spinal cord injury spinal cord injury sci damage spinal cord causes changes function temporary permanent changes translate loss muscle function sensation function parts body served spinal cord level injuries occur level spinal cord classified complete injury total loss sensation muscle function incomplete meaning nervous signals able travel past injured area cord depending location severity damage spinal cord symptoms vary widely pain ranges widely recovery rare cases permanent called injuries level neck lower injuries complications occur short long term injury include muscle pressure respiratory problems majority cases damage results physical trauma car accidents falls sports injuries result causes infection insufficient blood flow efforts prevent sci include individual measures safety equipment societal measures safety regulations sports traffic improvements equipment known ancient times catastrophic injury long believed sci seen great improvements care middle 20th century treatment spinal cord injuries starts spine controlling prevent damage needed vary widely depending location extent injury bed rest surgery cases spinal cord injuries require substantial long term physical therapy rehabilitation especially interfere activities daily living research new treatments spinal cord injuries includes stem cell engineered materials tissue support robotic classification spinal cord injury traumatic classified types based cause mechanical forces toxic lack blood flow damage divided primary secondary injury cell death occurs immediately original injury initiated original insult cause tissue damage secondary injury pathways include cascade swelling cell suicide place minutes weeks following injury level spinal column spinal nerves branch spinal cord exit pair specific body area skin specific spinal nerve called group muscles single spinal nerve called spinal cord damaged corresponds spinal nerves level injuries person level injury defined lowest level sensation function occurs legs affected spinal cord damage injuries occurs limbs affected damage sci classified degree international standards classification spinal cord injury published american spinal injury association asia widely document sensory motor following sci based responses touch tested strength muscles control key motions sides body muscle strength scored scale according table right sensation graded scale sensation altered decreased sensation sensation body graded independently complete incomplete injuries complete spinal injury functions injured area lost spinal cord severed incomplete spinal cord injury involves preservation motor sensory function level injury spinal cord classed incomplete preservation sensation motion areas voluntary external anal nerves area connected lowest region spinal cord retaining sensation function parts body indicates spinal cord partially damaged incomplete injury definition includes phenomenon known degree sensation preserved sensation impaired higher level attributed fact spinal pathways likely spinal pathways compressed injury fibers spinal cord spinal cord injury spinal column injury trauma causes fracture bone instability spinal column cause injury spinal cord injury occur spinal cord injury exists sci present evidence spinal column injury magnetic resonance imaging term coined common use central cord syndrome central cord syndrome resulting damage spinal cord characterized weakness arms relative legs spared sensation regions served segments loss sensation pain temperature light touch pressure level injury spinal tracts serve arms affected central location spinal cord fibers destined legs spared external location common incomplete sci central cord syndrome usually results neck older people spinal younger people commonly results neck common causes falls vehicle accidents possible causes include spinal spinal cord disk anterior cord syndrome anterior cord syndrome damage portion spinal cord reduction blood supply anterior spinal caused level injury motor function pain sensation temperature sensation lost sense touch sense position space remain intact differences relative locations spinal tracts responsible type function brown syndrome brown syndrome occurs spinal cord injured rare spinal cord truly severed partial penetrating wounds gunshot knife wounds fractured common injury body loses motor function senses vibration touch opposite injury loss pain temperature posterior cord syndrome posterior cord syndrome dorsal columns spinal cord affected usually seen cases chronic occur posterior spinal rare syndrome causes loss sense vibration level injury motor function sensation pain temperature touch remain intact usually posterior cord injuries result insults like disease trauma injury posterior spinal cord caused results loss touch sensation syndrome injury end spinal cord located adults region contains spinal segments responsible sexual functions disrupted type injury addition sensation disrupted causes include physical trauma syndrome results level spinal cord splits levels true spinal cord syndrome nerve roots damaged cord common nerves damaged time proximity occur alongside syndrome cause low pain weakness lower limbs loss sensation loss unlike syndrome symptoms occur body cause compression disk nerves damaged actually peripheral nerves branched spinal cord injury better recovery function peripheral nervous system greater capacity healing central nervous system signs symptoms signs observed symptoms experienced patient vary depending spine injured extent injury section skin specific spine called injury spine cause pain loss sensation related areas burning sensation affected areas skin person lowered level consciousness response painful certain point group muscles specific spine called injury spinal cord cause problems movements involve muscles muscles contract weak completely spinal shock loss activity including level injury occurs shortly injury usually goes away day specific parts body affected loss function determined level injury effects injuries regions spinal cord lower include decreased control legs system people injured level use hip knee muscles function regulated region common experience sexual injury including possible fail leading potentially harmful buildup sign spinal cord injury emergency providers find erection addition problems found lower level injuries chest height spinal affect muscles trunk injuries level result inability control abdominal muscles trunk stability affected higher level injuries lower level injury extensive effects injuries result partial loss trunk abdominal muscle control spinal injuries result function hands arms neck affected condition occurs typically level blood pressure increases dangerous levels high cause potentially deadly stroke results system pain level injury signals brain pass sympathetic nervous system response signs symptoms include anxiety ringing ears blurred vision skin nasal congestion occur shortly injury years later functions disrupted example problems body temperature regulation occur injuries result shock results output sympathetic nervous system responsible maintaining muscle tone blood vessels sympathetic input vessels relax shock presents dangerously low blood pressure low heart rate blood limbs results insufficient blood flow spinal cord potentially damage spinal cord injuries neck level result partial called depending specific location severity trauma limited function retained additional signs symptoms injuries include low heart rate low blood pressure problems regulating body temperature breathing injury high neck muscles involved breathing person able breathe help tube mechanical causes spinal cord injuries caused physical trauma forces involved forward movement head backward movement lateral stress sideways movement rotation twisting head compression force axis spine downward head upward distraction pulling apart traumatic sci result compression stretch injury motor vehicle accidents common cause second falls violence gunshot wounds sports injuries countries falls common surpassing vehicle crashes leading cause sci rates violence related sci depend heavily place time sports related shallow water common cause winter sports water sports increasing causes association football injuries declining hanging cause injury spine occur attempted suicide military conflicts cause occur associated increased rates sci potential cause sci injury caused medical procedure injection spinal column sci origin cause sci percentage varies influenced efforts prevent trauma developed countries higher sci conditions developing countries developed countries common cause sci diseases followed developing countries leading cause infection hiv tuberculosis sci occur disc disease spinal cord disease spontaneous bleeding occur outside protective membranes line cord damage result blood vessels blood lodged blood vessel cuts blood supply cord blood pressure drops blood flow spinal cord reduced potentially causing loss sensation voluntary movement areas supplied affected level spinal cord conditions cord cause sci multiple disease damage spinal cord infectious conditions tuberculosis prevention vehicle related sci prevented measures including societal individual efforts reduce driving influence drugs alcohol distracted driving driving efforts include increasing road safety marking hazards adding lighting vehicle safety prevent accidents routine maintenance brakes damage crashes head restraints air bags seat belts child safety seats falls prevented making changes environment materials grab bars showers stairs child safety gates windows gun related injuries prevented conflict resolution training gun safety education campaigns changes technology guns trigger locks improve safety sports injuries prevented changes sports rules equipment increase safety education campaigns reduce risky practices diving water unknown depth head association football diagnosis evaluation ray scan determine damage spinal column located rays commonly available detect instability spinal column detailed images miss injuries spinal cord displacement accompanying spinal column damage ray findings normal sci suspected pain sci symptoms gives greater detail rays patient radiation images spinal cord shows body structures greatest detail standard found sci thought unstable spinal column injury help determine degree performed initially repeatedly early stages treatment determines rate improvement deterioration informs treatment asia scale outlined determine level severity injury management treatment stage management suspected spinal cord injury geared basic life support preventing injury maintaining breathing circulation spine emergency setting subjected forces strong cause sci treated instability spinal column prevent damage spinal cord injuries head neck penetrating trauma near spine falls heights assumed associated unstable spinal column ruled hospital high speed vehicle crashes sports injuries involving head neck diving injuries mechanisms indicate high sci risk head spinal trauma frequently unconscious lowered level consciousness result head injury rigid collar applied neck head held blocks person devices people moving spine inside vehicle confined space modern trauma care includes step called clearing spine ruling spinal cord injury patient fully conscious influence drugs alcohol displays pain middle neck painful injuries distract neck pain absent necessary unstable spinal column injury moved damage occur spinal cord occur time initial trauma later treatment transport nature injury particularly case multiple massive trauma reflects failure spine adequately sci body ability warm warming blankets needed early hospital treatment initial care hospital setting aims ensure adequate breathing function spinal imaging spine presence sci need wait emergency surgery needed stabilize life threatening injury acute sci merits treatment intensive care unit especially injuries spinal cord patients sci need repeated assessments treatment blood pressure falls days injury blood supply spinal cord reduced resulting damage important maintain blood pressure central treat cases shock mean arterial blood pressure measured kept seven days injury treatment shock blood loss shock different shock harm people type necessary determine shock possible causes exist time important aspect care prevention insufficient oxygen spinal cord needed oxygen people injuries experience dangerously slowed heart rate treatment speed include electrical cardiac pacing swelling cause damage spinal cord reducing blood supply causing rise cascade release damages treatment geared limiting secondary injury people treated drugs reduce swelling drug commonly hours injury use controversial effects studies shown high dose improve outcomes given hours injury improvement shown clinical trials inconclusive comes cost increased risk infection bleeding pneumonia organizations set clinical guidelines increasingly stopped recommending treatment acute sci surgery necessary relieve excess pressure cord stabilize spine proper place cases involving instability compression failing operate lead condition surgery necessary pressing cord bone fragments blood material discs lodged object penetrating injury ideal timing surgery debated studies found earlier surgical intervention hours injury associated better outcomes patient injuries surgical candidate early surgery controversial potential complications infection cases clearly needed cord compressed doctors decide perform surgery based aspects patient condition beliefs risks benefits cases conservative approach chosen bed rest devices traction opt traction spine remove pressure spinal cord putting alignment prevent technique relieving pressure wells tool exert spinal traction reduce fracture affected areas rehabilitation sci patients require extended treatment specialized spinal unit intensive care unit rehabilitation process typically begins acute care setting usually phase lasts weeks rehabilitation phase lasts months followed yearly medical functional evaluation physical recreational nurses social workers health care professionals work team coordination decide goals patient develop plan discharge appropriate person condition acute phase physical focus patient respiratory status prevention indirect complications pressure maintaining range motion keeping available active people injuries high interfere breathing great emphasis clearance stage recovery weakness respiratory muscles ability effectively allowing accumulate lungs sci patients suffer reduced total lung capacity tidal volume physical teach breathing techniques breathing breathing typically taught healthy individuals physical therapy treatment clearance include manual vibrations drainage respiratory muscle training assisted techniques patients taught increase abdominal pressure leaning forward induce clear mild technique lying applying pressure abdomen rhythm maximize flow manual abdominal compression technique increase flow later improves techniques manage respiratory include respiratory muscle pacing use abdominal assisted speech mechanical ventilation functional recovery independence achieved terms activities daily living recreational activities employment affected level severity injury functional independence measure assessment tool aims evaluate function patients rehabilitation process following spinal cord injury illness injury track patient progress degree independence rehabilitation people sci need use specialized devices modifications environment order handle activities daily living function independently weak joints stabilized devices ankle foot knee walking require lot effort increasing activity increase chances recovery spinal cord injuries generally result best possible treatment best level injury measured asia scale score initial evaluation hours injury best function return people asia scores complete injuries functional motor recovery improvement occur patients incomplete injuries recover function chances recovering ability walk improve grade found initial examination asia score better chance walking score symptoms incomplete injuries vary difficult accurate prediction outcome person mild incomplete injury better chance legs person severe complete injury exactly place incomplete sci brown central cord best recovery anterior cord syndrome worst people causes sci found likely suffer complete injuries complications pressure deep vein shorter hospital stays scores functional tests better people traumatic sci hospital admission tested discharge traumatic sci improved groups results addition level injury age concurrent health problems affect extent person sci able live independently walk general people injuries likely able walk walk house live independently important motor recovery area presence sensation particularly pain perception motor recovery occurs year post injury modest improvements continue years sensory recovery limited recovery typically quickest months spinal shock suppressed occurs immediately injury resolves largely months continues resolving gradually sexual spinal injury common problems occur include loss ability insufficient reduced sensation impaired ability sexual common sci people learn ways adapt sexual practices lead satisfying sex lives life improved better care options good population higher level injury complete injury greater reduction life mortality elevated year injury complications complications spinal cord injuries include respiratory failure shock injury site long term loss muscle function additional effects including muscle lead pressure particularly bony areas requiring precautions extra turning bed hours acute setting relieve pressure long term people shift periodically relieve pressure pain including pain indication potential actual tissue damage pain nerves affected damage convey erroneous pain signals absence muscles level injury occurs chronic sci results lack input brain muscle responses stretch treated drugs physical therapy increases risk shortening muscles result lack use limb problem prevented moving limb range motion multiple times day problem lack mobility cause loss bone density changes bone structure loss bone density bone thought lack input weakened muscles increase risk conversely poorly understood phenomenon bone tissue soft tissue areas called occurs level injury possibly result happens significant extent people people sci especially high risk respiratory problems hospital staff avoid respiratory problems especially pneumonia leading cause death people sci followed usually pressure tract respiratory pneumonia accompanied breath fever anxiety potentially deadly threat deep blood forms limbs break form lodging lung cutting blood supply especially high risk sci particularly days injury occurring acute care setting measures include pressure moving patient limbs usual signs symptoms masked sci cases effects alterations pain perception nervous system functioning tract infection risk display usual symptoms pain urgency frequency instead associated worsened risk likely common long term heightened use necessary sci ability gets trigger damage permanently use intermittent regular intervals day decreased mortality kidney failure world problem developing countries estimated people sci suffer disorders depression suicide rate times rest population risk suicide worst years injury young people sci suicide leading cause death depression associated increased risk complications pressure occur self care neglected worldwide number new cases sci ranges people million year wide range numbers probably partly differences regions injuries reported north_america people million sci year western_europe million united_states spinal cord injury estimated cases million people year cases year china approximately year estimated prevalence number people living sci world ranges million estimates vary widely differences data collected techniques figures little information available asia africa south_america western_europe estimated prevalence million people north_america million estimated million iran million iceland million australia united_states individuals living spinal cord injuries different studies estimated million sci present cases blunt force trauma undergone force sufficient cause spinal injury high risk injuries sci cases injuries sustained time sci patients suffer head trauma facial trauma commonly associated injuries include chest trauma abdominal trauma pelvic long bone males account traumatic spinal cord injuries injuries occur men years age average age time injury slowly increased years 1970s rates injury lowest children highest late teens early twenties progressively lower older age groups rates rise elderly sweden cases sci occur people occur sci rates highest people age fewer occur people sci occurs breach injuries difference rates sexes injuries age younger number girls injured boys possibly cause injury child abuse shaken baby syndrome children common cause sci vehicle crashes high numbers adolescent injuries large traffic accidents sports injuries people falls common cause traumatic sci elderly people severe high risk sci defects spinal column sci gender difference smaller average age occurrence greater incomplete common history sci known devastating ancient egyptian smith known description injury says treated hindu texts dating mention sci describe traction techniques spine greek physician born fifth century described sci corpus invented traction devices born noted injury resulted rapid death spinal cord implicated condition second century greek physician experimented reported horizontal cut spinal cord caused lose sensation motion level cut seventh century greek physician paul described surgical techniques treatment broken removing bone fragments surgery relieve pressure spine little medical progress middle ages europe renaissance spine nerves accurately depicted human anatomy drawings surgeon named louis removed bullet spine patient regained motion legs surgeon smith performed successful improved patient sensation idea sci remained predominant early 20th century mortality rate years injury tract pressure half century imaging surgery medical care rehabilitation medicine contributed substantial improvement sci care relative incomplete compared complete injuries improved mid-20th century mainly emphasis faster better initial care spinal cord injury patients creation emergency medical services professionally transport people hospital given partial credit improvement outcomes 1970s improvements care accompanied increased life people sci survival times improved research directions scientists investigating avenues treatment spinal cord injury research focused main areas seeks prevent harm occurs secondary injury minutes weeks following insult aims broken circuits spinal cord allow function return drugs target secondary injury effects including damage free damage excessive signaling cell suicide potentially agents target pathways like investigation human clinical trials cell important avenue sci research goal replace lost spinal cord cells allow broken circuits create environment tissues favorable growth key avenue sci research research stem cells differentiate types cells including lost sci types cells researched use sci include stem cells stem cells stem cells cells cells activated induced stem cells hundreds stem cell studies humans promising inconclusive results type approach tissue engineering help rebuild damaged tissues investigated include natural substances synthetic ones like fall categories materials vehicle delivering gene therapy tissues avenue explored allow paralyzed people walk aid rehabilitation walking ability use powered robotic devices joints legs supply source power walk devices available sale investigation underway useful


cerebral cerebral presence acute blood drain blood brain symptoms include abnormal vision symptoms stroke weakness face limbs body diagnosis usually cat scan magnetic resonance imaging employing demonstrate treatment medication blood rarely destruction blood given usually underlying cause disease tests performed look disease complicated raised pressure warrant surgical intervention placement signs symptoms people tends period days develop suddenly cerebral patients symptoms stroke inability limbs weakness face difficulty speaking necessarily affect body common arterial stroke patients common women develop period giving birth affecting body occurring occasionally rarely lead status persistent seizure activity long period time elderly aforementioned symptoms occur common symptoms elderly condition unexplained changes mental status depressed level consciousness pressure brain rise causing swelling disc experienced visual severely raised pressure level consciousness decreased blood pressure rises heart rate falls patient assumes abnormal posture causes cerebral common particular situations patients risk factors tendency develop blood factor protein protein related problems syndrome kidney problem causing protein loss chronic diseases disease disease pregnancy period giving birth particular blood disorders especially nocturnal use containing forms ear nose throat area direct injury medical procedures head neck area cell primarily children diagnosis diagnosis suspected basis symptoms example combination signs raised pressure focal alternative causes excluded imaging investigations detect cerebral cerebral apparent detection commonly tests magnetic resonance imaging types perform veins brain phase detection rate regards exceeds test involves injection vein usually arm substance time allowed carry cerebral veins point scan performed sensitivity present incorrectly positive weeks delta sign observed later stages sign disappear magnetic resonance employs principles uses scanning advantage better detecting damage brain result increased pressure veins readily available hospitals interpretation difficult cerebral demonstrate smaller veins appearance requires advancing thin tube blood vessels brain injected ray images obtained performed tests unclear results treatments administered procedure study suggested blood test use diagnosis forms abnormal patients cerebral giving sensitivity negative value positive value furthermore level extent subsequent study showed patients confirmed normal presented normal study concludes useful situations difference lower probability cases tests patients direct cause cerebral readily apparent identifying source infection crucial common practice screen forms form blood veins brain superficial veins deep system carry blood vein heart cerebral blood usually form veins brain veins causes damage brain tissue insufficient blood supply results cerebral leads small merge large main mechanism increase pressure decreased fluid condition lead difference pressure parts brain blood forms formation blood protein major mechanisms alterations normal blood flow injury blood vessel wall alterations constitution blood cases cerebral possible break migrate lungs causing analysis earlier case reports concludes occurs cases poor treatment studies investigated use suppress blood formation cerebral trials conducted concern small areas brain bleed result treatment studies showed concern clinical practice guidelines recommend low molecular weight initial treatment followed provided bleeding risks treatments unsuitable experts discourage use extensive case recommend repeating imaging days decreased size started given reduction duration treatment depends circumstances underlying causes condition developed temporary circumstances pregnancy months regarded sufficient condition clear causes mild form months advised severe underlying disorder treatment need continue indefinitely removal blood medication described injection vein directly european federation societies recommends patients deteriorate despite adequate treatment causes deterioration eliminated unclear drug mode administration effective bleeding brain sites body major concern use american guidelines recommendation regards stating research needed raised pressure severe threatening vision require removal excessive fluid medication treatment nerve certain situations try prevent situations include focal problems inability limb focal changes brain tissue scan evidence support use drugs measure lacking adequately large scale study natural history long term condition reported showed months follow patients recovery respectively minor moderate severe symptoms died severe death likely aged years male affected coma mental status disorder deep cerebral system central nervous system infection cancer subsequent systematic review nineteen studies showed mortality total survivors total near total recovery months thirds cases resolution rate low children risk death high poor outcome likely child develops evidence imaging cerebral rare estimated cases million annual adults occur age groups common decade female given older studies difference men women suggested use oral women sexes report saudi_arabia found doubled cases attributed fact disease increases risk common middle_east report found found autopsy examination body death percent people elderly symptoms period leading death suffered heart failure children canadian study reported occurs million annually occur newborn month old year life newborn ill complications history description cerebral veins attributed french physician observed cerebral veins man suffered second half 20th century remained diagnosis generally death 1940s reports charles allowed clinical diagnosis cerebral characteristic signs symptoms results improvements diagnosis cerebral life introduction aided distinction similar presenting signs symptoms cases british credited introduction recently introduced treatment clinical trials 1990s finally resolved concern cases notable cases secretary state clinton hospitalized december treatment right transverse located base brain clinton episode discovered scan follow cerebral concussion suffered weeks fell suffering


decreased normally produced base brain decreased term pan meaning signs symptoms vary depending underlying cause diagnosis blood tests specific investigations needed find underlying cause ideal treatment controlled replaced rare disease significantly people previous traumatic brain injury description condition german physician morris signs symptoms different actions body symptoms depend symptoms subtle initially attributed causes cases common problem leading sex growth common people underlying causes additional symptoms arise underlying cause instance growth producing symptoms hands feet coarse facial features extends nerve visual field defects accompany addition sudden rapidly visual loss associated double vision results compression nerves adjacent control eye muscles failure results changes skin hair nails result absence action sites anterior anterior common individual referred leads different symptoms men women women experience light absent periods respectively men lose facial trunk hair suffering decreased muscle mass sexes experience decrease loss sexual function increased risk bone lack children associated delayed growth leads decrease muscle mass central increase body fat waist impaired attention memory children experience growth short stature leads lack production problem chronic symptoms consist fatigue weight loss failure thrive children delayed low blood sugar levels low levels onset abrupt collapse shock occur highly similar primary disease result direct damage form leads skin occur leads lack production typical symptoms cold weight gain hair loss slowed thinking slowed heart rate low blood pressure children leads delayed growth extreme forms syndrome called plays role inability point low levels posterior leads syndrome diabetes unrelated diabetes inability concentrate leading production large amounts clear low compensation extreme constant need drink high levels blood masked symptoms appearing replaced generally causes symptoms required time causes located base brain connected consists posterior consists nervous tissue branching anterior consists producing posterior blood causes develops week interactions brain nasal cavity brain cells oral cavity cellular signals stimulate group cells oral cavity form independent nasal cavity develops anterior process includes suppression production protein called sonic cells cells differentiate producing cells requires particular factors induce expression particular genes factors found forms rare combined deficiencies childhood factor acts particular groups cells genetic associated specific deficiencies instance known cause specific deficiencies growth addition factors required development organs associated specific birth defects anterior axis regulated number releasing according rhythm blood vessels supply anterior releasing releasing releasing growth releasing apart production response releasing rate anterior produces turn stimulate body acts directly breast produce sufficient cells sense abundance reduce posterior produced carried nerve endings posterior lobe feedback system located damage nerve endings lead release damage caused particular lack leads symptoms described excess particular indicate presence exception rule stalk decreased blood supply means cells produce receiving produce excess mild elevations attributed stalk compression high levels point strongly diagnosis diagnosis blood tests types blood tests confirm presence basal levels blood samples taken usually morning form dynamic tests blood tests taken injection substance measurement growth usually requires dynamic testing typically tested basal levels adequate direct test levels confirmed indirectly levels routinely measured generally finding combination low low indicative occasionally normal decreased case responding appropriately changes combination findings suggestive basal tests levels suppressed raised level low normal men combination low combination low confirms high indicate source body women diagnosis depends woman abnormal periods low levels confirm problem levels normally elevated produce low sufficient tests possible use encouraged basal measurements usually sufficient measurements ensure simply suppressing production response test releasing regarded useful measured basal level required interpretation results addition confirmation diagnosis tests growth certain tests abnormal like growth factor levels decreased case levels poorly presence testing tolerance test required performed lower blood sugar level occurs growth levels measured low despite effect low blood growth confirmed test risks especially prone known heart disease causes unpleasant symptoms alternative tests growth releasing test useful test diagnosis especially situations tolerance test thought dangerous suspected normal different tests needed confirmation morning levels unlikely level indicative levels require test tolerance test level achieving low blood sugar rules lower levels confirm diagnosis similar test releasing sensitive purposes investigation tolerance test yields abnormal result test measuring response synthetic test performed confirm diagnosis testing alternative suggest test sufficient line investigation tolerance test needed test tolerance test discouraged children tests perfect tests period time needed initial results conclusive symptoms diabetes prompt formal fluid test assess body response normally causes concentration increasing blood parameters unchanged administered concentrated blood falls lack lack function diabetes contrast change different problem diabetes investigations tests shows produced magnetic resonance imaging scan step identifying underlying cause assist causes smaller referred larger called available formal visual field testing recommended evidence nerve compression tests assist diagnosis especially found scan elevated converting ace levels elevated human elevated cell origin genetic cause suspected genetic testing performed treatment treatment removing underlying cause treating deficiencies addressing repercussions arise deficiencies underlying cause require treatment causing specific symptoms visual field defects excessive surgery removal operation nose apart addressing symptoms related improve function damaged result surgery removed opening skull recovery likely suitable way approach surgery time levels change significantly levels performed months later respond treatment medication action cells usually approach improve half cases treatment unnecessary specific underlying causes treated normally example treated regular removal fixed blood eventually decreases iron levels body improves function organs iron accumulated replacement replaced indirectly products male female usually unwanted effects growth available synthetic form needs administered injection replaced nose spray generally lowest dose replacement medication restore correct results excessive cause effects complications requiring usually instructed increase dose physically events injury dental work times normal dose inadequate putting patient risk crisis long term follow specialists generally needed people known apart ensuring right treatment right provides opportunity deal new symptoms address complications treatment difficult situations arise deficiencies axis people men women experience treated human action occasionally complications deficiencies associated lead secondary diseases instance growth associated raised syndrome lead effective treatment underlying deficiencies improve risks necessary treat directly studies shown associated increased risk disease increased risk death normal population difficult establish responsible risk patients studied growth studies answer question causes increased mortality risk attributed treatments sex recognized adverse effect risk largest study date followed thousand people years showed increased risk death compared normal population higher risk female sex absence treatment sex younger age time diagnosis diagnosis apart disease study showed increased risk death lung disease quality life significantly reduced people medical therapy report physical psychological problems likely commonly replacement completely mimic natural levels body health costs remain double normal population usually permanent requires lifelong treatment expect normal life span study measured prevalence total number cases population annual number new cases study conducted northern spain hospital records defined population study showed people diagnosed new cases year types causes cause identified recent studies shown people previous traumatic brain injury spontaneous type stroke radiation therapy involving head higher risk traumatic brain injury quarter persistent deficiencies people subtle non specific symptoms linked problems attributed previous condition possible cases remain annual rise annually people risk groups tested history known theories proposed role body major clues actual function advanced late 19th century described known report german physician morris described condition autopsy year old woman suffered severe fever years earlier subsequently suffered weakness signs rapid aging small remnants anterior posterior syndrome acquired especially general ill health classic causes described 20th century early 21st century saw recognition common previous head injury victims 1950s diagnosis disease remained based clinical features visual field examination aided ray field surgery developed time major breakthrough diagnosis came discovery solomon late 1950s allowed direct measurement result low concentrations blood previously hard measure tests developed 1960s triple test introduced test combined testing imaging identification structural causes improved radically introduction late 1970s magnetic resonance imaging 1980s


smallpox smallpox infectious disease caused virus variants major minor disease known latin names derived spotted disease originally known english red plague term smallpox britain 15th century distinguish great naturally occurring case smallpox minor diagnosed october infection smallpox focused small blood vessels skin mouth throat skin results characteristic later raised fluid filled major produced disease overall mortality rate percent minor caused form disease known cuban killed percent victims long term complications major infection included characteristic commonly face occur percent survivors resulting limb common complications seen percent cases smallpox believed emerged human populations earliest physical evidence probably body egypt disease killed estimated europeans annually closing years 18th century including reigning monarchs responsible infected percent percent infected children died disease smallpox responsible estimated million deaths 20th century recently world health organization estimated million people contracted disease million died year campaigns 19th 20th centuries certified global smallpox smallpox infectious diseases declared classification clinical forms smallpox major severe common form extensive higher fever minor common presentation severe disease historical death rates percent virus noted common addition form called smallpox seen generally persons form marked fever occurred usual period confirmed studies rarely virus isolation signs symptoms period obvious symptoms disease days major virus mouth throat respiratory regional begins initial growth phase virus cell cell 12th day infected cells occurs virus found large numbers called second wave occurs bone initial symptoms similar viral diseases common cold fever muscle pain digestive tract commonly involved occur stage usually lasts days days visible small reddish spots called appear membranes mouth tongue throat temperature falls near normal rapidly releasing large amounts virus smallpox virus attacks skin cells causing characteristic called associated disease develops skin hours membranes appear typically appear forehead rapidly spread face portions trunk lastly portions process takes hours new appear point major infection different courses resulting types smallpox disease based classification ordinary modified flat historically smallpox overall fatality rate percent forms usually fatal ordinary ninety percent smallpox cases persons ordinary type form disease second day raised fourth day filled fluid fluid hours giving appearance called filled tissue debris sixth seventh day skin seven days matured reached maximum size sharply raised typically round tense firm touch deeply embedded giving feel small skin fluid slowly leaked end second week started dry forming day formed started leaving ordinary smallpox generally produced stood skin separately distribution face trunk parts hands feet involved majority cases merged sheets forming began outer layers skin underlying flesh patients smallpox remained ill formed case series case fatality rate smallpox percent modified referring character eruption development modified smallpox occurred previously people form illness occurred severe ordinary type usually fever evolution skin tended fewer evolve quickly superficial uniform characteristic typical smallpox modified smallpox rarely fatal form major easily confused type smallpox called flat smallpox remained flush skin time raised form ordinary type unknown people developed type historically accounted percent cases majority percent children smallpox accompanied severe phase lasted days prolonged high fever severe symptoms tongue extensive skin matured slowly seventh eighth day flat appeared buried skin unlike ordinary type smallpox contained little fluid soft touch contained smallpox nearly fatal smallpox severe form accompanied extensive bleeding skin membranes tract form develops approximately percent occurred adults smallpox skin remains smooth instead bleeding occurs skin making look black form disease known black early form appears second day sub bleeding turns whites eyes deep red smallpox produces kidney muscle rarely liver death occurs suddenly fifth seventh days illness insignificant skin present later form disease occurs patients survive days appear early period flat progress stage patients early stage disease decrease factors increase circulating patients late stage significant factors severe late stage increased form smallpox occurs percent fatal cases depending smallpox strain smallpox usually fatal cause smallpox caused infection virus belongs genus family subfamily date appearance smallpox settled likely evolved virus years ago wide range dates different records molecular clock clade major strains severe form smallpox spread asia years ago second clade included minor mild smallpox described american continents west_africa diverged ancestral strain years present clade diverged years ago second estimate placed separation years ago consistent archaeological historical evidence appearance smallpox human disease suggests relatively recent origin rate assumed similar divergence date estimated years ago consistent published estimates suggests archaeological historical evidence incomplete better estimates rates needed large brick shaped virus measuring approximately single linear double stranded dna pairs size containing loop end classic varieties smallpox major minor cause infection humans virus humans nature animals infected laboratory setting humans animals nature life cycle complicated having multiple infectious forms differing mechanisms cell entry unique dna replicate cell nucleus order replicate produce variety specialized proteins produced dna important viral associated dna dependent infectious viral envelope modified membranes containing viral specific including infection major minor immunity transmission transmission occurs airborne virus usually expressed oral nasal infected person transmitted person primarily prolonged face face contact infected person usually distance feet spread direct contact infected contaminated objects clothing rarely smallpox spread virus carried air enclosed settings buildings buses trains virus cross smallpox relatively low smallpox notably infectious period viral usually delayed appearance accompanied mouth virus transmitted course illness frequent week skin intact days form infected person smallpox falls smallpox highly generally spreads slowly widely viral diseases transmission requires close contact occurs onset overall rate infection affected short duration infectious stage temperate areas number smallpox highest winter spring tropical areas seasonal variation evident disease present year age distribution smallpox depends acquired immunity immunity declines time probably lost thirty years smallpox known transmitted insects animals carrier state diagnosis clinical definition smallpox illness acute onset fever equal greater followed characterized firm deep seated stage development apparent cause clinical case observed smallpox confirmed laboratory tests produce characteristic important known bodies sites viral bodies readily identified skin stained appear pink found virtually absence bodies rule smallpox diagnosis infection rapidly electron microscopic examination fluid exhibit identical brick shaped electron particles characteristic morphology seen eliminate smallpox definitive laboratory identification virus involves growing virus membrane chicken embryo examining resulting defined temperature conditions strains characterized chain reaction restriction fragment length analysis tests linked measure virus specific developed assist diagnosis infection commonly confused smallpox immediate post era smallpox distinguished methods unlike smallpox usually affect additionally varying size variations timing eruption smallpox nearly size viral effect progresses uniformly variety laboratory methods available detecting evaluation suspected smallpox cases prevention earliest procedure prevent smallpox known introduction smallpox avoid possible confusion likely occurred india africa china practice arrived europe idea originated india challenged ancient sanskrit medical texts described process accounts smallpox china found early late 10th century procedure widely practiced 16th century dynasty successful produced lasting immunity smallpox person infected virus severe infection result person transmit smallpox percent mortality rate considerably percent mortality rate disease lady mary observed smallpox stay ottoman_empire writing detailed accounts practice letters enthusiastically promoted procedure england return cotton colleagues provoked controversy boston hundreds edward doctor berkeley gloucestershire rural england discovered immunity smallpox produced person material family called material root word latin cow procedure safer involve risk smallpox transmission prevent smallpox soon practiced world 19th century virus smallpox replaced virus family genetically distinct origin virus came known current smallpox live virus preparation infectious virus given needle solution needle skin usually upper arm number times seconds successful red bump develops site days week bump large called fills begins drain second week begins dry forms falls week leaving small induced cross protective smallpox days time seven days historically effective preventing smallpox infection percent smallpox provides high level immunity years decreasing immunity person later immunity lasts longer studies smallpox cases europe 1950s 1960s demonstrated fatality rate persons years exposure percent percent years prior percent years prior infection contrast percent persons died effects risks associated smallpox past people time experienced non life threatening reactions including toxic reaction site spread virus parts body individuals potentially life threatening reactions occurred people million people time based past experience estimated people million percent receive die result result severe area called progressive given risks smallpox effectively number naturally occurring cases fell number induced illnesses deaths routine childhood discontinued united_states abandoned european countries early 1970s routine health care workers discontinued military recruits military personnel deploying middle_east korea receive routine ceased countries primarily recommended laboratory workers risk exposure treatment smallpox days exposure prevent significantly severity smallpox symptoms vast majority people seven days exposure offer protection disease modify severity disease treatment smallpox primarily supportive wound care infection control fluid therapy possible assistance flat types smallpox treated treat shock fluid people semi types smallpox issues similar patients extensive skin burns drug currently approved treatment smallpox treatments improved large smallpox studies suggest drug useful agent drug administered cause kidney overall case fatality rate ordinary type smallpox percent varies distribution ordinary type fatal percent time ordinary type semi percent time cases case fatality rate percent overall fatality rate children younger year age percent flat types highest fatality rates fatality rate flat type percent greater nearly percent observed cases smallpox case fatality rate minor percent evidence chronic infection virus fatal cases ordinary smallpox death usually occurs tenth sixteenth days illness cause death smallpox clear infection known involve multiple organs circulating immune complexes overwhelming immune response contributing factors early smallpox death occurs suddenly days fever develops cause death cases involved heart failure accompanied late cases high sustained severe loss poor immune response cited causes death flat smallpox modes death similar burns loss fluid protein capacity body replace acquire complications complications smallpox arise commonly respiratory system range simple fatal pneumonia respiratory complications tend develop eighth day illness viral origin secondary infection skin relatively uncommon smallpox occurs fever usually remains elevated complications include patients common adults cause temporary disability permanent pitted notably face complications involving eyes percent cases form leading complications results approximately percent percent eyes affected smallpox cause percent young children smallpox reach joints bone causing symmetrical common cause separation marked reactions swollen joints limit movement lead limb bones joints fingers history disease emergence earliest credible clinical evidence smallpox found smallpox like disease medical writings ancient india early egyptian died years ago china speculated egyptian traders brought smallpox india 1st millennium remained endemic human disease years smallpox probably introduced china 1st century southwest 6th century carried china japan japan epidemic believed killed population seven religious deities specifically dedicated smallpox god religion india hindu goddess smallpox temples country timing arrival smallpox europe south western asia clear smallpox clearly described old new bible literature greeks romans identified plague athens said originated egypt plague lifted siege syracuse smallpox scholars agree unlikely disease major escaped described existed mediterranean region lifetime plague swept roman empire caused smallpox saint patron saint smallpox victims having supposedly survived bout saint gregory tours recorded similar outbreak france italy use term historians speculate arab armies carried smallpox africa southwestern europe 7th 8th centuries 9th century persian physician provided definitive descriptions smallpox differentiate smallpox book smallpox middle ages smallpox periodic incursions europe established population increased population movement active era 16th century smallpox established europe introduction populated areas india china europe smallpox affected mainly children periodic killed percent infected settled existence smallpox europe particular historical importance successive waves exploration colonization europeans tended spread disease parts world 16th century important cause mortality world credible descriptions smallpox like disease americas westward exploration europeans 15th century smallpox introduced caribbean island hispaniola mainland spanish settlers hispaniola arrived mexico bringing smallpox smallpox devastated native population important factor conquest settlement east_coast north_america plymouth massachusetts accompanied devastating smallpox native american populations subsequently native born colonists case fatality rates native american populations high smallpox introduced australia disease endemic continent principal cause death populations century smallpox major endemic disease world australia small islands europe smallpox leading cause death 18th century killing estimated europeans year percent swedish died smallpox year death rate russia higher widespread use countries notably great_britain north american colonies china somewhat reduced impact smallpox wealthy classes 18th century real reduction occur common practice end 19th century improved practice led substantial reduction cases europe north_america smallpox remained world united_states south_africa form smallpox minor recognized close 19th century mid-20th century minor occurred major varying proportions parts africa patients minor experience mild illness course disease able easily spread disease infection minor immunity deadly major form minor spread usa canada south american countries great_britain dominant form smallpox reducing mortality rates english physician edward demonstrated effectiveness protect humans smallpox attempts eliminate smallpox regional scale introduction new world took place trinity newfoundland john clinch friend medical colleague early spanish crown organized expedition transport spanish colonies americas philippines establish mass programs congress passed act ensure safe smallpox available american public solid state program existed dutch_east_indies british india program launched smallpox indian supervision european officials british efforts india burma particular hampered indigenous preference distrust despite tough legislation improvements local education efforts federal government united_states established smallpox program native americans united_kingdom banned later progressing mandatory british government introduced compulsory smallpox act parliament united_states massachusetts states required smallpox disliked measures coordinated efforts smallpox went disease continued diminish wealthy countries smallpox largely eliminated united_states northern europe number countries eliminated smallpox countries decreased comparatively low levels continued countries mid late 1970s protection australia new_zealand notable exceptions experienced endemic smallpox widely relying instead protection distance strict hemisphere wide effort smallpox pan american health organization campaign successful eliminating smallpox american countries argentina brazil colombia ecuador professor deputy minister health ussr called world health assembly undertake global initiative smallpox proposal resolution accepted point million people dying smallpox year overall progress disappointing especially africa indian international team smallpox unit formed leadership american henderson world health organization intensified global smallpox contributing million annually effort adopted new disease surveillance method promoted czech early 1950s estimated million cases smallpox occurred world year smallpox outbreak stopped spreading isolation cases lived close process known ring key strategy monitoring cases community known surveillance initial problem team faced inadequate reporting smallpox cases cases come attention authorities fact humans reservoir smallpox infection carriers exist played significant role smallpox established network assisted countries setting surveillance activities early donations provided primarily soviet_union united_states percent produced developing countries major european outbreak smallpox yugoslavia returned middle_east contracted virus epidemic infected people causing deaths authorities declared martial law enforced undertook widespread population enlisting help months outbreak prior smallpox outbreak july stockholm sweden brought far_east swedish sailor dealt measures local population end smallpox persisted horn africa conditions difficult roads civil war famine refugees task difficult intensive surveillance program undertaken countries early direction australian frank campaign neared goal team played important role naturally occurring case indigenous smallpox minor diagnosed ali hospital cook october naturally occurring case deadly major detected october year old girl global smallpox certified based intense activities countries commission eminent scientists december subsequently endorsed world health assembly sentences resolution read having considered development results global program smallpox initiated intensified declares world peoples won freedom smallpox devastating disease sweeping epidemic form countries earliest time leaving death wake decade ago rampant africa asia south_america post cases smallpox world occurred outbreak cases fatal birmingham medical photographer parker contracted disease university birmingham medical school died september professor henry scientist responsible smallpox research university committed suicide known stocks smallpox subsequently destroyed transferred designated reference laboratories facilities united_states centers disease control prevention russia state research center recommended destruction virus later set date destruction december postponed june resistance russia world health assembly agreed permit temporary retention virus stocks specific research purposes destroying existing stocks reduce risk involved ongoing smallpox research stocks needed respond smallpox outbreak scientists argued stocks useful developing new drugs tests review team public health experts appointed concluded essential public health purpose served russia continuing retain virus stocks view frequently supported scientific community particularly veterans smallpox program march smallpox found inside envelope book civil war medicine santa new_mexico envelope labeled containing gave scientists centers disease control prevention opportunity study history smallpox july smallpox discovered laboratory national health location maryland society culture biological warfare british smallpox biological warfare agent siege fort french indian wars france native american allies actual use smallpox official british officers including british commanding generals ordered sanctioned paid conducted use smallpox native americans described historians doubt british military authorities approved attempts spread smallpox enemy deliberate british policy indians smallpox june william trent local trader commander fort militia wrote regard gave blankets small hospital hope desired effect effectiveness effort broadcast disease unknown accounts smallpox weapon american revolutionary war according theory forward journal australian studies independent researcher british marines smallpox indigenous tribes new_south_wales occasion discussed earlier bulletin history medicine david day book claiming continent new history australia prior article theory disputed academics jack claimed cause outbreak question likely time identified mild form smallpox noted month voyage fleet following months reports smallpox colonists smallpox period days unlikely present fleet known likely source bottles smallpox virus possessed fleet actually report smallpox colonists information fleet smallpox world war scientists united_kingdom united_states japan unit imperial japanese army involved research producing biological weapon smallpox plans large scale production carried considered weapon effective wide scale availability soviet_union established smallpox weapons factory city northeast moscow outbreak smallpox occurred testing facility island sea general peter chief physician soviet army senior researcher soviet program biological weapons described incident island sea strongest recipes smallpox tested suddenly informed mysterious cases research ship fleet came island forbidden come closer lab technician ship took samples twice day deck smallpox exploded island got infected returning home infected people including children died suspected reason called chief general staff ministry defense requested stop alma moscow train result epidemic country prevented called time chief informed exclusive recipe smallpox obtained island contend patient contracted disease visiting cities boat docked responding international pressures soviet government allowed joint inspection team tour main weapons facilities met soviet scientists eventually ordered facility soviet alleged soviet program produced large tons smallpox possibly engineered resist alleged deliver stories soviet program smallpox activities independently verified russian government announced remaining smallpox samples moved institute breakup soviet_union unemployment weapons program scientists government officials expressed concern smallpox expertise available governments terrorist groups wish use virus means biological warfare specific allegations iraq respect proved mistaken concern expressed artificial gene synthesis recreate virus existing digital use biological warfare synthesized smallpox dna existing related theoretically recreate virus step risk suggested destroy remaining virus stocks enable possession virus notable cases famous historical figures contracted smallpox include chief sitting bull egypt emperor survived emperor emperor refer official history china date japan lost eye disease 10th ruler city died smallpox shortly introduction americas emperor died recent public figures include guru 8th guru peter russia died george_washington survived king louis died iii joseph bavaria prominent families world people infected disease example relatives henry_viii survived disease include sister margaret queen scotland fourth wife anne daughters mary england elizabeth england adult try disguise heavy makeup great niece mary queen scots contracted disease child visible europe deaths smallpox changed succession surviving son henry_viii edward died complications shortly apparently recovering disease henry efforts ensure male successor throne immediate successors women survived louis france succeeded great grandfather louis series deaths smallpox earlier succession line died disease william iii lost mother disease years old named uncle charles legal guardian death smallpox indirectly spark chain events eventually lead permanent stuart line british throne william iii wife mary england died smallpox russia peter russia died disease years age prior russian emperor peter iii caught virus suffered greatly left wife catherine great spared fear virus clearly effects feared son heir safety sure large crowds kept bay sought eventually decided scottish doctor thomas considered controversial method time succeeded son later catherine sought empire stating objective example save death multitude subjects knowing value technique frightened left danger approximately million administered russian_empire china dynasty extensive protect endemic smallpox presidents george_washington andrew jackson abraham_lincoln contracted recovered disease washington infected smallpox visit barbados jackson developed illness taken prisoner british american revolution recovered brother robert lincoln contracted disease presidency possibly son shortly giving address famous theologian edwards died smallpox following soviet leader joseph fell ill smallpox age seven face badly disease later photographs apparent hungarian poet wrote hungarian national anthem lost right eye smallpox tradition religion face devastation smallpox smallpox gods parts old world example china india china smallpox goddess referred chinese believers actively worked goddess pray mercy measures referring smallpox beautiful flowers intended goddess example related new year eve custom prescribed children house wear ugly masks sleeping conceal beauty avoid attracting goddess passing night case smallpox occur set homes victims offered disease ran course victim recovered removed carried away special paper chair boat burning patient recover shrine destroyed cursed expel goddess house india records smallpox found medical book dates book describes disease sounds exceptionally like smallpox india like china created goddess response exposure smallpox hindu goddess feared reign believed goddess evil kind ability inflict victims angered calm afflicted portraits goddess holding right hand continue disease pot cool water hand attempt victims created india natives healthy went worship attempt protect disease indian women attempt ward placed plates cooling foods water roofs homes cultures recognize smallpox deity nonetheless belief smallpox demons accordingly blamed disease beliefs prominent japan europe africa parts world nearly cultures believed demon believed afraid color red led invention called red treatment victims rooms decorated red practice spread europe 12th century practiced charles france elizabeth england afforded scientific credibility studies showing red light reduced belief persisted 1930s


reaction rapid onset cause death typically causes following throat tongue swelling breath low blood pressure symptoms typically come minutes hours common causes include insect bites foods causes include latex exposure exercise additionally cases occur obvious reason mechanism involves release certain types white blood cells triggered non mechanisms diagnosis based presenting symptoms signs exposure potential primary treatment injection muscle positioning person flat additional required measures carrying identification condition recommended people history worldwide population estimated experience point life rates appear increasing occurs young people females people hospital united_states die term comes ancient greek ancient greek protection signs symptoms typically presents different symptoms minutes hours average onset minutes exposure hours eating food common areas affected include skin respiratory heart central nervous system usually involved skin symptoms typically include swelling afflicted tissues describe burning sensation skin swelling tongue throat occurs cases features include nose swelling skin blue tinged lack oxygen respiratory respiratory symptoms signs present include breath typically caused muscles related upper secondary swelling pain occur occur subsequent cardiac arrest underlying disease greater risk cardiac effects related presence releasing cells heart fast heart rate caused low blood pressure common described cases slow heart rate associated low blood pressure drop blood pressure shock cause feeling loss consciousness rarely low blood pressure sign symptoms include abdominal pain confusion loss control pelvic pain similar blood vessels brain cause feeling anxiety impending doom described causes occur response foreign substance common include venom insect bites foods medication foods common trigger children young adults insect bites common older adults common causes include physical factors biological agents latex changes food food colors physical factors exercise known exercise induced temperature hot cold act direct effects mast cells events caused exercise frequently associated certain foods blocking agents latex common causes cause remains unknown cases referred recognized cause cause food foods trigger occur known common triggering foods vary world western cultures exposure wheat nuts certain types like milk eggs prevalent causes common middle_east rice frequently encountered sources asia severe cases usually caused people experience severe reaction contact children age children milk eggs experience isolated tolerate foods medication medication potentially trigger common followed implicated frequently reactions agent specific meaning typically tolerate different relatively common causes include preparations ray contrast cause directly triggering mast cell frequency reaction agent partly depends frequency use partly properties occurs proteins inside body agents binding easily occurs courses treatment death occurring fewer courses treatment occurs persons reaction risk reaction greater old agents caused reactions cases newer lower agents cause reactions cases venom venom biting insects ants bees kissing bugs cause susceptible people previous reactions local reaction site sting risk factor future half fatalities previous reaction risk factors people diseases high risk food latex agents study children found history previous diseases children die higher status increased risk longer time exposure agent question lower risk severe reaction rapid onset affecting body systems release mast cells typically reaction non mechanism mechanism foreign material reaction bound mast cells leads release subsequently increase smooth muscles trigger increase fluid blood vessels cause heart muscle depression mechanism rely known occurs humans non non mechanisms involve substances directly cause mast cells include agents contrast medium temperature hot cold vibration cause reactions non mechanisms diagnosis diagnosed basis person signs symptoms following occurs minutes hours exposure high likelihood involvement skin tissue plus respiratory difficulty low blood pressure causing symptoms following symptoms likely contact involvement skin respiratory difficulties low blood pressure symptoms low blood pressure exposure known skin involvement include swollen tongue respiratory difficulties include breath low oxygen levels low blood pressure defined greater decrease person usual blood pressure adults blood pressure attack blood tests released mast cells useful insect tests limited use cause food person normal blood pressure specific diagnosis classification main classifications shock associated causes low blood pressure definition lower person standard values symptoms hours exposure reports vary studies claiming cases typically occurs hours managed manner reactions type involve reaction direct mast cell non immune current term world organization recommending old terminology longer testing testing help determining trigger skin testing patch testing available certain foods blood testing specific useful confirm milk egg tree fish skin testing available confirm available non immune forms determined history exposure question skin blood testing differential diagnosis difficult distinguish panic attacks typically symptoms presents panic attack conditions present similarly include post findings person died autopsy heart attributed reduced return volume central peripheral compartment signs lungs heart tissues evidence laboratory findings detect increased levels increase total specific levels prevention avoidance trigger recommended cases possible option effective adults children bees fire ants oral effective people certain food including milk eggs nuts adverse effects common possible advised people simply avoid agent question react latex important avoid cross foods potatoes management medical emergency require measures management supplemental oxygen large volumes close monitoring administration treatment choice example period hospital observation hours recommended people returned normal concerns adrenaline primary treatment absolute use recommended solution given mid thigh soon diagnosis suspected injection repeated minutes insufficient response second dose needed episodes rarely required route preferred administration delayed absorption minor adverse effects include anxiety people resistant effects situation effective administered mechanism action independent necessary given solution associated self administration typically come adults children weigh children weigh commonly assumed effective based theoretical reasoning poorly supported evidence review find good quality studies base recommendations believed effect unlikely difference current episode hope decreasing risk effectiveness situations uncertain effective resolve blue responsive measures presumed effect smooth muscle people prone advised action plan parents advised inform schools children case emergency action plan usually includes use recommendation wear medical alert counseling avoidance available certain prevent future episodes multi year course found effective insects oral effective foods cause known prompt treatment available good cause unknown appropriate medication available generally good death occurs usually respiratory typically causes shock cases causing death cases death occurring minutes outcomes exercise induced typically good fewer severe episodes people older number people persons year lifetime risk people attack rates appear increasing numbers 1980s approximately year 1990s year increase appears primarily food induced risk greatest young people females currently leads deaths year million united_states deaths year united_kingdom million deaths year australia million mortality rates decreased 1970s 2000s australia death food induced occur primarily women deaths insect bites primarily occur males death commonly triggered history term coined charles later changed quality speech experiments injected dog sea attempt protect dog previously tolerated exposure dose weeks later developed fatal instead inducing tolerance lethal responses resulted previously tolerated coined word protection means ancient greek stated word changed sound subsequently awarded nobel prize physiology medicine work phenomenon described ancient times term comes greek words protection research ongoing efforts develop treat injection anti studied method preventing recommended


common cold common cold known simply cold viral infectious disease upper respiratory tract primarily affects nose throat voice box affected signs symptoms begin days following exposure include sore throat nose fever people usually recover seven days symptoms weeks health problems pneumonia occasionally develop virus strains implicated cause common cold common spread air close contact infected people indirectly contact objects environment followed transfer mouth nose risk factors include going sleeping psychological stress symptoms body immune response infection tissue destruction people similar symptoms people cold symptoms usually severe common cold primary methods prevention hand washing touching eyes nose mouth hands staying away sick people evidence supports use face masks cure common cold exists symptoms treated anti drugs help pain evidence support benefit common cold frequent infectious disease humans average adult gets year average child occur commonly winter humanity ancient times signs symptoms typical symptoms cold include nose nasal congestion sore throat accompanied muscle fatigue loss appetite sore throat present cases muscle occurs half adults fever generally present common young children usually mild compared accompanying fever indicate higher likelihood adults great deal similarity exists conditions number cause common cold result color nasal vary clear yellow green indicate class agent causing infection progression cold usually begins fatigue feeling followed couple days nose symptoms begin sixteen hours exposure typically peak days onset usually resolve seven days weeks average duration eighteen days cases people develop post viral infection gone children lasts days cases continues days cause common cold viral infection upper respiratory tract commonly implicated virus type known commonly implicated include human human respiratory virus human frequently virus present total different viral types associated transmission common cold virus typically transmitted airborne direct contact infected nasal contaminated objects routes primary importance determined hand hand hand surface hand contact importance transmission survive prolonged periods environment hours picked people hands subsequently carried eyes nose infection occurs transmission common school proximity children little immunity frequently poor brought home members family evidence air commercial flight method transmission people sitting close proximity appear greater risk infection caused infectious days symptoms infectious weather traditional theory cold caught prolonged exposure cold weather rain winter conditions disease got cause common seasonal occurring frequently cold wet weather reason determined possible explanations include cold temperature induced changes respiratory system decreased immune response low humidity causing increase viral transmission rates dry air allowing small viral disperse farther stay air longer apparent social factors people spending time indoors near infected people specifically children school controversy role low body temperature risk factor common cold majority evidence suggests result greater infection herd immunity generated previous exposure cold plays important role limiting viral spread seen younger populations greater rates respiratory poor immune function risk factor disease insufficient sleep associated greater risk developing infection following exposure believed effects immune function breast feeding decreases risk acute media lower respiratory tract diseases recommended breast feeding continued infant cold developed world breast feeding protective common cold symptoms common cold believed primarily related immune response virus mechanism immune response virus specific example typically acquired direct contact human unknown mechanisms trigger release produce symptoms generally cause damage nasal respiratory virus hand contracted direct contact airborne nose throat frequently spreading lower respiratory tract cause damage human virus typically results nose throat young children affects produce symptoms small size diagnosis distinction viral upper respiratory tract loosely based location symptoms common cold affecting primarily nose throat lungs significant overlap multiple areas affected common cold frequently defined nasal varying throat self diagnosis frequent isolation viral agent involved rarely performed generally possible identify virus type symptoms prevention useful ways reduce spread cold physical measures hand washing face masks healthcare environment gloves isolation disease widespread symptoms non specific proved difficult involved rapidly creation broadly effective highly regular hand washing appears effective reducing transmission cold especially children addition normal hand washing provides greater benefit unknown wearing face masks people infected beneficial insufficient evidence maintaining greater social distance help reduce prevalence routine reduce risk severity common cold reduce duration water found useful small trial management demonstrated duration infection treatment comprises relief getting plenty rest drinking maintain warm salt water reasonable conservative measures benefit treatment attributed effect treatments help alleviate symptoms include simple good evidence recommended use children lack evidence supporting effectiveness potential harm canada restricted use counter cold medication children years concerns risks benefits counter medicine led ban number countries adults improve symptoms day longer term benefit adverse effects effective adults nasal spray reduce symptoms nose little effect lack studies known increased fluid intake improves symptoms respiratory illness similar lack data use heated air study found chest provide relief nocturnal congestion sleep difficulty effect viral cause common cold effects cause overall harm frequently prescribed reasons commonly prescribed include people expectations physicians desire help difficulty excluding complications effective drugs common cold preliminary research shown benefits alternative medicine alternative treatments common cold insufficient scientific evidence support use insufficient evidence recommend honey tentative evidence support nasal irrigation treat symptoms studies suggesting taken hours onset symptoms reduces duration severity common cold healthy people wide differences studies research needed determine effective produce effects weak rationale physicians recommend treatment common cold directly applied inside nose led loss sense smell effect common cold extensively researched disappointing limited circumstances specifically individuals exercising vigorously cold environments firm evidence products provide meaningful benefit treating preventing unknown effective single trial find benefit common cold generally mild self limiting symptoms generally improving week half cases away days days severe complications occur usually old young secondary occur resulting ear infection estimated occurs ear infection cases common cold common human disease affects people globe adults typically annually children year year school children rates increase elderly declining immunity native americans likely infected develop complications media explained issues poverty ethnicity history cause common cold identified 1950s disease humanity ancient times symptoms treatment described egyptian oldest existing medical text written 16th century bce cold came use 16th century similarity symptoms exposure cold weather united_kingdom common cold unit set medical research council discovered 1970s demonstrated treatment phase infection protects somewhat disease practical treatment developed unit closed years completed research treatment successful treatment history unit society culture economic impact common cold understood world united_states common cold leads million physician visits annually conservative cost estimate billion year americans spend billion counter drugs million relief people saw doctor received implications resistance estimated million school days missed annually cold result parents missed million stay home care children added million missed employees suffering cold total economic impact cold related work loss exceeds billion year accounts time lost work united_states research directions tested effectiveness common cold found effective licensed use ongoing trials anti viral drug shows promise trials oral form safety issues form studied broad spectrum therapy shown preliminary effectiveness treating infectious known human strains


common solid cancer childhood common cancer infancy cases year cases year nearly half cases occur children younger years arising crest element sympathetic nervous system frequently originates develop nerve tissues neck chest abdomen human known demonstrate spontaneous state completely cellular appearance disease exhibiting extreme risk categories low intermediate high risk low risk disease common good outcomes common observation surgery high risk disease difficult treat successfully intensive multi available known believed arise classification remains controversial sympathetic nervous system distinct clinical entity confused signs symptoms symptoms vague making diagnosis difficult fatigue loss appetite fever joint pain common symptoms depend primary locations present abdomen cause swollen belly chest cause breathing problems pressing spinal cord cause weakness inability stand crawl walk bone legs cause pain bones eyes cause distinct swelling bone cause spreads parts body symptoms apparent cases present common location originate primary occurs localized cases widespread disease develop sympathetic nervous system chain neck frequencies different locations include neck chest abdomen non rare cases primary rare characteristic presentations include transverse spinal cord compression cases treatment resistant cases syndrome cases syndrome suspected cause cases compression cases cause understood great majority cases sporadic non cases run families linked specific gene cases caused rare gene gene implicated feature type syndrome common finding degree shows distribution fold fold presence highly advanced stages disease segments gene cells shown increase risk developing aggressive form cancer linked copy number variation gene results syndrome syndrome risk factors proposed subject ongoing research characteristic early onset studies focused parental factors conception gestation factors investigated included occupation exposure chemicals specific industries smoking alcohol consumption use medicinal drugs pregnancy birth factors results inconclusive studies examined possible links exposure infection early life use fertility drugs maternal use hair diagnosis diagnosis usually confirmed surgical taking account clinical presentation microscopic findings laboratory tests cases elevated levels found blood include acid acid imaging way detect scan taken termed avid mechanism taken sympathetic functioning analog radio radioactive good diagnosis monitoring response treatment disease half life hours preferred imaging sensitivity quality half life days higher effective therapy targeted radiation cells typically described small round blue patterns homer wright seen homer wright cells confused cells blood vessel distinct consist cells acidic protein positive processes tapering blood vessel combination variety distinguish peripheral similar origins wide pattern ranging rich cells highly distinction pre treatment important factor age index classification system system describes favorable unfavorable international committee established revised staging international staging system established revised according presence diagnosis stage localized confined area origin stage incomplete gross identifiable negative stage complete incomplete gross positive identifiable negative stage regional involvement involvement involvement stage distant bone bone liver organs defined stage stage age year old localized primary defined stage limited liver skin bone percent bone cells international agreement staging need international consensus risk assignment recognized order compare similar results studies beginning representatives major cooperative groups met review data patients treated europe japan usa canada australia task force proposed international risk group classification system retrospective studies revealed high survival rate month old age group previously categorized high risk prompted decision month old children commonly referred intermediate risk category new risk assignment classify diagnosis based new international risk group staging system stage localized disease image defined risk factors stage localized disease image defined risk factors stage disease stage disease special equivalent stage new risk based new staging system age months grade pre treatment risk groups low low intermediate high risk screening level elevated pre clinical screening weeks months year performed japan canada austria germany 1980s japan began screening month olds analysis levels acid acid screening halted studies canada germany showed reduction deaths caused increase disappeared treatment unnecessary surgery treatment localized generally long term survival children advanced disease older months age poor despite aggressive therapy intensive surgery radiation therapy stem cell agent called acid frequently anti therapy genetic characteristics identified added classic clinical staging allowed patient assignment risk groups planning treatment intensity criteria include age patient extent disease spread microscopic appearance genetic features including dna low intermediate high risk disease recent biology study analyzed patients spectrum risk assignment determined cases low risk intermediate risk high risk evidence low risk types caused different mechanisms merely different degrees expression mechanism different risk categories different low risk disease frequently observed treatment cured surgery intermediate risk disease treated surgery high risk treated intensive surgery radiation therapy bone stem cell biological based therapy acid therapy usually administered current treatments patients low intermediate risk disease excellent cure rates low risk intermediate risk contrast therapy high risk past decades resulted time addition therapy raised survival rates high risk disease significantly march early analysis children group study high risk patients showed years stem cell group receive alive disease free compared group receive stopped patients trial receive therapy agents combination found effective agents commonly induction stem cell conditioning platinum compounds agents newer include induction found effective disease high risk cases respond adequately induction high dose progressive completion therapy common treatment available phase phase clinical trials test new agents combinations agents outcome remains poor high risk disease long term survivors alive today low intermediate risk disease courses treatment compared high risk disease majority survivors long term effects treatment survivors intermediate high risk treatment experience hearing loss growth reduction function disorders learning difficulties greater risk secondary affect survivors high risk disease estimated survivors childhood cancer ultimately develop chronic life threatening health problem years cancer diagnosis profiles based series samples reported overall pattern tested array based outcome presenting exclusively copy number changes associated excellent survival presenting kind copy number changes associated high risk showing alterations additional independent decreased overall survival gain earlier publications categorized major based profiles favorable near numerical gains losses representing non stages found unfavorable widespread stages loss gain gain virtual performed fresh embedded assess copy number array virtual preferred samples including detect copy neutral loss acquired copy neutral equivalent detected key fish conventional detect copy neutral comprises childhood cancer deaths children annual mortality rate million children year old age group million year old age group highest year life cases age range broad including older children adults cases occur people older years age large european study reported cases years old history german physician describe abdominal child characteristics sympathetic nervous system noted german distinctive presentation stage liver bone described william pepper james homer wright understood originate primitive cells named noted circular cells bone samples termed homer wright note homer wright incorrect refers wright society culture legislative efforts representative edwards texas successfully introduced legislation million cure measure signed law july president george bush edwards inspired endeavor illness subsequent death erin daughter constituents walter head history department texas university fundraising organizations research global vision cancer care pioneer non profit organisation india supporting poor cancer patients tom honorary patron james fund leading fundraising organization support clinical research december foundation took james funds cincinnati announced donate proceeds jersey sales defensive devon jersey cincinnati children hospital presented check million daughter thursday night game november cincinnati defensive devon jersey 11th popular nfl research models patient derived created patient samples mice models advantages conventional cancer cell lines retain genetic corresponding patient display growth distant organs models clinical outcome compared conventional cancer cell line serve relevant models identify effective compounds treatments recent focus reduce therapy low intermediate risk maintaining survival rates study intermediate risk patients enrolled confirmed hypothesis therapy successfully reduced risk group favorable characteristics grade response received cycles unfavorable characteristics received cycles year event free survival overall survival stable entire future plans intensify treatment patients lack early response treatment contrast focus past years intensify treatment high risk induction variations timing surgery stem cell delivery schemes radiation use treat minimal disease continue examined recent phase iii clinical trials carried answer questions improve survival high risk disease european study group enrolled children bone therapy radiation therapy given arms patients recent long term follow report revealed significantly better year event free survival stage year old group versus treatment versus respectively european study high risk children year old revealed higher survival rate rapid sequence induction day cycle versus standard induction day cycle total dose year event free survival respectively non aggressive surgical approach bone stem cell groups phase iii trial high risk patients carried children cancer group demonstrated improved survival therapy total body acid patients arms study german study compared outcomes high risk patients stem cell consolidation results showed increased survival recent study questioned need stem cells local patients stem cells found improve survival concurrent study determined early review studied german lower dose improved survival total patients follow phase iii study opened jan patients gather safety data approval international society formed european group activated phase iii high risk protocol europe rapid cycles given day intervals followed study recently amended children treatment given chinese cells shows molecular functional differences compared trial study recently reported benefit growth factors patients receive acid trial patients year current german include therapy use therapy total risk groups roughly half high risk high risk protocol includes months acid month break months acid phase iii trial opened december compare single versus tandem induction begins cycles addition phase iii studies research institutions offer pilot treatment example recently finished testing new children included months maintenance stem cell alternating oral acid memorial cancer center new_york offers treatment includes mouse derived mid-1980s treating minimal disease consolidation instead stem cell new pilot protocol available newly diagnosed high risk children children group centers offer children particularly high risk cases respond completely treatment complete response good partial response labeled children removed therapy clinical trial eligible clinical trials new high risk children good response therapy achieve later disease children eligible new tested clinical trials frequently setting study patients comparing revealed complete partial response rate year progression free survival group oral oral phase phase trials currently testing new agents children resistant initial therapy investigators currently studying new agents new combinations small targeted therapy radiation therapy agents new new group children hospitals united_states known new advances therapy consortium coordinates radiation therapy trials consortium offers trials oral powder agents combining group investigated new delivery method anti given long term continuous combined order achieve better tolerated treatment research study groups research consortium conduct clinical trials treat institutions europe studying novel treat including stem cell hospitals conduct institutional studies protein believed play role development resistance november study mice shows new drug slow growth study physician tom van university hospital belgium colleagues protein protein ability trigger programmed cell death earlier studies shown specifically prevent