Clinical Aspects

At the clinical-hematological level, the severity of the p-thalassemias depends on the extent of a-chain/non-a-chain (p+g) imbalance. Clinically, we distinguish four conditions of increasing severity, i.e., silent p-thalasse-mia, the p-thalassemia carrier state, thalassemia intermedia, and thalassemia major. Silent p-thalassemia is produced by heterozygosity for extremely mild p-thalas-semia mutations. This develops a clinical, hematologi-cally silent phenotype and can only be recognized by a moderate imbalance of the a/non-a-chain synthesis. The p-thalassemia carrier state results from heterozygosity of typical p-thalassemia mutations and is clinically asymptomatic and hematologically defined by microcytosis (low MCV), hypochromia (low MCH), increased percentage of the minor fraction of adult Hb, namely, HbA2, and mild unbalance of the a/non-a-chain synthesis. Thalassemia intermedia most commonly results from homozygosity for p-thalassemia and is clinically characterized by micro-cytic anemia of variable severity, for which regular transfusions are not required. Thalassemia major, the most severe form, also results from homozygosity for p-thal-assemia and is characterized by a severe transfusion-dependent anemia.[2]

From the genetic point of view, p-thalassemia can be classified as a simple p-thalassemia, where only the p-globin gene is affected, and a complex p-thalassemia one in which also the g and 8 genes are involved.

Getting Started With Dumbbells

Getting Started With Dumbbells

The use of dumbbells gives you a much more comprehensive strengthening effect because the workout engages your stabilizer muscles, in addition to the muscle you may be pin-pointing. Without all of the belts and artificial stabilizers of a machine, you also engage your core muscles, which are your body's natural stabilizers.

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