Glossary - P

Polycythemia vera

Polycythemia vera is a clonal cell hematologic malignant disorder with excessive erythroid, myeloid and megakaryocytic elements in the bone marrow. It is one of a group of myeloproliferative disorders affecting the Hemic/Lymphatic/Immunologic system. There is no known genetic pattern. The incidence of the disease in the United States is 0.5 per 100,000 people. The predominant age affected is from the middle to the late years. The mean age is 60 years. Males are slightly more susceptible to the disease than women. The early stages may produce no symptoms. Symptoms in the later stages include headache, tinnitus, vertigo, blurred vision, epistaxis, increased blood viscosity, spontaneous bruising, upper gastro-intestinal bleeding, peptic ulcer disease, arterial and venous occlusive events, pruritus, sweating, weight loss, plethora (face,hand,feet), splenomegaly, hepatomegaly, hyperhistaminemia, bone pain and/or bone tenderness. While the causes are unknown, the origin of all three hematopoietic cell lines originate in a single clone. Those with Jewish ancestry, or familial history are more likely to contract the disease.

Pharyngitis

Pharyngitis is the inflammation of the pharynx most commonly caused by acute infection. Group A streptococcus is a focus of diagnosis due to its potential for preventable rheumatic sequelae. The gastrointestinal system is effected. Individuals with a positive family history of rheumatic fever have a higher risk of rheumatic sequelae following an untreated group A beta hemolytic streptococcal infection. In the US there is an estimated 30 million cases diagnosed annually. 11% of all school age children visit a physician annually with pharyngitis. Between 12 and 25% of sore throats seen by a physician are diagnosed as pharyngitis. Incidence of rheumatic fever is decreasing with estimate of 64 cases per 100,000. Pharyngitis occurs in all age groups. Streptococcal infection has the greatest incidence between 5 and 18 years of age. Male and female are equally susceptible to the disease. Signs and symptoms include, sore throat, enlarged tonsils, pharyngeal erythema, tonsillar exudates, soft palate petechiae, cervical adenopathy, absence of cough hoarseness or lower respiratory symptoms, fever, scarlet fever rash, gray pseudomembrane found in diphtheria, anorexia, chills, malaise headache and characteristic erythematous based clear vesicles and herpes stomatitis. Causes for acute- bacterial include, group A beta-hemolytic streptococci, neisseria gonorrhoeae, corynebacterium diptheriae, haemophilus influenzae, moraxella catarrhalis, and group C and G streptococcus (rarely). Causes of the acute virus include, rhinovirus, adenovirus, parainfluenza virus, coxsackievirus, coronavirus, echovirus, herpes simplex virus, Epstein-Bar virus, and cytomegalovirus. Cause for chronic include, chemical irritation, and neoplasms and vasculitides. Risk factors include group A beta hemolytic streptococcal epidemics, age, family history, close quarters, immunosuppression, fatigue, smoking, excess alcohol consumption, oral sex, diabetes mellitus and a recent illness.

Proctitis

Proctitis is an acute or chronic inflammation of the rectal mucosa. It affects the gastrointestinal system. Jews have a high incidence. The incidence in the United States is 0.5-3/100,000, while the prevalence is 10-30/100,000. The predominant age affected are adults, males more than females. The signs and symptoms of the disease include rectal and/or mucous discharge, tenesmus urgency constipation, fever, weight loss and weight loss. Causes include idiopathic, rectal gonorrhea, Crohns disease, syphilis, nonspecific sexually transmitted infection, herpes simplex, chlamydia. papillomavirus, amebiasis, lymphogranuloma venereum, ischemia, radiation therapy, toxins and/or vasculitis. Those at risk have had rectal intercourse, been exposed to radiation, have had a rectal injury and/or rectal medications.

Pruritus

Pruritus ani is an intense chronic itching in the anal and perianal skin. Its usual course is acute. Chronic pruritus ani is a symptom, not a diagnosis or disease. It affects the skin/exocrine system. There is no known genetic pattern. It is a common disorder in the USA and affects all ages. Males are more susceptable to the disease. Signs and symptoms include, rectal and anal itching, anal erythema, anal fissures, maceration, lichenification, excoriations, candidiasis and tinea. The dermatologic disorders are caused by allergies, fistulas, fissures, neoplasms, psoriasis, eczema, seborrheic dermatitis and contact dermatitis. Causes of an infection include, pinworms and other worms, scabies andf pediculosis. Other causes include, poor hygiene, diabetes mellitus, chronic liver disease, diarrheic alkalotic irritation and trauma from scented toilet paper. Risk factors include, overweight, hairy and tendency to perspire a great deal, and anxiety-itch-anxiety cycle.

 

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