tuberculosis tuberculosis infectious disease caused tuberculosis tuberculosis generally affects lungs affect parts body symptoms known tuberculosis progress active disease left kills half infected classic symptoms active chronic blood containing fever night weight loss historical term consumption came weight loss infection organs cause wide range symptoms tuberculosis spread air people active lungs spit speak people spread disease active infection occurs people hiv aids smoke diagnosis active based chest rays microscopic examination culture body diagnosis relies skin test blood tests prevention involves screening high risk early detection treatment cases high risk include household workplace social contacts people active treatment requires use multiple long period time resistance growing problem increasing rates multiple drug resistant tuberculosis world population thought infected new occur population year million cases active resulted million deaths deaths occurred developing countries number new cases year decreased people asian african countries test positive people united_states population tests positive test tuberculosis present humans ancient times signs symptoms tuberculosis body commonly occurs lungs known tuberculosis occurs tuberculosis develops outside lungs general signs symptoms include fever night loss appetite weight loss fatigue significant nail occur tuberculosis infection active commonly involves lungs cases symptoms include chest pain prolonged producing people symptoms remain occasionally people blood small amounts rare cases infection resulting massive bleeding tuberculosis chronic illness cause extensive upper lungs upper lung frequently affected tuberculosis lower ones reason difference clear better air flow poor drainage upper lungs active cases infection spreads outside lungs causing kinds collectively denoted tuberculosis occurs commonly persons young children hiv occurs cases notable infection sites include central nervous system system neck system tuberculosis bones joints disease spine spreads bones known tuberculosis form skin results originating nearby infected slowly appearance wash leather potentially widespread form called tuberculosis known tuberculosis makes cases causes main cause tuberculosis small high content accounts unique clinical characteristics divides hours extremely slow rate compared bacteria usually divide hour outer membrane stain performed weakly positive retain result high acid content cell wall withstand weak survive dry state weeks nature grow cells host organism tuberculosis laboratory samples called scientists identify microscope retains certain treated acidic solution classified acid fast common acid fast techniques stain stain acid fast bright red stands blue background tuberculosis complex includes causing widespread significant cause tuberculosis parts africa common cause tuberculosis introduction milk completely eliminated public health problem developed countries rare limited horn africa cases seen african rare seen people prevalence significantly known include species classified cause cause diseases resemble risk factors number factors people susceptible important risk factor globally hiv people infected virus particular problem sub africa rates hiv high people hiv infected tuberculosis develop active disease contrast hiv develop active disease tuberculosis closely linked making principal diseases poverty high risk include people illicit drugs inhabitants employees vulnerable people gather prisons homeless shelters medically resource poor communities high risk ethnic minorities children close contact high risk category patients health care providers serving patients chronic lung disease significant risk factor increases risk fold smoke cigarettes nearly twice risk compared disease states increase risk developing tuberculosis include alcoholism diabetes fold increase certain anti increasingly important risk factors especially developed world genetic exists overall importance remains mechanism transmission people active speak sing spit expel infectious diameter single release transmit disease infectious dose tuberculosis small fewer bacteria cause infection people prolonged frequent close contact people particularly high risk infected estimated infection rate person active tuberculosis people year transmission occur people active infection thought probability transmission person depends factors including number infectious expelled carrier effectiveness ventilation duration exposure tuberculosis strain level immunity person cascade person person spread active overt putting anti drug weeks effective treatment subjects active generally remain infected typically takes weeks newly infected person infectious transmit disease infected tuberculosis called lifetime chance infection progress overt active disease hiv risk developing active increases nearly year effective treatment given death rate active cases infection begins reach invade replicate identify foreign attempt eliminate process stored temporarily membrane bound called combines create cell attempts use oxygen species acid kill tuberculosis thick acid capsule protects toxic substances tuberculosis able reproduce inside eventually kill immune cell primary site infection lungs known focus generally located upper lower lobe lower upper lobe tuberculosis lungs occur infection blood stream known simon focus typically found lung transmission spread infection distant sites peripheral brain bones parts body affected disease unknown reasons rarely affects heart skeletal muscles tuberculosis classified diseases aggregate form surrounding infected attack infected fuse form giant cell prevent provide local environment interaction cells immune system recent evidence suggests bacteria use avoid destruction host immune system cells unable present immune response suppressed bacteria inside dormant resulting infection feature development abnormal cell death center naked eye texture soft white cheese termed bacteria gain entry blood stream area damaged tissue spread body set infection appearing tiny white tissues severe form disease common young children hiv called tuberculosis people high fatality rate treatment people infection tissue destruction balanced healing affected tissue replaced filled material active disease joined air passages material contains living bacteria spread infection treatment appropriate kills bacteria allows healing place cure affected areas eventually replaced tissue diagnosis active tuberculosis active tuberculosis based signs symptoms difficult disease diagnosis considered signs lung disease constitutional symptoms lasting longer weeks chest ray multiple cultures acid fast typically initial evaluation release skin tests little use developing world similar limitations hiv definitive diagnosis identifying tuberculosis clinical sample tissue difficult culture process slow growing organism weeks blood culture treatment begun cultures confirmed acid tests testing allow rapid diagnosis tests routinely recommended rarely alter person treated blood tests detect specific sensitive recommended tuberculosis skin test screen people high risk previously false positive test result test falsely negative notably active tuberculosis gamma release blood sample recommended positive test affected environmental generate fewer false positive results affected increase sensitivity addition skin test sensitive skin test prevention tuberculosis prevention control efforts rely primarily detection appropriate treatment active cases world health organization achieved success improved treatment small decrease case numbers available children decreases risk getting infection risk infection turning disease nearly widely worldwide children immunity decreases years tuberculosis uncommon canada united_kingdom united_states administered people high risk reasoning use makes skin test falsely positive reducing test use screening number new currently development public health world health organization declared global health emergency stop partnership developed global plan stop tuberculosis aims save million lives launch number targets set likely achieved increase hiv associated tuberculosis emergence multiple drug resistant tuberculosis tuberculosis classification system developed american society primarily public health programs management treatment uses kill bacteria effective treatment difficult unusual structure chemical composition cell wall entry drugs makes ineffective commonly treatments prolonged taking months treatment usually employs single active disease best treated combinations reduce risk bacteria developing resistance people treated prevent progressing active disease later life directly observed therapy having health care provider watch person recommended effort reduce number people appropriately taking evidence support practice people simply taking independently poor methods remind people importance treatment appear effective new onset recommended treatment new onset tuberculosis months combination containing months months resistance high added months alternative disease tuberculosis testing determine sensitive important determining treatment multiple drug resistant detected treatment effective months recommended medication resistance primary resistance occurs person infected resistant strain person fully susceptible develop secondary acquired resistance therapy inadequate treatment taking prescribed appropriately lack compliance low quality medication drug resistant public health issue developing countries treatment longer requires expensive drugs defined resistance effective line drugs extensively drug resistant resistant classes second line drugs totally drug resistant resistant currently drugs observed italy widely reported found iran india tentatively supported use multiple drug resistant term define extensively resistant constitutes cases cases identified countries progression infection overt disease occurs overcome immune system defenses begin primary disease cases occurs soon initial infection majority cases infection occurs obvious symptoms dormant produce active tuberculosis cases years infection risk increases caused infection hiv people tuberculosis hiv risk increases year studies dna tuberculosis strains shown contributes substantially previously thought estimates account reactivated cases areas common chance death case tuberculosis roughly world population infected tuberculosis new occurring population year tuberculosis cause disease remain estimated million chronic cases active million new cases diagnosed million deaths occurred occurring developing countries million deaths million occur infected hiv tuberculosis second common cause death infectious disease hiv aids total number tuberculosis cases decreasing new cases decreased china achieved particularly dramatic progress reduction mortality rate number new cases declined tuberculosis common developing countries population asian african countries test positive tests population test positive hopes totally controlling disease dramatically number factors including difficulty developing effective expensive time consuming process necessity months treatment increase hiv associated tuberculosis emergence drug resistant cases 1980s country highest estimated rate cases people india largest total estimated million new cases developed countries tuberculosis common found mainly urban areas rates people different areas world globally africa americas eastern mediterranean europe southeast_asia western pacific canada australia tuberculosis times common peoples especially remote areas united_states native americans greater mortality racial ethnic minorities accounted reported cases rates varies age africa primarily affects young adults countries rates declined dramatically united_states mainly disease older people risk factors listed worldwide high burden states countries experience cases deaths history tuberculosis present humans antiquity earliest detection tuberculosis involves evidence disease remains wyoming dated years ago tuberculosis originated transferred humans diverged common ancestor currently unclear comparison genes tuberculosis complex humans animals suggests humans acquire animals animal previously believed strains tuberculosis bacteria share common ancestor infected humans revolution skeletal remains prehistoric humans researchers found decay spines egyptian dating genetic studies suggest present americas industrial revolution folklore associated tuberculosis vampires member family died infected members lose health slowly people believed caused original person draining life family members form associated established richard variety symptoms identified single disease 1820s named tuberculosis john owner cave brought number people tuberculosis cave hope disease constant temperature purity cave air died year opened causing tuberculosis tuberculosis identified described march robert received nobel prize physiology medicine discovery believe cattle human tuberculosis diseases similar delayed recognition infected milk source infection later risk transmission source dramatically reduced invention process announced extract remedy tuberculosis calling effective later successfully adapted screening test presence pre tuberculosis world tuberculosis day established march reason albert achieved genuine success tuberculosis strain tuberculosis called humans france received widespread acceptance great_britain germany world war tuberculosis caused widespread public concern 19th early 20th centuries endemic disease urban poor deaths england consumption deaths france caused determined 1880s disease list britain campaigns started stop people public places infected poor encouraged enter resembled prisons middle upper classes offered excellent care constant medical attention purported benefits fresh air labor best conditions entered died years circa europe rates tuberculosis began rise early peak level 1800s caused nearly deaths 1950s mortality decreased nearly improvements public health began significantly reducing rates tuberculosis arrival disease remained significant threat public health medical research council formed britain initial focus tuberculosis research development effective treatment cure reality prior introduction drug treatment surgical intervention including technique involved collapsing infected lung rest allow heal emergence surgery introduced option generally accepted standard care treating current surgical involve removal chest lungs reduce number bacteria increase exposure remaining bacteria drugs simultaneously reducing total load increasing effectiveness therapy hopes completely eliminating smallpox population rise drug resistant strains 1980s subsequent resurgence tuberculosis resulted declaration global health emergency world health organization society culture names greek word consumption old term tuberculosis described disease dry seasons short public health efforts world health organization bill gates foundation government fast acting tuberculosis test use middle income countries addition fast acting test determine resistance indicate multi drug resistant tuberculosis accurate infected hiv resource poor places access india highest total number cases worldwide poor disease management private public health care sector programs revised national tuberculosis control program working reduce levels people receiving public health care healthcare report need address urging increased funding report cites like orphan neglected countries high burden forgotten donors investing health slow progress led frustration expressed executive director global fund fight aids tuberculosis malaria mark tools end public health threat planet international organizations pushing transparency treatment countries implementing mandatory reporting cases government adherence commercial treatment providers times second line drugs treatment promoting demands regulations government brazil provides universal care reduces problem conversely falling rates infection relate number programs directed reducing infection rates tied increased level education income health population costs disease calculated world bank exceed billion usd year high burden countries lack progress disease lack patient follow rural migrants china stigma slow progress preventing disease stigma associated stigma fear transmission affected individuals stigma additionally arise links poverty africa aids real perceived example individuals banned attending public gatherings stigma result delays seeking treatment lower treatment compliance family members keeping cause death secret allowing disease spread odds russia stigma associated increased treatment compliance stigma affects socially individuals greater degree varies regions way decrease stigma promotion clubs infected share experiences offer support counseling studies shown education programs effective decreasing stigma effective increasing treatment adherence despite studies relationship reduced stigma mortality lacking similar efforts decrease stigma surrounding aids effective claimed stigma worse disease healthcare providers unintentionally reinforce stigma perceived difficult undesirable greater understanding social cultural dimensions tuberculosis help stigma reduction research limitations research develop new ongoing number potential candidates currently phase clinical trials main approaches attempt improve available approach involves adding strategy attempting create new better live example currently trials south_africa based genetically modified virus hoped play significant role treatment active disease encourage discovery researchers promoting new economic models development including prizes tax incentives advance market commitments number groups including stop partnership south african tuberculosis initiative global foundation involved research global foundation received gift million bill gates foundation develop license improved tuberculosis use high burden countries number studied multi drug resistant tuberculosis including received food drug administration approval late safety effectiveness new agents uncertain based results relatively small studies existing data suggest patients taking addition standard therapy times likely die new drug resulted medical journal articles raising health policy questions approved drug financial ties company making influenced physicians support use animals different animals including birds reptiles subspecies tuberculosis rarely present wild animals effort tuberculosis caused cattle deer new_zealand relatively successful efforts great_britain successful tuberculosis appears widespread captive elephants believed animals originally acquired disease humans process called reverse disease spread air humans animals public health concern affecting


called low common disorder system produce cause number symptoms poor ability tolerate cold feeling depression weight gain occasionally swelling neck pregnancy lead delays growth intellectual development baby called worldwide little diet common cause countries diet common cause condition common causes include previous treatment radioactive injury anterior certain lack functioning birth previous surgery diagnosis suspected confirmed blood tests measuring levels prevention population level universal salt treated dose adjusted according symptoms levels medication safe pregnancy certain important excessive amounts certain types worldwide billion people estimated unknown results united_states occurs people form characterized normal levels elevated level thought occur people united_states common women men people age commonly affected dogs known develop rare cases cats horses disorder word greek meaning reduced shield form signs symptoms people mild symptoms numerous symptoms signs associated related underlying cause direct effect having present mass effect enlarged delayed testing ankle characteristic sign associated severity deficit coma coma rare life threatening state extreme occur known develop illness presentation illness characterized low body temperature confusion slow heart rate reduced breathing effort physical signs suggestive skin changes tongue pregnancy mild associated impaired fertility increased risk early pregnancy limited symptoms increase risk pre offspring lower intelligence risk infant death time birth women affected pregnancy associated diabetes birth baby weeks pregnancy children newborn children normal birth weight height head larger expected posterior open decreased muscle tone sounding cry feeding difficulties enlarged tongue dry skin decreased body temperature rare develop later children produce functioning develop children growing areas normal growth development delayed treating lead intellectual points lower severe cases problems include following large scale fine motor skills coordination reduced muscle tone decreased attention span delayed speaking tooth eruption delayed older children symptoms include fatigue cold muscle weakness delay growth overweight height coarse thick skin increased body hair irregular cycles girls delayed signs include delayed ankle slow heart beat present completely enlarged enlarged character causes caused inadequate function primary central primary common central common cause primary endemic worldwide areas world sufficient commonly caused disease chronic associated characterized specific women birth develop occur months characterized short period followed period remain permanently associated immune diseases diabetes type disease occur syndrome type type required normal functioning numerous tissues body health predominantly converted organs dependent nucleus cells turning particular genes production specific proteins additionally cell membrane hydrogen processes formation blood vessels cell growth blood bound proteins binding free active source body process requires acid taken incorporated molecules process controlled result decreased production axis plays key role maintaining levels normal limits production anterior stimulated turn releasing released production decreased negative feedback process uncommon lead production pregnancy leads marked changes physiology increased size production increased requirements increased women normal function evidence evidenced develop evidence giving birth diagnosis laboratory testing levels blood considered best initial test second level obtained weeks later confirmation levels abnormal context illnesses testing hospitalized people discouraged strongly suspected elevated level indicates producing free levels obtained measuring discouraged assessment number rating scales provide degree limited use diagnosis cases associated mild elevations liver blood typically return normal fully treated levels low density elevated impact parameters defined severe coma associated low levels blood elevations acute kidney function number causes diagnosis masses felt require imaging feels abnormal imaging recommended presence makes likely caused doubt needle required level normal low free levels low suggestive central features cycle evidence mass vision changes central investigated determine underlying cause overt overt primary levels high levels low overt diagnosed multiple occasions greater appropriate symptoms borderline low diagnosed greater form characterized elevated level normal free level form commonly caused adults diagnosed levels greater presentation variable classic signs symptoms observed people proportion develop overt year occurs occurs anti require treatment repeat function tests frequently yearly compared pregnancy pregnancy produce provide developing mother pregnancy free levels lower anticipated increased binding binding decreased binding corrected stage pregnancy total levels instead diagnosis values lower normal particularly normal range adjusted stage pregnancy pregnancy defined normal level considered overtly level normal important making decisions treatment determined women abnormal function tests determination considered assessment subtle associated pregnancy loss recommendation universal presence predict future outcome prevention prevented population adding commonly foods public health measure eliminated endemic childhood countries common addition promoting consumption rich foods dairy fish countries moderate implemented universal salt encouraged world health organization countries world population receiving salt countries salt added bread despite reappeared western countries result attempts reduce salt intake pregnant women require daily requirement non pregnant women getting world health organization recommends daily intake pregnant women women achieve sources american association recommends daily supplement mouth screening screening performed newborn period countries generally led early identification cases prevention developmental delay widely newborn screening test worldwide based screening identify common causes addition testing required pick central causes determination included screening birth identify cases central origin children considering children usually deficiencies early identification cases prevent complications adults widespread screening general population matter debate organizations united_states services task force state evidence insufficient support routine screening american association recommend intermittent testing certain age sexes women targeted screening appropriate number situations common diseases strong family history disease received radiation therapy neck previously undergone surgery abnormal examination psychiatric disorders people taking number health conditions certain heart skin conditions yearly function tests recommended people syndrome higher risk disease management replacement people symptoms confirmed treated synthetic long acting form known young healthy people overt replacement dose adjusted weight started immediately elderly people heart disease lower starting dose recommended prevent risk complications lower sufficient people central require higher average dose blood free levels monitored help determine dose adequate weeks start treatment change dose adequate replacement dose established tests repeated months change symptoms people central secondary reliable marker replacement decisions based mainly free level best taken minutes breakfast hours food certain substances food calcium absorption direct way increasing adding synthetic suggested measure provide better control confirmed studies british association stated combined therapy carried higher rate effects benefit similarly american guidelines discourage combination therapy lack evidence acknowledge people feel better receiving combination treatment treatment received study recommendation use shorter half life needs taken people feel despite optimal request treatment european association recommends support offered regards chronic nature disease causes symptoms excluded addition regarded experimental initially trial period months set ratio current dose explicitly aims enhance safety approach counter use animal extract animal based extract commonly pigs combination therapy containing forms contains produced involved regulation calcium levels present synthetic medication extract mainstream treatment use today evidence british association american professional guidelines discourage use little evidence benefit treating risks associated modest increase risk disease review found benefit replacement parameters profiles left function association increased risk bone consensus american british opinion general people require treatment american guidelines recommend treatment considered elevated people symptoms history heart disease increased risk heart disease coma coma severe usually requires admission intensive care close observation treatment breathing temperature control blood pressure levels mechanical ventilation required fluid replacement agents careful possible occur careful correction low levels achieved solutions antagonists rapid treatment administered particularly level consciousness low able safely swallow medication pregnancy women known pregnant recommended levels closely monitored levels normal range normal range second normal range treatment guided total free free index similarly results interpreted according appropriate reference range stage pregnancy dose needs increased pregnancy confirmed based limited evidence recommend required decisions need based levels women anti trying pregnant naturally assisted means require level normal particularly true previous past reduce risk birth possibly recommendation stronger pregnant women defined anti positive view risk overt decision treat close monitoring function weeks weeks pregnancy recommended anti positive treatment currently recommended suggested aforementioned recommendations lead unnecessary treatment sense levels restrictive ethnic groups little benefit treatment certain cases worldwide billion people estimated unknown results large population based studies western countries sufficient population overt larger proportion people level mark regarded threshold treatment children return normal function small proportion develops overt predicted evolving levels presence disease presence women likely develop men population based studies women seven times likely men levels people progress overt year risk higher estimated affect approximately children adults common elderly higher rate disorders common individuals syndrome turner syndrome severe coma rare estimated occur million people year majority cases occur women years age happen age groups primary nature central secondary affects population thousand people history bernard discovered present intake linked size jean proposed endemic result intake demonstrated tissue cases recognized mid-19th century 1870s connection discovered 1880s observed people following removal link confirmed late 19th century people animals removed showed improvement symptoms animal tissue severity associated risk mortality complications created interest discovering effective treatments tissue demonstrated relatively common required multiple repeat tissue english physician george murray introduced injected sheep extract followed shortly oral introduced 1930s synthetic available animal extract remained widely identified early attempts therapy proved difficult found cause lower basal rate marker guide adjustments therapy early 20th century low basal rate known non specific present laboratory test helpful assessing status protein bound came use 1950s developed specific marker assessing states patients people treated based basal rate symptoms based protein bound found excessive following year developed developed animals practice dogs species commonly affected majority cases occur result primary types recognized probably immune driven leads destruction leads gradual replacement tissue cold exercise weight gain furthermore skin changes fertility problems seen dogs number symptoms signs seen dogs prominence skin forehead cases coma encountered diagnosis confirmed blood test clinical impression lead associated typically advanced disease treatment replacement species commonly affected include cats horses large domestic animals cats usually result medical treatment surgery radiation young horses reported predominantly western canada linked mother diet


long lasting disease characterized patches abnormal skin skin patches typically red vary severity small localized complete body coverage injury skin trigger skin changes spot known phenomenon main types plaque plaque known makes cases typically presents red patches white scales areas body commonly affected drop shaped presents small non infectious filled forms red patches skin occurs widespread develop types affected people point time include pits nails changes nail color generally thought genetic disease triggered environmental factors twin studies identical twins times likely affected compared non identical twins suggests genetic factors symptoms winter certain beta psychological stress play role underlying mechanism involves immune system reacting skin cells diagnosis typically based signs symptoms cure treatments help control symptoms treatments include cream light immune system suppressing cases managed disease affects population men women affected equal frequency disease begin age associated increased risk disease disease depression affects individuals signs symptoms plaque known chronic stationary plaque like common form affects people plaque typically appears raised areas skin covered white skin areas called plaques commonly found knees involves widespread skin body surface accompanied severe swelling pain result unstable plaque particularly following abrupt withdrawal form fatal extreme disrupt body ability regulate temperature perform barrier functions appears raised filled skin surrounding red tender localized commonly hands feet widespread patches occurring randomly body form localized limited fingers toes spread hands feet form localized similar red tender skin found hands feet von known pregnancy rare severe form require development caused infection abrupt withdrawal treatment pregnancy following irritating treatment plaque form characterized acute onset numerous tender red skin skin eruption accompanied fever muscle elevated white blood cell count app rare form common type seen childhood app tends occur women frequently men usually severe forms form characterized ring shaped plaques edges yellow app affects neck arms legs skin additional types affecting skin include oral like known appears smooth patches skin patches frequently affect skin particularly thigh groin skin overweight abdomen known breasts fold heat trauma infection thought play role development form common characterized red silver scale area extend limbs characterized numerous small red pink like numerous spots appear large areas body primarily trunk limbs triggered infection typically reverse true oral rare contrast common disorder commonly involves skin mouth involves oral lining mouth appear white grey yellow plaques tongue common finding oral reported occur people affecting skin microscopic appearance oral affected geographic tongue migratory similar appearance modern studies failed demonstrate link conditions like common form clinical aspects difficult distinguish form typically red plaques scales areas higher production forehead skin nose skin surrounding mouth skin chest skin form chronic highly variable clinical presentation frequently occurs association skin nail typically involves painful joints surrounding tissue occur joint commonly affects joints fingers toes result shaped swelling fingers toes known affect knees spine joint individuals develop skin tend occur cases nail changes affect nails produces variety changes appearance finger toe nails nail occurs people affecting skin lifetime changes include pitting nails sized depressions nail seen nail nail small areas bleeding nail yellow reddish nails known oil drop salmon spot skin nail separation nail nail medical signs addition appearance distribution specific medical signs medical practitioners assist diagnosis include sign bleeding scale removed phenomenon skin induced trauma skin pain localized plaques causes cause fully understood number theories exist people report family history disease researchers identified genetic associated condition identical twin studies suggest chance twin developing twin disorder risk twins findings suggest genetic environmental response developing strong hereditary component genes associated unclear genes work identified genes relate immune system particularly major complex cells genetic studies valuable ability identify molecular mechanisms pathways study potential drug targets classic wide analysis identified different associated called genes pathways lead certain variations genes commonly found wide association identified genes altered characteristic variants genes express signal proteins affect cells immune system involved genes involved diseases major probably accounts controls genes affect immune system skin proteins located major complex controls important immune functions genes strong association variant class protein variant protein variant protein expressed layers major immune system genes investigation beta expresses expresses involved cell strongly linked cells involved process leads genes regulate factor nuclear factor genes involved recently gene directly linked identified rare gene protein plus environmental trigger cause plaque common form lifestyle conditions reported accompanying disease include chronic stress changes season climate include hot water skin skin excessive alcohol consumption cigarette smoking hiv rate hiv positive individuals comparable hiv negative individuals tends severe people infected hiv higher rate occurs hiv positive individuals infection immune response infected hiv typically characterized cellular signals cells immune response characterized pattern cellular signals typical cells cells diminished cell presence causes cells responsible hiv positive people hiv aids severe conventional therapy described occurring throat worsened skin gut colonization drug induced occur beta non anti drugs calcium channel colony factor lowering drugs withdrawal cream rebound effect mechanism characterized excessive rapid growth layer skin abnormal production skin cells especially wound repair skin cells result sequence events skin cells replaced days usual days changes believed stem premature maturation induced cascade involving cells cells white blood cells immune cells chemical signals factor signals believed stimulate hypothesis involves defect regulatory cells regulatory gene proteins involved skin ability function barrier identified markers development dna released dying cells acts certain cells turn produce response chemical messages cells cells factor signal downstream cells arrive stimulate additional cells bridge innate immune system immune system increased induce cells type cells targeted therapy reduce number cells favors cell pattern cell profile cells known induce production works combination induce attracting diagnosis diagnosis usually based appearance skin skin characteristics typical plaques patches skin painful special blood tests procedures needed diagnosis differential diagnosis includes conditions similar appearance confused nail fungus confused nail cell individuals cancer initially illnesses secondary confused clinical diagnosis uncertain skin performed rule disorders confirm diagnosis skin projections characteristic finding layer missing significantly decreased skin cells superficial layer skin abnormal fully mature unlike mature counterparts superficial cells nucleus typically examining skin tissue joint tissue affected skin tissue affected cells cells makes dermal layer skin joints classification morphological classified disorder commonly subdivided different categories based characteristics variants include plaque form dedicated code classified types classification scheme considers genetic demographic factors type positive family history starts age associated human conversely type family history presents age associated type accounts persons classification disease sparked considerable debate researchers proposed differing descriptions authors classified diseases classified distinct diseases referred immune diseases severity consensus classify severity mild defined percentage body surface area area severity index score life quality index score moderate severe defined group score score question tool measure impact diseases daily functioning score ranges minimal calculated answer assigned points higher scores indicating greater social area severity index widely measurement tool severity area affected combines factors single score disease disease use outside research settings led attempts index clinical use management cure available treatment options exist agents typically mild disease moderate disease agents severe disease agents preparations effective agents continuously weeks coal tar found limited benefit better greater benefit observed potent compared potent found significantly superior combination therapy superior treatment found superior coal tar chronic plaque mineral oil petroleum oil water found increase clearance plaques shown effective clearing plaques combined certain impact plaque clearance decrease clearance achieved acid structurally similar acid commonly found known interfere oil found decrease plaque clearance applied directly plaques help reduce remove built scale reduce skin turnover clear affected skin plaques containing coal tar example routinely use finger tip unit helpful guiding treatment use useful higher rate effects allow therapy treat form involves daily dead sea usually weeks benefit attributed sun exposure cost effective propagated effective way treat medication decreases scores greater months commonly observed effects mild theoretical risk skin cancer suggested recent studies determined appear increased risk long term data inconclusive respect skin cancer risk support idea therapy associated increased risk forms sun induced skin damage limited liver spots dead sea effective form sunlight long effective special lamps developed application exposure time controlled avoid exposure burning skin lamps turn lamp time ends light determined person skin type increased rates cancer treatment appear small narrow band light demonstrated similar major mechanism induction dna damage form type useful treatment formation cell cycle stops cell cycle induced opposes characteristic rapid division skin cells seen activity types immune cells found skin effectively suppressed treatments common short term effect form skin common effects treated skin eyes form cold virus skin surrounding lips eye protection usually given treatments combines oral administration exposure light mechanism action unknown probably involves activation light rapid production cells skin multiple mechanisms action associated including effects skin immune system associated fatigue burning long term treatment associated cell combination therapy moderate severe plus resulted benefit use associated birth defects liver damage agents resistant treatment treated including oral treatments patients undergoing treatment regular blood liver function tests check medication pregnancy avoided treatments majority people experience treatment discontinued non treatments frequently include drugs suppress immune system synthetic forms agents regarded line treatments manufactured proteins immune process involved unlike drug target specific aspects immune system contributing generally tolerated limited long term outcome data demonstrated safe long term use moderate severe plaque actions associated small increase risk infection professional guidelines regard line treatment plaque following inadequate response treatment non treatments safety pregnancy assessed european guidelines recommend avoiding pregnancy planned anti recommended use chronic carriers virus individuals infected hiv target molecules cells use send signals main developed signaling additional developed pro different point anti share common domain target recently approved drugs target cells specifically targets blocks molecules cells line blood vessels attract cells voluntarily withdrawn european market february market june manufacturer medication association cases progressive blocks molecules cells use communicate cells causes natural killer cells kill cells way controlling individuals develop occurs prevents binding laboratory test specifically occurs binding site instead longer factor alpha longer decreases reported drug fusion protein composed lack probably secondary innate presence development immune tolerance surgery limited evidence suggests removal benefit people chronic plaque alternative therapy studies suggested individuals benefit diet supplemented fish oil rich acid acid conflicting evidence exists indicating increased people disease disease severity decreased months free diet patients anti people experience mild skin treated effectively known negative impact quality life affected person individual family members depending severity location individuals experience significant physical discomfort disability pain interfere basic functions self care sleep participation sporting activities certain caring family members difficult activities plaques located hands feet plaques particularly embarrassing plaque hair mistaken individuals feel self conscious appearance poor self image stems fear public rejection concerns associated low self esteem depression common condition people feel commonly held incorrect belief psychological distress lead significant depression social isolation high rate thoughts suicide associated tools exist measure quality life patients disorders clinical research indicated individuals experience diminished quality life children encounter bullying conditions associated occur frequently older people nearly half individuals age thirds disease associated disturbances diabetes higher people affected condition severe strongly associated development diabetes mild younger people increased risk developing diabetes individuals slightly higher risk heart disease heart attacks compared general population disease risk appeared severity duration strong evidence suggest associated increased risk death events provide degree protection heart odds having times higher people condition odds higher severe cases similar association noted people odds having found times greater compared odds general population link currently understood mechanisms involved relationship include following system elevated levels blood increased stress heart rhythm times higher people mild times higher people severe slightly increased risk stroke associated especially severe cases treating high levels associated decreased severity measured score associated improvements disease risk factors markers effects attributed ability improve blood profile anti effects use associated decreased levels high sensitivity protein decreased activity immune protein compared individuals affected likely satisfy criteria syndrome diseases rates disease increased compared general population factor respectively studies evaluated association multiple relationship questioned associated increase overall relative risk non skin cancer people increased risk lung increase risk developing upper tract increase risk developing tract increase risk developing liver cancer increase risk developing cancer risk development non skin increased increases risk developing cell skin increases risk basal cell increased risk associated estimated affect population western world rate varies according age gender region ethnicity combination environmental genetic factors thought responsible differences occur age commonly appears time ages years approximately people report diagnosed age affects sexes equally affects million americans occurs frequently ages people disease disease increased risk developing common countries farther equator persons white european ancestry likely condition relatively uncommon african americans extremely uncommon native americans history scholars believe included skin conditions called translated hebrew bible condition imposed punishment patient deemed afflicted phase ultimately treated likely confusion arose use greek term conditions greeks term skin conditions term describe skin conditions known late 18th century english robert thomas differentiated skin diseases said distinguished regular circular form patches irregular identified categories thought described ancient rome disease classified english physician thomas british thomas described possible link symptoms history treatments dubious effectiveness high 18th 19th centuries solution contains poisonous compound treatment mercury treatment time period commonly treatments era incorrectly believed infectious disease coal widely light treatment approach early 1900s time period cases treated administered gold preparations manner treatments replaced modern etymology word greek meaning condition action condition society culture international federation associations global umbrella organization national regional patient associations leading experts research scientific conferences years international network program involved management non profit organizations national foundation united_states association united_kingdom australia offer advocacy education respective countries research role resistance currently investigation preliminary research suggested beneficial effects characteristic novel drugs researched target axis particularly present increased concentrations skin contributing protection targets play important roles avenue research focused use growth factor treat oral agents investigated alternatives administered injection include protein activated protein proven effective phase clinical trials agents potentially severe effects mechanisms


cancer pain pain cancer arise nearby body parts treatments procedures skin nerve changes caused immune response chronic long lasting pain caused illness acute short term pain caused treatment procedures produce painful conditions persist long treatment ended presence pain depends mainly location cancer stage disease given time half patients cancer experiencing pain thirds advanced cancer experience pain intensity adversely affects sleep mood social relations activities daily living competent management cancer pain eliminated controlled percent cases nearly patients developed world receives optimal care worldwide nearly percent people cancer receive little pain medication guidelines use drugs management cancer pain published world health organization healthcare professionals ethical obligation ensure possible patient patient guardian informed risks benefits associated pain management options adequate pain management slightly dying patient life pain pain classed acute short term chronic long term chronic pain continuous occasional sharp rises intensity intermittent periods interspersed periods pain despite pain controlled long acting drugs treatment occasionally felt called breakthrough pain treated quick acting majority patients chronic pain notice memory attention difficulties objective psychological testing found problems memory attention verbal ability mental flexibility thinking speed pain associated increased depression anxiety fear anger persistent pain reduces function overall quality life patients care pain intensity distinct example possible drug treatments suggestion reduce eliminate pain affecting intensity pain caused body feels like coming body called referred pain pain cancer produced mechanical chemical specialized pain signalling nerve endings found parts body caused damaged nerves case called pain pain accompanied feelings patient description best measure pain usually asked estimate intensity scale pain worst pain felt cause percent cancer pain caused illness remainder caused procedures treatment related cause pain crushing tissue triggering infection releasing chemicals normally non painful painful invasion bone cancer common source cancer pain usually felt constant background pain instances spontaneous movement related frequently described severe rib common breast rib blood system impacted solid percent deep vein caused cancer vein hint cancer present causes swelling pain legs especially rarely arms superior large vein carrying circulating blood heart compressed causing superior syndrome cause chest wall pain symptoms invade parts nervous system brain spinal cord nerves cause pain symptoms brain tissue contains pain sensors brain cause pain pressing blood vessels membrane brain indirectly causing build fluid pain sensitive tissue pain cancer organs stomach liver pain difficult locate referred distant usually superficial sites invasion soft tissue cause pain mechanical pain sensors destruction mobile structures skeletal muscles pain produced cancer varies depending affected tissue appear site cancer frequently upper thigh refer lower external procedures procedures post painful treatment related potentially painful cancer treatments include produce joint muscle pain cause skin reactions bone associated induced peripheral joint pain muscle pain abdominal pain therapy causes pain targeted cause muscle joint chest pain like known cause bone pain surgery produce post operative pain post pain pelvic floor infection chemical changes associated infection surrounding tissue cause rapidly escalating pain infection overlooked possible cause study found infection cause pain percent nearly cancer patients referred pain relief report described seven patients previously controlled pain escalated significantly days treatment produced pain relief patients days management cancer pain treatment aims relieve pain minimal adverse treatment effects allowing patient good quality life level function relatively death percent cancer pain eliminated controlled nearly half patients cancer pain developed world percent people cancer worldwide receive optimal care cancer changes time pain management needs reflect different types treatment required disease progresses pain managers clearly explain patient cause pain treatment possibilities consider drug therapy directly modifying underlying disease raising pain threshold destroying pain pathways suggesting lifestyle modification relief psychological social spiritual distress key element effective pain management patient pain controlled referred care pain management specialist clinic psychological strategies way person responds pain affects intensity pain moderately degree disability experience impact pain quality life strategies employed patients cope pain include enlisting help tasks despite pain distraction ideas prayer ritual people pain tend focus pain threatening meaning estimate ability deal pain poor tendency termed studies far conducted cancer pain suggested associated higher levels pain psychological distress cancer pain patients accept pain persist able engage meaningful life susceptible depression study patients desired goals motivation means achieve goals found studies experience lower levels pain fatigue depression patients confident understanding condition treatment confident ability control symptoms collaborate successfully informal communicate effectively health care providers experience better pain outcomes physicians steps encourage facilitate effective patient communication consider intervention affect pain experienced degree daily life american institute medicine american pain society support inclusion expert quality controlled care cancer pain management include education addressing things correct use effective communication reliably reduces pain experienced patient skills training changing thoughts emotions behaviors training skills problem solving distraction restructuring reduces psychological distress improves quality life cancer patients education helpful patients stage cancer skills training helpful stages iii patient adjustment cancer depends support family informal pain seriously disrupt relationships patients consider involving family informal expert quality controlled guidelines recommend prompt oral administration drugs pain occurs starting person severe pain non drugs non anti drugs complete pain relief achieved disease progression aggressive treatment mild added existing non regime insufficient mild replaced stronger continuing non therapy escalating dose person maximum possible relief effects achieved initial presentation severe cancer pain stepping process strong started immediately combination non authors challenge validity second step mild pointing higher low argue mild replaced small strong possible exception demonstrated cancer pain pain low properties reduced potential respiratory depression comparison conventional half people advanced cancer pain need strong combination non pain medicine produce acceptable percent cases review updated concluded effective relieving cancer pain rarely severe warrant stopping treatment usually occur initial dose significant increase strong improve week consistent treatment commenced concurrently strong counteract usual normally resolves weeks treatment need aggressively maintained taken demand clock hours dose delivered preceding dose worn sufficiently high ensure continuous pain relief people taking slow release provided immediate release rescue use necessary pain spikes breakthrough pain suppressed regular medication oral simplest mode delivery delivery routes spinal considered need urgent case impaired swallow tract poor absorption coma current evidence effectiveness patches controlling chronic cancer pain weak reduce complaints compared oral liver kidney disease affect biological activity people treated oral monitored possible need reduce dose extend intervals switch modes delivery benefit non anti drugs weighed risks pain yields completely classic drugs traditionally considered reduce pain cases employed concurrently stage class drugs choice pain percent people death carry significant risk complications anxiety reduction reduce pain effective moderate severe pain major add address anxiety depression disturbed sleep muscle recommended adequately relieve pain additional options available radiation drug treatment failing control pain growing bone commonly penetration soft tissue compression sensory nerves low adequate produce thought reduction pressure possibly interference production pain promoting chemicals target specific treat pain illnesses relief occur week treatment months block block deliberate injury nerve application chemicals case procedure called physical agents freezing heating cause nerve fibers temporary interference transmission pain signals procedures thin protective layer nerve fiber basal preserved damaged fiber travels basal tube connects correct loose end function restored cutting nerve basal tubes channel fibers lost connections painful pain develop preferred surgical block brief rehearsal block local tried actual block determine detect effects aim treatment pain elimination reduction pain point effective block lacks long term outcome studies evidence based guidelines use patients progressive cancer pain play essential role cutting destruction nervous tissue surgical cutting destruction peripheral central nervous tissue rarely treatment pain procedures include dorsal root entry zone cutting removal nerves patients short life unsuitable drug therapy nerves carry sensory motor fibers motor possible effect common result procedure pain months surgery pain returns greater intensity involves cutting nerve fibers run quadrant spinal cord carrying heat pain signals brain pain effectively treated dorsal root entry zone destruction region spinal cord peripheral pain signals cross spinal cord fibers major surgery carries risk significant effects involves cutting nerve fibers brain reduces pain affecting intensity effects destruction successfully breast cancer pain patient controlled pump pump directly fluid filled space cavity spinal cord protective providing enhanced reduced effects reduce level pain cases local infused long term outer layer surrounding spinal cord called mater surrounding space filled tissue fat blood vessels crossed spinal nerve roots long term inserted space months deliver line carrying drug skin emerge patient process called recommended long term use reduce chance infection exit site reaching space spinal cord electrical dorsal columns spinal cord produce leads guided patient report generator worn externally days assess pain reduced half therapy deemed suitable small pocket cut tissue beneath skin upper chest wall abdomen leads skin site pocket attached fitting generator helpful pain pain current evidence weak recommend use treatment cancer pain deep brain ongoing electrical structures deep brain produced impressive results patients results vary appropriate patient selection important study seventeen patients cancer pain found thirteen virtually pain free required release hospital intervention ultimately resort usually weeks life alternative medicine poor quality studies alternative medicine treatment cancer pain possible recommend integration management cancer pain weak evidence modest benefit studies therapy produced mixed results found pain relief weeks touch therapy results inconclusive studied treatment demonstrated benefit cancer pain evidence music therapy saw known toxic cancer patients promising evidence weak mind body techniques barriers treatment despite publication ready availability simple effective evidence based pain management guidelines world health organization medical care providers poor understanding key aspects pain management including assessment tolerance addiction effects know pain controlled cases canada instance times training pain physicians times training nurses physicians pain fear regulatory body institutional problems delivery pain management include lack resources adequate training physicians time constraints failure refer patients pain management clinical setting inadequate insurance pain management lack sufficient stocks pain poorer areas outdated government policies cancer pain management excessively complex restrictive government institutional regulations supply administration patients report pain costs treatment belief pain inevitable treatment effects fear developing addiction tolerance fear distracting doctor treating illness fear important monitoring progress illness patients reluctant adequate pain medicine unaware unwilling accept diagnosis patient failure report pain reluctance pain medicine overcome sensitive coaching percent patients cancer percent patients receiving treatment percent patients advanced stage disease percent patients completion treatment experience pain evidence prevalence pain newly diagnosed cancer scarce study found pain percent newly diagnosed cases found percent new patients experienced pain preceding weeks reported pain early percent cases patients cancer pain describe pain moderate severe primary following locations associated relatively high prevalence pain head neck percent percent percent system percent breast percent percent percent patients advanced multiple advanced likely experience pain legal ethical considerations international economic social cultural rights nations pain treatment available borders duty human right health failure reasonable measures relieve suffering pain seen failure protect treatment article universal declaration human rights right adequate care affirmed supreme_court cases washington decided right confirmed statutory law california business professional code case law circuit courts reviewing courts medical treatment act australian capital territory states patient care health professional right receive relief pain suffering maximum extent reasonable circumstances doctors nurses ethical obligation ensure consent pain treatment withheld given possible withheld given fully informed patient patients guardians risks common effects pain treatments appears obviously acceptable risk harm professional unacceptable patient instance patients experience pain movement willing strong order enjoy periods choose clock remain pain free care provider insist treatment patient rejects provide treatment provider believes harmful possible benefits justify patients particularly ill wish involved making pain management decisions delegate choices treatment providers patient participation right obligation reduced patient involvement result optimal pain management choice respected medical professionals better informed relationship physical emotional social spiritual pain demonstrated benefit physical pain forms suffering inclined question patient family relationships patient asked intervention freely questioning intrusion patient personal affairs analogous providing drugs patient informed consent obligation professional medical care provider alleviate suffering occasionally come conflict obligation life ill patient prefers despite high level risk shortening life provided desired pain relief despite cost possibly slightly shorter life patient unable involved type decision law medical profession united_kingdom allow doctor assume patient prefer provider administer adequate treatment slightly death taken underlying cause death case illness necessary pain management philosophical justification approach doctrine double effect justify act involving good bad effect conditions necessary act good overall morally neutral person acting intend good effect bad effect considered unwanted effect bad effect cause good effect good effect bad effect cited works cancer pain assessment diagnosis management philadelphia isbn


abbreviated spelled genetic disorder characterized high levels specifically high levels low density bad blood early disease individuals underlying body slightly different high levels responsive kinds control methods usually effective people modification treatment including higher usually effective people gene protein normally removes circulation genes rare people abnormal copy gene develop disease prematurely age having abnormal copies cause severe disease childhood common genetic disorder inherited dominant pattern occurring people countries occurring million normally treated acid lowering agents lower levels new cases generally offered genetic counseling respond medical therapy require treatments including removal method similar occasionally liver signs symptoms physical signs high levels normally cause symptoms yellow deposits rich fat seen places body known outer margin iris known hands knees feet particularly known disease accelerated deposition walls leads underlying cause disease common problem development disease supply heart younger age expected general population lead chest pain heart attacks commonly brain affected lead attacks brief episodes weakness body inability talk occasionally stroke peripheral disease legs occurs mainly people smoke cause pain muscles walking resolves rest intermittent problems decreased blood supply feet risk increased age smoke diabetes high blood pressure family history disease diagnosis approximately individuals disorder diagnosed consequently receiving lowering treatments physical examination findings help physician diagnosis seen individuals condition seen common signs supportive diagnosis non specific findings measurements levels determined health screening health insurance health external physical signs noticed symptoms disease develop family member found pattern compatible type classification typically found raised level total markedly raised level low density normal level high density normal level total levels typical total levels typical typically 75th healthy population lower level levels drastically higher people analysis basis isolated high clinical criteria differ country genetic testing performed detected cases higher levels fact causes high combined syndrome differential diagnosis needs distinguished combined levels presence confirm diagnosis rare conditions present premature condition involve psychiatric skeletal common genetic defects prevalence depending population prevalence related disease similarities features accumulation tissues gene located short arm comprises spans protein gene product contains mature form single abnormal copy causes disease age cases having abnormal copies causes accelerated childhood including complications levels related activity activity processing activity depending nature different known major classes class synthesized class properly transported apparatus expression cell surface class iii properly cell surface defect class bound properly cluster coated pits step class recycled cell surface step form main protein particle gene located second long associated causes replacement position located protein normally binding reduced result like number abnormal copies determines severity type gene linked dominant requiring abnormal copy report gene located acid protein expressed liver suggested causes mainly reducing number liver cells gene known reported family contrast causes abnormal copies gene required develop protein tend cause production shortened protein real function unclear play role relation coated pits people tend severe disease severe normally body days subsequently portion liver cells triggering process results removal system synthesis liver suppressed function reduced absent average duration days resulting significantly increased level blood normal levels reduced binding particles causes increased level known causes occurs certain degree people people develop accelerated excess level degree approximately depends number expressed functionality forms function mildly impaired levels remain relatively low forms expressed studies suggest additional risk factors generally play person develops addition classic risk factors smoking high blood pressure diabetes genetic studies shown common gene increases risk events people studies found high level additional risk factor heart disease risk found higher people specific converting ace screening screening family members people known cost effective strategies universal screening age suggested approach cost effective short term screening age lower lead high rate false analysis found proposed strategy screening children parents considerable impact preventing medical consequences disorder generations simultaneously use total best people ages years treatment usually treated act liver response liver produces remove circulating blood effectively lower levels add therapy drugs required acid acid preparations control risk factors disease required risk remains somewhat elevated levels controlled professional guidelines recommend decision treat person based usual risk prediction tools derived heart study likely risk disease unlike rest population high levels birth probably increasing relative risk prior introduction older caused especially large reduce levels controversial addition absorption gut reduces appear improve marker called media thickness means overall benefit unknown studies directly mortality benefit lowering evidence benefit derived number trials conducted people plays smaller role study large british registry showed mortality people started improve early 1990s introduced study suggested treatment leads reduction death heart disease point people likely die heart disease general population person heart disease reduction results emphasize importance early identification treatment specifically indicated diet tolerated therapy treatment adults require additional lowering harder treat functional high combination effective improving levels medical therapy successful reducing levels filters process reminiscent severe cases considered liver provides liver normally functional leads rapid improvement levels risk complications solid organ rejection effects medication required suppress rejection surgical techniques include partial bypass surgery small bypassed decrease absorption nutrients surgery portal vein connected allow blood nutrients bypass liver transfer protein approved december orphan drug treatment january approved action gene treatment gene therapy possible future alternative children given present birth changes begin early life necessary treat teenagers agents originally developed adults safety concerns physicians prefer use acid licensed children safe effective older children adults expert panel advised early combination therapy absorption children highest risk global prevalence approximately million people populations studied occurs people develop symptoms occurs common certain populations presumably genetic phenomenon known founder effect founded small group individuals carrier french canadians christians high rates specific particularly common groups common central europe history norwegian physician associated physical signs high levels dominant inheritance early 1970s 1980s genetic cause described joseph michael brown dallas texas initially found increased activity studies showed explain abnormal levels people focus shifted binding effects impaired binding proved underlying mechanism subsequently numerous protein directly identified later won nobel prize medicine discovery impact


infectious disease caused virus primarily affects liver initial infection people mild symptoms occasionally fever dark abdominal pain yellow tinged skin occurs virus liver initially infected early chronic infection typically symptoms years leads liver disease occasionally cases develop complications liver failure liver cancer spread primarily blood blood contact associated drug use poorly medical equipment injuries healthcare blood screening risk million spread infected mother baby birth spread superficial contact known diagnosis blood testing look virus testing recommended people risk prevention includes harm reduction efforts people use drugs testing donated blood chronic infection cured time treatments include previous combination cure rate greater effects getting access newer treatments expensive develop liver cancer require liver leading reason liver virus usually estimated million people worldwide infected million new cases occurred occurs commonly africa central east asia deaths liver cancer deaths occurred existence originally identifiable type non non suggested 1970s proven humans signs symptoms acute infection infection causes acute symptoms cases symptoms generally mild vague including decreased appetite fatigue muscle joint pains weight loss rarely acute liver failure result cases acute infection associated infection resolves spontaneously cases occurs frequently individuals young female chronic infection exposed virus develop chronic infection defined presence viral months experience minimal symptoms initial decades infection chronic associated fatigue mild problems chronic infection years cause liver cancer liver normal late apparent cure reported difficult distinguish changes liver occur half infected usually present develops usually time change affects liver worldwide cause cases infected develop years common infected hiv male gender excess alcohol increases risk developing fold develop fold greater risk transformation occurs rate year infected addition increases risk liver lead portal accumulation fluid abdomen easy bleeding enlarged veins especially stomach syndrome known occurs stage half chronic infection complications common problem involving liver mixed usually type form small medium sized blood vessels associated disorder syndrome low count resistance diabetes cell disorders people infected factor type possible associations include associated abnormal heart rhythms reported variety central nervous system disorders reported chronic infection associated increased risk cancer infection persons infected appear clear virus remain infected virus conventional testing found ultra sensitive tests original method detection demonstrating viral liver newer methods include test virus core protein detection viral concentrating viral particles form infection moderately elevated liver reported form known infection clinical pictures associated type infection found people anti normal levels liver negative people ongoing elevated liver unknown cause healthy populations evidence liver disease groups risk infection including family members people clinical relevance form infection investigation consequences infection appear severe chronic infection vary minimal rate infection apparently cured controversial appears low negative absence viral virus liver commonly occurs children unknown virus small single stranded positive sense virus member genus family seven major known seven divided number depending united_states cases caused common south_america europe half life virus particles hours short minutes infected person virus particles produced day addition liver virus transmission primary route transmission developed world drug use developing world main methods blood unsafe medical procedures cause transmission remains unknown cases believed accounted drug use drug use major risk factor parts world countries reviewed including united_states found drug user population countries rates greater believed million drug users infected china million united_states million russia million highest absolute totals occurrence prison inmates united_states times occurrence observed general population attributed high risk behavior prisons equipment shared drug use risk factor healthcare exposure blood blood products organ screening carry significant risks infection united_states instituted universal screening canada instituted universal screening decreased risk units unit blood low risk remains period days potential blood donor acquiring blood testing positive depending method countries screen cost experienced needle stick injury positive chance subsequently contracting disease risk greater needle question hollow wound deep risk blood risk low risk blood exposure occurs intact skin hospital equipment documented method transmission including reuse multiple use medication bags surgical equipment limitations implementation enforcement stringent standard precautions public private medical dental facilities known primary cause spread egypt country highest rate infection world sexual intercourse transmitted sexual activity controversial association high risk sexual activity multiple sexual partners risk factor conclusive evidence transmitted sexual activity people report transmission sex risk factor actually drugs denied majority evidence supports risk couples sexual partner sexual practices involve higher levels trauma anal sex occur concurrent sexually transmitted infection including hiv present risk united_states department veterans affairs recommends use prevent transmission multiple partners relationships involve single partner body modification associated increased risk equipment contamination performed mid-1980s underground particular concern sterile techniques settings lacking risk appears greater larger estimated nearly half prison inmates share equipment rare licensed facility directly associated infection shared personal items personal care items equipment contaminated blood sharing items potentially lead exposure appropriate caution taken medical condition results bleeding cuts spread casual contact kissing sharing eating cooking transmitted food water mother child transmission mother child transmission occurs measures alter risk clear transmission occurs pregnancy occur gestation delivery long labor associated greater risk transmission evidence breast feeding spreads cautious infected mother advised avoid cracked bleeding viral loads high diagnosis number tests including chain reaction detected typically weeks infection substantially longer form detected chronic defined infection virus months based presence chronic typically decades commonly discovered following investigation elevated liver levels routine screening high risk individuals testing able distinguish acute chronic diagnosis infant difficult maternal persist months testing typically begins blood testing detect presence test positive test performed verify determine viral load verify viral load determined chain reaction positive means person tested previous infection cleared treatment spontaneously negative means wrong takes weeks following infection test positive number tests available point care testing means results available minutes liver variable initial infection average begin rise seven weeks infection elevation liver closely follow disease severity liver determine degree liver damage present risks procedure typical changes seen portal changes number blood tests available try determine degree alleviate need screening believed infected united_states canada aware status testing recommended high risk includes injection drug users received blood jail long term screening recommended elevated liver frequently sign chronic routine screening currently recommended united_states centers disease control prevention added recommendation single screening test born prevention approved protects contracting number development shown encouraging results combination harm reduction strategies provision new treatment substance use decreases risk drug users screening blood donors important national level universal precautions healthcare facilities countries insufficient supply sterile given injection possible treatment chronic infection infected persons approximately clear treatment rare cases infection clear treatment chronic advised avoid alcohol toxic liver surveillance recommended accompanying treatment medication recommended people proven chronic high risk dying causes people highest risk treated risk complications based degree liver initial recommended treatment depends type virus person infected weeks weeks weeks weeks weeks weeks weeks weeks appears effective disease appears effective type disease higher rate adverse effects treatments contain success rates expensive infection effective cases tentative data use type disease prior treatments consisted combination alpha period weeks depending produces cure rates respectively adverse effects treatments common half people getting flu like symptoms experiencing emotional problems treatment months effective chronic surgery common reason liver virus usually cases infection leads people developing years treatment post decreases risk alternative medicine alternative claimed proponents helpful including milk silver alternative therapy shown improve outcomes evidence exists alternative effect virus responses treatment measured sustained viral response defined absence virus blood weeks treatment rapid response defined levels achieved weeks treatment successful treatment decreases future risk prior sustained response occurs people given weeks treatment sustained response seen people weeks treatment sustained response occurs weeks treatment evidence treatment disease sparse evidence supports weeks treatment disease estimated million people world population living chronic million people infected year people die yearly related diseases estimated people died acute deaths occurred liver cancer secondary infection rates increased substantially 20th century combination drug abuse reused poorly medical equipment rates high population infected central east asia north_africa middle_east intermediate south southeast_asia sub africa central southern latin_america caribbean oceania central eastern western_europe low asia pacific tropical latin_america north_america infected risk years varies studies estimated men women reason difference known established rate developing year rates new decreased western world 1990s improved screening blood united_states people number new cases year stabilized number deaths increased overtaken hiv aids cause death usa mortality rate expected increase infected testing apparent europe percentage people chronic estimated england people infected received treatment total number people infection higher countries africa asia countries particularly high rates infection include egypt pakistan china believed high prevalence egypt linked discontinued mass treatment campaign glass history mid-1970s harvey alter chief infectious disease section department medicine national health research team demonstrated post cases despite discovery international research efforts identify virus initially called non non failed decade michael george corporation collaborating bradley centers disease control prevention novel molecular approach identify unknown organism develop test alter confirmed virus presence panel specimens april discovery published articles journal science discovery led significant improvements diagnosis improved treatment alter honored award clinical medical research pioneering work leading discovery virus causes development screening methods reduced risk blood associated virtually zero filed patents virus diagnosis competing patent application dropped paid million bradley bradley sued seeking patent included receive damages royalty income dropped suit losing appeals court society culture world day held july coordinated world alliance economic costs significant individual society united_states average lifetime cost disease estimated usd cost liver costing approximately usd canada cost course treatment high united_states costs usd areas world people unable afford treatment lack insurance coverage insurance pay english national health service treatment rates higher groups data spanish juan infected patients patients jailed research development include treat potential new treatments come better understanding virus combination trial reported resulted cure rates animal models barrier finding treatments lack suitable animal model despite moderate success current research highlights need pre clinical testing systems mouse particularly development poorer communities currently remain available living system study use ethical concerns regulatory restrictions scientists use human cell culture systems questions raised accuracy reflecting body response infection aspect research reproduce models strategy introduce liver tissues humans mice technique known generating mice exposing mice infection engineering process known create mice provide opportunities study architectural design liver evaluating compounds alternatively generating mice process studying mouse models special populations children pregnancy compared adults infection children understood worldwide prevalence virus infection pregnant women children estimated respectively vertical transmission rate estimated high rate spontaneous clearance children higher rates reported vertical transmission prevalence children developed countries transmission time birth leading cause infection absence virus mother blood transmission rare factors associated increased rate infection include membrane longer hours delivery procedures exposing infant maternal blood sections recommended considered safe damaged infection time birth child increase risk subsequent pregnancy appear risk transmission infection frequently found children previously presumed non non liver disease presentation childhood elevated liver function tests infection commonly liver failure occur childhood rate people higher normal population particularly true human virus infection recipients organ infection people associated unusually rapid progression


abbreviated known von disease bone confused von disease type skeletal disorder caused surplus active surplus activity cells break bone process known bone triggered hereditary factors bone releases minerals including calcium bone addition elevated blood calcium levels activity process results loss bone mass weakening bones supporting structures replaced tissue formation like brown bone symptoms disease consequences general bones excess calcium blood include bone kidney stones eaten appearance bones appetite loss weight loss described nineteenth century currently detected combination blood testing rays tissue sampling half diagnosed united_states saw progress early identification techniques improved treatment methods instances developed countries increasingly rare treatment required normally involves addressing underlying commencing long term treatment depending cause severity range exercise surgical intervention classification defined classic skeletal manifestation advanced classification system established world health organization listed category primary signs symptoms major symptoms bone pain bone skeletal bones underlying cause kidney stones fatigue weakness rays indicate thin bones commonly localized arms legs spine addition weight loss appetite loss aforementioned symptoms indicate result uncommon cancer generally indicated calcium levels higher usual comparison high calcium levels generally presents symptoms severe generally presence neck mass indicative cancer occurring approximately virtually individuals different origin causes result results causes release calcium bones blood calcium kidney excess causes elevated blood calcium levels major causes primary result vast majority cases result random formation active instances comprise approximately documented cases hereditary factors approximately documented cases result hereditary factors disorders multiple type men type jaw syndrome left result men type dominant disorder common hereditary form affecting genetic cases tends affect younger patients forms major lead generally involve proteins certain genetic linked higher rate occurrence specifically gene codes protein cancer cause accounting cases onset difficult complications common presentation term refer skeletal complications end stage disease occurs approximately patients occurs fail produce form assists absorption calcium bones levels decrease levels increase halting storage calcium instead triggering removal bones concept currently included broader term chronic kidney disease mineral bone disorder effects bone largely dependent duration disease level produced responsible maintaining calcium concentration blood related protein located responsible building bone affecting cause surplus turn increases activity frequency increased levels trigger release stored calcium dissolution old bone conservation calcium cessation production new bone generally bones affected fingers facial bones ribs long bones longer wide affected disease progresses bone affected diagnosis diagnosed variety techniques muscles patients afflicted appear unaffected muscular symptoms appear onset generally sluggish muscles condition shifts position neck conjunction known symptoms point diagnosis blood tests patients generally high levels calcium normal levels considered range levels generally opposed normal upper range value normal range rays disease usually rays extremely thin bones fractured symptoms associated bone diseases generally bones symptoms ray fingers furthermore brown especially manifested facial bones distinctly bone rays skull depict image described ground glass salt pepper dental rays abnormal lined blood lend notion brown identified nuclear imaging combined specific identification muscular lack occur clinical testing deep test fine needle bone found ray scan tests vital diagnosis prevent unnecessary treatment invasive surgery conversely recommended fact harmful needle leading possible spread cells brown commonly associated display characteristics cells feature dense nucleus tends shape comparatively fine tend smaller average management medical medical management consists treatment generally delivered studies shown cases caused end stage disease primary method successful treating underlying causing brown symptoms surgery especially severe cases removal chosen route treatment shown result reversal bone complete brown situations present surgery remove led symptoms bone proven successful filling caused report showed instances caused filled bone healed bone blended rapidly seamlessly original bone undergo experience increased bone density repair skeleton weeks additionally patients undergone begin brown months following common results combination suppressed prolonged need calcium new bone thirty percent patients caused undergo surgery local symptoms post surgical survival rate seven years patients undergo surgery survival rate years long rare disease today appears individuals diagnosed primary accounts instances disease primary times common individuals diabetes rate united_states disease definite tendency affect younger individuals typically appearing age study reporting cases display symptoms age primary common countries treatment improved 1950s half diagnosed saw progress rates increase alongside cases primary developing countries india rates disease case reports mirror published past decades developed world cases primarily caused primary increase number cells accounts cases occurring frequently individuals years age stark contrast result primary showing gender preference approximately caused genetic factors attributed men type tends affect younger individuals history condition described friedrich daniel von william hunter died credited finding example disease von disease qualification bone completely unrelated disorder termed davies delivered presentation society london detailed manifestation brown makeup discovery subsequent description credited publication new man mammals received little attention eugene compounded research credited discovery function research surgical removal inch removed man suffering advanced patient symptoms disappeared return approximately years result stones diagnosed patient died blood tests female patient suffering stone based revealed extremely high blood calcium levels fuller diagnosed treated woman suffered large neck stones published literature describe brown linked published clinical reports draw disease previous publication advent 1960s 70s led increase early diagnosis primary increase led sharp decline prolonged manifestation disease leading drop number cases early detection invention diagnosis primary generally prolonged emergence severe