reverse it. However, giving up smoking
w ill greatly reduce the rate at w hich the
lungs deteriorate. The efficiency of the
remaining lung tissue may be improved
in various ways. For example,
may be given to widen the
bronchioles and patients who are defi-
cient in alphaj-antitrypsin may be given
replacement alphaj-antitrypsin therapy.
To treat oedema,
help to reduce the volume of fluid in the
body by promoting its output through
increased urine production. If the blood
oxygen level is continually low,
at home may be needed.
People who have a localized area of
emphysema in one lung may be offered
surgery to remove the affected area of
tissue, w hich w ill allow the remaining
lung tissue to re-expand. A single lung
transplant operation (see
may be considered if respiratory
failure is life-threatening.
The abnormal presence of air in tissues
under the skin following surgery or
injury. Surgical emphysema most com-
(the abnormal presence of
air in the pleural cavity between the
lung and the chest wall).
Treatment that is given simply on the
grounds that its effectiveness has been
treatment that is based on an under-
standing of the nature of a disorder and
the way in w hich the particular method
of treatment works.
An accumulation of
in a body cavity
or an internal organ. Empyema can
occur around a lung as a rare complica-
tion of an infection such as
The main symptoms are
chest pain, breathlessness, and fever.
Treatment is generally by
moval of the pus by suction) and the
tion to open the chest cavity and drain
the pus may sometimes be performed.
Empyema of the
is a com-
of the gallbladder), causing abdominal
pain, fever, and
the skin and the whites of the eyes).
This type of empyema is treated by sur-
gical removal of the gallbladder.
urine, a specimen of urine collected on
the patient’s first visit to the toilet after
waking up. This type of urine specimen
is often requested in an investigation for
affecting the kidney.
A type of
ing wax, white soft paraffin, and liquid
paraffin. Emulsifying ointment is used
to smooth, soothe, and hydrate the skin
in all dry or scaling conditions. Rarely,
ingredients such as preservatives may
result in skin sensitization.
ACE inhibitor drug
that is used in the
pumping efficiency of the heart). The
drug inhibits a chemical reaction that
causes blood vessels to constrict, and
thus allows vessels to dilate (widen); as
a result, it lowers blood pressure and
reduces the workload of the heart.
One side effect of enalapril is a sud-
den drop in blood pressure on taking
patient should rest while the dose is
taken and for two or three hours after-
wards. More common adverse effects of
the drug include headaches and dizzi-
ness; these effects should diminish with
The hard outer layer of a tooth (see
that protects the inner structures.
Inflammation of the
membranes that cover and protect the
brain and the spinal cord), usually due
to a viral infection. Encephalitis varies
in severity from a m ild problem, in
w hich symptoms are barely noticeable,
to a serious and potentially life-threat-
M ild cases of encephalitis may be due to
glandular fever (see
) or may be a complication of viral
diseases such as
In Europe, the most common cause of
In South-east Asia,
due to a virus spread by
mosquitoes, is the most dangerous type.
Occasionally, outbreaks of viral enceph-
alitis occur elsewhere in the world; for
example, an outbreak of
West Nile virus
another mosquito-borne form of the
disease, occurred in New York in 1999.
are particularly at risk
from severe viral encephalitis, and may
also develop cerebral abscesses (collec-
tions of pus in the brain tissue).
M ild cases of encephalitis usually de-
velop over several days and may cause
only a slight fever and mild headache. In
serious cases of encephalitis, the symp-
and hearing problems; and a gradual loss
(a state of uncon-
external stimuli) and
occur. If the meninges are inflamed, cer-
tain other symptoms (for example, a stiff
neck and abnormal sensitivity to light)
may develop (see
Diagnosis is based on results of blood
produce cross-sectional or three-dimen-
of the brain);
method of recording the electrical activ-
ity of the brain);
a sample of fluid from the spinal canal
for analysis); and, very occasionally, a
(removal of a small sample
of tissue for analysis).
Encephalitis due to herpes simplex is
no known treatment for encephalitis
caused by other viral infections.
An epidemic form of
major outbreaks of the condition since
the 1920s, but rare sporadic cases still
occur. Symptoms of encephalitis leth-
argica are those of encephalitis, with
additional lethargy and drowsiness.
Many survivors of the initial illness
during the major epidemics developed a
movement disorder that became known
A type of
neural tube defect
defects of the brain rather than of the
spinal cord, as occurs in
Inflammation of the
resulting in damage to the
usually due to a viral infection.