Chronic Health Dictionary

(CFS) is a recently designated semi-disease, often attributed to EBV (the Epstein-Barr virus) or CMV (Cytomegalovirus) infections, characterized by FUOs (Fevers of Unknown Origin) and resulting in the patient suffering FLS (Feels Like Shit). In most of us, the microorganisms involved in CFS usually provoke nothing more than a head cold; in some individuals, however, they induce a long, grinding, and debilitating disorder, characterized by exhaustion, depression, periodic fevers...a crazy-quilt of symptoms that frustrates both the sufferer and the sometimes skeptical physician. MCS (Multiple Chemical Sensitivities) are another syndrome that is often lumped with CFS, and they may often be two faces of the same condition. I am not using all these acronyms to mock the conditions, but as an irony. There is too much (Acronym Safety Syndrome) in medicine, reducing complex and frustrating conditions to insider’s techno-babble, somehow therein trivializing otherwise complex, painful and crazy-making problems. The widest use of acronyms (AIDS, HIV, CFS, MCS, MS etc.) seems to be for diseases hardest to treat, least responsive to procedural medicine, and most depressing to discuss with patients or survivors.... chronic fatigue syndrome

See pulmonary disease, chronic obstructive.... chronic obstructive pulmonary disease

The ‘English Disease’. The result of repeated attacks of the acute condition. Menace to the elderly when bronchi becomes thickened and narrowed. Inelastic walls secrete a thick purulent mucus of fetid odour which plugs tubes and arrests oxygen intake. Aggravated by cold and damp, hence the need of a warm house with warm bedroom. Causes are many: smoking, industrial pollution irritants, soot, fog, etc. Breathlessness and audible breathing sounds may present an alarming spectacle.

A steady herbal regime is required including agents which may coax sluggish liver or kidneys into action (Dandelion, Barberry). Sheer physical exhaustion may require Ginseng. For purulent sputum – Boneset, Elecampane, Pleurisy root. To increase resistance – Echinacea. Where due to tuberculosis – Iceland Moss. For blood-streaked mucus – Blood root. For fever – Elderflowers, Yarrow. To conserve cardiac energies – Hawthorn, Motherwort. A profuse sweat affords relief – Elderflowers.

Alternatives. Capsicum, Ephedra, Fenugreek, Garlic, Grindelia, Holy Thistle, Iceland Moss, Lobelia, Mullein, Pleurisy Root, Wild Cherry.

Tea. Formula. Iceland Moss 2; Mullein 1; Wild Cherry bark 1. 1 heaped teaspoon to each cup water gently simmered 10 minutes. Dose: 1 cup 2-3 times daily.

Powders. Pleurisy root 2; Echinacea 1; Holy Thistle 1. Pinch Ginger. Mix. Dose: 500mg (two 00 capsules or one-third teaspoon) 2-3 times daily.

Tinctures. Formula. Iceland Moss 2; Lobelia 2; Grindelia quarter; Capsicum quarter. Dose: 1-2 teaspoons two or more times daily.

Practitioner. Liquid Extract Ephedra BHP (1983), dose 1-3ml. Or: Tincture Ephedra BHP (1983), dose 6-8ml.

Topical. Same as for acute bronchitis.

Note: In a test at Trafford General Hospital, Manchester, blowing-up balloons proved of benefit to those with chronic bronchitis. Fourteen patients were asked to inflate balloons and 14 refrained from doing so. After 8 weeks, the balloon-blowers showed considerable improvement in walking and a sense of well- being. Breathlessness was reduced. Condition of the others was either unchanged or worse. ... bronchitis, chronic

The ongoing provision of medical, functional, psychological, social, environmental and spiritual care services that enable people with serious and persistent health and/or mental conditions to optimize their functional independence and well-being, from the time of condition onset until problem resolution or death. Chronic care conditions are multidimensional, interdependent, complex and ongoing.... chronic care

A disease which has one or more of the following characteristics: is permanent; leaves residual disability; is caused by non­reversible pathological alternation; requires special training of the patient for rehabilitation; or may be expected to require a long period of supervision, observation or care.... chronic condition / disease

Refers to diarrhoeal episodes of presumed infectious aetiology that begin acutely but have an unusually long duration, usually more than 14 days (see also WHO Classification).... chronic diarrhoea

A persistent or recurring condition or group of symptoms. Chronic disorders are customarily contrasted with acute diseases which start suddenly and last a short time. The symptoms of acute disease often include breathlessness, fever, severe pain and malaise, with the patient’s condition changing from day to day or even hour to hour. Those suffering from chronic conditions – for example, severe arthritis, protracted lung disease, ASTHMA or SILICOSIS – should be distinguished from those with a ‘static disability’ following a stroke or injury. Chronic disorders steadily deteriorate, often despite treatment and the patient is increasingly unable to carry out his or her daily activities.... chronic disorder

See also MYALGIC ENCEPHALOMYELITIS (ME). A condition characterised by severe, disabling mental and physical fatigue brought on by mental or physical activity and associated with a range of symptoms including muscle pain, headaches, poor sleep, disturbed moods and impaired concentration. The prevalence of the condition is between 0.2 and 2.6 per cent of the population (depending on how investigators de?ne CFS/ME). Despite the stereotype of ‘yuppie ?u’, epidemiological research has shown that the condition occurs in all socioeconomic and ethnic groups. It is commoner in women and can also occur in children.

In the 19th century CFS was called neurasthenia. In the UK, myalgic encephalomyelitis (ME) is often used, a term originally introduced to describe a speci?c outbreak such as the one at the Royal Free Hospital, London in 1955. The term is inaccurate as there is no evidence of in?ammation of the brain and spinal cord (the meaning of encephalomyelitis). Doctors prefer the term CFS, but many patients see this as derogatory, perceiving it to imply that they are merely ‘tired all the time’ rather than having a disabling illness.

The cause (or causes) are unknown, so the condition is classi?ed alongside other ‘medically unexplained syndromes’ such as IRRITABLE BOWEL SYNDROME (IBS) and multiple chemical sensitivity – all of which overlap with CFS. In many patients the illness seems to start immediately after a documented infection, such as that caused by EPSTEIN BARR VIRUS, or after viral MENINGITIS, Q FEVER and TOXOPLASMOSIS. These infections seem to be a trigger rather than a cause: mild immune activation is found in patients, but it is not known if this is cause or e?ect. The body’s endocrine system is disturbed, particularly the hypothalamopituitary-adrenal axis, and levels of cortisol are often a little lower than normal – the opposite of what is found in severe depression. Psychiatric disorder, usually depression and/or anxiety, is associated with CFS, with rates too high to be explained solely as a reaction to the disability experienced.

Because we do not know the cause, the underlying problem cannot be dealt with e?ectively and treatments are directed at the factors leading to symptoms persisting. For example, a slow increase in physical activity can help many, as can COGNITIVE BEHAVIOUR THERAPY. Too much rest can be harmful, as muscles are rapidly weakened, but aggressive attempts at coercing patients into exercising can be counter-productive as their symptoms may worsen. Outcome is in?uenced by the presence of any pre-existing psychiatric disorder and the sufferer’s beliefs about its causes and treatment. Research continues.... chronic fatigue syndrome (cfs)

A facility that serves patients who do not need acute care or care in another kind of specialty hospital and whose needs for frequency of monitoring by a medical practitioner and for frequency and duration of nursing care exceed the requirements for care in a comprehensive care or extended care facility.... chronic hospital

UK legislation that provides for the identi?cation and care of individuals who have an incurable chronic or degenerative disorder. The patients are usually distinguished from elderly people with chronic disorders. Local authorities identify relevant individuals and arrange for appropriate services. The legislation does not, however, compel doctors and nurses in the community to inform local authorities of potential bene?ciaries. This may be because the individuals concerned dislike being on a register of disabled, or because questions of con?dentiality prevent health sta? from reporting the person’s condition.... chronic sick and disabled act 1970

This is a term encompassing chronic BRONCHITIS, EMPHYSEMA, and chronic ASTHMA where the air?ow into the lungs is obstructed.

Chronic bronchitis is typi?ed by chronic productive cough for at least three months in two successive years (provided other causes such as TUBERCULOSIS, lung cancer and chronic heart failure have been excluded). The characteristics of emphysema are abnormal and permanent enlargement of the airspaces (alveoli) at the furthermost parts of the lung tissue. Rupture of alveoli occurs, resulting in the creation of air spaces with a gradual breakdown in the lung’s ability to oxygenate the blood and remove carbon dioxide from it (see LUNGS). Asthma results in in?ammation of the airways with the lining of the BRONCHIOLES becoming hypersensitive, causing them to constrict. The obstruction may spontaneously improve or do so in response to bronchodilator drugs. If an asthmatic patient’s airway-obstruction is characterised by incomplete reversibility, he or she is deemed to have a form of COPD called asthmatic bronchitis; sufferers from this disorder cannot always be readily distinguished from those people who have chronic bronchitis and/ or emphysema. Symptoms and signs of emphysema, chronic bronchitis and asthmatic bronchitis overlap, making it di?cult sometimes to make a precise diagnosis. Patients with completely reversible air?ow obstruction without the features of chronic bronchitis or emphysema, however, are considered to be suffering from asthma but not from COPD.

The incidence of COPD has been increasing, as has the death rate. In the UK around 30,000 people with COPD die annually and the disorder makes up 10 per cent of all admissions to hospital medical wards, making it a serious cause of illness and disability. The prevalence, incidence and mortality rates increase with age, and more men than women have the disorder, which is also more common in those who are socially disadvantaged.

Causes The most important cause of COPD is cigarette smoking, though only 15 per cent of smokers are likely to develop clinically signi?cant symptoms of the disorder. Smoking is believed to cause persistent airway in?ammation and upset the normal metabolic activity in the lung. Exposure to chemical impurities and dust in the atmosphere may also cause COPD.

Signs and symptoms Most patients develop in?ammation of the airways, excessive growth of mucus-secreting glands in the airways, and changes to other cells in the airways. The result is that mucus is transported less e?ectively along the airways to eventual evacuation as sputum. Small airways become obstructed and the alveoli lose their elasticity. COPD usually starts with repeated attacks of productive cough, commonly following winter colds; these attacks progressively worsen and eventually the patient develops a permanent cough. Recurrent respiratory infections, breathlessness on exertion, wheezing and tightness of the chest follow. Bloodstained and/or infected sputum are also indicative of established disease. Among the symptoms and signs of patients with advanced obstruction of air?ow in the lungs are:

RHONCHI (abnormal musical sounds heard through a STETHOSCOPE when the patient breathes out).

marked indrawing of the muscles between the ribs and development of a barrel-shaped chest.

loss of weight.

CYANOSIS in which the skin develops a blue tinge because of reduced oxygenation of blood in the blood vessels in the skin.

bounding pulse with changes in heart rhythm.

OEDEMA of the legs and arms.

decreasing mobility.

Some patients with COPD have increased ventilation of the alveoli in their lungs, but the levels of oxygen and carbon dioxide are normal so their skin colour is normal. They are, however, breathless so are dubbed ‘pink pu?ers’. Other patients have reduced alveolar ventilation which lowers their oxygen levels causing cyanosis; they also develop COR PULMONALE, a form of heart failure, and become oedematous, so are called ‘blue bloaters’.

Investigations include various tests of lung function, including the patient’s response to bronchodilator drugs. Exercise tests may help, but radiological assessment is not usually of great diagnostic value in the early stages of the disorder.

Treatment depends on how far COPD has progressed. Smoking must be stopped – also an essential preventive step in healthy individuals. Early stages are treated with bronchodilator drugs to relieve breathing symptoms. The next stage is to introduce steroids (given by inhalation). If symptoms worsen, physiotherapy – breathing exercises and postural drainage – is valuable and annual vaccination against INFLUENZA is strongly advised. If the patient develops breathlessness on mild exertion, has cyanosis, wheezing and permanent cough and tends to HYPERVENTILATION, then oxygen therapy should be considered. Antibiotic treatment is necessary if overt infection of the lungs develops.

Complications Sometimes rupture of the pulmonary bullae (thin-walled airspaces produced by the breakdown of the walls of the alveoli) may cause PNEUMOTHORAX and also exert pressure on functioning lung tissue. Respiratory failure and failure of the right side of the heart (which controls blood supply to the lungs), known as cor pulmonale, are late complications in patients whose primary problem is emphysema.

Prognosis This is related to age and to the extent of the patient’s response to bronchodilator drugs. Patients with COPD who develop raised pressure in the heart/lung circulation and subsequent heart failure (cor pulmonale) have a bad prognosis.... chronic obstructive pulmonary disease (copd)

Diarrhoea that begins acutely but lasts more than 21 days. The usual enteropathogens are Shigella spp., Salmonella spp., Campylobacter jejuni, Yersinia enterocolitica, Capillaria philippinensis, Cryptosporidium. Giardia can also be a cause.... persistent chronic diarrhoea

A type of leukaemia caused by proliferation of mature lymphocytes. Although it is incurable, the disease is not always fatal. The cause is unknown.

Symptoms develop slowly, often over many years. As well as symptoms and signs common to acute forms of leukaemia (see leukaemia, acute), there may be enlargement of the liver and spleen, persistent raised temperature, and night sweats. Diagnosis is by blood tests and a bone marrow biopsy. In many mild cases, no treatment is needed. To treat severe cases, anticancer drugs are given, sometimes with radiotherapy.... leukaemia, chronic lymphocytic

See pulmonary disease, chronic obstructive.... lung disease, chronic obstructive

A group of rheumatoid conditions of unknown causation with onset before 16 years. Girls more than boys. Still’s disease being the form presenting with enlargement of spleen and lymph nodes, high temperature with macular rash comes and goes. Children usually ‘grow out of it’ although stiffness may continue. Deformities possible. Tardy bone growth of the mandibles giving the face a birdlike look. May progress to rheumatoid arthritis (girls) or ankylosing spondylitis (boys). So strong is psychosomatic evidence that sociologists believe it to be a sequel to broken families, divorce or bereavement. Few patients appear to come from a balanced environment or happy home.

Treatment. BHP (1983) recommends: Meadowsweet, Balm of Gilead, Poke root, Bogbean, Hart’s Tongue fern, Mountain Grape.

Teas: Singly or in combination (equal parts): Chamomile, Bogbean, Nettles, Yarrow. 1-2 teaspoons to each cup boiling water; infuse 5-10 minutes. 1 cup thrice daily before meals.

Tablets/capsules. Blue Flag root, Dandelion root, Poke root, Prickly Ash bark.

Formula. White Poplar bark 2; Black Cohosh half; Poke root quarter; Valerian quarter; Liquorice quarter. Mix. Dose: Powders: 500mg (two 00 capsules or one-third teaspoon) (children 5-12 years: 250mg – one 00 capsule or one-sixth teaspoon). Liquid extracts: 1 teaspoon: (children 5-12: 3-10 drops). Tinctures: 2 teaspoons: (children 5-12: 5-20 drops).

Evening Primrose oil. Immune enhancer.

Topical. Hot poultice: Slippery Elm, Mullein or Lobelia.

Diet: Lacto vegetarian. Kelp. Comfrey tea. Molasses. Low fat.

General. Adequate rest, good nursing, gentle manipulation but no massage to inflamed joints. Natural lifestyle. Parental emotional support.

Oily fish. See entry. ... arthritis, juvenile, chronic

Chronic glomerulonephritis. The final stage. May follow the sub- acute stage or repeated attacks of the acute stage. Kidneys small and white due to scar tissue. Amount of urine passed is considerably increased, pale and low specific gravity. Kidneys ‘leak’ protein in large quantities of water passed, their efficiency as filters greatly impaired. Tissues of eyelids and ankles waterlogged. Symptoms include loin pain, anaemia, loss of weight, progressive kidney damage.

A constant fear is the onset of uraemia caused by accumulation in the blood of waste by-products of protein digestion, therefore the patient should reject meat in favour of fish. Eggs and dairy products taken in strict moderation.

Where urea accumulates in the circulation ‘sustaining’ diuretics are indicated; these favour excretion of solids without forcing the discharge of more urine: including Shepherd’s Purse, Gravel root, or Uva Ursi when an astringent diuretic is needed for a show of blood in the urine. According to the case, other agents in common practice: Dandelion root, Yarrow, Hawthorn, Marigold, Stone root, Hydrangea. Parsley Piert, Buchu, Hawthorn, Golden Rod.

The patient will feel the cold intensely and always be tired. Warm clothing and ample rest are essential. Heart symptoms require treatment with Lily of the Valley or Broom.

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

Treatment. As kidney damage would be established, treatment would be palliative; efforts being to relieve strain and obtain maximum efficiency. There may be days of total bed-rest, raw foods and quiet. Consumption of fluids may not be as abundant as formerly. Soothing herb teas promote well-being and facilitate elimination. Oil of Juniper is avoided.

Efforts should be made to promote a rapid absorption – to restore the balance between the circulation and the lymphatics. For this purpose Mullein is effective. A few grains of Cayenne or drops of Tincture Capsicum enhances action.

Indicated. Antimicrobials, urinary antiseptics, diuretics, anti-hypertensives. For septic conditions add Echinacea.

Of Therapeutic Value. Alfalfa, Broom, Buchu, Couchgrass, Cornsilk, Dandelion, Lime flowers, Marigold, Mullein, Marshmallow, Parsley Piert, Periwinkle (major), Wild Carrot, Water Melon seed tea. Tea. Combine equal parts: Couchgrass, Dandelion, Mullein. 2 teaspoons to each cup boiling water. Infuse 5-15 minutes. 1 cup freely.

Powders. Combine equal parts: Stone root, Hydrangea, Hawthorn. Dose: 500mg (two 00 capsules or one-third teaspoon) 3 or more times daily in water or cup Cornsilk tea. A few grains Cayenne enhances action. Formula. Buchu 2; Mullein 2; Echinacea 1; Senna leaves half. Mix. Liquid extracts: 1 teaspoon. Tinctures: 2 teaspoons. In water or cup Cornsilk tea 3 or more times daily. 2-3 drops Tincture Capsicum to each dose enhances action.

Diffusive stimulant for the lymphatic vessels. Onion milk is an effective potassium-conserving diuretic and diaphoretic. Onions are simmered gently in milk for 2 hours and drunk when thirsty or as desired – a welcome alternative to water. May be eaten uncooked.

Diet. Salt-free, low fat, high protein. Spring water. Raw goat’s milk, potassium broth. Fish oils. Avoid eggs and dairy products. No alcohol.

Supplements. Vitamins A, B-complex, C plus bioflavonoids, B6, D, E, Magnesium, Lecithin. Herbal treatment offers a supportive role. ... bright’s disease (chronic)

see persistent idiopathic facial pain.... chronic idiopathic facial pain

(CPP) intermittent or constant pain in the lower abdomen or pelvis of at least six months’ duration, not occurring exclusively with menstruation or intercourse and not associated with pregnancy. It may be caused by an underlying gynaecological condition, such as *endometriosis or adhesions, but bowel or bladder disorders (e.g. irritable bowel syndrome, interstitial cystitis), visceral hypersensitivity, and psychological conditions may all contribute.... chronic pelvic pain

(CTO) a complete arterial blockage (usually coronary) that has been present for at least three months. Fibrosis and calcification at the site of occlusion are well established by this time, making *percutaneous coronary intervention to open the artery much more difficult.... chronic total occlusion

(neurodermatitis) thickened eczematous skin that develops at the site of constant rubbing in susceptible individuals. Common sites are the nape of the neck in women and the lower legs or scrotum in men. Stress may be a relevant factor.... lichen simplex chronicus

 The main symptom is hoarseness or loss of voice from malfunction of the vocal cords by disease, stroke, stress, or nerve disorder. Pain on speaking. “Raw throat.”

Constitutional disturbance: fever, malaise.

Many causes, including: drugs, drinking spirits. Gross mis-use of voice (singing or talking) may produce nodules (warts) on the cords. The smoker has inflammatory changes. Nerve paralysis in the elderly. Carcinoma of the larynx. Voice changes during menstruation are associated with hormonal changes (Agnus Castus). Professional singers, members of choirs benefit from Irish Moss, Iceland Moss, Slippery Elm or Poke root.

Alternatives. Cayenne, Caraway seed, Balm of Gilead, Lungwort, Queen’s Delight, Thyme, Wild Indigo, Marsh Cudweed, Mullein, Marshmallow.

For most infections: Equal parts, Tinctures Goldenseal and Myrrh: 3-5 drops in water 3-4 times daily; use also as a spray or gargle.

Tea. Formula. Equal parts: Mullein, Marshmallow root, Liquorice. 2 teaspoons to each cup water brought to boil; vessel removed on boiling. Drink freely.

Practitioner. Combine equal parts: Senega, Ipecacuanha and Squills (all BP). 5-10 drops thrice daily in water. Also gargle.

Poke root. Reliable standby. Decoction, tablets/capsules. Tincture: dose, 5-10 drops thrice daily in water or honey.

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

Diet. Slippery Elm gruel. Salt-free. Avoid fried foods.

Supplements. Daily. Vitamin A (7500iu). Vitamin C (1 gram thrice daily).

To prevent voice damage. The voice should not be strained by talking too much, shouting or singing – especially with a cold. Try not to cough or keep clearing the throat but instead, swallow firmly. Do not whisper – it will strain the voice.

A common cause of laryngitis is growth of a nodule, cyst or polyp on the vocal cords. They are visible on use of an endoscope. There are two vocal cords which, in speech, come together and vibrate like a reed in a musical instrument. In formation of a nodule they cannot meet, air escapes and the voice becomes hoarse. Relaxation technique.

Where the condition lasts for more than 4 weeks an ENT specialist should be consulted. ... laryngitis, chronic

Term referring to hepatitis where the condition is the result of acute attacks of more than six months duration.

Causes: alcohol excess, drugs (Paracetamol prescribed for those who cannot tolerate aspirin), autoimmune disease, toxaemia, environmental poisons. Clinically latent forms are common from carbon monoxide poisoning. May lead to cirrhosis.

Symptoms. Jaundice, nausea and vomiting, inertia.

Treatment. Bile must be kept moving.

Alternatives:– Decoction. Formula. Milk Thistle 2; Yellow Dock 1; Boldo 1. 1 heaped teaspoon to each cup water gently simmered 20 minutes. Half-1 cup thrice daily.

Formula. Barberry bark 1; German Chamomile 2. Dose: Liquid Extracts: 2 teaspoons. Tinctures: 2-3 teaspoons. Powders: 750mg (three capsules or half a teaspoon) thrice daily.

Tablets/capsules. Blue Flag root. Goldenseal.

Astragalus. Popular liver tonic in Chinese medicine. A liver protective in chemotherapy.

Diet. Fat-free. Dandelion coffee. Artichokes. Lecithin.

Supplements. B-vitamins, B12, Zinc.

Treatment by or in liaison with a general medical practitioner. ... liver – hepatitis, chronic

(SCUAD) severe *rhinitis and *rhinosinusitis that has not been fully controlled by optimal pharmacological treatment.... severe chronic upper airway disease

Inflammation of the liver persisting for a prolonged period. Eventually, scar tissue forms and liver cirrhosis may develop.Chronic hepatitis may develop following an attack of acute hepatitis (see hepatitis, acute). It may also occur as the result of an autoimmune disorder, a viral infection (see hepatitis, viral), a reaction to certain types of drugs or, more rarely, to a metabolic disorder, such as haemochromatosis or Wilson’s disease.

Chronic hepatitis may cause slight tiredness or no symptoms at all.

It is diagnosed by liver biopsy.

Autoimmune hepatitis is treated with corticosteroid drugs and immunosuppressants.

Viral infections often respond to interferon.

In the drug-induced type, withdrawal of the medication can lead to recovery.

For metabolic disturbances, treatment depends on the underlying disorder.... hepatitis, chronic

A rare form of arthritis affecting children. Juvenile chronic arthritis occurs more often in girls, and usually develops between 2 and 4 years of age or around puberty. There are 3 main types. Still’s disease (systemic onset juvenile arthritis) starts with fever, rash, enlarged lymph nodes, abdominal pain, and weight loss. These symptoms last for a period of several weeks. Joint pain, swelling, and stiffness may develop after several months. Polyarticular juvenile arthritis causes pain, swelling, and stiffness in many joints. Pauciarticular juvenile arthritis affects 4 joints or fewer.

Possible complications include short stature, anaemia, pleurisy, pericarditis, and enlargement of the liver and spleen. Uveitis may develop, which, if untreated, may damage vision. Rarely, amyloidosis may occur or kidney failure may develop. Diagnosis is based on the symptoms, together with the results of X-rays and blood tests, and is only made if the condition lasts for longer than 3 months.

Treatment may include antirheumatic drugs, corticosteroid drugs, nonsteroidal anti-inflammatory drugs, or aspirin. Splints may be worn to rest inflamed joints and to reduce the risk of deformities. Physiotherapy reduces the risk of muscle wasting and deformities.

The arthritis usually clears up after several years. However, in some children, the condition remains active into adult life.

– kala-azar A form of leishmaniasis that is spread by insects. Kala-azar occurs in parts of Africa, India, the Mediterranean, and South America.... juvenile chronic arthritis

A type of leukaemia, also called chronic granulocytic leukaemia, which is caused by the overproduction of granulocytes, neutrophils, or polymorphonuclear leukocytes (see blood cells). The cause is unknown. This type of leukaemia usually has 2 phases: a chronic phase, which may last for several years, and a more cancerous phase, which is known as the blastic, accelerated, or acute phase.

During the chronic phase, symptoms may include fever, night sweats, and weight loss. Visual disturbances, abdominal pain, and priapism may also occur. The symptoms of the more cancerous phase are like those of the acute forms of leukaemia (see leukaemia, acute). The diagnosis is made from blood tests and a bone marrow biopsy. Treatment of the chronic phase includes anticancer drugs. When the disease transforms into the acute phase, treatment is similar to that given for acute leukaemia.... leukaemia, chronic myeloid

A combination of chronic bronchitis and emphysema, in which there is persistent disruption of air flow into or out of the lungs. Patients are sometimes described as either pink puffers or blue bloaters, depending on their condition. Pink puffers maintain adequate oxygen in their bloodstream through an increase in their breathing rate, and remain “pink” despite damage to the lungs. However, they suffer from almost constant shortness of breath. Blue bloaters are cyanotic (have a bluish discoloration of the skin and mucous membranes) because of obesity, and sometimes oedema, mainly due to heart failure resulting from the lung damage.... pulmonary disease, chronic obstructive

(in Britain) an Act providing for the identification and care of those suffering from a chronic or degenerative disease for which there is no cure and which can be only partially alleviated by treatment. Such people are usually distinguished from the elderly who may also suffer from chronic diseases. It is the responsibility of local authorities to identify those with such problems and to ensure that services are available to meet their needs. Identification can be difficult because of the lack of a clear and agreed definition of what constitutes a disability of such severity as to warrant inclusion in such a register.... chronic sick and disabled persons act 1970