Tsva itsva tsvakurudzo inotarisana nekutambudza mutsva mutsva
Mumakore makumi maviri adarika, nhamba yekurova yakaderera. Zvisinei, izvi zvinoshanda kune vanhu vakwegura. Nekuremekedza vakuru vechidiki, kusanganisira zviuru zvemakore, pane kuwedzera kwehuwandu hwekurova. Iko kukura kunogona kunge kwakakonzerwa nekuwedzera mune zvimwe zvipingamupinyi pakati pevanhu vaduku, kusanganisira kurema, chirwere cheshuga, nehutachiona.
Stroke
Muchikamu che 2017 chakabudiswa muJAMA Neurology , George uye vanyori vanyori vakaongorora kuwedzerwa kwemaitiro akaoma eproke pakati pevechidiki.
Vatsvakurudzi vakaongorora zvipatara zvinokwana 362 339 kubva pakati pa2003 na2004 uye 421 815 hospital hospitals kubva pakati pe2011 na2012 kuti vaone kuitika kwechirwere chakaoma. Vakashandisawo dhiyabhorosi kubva pakati pe2003 na2012 kuti vaone kuwanda kwemavhudhi mashanu ehutano zvinokonzerwa nehutachiona hwehutachiona: hypertension, chirwere cheshuga , zvinokonzerwa nemapidhi, kuneta , uye kushandiswa kwefodya.
George nevakashamwaridzana vakawana kuti kuwanda kwezvipatara nekuda kwechirwere cheschemic chakanyanya chawedzera ne50 kubva muzana yevarume nevakadzi pakati pe18 ne 34. Kunyanya, kune varume, kubva muna 2003 kusvika 2012, kwakawedzera kuwedzera kubva 11.2 kusvika 18.0 maitiro maviri 10,000 hospitalizations. Kune vakadzi, paiva nekuwedzera kubva kubva pamatatu kusvika ku8 kusvika ku58.
Kudzokera shure, kubva pakati pa1995 na1996, mitero yekurohwa inenge inopetwa kaviri kune varume vane makore 18 kusvika ku34.
Pano pane zvimwe zvakawanikwa kubva pachidzidzo pamusoro pehutano hwehutano hwevanhu vane makore gumi nemasere kubva pakati pe18 ne64 avo vakagara muchipatara nekuda kwechirwere cheschemic zvakanyanya pakati pa2003 na2012:
- Dhiyabhorosi yakanyanya kuwedzera pakati pe4 muzana uye 11 muzana.
- Mahara ehutachiona hwepfungwa (kureva, hypercholesterolemia kana cholesterol yakakwirira) yakawedzera pakati pe12 muzana ne21 muzana.
- Mibare yehuga yehuga yakakura pakati pe4 muzana ne7 muzana.
- Mari yefodya inoshandiswa yakawedzera pakati pe5 kubva muzana uye 16 muzana.
- Nhamba yekuwedzera kuneta yakawedzera pakati pe4 muzana uye 9 muzana.
Mukutsvakurudza kwepakutanga, Scientific American yakatora mhinduro dzechidzidzo ichi chimwe chiito chinopfuurira. Vakatarisisa zvakananga kupi muUnited States maiva nehokuwedzera kuwedzerwa mukurohwa pakati pevechidiki. Vakaona kuti kuwedzera kwakanyanya kwaive kuWest uye Midwest. Uyezve, maguta akaona kuwedzera kukura kudarika kumaruwa.
Kunyange zvazvo South ichitumidzwa se "Stroke Belt," uye nhamba yepamusoro yakawanda yezviroto inowanika ipapo, kuwedzera kukuru kwekurohwa kwechirwere pakati pevechidiki kuri kuitika kuMadokero uye kuMidwest. Nhamba yekurohwa muSouth yakanga yato yakakwirira; nokudaro, kuwedzera kwakanyanya mukurohwa kwechikwata hakusi kufanana neWest uye Midwest, uko kushaya kwemitengo kwakaderera.
Teknolojia inogonawo kuita basa mukuwedzera kunoshamisa kwekurohwa kwemaitiro kuWest uye Midwest.
Kunyanya, kumativi ekumaodzanyemba kwakadziva kumativi ekumaodzanyemba, uko kuwirirana kwevanhu vaduku hakukwanisi kuwedzerwa, kufungidzira kufungidzira kwakafanana neMRI kunogona kuwanika nyore nyore uye mamwe shamhu angangowanikwa.
Nezvimwe zvirwere zvakagadziriswa pane zvepakutanga, pangangodaro kuwedzera kuwedzera kwechikwata pamusana pemaitiro. Mune mamwe mazwi, nzvimbo dzakadai seNorth West dzingadai dzisina kukura kwekuwedzera kwechirwere nokuti kuwanikwa kwekombiyuta yeMRI kunoreva zvirwere zvakawanda zvakaonekwa kuti kutanga.
Kushandiswa kwezvinodhaka zvisina kukodzera, zvakadai se meth uye crack, zvinogona kuita basa mukuwedzera kwezvakaitika zvinokonzera kusvuta.
Nyanzvi dzinofungidzira kuti chimwe chikonzero nei shamhu dzinowanzoitika mumaguta pane nzvimbo dzomumaruwa nekuti nzvimbo dzomumaguta dzakasvibiswa.
Uyezve, sezvo zvipatara zvakawanda zvekumaruwa zvakadzivirirwa mumakore achangobva kupfuura, vanhu vanogara kumaruwa vangave vachienda kune zvipatara zvemaguta kuti vawane kurapwa, nokudaro vanoita kuti zvipembenene zvive zvemaguta.
Tinofanira kuramba tichifunga kuti izvi zvose zvinogona kutsanangurwa-kufungidzira mifananidzo, zvinodhaka, kusvibiswa, uye urombo hwekuchengetwa kwehutano hwemaruwa-inongova mafungiro. Tsvakurudzo yakawanda inofanira kuitwa kuti inzwisise mafambiro ekurohwa kwepakati.
Kuwedzera kwekurohwa kwemaitiro pakati pevechidiki vanozadzisa zvimwe kuwedzerwa kwehutano hwehutano hwehutano, hwakadai sekuwedzerwa muviri nekuwedzerwa uye chirwere cheshuga.
Kuwedzera muviri
Mumakore achangobva kupfuura, vatapi venhau vakataura kuti kune kuve nekuderera muhutano hwehuduku. Izvi, zvisinei, hazvina kururama. Muzvokwadi, kumwe kutsvakurudza kunoratidza kuti pane kuve nekuderera kwekuninipisa muvana vaduku vasina mari yepamusoro-soro kana nzvimbo dzakasiyana-siyana. Ichi tsvakurudzo, zvisinei, hachikwanisi kubudiswa kune vanhu vakawanda. Dhiyabhorosi kubva pakati pa2007 na2010 inoratidza kuti pakanga pasina kuora kwekuneta. Kutaura zvazviri, pane kuwedzera kwemarudzi akakura ekuderedza kune vechidiki.
Mutsara wegore ra2014 wakabudiswa muJAMA Pediatrics , Skinner uye Skelton vakanyatsoongorora zvikamu zvakasiyana-siyana zvevanhu veUnited States pakati pe1999 na2012. Izvi zvakasanganisira vana vari pakati pemakore maviri ne19.
Vatsvakurudzi vakaona kuti pangave nekugadzikana mukuwedzera kwekuwedzera. Kunyange zvakadaro, pane nyoka muzvikwata zvepamusoro zvekuneta (kureva, BMI ye 35 kana kupfuura). Nenzira, maitiro akaoma zvikuru ekudisa ane hukama hwakanyanya nehupenyu hwehutachiona, kusanganisira sitiroko.
Tora 2 Chirwere cheshuga
Mukudzidza kwe 2017 yakabudiswa muJAMA , Mayer-Davis uye vanyori vanyori vakaona kuti chiitiko chechirwere cheshuga chechipiri chakasimuka kubva pakati pe2002 na2012. Rudzi rwechipiri chirwere cheshuga chirwere chemwoyo chinokonzera uye chinokonzera kurohwa.
Kushandisa kuongororwa kwevanhu, kubva kune vane makore pakati pe10 ne19, vakaona kuti paiva nekukwira kwegore negore kwe 4.8 kubva muhuwandu hwechirwere cheshuga chechipiri. Iko kukura kwainyanya kutaurwa pakati pevashoma vemadzinza uye madzinza. Semuenzaniso, pakati pevechidiki vechiNamerica, pakanga paine kuwedzera kubva kubva ku 3.1 kusvika ku8,9 muzana.
Nyaya, zvigadziro zvekudzidza uku zvinopesana nezvakawanikwa kubva kutsvakurudzo yapfuura zvakaitwa nevatsvakurudzi vakafanana: Kubvira muna 2001 kusvika muna 2009, kwaivewo nekuwedzera kwechirwere chechirwere cheshuga pakati pevechidiki.
Zvinetso
Kuwedzera kwechirwere uye kuwirirana kune zvimwe zvinowanzoitika pakati pevechidiki ndezvezvikonzero zvikonzero zviviri:
- Kurohwa kunogona kukonzera kuremara kwakakomba, uye kana wechiduku akaremara kubva pakurohwa, kukwanisa kwavo kurarama kunokanganisa. Maitiro ehupfumi nehupfumi haisi kungogunzva munhu ane urema hwehutano, asiwo nhengo dzemhuri. Kurohwa kunogona kudzokorora hupenyu huri kuipa.
- Kunyange zvazvo kurohwa kwekutanga kunowanzova kwakaoma, nhoroondo yekurohwa mumusikana wechidiki inoshanda searyary mumigodhi yemarasha. Mhirizhonga inotevera inonyanya kuipa uye inokanganisa kupfuura yekutanga. Nokudaro, kuwedzera uku mukurohwa kwechirwere muvakuru vechidiki kunogona kuva chiratidzo chokutanga chechirwere chinoparadza zvikuru chinogona kutamba mumakumi emakumi mashomanana anotevera.
Kurapa
Kuziva chiitiko mukusimudza kurwadziwa uye kushaya mungozi zvinokonzerwa pakati pevechidiki ndezvekutanga. Mubvunzo mukuru ndeyekurapa chii chinogona kuva denda guru.
Munyaya yegore ra2015 muStroke yakanzi "Kunyanya Kuwedzera Kunowedzera Dambudziko reScroke muVaduku Vakuru Mikana Yokudzivirira," Kernan naDearborn vanyora zvinotevera:
Mune imwe musasa, ndeavo vanoona kuti kupisa kunobatanidzwa nehuwandu hwekurohwa uye kutaura kuti ichi chinangwa chakakosha chekudzivirira kwekutanga uye yechipiri. Mune rimwe, ndeavo vanobvumirana kuti kuneta kunowedzera kushungurudzika asi vanoti zvinonyatsoshanda kurapa zvinokonzerwa nekudisa izvo zvinokonzera dambudziko rekurohwa (kureva, kuwedzera kwehutachiona uye dyslipidemia) kudarika kuneta zvakanyanya.
Mune mamwe mazwi, hazvisati zvave pachena kana kudzivirira kwekurohwa kunofanira kuisa pfungwa kune hutano kana kuti mamiriro ezvinhu anokonzerwa nekudisa, zvakadai sekukwirira kweropa uye cholesterol yakakwirira.
Vanyori vanoti kana tikanga tine nzira dzakanakisisa dzokurapa dzekuneta, hapangavi nemubvunzo kuti kuneta kunofanira kunge kuri kuisa pfungwa yekudzivirira chirwere pakati pevechidiki. Uyezve, kurapa huwandu hwehuwandu, kunyange zvazvo huchikonzera kukurudzirwa kwechirwere, kunogona kusiya zvimwe zvinhu zvinosara zvisingateereri.
Zvakare, maererano nevatsvakurudzi:
[E] ven optimal prescription yemukana-kuderedza chirwere (semuenzaniso, chirwere chekuwedzera kwehutachiona) chinoramba ichisiya varwere vakawanda vakaoma vanoratidzirwa kune ngozi isingateereri. Izvi zvinonyanya kukosha nokuti iyo chete inobatsira ngozi-kuderedza kurapwa kwevanopindirana vezvirwere zvevascular mukuninipisa chirwere chekuwedzera kwehutano. Tsvakurudzo haisati yakanyatsosimbisa kuti kushanda kwakasimba kwechirwere cheshuga mellitus kunoderedza ngozi yevascular disease; hapana hutano hwakarongwa hunorayirwa kuporesa kuputika kwekuneta, uye varwere vaduku vakawanda havasati vava kuongororwa kuti vabatsirwe kupera-kurapa kurapa.
Mune mamwe mazwi, zvakaoma kurapa varwere pamusana pezvipingamupinyi zvekurohwa kunokonzerwa nekuwedzerwa. Kurapa kwechirwere cheshuga hachina kuonekwa kuti kuderedza ngozi yemaitiro. Uyezve, hapana nzira chaiyo yekurapa kuvhiringidza kunofambidzana nekudisa kunotangira kunetseka uye chirwere chemwoyo. Pakupedzisira, vechidiki vakawanda havazokwanisi kubhadhara-kurapa kurapa, zvakadai semasitini .
Shoko Rinobva
Kutsvakurudza kwakaratidza kuwedzera kwekurohwa uye kuenderana nehutano hwepfungwa pakati pevechidiki. Izvi zvinowanzoitika nokuti zvinogona kureva nyaya huru, ine huwandu hwakanyanya hukuru hwehukuru, hutachiona hwekushaya sitiroko mumakore anotevera.
Pari zvino, hapana kubvumirana kune imwe nzira yekudzivisa kurwadziwa, chirwere chinogona kunge chinokanganisa uye chinokanganisa vanhu nemhuri. Zano rakanakisisa rekudzivirira iyo jaya rinogona kutevera ndeyokudzivirira zvipingamupinyi zvinokonzerwa nehutachiona hwekushaya sitiroko kutanga. Vechidiki vanofanira kuve vasina kuneta, kudzivisa kusvuta, uye kugamuchira kurapa kwakakodzera kwehutano hwehutano.
Pakupedzisira, ndapota ramba uchiyeuka kuti kungova vashoma bedzi-pakati pe5 ne10 muzana-kunoitika kuvana nevakuru vechidiki. Hazvirevi kuti nhamba yemarwadzo anokwira mireniyadhi akawanda ehuroti. Kunyange zvakadaro, chero chiitiko chekurova kwechirwere chinokonzera wechidiki chinonyanya kutaura pamusoro, uye kuwedzera mitoo inonyanya kukoshesa hutano.
> Sources:
> George, MG, Tong, X, Bowman, BA. Kuwanda kweMwoyo Yehutano Ngozi Dambudziko neSrokes in Vaduku Vakuru. JAMA Neurology. 2017; 74: 695-703.
> Kernan, WN, Dearborn, JL. Kuwedzerwa kwehuputa kunowedzera dambudziko reSroke muVaduku Vakuru Mikana yekudzivirira. Stroke. 2015; 46: 1435-1436.
> Maron, DF. Mamwe Makore Ane Zviuru Ari Kuva Nokurova. Scientific American. June 28, 2017. [e-pub]
> Mayer-Davis, EJ, et al. Nharaunda Mitoo yeChipiri 1 uye Type 2 Chirwere cheshuga pakati pevechidiki, 2002-2012. The New England Journal of Medicine. 2017; 376: 1419-1429.
> Skinner, AC, Skelton, JA. Kuwandisa uye Tendamende mukuderera uye kuwedzera kwakanyanya pakati pevana muUnited States, 1999-2012. JAMA Pediatrics. 2014; 168: 561-566.