Amaphupha okuphanda amatsha kwiindlela ezintsha eziphazamisayo
Ngexesha elidlulileyo kwiminyaka eyi-20 edlulileyo, inani lemivimbo liye lahla. Nangona kunjalo, lo mkhuba usebenza kubantu abadala. Ngokumalunga nabantu abadala, kuquka namawaka eminyaka, kukho ukunyuka kwinani lemivimbo. Olu konyuka lusekelwe kwenyuka kwezinye izinto ezinobungozi phakathi kwabantu abancinci, kubandakanya ukukhuluphala, isifo sikashukela, kunye negazi.
Stroke
Kwinqaku le-2017 elipapashwe kwi- JAMA Neurology , uGeorge kunye nababhali-mbhalisi bavanya ukunyuka kobunzima be-acrochemical attack among young people.
Abaphandi bahlalutya izibhedlele ezingama-362,339 ukususela phakathi kuka-2003 no-2004 kunye nama-421,815 kwizibhedlele ezikhungweni eziphakathi kuka-2011 no-2012 ukucacisa iziganeko zesifo esibuhlungu. Baye basebenzisa idatha ukusuka phakathi kuka-2003 no-2012 ukucacisa ubuninzi bezinto ezinobungozi ezintlanu zempilo yengqondo ezinokubangela ukubetha kanzima: ingozi yomshukela, isifo sikashukela , isifo se- lipid, ukunyanya , kunye nokusetyenziswa kwecuba.
UGeorge kunye noogqirha bafumene ukuba iirhafu zezibhedlele ngenxa yesifo esiqhekeza isiciksi sanda ngamaphesenti angaphezu kwama-50 amadoda namabhinqa phakathi kwe-18 no-34. Ngokukodwa, amadoda, phakathi kuka-2003 no-2012, kukho ukwanda ukusuka ku-11.2 ukuya kwi-18.0 imivimbo emininzi Ezili-10 ezibhedlele. Kubafazi, kwabakho ukwanda ukusuka kwi-3.8 ukuya kwi-5.8 imivimbo emibi kwi-10 hospital hospitals.
Ukubuya emva koko, ukususela phakathi kuka-1995 no-1996, iirhafu zokubetha ziphindwe kabini kubafana abaneminyaka eliphakathi kwe-18 no-34.
Nazi ezinye iziphumo ezivela kwisifundo malunga neengxaki zempilo yengqondo yabantu abaneminyaka eliphakathi kwe-18 no-64 ababethelwa esibhedlele ngenxa yesifo esibuhlungu esicacisayo phakathi kuka-2003 no-2012:
- Ixabiso lexinzelelo lonyuka likhuphuke phakathi kwama-4 ekhulwini kunye ne-11 ekhulwini.
- Ixabiso le-lipid disorder (okt, hypercholesterolemia okanye i-cholesterol ephezulu) yanda phakathi kwama-12 ekhulwini kunye nama-21 ekhulwini.
- Iirhafu zesifo sikashukela zenyuka phakathi kwama-4 ekhulwini kunye nama-7 ekhulwini.
- Ukusetyenziswa koTywala kwanda phakathi kweepesenti ezingama-5 kunye neepesenti ezili-16.
- Ixabiso lokunyameka linyuka phakathi kwama-4 ekhulwini kunye ne-9 ekhulwini.
Ngophando loqobo, iScientific American ithathe iziphumo zolu pho nonongo. Bajonga ngokukodwa apho e-United States kukho ukunyuka okuphezulu kwintlanzi phakathi kwabantu abatsha. Bafumanise ukuba ukwanda okukhulu kunaseNtshona naseMidwest. Ukongezelela, iidolophu zabona ukwanda okukhulu kunendawo ezisemaphandleni.
Nangona uMzantsi ubizwa ngokuba yi "Stroke Belt," kunye nenani elona liphezulu kakhulu leemivimbo ezenzeka khona, ukunyuka okukhulu kwimizila yevalo phakathi kwabantu abatsha kwenzeka eNtshona naseMidwest. Inani leemivimbo eMzantsi sele lide liphezulu; Ngako oko, ukwanda kwenani eliqhelekileyo kwi-stroke frequency alikho nakwi-West nakwi-Midwest, apho amazinga okuhlaselwa aphantsi.
I-teknoloji inokudlala indima ekunyuseni okukhulu kwimizila ye-stroke ebonakalayo eNtshona naseMidwest.
Ngokukodwa, kwiNyakatho-mpuma, apho ukuhlaselwa kwesantya phakathi kwabantu abancinci abangezanga ukwandisa kakhulu, ukucinga ngomfanekiso we-MRI kunokufumaneka ngokuthe xaxa kwaye izibetho ezingaphezulu zifumaneke.
Ngemivimbo eminye efunyaniswe kwisiseko, kunokunyuka okuncinci kwesantya. Ngamanye amazwi, iindawo ezifana neNyakatho-mpahla aziyi kuba nekhulu lokwanda kwimizila ye-stroke ngenxa yokuba ukufumaneka kweteknoloji ye-MRI kuthetha ukuba imivimbo eninzi yafunyanwa ukuba iqale.
Ukusetyenziswa kweziyobisi ezingekho mthethweni, njenge-meth kunye ne-crack, kunokudlala indima ekunyuseni kwimivimbo emibi.
Iingcali zicinga ukuba esinye sezizathu ezenza ukuba izibetho zidla ngokuphindaphindiweyo kwiidolophini kuneendawo ezisemaphandleni kuba iindawo ezisemadolophini zihlambulukile.
Ngaphezu koko, ngenxa yokuba ezininzi izibhedlele zasemaphandleni ziye zavalwa kwiiminyaka yakutshanje, abantu abahlala kwimimandla yasemaphandleni babenokuya kwizibhedlele zasezidolophini unyango, ngoko ke ukuphazamisa ukuhlaselwa kwezidumbu zendawo.
Simele sihlale sikhumbula ukuba zonke ezi nkcazo ezinokwenzeka-imifanekiso yokuxilonga, iziyobisi, ukungcola, kunye nokunyanzeliswa kwempilo yezilwanyana zasemaphandleni-ziyinto yokuzimela nje. Uphando olungakumbi kufuneka lwenziwe ukuze kuqondwe imilinganiselo yokuvakala kwesantya.
Ukwandiswa kwamazinga okubetha phakathi kwabantu abancinci bancedisa ukunyuka kweemeko ezinobungozi benhliziyo, ezifana nokukhuluphala ngokwegazi kunye nesifo sikashukela.
Ukunyanya
Kwiminyaka yakutshanje, abeendaba baye babika ukuba kukho ukunciphisa ukunyanya komntwana. Le mabango, nangona kunjalo, ayilunganga. Enyanisweni, uphando oluthile lubonisa ukuba kuncipha ukunyanyisa kwizingane ezineminyaka engaphantsi-mali engenamakhaya okanye kwiindawo ezithile. Uphando, nangona kunjalo, alukwazi ukugqitywa ngokubanzi kubantu bonke. Idatha ephakathi kuka-2007 no-2010 ibonisa ukuba akukho nto iyancipha ekunyanyeni. Enyanisweni, kukho ukunyuka kwiintlobo ezinzima zokuthobeka kubantu abancinci.
Kwinqaku le-2014 elipapashwe kwi- JAMA Pediatrics , i-Skinner no-Skelton bavavanya amacandelo ahlukeneyo e-US phakathi kuka-1999 no-2012. Ezi sampuli zaziquka abantwana phakathi kweminyaka emi-2 no-19 ubudala.
Abaphandi bafumanisa ukuba kunokubakho ukuzinza ekukhuseni ukukhuluphala. Nangona kunjalo, kukho i-spike kwiiklasi eziphezulu zokukhuluphala (oko kukuthi, i-BMI ye-35 okanye ngaphezulu). Ingqalelo, iintlobo ezinzima kakhulu zokugqithisa zihambelana kakhulu nomngcipheko we-cardiometabolic, kubandakanywa nesifo.
Uhlobo lweSwekile 2
Ngophando lwango-2017 olupapashwe kwi- JAMA , uMeyi-Davis kunye nabalobi bezobambisene nabo bafumene ukuba iziganeko zesifo sikashukela se-2 zanyuka phakathi kuka-2002 no-2012. Uhlobo lwe-2 lwesifo sikashukela luyisifo sengozi yomzimba kunye negalelo lokushaya.
Ukusebenzisa uhlalutyo olusuka kubemi, kubantwana abaneminyaka engama-10 ukuya ku-19 ubudala, bafumene ukuba kukho i-4,8 ekhulwini kunyuka ngonyaka kwiziganeko zesifo sikashukela se-2. Olu konyuka luchazwe ngokukhethekileyo phakathi kweentlanga ezincinci kunye namahlanga. Ngokomzekelo, phakathi kwentsha yaseMelika yaseMelika, kukho ukwanda ukusuka kwi-3.1% ukuya kuma-8.9 ekhulwini.
Ingqalelo, iziphumo zolu cwaningo ziyavumelana neziphumo ezivela kwiphando langaphambilini eyenziwa ngabaphandi abafanayo: Phakathi ko-2001 no-2009, kukho nokwanda kwenyama yesifo sikashukela phakathi kolutsha.
Impembelelo
Ukunyuka kwesibalo kunye neengxaki ezinxulumene nomngcipheko phakathi kwabantu abadala ziphathelele ubuncinane izizathu ezibini:
- Izibetho zingabangela ukukhubazeka okukhulu, kwaye xa umntu osemtsha ekhubazeka ngenxa yesigxina, amandla abo okwenza ubomi ahlaselwe. Impembelelo yengqondo kunye nezoqoqosho ayithinteli kuphela umntu onokukhubazeka okuchaphazelekayo, kodwa kunye namalungu entsapho. Izibetho ziyakwazi ukulungisa ubomi ngokubhetele.
- Nangona izibetho zokuqala ziba nzima, imbali yokubethelwa komntu osemncinci ukhonza njengowomnquba kwimayini yamalahle. Imivimbo yexesha elizayo yimbi kakhulu kwaye iyancipha ngakumbi kuneyokuqala. Ngaloo ndlela, ukunyuka kwamaxesha amaninzi kubantu abadala abasenokuba ngumqondiso wokuqala wendyikitya ebhubhisayo engayidlala kwiminyaka embalwa elandelayo.
Unyango
Ukuchonga umgangatho wokunyuka kwesifo kunye neengxaki zempilo yengqondo phakathi kwabantu abadala kukuphela kwesinyathelo. Umbuzo omkhulu kukuba ungayiphatha njani into enokuba yindlala ebalulekileyo.
Kwinqaku le-2015 kwi- Stroke ebizwa ngokuthi "Ubuthakathaka bunyukisayo ingozi ye-Stroke kwi-Young Adult Opportunity for Prevention," uKernan noDearborn babhale oku okulandelayo:
Kwenkampu enye, ngaba abo babona ukuba ukunyanya kunxulumene nomngcipheko ophezulu wokuba uhlangothi luze lube lujoliso olubalulekileyo ekukhuselweni kweprayimari nolwesibini. Kwelinye icala, ngaba abo bavuma ukuba ukunyanya ukunyuka kunokwanda komzimba kodwa bathi kuyaphumelela ukuphatha umphumo wokunyanyisa obangela uxanduva lokushaya umthamo (oko kukuthi, uxinzelelo lwegazi kunye ne-dyslipidemia) kunokugqithisa ngokwalo.
Ngamanye amagama, kusengacacanga ukuba ukukhuselwa kwesifo kufuneka kugxininise ekutheni ukukhuluphala okanye imeko ezibangelwa ukukhuluphala, njengengcinezelo ephezulu yegazi kunye ne-cholesterol ephezulu.
Ababhali bathi xa sineendlela ezinonophelo zokonyanyisa, akukho mbuzo ukuba ukukhuluphala kufuneka kube yinto ekujoliswe ngayo ekukhuselweni kwesibindi phakathi kwabantu abadala. Ngaphezu koko, unyango lwexinzelelo, nangona sisona sizathu ekuphuhliseni isisu, singashiya ezinye izinto ezishiyekileyo ezingaphendulwanga.
Kwakhona, ngokutsho kwabaphandi:
[E] i-prescription esemgangathweni yonyango lokunciphisa ingozi (umz., Unyango lwe-hypertension) luya kushiya izigulane ezininzi ezincinci zibonakaliswe kwingozi engaphazamiseki. Oku kuyinyani ngokunyanisekileyo kuba ukuphela kweengcipheko zokunciphisa ingozi kubalamli beesifo se-vascular ekunyanyeni kukunyango lwexinzelelo. Uphando aluqinisekanga ukuba ukulawulwa okunamandla kwesifo sikashukela sinciphisa umngcipheko wesifo se-vascular; akukho zonyango ezithile ezicetyiswayo ekuphatheni ukuvuvukala kokukhuluphala, kwaye izigulane ezininzi ezincinci zingabonwa njengabaviwa be-infid-infing-treatment.
Ngamanye amazwi, kunzima ukugulisa izigulane ngenxa yemingcipheko yokubethwa kwesifo ngenxa yokukhuluphala. Ukulawulwa kwesifo sikashukela asizange kubonakaliswe ukunciphisa umngcipheko we-stroke. Ngaphezu koko, akukho ndlela ekhethekileyo yokunyanga ukuvuvukala okuhamba kunye nokukhuluphala okunokubangela ukubetha nesifo senhliziyo. Ekugqibeleni, abaninzi abantu abaselula abayi kuba nelungelo lokufumana unyango lwe-lipid, olunjengeemimiselo.
ILizwi
Uphando luye lwabonisa ukwandiswa kwesifo soxinzelelo kunye neengxaki ezinxulumene nobomi be-cardiovascular among adults. Oku kufunyanisiweyo kukubhekiselele kuba kungabonakalisa inkxalabo enkulu, eneziganeko eziphezulu kakhulu, ukuphazamiseka okukhulu kwesichakamiso kwiminyaka ezayo.
Okwangoku, akukho nanye evunyelwene ngayo indlela yokukhusela isifo, isifo esinokuthi siphumelele kwaye sithintele kakhulu abantu kunye neentsapho. Isiluleko esilungileyo sokukhusela umntu osemtsha angayilandela kukukhawulela umngcipheko we-acrochemical attack to begin with. Abantu abaselula kufuneka baphephe ukugqithisa, bagweme ukutshaya, baze bafumane unyango olufanelekileyo lwegazi lokushushu.
Ekugqibeleni, nceda uhlale ukhumbule ukuba kuphela iincinci-eziphakathi kwe-5 ne-10 ekhulwini-ezivela kubantwana nakubantu abadala. Akunjalo nayiphi inani leemivimbo ezithinta iwaka leminyaka ininzi yezibetha. Nangona kunjalo, nayiphi na imeko yecroke echaphazelekayo echaphazela umntu omncinci ngokubhekiselele, kwaye ukwanda kweendlela kukubaluleke kakhulu kwimpilo yoluntu.
> Imithombo:
> George, MG, Tong, X, Bowman, BA. Ubuninzi bezinto ezinobungozi be-Cardiovascular Risk and Strokes kwaBantu abadala. JAMA Neurology. 2017; 74: 695-703.
> Kernan, WN, Dearborn, JL. Ukunyanya Ubuninzi Kukhulisa Umngcipheko We-Stroke kwi-Young Adults Opportunity for Prevention. Stroke. 2015; 46: 1435-1436.
> Maron, DF. Uninzi lweeMillennials Zineentsimbi. Scientific American. NgoJuni 28, 2017. [e-pub]
> Mayer-Davis, EJ, et al. Iingxaki zemiba yohlobo lwe-1 kunye nohlobo lwe-2 lwesifo sikashukela phakathi koLutsha, ngo-2002-2012. I-New England Journal of Medicine. 2017; 376: 1419-1429.
> Skinner, AC, Skelton, JA. Ubuninzi kunye nemigudu yokunyamekela kunye nobutyebi obukhulu phakathi kwabantwana baseUnited States, ngo-1999-2012. JAMA Pediatrics. 2014; 168: 561-566.