DYS-
D
PHYSICAL CARE
Pain can be relieved by regular low
doses of
analgesic drugs
.
O pioid anal-
gesics, such as
morphine
,
may be given
if pain is severe. Other methods of pain
relief include
nerve blocks
,
cordotomy,
and
TENS
.
Nausea and vomiting may be
controlled by drugs. Constipation can
be treated with
laxatives
.
Breathlessness
is another common problem in the
dying, and this may be relieved by
administering morphine.
Towards the end, the dying person
may be restless and may suffer from
breathing difficulty due to
heart failure
or
pneumonia
.
These symptoms can be
relieved by drugs and by placing the
patient in a more comfortable position.
EMOTIONAL CARE
Emotional care is as important as the
relief of physical symptoms. Many peo-
ple w ho are terminally ill feel angry or
depressed, and feelings of guilt or of
regret are common responses. Loving,
caring support from family,
friends,
and others is very important.
HOME OR HOSPICE?
Many terminally ill people would prefer
to die at home, and few terminally ill
patients need specialized nursing for
a prolonged period. Specially trained
nurses or health-care workers from a
hospital, hospice, or charity may be
able to provide additional support for
the dying person and his or her carers.
Care in a hospice may be offered.
Hospices are small units that have been
established specifically to care for ter-
minally ill people and their families.
dys-
A prefix meaning abnormal, difficult,
painful, or faulty, as in dysuria (pain on
passing urine).
dysarthria
A
speech disorder
caused by disease or
damage to the physical apparatus of
speech or to the nerves controlling this
apparatus. Affected people can form u-
late, select, and write out words and
sentences grammatically; the problem
is with vocal expression only.
CAUSES
Dysarthria is common in many degen-
erative neurological conditions, such as
multiple sclerosis
and
Parkinson’s disease
.
It may also result from a
stroke
,
brain
tumour
,
or an isolated defect or damage
to a particular nerve. Structural defects
of the mouth, as occur in
cleft lip and
palate
,
can also cause dysarthria.
TREATMENT
Drug or surgical treatment of the under-
lying disease or structural defect may
improve the person’s ability to speak
clearly.
Speech therapy
is also useful.
dyscalculia
A disorder in w hich there is difficulty
in solving mathematical problems. (See
also
learning difficulties.)
dyschondroplasia
A rare disorder, also called multiple
enchondromatosis or O llier’s disease,
that is present from birth and charact-
erized
by
the
presence
of multiple
tumours of cartilaginous tissue within
the bones of a limb. It is caused by a
failure
of normal
ossification
during
bone development. The bones are short-
ened, resulting in deformity. Rarely, a
tumour in the bone may become can-
cerous (see
chondrosarcoma).
dysentery
An intestinal infection, causing diar-
rhoea (often mixed w ith blood, pus, or
mucus) and abdominal pain. There are
two distinct forms of dysentery:
shigel-
losis,
w hich is due to shigella bacteria;
and
amoebic dysentery,
w hich is caused
by the
protozoan parasite E
ntamoeba
histolytica
. The main risk w ith dysen-
tery is
dehydration
caused by loss of
fluid in the diarrhoea.
dysfunction
An abnormality or impairment in the
functioning of an organ or body sys-
tem.
(See
also
bleeding, dysfunctional
uterine
;
minimal brain dysfunction
;
psycho-
sexual dysfunction
.)
The term “ dysfunctional”
may be
used to describe a poor relationship
between two or more people.
dysgraphia
Problems with w riting (see
learning dif-
ficulties).
dyskaryosis
Abnormal changes in the nuclei of
cells, particularly in the early stages of
cancer.
Dyskaryosis may be detected by
microscopic examination of cells in
procedures such as a
cervical smear test.
dyskeratosis
An abnormality in keratinization (the
deposition of the tough protein
keratin
)
in the surface of the skin or nails. One
form is due to a rare, inherited disorder
that is most often caused by an X-
linked recessive genetic trait, although
autosomal
dominant
and
autosomal
recessive forms also exist (see
genetic
disorders
). The condition affects more
males than females and first become
apparent in childhood.
Dyskeratosis is characterized by pre-
mature thickening of epithelial cells
(see
epithelium
) in the skin;
leukoplakia
(raised white patches on the mucous
membranes of the mouth or vulva);
nail dystrophy (a disorder caused by
inadequate nutrition); and
pancytopenia
(a simultaneous decrease in the num -
ber of red cells,
(
anaemia
) ,
white cells
(
neutropenia
), and platelets (
thrombocy-
topenia
) in the blood).
dyskinesia
Abnormal muscular movements. These
uncontrollable
twitching,
jerking,
or
writhing movements cannot be sup-
pressed, and they may affect control of
voluntary
movements.
The
disorder
may involve the whole body or be
restricted to a group of muscles.
Types of dyskinesia include
chorea
(jerking movements),
athetosis
(writhing
movements),
choreoathetosis
(a combined
form ),
myoclonus
(muscle spasms),
tics
(repetitive fidgets), and
tremors
.
Dyskinesia may
result from
brain
damage at birth or may be a side effect
of certain drugs (see
tardive dyskinesia
),
w hich often disappears when the drug
is stopped. Otherwise, dyskinesia is dif-
ficult to treat. (See also
parkinsonism
. )
dyslexia
A reading disability characterized by
difficulty interpreting written symbols.
CAUSE
Dyslexia is more common in males,
and evidence suggests that a specific,
sometimes inherited, neurological dis-
order underlies true dyslexia.
SYMPTOMS
A child with dyslexia has normal intel-
ligence, but his or her attainment of
reading skills lags far behind other
scholastic abilities.
W hile many young children tend to
reverse letters and words (for example,
w riting or reading p for q, or was for
saw), most soon learn to correct such
errors. Dyslexic children continue to
confuse these symbols. Letters are often
transposed (as in pest for step), and
spelling errors are common. The chil-
dren may even be unable to read words
that they can spell correctly.
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