Without early diagnosis, working memory impairment negatively impacts a child's performance throughout their scholastic career.

Without this tenderness, a diagnosis of costochondritis is unlikely.

Without a known family history of LHON the diagnosis usually requires a neuro-ophthalmological evaluation and blood testing for mitochondrial DNA assessment.

Without treatment, an acute attack of gout usually resolves in five to seven days.

Without treatment, episodes of acute gout may develop into chronic gout with destruction of joint surfaces, joint deformity, and painless tophi.

Without timely treatment, these new blood vessels can bleed, cloud vision, and destroy the retina.

Without special treatment after circulation is restarted, full recovery of the brain after more than 3 minutes of clinical death at normal body temperature is rare.

Without treatment, the disease is invariably fatal, with progressive mental deterioration leading to coma and death.

Without treatment, about 12-13 % of patients will spontaneously improve over time, 40-50 % will get worse and the rest will be relatively stable.

Without treatment, symptoms may worsen, leading ( in extreme cases ) to suicide attempts.

Without renouncing its " Third-worldism " position, it extended the treatment of its subjects, concentrating on international economic and monetary problems, strategic relations, the Middle-East conflict, etc.

Without effective water treatment, a cooling water system can suffer from scale formation, corrosion and fouling and may become a breeding ground for harmful bacteria such as those that cause Legionnaires ' Disease.

Without treatment, the individual with schizoaffective disorder may further worsen in their abnormal emotions and delusional thought processes.

Without urgent treatment these result in sudden death.

Without necessarily receiving great remuneration ( pay differentials under Zhivkov were within the 5: 1 range, with the overwhelming majority of salaries being within the 3: 1 range ), Party members and DS informers received very significant perquisites which involved access to accommodation, luxury imported goods, hard currency, the ability to travel abroad, superior medical and dental treatment and unhindered entry to higher education for their children.

Without insight into what the problem is, it is much harder for behavioral therapy to be the key to the successful treatment of compulsive hoarders.

Without treatment, mortality in infants with galactosemia is about 75 %.

Without treatment, persons afflicted often appear to walk on their ankles, or on the sides of their feet.

Through its breakthrough price offers to developing country governments and leading NGOs such as Doctors Without Borders ( MSF ) and Oxfam, along with its keen participation in PEPFAR, the Global Fund, the Clinton Foundation's HIV / AIDS Initiative and other major donor programs fighting HIV / AIDS in Africa and elsewhere in the resource-poor world, Cipla has played an unparalleled leadership role in ensuring access to antiretroviral treatment ( ART ) rose from under 10, 000 on the entire African continent at the time of its $ 350 per patient per year offer in 2001, to over 8 million in the developing world by 2012.

Without treatment, children often die in the first decade of life.

Without much exchange with the ocean outside the Island, the Lake water quality is threatened by runoff from human activities in the surrounding watershed, especially from sewage treatment plants and septic tanks, ocean going ships and small craft plying the lake system.

Without treatment, the disease is often fatal.

Without treatment death usually occurs due to heart failure and respiratory weakness.

Without treatment the disease is particularly lethal in infants and young children.

Without treatment, mortality may approach 1 %, usually within six weeks of onset.

Without treatment, kidney damage occurs and death in the more severe cases.

* Sea Without Shore: A Manual of the Sufi Path, an extensive treatment of the science of tasawwuf.

Without the intervention of winds or drafts the distance over which airborne infection takes place is short, say 10 to 20 feet.

Without an infection, the thrombus may become detached and enter circulation as an embolus, finally lodging in and completely obstructing a blood vessel, which unless treated very quickly will lead to tissue necrosis ( an infarction ) in the area past the occlusion.

Without surgery and medical assistance, such as antibiotics, the infection will rapidly progress and will eventually lead to death.

Without the virus infection, phagocytic hemocytes ( blood cells ) will encapsulate and kill the wasp egg but the immune suppression caused by the virus allows for survival of the wasp egg, leading to hatching and complete development of the immature wasp in the caterpillar.

Without a competent immune system, the animal or human will most likely die from the infection.

Without treatment, the infection usually resolves on its own, although it may take up to a year to do so.

Without saying or seeming to say that in portraying the Sartoris and the Compson families Faulkner's chief concern is social criticism, we can say nevertheless that through those families he dramatizes his comment on the planter dynasties as they have existed since the decades before the Civil War.

Without careful qualification this can be misleading.

Without a system of values there can be no society.

Without that knowledge, without that capacity to think, you can easily become a victim of people who seek to take advantage of you ".

Without clear documentation, software can be hard to use — especially if it is very specialized and relatively complex like Photoshop or AutoCAD.

According to Tibor R. Machan, " Without a market in which allocations can be made in obedience to the law of supply and demand, it is difficult or impossible to funnel resources with respect to actual human preferences and goals.

Without data decoding, the carrier can be detected by much simpler ground antennas and receivers.

Without this restriction, bizarre maps ( using regions of finite area but infinite perimeter ) can require more than four colors.

Without any such logical operators of valence 0, these two constants can only be expressed using quantifiers.

Without first finding the radian frequency, the natural frequency can be found directly using:

Without intension of some sort, words can have no meaning.

Without proper strength and flexibility, throwers can become extremely injury prone, especially in the shoulder and elbow.

Without knowledge of the Bible there can be no peace in the life of the Church or of society, and outside of it there is no real and abiding good ; it is the one authority for the faith.

Without L cuts, a conversation between two people can feel like a tennis match.

Without efforts to damp this noise, it can approach 130 decibels ( dB ) with strong fields ( see also the subsection on acoustic noise ).

Without re-enacting scenes, artists can then manipulate the demo files to add cameras, tweak timing and lighting, and change the surroundings.

* Without an MDI frame window, floating toolbars from one application can clutter the workspace of other applications, potentially confusing users with the jumble of interfaces.

Terminator X's innovative scratching tricks can be heard on the songs " Rebel Without a Pause ,", " Night of the living Baseheads " and " Shut Em Down ".

Near the end of her time as governor general, Adrienne Clarkson stated: " My constitutional role has lain in what are called ' reserve powers ': making sure that there is a prime minister and a government in place, and exercising the right ' to encourage, to advise, and to warn '[...] Without really revealing any secrets, I can tell you that I have done all three.

Without altering the system, we can take multiple samples, which will have a range of values of k, but the system will always be characterized by the same λ.

In 2007 the media rights body Reporters Without Borders praised reforms to the criminal code ; journalists can no longer be jailed on defamation charges.

Without referential transparency, such difference can be easily made and utilized in programs.

Without taking symmetries into account, the number of possible games can be determined by hand with an exact formula that leads to 255, 168 possible games ( see Henry Bottomley, 2001, or Steve Schaeffer, 2002 ).

Without an article, the term can refer to the entirety of humanity ( also: " society in general ", " society at large ", etc.