He raruraru homoni tāu tamaiti? Me kōrero tātou mō tētahi tākuta hinengaro tamariki!

I ētahi wā ka whakaaro tātou ki ngā mate e pā ana ki ā tātou tamariki, ina koa he ahua uaua, ka nui te taumahatanga o ō tātou ngākau, kāore? He rite tonu ngā raruraru e pā ana ki ngā homoni. Engari kāore he take e manukanuka ai. Nā te mea he tohunga kei reira hei āwhina i a koe me tāu tamaiti i ngā wā penei. Koinei te momo tangata he tākuta endocrinologist tamariki , e ai ki tā mātou i te reo Pākehā, he "Pediatric Endocrinologist". Nō reira, i tēnei rā, me kōrero tātou mō tēnei tohunga.

Ko wai te tohunga endocrinologist tamariki?

I ngā kupu māmā noa iho, he tākuta te tohunga homoni tamariki e tātaritanga ana, e rongoā ana hoki i ngā mate e pā ana ki ngā homoni i roto i ngā tamariki me ngā taiohi , arā, ngā raruraru o te pūnaha endocrine. Mena kei te pāngia tō tamaiti e ngā raruraru o te pakeketanga , ngā raruraru tipu , ngā āhuatanga pēnei i te mate huka , tetahi atu āhuatanga rānei e pā ana ki ngā homoni me ngā repe e whakaputa ana i aua mea, ka taea e tēnei tohunga te āwhina.

Na he aha te tikanga o tēnei endocrinology?

Ko te Endocrinology te peka o te rongoā e ako ana i te pūnaha endocrine i roto i tō tātou tinana. He mea hanga tēnei pūnaha i ngā repe endocrine, ngā whekau endocrine, me ngā homoni. Whakaarohia he huarahi motuhake tēnei mō ō tātou tinana ki te tuku karere.

Ngā Repe Endocrine

He kiko motuhake ēnei i roto i tō tātou tinana e whakaputa ana i ngā homoni, ā, e tuku ana i aua homoni ki roto i te toto. He maha ngā momo matua o ngā repe:

• Ngā repe adrenal: He repe iti ēnei e rua kei runga ake i ō tātou whatukuhu. Ka whakaputahia e rātou ngā homoni e aro ana ki te ahotea, me ngā homoni hoki e whakahaere ana i ngā taumata tote.
• Repe pituitary : Ko tēnei repe iti, rite ki te wheua, kei raro noa i te roro, e whakahaere ana i ngā repe maha atu, nō reira i ētahi wā ka kiia ko te "repe matua".
• Tairoiti : Kei mua o te kaki tēnei repe āhua pūrerehua e whakaputa ana i ngā homoni e whakahaere ana i te tere o te whakamahinga o te pūngao e te tinana.
• Ngā repe parathyroid: Ko ēnei repe iti e whā kei muri i te repe thyroid ka whakahaere i ngā taumata konupūmā i roto i te tinana.

Ngā whekau Endocrine

Ka whakaputa hoki ēnei whekau i ngā homoni me te mahi i ētahi atu mahi motuhake.

• Repeure : Kei te puku o runga tēnei okana e pā ana ki te mate huka.Ka whakaputahia e ia te homoni insulin .
• Hypothalamus: Ko tēnei wāhanga o te roro e whakahaere ana i te repe pituitary.
• Ngā whekau : He wāhanga o te pūnaha whakaputa uri wahine e whakaputa ana i ngā homoni ira tangata.
• Ngā whakamātautau : He wāhanga o te pūnaha whakaputa uri tāne e whakaputa ana i ngā homoni ira tangata.

Ngā homoni

He rite ngā homoni ki ngā karere matū i roto i ō tātou tinana. Ka haere rātou mai i tētahi repe ki tētahi atu mā roto i te toto, ā, ka pā ki tētahi atu okana, ki tētahi kiko rānei. He maha ngā tukanga nui e pā ana ki ngā homoni i roto i ō tātou tinana. Anei ētahi tauira:

• Te Pūnaha Whakaora : Ko te tukanga e hurihia ai e te tinana te kai hei pūngao, ā, ka whakamahia ai taua pūngao.
• Te tipu: Te ara e roa ai tātou, me te tipu o ō tātou tinana.
• Te whakaputa uri ā-ira tangata: Ngā mea pēnei i te pakeketanga me te kaha ki te whakaputa uri.
• Moe: Te whakahaere i ā tātou huringa moe me te ara ake.

He aha te rerekētanga i waenga i te tohunga homoni tamariki me te tohunga homoni whānui?

He take tino nui tēnei. Ehara ngā tamariki i te hunga nohinohi. He rerekē rawa te tipu o ō rātou tinana me te mahi a ā rātou homoni i ngā pakeke. Tērā pea he rerekē ngā raruraru homoni e pā ana ki ngā tamariki i ērā e pā ana ki ngā pakeke. Ko ngā tohunga homoni tamariki he tākuta kua whiwhi whakangungu motuhake mō te pānga o ēnei raruraru homoni ki te tipu me te whanaketanga o ngā tamariki. Nō reira, ka taea e rātou te whakarato maimoatanga motuhake mō ngā tamariki.

He aha te mahi a te tohunga homoni tamariki? He aha ngā mate e rongoatia ana e rātou?

Ka tātaritanga, ka rongoā, ka whakahaere hoki te tohunga endocrine tamariki i ngā momo āhuatanga e pā ana ki te pūnaha endocrine o te tamaiti. Me titiro tātou ki ētahi o ēnei āhuatanga.

Ngā mate o te repe adrenal

He maha ngā homoni nui e whakaputaina ana e ō tātou repe adrenal. Ko ētahi o ngā raruraru ka pā ki ēnei repe ko:

• Te mate a Addison: Ka puta tēnei ina kore te tinana o te tamaiti e whakaputa i ngā homoni e rua, arā, te cortisol (he homoni e aro ana ki te ahotea) me te aldosterone (he homoni e whakahaere ana i ngā taumata tote).
• Te hyperplasia adrenal whānau: He āhuatanga ira tēnei e pā ana ki te whakaputanga a te tamaiti i ngā homoni cortisol, aldosterone, me te androgen (he momo homoni tāne).
• Te mate a Cushing:Ka kiia hoki tēnei ko te `(Hypercortisolism)`. Ko te mea e tupu ana i konei, ka nui rawa te homoni `(Cortisol)` e whakaputaina ana e te tinana o te tamaiti.

Ngā āhuatanga o te wheua me te konupūmā

He maha ngā homoni e whai wāhi ana ki te pupuri i te kaha o ō tātou wheua, me te pupuri i ngā taumata konupūmā tika.

• Hypercalcemia: He āhuatanga e teitei ake ai te taumata konupūmā i roto i te toto o te tamaiti i te mea noa.
• Hypocalcemia: He āhuatanga e iti iho ai te taumata konupūmā i roto i te toto o te tamaiti i te mea noa.
• Rīketia: He mate tēnei e puta mai ana i te korenga o te Huaora D. Ka ngoikore pea ngā wheua o ngā tamariki, ka piko hoki.

Te mate huka me ngā āhuatanga pākia

Ka rongoatia hoki e ngā tohunga homoni tamariki ngā raruraru e pā ana ki te pākia o te tinana, arā, te hanga pūngao. He mate tino noa te mate huka.

• Mate huka momo 1: Koinei te wā e whakangaromia ai e te pūnaha ārai mate o te tamaiti (whakaekenga ārai mate) ngā pūtau o te repe taiaki e hanga ana i te insulin. Nō reira, kāore e taea e te repe taiaki te hanga i te insulin.
• Mate huka momo 2: I tēnei āhua, ka whakaputa te repe taiaki i te insulin, engari kāore e taea e te tinana te whakamahi tika. He maha ngā wā ka honoa tēnei ki te momonatanga.
• Momona: He āhuatanga uaua, he roa te wā e kohia ai te ngako nui rawa o te tinana, ā, he kino ki te hauora. Ka honoa anō hoki tēnei ki te kore taurite o ngā homoni.

Ngā mate o te whanaketanga ira tangata

I ētahi wā, ka pāngia pea ngā tamariki e ngā āhuatanga rerekē o te whanaketanga ā-ira tangata. Hei tauira, he āhuatanga e kiia nei ko te momo ira tangata kāore i te āhua noa. He āhuatanga ira tangata onge tēnei. I tēnei wā, kāore pea te ira tangata o waho o te tamaiti e rite ki te āhua tāne, wahine rānei, engari ka puta pea i waenganui. Ka taea e te tohunga homoni tamariki te tātaritanga i ēnei āhuatanga me te whakarato i ngā tohutohu me ngā maimoatanga e tika ana.

Ngā mate endocrine ira

Ka taea te whakaputa i ētahi raruraru homoni e ngā āhuatanga ira.

• Te mate Turner: Ka pāngia ngā kōtiro anake e tēnei mate. Kua ngaro tetahi, kua ngaro katoa rānei ō rātou ira X. Ka pā tēnei ki ngā mea pēnei i te tipu me te mahi o te whatukuhu.
• Te mate Prader-Willi: He mate ira anō hoki tēnei. Ka pā ki te pākia o te tinana o te tamaiti, ka puta he huringa tinana me te whanonga (hei tauira, te hiakai nui, ngā raruraru tipu).

Ngā raruraru e pā ana ki te tipu me te pakeketanga

He mea tino nui ngā homoni mō te tipu me te whanaketanga o te tamaiti, kia eke ai rātou ki te pakeketanga i te wā tika. Ko ngā raruraru ka puta ake i tēnei āhuatanga ko:

• Te roa poto:He poto ake te tamaiti i te 95% o ngā tamariki o te tau me te ira tangata kotahi. He maha ngā take mō tēnei, ko tētahi o ēnei ko te koretake o ngā homoni.
• Te pakeketanga o mua : Ki te whakaatu te kōtiro i ngā tohu o te pakeketanga (hei tauira, te whanaketanga o ngā ū i roto i ngā kōtiro, te whakanui o ngā rauropi i roto i ngā tama) i mua i te 8 tau te pakeke, i te tama rānei i mua i te 9 tau te pakeke, ka kiia he pakeketanga o mua.
• Te roa o te pakeketanga : Ki te kore e tīmata te pakeketanga tae noa ki te roa rawa atu i te wā noa, arā, kāore anō te kōtiro kia whakaatu i ngā tohu o te pakeketanga i te 13 tau te pakeke, te tama rānei i te 14 tau te pakeke, tera pea he roa te pakeketanga.

Ngā mate o te repe pituitary

E ai ki tā tātou i kōrero ai i mua, he maha ngā homoni nui e whakaputaina ana e te repe pituitary. Mēnā he raruraru kei te mahi a tēnei repe, ka puta ake ngā tohu maha.

• Mate huka insipidus: Kāore tēnei i rite ki te mate huka. Ko te mea ka tupu i konei ko te nui rawa o te mimi e ngaro ana i te tinana, ā, kāore e taea te pupuri tika i te wai. Ko te matewai nui tētahi o ngā tohu o tēnei.
• Te ngoikore o te pituitary gland: Ka pāngia te tipu, te mahi tairoi, te mahi adrenal, te pakeketanga, me te whakahaere i te matewai e te korenga o te whakaputanga iti o tētahi, neke atu rānei o ngā homoni e te repe pituitary gland.

Ngā mate o te tairoi

Ahakoa he iti, he nui rānei te nui o ngā homoni e hangaia ana e te repe tairoi, ka puta ake ngā raruraru.

• Te mate puku: He repe tairoiti kua rahi. Ka pā tēnei ki ngā āhuatanga katoa e noho noa ana, e iti ana, e teitei ana rānei ngā taumata homoni.
• Hypothyroidism: Kāore e nui ngā homoni thyroid e tukuna ana e te repe thyroid ki roto i te toto. Ka taea e tēnei te whakaroa i te mahi a te tinana, te whakanui i te taumaha, me te mate puku.
• Hyperthyroidism: He āhuatanga e nui rawa ai te homoni thyroid e whakaputaina ana e te repe thyroid, ā, ka tukuna ki roto i te toto. Ka tere ake te manawa o te ngakau, ka heke te taumaha, ka nui haere te werawera.

He aha ngā mea ka tumanakohia e koe ina toro atu koe ki tētahi tohunga homoni tamariki mō te wā tuatahi?

Ina tūtaki tuatahi kōrua ko tāu tamaiti ki tētahi tohunga homoni tamariki, ka pātai nui te tākuta ki a koe mō ngā tohumate o tāu tamaiti, ōna hītori hauora whānau, me ngā rongoā e tangohia ana e tāu tamaiti i tēnei wā . Ka tirotirohia anō hoki e ia tōna tinana . I ētahi wā, ka tūtohutia pea kia whakamātauria he whakamātautau toto me he matawai. Kaua e manukanuka, ka mahia ēnei katoa kia pai ake ai te mārama ki te āhua o tāu tamaiti.

Ko te mea nui ko te kōrero i ngā kōrero katoa e mōhio ana koe ki te tākuta , ahakoa te iti. Mā tēnei ka āwhina i a rātou ki te whakatau tika i te mate.

Me pēhea koe e noho ai hei tohunga homoni tamariki?

He mea pai hoki kia mōhio ki tēnei. Ko te tākuta endocrinologist tamariki he tangata e whakaoti ana i te tohu hauora whānui (4-5 tau) kātahi ka whai whakangungu motuhake i roto i te pediatrics (tata ki te 3 tau). Whai muri i tēnā, me whai anō rātou i ētahi atu 3 tau o te whakangungu motuhake (fellowship) i roto i te pediatric endocrinology, arā, ngā mate homoni tamariki. Me whakaaetia hoki tēnei whakangungu e te kaunihera mātauranga hauora whaimana (pēnei i te Accreditation Council of Graduate Medical Education - ACGME). Hei tāpiri, ko te tiwhikete mai i ngā whare whaimana pēnei i te American Board of Pediatrics (ABP) e whakaū ana i ō rātou tohungatanga. Nā tēnei whakangungu roa ka whiwhi rātou i te mātauranga hōhonu mō tēnei mara uaua.

Engari i tō tātou whenua, arā, i Sri Lanka, he rerekē te huarahi hei noho hei Kaitohutohu Endocrinologist Paediatric. Mā te PGIM (Post Graduate Institute of Medicine) e hono ana ki te Whare Wānanga o Colombo ka mahia.

I Sri Lanka, ko te raupapa o tēnei haerenga koia tēnei:

1. Ngā Tohu Paetae Taketake (MBBS me te Mahi Tauira): Tuatahi, me whiwhi koe i te tohu MBBS mai i tētahi kura hauora, whakaoti i tētahi mahi tauira ā-ture, ā, me rēhita ki SLMC.

2. Whakamātautau Whakauru (Whakamātautau Kōwhiri): Kātahi ka puta koe i te "Whakamātautau Kōwhiri MD (Paediatrics)" e whakahaerehia ana e PGIM. He whakamātautau whakataetae tēnei.

3. Whakangungu Tamariki Whānui - Kai-Rehita: Kia puta koe i te whakamātautau, e toru tau pea tō whakangungu (wā Kai-Rehita). I roto i tēnei, ka ako koe i te nuinga o ngā mea mō ngā tamariki whānui.

4. Whakamātautau MD: I te mutunga o ēnei tau e 3, ka tū te "Whakamātautau MD (Paediatrics)". Ko te angitu i tēnei ko te tohu matua hei "tākuta tohunga".

5. Kōwhiringa Tohunga-iti: I muri i te whiwhinga i te tohu MD, me whakatau te tangata ko tēhea te huarahi e haere ai. I reira, me whiriwhiri te tohungatanga-iti e kiia nei ko te "Paediatric Endocrinology" (ngā homoni tamariki). (Kei te wātea tēnei i runga i te Hiranga me ngā wāhi wātea).

6. Whakangungu Whai muri i te MD - Kai-Rehita Matua: Koinei te wāhi ka tīmata ai te whakangungu motuhake mō ngā homoni. E rua, e toru rānei ngā tau e pau ana mō tēnei.

   • Whakangungu ā-Rohe:Me mahi koe mō te tau kotahi i tētahi wāhanga homoni tamariki i tētahi hōhipera nui i Sri Lanka.

   • Whakangungu ki tāwāhi: Me whiwhi koe i te whakangungu mō te tau, e rua rānei ki tāwāhi (i te UK, i Ahitereiria rānei i ētahi wā) i tētahi pokapū whai mana.

7. Tiwhikete Poari: Kia oti katoa ēnei mea, ka whai tiwhikete koe hei "Tohunga Rongoā Tamariki Whai Tiwhikete Poari" nā PGIM.

Nō reira, pērā i te tukanga whānui i kōrerotia i mua ake nei, i Sri Lanka anō hoki, he haerenga tēnei e hiahia ana ki te nui o te whakapau kaha mō ētahi atu tau 6-7 i muri i te MBBS.

Nā, he aha te mea tino nui hei maumahara mā tātou i roto i ngā kōrero kua kōrerotia nei? (Karere hei tango ki te kāinga)

• Ki te whakaaro koe he raruraru tāu tamaiti e pā ana ki ngā homoni, te tipu, te pakeketanga, te mate huka rānei, me toro atu ki tō tākuta whānau, ki tō tākuta tamariki rānei i te tuatahi.
• Ki te whakaaro rātou he mea tika, ka tukuna koe e rātou ki tētahi tākuta hinengaro tamariki.
• He tākuta ēnei tohunga , he mātauranga motuhake, he whakangungu hoki ō rātou mō ngā raruraru homoni o ngā tamariki. Ka taea e rātou te tātari tika i te āhua o te tamaiti, me te whakarato i te maimoatanga me ngā mahere whakahaere pai rawa atu.
• Kia maumahara, he rerekē ngā raruraru homoni o ngā tamariki i ērā o ngā pakeke, nō reira he mea nui kia rapu awhina mai i te tohunga.

Nō reira, ki te pāngia tō tamaiti e tētahi o ēnei āhuatanga, kaua e mataku, engari me rapu tohutohu hauora tika. He otinga mō ngā mea katoa! Ngā Homoni, Ngā Tamariki, Te Tipu, Te Puāwaitanga, Te Mate Huka, Te Pūnaha Endocrine, Ngā Tohunga Homoni Tamariki