These are medical definitions of medical terms from the MedTerms.com medical dictionary that appear in the Liver Transplant article.
Abdomen: The belly , that part of the body that contains all of the structures between the chest and the pelvis . The abdomen is separated anatomically from the chest by the diaphragm , the powerful muscle spanning the body cavity below the lungs .
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Abdominal: Relating to the abdomen, the belly , that part of the body that contains all of the structures between the chest and the pelvis . The abdomen is separated anatomically from the chest by the diaphragm , the powerful muscle spanning the body cavity below the lungs .
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Abnormal: Not normal. Deviating from the usual structure, position, condition, or behavior. In referring to a growth, abnormal may mean that it is cancerous or premalignant (likely to become cancer ).
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Absorb: 1. To take something in, as through the skin or the intestine.
2. To react with radiation and reduce it in intensity, as with a dose of radiation or transmitted light.
See also: Absorbed dose ; Absorption ; Malabsorption ; Reabsorption .
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Absorption: Uptake. In the biomedical sciences, absorption has diverse specific meanings.
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Acetaminophen: A pain reliever and fever reducer. Brand name: Tylenol. The exact mechanism of action of acetaminophen is not known. Acetaminophen relieves pain by elevating the pain threshold (that is, by requiring a greater amount of pain to develop before it is felt by a person). Acetaminophen reduces fever through its action on the heat-regulating center (the "thermostat") of the brain. Generic is available.
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Acne: Localized skin inflammation as a result of overactivity of the oil glands at the base of hair follicles. Acne happens when oil (sebaceous) glands come to life around puberty, when these glands are stimulated by male hormones that are produced in the adrenal glands of both boys and girls.
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Acute: Of abrupt onset, in reference to a disease. Acute often also connotes an illness that is of short duration, rapidly progressive, and in need of urgent care.
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Albumin: The main protein in human blood and the key to the regulation of the osmotic pressure of blood. Chemically, albumin is soluble in water, precipitated by acid, and coagulated by heat.
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Alcohol: An organic chemical in which one or more hydroxyl (OH) groups are attached to carbon (C) atoms in place of hydrogen (H) atoms. Common alcohols include ethyl alcohol or ethanol (found in alcoholic beverages), methyl alcohol or methanol (can cause blindness) and propyl alcohol or propanol (used as a solvent and antiseptic ). Rubbing alcohol is a mixture of acetone , methyl isobutyl ketone, and ethyl alcohol. In everyday talk, alcohol usually refers to ethanol as, for example, in wine, beer, and liquor. It can cause changes in behavior and be addictive.
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Alcoholism: Physical dependence on alcohol to the extent that stopping alcohol use will bring on withdrawal symptoms. In popular and therapeutic parlance, the term may also be used to refer to ingrained drinking habits that cause health or social problems. Treatment requires first ending the physical dependence, then making lifestyle changes that help the individual avoid relapse . In some cases, medication or hospitalization are needed. Alcohol dependence can have many serious effects on the brain , liver , and other organs of the body.
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Allograft: The transplant of an organ or tissue from one individual to another of the same species with a different genotype . A transplant from one person to another, but not an identical twin, is an allograft. Allografts account for many human transplants, including those from cadaveric, living related, and living unrelated donors. Called also an allogeneic graft or a homograft.
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Angiography: A procedure performed to view blood vessels after injecting them with a radioopaque dye that outlines them on x-ray . This technique can be usefully used to look at arteries in many areas of the body, including the brain, neck ( carotids ), heart , aorta , chest , pulmonary circuit, kidneys , gastrointestinal tract, and limbs .
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Antibiotic: A drug used to treat infections caused by bacteria and other microorganisms. Originally, an antibiotic was a substance produced by one microorganism that selectively inhibits the growth of another. Synthetic antibiotics, usually chemically related to natural antibiotics, have since been produced that accomplish comparable tasks.
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Antifungal: A drug used to treat fungal infections.
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Antiviral: An agent that kills a virus or that suppresses its ability to replicate and, hence, inhibits its capability to multiply and reproduce.
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Arm: 1. In popular usage, the appendage that extends from the shoulder to the hand. However, the medical definition refers to the upper extremity extending from the shoulder only to the elbow, excluding the forearm, which extends from the elbow to the wrist. The arm contains one bone: the humerus. 2. In a randomized clinical trial, any of the treatment groups. Most randomized trials have two "arms," but some have three "arms," or even more.
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Ascites: Abnormal buildup of fluid in the abdomen. Ascites can occur as a result of a number of conditions, including severe liver disease and the presence of malignant cells within the abdomen.
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Aspirin: A good example of a tradename that entered into the language, Aspirin was once the Bayer trademark for acetylsalicylic acid .
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Atresia: Absence of a normal opening or failure of a structure to be tubular.
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Bacteria: Single-celled microorganisms which can exist either as independent (free-living) organisms or as parasites (dependent upon another organism for life).
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Bacterial: Of or pertaining to bacteria . For example, a bacterial lung infection .
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Belly: That part of the body that contains all of the structures between the chest and the pelvis. Also called the abdomen.
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Benzodiazepines: A class of drugs that act as tranquilizers and are commonly used in the treatment of anxiety. Benzodiazepines can cause drowsiness.
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Bile: Bile is a yellow-green fluid that is made by the liver, stored in the gallbladder and passes through the common bile duct into the duodenum where it helps digest fat. The principal components of bile are cholesterol, bile salts, and the pigment bilirubin.
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Biliary: Having to do with the gallbladder , bile ducts , or bile. The biliary system itself consists of the gallbladder and bile ducts and, of course, the bile.
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Biliary atresia: Congenital absence or closure of the major bile ducts, the ducts that drain bile from the liver .
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Bilirubin: A yellow-orange compound produced by the breakdown of hemoglobin from red blood cells.
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Biopsy: The removal of a sample of tissue for purposes of diagnosis. (Many definitions of "biopsy" stipulate that the sample of tissue is removed for examination under a microscope. This may or may not be the case. The diagnosis may be achieved by other means such as by analysis of chromosomes or genes.)
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Blood: The familiar red fluid in the body that contains white and red blood cells , platelets , proteins , and other elements. The blood is transported throughout the body by the circulatory system . Blood functions in two directions: arterial and venous. Arterial blood is the means by which oxygen and nutrients are transported to tissues while venous blood is the means by which carbon dioxide and metabolic by-products are transported to the lungs and kidneys, respectively, for removal from the body.
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Blood clot: Blood that has been converted from a liquid to a solid state. Also called a thrombus .
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Blood pressure: The blood pressure is the pressure of the blood within the arteries. It is produced primarily by the contraction of the heart muscle . It's measurement is recorded by two numbers. The first ( systolic pressure) is measured after the heart contracts and is highest. The second ( diastolic pressure) is measured before the heart contracts and lowest. A blood pressure cuff is used to measure the pressure. Elevation of blood pressure is called " hypertension ".
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Blood sugar: Blood glucose . See also: High blood sugar ; Low blood sugar .
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Blurred vision: Lack of sharpness of vision with, as a result, the inability to see fine detail. Blurred vision can occur when a person who wears corrective lens is without them. Blurred vision can also be an important clue to eye disease.
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Body type: A somewhat old-fashioned term used to classify the human shape into three primary types: ectomorphic, mesomorphic, or endomorphic.
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Bone: Bone is the substance that forms the skeleton of the body. It is composed chiefly of calcium phosphate and calcium carbonate . It also serves as a storage area for calcium, playing a large role in calcium balance in the blood.
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Bone marrow: The soft blood-forming tissue that fills the cavities of bones and contains fat and immature and mature blood cells, including white blood cells, red blood cells, and platelets. Diseases or drugs that affect the bone marrow can affect the total counts of these cells.
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Bowel: Another name for the intestine . The small bowel and the large bowel are the small intestine and large intestine , respectively.
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Brain: That part of the central nervous system that is located within the cranium ( skull ). The brain functions as the primary receiver, organizer and distributor of information for the body. It has two (right and left) halves called "hemispheres."
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Breastfeeding: Feeding a child human breast milk . According to the American Academy of Pediatrics , human breast milk is preferred for all infants. This includes even premature and sick babies, with rare exceptions. It is the food least likely to cause allergic reactions; it is inexpensive; it is readily available at any hour of the day or night; babies accept the taste readily; and the antibodies in breast milk can help a baby resist infections.
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Breathing: The process of respiration, during which air is inhaled into the lungs through the mouth or nose due to muscle contraction, and then exhaled due to muscle relaxation.
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Calcium: A mineral found mainly in the hard part of bones, where it is stored. Calcium is added to bones by cells called osteoblasts and is removed from bones by cells called osteoclasts. Calcium is essential for healthy bones. It is also important for muscle contraction, heart action, nervous system maintenance, and normal blood clotting. Food sources of calcium include dairy foods, some leafy green vegetables such as broccoli and collards, canned salmon, clams, oysters, calcium-fortified foods, and tofu. According to the National Academy of Sciences, adequate intake of calcium is 1,200 milligrams a day (four glasses of milk) for men and women 51 and older, 1,000 milligrams a day for adults 19 through 50, and 1,300 milligrams a day for children 9 through 18. The upper limit for calcium intake is 2.5 grams daily.
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Cancer: An abnormal growth of cells which tend to proliferate in an uncontrolled way and, in some cases, to metastasize (spread).
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Cardiologist: A doctor who specializes in treating heart disorders.
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Cell: The basic structural and functional unit in people and all living things. Each cell is a small container of chemicals and water wrapped in a membrane .
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Chest: The area of the body located between the neck and the abdomen . The chest contains the lungs , the heart and part of the aorta . The walls of the chest are supported by the dorsal vertebrae , the ribs , and the sternum .
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Chickenpox: A highly infectious viral disease also known medically as varicella -- in many countries, this disease is always called "varicella" -- that causes a blister-like rash, itching, fatigue and fever. The rash crops up first on the face and trunk and can spread over the entire body resulting in 250 to 500 itchy blisters.
Chocolate: A food or flavoring made from the seeds of the cacao or chocolate tree. Chocolate is rich in flavinoids, compounds that act as antioxidants. Flavinoids may also lower blood pressure and improve blood flow, by regulating the synthesis of nitric oxide, which dilates blood vessels. Flavinoids, like aspirin, help keep platelets from aggregating on vessel walls. Thus, chocolate may have health benefits, provided it is consumed in moderation.
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Cholesterol: The most common type of steroid in the body, cholesterol has gotten something of a bad name. However, cholesterol is a critically important molecule.
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Chronic: This important term in medicine comes from the Greek chronos, time and means lasting a long time.
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Cirrhosis: An abnormal liver condition characterized by irreversible scarring of the liver. Alcohol and viral hepatitis B and C are among the many causes of cirrhosis. Cirrhosis can cause yellowing of the skin ( jaundice ), itching, and fatigue. Diagnosis of cirrhosis can be suggested by physical examination and blood tests, and can be confirmed by liver biopsy in some patients. Complications of cirrhosis include mental confusion, coma, fluid accumulation (ascites), internal bleeding, and kidney failure. Treatment of cirrhosis is designed to limit any further damage to the liver as well as complications. Liver transplantation is becoming an important option for patients with advanced cirrhosis.
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Coma: A state of deep unarousable unconsciousness.
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Complication: In medicine, an additional problem that arises following a procedure, treatment or illness and is secondary to it. A complication complicates the situation.
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Condition: The term "condition" has a number of biomedical meanings including the following:
Cough: A rapid expulsion of air from the lungs typically in order to clear the lung airways of fluids, mucus, or material. Also called tussis.
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Creatinine: A chemical waste molecule that is generated from muscle metabolism. Creatinine is produced from creatine, a molecule of major importance for energy production in muscles. Approximately 2% of the body's creatine is converted to creatinine every day. Creatinine is transported through the bloodstream to the kidneys. The kidneys filter out most of the creatinine and dispose of it in the urine.
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CT scan: Computerized tomography scan. Pictures of structures within the body created by a computer that takes the data from multiple X-ray images and turns them into pictures on a screen. CT stands for computerized tomography.
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Diabetes: Refers to diabetes mellitus or, less often, to diabetes insipidus . Diabetes mellitus and diabetes insipidus share the name "diabetes" because they are both conditions characterized by excessive urination (polyuria).
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Discharge: 1.The flow of fluid from part of the body, such as from the nose or vagina.
2. The passing of an action potential, such as through a nerve or muscle fiber .
3. The release of a patient from a course of care. The doctor may then dictate a discharge summary.
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Diuretic: Anything that promotes the formation of urine by the kidney. (The word "diuretic" comes from a combination of the Greek "dia-", thoroughly + "ourein", to urinate = to urinate thoroughly).
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Donor: The giver of a tissue or organ, for example, of blood or a kidney.
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Drain: A device for removing fluid from a cavity or wound. A drain is typically a tube or wick. As a verb, to allow fluid to be released from a confined area.
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Duct: A passage or a tube with well-defined walls suitable for the conveyance of air or liquids, as the bile duct and the pancreatic duct.
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ECG: Abbreviation for electrocardiogram or EKG. The K is from "kardio" (in German).
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Electrocardiogram : A recording of the electrical activity of the heart. An electrocardiogram is a simple, non-invasive procedure. Electrodes are placed on the skin of the chest and connected in a specific order to a machine that, when turned on, measures electrical activity all overaround the heart. Output is usually in the form of a long scroll of paper displaying a printed graph of activity. Newer models output the data directly to a computer and screen, although a print-out may still be made.
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Emergency department: The department of a hospital responsible for the provision of medical and surgical care to patients arriving at the hospital in need of immediate care. Emergency department personnel may also respond to certain situations within the hospital such cardiac arrests.
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Esophagus: The tube that connects the pharynx (throat) with the stomach. The esophagus lies between the trachea (windpipe) and the spine. It passes down the neck, pierces the diaphragm just to the left of the midline, and joins the cardiac (upper) end of the stomach. In an adult, the esophagus is about 25 centimeters (10 inches) long. When a person swallows, the muscular walls of the esophagus contract to push food down into the stomach. Glands in the lining of the esophagus produce mucus, which keeps the passageway moist and facilitates swallowing. Also known as the gullet or swallowing tube. From the Greek oisophagos, from oisein meaning to bear or carry + phagein, to eat.
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Essential: 1. Something that cannot be done without.
2. Required in the diet, because the body cannot make it. As in an essential amino acid or an essential fatty acid.
3. Idiopathic. As in essential hypertension. "Essential" is a hallowed term meaning "We don't know the cause."
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Event: A set of outcomes. Cardiovascular events might include a heart attack and gastrointestinal events a GI bleed. The use of the term "event" in medicine comes from probability theory.
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Fats: Plural of the word "fat". See the definition of fat .
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Fever : Although a fever technically is any body temperature above the normal of 98.6 degrees F. (37 degrees C.), in practice a person is usually not considered to have a significant fever until the temperature is above 100.4 degrees F (38 degrees C.).
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Fungal: Pertaining to a fungus . For example, a fungal skin infection.
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Fungi: Plural of fungus .
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Fungus: A single-celled or multicellular organism. Fungi can be true pathogens (such as histoplasmosis and coccidioidomycosis ) that cause infections in healthy persons or they can be opportunistic pathogens (such as aspergillosis , candidiasis , and cryptococcosis) that cause infections in immunocompromised persons (including cancer patients, transplant recipients, and persons with AIDS ). An example of a common fungus is the yeast organism which causes thrush and diaper rash (diaper dermatitis ). Fungi are also used for the development of antibiotics, antitoxins, and other drugs used to control various human diseases.
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Gallbladder: A pear-shaped organ just below the liver that stores the bile secreted by the liver. During a fatty meal, the gallbladder contracts, delivering the bile through the bile ducts into the intestines to help with digestion. Abnormal composition of bile leads to formation of gallstones , a process termed cholelithiasis . The gallstones cause cholecystitis , inflammation of the gallbladder.
Gastric: Having to do with the stomach.
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Gastroenterologist: A physician who specializes in the diagnosis and treatment of disorders of the gastrointestinal tract , including the esophagus , stomach , small intestine , large intestine , pancreas , liver , gallbladder , and biliary system.
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Gastroenterology: The medical specialty devoted to the study, diagnosis and treatment of disorders of the digestive system . These disorders may affect the esophagus (swallowing tube), stomach , small intestine , large intestine ( colon ), rectum , liver , gallbladder , or pancreas .
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Gastrointestinal: Adjective referring collectively to the stomach and small and large intestines.
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Genital: Pertaining to the external and internal organs of reproduction. (Not to be confused with genetic.)
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Glucose: The simple sugar (monosaccharide) that serves as the chief source of energy in the body. Glucose is the principal sugar the body makes. The body makes glucose from proteins, fats and, in largest part, carbohydrates. Glucose is carried to each cell through the bloodstream. Cells, however, cannot use glucose without the help of insulin . Glucose is also known as dextrose.
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Graft: Healthy skin, bone, or other tissue taken from one part of the body to replace diseased or injured tissue removed from another part of the body.
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Gynecologist: A doctor who specializes in treating diseases of the female reproductive organs. The word "gynecologist" comes from the Greek gyno, gynaikos meaning woman + logia meaning study, so a gynecologist is literally a student of women, a women's doctor. However, these days gynecologists do not address all of women's medicine but instead focus mainly on disorders of the female reproductive organs.
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Heart: The muscle that pumps blood received from veins into arteries throughout the body. It is positioned in the chest behind the sternum (breastbone; in front of the trachea, esophagus, and aorta; and above the diaphragm muscle that separates the chest and abdominal cavities. The normal heart is about the size of a closed fist, and weighs about 10.5 ounces. It is cone-shaped, with the point of the cone pointing down to the left. Two-thirds of the heart lies in the left side of the chest with the balance in the right chest.
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Heart rate: The number of heart beats per unit time, usually per minute. The heart rate is based on the number of contractions of the ventricles (the lower chambers of the heart). The heart rate may be too fast ( tachycardia ) or too slow ( bradycardia ). The pulse is bulge of an artery from the wave of blood coursing through the blood vessel as a result of the heart beat. The pulse is often taken at the wrist to estimate the heart rate.
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Hepatic: Having to do with the liver. Pronounced hi-'pa-tik. From the Latin hepaticus derived from the Greek hepar meaning (not too surprisingly) the liver.
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Hepatic encephalopathy: Brain dysfunction directly due to liver dysfunction, most often recognized in advanced liver disease. Hepatic encephalopathy may cause disturbances of consciousness and progress to coma .
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Hepatitis: Inflammation of the liver from any cause.
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Hepatitis B: Inflammation of the liver due to the hepatitis B virus (HBV), once thought to be passed only through blood products. It is now known that hepatitis B can also be transmitted via needle sticks, body piercing and tattooing using un sterilized instruments, the dialysis process, sexual and even less intimate close contact, and childbirth. Symptoms include fatigue, jaundice , nausea, vomiting, dark urine, light stools. Diagnosis is by blood test. Treatment is via anti-viral drugs and/or hepatitis B immunoglobulin (HBIG).
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Hepatitis C: Inflammation of the liver due to the hepatitis C virus (HCV), which is usually spread by blood transfusion, hemodialysis, and needle sticks. HCV causes most transfusion-associated hepatitis, and the damage it does to the liver can lead to cirrhosis and cancer. Transmission of the virus by sexual contact is rare. At least half of HCV patients develop chronic hepatitis C infection. Diagnosis is by blood test. Treatment is via anti-viral drugs. Chronic hepatitis C may be treated with interferon , sometimes in combination with anti-virals. There is no vaccine for hepatitis C. Previously known as non-A, non-B hepatitis.
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Hepatology: The field of liver disease . The liver is the body's largest organ and hepatology is a large field. It includes, but is not limited to, the study of acute and chronic hepatitis , viral hepatitis , cirrhosis , genetic and metabolic liver diseases and their complications, liver cancer, liver transplantation, drug metabolism (which depends largely upon the liver), and immunology as it pertains to the liver.
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Herpes: A family of viruses. Herpes also refers to infection with one of the human herpesviruses, especially herpes simplex types 1 and 2.
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Herpes zoster: Also called shingles , zona, and zoster. The culprit is the varicella-zoster virus. Primary infection with this virus causes chickenpox (varicella). At this time the virus infects nerves (namely, the dorsal root ganglia) where it remains latent (lies low) for years. It can then be reactivated to cause shingles with blisters over the distribution of the affected nerve accompanied by often intense pain and itching.
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Herpesvirus: One of a family of double-stranded DNA viruses that cause common infections in humans. These include: herpes , CMV , chickenpox , shingles , mono , measles , and Kaposi sarcoma .
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High blood pressure : Also known as hypertension, high blood pressure is, by definition, a repeatedly elevated blood pressure exceeding 140 over 90 mmHg -- a systolic pressure above 140 with a diastolic pressure above 90.
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HIV: Acronym for the Human Immunodeficiency Virus , the cause of AIDS (acquired immunodeficiency syndrome). HIV has also been called the human lymphotropic virus type III, the lymphadenopathy-associated virus and the lymphadenopathy virus . No matter what name is applied, it is a retrovirus. (A retrovirus has an RNA genome and a reverse transcriptase enzyme. Using the reverse transcriptase , the virus uses its RNA as a template for making complementary DNA which can integrate into the DNA of the host organism).
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Hospital: It may seem unnecessary to define a "hospital" since everyone knows the nature of a hospital. A hospital began as a charitable institution for the needy, aged, infirm, or young.
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Immune: Protected against infection. The Latin immunis means free, exempt.
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Immune system: A complex system that is responsible for distinguishing us from everything foreign to us, and for protecting us against infections and foreign substances. The immune system works to seek and kill invaders.
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Immunosuppressant: An agent that can suppress or prevent the immune response. Immunosuppressants are used to prevent rejection of a transplanted organ and to treat autoimmune diseases such as psoriasis , rheumatoid arthritis , and Crohn's disease . Some treatments for cancer act as immunosuppressants. Also called an immunodepressant.
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Immunosuppression: Suppression of the immune system . Immunosuppression may result from certain diseases such as AIDS or lymphoma or from certain drugs such as some of those used to treat cancer . Immunosuppression may also be deliberately induced with drugs, as in preparation for bone marrow or other organ transplantation to prevent the rejection of the transplant .
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Immunosuppressive: 1. Pertaining to immunosuppression , the suppression of the immune system .
2. An agent capable of suppressing the immune response .
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Incidence: The frequency with which something, such as a disease, appears in a particular population or area. In disease epidemiology, the incidence is the number of newly diagnosed cases during a specific time period. The incidence is distinct from the prevalence which refers to the number of cases alive on a certain date.
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Incision: A cut. When making an incision, a surgeon is making a cut.
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Indicate: In medicine, to make a treatment or procedure advisable because of a particular condition or circumstance. For example, certain medications are indicated for the treatment of hypertension during pregnancy while others are contraindicated .
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Indication: 1. In medicine, a condition which makes a particular treatment or procedure advisable. CML (chronic myeloid leukemia ) is an indication for the use of Gleevec (imatinib mesylate). 2. A sign or a circumstance which points to or shows the cause, pathology , treatment, or outcome of an attack of disease. The presence of the Philadelphia chromosome in peripheral blood cells is an indication of a relapse in CML.
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Infection: The growth of a parasitic organism within the body. (A parasitic organism is one that lives on or in another organism and draws its nourishment therefrom.) A person with an infection has another organism (a "germ") growing within him, drawing its nourishment from the person.
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Inflammatory response: A fundamental type of response by the body to disease and injury, a response characterized by the classical signs of "dolor, calor, rubor, and tumor " -- pain , heat (localized warmth), redness, and swelling.
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Injury: Harm or hurt. The term "injury" may be applied in medicine to damage inflicted upon oneself as in a hamstring injury or by an external agent on as in a cold injury . The injury may be accidental or deliberate, as with a needlestick injury . The term "injury" may be synonymous (depending on the context) with a wound or with trauma .
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INR: International normalized ratio, a system established by the World Health Organization (WHO) and the International Committee on Thrombosis and Hemostasis for reporting the results of blood coagulation (clotting) tests. All results are standardized using the international sensitivity index for the particular thromboplastin reagent and instrument combination utilized to perform the test.
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Intensive care: See critical care .
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Internal medicine: A medical specialty dedicated to the diagnosis and medical treatment of adults. A physician who specializes in internal medicine is referred to as an internist. A minimum of seven years of medical school and postgraduate training are focused on learning the prevention, diagnosis, and treatment of diseases of adults. Subspecialties of internal medicine include allergy and immunology, cardiology (heart), endocrinology (hormone disorders), hematology (blood disorders), infectious diseases, gastroenterology (diseases of the gut), nephrology (kidney diseases), oncology (cancer), pulmonology (lung disorders), and rheumatology ( arthritis and musculoskeletal disorders).
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International normalized ratio: A system, commonly called the INR, established by the World Health Organization (WHO) and the International Committee on Thrombosis and Hemostasis for reporting the results of blood coagulation (clotting) tests. All results are standardized using the international sensitivity index for the particular thromboplastin reagent and instrument combination utilized to perform the test.
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Intervention: The act of intervening, interfering or interceding with the intent of modifying the outcome. In medicine, an intervention is usually undertaken to help treat or cure a condition. For example, early intervention may help children with autism to speak. "Acupuncture as a therapeutic intervention is widely practiced in the United States," according to the National Institutes of Health. From the Latin intervenire, to come between.
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Itching: An uncomfortable sensation in the skin that feels as if something is crawling on the skin or in the skin, and makes the person want to scratch the affected area.
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Jaundice: Yellow staining of the skin and sclerae (the whites of the eyes) by abnormally high blood levels of the bile pigment bilirubin . The yellowing extends to other tissues and body fluids. Jaundice was once called the "morbus regius" (the regal disease) in the belief that only the touch of a king could cure it.
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Kidney: One of a pair of organs located in the right and left side of the abdomen which clear "poisons" from the blood, regulate acid concentration and maintain water balance in the body by excreting urine. The kidneys are part of the urinary tract. The urine then passes through connecting tubes called "ureters" into the bladder. The bladder stores the urine until it is released during urination.
Laboratory: A place for doing tests and research procedures and preparing chemicals, etc. Although "laboratory" looks very like the Latin "laboratorium" (a place to labor, a work place), the word "laboratory" came from the Latin "elaborare" (to work out, as a problem, and with great pains), as evidenced by the Old English spelling "elaboratory" designating "a place where learned effort was applied to the solution of scientific problems."
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Liver: An organ in the upper abdomen that aids in digestion and removes waste products and worn-out cells from the blood. The liver is the largest solid organ in the body. The liver weighs about three and a half pounds (1.6 kilograms). It measures about 8 inches (20 cm) horizontally (across) and 6.5 inches (17 cm) vertically (down) and is 4.5 inches (12 cm) thick.
Liver biopsy : A procedure in which a small sample of the liver is removed for the diagnosis of abnormal liver conditions.
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Liver disease: Liver disease refers to any disorder of the liver. The liver is a large organ in the upper right abdomen that aids in digestion and removes waste products from the blood.
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Liver transplant: Surgery to remove a diseased liver and replace it with a healthy liver (or part of one) from a donor . The most common reasons for liver transplantation in children is biliary atresia (a disease in which the ducts that carry bile out of the liver are missing or damaged) while in adults the most common reason for a liver transplant is cirrhosis (a disease in which healthy liver cells are killed and replaced with scar tissue ).
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Living donor liver transplantation: An option for patients who need a liver transplant . In this procedure, a healthy person (usually a family member, friend or co-worker) donates a portion of their liver to the transplant patient. One of the two lobes of the donor's liver is removed. The recipient's damaged liver is also removed. The healthy liver lobe is then attached in the place from which the recipient's liver was removed. There it begins rapidly to regenerate healthy liver tissue. The donor's liver also quickly regenerates and continues to function normally. Both operations are performed at the same time in different operating rooms. There are several advantages of living donor liver transplants. The surgery can be scheduled. (About one in six persons who need a new liver dies while waiting for one.) The surgery can be done before the recipient becomes extremely ill. Living donor liver transplantation usually leads to fewer complications, faster recovery and better long-term results than a transplant from a cadaver . However, the procedure is not risk-free for the donor. The risk of the donor dying is about 1 in 350. There is also a 10% risk to the donor of complications including bile leaks, bleeding and infections. Also see: Liver transplant .
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Lungs: The lungs are a pair of breathing organs located with the chest which remove carbon dioxide from and bring oxygen to the blood. There is a right and left lung.
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Marrow: The bone marrow .
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Medication: 1. A drug or medicine. 2. The administration of a drug or medicine. (Note that "medication" does not have the dangerous double meaning of "drug.")
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MELD: Acronym for Model End Stage Liver Disease. A disease severity scoring system for adults with liver disease, designed to improve the organ allocation in transplantation based on the severity of liver disease rather than the length of time on the waiting list. The MELD score is based only on laboratory data in order to be as objective as possible. The laboratory values used are a patient's creatinine , bilirubin , and international normalized ratio , or INR (a measure of blood-clotting time). The pediatric version of MELD is called PELD.
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Mouth: 1. The upper opening of the digestive tract, beginning with the lips and containing the teeth, gums, and tongue. Foodstuffs are broken down mechanically in the mouth by chewing and saliva is added as a lubricant. Saliva contains amylase, an enzyme that digests starch. 2. Any opening or aperture in the body. The mouth in both senses of the word is also called the os, the Latin word for an opening, or mouth. The o in os is pronounced as in hope. The genitive form of os is oris from which comes the word oral.
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Muromonab-CD3: A murine monoclonal antibody . See: OKT3 .
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Muscle: Muscle is the tissue of the body which primarily functions as a source of power. There are three types of muscle in the body. Muscle which is responsible for moving extremities and external areas of the body is called "skeletal muscle." Heart muscle is called "cardiac muscle." Muscle that is in the walls of arteries and bowel is called "smooth muscle."
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Nausea: Nausea, is the urge to vomit. It can be brought by many causes including, systemic illnesses, such as influenza , medications, pain, and inner ear disease. When nausea and/or vomiting are persistent, or when they are accompanied by other severe symptoms such as abdominal pain , jaundice , fever, or bleeding, a physician should be consulted.
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Obese: Well above ones normal weight. A person has traditionally been considered to be obese if they are more than 20 percent over their ideal weight. That ideal weight must take into account the person's height, age, sex, and build.
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Objective: In a microscope, the objective (also called the objective lens) is the lens nearest to the object being examined whereas the lens closest to the eye is termed the ocular (the eyepiece).
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OKT3: Brand name for muromonab-CD3, an immunosuppressant drug given intravenously to reverse acute rejection of transplanted organs, including the heart, kidneys and liver. OKT3 was the first monoclonal antibody used to treat patients.
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Organ: A relatively independent part of the body that carries out one or more special functions. The organs of the human body include the eye , ear , heart , lungs , and liver .
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Osteoporosis: Thinning of the bones with reduction in bone mass due to depletion of calcium and bone protein . Osteoporosis predisposes a person to fractures, which are often slow to heal and heal poorly. It is more common in older adults, particularly post-menopausal women; in patients on steroids; and in those who take steroidal drugs. Unchecked osteoporosis can lead to changes in posture , physical abnormality (particularly the form of hunched back known colloquially as " dowager's hump "), and decreased mobility.
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Outpatient: A patient who is not an inpatient (not hospitalized) but instead is cared for elsewhere -- as in a doctor's office, clinic, or day surgery center. The term outpatient dates back at least to 1715. Outpatient care today is also called ambulatory care .
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Oxygen: A colorless, odorless and tasteless gas that makes up about 20% of the air we breathe (and at least half the weight of the entire solid crust of the earth) and which combines with most of the other elements to form oxides. Oxygen is essential to human, animal and plant life.
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Pain: An unpleasant sensation that can range from mild, localized discomfort to agony. Pain has both physical and emotional components. The physical part of pain results from nerve stimulation. Pain may be contained to a discrete area, as in an injury, or it can be more diffuse, as in disorders like fibromyalgia . Pain is mediated by specific nerve fibers that carry the pain impulses to the brain where their conscious appreciation may be modified by many factors.
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Pediatric: Pertaining to children.
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PELD: Pediatric End-Stage Liver Disease. A disease severity scoring system for children under 18 years of age, designed to improve the organ allocation in transplantation based on the severity of liver disease rather than time on the waiting list. The PELD score is based on both laboratory data and growth data. The laboratory values are a patient's albumin , bilirubin , and international normalized ratio , or INR (a measure of blood-clotting time). These values are used together with the patient's degree of growth failure to determine the PELD score. The adult version of PELD is called MELD .
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Peritonitis: Inflammation of the peritoneum (The peritoneum is the tissue layer of cells lining the inner wall of the abdomen and pelvis). Peritonitis can result from infection (such as bacteria or parasites), injury and bleeding, or diseases (such as systemic lupus erythematosus ).
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Pharmacy: A location where prescription drugs are sold. A pharmacy is, by law, constantly supervised by a licensed pharmacist.
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Pneumocystis: Pneumocystis jiroveci (previously classified as Pneumocystis carinii), the fungus that causes pneumocystis pneumonia ( PCP ). Pneumocystis jiroveci is found worldwide, in humans and animals. Serologic evidence indicates that most healthy children have been exposed to it by age 3 to 4. Pneumocystis pneumonia (PCP) occurs in immunosuppressed individuals and in premature, malnourished infants.
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Pneumocystis carinii: Now called Pneumocystis jiroveci. See: Pneumocystis .
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Pneumonia: Inflammation of one or both lungs with consolidation. Pneumonia is frequently but not always due to infection. The infection may be bacterial, viral, fungal or parasitic. Symptoms may include fever, chills, cough with sputum production, chest pain, and shortness of breath.
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Poisoning: Taking a substance that is injurious to health or can cause death. Poisoning is still a major hazard to children, despite child-resistant (and sometimes adult-resistant) packaging and dose-limits per container.
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Polio: Abbreviation for poliomyelitis, an acute and sometimes devastating disease caused by a virus. Man is the only natural host for polio virus. The virus enters the mouth and multiplies in lymphoid tissues in the throat and intestine. Small numbers of virus enter the blood and go to other sites where the virus multiplies more extensively. Another round of viremia (virus in the bloodstream) leads to invasion of the central nervous system (CNS), the spinal cord and brain, the target sites struck by the virus.
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Potassium: The major positive ion (cation) found inside of cells. The chemical notation for potassium is K+.
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PPD: 1. Postpartum depression . 2. Purified protein derivative (the PPD skin test for tuberculosis ).
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Pregnancy : The state of carrying a developing embryo or fetus within the female body. This condition can be indicated by positive results on an over-the-counter urine test, and confirmed through a blood test, ultrasound, detection of fetal heartbeat, or an X-ray. Pregnancy lasts for about nine months, measured from the date of the woman's last menstrual period (LMP). It is conventionally divided into three trimesters, each roughly three months long.
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Pregnant: The state of carrying a developing fetus within the body.
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Primary: First or foremost in time or development. The primary teeth (the baby teeth) are those that come first. Primary may also refer to symptoms or a disease to which others are secondary.
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Probability: The likelihood that something will happen. For example, a probability of less than .05 indicates that the probability of something occurring by chance alone is less than 5 in 100, or 5 percent. This level of probability is usually taken as the level of biologic significance, so a higher incidence may be considered meaningful. The abbreviation for probability is P.
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Prograf: Brand name of tacrolimus. See: Tacrolimus .
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Protein: A large molecule composed of one or more chains of amino acids in a specific order determined by the base sequence of nucleotides in the DNA coding for the protein.
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Proteins: Large molecules composed of one or more chains of amino acids in a specific order determined by the base sequence of nucleotides in the DNA coding for the protein.
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Psychiatrist: A physician (an M.D.) who specializes in the prevention , diagnosis, and treatment of mental illness . Psychiatrists must receive additional training and serve a supervised residency in their specialty. They may also have additional training in a psychiatric specialty, such as child psychiatry or neuropsychiatry. They can prescribe medication, which psychologists cannot do.
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Pulse: The rhythmic contraction and expansion of an artery due to the surge of blood from the beat of the heart. The pulse is most often measured by feeling the arteries of the wrist. There is also a pulse, although far weaker, in veins.
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Quality of life: An important consideration in medical care, quality of life refers to the patient's ability to enjoy normal life activities. Some medical treatments can seriously impair quality of life without providing appreciable benefit, while others greatly enhance quality of life.
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Rash : Breaking out (eruption) of the skin. Medically, a rash is referred to as an exanthem.
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Recipient: In medicine, a recipient is someone who receives something like a blood transfusion or an organ transplant. The recipient is beholden to the donor.
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Registry: Although a registry was originally the place (like Registry House in Edinburgh) where information was collected (in registers), the word registry has also come to mean the collection itself. A registry is usually organized so the data can be analyzed. For example, analysis of data in a tumor registry maintained at a hospital may show a rise in lung cancer among women.
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Rejection: In transplantation biology, the refusal by the body to accept transplanted cells, tissues or organs. For example, a kidney transplanted may be rejected.
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Rest: 1. Repose. Relaxation.
2. A fragment of embryonic tissue that has been retained after the period of embryonic development. Also called an embryonic rest.
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Scan: As a noun, the data or image obtained from the examination of organs or regions of the body by gathering information with a sensing device.
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Sensation: In medicine and physiology , sensation refers to the registration of an incoming ( afferent ) nerve impulse in that part of the brain called the sensorium , which is capable of such perception. Therefore, the awareness of a stimulus as a result of its perception by sensory receptors. (Sensory is here synonymous with sensation.)
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Shingles: An acute infection caused by the herpes zoster virus, the same virus as causes chickenpox. Shingles is most common after the age of 50 and the risk rises with advancing age. Shingles occurs because of exposure to chickenpox or reactivation of the herpes zoster virus. The virus remains latent (dormant) in nerve roots for many years following chickenpox.
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Sign: Any objective evidence of disease. Gross blood in the stool is a sign of disease. It can be recognized by the patient, doctor, nurse, or others. In contrast, a symptom is, by its nature, subjective. Abdominal pain is a symptom. It is something only the patient can know.
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Sirolimus: A naturally occurring substance discovered in a soil sample from Easter Island. Sirolimus was initially thought to hold promise as an antifungal antibiotic but this idea was dropped when sirolimus was unexpectedly found to have immunosuppressive activity. The US Food and Drug Administration in 1999 approved the use of sirolimus as an immunosuppressant agent. But earlier in the nineties, evidence had been uncovered that sirolimus was also a potent inhibitor of the growth of smooth muscle cells in blood vessels. The idea was then "hatched" that sirolimus might be used to inhibit the restenosis (reclosure) of coronary arteries. (Today, after a balloon angioplasty has been done to open a clogged coronary artery, a mesh tube called a stent is often inserted to keep the artery open. However, restenosis occurs in up to a third of cases when smooth muscle cells migrate from the vessel wall into the stent. The muscle cells proliferate there and narrow the interior diameter of the stent.) To prevent restenosis, stents coated, or "medicated", with sirolimus came into use. The sirolimus is eluted continuously from the stent and deters or slows restenosis.
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Skin: The skin is the body's outer covering. It protects us against heat and light, injury, and infection. It regulates body temperature and stores water, fat, and vitamin D. Weighing about 6 pounds, the skin is the body's largest organ. It is made up of two main layers; the outer epidermis and the inner dermis.
Sleep : The body's rest cycle.
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Spleen: An organ located in the upper left part of the abdomen near the stomach . The spleen produces lymphocytes ; it is the largest lymphatic organ in the body. The spleen also filters the blood, serves as a major reservoir for blood and destroys blood cells that are aged.
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Sputum: The mucus and other matter brought up from the lungs , bronchi , and trachea that one may cough up and spit out or swallow. The word "sputum" is borrowed directly from the Latin "to spit." Called also expectoration.
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Stage: As regards cancer , the extent of a cancer, especially whether the disease has spread from the original site to other parts of the body. See also: Staging .
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Stenosis: A narrowing, as in:
Steroid: A general class of chemical substances that are structurally related to one another and share the same chemical skeleton (a tetracyclic cyclopenta[a]phenanthrene skeleton).
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Stomach: 1. The sac-shaped digestive organ that is located in the upper abdomen, under the ribs. The upper part of the stomach connects to the esophagus, and the lower part leads into the small intestine.
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Substance: 1. Material with particular features, as a pressor substance .
2. The material that makes up an organ or structure. Also known in medicine as the substantia.
3. A psychoactive drug as, for example, in substance abuse .
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Substance abuse: The excessive use of a substance, especially alcohol or a drug. (There is no universally accepted definition of substance abuse.)
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Surgeon: A physician who treats disease, injury, or deformity by operative or manual methods. A medical doctor specialized in the removal of organs, masses and tumors and in doing other procedures using a knife (scalpel). The definition of a "surgeon" has begun to blur in recent years as surgeons have begun to minimize the cutting, employ new technologies that are "minimally invasive," use scopes, etc.
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Surgery: The word "surgery" has multiple meanings. It is the branch of medicine concerned with diseases and conditions which require or are amenable to operative procedures. Surgery is the work done by a surgeon. By analogy, the work of an editor wielding his pen as a scalpel is s form of surgery. A surgery in England (and some other countries) is a physician's or dentist's office.
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Swallowing tube: Descriptive term for the esophagus. See: Esophagus .
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Tacrolimus: A drug that suppresses the immune system and prevents transplant rejection . The drug acts by inhibiting the activation of T cells .
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Temple: An area just behind and to the side of the forehead and the eye, above the side of the check bone (the zygomatic arch) and in front of the ear.
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Therapy: The treatment of disease .
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Throat: The throat is the anterior (front) portion of the neck beginning at the back of the mouth , consisting anatomically of the pharynx and larynx . The throat contains the trachea and a portion of the esophagus .
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Tired: A feeling of a lessened capacity for work and reduced efficiency of accomplishment, usually accompanied by a sense of weariness and fatigue.
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Tiredness: See: Tired .
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Tissue: A tissue in medicine is not like a piece of tissue paper. It is a broad term that is applied to any group of cells that perform specific functions. A tissue in medicine need not form a layer. Thus,
Tongue: The tongue is a strong muscle anchored to the floor of the mouth. It is covered by the lingual membrane which has special areas to detect tastes.
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Trachea: A tube-like portion of the breathing or "respiratory" tract that connects the "voice box" (larynx) with the bronchial parts of the lungs.
Transplant: The grafting of a tissue from one place to another, just as in botany a bud from one plant might be grafted onto the stem of another. The transplanting of tissue can be from one part of the patient to another (autologous transplantation), as in the case of a skin graft using the patient's own skin; or from one patient to another (allogenic transplantation), as in the case of transplanting a donor kidney into a recipient.
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Trauma: Any injury , whether physically or emotionally inflicted. "Trauma" has both a medical and a psychiatric definition. Medically, "trauma" refers to a serious or critical bodily injury, wound, or shock . This definition is often associated with trauma medicine practiced in emergency rooms and represents a popular view of the term. In psychiatry , "trauma" has assumed a different meaning and refers to an experience that is emotionally painful, distressful, or shocking, which often results in lasting mental and physical effects.
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Troche: A small medicated lozenge designed to dissolve. For example, to soothe the throat as a cough drop.
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Tuberculosis : A highly contagious infection caused by the bacterium called Mycobacterium tuberculosis. Abbreviated TB. Tubercles (tiny lumps) are a characteristic finding in TB. Diagnosis may be made by skin test, which if positive should will be followed by a chest X-ray to determine the status (active or dormant) of the infection. Tuberculosis is more common in people with immune system problems, such as AIDS, than in the general population. Treatment of active tuberculosis is mandatory by law in the US, and should be available at no cost to the patient through the public health system. It involves a course of antibiotics and vitamins that lasts about six months. It is important to finish the entire treatment, both to prevent reoccurrence and to prevent the development of antibiotic-resistant tuberculosis. Most patients with tuberculosis do not need to be quarantined, but it is sometimes necessary.
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Tylenol: See: Acetaminophen .
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Ultrasound : High-frequency sound waves. Ultrasound waves can be bounced off of tissues using special devices. The echoes are then converted into a picture called a sonogram. Ultrasound imaging, referred to as ultrasonography, allows physicians and patients to get an inside view of soft tissues and body cavities, without using invasive techniques. Ultrasound is often used to examine a fetus during pregnancy . There is no convincing evidence for any danger from ultrasound during pregnancy.
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UNOS: Acronym for the United Network for Organ Sharing, the nationwide umbrella for transplantation organ sharing in the U.S.
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Unwell: Not well or in good health, ailing, sick, indisposed. For example, "I am well-nigh choked with the sulfurous heat of the weather -- or I am unwell." (1826, Journal of Sir Walter Scott)
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Urine: Liquid waste. The urine is a clear, transparent fluid. It normally has an amber color. The average amount of urine excreted in 24 hours is from 40 to 60 ounces (about 1,200 cubic centimeters). Chemically, the urine is mainly an aqueous (watery) solution of salt (sodium chloride) and substances called urea and uric acid. Normally, it contains about 960 parts of water to 40 parts of solid matter. Abnormally, it may contain sugar (in diabetes), albumen (a protein) (as in some forms of kidney disease), bile pigments (as in jaundice ), or abnormal quantities of one or another of its normal components.
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Vaccines: Microbial preparations of killed or modified microorganisms that can stimulate an immune response in the body to prevent future infection with similar microorganisms. These preparations are usually delivered by injection.
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Vagina: The muscular canal extending from the cervix to the outside of the body. It is usually six to seven inches in length, and its walls are lined with mucus membrane . It includes two vaultlike structures, the anterior (front) vaginal fornix and the posterior (rear) vaginal fornix . The cervix protrudes slightly into the vagina, and it is through a tiny hole in the cervix (the os) that sperm make their way toward the internal reproductive organs. The vagina also includes numerous tiny glands that make vaginal secretions.
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Vaginal discharge: Vaginal discharge is a fluid produced by glands in the vaginal wall and cervix that drains from the opening of the vagina . The amount and appearance of normal vaginal discharge varies throughout the menstrual cycle . An increase in the amount of vaginal discharge, an abnormal odor or consistency of the fluid, or pain that accompanies vaginal discharge can all be signs of infection or other disorders. Such disorders include (this is not an all inclusive list) bacterial vaginosis , yeast vaginitis , and vaginitis .
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Vaginal yeast infection: Infection of the vagina caused by a fungus known as Candida. A yeast vaginal infection is characterized by itching, burning, soreness, pain during intercourse and/or urination, and vaginal discharge that is typically cheesy white in color. The diagnosis is confirmed through identification of the yeast under a microscope from a specimen scraped from the vaginal area. A yeast vaginal infection that is causing symptoms is treated with topical medications applied in and around the vagina and with medications taken by mouth. Topical antibiotic creams include butoconazole (Femstat 3), clotrimazole (Lotrimin), miconazole (Monistat), and terconazole (Terazol 3). Clotrimazole, miconazole, terconazole, and nystatin (Mycostatin) are also available as vaginal tablets. Oral antibiotics for yeast vaginitis include fluconazole (Diflucan). During pregnancy, only the topical creams are used.
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Viral: Of or pertaining to a virus. For example, "My daughter has a viral rash ."
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Virus: A microorganism smaller than a bacteria, which cannot grow or reproduce apart from a living cell. A virus invades living cells and uses their chemical machinery to keep itself alive and to replicate itself. It may reproduce with fidelity or with errors (mutations)-this ability to mutate is responsible for the ability of some viruses to change slightly in each infected person, making treatment more difficult.
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Viruses: Small living particles that can infect cells and change how the cells function. Infection with a virus can cause a person to develop symptoms. The disease and symptoms that are caused depend on the type of virus and the type of cells that are infected.
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Vital: Necessary to maintain life. Breathing is a vital function.
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Vitamins: The word "vitamin" was coined in 1911 by the Warsaw-born biochemist Casimir Funk (1884-1967). At the Lister Institute in London, Funk isolated a substance that prevented nerve inflammation (neuritis) in chickens raised on a diet deficient in that substance. He named the substance "vitamine" because he believed it was necessary to life and it was a chemical amine. The "e" at the end was later removed when it was recognized that vitamins need not be amines.
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White blood cell: One of the cells the body makes to help fight infections. There are several types of white blood cells ( leukocytes ). The two most common types are the lymphocytes and neutrophils (also called polymorphonuclear leukocytes, PMNs, or "polys").
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White blood cell count (leukocyte count): The number of white blood cells (WBCs) in the blood. The WBC is usually measured as part of the CBC ( complete blood count ). White blood cells are the infection-fighting cells in the blood and are distinct from the red (oxygen-carrying) blood cells known as erythrocytes. There are different types of white blood cells, including neutrophils (polymorphonuclear leukocytes ; PMNs), band cells (slightly immature neutrophils), T-type lymphocytes (T cells), B-type lymphocytes (B cells), monocytes, eosinophils, and basophils. All the types of white blood cells are reflected in the white blood cell count. The normal range for the white blood cell count varies between laboratories but is usually between 4,300 and 10,800 cells per cubic millimeter of blood. This can also be referred to as the leukocyte count and can be expressed in international units as 4.3 - 10.8 x 109 cells per liter.
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X-ray: 1. High-energy radiation with waves shorter than those of visible light. X-rays possess the properties of penetrating most substances (to varying extents), of acting on a photographic film or plate (permitting radiography), and of causing a fluorescent screen to give off light (permitting fluoroscopy). In low doses X-rays are used for making images that help to diagnose disease, and in high doses to treat cancer . Formerly called a Roentgen ray. 2. An image obtained by means of X-rays.
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Yeast: A group of single-celled fungi that reproduce by budding.
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Yeast infection: Overgrowth of yeast can affect the skin (yeast rash ), mouth (thrush), digestive tract, esophagus, vagina ( vaginitis ), and other parts of the body. Yeast infections occur most frequently in moist areas of the body. Although Candida albicans and other Candida yeasts are the most frequent offenders, other yeast groups are known to cause illness, primarily in immunocompromised patients. These include Torulopsis, Cryptococcus, Malassezia, and Trichosporon yeasts. Diagnosis is by observation, and can be confirmed by culturing a stool or mucosa sample, or a scraping from the affected area. Treatment is by topical or oral antifungal medications. Acidophilous, a helpful bacteria that normally helps to keep yeast in check, can also be tried in supplement form or in yogurt with live cultures.
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