Ukuthuthukiswa Okusha Kwezokwelapha Oku-5 Okungase Kunciphise Ukusetshenziswa Kwe-Opioid

-Delile

• Ama-Lasers wamazinyo
• Khipha kancane i-Anesthetics Yendawo
• I-C-Section Tech entsha
• Ukuhlolwa kwe-DNA
• Imithi Yokuvuselela
• Buyekeza kwe-

IMelika iphakathi kwenkinga ye-opioid. Yize kungahle kungabonakali njengokuthile okufanele ukhathazeke ngakho, kubalulekile ukuqaphela ukuthi abesifazane bangaba nengozi enkulu yokuba umlutha wamaphilisi ezinhlungu, okuvame ukunqunywa ngemuva kokuhlinzwa okujwayelekile. Futhi nakuba zisetshenziselwa ukwelapha ubuhlungu obungapheli, ucwaningo lubonisa ukuthi ama-opioid angase angasizi ukuletha ukukhululeka kobuhlungu esikhathini eside. Ngaphezu kwalokho, yize kungebona bonke abantu abasebenzisa ama-opioid baba imilutha, abaningi benza, futhi isikhathi sokuphila se-U.S sehlile njengoba abantu abaningi bebulawa ngama-opioid overdoses.

Ingxenye enkulu yomzamo wokulwa nalolu bhubhane ukuthola lapho ama-opioid engadingekile kanye nokuthola ezinye izindlela zokwelapha. Noma kunjalo, odokotela abaningi banenkani yokuthi ama-opioid abalulekile ezimweni ezithile zobuhlungu-zombili ezingapheli nezimbi. "Ngenxa yokuthi ubuhlungu obungapheli buyisimo esiyinkimbinkimbi se-biopsychosocial-okusho ukuthi kuhilela ukusebenzisana kwezinto eziphilayo, ezingokwengqondo, nezenhlalo-kumuntu siqu futhi kuthinta umuntu ngamunye ngendlela ehlukile," kuchaza u-Shai Gozani, MD, Ph.D., umongameli kanye ne-CEO ku- I-NeuroMetrix. Ama-opioid ngezinye izikhathi ayadingeka uma othile enobuhlungu obukhulu, njengalapho ngemva kokuhlinzwa noma ukulimala. "Njengoba kunikezwe ukuthi ubuhlungu buyinto enjalo, izindlela zokwelashwa zidinga ukwenziwa ngezifiso." Kwesinye isikhathi, lokho kufaka ukusetshenziswa kwama-opioid, futhi kwesinye isikhathi akunjalo.

Ochwepheshe bayavuma ukuthi kunezinye izindlela eziningi zokwelapha ubuhlungu ezingalashwa ezinengozi encane yokulutha. Akunakuphikwa ukuthi ukwelashwa ngokomzimba, ezinye izindlela zokwelapha ezinjengokulashwa kwesikhumba, ngisho ne-psychotherapy kungasiza ekunciphiseni ukusetshenziswa kwama-opioid, kepha omunye umugqa wokuzivikela kubhubhane lwe-opioid ubuchwepheshe obuvelayo obenziwa buphelele futhi bube bukhulu ukwamukelwa kabanzi. Nazi ezinhlanu ezingasiza ukunciphisa ukusetshenziswa kwe-opioid.

Ama-Lasers wamazinyo

Ucwaningo lubonisa ukuthi abantu ngokuvamile banemithi yezinhlungu esele ngemva kokuhlinzwa ngomlomo, njengokukhipha izinyo elihlakaniphile, okushiya umnyango uvulekele ukusetshenziswa kabi kwawo okungaba khona. Uma ucabanga ukuthi ngaphezu kweziguli ezingama-90 zeziguli ezihlinzwa ngokujwayelekile ngomlomo (cabanga: ukukhishwa kwamazinyo, ukuhlinzwa kwezinsini okubandakanya imithungo) kunqunywa ama-opioid, ngokusho kukaRobert H. Gregg, DDS, ongumsunguli obambisene weMillennium Dental Technologies kanye ne-Institute for Advanced Laser Dentistry, yilokho uhlobo into enkulu.

Yingakho asungula i-LANAP laser, engasetshenziswa ukwenza ukuhlinzwa kwamazinyo futhi yehlise ubuhlungu, ukopha, nesikhathi sokululama. UDkt. Gregg uthi iziguli ezikhetha i-laser zinikezwa kuphela ama-opioid 0.5 amaphesenti wesikhathi - umehluko omkhulu.

Njengamanje, ama-lasers asetshenziswa emahhovisi wamazinyo ahlukene we-2,200 ezweni lonke, futhi uDkt Gregg uthi ulindele ukuthi lelo nani likhule kancane njengoba abantu befunda kabanzi mayelana nodokotela wamazinyo we-laser futhi baqonde ukwehla kokubeka ama-opioid ekuhlinzeni ngomlomo.

Khipha kancane i-Anesthetics Yendawo

Lezi zinhlobo zemithi sekuneminyaka impela zikhona, kepha ziya ngokuya zihlinzekwa ezinhlotsheni ezahlukahlukene zokuhlinzwa. Okuvame kakhulu kubizwa nge-Exparel, okuyifomu elikhipha kancane le-anesthetic yendawo ebizwa nge-bupivacaine. "Ungumuthi osebenza isikhathi eside okindishayo ojojowe ngesikhathi sokuhlinzwa ongalawula izinhlungu ezinsukwini ezimbalwa zokuqala ngemuva kokuhlinzwa, lapho iziguli zibudinga kakhulu," kuchaza uJoe Smith, M.D., ongudokotela obulala izinzwa esibhedlela i-Inova Loudon Hospital eLeesburg, eVirginia. "Lokhu kunciphisa, noma kwezinye izimo kuqeda, isidingo sama-opioid. Lokhu akusizi nje kuphela iziguli ukuthi zigweme ingozi ebonakalayo yokuthembela, kepha nemiphumela emibi yezidakamizwa ezifana nokudangala ngokuphefumula, isicanucanu nokuhlanza, ukuqunjelwa, isiyezi nokudideka, ukubala abambalwa."

Enye yezinto ezinhle kakhulu ngalesi sixazululo ukuthi singasetshenziselwa izinhlobo eziningi zokuhlinza, okuhlanganisa ukuhlinzwa kwamathambo njengokuhlinzwa kwehlombe, ukulungiswa kwe-ACL, nokunye okuningi, uDkt Smith uthi. Ibuye isetshenziselwe ukuhlinzwa ngezinyawo, izingxenye ze-c, ukuhlinzwa kwepulasitiki, ukuhlinzwa ngomlomo, nokuningi. Abantu abaningi bayilungele, ngaphandle kwalabo abaphikisana ne-anesthetics yendawo nalabo abanesifo sesibindi, ngokusho kukaDkt.Smith.

Okubi kuphela? "Yize i-anesthetics yendawo esebenza isikhathi eside efana ne-Exparel ingasiza ekwehliseni isidingo sama-opioid asemva kokuhlinzwa, lokhu kuyabiza futhi iziguli eziningi zikhetha umnotho wenketho ye-opioid," kusho u-Adam Lowenstein, MD, udokotela ohlinzayo weplastiki kanye ne-migraine. Ezinye izinhlelo zomshwalense zingayimboza noma ziyimboze kancane, kodwa akuwona neze umkhuba. Noma kunjalo, inikeza inketho ewusizo kulabo abanesiqiniseko sokuthi abafuni ama-opioid post-op.

I-C-Section Tech entsha

"Izingxenye ze-C zingukuhlinzwa okukhulu, ngakho-ke cishe bonke abesifazane bathola ama-opioid post cearean," kusho uRobert Phillips Heine, MD, ob-gyn eDuke University Medical Center. "Njengoba ukubeletha ngokuhlinzwa kuyinqubo yokuhlinzwa evame ukuhlinzwa e-United States, kungaba yinzuzo ukunciphisa inani le-narcotic elidingekayo, njengoba ukuhlinzwa okukhulu kuyisango elaziwayo lokuxhomeka kwe-opioid," uyanezela. (Okuhlobene: Ingabe Ama-Opioid Ayadingeka Ngempela Ngemva Kwesigaba C?)

Ngaphezu kokukhethwa kukho okubulala izinzwa okufana ne-Exparel, kunokuthile futhi okubizwa ngokuthi ukwelashwa kwengcindezi okungekho emthethweni okunganciphisa isidingo sama-opioid ngemuva kwesigaba se-c. "Ukwelashwa kokucindezela okungalungile okuvaliwe kuvikela ukusika ekungcoleni kwangaphandle, kusiza ukubamba imiphetho yokusikela ndawonye, ​​futhi kususe izinto eziwuketshezi nezokutheleleka," kusho uDkt. Heine. "Kuyindlela yokugqoka eyinyumba efakwa emgodini wokuhlinzwa futhi inamathiselwe kupompo eletha ingcindezi engapheli eqhubekayo futhi ihlala izinsuku ezinhlanu kuya kweziyisikhombisa." Lokhu kwaqaliswa ekuqaleni ukuvikela ukutheleleka ngemuva kokuhlinzwa, kepha odokotela bathola ukuthi futhi kudale ukwehla kwenani lemithi yezinhlungu edingwa ngabesifazane abanayo. Njengamanje, le ndlela isetshenziswa kakhulu ezigulini ezisengozini enkulu yokutheleleka, njengalezo ezine-BMI engaphezu kwengu-40, ngoba lezo ucwaningo lweziguli lukhombisa izinzuzo zalo, kusho uDkt Heine. "Uma kutholakala eminye imininingwane ephakamisa ukuthi ivimbela ukutheleleka kanye / noma yehlise ukusetshenziswa kwezidakamizwa ezigulini ezisengozini encane, kungenzeka isetshenziswe nakuleso sabantu."

Ukuhlolwa kwe-DNA

Siyazi ukuthi ukulutheka kuyingxenye yofuzo, futhi abacwaningi bakholelwa ukuthi bahlukanise ezinye zofuzo ezingabikezela ukuthi ngabe umuntu uzoba umlutha wama-opioid noma cha. Manje, kukhona ukuhlolwa kwasekhaya ongakwenza ukuze uhlole ubungozi bakho. Enye yezinto ezidume kakhulu ibizwa ngeLifeKit Predict, eyenziwa yiPrescient Medicine. Ngokocwaningo olushicilelwe ku Ama-Annals of Clinical Laboratory Science, izindlela ezintsha zokuhlola ezisetshenziswe yiPrescient zingabikezela ngokuqiniseka ngamaphesenti angama-97 ukuthi ngabe umuntu unengozi encane yokulutha i-opioid. Nakuba lolu cwaningo beluluncane uma kuqhathaniswa futhi abanye odokotela abathintekayo enkampanini bebeyingxenye yocwaningo, kubonakala sengathi kukhombisa ukuthi ukuhlolwa kungaba wusizo kumuntu okhathazekile ngengozi yakhe yokuba umlutha.

Kubaluleke kakhulu ukuqaphela ukuthi lokhu kuhlolwa akunakuqinisekisa ukuthi othile uzoba umlutha wama-opioid noma ngeke abe umlutha wawo, kepha kunganikeza imininingwane ewusizo kulabo abenza isinqumo sokwazi ukuthi bazoyisebenzisa yini. Isivivinyo sihlanganiswa nezinhlelo ezithile zomshuwalense, futhi yize ungadingi imishanguzo yokuyithatha, uPrescient uncoma kakhulu ukubonisana nodokotela wakho mayelana nokuhlolwa nemiphumela uma usuyitholile. (Kuhlobene: Ingabe Ukuhlolwa Kwezokwelapha Ekhaya Kuyakusiza Noma Kuyakulimaza?)

Imithi Yokuvuselela

Uma uke wezwa kuphela ngamaseli e-stem ngokubhekisela ekuhlanganiseni, ungase umangale ukuthola ukuthi asetshenziswa kakhulu emithini njengendlela yokubhekana nobuhlungu. Ukwelashwa kwe-stem cell kuyingxenye yomkhuba omkhulu obizwa ngokuthi umuthi wokuzivuselela. "Imithi yokuvuselela iyindlela yokuguqula ekwelapheni izifo eziningi eziwohlokayo kanye nokulimala," kuchaza uKristin Comella, Ph.D., Isikhulu Esiyinhloko Sesayensi Yezikhungo Zokusebenza Ezinhle Ze-American Stem Cell. "Ikhula njalo, futhi ifaka phakathi amasu ahlukahlukene ahlukahlukene, njenge-stem cell therapy, ukusebenzisa izindlela zokuphulukisa zemvelo zomzimba wakho." Nakuba imithi ye-opioid ibhekana nezimpawu zobuhlungu, ukwelashwa kwe-stem cell kuhloswe ukubhekana nembangela yobuhlungu. "Ngale ndlela, i-stem cell therapy ilawula ngempumelelo ubuhlungu futhi inganciphisa isidingo sokudambisa izinhlungu ngama-opioid," kusho uComella.

Ngakho-ke ukwelashwa kuhilelani ngempela? "Ama-stem cell akhona kuzo zonke izicubu emizimbeni yethu futhi umsebenzi wawo oyinhloko ukugcina nokulungisa izicubu ezilimele," kuphawula uComella. "Zingahlukaniswa endaweni eyodwa emzimbeni wakho futhi zithuthelwe kwenye ingxenye edinga ukuphulukiswa, ukubhekana nobuhlungu ezindaweni ezihlukahlukene." Okubalulekile, ama-stem cell asetshenziswa kuphela kusuka kuwe okwakho umzimba kulokhu kwelashwa, okususa ezinye zezincazelo zokuziphatha ezihambisana negama elithi "stem cells."

Kwesinye isikhathi, ukwelashwa kwe-stem cell kuhlanganiswa ne-platelet-rich plasma therapy (PRP), uComella athi isebenza njengomanyolo wamaseli ama-stem. "I-PRP iwumphakathi ocebile wezici zokukhula kanye namaprotheni atholakala egazini lomuntu. Ithuthukisa i-cascade yokuphulukisa ekhiqizwa amangqamuzana e-anti-inflammatory avela ngokwemvelo," uyachaza. "I-PRP iphumelela kakhulu ekwelapheni ubuhlungu obubangelwa ukulimala okusha ngoba kukhulisa amaseli ezinhlonzi zokuphulukisa asevele elima njengoba ngokwemvelo eya endaweni elimele." Futhi, ukwelashwa kungasetshenziswa futhi ukusheshisa ukukhululeka kobuhlungu obunqanda ukuvuvukala ezindabeni ezingapheli ezifana ne-osteoarthritis, kusho uComella.

Kuyaphawuleka ukuthi i-stem cell therapy ayikho impela okujwayelekile, futhi akuvunyelwe yi-FDA. Ngenkathi i-FDA (nabacwaningi abaningi bezokwelapha, ngaleyo ndaba) bevuma ukuthi ukwelashwa kwamaseli e-stem kuyathembisa, abakholelwa ukuthi kukhona ucwaningo olwanele ngalo ukuze bayivume njengokwelashwa. Indaba emfushane: Akukona kangako ukuthi i-FDA ayicabangi ukuthi ukwelashwa kwe-stem cell kuyasebenza, kungaphezulu ukuthi asinalo ulwazi olwanele lokuyisebenzisa ngokuphepha noma ngokuthembekile.Ngokwenza kuphela iziguli ezingalali ngaphandle, izinqubo ezijwayelekile ezingenazo izinzwa ezinikezwa odokotela abasebenzisa amaseli eziguli, noma kunjalo, imitholampilo yama-stem cell iyakwazi ukusebenza ngaphakathi kwemihlahlandlela ye-FDA.

Nakuba umuthi ovuselelayo ungase ungatuswa udokotela wakho—futhi ngokuqinisekile ngeke ukhavwe umshwalense wakho—kusewukubheka okuthakazelisayo okuzayo kokuthi yimuphi umuthi ongase ube njengamashumi eminyaka kusukela manje.

Buyekeza kwe-