He nui rawa ngā pūtau toto e whakaputaina ana e koe i roto i tō tinana? Me ako tātou mō ēnei Myeloproliferative Neoplasms (MPN)!

Kua whakaaro koe he aha ka puta mēnā he nui rawa ngā pūtau toto i roto i tō tinana e whakaputahia ana e tō hinu wheua? Koinei te āhua o ngā neoplasms myeloproliferative, arā, MPN . He mate pukupuku toto onge tēnei, engari he morearea ki te ora, ā, ka mate pea mēnā kāore e tika te whakahaere. Me kōrero tātou mō tēnei i roto i tētahi huarahi māmā e mārama ai koe.

He aha tēnei neoplasm myeloproliferative (MPN)?

I te whakarapopototanga, ko ngā neoplasm myeloproliferative (MPN) he āhuatanga e hanga ana e tō hinu wheua (he kiko ngohengohe kei roto i ō wheua) he nui ake ngā toto whero, ngā toto mā, ngā pereti toto rānei (ngā pūtau e āwhina ana i tō toto kia totoka). Whakaarohia he rite ki tētahi wheketere e whakaputa ana i te maha rawa o ngā hua. Ka puta tēnei ina he tetahi mea e hē ana i roto i te tukanga hanga toto.

He puhoi rawa te whanaketanga o ēnei āhuatanga MPN. Nō reira, kāore pea ētahi tāngata e kite i ngā tohu mō ngā tau. Koia hoki te take i huaina ai rātou he "pūmau" he neoplasm myeloproliferative roa rānei. Heoi, i ētahi wā onge, ka taea e ēnei āhuatanga MPN te whanake hei mea kino ake.

Kaua e manukanuka, he pai ngā maimoatanga hei whakahaere i ngā tohu o tēnei mate, hei ārai hoki i tōna kino haere.

He aha ngā momo MPN kei ​​reira?

He maha ngā momo MPN. Ka pā ia momo ki te momo pūtau toto e nui rawa ana te whakaputanga a tō hinu wheua. I ētahi wā, ko ngā pūtau toto whero anake ka puta, i ētahi wā, ko ngā pūtau toto mā, ko ngā pereti toto rānei ka puta. I ētahi momo MPN, ka nui rawa te whakaputanga o ēnei momo pūtau. Ko tētahi atu take, he rerekē te whanonga o ēnei pūtau nui i ngā pūtau toto hauora.

Ko wai te mea tino pāngia e tēnei āhuatanga?

Ko ētahi o ngā mea matua e pā ana ki te putanga mai o te MPN ko tō tau me tō ira tangata .

• Tau: Ahakoa ka taea e te MPN te puta i roto i ngā tāngata o ngā reanga katoa, ka kitea nuitia i roto i te hunga 50, 60, neke atu rānei te pakeke .
• Ira Tangata: Hei tauira, ko te polycythemia vera, he momo MPN, he mea noa ake i roto i ngā tāne. Ko te thrombocythemia matua he mea noa ake i roto i ngā wāhine. Ka taea e ētahi atu momo MPN te pā ki ngā ira tangata e rua.

He aha te pānga o te MPN ki tō tinana?

Ka puta ēnei mate e pā ana ki te toto ina nui ake te whakaputanga a tō hinu wheua i tētahi momo toto motuhake i tā te tinana e hiahia ana. Nō reira, ko te pānga o tēnei ki tō tinana ka whakawhirinaki ki te momo toto e whakaputahia ana i te nui rawa . Hei tauira, ka taea e tētahi momo MPN te whakanui ake i tō tūponotanga ki te pāngia e te mate manawa, te whiu rānei. Ka taea e tētahi atu momo te whakararu i te anemia.

Hei mārama ake i ēnei āhuatanga onge, he mea āwhina kia mārama ake koe ki te hanganga o tō hinu wheua me ngā pūtau toto. Ka tīmata katoa ā tātou pūtau toto hei pūtau take i roto i tō hinu wheua. Ko tēnei hinu wheua te kiko ngohengohe, he hautai kei roto i ō wheua. Ko ngā pūtau take e tupu mai ana i a ia ka huri hei pūtau take myeloid, hei pūtau take lymphoid rānei.

• Ko ngā pūtau take lymphoid ngā momo pūtau toto mā e whawhai ana ki ngā mate pāwera.
• Ka taea e ngā pūtau take myeloid te whakaputa i ngā pūtau toto whero (e kawe ana i te hāora puta noa i te tinana), ētahi atu momo pūtau toto mā, me ngā pereti toto (e āwhina ana ki te aukati i te toto ina puta).

Pērā i ngā pūtau katoa, ka mahi ēnei pūtau take i runga i ngā tohutohu i homai ki a rātou e ngā ira. I te nuinga o te wā, ka wehea, ka whakanuia ēnei pūtau take i roto i tō hinu wheua hei hanga pūtau hou. Heoi, ki te mea he whakarerekētanga i roto i ēnei ira, arā, ki te huri ngā ira, ka tukuna e aua ira ngā tohutohu hē ki ngā pūtau take kia haere tonu te wehenga me te whakanui. Ā tōna wā, ka kohia ēnei pūtau toto taikaha ki roto i te hinu wheua, ki roto rānei i ngā oko toto, ka aukati i te rere o te toto. Ina aukatia tēnei rere o te toto, ka puta pea ngā raruraru hauora nui.

He aha ngā momo MPN e tino kitea ana?

E toru ngā momo MPN e tino kitea ana: te polycythemia vera, te thrombocythemia nui, me te myelofibrosis tuatahi.

Polycythemia Vera

Koinei te momo MPN tino noa . Ka puta mai ina nui rawa ngā toto whero e hangaia ana e tō hinu wheua. Ka matotoru, ka pōturi hoki te rere o ō toto. Ko te hunga whai polycythemia vera he nui ake te mōrearea o te toto totoka. Ka taea e ēnei totoka te whakararu i te ngakau me te whiu. He tino onge, ka taea e tēnei āhuatanga te whanake hei mate pukupuku toto kino e kiia nei ko te leukemia acute.

Myelofibrosis

Koinei te momo MPN tino kaha rawa atu . I roto i te myelofibrosis, ka puta he pūtau take rerekē i roto i tō hinu wheua. Ka mumura ēnei pūtau, ā, ka puta he kiko whara i roto i te hinu wheua. I roto i te wā, ka kī te hinu wheua i tēnei kiko whara. Kātahi ka kore e taea e te hinu wheua te hanga i ngā pūtau toto whero hei kawe i te hāora puta noa i te tinana. Ka taea e tēnei te whakawhanake i te anemia. He iti hoki tō hanga pereti toto. Ka taea hoki e ētahi tāngata whai myelofibrosis te whakawhanake i te leukemia myeloid acute (AML).

Te Thrombocythemia Tino Nui

Ko te thrombocythemia nui he āhuatanga e nui rawa ai ngā pereti toto e hangaia ana e tō hinu wheua.Te Hanga. I te nuinga o te wā, ina pakaru te oko toto, ka piri tahi ngā pereti toto hei hanga i te toto totoka, hei aukati i te toto. Engari i roto i tēnei āhuatanga, ka hangaia ngā pereti totoka i roto i te hinu wheua, kāore he take. Ka taea e ēnei pereti totoka tāpiri te whakapūpū i te toto, ā, ka piki ake te mōrearea o ngā mate manawa me ngā whiu. Pērā i ētahi atu MPN, ka āta puta ngā tohu. Ko te nuinga o te tangata ka kitea tēnei āhuatanga ina whakaatuhia he taumata pereti toto teitei i roto i te whakamātautau toto noa. I roto i ētahi tāngata, ka taea e te āhuatanga te ahu whakamua ki te leukemia.

He momo MPN anō kei reira?

Āe, he maha atu anō ngā momo MPN. Ko ētahi o ēnei:

• Te mate toto toto eosinophilic mau tonu (CEL): He āhuatanga tēnei e nui rawa ai te whakaputanga o tētahi momo toto toto mā e kiia nei ko te eosinophil. I te nuinga o te wā ka puta i roto i te whēkau. I ētahi wā, ka taea te whanake hei mate toto toto myeloid acute (AML). Ka kiia hoki tēnei ko te hypereosinophilic syndrome.
• Te mate toto toto myelogenous mau tonu (CML): He momo toto toto mā tēnei e kiia nei ko ngā granulocytes, he nui rawa te whakaputa. Ka kohia ēnei pūtau, ā, ka uaua ki te hinu wheua te hanga i ētahi atu pūtau toto e tika ana.
• Te mate pukupuku toto neutrophilic mau tonu (CNL): I roto i tēnei, ka nui rawa te whakaputanga o tētahi momo toto ma e kiia nei ko ngā neutrophils.
• Te neoplasm myeloproliferative, kāore e taea te whakarōpū (MPN-U): He momo MPN tēnei kāore e uru ki tētahi o ngā wāhanga kē atu. Ka taea e ia te whakaputa nui rawa o ngā momo pūtau toto rerekē, pērā i ngā pūtau toto mā, ngā pūtau toto whero, ngā pereti toto rānei.

He aha ngā tohu o te MPN?

I ngā wāhanga tōmua, kāore pea koe e kite i tētahi tohu . I a koe e haere tonu ana te mate, ka kite pea koe i ngā tohu o te whēkau pupuhi (splenomegaly). Kei tō taha maui te whēkau i raro i ō rara. Tērā pea ka kī tonu, ka maro, ka kore e pai te ahua. Ahakoa he mea noa tēnei pupuhi o te whēkau ki te maha o ngā momo MPN, kāore i te tino noa i roto i te thrombocythemia nui.

Ka rerekē ētahi atu tohu i runga i te momo MPN .

Te mate pukupuku toto eosinophilic mau tonu (CEL)

• Ko te tohu tino kitea ko te ponana kiri .
• Tērā pea ka pāngia koe e te ngenge me te kirika.
• Ko ētahi atu tohu e whakawhirinaki ana ki ngā wāhanga o tō tinana e pāngia ana e ō taumata eosinophil teitei.

Te mate pukupuku toto myelogenous mau tonu (CML) me te mate pukupuku toto neutrophilic mau tonu (CNL)

• Mamae wheua
• Te werawera o te pō
• Te kirika me te ngenge
• Ngāwari te marō
• Te ngaronga o te hiahia kai me te mate taimaha

Te toto toto nui

• Ngāwari te marō
• Te toto mai i te ihu, te waha, te kapia rānei, kāore he take
• Te toto mai i te puku, i ngā whekau rānei
• Te toto i roto i te mimi

Polycythemia vera

• Ānini
• Pōuriuri
• Ngenge
• Te tirohanga pōuri, te tirohanga takirua rānei

Myelofibrosis tuatahi

• Tērā pea ka puta ngā tohu o te anemia (te ngenge, te ngoikore, te poto o te manawa).
• Ētahi atu āhuatanga:
• Kiri mā
• Te werawera o te pō
• Kirika
• Kiri mākūkū
• Te kai nui, te mākona wawe rānei i muri i te kai (te mākona wawe)
• Te whakahekenga taumaha
• Mamae wheua

He aha ngā take o te MPN?

He mate ira whiwhi ngā āhuatanga MPN katoa. Ko te tikanga, ehara i te mea i riro mai i ō mātua. Ka puta ēnei ina puta he whakarerekētanga ira, i ngā whakarerekētanga rānei i roto i ngā ira e whakahaere ana i te tipu o ngā pūtau, ka puta ai te tipu hē o ngā pūtau toto.

Kua kitea e ngā kairangahau hauora ēnei kitenga e whai ake nei mō ngā whakarerekētanga ira e puta ai te MPN:

• Ngā whakarerekētanga Janus kinase (JAK): Ko ngā āhuatanga pēnei i te polycythemia vera, te myelofibrosis tuatahi, me te thrombocythemia matua, he maha ngā wā ka puta mai i ngā whakarerekētanga o te ira e kiia nei ko te Janus kinase 2 (JAK2) . Ka taea e tēnei whakarerekētanga te wehewehe i ngā pūtau me te kore e taea te whakahaere.
• Ngā whakarerekētanga ira i roto i te ira MPL, i te ira CALR rānei: Ko te hunga whai thrombocythemia matua me te myelofibrosis tuatahi he maha ngā whakarerekētanga ira i roto i tō rātou ira MPL, i te ira CALR rānei.
• Ngā hapa ira: Ko te hunga whai mate pukupuku toto myelogenous mau tonu (CML) he hapa motuhake kei roto i ā rātou ira (te hanganga kei roto ngā ira). I roto i te CML, ka whakawhitihia tetahi wahi o tētahi ira ki tētahi atu ira, ka hanga he "ira Philadelphia."

Ahakoa kāore ēnei kitenga e whakamārama tika ana i te pūtake o ngā huringa ira, ka āwhina i ngā tākuta ki te tautuhi i ngā mate me te whakawhanake i ngā maimoatanga e aro ana ki ēnei whakarerekētanga ira.

He aha ngā āhuatanga mōrearea mō te MPN?

Mā te hītori whānau o te mate (ahakoa he mate whiwhi ēnei, tera pea ētahi whānau e whakaatu ana i tētahi āhuatanga ngāwari), te tau, me te ira tangata ka piki ake te mōrearea ki te whakawhanake i te MPN.

Kua kitea hoki e ngā kairangahau ngā hononga i waenga i te MPN me te pānga ki ētahi paitini me te irahiko . E whakaatu ana ētahi rangahau ko te hunga e pāngia ana e ngā taumata teitei o te irahiko me ētahi paitini, pērā i te benzene, ka nui ake te mōrearea ki te whakawhanake i ngā MPN, pērā i te polycythemia vera, te myelofibrosis tuatahi, me te leukemia myelogenous mau tonu.

Me pēhea te tātaritanga o te MPN?

Ka pātai tō tākuta mō ō tohu me tō hītori hauora. Kātahi ka tirotirohia ō tohu o te MPN. Ka whakamātauria ō toto me tō hinu wheua hei tautuhi i te mate.

• Te tatau toto katoa (CBC):Ka inehia e tēnei ngā taumata o ō momo pūtau toto katoa. I roto i te thrombocythemia matua, ka tirohia ngā taumata o ngā pereti toto. I roto i te polycythemia vera, ka tirohia te hemoglobin (he pūmua kei roto i ngā pūtau toto whero), me ngā taumata o ngā pūtau toto mā me ngā pereti toto.
• Te whakamātautau toto ā-taha (PBS): Ka taea e tēnei whakamātautau te rapu i ngā āhua rerekē o ngā pūtau toto, ka taea te whakarato tohu mō tētahi mate hauora.
• Ngā whakamātautau matū toto: Ka taea e ēnei te ine i ngā taumata o ngā matū rerekē (pērā i ngā pūmua, ngā whākōkī, me te hukahuka) i roto i ō toto. Ka taea e ēnei tau te whakaatu i ngā tohu mō te mahi a ō whekau, ka ara ake ai te whakapae mō te MPN.
• Te koiora wheua wheua: Tērā pea ka whakahaerehia e tō tākuta he tangohanga wheua wheua, he koiora wheua wheua rānei. Ko te tikanga o tēnei ko te tango i tētahi tauira o tō wheua wheua, ka tirotirohia mō ngā pūtau toto. Kātahi ka tirotirohia e ngā tākuta mate pukupuku ngā pūtau toto me te kiko i raro i te karuārai hei rapu i ngā rerekētanga i waenga i ngā pūtau noa me ngā pūtau rerekē. Ka rapua hoki e rātou ngā pūtau take rerekē. Ka rapua hoki e rātou ngā huringa ira me ētahi atu momo ira e tohu ana i tētahi momo MPN.
• Whakamātautau ira: Ka taea e ngā tākuta te tātari i ō pūtau toto kia kite ai mēnā he huringa kei roto i ngā ira e pā ana ki te hanga pūtau toto.

Ka taea te whakaora katoa i te MPN? He aha ngā maimoatanga?

Ko te whakawhitinga pūtau take allogeneic anake te rongoā whakaora e wātea ana mō ēnei mate . Engari, he tokomaha ngā tāngata kāore e taea te mahi i tēnei whakawhitinga pūtau take nā te mea he mahi uaua, he mahi uaua hoki.

Ka tohua e tō tākuta ngā maimoatanga hei whakahaere i tō āhua, hei whakaiti i te maha o ngā pūtau toto, hei whakaora i ngā tohu, hei ārai hoki i ngā raruraru. Ka taea e ētahi maimoatanga te whakaiti i te mate. He rerekē ngā maimoatanga mō te MPN i runga i te momo:

• Te mate pukupuku eosinophilic mau tonu (CEL): Ka whakamahia pea e tō tākuta te chemotherapy, te corticosteroids, te immunotherapy rānei hei whakaiti i ō taumata eosinophil.
• Te mate pukupuku toto myelogenous mau tonu (CML): Ko te maimoatanga e whakamahia whānuitia ana ko te rongoā arotahi, e aukati ana i te whakanui haere o ngā pūtau. Ko ētahi atu maimoatanga ko te chemotherapy, te immunotherapy, te radiation therapy, me ngā whakawhitinga pūtau take.
• Te mate pukupuku toto neutrophilic mau tonu (CNL): Ka uru pea ki te maimoatanga te chemotherapy, te immunotherapy, me ngā whakawhitinga pūtau take.
• Te thrombocythemia nui:Ki te kore he tohu e pā mai ana ki a koe, ka whakatau pea tō tākuta ki te aro turuki i tō āhua, kaua ki te tuku rongoā. Ki te pā mai he tohu, me tango pea e koe he rongoā hei aukati i te whakanui haere o ngā pūtau. Me tango pea hoki e koe he rongoā hei whakaiti i te tūponotanga o te toto totoka, hei aukati rānei i te hanga nui rawa o ngā pereti toto i roto i tō hinu wheua.
• Polycythemia vera: Ko te phlebotomy te maimoatanga tino noa mō te polycythemia vera. I roto i tēnei tikanga, ka tangohia e tō tākuta he iti noa te toto (pēnei i te whakawhiti toto) hei whakaiti i te nui o tō toto me te tango i ngā toto toto whero nui rawa atu. Mena he tohu kei a koe, ka hoatu pea he rongoā arotahi ki a koe hei aukati i te whakanui haere o ngā pūtau. Ka hoatu pea hoki he rongoā ki a koe hei whakaiti i te mōrearea o te toto totoka (pēnei i te aspirin) he rongoā rānei hei whakaiti i te maha o ngā toto toto whero.
• Myelofibrosis tuatahi: Mena kāore he tohu, ka whakatau pea tō tākuta ki te aroturuki tata i tō āhua. He maha ngā tikanga, ngā rongoā rānei ka taea te whakamahi hei rongoā i te anemia. Hei tauira, ki te kore e nui ngā toto whero e hangaia ana e tō hinu wheua, me whakawhiti toto pea koe. Me tango pea koe i ngā rongoā e whakaoho ana i te hinu wheua kia nui ake ngā toto. Ko ētahi atu maimoatanga ko te rongoā arotahi, te chemotherapy, te immunotherapy, te radiation therapy, me te whakawhitinga pūtau take.

Kia pēhea te roa e ora ai te tangata whai MPN?

He rerekē rawa tēnei i ia tangata, i ia tangata . He maha ngā āhuatanga e pā ana ki tēnei, tae atu ki te momo MPN, te wawe o te tautuhi i te mate, me te pai o tō urupare ki te maimoatanga. Mēnā he pai te aroturuki me te maimoatanga, he maha ngā tāngata e ora ana mō ngā tau maha . Kāore he matapae kotahi, he putanga rānei e tumanakohia ana mō ēnei āhuatanga. I te nuinga o te wā, ko te nuinga o te hunga kua tautuhia he MPN kei ​​te ora tonu i muri i ngā tau e rima.

Ko ngā reiti oranga mō ngā momo MPN motuhake e whai ake nei:

• Te mate toto toto myelogenous mau tonu (CML): Kua tino piki ake te auau oranga e pā ana ki te CML nā te angitu o ngā maimoatanga hou kua arotahihia. Ko te auau oranga e rima tau mō te CML he 90%.
• Te mate toto toto korehau mau tonu (CNL) me te polycythemia vera: Ki te pai te whakahaere, ko te nuinga o te iwi e ora ana i te toharite o te 20 tau i muri i te tautuhi.
• Te thrombocythemia nui: He maha ngā tāngata e ora ana mō ngā tau maha ina tango rātou i ngā rongoā hei ārai i ngā raruraru morearea pēnei i te toto totoka.
• Myelofibrosis tuatahi: Ko te nuinga o te hunga e pangia ana e te myelofibrosis tuatahi ka ora i te rima ki te tekau tau i muri i te tautuhi.

Mena kei a koe tēnei mate, pātai atu ki tō tākuta mō tō matapae. Ko rātou te hunga e mōhio ana ki ngā āhuatanga katoa e pā ana ki te matapae. Ā, ko te mea nui, e mōhio ana rātou ki a koe, ki tō tau, me tō hauora whānui, tae atu ki ngā āhuatanga mōrearea e pā ana ki te matapae.

He mate whakamate ēnei mate?

Ehara ēnei i te mate whakamate i a rātou anō , engari ko ētahi momo MPN ka pā mai he raruraru morearea pērā i te mate manawa me te whiu.

He aha ngā pātai me pātai atu e au ki taku tākuta?

He mate uaua te MPN. He maha ngā kōwhiringa maimoatanga, ā, i ētahi wā he pānga taha. Waihoki, he maha ngā raruraru ka puta i runga i tō āhua. He mea nui kia mōhio koe ki ngā tohumate me mōhio koe. Kōrero ki tō tākuta kia mārama ai koe ki tō mate me te whakatau i ngā whakatau mō te maimoatanga.

Ko ētahi pātai ka taea e koe te pātai:

• He aha te whāinga o te maimoatanga (hei whakaora i te mate, hei whakaiti i ngā tohu, hei ārai i ngā raruraru, me ētahi atu)?
• He aha aku kōwhiringa maimoatanga?
• He aha ngā pānga taha ka puta mai i te maimoatanga?
• Kia pēhea te roa e hiahiatia ana ahau kia rongoatia mō tōku āhua?
• Kia pēhea te auau o ngā whakamātautau (whakaahua, mahi toto rānei) hei aroturuki i tōku āhua?
• He aha ngā tohu hei āwhina i ahau ki te mōhio kei te pai haere, kei te kino haere rānei tōku āhua?
• He aha ngā tohu e whakatūpato ana i ahau mō tētahi raruraru?
• He aha ngā raruraru e hiahia ana ki te maimoatanga hauora ohorere?
• He aha te matapae e tumanakohia ana mō tōku āhua?
• He aha ngā huringa āhua noho e taunaki ana koe hei whakahaere i tōku āhua me ngā pānga taha o te maimoatanga?

Me pēhea taku tiaki i ahau anō? (Ētahi mea nui māu)

He āhua pōhēhē te noho me te MPN i ētahi wā. Tērā pea kei te pai koe, ā, kāore he raruraru, engari tērā pea ka whakaaro koe mēnā he mea ka taea e au te mahi hei ārai i ngā tohu. Mēnā kei te whiwhi maimoatanga koe, me āwhina pea koe ki te whakahaere i ngā pānga taha o te maimoatanga me ngā tohu. Heoi anō, me noho koe me tēnei mate mō ngā tau maha kei te heke mai. Anei ētahi whakaaro hei āwhina i a koe:

• Kia mārama ki tō āhua hauora: He rite tonu ngā tohumate o te MPN ki ērā o ētahi atu mate kāore i te tino kino. Ko ētahi tohumate he tohu pea mō ngā raruraru hauora nui. He uaua ki te kite i te rerekētanga, ā, tera pea ka rite koe ki te ngaro i ngā tohu nui. Pātai atu ki tō tākuta kia whakamārama mai me pēhea te pānga o tēnei mate ki a koe. Mā te mōhio ki ngā mea hei tumanako atu ka āwhina i a koe kia māia ake mō tō āhua.
• Whakahaerehia tō ahotea: Ka taea e te noho me te mate roa te whakararuraru. Mena kei te āwangawanga koe mō tō āhua, kōrero ki tō tākuta mōna. Ka taea e rātou te whakamārama i ngā mea ka taea e rātou te mahi hei āwhina i a koe i nāianei me ngā mea ka taea e rātou te mahi hei āwhina i a koe ā muri ake nei.
• Kai i tētahi kai hauora taurite:Mā te kai pai koe e āwhina ki te whakahaere i tō āhua. Kōrero ki tētahi tohunga kai mēnā e hiahia ana koe ki te āwhina ki te whakawhanake i ngā tikanga kai hauora.
• Whakakorikori tinana: He huarahi pai te whakakorikori tinana hei whakahaere i te ahotea.
• Kimihia he tautoko: He mate onge te MPN. He huarahi pai ngā rōpū tautoko ki te hono atu me te kōrero ki te hunga e mōhio ana ki ō wheako.

Kia maumahara, ahakoa tēnei āhua, ka taea tonu e koe te noho ora pai mā te mōhio me te whai i ngā tohutohu hauora.

Āhea ahau me toro atu ki te tākuta?

Mena kei a koe te MPN engari kāore he tohu, ki te kite rānei koe i ngā huringa o tō tinana e tohu ana i ngā tohu, me toro atu ki tō tākuta tonu.

He mea ngaro te MPN. E mōhio ana ngā kairangahau he hononga te MPN ki te tipu toto rerekē. E mōhio ana hoki rātou he mate ira ēnei, engari kāore anō kia mōhiotia te pūtake tuturu o ngā whakarerekētanga ira e puta ai te MPN . Nā te mea he mate onge ēnei, he tokomaha te hunga kāore e mōhio ki te āhua o te noho me te MPN. Engari kei te ako atu ngā tākuta me ngā kairangahau mō te MPN, inā koa mō ngā huarahi whai hua ake hei whakahaere i ngā tohu me te whakaiti i te tūponotanga o ngā raruraru hauora nui. Nō reira, kaua e mutu te tumanako .

` Ngā pūtau toto nui, MPN, matepukupuku toto, hinu wheua, toto whero, toto mā, pereti toto, tohu, maimoatanga