Atypical disease development is a deviation from above destribed periodicity. The following basic forms of atypical disease development are known: relapse, remission, exacerbation, complication, abortive form and slight form.
Relapse (or recidivation) is a recurrence of the morbid phenomena after seeming recovery. Cause of relapse is the same as one of the primary basic disease. Relapse may be often observed
1) in infectious diseases not providing the steady immune resistance;
2) as a consequence of action of provoking factors decreasing organisms resistance (for example, professional and other intoxications, overcooling, psychic strain, bad conditions of life and etc.);
3) as a result of incomplete cure.
To prevent relapse of disease it is necessary:
1) rational treatment of the primary acute disease,
2) elimination of actions decreasing organism resistance and using of ones increasing it.
Remission is weakening of morbid phenomena in result of successful clinical cure or hightening of non-specific resistance of organism. In infectious and psychic disease remission may be natural phase of the disease and a constituent of its cyclic development. The following types of remission are known: (i) complete or incomplete; (ii) long (stable) or short-term.
In chronic disease stable and complete remission may last for several years but it should not regarded as recovery. So the physician have to undertake measures for prevention of relapse.
Excerbation (or acute condition) is enhancing of disease manifestation. As a rule it is peculiar to chronic diseases but may also occur in acute ones. It arises as a result of cure stopping and decreasing in general organism's resistance.
Complication is a quite new disease arising in the organism weakened in result of the primary basic disease. It may arise during of the periods of marked manifestation and the recovery.
For example, influenza virus decreases in resistance of the pulmonary tissue and in result of it pneumococcus may cause pneumonia as the complication of influenza.
To prevent complication it is necessary to provide:
1) rational cure of basic disease;
2) maintanence of defensive possibilities or organism;
3) favorable conditions of functioning of open to injury organs.
Slight (effaced) forms. Weak expression of detectable morbid phenomena even in the period of marked signs characterizes the slight (effaced) form of disease. In this case it is difficult to diagnosticate disease correctly and begin the treatment in time.
Abortive form. Short duration of pathologic manifestations in the most of diseases. In this case it is necessary to take into consideration that structural changes in tissues and organs may persist for a long period after disappearance of disease manifestations. Therefore, appropriate treatment and regimen must be continued in due manner.
The main principles of disease classification.
Diseases are divided according to:
1) etiology into infectious, uninfectious, traumatic, professional and etc.;
2) primary pathogenesis mechanism into diseases with primary physiological mechanism of pathogenesis and diseases with primary genetic lesions;
3) level of injury to functioning structures into: molecular, chromosome, cellular, tissue, organ and systemic diseases;
4) changes of immune reactivity into allergic, non-allergic, immune defficiences;
5) prevalent injury of organs and systems or organism into: diseases of the heart and vessels; the respiratory diseases, diseases of degestive system and so on;
6) clinical cure method into: surgery diseases, therapeutic diseases and so on;
7) patient's age into: infantile diseases, children's diseases, diseases of adults and etc.;
8) sex into femal and male diseases;
9) disease duration into acute, subacute and chronic; 10) international statistic classification.
Acute diseases last a short time - from several days to 2-3 weeks, subacute - from 3 to 6 weeks; chronic diseases are last more infrequently results of acute disease and last more than 6 weeks. However, these periods cannot be definitely fixed. The duration of a disease depends on the characterstics of the infective agent and the intensity and duration of its action on the given organism, as well as onthe properties of the infected organism.
The international Statistic Classifiction of diseases was affirmed by World Health Service Organization in 1975. It is the certain system of distribution and grouping of diseases and pathologic states according to special criterions, namely: the etiology, morbid anatomy, basic localization of changes in organs and systems. The statistic classificaton of diseases is used for analysis of disease incidence and mortality of population in different countries over the world.
Death
Death is extinction and stopping of vital functions of organism. This is a process having certain dynamics. The principal periods of dying are called "terminal states". They are: 1) pre-agony, 2) terminal pause, 3) agony, 4) clinical death (reversible), 5) biological death (irreversible).
Pre-agony has different duration (hours, days). Dyspnea, drop in arterial pressure, tachycardia, disorder in consciousness characterize this period. Pre-agony is followed by agony.
Agony (from the Greek word "agon" - struggle) is charactarized by the progressive ex-unction of vital functions, namely, by disordered activity of the central nervous system and disturbances in all the vital functions of the organism - irregular and intermittent respiration, weakened heart action, relaxation of the sphincters, drop in temperature and, not infrequently, loss of consciousness. Agony preceeds clinical death and may last from several minutes to hours.
Clinical death is the state when all vital functions are stopped and the signs of life are disappeared. This state is characterized by the deepest depression of the functions of CNS. The metabolic processes are noticeably disturbed, the energy reserves become depleted, but the changes in the tissues are still reversible, for which reason restoration of the vital functions of the organism is sometimes possible during clinical death which lasts 5-6 minutes. But with the appearance of irreversible changes in the tissues, which first occur in the higher parts of CNS, a state of biological or true death sets in.