Ingabe iziguli zezinso ziyazi ngalokhu uma zithola i-MRI? Ake sixoxe nge-Nephrogen Systemic Fibrosis (NSF)!

Ingabe unezinkinga zezinso? Noma ingabe udokotela ukutshelile ukuthi izinso zakho azisebenzi kahle? Ngezinye izikhathi, uma kufanele uskene njenge-Magnetic Resonance Imaging (MRI), udinga ukuqaphela kancane ngedayi ekhethekile esetshenziswayo. Namuhla, sizokhuluma ngesimo esingase senzeke ngezikhathi ezinjalo, kodwa esingavamile kakhulu manje, kodwa kufanelekile ukwazi ngaso. Lokhu kubizwa ngokuthi i-Nephrogenic Systemic Fibrosis (NSF).

Iyini le NSF (Nephrogenic Systemic Fibrosis)? Kalula nje...

Kalula nje, i-Nephrogenic Systemic Fibrosis (NSF) iyisimo esingavamile kakhulu. Sivame kakhulu kubantu abanesifo sezinso, ikakhulukazi labo abanenkinga yokusebenza kwezinso. Lesi simo singavela kuphela ngemva kokuba umuntu enikezwe ama-gadolinium-based contrast agents (GBCAs) ngesikhathi sokuskena, njenge-MRI, ukuze kwenziwe izithombe zicace.

Cabanga ngakho, izinso zethu yizo ezihlunga izinto ezingafuneki emzimbeni wethu bese ziphuma nomchamo. Ngakho-ke, lapho lezi okuthiwa "ama-GBCA" zingena emzimbeni womuntu onso zakhe zingasebenzi kahle, azikhishwa kahle emzimbeni. Yilapho-ke kuvela khona ingozi ye-NSF.

Uyazi ukuthi yini ebangela i-NSF? Isikhumba sakho singaba sikhulu, siqine, sivuvuke, futhi silume. Ngezinye izikhathi, ngisho namalunga angaba lukhuni futhi avaleleke endaweni eyodwa. Lokhu kubizwa ngokuthi "i-joint contracture". Akukhona lokho kuphela, kodwa nakwabanye abantu, lesi simo singathinta nezitho zomzimba ngaphakathi komzimba, njengemisipha yesifuba, inhliziyo, namaphaphu. Okwenzekayo ukuthi izicubu ezizungeze lezo zitho nazo ziyaqina futhi ziqine.

Into ebaluleke kakhulu ukuthi, uma i-NSF isivele ikhona, okwamanje akukho ukwelashwa okucacile kokuyimisa noma ukuyibuyisela emuva.

Kodwa, ungakhathazeki! Ngisho ne-US Food & Drug Administration (FDA) ikweluleke kakhulu ukusetshenziswa kwama-GBCA amadala ezigulini zezinso. Ama-GBCA amasha emakethe awabikwanga ukuthi abangela i-NSF ezigulini zezinso. Lokho kuyimpumuzo enkulu.

I-NSF ivame kangakanani manje?

Eqinisweni, kuyinto engavamile kakhulu manje. Eqinisweni, azikho izigameko ezintsha ze-NSF ezibikiwe eminyakeni engaphezu kwe-10. Ngemva kuka-2006, lapho umphakathi wezokwelapha uqaphela ukuxhumana phakathi kwalawa "(ama-GBCA)" nesifo sezinso, inani lemibiko yalesi sifo lehla kakhulu.

I-NSF ikhula kanjani? Ziyini izimpawu?

Izimpawu ze-NSF zingavela ngosuku olufanayo lapho ama-gadolinium-containing contrast agents (GBCAs) efakwa khona emzimbeni. Noma, zingavela ezinyangeni kamuva. Kolunye ucwaningo, cishe abantu abangu-50% bathola izimpawu zingakapheli izinsuku ezingu-12.

Izimpawu eziyinhloko ezingabonakala yilezi:

• Ukuvuvukala, ukuqina, kanye nokuqina kwesikhumba: Lokhu kuvame ukuthinta izindawo ezifana nezingalo, imilenze, isifuba kanye nesisu. Ubuso abuvami ukuthintwa.
• Amabala amnyama noma amaqhubu esikhumbeni: Ngezinye izikhathi isikhumba singaba maqhubu, njengekhasi eliphuzi.
• Isikhumba sizizwa siluma, sivuvukele, noma sibuhlungu.
• Ukungakwazi ukuhambisa izitho namalunga ngendlela evamile ngenxa yokuqina nokuvuvukala kwesikhumba.

Kwabanye abantu, lezi zimpawu zingathinta nezitho zangaphakathi zomzimba kanye nemisipha. Nazi ezinye izinto ongase uzizwe:

• Ubuthakathaka obukhulu bemisipha.
• Ngenxa yokuqina kwemisipha, izitho azikwazi ukugoba noma ukwelulwa kahle (okungukuthi, ububanzi bokunyakaza buyancipha).

Uma le fibrosis, noma ukuqina kwezicubu, iqhubeka phambili, ingaholela ekwakhekeni kwama-hard deposits emisipheni, emaphashini, emhubheni, emehlweni, ngisho nasenhliziyweni. Lokhu kungaphazamisa ukusebenza kwalezi zitho. Lokhu kungaholela ekukhubazekeni kwesikhathi eside, okuhlala njalo, futhi kwezinye izimo, ngisho nasekufeni.

Iyini imbangela eyinhloko ye-NSF?

I-NSF cishe ibangelwa ukuchayeka ku-`(ama-gadolinium-based contrast agents - ama-GBCA)` ashiwo ngenhla. Leli khemikhali elibizwa ngokuthi i-gadolinium lisetshenziselwa ukucacisa izithombe kuma-`(MRI)` scans. Akukacaci kahle ukuthi i-gadolinium iyibangela kanjani i-NSF. Kodwa-ke, kusobala ukuthi kukhona ukuxhumana phakathi kwesifo sezinso kanye ne-`(GBCAs)`. Kuye kwaboniswa nokuthi ingozi iyanda uma inani le-gadolinium elinikezwa emzimbeni liphezulu, noma uma kusetshenziswa izinhlobo ezithile ze-`(GBCAs)`.

I-NSF ivame kakhulu kubantu abanesifo sezinso esingamahlalakhona (CKD) kanye nalabo abasebenzisa i-dialysis ngenxa yokwehluleka kwezinso.

Kodwa, khumbula, azikho izigameko ezintsha ze-NSF ezibikiwe cishe eminyakeni eyi-15!

Lokhu kungenxa yokuthi ama-GBCA amanje azinzile futhi awanobuthi kangako. Futhi, ukusetshenziswa kwe-gadolinium kuvinjelwe kubantu abanesifo sezinso. Ngisho ne-FDA incoma ukuthi abantu abanesifo sezinso noma izinkinga zezinso bangasebenzisi ama-GBCA amadala.

Ubani okungenzeka kakhulu ukuthi athole lokhu? (Izici Eziyingozi)

Isici esiyinhloko sengozi yokuthola i-NSF isifo sezinso noma ukungasebenzi kahle kwezinso. Lokhu kufaka phakathi ukuhlinzwa kwezinso ngaphambilini, ukufakelwa izinso, noma ukuba nenso eyodwa kuphela. Futhi, uma umuntu onesifo sezinso enezinye izimo, njengezinkinga zokujiya kwegazi noma ukutheleleka, ingozi ye-NSF ingaba phezulu kancane.

Kodwa-ke, odokotela manje sebeqaphela kakhulu ingozi engaba khona engabangwa yi-GBCA ezindala kubantu abangasebenzi kahle kwezinso. Ngakho-ke, ngezindlela eziphephile ezitholakalayo namuhla, ingozi yakho yokuthola lesi simo iphansi kakhulu.

Yiziphi izinkinga ezingaba khona ze-NSF?

Izinkinga ze-NSF zingaba zimbi kakhulu futhi ngezinye izikhathi zibulale. Uphawu lokuqala ukuqina kwesikhumba. Kodwa-ke, njengoba isimo siba sibi kakhulu, lokhu kuqina kungathinta nezitho zomzimba kanye nemisipha emzimbeni. Isibonelo, imisipha namalunga akho angase aqine kangangokuthi awukwazi ukuwashukumisa, okwenza kube nzima ukuhamba. Uma i-NSF ithinta amaphaphu noma inhliziyo, ingabangela ubunzima bokuphefumula noma iphazamise ikhono lenhliziyo lokupompa igazi.

Lesi sifo sihlolwa kanjani ngokunembile? (Ukuxilongwa)

Ukuphela kwendlela yokwazi ngokuqinisekile ukuthi une-NSF ukwenza i-biopsy yesikhumba. Lokhu kuhilela udokotela ukuthatha isampula encane yesikhumba sakho bese eyithumela elabhorethri ukuze ihlaziywe. Kodwa-ke, udokotela uzoyala lokhu kuhlolwa kuphela uma, ngemva kokuthatha umlando wakho wezokwelapha nokwenza ukuhlolwa ngokomzimba, benokusola okunengqondo ukuthi ungase ube ne-NSF.

Yiziphi izindlela zokwelapha i-NSF?

Eqinisweni, okwamanje azikho izindlela zokwelapha ezithile ezivunyelwe i-NSF. Ngenxa yokuthi lesi sifo asivamile, ucwaningo ngezokwelapha lulinganiselwe. Kodwa-ke, kunezindlela zokwelapha ezimbalwa ezibikwe ukuthi zinikeza impumuzo ethile kwezinye iziguli ze-NSF:

• Ngemva kwe-MRI, i-dialysis ingasusa i-gadolinium emzimbeni. Lokhu kungaba usizo kubantu abanesifo sezinso esingamahlalakhona. Kodwa-ke, abukho ubufakazi bokuthi lokhu kuzomisa ngokuphelele ukuthuthukiswa kwe-NSF.
• Ukwelashwa ngokomzimba kungasiza ekulondolozeni ukuguquguquka nokunyakaza kwamalunga.
• Ukufakelwa izinso kuyindlela abanye abaguli be-NSF abangayicabangela.

Uma unesifo sezinso, kungcono ukugwema ukuchayeka ku-gadolinium. Kodwa-ke, ngezinye izikhathi i-gadolinium ingadingeka ukuze uthole izithombe ezinhle kakhulu ezivela ku-MRI. Ezimweni ezinjalo, odokotela kumele balinganise izinzuzo ze-MRI nezingozi zokuchayeka ku-gadolinium. Uma unezinkinga zezinso futhi udokotela wakho eyala i-MRI ngedayi, qiniseka ukuthi ubuza udokotela wakho ukuthi usengozini yini ye-NSF.

Ingabe zikhona izindlela zokugwema i-NSF? (Ukuvimbela)

Indlela engcono kakhulu yokuvimbela i-NSF ukugwema ukusebenzisa ama-GBCA amadala kubantu abanesifo sezinso. Ama-GBCA amasha aphephile futhi awanobuthi kangako ezigulini zezinso.

I-FDA itusa ukuthi abantu abanezinkinga ezithile zezinso bangasebenzisi amadayi aqukethe i-gadolinium ngaphandle kokuthi kungekho enye indlela.

Kubantu abanomsebenzi ojwayelekile wezinso, kubonakala sengathi akukho bungozi bokusebenzisa ama-GBCA.

Lingakanani izinga lokufa ngenxa ye-NSF?

Ngaphambi kuka-2019, i-FDA yayibike amacala angu-3,094 e-NSF kanye nokufa okuhlobene okungu-742. Kodwa-ke, njengoba kushiwo ngaphambili, awekho amacala amasha abikiwe eminyakeni engaphezu kwe-10. Isizathu esiyinhloko salokhu ukuthi i-FDA kanye nomphakathi wezokwelapha bayazi ngemiphumela ye-GBCA ezigulini zezinso.

Kunini lapho kufanele sifune khona iseluleko sezokwelapha?

Uma unesifo sezinso futhi uhlangabezana nanoma yiziphi izimpawu ezilandelayo, xhumana nodokotela ngokushesha ngoba zingaba uphawu lwe-NSF:

• Ukuqina kwesikhumba noma ukuqina.
• Isikhumba esilumayo noma esivuvukele.
• Amabala abomvu noma amnyama esikhumbeni.

Ngezinqubo zokuphepha zamanje, amathuba okuthi utholakale une-NSF aphansi kakhulu. Kodwa-ke, uma unesifo sezinso futhi udinga ukwenza i-MRI, khuluma nodokotela wakho nge-NSF kanye nezingozi ezikuyo. Ngisho noma ama-GBCA amasha engenabo ubuthi futhi ebonakala ephephile, kuhlale kungumqondo omuhle ukwabelana ngomlando wakho wezempilo nodokotela wakho futhi nixoxe ngezingozi.

Umlayezo Wokuya Nawe Ekhaya

Kulungile, manje usuyiqonda kangcono i-NSF esikhulume ngayo. Ake sibukeze izinto ezibaluleke kakhulu futhi:

• I-NSF iyisifo esingavamile kakhulu, ikakhulukazi kubantu abanesifo sezinso, futhi singabangelwa ezinye izidakamizwa zokuhlukanisa ze-MRI ezindala.
• Azikho izimo ezintsha ze-NSF ezibikiwe manje. Lokhu kungenxa yokusetshenziswa kwama-contrast agent amasha aphephile kanye nokwaziwa kodokotela.
• Izimpawu eziyinhloko ukuqina kwesikhumba, ukuqina, ukulunywa, kanye nezinkinga zamalunga.
• Uma unesifo sezinso, qiniseka ukuthi ukhuluma nodokotela wakho mayelana nodayi osetshenzisiwe kanye nengozi ye-NSF ngaphambi kokwenza i-MRI.
• Akukho okufanele ukhathazeke ngakho, ngoba ngezindlela zamanje, le ngozi iphansi kakhulu. Kodwa-ke, kuhlale kufanele ukuqashelwa.

Ukunakekela impilo yakho kuyinto ebaluleke kakhulu. Uma unemibuzo noma ukukhathazeka, ungalokothi ulibale ukufuna iseluleko sezokwelapha.

I- Nephrogenic systemic fibrosis, isifo sezinso, i-MRI scan, i-gadolinium, izifo zesikhumba, ama-GBCA, izifo ezingavamile