He ʻōkana koʻikoʻi loa ka puʻuwai i loko o ko kākou kino. Ua like ia me ka mīkini o ko kākou kino. Akā i kekahi manawa hiki i kēia puʻuwai ke loaʻa nā maʻi like ʻole. I kēia lā e kamaʻilio kākou e pili ana i kahi maʻi e hiki ke ulu i loko o ka puʻuwai, kahi e pono ai ka mālama iki, akā hiki ke kāohi ʻia inā ʻoe e ʻike pono. He maʻi ia i kapa ʻia ʻo `(Infective Endocarditis)` . ʻAʻole paha ʻoe i lohe i kēia inoa, akā he mea nui loa ia e ʻike e pili ana i kēia.
He aha kēia `(Infective Endocarditis)`? I ka ʻōlelo maʻalahi...
I ka ʻōlelo maʻalahi, ʻo ke ʻano o ka `(Infective Endocarditis)`, ʻo ia hoʻi ke komo ʻana o kahi germ i loko o ka papa o loko o kou puʻuwai, ʻo ia hoʻi, ka `(Endocardium)` , a i ʻole nā valves o ka puʻuwai (Valves), a hoʻoulu i kahi maʻi. E noʻonoʻo, ua like nā valves o ko kākou puʻuwai me nā puka. Kōkua kēia mau valves i ke kahe ʻana o ke koko i hoʻokahi ala wale nō. ʻO ka maʻamau, ikaika loa kēia mau valves a pale maʻalahi i nā germs (bacteria, fungi). ʻO ia ke kumu he mea kakaikahi kēia ʻano i kapa ʻia ʻo `(Infective Endocarditis)`. Akā inā loaʻa, hiki ke koʻikoʻi iki.
Pehea e hiki ai kēia? Pehea e hiki ai i nā germs ke komo i ka puʻuwai?
ʻAe, i kēia manawa e nānā kākou pehea e ulu ai kēia `(Infective Endocarditis)`. Hoʻomaka ia i ka wā e komo ai ka bacteria (Bacteria) a i ʻole fungi (Fungi) i loko o kou koko. ʻO ka hapa nui o ka manawa, ʻo ia hoʻi , ma kahi o ʻehā o kēlā me kēia ʻelima mau hihia, ua hoʻokumu ʻia e ka bacteria i kapa ʻia ʻo `(Streptococcus)` a me `(Staphylococcus)`.
Ke noʻonoʻo nei paha ʻoe, "Auē, pehea lā e hiki ai i kēia mau bacteria ke komo i loko o ke koko?" E noʻonoʻo, inā loaʻa iā ʻoe kahi ʻoki liʻiliʻi ma kou ʻāʻī i ka wā e palaki ana i kou mau niho, hiki i nā bacteria ke komo i loko o ke koko. A i ʻole, inā paha e hana ʻia ana ʻoe i ke ʻoki kino nui, ʻoiai ke ʻoki kino puʻuwai hāmama, hiki i nā bacteria ke komo.
ʻO nā bacteria e komo i loko o ke koko, hele ma ke kahe koko, a noho i nā wahi i hōʻino mua ʻia, e like me ka endocardium a i ʻole nā valves o ka puʻuwai. E like me nā ʻāpana lepo e pipili ana i kahi ʻili pulu. Ma laila, hana kēia mau bacteria i nā kolone. Kāhea mākou i kēia mau "mea kanu." Hoʻokuʻu kēia mau kolone i nā mea ʻawahia a me nā enzymes. Hoʻopau kēia mau mea i nā cell olakino a hoʻopilikia i ke kaʻina hana ho'ōla.
ʻO wai ka mea i ʻoi aku ka paʻakikī o ka loaʻa ʻana o kēia? (Nā kumu pilikia)
ʻOiai hiki i kekahi ke loaʻa i ka endocarditis infective, ʻoi aku ka nui o ka pilikia o kekahi poʻe. He ʻoiaʻiʻo loa kēia no ka poʻe me ka maʻi puʻuwai structural . Hoʻokomo pū ʻia kēia:
- ʻO ka poʻe i hōʻino ʻia nā kiwikā puʻuwai ma muli o nā kūlana olakino ʻē aʻe: No ka laʻana, ʻo ka poʻe i hōʻino ʻia nā kiwikā ma muli o ka `(Rheumatic Heart Disease)`.
- Nā kānaka me ka maʻi puʻuwai hānau: ʻO ia hoʻi, nā kānaka i hānau ʻia me kekahi ʻano kīnā puʻuwai.
Hiki i kēia mau kūlana ke hoʻopilikia i ka hana o nā valves puʻuwai. Eia kekahi laʻana:
- ʻO ka Stenosis Valve Aortic
- ʻO ka maʻi valve aortic bicuspid (Bicuspid Aortic Valve Disease)
- Regurgitation (ke kahe ʻana o ke koko mai nā valves o ka puʻuwai)
- ʻO ka Mitral Valve Prolapse
Ma waho aʻe o kēia, aia kekahi mau kumu pilikia ʻē aʻe:
- Nā Kāne: ʻOi aku ka nui o ka loaʻa ʻana o kēia maʻi i nā kāne ma mua o nā wahine.
- ʻElemakule: ʻIke pinepine ʻia kēia i nā poʻe ma luna o 50 mau makahiki.
He aha nā hopena ʻaoʻao e hiki mai ana o kēia?
Inā ʻaʻole i ʻike ʻia a mālama ʻia kahi maʻi i kapa ʻia ʻo "Infective Endocarditis" i ka wā mua, hiki i ka bacteria ke ulu a pālahalaha, e hana ana i nā hopena ʻaoʻao koʻikoʻi. ʻO kekahi o nā mea nui ka hāʻule ʻana o ka puʻuwai.
Eia kekahi, inā ʻaʻole holomua ka lāʻau mua, hiki ke loaʻa kahi maʻi i kapa ʻia ʻo `(Emboli)`. ʻO `(Emboli)` he mau ʻūpā koko liʻiliʻi e haki ana mai nā kolone bacteria i ʻōlelo ʻia ma luna (Nā mea kanu). Inā hele kēia mau mea ma ke kahe koko a paʻa i loko o kahi kīʻaha koko, hiki iā lākou ke ālai i ke kahe o ke koko i kahi ʻōkana koʻikoʻi. Hiki i kēia ke hana i nā pilikia e hiki ai ke hoʻoweliweli i ke ola.
E noʻonoʻo, ua like kēia me ka wā e paʻa ai kahi ʻāpana ʻōpala i loko o kahi paipu wai, a laila e pau ke kahe ʻana o ka wai.
ʻO nā hopena ʻaoʻao e hiki mai ana o kēia mau `(Emboli)`:
- Ka hoʻonui ʻia ʻana o ka spleen a me ka ʻeha.
- Ka pōʻino o nā puʻupaʻa.
- Nā ʻūpā koko e hele ana i nā māmā (Pulmonary Embolism).
- Hahau.
- Ka hōʻino ʻana i nā lālā distal, e like me nā manamana lima.
He aha nā kumu nui o ka `(Infective Endocarditis)`?
Hiki i kekahi mau maʻi puʻuwai a me nā lāʻau lapaʻau puʻuwai ke ʻae i ka bacteria e komo i ke koko. ʻO kēia nā kumu nui o ka "Infective Endocarditis".
- Nā Kiwikā Puʻuwai Artificial: ʻOi aku ka nui o ka hiki ke hoʻomohala i nā maʻi ma mua o nā kiwikā kūlohelohe.
- Nā kūlana e pono ai ke hoʻokomo ʻia o nā mea hana e like me nā pacemakers: ʻOi loa inā hele nā uea o kēia mau mea hana ma o nā kīʻaha koko.
- Inā ua loaʻa iā ʻoe kahi hoʻoili puʻuwai.
- He kūlana i kapa ʻia ʻo `(Hypertrophic Cardiomyopathy)` (mānoanoa o ka ʻiʻo puʻuwai).
- Inā ua hana ʻia ʻoe i ke ʻoki puʻuwai hāmama.
- Inā ua loaʻa iā ʻoe ma mua ka `(Infective Endocarditis)`.
Aia kekahi mau kumu ʻē aʻe?
ʻAʻole pinepine loa, hiki ke loaʻa kēia ʻano maʻi i nā poʻe me nā puʻuwai olakino. ʻO nā kumu paha:
- ʻO ka catheter kahi mea e noho mau ana i loko o nā kīʻaha koko no ka manawa lōʻihi: no ka laʻana, nā catheters lōʻihi i hoʻohana ʻia e hāʻawi i ka chemotherapy i nā poʻe maʻi kanesa.
- Nā maʻi e hoʻonāwaliwali ai i ka ʻōnaehana pale: No ka laʻana, `(HIV)` a me `(AIDS)`.
- Loaʻa kahi maʻi ma kahi ʻē aʻe o ke kino.
- He mea weliweli loa ka hoʻokomo ʻana i nā lāʻau lapaʻau alanui ma ke kino me ka hoʻohana ʻana i nā nila lepo .
- Ka hoʻomaʻemaʻe waha maikaʻi ʻole: ʻO kēia ke kumu o ka hōʻiliʻili ʻana o ka nui o nā bacteria i loko o ka waha.
- Ke hoʻohana nei i kahi nila lepo i ka wā e hoʻokomo ai i ka lāʻau lapaʻau i loko o kahi aa koko no nā kumu lapaʻau.
He aha nā hōʻailona o kēia maʻi? Nā mea hiki iā ʻoe ke ʻike...
Hoʻopilikia pinepine nā hōʻailona o ka `(Infective Endocarditis)` i kou puʻuwai a me ka ʻōnaehana hanu. Hiki iā ʻoe ke ʻike i nā mea e like me:
- ʻEha ka umauma.
- He kani puʻuwai ʻē aʻe (he "Heart Murmur" a ke kauka e lohe ai i ka wā e hoʻolohe ai me ka "stethoscope").
- Paʻakikī ka hanu ʻana (Dyspnea).
- Ka wikiwiki o ka puʻuwai (Tachycardia).
Ma waho aʻe o kēia, hiki ke ʻike ʻia nā hōʻailona ʻē aʻe:
- Ke koko i loko o ka mimi (Hematuria).
- Nā anu.
- Luhi.
- `(Janeway Lesions)`: Nā kiko ʻulaʻula, ʻeha ʻole e kū mai ana ma nā poho lima a me nā kapuwaʻi o nā wāwae.
- ʻEha hui.
- Ka nalowale o ka makemake a me ka pohō kaumaha i wehewehe ʻole ʻia.
- He kuni haʻahaʻa mau loa ʻaʻole hiki ke loaʻa ke kumu.
- ʻEha ʻiʻo.
- Ka hou nui ʻana i ka pō (Night Sweats).
- Nā Nodules Osler: Nā puʻupuʻu ʻeha e kū mai ana ma nā lima a me nā wāwae.
- Nā Kokoke ʻĀpana: Nā wahi koko liʻiliʻi e like me ke koko i ʻike ʻia ma lalo o nā kui.
- ʻO ke kahe koko ma lalo o ka conjunctival: He ʻano kahe koko ke nānā aku ma ka keʻokeʻo o ka maka.
- Ka pehu ʻana ma ka ʻōpū a i ʻole ke kino lalo.
Hiki ke ʻike koke ʻia kēia mau hōʻailona a i ʻole lohi. I kekahi manawa ua like paha kēia mau hōʻailona me ka maʻi palū maʻamau, akā he mea nui e makaʻala i kēia mau hōʻailona, ʻoiai inā he maʻi puʻuwai kou.
Pehea e ʻike ʻia ai kēia maʻi? He aha ka hana a nā kauka?
Hoʻomaka ka ʻike ʻana me kāu mau hōʻailona a me ka mōʻaukala olakino. Inā ua loaʻa iā ʻoe kahi maʻi valve puʻuwai ma mua a loaʻa iā ʻoe ke kuni me ke kumu ʻole, he kānalua nui kēlā. Eia kekahi, inā loaʻa iā ʻoe ka hui pū ʻana o nā hōʻailona ʻē aʻe e pili ana i ka maʻi `(Infective Endocarditis)`, hiki ke kū mai ka kānalua. Eia naʻe, no ka ʻike pono ʻana, pono ʻoe e hoʻāʻo ʻia.
He aha nā hoʻokolohua e hana ʻia?
- Hoʻāʻo moʻomeheu bacteria: Kōkua kēia i ka hoʻoholo ʻana inā he bacteria i loko o ke koko, a inā pēlā, he aha ke ʻano.
- Eia kekahi, pono paha nā hoʻokolohua ʻē aʻe e hoʻolālā i ka lāʻau lapaʻau. ʻO kēia mau mea:
- Nā Hoʻāʻo Serology Antibody: Hiki i kēia ke hōʻoia i ke ʻano kikoʻī o ka bacteria i loko o ke koko.
- Nā hoʻāʻo puʻuwai `(Echocardiogram)`: Hiki i kēia ke nānā i ke kūlana o nā valves puʻuwai, inā he mau kolone bacteria i kapa ʻia ʻo `(Vegetations)`, a pehea ko lākou nui. ʻElua ʻano o `(Echocardiogram)`:
- ʻO Transthoracic Echocardiogram (TTE): He scan kēia i hana pinepine ʻia ma ka ʻili o ka umauma.
- ʻO ka Transesophageal Echocardiogram (TEE): Pili kēia i ke komo ʻana i kahi probe liʻiliʻi ma o ka puʻu a me ke scan ʻana i ka puʻuwai. Hiki i kēia ke hana i nā kiʻi ʻoi aku ka maopopo ma mua o ka TTE.
He aha ka lāʻau lapaʻau no kēia?
ʻO ka lāʻau lapaʻau mua no ka endocarditis maʻi he mau antibiotics. Hāʻawi mua ʻia nā antibiotics ākea. Hiki i kēia ke kōkua i ka hōʻoluʻolu ʻana i nā hōʻailona, akā ʻaʻole lawa paha lākou e hoʻopau loa i ka maʻi.
Ke hoʻi mai nā hopena o ka "Antibody Serology Test" i ʻōlelo ʻia ma luna, e hoʻololi nā kauka iā ʻoe i kahi "Targeted Antibiotic" e kuhikuhi ana i ke ʻano kikoʻī o ka bacteria i loko o kou koko. Pono paha e hāʻawi ʻia kēia lāʻau lapaʻau ma ke ʻano intravenous (IV) no ʻehā a ʻeono pule. ʻO ia hoʻi paha ka noho ʻana ma ka haukapila.
Pono anei au e hana i ke ʻoki kino?
Inā liʻiliʻi nā kolone bacteria, a i ʻole '(Nā Mea Kanu),' ua lawa paha nā antibiotics. Eia nō naʻe, inā nui kēia mau '(Nā Mea Kanu)', pono paha ke ʻoki kino (Infective Endocarditis Surgery) e wehe iā lākou a hoʻololi i nā valves i hōʻino ʻia.
Eia kekahi, inā e pālahalaha kēia mau '(Nā mea kanu)' i nā ʻiʻo a puni, pono paha ke ʻoki kino. I kekahi mau hihia koʻikoʻi, ʻoi aku ka maikaʻi o ka hana ʻana i ke ʻoki kino ma mua o ka hoʻomaka ʻana i nā antibiotics. Eia nō naʻe, ke aʻo nei nā mea noiʻi i nā kūlana e kūpono ai ke ʻoki kino ma mua o nā antibiotics.
Pehea e hiki ai iaʻu ke pale aku i kēia mai ka hana ʻana? ʻO ke kāohi ʻana ka mea maikaʻi loa!
I ka wā ma mua, ua hāʻawi ʻia nā poʻe i pilikia i ka loaʻa ʻana o ka "Infective Endocarditis" i nā lāʻau antibiotic i kēlā me kēia lā. Eia nō naʻe, ua hoʻololi ʻia kēia ʻano hana i kēia manawa no ka mea e hoʻonui ana i ka pilikia o ka loaʻa ʻana o nā bacteria kūʻē i ka antibiotic.
I kēia manawa, ua kuhikuhi nā kauka i nā lāʻau antibiotic pōkole ma mua o kekahi mau kaʻina hana lapaʻau, e like me nā kaʻina hana niho. Hoʻohana wale ʻia nā lāʻau antibiotic prophylactic i ka poʻe i loaʻa ka pilikia nui o ka hoʻomohala ʻana i ka endocarditis infective, e like me ka poʻe me nā valves puʻuwai prosthetic.
ʻO ka mea nui loa, ʻo ia ka mālama pono ʻana i kou olakino waha a me kou niho. He mea nui loa ka palaki pono ʻana i kou mau niho i ʻelua manawa i ka lā a me ka hoʻohana ʻana i ka floss niho.
He aha nā manawa kūpono e ho'ōla ai i kēia maʻi?
Inā ʻaʻole i ʻike koke ʻia a mālama ʻia me nā lāʻau antibiotic wikiwiki a ikaika, ua liʻiliʻi ka manawa e hoʻōla ai mai kēia maʻi. ʻO ia hoʻi, ʻo ka lōʻihi o ka hoʻopaneʻe ʻia ʻana o ka lāʻau lapaʻau, ʻoi aku ka koʻikoʻi o ke kūlana. Inā mālama koke ʻia a kūpono hoʻi, kiʻekiʻe ka manawa e ola ai. Eia nō naʻe, inā loaʻa nā hopena ʻaoʻao, hiki ke hoʻolōʻihi ʻia ka manawa hoʻōla.
Pehea lā ke ʻano o ke ola ma hope o ka loaʻa ʻana o ka `(Infective Endocarditis)`?
Inā ua loaʻa iā ʻoe ka Infective Endocarditis i hoʻokahi manawa, ʻoi aku ka nui o kou pilikia o ka loaʻa hou ʻana. Akā, mai hopohopo, aia kekahi mau mea hiki iā ʻoe ke hana e hōʻemi i kou pilikia:
- E palaki a hoʻohana i ka floss i ʻelua manawa i ka lā. ʻO ke olakino waha ka mea nui loa.
- E kamaʻilio me nā mea a pau, me kāu mau kauka a me ke kauka niho, e pili ana i kou pilikia o ka loaʻa ʻana o ka `(Infective Endocarditis)`. E hoʻomau i ka hoʻomaopopo iā lākou.
- E hoʻomaʻemaʻe i kou mau niho e ke kauka niho i kēlā me kēia ʻeono mahina.
- Inā loaʻa iā ʻoe ka maʻi valve puʻuwai, e hahai pono i nā ʻōlelo a kāu kauka e pale aku i ka ʻino ʻana o kāu mau hōʻailona.
ʻO ka infective endocarditis kahi maʻi bacteria i ka uhi o kou mau valves puʻuwai. ʻOiai he kūlana kakaikahi kēia, hiki ke paʻakikī ke mālama. Eia nō naʻe, hiki ke ho'ōla ʻia. Inā pilikia ʻoe, he mea nui e hōʻemi i kou pili ʻana i ka bacteria. Hiki iā ʻoe ke hana i kēia ma ka mālama pono ʻana i kou mau niho a me kou mau ʻāʻī. Inā e hana ʻoe i kahi hana lapaʻau, e kamaʻilio me kāu kauka e pili ana i nā ala e pale aku ai iā ʻoe iho.
No laila, he aha nā mea e pono ai kākou e hoʻomanaʻo mai kēia moʻolelo?
ʻAe, ua kamaʻilio nui mākou e pili ana i ka `(Infective Endocarditis)` i kēia manawa. ʻO ka mea hope loa, eia nā mea nui loa e pono ai ʻoe e hoʻomanaʻo:
* ʻO ka `(Infective Endocarditis)` he maʻi koʻikoʻi ia o ka uhi o loko o ka puʻuwai a i ʻole kona mau valves.
* ʻOiai he mea kākaʻikahi kēia, pono e mālama koke ʻia inā loaʻa.
* He mea nui loa ka hoʻomaʻemaʻe waha a me nā niho! Mai poina e palaki a hoʻohana i ka floss i kou mau niho i kēlā me kēia lā.
* Inā loaʻa iā ʻoe ka maʻi puʻuwai, e makaʻala pono i nā hōʻailona e like me ke kuni a me ka luhi.
* Ma mua o kekahi lāʻau lapaʻau, e hoʻomaopopo i kāu kauka inā ʻoe i ka pilikia no ka `(Infective Endocarditis)`.
* Mai hopohopo, akā e makaʻala. Inā ʻike mua ʻia, hiki ke mālama pono ʻia.
Inā he mau nīnau hou aku kāu e pili ana i kēia, e nīnau i kāu kauka ʻohana a i ʻole ke kauka puʻuwai. He mea nui ka puʻuwai olakino i nā mea āpau!
ʻO ka maʻi puʻuwai, nā maʻi puʻuwai, endocarditis, nā maʻi bacteria, nā valves puʻuwai, nā hōʻailona, lāʻau lapaʻau











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