Myoglobinuric acute renal failure Health Dictionary

Myoglobinuric Acute Renal Failure: From 1 Different Sources


acute kidney injury caused by myoglobin that is released from damaged skeletal muscle (*rhabdomyolysis). This is usually the result of trauma and the condition was first recognized in victims trapped and crushed during the London Blitz. Muscle injury can also occur with pressure necrosis, particularly in the unconscious or immobile patient, or with a *compartment syndrome. Rarely it may complicate intensive muscular exercise or extensive viral myositis and it is a recognized complication of modest overexertion in some inherited disorders of muscle metabolism, such as *McArdle’s disease.
Health Source: Oxford | Concise Colour Medical Dictionary
Author: Jonathan Law, Elizabeth Martin

Acute

A type of disease or disorder having a sudden onset with severe symptoms, and generally a short or self-limited duration (such as a head cold or sprain). The opposite of CHRONIC.... acute

Renal

Relating to the kidneys... renal

Renal Cell Carcinoma

See HYPERNEPHROMA.... renal cell carcinoma

Abdomen, Acute

See ABDOMEN, DISEASES OF.... abdomen, acute

Renal Tubule

See KIDNEYS.... renal tubule

Failure To Thrive

Failure of expected growth in an infant or toddler, usually assessed by comparing the rate at which a baby gains weight with a standardized growth chart. An undiagnosed illness such as a urinary infection may be the cause. Emotional or physical deprivation can also cause failure to thrive. A child who fails to grow at the appropriate rate needs tests to determine the cause.... failure to thrive

Bronchitis, Acute

Inflammatory condition of the bronchial tubes caused by cold and damp or by a sudden change from a heated to a cold atmosphere. Other causes: viral or bacterial infection, irritating dust and fumes, colds which ‘go down to the chest’.

Symptoms: short dry cough, catarrh, wheezing, sensation of soreness in chest; temperature may be raised. Most cases run to a favourable conclusion but care is necessary with young children and the elderly. Repeated attacks may lead to a chronic condition.

Alternatives. Teas – Angelica, Holy Thistle, Elecampane leaves, Fenugreek seeds (decoction), Hyssop, Iceland Moss, Mouse Ear, Mullein, Nasturtium, Plantain, Wild Violet, Thyme, White Horehound, Wild Cherry bark (decoction), Lobelia, Liquorice, Boneset. With fever, add Elderflowers.

Tea. Formula. Equal parts: Wild Cherry bark, Mullein, Thyme. Mix. 1 heaped teaspoon to cup water simmered 5 minutes in closed vessel. 1 cup 2-3 times daily. A pinch of Cayenne assists action.

Irish Moss (Carragheen) – 1 teaspoon to cup water gently simmered 20 minutes. It gels into a viscous mass. Cannot be strained. Add honey and eat with a spoon, as desired.

Tablets/capsules. Iceland Moss. Lobelia. Garlic. Slippery Elm.

Prescription No 1. Morning and evening and when necessary. Thyme 2; Lungwort 2; Lobelia 1. OR Prescription No 2. Morning and evening and when necessary. Iceland Moss 2; Wild Cherry bark 1; Thyme 2.

Doses:– Powders: one-third teaspoon (500mg) or two 00 capsules. Liquid Extracts: 30-60 drops. Tinctures: 1-2 teaspoons.

Practitioner. Alternatives:–

(1) Tincture Ipecacuanha BP (1973). Dose, 0.25-1ml.

(2) Tincture Grindelia BPC (1949). Dose, 0.6-1.2ml.

(3) Tincture Belladonna BP (1980). Dose, 0.5-2ml.

Black Forest Tea (traditional). Equal parts: White Horehound, Elderflowers and Vervain. One teaspoon to each cup boiling water; infuse 5-15 minutes; drink freely.

Topical. Chest rub: Olbas oil, Camphorated oil. Aromatherapy oils:– Angelica, Elecampane, Mullein, Cajeput, Lemon, Eucalyptus, Lavender, Mint, Onion, Pine, Thyme.

Aromatherapy inhalants: Oils of Pine, Peppermint and Hyssop. 5 drops of each to bowl of hot water.

Inhale: head covered with a towel to trap steam.

Diet: Low salt, low fat, high fibre. Halibut liver oil. Wholefoods. Avoid all dairy products. Supplements. Vitamins A, C, D, E. ... bronchitis, acute

Renal Tubular Acidosis

A condition in which the kidneys are unable to excrete normal amounts of acid made by the body.

The blood is more acidic than normal, and the urine less acidic.

Causes include kidney damage due to disease, drugs, or a genetic disorder; but in many cases the cause is unknown.

The acidosis may result in osteomalacia, kidney stones (see calculus, urinary tract), nephrocalcinosis, and hypokalaemia (an abnormally low level of potassium in the blood).... renal tubular acidosis

Heart Failure

Inability of the heart to cope with its workload of pumping blood to the lungs and to the rest of the body. Heart failure can primarily affect the right or the left side of the heart, although it most commonly affects both sides, in which case it is known as congestive, or chronic, heart failure.

Left-sided heart failure may be caused by hypertension, anaemia, hyperthyroidism, a heart valve defect (such as aortic stenosis, aortic incompetence, or mitral incompetence), or a congenital heart defect (see heart disease, congenital). Other causes of left-sided heart failure include coronary artery disease, myocardial infarction, cardiac arrhythmias, and cardiomyopathy.

The left side of the heart fails to empty completely with each contraction, or has difficulty in accepting blood that has been returned from the lungs. The retained blood creates a back pressure that causes the lungs to become congested with blood. This condition leads to pulmonary oedema.

Right-sided heart failure most often results from pulmonary hypertension, which is itself caused by left-sided failure or by lung disease (such as chronic obstructive pulmonary disease (see pulmonary disease, chronic obstructive). Right-sided failure can also be due to a valve defect, such as tricuspid incompetence, or a congenital heart defect.

There is back pressure in the circulation from the heart into the venous system, causing swollen neck veins, enlargement of the liver, and oedema, especially of the legs and ankles. The intestines may become congested, causing discomfort.

Immediate treatment consists of bed rest, with the patient sitting up. Diuretic drugs are given, and digitalis drugs and vasodilators, especially ACE inhibitors, may also be administered. Morphine and oxygen may be given as emergency treatment in acute left-sided failure.... heart failure

Acute Care / Acute Health Care

Care that is generally provided for a short period of time to treat a new illness or a flare-up of an existing condition. This type of care may include treatment at home, short-term hospital stays, professional care, surgery, X-rays and scans, as well as emergency medical services.... acute care / acute health care

Acute Disease / Illness

A disease which is characterized by a single or repeated episode of relatively rapid onset and short duration from which the patient usually returns to his/her normal or previous state or level of activity. An acute episode of a chronic disease (for example, an episode of diabetic coma in a patient with diabetes) is often treated as an acute disease.... acute disease / illness

Acute Life-threatening Event (alte)

See ALTE.... acute life-threatening event (alte)

Acute Respiratory Distress Syndrome (ards)

Formerly known as adult respiratory distress syndrome. A form of acute respiratory failure in which a variety of di?erent disorders give rise to lung injury by what is thought to be a common pathway. The condition has a high mortality rate (about 70 per cent); it is a complex clinical problem in which a disproportionate immunological response plays a major role. (See IMMUNITY.)

The exact trigger is unknown, but it is thought that, whatever the stimulus, chemical mediators produced by cells of the immune system or elsewhere in the body spread and sustain an in?ammatory reaction. Cascade mechanisms with multiple interactions are provoked. CYTOTOXIC substances (which damage or kill cells) such as oxygen-free radicals and PROTEASE damage the alveolar capillary membranes (see ALVEOLUS). Once this happens, protein-rich ?uid leaks into the alveoli and interstitial spaces. SURFACTANT is also lost. This impairs the exchange of oxygen and carbon dioxide in the lungs and gives rise to the clinical and pathological picture of acute respiratory failure.

The typical patient with ARDS has rapidly worsening hypoxaemia (lack of oxygen in the blood), often requiring mechanical ventilation. There are all the signs of respiratory failure (see TACHYPNOEA; TACHYCARDIA; CYANOSIS), although the chest may be clear apart from a few crackles. Radiographs show bilateral, patchy, peripheral shadowing. Blood gases will show a low PaO2 (concentration of oxygen in arterial blood) and usually a high PaCO2 (concentration of carbon dioxide in arterial blood). The lungs are ‘sti?’ – they are less e?ective because of the loss of surfactant and the PULMONARY OEDEMA.

Causes The causes of ARDS may be broadly divided into the following:... acute respiratory distress syndrome (ards)

Post-acute Care

See “transitional care”.... post-acute care

Renal Calculi

Calculi relating to kidney... renal calculi

Renal Diseases

See KIDNEYS, DISEASES OF.... renal diseases

Renal Failure (acute)

Inefficient functioning of the kidney, leading to death unless acute medical attention is available. Envenomation (especially snake bite) is a common cause, as well as a range of medical conditions, including infection..... renal failure (acute)

Severe Acute Respiratory Syndrome (sars)

See SARS.... severe acute respiratory syndrome (sars)

Sub-acute Care

Sub-acute care is a bridge between acute care and home care. It is medical and skilled nursing services provided to persons who are not in the acute phase of an illness but who require a level of care higher than that provided in a long-term care setting.... sub-acute care

Liver – Acute Yellow Atrophy

Necrosis. Fatal disease in which the substance of the liver is destroyed. Incidence is rare since the public has been alerted to the dangers of certain chemical toxins, fumes from synthetic glues, solvents, and poisonous fungi.

Symptoms: jaundice, delirium and convulsions.

As it is the work of the liver to neutralise incoming poisons it may suffer unfair wear and tear, alcohol and caffeine being common offenders.

Treatment for relief of symptoms only: same as for abscess of the liver.

Treatment by or in liaison with a general medical practitioner. ... liver – acute yellow atrophy

Adrenal Failure

Insufficient production of hormones by the adrenal cortex (the outer part of the adrenal glands).

It can be acute or chronic.

Adrenal failure may be caused by a disorder of the adrenal glands, in which case it is called Addison’s disease, or by reduced stimulation of the adrenal cortex by ACTH, a hormone produced by the pituitary gland.... adrenal failure

Brain Failure

See brain syndrome, organic.... brain failure

Congestive Heart Failure

See heart failure.... congestive heart failure

Bright’s Disease (acute)

Glomerulonephritis. Recognised by slight puffiness of the eyes and a dropsical accumulation of fluid in body cavities. Blood pressure rises. Appetite disappears. Digestion is deranged, urine may be blood-stained and a variety of symptoms present as dizziness, headache, nausea. Commonly caused by post streptococcal throat infection circulating in the blood, yet it is now known that the condition may arise from exposure to common garden insecticides and toxic substances of commercial importance that alter the body’s immune system and affect kidney function.

Acute toxic nephritis is possible in the convalescent stage of scarlet and other infectious fevers, even influenza. Causes are legion, including septic conditions in the ear, nose, throat, tonsils, teeth or elsewhere. Resistance to other infections will be low because of accumulation of toxins awaiting elimination. When protein escapes from the body through faulty kidneys general health suffers.

This condition should be treated by or in liaison with a qualified medical practitioner.

Treatment. Bedrest essential, with electric blanket or hot water bottle. Attention to bowels; a timely laxative also assists elimination of excessive fluid. Diuretics. Diaphoretics. Abundant drinks of bottled water or herb teas (3-5 pints daily). Alkaline drinks have a healing effect upon the kidneys. Juniper is never given for active inflammation.

Useful teas. Buchu, Cornsilk, Couchgrass, Clivers, Bearberry, Elderflowers, Marshmallow, Mullein, Marigold flowers, Wild Carrot, Yarrow.

Greece: traditional tea: equal parts, Agrimony, Bearberry, Couchgrass, Pellitory.

Powders. Equal parts: Dandelion, Cornsilk, Mullein. Dose: 750mg (three 00 capsules or half teaspoon) every 2 hours. In water or cup of Cornsilk tea.

Tinctures. Equal parts: Buchu, Elderflowers, Yarrow. Mix. Dose: 1-2 teaspoons in water or cup of Cornsilk tea, every two hours.

Topical. Hot poultices to small of the back; flannel or other suitable material saturated with an infusion of Elderflowers, Goldenrod, Horsetail or Yarrow. Herbal treatment offers a supportive role. ... bright’s disease (acute)

Dropsy, Renal

 Oedema. Hydrops. Not a disease but a condition. An abnormal accumulation of fluid in a body cavity or beneath the skin. Due to weakened walls of capillaries caused by circulating toxins obstructing the flow of blood or lymph. Gross oedema of nephrotic syndrome associated with low plasma protein level and high proteinuria.

Renal dropsy is worse in the early morning, with loose tissues under the eyes.

Treatment. When fluid rapidly collects it may have to be aspirated (drawn off) but before this stage is reached herbal diuretics and cardiac tonics have much to offer. In acute conditions, sweat glands should be stimulated by suitable diaphoretics to assist elimination of excess fluid through the skin. Attention to the bowels is important; a timely copious bowel action greatly assisting elimination. A well-known diuretic for dropsy is Juniper, 3 to 5 drops taken in honey 2 or 3 times daily.

Alternatives. Teas. (Simple infusions): Agrimony, Bearberry, Boldo, Boneset, Borage, Buchu, Celery seed, Clivers, Corn Silk, Dandelion leaves, Parsley leaves, Elderflowers, Bogbean, Heartsease, Lime flowers, Parsley Piert, Pellitory, Plantain, Sea Holly, Wild Carrot, Yarrow.

Decoctions. Broom tops, Lovage, Burdock root, Couchgrass, Dandelion root, Juniper berries, Blue Flag root.

Bean Cure (Phaseolus vulgaris). 1 tablespoon kidney (haricot) bean pods, sliced, in cup water simmered gently for 5 minutes. 1 cup morning and mid-day.

Sassafras root. An old Swedish colonist of the late 18th century related how his mother cured many cases of dropsy with a decoction of Sassafras root. (American Indian Medicine. Virgil Vogel, p.363) Of historic interest only, this root is no longer used in herbal practice.

Tablets/capsules. Buchu. Dandelion. Juniper. Celery. Garlic. Blue Flag.

Powders. Equal parts: Buchu, Dandelion root, Stone root, Senna leaf. Mix. Dose: 500-750mg (2 × 3 × 00 capsules or one-third to half a teaspoon) thrice daily.

Liquid Extracts. Equal parts: Buchu, Clivers, Blue Flag. Mix. 30-60 drops, thrice daily.

Practitioner. Alternatives with a record of efficacy. Tinctures.

Formula 1. Burdock, 20ml; Buchu, 20ml; Bearberry, 20ml; Aqua to 100ml. Dose: 5ml 3 times daily in water.

Formula 2. Juniper, 10ml; Buchu, 20ml; Broom, 10ml; Dandelion, 10ml. Aqua to 100ml. Dose: 5ml, 3 times daily, in water.

Topical. Poultice over kidney area: quarter of an ounce Irish Moss gently simmered in half a pint water to a jellied mass and applied on linen or suitable material to the small of the back. Repeat 2 or 3 times with fresh hot poultices.

Diet. High protein, low salt. Fresh conservatively-cooked vegetables, polyunsaturated oils. Bottled or spring water.

Supplementation. Vitamin A, B-complex, B1, B6, C, E, Potassium.

General. Elevation of affected limbs above level of abdomen.

This condition should be treated by or in liaison with a qualified medical practitioner. ... dropsy, renal

Heart – Left Ventricular Failure (lvf)

Failure of the left ventricle to receive blood from the pulmonary circulation and to maintain efficient output of incoming blood to the arterial system. Failure to do so leads to congestion of blood in the lungs followed by fluid retention. If uncorrected, leads to kidney disturbance, low blood pressure, cyanosis (blueness of the skin). Onset may be tragically sudden.

Failure of the left ventricle may occur in cases of pericarditis, disease of the aortic valve, nephritis or high blood pressure.

Left ventricular failure is often of sudden onset, urgent, and may manifest as “cardiac asthma”.

Causes: blood clot, anaemia, thyroid disorder, coronary disease, congenital effects, drug therapy (beta blockers, etc), and to fevers that make heavy demands on the left ventricle.

Symptoms: breathlessness, wheezing, sweating, unproductive cough, faintness, bleeding from the lungs, palpitation. Cardiac asthma at night: feels he needs air; better upright than lying flat. Exertion soon tires. Sensation as if heart would stop. Blueness of lips and ears from hold-up in circulation of the blood through the lungs. Frequent chest colds. Awakes gasping for breath. Always tired. Cold hands and feet. Symptoms abate as compensation takes place. ‘Cream and roses’ complexion. The failure of left ventricle soon drags into failure of the right ventricle.

Right ventricular failure leads to congestive heart failure, with raised venous pressure in neck veins and body generally, causing oedema, ascites and liver engorgement.

Treatment. Agents to strengthen, support, and eliminate excess fluids from the body. BHP (1983) advises four main remedies: Hawthorn, Motherwort, Broom and Lily of the Valley. The latter works in a digitaloid manner, strengthening the heart, contracting the vessels, and lessening congestion in the lungs. Tinctures. Hawthorn 2; Stone root 1. Lily of the Valley 1. Dose: 15-45 drops thrice daily.

Broom tea. 2 teaspoons flowers, or 2-3 teaspoons tops and flowers, in cup water brought to boil and simmered one minute. 1 cup freely.

To remove fluid retention in the lungs, diuretics are indicated; chief among which is Dandelion root because of its high potassium content to prevent hypokalaemia. Dandelion coffee. As urinary excretion increases, patient improves.

Vitamin E. Not to be taken in left ventricular disorders.

Diet. See entry: DIET – HEART AND CIRCULATION.

UK Research. Researchers found that left ventricular failure was reduced by a quarter when patients were given magnesium intravenously for the first 24 hours after admission to the coronary care unit. They conclude that it should be given before any other heart therapy is commenced, and that patients should receive regular infusions if no other drug treatment is used. (The Lancet, 2.4.1994). This supports the use of magnesium sulphate (Epsom’s salts) by a past generation of herbal practitioners for the condition. ... heart – left ventricular failure (lvf)

Heart – Right Ventricular Failure (rvf)

Failure of the right ventricle to hold its own with the return flow of blood and to re-direct it through the lungs where it is re-oxygenated before entering the left ventricle for completing the circulatory cycle. Usually secondary to failure of the left ventricle. May be caused by valvular disease, especially narrowing of the orifice of the mitral valve.

Mitral disease leads to heart failure either by a narrowing of the orifice (stenosis) or a regurgitation blocks the passage of blood from the left atrium (auricle) to the left ventricle. The left atrium enlarges (hypertrophies) in an effort to counter the impediment. Real compensation – increased thrust of the blood – is provided by the right ventricle. In order to overcome a mitral impediment the right ventricle has to enlarge.

Sooner or later the right ventricle cannot enlarge any further and general heart failure sets in. Though caused primarily by a lesion of the mitral valve, it may be secondary to left ventricular failure (LVF), thyroid disorder (thyrotoxicosis), pericarditis, congenital heart disease, or any disease which weakens ventricular muscle.

Venous congestion and back pressure of RVF leads to congestion and accumulation of fluid in the lungs, cough and spitting of blood, painful swelling of the liver, nausea, loss of appetite and severe wasting.

Where the right ventricle fails to move the blood forward as it arrives from the systemic circulation, generalised dropsy sets in. Congestion of the kidneys leads to reduced urinary excretion and presence of albumin in the urine.

The picture is well known to the cardiac practitioner: blueness of the skin, congestion of the brain circulation with sleeplessness and delirium. Soon the tension of water-logged tissues results in pain and extreme anxiety. Feet are swollen and ankles pit on pressure; chest cavities fill with fluid and the abdomen swells (ascites).

Alternatives. Cardio-tonics would be given to strengthen the ventricle and diuretics to correct fluid retention: Lily of the Valley, Hawthorn, Motherwort, Broom. BHP (1983).

Due to rheumatic fever: Hawthorn.

High Blood Pressure: Mistletoe.

Effort Syndrome: Motherwort.

Tinctures. Combine, Lily of the Valley 2; Hawthorn 2; Motherwort 3. Dose: 1 teaspoon thrice daily after meals.

Diet. Low salt, low fat, high fibre. Restricted fluids, vegetarian protein foods, yoghurt. See also: DIET – HEART AND CIRCULATION.

Supplements. Potassium (bananas), Vitamin B6.

General. Stop smoking. Correction of overweight. Complete bed-rest with legs raised above level of the abdomen and patient propped-up to relieve difficult breathing. ... heart – right ventricular failure (rvf)

Renal Biopsy

See kidney biopsy.... renal biopsy

Renal Colic

Spasms of severe pain on one side of the back, usually caused by a kidney stone (see calculus, urinary tract) passing down the ureter.

There may also be nausea, vomiting, sweating, and blood in the urine.

Treatment is usually with bed rest, plenty of fluids, and injections of an analgesic drug, such as pethidine.... renal colic

Renal Failure

See kidney failure.... renal failure

Renal Transplant

Another term for kidney transplant.... renal transplant

Laryngitis, Acute

 Inflammation of the vocal cords. May be associated with the common cold, influenza, and other viral or bacterial infections.

Causes: smoking, mis-use of the voice in talking or singing (Ginseng).

Symptoms: voice husky or absent (aphonia). Talking causes pain. Self-limiting.

Treatment. Stop talking for 2 days. Care is necessary: neglect or ineffective treatment may rouse infection and invade the windpipe and bronchi resulting in croup.

Differential: croup is alerted by high fever and characteristic cough, requiring hospital treatment. Alternatives. Teas: Red Sage. Garden Sage. Thyme, wild or garden.

Effective combination: equal parts, Sage and Raspberry leaves. Used also as a gargle.

Tablets/capsules. Poke root. Lobelia. Iceland Moss.

Cinnamon. Tincture, essence or oil of: 3-5 drops in teaspoon honey.

Horseradish. 1oz freshly scraped root to steep in cold water for two hours. Add 2 teaspoons runny honey. Dose: 2-3 teaspoons every two hours.

Topical. Equal parts water/cider vinegar cold pack round throat. Renew when dry.

Traditional: “Rub soles of the feet with Garlic and lard well-beaten together, overnight. Hoarseness gone in the morning.” (John Wesley) Friar’s balsam.

Aromatherapy. Steam inhalations. Oils: Bergamot, Eucalyptus, Niaouli, Geranium, Lavender, Sandalwood.

Diet. Three-day fruit fast.

Supplements. Daily. Vitamin A (7500iu). Vitamin C (1 gram thrice daily). Beta carotene 200,000iu. Zinc 25mg. ... laryngitis, acute

Liver – Acute Infectious Hepatitis

Inflammation of the liver from virus infection. As the commonest form of liver disorder, it is often without jaundice or marked liver symptoms apart from general malaise and abdominal discomfort, ‘Gippy tummy’, ‘chill on the liver’. For feverishness, add a diaphoretic.

Treatment. Bitter herbs keep the bile fluid and flowing.

Alternatives. Teas. Agrimony, Lemon Balm, Boldo, Bogbean, Centuary, Dandelion, Hyssop, Motherwort, Wormwood, Yarrow.

Maria Treben. Equal parts: Bedstraw, Agrimony, Woodruff. 2 teaspoons to cup boiling water.

Cold tea: 2 teaspoons Barberry bark to each cup cold water. Infuse overnight. Half-1 cup freely. Tablets/capsules: Blue Flag. Dandelion. Wild Yam. Liquorice.

Formula. Equal parts: Turkey Rhubarb, Dandelion, Meadowsweet. Dose: Liquid Extracts: 1-2 teaspoons. Tinctures: 2-3 teaspoons. Powders: 500mg (two 00 capsules or one-third teaspoon). 3-4 times daily. Alfred Vogel. Dandelion, Devil’s Claw, Artichoke.

Antonius Musa, physician to Emperor Augustus Caesar records: “Wood Betony preserves the liver and bodies of men from infectious diseases”.

Preventative: Garlic. (Old Chinese)

Milk Thistle: good responses observed.

General. Bedrest until motions are normal. Enema with any one of above herb teas.

Diet. Fat-free. Fasting period from 1-3 days on fruit juices and herb teas only. Artichokes. Dandelion coffee. Lecithin.

See: COCKROACH, The.

Treatment by or in liaison with a general medical practitioner. ... liver – acute infectious hepatitis

Gingivitis, Acute Ulcerative

Painful infection and ulceration of the gums due to abnormal growth of bacteria that usually exist harmlessly in small numbers in gum crevices. Predisposing factors include poor oral hygiene, smoking, throat infections, and emotional stress. In many cases the disorder is preceded by gingivitis or periodontitis. The condition is uncommon, primarily affecting people aged 15–35.

The gums become sore and bleed at the slightest pressure. Crater-like ulcers develop on the gum tips between teeth, and there may be a foul taste in the mouth, bad breath, and swollen lymph nodes. Sometimes, the infection spreads to the lips and cheek lining (see noma).

A hydrogen peroxide mouthwash can relieve the inflammation.

Scaling is then performed to remove plaque.

In severe cases, the antibacterial drug metronidazole may be given to control infection.... gingivitis, acute ulcerative

Respiratory Failure

A condition in which there is a buildup of carbon dioxide and a fall in the level of oxygen in the blood (see hypoxia). Causes include lung disorders, such as severe asthma, emphysema, or chronic bronchitis (see pulmonary disease, chronic obstructive), or damage to the respiratory centre in the brain due to, for example, an overdose of opioid drugs, a stroke, or serious head injury.

Treatment is with ventilation and oxygen for the underlying cause.... respiratory failure

Urethral Syndrome, Acute

A set of symptoms, usually affecting women, that are very similar to cystitis but which occur in the absence of infection.... urethral syndrome, acute

Ventilatory Failure

A life-threatening condition in which the amount of carbon dioxide in the blood rises, and the amount of oxygen falls, due to disruption of the normal exchange of gases between the air in the lungs and the blood. Ventilatory failure may be due to brain damage or to depression of the respiratory centres by excessive doses of drugs such as morphine. Treatment may involve artificial ventilation or, in some cases, the use of respiratory stimulant drugs. (See also respiratory failure.)... ventilatory failure

Hepatitis, Acute

Short-term inflammation of the liver, which usually recovers in 1–2 months. In some cases, acute hepatitis may progress to chronic hepatitis (see hepatitis, chronic), but it rarely leads to acute liver failure.

Acute hepatitis is fairly common.

The most frequent cause is infection with one of the hepatitis viruses (see hepatitis, viral), but it can arise as a result of other infections such as cytomegalovirus infection or Legionnaires’ disease.

It may also occur as a result of overdose of halothane or paracetamol or exposure to toxic chemicals including alcohol (see liver disease, alcoholic).

Symptoms range from few and mild to severe with pain, fever, and jaundice.

Blood tests, including liver function tests, may be used for diagnosis.

In most cases of acute viral hepatitis, natural recovery occurs within a few weeks.

If the disorder is caused by exposure to a chemical or drug, detoxification using an antidote may be possible.

Intensive care may be required if the liver is badly damaged.

Rarely, a liver transplant is the only way of saving life.

In all cases, alcohol should be avoided.... hepatitis, acute

Leukaemia, Acute

A type of leukaemia in which excessive numbers of immature white blood cells called blasts are produced in the bone marrow. If untreated, acute leukaemia can be fatal within a few weeks or months. The abnormal cells may be of 2 types: lymphoblasts (immature lymphocytes) in acute lymphoblastic leukaemia, and myeloblasts (immature forms of other types of white cell) in acute myeloblastic leukaemia.

Exposure to certain chemicals (such as benzene and some anticancer drugs) or high levels of radiation may be a cause in some cases. Inherited factors may also play a part; there is increased incidence in people with certain genetic disorders (such as Fanconi’s anaemia) and chromosomal abnormalities (such as Down’s syndrome). People with blood disorders such as chronic myeloid leukaemia (see leukaemia, chronic myeloid) and primary polycythaemia are at increased risk, as their bone marrow is already abnormal.

The symptoms and signs of acute leukaemia include bleeding gums, easy bruising, headache, bone pain, enlarged lymph nodes, and symptoms of anaemia, such as tiredness, pallor, and breathlessness on exertion. There may also be repeated chest or throat infections. The diagnosis is based on a bone marrow biopsy. Treatment includes transfusions of blood and platelets, the use of anticancer drugs, and possibly radiotherapy. A bone marrow transplant may also be required. The outlook depends on the type of leukaemia and the age of the patient. Chemotherapy has increased success rates and 6 in 10 children with the disease can now be cured, although treatment is less likely to be completely successful in adults.... leukaemia, acute

Liver Failure

Severe impairment of liver function that develops suddenly or at the final stages of a chronic liver disease. Because the liver breaks down toxins in the blood, liver failure causes the levels of the toxins to rise, affecting the functioning of other organs, particularly the brain. Liver failure may be acute or chronic. Symptoms of acute liver failure develop rapidly and include impaired memory, agitation, and confusion, followed by drowsiness. The functioning of other organs may become impaired, and the condition may lead to coma and death. Features of chronic liver failure develop much more gradually and include jaundice, itching, easy bruising and bleeding, a swollen abdomen due to accumulated fluid, red palms and, in males, gynaecomastia (enlarged breasts) and shrunken testes. Chronic liver failure may suddenly deteriorate into acute liver failure.

Acute liver failure requires urgent hospital care.

Although no treatment can repair damage that has already occurred in acute and chronic liver failure, certain measures, such as prescribing diuretic drugs to reduce abdominal swelling, may be taken to reduce the severity of symptoms.

Consumption of alcohol should cease in all cases.

The prognoses for sufferers of chronic liver failure vary depending on the cause, but some people survive for many years.

For acute liver failure, a liver transplant is necessary to increase the chances of survival.... liver failure

Acute Abdomen

the sudden uncontrolled development of severe abdominal symptoms secondary to disease or injury. Failure to establish a prompt diagnosis may lead to rapid clinical decline. Perforation of a peptic ulcer, an inflamed appendix or colonic diverticulum, or rupture of the liver or spleen following a crush injury all produce an acute abdomen requiring urgent treatment.... acute abdomen

Acute Coronary Syndrome

a combination of angina (unstable or stable), non-S–T elevation *myocardial infarction (NSTEMI), and S–T elevation myocardial infarction (STEMI). It implies the presence of coronary artery disease.... acute coronary syndrome

Acute Fatty Liver Of Pregnancy

a rare and life-threatening complication of pregnancy that usually presents in the third trimester with symptoms of nausea, vomiting, malaise, and abdominal pain. Liver function tests are abnormal and the features of *pre-eclampsia and often *HELLP syndrome are present. *Hepatic encephalopathy, *disseminated intravascular coagulation, and renal failure may develop, and the condition is associated with a high maternal and fetal mortality. Treatment involves a multidisciplinary approach, usually in an intensive care unit.... acute fatty liver of pregnancy

Acute Generalized Exanthematous Pustulosis

(toxic pustuloderma) a reaction to a medication, resulting in the appearance of fine sterile *pustules on inflamed skin; the pustules may easily be overlooked. Common causes include penicillins, and pustular psoriasis must be excluded from the diagnosis.... acute generalized exanthematous pustulosis

Acute Kidney Injury

see AKI.... acute kidney injury

Acute Renal Failure

acute kidney injury (see AKI).... acute renal failure

Acute Respiratory Distress Syndrome

see adult respiratory distress syndrome.... acute respiratory distress syndrome

Acute Respiratory Failure

(ARF) a primary disorder of gaseous exchange (as distinct from failure of the mechanical process of breathing). The prototype of ARF is *adult respiratory distress syndrome, but the term sometimes also refers to disruption of any other part of the respiratory system, including the respiratory control centre in the brain with its *efferent and *afferent pathways.... acute respiratory failure

Acute Retinal Necrosis

(ARN) severe inflammation and necrosis of the retina associated with inflammation and blockage of retinal blood vessels, haemorrhage and death of retinal tissue, and retinal detachment. It may affect both eyes (bilateral acute retinal necrosis, BARN), and visual prognosis is poor. ARN is thought to be due to viral infection.... acute retinal necrosis

Acute Rheumatism

see rheumatic fever.... acute rheumatism

Acute Tubular Necrosis

(ATN) a condition caused by acute renal injury from either ischaemia or toxins and associated with tubular damage that is usually reversible. The earliest feature is *isosthenuria, which may occur while there is still a high urine flow rate. This is followed by a reduction in *glomerular filtration rate. *Oliguria is common and dialysis often needed for survival. If the cause of the initial damage can be removed, recovery of renal function within six weeks can be expected in most cases.... acute tubular necrosis

Atheroembolic Renal Disease

a disease associated with diffuse atherosclerosis and sloughing of atheromatous plaques in the aorta and main renal arteries. This results in occlusion of smaller arteries and arterioles downstream within the kidney, with ischaemic and inflammatory reactions. This leads to the onset of renal impairment. Precipitating factors include invasive procedures with aortic cannulae, vascular surgery, and therapy with thrombolytics or anticoagulants. Less commonly the condition can occur spontaneously.... atheroembolic renal disease

Congestive Cardiac Failure

(CCF, congestive heart failure) see heart failure.... congestive cardiac failure

End-stage Renal Failure

(ESRF, CKD 5) the most advanced stage of kidney failure, which is reached when the *glomerular filtration rate (GFR) falls to 15 ml/min (normal GFR = 100 ml/min).... end-stage renal failure

Left Ventricular Failure

see heart failure.... left ventricular failure

Multi-organ Failure

(MOF) see multiple organ dysfunction syndrome.... multi-organ failure

Premature Ovarian Failure

menopause occurring before the age of 40. It may be caused by autoimmunity, chemotherapy, radiotherapy, or genetic factors, for example a mutation in the FSH receptor gene causing excess secretion of gonadotrophins and small underdeveloped ovaries. Treatment is by hormone replacement, either with the contraceptive pill or HRT. *Oocyte donation should be discussed if the patient wishes for assisted conception.... premature ovarian failure

Renal Artery

either of two large arteries arising from the abdominal aorta and supplying the kidneys. Each renal artery divides into an anterior and a posterior branch before entering the kidney.... renal artery

Renal Function Tests

tests for assessing the function of the kidneys. These include measurements of the specific gravity of urine, creatinine *clearance time, and blood urea levels; intravenous urography; and renal angiography.... renal function tests

Renal Osteodystrophy

see osteodystrophy.... renal osteodystrophy

Renal Transplantation

see transplantation.... renal transplantation



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