*Databases allow users instant access to the information contained in the dataset. It is virtually impossible to access targeted information from the electronic versions of the venerated (Dorland’s Medical Dictionary, Stedman’s Medical Dictionary and Taber’s Medical Dictionary), precisely because they’re text-based. To access information from text-based information, a computer has the daunting task of sifting through ALL the information in the data set, a problem that doesn’t occur with relational database searches.
In reviewing the electronic version of the Dorland’s Medical Dictionary on amazon.com, on January 4, 2015, dominique johnson said, Massive amount of data without proper indexing, I thought that having it in Kindle would allow me to just type in a term in the “find” field and let the device find the entry, but that takes way longer than when i open the physical copy myself.
The Concise Dictionary of Medicine and a handful of other text-based eBooks I’ve written over the last few decades have this same indexing issue. Whilst they are available on the various eBook stores (iTunes, Kindle, Nook, etc) for those who like the text format and want them on their iPads, tablets, etc, database apps are the future of medical lexicography and as I go online with the database version of each, I expect to retire the eBook version.
I began collecting new medical terms as a hobby in 1984 during my residency in pathology at LIJ, now part of the massive North Shore-LIJ Health System on Long Island, premised on my belief that the standard medical dictionaries were losing touch with the spoken and working language of medicine.
You’ll find my musings on medical lexicography on:
I went live with this website in May, 2012 and blog about 5 terms/day, which derive from a growing database that now has 183,213 entries*
*The Dorland’s has less than 124,000 entries.
I’ll be making portions of the database available as iOS/Android apps…the first product, Medical Abbreviations, will be out soon…stay tuned.
Most of the terms I’ve blogged fall into one of 3 general categories:
• Popular terms–e.g., champagne bottle leg, Michael Jackson syndrome(s), Mickey Mouse sign(s), bubble pattern, Sutton’s law, etc.
I’ve tried to include something for everyone, in particular as relates to the cultural savvy that doctors are expected to have vis-à-vis music, literature, the arts and the world in general. Even if you’re not in health care, the material is “edutaining”, occasionally droll…
• New biomedical terms–e.g., from genomics and molecular biology, evidence-based medicine, informatics, managed care, sport medicine, etc
• Old terms due for burial with comments on usage
I encourage the reader to look over the 4500+ terms now found on this website.*
*To improve the user experience, and for search engine optimisation, parts of modernmedicaldictionary.com are under construction. I’m not going through this daunting task alone and have enlisted the help of a database guru and webmaster, Kent Hummel. I expect to be fully back up and running by the end of June—an ambitious target, to say the least.
During this transition period, the viewer will see a growing pool of reworked material as separate pages (one entry per page) and a shrinking pool of 25-entry blocks of material. The reworked entries will pop right up when you type the term in the search bar located at the top right corner of this website.
I plan to offer this growing pool of blogged terms as an annual subscription, updated monthly.
Format of entries Whilst I believe the format is self-explanatory, I am biased and may be assuming too much. The following few lines are meant to explain the elements found in most of the terms blogged on this website.
• Entry name bailout
• Area of interest SURGERY
• SynonymsBailout procedure, damage control surgery
• Definition The immediate closure…
A lexicon written in the 21st Century cannot, given of the diverse sources from which its material derives, escape some tongue-in-cheek and even outright comedy.
I tried to confine the jocularity to the choice of illustrations so as to not diminish the value of the work. For most of the terms, the illustration is on point. For others, I took liberties, such as those taken for genes–e.g., HOMER2, which got a mugshot of Homer Simpson and HIP2, which got an illustration from hipster artist Josh Agle.
Small minds, as they say, easily amused…
If you have a new term that you feel has gotten short shrift in a medical dictionary, shoot me an email at email@example.com and I’ll add it if I agree. And feel free to back-link to this website.
The reader will note that the spelling follows that extant on the other side of the pond. Unless they change the name of the language we speak to American, orthographic principles should follow received pronunciation (Queen’s English).
RESEARCH ETHICS Any method used to “correct” experimental data by eliminating (trimming) high and low values or data points which are most in excess of the mean in an experimental run or series. Trimming is a form of scientific misrepresentation.
Reference C Babbage, Reflections on the Decline of Science, London, 1830
30 March 2015
FOOD INDUSTRY, VETERINARY MEDICINE A somewhat self-explanatory term for a pig or hog weighing about 30+ kg, which is being fed to market weight–i.e., to finish them before finishing them off.
SURGERY Elective hemicorpectomy, halfectomy, operative hemicorpectomy, translumbar amputation A radical (read, draconian) procedure in which the entire body below the waist is surgically amputated at the level of the lumbar vertebrae. Elective hemicorpectomy may be the only therapeutic option in certain pelvic and lower extremity malignancies, recalcitrant infections, severe trauma–e.g., complicated open book fractures, failed pelvic exenteration.
The severe mutilation inherent in hemicorpectomy is justified in patients to relieve pain and remove of dirty, malodorous lesions, if the patient is willing to accept the loss of faecal continence and sexual activity. Operative hemicorporectomy is likely to fail if the patient lacks emotional and psychological coping mechanisms and the determination and strength to undergo the intensive rehabilitation.
MEDIA & MEDICINE A coinage for a permutation of deus ex machina of Greek tragedy vintage, which is often used by creators of children’s entertainment–e.g., animations and TV shows to whitewash the consequences–e.g., death, injury, of violent acts used as plot devices.
The term obtains from Cobra agents who parachute out of harm’s way in response to GI Joe operatives’ fire fights, which is to say that the “bad guys” don’t die. The downside of using “parachutes” is that young children can’t understand the finality of picking up Daddy’s gun, pointing it at a playmate and pulling the trigger.
While this term fills a lexical void, it is not a medical syndrome.
OBSTETRICS Shoulder presentation (in part) A non-cephalic, non-breech position, in which the foetus’ long axis is perpendicular to that of the mother’s. Transverse lies occur in 1:300 births, and are caused by lower uterine obstruction–e.g., placenta previa, intrauterine leiomyomas or an ovarian tumour in the cul-de-sac, or in a multiparous uterus with a lax wall.
Management C-section, less commonly, by gentle external version, if the membranes have not ruptured.
The risk of complications from an internal version are unacceptably high and rarely performed.
MOLECULAR MEDICINE A gene on chromosome 1p32.3 that encodes a ubiquitous early endosomal protein which recruits SMAD2/SMAD3 to intracellular membranes and TGF-beta receptor, playing a key role in TGF-mediated signaling by regulating the subcellular location of SMAD2 and SMAD3 and by modulating the SMAD3/SMAD4 complex’s transcriptional activity.
MEDSPEAK Disruptive doctor, disruptive health care provider, misbehaving doctor, misbehaving physician A physician who repeatedly causes disruptions in the workplace and compromises the quality of patient care. These physicians may, depending on the circumstances, be dealt with in a variety of ways from a friendly but firm discussion to loss of hospital staff membership and privileges.
The definition often excludes sexual harassment–a constellation of issues a sui generis and vocal advocacy for better patient management or for the political minority position on a medical staff.
CELL BIOLOGY A gene on chromosome 5p13.2 that encodes a homolog of the Drosophila nipped-B gene product, which facilitates enhancer-promoter communication and plays a role in regulating development. NIPBL has a nuclear targeting sequence and a HEAT repeat, which it shares with condensins, cohesins and complexes with chromosome-related activity.
Molecular pathology Defects of NIPBL cause Cornelia de Lange type 1, a clinically heterogeneous developmental disorder associated with defects affecting multiple systems.
TOXICOLOGY Pressure-treated wood Wood–in particular, that used for construction–which is impregnated with preservatives–e.g., chromium-copper-arsenate, creosote, inorganic arsenicals, pentachlorophenol, to increase its useful life, thwarting insects, fungi, etc. Chronic exposure to the fumes of burning wood or skin contact with treated wood may produce heavy metal intoxication.
On 31.12.2003, the US lumber industry stopped treating residential lumber with arsenic and chromium–chromated copper arsenate, or CCA, replacing CCA with copper based pesticides.
HAND SURGERY A movement that an active and highly-motivated person performs to circumvent limitations of musculoskeletal paralysis.
Trick movements are never normal and often bizarre and uncoordinated. Prolonged trick type compensation may stretch various hand tissues and “trick” may persist despite surgical correction, either due to the tissue stretching or because a habit formed that proves difficult to unlearn.
PSYCHIATRY TCA suicide A self-explanatory term for a suicide occurring in a depressed patient receiving tricyclic antidepressants–TAs.
Once regarded as a statistical blip, given that TAs are widely prescribed, they are the most common drug involved in suicide attempts by single, young women without previous history of autodestructive thoughts. This finding was confirmed in males taking nortriptyline (a TA), who were 2.4 times more likely to have an increase in suicidal thoughts than were those taking escitalopram (a selective serotonin reuptake inhibitor–SSRI), per N Perroud, et al, of King’s College London. Nortriptyline was also associated with a 9.8-fold higher risk of new onset of suicidal ideation compared with escitalopram in a prospective open-label trial.
Note: The reported TA overdose mortality of < 15% includes the elderly and children–including accidental TA overdoses may in fact underestimate the true incidence of TASs, as up to 70% of TA suicides are successful and never reach the hospital.
SOCIOPSYCHOLOGY A phenomenon in which a person who migrates to a particular place wants it to remain as it was when he or she–the last settler–arrived, i.e., the most recent settler wants to be the last.
For some authors, the syndrome is nothing more than a synonym for pioneer spirit, a distinctly American philosophy that triggered the migration of the country’s emigrants to the then-new country from the East Coast to the West. While the term fills a lexical void, it is not a medical syndrome.
CELL BIOLOGY, PAEDIATRICS Growth and mental retardation—mandibulofacial dysostosis—and cleft palate, mandibulofacial dysostosis with microcephaly A rare syndrome OMIM:610536 characterised by microcephaly, midface and malar hypoplasia, micrognathia, microtia, dysplastic ears, preauricular skin tags, significant developmental and speech delay, variably accompanied by choanal atresia and respiratory difficulties, conductive hearing loss, and cleft palate
Molecular pathology Defects* of EFTUD2, which encodes a GTPase that processes precursor mRNAs into mature mRNAs, cause mandibulofacial dysostosis—Guion-Almeda type.
*In the form of haploinsufficiency due to deletions, frameshifts, splice site, nonsense, and missense mutations.
PHYSIOLOGY A gene on chromosome 3p22.1 that encodes a sucrose nonfermenting serine/threonine kinase which phosphorylates target proteins and may play a role in hematopoietic cell proliferation or differentiation and neuronal apoptosis.
NEUROLOGY Sentinel headache, warning headache, worst headache of my life A popular term for a distinct severe headache of sudden onset, which develops days to weeks before an index episode of intracranial bleeding, typically a subarachnoid haemorrhage–seen in 20% to 50% of patients.
Clinical findings It appears within seconds, peaks in minutes, and lasts for hours to days; the headache may be accompanied by nuchal rigidity, decreased consciousness, papilloedema, retinal haemorrhage, 3rd and/or 6th nerve palsy, bilateral leg weakness, nystagmus, ataxia, aphasia, abulia, hemiparesis, left-sided visual neglect.
PUBLIC HEALTH, TROPICAL MEDICINE Emporiatrics, traveler’s medicine, traveller medicine The subspecialty of internal medicine which studies and manages health issues, vaccination, preventing infections, injuries, and other conditions related to international travel.
Travel medicine is an eclectic mix of health care which takes cues from epidemiology, infectious disease, public health, tropical medicine, high altitude physiology, obstetrics, psychiatry, occupational medicine, military and migration medicine, and environmental health.
(1) Cattle class syndrome, coach class syndrome, coach seat clot, coach seat syndrome, economy class clot, economy class thrombosis, immobile traveller’s syndrome, steerage syndrome, steerage class syndrome, traveler clot, traveler syndrome, traveler thrombosis, traveler clot, travellers syndrome, travellers thrombosis A popular term for deep vein thrombosis formed in the lower leg after prolonged immobilisation in the cramped economy class seats during long-haul air flights. Risk factors Oral contraceptive use, advanced age, sitting in a window seat–reduced likelihood of moving around cabin.
While regarded as synonymous with DVT, the ECS has not been formally studied and might encompass other musculoskeletal and possibly also GI disorders, which are related to the lesser accommodations and cuisine typical of airborne “steerage”. In early 2012, the American College of Chest Physicians concluded that there was no evidence to support this condition.
(2) A popular term for the constellation of ignominies suffered by air passengers travelling in cattle class.
CELL BIOLOGY A gene on chromosome 4p15.32 that encodes fibroblast growth factor binding protein 1–FGFBP1, which acts as a carrier protein, releasing fibroblast-binding factors–FGFs from the extracellular matrix, thereby enhancing FGFs’ mitogenic activity. It plays a key role in cell proliferation, differentiation and migration by binding to FGFs and potentiating their effects on target cells; it is thought to play a role in tumour growth, acting as an angiogenic switch. It is upregulated in epithelial cells in response to injury.
Molecular pathologyFGFBP1 is upregulated in carcinogen-induced skin neoplasms, squamous cell carcinoma, pancreatic and colorectal adenocarcinomas.
MEDSPEAKUK A UK Parliamentary Act which provides the statutory framework to empower and protect vulnerable people unable to make their own decisions, and clarifies who can make those decisions, in which situations, and how they should go about it, and enables people to plan ahead for a time when they may lose capacity.
The Act gives the state power to have a person lacking capacity, who is self-neglecting and becoming undernourished, to be admitted to hospital for treatment as long as their treatment in hospital does not amount to a deprivation of their liberty. The Act does not apply to any treatment for mental disorder–e.g., electroconvulsive therapy–being given in accordance with the rules about compulsory treatment set out in the Mental Health Acts 1983, 2007.
Mental Capacity Act, 5 key principles
• Presumption of capacity to make decisions unless clearly proven otherwise
• The right for individuals to make their own decisions, unless they’re clearly incapable
• That individuals have the right to make what seem to be eccentric or unwise decisions
• Best interests–anything done for people without capacity must be in their best interests; and
• Least restrictive intervention–anything done for people without capacity should be the least restrictive of their basic rights and freedoms.
EVIDENCE-BASED MEDICINE, CLINICAL TRIALS The injection of a placebo–e.g., saline solution, or agent that simulates a drug, being administered in a clinical trial. Sham injections are intended to reduce or eliminate trial subjects’ bias related to route of administration of an agent under evaluation in a clinical trial.
Reference Arch Ophthalmol. 2012 Feb;130(2):190-4.
INTENSIVE CARE STICU, surgical trauma ICU, trauma intensive care unit An ICU that supports the needs of trauma victims after initial surgical management, by monitoring vitals, as well as controlling infection and optimising nutrition, both of which impact on morbidity and mortality. Penetrating trauma is best managed in STICUs, which have the kit and personnel trained to care for complex multi-trauma patients.
Duane TM, et al, J Emerg Trauma Shock 2008;1:74-7
26 March 2015
beating the breathalyzer test
PUBLIC HEALTH The breathalyzer test is often used by police in the US as well as in socially advanced countries to assess whether a driver is two or more sheets to the wind and should be in the front seat of his car on his way home or in the rear seat of a cop car on his way to County lockup. Popular myth holds that one can beat the test, even if one’s blood alcohol levels are above the legal limit.
Mythbusters (a US TV show) debunked the best-known of these wives’ tales.
The following do not work:
• Eating breath mints or onions
• Denture cream or mouth wash or hyperventilating before the test
• Holding batteries or copper coins in one’s mouth during the test.
FOOD INDUSTRY Latin, faecula, diminutive of faex, dregs A flavourless polysaccharide food thickener, which is a powdered starch obtained from arrowroot, corn, katakuri, potato, sago, or tapioca and their derivatives.
A gene on chromosome Xq22 that encodes a component of the NuA4 histone acetyltransferase–HAT complex*, which is involved in transcriptional activation of select genes principally by acetylating nucleosomal histones H4 and H2A. Acetylation alters nucleosome-DNA interactions and promotes interaction of the modified histones with other proteins, upregulating transcription. MORF4L2 is also part of the MSIN3A complex which down-regulates transcription by deacetylating nucleosomal histones.
*The HAT complex may be required for activating transcriptional pathways associated with oncogene and proto-oncogene mediated growth induction, tumoru suppressor mediated growth arrest and replicative senescence, apoptosis, and DNA repair.
SEXOLOGY A popular term referring to a person’s sexual relationships and level of sexual activity–i.e., whether a person is getting ‘”it” or doing “it”.
SEXOLOGY The directions and manifestations of the sexual drive that contribute to a person’s life-style, sometimes confined to genital activity and sometimes referring to all of the manifestations of libidinal energy in the subject’s personality and relationships
Reference Intl Dict Med, J Wiley Sons, NY, 1986
CARDIOLOGY A palpable murmur that correlates with zones of maximum intensity of auscultated sounds; rough lower sternal border thrills occur in ventricular septal defect, apical systolic thrills are associated with mitral valve insufficiency; diastolic thrills may be palpated in AV valve stenosis