medical condition excess body fat accumulated extent negative effect health people generally considered body mass index bmi measurement obtained dividing person weight square person height range defined overweight east asian countries use lower values increases likelihood diseases particularly heart disease type diabetes sleep certain types cancer commonly caused combination excessive food intake lack physical activity genetic cases caused primarily genes disorders mental illness evidence support view people eat little gain weight slow generally supported average people greater energy expenditure thin counterparts energy required maintain increased body mass combination social changes personal choices changes diet exercising main treatments diet quality improved reducing consumption energy dense foods high fat increasing intake fiber taken suitable diet reduce appetite decrease fat absorption diet exercise medication effective balloon surgery performed reduce stomach volume length leading feeling earlier reduced ability absorb nutrients food leading cause death worldwide increasing rates adults children million adults million children age common women men authorities view public health problems 21st century modern world particularly western world seen symbol wealth fertility times history parts world american medical association classified disease classification medical condition excess body fat accumulated extent adverse effect health defined body mass index bmi evaluated terms fat distribution waist hip ratio total risk factors bmi closely related percentage body fat total body fat children healthy weight varies age sex children defined absolute number relation historical normal group bmi greater reference data based date affected recent increases weight bmi defined subject weight divided square height calculated follows formula subject weight height respectively bmi usually expressed kilograms square metre resulting weight measured kilograms height metres convert pounds square inch commonly definitions established world health organization published provide values listed table modifications definitions particular bodies surgical literature breaks class iii categories exact values disputed bmi severe bmi experiencing related health conditions bmi super asian populations develop negative health consequences lower bmi nations japanese defined bmi greater china uses bmi greater effects health excessive body weight associated diseases particularly diseases diabetes type sleep certain types cancer result found reduce life mortality leading causes death worldwide number reviews found mortality risk lowest bmi non current risk increasing changes direction appears apply continents contrast review found grade bmi associated higher mortality normal weight overweight bmi associated lower mortality normal weight bmi evidence suggests association bmi waist mortality shaped association waist hip ratio waist height ratio mortality positive risk begins increase bmi associated doubled mortality rate women year period united_states estimated cause deaths year million deaths europe attributed excess weight average reduces life seven years bmi reduces life years severe bmi reduces life years increases risk physical mental conditions commonly shown syndrome combination medical disorders includes diabetes type high blood pressure high blood high levels complications directly caused indirectly related mechanisms sharing common cause poor diet lifestyle strength link specific conditions varies strongest link type diabetes excess body fat cases diabetes men cases women health consequences fall broad categories effects increased fat mass sleep social increased number fat cells diabetes cancer disease non alcoholic liver disease increases body fat alter body response potentially leading resistance increased fat creates state state survival negative health consequences general population supported available evidence health outcomes certain improved increased bmi phenomenon known survival described overweight people undergoing subsequently found heart failure peripheral disease pad people heart failure bmi lower mortality normal weight attributed fact people lose weight progressively ill similar findings types heart disease people class heart disease greater rates heart problems people normal weight heart disease people greater degrees risk events increased cardiac bypass surgery increase mortality seen overweight study found improved survival explained aggressive treatment people receive cardiac event found takes account chronic disease pad benefit longer exists causes individual level combination excessive food energy intake lack physical activity thought explain cases limited number cases primarily medical reasons psychiatric illness contrast increasing rates societal level felt easily accessible diet increased reliance cars manufacturing review identified possible contributors recent increase insufficient sleep environmental interfere decreased ambient temperature decreased rates smoking smoking appetite increased use cause weight gain proportional increases ethnic age groups tend heavier pregnancy later age cause children risk factors passed natural selection higher bmi mating leading increased concentration risk factors increase number people increasing population weight substantial evidence supporting influence mechanisms increased prevalence evidence inconclusive authors state probably influential ones discussed previous diet energy supply capita varies markedly different regions countries changed significantly time early 1970s late 1990s average food energy available person day food bought increased parts world eastern_europe united_states highest availability person increased late 1990s europeans person developing areas asia person sub africa people person total food energy consumption found related widespread availability guidelines little address problems poor choice rates united_states increased period increase occurred average food energy consumed women average increase day men average increase day extra food energy came increase consumption fat consumption primary sources extra account percent daily food energy young adults america potato chips consumption drinks soft drinks fruit drinks tea energy water drinks believed contributing rising rates increased risk syndrome type diabetes societies increasingly reliant energy dense big portions fast food meals association fast food consumption concerning united_states consumption fast food meals food energy intake meals agricultural policy techniques united_states europe led lower food prices united_states corn wheat rice farm bill main sources processed food cheap compared fruits vegetables count laws nutrition facts labels attempt steer people making food choices including awareness food energy consumed people consistently report food consumption compared people normal weight supported tests people carried room direct observation lifestyle lifestyle plays significant role worldwide large shift physically demanding work currently world population gets insufficient exercise primarily increasing use transportation greater prevalence labor saving technology home children appear declines levels physical activity walking physical education world trends active leisure time physical activity clear world health organization indicates people worldwide taking active recreational pursuits study finland found increase study united_states found leisure time physical activity changed significantly children adults association television viewing time risk review found studies showed increased rate childhood increased media exposure rates increasing time spent watching television like medical conditions result genetic environmental factors genes controlling appetite sufficient food energy present sites human linked development favorable environment present people copies gene fat mass associated gene found average weigh fold greater risk compared risk differences bmi people varies depending population examined major feature syndrome syndrome syndrome syndrome term non exclude conditions people early onset severe defined onset years age body mass index standard normal harbor single point dna studies focused inheritance patterns specific genes found offspring parents contrast offspring parents normal weight different people exposed environment different risks underlying gene hypothesis human evolution people prone ability advantage rare periods abundance storing energy fat times varying food availability individuals greater reserves likely survive famine tendency store fat societies stable food supplies theory received criticisms based theories gene hypothesis hypothesis proposed illnesses certain physical mental illnesses substances treat increase risk medical illnesses increase risk include rare genetic listed acquired conditions syndrome growth eating disorders eating disorder night eating syndrome regarded psychiatric disorder listed psychiatric illness risk overweight higher patients psychiatric disorders persons psychiatric disorders certain cause weight gain changes body composition include certain forms social genetic influences important understanding explain current dramatic increase seen specific countries globally accepted energy consumption excess energy expenditure leads individual basis cause shifts factors societal scale debated number theories cause believe combination factors social class bmi varies globally review found developed countries women high social class likely significant differences seen men different social classes developing world women men children high social classes greater rates update review carried found relationships weaker decrease strength felt effects developed countries levels adult percentage teenage children overweight income inequality similar relationship seen states adults higher social classes unequal states explanations forth associations bmi social class thought developed countries wealthy able afford food greater social pressure remain slim opportunities greater expectations physical fitness undeveloped countries ability afford food high energy expenditure physical labor cultural values favoring larger body size believed contribute observed patterns attitudes body weight held people life play role bmi changes time found friends siblings stress perceived low social status appear increase risk smoking significant effect individual weight quit smoking gain average kilograms men kilograms women years changing rates smoking little effect overall rates united_states number children person related risk woman risk increases child man risk increases child partly explained fact having dependent children decreases physical activity western parents developing world playing role increasing rate china overall rates cities rates greater early life believed play role rising rates developing world changes occur periods promote storage fat food energy available consistent data numerous studies confirm associated causes vice versa unclear present infectious agents study effect infectious agents early stages gut flora shown differ lean humans indication gut flora lean individuals affect potential apparent alteration potential believed greater capacity harvest energy contributing differences direct cause result determined association found humans different animal species associations contributed rising rate determined possible mechanisms involved development maintenance field research gene discovered laboratory investigators factor mouse gene resulted opening possibility therapy human soon laboratory detect gene humans contrary expression increased proposing possibility resistance human discovery mechanisms participate regulation appetite food intake storage patterns tissue development resistance discovery studied produced tissue action thought modify related diseases considered influence appetite produced stomach short term control eat stomach stop stomach stretched produced tissue signal fat storage reserves body long term controls eat fat low fat high administration effective small individuals individuals thought resistant found high levels resistance thought explain administration shown effective suppressing appetite people produced control appetite actions central nervous system particular appetite related act region brain central regulation food intake energy expenditure circuits contribute role integrating appetite understood circuit begins area nucleus lateral brain feeding centers respectively nucleus contains distinct groups group related second group pro regulated cart consequently stimulate feeding cart stimulate feeding groups nucleus regulated group cart group signaling resistance leads account genetic acquired forms public health world health organization overweight soon replace traditional public health concerns infectious diseases significant cause poor health public health policy problem prevalence costs health effects united_states services task force recommends screening adults followed public health efforts seek understand correct environmental factors responsible increasing prevalence population solutions look changing factors cause excess food energy consumption physical activity efforts include federally meal programs schools limiting direct food marketing children decreasing access sugar schools constructing urban environments efforts increase access parks develop pedestrian routes countries groups published reports pertaining federal guidelines published titled clinical guidelines identification evaluation treatment overweight adults evidence report canadian network published canadian clinical practice guidelines management prevention adults children comprehensive evidence based address management prevention overweight adults children united_kingdom royal college physicians faculty public health royal college child health released report storing problems highlighted growing problem year house_of_commons health select committee published comprehensive inquiry undertaken impact health society possible approaches problem national institute health clinical excellence nice issued diagnosis management policy implications non healthcare organizations local councils report produced sir king fund warned action taken capacity national health service financially comprehensive approaches looked address rising rates policy action framework divides measure upstream policies policies downstream policies upstream policies look changing society policies try alter individuals behavior prevent downstream policies try treat currently afflicted people management main treatment consists physical exercise diet programs produce weight loss short term maintaining weight loss frequently difficult requires making exercise lower food energy diet permanent person lifestyle short term low appear better low fat weight loss long term types low low fat appear equally beneficial review found heart disease diabetes risks associated different appear similar promotion mediterranean lower risk heart disease decreased intake sweet drinks related weight loss success rates long term weight loss maintenance lifestyle changes low ranging lifestyle changes effective limiting excessive weight gain pregnancy improve outcomes mother child intensive counseling recommended risk factors heart disease combination currently available evidence long term use weight loss modest average years use associated high rates effects concerns raised negative effects available united_states europe results average weight loss body weight greater year increase heart valve problems combination somewhat effective associated heart problems information drugs affect longer term complications disease death effective treatment surgery surgery severe associated long term weight loss improvement related conditions decreased overall mortality study found weight loss depending type procedure performed years reduction cause mortality compared standard weight loss measures complications occur cases needed cases cost risks researchers searching effective invasive treatments including devices occupy space stomach earlier historical periods rare small elite recognised problem health prosperity increased early modern period affected increasingly larger groups population formally recognized global epidemic estimates million adults greater higher rates women men rate increases age years old severe united_states australia canada increasing faster overall rate considered problem high income countries rates rising worldwide affecting developed developing world increases felt dramatically urban settings remaining region world common sub africa history etymology latin means stout fat past eat added oxford english dictionary documents usage historical attitudes ancient greek medicine recognizes medical disorder records ancient saw way wrote disease indian surgeon 6th century bce related diabetes heart disorders recommended physical work help cure effects human history mankind struggled food historically viewed sign wealth prosperity common high officials europe middle ages renaissance ancient east asian 17th century english medical author credited refer term societal disease published english language book onset industrial revolution realized military economic nations dependent body size strength soldiers workers increasing average body mass index considered normal range played significant role development societies height weight increased 19th century developed world 20th century populations reached genetic potential height weight began increasing height resulting 1950s increasing wealth developed world decreased child mortality body weight increased heart kidney disease common time period insurance companies realized connection weight life increased cultures history viewed result character flaw fat character greek comedy figure christian times food viewed gateway sins lust modern western culture excess weight regarded commonly associated negative stereotypes people ages face social targeted peers public perceptions western society healthy body weight differ weight considered ideal changed beginning 20th century weight viewed ideal lower 1920s illustrated fact average height miss america winners increased average weight decreased hand people views concerning healthy weight changed opposite direction britain weight people considered overweight significantly higher changes believed increasing rates leading increased acceptance extra body fat normal seen sign wealth parts africa particularly common hiv epidemic began arts representations human body years ago depict females attribute venus tendency emphasize fertility feel represent people time absent greek roman art probably keeping ideals continued christian european history low status depicted renaissance upper class began large size seen portraits henry_viii england del regularly depicted bodied women pictures derives term women maintained shape relationship fertility 19th century views changed western world centuries synonymous wealth social status began seen desirable standard society culture economic impact addition health impacts leads problems including employment increased business costs effects felt levels society individuals corporations governments medical costs estimated billion medical expenditures cost canada estimated billion total health costs total annual direct cost overweight australia billion overweight australians received billion government subsidies estimate range annual expenditures diet products billion billion prevention programs found reduce cost treating related disease longer people live medical costs researchers conclude reducing improve public health unlikely reduce overall health spending lead social employment compared normal weight counterparts workers average higher rates work disability leave increasing costs employers decreasing productivity study examining duke university employees found people bmi filed twice workers compensation claims bmi times lost work days common injuries group falls lifting affecting lower hands backs alabama state employees insurance board approved controversial plan charge workers month health insurance free steps lose weight improve health measures started january apply state workers bmi exceeds fail improvements health year research shows people likely hired job likely promoted people paid non counterparts equivalent job women average men specific industries airline healthcare food industries special concerns rising rates face higher fuel costs pressures increase seating width extra weight passengers cost million healthcare industry invest special facilities handling severely patients including special lifting equipment costs restaurants increased litigation accusing causing congress discussed legislation prevent civil lawsuits food industry relation law american medical association classification chronic disease thought health insurance companies likely pay treatment counseling surgery cost research development fat treatment pills gene therapy treatments affordable help cost classification legally binding health right reject coverage treatment procedure european court justice ruled disability court argued employee prevents effective participation person professional life equal basis workers shall considered disability firing grounds size acceptance principal goal fat acceptance movement decrease discrimination people overweight movement attempting challenge established relationship negative health outcomes number organizations exist promote acceptance increased prominence half 20th century based national association advance fat acceptance formed describes civil rights organization dedicated ending size discrimination international size acceptance association non governmental organization founded global orientation describes mission promoting size acceptance helping end weight based discrimination groups argue recognition disability americans disabilities act american legal system decided potential public health costs exceed benefits extending anti discrimination law cover childhood healthy bmi range varies age sex child children defined bmi greater reference data based affected recent increases rates childhood reached epidemic proportions 21st century rising rates developed developing world rates canadian boys increased 1980s 1990s time period rates increased brazilian children adults factors contribute rising rates childhood changing diet decreasing physical activity believed important causes recent increase child childhood adulthood associated numerous chronic illnesses children tested diabetes liver treatments children primarily lifestyle techniques efforts increase activity children little success united_states approved use age group animals pets common countries united_states dogs overweight rate cats slightly higher australia rate dogs setting found risk dogs related owners similar cats owners


syndrome syndrome referred linked mental syndrome linked genetic disorder causes mild moderate intellectual disability features described referring group physical characteristics similar found syndrome features include tall thin stature long slender limbs associated exhibits number affecting brain heart disorder inherited linked dominant manner attributed gene currently treatment therapy underlying malfunction exact disorder remains unclear characteristics intellectual disability usually ranges mild moderate severe cases reported relatively common brain seen corpus error development corpus structure brain composed nerves allows communication left right cerebral present number adverse effects found absence corpus intellectual disability shown occur rate approximately percent corpus intellectual disability suggested psychiatric related typically seen considered diagnosis disorder common like spectrum disorder considered number genetic disorders associated additional alterations observed include behavior attention deficit disorder aggression defiant disorder obsessive disorder extreme learning disability short term memory deficit low frustration tolerance social lack impulse control eating disorder associated attributed loss appetite psychiatric conditions like expected cases disorder preservation mental abilities problem solving reasoning normal intelligence usually exhibits diagnosed individual known affected intellectual disability considered differential diagnosis confirmation appropriate psychiatric genetic evaluation methods distinguished linked forms intellectual disability accompanying presence describes group physical features common syndrome including syndrome features type observed disorders multiple type specific features identified include long narrow face tall thin stature long slender limbs fingers toes unlike joint shortened big toes long second toes diagnosis delayed physical features characteristics associated usually evident features include upper jaw bone small lower jaw bone chin high arched roof mouth upper teeth enlarged skull prominent forehead speech voice long nose high narrow nasal bridge deep short upper lip beneath nose low set ears apparent decreased muscle tone chest slightly enlarged normal size males speech primarily result allows air nasal cavity speech caused failure soft reach wall interior cavity throat generally occurs speech condition associated number features involving heart noted cases significant root section ascending root associated greatly increased risk wall resulting presents possible life threatening consequence routine cardiac evaluation methods implemented disorder diagnosed brain screen suspected corpus additional effects heart reported defect cause gene located human established cause genetic point acid belong sequence particular protein erroneously substituted acid supposed included sequence specific location gene causes identified indicates acid normally located position sequence mistakenly replaced causes incorrect expression activity protein resulting disorder complex complex required acts bridge different gene specific factors contain required regulation particular tissues cells currently exact mechanism results associated physical characteristics unclear highly arched features found syndrome tissue disorder finding root disorders suggests unspecified tissue regulating gene contribute number interesting experimental results obtained studying animal model representing found responsible defects types affected introduction human normal development critical gene involved developmental regulation bone defects cause structures crest alter function peripheral nervous systems cause cell types serving bone features found like corpus related similar defects found associated syndrome inherited linked dominant manner means gene responsible disorder located copy gene sufficient cause disorder inherited parent disorder males normally having copy result linked dominant disorders usually higher males females phenomenon thought occur sex linked inheritance determined gender parent carrying specific gene complex typically females copies males copy difference dominant inheritance patterns plays role determining chances child linked disorder linked dominant inheritance suspected boy girl siblings family exhibited disorder scenario possible linked inheritance particular case report girl believed carrying copy gene sporadic cases disorder present individual prior family history reported small number affected males similarities genetic diseases individual exhibiting intellectual disability symptoms similar found terminal region short arm area associated intellectual disability behavior like speech disorder chat syndrome suggests detailed examination fish performed differential diagnosis gene found cause linked intellectual disability nonsense decay complex performs surveillance detecting sequences erroneously truncated shortened presence nonsense alter prevent normal function resulting translation expression truncated sequences proteins associated developmental errors intellectual disability individuals families diagnosed family found confirming clinical presentations different overlap diagnosis usually suspected intellectual disability observed patient diagnosis confirmed presence gene differential diagnosis differential diagnosis disorder exhibits features symptoms associated syndrome common features shared include linked intellectual disability corpus notable features reported include excessive consistent strength skills extremely wide set eyes associated associated disorders originate identical type gene exhibiting similar distinct characteristics considered context suggests disorder related way respective alter sequence function treatment specific treatment underlying genetic cause procedures intervention measures considered treatment management psychiatric problems associated disorder pressing issues cardiac involvement routinely examined monitored close attention specialized follow care including evaluation methods special education given prevent psychiatric disorders related problems aggression syndrome rare linked dominant syndrome common males females prevalence general population determined history syndrome named physicians jean initial observation suspected linked intellectual disability features effects high arched described report affected male members large family noted additional investigations combined linked intellectual disability families including brothers reported beginning disorder soon known syndrome


syndrome syndrome known syndrome condition severely overweight people fail breathe rapidly deeply resulting low blood oxygen levels high blood carbon dioxide levels people condition frequently stop breathing altogether short periods time sleep sleep resulting partial night leads continual day disease puts strain heart eventually lead symptoms heart failure leg swelling related symptoms effective treatment weight loss possible relieve symptoms nocturnal ventilation positive pressure related methods syndrome defined combination body mass index falling oxygen levels blood sleep increased blood carbon dioxide levels day resulting excessively slow shallow breathing disease known 1950s initially syndrome reference character currently descriptive classification syndrome form sleep breathing recognized depending nature breathing detected investigations context sleep confirmed occurrence episodes respiratory related hour high index sleep second primarily sleep syndrome requires rise levels kpa sleep compared awake measurements overnight drops oxygen levels simultaneous overall people fall category second signs symptoms people syndrome concurrent sleep condition characterized brief episodes cessation breathing night interrupted sleep excessive daytime worsened elevated blood levels carbon dioxide causes symptoms present conditions depression high blood pressure difficult control medication high carbon dioxide cause tend worse morning low oxygen level leads excessive strain right heart known symptoms disorder occur heart difficulty pumping blood body lungs fluid accumulate skin legs form swelling abdominal cavity form decreased exercise tolerance chest pain occur physical examination characteristic findings presence raised pressure heart blood leaking valve enlarged liver leg occurs people mechanism fully understood people develop syndrome likely result processes firstly work breathing increased tissue normal movement chest muscles makes chest wall moves effectively respiratory muscles easily lung impaired excessive tissue head neck area people need energy breathe effectively factors lead sleep breathing inadequate removal carbon dioxide circulation given carbon dioxide solution combines water form acid excess causes increased blood normal circumstances central brain stem detect respond increasing respiratory rate response response attributed factors people tend raised levels tissue normal circumstances increases ventilation effect reduced furthermore episodes nighttime sleep lead compensation retention blood stays longer episodes lead relatively mild reduced response vicious circle low oxygen levels lead small blood vessels lung create optimal distribution blood lung low oxygen levels causing chronic leads increased pressure turn puts strain right heart pumps blood lungs right undergoes able remove blood veins case raised pressure leads accumulation fluid skin severe cases liver abdominal cavity low oxygen levels blood lead increased release activation production red blood cells results increased numbers circulating red blood cells elevated diagnosis formal criteria diagnosis body mass index measure obtained taking weight kilograms dividing height meters squared arterial carbon dioxide level kpa determined arterial blood gas measurement alternative explanation use severe lung disease severe chest wall disorders severe disease central syndrome suspected tests required confirmation important initial test demonstration elevated carbon dioxide blood requires arterial blood gas determination involves taking blood sample usually radial given complicated perform test patient sleep related breathing problems suggest measuring levels normal blood reasonable screening test elevated higher blood gases measured distinguish required usually requires brief admission hospital specialized sleep medicine department number different measurements conducted subject asleep includes electronic registration electrical activity brain electrical activity heart pulse measurement oxygen levels blood tests recommended identification distinguish lung diseases cause similar symptoms medical imaging lungs chest ray cat scan performed strain right heart caused restrictive pattern related treatment people stable important treatment weight loss diet exercise medication weight loss surgery surgery shown improve symptoms resolution high carbon dioxide levels weight loss long time successful surgery avoided possible given high rate complications considered treatment ineffective improving oxygen levels symptoms symptoms significant nighttime positive pressure treatment tried involves use machine assist breathing exists forms ideal strategy uncertain tried stimulate breathing correct underlying benefit uncertain people syndrome cared basis deteriorate suddenly admitted hospital severe markedly blood depressed level consciousness high carbon dioxide levels occasions admission intensive care unit mechanical ventilation necessary level positive pressure section commonly stabilize patient followed conventional treatment positive pressure positive pressure initially form continuous positive pressure useful treatment syndrome particularly sleep exists requires use sleep machine delivers continuous positive pressure preventing collapse soft tissues throat breathing administered mask mouth nose tolerated nose nasal features sleep sufficient remove resultant accumulation carbon dioxide pressure increased symptoms periods disappeared effective people occasions oxygen levels low oxygen case improved switching treatment alternate device delivers level positive pressure higher pressure inspiration breathing lower pressure breathing ineffective increasing oxygen levels addition oxygen therapy necessary resort necessary involves making surgical opening bypass related neck combined mechanical ventilation assisted breathing device opening treatments shown improve response poorly studied associated increased risk similarly drug reduce levels augment normal response researched recommend wide application syndrome associated reduced quality life people condition increased healthcare costs largely hospital including observation treatment intensive care units occurs medical conditions type diabetes main heart failure affects patients severe warrant treatment increased risk death reported months months risk reduced receiving treatment treatment reduces need hospital reduces healthcare costs exact prevalence syndrome unknown thought people symptoms diagnosed people body mass index exceeding elevated carbon dioxide levels blood examining groups people sleep researchers found meet criteria risk higher severe body mass index bmi higher twice common men compared women average age diagnosis american black people likely american whites likely develop likely people lower bmi result physical characteristics anticipated rates rise prevalence rises explain commonly reported united_states common countries history discovery syndrome generally attributed authors report professional poker player gaining weight prone fall asleep day developing legs suggesting heart failure authors coined condition syndrome character joe posthumous papers club markedly tended fall asleep day report preceded descriptions 1960s discoveries led distinction sleep sleep


concussion concussion latin shake violently action striking common type traumatic brain injury terms mild brain injury mild traumatic brain injury mild head injury minor head trauma concussion treated narrower category term concussion sports literature general clinical medical literature uses instead article concussion frequently defined head injury temporary loss brain function concussion causes variety physical emotional symptoms recognized subtle treatment involves monitoring physical rest reduction activities school work playing video games text symptoms usually resolve weeks persist complications occur concussion susceptible especially new injury occurs symptoms previous concussion completely resolved negative progressive process smaller impacts cause severity repeated increase risk later life disease depression variety signs accompany concussion including feeling fog emotional emotional physical signs loss consciousness amnesia changes slowed reaction times sleep disturbances fewer sports related children associated loss consciousness varying definitions possible rate concussion occurs annually accurately known estimated people common causes include sports injuries bicycle accidents car accidents falls frequent causes adults addition blow head concussion caused acceleration forces direct impact battlefield potential consequence nearby explosions clear exactly damage symptoms caused stretching changes channels involved cellular damage reportedly found brains artifacts studies currently thought structural factors responsible effects concussion signs symptoms concussion associated variety symptoms typically occur rapidly injury early symptoms usually days weeks number type symptoms individual suffers varies widely physical common include lack motor coordination difficulty balancing problems movement sensation visual symptoms include light sensitivity seeing bright lights blurred vision double vision ringing ears commonly reported seventy occur place immediately concussion post traumatic unlike post traumatic post traumatic requires form structural brain damage disruption normal brain functioning thought result temporary loss motor function associated structural damage associated particular high rate favorable outcomes emotional symptoms include confusion difficulty focusing attention loss consciousness occur necessarily severity concussion brief post traumatic amnesia events following injury recalled concussion confusion concussion present immediately develop minutes person repeat questions slow respond questions directions vacant speech symptoms include changes sleeping patterns difficulty reasoning concentrating performing everyday activities concussion result changes mood including loss interest favorite activities items displays emotion inappropriate situation common symptoms children include mechanism brain surrounded fluid protects light trauma severe impacts forces associated rapid acceleration absorbed concussion caused impact forces head strikes struck forces head moves subject blunt trauma example chest hits head forward forces cause linear angular movement brain combination movement head turns center gravity angular movement turns axis center gravity force thought major component concussion severity studies athletes shown force location impact necessarily severity concussion symptoms called question threshold concussion previously thought exist parts brain affected forces thought forces injury disrupt normal cellular activities system located areas disruption produces loss consciousness seen concussion areas brain affected include upper brain stem corpus temporal lobe frontal lobe angular estimated risk respectively animals humans alter brain physiology hours years setting motion variety events example animal models initial increase subsequent reduced state persist weeks injury events thought interfere brain function processes follow concussion large majority affected brain cells cells die injury included cascade events brain concussion impaired loss regulation energy use cellular reduction cerebral blood flow chemicals serve stimulate nerve cells released excessive amounts resulting cellular causes fire excessively creates potassium calcium cell membranes process like time cerebral blood flow relatively reduced unknown reasons reduction blood flow severe cells normally causes energy crisis concurrently processes activity reduced causes cells rely produce energy increasing levels period minutes days concussion brain especially vulnerable changes pressure blood flow according studies performed animals applicable humans large numbers die period response slight normally changes blood flow concussion involves opposed focal brain injury meaning occurs widespread area brain particular spot thought type injury injured minor extent stretching animal studies revealed damage brain tissues small injury damage found brains concussion died causes inadequate blood flow brain injuries contributed findings study brains deceased nfl athletes received suggest lasting damage injuries damage severity increases cumulative number sustained lead variety health issues debate concussion functional structural phenomenon ongoing structural damage found mildly injured brains animals clear findings apply humans changes brain structure responsible certain symptoms visual disturbances sets symptoms especially psychological nature likely caused changes cellular function occur concussion alterations changes explain frequently temporary task force head injury experts called concussion sport group met decided concussion result changes acute clinical symptoms largely reflect functional disturbance structural injury summary animal studies concussion start disruption cell membrane nerve cells results migration potassium cell space subsequent release potassium shift turn resulting suppression nerve activity effort restore balance potassium pumps increase activity results excessive consumption cerebral blood flow decreases leads proposed energy crisis increase subsequent lower state persist weeks injury completely separate involves large calcium accumulating cells begin pathways result cell death main pathways established animal studies extent apply humans somewhat unclear diagnosis head trauma recipients initially assessed exclude severe emergency includes breathing circulation spine assumed injured athlete found unconscious head neck injury indications screening injury needed include symptoms persistent increasing deteriorating level consciousness unequal pupil size symptoms higher risk brain injury undergo brain imaging detect frequently observed hours brain brain avoided progressive symptoms focal findings concern skull fracture exam diagnosis based physical examination findings duration usually minutes post traumatic amnesia usually hours glasgow coma scale scores tests exist measure function international consensus meeting recommended use test tests administered hours days weeks injury different times demonstrate trend increasingly athletes tested pre season provide comparison event injury reduce risk affect return play glasgow coma scale hours time recommended addition scan likely performed observation discharge assured present suspected increased risk bleeding age greater detected changes reported imaging concussion normal post concussion syndrome associated visible pet mild head injury produce abnormal readings concussion diagnosed lack highly noticeable signs symptoms athletes minimize injuries remain competition retrospective survey suggested diagnosis complex concussion shares symptoms conditions example post concussion symptoms problems brain injury fact post traumatic stress disorder classification single definition concussion minor head injury mild traumatic brain injury universally accepted expert concussion sport group international concussion sport defined concussion complex process affecting brain induced traumatic forces agreed concussion typically involves temporary function time normally shows gross structural changes brain result condition structural brain damage occurs according classic definition researchers included injuries structural damage occurred national institute health clinical excellence definition includes physical disruption brain definition concussion historically involved loss consciousness definition evolved time include change consciousness amnesia controversy continues definition include injuries loss consciousness occurs debate best known concussion grading scales episodes involving loss consciousness graded severe definitions mild traumatic brain injury inconsistent world health organization international statistical classification diseases related health problems provided consistent authoritative definition organizations american congress rehabilitation medicine american psychiatric association statistical manual mental disorders defined combination loss consciousness post traumatic amnesia glasgow coma scale concussion falls classification mild clear concussion implied mild brain injury mild head injury concussion treated synonyms medical literature injuries necessarily mild head injury concussion associated abnormal considered complicated concussion considered imply state brain function temporarily impaired imply state practice researchers distinguish terms descriptions condition including severity area brain affected concussion clinical grading systems systems measure severity grade mild head injury little agreement best effort 2nd international conference concussion sport meeting prague decided systems abandoned favor simple complex classification meeting abandoned simple versus complex terminology participants agree concept resolve short period days recovery time frame longer children past decision allow athletes return participation frequently based grade concussion current research recommendations professional organizations including national athletic trainers association recommend use grading systems currently injured athletes prohibited returning play free rest results tests returned pre injury levels grading systems widely followed robert colorado medical society american academy employs grades summarized following table prevention prevention involves general measures wearing seat belts cars older people encouraged reduce fall risk keeping floors free wearing thin flat shoes hard interfere balance protective equipment found reduce number athletes improvements design helmets decrease number severity new head impact system technology placed helmets study injury mechanisms generate knowledge potentially help reduce risk american football players changes rules enforcing existing rules sports head associated high injury rate prevent treatment exclusion neck injury observation continued hours repeated seizure activity excessive double vision speech walk weakness arms legs signs skull fracture develop immediate assessment emergency department initial period passed debate necessary person times night traditionally benefit sleep physical rest continued symptoms resolved resolving seven days recovery time longer children rest includes reducing activities require concentration attention school work video games text suggested leisure reading commonly symptoms children proposals include time school attending partial days students appear normal continuing education relevant school personnel needed concussion generally prescribed rest including adequate nighttime sleep daytime rest rest includes physical rest symptoms clear gradual return normal activities pace cause symptoms recommended education symptoms management normal time course lead improved outcome persons participating athletics consensus statement concussion sport recommends participants free progress series graded steps steps include complete physical rest light activity maximum heart rate sport specific activities running drills skating drills non contact training drills exercise coordination load contact practice contact games free hours progression step occur symptoms occur person drop previous level hours emphasis remaining free taking medium steps steps prescribed treat sleep problems depression taken preferred minimize risk individuals advised use alcohol drugs approved doctor healing activation database guided shown return memory abilities individual levels better control group percent people receive treatment need surgery brain injury observation monitor condition important treatment health care providers recommend suffering concussion return medical care evaluation hours event symptoms athletes especially professional typically followed closely team athletic trainers period access level health care sent home minimal monitoring people released assessment hospital emergency room care trusted person instructions return display symptoms indicate condition change consciousness severe weakness new bleeding ears people concussion susceptible particularly new injury occurs symptoms previous concussion completely gone away negative process smaller impacts cause severity repeated increase person risk later life disease depression mortality rate zero symptoms resolve weeks problems persist seldom permanent outcome usually excellent overall recovery influenced variety factors include age time injury intellectual abilities family environment social support system status strategies financial circumstances people age longer heal heal similarly factors previous head injury medical condition found predict longer lasting post concussion symptoms factors recovery time include psychological problems substance abuse clinical depression poor health injury additional injuries sustained life stress longer periods amnesia loss consciousness immediately injury indicate longer recovery times symptoms unknown reasons having concussion significantly increases person risk having having previously sustained sports concussion found strong factor increasing likelihood concussion future strong factors include participation contact sport body mass size differ adults children little research concussion population concern exists severe interfere brain development children study found individuals history demonstrate decline physical mental performance longer years compared peers history brain trauma concussion exhibited effects including loss episodic memory reduced muscle speed post concussion syndrome post concussion syndrome symptoms resolve weeks months years concussion occasionally permanent people post concussion syndrome month symptoms include fatigue anxiety memory attention problems sleep problems scientifically established treatment rest recommended recovery technique limited effectiveness symptoms usually away months question syndrome structural damage factors psychological ones combination long subject debate cumulative effects cumulative effects poorly understood true children severity symptoms successive injuries subsequent injury occurs months years initial symptoms severe changes occur subsequent studies conflicting findings athletes longer recovery times repeat cumulative effects memory occur cumulative effects include psychiatric disorders loss long term memory example risk developing clinical depression found significantly greater retired american football players history concussion history associated greater chance developing disease earlier greater chance developing memory chronic traumatic example cumulative damage occur result multiple severe blows head condition previously referred punch drunk syndrome noted disease lead physical speech memory problems slowed mental processing depression inappropriate behavior shares features disease second impact syndrome second impact syndrome brain swells dangerously minor blow occur rare cases condition develop people receive second blow days weeks initial concussion symptoms gone away certain cause fatal commonly thought swelling occurs brain lose ability regulate diameter causing loss control cerebral blood flow brain swells pressure rapidly rises brain brain stem fail minutes boxing cases occurred athletes age small number documented cases diagnosis controversial doubt exists validity review article stated debate brain swelling separate hits hit case catastrophic football head injuries times likely high school athletes college athletes cases traumatic brain injury world health organization study estimated head injuries receive treatment mild widely varying definitions concussion difficult estimate common condition estimates concussion artificially low example fail assessed medical professional group reviewed studies found hospital treatment rate people treated hospitals estimated rate year general population people young children highest concussion rate age groups people suffer concussion young adults canadian study found yearly lower older age groups right studies suggest males suffer twice rate female counterparts female athletes higher risk suffering concussion male counterparts percent sports injuries centers disease control prevention estimates sports related occur yearly number includes athletes lost consciousness loss consciousness thought occur estimate likely lower real number sports concussion particularly common include football boxing boxer aims knock mild traumatic brain injury opponent injury common medical groups called ban sport including american academy world medical association medical associations australia canada lack consistent definition economic costs known estimated high high costs large percentage hospital head injury mild head trauma indirect costs lost work time early retirement account bulk costs direct indirect costs cause expense mild brain trauma rival moderate severe head injuries history corpus collection medical works ancient greece mentions concussion later translated discusses loss speech hearing sight result brain idea disruption mental function shaking brain remained widely accepted understanding concussion 19th century persian physician muhammad ibn write concussion distinct types head injury 10th century use term cerebral concussion definition condition loss function physical damage set stage medical understanding condition centuries 13th century physician milan described concussion brain recognizing difference concussion types traumatic brain injury contemporaries discussing post concussion symptoms result temporary loss function injury 14th century surgeon guy pointed relatively good concussion compared severe types head trauma skull penetrating head trauma 16th century term concussion came use symptoms confusion memory problems described 16th century physician term shaking brain concussion 17th century concussion usually described clinical features invention microscope physicians began exploring underlying physical structural mechanisms prevailing view 17th century injury result physical damage view continued widely held 18th century word concussion time describe state functional problems resulted impact condition described brain involve small showed difference associated damage brain concussion injury animal experiments showed damage occurs concussion research tentative success animal models measurement visual tracking studied screening technique identify mild traumatic brain injury head mounted display unit eye tracking capability shows moving object pattern person follow eyes people brain injury able track moving object smooth pursuit eye movements correct trajectory mild traumatic brain injury


hiv human virus hiv causes hiv infection time acquired syndrome aids aids condition humans progressive failure immune system allows life threatening thrive treatment average survival time infection hiv estimated years depending hiv infection hiv occurs transfer blood fluid pre breast milk hiv present free virus particles virus infected immune cells hiv vital cells human immune system cells specifically cells cells hiv infection leads low levels cells number mechanisms including infected cells cells direct viral killing infected cells killing infected cells recognize infected cells cell numbers decline critical level cell immunity lost body progressively susceptible classification hiv member genus family biological properties common species infected responsible long duration illnesses long period transmitted single stranded positive sense entry target cell viral converted reverse double stranded dna reverse transported viral virus particle resulting viral dna imported cell nucleus integrated cellular dna host factors integrated virus allowing virus host cell avoid detection immune system alternatively virus producing new viral proteins packaged released cell new virus particles begin cycle types hiv characterized virus initially discovered termed iii cause majority hiv globally lower compared implies fewer exposed infected exposure relatively poor capacity transmission largely confined west_africa structure hiv different structure roughly spherical diameter times smaller red blood cell composed copies positive single stranded codes virus genes enclosed conical composed copies viral protein single stranded tightly bound proteins needed development reverse matrix composed viral protein surrounds ensuring integrity particle turn surrounded viral envelope composed taken membrane human cell newly formed virus particle cell viral envelope contains proteins host cell relatively copies hiv envelope protein consists cap molecules known stem consisting molecules anchor structure viral envelope envelope protein hiv gene allows virus attach target cells fuse viral envelope target cell membrane releasing viral contents cell initiating infectious cycle sole viral protein surface virus envelope protein major target hiv efforts half mass envelope spike linked density high shield underlying viral protein densely molecules known density sufficiently high prevent normal maturation process apparatus majority stalled immature high normally present cell surface human unusual processing high density means broadly far identified patients infected months years adapted cope envelope molecular structure viral spike determined ray electron advances structural biology possible development stable forms viral spike introduction bond called reproduce properties native viral spike display degree immature presented native virus viral spikes promising candidates display non act suppress immune response target consists seven structural landmarks tar slip ins genes gag tenth fusion proteins genes gag contain information needed structural proteins new virus particles example codes protein called cut cellular form remaining genes case regulatory genes proteins control ability hiv cells produce new copies virus replicate cause disease proteins promoter acting binding tar element tar processed regulate genes protein involved nucleus binding element protein prevents action cellular protein single stranded viral dna reverse protein arrests cell division protein major viral class class molecules domains protein influences release new virus particles infected cells ends strand hiv contain sequence called long terminal repeat regions act switches control production new triggered proteins hiv host cell psi element involved viral packaging recognized gag proteins slip element involved gag reading frame required functional term viral refers cell types virus hiv variety immune cells cells cells entry cells interaction envelope target cells strains non inducing strains called use entry able replicate cells primary regardless viral genetic play key role critical aspects hiv infection appear cells infected hiv source hiv production cells depleted patient cells cells infected hiv central nervous system hiv infected patients fuse giant cells produce huge amounts virus inducing called strains replicate primary cells use entry dual strains thought transitional strains able use viral entry regulating expression surface cells hiv use termed use termed use use explain viral able use productive infection hiv cells probably constitute reservoir maintains infection cell numbers declined extremely low levels people resistant certain strains hiv example people resistant infection virus stops hiv binding reducing ability target cells sexual intercourse major mode hiv transmission hiv present seminal fluid passed male sexual partner numerous cellular targets organism selection process leads predominant transmission virus selective process works investigation model carry hiv possess surface cells virus patients infected switch late stage disease variants appear variety cells variants replicate aggressively heightened causes rapid cell immune system collapse mark advent aids course infection viral adaptation use instead key step progression aids number studies infected individuals determined percent aids patients harbour presumed restricted worldwide distribution adoption genes pattern usage including independence assist virus adaptation avoid innate restriction factors present host cells adaptation use normal cellular machinery enable transmission productive infection aided establishment humans survival strategy infectious agent kill host ultimately organism having achieved low time variants successful transmission selected cycle entry cell hiv enters cells surface target cell followed fusion viral envelope cell membrane release hiv cell entry cell begins interaction envelope complex spike generally known interact cell surface central involved establishment facilitate efficient cell cell spreading spike contains binding domains step fusion involves high affinity attachment binding domains bound protein envelope complex undergoes structural change exposing binding domains allowing interact target allows stable attachment allows terminal fusion penetrate cell membrane repeat sequences interact causing collapse portion loop structure brings virus cell membranes close allowing fusion membranes subsequent entry viral hiv bound target cell hiv including reverse injected cell based transport nucleus viral single strand double strand dna integrated host hiv cells route route specific type sign cells encountered virus sexual transmission currently thought play important role hiv cells virus captured presence occurs naturally believed prevent infection cells hiv entry entry long believed occur exclusively membrane recently productive infection independent dependent reported recently suggested constitute route productive entry shortly viral enters cell called reverse single stranded attached viral proteins copies dna process reverse extremely error prone resulting cause drug resistance allow virus evade body immune system reverse activity viral synthesis dna dependent dna activity creates sense dna complement form double stranded viral dna transported cell nucleus integration viral dna host cell carried viral called integrated viral dna lie dormant stage hiv infection actively produce virus certain cellular factors need present important cells activated means cells likely killed hiv currently fighting infection viral integrated dna undergo produce mature exported nucleus translated regulatory proteins encourages new virus production newly produced protein nucleus length copies virus allows leave nucleus length function new copies virus function translated produce structural proteins gag gag proteins copies virus package new virus particles appear package differently appropriate create gag protein particle structure hiv infection reverse occur occurs single strand reverse form dna reverse nascent dna switch multiple times copies viral form known copy choice events occur events occur cycle events rapidly shuffle genetic information transmitted parental viral produces genetic variation likely contributes evolution resistance anti therapy contribute principle overcoming immune defenses host advantages genetic variation realized viral packaged individual virus particles need arisen separate parental differing genetic constitution unknown mixed packaging occurs natural conditions suggested template switching reverse acts repair process deal breaks addition suggested adaptation repair damage strand switching copy choice reverse generate undamaged copy dna damaged copies view benefit hiv explain hiv particle contains complete furthermore view repair process implies benefit repair occur cycle benefit realized differ genetically view hiv repair process generation variation consequence cause evolution template switching infection causes chronic ongoing production oxygen species hiv vulnerable damages including breaks single stranded hiv generally successful infection depends overcoming host defensive strategies include production damaging oxygen suggested adaptation repair damages variation provide separate benefit assembly release final step viral cycle assembly new begins membrane host cell goes transported complex resulting hiv envelope transported membrane host cell anchors membrane infected cell gag gag associate inner surface membrane hiv forming begins host cell immature gag need actual matrix proteins packaged viral drugs class structural components assemble produce mature hiv mature able cell spread body hiv known spread cells parallel routes cell free spread cell cell spread employs hybrid spreading mechanisms cell free spread virus particles infected cell enter blood fluid cell following chance encounter hiv direct transmission cell process cell cell spread pathways cell cell transmission reported firstly infected cell transmit virus directly target cell secondly presenting cell transmit hiv cells process involves productive infection case capture transfer trans case cells infection cell cell transfer reported efficient cell free virus spread number factors contribute increased efficiency including virus site cell cell contact close cells fluid phase hiv entry target cell contact zone cell cell spread thought particularly important tissues densely packed likely frequently interact imaging studies supported concept hiv hybrid spreading mechanisms hiv contribute virus ongoing genetic hiv differs high genetic diversity result fast cycle generation day coupled high rate approximately base cycle properties reverse complex scenario leads generation variants hiv single infected patient course day compounded single cell simultaneously infected different strains hiv simultaneous infection occurs composed strands different strains hybrid new cell undergoes happens reverse jumping forth different generate newly synthesized dna sequence parental obvious occurs closely related virus evolved strains classified natural host species strains african green monkey thought long evolutionary history hosts hosts adapted presence virus present high levels host blood evokes mild immune response cause development aids undergo extensive typical hiv infection humans contrast strains species adapted hosts animals develop aids virus generates genetic diversity similar seen human hiv infection closest genetic relative associated increased mortality aids like symptoms natural host appears transmitted relatively recently human populations hosts adapted virus virus lost function gene present non variants cell activation marker function non forms expression signals affect cell trafficking cell activation lost function function cell likely leading groups identified basis differences envelope region group prevalent subdivided based geographically distinct prevalent found mainly north_america europe found mainly africa found mainly africa asia form branches phylogenetic tree representing lineage group distinct gives rise circulating forms year analysis global prevalence worldwide remaining composed research focused laboratories focus existence fourth group based virus isolated strain apparently derived isolated western lowland closest relative strain found derived genetic sequence partially closely resembles diagnosis hiv positive people unaware infected virus example sexually active urban population africa tested proportion lower rural populations furthermore pregnant women attending urban health facilities tested receive test results proportion lower rural health facilities donors unaware infection donor blood blood products medicine medical research routinely screened hiv testing initially linked detect specimens result initial considered hiv negative new exposure infected partner partner unknown hiv status occurred specimens result duplicate result duplicate test specimen reported repeatedly undergoes testing specific supplemental test western commonly specimens repeatedly positive western considered hiv positive indicative hiv infection specimens repeatedly occasionally provide western result incomplete response hiv infected person reactions person confirm infection ambiguous cases widely general second specimen collected month later persons western results commonly available acid testing viral dna method help diagnosis certain situations addition tested specimens provide inconclusive results low quantity specimen situations second specimen collected tested hiv infection modern hiv testing extremely accurate single screening test correct time chance false positive result standard step testing protocol estimated low risk population testing post exposure recommended initially weeks months months latest recommendations hiv testing start combination test negative result rules hiv exposure positive followed detect present gives rise possible scenarios detected detected hiv detected acid test carried detect acute infection absence updated published june recommends diagnosis starts test negative result rules infection positive followed positive test confirms diagnosis negative result followed acid test positive result confirms infection negative result rules infection false positive research hiv aids research includes medical research attempts prevent treat cure hiv aids fundamental research nature hiv infectious agent aids disease caused hiv governments research institutions participate hiv aids research research includes health research sex education drug development research sexually transmitted diseases hiv drugs medical research areas include topics pre exposure post exposure hiv accelerated aging effects history discovery aids observed united_states initial cases cluster injection drug users gay men known cause impaired immunity showed symptoms pneumonia rare infection known occur people compromised immune systems soon additional gay men developed previously rare skin cancer called cases emerged centers disease control prevention task force formed monitor outbreak earliest described case aids believed norway beginning beginning official disease referring way diseases associated example disease hiv originally named virus task force set general press term grid stood gay related immune coined search looking infected communities coined disease single heroin users determining aids isolated gay community realized term grid misleading aids introduced meeting july september started aids separate research groups led robert independently declared novel aids patients published findings issue journal science claimed virus group isolated person aids similar shape human group group called newly isolated virus iii time group isolated virus patient presenting swelling neck physical weakness classic symptoms aids report group colleagues showed core proteins virus different group named isolated virus associated virus turned iii renamed hiv origins believed originated non human west central africa believed transferred humans process known early 20th century appears originated southern evolution virus wild descends endemic subspecies pan closest relative virus old world monkey living west_africa southern western new world owl monkey resistant infection possibly fusion viral resistance genes thought jumped species barrier separate occasions giving rise groups virus evidence humans participate activities hunters vendors commonly acquire weak virus typically suppressed human immune system weeks infection thought virus individual individual quick succession necessary allow time hiv furthermore relatively low person person transmission rate spread population presence high risk transmission channels thought absent africa prior 20th century specific proposed high risk transmission channels allowing virus adapt humans spread society depend proposed timing animal human crossing genetic studies virus suggest recent common ancestor group dates circa proponents dating link hiv epidemic emergence growth large colonial african cities leading social changes including higher degree sexual spread prostitution high frequency diseases nascent colonial cities transmission rates hiv intercourse typically low increased fold partners suffers sexually transmitted infection resulting early 1900s colonial cities notable high prevalence prostitution degree female residents eastern thought prostitutes residents city infected forms alternative view holds unsafe medical practices africa years following world war reuse single use mass anti malaria treatment campaigns initial allowed virus adapt humans spread earliest documented case hiv human dates belgian virus present united_states early mid late 1950s sixteen year old male presented symptoms died


poisoning poisoning caused primary ingredient automotive toxic liquid sweet taste accidentally consumed children animals sweetness following symptoms poisoning progress signs similar finally acute kidney failure major cause mainly acid acid treatment poisoning needs started soon possible effective earlier treatment started greater chance survival kidney failure develops dogs cats poor poisoning relatively common taste children domestic animals wildlife consume substance added products discourage accidental deliberate medical diagnosis poisoning reliably measuring blood hospitals facilities perform test need rely body poisoning calcium crystals present treatment consists initially patient followed use work blocking responsible halt progression poisoning help remove blood long medical treatment undertaken generally good patients making recovery signs symptoms signs poisoning depend time symptoms usually follow step progression poisoned individuals develop stage stage minutes hours consists symptoms looks similar alcohol poisoning poisoned individuals appear lacking coordination muscle movements depressed speech abnormal eye movements confusion stomach cause seen excessive time body stage hours signs alcohol poisoning appear resolve underlying severe internal damage occurring elevated heart rate increased breathing effort start develop high blood pressure symptoms result accumulation organic formed additionally low calcium concentrations blood muscle muscle interval heart failure occur death commonly occurs period stage hours kidney failure result poisoning cats stage occurs hours getting dogs hours getting stage severe kidney failure developing secondary calcium crystals forming severe coma depression seen symptoms include acute tubular red blood cells excess proteins lower pain decreased absent production elevated blood concentration potassium acute kidney failure kidney failure occurs typically weeks months supportive care including required kidney function returns main systems affected poisoning central nervous system processes central nervous system affected early course poisoning result direct action similar causes followed coma occur direct effect toxic mechanism poisoning mainly initially alcohol acid increase cause cerebral effects occur hours post causing primarily mainly accumulated acid additionally effect steps increase blood concentration acid occurs contributing formation acid causes pathways occurs hours post caused direct effect acid acid acid finally acid acid calcium form calcium crystals deposit cause damage areas body including brain heart lungs significant effect accumulation calcium crystals causes kidney damage leading acute kidney failure rate limiting step cascade conversion acid accumulation acid body mainly responsible shown toxic humans toxic domestic pets cats dogs toxic dose requiring medical treatment varies considered body weight pure substance roughly adult child poison control centers use taste child adult dose requiring hospital assessment lethal dose humans reported approximately pure approximately adult child survival medical treatment occurred higher death occurred concentrate adult classification dangerous substances harmful toxic substances classified toxic toxic environmental protection agency generally puts substances lethal adults class iii low pressure readily normal temperatures high concentrations air unlikely occur following slight risk poisoning generated rarely leads poisoning causes victims presence absorbed skin meaning poisoning following dermal exposure uncommon prevention products automotive use containing place available generally considered safer use possesses unpleasant taste contrast perceived sweet taste toxic based produces acid animal body muscles exercised products containing recommended safety measures include cleaning spill immediately thoroughly cleaned cat litter sand material directly spill fully absorbed wearing protective gloves material plastic bag sealed disposed spill area stiff brush warm water water recommended drained storm drain checking vehicles regularly leaks storing clearly marked original sealed containers areas inaccessible pets small children keeping pets small children away area draining car taking service station placed toilets ensuring lid door closed diagnosis clinical signs symptoms poisoning occur diagnosis difficult reliably diagnosed measurement blood concentration biological determined gas hospital laboratories ability perform blood test absence test diagnosis based clinical presentation patient situation helpful test poisoning measurement gap patients measured freezing point depression compared predicted based patients measured blood nitrogen presence large gap supports diagnosis poisoning normal gap rule exposure wide individual increased gap caused progresses decrease blood concentration gap making test useful additionally presence conditions alcoholic kidney failure produce elevated gap leading false diagnosis laboratory suggest poisoning especially presence particularly characterized large gap large gap usually present initial stage poisoning large number differential diagnosis including poisoning iron conditions alcoholic diagnosis poisoning considered patient severe reveal needle envelope shaped calcium crystals suggest poisoning crystals present late stages poisoning finally commercial products added enable leaks detected wood lamp following products containing wood lamp reveal patient mouth area clothing help poisoning treatment important initial treatment poisoning patient rapidly absorbed unlikely benefit performed minutes traditionally contents common methods employed poisoning questioned longer routinely poisoning situations induced recommended activated recommended effective preventing absorption presence toxic dose poison drug patients significant poisoning present critical condition situation patient including management performed preference patients presenting require treatment respectively increasing protein binding calcium occurs treated calcium replacement calcium increase precipitation calcium crystals leading tissue damage respiratory support required severely patients patients require treatment possibly following institution supportive measures priority poisoning treatment forms management poisoning comes acid acid goal prevent formation acts competing alcohol degradation higher affinity alcohol times greater affinity successfully blocks breakdown prevents degradation acid formation effects avoided present body eventually supportive therapy depression required concentrations fall toxic limits grade usually given solution given form strong spirit potent alcohol similar acts block formation toxic shown highly effective poisoning approved food drug administration treatment poisoning advantages readily available hospitals inexpensive administered adverse effects include children possible liver patients receiving therapy require frequent blood concentration measurements adjustments maintain concentration patients monitored intensive care unit alternatively adverse effects minimal approved maintains concentrations need monitor blood concentrations drug disadvantage expensive costing average course adult poisoning cost approximately despite cost gradually replacing choice poisoning agents including given help prevent formation acid use agents based theoretical observations limited evidence support use treatment particular benefit people alcoholic patients addition important treatment poisoning use enhance removal body shown highly effective removal blood added benefit supporting deteriorating kidney function usually indicated patients severe blood kidney failure severe patients condition deteriorating despite treatment treatment treatment poisoning remove blood need increased compensate available removes efficiently treatment poisoning needs started soon possible effective earlier treatment started greater chance survival cats treated hours effective dogs treated hours kidney failure develops poor generally patient treated survives recovery expected patients present early medical facilities prompt medical treatment typically favorable outcome alternatively patients presenting late signs symptoms coma severe poor patients develop severe central nervous system stroke survive long term cases recover prolonged significant long term related cases permanent kidney damage requiring chronic kidney reported severe poisoning poisoning relatively common occurrence worldwide human poisoning occurs isolated cases occur cases poisoning result cheap substitute alcohol intentional suicide attempts commonly means homicide children animals exposed accidental children animals consume large amounts having sweet taste united_states cases reported poison centers additionally common chemical responsible deaths reported poison centers australia cases reported victorian poison center cases reported new_south_wales poison center numbers actual numbers cases reported poison control centers deaths intentional deaths children extremely rare effort prevent poisoning agent called known trade added preparations prevent accidental intentional agent thought stop human defense harmful substances rejection bitter substances united_states states oregon california new_mexico virginia arizona maine tennessee washington addition agents compulsory follow studies targeting limited populations persons assess agents preventing death shown limited benefit preparations populations specifically finds reduce reported cases poisoning state oregon similarly white found adding agents decrease frequency severity children age additionally study white found persons taste attempts kill studies focus poisoning domestic pets livestock example exposure large population non age children poisoning diagnosed prince edward island canada online manual provides information lethal chicken cattle cats dogs adding younger animals susceptible environmental effects involved aircraft anti operations released land eventually waterways report prepared world health organization stated laboratory tests exposing aquatic organisms stream water receiving runoff airports shown toxic effects death field studies vicinity airport reported toxic signs consistent poisoning fish kills reduced biodiversity effects definitively ascribed process increases risk organisms oxygen levels depleted surface waters study found aquatic organisms relatively low oxygen effect release relatively toxic canada environment canada reports recent years management practices canada major airports improved installation new application facilities improvements existing ones federal airports comply guidelines canadian environmental protection act monitoring reporting concentrations surface water detailed plans include storage handling issues spill response procedures measures taken reduce volumes fluid considering factors seasonal nature releases ambient temperatures rates duration exposure environment canada stated proposed entering environment quantity concentration conditions immediate long term harmful effect environment biological diversity airports required obtain discharge permits ensure operations properly collected treated large new airports required collect percent aircraft fluid airports discharge collected aircraft fluid directly waters meet discharge requirements chemical oxygen demand report stated popular aircraft reporting requirements adverse environmental impacts noted shift use history thought suggested suitable use vehicle preparations numerous cases poisoning reported shown toxic humans