case counselling may help, or it may be
a complication of a disorder such as
diabetes mellitusor alcohol dependence.
In some cases, inhibited ejaculation oc-
curs as a side effect of particular drugs,
such as some antihypertensive and anti-
depressant drugs.
In retrograde ejaculation, the valve at
the base of the bladder, which normally
closes during ejaculation, stays open.
As a result, ejaculate is forced back into
the bladder. Retrograde ejaculation may
occur as a result of a neurological dis-
ease, after surgery on the bladder or
prostatectomy. There is no treatment,
but intercourse with a full bladder can
sometimes result in normal ejaculation.
(See also azoospermia; psychosexual
dysfunction;sexual problems.)
elbowThe hinge joint formed where the
lower end of the humerusmeets the
upper ends of the radiusand ulna. The
elbow is stabilized by ligamentsat the
front, back, and sides. It enables the
arm to be bent and straightened, and
the forearm to be rotated through
almost 180 degrees around its long axis
without more than very slight move-
ment of the upper arm.
Disorders of the elbow include arthri-
tisand injuries to the joint and its
surrounding muscles, tendons, and lig-
aments. Repetitive strain on the tendons
of the muscles of
the forearm, where
they attach to the
elbow, can result
in an inflammation
that is known as
epicondylitis. There
are 2 principle types
of epicondylitis: ten-
nis elbowand golfer’s
elbow. Alternatively,
a sprainof the lig-
aments may occur.
Olecranon bursitis
develops over the
tip of the elbow in
response to local
irritation. Strain on
the joint can produce an effusionor
traumatic synovitis. A fall on to the
hand or on to the elbow can cause a
fracture or dislocation.elderly, care of theAppropriate care
to help minimize physical and mental
deterioration in the elderly. For exam-
ple, failing vision and hearing are often
regarded as inevitable in old age, but
removal of a cataractor use of a hear-
ing-aidcan often improve quality of life.
Isolation or inactivity leads to depres-
sionin some elderly people. Attending a
day-care centre can provide social con-
tact and introduce new interests.
Many elderly people are cared for by
family members. Voluntary agencies
can often provide domestic help to ease
the strain on carers. Sheltered housing
allows independence while providing
assistance when needed. Elderly people
who have dementiaor physical disabili-
ty usually require supervision in a
residential care or hospital setting. (See
also geriatric medicine.)
electiveA term used to describe a pro-
cedure, usually a surgical operation,
that is not urgent and can be performed
at a scheduled time.
electrical injuryDamage to the tis-
sues caused by the passage of an
electric current through the body and by
its associated heat release. The internal
tissues of the body, being moist and
salty, are good conductors of electricity.
Dry skin provides a high resistance to
current flow, but moist skin has a low
resistance and thus allows a substantial
current to flow into the body. Serious
injury or death from domestic voltage
levels is thus more likely to occur in the
presence of water.
All except the mildest electric shocks
may result in unconsciousness. Alter-
nating current (AC) is more dangerous
than direct current (DC) because it
causes sustained muscle contractions,
which may prevent the victim from let-
ting go of the source of the current. A
current as small as 0.1 of an amp pass-
ing through the heart can cause a fatal
arrhythmia. The same current passing
through the brainstemmay cause the
heart to stop beating and breathing to
cease. Larger currents, generated by
high voltages, may cause charring of tis-
sues, especially where the current
enters and exits the body.
electric shock treatmentSee ECT.ELBOW ELECTRIC SHOCK TREATMENTE
UlnaRadiusHumerusELBOWOlecranon process