Umuthi Wokugoma kaJohnson & Johnson Usungule Ingxoxo Mayelana Nokulawulwa Kokuzalwa Namahlule Egazi

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Ngasekuqaleni kwaleli sonto, i-US Centers for Disease Control and Food and Drug Administration idale isiyaluyalu ngokuncoma ukuthi ukusatshalaliswa kwekhefu lokugoma likaJohnson & Johnson COVID-19 ngemuva kwemibiko ebibonakala yabesifazane abayisithupha ababhekene nohlobo lwegazi olungajwayelekile nolweqile ngemuva kokuthola umuthi wokugoma . Lezi zindaba zisuse izingxoxo ezinkundleni zokuxhumana mayelana nobungozi bokuthi amahlule egazi, enye yazo imayelana nokulawula inzalo.

Uma lokhu kuyizindaba kuwe, nakhu okudingeka ukwazi: Ngo-Ephreli 13, i-CDC ne-FDA bakhiphe isitatimende esihlangene sincoma ukuthi abahlinzeki bezokunakekelwa kwezempilo bayeke okwesikhashana ukuphatha umuthi wokugoma kaJohnson & Johnson. Bebethole imibiko eyisithupha yabesifazane abake babhekana ne-cerebral venous sinus thrombosis (i-CVST), ifomu elingavamile nelibi legazi elihlanganisiwe, ngokuhlanganiswa namazinga aphansi egazi. (Sekuvele ezinye izimo ezimbili, oyedwa owesilisa.) Lezi zimo ziyaphawuleka njengoba inhlanganisela ye-CVST nama- platelet aphansi akufanele elashwe ngokwelashwa okujwayelekile, i-anticoagulant ebizwa ngokuthi i-heparin. Esikhundleni salokho, kubalulekile ukubaphatha ngama-non-heparin anticoagulants kanye ne-high-dose intravenous immune globulin, ngokwe-CDC. Ngoba la mahlule abucayi futhi ukwelashwa kuyinkimbinkimbi kakhulu, i-CDC ne-FDA bancoma ikhefu emuthini wokugoma kaJohnson & Johnson futhi bayaqhubeka nokubheka amacala ngaphambi kokunikeza isinyathelo esilandelayo.

Ngabe ukulawula inzalo kunomthelela kanjani kukho konke lokhu? Abasebenzisi be-Twitter bebelokhu bekhulisa ishiya elibonakalayo ocingweni lwe-CDC ne-FDA lokuhlaba ikhefu kumuthi wokugoma, okugcizelela ubungozi obandayo bamahlule egazi ahlobene nokulawulwa kokuzalwa kwamahomoni. Amanye ama-tweets aqhathanisa inani lamacala e-CVST kuwo wonke umuntu othole umgomo ka-Johnson & Johnson (abayisithupha cishe ezigidini ezingu-7) nezinga lamahlule egazi kubantu abasebenzisa amaphilisi okulawula ukuzalwa ngamahomoni (cishe elilodwa kwayi-1,000). (Okuhlobene: Nansi Indlela Yokuthola Ukulawulwa Kokubeletha Kulethwe Khona Emnyango Wakho)

Ngaphandle, ingozi yamahlule egazi ahambisana nokulawulwa kokuzalwa ibonakala ibaluleke kakhulu kunengozi yamahlule egazi ahlobene nomgomo we-J & J - kodwa ukuqhathanisa kokubili kufana nokuqhathanisa ama-apula namawolintshi.

"Uhlobo lwamahlule egazi angaxhunyaniswa nomuthi wokugoma kubonakala kungenxa yesizathu esihlukile kunaleso esihlobene nokulawulwa kokubeletha," kusho uNancy Shannon, M.D., Ph.D., udokotela wezokunakekelwa okuyisisekelo kanye nomeluleki omkhulu wezokwelapha eNurx. Amacala okugonywa ngemuva kokugoma i-FDA ne-CDC angenile kuwo kufaka phakathi izimo ze-CVST, uhlobo olungavamile lwegazi eliqhekezayo ebuchosheni, kanye namazinga aphansi eplatelet. Ngakolunye uhlangothi, uhlobo lwamahlule oluvame ukuhlotshaniswa nokulawulwa kokubeletha yi-vein thrombosis ejulile (ukujiya emithanjeni emikhulu) yemilenze noma yamaphaphu. (Qaphela: It kuyinto kungenzeka ekulawuleni ukuzalwa kwamahomoni ukuze kubangele amahlule egazi lobuchopho, ikakhulukazi kulabo abaphathwa yimigraines nge-aura.)

I-vein thrombosis ejulile iphathwa ngokuncipha kwegazi, ngokusho kweMayo Clinic. I-CVST, nokho, ayivamile kune-deep vein thrombosis, futhi uma ibonakala ihlanganiswe namazinga aphansi eplatelet (njengoba kunjalo ngomgomo wokugomela i-J & J), idinga inkambo yesenzo ehlukile kunokwelashwa okujwayelekile kwe-herapin. Kulezi zimo, ukopha okungavamile kwenzeka kuhlangene namahlule, kanti i-heparin empeleni ingenza izinto zibe zimbi kakhulu. Lesi yisizathu se-CDC ne-FDA ngemuva kokuphakamisa ukuthi ume isikhashana kumuthi wokugoma kaJohnson & Johnson.

Kungakhathalekile ukuthi ungaziqhathanisa ngqo lezi ezimbili, kubalulekile ukuxoxa ngobungozi bamahlule egazi ahlobene nokuthatha inzalo, futhi kuyinto efanele ukubhekwa uma usuvele ukhona noma ucabanga nge-BC. "Kowesifazane ongenazo izimo zempilo eziyisisekelo noma izici eziyingozi eziphakamisa ukuthi kungenzeka ukuthi abe nehlule, ingozi yokuba nehlule legazi iyanda ngokuphindwe kathathu kuya kahlanu ngenkathi ekuvimbeleni inzalo okuhlanganisiwe uma kuqhathaniswa nabesifazane hhayi kunoma yiluphi uhlobo lwegazi. ukuvimbela inzalo, "kusho uDkt. Shannon. Ngokubuka, izinga lamahlule egazi phakathi kwabesifazane abangakhulelwe abaneminyaka yobudala yokuzala abangasebenzisi ukulawulwa kokubeletha kwamahomoni kungokukodwa kuya kwabahlanu kwabayi-10 000, kepha phakathi kwabesifazane abangakhulelwe abaneminyaka yobudala yokuzala abasebenzisa ukulawulwa kokuzalwa kwamahomoni, kuthathu kuya kwesishiyagalolunye kwezingu-10 000, ngokusho kwe-FDA. (Okuhlobene: Ingabe ama-Antibiotic Enza Ukulawulwa Kwakho Kokuzalwa Kungasebenzi Kangako?)

Umehluko obalulekile: Amahlule egazi ahlotshaniswa nokulawulwa kokuzalwa okuqukethe i-estrogen ngokuqondile. "Uma sikhuluma ngengcuphe yegazi maqondana nokulawulwa kokuzalwa, sikhuluma kuphela ngokulawulwa kokuzalwa okuqukethe i-estrogen, okubandakanya amaphilisi okuhlanganisa inzalo [okusho amaphilisi aqukethe i-estrogen ne-progestin], izindandatho zokulawula inzalo, kanye nolawulo lokuzalwa isichibi," kusho uDkt. Shannon. "Ukulawulwa kokuzalwa kwama-hormone okuqukethe kuphela i-hormone i-progestin akubeki le ngozi eyengeziwe. Izinhlobo zokulawula inzalo ezine-progestin kuphela zihlanganisa amaphilisi e-progestin kuphela (ngezinye izikhathi abizwa ngokuthi ama-minipill), isibhamu sokulawula inzalo, isitshalo sokulawula inzalo, kanye ne-progestin IUD. . " Njengoba kunjalo, udokotela wakho angakuholela endleleni ye-progestin kuphela uma ufuna ukuqhubeka nokulawula ukubeletha kepha unezici ezingakwenza uthambekele kakhulu kumahlule, njengokuthi uneminyaka engama-35 noma ngaphezulu, obhemayo, noma umuntu ohlangabezana nakho i-migraine ene-aura.

Ngisho nasekulawulweni kokuzalwa kwama-hormone okuhlangene, ingozi yokunqanda "isephansi impela," kusho uDkt Shannon. Noma kunjalo, akuyona into okufanele uyithathe kancane, ngoba lapho amahlule avela, angabeka impilo engozini uma engatholakali ngokushesha. Ngakho-ke, kubaluleke kakhulu ukwazi izimpawu zehlule legazi uma uku-BC. "Noma yikuphi ukuvuvukala, ubuhlungu, noma isizungu esithweni somzimba, ikakhulukazi emlenzeni, kufanele kuhlolwe masinyane ngudokotela ngoba lokho kungaba uphawu lokuthi ihlule legazi selakhekile," kusho uDkt Shannon. "Izimpawu zokuthi kungenzeka ukuthi ihlule laya emaphashini zihlanganisa ubunzima bokuphefumula, ubuhlungu besifuba noma ukungakhululeki, ukushaya kwenhliziyo okusheshayo noma okungavamile, ikhanda elilula, umfutho wegazi ophansi, noma ukuquleka. Uma noma ubani ehlangabezana nalokhu kufanele aqonde ngqo kwa-ER noma ashayele ucingo u-911." Futhi uma uhlakulela i-migraine nge-aura ngemva kokuqala ukulawula ukuzalwa, kufanele utshele udokotela wakho nakanjani. (Okuhlobene: UHailey Bieber Uvulelwe Ukuba Nendlebe "Ebuhlungu" Ngemuva Kokuthola IUD)

Futhi, ngokwerekhodi, “abantu abasebenzisa amaphilisi okulawula inzalo, ama-patches, noma izindandatho abathole umgomo ka-Johnson & Johnson akufanele bayeke ukusebenzisa ukuvimbela inzalo,” kusho uDkt. Shannon.

Kungase kube usizo kakhulu ukuqhathanisa ubungozi bokujiya kwegazi nokulawulwa kokuzalwa kanye nomgomo we-COVID-19 nalokho eziklanyelwe ukukunqanda. Ingozi yamahlule egazi ngesikhathi sokukhulelwa "iphakeme kakhulu kunaleyo ebangelwa ukulawulwa kokuzalwa," kusho uDkt Shannon. Futhi isifundo se-University of Oxford sikhombisa ukuthi ingozi yokuthola i-cerebral venous sinus thrombosis empeleni iphakeme kakhulu phakathi kwalabo uthelelekile nge-COVID-19 kunalabo abathole imijovo yokugoma iModerna, Pfizer, noma i-AstraZeneca. (Ucwaningo aluzange lubike ngezinga le-cerebral venous sinus thrombosis phakathi kwabantu ababenomuthi wokugoma u-Johnson & Johnson.)

Ngezansi? Izindaba zakamuva akufanele zikuvimbe ekubekeni i-aphoyintimenti yokugoma noma ukukhuluma ngazo zonke izinketho zakho zokulawula ukuzalwa nodokotela wakho. Kodwa kuyakhokha ukufundiswa ngazo zonke izingozi ezingaba khona zombili, ukuze ukwazi ukugcina ngokufanelekile amathebhu empilweni yakho.

Imininingwane ekule ndaba inembile njengesikhathi sokushicilela. Njengoba izibuyekezo mayelana ne-coronavirus COVID-19 ziqhubeka nokuvela, kungenzeka ukuthi ulwazi oluthile nezincomo kule ndaba kushintshile kusukela ekushicilelweni kokuqala. Sikukhuthaza ukuthi uhlole njalo izinsiza ezifana ne-CDC, i-WHO, kanye nomnyango wezempilo womphakathi wendawo ukuze uthole imininingwane yakamuva nezincomo.

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