicap.

The standard international classification for statistical, administrative, and epidemiological purposes, as supplied by the World Health Organization

The WHO framework for measuring health and disability in individuals and populations... international classification of diseases

see INR.... international normalized ratio

(IPSS) a self-administered questionnaire, completed by men with *lower urinary tract symptoms, which consists of seven questions based on the extent of symptoms and a single quality-of-life question. It gives a numerical score, on a scale of 0 to 35, to indicate the severity of the patient’s symptoms. A score of 0–7 indicates mild symptoms, 8–19 moderate symptoms, and 20–35 severe symptoms. The quality-of-life question is scored from 0–6.... international prostate symptom score

n. a neuron in the central nervous system that acts as a link between the different neurons in a *reflex arc. It usually possesses numerous branching processes (dendrites) that make possible extensive and complex circuits and pathways within the brain and spinal cord.... interneuron

(INO) see ophthalmoplegia.... internuclear ophthalmoplegia

(in statistical surveys) see validity.... interobserver error

n. any *receptor organ composed of sensory nerve cells that respond to and monitor changes within the body, such as the stretching of muscles or the acidity of the blood.... interoceptor

(inca bone, incarial bone) the bone lying between the *parietal bones, at the back of the skull.... interparietal bone

adj. situated between the peduncles of the cerebrum or cerebellum.... interpeduncular

(interkinesis) n. the period when a cell is not undergoing division (mitosis), during which activities such as DNA synthesis occur.... interphase

n. a small space in a tissue or between parts of the body. —interstitial adj.... interstice

see luteinizing hormone.... interstitial-cell-stimulating hormone

a chronic nonbacterial inflammation of the bladder accompanied by an urgent desire to pass urine frequently and bladder pain; it is sometimes associated with an ulcer in the bladder wall (Hunner’s ulcer). The cause is unknown and *contracture of the bladder eventually occurs. Treatment is by distension of the bladder under spinal or epidural anaesthetic, instillation of anti-inflammatory solutions into the bladder, and administration of steroids or *NSAIDs. Bladder enhancement or augmentation (see cystoplasty) may be required for a contracted bladder.... interstitial cystitis

disease of the *tubulointerstitium of the kidney. Acute interstitial nephritis (AIN) represents in many cases an allergic reaction to drugs (especially ampicillin, cephalexin, NSAIDs, allopurinol, and frusemide). AIN can also be associated with acute infections and autoimmune disease. Thirst and polyuria may be prominent, and renal function severely affected. In allergic cases, the use of steroids hastens recovery after the allergen has been removed. Chronic interstitial nephritis (CIN) is associated with progressive scarring of the tubulointerstitium, often with lymphocyte infiltration. Primary causes of CIN include gout, radiation nephropathy, sarcoidosis, *analgesic nephropathy, reflux nephropathy, chronic hypokalaemia and hypercalcaemia, and *Aristolochia-associated nephropathies. Management of CIN involves removal of the precipitating cause, where identified, and control of hypertension.... interstitial nephritis

(interstitial pneumonitis) an alternative name for *idiopathic pulmonary fibrosis used by lung pathologists to classify the different cellular types of the disease. The most common cellular pattern is usual interstitial pneumonia (UIP). A differing cellular pattern is seen in patients with nonspecific interstitial pneumonia (NSIP), who have a better prognosis than those with UIP. There are two variants of NSIP: cellular and fibrosing. The former has chronic inflammatory cells with minimal collagen deposition, while the latter consists of diffuse interstitial fibrosis with fewer inflammatory cells. It is believed that corticosteroid therapy can slow the progression of cellular to fibrosing NSIP.... interstitial pneumonia

a subspecialty of cardiology concerned with the treatment of heart conditions using cardiac *catheterization techniques under local anaesthetic and X-ray control, including *percutaneous coronary intervention and percutaneous balloon mitral *valvuloplasty.... interventional cardiology

a branch of radiology in which complex procedures are performed using imaging guidance, which avoids patients having to undergo invasive surgery to achieve the same results. This is often termed ‘pinhole surgery’. Guidance is commonly by X-ray fluoroscopy, ultrasound, or computerized tomography, and recently also by magnetic resonance imaging. Procedures commonly performed include angioplasty and stenting of vascular structures, drainage of fluid collections or abscesses, stenting of obstructions to the gastrointestinal tract, embolization, cryotherapy, and radiofrequency ablation.... interventional radiology

a technique that combines psychiatric assessment with elements of problem-solving *psychotherapy. It is mostly used with patients who have substance misuse problems. The interviewer elicits the psychiatric history and the extent of the patient’s difficulties, gives educational information, and tries to motivate the patient to change his or her habits.... motivational interviewing

(NSIP) see interstitial pneumonia.... nonspecific interstitial pneumonia

(PCI) treatment of coronary artery disease delivered by cardiac *catheterization. This usually means *coronary angioplasty followed by insertion of a coronary *stent, but also includes more specialized procedures, such as rotational *atherectomy (rotablation). Primary PCI refers to the use of PCI as the first-line treatment to relieve coronary obstruction in S-T elevation *myocardial infarction, rather than *thrombolysis. Rescue PCI is used in the event of unsuccessful thrombolysis.... percutaneous coronary intervention

the interval on an *electrocardiogram between the onset of atrial activity and ventricular activity. It represents the time required for the impulse from the *sinoatrial node to reach the ventricles.... p–r interval

1. the expression of concern about performance or competence that is privileged at law by virtue of the Public Interest Disclosure Act 1998. The statute provides that where an employee acts in good faith in questioning the behaviour or performance of another member of staff or an organization, he or she should be protected from such penalties as disciplinary procedures, suspension, or dismissal. See also whistle-blowing. 2. circumstances in which *confidentiality can be breached because there is a serious risk of physical harm to an identifiable individual or individuals. The basis on which confidentiality can be breached in the public interest were defined in the case of W v Egdell, in which the court held that the risk had to be of physical harm to identifiable person(s) and must not be merely ‘fanciful’. Where there is a serious risk of physical harm to a specific person, there is an entitlement but not a duty to breach confidentiality, and the *General Medical Council requires that doctors must be prepared to justify their decision either way.... public interest disclosure

(RNAi) a mechanism, either natural or the result of biotechnological manipulation, by which *RNA suppresses or interferes with the expression of a gene or genes. Its possible role in gene-specific therapy is under investigation.... rna interference

see radioembolization.... selective internal radiation therapy

a framework for exploring how care is delivered, based on the idea that there are six main styles of interaction (prescriptive, informative, confronting, cathartic, catalytic, and supportive). The analysis is widely used to help health-care professionals develop an understanding of interpersonal relationships, reflect on their own practice, and enhance their interactions with clients.... six-category intervention analysis

see UICC.... union international contre le cancer

(UIP) see interstitial pneumonia; idiopathic pulmonary fibrosis.... usual interstitial pneumonia