I
DISULFIRAM
tests
and urine tests (see
urinalysis
)
are
needed during treatment to monitor
the effects of DMARDs on the bone
marrow, kidneys, and liver.
disinfectants
Substances
that
kill
microorganisms
and thus prevent infection. The term is
usually applied to strong chemicals that
are used to decontaminate objects, such
as items of medical equipment.
dislocation, joint
Complete
displacement
of the
two
bones in a joint so that they are no
longer in contact, usually as a result of
injury.
(Displacement that leaves the
bones in partial contact is called
sublux-
ation
. )
It is usually accompanied by
tearing of the joint ligaments and damage
to the membrane encasing the joint.
SYMPTOMS AND COMPLICATIONS
Dislocation
restricts
or
prevents
the
movement of the joint; it is usually
very painful. The affected joint looks
misshapen and swells. Injuries that are
severe
enough
to
cause
dislocation
often also cause
fractures
.
In some cases,
dislocation is followed by complica-
tions such as
paralysis
.
TREATMENT
The joint may be X-rayed to confirm
dislocation and check for fracture. The
bones are then manipulated back into
their proper position, or an operation
is performed to reset them. The bones
are then im m obilized in a
splint
or
cast
to allow healing to take place.
disodium etidronate
See
etidronate disodium.
disopyramide
An
antiarrhythmic drug
that is used to
treat an abnormally rapid heartbeat, as
may occur after a
myocardial infarction
(heart attack). It reduces the force of
heart muscle contraction. As a result, it
may aggravate pre-existing
heart failure
.
Other possible side effects include dry
mouth and constipation.
disorder
Any abnormality of physical or mental
function.
disorientation
Confusion as to time, place, or personal
identity. Speech and behaviour tend to
be muddled, and the affected person
often cannot answer questions about
time, date, present location, name, or
address. Disorientation is usually due
to a
head injury
,
intoxication
,
or a chron-
ic brain disorder, such as
dementia
.
It
may occasionally be due to
somatization
disorder
(a psychological illness). (See
also
confusion
;
delirium
.)
dispense
To prepare and distribute medicines to
a patient according to the details on a
doctor’s
prescription
.
displacement
The transference of feelings from one
object or person to another. Displace-
ment is usually performed consciously
to obtain emotional relief in a manner
that w ill not cause harm to oneself or
to another person. Some psychothera-
pists believe that displacement is an
unconscious
defence mechanism
.
dissecting aneurysm
An
aneurysm
(ballooning of an artery)
that usually affects the first part of the
aorta
.
It is caused by a tear in the inner
layer of the arterial wall, w hich results
in the inner layer peeling away from
the outer layer. This results in blood
collecting in the space between the
inner and outer layers.
A dissecting aneurysm may rupture
or may compress the blood vessels leav-
ing
the
aorta,
producing
infarction
(localized tissue death due to lack of
blood supply) in the organs supplied
by them. The patient w ill suffer from
severe chest pain that often spreads
to the back or the abdomen. Surgical
repair may help relieve the symptoms.
dissection
Cutting of body tissues during surgery
or for the purpose of anatomical study.
disseminated intravascular
coagulation (DIC)
A type of
bleeding disorder
in w hich
abnormal clotting of blood leads to a
depletion of coagulation factors in the
blood; the consequence may be severe
and spontaneous bleeding.
disseminated lupus
erythematosis
An alternative name for systemic
lupus
erythematosus
.
disseminated tuberculosis
A state in w hich the infectious disease
tuberculosis
has spread from the site of
the original infection to affect several
other parts of the body, either via the
lymphatic system
or in the bloodstream
(see
miliary tuberculosis
) .
dissociative disorders
A group of psychological conditions
in w hich a particular mental function
becomes cut off from the rest of the
mind. Examples of dissociative disor-
ders include hysterical amnesia
(see
hysteria
) ,
fugue
,
multiple personality dis-
order
,
and
depersonalization
.
(See also
conversion disorder
.)
dissociative reaction
A psychological
defence mechanism
in
w hich a person views unpleasant ideas
or events, such as being assaulted, in an
unusually detached way in order to
protect him self or herself from over-
whelm ing feelings such as fear. In more
severe cases, certain mental processes
are split off from the rest of a person’s
mental activity and may function inde-
pendently (see
dissociative disorders
) .
dissonance
A term that is used in social psycholo-
gy to describe a state that arises when
an individual has m inim al awareness
of any discord, disagreement, or con-
flict w ithin him self or herself. (See also
cognitive dissonance
.)
distal
A term describing a part of the body
that is further away from another part
w ith respect to a central point of ref-
erence, such as the trunk. For example,
the fingers are distal to the arm. The
opposite of distal is
proximal
.
Distalgesic
A brand name for
co-proxamol
,
an
anal-
gesic drug
containing
paracetamol
and
the weak opioid
dextropropoxyphene
.
disulfiram
A drug that acts as a deterrent to
drinking
alcohol
.
It is prescribed for
people w ho request help in overcom-
ing
alcohol dependence
.
Treatment with
the drug is usually combined w ith a
counselling programme.
Disulfiram
causes
a
buildup
of
acetaldehyde in the body, causing flush-
ing, headache, nausea, dizziness, and
palpitations. Symptoms may start w ith-
in
10
minutes of drinking alcohol and
can last for several hours. Occasionally,
large amounts of alcohol taken during
treatment can cause unconsciousness.
D
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