ABSTRACT
One of the major impacts following a neck of femur fracture is pain. Most patients (nearly all) undergo an operation. This usually includes the frailest terminal patients and deemed a palliative procedure to reduce ongoing pain. The operation comes with risks and can reduce life expectancy in these patients and result in prolonged hospital admission, delirium, and postoperative complications. This case highlights a novel approach to managing the frailest end-of-life patients that does not require them to undergo a conventional operation. The case resulted in a quick discharge from hospital and for the patient and family to maximise the time out of hospital, with a reduced analgesic burden and a peaceful passing away. We feel that this could be an alternative, more humane option for such patients.
ABSTRACT
Chronic myeloid leukaemia is a condition that affects around 600 people a year in the UK. The only curative intervention to date has been bone-marrow transplantation. A combined drug therapy featuring interferon and a new drug called imatinib has shown encouraging results in recent trials. In one trial of 532 patients, 60% achieved a major cytogenetic response, while in 41% no leukaemia could be detected using normal cytogenetic techniques. This article provides background on the nature of chronic myeloid leukaemia, and discusses the imatinib trial results and indications for future treatments.