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Ko te nephrogenic systemic fibrosis (NSF) he mate onge engari he kino e puta ai te kiri mātotoru, pakeke, ā, e pā ana ki ngā whekau o roto. Ka tupu nui ake i ngā tāngata he mate whatukuhu kino kei a rātou, kua whakamahia ki ētahi kaiwhakaatu whakapae i te whakaahua hauora.
I kite tuatahitia tēnei mate i ngā tau 1990, ā, ahakoa e rangona ana he wehi, ka āhei te mārama ki te NSF kia āhei ai koe te whakatau whakamārama mō tō rongoā. Ko te rongo pai, me ngā tikanga haumaru o nāianei, kua iti haere te NSF i te wā i mua.
Ko te NSF he mate ka nui rawa te collagen e hangaia ana e tō tinana, te pūmua e homai ana i te hanganga ki tō kiri me ō whekau. Ko te nui o te collagen nei e hanga ana i ngā wahi kiri mātotoru, rite ki te kiri hipi, ā, ka puta ai te toka i roto i tō ngākau, ngā pūkahukahu, me ētahi atu whekau nui.
Ka whiwhi tēnei mate i tōna ingoa no te mea i whakaarohia tuatahi noa atu he pā ki te kiri (systemic fibrosis) ā, ka tata noa atu ki te puta i ngā tāngata he raruraru whatukuhu (nephrogenic). Heoi, e mohio ana ngā tākuta inaianei ka pā pea ki ngā pūnaha whekau maha puta noa i tō tinana.
Ka tupu te NSF i ngā wiki ki ngā marama i muri i te whakamahinga o ngā kaiwhakaatu whakapae e whakamahia ana te gadolinium. Ko ēnei he tae motuhake e whakamahia ana i ngā whakamātautau MRI me ētahi atu tikanga whakaahua kia āhei ai ngā tākuta te kite i ō whekau mārama ake.
Ka tīmata haere mā te iti ngā tōmhanga o te NSF, ā, ka ngāwari pea te whakaaro he mate ke i te tīmatanga. Ko ngā huringa o tō kiri te nuinga o ngā tohu o te tīmatanga, ahakoa ka pā pea tēnei mate ki tō tinana katoa.
Ko ngā tōmhanga kiri tino noa e whai ake nei:
Ko ēnei huringa kiri te nuinga o te wā ka puta ki ō ringa me ō waewae, engari ka horapa pea ki tō puku, ki tō mata, me ētahi atu wāhi. Ka āhei pea te kiri e pā ana te whakapakari i ō hononga, te neke noa rānei.
I tua atu i ngā tohu kiri, ka taea e te NSF te whakaeke i ngā raruraru o roto kaha ake:
I roto i ngā take onge, ka tere te whakawhāiti o te NSF, ā, ka mate pea. Ka kite ētahi i te kino ohorere o ngā tohu, ka whanake ētahi atu i ngā raruraru e pā ana ki to ratou ngakau, ngā pūkahukahu, ngā oko toto rānei.
Ko te NSF te hua o te whakamahinga o ngā kaiwhakaatu whakapae i hāngai ki te gadolinium i roto i te hunga kaore e taea e o ratou whatukuhu te whakakore i ēnei mea mai i o ratou toto. Ki te roa rawa te noho o te gadolinium i roto i tō tinana, ka taea e ia te whakaoho i te whakautu mate koretake e ārahi ana ki te nui o te whakaputa collagen.
He konganuku taimaha te Gadolinium e haumaru ake ana ina honoa ki ētahi atu ngota i roto i ngā kaiwhakaatu whakapae. Heoi, i roto i te hunga he mate whatukuhu kino, ka taea e ēnei hononga te pakaru, te tuku i te gadolinium koreutu ki roto i ō kiko. E kite ana te gadolinium koreutu nei ki te whakahohe i ētahi pūtau mate e whakatairanga ana i te pakaru me te fibrosis.
He maha ngā take e whakatau ana i tō tūponotanga ki te whanake i te NSF i muri i te whakamahinga o te gadolinium:
Kāore ngā taonga whakaatu katoa e whakamahia ana te gadolinium e mau ana i te tūponotanga kotahi. He maha atu ngā taonga tawhito, ngā taonga rārangi e tino tukuna ana te gadolinium koreutu i ngā whakaritenga hou, ā, tino pumau. Koia tēnei te take i whakawhiti ai ngā pokapū hauora maha ki ētahi atu whiringa haumaru ake i te whakaahua i ngā turoro he mate whatukuhu.
Me whakapiri atu koe ki tō kaiwhakarato hauora tonu mēhemea ka whanake koe i ētahi huringa kiri i muri i te whakamātautau MRI, i ētahi atu rangahau whakaahua me te whakaatu, ā, tērā anō mēhemea he mate whatukuhu tōu. Ka taea e te mohiotanga me te maimoatanga wawe te āwhina i te aukati i te kino o te āhuatanga.
Rapua te tiaki hauora tere mēhemea ka pāngia koe e:
Ahakoa ngā tohu ngāwari, he mea nui kia arotakehia wawetia. Ka taea e te NSF te tere haere i ētahi tāngata, ā, ka taea e te whakauru wawe te āwhina i te whakaheke, i te aukati i ngā raruraru atu.
Mēhemea he mate whatukuhu tōu, ā, kei te whakaritea koe mō tētahi rangahau whakaahua, kōrerohia ngā tūponotanga me ngā painga ki tō tākuta i mua. Ka taea e rātou te āwhina i te whakatau mēhemea he mea tika te karapa, ā, he aha ngā whakatūpato e tika ana.
Ko tō tūponotanga ki te whanake i te NSF e whakawhirinaki ana ki te hauora o ō whatukuhu me tō whakaaturanga ki ngā taonga whakaatu e whakamahia ana te gadolinium. Ka taea e te mārama ki ēnei take tūponotanga te āwhina i a koe me tō rōpū hauora ki te whakatau i ngā whakatau whakamārama mō te whakaahua hauora.
Ko ngā take tino nui e pā ana ki te mate ko:
Ko te tikanga ka tāpirihia e ō whatukuhu te gadolinium i tō toto i roto i ngā haora i muri i te whakamahinga. Ki te kore e mahi tika, ka noho pea te gadolinium ki roto i tō pūnaha mō ngā wiki, mō ngā marama rānei, ka piki ake te tūponotanga ka puta he raruraru.
Ko ētahi atu take ka piki ake ai tō tūponotanga ko:
He mea tika te kōrero, he tino onge te NSF ki ngā tāngata he mahi noa o te whatukuhu. Ko te nuinga o ngā keehi ka puta ki ngā tangata he ngoikore nui o te whatukuhu, koia te take i arotahi ai ngā aratohu o nāianei ki te tiaki i tēnei taupori ngoikore.
Ka taea e te NSF te arahi ki ngā raruraru kino e pā ana ki tō kounga ora me tō hauora whānui. Ahakoa ko ngā huringa kiri te raruraru tino kitea, ko ngā pānga o roto ka nui ake te kino me te mate.
Ko ngā raruraru tino noa e pā ana ki tō kaha neke me tō mahi o ia rā:
Ko ēnei whakatau ā-tinana ka pā kino ki tō rangatiratanga me tō oranga hinengaro. He tokomaha ngā tāngata e pangia ana e te NSF e hiahia ana ki te āwhina mō ngā mahi o ia rā, pēnei i te kakahu, te horoi, te whakarite kai rānei.
Ko ngā raruraru o roto ka nui ake te kino:
I ngā take tino kino, ka mate pea te NSF. Ko te mate te tikanga mai i te korenga o te ngakau, ngā toto kōtiti, te korenga o te manawa ranei nā te whākāka o te pūkahukahu. Heoi, he mea onge tēnei hua, ina koa me ngā mahi ārai o nāianei me te pai ake o te mohiotanga ki te āhuatanga.
He rerekē te whānuitanga o te NSF i waenga i ngā tāngata. Ka pāngia etahi i te whakaiti haere, te whakaiti haere rānei i roto i ngā marama, ngā tau rānei, ka tere te heke o ētahi atu i roto i ngā wiki i muri i te tīmatanga o ngā tohu.
Ko te whakatau i te NSF e hiahia ana ki te aromatawai tika o ō tohu, hītori hauora, me te biopsy kiri i te nuinga o te wā hei whakau i te whakatau. Ka titiro tō tākuta ki te tauira āhuatanga o ngā huringa o te kiri me te kiko me te hītori o te whakamahinga o te gadolinium i roto i te āhuatanga o te mate whatukuhu.
Ka tīmata tō kaiwhakarato hauora mā te uiui i ngā pātai taipitopito e pā ana ki ō tohu me tō hītori hauora. Ka hiahia rātou ki te mohio ki ngā rangahau whakaahua hou, tō mahi whatukuhu, me te wā i puta mai ai ō tohu. Ka āwhina tēnei mōhiohio ki te whakatū i te mea he whakatau pea te NSF.
Ko te whakamātautau tinana e aro ana ki tō kiri me ō hononga:
He mea tika te tango i te kōeke kiri hei whakau i te whakatau. Ko te tikanga tenei o te tango i te tauira iti o te kōeke kiri e pā ana kia tirotirohia i raro i te microscope. Ka whakaatu te kōeke i te tauira āhuatanga o te collagen nui me ngā huringa mumura e whakatau ana i te NSF.
Āhei ngā whakamātautau atu, tae atu ki te mahi toto hei tirotiro i te mahi o ō whatukuhu me ngā rangahau whakaahua hei aromatawai i tō ngākau me ō ngā pūkahukahu. Heoi, he tino tupato ngā tākuta mō te whakamahi i te whakakā tātai-gadolinium i roto i ngā take NSF e whakapaetia ana, e whiriwhiri pinepine ana i ētahi atu tikanga whakaahua ina taea.
Āe, kāore he whakamātautau toto kotahi, kāore rānei he rangahau whakaahua e taea te whakatau i te NSF. Ko te whakatau kei runga i te whakakotahi i ngā mōhiohio maha, koia te take i nui ai te mahi tahi me ngā kaiwhakarato hauora whai wheako.
I tēnei wā, kāore he rongoā mō te NSF, engari he maha ngā maimoatanga ka taea te awhina i te whakahaere i ngā tohu me te whakaheke pea i te whānuitanga o te mate. Ko te mahi nui ko te whakapai ake i te mahi o ō whatukuhu ina taea, na te mea ka taea e tēnei te awhina i tō tinana ki te horoi i te gadolinium e toe ana.
Ki te kore koe i runga i te dialysis, ka taea e te tīmatanga o ngā maimoatanga dialysis te awhina i te tango i te gadolinium i roto i tō pūnaha. Mō ētahi tāngata, ka taea e tēnei te arahi ki te whakapainga i ō rātou tohu NSF, ahakoa he rerekē te whakautu i waenga i ngā tangata.
Ko te whakawhiti whatukuhu te tumanako pai rawa atu mō te whakapai ake i ngā tohu o te NSF. He tokomaha ngā tāngata e whiwhi ana i ngā whakawhiti whatukuhu angitu e kite ana i te ngawari haere o o rātou kiri me te whakapai ake o te nekehanga i te wā. Heoi, ehara i te mea ka taea te whakawhiti mō te katoa, ā, pea ka roa ngā marama, ngā tau rānei kia puta mai te whakapai ake.
Ko ngā maimoatanga tautoko e aro ana ki te whakahaere i ngā tohu me te pupuri i tō kounga ora:
Kua whakamātau etahi tākua i ngā rongoā maha hei whakaora i te NSF, tae atu ki ngā rongoā whakakore i te pūnaha ārai, engari kua rerekē ngā hua. Kei te whakaarohia tonu ko ēnei maimoatanga he whakamātautau, ā, pea ka mau mai ō rātou tūponotanga ake.
Kua whakaatu te phototherapy (maimoatanga mā te mārama ultraviolet) i te tumanako i ētahi rangahau iti, engari he nui ake te rangahau e hiahiatia ana kia whakapumautia tōna whai hua me tōna haumaru. Ko ētahi atu maimoatanga whakamātautau kei te akohia ko ētahi mate huaketo me ngā rongoā whakangawari mate.
Ko te matua o te whakahaere i te NSF ko te mahi tahi me te rōpū o ngā kaiwhakarato hauora e mārama ana ki te āhuatanga. Pea ka uru atu ki konei ngā nephrologists, ngā dermatologists, ngā rheumatologists, me ngā tohunga whakaora.
Ko te whakahaere i te NSF i te kāinga e pā ana ki te aro ki te tiaki kiri, te pupuri i te nekehanga, me te aukati i ngā raruraru. Ahakoa ka hiahia koe ki te tirotiro hauora auau, he maha ngā mea ka taea e koe te mahi hei āwhina i te whakahaere i ō tohu me te pupuri i tō kounga ora.
He mea nui te tiaki kiri mō te hunga e pangia ana e te NSF. Kia makuku tonu tō kiri mā te whakamahi i ngā kirikiri ngawari, kāore hoki he kakara. Whakamahia te kirikiri i te wā kei te makuku tonu tō kiri i muri i te kaukau kia āwhina ai ki te pupuri i te makuku. Kaua e whakamahi i ngā hautai kaha, i ngā hua rānei e āwangawanga ai tō kiri nā te ngawari.
He mea nui te noho mahi i roto i ō kāo ārai hei pupuri i te nekehanga o ngā hononga:
Ko te whakahaere mamae i te kāinga pea ka uru atu ki ngā kaiwhakaora mamae kore-whakahaunga e taunaki ana tō tākuta, me ngā huarahi kore-rākau penei i te rongoā wera, te rongoā makariri rānei, te mirimiri ngawari, me ngā tikanga whakahaumaru.
He mea nui te tiaki i tō kiri kei te whara nā te mea pea kaore e ora pai te kiri e pā ana ki te NSF:
Ko te pupuri i te kai pai me te noho makuku ka tautoko i tō hauora whānui, ā, pea ka āwhina i tō tukanga whakaora. Ki te mea kei runga koe i te dialysis, whai i ō whakawhāiti kai mā te atawhai.
Whakaarohia te whakauru ki ngā rōpū tautoko, ki te hono atu rānei ki ētahi atu e pangia ana e te NSF. Ko te whakawhiti wheako me ngā rautaki whakahaere ka tino whai hua ki te whakahaere i ngā āhuatanga hinengaro o te noho tahi me tēnei mate.
Ko te whakarite mō ō hui hauora ka āwhina i te whakarite kia whiwhi koe i te painga nui mai i tō wā me ngā kaiwhakarato hauora. Ko te whai i ngā korero whakarite me ngā pātai mārama e rite ana ka āwhina i tō tākuta ki te whakarato i te tiaki pai rawa atu mō tō NSF.
I mua i tō whakatau, kohikohia ngā mōhiohio hauora nui:
Kia mau ki te tātai tohu i waenga i ngā whakataunga. Tākina tetahi huringa i tō kiri, ngā taumata mamae, te nekehanga, tetahi atu rānei tohu. Ka āwhina tēnei mōhiohio i tō tākuta ki te aroturuki i te ahu whakamua o tō mate, ā, whakaritea te maimoatanga kia rite.
Whakamahia he rārangi o ngā pātai hei ui ki tō rōpū hauora:
Whakaarohia te kawe mai i tētahi mema whānau, hoa rānei ki ngā whakatau nui. Ka taea e rātou te āwhina i a koe ki te maumahara ki ngā mōhiohio i kōrerotia, ā, whakarato i te tautoko hinengaro i ngā wā e pēnei ana i ngā toro hauora e pēnei ana.
Kaua e whakaroa ki te tono mārama ki te kore koe e mōhio ki tetahi mea e whakamārama ana tō tākuta. He āhuatanga uaua te NSF, ā, he mea nui kia pai tō ngākau ki ngā mōhiohio me ngā tūtohu e whiwhi ana koe.
Ko te huarahi pai ki te ārai i te NSF ko te karo i te whakamahinga koretake o ngā kaiwhakaatu whakakāhua e whakamahia ana te gadolinium,inā ki te pēhea koe he mate whatukuhu. Kua whakaitihia te tūponotanga o te NSF e ngā aratohu hauora o nāianei mā te tirotiro tika me ngā mahi haumaru.
Mēnā kei a koe te mate whatukuhu, kia mohiotia e ngā kaiwhakarato hauora katoa tō mate. Kei roto i ēnei ngā tākuta tiaki matua, ngā tohunga, me ētahi wāhi ka taea te mahi whakaahua. Kia whakamārama tonu koe i ō raruraru whatukuhu i te wā e whakarite ana i te MRI, i ētahi atu tukanga whakapaipai whakawhānui.
E whai ana inaianei ngā kaiwhakarato hauora i ngā aratohu kaha mō te whakamahinga o te gadolinium:
Mēnā ka hiahia koe ki te MRI, ā, kei a koe te mate whatukuhu, kōrerohia ngā huarahi atu ki tō tākuta. I etahi wā, ka taea e te MRI kore-whakawhānui te whakarato i ngā korero tika, i ētahi atu tikanga whakaahua penei i te ultrasound, i te CT kaore he whakawhānui.
Ina tino tika te whakamahinga o te gadolinium mō te tangata he mate whatukuhu, ka whakarato etahi pokapū hauora i ētahi huihuinga dialysis atu i muri mai hei awhina i te tango atu i te whakawhānui atu tere atu. Heoi, kāore i whakamāramahia tēnei huarahi hei aukati i te NSF katoa.
Ko te pupuri i te hauora whatukuhu pai rawa atu ka taea te whakaiti i tō tūponotanga. Kei roto i ēnei te whakahaere i ngā āhuatanga penei i te mate huka me te toto teitei ka taea te whakaiti i te mahi o te whatukuhu, te noho makuku, me te karo i ngā rongoā ka taea te kino ki ō whatukuhu ki te taea.
Kua whakaitihia te maha o ngā keehi NSF hou i ngā tau tata nei i te whakamahi i ēnei tikanga aukati. Ahakoa i te nuinga o te tīmatanga o te tau 2000, kua tino iti ake te kitea i enei ra, na te whakapai ake o te matauranga me ngā tikanga haumaru.
Ko te NSF he mate kino engari he iti te tūponotanga, e pā ana te nuinga ki te hunga e mate kino ana o te whatukuhu, kua whakamahia hoki ētahi whakamahinga whakaatu i roto i ngā whakaahua hauora. Ahakoa kāore he rongoā i tēnei wā, ka taea e te mārama ki te NSF te āwhina i a koe ki te whakatau whakamārama mō tō rongoā hauora me te whakahaere i te mate mena ka puta.
Ko te mea nui rawa atu hei mahara ko te NSF ka taea te aukati i te nuinga mā te tirotiro tika me ngā mahi hauora haumaru. Kua whakaitihia te tūponotanga mō te hunga e mate ana o te whatukuhu e ngā aratohu o nāianei, ā, he nui atu te mōhio o ngā kaiwhakarato hauora ki te mate i te wā o mua.
Mena kei a koe te mate whatukuhu, whakamōhiotia tonutia ō kaiwhakarato hauora i mua i ngā rangahau whakaahua. Kaua e tuku i te wehi ki te NSF kia ārai i a koe ki te whiwhi i te tiaki hauora e tika ana, engari kia mohio tō rōpū hauora ki te mahi a tō whatukuhu kia taea ai e rātou te whakatau i ngā kōwhiringa haumaru rawa atu mō tō āhuatanga.
Mō te hunga e ora ana me te NSF, arotahi ki te mahi tahi me ngā kaiwhakarato hauora whai wheako me te pupuri i te kounga ora pai rawa atu mā ngā maimoatanga tika me te tiaki whaiaro. Ahakoa he wero nui te mate, he maha ngā tāngata e mate ana i te NSF e kimi ana i ngā huarahi hei whakarite me te whakahaere tonu i ngā oranga whai kiko.
Kia mau ki te whakamōhiotia e ngā whakawhanaketanga hou i roto i te rangahau NSF me te maimoatanga. I te whakarahi haere o to tatou mōhiotanga ki tēnei mate, ka taea pea te wātea mai ngā kōwhiringa rongoā hou ka taea te whakapai ake i ngā hua mō te hunga e pā ana ki te NSF.
Kāo, ehara te NSF i te mate pāhoko. Kāore e taea e koe te hopu mai i tētahi atu, kāore hoki e horapa ki ētahi atu tāngata. Ka puta te NSF hei tauhohenga ki ngā whakamahinga whakaatu gadolinium i roto i te hunga e mate ana o te whatukuhu, ehara i te mea mai i tetahi mea mate pērā i ngā pūngao, i ngā huaketo rānei.
Ka taea te puta mai te NSF ki ngā tamariki, engari he tino onge. Ko te nuinga o ngā take i pūrongotia kua puta ki ngā tamariki he mate whatukuhu kino e whiwhi ana i te whakakā me te gadoliniumi mō te whakaahua hauora. Ko ngā tupato anō e whakamahia ana ki ngā pakeke e whakamahia ana ki ngā tamariki he mate whatukuhu.
E puta ana ngā tohu o te NSF i roto i ngā rā ki ngā marama i muri i te whakamahinga o te gadoliniumi, me te nuinga o ngā take e puta ana i roto i te 2-3 marama. Heoi, kua puta mai etahi tohu ki ētahi tangata i muri i ngā wiki, ā, tae noa ki te tau kotahi i muri i te whakamahinga o te whakakā. Ka rerekē te wā e whakahaeretia ana e te mahi o tō whatukuhu me ētahi atu āhuatanga takitahi.
Ahakoa ka rongo pea etahi i te pumau o ō rātou tohu, kaore e tino pai ake te NSF me te kore whakauru. Ko te huarahi pai rawa atu ki te whakapai ake ko te whakahoki i te mahi o te whatukuhu mā te whakawhiti whatukuhu angitu, ahakoa i reira, ka taea te whakaora i te iti me te kore katoa.
Kāo, he rerekē ngā taumata o te tūponotanga o ngā kaiwhakakā e whakamahia ana te gadoliniumi. Ko ngā kaiwhakakā rārangi, he iti ake te pumau, he nui ake te tūponotanga i ngā kaiwhakakā macrocyclic, he tino pumau me te iti ake te tuku i te gadoliniumi koreutu. Kua whakamahi te nuinga o ngā pokapū hauora i ngā whakaritenga haumaru ake, ina koa ki ngā turoro he mate whatukuhu.