genre the diving bell and the butterfly
Atrial fibrillation ( AF or A - fib ) is an abnormal heart ___MASK3___ characterized by rapid and irregular beating . Often it starts as brief periods of abnormal beating which become longer and possibly constant over time . Most episodes have no symptoms . Occasionally there may be heart palpitations , fainting , lightheadedness , shortness of breath , or chest pain . The disease is associated with an increased risk of heart failure , dementia , and stroke . It is a type of supraventricular tachycardia . High blood pressure and valvular heart disease are the most common alterable risk factors for AF . Other heart - related risk factors include heart failure , coronary artery disease , cardiomyopathy , and congenital heart disease . In the developing world valvular heart disease often occurs as a result of rheumatic fever . Lung - related risk factors include COPD , obesity , and sleep apnea . Other factors include excess alcohol intake , diabetes mellitus , and thyrotoxicosis . However , half of cases are not associated with one of these risks . A diagnosis is made by feeling the pulse and may be confirmed using an electrocardiogram ( ECG ). A typical ECG in AF shows no P waves and an irregular ventricular rate . AF is often treated with medications to slow the heart rate to a near normal range ( known as rate control ) or to convert the ___MASK3___ to normal sinus ___MASK3___ ( known as ___MASK3___ control ). Electrical cardioversion can also be used to convert AF to a normal sinus ___MASK3___ and is often used emergently if the person is unstable . Ablation may prevent recurrence in some people . Depending on the risk of stroke either aspirin or anti - clotting medications such as warfarin or a novel oral anticoagulant may be recommended . While these medications reduce this risk , they increase rates of major bleeding . Atrial fibrillation is the most common serious abnormal heart ___MASK3___ . In Europe and North America , as of 2014 , it affects about 2 % to 3 % of the population . This is an increase from 0 . 4 to 1 % of the population around 2005 . In the developing world about 0 . 6 % of males and 0 . 4 % of females are affected . The percentage of people with AF increases with age with 0 . 14 % under 50 years old , 4 % between 60 and 70 years old , and 14 % over 80 years old being affected . A - fib and atrial flutter resulted in 112 , 000 deaths in 2013 , up from 29 , 000 in 1990 . The first known report of an irregular pulse was by Jean - Baptiste de Sénac in 1749 . This was first documented by ECG in 1909 by Thomas Lewis . Signs and symptoms . AF is usually accompanied by symptoms related to a rapid heart rate . Rapid and irregular heart rates may be perceived as palpitations or exercise intolerance and occasionally may produce anginal chest pain ( if the high heart rate causes ischemia ). Other possible symptoms include congestive symptoms such as shortness of breath or swelling . The arrhythmia is sometimes only identified with the onset of a stroke or a transient ischemic attack ( TIA ). It is not uncommon for a patient to first become aware of AF from a routine physical examination or ECG , as it often does not cause symptoms . Headache is the symptom of pain anywhere in the region of the head or neck . It occurs in migraines , tension - type headaches , and cluster headaches . Frequent headaches can affect relationships and employment . There is also an increased risk of depression in those with severe headaches . Headaches can occur as a result of many conditions whether serious or not . There are a number of different classification systems for headaches . The most well - recognized is that of the International Headache ___MASK72___ . Causes of headaches may include fatigue , sleep deprivation , stress , the effects of medications , the effects of recreational drugs , viral infections , loud noises , common colds , head injury , rapid ingestion of a very cold food or beverage , and dental or sinus issues . Treatment of a headache depends on the underlying cause , but commonly involves pain medication . Some form of headache is one of the most commonly experienced of all physical discomforts . About half of adults have a headache in a given year . Tension headaches are the most common affecting about 1 . 6 billion people ( 21 . 8 % of the population ) followed by migraine headaches which affect about 848 million ( 11 . 7 %). Cause . There are more than two hundred types of headaches . Some are harmless and some are life - threatening . The description of the headache and findings on neurological examination , determine whether additional tests are needed and what treatment is best . A CT scan ( often referred to as a ___MASK17___ scan ) makes use of computer - processed combinations of many X - ray images taken from different angles to produce cross - sectional ( tomographic ) images ( virtual " slices ") of specific areas of a scanned object , allowing the user to see inside the object without cutting . A ___MASK19___ , or simply bio , is a detailed description of a person ' s life . It involves more than just the ___MASK10___ facts like education , work , relationships , and death ; it portrays a person ' s experience of these life events . Unlike a profile or curriculum vitae ( résumé ), a ___MASK19___ presents a subject ' s life story , highlighting ___MASK67___ aspects of his or her life , including intimate details of experience , and may include an analysis of the subject ' s personality . Obesity is a medical condition in which excess body fat has accumulated to the extent that it may have a negative effect on ___MASK75___ . People are generally considered obese when their body ___MASK32___ index ( BMI ), a measurement obtained by dividing a person ' s weight by the square of the person ' s height , is over , with the range defined as overweight . Some East Asian countries use lower values . Obesity increases the likelihood of various diseases , particularly heart disease , type 2 diabetes , obstructive sleep apnea , certain types of cancer , and osteoarthritis . Obesity is most commonly caused by a combination of excessive food intake , lack of physical activity , and genetic susceptibility . A few cases are caused primarily by genes , endocrine disorders , medications , or mental illness . The view that obese people eat little yet gain weight due to a slow metabolism is not generally supported . On average , obese people have a greater energy expenditure than their thin counterparts due to the energy required to maintain an increased body ___MASK32___ . Obesity is mostly preventable through a combination of social changes and personal choices . Changes to diet and exercising are the main treatments . Diet quality can be improved by reducing the consumption of energy - dense foods , such as those high in fat and sugars , and by increasing the intake of dietary fiber . Medications may be taken , along with a suitable diet , to reduce appetite or decrease fat absorption . If diet , exercise , and medication are not effective , a gastric balloon or surgery may be performed to reduce stomach volume or bowel length , leading to feeling full earlier or a reduced ability to absorb nutrients from food . Obesity is a leading preventable cause of death worldwide , with increasing rates in adults and children . In 2014 , 600 million adults ( 13 %) and 42 million children under the age of five were obese . Obesity is more common in women than men . Authorities view it as one of the most serious public ___MASK75___ problems of the 21st century . Obesity is stigmatized in much of the modern world ( particularly in the Western world ), though it was seen as a symbol of wealth and fertility at other times in history and still is in some parts of the world . In 2013 , the American Medical Association classified obesity as a disease . An ___MASK78___ ( from the Greek ,  -" autos " self +  -" bios " life +  -" graphein " to write ) is a written account of the life of a person written by that person . In other words , it is a self - written life story . Magnetic resonance imaging ( MRI ) is a medical imaging technique used in radiology to form pictures of the anatomy and the physiological processes of the body in both ___MASK75___ and disease . MRI scanners use strong magnetic fields , ___MASK37___ waves , and field gradients to generate images of the inside of the body . The brain is an organ that serves as the center of the nervous system in all vertebrate and most invertebrate animals . The brain is located in the head , usually close to the sensory organs for senses such as vision . The brain is the most complex organ in a vertebrate ' s body . In a human , the cerebral cortex contains approximately 15  33 billion neurons , each connected by synapses to several thousand other neurons . These neurons communicate with one another by means of long protoplasmic fibers called axons , which carry trains of signal pulses called ___MASK59___ potentials to distant parts of the brain or body targeting specific recipient cells . Stroke is when poor blood flow to the brain results in cell death . There are two main types of stroke : ischemic , due to lack of blood flow , and hemorrhagic , due to bleeding . They result in part of the brain not functioning properly . Signs and symptoms of a stroke may include an inability to move or feel on one side of the body , problems understanding or speaking , feeling like the world is spinning , or loss of vision to one side . Signs and symptoms often appear soon after the stroke has occurred . If symptoms last less than one or two hours it is known as a transient ischemic attack ( TIA ) or mini - stroke . A hemorrhagic stroke may also be associated with a severe headache . The symptoms of a stroke can be permanent . Long - term complications may include pneumonia or loss of bladder control . The main risk factor for stroke is high blood pressure . Other risk factors include tobacco smoking , obesity , high blood cholesterol , diabetes mellitus , previous TIA , and atrial fibrillation . An ischemic stroke is typically caused by blockage of a blood vessel , though there are also less common causes . A hemorrhagic stroke is caused by either bleeding directly into the brain or into the ___MASK44___ between the brain ' s membranes . Bleeding may occur due to a ruptured brain aneurysm . Diagnosis is typically with medical imaging such as a CT scan or magnetic resonance imaging ( MRI ) scan along with a physical exam . Other tests such as an electrocardiogram ( ECG ) and blood tests are done to determine risk factors and rule out other possible causes . Low blood sugar may cause similar symptoms . Prevention includes decreasing risk factors , as well as possibly aspirin , statins , surgery to open up the arteries to the brain in those with problematic narrowing , and warfarin in those with atrial fibrillation . A stroke or TIA often requires emergency care . An ischemic stroke , if detected within three to four and half hours , may be treatable with a medication that can break down the clot . Aspirin should be used . Some hemorrhagic strokes benefit from surgery . Treatment to try recover lost function is called stroke rehabilitation and ideally takes place in a stroke unit ; however , these are not available in much of the world . In 2013 approximately 6 . 9 million people had an ischemic stroke and 3 . 4 million people had a hemorrhagic stroke . In 2010 there were about 33 million people who had previously had a stroke and were still alive . Between 1990 and 2010 the number of strokes which occurred each year decreased by approximately 10 % in the developed world and increased by 10 % in the developing world . In 2013 , stroke was the second most frequent cause of death after coronary artery disease , ___MASK62___ for 6 . 4 million deaths ( 12 % of the total ). About 3 . 3 million deaths resulted from ischemic stroke while 3 . 2 million deaths resulted from hemorrhagic stroke . About half of people who have had a stroke live less than one year . Overall , two thirds of strokes occurred in those over 65 years old . Pneumonia is an inflammatory condition of the lung affecting primarily the microscopic air sacs known as alveoli . Typical signs and symptoms include a varying severity and combination of productive or dry cough , chest pain , fever , and trouble breathing , depending on the underlying cause . Pneumonia is usually caused by infection with viruses or bacteria and less commonly by other microorganisms , certain medications and conditions such as autoimmune diseases . Risk factors include other lung diseases such as cystic fibrosis , COPD , and asthma , diabetes , heart failure , a ___MASK80___ of smoking , a poor ability to cough such as following a stroke , or a weak immune system . Diagnosis is often based on the symptoms and physical examination . Chest X - ray , blood tests , and culture of the sputum may help confirm the diagnosis . The disease may be classified by where it was acquired with community , hospital , or ___MASK75___ care associated pneumonia . Vaccines to prevent certain types of pneumonia are available . Other methods of prevention include handwashing and not smoking . Treatment depends on the underlying cause . Pneumonia believed to be due to bacteria is treated with antibiotics . If the pneumonia is severe , the affected person is generally hospitalized . Oxygen therapy may be used if oxygen levels are low . Pneumonia affects approximately 450 million people globally ( 7 % of the population ) and results in about 4 million deaths per year . Pneumonia was regarded by William Osler in the 19th century as " the captain of the men of death ". With the introduction of antibiotics and vaccines in the 20th century , survival improved . Nevertheless , in developing countries , and among the very old , the very young , and the chronically ill , pneumonia remains a leading cause of death . Pneumonia often shortens suffering among those already close to death and has thus been called " the old man ' s friend ". Statins , also known as HMG - CoA reductase inhibitors , are a class of lipid - lowering medications . Statins have been found to reduce cardiovascular disease ( CVD ) and mortality in those who are at high risk . The evidence is strong that statins are effective for treating CVD in the early stages of a disease ( secondary prevention ) and in those at elevated risk but without CVD ( primary prevention ). Side effects of statins include muscle pain , increased risk of diabetes mellitus , and abnormalities in liver enzyme tests . Additionally , they have rare but severe adverse effects , particularly muscle damage . They inhibit the enzyme HMG - CoA reductase which plays a central role in the production of cholesterol . High cholesterol levels have been associated with cardiovascular disease ( CVD ). , a number of statins are on the market : atorvastatin , fluvastatin , lovastatin , pitavastatin , pravastatin , rosuvastatin and simvastatin . Several combination preparations of a statin and another agent , such as ezetimibe / simvastatin , are also available . In 2005 , sales were estimated at US $ 18 . 7billion in the United States . The best - selling statin is atorvastatin , which in 2003 became the best - selling pharmaceutical in ___MASK80___ . The manufacturer Pfizer reported sales of US $ 12 . 4billion in 2008 . Due to patent expirations , several statins are now available as less expensive generics . A transient ischemic attack ( TIA ) is a transient episode of neurologic dysfunction caused by ischemia ( loss of blood flow )  either focal brain , spinal cord , or retinal  without acute infarction ( tissue death ). TIAs have the same underlying cause as strokes : a disruption of cerebral blood flow ( CBF ), and are often referred to as mini - strokes . Symptoms caused by a TIA resolve in 24 hours or less . TIA was originally defined clinically by the temporary ___MASK33___ of less than 24 hours of the associated neurologic symptoms . Recently , the American Heart Association and American Stroke Association ( AHA / ASA ) defined TIA as transient episode of neurologic dysfunction caused by focal brain , spinal cord , or retinal ischemia , without acute infarction . TIAs cause the same symptoms associated with stroke , such as contralateral paralysis ( opposite side of body from affected brain hemisphere ) or sudden weakness or numbness . A TIA may cause sudden dimming or loss of vision ( amaurosis fugax ), aphasia , slurred speech ( dysarthria ) and mental confusion . But unlike a stroke , the symptoms of a TIA can resolve within a few minutes or within 24 hours . Brain injury may still occur in a TIA lasting only a few minutes . Having a TIA is a risk factor for eventually having a stroke or a silent stroke . The Diving Bell and the Butterfly ( original French title : Le Scaphandre et le Papillon ) is a ___MASK12___ by journalist Jean - Dominique Bauby . It describes what his life is like after suffering a massive stroke that left him with locked - in syndrome . It also details what his life was like before the stroke . On December 8 , 1995 , Bauby , the editor - in - chief of French Elle ___MASK63___ , suffered a stroke and lapsed into a coma . He awoke 20 days later , mentally aware of his surroundings , but physically paralyzed with what is known as locked - in syndrome , with the only exception of some movement in his head and eyes . His right eye had to be sewn up due to an irrigation problem . The entire book was written by Bauby blinking his left eyelid , which took ten months ( four hours a day ) . Using partner assisted scanning , a transcriber repeatedly recited a French language frequency - ordered alphabet ( E , S , A , R , I , N , T , U , L , etc . ) , until Bauby blinked to choose the next letter . The book took about 200 , 000 blinks to write and an average word took approximately two minutes . The book also chronicles everyday events for a person with locked - in syndrome . These events include playing at the beach with his family , getting a bath , and meeting visitors whilst in hospital at Berck - sur - Mer . The French edition of the book was published on March 7 , 1997 . It received excellent reviews , sold the first 25 , 000 copies on the day of publication , reaching 150 , 000 in a week . It went on to become a number one bestseller across Europe . Its total sales are now in the millions . On March 9 , 1997 , two days after the book was published , Bauby died of pneumonia . Jean - Dominique Bauby ( 23 April 1952  9 ___MASK94___ 1997 ) was a French actor , author and editor of the French ___MASK92___ " ELLE ". He had two children with Sylvie de la Rochefoucauld , a son named Théophile and a daughter named Céleste . Medical imaging is the technique and process of creating visual representations of the interior of a body for clinical analysis and medical intervention , as well as visual ___MASK66___ of the function of some organs or tissues ( physiology ). Medical imaging seeks to reveal internal structures hidden by the skin and bones , as well as to diagnose and treat disease . Medical imaging also establishes a database of normal anatomy and physiology to make it possible to identify abnormalities . Although imaging of removed organs and tissues can be performed for medical reasons , such procedures are usually considered part of pathology instead of medical imaging . Coronary artery disease ( CAD ), also known as ischemic heart disease ( IHD ), is a group of diseases that includes : stable angina , unstable angina , myocardial infarction , and sudden cardiac death . It is within the group of cardiovascular diseases of which it is the most common type . A common symptom is chest pain or discomfort which may ___MASK69___ into the shoulder , arm , back , neck , or jaw . Occasionally it may feel like heartburn . Usually symptoms occur with exercise or emotional stress , last less than a few minutes , and get better with rest . Shortness of breath may also occur and sometimes no symptoms are present . The first sign is occasionally a heart attack . Other complications include heart failure or an irregular heartbeat . A ___MASK12___ ( from French : " mémoire ": " memoria ", meaning " memory " or " reminiscence ") is a collection of memories that an individual writes about moments or events , both public or private , that took place in the subject ' s life . The assertions made in the work are understood to be factual . While ___MASK12___ has historically been defined as a subcategory of biography or ___MASK78___ since the late 20th century , the genre is differentiated in form , presenting a narrowed focus . A biography or ___MASK78___ tells the story " of a life ", while a ___MASK12___ often tells " a story from a life ", such as touchstone events and turning points from the author ' s life . The author of a ___MASK12___ may be referred to as a " memoirist " or a " memorialist ". A blood test is a laboratory analysis performed on a blood sample that is usually extracted from a vein in the arm using a needle , or via fingerprick . Multiple tests for specific blood components ( such as a glucose test or a cholesterol test ) are often grouped together into one test panel called a blood panel or blood work . Blood tests are often used in ___MASK75___ care to determine physiological and biochemical states , such as disease , mineral content , pharmaceutical drug effectiveness , and organ function . Typical clinical blood panels include a basic metabolic panel or a complete blood count . Blood tests are also used in drug tests to detect drug abuse . In some of the United States , a blood test is required before marriage ; historically , this was previously true in more states . Tobacco smoking is the practice of burning tobacco and inhaling the smoke ( consisting of particle and gaseous phases ). ( A more broad definition may include simply taking tobacco smoke into the mouth , and then releasing it , as is done by some with tobacco pipes and cigars .) The practice was believed to begin as early as 5000  3000 BC . Tobacco was introduced to Eurasia in the late 17th century where it followed common trade routes . The practice encountered ___MASK14___ from its first import into the Western world onwards , but embedded itself in certain strata of a number of societies before becoming widespread upon the introduction of automated cigarette - rolling apparatus .