Cardiac stress test Health Dictionary

Cardiac Stress Test: From 1 Different Sources


One of a group of tests used to assess the function of the heart in people who experience chest pain, breathlessness, or palpitations during exercise. The test establishes whether the patient has coronary artery disease. An ECG machine records the patterns of the heart’s electrical activity while the heart is stressed. This is usually achieved by the patient exercising on a treadmill or cycling. Specific changes in the electrical pattern as exercise levels increase indicate angina. Cardiac stress testing may be used in conjunction with radionuclide scanning to identify damaged areas of heart muscle.
Health Source: BMA Medical Dictionary
Author: The British Medical Association

Cardiac Arrest

Absence of a palpable pulse, and thus of circula tion of blood around the body by the heart contraction. The cause may be asystole or ventricular fibrillation.... cardiac arrest

Cardiac

Relating to the heart... cardiac

Testosterone

The principal reproductive androgen of males, largely responsible for sexual maturation, some libido, and a range of metabolic reactions that, while supplying short-term strengths, creates a long-term fragility and brittleness if not in balance with less garish but more sustainable metabolic buffers. It is secreted by the Leydig cells of the testes, as well as smaller amounts in the adrenal cortices of both sexes. It is made under the direction of LH from the pituitary, and, if oversecreted, can be inhibited by sperm-producing cells, diminished pituitary support, and a rise in blood levels of its waste-product, stored in adipose tissues...estradiol... testosterone

Cardiac Cycle

The various sequential movements of the heart that comprise the rhythmic relaxation and expansion of the heart muscles as ?rst the atria contract and force the blood into the ventricles (diastole), which then contract (systole) to pump the blood round the body. (See ELECTROCARDIOGRAM (ECG).)

Cardiac Disease

See HEART, DISEASES OF.... cardiac cycle

Cardiac Output

The volume of blood pumped out per minute by the ventricles of the heart. It is one measure of the heart’s e?ciency. At rest, the heart of a healthy adult will pump between 2.5 and 4.5 litres of blood every minute. Exercise will raise this to as much as 30 litres a minute but, if this ?gure is low, it suggests that the heart muscle may be diseased or that the person has suffered severe blood loss.... cardiac output

Heaf Test

A skin test to ?nd out if a person is immune to TUBERCULOSIS. TUBERCULIN (a preparation derived from the TUBERCLE bacillus) is injected via punctures in the skin of the forearm, using a spring-loaded gunlike instrument with six very short needles set in circular form. A positive test is indicated by a red raised reaction of the skin: this means that the subject is immune. If the result is negative, the subject can be given BCG VACCINE.... heaf test

Mantoux Test

A test for TUBERCULOSIS. It consists in injecting into the super?cial layers of the skin (i.e. intradermally) a very small quantity of old TUBERCULIN which contains a protein ANTIGEN to TB. A positive reaction of the skin – swelling and redness – shows that the person so reacting has been infected at some time in the past with Mycobacterium tuberculosis. However, it does not mean that such a person is suffering from active tuberculosis.... mantoux test

Patch Test

This is used to identify possible substances that may be causing a patient’s ALLERGY. Small amounts of di?erent substances are placed on the skin – usually of the back or arm. If the patient is allergic then a red ?are and swelling will appear, usually within about 15 minutes. Sometimes the reaction may take longer – up to three days – to develop.... patch test

Rorschach Test

A psychological test (see PSYCHOLOGY) for investigating personality and disorders of personality. Also called the ‘ink blot test’, it is now rarely used. It was devised by a Swiss psychiatrist, Hermann Rorschach (1884–1922), who determined individuals’ reactions to a series of symmetrical ink-blots, ten in number and standardised by him.... rorschach test

Testis

See TESTICLE.... testis

Stress

Any factor or event that threatens a person’s health or adversely affects his or her normal functioning. Injury, disease or worry are common examples; others include internal con?icts, emotive life events – such as the death of a close relative or friend, the birth of a baby, separation or divorce – pressures at work or a hostile environment such as war or famine. Some individuals seem to be more prone than others to develop medical problems related to stress.

Stress prompts the body to raise its output of HORMONES such as ADRENALINE and CORTISOL, causing changes in blood pressure, heart rate and metabolism. These are physiological responses intended to improve a person’s physical and mental performance – the ‘?ght or ?ight’ reaction to fear. Stress may, however, disrupt the ability to cope. Constant or recurrent exposure to stress may produce symptoms such as anxiety, depression, headaches, indigestion, diarrhoea, palpitations and general malaise (see POST-TRAUMATIC STRESS DISORDER (PTSD)). Treatment can be di?cult and prolonged; counselling can help as can ANXIOLYTICS or ANTIDEPRESSANT DRUGS – but a change in job or lifestyle may be necessary in some circumstances.... stress

Test Meal

(1) The name given to a gastric-function test, involving injection of HISTAMINE – a powerful stimulator of gastric juice, or pentagastin. After the stimulant has been injected, the digestive juices are withdrawn through a stomach tube (inserted through the nose and throat) and their volume and chemistry measured. A similar test is used to assess the working of the PANCREAS.

(2) The second meaning (also called test feed) applies to a diagnostic procedure for congenital PYLORIC STENOSIS, whereby a paediatrician feels over the baby’s abdomen while he or she is feeding. The pyloric mass can be felt as a ?rm swelling with the consistency of a squash ball, which comes and goes under the examiner’s ?ngers.... test meal

Testicle

Every man has two testicles or testes which are the sexual glands. In the fetus, they develop in the abdomen, but before birth they descend into a fold or pouch of skin known as the SCROTUM. Each testicle consists of up to 1,000 minute tubes lined by cells from which the spermatozoa (see SPERMATOZOON) are formed. Around 4·5 million spermatozoa are produced per gram of testicle per day. These tubes communicate with one another near the centre of the testicle, and are connected by a much coiled tube, the EPIDIDYMIS, with the ductus, or VAS DEFERENS, which enters the abdomen and passes on to the base of the bladder. This duct, after joining a reservoir known as the seminal vesicle, opens, close to the duct from the other side of the body, into the URETHRA where it passes through the PROSTATE GLAND. Owing to the convolutions of these ducts leading from the testicles to the urethra, and their indirect route, the passage from testicle to urethra is over 6 metres (20 feet) in length. In addition to producing spermotozoa, the testicle also forms the hormone TESTOSTERONE which is responsible for the development of male characteristics.... testicle

Blood Test

Removal of venous, capillary or arterial blood for haematological, microbiological or biochemical laboratory investigations.... blood test

Caloric Test

A test for vestibular function (see EAR). It is performed by irrigating the external auditory meatus of the ear with alternate cold and hot water. This usually stimulates the vestibular apparatus, causing nystagmus (see DIABETES MELLITUS – Diabetic eye disease). If the vestibular apparatus is affected by disease, the response may be absent or reduced.... caloric test

Cardiac Glycosides

Drugs whose main actions are to increase the force of myocardial contraction and reduce the conductivity of the nerve ?bres in the atrioventricular node of the heart. They are useful in treating supraventricular tachycardias (rapid heart rhythm) and some forms of heart failure. Glycosides are a traditional group of cardiac drugs, originally derived from the leaves of foxglove plants and used as digitalis. The active principle has long been synthesised and used as DIGOXIN. They are potentaially toxic and their use, especially during initial treatment, should be monitored. Side-effects include ANOREXIA, nausea, vomiting, diarrhoea and abdominal pain; drowsiness, confusion and DEPRESSION may occur. An abnormally slow heart rate may develop. The glycosides should be used with special care in the elderly who are sometimes particularly susceptible to their toxic effects.... cardiac glycosides

Cardiac Muscle

The muscle, unique to the heart, which comprises the walls of the atria and ventricles. It consists of long broadening cells (?bres) with special physiological characteristics which enable them to keep contracting and expanding inde?nitely.... cardiac muscle

Cardiac Neurosis

Obsessional fear about the state of the heart. It tends to occur after a heart attack and may result in the patient’s experiencing the symptoms of another attack.... cardiac neurosis

Cardiac Tamponade

Compression of the heart due to abnormal accumulation of ?uid within the ?brous covering of the heart (PERICARDIUM). The result is irregular rhythm and death if the ?uid is not removed.... cardiac tamponade

Cardiac Massage

The procedure used to restart the action of the heart if it is suddenly arrested. In many cases the arrested heart can be made to start beating again by rhythmic compression of the chest wall. This is done by placing the patient on a hard surface – a table or the ?oor – and then placing the heel of the hand over the lower part of the sternum and compressing the chest wall ?rmly, but not too forcibly, at the rate of 60–80 times a minute. At the same time arti?cial respiration must be started by the mouth-tomouth method. (See APPENDIX 1: BASIC FIRST AID.) Open heart massage is sometimes undertaken if an arrest occurs during a chest operation – the heart being directly handled by the resuscitator.... cardiac massage

Coomb’s Test

A sensitive test that detects ANTIBODIES to the body’s red cells (see ERYTHROCYTE). There are two methods: one – the direct method – identi?es those antibodies that are bound to the cells; the other, indirect, method identi?es those circulating unattached in the serum.... coomb’s test

Dick Test

Skin test used to determine the immune s tatus to scarlet fever.... dick test

Glucose-tolerance Test

A way of assessing the body’s e?ciency at metabolising GLUCOSE. The test is used in the diagnosis of DIABETES MELLITUS. The patient is starved for up to 16 hours, after which he or she is fed glucose by mouth. The concentrations of glucose in the blood and urine are then measured at half-hour intervals over a period of two hours.... glucose-tolerance test

Intelligence Test

A standardised procedure of mental assessment to determine an individual’s intellectual ability. The result is produced as a score termed the INTELLIGENCE QUOTIENT (IQ). The Wechsler Adult Intelligence Scale (WAIS) and one for children, the Wechsler Intelligence Scale for Children (WICS), are commonly used, as is the Stanford-Binet Scale. Assessments are made for educational purposes and to help in the diagnoses of people with possible mental retardation or intellectual deterioration.... intelligence test

Kveim Test

The characteristic histological test used for the diagnosis of SARCOIDOSIS. The test involves an intradermal injection of sarcoid SPLEEN tissue. If positive, non-caseating granulomata (see GRANULOMA) are seen at the injection site in 4– 6 weeks. A positive test is highly speci?c for sarcoid, but if negative, this would not be excluded.... kveim test

Papanicolaou Test

See CERVICAL SMEAR.... papanicolaou test

Pregnancy Tests

There are several tests for pregnancy (see PREGNANCY AND LABOUR) in its early stages, and these can be done on blood or urine; some of the urine tests may be carried out at home. Most tests are based on the detection of HUMAN CHORIONIC GONADOTROPHIN (HCG) in the woman’s urine. They are nearly 100 per cent accurate and may show positive as early as 30 days after the ?rst day of the last normal period.

The haemagglutination inhibition test This, and the subsequent tests to be mentioned, are known as immunological tests. They are based upon the e?ect of the urine from a pregnant woman upon the interaction of red blood cells, which have been sensitised to human gonadotrophin, and anti-gonadotrophin serum. They have the great practical advantage of being performed in a test-tube or even on a slide. Because of their ease and speed of performance, a result can be obtained in two hours.

Enzyme-linked immunosorbent assay (ELISA) This is the basis of many of the pregnancy-testing kits obtainable from pharmacies. It is a highly sensitive antibody test and can detect very low concentrations of human chorionic gonadotrophin. Positive results show up as early as ten days after fertilisation – namely, four days before the ?rst missed period.

Ultrasound The fetal sac can be detected by ULTRASOUND from ?ve weeks, and a fetal echo at around six or seven weeks (see also PRENATAL SCREENING OR DIAGNOSIS).... pregnancy tests

Pulmonary Function Tests

Tests to assess how the LUNGS are functioning. They range from simple spirometry (measuring breathing capacity) to sophisticated physiological assessments.

Static lung volumes and capacities can be measured: these include vital capacity – the maximum volume of air that can be exhaled slowly and completely after a maximum deep breath; forced vital capacity is a similar manoeuvre using maximal forceful exhalation and can be measured along with expiratory ?ow rates using simple spirometry; total lung capacity is the total volume of air in the chest after a deep breath in; functional residual capacity is the volume of air in the lungs at the end of a normal expiration, with all respiratory muscles relaxed.

Dynamic lung volumes and ?ow rates re?ect the state of the airways. The forced expiratory volume (FEV) is the amount of air forcefully exhaled during the ?rst second after a full breath – it normally accounts for over 75 per cent of the vital capacity. Maximal voluntary ventilation is calculated by asking the patient to breathe as deeply and quickly as possible for 12 seconds; this test can be used to check the internal consistency of other tests and the extent of co-operation by the patient, important when assessing possible neuromuscular weakness affecting respiration. There are several other more sophisticated tests which may not be necessary when assessing most patients. Measurement of arterial blood gases is also an important part of any assessment of lung function.... pulmonary function tests

Test-tube Baby

See EMBRYO TRANSFER.... test-tube baby

Screening Test

The screening of apparently healthy people to identify those who may have treatable diseases. Cervical smears are done when screening women to detect if they have cancer or precancer of the neck of the womb (cervix). Newborn babies are screened for hip dislocation. Screening tests are not designed to diagnose individual persons, but rather to divide a population into a large number at low risk and a small number at high risk of a condition. This allows clinicians to concentrate on a sub-section of the population. All screening tests produce false negative and false positive results, a problem often misunderstood by those at the receiving end. Factors to be assessed when planning screening procedures include the severity, frequency and distribution of the disease, and the availability and e?ectiveness of treatment. Convenience, safety, sensitivity and cost should also be assessed. In the United Kingdom the government has supported the extension of screening procedures for breast cancer, cervical cancer, hypertension and diabetes. (See PREVENTIVE MEDICINE.)... screening test

Van Den Bergh Test

A test done on SERUM from patients with JAUNDICE to discover whether the excess BILIRUBIN in the blood – which causes the jaundice

– is conjugated or unconjugated. If conjugated, this indicates that HAEMOLYSIS is causing the jaundice; if unconjugated, disease of the LIVER or BILE DUCT is the likely diagnosis.... van den bergh test

Vision Tests

Most vision tests examine a person’s sharpness of VISION (visual acuity) and often of the ?eld of vision (see VISION, FIELD OF). Refraction tests assess whether a person has an error that can be corrected with glasses such as ASTIGMATISM, HYPERMETROPIA or MYOPIA. Visual acuity is tested using a Snellen chart when the patient tries to read letters of di?ering standard sizes from 6 metres away. The optician will prescribe lenses to correct any defects detected by vision tests.... vision tests

Post-traumatic Stress Disorder

A form of anxiety that develops after a stressful or frightening event.

Common causes include natural disasters, violence, rape, torture, serious physical injury, and military combat.

Symptoms, which may develop many months after the event, include recurring memories or dreams of the event, a sense of personal isolation, and disturbed sleep and concentration.

There may be a deadening of feelings, or irritability and feelings of guilt, sometimes building up to depression.

Most people recover, in time, with emotional support and counselling.... post-traumatic stress disorder

Stress Fracture

A fracture that occurs as a result of repetitive jarring of a bone. Common sites include the metatarsal bones in the foot (see March fracture), the tibia or fibula, the neck of the femur, and the lumbar spine. The main symptoms are pain and tenderness at the fracture site. Diagnosis is by bone imaging. Treatment consists of resting the affected area for 4–6 weeks. The fracture may be immobilized in a cast.... stress fracture

Testis, Retractile

A testis that is drawn up.... testis, retractile

Testicular Feminization Syndrome

A rare inherited condition in which a genetic male with internal testes has the external appearance of a female. The syndrome is a form of intersex and is the most common form of male pseudohermaphroditism.

The cause is a defective response of the body tissues to testosterone.

The causative genes are carried on the X chromosome, and so females can be carriers. Affected individuals appear to be girls throughout childhood, and most develop female secondary sexual characteristics at puberty; but amenorrhoea occurs, and a diagnosis is usually made during investigations to find its cause. Chromosome analysis shows the presence of male chromosomes and blood tests show male levels of testosterone. Treatment of testicular feminization syndrome involves surgical removal of the testes, to prevent cancerous change in later life, and therapy with oestrogen drugs. An affected person is not fertile but can live a normal life as a woman.... testicular feminization syndrome

B Nosed. The Test For Brain-stem Death Are:

Fixed dilated pupils of the eyes

Absent CORNEAL REFLEX

Absent VESTIBULO-OCULAR REFLEX

No cranial motor response to somatic (physical) stimulation

Absent gag and cough re?exes

No respiratory e?ort in response to APNOEA despite adequate concentrations of CARBON DIOXIDE in the arterial blood.... b nosed. the test for brain-stem death are:

Barany’s Test

A test for gauging the e?ciency of the balancing mechanism (the vestibular apparatus) by applying hot or cold air or water to the external ear.... barany’s test

Bolam Test

A medico-legal defence for a clinician accused of failing to provide an acceptable standard of care for one of his or her quali?cation and experience. The defence is that a responsible body of medical practitioners would have taken the same action, even though others would have acted di?erently. The precise size of a ‘responsible body’ has not been de?ned. The test has been modi?ed following a case referred to as Bolitho, in which it was held that the Bolam defence failed if it could be shown that the actions relied upon, although shown to be carried out by some responsible doctors, were nonetheless illogical.... bolam test

Cardiac Arrhythmia

Abnormal rhythm of the heartbeat. Most commonly seen after someone has had a myocardial infarction, but also present in some normal individuals – especially if they have taken a lot of co?ee or other stimulant – and in those with a congenital abnormality of the heart-muscle conducting system. The cause is interference in the generation or transmission of electrical impulses through the heart’s conducting system. Occasional isolated irregular beats (ectopic beats) do not necessarily mean that conduction is faulty. Arrhythmias can be classi?ed as tachycardias (more than 100 beats a minute) or bradycardias (slower than 60 beats a minute). Heartbeats may be regular or irregular. (See HEART, DISEASES OF.)... cardiac arrhythmia

Cardiac Catheterisation

A diagnostic procedure in which a tube is inserted into a blood vessel under local anaesthetic and threaded through to the chambers of the heart to monitor blood ?ow, blood pressure, blood chemistry and the output of the heart, and to take a sample of heart tissue. The technique is used to diagnose congenital heart disease and coronary artery disease. Another application is in the diagnosis and treatment of valvular disease in the heart.... cardiac catheterisation

Cardiac Depressant

Slowing the action of the heart... cardiac depressant

Cardiac Pump

See HEART, ARTIFICIAL.... cardiac pump

Cardiac Pacemaker

The natural pacemaker is the sinuatrial node, found at the base of the heart. The heart normally controls its rate and rhythm; heart block occurs when impulses cannot reach all parts of the heart. This may lead to ARRHYTHMIA, or even cause the heart to stop (see HEART, DISEASES OF). Arti?cial pacemakers may then be used; in the United Kingdom these are required for around one person in every 2,000 of the population. Usually powered by mercury or lithium batteries, and lasting up to 15 years, they are either ?xed to the outside of the chest or implanted in the armpit, and connected by a wire passing through a vein in the neck to the heart. Normally adjusted to deliver 65–75 impulses a minute, they also ensure a regular cardiac rhythm. Patients with pacemakers may be given a driving licence provided that their vehicle is not likely to be a source of danger to the public, and that they are receiving adequate and regular medical supervision from a cardiologist.

Although there are numerous possible sources of electrical interference with pacemakers, the overall risks are slight. Potential sources include anti-theft devices, airport weapon detectors, surgical diathermy, ultrasound, and short-wave heat treatment. Nevertheless, many pacemaker patients lead active and ful?lling lives.... cardiac pacemaker

Cognitive Testing

In surveys, studying the process of interpretation of questions and the formation and reporting of responses by respondents to learn how to make the questions more accurately obtain the data the questionnaire is seeking.... cognitive testing

External Cardiac Compression

Compression of the outside of the sternum and ribs, effectively emptying and filling the heart to push blood through arteries to supply oxygen to the body - particularly to the brain.... external cardiac compression

Gene Testing

See GENETIC SCREENING.... gene testing

Ishihara’s Test

A test for colour vision, introduced by a Japanese doctor, comprising several plates with round dots of di?erent colours and sizes. It is also the name of a type of blood test for SYPHILIS.... ishihara’s test

Maldescended Testis

See under TESTICLE, DISEASES OF.... maldescended testis

Means Test

The determination of eligibility for a publicly financed programme on the basis of an applicant’s income and assets (means).... means test

Paul-bunnell Test

A test for MONONUCLEOSIS which is based upon the fact that patients with this disease develop ANTIBODIES which agglutinate sheep red blood cells.... paul-bunnell test

Post-coital Test

A test for INFERTILITY. A specimen of cervical mucus, taken up to 24 hours after coitus (during the post-ovulatory phase of the menstrual cycle), is examined microscopically to assess the motility of the sperms. If motility is above a certain level, then sperms and mucus are not interacting abnormally – thus eliminating one cause of sterility.... post-coital test

Post-traumatic Stress Disorder (ptsd)

A term introduced to PSYCHIATRY in 1980 after the Vietnam War. It is one of several psychiatric disorders that can develop in people exposed to severe trauma, such as a major physical injury, participation in warfare, assault or rape, or any event in which there is major loss of life or a threat of loss of life. Most people exposed to trauma do not develop psychiatric disorder; however, some develop immediate distress and, occasionally, the reaction can be delayed for many months. Someone with PTSD has regular recurrences of memories or images of the stressful event (‘?ashbacks’), especially when reminded of it. Insomnia, feelings of guilt and isolation, an inability to concentrate and irritability may result. DEPRESSION is very common. Support from friends and family is probably the best management, but those who do not recover quickly can be helped by antidepressants and psychological treatments such as COGNITIVE BEHAVIOUR THERAPY. Over the past few years, PTSD has featured increasingly in compensation litigation.... post-traumatic stress disorder (ptsd)

Rinnes Test

A hearing test in which a vibrating tuning fork is placed on the mastoid process (see EAR). When the subject can no longer hear the ringing, it is placed beside the ear. Normal subjects can then hear the noise once more, but in people with conductive DEAFNESS, air conduction does not persist after bone conduction has ceased. It can help to distinguish between nerve (sensorineural) and conduction deafness.... rinnes test

Test-tube

A tube of thin glass closed at one end, which is used for observing chemical reactions or for bacterial culture.... test-tube

Statistical Test

A mathematical formula (or function) that is used to determine if the difference between outcomes of a treatment or intervention and a control group is great enough to conclude that the difference is statistically significant. Statistical tests generate a value that is associated with a particular P value. Among the variety of common statistical tests are: F, t, Z, and chi-square. The choice of a test depends upon the conditions of the study, e.g. what type of outcome variable is used, whether or not the subjects are randomly selected from a larger population, and whether it can be assumed that the outcome values of the population have a normal distribution or other type of distribution.... statistical test

Stress Fractures

Stress fractures are comparatively common in sportspeople. They tend to occur when an undue amount of exercise is taken – that is, an amount of exercise which an individual is not capable of coping with in his or her state of training. The main initial feature is pain over the affected bone that has been subjected to abnormal physical stress. This is usually insidious in onset, and worse at night and during and after exercise. It is accompanied by tenderness, and a lump may be felt over the affected site. X-ray evidence only appears after several weeks. Treatment consists of rest, some form of external support, and in the initial stage ANALGESICS to deaden or kill the pain. (See also BONE, DISORDERS OF – Bone fractures.)... stress fractures

Tourniquet Test

A positive tourniquet test with scattered fine petechiae is one of the earliest clinical signs in dengue haemorrhagic fever.... tourniquet test

Undescended Testis

See under TESTICLE, DISEASES OF.... undescended testis

Vdrl Test

Venereal Diseases Research Laboratory Test. One of the non-treponemal reaginic tests for syphilis.... vdrl test

Weber’s Test

A test with a tuning fork that is used to assess a person’s DEAFNESS.... weber’s test

Weil-felix Test

An agglutination test used in the laboratory to diagnose rickettsial diseases. It depends on a nonspecific cross reaction between antibodies produced by the rickettsial infection with the OX-2, OX-19 and OXK antigens of the Gram negative rod, Proteus.... weil-felix test

Widal Test

A serological test used to detect antibodies in the diagnosis of typhoid. Antigens detected are the O (somatic), H (flagellar) and Vi (virulence) antigens.... widal test

Tea For Stress

Stress is known as a general state of fatigue and exhaustion due to sleeplessness or other causes such as sitting in one position for too long or having a lot to deal with. Stress is both a physical and a mental disorder, triggered by the body exhaustion due to hard working. The best way to deal with stress is to take some time off from school or work, but if you cannot afford that luxury, try a natural remedy. Some say that stress implies having too little time to solve too many problems while already being exhausted. At times, stress accumulations may lead to faints, blackouts or severe mental problems, such as paranoia or schizophrenia. How Tea for Stress Works A Tea for Stress’ main purpose is to make your body release enough endorphins to create a state of relaxation. These teas contain nutrients, enzymes and volatile oils capable to induce joy and happiness. Many of these teas can contain tannins, which is a substance whose main purpose is to calm the affected areas and nourish the nervous system. If you’re feeling down and stress is the main cause, try a Tea for Stress and enjoy its organic benefits! Efficient Tea for Stress When choosing a Tea for Stress, you need to make sure the one you’re picking is both safe and very effective, in order to avoid other unnecessary complications. If you’re thinking about taking a tea and you don’t know which one fits your needs best, here are some guidelines: - Chamomile Tea – also used as an adjuvant in the pharmaceutical and the cosmetic industry, Chamomile Tea can treat a number of affections, such as sore throat, flu, colds, pleurisy and pulmonary edema. Also, Chamomile is one of the safest and the most popular stress treatments and it can be found in almost any teashop or grocery store! - Mint Tea – contains an active ingredient called menthol which is responsible for this tea’s curative properties. This is a very important Tea for Stress, since its action doesn’t imply only the stress triggers, but also a large variety of affections, such as respiratory problems and ailments of the digestive tract (diarrhea, upset stomach, gastritis). This tea is also one hundred percent safe; just don’t take more than 6 cups per day! - Ginseng Tea – probably the most effective Tea for Stress, Ginseng Tea is also the most dangerous one. Make sure you don’t drink more than a cup per day for a short amount of time and that in case you’re experiencing some unusual reactions, you’ll talk to a specialist right away! - Lavender Tea – used for its fragrance and curative properties, lavender was used by the ancient Romans as a sleeping aid and a good relaxer. Modern medicine, however, found out that a cup of Lavender Tea per day will destroy both the stress and the tension in your body. Besides, you can find it almost anywhere! Tea for Stress Side Effects When taken properly, a Tea for Stress is generally safe. However, high dosages may lead to a number of health complications, such as diarrhea, constipation, upset stomach, vomiting and ulcers. Just make sure you follow the instructions. To gather more information, talk to a specialist before making any move. If you’re pregnant, breastfeeding, on blood thinners or anticoagulants or if you’re preparing for a major surgery, it’s best to talk to your doctor before taking one of these teas. Other than that, give any Tea for Stress a try and enjoy its wonderful benefits responsibly!... tea for stress

Manager’s Stress

All in charge of other people are subject to a wide range of environmental stress, working conditions, conflict with superiors. Some are more predisposed to stress than others. Alternatives. Ginseng, Valerian, Skullcap, Oats, Gotu Kola.

Tea. Skullcap 1; Oats 2; Valerian half. Mix. 1 teaspoon to each cup boiling water. 1 cup as desired.

Life Drops. Few drops in tea.

Lime flower tea, at night.

Ginkgo. For brain fatigue.

Diet. Avoid strong tea, coffee, alcohol. ... manager’s stress

Asthma, Cardiac

Breathing difficulty in which bronchospasm and wheezing are caused by accumulation of fluid in the lungs (pulmonary oedema). This is usually due to reduced pumping efficiency of the left side of the heart (see heart failure) and is not true asthma. Treatment is with diuretic drugs.... asthma, cardiac

Binet Test

The first intelligence test that attempted to measure higher mental functions, devised in 1905.... binet test

Blood-clotting Tests

Tests to screen for and diagnose bleeding disorders, usually resulting from deficiencies or abnormalities of blood coagulation factors or of platelets (see blood clotting). Tests are also used to monitor treatment with anticoagulant drugs.... blood-clotting tests

Catheterization, Cardiac

A diagnostic test in which a fine, sterile catheter is introduced into the heart via a blood vessel. It is used to diagnose and assess the extent of congenital heart disease (see heart disease, congenital) and coronary artery disease, and to diagnose and treat some disorders of the heart valves (see valvuloplasty). During the procedure, the pressure within the heart’s chambers can be measured, samples of blood and tissue can be taken, and a radiopaque substance can be injected to allow the heart’s cavities to be X-rayed.... catheterization, cardiac

Teas For Stress

Unlike migraines, stress is an accumulation of disorganized pain that takes your body by surprise, inducing a state of general fatigue and irritation. Although migraines teas could also be used as a remedy for stress, it is possible that their effect on your general health to pass unnoticed. Since stress has a more profound characteristic, it’s best if you choose one of the following teas: - Green Tea (thanks to its calming amino acid which can be found in the leaves) - Kava Tea (induces a state of calmness without having the side effects of a traditional drug). How Teas for Stress Work First of all, if you’ve decided to go with Teas for Stress instead of traditional drugs, you need to know that, although the amount of side effects is very low, you still have to pay attention to the amount of tea you’re taking. Thanks to their main ingredients, which include tannin, caffeine, proteins, carbohydrates and vitamin C, their main responsibility is restoring your general well-being by enhancing the number of anti bodies and by fighting all pain triggers. Actually, these Teas for Stress focus on any type of fatigue accumulation that shouldn’t appear in your system. The enzymes contained have anti-inflammatory properties which can lower your nervous deviations and increase your blood flow in order to wash away the unwanted microbes. Efficient Teas for Stress When you’re looking for Teas for Stress, you have plenty oh choices. Aside from Green Tea and Kava Tea, you can also add the following teas to your medical cabinet: - Chamomile Tea – thanks to its curative properties, this remedy can bring you calmness without having to worry about any side effects. Its main plus consists in the fact that it is one hundred percent safe. - Valerian Tea – also used as a diuretic and a pain reliever, Valerian Tea is probably the most notorious name in this Teas for Stress list. Ancient Romans used it as a sedative and sleep aid. All these curative properties are generated by a substance called valepotriates, which can be found in both Valerian leaves and flowers. - Mint Tea – one of the world’s greatest panacea and a good replacer for your morning coffee, Mint Tea is the most popular medical treatment when it comes to stress too. When looking for Teas for Stress, you don’t have to go too far. If you have Mint in your kitchen, just reach for it and enjoy its wonderful benefits! - Ginseng Tea – you might find Ginseng a bit strong for your taste, but its action is strong and quickly. It is said that Ginseng clears out the exhaust and stress immediately, thanks to a series of natural enzymes. If the taste seems a bit unpleasant to you, just add a small amount of honey and lemon. Teas for Stress Side Effects It is important to remember that all medical treatments should be taken according to their specifications and that exceeding the number of teacups per day might cause you severe damages. However, when it comes to these Teas for Stress, the only thing you need to be careful about is the time period in which you take them. If you know you suffer from chronic stress symptoms, drink Mint Tea or Chamomile Tea, since they have no side effects. Aside from being a good help in cases of stress, Ginger Tea may cause diarrhea, nausea and other problems, so you need to pay attention to your treatment. Also, only take the tea are long as you feel sick and don’t make a habit out of it! Other than that, there’s no reason not to give these Teas for Stress a try and enjoy their natural benefits wisely!... teas for stress

Testicle, Diseases Of

The SCROTUM may be affected by various skin diseases, particularly eczema (see DERMATITIS) or fungal infection. A HERNIA may pass into the scrotum. Defective development of the testicles may lead to their retention within the abdomen, a condition called undescended testicle.

Hydrocoele is a collection of ?uid distending one or both sides of the scrotum with ?uid. Treatment is by withdrawal of the ?uid using a sterile syringe and aspiration needle.

Hypogonadism Reduced activity of the testes or ovaries (male and female gonads). The result is impaired development of the secondary sexual characteristics (growth of the genitals, breast and adult hair distribution). The cause may be hereditary or the result of a disorder of the PITUITARY GLAND which produces GONADOTROPHINS that stimulate development of the testes and ovaries.

Varicocoele is distension of the veins of the spermatic cord, especially on the left side, the causes being similar to varicose veins elsewhere (see VEINS, DISEASES OF). The chief symptom is a painful dragging sensation in the testicle, especially after exertion. Wearing a support provides relief; rarely, an operation may be advisable. Low sperm-count may accompany a varicocele, in which case surgical removal may be advisable.

Orchitis or acute in?ammation may arise from CYSTITIS, stone in the bladder, and in?ammation in the urinary organs, especially GONORRHOEA. It may also follow MUMPS. Intense pain, swelling and redness occur; treatment consists of rest, support of the scrotum, analgesics as appropriate, and the administration of antibiotics if a de?nitive microorganism can be identi?ed. In some patients the condition may develop and form an ABSCESS.

Torsion or twisting of the spermatic cord is relatively common in adolescents. About half the cases occur in the early hours of the morning during sleep. Typically felt as pain of varying severity in the lower abdomen or scrotum, the testis becomes hard and swollen. Treatment consists of immediate undoing of the torsion by manipulation. If done within a few hours, no harm should ensue; however, this should be followed within six hours by surgical operation to ensure that the torsion has been relieved and to ?x the testes. Late surgical attention may result in ATROPHY of the testis.

Tuberculosis may occur in the testicle, especially when the bladder is already affected. Causing little pain, the infection is often far advanced before attracting attention. The condition generally responds well to treatment with a combination of antituberculous drugs (see also main entry for TUBERCULOSIS).

Tumours of the testes occur in around 600 males annually in the United Kingdom, and are the second most common form of malignant growth in young males. There are two types: SEMINOMA and TERATOMA. When adequately treated the survival rate for the former is 95 per cent, while that for the latter is 50 per cent.

Injuries A severe blow may lead to SHOCK and symptoms of collapse, usually relieved by rest in bed; however, a HAEMATOMA may develop.... testicle, diseases of

Cervical Smear Test

A test to detect cervical dysplasia (abnormal changes in the cells of the cervix) that could develop into cervical cancer (see cervix, cancer of). A smear test also detects viral infections of the cervix, such as herpes simplex and papilloma (see warts, genital). The test should be carried out 6 months after a woman starts to have sexual intercourse, with a repeat test 6–12 months later, and then every 3 years.

A sample of cells is taken from the surface of the cervix using a spatula and examined under a microscope.

If cells appear normal, nothing further needs to be done.

If cells show dysplasia, further investigations may be required.... cervical smear test

Cancer – Testicles

Rare, but increasing in most countries. Three main types: teratomas, seminomas and lymphomas. The latter affect older men.

Symptoms. A hard usually painless mass in the scrotum can give rise to gynaecomastia – abnormal enlargement of the male breasts.

Of possible value. Alternatives: – Abundant herb teas – Cornsilk, Red Clover, Violet leaves.

Decoction. Echinacea 2; Kava Kava 1; Sarsaparilla 1. Mix. Half an ounce (15g) to 1 pint (500ml) water simmered gently 20 minutes. Cup thrice daily.

Formula. Sarsaparilla 2; Kava Kava l; Pulsatilla half; Thuja quarter. Mix. Dose: Powders: 500mg (two 00 capsules or one-third teaspoon). Liquid extracts: 1 teaspoon. Tinctures: 2 teaspoons. Thrice daily. Vinchristine.

Diet. See: DIET – CANCER. Researchers from Cambridge University found that an extra pint of milk a day during adolescence was associated with 2 and a half times increased risk of testicular cancer. (Journal of Epidemiology and Community Health, Oct. 1993)

Treatment by or in liaison with a general medical practitioner. ... cancer – testicles

Cardiac Dropsy

Dropsy of heart origin is distinguished from renal dropsy by an increase in oedema as the day proceeds. In the morning there may be no swelling but by the evening legs become swollen from the ankles upwards. Fluids stagnate in the tissues from inability of the heart to perform efficiently as a pump. The condition is a symptom of heart failure with increasing breathlessness which may lead to general dropsy.

Symptoms: worse after exercise, breathlessness, headache, general weakness, feeble pulse, pale face, skin cold, swollen tissues pit on pressure.

Treatment. Alternatives:– Teas. Black Cohosh, Broom tops, Buchu, Dandelion, Hawthorn, Parsley root. Tea. Formula. Equal parts: Broom tops, Motherwort, Yarrow. 2 teaspoons to each cup water brought to boil and simmered 5 minutes in covered vessel. 1 cup 3-4 times daily.

Tablets/capsules. Buchu, Dandelion, Hawthorn, Juniper, Motherwort.

Formula. Dandelion 2; Hawthorn 2; Stone root 1. Mix. Dose: Powders: 750mg (three 00 capsules or half a teaspoon). Liquid extracts: 1 teaspoon. Tinctures: 2 teaspoons. Thrice daily.

Practitioner. Lily of the Valley, BPC 1934: 5-20 drops, 2-3 times daily.

Squills, tincture: resembles Digitalis in action. Dose: 1-3 drops, as prescribed.

Tinctures. Dandelion 2; Lily of the Valley 2; Stone root 1; Cayenne (tincture) quarter. Mix. Dose: 1 to 2 teaspoons thrice daily.

Popular formula. Tincture Scilla 5.0; Tincture Crataegus 10.0; Tincture Valerian to make 30.0. 15 drops thrice daily. (German Extemporaneous Formulae)

Diet. High protein. See: DIET – HEART AND CIRCULATION. ... cardiac dropsy

Dropsy: Cardiac

 Oedema (excess fluid in the tissues) may be due to poor circulation from impaired heart action. The condition is worse at the end of the day.

Treatment. Agents in frequent use: Broom, Lily of the Valley, Hawthorn (blossoms or berries), Motherwort.

Tea. Combine equal parts: Dandelion root, Motherwort, Yarrow. 2 teaspoons to each cup boiling water; infuse 5-15 minutes; 1 cup thrice daily.

Powders. Equal parts: Dandelion root, Juniper berries, Hawthorn berries. Mix. Dose: 500mg (two 00 capsules or one-third teaspoon).

Practitioner. Lily of the Valley. Dose as BHP (1983): Liquid Extract: 1:1 in 25 per cent alcohol, 0.6-2ml. Tincture: 1:5 in 40 per cent alcohol, 0.5-1ml. Thrice daily.

Dropsy in children: cucumber juice extracted from vegetable with aid of a juicer. As many cupfuls as well-tolerated. If vomiting is induced, it should be regarded as favourable.

Diet. Lacto-vegetarian, salt-free, bottled or spring water, honey. ... dropsy: cardiac

Arrhythmia, Cardiac

An abnormality of the rhythm or rate of the heartbeat. Arrhythmias, which are caused by a disturbance in the electrical impulses in the heart, can be divided into 2 main groups: tachycardias, in which the rate is faster than normal, and bradycardias, in which the rate is slower.

In sinus tachycardia, the rate is raised, the rhythm is regular, and the beat originates in the sinoatrial node (see pacemaker). Supraventricular tachycardia is faster and the rhythm is regular. It may be caused by an abnormal electrical pathway that allows an impulse to

circulate continuously in the heart and take over from the sinoatrial node. Rapid, irregular beats that originate in the ventricles are called ventricular tachycardia. In atrial flutter, the atria (see atrium) beat regularly and very rapidly, but not every impulse reaches the ventricles, which beat at a slower rate. Uncoordinated, fast beating of the atria is called atrial fibrillation and produces totally irregular ventricular beats. Ventricular fibrillation is a form of cardiac arrest in which the ventricles twitch very rapidly in a disorganized manner.

Sinus bradycardia is a slow, regular beat. In heart block, the conduction of electrical impulses through the heart muscle is partially or completely blocked, leading to a slow, irregular heartbeat. Periods of bradycardia may alternate with periods of tachycardia due to a fault in impulse generation (see sick sinus syndrome).

A common cause of arrhythmia is coronary artery disease, particularly after myocardial infarction. Some tachycardias are due to a congenital defect in the heart’s conducting system. Caffeine can cause tachycardia in some people. Amitriptyline and some other antidepressant drugs can cause serious arrhythmias if they are taken in high doses.

An arrhythmia may be felt as palpitations, but in some cases arrhythmias can cause fainting, dizziness, chest pain, and breathlessness, which may be the 1st symptoms.

Arrhythmias are diagnosed by an ECG. If they are intermittent, a continuous recording may need to be made using an ambulatory ECG.

Treatments for arrhythmias include antiarrhythmic drugs, which prevent or slow tachycardias.

With an arrhythmia that has developed suddenly, it may be possible to restore normal heart rhythm by using electric shock to the heart (see defibrillation).

Abnormal conduction pathways in the heart can be treated using radio frequency ablation during cardiac catheterization (see catheterization, cardiac).

In some cases, a pacemaker can be fitted to restore normal heartbeat by overriding the heart’s abnormal rhythm.... arrhythmia, cardiac

Dysrhythmia, Cardiac

A medical term meaning disturbance of heart rhythm, sometimes used as an alternative to arrhythmia (see arrhythmia, cardiac).... dysrhythmia, cardiac

Elisa Test

A laboratory blood test commonly used in the diagnosis of infectious diseases. stands for enzyme-linked immunosorbent assay.

(See also immunoassay.)... elisa test

Blood Tests

Analysis of a sample of blood to give information on its cells and proteins and any of the chemicals, antigens, antibodies, and gases that it carries. Such tests can be used to check on the health of major organs, as well as on respiratory function, hormonal balance, the immune system, and metabolism. Blood tests may look at numbers, shape, size, and appearance of blood cells and assess the function of clotting factors. The most important tests are blood count and blood group tests if transfusion is needed. Biochemical tests measure chemicals in the blood (see acid–base balance; kidney function tests; liver function tests). Microbiological tests (see immunoassay) look for microorganisms that are in the blood, as

in septicaemia. Microbiology also looks for antibodies in the blood, which may confirm immunity to an infection. blood transfusion The infusion of large volumes of blood or blood products directly into the bloodstream to remedy severe blood loss or to correct chronic anaemia. In an exchange transfusion, nearly all of the recipient’s blood is replaced by donor blood. Before a transfusion, a sample of the recipient’s blood is taken to identify the blood groups, and it is matched with suitable donor blood. The donor blood is transfused into an arm vein through a plastic cannula. Usually, each unit (about 500 ml) of blood is given over 1–4 hours; in an emergency, 500 ml may be given in a couple of minutes. The blood pressure, temperature, and pulse are monitored during the procedure.

If mismatched blood is accidentally introduced into the circulation, antibodies in the recipient’s blood may cause donor cells to burst, leading to shock or kidney failure. Less severe reactions can produce fever, chills, or a rash. Reactions can also occur as a result of an allergy to transfused blood components. All

blood used for transfusion is carefully screened for a number of infectious agents, including HIV (the AIDS virus) and hepatitis B and hepatitis C.

In elderly or severely anaemic patients, transfusion can overload the circulation, leading to heart failure.

In patients with chronic anaemia who need regular transfusion over many years, excess iron may accumulate (haemosiderosis) and damage organs such as the heart, liver, and pancreas.

Treatment with desferrioxamine to remove excess iron may be needed.... blood tests

Fitness Testing

A series of exercises designed to determine an individual’s level of fitness, primarily cardiovascular fitness and muscle performance. Fitness testing is often carried out before a person starts an exercise programme to evaluate its safety and suitability or to monitor progress thereafter.

A physical examination is usually performed, including measurement of body fat, height, and weight. Blood and urine tests may be done, including an analysis of blood cholesterol. The performance of the heart is measured by taking the pulse before, during, and after aerobic exercise. Another test involves measuring a person’s overall performance in a standard exercise. (See also aerobics; exercise.)... fitness testing

Glass Test

A test for meningitis that involves pressing a clear glass against a rash. If the rash remains visible, it may be a form of purpura, which sometimes occurs in meningitis.... glass test

Hearing Tests

Tests carried out to assess hearing. Hearing tests are performed as part of a routine assessment of child development and when hearing impairment is suspected. The tests are sometimes included in a general medical examination. Hearing tests may also be used to identify the cause of tinnitus or dizziness.

An audiometer (an electrical instrument) is used to test an individual’s ability to hear sounds at different frequencies and volumes. The lowest level at which a person can hear and repeat words (the speech reception threshold) is tested, as is the ability to hear words clearly (speech discrimination). The type of hearing loss (see deafness) is determined by holding a tuning fork to different parts of the ear.... hearing tests

Ink-blot Test

An outdated psychological test in which the subject was asked to interpret the appearance of a number of ink blots. The most widely used example was the Rorschach test.... ink-blot test

Intelligence Tests

Tests designed to provide an estimate of a person’s mental abilities. The most widely used are Wechsler tests of which there are 2 basic types: the Wechsler Adult Intelligence Scale (WAIS) and the Wechsler Intelligence Scale for Children (WISC). Each is divided into verbal (concerned with language skills) and performance sections, including measures of constructional ability and visual-spatial and perceptual ability (interpretation of shapes). Other tests include the Stanford–Binet test, which is used mainly as a measure of scholastic ability.

In most intelligence tests, scoring is based on mental age (MA) in relation to chronological age (CA). The intelligence quotient (IQ) is MA divided by CA, multiplied by 100. The tests are devised to ensure that 3 in 4 people have an IQ between 80 and 120. They are standardized so that the score indicates the same relative ability at different age levels.

Intelligence tests may be used to assess school or job aptitude. However, they have been criticized for their alleged bias regarding gender and race.... intelligence tests

Kidney Function Tests

Tests performed to investigate kidney disorders.

Urinalysis is a simple test in which a urine sample is examined under a microscope for blood cells, pus cells, and casts (cells and mucous material that accumulate in the tubules of the kidneys and pass into the urine).

Urine may be tested for substances, such as proteins, that leak into the urine when the kidneys are damaged.

Kidney function can be assessed by measuring the concentration in the blood of substances, such as urea and creatinine, that the kidneys normally excrete.

Kidney function may also be assessed by kidney imaging techniques.... kidney function tests

Liver Function Tests

Tests of blood chemistry that can detect changes in the way the liver is making new substances and breaking down and/or excreting old ones.

The tests can also show whether liver cells are healthy or being damaged.... liver function tests

Lung Function Tests

See pulmonary function tests.... lung function tests

Paternity Testing

The use of blood tests to help decide whether a man is the father of a child.

Blood samples are taken from the child, from the suspected father, and sometimes from the mother.

The samples are tested for blood groups, histocompatibility antigens, and similarities in DNA.

Genetic fingerprinting provides the most decisive result.... paternity testing

Personality Tests

Questionnaires designed to define various personality traits or types. Tests may be designed to detect psychiatric symptoms, underlying personality traits, how outgoing or reserved a person is, and predisposition to developing neurotic illness.... personality tests

Pku Test

See Guthrie test.... pku test

Respiratory Function Tests

See pulmonary function tests.... respiratory function tests

Skin Tests

Procedures for determining the body’s reaction to various substances by injecting a small quantity of the substance under the skin or by applying it to the skin (usually on patches).

Patch tests are used in the diagnosis of contact allergic dermatitis.

They can also be used to test immunity to certain infectious diseases (such as in the tuberculin test).... skin tests

Stanford–binet Test

A type of intelligence test.... stanford–binet test

Stress Ulcer

An acute peptic ulcer that develops after shock, severe burns or injuries, or during a major illness.

Stress ulcers are usually multiple and are most common in the stomach.

The exact cause is unknown.

Drugs are often given to severely ill patients in hospital to prevent the development of stress ulcers.... stress ulcer

Testis, Cancer Of

A rare, cancerous tumour of the testis. Testicular cancer is most common in young to middle-aged men, and the risk increases in individuals with a history of undescended testis (see testis, undescended). The most common types of testicular cancer are seminomas, which are made up of only 1 type of cell, and teratomas. The cancer usually appears as a firm, painless swelling of 1 testis. There may also be pain and inflammation. Biopsy, followed by orchidectomy, is the usual treatment, and may be combined with chemotherapy. The tumours usually respond well to treatment.... testis, cancer of

Testis, Ectopic

A testis that is absent from the scrotum because it has descended into an abnormal position, usually in the groin or at the base of the penis. The condition is most often discovered soon after birth during a routine physical examination. It is treated by orchidopexy. (See also testis, undescended.) ... testis, ectopic

Testis, Pain In The

Pain in a testis may be caused by mild injury, a tear in the wall of the testis due to a direct blow, orchitis, epididymo-orchitis, and torsion of the testis (see testis, torsion of). Sometimes, no cause is found and the pain disappears without treatment. If the wall of the testis is torn, an operation to repair it may be needed. ... testis, pain in the

Testis, Swollen

Swelling of the testis or the surrounding tissues in the scrotum. Harmless and painless swellings include epididymal cysts, hydroceles, varicoceles, and spermatoceles. Cancer of the testis (see testis, cancer of) is rare but may be a cause of painless swelling. Swelling that is painful may be caused by a direct blow, torsion of the testis (see testis, torsion of), orchitis, epididymoorchitis, or, in very rare cases, cancer of the testis. Any swelling of the testes should be assessed promptly by a doctor.... testis, swollen

Thyroid-function Tests

A group of blood tests used to evaluate the function of the thyroid gland and to detect or confirm any thyroid disorder. The thyroid hormones T3 and T4 are measured, as well as thyroid-stimulating hormone (TSH), the pituitary gland hormone that stimulates the thyroid gland.... thyroid-function tests

Testis, Torsion Of

Twisting of the spermatic cord that causes severe pain and swelling of the testis. The pain develops rapidly and is sometimes accompanied by abdominal pain and nausea. The testis becomes swollen and very tender, and the skin of the scrotum becomes discoloured. Unless the torsion is treated within a few hours, permanent damage to the testis results. The condition is most common around puberty. It is more likely to occur if the testis is unusually mobile within the scrotum.

Diagnosis is by physical examination.

Surgery is performed to untwist the testis and anchor it in the scrotum with small stitches to prevent recurrence.

If irreversible damage has occurred, orchidectomy is performed.

In either case, the other testis is anchored to the scrotum to prevent torsion on that side.

With prompt treatment, recovery of the testis is complete.... testis, torsion of

Testis, Undescended

A testis that has failed to descend from the abdomen to the scrotum. The condition usually affects only 1 testis and occurs in about 1 per cent of full-term and 10 per cent of premature male babies. An undescended testis often descends within months of birth but rarely descends after this time. An undescended testis does not develop normally, is incapable of normal sperm production, and is at increased risk of developing testicular cancer (see testis, cancer of). If both testes are undescended, infertility results.

A diagnosis is made during a physical examination after birth or later in infancy.

Treatment is by orchidopexy, which usually reduces the risk of later infertility or testicular cancer (see testis, cancer of).

A poorly developed undescended testis may be removed if the other is normal.... testis, undescended

Tests, Medical

Tests may be performed to investigate the cause of symptoms and establish a diagnosis, to monitor the course of a disease, or to assess response to treatment. A medical testing programme carried out on apparently healthy people to find disease at an early stage is known as screening.

The accuracy of a test is based on its sensitivity (ability to correctly identify diseased subjects), specificity (ability to correctly identify healthy subjects), and predictive value.

The predictive value is determined by a mathematical formula that involves the number of accurate test results and the total number of tests performed.

The best tests have both high specificity and high sensitivity, and therefore high predictive value.... tests, medical

Tuberculin Tests

Skin tests used to determine whether or not a person has been exposed to the bacterium that causes tuberculosis. Tuberculin tests are carried out for diagnosis of tuberculosis, and before BCG vaccination. A small amount of tuberculin (purified protein from the bacteria) is injected into the skin. A few days later, the skin reaction, if any, is noted. A reaction indicates previous exposure.... tuberculin tests

Tuning Fork Tests

Hearing tests carried out to diagnose conductive deafness. In the Weber test, a vibrating tuning fork is held against the forehead. If there is conductive hearing loss, the sound seems louder in the affected ear. In the Rinne test, a vibrating tuning fork is held first near the ear, and then against the bone behind it. If it sounds louder when held against the bone, there is conductive hearing loss.... tuning fork tests

Urine Tests

See urinalysis.... urine tests

Benedict’s Test

a test for the presence of sugar in urine or other liquids. A few drops of the test solution are added to Benedict’s solution, prepared from sodium or potassium citrate, sodium carbonate, and copper sulphate. The mixture is boiled and shaken for about two minutes, then left to cool. The presence of up to 2% glucose is indicated by the formation of a reddish, yellowish, or greenish precipitate, the highest levels corresponding to the red coloration, the lowest (about 0.05%) to the green. [S. R. Benedict (1884–1936), US surgeon]... benedict’s test

Bolam And Bolitho Tests

where clinical *negligence is claimed, tests used to determine the standard of care owed by professionals to those whom they serve, e.g. the standards of care provided to patients by doctors. The 1957 case of Bolam v Friern Hospital Management Committee established that if a doctor acts in accordance with a responsible body of medical opinion, he or she will not be negligent. In 1997 this standard of care test was amended by the case of Bolitho v City and Hackney Health Authority, which requires the doctor’s behaviour to satisfy the judgment not only of responsible medical opinion but also of a court’s own independent logical analysis.... bolam and bolitho tests

Cardiac Arrest Simulation

a form of education in resuscitation skills using a *resuscitation mannikin wired up to a heart rhythm simulator that can mimic all common cardiac arrest situations. Candidates may be expected to perform basic life support as well as advanced life support and display skills in airway maintenance and team leadership. This form of teaching and assessment is widely used in advanced life support courses.... cardiac arrest simulation

Cardiac-arrest Team

a designated team of doctors in a hospital who attend *cardiac arrests as they occur and administer protocol-driven treatment according to the latest guidelines. See also medical emergency team.... cardiac-arrest team

Cardiac Index

the volume of blood pumped from the heart’s left ventricle divided by body surface area, expressed as litres per minute per square metre (l/min/m2). It is determined by heart rate and stroke volume index (the volume of blood pumped by the heart with each beat), and provides a normal range (2.5–4.0 l/min/m2) regardless of the size of the patient.... cardiac index

Cardiac Reflex

reflex control of the heart rate. Sensory fibres in the walls of the heart are stimulated when the heart rate increases above normal. Impulses are sent to the cardiac centre in the brain, stimulating the vagus nerve and leading to slowing of the heart rate.... cardiac reflex

Cardiac Rehabilitation

a programme of staged exercises and lifestyle classes designed for people recovering from a heart attack and run through the local hospital by dedicated health care professionals, who may include specialist nurses, occupational therapists, and physiotherapists.... cardiac rehabilitation

Cardiac Resynchronization Therapy

(CRT) a treatment for heart failure that involves ventricular pacing with multiple *leads. The aim is to restore coordinated ventricular contraction and hence improve cardiac function.... cardiac resynchronization therapy

Chi-square Test

(in statistics) a test to determine if the difference between two groups of observations is statistically significant (see significance), used in controlled trials and other studies. It measures the differences between theoretical and observed values and identifies whether or not *variables are related.... chi-square test

Congestive Cardiac Failure

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

Cover Test

a test used to detect a squint. The observer looks at a target object, one eye at a time being covered. If the uncovered eye deviates to focus on the target, then a squint is confirmed. The movement can be up, down, sideways, or a combination, depending on the type of squint (see strabismus).... cover test

Crafft Screening Test

a screening tool for young people under the age of 21 to identify alcohol and drug use. The first part consists of three questions about drug or alcohol use over the past year. Participants giving positive answers to two or more questions proceed to the second part (from which the name derives), which contains six questions with the key words car, relax, alone, family/friends, forget, trouble, used to assess the need for further input.... crafft screening test

Dexamethasone Suppression Tests

(DSTs) tests based on the principle that appropriate doses of *dexamethasone can suppress the output of cortisol from the adrenal glands in the normal state and that this ability is reduced or lost in *Cushing’s syndrome. In the overnight DST 1 mg of dexamethasone is administered at midnight and the serum cortisol level is measured at 9.00 am the next morning. Failure to suppress cortisol output may indicate Cushing’s syndrome but also occurs in patients with obesity and depressive illness. In the low-dose DST (0.5 mg dexamethasone every 6 hours for 48 hours), cortisol suppression occurs in patients with obesity and depression but not in those with Cushing’s syndrome. In the high-dose DST (2 mg dexamethasone every 6 hours for 48 hours), cortisol is suppressed in patients with Cushing’s disease (in which excess amounts of ACTH are secreted by the pituitary gland) but not in those with Cushing’s syndrome due to other causes. Although the low- and high-dose tests are unreliable, all three tests should be performed to aid the diagnosis of Cushing’s syndrome.... dexamethasone suppression tests

Distraction Test

a hearing test used for screening infants between the ages of six and ten months. The infant is placed on its carer’s knee, one examiner sits in front of the infant and gains its attention, and a second examiner is situated just behind the infant. At a given moment the first examiner becomes very still and the second examiner makes a sound at the level of the infant’s ear to one side or the other. If the infant can hear it turns in the direction of the sound. The sounds made should be of different pitches and a given loudness.... distraction test

Dix–hallpike Test

(Hallpike test) a test for *benign paroxysmal positional vertigo (BPPV), performed with the patient first sitting upright on an examination couch and then lying supine with the head and neck extended beyond the edge of the couch. The patient’s head is rotated to the left (or right) and supported by the examiner while the patient assumes the supine position and keeps his or her eyes focused on the examiner’s eyes. The test is then repeated with the other ear facing down. In patients with BPPV, after a short delay rotatory *nystagmus is seen, in association with severe vertigo and nausea, which gradually abates. The effect diminishes with repeated manoeuvres. In conditions affecting the cerebellum or brainstem, the nystagmus occurs immediately, in any direction, and does not diminish, and patients do not feel especially nauseated. [M. R. Dix and C. S. Hallpike (20th century), British otologists]... dix–hallpike test

Faecal Occult Blood Test

(FOBT) a noninvasive test used to identify microscopic blood (see occult) in faeces. It is widely used as a screening test for colorectal cancer.... faecal occult blood test

Fehling’s Test

a test for detecting the presence of sugar in urine, which has now been replaced by better and easier methods. [H. von Fehling (1812–85), German chemist]... fehling’s test

Figlu Test

a test for folate or vitamin B12 deficiency. A dose of the amino acid histidine, which requires the presence of folate or vitamin B12 for its complete breakdown, is given by mouth. In the absence of these vitamins, formiminoglutamic acid (figlu) – an intermediate product in histidine metabolism – accumulates and can be detected in the urine.... figlu test

Finger–nose Test

a test for *ataxia or cerebral lesions. Using the index finger, the patient alternately touches his or her nose and then the examiner’s finger, which is shifted to a new position for each of the patient’s movements. The test is positive if the patient misses a target or develops a tremor as the target is approached (intention tremor).... finger–nose test

Forced Preferential Looking Test

(FPL test) a test used to evaluate the *visual acuity of infants and young children by observing whether the child looks at a blank screen or one with stripes, the spatial frequency of which can be changed.... forced preferential looking test

Fpl Test

see forced preferential looking test.... fpl test

Frei Test

a rarely used diagnostic test for the sexually transmitted disease *lymphogranuloma venereum. A small quantity of the virus, inactivated by heat, is injected into the patient’s skin. If the disease is present a small red swelling appears at the site of injection within 48 hours. [W. S. Frei (1885–1943), German dermatologist]... frei test

Genuine Stress Incontinence

see incontinence.... genuine stress incontinence

Glucagon Stimulation Test

a test for *phaeochromocytomas not displaying typically high levels of plasma *catecholamines. An intravenous bolus of *glucagon is administered and the test is positive when there is a threefold increase in plasma catecholamine levels with a consequent rise in blood pressure. The test is now very rarely used due to safer and more sensitive screening tests, combined with modern tumour imaging techniques.... glucagon stimulation test

Guthrie Test

(heel-prick blood test) a blood test performed on all newborn babies at the end of the first week of life. The blood is obtained by pricking the heel of the baby. The test can detect several *inborn errors of metabolism (including *phenylketonuria) and *hypothyroidism; it can also be used for detecting *cystic fibrosis, although this is not routinely offered. [R. Guthrie (1916–95), US paediatrician]... guthrie test

Hallpike Test

see Dix–Hallpike test.... hallpike test

Heel-prick Blood Test

see Guthrie test.... heel-prick blood test

Heller’s Test

a test for the presence of protein (albumin) in the urine. A quantity of urine is carefully poured onto the same quantity of pure nitric acid in a test tube. A white ring forms at the junction of the liquids if albumin is present. However, a similar result may be obtained if the urine contains certain drugs or is very concentrated. A dark brown ring indicates the presence of an abnormally high level of potassium indoxyl sulphate in the urine (see indicanuria). [J. F. Heller (1813–71), Austrian pathologist]... heller’s test

Insulin Stress Test

an important but potentially dangerous test of anterior pituitary function involving the deliberate induction of a hypoglycaemic episode with injected insulin and the subsequent measurement of plasma cortisol and growth hormone at regular intervals over the next three hours. The stress of the hypoglycaemia should induce a rise in the levels of these hormones unless the anterior pituitary or the adrenal glands are diseased. The test can induce epileptic seizures or angina in those with a predisposition and should not be performed in susceptible individuals. It is often combined with the thyrotrophin-releasing hormone (TRH) test and the gonadotrophin-releasing hormone (GnRH) test in what is known as the triple test (or dynamic pituitary function test).... insulin stress test

Jaeger Test Types

a card with text printed in type of different sizes, used for testing acuity of near vision. [E. R. Jaeger von Jastthal (1818–84), Austrian ophthalmologist]... jaeger test types

Kleihauer–betke Test

a test to detect and measure fetal red blood cells in the maternal circulation of Rh-negative women who have *antepartum haemorrhage or have previously had a Rh-positive baby. It is used to calculate the correct dose of *anti-D immunoglobulin that will prevent *haemolytic disease of the newborn.... kleihauer–betke test

Levodopa Test

a test of the ability of the pituitary to secrete growth hormone, in which levodopa is administered by mouth and plasma levels of growth hormone are subsequently measured (they should peak within the following hour). It is a safer alternative to the *insulin stress test but does not give information on cortisol production, which is usually more clinically important to know.... levodopa test

Mann–whitney U Test

see significance.... mann–whitney u test

Mccormick Toy Test

a hearing test used in preschool children in which the child must discriminate between similar speech sounds. The test consists of 14 toys that are paired because their names sound similar; for example, tree and key, plane and plate. Having first identified all the objects, the child is then asked in a quiet voice to indicate a particular toy (e.g. Can you find the key?).... mccormick toy test

Mouthwash Test

a simple noninvasive procedure that enables the detection of *carriers for single gene defects, e.g. *cystic fibrosis. Epithelial cells from the buccal cavity are obtained from a saline mouthwash: from these it is possible to isolate DNA, which is amplified by the *polymerase chain reaction to enable gene analysis.... mouthwash test

Paddington Alcohol Test

a three-question tool designed to uncover any connection between an individual’s attendance at an A & E department and alcohol-related problems, thereby creating the potential for intervention and referral.... paddington alcohol test

Parametric Test

see significance.... parametric test

Postcoital Test

a test used in the investigation of infertility. A specimen of cervical mucus, taken 6–24 hours after coitus, is examined under a microscope. The appearance of 10 or more progressively motile spermatozoa per high-power field in the specimen indicates that there is no abnormal reaction between spermatozoa and mucus. The test should be undertaken in the postovulatory phase of the menstrual cycle.... postcoital test

Pregnancy Test

any of several methods used to demonstrate whether or not a woman is pregnant. Most pregnancy tests are based on the detection of a hormone, *human chorionic gonadotrophin (hCG), in the urine. The sample of urine is mixed with serum containing antibodies to hCG and marker particles (sheep red cells or latex particles) coated with hCG. In the absence of pregnancy, the antibodies will cause *agglutination of the marker particles. If the urine is from a pregnant woman, the antibodies will be absorbed and no agglutination will occur. These tests may be positive for pregnancy as early as 30 days after the date of the last normal period and are 98% accurate. Newer tests using *monoclonal antibodies (beta hCG) are more easily interpreted. When carried out on serum rather than urine, these tests give even earlier positive results.... pregnancy test

Projective Test

(in psychology) a way of measuring aspects of personality, in which the subject is asked to talk freely about ambiguous objects. His responses are then analysed. Examples are the *Rorschach test and the Thematic Apperception Test (in which the subject invents stories about a set of pictures).... projective test

Queckenstedt Test

a part of the routine *lumbar puncture procedure. It is used to determine whether or not the flow of cerebrospinal fluid is blocked in the spinal canal. [H. H. G. Queckenstedt (1876–1918), German physician]... queckenstedt test

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

Rinne’s Test

a test to determine whether *deafness is conductive or sensorineural. A vibrating tuning fork is held first in the air, close to the ear, and then with its base placed on the bone (mastoid process) behind the ear. If the sound conducted by air is heard louder than the sound conducted by bone the test is positive and the deafness sensorineural; a negative result, when the sound conducted by bone is heard louder, indicates conductive deafness. [H. A. Rinne (1819–68), German otologist]... rinne’s test

Rothera’s Test

a method of testing urine for the presence of acetone or acetoacetic acid: a sign of *diabetes mellitus. Strong ammonia is added to a sample of urine saturated with ammonium sulphate crystals and containing a small quantity of sodium nitroprusside. A purple colour confirms the presence of acetone or acetoacetic acid. [A. C. H. Rothera (1880–1915), Australian biochemist]... rothera’s test

Schick Test

a test to determine whether a person is susceptible to diphtheria. A small quantity of diphtheria toxin is injected under the skin; a patch of reddening and swelling shows that the person has no immunity and – if at particular risk – should be immunized. With safer *toxoids, this test is no longer necessary. [B. Schick (1877–1967), US paediatrician]... schick test

Schilling Test

a test used to assess a patient’s capacity to absorb vitamin B12 from the bowel. Radioactive vitamin B12 is given by mouth and urine collected for 24 hours. A normal individual will excrete at least 10% of the original dose over this period; a patient with *pernicious anaemia will excrete less than 5%. [R. F. Schilling (1919), US physician]... schilling test

Sheridan–gardiner Test

a test for detecting visual impairment in children who are too young to be able to read the *Snellen chart. A series of cards, each marked with a single letter of a specific size, are held up at a distance of 6 metres from the child being tested. The child is provided with an identification card containing a selection of letters and is asked to point to the letter that is the same as the one on the card in the distance. The test is suitable for children between the ages of two and seven.... sheridan–gardiner test

Stress Incontinence

see incontinence.... stress incontinence

Stress Test

an investigation to seek evidence of cardiac *ischaemia. The heart is stressed by exercise or by the administration of an intravenous drug that increases heart rate (i.e. mimicked exercise). Ischaemia may then be detected by electrocardiography (stress ECG or exercise ECG), *echocardiography (showing the development of impaired function in areas of heart muscle that are ischaemic), *myocardial perfusion scan, or cardiac MRI.... stress test

Stress Ulcers

gastric or duodenal ulcers that can be associated with physiological stress from severe head injury (Cushing’s ulcers) or major burns (Curling’s ulcers).... stress ulcers

Student’s T Test

see significance. [Pseudonym of W. S. Gosset (1876–1937), British statistician]... student’s t test

Stycar Tests

Standard Tests for Young Children and Retardates: tests to detect visual problems in children between the ages of six months and five years. They consist of a series of standardized balls, toys, or letters. The tests were developed by the paediatrician Mary Sheridan.... stycar tests

Synacthen Tests

tests used to assess the ability of the adrenal cortex to produce cortisol. Serum cortisol is measured before and then 30 minutes (or 5 hours) after an intramuscular injection of 250 ?g (or 1 mg) tetracosactide (Synacthen), an analogue of *ACTH. The adrenal glands are considered to be inadequate if there is a low baseline concentration of cortisol or the rise is less than a certain predefined amount.... synacthen tests

Trendelenburg’s Test

(Trendelenburg’s sign) a test for detecting dysfunction of the hip joint. Normally when a leg is lifted off the ground, the pelvis on the same side is raised by the hip abductor muscles on the other side. If these muscles cannot raise the pelvis against body weight, the pelvis will tilt downwards and the test is positive, indicating arthritis, paralysis of the muscles due to superior gluteal nerve injury, or other hip pathology (e.g. congenital hip dislocation). [F. Trendelenburg]... trendelenburg’s test

Triple Test

1. (in *prenatal screening) a blood test that can be performed between the 15th and 20th weeks of pregnancy but has largely been replaced by combined first-trimester *PAPP-A screening and *nuchal translucency scanning. Levels of *alpha-fetoprotein (AFP), *unconjugated oestriol (uE3), and *human chorionic gonadotrophin (hCG) in the serum are computed with maternal age to determine the statistical likelihood of the fetus being affected by Down’s syndrome or spina bifida. The double test is similar but omits measurement of uE3. 2. see insulin stress test.... triple test

Vestibular Evoked Myogenic Potential Test

(VEMP) a test used to measure the response of the *saccule. It is used in the diagnosis of *superior canal dehiscence syndrome, *Ménière’s disease, and other disorders of the inner ear.... vestibular evoked myogenic potential test

Water-deprivation Test

a test for *diabetes insipidus in which fluid and food intake is withheld completely for up to 24 hours, with regular measurement of plasma and urinary *osmolality and body weight. Normally (and in a person with psychogenic *polydipsia) the output of *vasopressin will be increased in order to concentrate the urine as the plasma osmolality rises; correspondingly, the urine osmolality also rises and its volume diminishes. In a patient with diabetes insipidus, however, the urine osmolality will remain low and of high volume while the patient steadily dehydrates. The test must be abandoned if the patient loses 3% of body weight.... water-deprivation test

Weber’s Test

a hearing test in which a vibrating tuning fork is placed at the midpoint of the forehead. A normal individual hears it equally in both ears, but if one ear is affected by conductive *deafness the sound appears louder in the affected ear. If one ear has a sensorineural deafness the sound appears louder in the unaffected ear. [F. E. Weber (1832–91), German otologist]... weber’s test

Whitaker’s Test

a direct percutaneous renal infusion test to investigate possible obstruction of the ureter or kidney. It detects subtle obstructions that cannot be detected by imaging. [R. Whitaker (20th century), British urologist]... whitaker’s test



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