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Anaphylaxis

Anaphylaxis is a serious allergic reaction, rapid in onset and may cause death. It causes more than one of the following: an itchy rash, throat or tongue swelling, shortness of breath, vomiting and low blood pressure; these symptoms come on over minutes to hours. Common causes include insect bites and stings and medications. Other causes include latex exercise. Additionally, cases may occur without an obvious reason; the mechanism involves the release of mediators from certain types of white blood cells triggered by either immunologic or non-immunologic mechanisms. Diagnosis is based on the presenting signs after exposure to a potential allergen; the primary treatment of anaphylaxis is epinephrine injection into a muscle, intravenous fluids, positioning the person flat. Additional doses of epinephrine may be required. Other measures, such as antihistamines and steroids, are complementary. Carrying an epinephrine autoinjector and identification regarding the condition is recommended in people with a history of anaphylaxis.

Worldwide, 0.05–2% of the population is estimated to experience anaphylaxis at some point in life. Rates appear to be increasing, it occurs most in young people and females. Of people who go to a hospital with anaphylaxis in the United States about 99.7% survive. The term comes from the Ancient Greek: ἀνά, romanized: ana, lit.'against', the Ancient Greek: φύλαξις, romanized: phylaxis, lit.'protection'. Anaphylaxis presents many different symptoms over minutes or hours with an average onset of 5 to 30 minutes if exposure is intravenous and 2 hours if from eating food; the most common areas affected include: skin, gastrointestinal and vasculature, central nervous system with two or more being involved. Symptoms include generalized hives, flushing, or swelling of the afflicted tissues; those with angioedema may describe a burning sensation of the skin rather than itchiness. Swelling of the tongue or throat occurs in up to about 20% of cases. Other features may include swelling of the conjunctiva; the skin may be blue tinged because of lack of oxygen.

Respiratory symptoms and signs that may be present include shortness of wheezes, or stridor. The wheezing is caused by spasms of the bronchial muscles while stridor is related to upper airway obstruction secondary to swelling. Hoarseness, pain with swallowing, or a cough may occur. While a fast heart rate caused by low blood pressure is more common, a Bezold–Jarisch reflex has been described in 10% of people, where a slow heart rate is associated with low blood pressure. A drop in blood pressure or shock may cause the feeling of lightheadedness or loss of consciousness. Low blood pressure may be the only sign of anaphylaxis. Coronary artery spasm may occur with subsequent myocardial infarction, dysrhythmia, or cardiac arrest; those with underlying coronary disease are at greater risk of cardiac effects from anaphylaxis. The coronary spasm is related to the presence of histamine-releasing cells in the heart. Gastrointestinal symptoms may include crampy abdominal pain and vomiting. There may be a loss of bladder control or pelvic pain similar to that of uterine cramps.

Dilation of blood vessels around the brain may cause headaches. A feeling of anxiety or of "impending doom" has been described. Anaphylaxis can occur in response to any foreign substance. Common triggers include venom from insect bites or stings and medication. Foods are the most common trigger in children and young adults while medications and insect bites and stings are more common in older adults. Less common causes include: physical factors, biological agents such as semen, hormonal changes, food additives such as monosodium glutamate and food colors, topical medications. Physical factors such as exercise or temperature may act as triggers through their direct effects on mast cells. Events caused by exercise are associated with the ingestion of certain foods. During anesthesia, neuromuscular blocking agents and latex are the most common causes; the cause remains unknown in 32–50% of cases, referred to as "idiopathic anaphylaxis." Six vaccines are recognized as a cause for anaphylaxis, HPV may cause anaphylaxis as well.

Physical exercise is an uncommon cause of anaphylaxis. Many foods can trigger anaphylaxis. Common triggering foods vary around the world. In Western cultures, ingestion of or exposure to peanuts, nuts, certain types of seafood like shellfish and eggs are the most prevalent causes. Sesame is common in the Middle East, while rice and chickpeas are encountered as sources of anaphylaxis in Asia. Severe cases are caused by ingesting the allergen, but some people experience a severe reaction upon contact. Children can outgrow their allergies. By age 16, 80% of children with anaphylaxis to milk or eggs and 20% who experience isolated anaphylaxis to peanuts can tolerate these foods. Any medication may trigger anaphylaxis; the most common are β-lactam antibiotics followed by aspirin and NSAIDs. Other antibiotics are implicated less frequently. Anaphylactic reactions to NSAIDs are either agent specific or occur among those that are structurally similar meaning that those who are allergic to one NSAID can tol

Nobody Will Speak of Us When We're Dead

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Drilolestes retowskii

Drilolestes retowskii is a species of predatory air-breathing land slug. It is a shell-less pulmonate gastropod mollusc in the family Trigonochlamydidae. Drilolestes retowskii is the only species in the genus Drilolestes; the generic name Drilolestes contains the suffix -lestes, that means "robber". The distribution of Drilolestes retowskii includes northern Turkey and Georgia in the Caucasus region on the Psyrtzkha River in Abkhazia, near the New Athos Cave; the size of preserved specimens is 12–18 mm. Live individuals are larger. Drilolestes retowskii inhabits forests and alpine zone