about leukemia

Leukemia (American English) or leukaemia (British English) is a type of cancer of the blood or bone marrow characterized by an abnormal increase of white blood cells. Leukemia is a broad term covering a spectrum of diseases. In turn, it is part of the even broader group of diseases called hematological neoplasms.
In 2000, approximately 256,000 children and adults around the world developed some form of leukemia, and 209,000 died from it. About 90% of all leukemias are diagnosed in adults.

Classification

Four major kinds of leukemia

Cell type	Acute	Chronic
Lymphocytic leukemia (or "lymphoblastic")	Acute lymphoblastic leukemia (ALL)	Chronic lymphocytic leukemia (CLL)
Myelogenous leukemia (also "myeloid" or "nonlymphocytic")	Acute myelogenous leukemia (AML)	Chronic myelogenous leukemia (CML)

Clinically and pathologically, leukemia is subdivided into a variety of large groups. The first division is between its acute and chronic forms:

• Acute leukemia is characterized by a rapid increase in the numbers of immature blood cells. Crowding due to such cells makes the bone marrow unable to produce healthy blood cells. Immediate treatment is required in acute leukemia due to the rapid progression and accumulation of the malignant cells, which then spill over into the bloodstream and spread to other organs of the body. Acute forms of leukemia are the most common forms of leukemia in children.
• Chronic leukemia is characterized by the excessive build up of relatively mature, but still abnormal, white blood cells. Typically taking months or years to progress, the cells are produced at a much higher rate than normal cells, resulting in many abnormal white blood cells in the blood. Whereas acute leukemia must be treated immediately, chronic forms are sometimes monitored for some time before treatment to ensure maximum effectiveness of therapy. Chronic leukemia mostly occurs in older people, but can theoretically occur in any age group.

Additionally, the diseases are subdivided according to which kind of blood cell is affected. This split divides leukemias into lymphoblastic or lymphocytic leukemias and myeloid or myelogenous leukemias:

• In lymphoblastic or lymphocytic leukemias, the cancerous change takes place in a type of marrow cell that normally goes on to form lymphocytes, which are infection-fighting immune system cells. Most lymphocytic leukemias involve a specific subtype of lymphocyte, the B cell.
• In myeloid or myelogenous leukemias, the cancerous change takes place in a type of marrow cell that normally goes on to form red blood cells, some other types of white cells, and platelets.

Combining these two classifications provides a total of four main categories. Within these main categories, there are typically several subcategories. Finally, some rarer types are usually considered to be outside of this classification scheme.

• Acute lymphoblastic leukemia (ALL) is the most common type of leukemia in young children. This disease also affects adults, especially those age 65 and older. Standard treatments involve chemotherapy and radiation. The survival rates vary by age: 85% in children and 50% in adults.Subtypes include precursor B acute lymphoblastic leukemia, precursor T acute lymphoblastic leukemia, Burkitt's leukemia, and acute biphenotypic leukemia.
• Chronic lymphocytic leukemia (CLL) most often affects adults over the age of 55. It sometimes occurs in younger adults, but it almost never affects children. Two-thirds of affected people are men. The five-year survival rate is 75%.It is incurable, but there are many effective treatments. One subtype is B-cell prolymphocytic leukemia, a more aggressive disease.
• Acute myelogenous leukemia (AML) occurs more commonly in adults than in children, and more commonly in men than women. AML is treated with chemotherapy. The five-year survival rate is 40%. Subtypes of AML include acute promyelocytic leukemia, acute myeloblastic leukemia, and acute megakaryoblastic leukemia.
• Chronic myelogenous leukemia (CML) occurs mainly in adults. A very small number of children also develop this disease. Treatment is with imatinib (Gleevec) or other drugs. The five-year survival rate is 90%^.One subtype is chronic monocytic leukemia.
• Hairy cell leukemia (HCL) is sometimes considered a subset of CLL, but does not fit neatly into this pattern. About 80% of affected people are adult men. There are no reported cases in young children. HCL is incurable, but easily treatable. Survival is 96% to 100% at ten years.
• T-cell prolymphocytic leukemia (T-PLL) is a very rare and aggressive leukemia affecting adults; somewhat more men than women are diagnosed with this disease.Despite its overall rarity, it is also the most common type of mature T cell leukemia;nearly all other leukemias involve B cells. It is difficult to treat, and the median survival is measured in months.
• Large granular lymphocytic leukemia may involve either T-cells or NK cells; like hairy cell leukemia, which involves solely B cells, it is a rare and indolent (not aggressive) leukemia.
• Adult T-cell leukemia is caused by human T-lymphotropic virus (HTLV), a virus similar to HIV. Like HIV, HTLV infects CD4+ T-cells and replicates within them; however, unlike HIV, it does not destroy them. Instead, HTLV "immortalizes" the infected T-cells, giving them the ability to proliferate abnormally.http://en.wikipedia.org/wiki/Leukemia

about thalassemia

Thalassemia (also spelled thalassaemia) is an inherited autosomal recessive blood disease. In thalassemia the genetic defect, which could be either mutation or deletion, results in reduced rate of synthesis or no synthesis of one of the globin chains that make up hemoglobin. This can cause the formation of abnormal hemoglobin molecules, thus causing anemia, the characteristic presenting symptom of the thalassemias.
Thalassemia is a quantitative problem of too few globins synthesized, whereas sickle-cell anemia (a hemoglobinopathy) is a qualitative problem of synthesis of an incorrectly functioning globin. Thalassemias usually result in underproduction of normal globin proteins, often through mutations in regulatory genes. Hemoglobinopathies imply structural abnormalities in the globin proteins themselves.^[1] The two conditions may overlap, however, since some conditions which cause abnormalities in globin proteins (hemoglobinopathy) also affect their production (thalassemia). Thus, some thalassemias are hemoglobinopathies, but most are not. Either or both of these conditions may cause anemia.

Medication

Medical therapy for beta thalassemia primarily involves iron chelation. Deferoxamine is the intravenously or subcutaneously administered chelation agent currently approved for use in the United States. Deferasirox (Exjade) is an oral iron chelation drug also approved in the US in 2005. Deferoprone is an oral iron chelator that has been approved in Europe since 1999 and many other countries. It is available under compassionate use guidelines in the United States.
The antioxidant indicaxanthin, found in beets, in a spectrophotometric study showed that indicaxanthin can reduce perferryl-Hb generated in solution from met-Hb and hydrogen peroxide, more effectively than either Trolox or Vitamin C. Collectively, results demonstrate that indicaxanthin can be incorporated into the redox machinery of β-thalassemic RBC and defend the cell from oxidation, possibly interfering with perferryl-Hb, a reactive intermediate in the hydroperoxide-dependent Hb degradation.http://en.wikipedia.org/wiki/Thalassemia

Hypertension (HTN) or high blood pressure is a cardiac chronic medical condition in which the systemic arterial blood pressure is elevated. It is the opposite of hypotension. Hypertension is classified as either primary (essential) or secondary. About 90–95% of cases are termed "primary hypertension", which refers to high blood pressure for which no medical cause can be found.The remaining 5–10% of cases (Secondary hypertension) are caused by other conditions that affect the kidneys, arteries, heart, or endocrine system.
Persistent hypertension is one of the risk factors for stroke, myocardial infarction, heart failure and arterial aneurysm, and is a leading cause of chronic kidney failure. Moderate elevation of arterial blood pressure leads to shortened life expectancy. Dietary and lifestyle changes can improve blood pressure control and decrease the risk of associated health complications, although drug treatment may prove necessary in patients for whom lifestyle changes prove ineffective or insufficient.

Classification

Classification	Systolic pressure		Diastolic pressure
	mmHg	kPa	mmHg	kPa
Normal	90–119	12–15.9	60–79	8.0–10.5
Prehypertension	120–139	16.0–18.5	80–89	10.7–11.9
Stage 1	140–159	18.7–21.2	90–99	12.0–13.2
Stage 2	≥160	≥21.3	≥100	≥13.3
Isolated systolic hypertension	≥140	≥18.7	<90	<12.0
Source: American Heart Association (2003).

Blood pressure is usually classified based on the systolic and diastolic blood pressures. Systolic blood pressure is the blood pressure in vessels during a heart beat. Diastolic blood pressure is the pressure between heartbeats. A systolic or the diastolic blood pressure measurement higher than the accepted normal values for the age of the individual is classified as prehypertension or hypertension.
Hypertension has several sub-classifications including, hypertension stage I, hypertension stage II, and isolated systolic hypertension. Isolated systolic hypertension refers to elevated systolic pressure with normal diastolic pressure and is common in the elderly. These classifications are made after averaging a patient's resting blood pressure readings taken on two or more office visits. Individuals older than 50 years are classified as having hypertension if their blood pressure is consistently at least 140 mmHg systolic or 90 mmHg diastolic. Patients with blood pressures higher than 130/80 mmHg with concomitant presence of diabetes mellitus or kidney disease require further treatment.
Hypertension is also classified as resistant if medications do not reduce blood pressure to normal levels.
Exercise hypertension is an excessively high elevation in blood pressure during exercise. The range considered normal for systolic values during exercise is between 200 and 230 mm Hg.Exercise hypertension may indicate that an individual is at risk for developing hypertension at rest.

 Signs and symptoms

Mild to moderate essential hypertension is usually asymptomatic.

Accelerated hypertension

Accelerated hypertension is associated with headache, drowsiness, confusion, vision disorders, nausea, and vomiting symptoms which are collectively referred to as hypertensive encephalopathy. Hypertensive encephalopathy is caused by severe small blood vessel congestion and brain swelling, which is reversible if blood pressure is lowered.

Children

Some signs and symptoms are especially important in newborns and infants such as failure to thrive, seizures, irritability, lack of energy, and difficulty breathing.In children, hypertension can cause headache, fatigue, blurred vision, nosebleeds, and facial paralysis.
Even with the above clinical symptoms, the true incidence of pediatric hypertension is not known. In adults, hypertension has been defined due to the adverse effects caused by hypertension. However, in children, similar studies have not been performed thoroughly to link any adverse effects with the increase in blood pressure. Therefore, the prevalence of pediatric hypertension remains unknown due to the lack of scientific knowledge.

Secondary hypertension

Some additional signs and symptoms suggest that the hypertension is caused by disorders in hormone regulation. Hypertension combined with obesity distributed on the trunk of the body, accumulated fat on the back of the neck ('buffalo hump'), wide purple marks on the abdomen (abdominal striae), or the recent onset of diabetes suggests that an individual has a hormone disorder known as Cushing's syndrome. Hypertension caused by other hormone disorders such as hyperthyroidism, hypothyroidism, or growth hormone excess will be accompanied by additional symptoms specific to these disorders. For example, hyperthyrodism can cause weight loss, tremors, heart rate abnormalities, reddening of the palms, and increased sweating.Signs and symptoms associated with growth hormone excess include coarsening of facial features, protrusion of the lower jaw, enlargement of the tongue,excessive hair growth, darkening of the skin color, and excessive sweating. Other hormone disorders like hyperaldosteronism may cause less specific symptoms such as numbness, excessive urination, excessive sweating, electrolyte imbalances and dehydration, and elevated blood alkalinity.and also cause of mental pressure.

Pregnancy

Hypertension in pregnant women is one symptom of pre-eclampsia. Pre-eclampsia can progress to a life-threatening condition called eclampsia, which is the development of protein in the urine, generalized swelling, and severe seizures. Other symptoms indicating that brain function is becoming impaired may precede these seizures such as nausea, vomiting, headaches, and vision loss.
In addition, the systemic vascular resistance and blood pressure decrease during pregnancy. The body must compensate by increasing cardiac output and blood volume to provide sufficient circulation in the utero-placental arterial bed.

Causes

Essential hypertension

Main article: Essential hypertension

Essential hypertension is the most prevalent hypertension type, affecting 90–95% of hypertensive patients.Although no direct cause has been identified, there are many factors such as sedentary lifestyle,smoking, stress, visceral obesity, potassium deficiency (hypokalemia), obesity (more than 85% of cases occur in those with a body mass index greater than 25),salt (sodium) sensitivity, alcohol intake, and vitamin D deficiency that increase the risk of developing hypertension.Risk also increases with aging,some inherited genetic mutations, and having a family history of hypertension.An elevated level of renin, a hormone secreted by the kidney, is another risk factor, as is sympathetic nervous system overactivity. Insulin resistance, which is a component of syndrome X (or the metabolic syndrome), is also thought to contribute to hypertension.Recent studies have implicated low birth weight as a risk factor for adult essential hypertension.

Secondary hypertension

Main article: Secondary hypertension

Secondary hypertension by definition results from an identifiable cause. This type is important to recognize since it's treated differently to essential hypertension, by treating the underlying cause of the elevated blood pressure. Hypertension results in the compromise or imbalance of the pathophysiological mechanisms, such as the hormone-regulating endocrine system, that regulate blood plasma volume and heart function. Many conditions cause hypertension, some are common and well recognized secondary causes such as Cushing's syndrome, which is a condition where the adrenal glands overproduce the hormone cortisol.^{http://en.wikipedia.org/}In addition, hypertension is caused by other conditions that cause hormone changes such as hyperthyroidism, hypothyroidism (citation needed), and certain tumors of the adrenal medulla (e.g., pheochromocytoma). Other common causes of secondary hypertension include kidney disease, obesity/metabolic disorder, pre-eclampsia during pregnancy, the congenital defect known as coarctation of the aorta, and certain prescription and illegal drugs.

nursing task

 Contextual exchanges
a. A visit to the Hospital Kunjungan ke Rumah Sakit
Visitor: Hello, Joni, How are you? You look fine? Pengunjung: Halo, Joni, Apa kabar? Kamu kelihatan
sehat.
Patient: Hello, Hadi! I’m much better, thanks. I’m
allowed to sit up now.
Orang yang sakit: Halo, Hadi! Saya telah mulai baik,
terima kasih. Saya telah diperbolehkan duduk
Hadi: I’m glad to hear that! What was it? Pneumonia? Hadi: Bagus! (Saya senang mendengar itu). Apakah
penyakitnya? Radang paru-paru
Joni: Yes, I had a bad cold and cough, but I was so
busy, I just kept on working. Then the cough got worse,
and my temperature went up, and I nearly collapsed.
Joni: Ya, saya mendapat pilek yang hebat, dan batuk,
tetapi saya begitu sibuk, saya terus saja bekerja.
Batuknya bertambah, dan panasnya naik. Dan hampir
habis kekuatan saya.
Hadi: How long di you have to stay in the hospital? Hadi: Berapa lama kamu harus tinggal di rumah sakit?
Joni: Two more weeks, I think. The
last X-ray was better, but I’m not well enough to go
home yet. I still feel weak.
Joni: Dua minggu lagi, saya rasa Ronsen yang terakhir
baik, tetapi saya belum sembuh benar untuk pulang.
Saya masih merasa lemas.
Hadi: I think you’re in goods hands here Hadi: Saya rasa kamu dalam perawatan baik di sini
Joni: Yes, indeed. The doctors and nurses are wonderful Joni: Memang, Dokter dan jururawatnya baik sekali
Bill: There’s the bell. I have to leave now Bill: Itu bel sudah berbunyi. Saya harus pergi sekarang
John: Thanks so much for your visit John: Terima kasih kembali. Saya harap kamu lekas
sembuh
b. What’s the matter? What’s
wrong What the matter
with you is? What’s wrong with you?
Ada apa? Mengapa anda?
I have a headache
a stomach-ache
a toothache
an earache
Saya sakit kepala
Perut
Gigi
Telinga
I have a cold
I’ve caught a cold
Selesma (masuk angin)
I’ve been sneezing and sniffling and blowing my nose
all morning
Dari pagi saya bersin-bersin dan mendengus, dan
membersihkan hidung
I have a sore throat.
cough
Cold
Saya sakit tenggorokan
Saya sakit batuk
Saya sakit influenza
I have a fever Saya sakit demam
(Kadang-kadang “temperatur”/suhu badan dipakai untuk “fever”)
He has a high fever
He has a high temperature Suhu badannya tinggi
He has temperature of 38,9
His temperature has gone down Suhu badannya turun
His temperature is normal Suhu badannya normal
Take his temperature Ukurlah suhu badnnya
How do you feel? Bagaimana rasanya?
I don’t feel very well Saya merasa tidak begitu enak badan
I feel sick Saya merasa sakit
Sick: arti umumnya: sakit, sama dengan ill; sick juga dapat berarti mual
I feel sick = I feel like vomiting/ I feel like
throwing up – muntah
Juga: I have an upset stomach
Airsick - mabuk waktu terbang
Ceasick - mabuk waktu berlayar
Car - mabuk waktu naik mobil
Homesick - rindu kampung halaman; ingin pulang
To ache juga berarti merasa sakit.
My whole body aches
Seluruh badan saya merasa sakit
Children’s diseases Penyakit anak-anak
Smallpox Cacar
Measles Campak
Mumps Gondongan/ gondok
Whooping-cough Batuk kodok (kinkhus)
Chicken-pox Cacar air
Polio (infantile paralysis) Sakit lumpuh (polio)
Diphtheria Dipteral
These diseases are all contagious Penyakit-penyakit ini semuanya menular
Some of them can be prevented by
vaccination
Ada diantaranya yang dapat dicegah dengan vaksinasi
Have the children been vaccinated yet? Apakah anak-anak sudah dicacar (disuntik)?
Yes, they have just had their smallpox
vaccination
Ya, mereka baru dicacar
They have been vaccinated against
smallpox
(Melawan sakit cacar)
Other illness Penyakit-penyakit lain
Dysentery Mejan, disentri
Tonsillitis Sakit amandel
Appendicitis Sakit usus buntu
Pneumonia Radang paru-paru
Indigestion Pencernaan makanan kurang baik
Rheumatism Encok, rematik
Heart trouble Sakit jantung
High blood pressure Darah tinggi
Diabetes Kencing manis, penyakit gula
Hepatitis, jaundice Sakit kuning
Tuberculosis TBC
Malaria Malaria
Cancer Kanker
Dengue Demam berdarah
c. At the Hospital Di Rumah Sakit
He’s in (the) hospital Ia di rumah sakit
He has to go to (the) hospital Ia harus pergi ke rumah sakit
He was taken to (the) hospital Ia dibawa ke rumah sakit
He went by ambulance Ia dibawa ke rumah sakit pakai ambulans
Please phone Emergency and call for an
ambulance
Toonglah, telpon nomor Darurat, dan minta dikirim ambulans
He has to be operated on
He has to have an operation
Ia harus dioperasi
He has been operated on
He has had an operation
Ia telah dioperasi
The operation was successful Operasinya berhasil
Was he under anesthesia Apakah ia dibius?
What are the visiting hours? Jam berapa terima tamu (waktu kunjungan)?
The visiting hours is from eleven to twelve Waktu kunjungan dari jam 11 sampai 12