chronic disease chronic disease type lung disease characterized long term poor main symptoms include breath production typically time eventually walking stairs carrying things difficult chronic older terms different types term chronic define productive present months year years tobacco smoking common cause number factors air pollution playing smaller role developing world common sources air pollution poorly heating cooking fires long term exposure causes response lungs resulting small breakdown lung tissue diagnosis based poor measured lung function tests contrast reduction improve use cases prevented reducing exposure risk factors includes decreasing rates smoking improving indoor outdoor air quality treatment slow cure treatments include stopping smoking respiratory rehabilitation people benefit long term oxygen therapy lung periods acute increased use needed affects million people nearly percent global population typically occurs people age males females affected equally commonly resulted million deaths million deaths deaths occur developing world number deaths projected increase higher smoking rates aging population countries resulted estimated economic cost signs symptoms common symptoms production breath productive symptoms present prolonged period time typically time unclear different types exist previously divided chronic description lung changes disease chronic simply symptoms occur chronic develop months year years combination production explanation definition chronic condition occur fully develops produced change hours days cases present occur occasionally productive people attribute symptoms depending social cultural factors vigorous lead rib brief loss consciousness history common long time breath breath people commonly described breathing requires effort feel breath air different terms different cultures typically breath worse prolonged duration time advanced stages occurs rest present source anxiety poor quality life people advanced breathe lips action improve breath features longer breathe breathe chest occur common caused problem decreased sounds air entry examination chest barrel chest characteristic sign relatively uncommon positioning occur disease advanced leads high pressure lung strains right heart situation referred leads symptoms leg swelling neck veins common lung disease cause common use supplemental oxygen occurs number conditions shared risk factors conditions include heart disease high blood pressure diabetes muscle lung cancer anxiety disorder depression severe disease feeling tired common specific prompt investigations underlying lung cancer acute defined increased breath increased production change color clear green yellow increase present signs increased work breathing fast breathing fast heart rate active use muscles neck bluish skin confusion behavior severe heard lungs examination cause primary cause tobacco smoke exposure pollution indoor fires significant causes countries typically occur decades symptoms develop person genetic makeup affects risk smoking primary risk factor globally tobacco smoking smoke lifelong half united_states united_kingdom current previously smoked likelihood developing increases total smoke exposure additionally women susceptible harmful effects smoke men non smoke cause cases types smoke marijuana cigar water pipe smoke risk women smoke pregnancy increase risk child air pollution poorly cooking fires fueled coal wood animal lead indoor air pollution common causes developing countries fires method cooking heating nearly billion people health effects greater women exposure main source energy homes india china sub africa people live large cities higher rate compared people live rural areas urban air pollution contributing factor overall role cause unclear areas poor outdoor air quality including exhaust gas generally higher rates overall effect relation smoking believed small intense prolonged exposure workplace chemicals increase risk workplace believed cause cases united_states believed related cases smoked probably represent greater risk countries sufficient regulations number industries sources implicated including high levels dust coal mining gold mining cotton textile industry involving working agriculture risk risks estimated equivalent half packs cigarettes day dust exposure lead risk unrelated negative effects dust exposure cigarette smoke exposure appear possibly play role development common relatives smoke unrelated currently clearly inherited risk factor alpha risk particularly high alpha responsible cases condition present people genetic factors investigated likely number factors closely linked risk greater poor clear poverty risk factors associated poverty air pollution tentative evidence increased risk birth factors low birth weight play role number infectious diseases including hiv aids tuberculosis respiratory pneumonia appear increase risk adults acute sudden symptoms commonly triggered infection environmental factors improper use appear cause cases bacteria environmental include poor indoor outdoor air quality exposure personal smoke smoke increases risk cold temperature play role occurring commonly winter severe underlying disease frequent mild disease year moderate year severe year faster rate deterioration lung function blood lungs symptoms pre existing type lung disease chronic poor limitation inability breathe fully air trapping exist poor result breakdown lung tissue known small disease known relative contributions factors vary people severe destruction small lead formation large air pockets known replace lung tissue form disease called develops significant chronic response chronic add state cells involved include types white blood cell smoke additionally involvement people involvement similar cell response brought factors processes involved lung damage include stress produced high concentrations free tobacco smoke released cells breakdown tissue lungs destruction tissue lungs leads contributes poor finally poor absorption release respiratory gases general muscle occurs partly released lungs blood occurs contributes inability breathe fully greatest reduction air flow occurs breathing pressure chest time result air previous breath remaining lungs breath started resulting increase total volume air lungs given time process called air trapping exercise linked breath comfortable breathe lungs partly degree similar found low oxygen levels eventually high carbon dioxide levels blood occur poor gas exchange decreased ventilation reduced desire breathe increased resulting increased reduced gas transfer lead insufficient ventilation eventually low blood oxygen levels low oxygen levels present prolonged period result lungs leads breakdown lungs changes result increased blood pressure cause diagnosis diagnosis considered age breath chronic production frequent winter history exposure risk factors disease confirm diagnosis screening symptoms recommended measures present generally carried use medication open main components measured diagnosis forced volume second greatest volume air second breath forced vital capacity greatest volume air single large breath normally comes second ratio symptoms defines person having disease based measurements lead diagnosis elderly national institute health care excellence criteria additionally require predicted evidence symptoms effort condition earlier uncertain effect currently recommended peak flow maximum speed commonly sufficient diagnosis severity number methods determine affecting given individual modified british medical research council assessment test cat simple determine severity symptoms scores cat range higher score severe disease help determine severity limitation typically based expressed percentage predicted normal person age gender height weight american european guidelines recommended partly basing treatment recommendations gold guidelines suggest dividing people categories based symptoms assessment limitation weight loss muscle weakness presence diseases taken account tests chest ray complete blood count useful exclude conditions time diagnosis characteristic signs ray lungs flattened increased help exclude lung diseases pneumonia high resolution scan chest distribution lungs useful exclude lung diseases surgery planned rarely affects management analysis arterial blood determine need oxygen recommended predicted peripheral oxygen symptoms heart failure areas world common people particularly age affecting lower parts lungs considered testing differential diagnosis need differentiated causes breath heart failure pneumonia people mistakenly think distinction basis symptoms smoking history limitation tuberculosis present chronic considered locations common common conditions present similarly include chronic occur normal situation classified prevention cases potentially decreasing exposure smoke improving air quality annual reduce death beneficial smoking cessation keeping people starting smoking key aspect preventing policies governments public health agencies anti smoking organizations reduce smoking rates people starting encouraging people stop smoking smoking public areas places work important measures decrease exposure smoke places instituted recommended smoke stopping smoking measure shown slow late stage disease reduce rate lung function delay onset disability death smoking cessation starts decision stop smoking leading attempt attempts required long term achieved attempts years lead success nearly people achieve long term smoking cessation smoking highly addictive need support chance improved social support engagement smoking cessation program use replacement therapy health number measures taken reduce likelihood workers risk industries coal mining construction develop examples measures include creation public policy education workers management risks promoting smoking cessation checking workers early signs use dust control effective dust control achieved improving ventilation water mining techniques minimize dust generation worker develops lung damage reduced avoiding ongoing dust exposure example changing work role air pollution indoor outdoor air quality improved prevent slow existing disease achieved public policy efforts cultural changes personal involvement number developed countries successfully improved outdoor air quality regulations resulted improvements lung function populations experience fewer symptoms stay indoors days outdoor air quality poor key effort reduce exposure smoke cooking heating improved ventilation homes better chimneys proper improve indoor air quality alternative energy sources solar cooking electrical heating effective coal bad traditional wood management known cure symptoms progression delayed major goals management reduce risk factors manage stable prevent treat acute manage associated illnesses measures shown reduce mortality smoking cessation supplemental oxygen stopping smoking decreases risk death recommendations include year years reduction exposure environmental air pollution advanced disease care reduce symptoms improving feelings breath ventilation support breathing exercise rehabilitation program exercise disease management counseling coordinated benefit individual recent rehabilitation appears improve overall quality life ability exercise reduce mortality shown improve sense control person disease emotions breathing exercises appear limited role lip breathing exercises useful overweight affect symptoms degree disability people improve breathing muscle strength increasing intake combined regular exercise rehabilitation program lead improvements symptoms supplemental nutrition useful primary result small overall benefit major types exist long acting short acting forms reduce breath exercise limitation resulting improved quality life unclear change progression underlying disease mild disease short acting agents recommended needed basis severe disease long acting agents recommended long acting agents partly work improving long acting insufficient typically added respect long acting agents unclear long acting long acting beta better worth trying continuing worked best types agent appear reduce risk acute time benefit questionable significance short acting available including provide relief symptoms hours long acting maintenance therapy feel evidence benefits limited view evidence benefit established long term use appears safe adverse effects include heart increase risk pneumonia work better unclear slight benefit increased risks main short acting agent long acting associated decrease improved quality life provides benefits better appear affect mortality overall rate cause dry mouth tract symptoms associated increased risk heart disease stroke long acting agent came market alternative usually form treat prevent acute shown benefit people mild decrease acute moderate severe disease effect overall year mortality unclear affect progression disease combination decrease mortality compared associated increased rates pneumonia long term treatment associated significant effects medication long term specifically class reduce frequency year practice cost effective areas world concerns include resistance hearing problems generally cause harm benefit usually recommended second line agent controlled measures help reduce people chronic recommended oxygen supplemental oxygen recommended low oxygen levels rest partial pressure oxygen oxygen group people decreases risk heart failure death hours day improve people ability exercise normal mildly low oxygen levels oxygen improve breath risk fires little benefit oxygen continue smoke situation recommend use acute require oxygen therapy use high concentrations oxygen taking account person oxygen lead increased levels carbon dioxide worsened outcomes high risk high carbon dioxide levels oxygen recommended risk recommended levels surgery severe disease surgery helpful include lung lung volume reduction surgery lung volume reduction surgery involves removing parts lung damaged allowing remaining relatively good lung expand work better lung performed severe particularly younger individuals acute typically treated increasing usage short acting commonly includes combination short acting beta given dose appearing equally effective easier oral improve chance recovery decrease overall duration symptoms work equally appear fewer effects days work fourteen severe improve outcomes number different including unclear better recommends use options available higher risks effects clear evidence severe cases type respiratory failure raised levels non invasive positive pressure ventilation decreases probability death need intensive care admission additionally role respond measures fewer require hospital admission respiratory failure home care hospital home able help avoid usually gets gradually worse time ultimately result death estimated disability related proportion disability globally decreased improved indoor air quality primarily asia overall number years lived disability increased rate varies presence factors predict poor outcome including severe little ability exercise breath significantly overweight heart failure continued smoking frequent long term outcomes estimated index gives score zero depending body mass index distance walked minutes modified scale significant weight loss bad sign results good future progress disease good index globally affected approximately million people population disease affects men women equally increased tobacco use women developed world increase developing world 2000s believed related increasing rates smoking region increasing population aging population fewer deaths causes infectious diseases developed countries seen increased rates remained stable seen decrease prevalence global numbers expected continue increasing risk factors remain common population continues older number deaths decreased slightly million million fourth leading cause death leading cause number deaths rose million countries mortality decreased men increased women likely rates smoking women men similar common older people affects people older years depending population review england estimated million people million diagnosis translates approximately person receiving diagnosis point lives deprived parts country people diagnosed compared affluent areas united_states approximately adult population totaling approximately million people diagnosed million people currently cases included approximately united_states united state estimated leading cause death history word derived greek meaning composed meaning meaning breath blast term chronic came use term believed previously known number different names including chronic disease chronic respiratory disease chronic chronic limitation chronic lung disease chronic disease syndrome terms chronic formally defined guest american society committee meeting standards early descriptions probable include condition lungs lungs particularly air drawings followed pictures matthew descriptions destructive nature condition charles describe excess chronic physician invented term book treatise diseases chest describe lungs collapse opened chest autopsy noted collapse usual air filled john invented allowed measurement vital capacity lungs measure volume described principles measuring george american described new disease named respiratory syndrome journal american medical association association tobacco smoking chronic respiratory disease early treatments included modern treatments developed second half 20th century evidence supporting use published late 1950s came use 1960s following promising trial developed 1970s use began mid-1990s society culture referred lung people known pink type frequent pink fast respiratory rate lips people chronic referred blue type bluish color skin lips low oxygen levels ankle swelling terminology longer accepted useful people combination chronic health systems difficulty ensuring appropriate identification diagnosis care people britain department health identified major issue national health service introduced specific strategy tackle problems economics globally estimated result economic costs half occurring developing world total estimated direct costs medical care indirect costs missed work expected double year europe represents healthcare spending united_states costs disease estimated billion expensive conditions seen hospitals total cost billion research immune suppressing tested evidence benefit possibility harm shows promise decreasing rate appear change quality life number new long acting agents development treatment stem cells study tentative data safe promising animal data little human data human data available found poor results animals chronic disease occur number animals caused exposure tobacco smoke cases disease relatively mild horses known severe linked reaction fungus contained contaminated hay straw commonly found old dogs


pneumonia pneumonia condition lung affecting primarily microscopic air known typical signs symptoms include varying severity combination productive dry chest pain fever trouble breathing depending underlying cause pneumonia usually caused infection bacteria commonly certain conditions diseases risk factors include lung diseases diabetes heart failure history smoking poor ability following stroke weak immune system diagnosis based symptoms physical examination chest ray blood tests culture help confirm diagnosis disease classified acquired community hospital health care associated pneumonia prevent certain types pneumonia available methods prevention include smoking treatment depends underlying cause pneumonia believed bacteria treated pneumonia severe affected person generally hospitalized oxygen therapy oxygen levels low pneumonia affects approximately million people globally population results million deaths year pneumonia regarded william 19th century captain men death introduction 20th century survival improved developing countries old young ill pneumonia remains leading cause death pneumonia suffering close death called old man friend signs symptoms people infectious pneumonia productive fever accompanied shaking breath sharp stabbing chest pain deep increased rate breathing elderly confusion prominent sign typical signs symptoms children fever fast difficult breathing fever specific occurs common illnesses absent severe disease elderly addition frequently absent children months old severe signs symptoms children include blue tinged skin drink ongoing extremes temperature decreased level consciousness viral cases pneumonia usually present similar symptoms causes associated classic non specific clinical characteristics pneumonia caused occur abdominal pain confusion pneumonia caused associated colored pneumonia caused bloody described bloody known occur tuberculosis negative pneumonia lung commonly acute pneumonia occur association swelling neck joint pain middle ear infection viral pneumonia presents commonly pneumonia pneumonia historically divided typical based belief presentation predicted underlying cause evidence supported distinction longer emphasized cause pneumonia caused primarily bacteria commonly fungi parasites strains infectious agents identified responsible majority cases mixed bacteria occur children adults agent isolated approximately half cases despite careful testing term pneumonia broadly applied condition resulting lungs caused example diseases chemical burns drug reactions accurately referred conditions risk factors pneumonia include smoking alcoholism chronic disease chronic kidney disease liver disease use acid suppressing pump associated increased risk pneumonia risk increased old age bacteria bacteria common cause community acquired pneumonia cap isolated nearly cases commonly isolated bacteria include cases negative number drug resistant versions common including drug resistant resistant spreading organisms facilitated risk factors present alcoholism associated organisms tuberculosis smoking effects exposure birds associated farm animals stomach contents organisms common winter suspected persons large organisms adults account approximately children pneumonia cases commonly implicated agents include virus respiratory virus virus rarely causes pneumonia groups persons cancer recipients people significant burns people following organ present high rates pneumonia viral infected bacteria particularly health problems present different different periods year season example account half viral cases occasionally occur including fungi fungal pneumonia uncommon occurs commonly individuals weakened immune systems aids drugs medical problems caused pneumonia common mississippi_river basin common southwestern united_states number cases increasing later half 20th century increasing travel rates population parasites variety parasites affect lungs including organisms typically enter body direct contact skin insect parasites affect specifically lungs involve lungs sites parasites particular belonging genera stimulate strong reaction result pneumonia malaria lung involvement primarily induced developed world common people returning travel immigrants world common pneumonia pneumonia class lung diseases include damage organizing pneumonia pneumonia pneumonia pneumonia respiratory lung disease usual pneumonia mechanisms pneumonia frequently starts upper respiratory tract infection moves lower respiratory tract lung combined consolidation liquid spaces normally inflated air viral reach lung number different routes respiratory virus typically contracted people touch contaminated objects touch eyes nose viral occur contaminated airborne mouth nose upper way lungs invade cells lining lung reach lungs blood invasion lungs lead varying degrees cell death immune system responds infection lung damage occur primarily white blood cells mainly cells generate damaging lungs simultaneously affect organs disrupt body functions body susceptible way pneumonia arise condition bacteria enter lungs small aspirations organisms residing throat nose half normal people small aspirations sleep throat contains bacteria potentially infectious ones reside certain times certain conditions minority types bacteria tuberculosis reach lungs contaminated airborne bacteria spread blood lungs bacteria invade spaces cells defensive white blood cells attempt bacteria release causing general activation immune system leads fever fatigue common pneumonia bacteria fluid surrounding blood vessels fill resulting consolidation seen chest ray diagnosis pneumonia typically diagnosed based combination physical signs chest ray underlying cause difficult confirm definitive test able distinguish non origin world health organization defined pneumonia children based difficulty breathing rapid respiratory rate chest decreased level consciousness rapid respiratory rate defined greater minute children months old minute children months year old greater minute children years old children increased respiratory rate lower chest sensitive hearing chest nasal useful signs children general adults investigations needed mild cases low risk pneumonia vital signs normal persons requiring pulse chest blood tests including complete blood count protein level possibly liver function tests recommended diagnosis like illness based signs symptoms confirmation infection requires testing treatment frequently based presence community rapid test physical exam physical examination reveal low blood pressure high heart rate low oxygen respiratory rate faster normal occur day signs examination chest normal decreased chest expansion affected harsh breath sounds larger transmitted lung termed breathing heard heard affected area inspiration percussion affected lung increased decreased vocal resonance distinguishes pneumonia imaging chest frequently diagnosis people mild disease imaging needed potential complications having improved treatment cause uncertain person sufficiently sick require chest recommended findings match severity disease reliably separate infection viral infection ray presentations pneumonia classified pneumonia known pneumonia pneumonia community acquired pneumonia lung consolidation lung lobe known pneumonia findings vary patterns common types pneumonia pneumonia present primarily bases lungs right viral pneumonia appear normal appear hyper inflated areas present similar pneumonia consolidation findings present early stages disease especially presence difficult interpreted history lung disease scan additional information cases patients managed community determining agent cost effective typically alter management people respond treatment culture considered culture tuberculosis carried persons chronic productive testing specific organisms recommended public health reasons hospitalized severe disease blood cultures recommended testing viral confirmed detection virus culture chain reaction techniques agent determined cases routine tests classification refers lung pneumonia refers usually infection non infectious additional feature consolidation pneumonia commonly classified acquired community acquired healthcare associated hospital acquired associated pneumonia classified area lung affected pneumonia pneumonia acute pneumonia organism pneumonia children additionally classified based signs symptoms non severe severe severe setting pneumonia develops important treatment likely suspects mechanisms likely likely work fail complications expected based person health status community community acquired pneumonia cap acquired community outside health care facilities compared health care associated pneumonia likely involve resistant bacteria longer rare cap likely healthcare health care associated pneumonia infection associated recent exposure health care system including hospital clinic nursing home center treatment home care called medical care associated pneumonia hospital hospital acquired pneumonia acquired hospital specifically pneumonia occurs hours admission time admission likely involve hospital acquired higher risk resistant hospital patients ill present hospital issue associated pneumonia occurs people breathing help mechanical ventilation specifically pneumonia arises hours like medical device involve risk infection difficult prevent bacteria internal parts surfaces cleaning people need typically ill begin superimposed pneumonia easily managed involved poor status disorders differential diagnosis diseases present similar signs symptoms pneumonia chronic disease lung cancer unlike pneumonia typically present presents abnormal cancer present longer duration presents acute onset sharp chest pain breath prevention prevention includes environmental measures appropriate treatment health problems believed appropriate measures instituted globally mortality children reduced proper treatment universally available childhood deaths decreased prevents certain viral children adults effective preventing symptoms center disease control prevention recommends yearly person months older health care workers decreases risk viral pneumonia patients good evidence support use children led decreased adults adults acquire children available adults found decrease risk invasive disease support protective effect pneumonia include occur help prevent condition associated effects decrease chance exposed develop symptoms recommended potential effects taken account smoking cessation reducing indoor air pollution cooking indoors wood recommended smoking appears single biggest risk factor pneumonia healthy adults hand sleeve effective measures wearing surgical masks sick prevent illness appropriately treating underlying illnesses hiv aids diabetes decrease risk pneumonia children months age exclusive breast feeding reduces risk severity disease hiv aids count cells decreases risk pneumonia useful prevention hiv testing pregnant women group treatment needed reduces rates pneumonia measures hiv transmission mother child efficient mouth throat stained fluid found reduce rate pneumonia cause potential harm practice recommended majority situations elderly good oral health care lower risk pneumonia children months years old appears reduce rates pneumonia management oral rest simple usually complete resolution medical conditions elderly significant trouble breathing require advanced care symptoms pneumonia improve home treatment complications occur required worldwide approximately cases children result developed world adults community acquired pneumonia admitted score useful determining need admission adults score people typically managed home short hospital stay close follow needed recommended children respiratory distress oxygen hospitalized utility chest pneumonia determined non invasive ventilation beneficial admitted intensive care unit counter medicine found effective use children insufficient evidence improve outcomes pneumonia choice depends initially characteristics person affected age underlying health location infection acquired treatment culture results recommended line community acquired pneumonia alternatives north_america forms community acquired pneumonia common displaced line treatment adults children mild moderate symptoms remains line use cases discouraged concerns effects generating resistance light greater clinical benefit require caught pneumonia community use plus recommended addition appears improve outcomes duration treatment traditionally seven days increasing evidence suggests shorter courses days similarly effective recommended hospital acquired pneumonia include fourth generation given combination treated hospital improve initial viral treat viral pneumonia caused specific recommended types community acquired viral including virus treated treated benefit started hours onset symptoms strains known bird flu shown resistance use viral pneumonia recommended experts impossible rule infection british society recommends withheld mild disease use controversial general treated indicated pneumonia choice depend factors including suspected organism pneumonia acquired community developed hospital setting common options include combination beta pneumonia limited evidence support effectiveness treatment types pneumonia stabilize days takes weeks symptoms resolve ray finding typically clear weeks mortality low elderly people lung problems recovery weeks persons requiring mortality high requiring intensive care reach pneumonia common hospital acquired infection causes death advent mortality typically hospitalized complications occur particular elderly underlying health problems include lung acute respiratory distress syndrome underlying health problems clinical prediction rules clinical prediction rules developed predict outcomes pneumonia rules deciding person pneumonia severity index psi score score takes account severity symptoms underlying diseases age pneumonia collection fluid form space surrounds lung occasionally fluid causing distinguish common simple fluid collected needle examined shows evidence complete drainage fluid necessary requiring drainage severe cases surgery needed infected fluid drained infection persist penetrate cavity fluid sterile drained causing symptoms remains unresolved rare circumstances bacteria lung form pocket infected fluid called lung lung usually seen chest ray frequently require chest scan confirm diagnosis typically occur pneumonia contain types bacteria long term usually adequate treat lung drained surgeon respiratory failure pneumonia cause respiratory failure triggering acute respiratory distress syndrome results combination infection response lungs quickly fill fluid stiff combined severe difficulties oxygen fluid require long periods mechanical ventilation survival potential pneumonia occurs usually people poor immunity organisms commonly involved causes symptoms considered pneumonia common illness affecting approximately million people year occurring parts world major cause death age groups resulting million deaths world total death yearly rates greatest children adults older years occurs times frequently developing world developed world viral pneumonia accounts million cases united_states pneumonia 8th leading cause death children pneumonia occurred approximately million children million developing world million developed world resulted million deaths deaths years occurred developing world countries greatest burden disease include india million china million pakistan million leading cause death children low income countries deaths occur newborn period world health organization estimates newborn infant deaths pneumonia approximately half deaths prevented caused bacteria effective available pneumonia common reason admission hospital emergency department visit children history pneumonia common disease human history symptoms described affections observed fever acute pains present blond color likewise thin having character different common pneumonia height case remedy bad thin come neck head bad proceeding violence disease obtaining upper hand referred pneumonia disease named reported results surgical drainage observed basic symptoms occur pneumonia lacking follows acute fever sticking pain short rapid pulse clinical description similar found modern textbooks reflected extent medical knowledge middle ages 19th century observe bacteria persons having died pneumonia initial work identifying common causes performed albert respectively initial work introduced stain fundamental laboratory test today identify bacteria christian paper describing procedure helped differentiate bacteria showed pneumonia caused sir william known father modern medicine appreciated death disability caused pneumonia describing captain men death overtaken tuberculosis leading causes death time phrase originally coined john reference consumption tuberculosis described pneumonia old man friend death quick slower painful ways die developments 1900s improved outcome pneumonia advent modern surgical techniques intensive care 20th century mortality pneumonia approached dropped developed world type began led dramatic decline cases shortly adults began children resulting similar decline society culture awareness relatively low awareness disease november declared annual world pneumonia day day concerned citizens policy makers action disease costs global economic cost community acquired pneumonia estimated billion annually estimates considerably higher estimated aggregate costs treating pneumonia united_states billion median cost single pneumonia related according data released centers services average hospital charges treatment pneumonia ranged high average cost emergency room consult pneumonia average cost medication aggregate annual costs treating pneumonia europe estimated billion


post traumatic post traumatic form results brain damage caused physical trauma brain traumatic brain injury abbreviated person suffers repeated post traumatic result week initial injury estimated constitute cases cases caused identifiable organic brain condition known predict develop likelihood person develop influenced severity type injury example penetrating injuries involve bleeding brain higher risk onset occur short time physical trauma causes months years people head trauma remain higher risk general population decades injury caused processes occur brain trauma including brain cells damage brain tissues free measures include brain imaging techniques magnetic resonance imaging totally reliable drugs prevent development head injury treat condition occur medication work control surgery needed modern surgical techniques roots 19th century cutting hole skull condition ancient cultures classification occur traumatic brain injury known post traumatic post traumatic continue post traumatic chronic condition terms medical literature post traumatic differentiated non post traumatic based cause timing trauma person suffers late occurring week initial trauma late considered early occurring week trauma thought result direct effects injury provoked seizure results exceptional cause immediate effects trauma defect brain indication diagnosis disagreement exists define occurrence late condition diagnosed people medical sources usually consider present seizure occurs recently accepted restrict definition types include conditions occur requiring seizure diagnosis line modern definition people controlled medication seizure forms seizure types partial affecting hemisphere brain affecting associated loss consciousness cases people partial simple complex simple partial level consciousness altered complex partial consciousness impaired occur start partial spread causes clear patients similar injuries possible risk factors identified including severity type injury presence early genetic factors play role risk person develop people higher risk genetic risk factor possibly poorly allows iron escape damage tissues studies found having family members significantly increase risk suggesting strong risk factor severity trauma severe brain trauma likely person suffer late evidence suggests mild head injuries increased risk developing severe types simple mild risk times population estimates half severe brain trauma experience estimates place risk patients severe study found year risk developing mild moderate severe injuries shown chart right nature trauma nature head trauma influences risk people suffer depressed skull penetrating head trauma early especially likely suffer occurs people findings patients penetrating head trauma develop missile injuries loss brain volume associated especially high likelihood developing condition injuries occur military settings carry higher usual risk probably commonly involve penetrating brain injury brain damage widespread area blood inside skull important risk factors higher risk possibly causes damage brain tissue repeated surgery high risk late possibly people need surgery likely factors associated worse brain trauma large cerebral swelling addition chances developing differ location brain brain occurs frontal found carry risk carries risk temporal lobe carries chance occur risk frontal temporal post traumatic risk person develop heightened occur risk factors early unknown occurrence risk factor independent common risk factors early found increase risk studies person late seizure greater risk having early occurs people late seizure status continuous seizure multiple rapid succession especially strongly development status occur associated time quickly halting status seizure reduces chances development unknown reasons trauma cause changes brain lead number proposed mechanisms causes present given person period brain injury onset brain cells form new undergo experience altered gene expression addition damage particularly vulnerable areas rise blood brain injury damage brain tissue cause products result breakdown blood toxic brain tissue iron hypothesis holds damage oxygen free formation iron blood animal experiments rats shown produced iron brain iron formation reaction free damage brain cells membranes iron blood reduces activity called factor thought contribute exist release chemicals brain cells communicate play role development lead excessive release stimulate brain cells increase likelihood fire excessive release lead damage brain cells respond damages example leads formation free possible factor development lead formation chronic focus focus brain originate addition chemical changes cells structural changes lead occur brain occur shortly networks cause occur repeatedly spontaneously later hypothesis suggests new connections formed brain cause increase word metaphor way brain response increases repeated similar way small burning twigs produce large fire reorganization networks state trauma create focus brain leads addition increase accompany loss normally serve reduce likelihood fire changes produce diagnosis diagnosed person history head trauma history prior injury witnessing seizure effective way tool seizure disorder large portion people abnormal findings indicative study fifth people normal months injury later developed useful predicting develop useful focus determine severity predict person suffer stop taking magnetic resonance imaging performed people scanning detect brain unavailable frequently possible detect focus diagnosis obvious cause occur head injury necessarily head trauma like survivors suffer factors including fluid causes insufficient oxygen insufficient blood flow brain withdrawal alcohol potential cause factors ruled causes people head injury diagnosis prevention prevention involves preventing brain trauma general protective measures include bicycle helmets child safety seats specific treatment exists prevent development occurs past drugs intent preventing development drugs prevent early clinical studies failed use drugs prevents development drugs clinical trials failed stop developing clear explanations offered drugs simply capable preventing drug trials set way allow benefit drugs found drugs given late inadequate animal studies similarly failed protective effect commonly seizure trials drugs recommended prevent late people diagnosed measure basis aforementioned studies treatment widely accepted prevent development proposed narrow window hour exist administration prevent development investigated prevention clinical trials revealed drugs reduce late actually linked increase number early treatment drugs given prevent drugs completely eliminate people prevent taken reduce occurrence patient stops taking drugs medication stopped controlled years commonly difficult treat drug therapy drugs associated effects common drugs treat increase risk effects impaired thinking drugs commonly treat include drugs tested seizure prevention evidence controlled trials shown superiority people respond medication undergo surgery remove focus brain causing surgery difficult causes likely helpful forms particularly difficult focus affect areas brain difficulty locating seizure focus seen surgery people temporal lobe inner aspect temporal lobe comprise people surgery likely good outcome multiple focus localized drug therapy effective nerve option treating people follow visits health care providers monitor function assess effects types advised exercise caution performing activities particularly risky rock climbing trauma worse cause people thought shorter life people brain injury suffer compared people similar structural brain injuries people longer recover injury motor problems perform worse everyday tasks finding suggest indicator severe brain injury outcome found associated worse social functional outcomes patients rehabilitation ability return work people trouble finding employment admit having especially work involves operating heavy machinery period time injury development varies uncommon injury followed period longer person goes developing lower chances develop people seizure years people years injury chance developing study found head trauma survivors increased risk years moderate years severe head trauma fairly common occur late injury difficult determine case resulted head trauma past trauma incidental question long person remains higher risk general population controversial half cases cases occur later smaller chance studies found ranges varying severity injury time studies followed subjects brain trauma strongest factors development especially important factor young adults young adults highest risk head injury highest rate largest cause new onset cases young people children lower risk developing children severe similarly injured adults develop older factor development brain trauma study found common male survivors females history records exist early hole cut skull treat ancient cultures early 19th century baron wells reported having performed operation french educated american surgeon benjamin performed years kentucky good results despite surgery involved opening skull site injury injured tissue draining blood fluid mater work largest series kind point encouraged use post traumatic reports operations came accepted surgery relieve excess pressure skull effective treating helped set stage common practice procedure accepted late 19th century available cerebral localization familiar concept prominent german physician von criticized procedure questioned particular circumstances suggested operations declared successful soon procedures know long term benefit late 19th century saw advent surgery operating brain believed causing step surgery involved skull operations performed limited success surgery standard treatment years following world war condition received attention soldiers survived head trauma developed increased need drugs treat led trials early trials suggested drugs prevent development thought drugs prevent 1970s physicians surveyed prevent clinical trials supported protective effect later controlled trials drugs failed demonstrate effect studies prevented occurring week injury task force brain trauma foundation published recommendation suggesting use protect early trauma recommendations published use drugs week injury brain injury special interest group american academy physical medicine rehabilitation american association research develops insult brain fully understood gaining understanding help researchers find ways prevent severe easier treat researchers hope identify biological indications occurring means find drugs target pathways develops example drugs developed interfere secondary brain injury injury occur moment trauma results processes initiated blocking pathways free radical damage brain tissue increase understanding age differences development trauma help researchers find interest finding drugs potential interfere new drugs developed shown promise treatment animal model characteristics humans research efforts aim identify model help researchers find new treatments identify processes involved


pelvic disease pelvic disease pelvic disorder infection upper female reproductive system tubes inside symptoms signs symptoms present include lower abdominal pain discharge fever burning pain sex irregular result long term complications including pregnancy chronic pelvic pain cancer disease caused bacteria spread present percent cases multiple different bacteria involved treatment percent infection percent infection develop risk factors similar sexually transmitted generally include high number sexual partners drug use increase risk diagnosis typically based presenting signs symptoms recommended disease considered women age lower abdominal pain definitive diagnosis finding involving tubes surgery useful diagnosis efforts prevent disease include having sex having sexual partners screening women risk infection followed treatment decreases risk diagnosis suspected treatment typically advised treating woman sexual partners occur mild moderate symptoms single injection weeks possibly mouth recommended improve days severe disease globally million cases million cases occurred number cases clear estimated affect percent young women yearly united_states estimated affect million people yearly type device known shield led increased rates 1970s current associated problem month signs symptoms symptoms range severe symptoms fever motion lower abdominal pain new different discharge painful intercourse irregular noted complications include pelvic cause usually main cause data suggest isolated obtained upper tract isolated tubes organisms recovered tissues structure internal organs tissues female reproductive tract provides ascend pelvic cavity thorough disturbance naturally occurring associated increases risk common organisms common caused exclusively organisms bacteria isolated percent patients recovered bacteria present upper tract nearly thirds patients tests associated extremely organism factor associated listed bacteria involved diagnosis pelvic examination motion experienced observed severe cases testing required abdominal bacteria sampling tissue violin string characteristic hugh curtis present imaging methods magnetic imaging aid diagnosis blood tests help identify presence infection rate protein level dna acid tests direct tests linked highly sensitive tests identify specific present testing useful presence healthy people interpreting levels levels indicate infection recent long term definitive criteria include evidence filled tubes findings stain definitive identification rare possibly organisms thirds patients evidence previous aware cause harm identification helpful disease percent percent positive value exists patients presumed potential finding complex pelvic structures evidenced vague margins formation differential diagnosis number causes produce similar symptoms including pregnancy pelvic disease likely prior history infection recent sexual contact recent onset device place partner sexually transmitted infection acute pelvic disease highly unlikely recent intercourse taken place sensitive pregnancy test typically obtained rule pregnancy differentiate pregnancy pelvic pelvic appendix pelvic helpful diagnosis early stages infection appear normal disease progresses findings include free pelvic fluid cavity fluid gas instances borders appear indistinct enlarged accompanied increased numbers small pelvic disease readily available detect subtle tubes fails detect conducted diagnosis certain person responded therapy hours single test adequate sensitivity pelvic disease large study found motion minimum clinical criterion increases sensitivity criteria percent percent modified criteria identify women disease prevention regular testing sexually transmitted encouraged prevention risk contracting pelvic disease reduced following barrier methods human sexual behavior listings seeking medical attention experiencing symptoms combined pills helps reducing chances plug preventing ascent organisms lower tract seeking medical attention learning current sex partner sexually transmitted infection getting history current partner strongly encouraging tested treated intercourse avoiding activity particularly intercourse end pregnancy delivery abortion certain procedures ensure closes sexual sexual activities partners remaining sexually exclusive having outside sex partners treatment treatment started confirmation infection complications result delayed treatment treatment depends infectious agent generally involves use therapy improvement days patient typically advised seek medical attention necessary complications treating sexual partners possible help treatment prevention women mild moderate severity oral appear effective matter long term outcome administered typical include plus plus alternative plus alternative use plus clinical experience guides decisions transition oral therapy usually initiated hours clinical improvement infection cured effects infection permanent makes early identification essential treatment resulting cure important prevention damage reproductive system formation tissue episodes lead increasing risk inability pregnant long term pelvic abdominal pain certain occurrences post pelvic operation period time immediately abortion increases risk acquiring infection leading complications cause inside reproductive system later cause complications including chronic pelvic pain pregnancy leading cause pregnancy related deaths adult females complications pregnancy occasionally infection spread causing formation tissue external surface liver hugh curtis syndrome globally million cases million cases occurred number cases clear estimated affect percent young women yearly united_states estimated affect million people yearly rates highest teenagers time mothers causes women year


knee marked swelling knee tender touch restrict knee range motion commonly caused trauma knee single acute instance chronic trauma time commonly occurs individuals require frequent kneeling definitive diagnosis condition usually clinical history physical examination obtained determining straightforward treatment depends severity symptoms mild cases require rest knee number different treatment options severe cases including surgical irrigation signs symptoms primary swelling area generally produce significant pain pressure applied directly swelling area swelling red warm touch surrounded particularly area infected cases accompanied fever unlike generally affect range motion knee cause discomfort knee completely extension knee cause causes human anatomy small filled fluid purpose reduce friction adjacent structures knee joint located skin readily irritated walls thin common cause knee pain caused single instance acute trauma knee repeated minor trauma knee trauma cause nearby response response occurs phases phase blood flow surrounding area increases cellular phase migrate blood affected area possible causes include crest syndrome diabetes alcohol abuse chronic disease cases caused trauma patient remember likely infected typically occurs trauma knee causes possible infection caused bacteria traveling blood pre existing infection site approximately cases infection caused common highly unusual caused fungi negative bacteria rare cases infection caused tuberculosis diagnosis types cause knee pain including injuries diagnosis based physical examination presence risk factors person medical history swelling knee combined profession requires frequent kneeling suggest swelling multiple joints restricted range motion indicate instead physical examination medical history generally distinguish infectious non infectious fluid required cell culture stain fluid diagnosed fluid found count threshold significantly lower cells tuberculosis infection confirmed prevention possible prevent onset prevent symptoms avoiding trauma knee frequent kneeling protective knee pads help prevent require frequent kneeling athletes play contact sports american football basketball wrestling treatment non treated rest application ice affected area anti drugs particularly elevation affected leg rest recovery process severe cases require fine needle fluid coupled studies shown effective treatment option treated exercise help improve joint mechanics reduce chronic pain opinions vary treatment options effective smith recommend course oral usually assert surgery drainage unnecessary wilson argues oral inadequate recommends managing infection authors suggest surgical irrigation means tube suggest necessary cases operation procedure performed half hour nicknames associated arise fact commonly occurs individuals require frequent kneeling carpet layers mechanics miners exact condition known difficult estimate severe cases require hospital admission mild non cases generally common males females affects age groups likely occurs children


induced induced hit development low count administration forms hit abnormal formation blood inside blood vessel identified condition called induced hit caused formation abnormal activate receiving develops new count falls hit confirmed specific blood tests treatment hit requires protection choice agent reduce count alternatives available purpose mainly discovered 1930s hit reported 1960s signs symptoms prevention treatment exists main forms form injected skin low molecular weight form generally given administered skin commonly low molecular weight hit count blood falls normal range condition called generally low lead increased risk bleeding people hit experience symptoms typically count fall days given received previous months fall count occur sooner day common hit extension previously diagnosed blood development new blood body form veins causing arterial respectively examples arterial stroke heart attack acute leg occur leg arm form deep vein lung form usually originate leg migrate lung receiving complex symptoms reaction occur started include fever high blood pressure fast heart rate breath chest pain happens quarter people hit develop skin consisting red spots mechanism occurs naturally human body development hit suggests act targeted immune system hit immune system forms bound protein called factor usually class development usually takes days exposed months circulating type generally continue produced removed similar immunity certain difference hit persist months hit found individuals prior exposure majority found people receiving form complex tail protein surface results activation formation initiate formation blood count falls result leading formation common people receiving proportion develop referred phenomenon diagnosis hit suspected blood tests falling count receiving discontinued professional guidelines recommend people receiving complete blood count includes count regular basis receiving people falling count receiving turn hit timing severity occurrence new presence alternative explanations determine likelihood hit present commonly score predict likelihood hit score introduced score points generated score hit unlikely score indicates intermediate probability score makes highly likely high score need treated alternative drug sensitive specific tests hit performed low score safely continue receiving likelihood hit extremely low analysis reliability score low score negative value intermediate score positive value high score positive value intermediate high scores warrant investigation screening test suspected having hit aimed detecting complexes laboratory test linked type test circulating complexes falsely identify cause hit positive tested functional test uses patient washed mixed sample tested release marker activation release shows high release diagnosis hit confirmed test difficult perform usually regional laboratories diagnosed hit recommend routine leg veins identify deep vein common hit treatment given fact hit strongly new episodes sufficient simply administration generally alternative needed suppress tendency generation stops count recovers matters complicated commonly hit count high risk people hit low counts development skin receiving similar patient receiving time hit diagnosed activity reversed discouraged theoretical risk risk count rarely low principal cause significant non agents provide strongly suspected proven hit alternatives therapy agents available countries approved specific use instance recently licensed united_kingdom available united_states factor commonly label hit treatment united_states according systematic review people hit treated showed relative risk reduction clinical outcome death etc compared patient controls addition people treated hit showed relative risk reduction clinical outcomes production stopped exact number cases hit general population unknown known women receiving recent surgical procedure particularly surgery higher risk risk low women giving birth studies shown hit common receiving low molecular weight history introduced clinical use late 1930s new people treated described reported association fact phenomenon occurred reported prior time counts routinely performed report established hit diagnosis suggesting features result immune process initially theories existed exact cause low hit gradually evidence accumulated exact underlying mechanism john colleagues university medical school developed laboratory tests confirm exclude induced treatment initially limited 1990s saw introduction number agents provide risk hit older terminology distinguishes forms induced type mild non immune self limiting fall count type form described currently term hit describe immune severe form


syndrome syndrome syndrome syndrome rare disorder characterized muscle weakness limbs result reaction formed voltage calcium channels likely nerve terminal proteins junction connection nerves muscle supply prevalence cases million underlying commonly small cell lung cancer regarded syndrome condition arises result cancer body usually occurs people years age occur age diagnosis usually confirmed blood tests distinguish related disease disease associated cancer direct treatment cancer symptoms treatments suppress immune system enhance transmission occasionally exchange required remove signs symptoms weakness typically involves muscles arms legs muscles closer trunk contrast weakness affects legs arms leads difficulties climbing stairs rising sitting position weakness relieved temporarily physical exercise high temperatures symptoms weakness muscles muscles mouth throat occasionally encountered weakness eye muscles uncommon double vision difficulty generally leg weakness distinguishes eye signs common advanced stages disease weakness respiratory muscles occur experience problems coordination quarters people disruption nervous system experienced dry mouth blurred vision impaired falls blood pressure standing potentially leading report metallic taste mouth examination weakness demonstrated normal testing power severe expected basis symptoms strength improves repeated testing improvement power repeated hand grip phenomenon known sign rest typically reduced muscle use strength increases characteristic feature light sluggish associated lung cancer suggestive symptoms cancer time blood weight loss suggested associated lung cancer severe causes associated lung cancer specifically small cell making syndrome people small cell lung cancer cases lung cancer associated diseases diabetes type happen presence chest people people similar genetic variations diseases particular mechanism normal function nerve impulse carried long projection nerve cell spinal cord nerve ending junction impulse transferred muscle cell nerve impulse leads opening voltage calcium channels influx calcium nerve terminal calcium dependent triggering fusion membrane contain released muscle muscle contracts particularly type decrease calcium enter nerve ending released junction apart skeletal muscle nervous system requires explains occurrence symptoms voltage calcium channels found explaining experience problems coordination particularly known domain iii protein calcium regulated fusion people thought presence lack compensation weak calcium influx apart decreased calcium influx disruption active zone release sites thought dependent people components active zones including voltage dependent calcium channels lead decrease muscle repeated period seconds eventually lead sufficient delivery calcium increase muscle normal levels demonstrated medicine study called needle increasing repeated compound muscle action shown found associated lung cancer calcium channels cancer cells presumed originally develop reaction cells suggested immune reaction cancer cells growth improves cancer diagnosis diagnosis usually standard tests investigation unexplained muscle weakness involves small nerves supplying muscles small electrical measuring electrical response muscle question investigations characteristic compound motor action single fiber examination shows small normal repeated administered second normal smaller motor end plate depleted decrease larger observed normally eventually stored available increase remains insufficient reach level sufficient transmission impulse nerve muscle attributed insufficient calcium nerve terminal similar pattern witnessed response exercising muscle increases greatly occurs administration rapid burst electrical second seconds attributed influx calcium response single fiber examination features include increased seen diseases transmission blocking blood tests performed exclude causes muscle disease elevated indicate abnormal function tests indicate voltage calcium channels identified people confirmed diagnosed investigations scan chest usually performed identify possible underlying lung discovered immediately diagnosis remainder diagnosed later usually years typically years result typically repeated months years diagnosis lungs usually adequate pet scan body performed search particularly lung treatment caused underlying cancer treatment usually leads resolution symptoms treatment usually consists radiation therapy limited disease treatment aimed improving symptoms directly work improve transmission decreases degradation release improves muscle potassium channel base water marketed delay nerve discharge allowing calcium accumulate nerve terminal united_states stable require free base undergoing clinical trials treat pending completion trials submission available people free base available distribution program company salt available people expanded access program catalyst source europe sold free base compounded usually hospital older agent causes effects recommended agent related causes effects recommended immune suppression tends effective diseases immune response agent replace effect achieved degree effectiveness exchange removal proteins replacement normal provide improvement acute severe weakness exchange effective related conditions additional medication needed according systematic review collaboration best evidence treatment exists history anderson colleagues thomas hospital london mention case possible clinical findings clinic physicians substantially describe clinical findings disease diseases led hypothesis caused studies 1980s confirmed nature research 1990s demonstrated link type voltage calcium channels


low pain low pain common disorder involving muscles nerves bones pain vary dull constant sudden sharp feeling low pain classified duration acute pain lasting weeks sub chronic weeks chronic weeks condition classified underlying cause mechanical non mechanical referred pain symptoms low pain usually improve weeks time start people completely better weeks episodes low pain specific underlying cause identified looked pain believed mechanical problems muscle joint strain pain away conservative treatment accompanied red flags unexplained weight loss fever significant problems feeling movement testing needed look underlying problem cases imaging tools ray useful carry risks despite use imaging low pain increased low pain caused damaged discs straight leg raise test useful identify cause chronic pain pain processing system malfunction causing large amounts pain response non events treatment acute low pain rapid onset typically simple pain continuation normal activity pain allows recommended duration helpful known preferred medication number options available improve usual treatment useful simple pain generally recommended effects surgery beneficial disc related chronic pain disability spinal clear benefit found cases non specific low pain low pain affects mood improved counseling additionally alternative medicine including alexander technique evidence recommend evidence care spinal manipulation mixed approximately people million given point time nearly report having point month period people point lives estimates high people developed world difficulty begins years age men women equally affected low pain common people aged years overall number individuals affected expected increase population ages signs symptoms common presentation acute low pain pain develops movements involve lifting twisting forward bending symptoms start soon movements waking following morning description symptoms range particular point pain certain movements raising leg positions sitting standing pain legs known present experience acute low pain typically ages person reason medical professional adult episodes occur half people repeated episodes generally painful problems occur low pain chronic low pain associated sleep problems including greater time needed fall asleep disturbances sleep shorter duration sleep satisfaction sleep addition majority chronic low pain symptoms depression anxiety causes low pain specific disease complaint caused large number underlying problems varying levels seriousness majority clear cause believed result non muscle skeletal issues strains smoking weight gain pregnancy stress poor physical condition poor posture poor sleeping position contribute low pain list possible causes includes common conditions physical causes include discs spinal disc broken rarely infection spine women acute low pain medical conditions affecting female reproductive system including cancer nearly half pregnant women report pain lower area pregnancy changes posture center gravity causing muscle strain low pain broadly classified main categories mechanical including muscle strain muscle nucleus disk spinal compression fracture associated including disease bone lung breast infectious structures lower region including discs act preventing time protecting spinal cord nerves come spinal cord specific openings providing skin messages muscles stability spine provided muscles abdomen small joints called joints limit direct motion spine muscles run spine important keeping spine straight stable common movements sitting walking lifting problem muscles found chronic low pain pain causes person use muscles trying avoid pain problem muscles continues pain goes away probably important reason pain comes teaching people chronic low pain use muscles recommended recovery program disc gelatinous core surrounded ring normal state disc served nervous systems blood nerves run outside disc specialized cells survive direct blood supply inside disc time discs lose flexibility ability absorb physical forces decreased ability handle physical forces increases stresses parts spine causing spine bony develop result space spinal cord nerve roots pass disc result injury disease makeup disc changes blood vessels nerves grow interior disc material push directly nerve root changes result pain pain sensation pain generally unpleasant feeling response event damages potentially damage body tissues main steps process feeling pain transmission perception nerve cells detect pain cell bodies located dorsal root fibers transmit signals spinal cord process pain sensation starts pain causing event endings appropriate sensory nerve cells type cell converts event electrical signal different types nerve fibers carry transmission electrical signal cell posterior horn spinal cord brain stem brain stem parts brain system brain pain signals processed given context process pain perception brain modify sending nerve decreasing increasing release parts pain sensation processing system function properly creating feeling pain outside cause exists signaling pain particular cause signaling pain normally non painful event additionally pain mechanisms function properly phenomena involved chronic pain diagnosis structure complex reporting pain affected social factors diagnosis low pain straightforward low pain caused muscle joint problems cause separated problems spinal fracture spine classification number ways classify low pain consensus method best general types low pain cause mechanical pain including strains discs compressed nerve roots discs joint disease broken non mechanical pain conditions referred pain internal organs disease kidney stones kidney mechanical problems cases specific cause identified thought muscle strain injury rarely complaints low pain result psychological problems disorders low pain classified based signs symptoms pain change response particular movements localized lower classified common classification pain leg knee located case disc sides spinal changes severity response certain positions maneuvers making cases pain accompanied red flags trauma fever history cancer significant muscle weakness indicate underlying problem classified needing urgent specialized attention symptoms classified duration acute sub chronic known sub acute chronic specific duration required meet universally agreed generally pain lasting weeks classified acute pain lasting weeks sub chronic weeks chronic management change based duration symptoms red flags presence certain signs termed red flags indicate need testing look underlying problems require immediate specific treatment presence red flag mean significant problem suggestive people red flags underlying problem red flags present performing imaging laboratory testing weeks start symptoms shown useful red flags poorly supported evidence useful detecting fracture older age use significant trauma especially results skin markings best presence cancer history causes ruled people non specific low pain typically treated exact determination cause efforts uncover factors diagnosis depression substance abuse agenda concerning insurance payments helpful tests imaging indicated red flags ongoing symptoms resolve ongoing pain particular early use imaging recommended suspected cancer infection syndrome slightly better identifying disc disease technologies equally useful spinal physical tests helpful straight leg raise test positive disc provocative discography useful identify specific disc causing pain chronic high levels low pain similarly procedures nerve blocks determine specific source pain evidence supports use joint tests physical tests evaluating muscle weakness impaired little use complaints low pain common reasons people visit doctors pain lasted weeks pain likely person medical history physical examination suggest specific disease cause medical societies advise imaging tests rays individuals want tests red flags present unnecessary health care routine imaging increases costs associated higher rates surgery overall benefit radiation harmful health fewer imaging tests identify cause problem imaging detect harmless encouraging people request unnecessary testing worry region increased united_states prevention exercise appears useful preventing low pain exercise probably effective preventing pain lasted weeks medium firm beneficial chronic pain firm little evidence belts helpful preventing low pain education proper lifting techniques shoe help prevent low pain management management low pain depends general categories cause mechanical problems non mechanical problems referred pain acute pain causing mild moderate problems goals restore normal function return individual work minimize pain condition normally resolves recovery helped attempting return normal activities soon possible limits pain providing individuals skills facts useful speeding recovery sub chronic chronic low pain treatment programs help physical management increasing general physical activity recommended clear relationship pain disability found treatment acute episode pain acute pain moderate quality evidence supports walking treatment according method somewhat effective acute low pain benefit short term appear significant tentative evidence support use heat therapy acute sub chronic low pain little evidence use heat cold therapy chronic pain weak evidence suggests belts decrease number missed suggest help pain shock wave appear effective recommended exercise therapy effective decreasing pain improving function chronic low pain appears reduce rates long months completion program improves long term function evidence particular type exercise therapy effective alexander technique appears useful chronic pain tentative evidence support use electrical nerve tens found effective chronic low pain evidence use shoe treatment inconclusive peripheral nerve invasive procedure useful cases chronic low pain respond measures evidence supporting conclusive effective pain leg management low pain includes duration beneficial episode low pain hope complete cure problem chronic goals change pain management recovery function possible pain somewhat effective expectations benefit differ reality lead decreased satisfaction medication typically recommended people standard safe high cause liver problems high fatal high quality reviews found effective improving pain quality life function effective acute episodes carry greater risk effects including kidney failure stomach possibly heart problems second choice recommended pain handled available different classes evidence support use class respect benefits respect safety best muscle beneficial pain managed adequately short term use useful carry risk addiction negative interactions drugs greater risk effects including suitable short term management severe acute pain causing significant problems specialist groups advise general long term use chronic low pain older people chronic pain present great risk including diabetes stomach heart problems useful select group people pain effective treating chronic pain associated symptoms depression risk effects drugs chronic low pain relieve pain insufficient evidence support use oral shown useful low pain joint discs found effective persistent non pain considered persistent pain provide slight questionable short term improvement long term benefit concerns potential effects surgery surgery useful disc causing significant pain leg significant leg weakness problems loss control useful spinal absence issues clear evidence benefit surgery partial removal disc causing leg pain provide pain relief sooner treatments better outcomes year years invasive shown result different outcome regular conditions evidence provide recommendations surgical options long term effect surgery disc disease clear invasive surgical options improved recovery times evidence effectiveness insufficient pain localized lower disc fair evidence supports spinal fusion equal intensive physical therapy slightly better low intensity measures fusion considered low pain acquired displaced improve conservative treatment spinal fusion experience good results number different surgical procedures achieve fusion clear evidence better adding spinal devices fusion increases risks provides added improvement pain function alternative medicine unclear care spinal manipulation therapy improves outcomes low pain treatments reviews find results equal better improvements pain function compared commonly short intermediate long term follow reviews find effective reducing pain manipulation treatments conclude adding treatments improve outcomes national guidelines reach different conclusions recommending spinal manipulation describing manipulation optional recommending short course improve treatments manipulation medically assisted manipulation evidence confident recommendation better usual care acute pain sub chronic pain chronic pain improves pain little treatment help disability pain benefit present right treatment follow reasonable method try chronic pain respond treatments like conservative care therapy appear provide benefit acute low pain help sub chronic chronic pain particularly combined physical exercises education tentative evidence suggests better practice solutions joints areas cause stimulate body healing response found effective helpful added therapy poorly supported evidence treatments devil white willow reduce number individuals reporting high levels pain taking pain difference significant form plaster cast found reduce pain increase function therapy useful chronic pain types available including conditioning uses reinforcement reduce undesirable behaviors increase desirable behaviors therapy helps people identify correct negative thinking behavior conditioning modify individual response pain medical providers develop integrated program evidence inconclusive based stress reduction reduces chronic pain intensity associated disability suggests useful improving acceptance existing pain tentative evidence supports small pieces metal placed skin ear non specific low pain overall outcome acute low pain positive pain disability usually improve great deal weeks complete recovery reported symptoms weeks improvement generally slower small gains year year pain disability levels low minimal people distress previous low pain job satisfaction long term outcome episode acute pain certain psychological problems depression loss employment episode low pain following episode pain occur half people persistent low pain short term outcome positive improvement weeks little improvement year chronic low pain usually continue moderate pain disability people higher risk long term disability include poor skills fear activity times likely poor outcomes year poor ability cope pain functional poor general health significant psychiatric psychological component pain signs low pain lasts day limits activity common complaint globally people point lives estimates high people developed world approximately people million given point time nearly quarter report having point month period difficulty begins years age low pain common people aged years overall number individuals affected expected increase population ages clear men women higher rates low pain review reported rate males females review found higher rate females males reviewers felt possibly greater rates pains pregnancy women possibly women willing report pain men estimated women experience pain pregnancy rate higher pregnancy current especially likely low pain likely low pain smoked history low pain humans bronze age oldest known surgical treatise smith dating bce describes test treatment bce bce use term pain low pain active mid late second century described concept detail physicians end millennium attempt surgery recommended waiting medieval period folk medicine practitioners provided treatments pain based belief caused spirits start 20th century physicians thought low pain caused damage nerves frequently mentioned medical literature time popularity proposed causes decreased 20th century early 20th century american harvey williams increased acceptance surgical treatments low pain 1920s 1930s new theories cause arose physicians proposing combination nervous system psychological disorders nerve weakness female muscular called cited increasing frequency emerging technologies rays gave physicians new tools revealing disc source pain cases surgeon joseph reported cases disc related improved cured surgery result work 1940s disc model low pain took dominating literature 1980s aiding rise new imaging technologies discussion subsided research showed disc problems relatively uncommon cause pain physicians come realize unlikely specific cause low pain identified cases question need find time symptoms resolve weeks regardless treatment society culture low pain results large economic costs united_states common type pain adults responsible large number missed work days common complaint seen emergency department estimated responsible billion annual health care costs individuals costs increase spinal fusion despite fact changes indications surgery new evidence greater costs occur form lost income productivity low pain responsible missed work days united_states low pain causes disability larger percentage workforce canada great_britain netherlands sweden germany workers experience acute low pain result work injury asked employers rays cases testing indicated red flags present employer concern legal liability medical indication justify medical testing indicated legal reason encouraging people tests health care provider determines indicated research total disc replacement experimental option significant evidence supports use fusion researchers investigating possibility growing new structures use injected human growth factors substances cell therapy tissue engineering


syndrome syndrome rapid onset muscle weakness caused immune system damaging peripheral nervous system experience changes sensation develop pain followed muscle weakness beginning feet hands symptoms develop half day weeks acute phase disorder life threatening quarter developing weakness breathing muscles requiring mechanical ventilation affected changes function nervous system lead dangerous heart rate blood pressure disease caused body immune system mistakenly attacking peripheral nerves damaging immune triggered infection diagnosis usually based signs symptoms exclusion alternative causes supported tests nerve studies examination fluid classifications exist depending areas weakness results nerve studies presence classified acute severe weakness prompt treatment supportive care lead good recovery majority experience ongoing difficulty walking painful symptoms require long term breathing support syndrome rare cases people year syndrome named french jean described signs symptoms symptoms syndrome pain combination followed weakness legs arms affects sides equally time weakness half day weeks reach maximum severity steady people weakness continues progress long weeks muscles neck affected half experience involvement nerves supply head face lead weakness muscles face difficulties weakness eye muscles weakness affects legs involvement muscles control unusual total people syndrome continue able walk weakness stopped progressing stable level plateau phase improvement occurs plateau phase days months common duration week pain related symptoms affect half include pain painful muscle pain pain head neck relating lining brain people syndrome experienced signs symptoms infection weeks prior onset symptoms consist upper respiratory tract infection sore throat children particularly younger years old diagnosis difficult condition initially mistaken weeks causes pains difficulty walking viral bone joint problems examination characteristic features reduced power reduced absent respectively small proportion normal affected limbs developing exaggerated miller fisher variant syndrome weakness eye muscles pronounced occur coordination level consciousness normally unaffected syndrome feature coma respiratory failure quarter people syndrome develop weakness breathing muscles leading respiratory failure inability breathe adequately maintain healthy levels oxygen carbon dioxide blood life threatening scenario complicated medical problems pneumonia severe blood lungs bleeding digestive tract require artificial ventilation nervous system involved control body functions heart rate blood pressure affected thirds people syndrome impact variable percent experience severe blood pressure fluctuations irregularities heart beat point heart beat stops requiring based treatment associated problems changes pupils nervous system involvement affect severe muscle weakness causes thirds people syndrome experienced infection onset condition commonly episodes respiratory tract infection cases exact nature infection confirmed approximately cases provoked bacteria cause despite people develop syndrome episodes respectively strain involved determine risk different forms bacteria different surface induce illness links certain virus virus associated tropical viral infection fever virus associated episodes previous virus infection found common people syndrome cases triggered virus potentially increased syndrome followed followed flu outbreak cases million recipients developed close monitoring cases demonstrated induce small increases observed subsequent campaigns extent flu flu virus cause significant increase cases considered benefits preventing small risks previously experienced syndrome considered safe receive future associated risk mechanism nerve syndrome caused immune attack nerve cells peripheral nervous system support structures nerve cells body spinal cord long projection carries electrical nerve junction impulse transferred muscle wrapped cells contain cells gaps exposed different types syndrome feature different types immune attack variant features damage white blood cells process preceded activation group blood proteins known complement contrast variant complement cell membrane covering direct involvement directed nerve cells reported syndrome shown group substances found peripheral nerves consisting bound small group type containing numbers acid groups key described different anti associated particular features instance linked miller fisher variant related forms including production infection probably result molecular immune system reacting substances resultant react substances occurring naturally body infection body produces class small proportion people produce substance cell wall substances human nerve cell currently known process escapes central tolerance meant suppress production body substances cause disease recently suggested type simultaneously binding determines response furthermore development depend presence strains bacteria diagnosis diagnosis syndrome depends findings rapid development muscle absent absence fever likely cause fluid analysis spinal nerve studies supportive investigations commonly performed diagnosis testing performed contribution diagnosis usually limited blood tests generally performed exclude possibility cause weakness low level potassium blood low level blood encountered syndrome attributed inappropriate leading relative retention water cases magnetic resonance imaging spinal cord performed distinguish syndrome conditions causing limb weakness spinal cord compression scan shows nerve roots indicative children feature present specific syndrome confirmation needed spinal fluid fluid brain spine spinal tap removal small fluid needle inserted characteristic findings syndrome elevated protein level usually greater fewer white blood cells cubic millimeter fluid combination distinguishes syndrome conditions protein cell count elevated elevated protein levels found approximately patients days onset weakness increases week repeating disease course recommended protein levels rise treatment administered directly assessing nerve electrical exclude causes acute muscle weakness distinguish different types syndrome needle nerve studies performed weeks investigations studies required diagnosis formal criteria exist main syndrome cases particularly failure changes criteria proposed repeated testing helpful clinical number syndrome recognized despite people overlapping symptoms classification difficult individual cases types partial forms instance people experience isolated eye movement coordination problems thought miller fisher syndrome similar patterns entities included spectrum syndrome instance group conditions regarded forms miller fisher syndrome anti syndrome related condition labelled acute coordination problems present muscle weakness detected characterized rapid onset disturbance consciousness associated absent decreased sign course disease usually episodes reported reported isolated acute sensory loss regarded form syndrome matter dispute rare occurrence compared muscle weakness sensory symptoms treatment main treatments attempts reduce body attack nervous system similarly administration harmful treatments equally effective combination significantly better speeds recovery weeks onset symptoms works started weeks onset symptoms fewer complications usually ease administration safety use risk occasionally causes liver rare cases kidney failure found effective speeding recovery potentially delay recovery respiratory failure respiratory failure require breathing support mechanical ventilation generally intensive care unit need support anticipated measurement based breathing tests forced vital capacity negative force kilogram body weight considered markers severe respiratory failure pain pain common people syndrome studies comparing different types pain medication insufficient recommendation rehabilitation following acute phase people require intensive rehabilitation help team focus improving activities daily living studies subject limited likely intensive rehabilitation improves long term symptoms teams include physical social workers allied health professionals nurses team usually works supervision rehabilitation physician directing treatment goals include strength endurance training graduated increases mobility maintenance posture alignment joint function therapy aims improve everyday function domestic community tasks driving work home modifications aids provided speech language input required speech problems support communication require ongoing breathing support support provided team provide counseling support psychological required anxiety fear depression syndrome lead death result number complications severe blood cardiac arrest likely despite care occurs cases variation rate extent recovery syndrome determined mainly age poorer outcome severity symptoms weeks furthermore experienced onset disease worse nerve study presence block poorer outcome months received smaller increase blood weeks administration associated poorer mobility outcomes months level increased substantially disease continues progress weeks multiple fluctuations severity weeks diagnosis chronic treated differently research studies outcome episode syndrome recorded scale denotes completely healthy minor symptoms able run able walk run requiring stick support confined bed chair requiring long term respiratory support death health related quality life attack syndrome significantly impaired fifth unable walk months experience chronic pain fatigue difficulty work education social activities improves significantly year western countries number new episodes year estimated cases people children young adults likely affected elderly risk increases decade life men likely develop syndrome women relative risk men compared women distribution varies countries europe united_states people syndrome affects small number asia central south_america proportion significantly higher related exposure different kinds infection genetic characteristics population miller fisher variant thought common southeast_asia history french physician jean octave described disorder jean diagnosed soldiers illness described key increased spinal fluid protein concentration normal cell count canadian miller fisher described variant bears british based birmingham described type philip contributions paper reported features prior description described form featuring pure type causing weakness described 1990s criteria developed late 1970s series cases associated flu refined case definition revised brighton collaboration safety mainly intended research exchange benefit confirmed larger studies introduced non compared exchange demonstrated studies early 1990s research directions understanding disease mechanism syndrome evolved recent years development new treatments limited introduced 1980s 1990s current research aimed demonstrating people received benefit second course levels measured blood treatment shown small increase studies drug brain derived factor beta demonstrated benefit support widespread use animal model experimental rats studies agents shown promise heart drug targeted anti shown benefit laboratory research given role complement system suggested complement drug effective