n. (in dentistry) 1. forward movement of the lower jaw. 2. a *malocclusion in which some of the teeth are further forward than usual. Compare retrusion.
Treatment varies, depending (amongst other things) on the severity of the condition. In the acute phase, rest in bed is advisable, along with ANALGESICS. Later, exercise and physiotherapy are helpful, and in some cases manipulation of the spine brings relief by allowing the herniated, or prolapsed, disc to slip back into position. The injection of a local anaesthetic into the spine (epidural ANAESTHESIA) is yet another measure that often helps the more chronic cases. If those measures fail, surgery to remove the prolapsed disc may be necessary, but the patient’s condition should be carefully reviewed before surgery is considered since success is not certain. An alternative form of treatment is the injection into the disc of chymopapain, an ENZYME obtained from the paw-paw, which dissolves the disc.... prolapsed intervertebral disc
In exophthalmos due to thyroid disease, treatment of the thyroid disorder may relieve the exophthalmos, but, if the cause is Graves’ disease, exophthalmos may persist even if thyroid function returns to normal. Early treatment of the condition usually returns vision to normal. Occasionally, surgery may be required to relieve pressure on the eyeball and optic nerve.... exophthalmos
Much more serious is spina bi?da cystica, in which the spinal-wall defect is accompanied by a protrusion of the spinal cord. This may take two forms: a meningocele, in which the MENINGES, containing CEREBROSPINAL FLUID, protrude through the defect; and a meningomyelocele, in which the protrusion contains spinal cord and nerves.
Meningocele is less common and has a good prognosis. HYDROCEPHALUS and neurological problems affecting the legs are rare, although the bladder may be affected. Treatment consists of surgery which may be in the ?rst few days of life or much later depending upon the precise situation; long-term follow-up is necessary to pick up any neurological problems that may develop during subsequent growth of the spine.
Meningomyelocele is much more serious and more common, accounting for 90 per cent of all cases. Usually affecting the lumbo-sacral region, the range of severity may vary considerably and, while early surgery with careful attention in a minor case may achieve good mobility, normal bladder function and intellect, a more extensive protrusion may cause complete ANAESTHESIA of the skin, with increased risk of trauma; extensive paralysis of the trunk and limbs, with severe deformities; and paralysis and insensitivity of the bladder and bowel. Involuntary movements may be present, and hydrocephalus occurs in 80 per cent of cases. The decision to operate can only be made after a full examination of the infant to determine the extent of the defect and any co-existent congenital abnormalities. The child’s potential can then be estimated, and appropriate treatment discussed with the parents. Carefully selected patients should receive long-term treatment in a special centre, where full attention can be paid to all their various problems.
There is growing evidence of the value of vitamin supplements before and during pregnancy in reducing the incidence of spina bi?da. Parents of affected infants may obtain help, advice, and encouragement from the Association for Spina Bi?da and Hydrocephalus which has branches throughout the country, or the Scottish Spina Bi?da Association.... spina bifida
Imperforate anus, or absence of the anus, may occur in newly born children, and the condition is relieved by operation.
Itching at the anal opening is common and can be troublesome. It may be due to slight abrasions, to piles, to the presence of threadworms (see ENTEROBIASIS), and/or to anal sex. The anal area should be bathed once or twice a day; clothing should be loose and smooth. Local application of soothing preparations containing mild astringents (bismuth subgallate, zinc oxide and hamamelis) and CORTICOSTEROIDS may provide symptomatic relief. Proprietary preparations contain lubricants, VASOCONSTRICTORS and mild ANTISEPTICS.
Pain on defaecation is commonly caused by a small ulcer or ?ssure, or by an engorged haemorrhoid (pile). Haemorrhoids may also cause an aching pain in the rectum. (See also PROCTALGIA.)
Abscess in the cellular tissue at the side of the rectum – known from its position as an ischio-rectal abscess – is fairly common and may produce a ?stula. Treatment is by ANTIBIOTICS and, if necessary, surgery to drain the abscess.
Prolapse or protrusion of the rectum is sometimes found in children, usually between the ages of six months and two years. This is generally a temporary disorder. Straining at defaecation by adults can cause the lining of the rectum to protrude outside the anus, resulting in discomfort, discharge and bleeding. Treatment of the underlying constipation is essential as well as local symptomatic measures (see above). Haemorrhoids sometimes prolapse. If a return to normal bowel habits with the production of soft faeces fails to restore the rectum to normal, surgery to remove the haemorrhoids may be necessary. If prolapse of the rectum recurs, despite a return to normal bowel habits, surgery may be required to rectify it.
Tumours of small size situated on the skin near the opening of the bowel, and consisting of nodules, tags of skin, or cauli?ower-like excrescences, are common, and may give rise to pain, itching and watery discharges. These are easily removed if necessary. Polypi (see POLYPUS) occasionally develop within the rectum, and may give rise to no pain, although they may cause frequent discharges of blood. Like polypi elsewhere, they may often be removed by a minor operation. (See also POLYPOSIS.)
Cancer of the rectum and colon is the commonest malignancy in the gastrointestinal tract: around 17,000 people a year die from these conditions in the United Kingdom. Rectal cancer is more common in men than in women; colonic cancer is more common in women. Rectal cancer is a disease of later life, seldom affecting young people, and its appearance is generally insidious. The tumour begins commonly in the mucous membrane, its structure resembling that of the glands with which the membrane is furnished, and it quickly in?ltrates the other coats of the intestine and then invades neighbouring organs. Secondary growths in most cases occur soon in the lymphatic glands within the abdomen and in the liver. The symptoms appear gradually and consist of diarrhoea, alternating with attacks of constipation, and, later on, discharges of blood or blood-stained ?uid from the bowels, together with weight loss and weakness. A growth can be well advanced before it causes much disturbance. Treatment is surgical and usually this consists of removal of the whole of the rectum and the distal two-thirds of the sigmoid colon, and the establishment of a COLOSTOMY. Depending upon the extent of the tumour, approximately 50 per cent of the patients who have this operation are alive and well after ?ve years. In some cases in which the growth occurs in the upper part of the rectum, it is now possible to remove the growth and preserve the anus so that the patient is saved the discomfort of having a colostomy. RADIOTHERAPY and CHEMOTHERAPY may also be necessary.... rectum, diseases of
“Internal remedies should be carefully selected, because each case is different,” writes Margaret Wilkenloh, MD, Chicago (Ellingwood). “The best remedies to my mind are Echinacea, Pulsatilla, Skullcap and Hawthorn.” These are available as herbs, tablets, powders, liquid extracts or tinctures. Specimen combination: Liquid extracts: Echinacea 2; Pulsatilla half; Skullcap 1; Hawthorn 1. Mix. One to two 5ml teaspoons in water thrice daily. ... exophthalmus
Keratoses occur mainly in elderly people.
Seborrhoeic keratoses are harmless growths that occur mainly on the trunk.
The growths range in appearance from flat, dark-brown patches to small, wart-like protrusions.
They do not need treating unless they are unsightly.
Solar keratoses are small, wart-like, red or flesh-coloured growths that appear on exposed parts of the body as a result of overexposure to the sun over many years.
Rarely, they may develop into skin cancer, usually squamous cell carcinoma, and must be surgically removed.... keratosis
Malocclusion usually develops during childhood. It is inherited, or is caused by thumb-sucking or a mismatch betweenthe teeth and jaws – for example, the combination of large teeth and a small mouth (see overcrowding, dental).
Orthodontic appliances (braces) may be used to move teeth into the proper position, and if there is dental overcrowding, some teeth may be extracted. Orthognathic surgery is used to treat severe recession or protrusion of the lower jaw. Treatment is best carried out in childhood or adolescence.... malocclusion
Symptoms include severe headache, high fever, pain and loss of sensation in and above the affected eye, and proptosis (protrusion of the eyeball). Vision may become blurred and eye movements paralysed due to pressure on the optic nerve and other cranial nerves. Treatment with antibiotic drugs and anticoagulant drugs can save vision. Left untreated, blindness results, and the infection may prove fatal.... cavernous sinus thrombosis
liquid paraffin A lubricant laxative drug obtained from petroleum. It can cause anal irritation, and prolonged use may impair the absorption of vitamins from the intestine into the blood. lisinopril An ACE inhibitor drug commonly used to treat hypertension. lisp A common speech disorder caused by protrusion of the tongue between the teeth so that the “s” sound is replaced by “th”. Sometimes the cause is a cleft palate (see cleft lip and palate). In most children, there is no physical defect and lisping disappears by the age of about 4. listeriosis An infection that is common in animals and may also affect humans. It is caused by the bacterium LISTERIA MONOCYTOGENES, which is widespread in the environment, especially in soil. Possible sources of human infection include soft cheese, ready-prepared coleslaw and salads, and improperly cooked meat.
In most adults, the only symptoms are fever and aching muscles. There may also be sore throat, conjunctivitis, diarrhoea, and abdominal pain. Pneumonia, septicaemia, and meningitis may develop in severe cases. However, listeriosis can be life-threatening, particularly in elderlypeople, those with reduced immunity, and newborn babies. In pregnant women, infection may cause a miscarriage.
The condition is diagnosed by blood tests and analysis of other body fluids, such as urine. Treatment is with antibiotic drugs, such as ampicillin.... lip-reading
There are different forms of spina bifida. In spina bifida occulta, the only defect is a failure of the fusion of the bony arches behind the spinal cord, which may not cause any problems. When the bone defect is more extensive, there may be a meningocele, a protrusion of the meninges, or a myelomeningocele, a malformation of the spinal cord. Myelomeningocele is likely to cause severe handicap, with paralysis of the legs, loss of sensation in the lower body, hydrocephalus, and paralysis of the anus and bladder, causing incontinence. Associated problems include cerebral palsy, epilepsy, and mental handicap.
Surgery is usually performed a few days after birth. In mild cases, the defect can usually be corrected, but in myelomeningocele, some handicap will remain.
Genetic factors play a part in neural tube defects, which show multifactorial inheritance. Couples who have had an affected child or who have a family history of neural tube defects should seek genetic counselling. The risk of a neural tube defect occurring can be substantially reduced if the mother takes folic acid supplements for a month before conception and during the early part of the pregnancy.
Ultrasound scanning and amniocentesis allow accurate antenatal testing for neural tube defects.... neural tube defect
The term also refers to a small rounded protrusion on the surface of a bone.... tubercle
rectal examination Examination of the anus and rectum, performed as part of a general physical examination, to assess symptoms of pain or changes in bowel habits, and to check for the presence of tumours of the rectum or prostate gland. rectal prolapse Protrusion outsid.
nent in elderly people. If the prolapse is large, leakage of faeces may occur.
Treatment is with a fibre-rich diet.
Surgery may also be performed.... rectal bleeding
Umbilical hernias sometimes develop in adults, especially in women after childbirth. Surgery may be necessary for a large, persistent, or disfiguring hernia.... umbilical hernia
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