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Osteoarthritis is a degenerative joint disease that is caused by the chronic breakdown and eventual loss of cartilage within the joints. As the cartilage wears away, the bones that meet at the joint begin to rub against each other. This can cause extreme pain and can severely reduce movement and flexibility of the joint. Growths of bone, called bone spurs, can also form around the edges of the joint and cause pain. Joint swelling can also occur if the synovial membrane lining the joint becomes irritated, producing excess fluid that collects inside the joint. What Causes Osteoarthritis? More than half of the population age 65 or older have osteoarthritis in at least one joint. Osteoarthritis usually results from injury to a joint or from wear and tear over time. Heredity, lack of use, and being overweight also contribute to the development of osteoarthritis. Treating Osteoarthritis Treatment can include weight loss, physiotherapy, and medication. If the condition becomes severe and mobility is greatly reduced, hip replacement surgery may be necessary.
Male 19 y. age victim of penetrating brain injury. All the criteria for the encephalic death diagnosis were present. The presence of this complex spinal reflex doesn't exclude the brain death diagnosis and must be known and understood by the professionals involved in this very important diagnosis
Chronic myelogenous leukemia (CML), also known as chronic myeloid leukemia, is a myeloproliferative disorder characterized by increased proliferation of the granulocytic cell line without the loss of their capacity to differentiate. Consequently, the peripheral blood cell profile shows an increased number of granulocytes and their immature precursors, including occasional blast cells.
CML is one of the few cancers known to be caused by a single, specific genetic mutation. More than 90% of cases result from a cytogenetic aberration known as the Philadelphia chromosome (see Pathophysiology).
CML progresses through 3 phases: chronic, accelerated, and blast. In the chronic phase of disease, mature cells proliferate; in the accelerated phase, additional cytogenetic abnormalities occur; in the blast phase, immature cells rapidly proliferate.[1] Approximately 85% of patients are diagnosed in the chronic phase and then progress to the accelerated and blast phases after 3-5 years. The diagnosis of CML is based on the histopathologic findings in the peripheral blood and the Philadelphia chromosome in bone marrow cells (see Workup).
CML accounts for 20% of all leukemias affecting adults. It typically affects middle-aged individuals. Uncommonly, the disease occurs in younger individuals. Younger patients may present with a more aggressive form of CML, such as in accelerated phase or blast crisis. Uncommonly, CML may appear as a disease of new onset in elderly individuals.
The goals of treatment are to achieve hematologic, cytogenetic, and molecular remission. Although a variety of medications have been used in CML, including myelosuppressive agents and interferon alfa, the tyrosine kinase inhibitor imatinib mesylate is currently the agent of choice, and other drugs in this category are playing increasingly important roles. However, allogeneic bone marrow transplantation is currently the only proven cure for CML.