Isitofu sokugonya iJohnson & Johnson Siye saqala incoko malunga nolawulo lokuzalwa kunye namahlwili egazi

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Kwangoko kule veki, amaziko aseMelika oLawulo lweZifo noLawulo lokuTya kunye noLawulo lweziyobisi abangele isiphithiphithi ngokucebisa ukuba ukusasazwa kwekhefu lokugonya likaJohnson & Johnson COVID-19 emva kweengxelo kwabasetyhini abathandathu abafumana uhlobo olunqabileyo nolunqabileyo lwegazi emva kokufumana isitofu . Ezi ndaba zibangele iingxoxo kumajelo asekuhlaleni malunga nomngcipheko we-blood clot, enye yazo ijikeleza malunga nokulawulwa kokuzalwa.

Ukuba ezi ziindaba kuwe, nantsi into ekufuneka uyazi: Ngo-Epreli 13, i-CDC kunye ne-FDA bakhuphe ingxelo edibeneyo yokucebisa ababoneleli ngezempilo ukuba bayeke okwethutyana ukulawula isitofu sokugonya sikaJohnson & Johnson. Bafumene iingxelo ezintandathu zabasetyhini abaye banamava e-cerebral venous sinus thrombosis (i-CVST), uhlobo olunqabileyo nolunzima lwegazi, ngokudibanisa namanqanaba asezantsi eeplatelets zegazi. (Iimeko ezimbini ezingakumbi sele zivele, enye yindoda.) Ezi meko ziphawuleka njengoko i-combo ye-CVST kunye nee-platelet ezisezantsi akufuneki zinyangwe ngonyango oluqhelekileyo, i-anticoagulant ebizwa ngokuba yi-heparin. Endaweni yoko, kubalulekile ukuba ubaphathe nge-non-heparin anticoagulants kunye ne-dose ephezulu ye-immune globulin, ngokwe-CDC. Ngenxa yokuba la mahlwili amahlwili anobuzaza kwaye nonyango luntsonkothile kakhulu, i-CDC kunye ne-FDA bandulule ukuba kunqumame kwisitofu sokugonya sikaJohnson & Johnson kwaye bayaqhubeka nokujonga iimeko phambi kokuba babonelele ngenyathelo elilandelayo.

Njani into yolawulo lokuzalwa kuyo yonke le nto? Abasebenzisi be-Twitter baphakamise i-eyebrow ebonakalayo kwi-CDC kunye ne-FDA yomnxeba wokuphumla, beqaqambisa umngcipheko okhulayo wamahlwili egazi ahambelana nolawulo lokuzalwa kwehomoni. Ezinye zeetweets zithelekisa inani lamatyala e-CVST kuwo wonke umntu ofumene isitofu sokugonya sikaJohnson & Johnson (ezintandathu kwezi ziphantse zazizigidi ezisixhenxe) ukuya kwinqanaba lamahlwili egazi kubantu abakwiipilisi zolawulo lokuzalwa kwehomoni (malunga nelinye kwayiwaka). (Eyeleleneyo: Nantsi indlela yokufumana ulawulo lokubeleka luhanjiswe eLungelo kumnyango wakho)

Kumphezulu, umngcipheko wamahlwili egazi anxulumene nokulawulwa kokuzalwa kubonakala kubaluleke kakhulu kunomngcipheko wamahlwili egazi anxulumene nesitofu sokugonya i-J & J - kodwa ukuthelekisa ezi zimbini kufana nokuthelekisa ii-apile neeorenji.

UNancy Shannon, MD, Ph.D., ugqirha wokhathalelo lokuqala kunye nomcebisi omkhulu kwezonyango eNurx. Iimeko zasemva kokugonya i-FDA kunye ne-CDC ziye zangena kuzo zibandakanya iimeko ze-CVST, uhlobo olunqabileyo lwehlwili legazi ebuchotsheni, ecaleni kwamanqanaba asezantsi eplatelet. Kwelinye icala, uhlobo lwamahlwili oludla ngokunxulunyaniswa nokulawulwa kokuzalwa yi-thrombosis enzulu yemithambo (ukuvaleka kwimithambo emikhulu) yemilenze okanye yemiphunga. (Qaphela: It ngu Ukulawulwa kokuzalwa kwehomoni kunokubangela amahlwili egazi engqondo, ngakumbi phakathi kwabo bafumana imigraines ene-aura.)

I-vein thrombosis enzulu iphathwa ngokucheba kwegazi, ngokwe-Mayo Clinic. I-CVST, nangona kunjalo, inqabile kune-vein thrombosis enzulu, kwaye xa ibonwa ngokudibanisa namanqanaba asezantsi eplatelet (njengoko kunjalo ngogonyo lwe-J & J), ifuna ikhondo elahlukileyo lesenzo kunonyango oluqhelekileyo lwe-herapin. Kwezi meko, ukuphuma gazi ngokungaqhelekanga kwenzeka ngokudibanisa amahlwili, kwaye i-heparin inokwenza izinto zibe mbi ngakumbi. Le yi-CDC kunye ne-FDA yokuqiqa ngasemva kokucebisa ukunqumama kwisitofu sokugonya sikaJohnson & Johnson.

Nokuba ungazithelekisa ngokuthe ngqo ezi zinto zimbini, kubalulekile ukuxoxa ngomngcipheko wamahlwili egazi ahambelana nokuthatha ulawulo lokuzalwa, kwaye yinto ekufanele ukuba ujonge kuyo ukuba sele ukhona okanye ucinga nge-BC. "Kumntu obhinqileyo ongenazo iimeko zonyango okanye izinto ezinobungozi ezibonisa ukuba kunokwenzeka ukuba abe nehlwili, umngcipheko wokuphuhlisa ihlwili legazi uphindaphindeka kathathu ukuya kahlanu ngelixa udityanisiwe lokuthintela ukukhulelwa xa kuthelekiswa nabasetyhini abangekho kulo naluphi na uhlobo lokukhulelwa. uqingqo-nzala,” utsho uGqr. Shannon. Ngokombono, inqanaba lamahlwili egazi phakathi kwabasetyhini abangakhulelwanga abaneminyaka engazisebenzisiyo yolawulo lokuzalwa kwehomoni lunye ukuya kwabahlanu kwabali-10 000, kodwa phakathi kwabasetyhini abangakhulelwanga abaneminyaka yobudala besebenzisa ulawulo lokuzalwa kwehomoni, sisithathu ukuya kwisithoba kwi-10,000, ngokutsho kwe-FDA. (Eyeleleneyo: Ngaba ii-Antibiotics zingenza ukuba ulawulo lwakho lokubeleka lungasebenzi?)

Umahluko obalulekileyo: Amahlwili egazi ayanyaniswa nolawulo lokuzalwa oluqukethe i-estrogen. "Xa sithetha ngomngcipheko we-clot yegazi ngokunxulumene nolawulo lokuzalwa, sithetha kuphela ngolawulo lokuzalwa oluqulathe i-estrogen, ebandakanya indibaniselwano yeepilisi zokulawula ukuzalwa isiqwenga,” utsho uGqr. Shannon. "Ukulawulwa kokuzalwa ngeHormonal equlethe ihomoni yeprogestin kuphela ayibangeli lo mngcipheko unyukileyo. Iindlela zokulawula ukuzalwa zeprogestin kuphela ziquka iipilisi ezineprogestin kuphela (ngamanye amaxesha zibizwa ngokuba ziiminipills), ishot yokulawula ukuzalwa, implanti yokulawula ukuzalwa, kunye neprogestin IUD. " Kuba kunjalo, ugqirha wakho unokukuqhubela kwindlela ye-progesin kuphela ukuba ufuna ukuya kulawulo lokuzalwa kodwa unezinto ezinokukwenza ukuba uthambekele ngakumbi kumahlwili, njengama-35 okanye ngaphezulu, ukutshaya, okanye umntu onamava migraine kunye ne-aura.

Kwanaxa kudityanisiwe ulawulo lokuzala, umngcipheko wokujiya “usephantsi kakhulu,” utsho uGqr. Shannon. Okwangoku, ayisiyonto ekufuneka uyithathe kancinci, kuba xa amahlwili esenzeka, anokubusongela ubomi ukuba akafumaneki ngokukhawuleza. Ngoko ke, kubaluleke kakhulu ukwazi iimpawu zehlwili legazi ukuba uku-BC. "Nakuphi na ukuvuvukala, intlungu, okanye ukunyamezela kwilungu, ngokukodwa emlenzeni, kufuneka kuhlolwe ngokukhawuleza ngugqirha njengoko loo nto ingaba ngumqondiso wokuba i-blood clot yenziwe," kusho uDkt. "Iimpawu ezinokuthi i-clot ihambe ukuya kwimiphunga ibandakanya ubunzima bokuphefumla, intlungu yesifuba okanye ukungahambi kakuhle, ukubetha kwentliziyo ngokukhawuleza okanye okungaqhelekanga, ukukhanya, uxinzelelo lwegazi oluphantsi, okanye ukuphelelwa amandla. Ukuba nabani na ufumana oku kufuneka baqonde ngqo kwi-ER okanye babize i-911." Kwaye ukuba uhlakulela i-migraine kunye ne-aura emva kokuqala kolawulo lokuzalwa, kuya kufuneka uxelele ugqirha wakho. (Eyeleleneyo: U-Hailey Bieber Uvule Ngokumalunga nokuba "Nentlungu" ye-Hormonal Acne Emva kokufumana i-IUD)

Kwaye, ngenxa yerekhodi, "abantu abasebenzisa iipilisi zolawulo lokuzalwa, iipatches, okanye iiringi abafumene iyeza lokugonya likaJohnson & Johnson akufuneki bayeke ukusebenzisa izinto zokuthintela ukukhulelwa kwabo," utshilo uGqirha Shannon.

Kungaba luncedo ngakumbi ukuthelekisa umngcipheko wokugubungela igazi kunye nolawulo lokuzalwa kunye nokugonya kwe-COVID-19 kuleyo bayilelwe ukuyikhusela. Umngcipheko wamahlwili egazi ngexa lokukhulelwa "uphezulu kakhulu kunalowo wolawulo lokuzalwa," utshilo uGqirha Shannon. Kwaye uphando lweYunivesithi yaseOxford lubonisa ukuba umngcipheko wokufumana isifo se-cerebral venous sinus thrombosis siphezulu kakhulu phakathi kwabo usulelekile nge-COVID-19 kunabo bafumana iyeza lokugonya iModerna, Pfizer, okanye i-AstraZeneca. (Olu phononongo aluzange luxele ngezinga le-cerebral venous sinus thrombosis phakathi kwabantu ababenaye ugonyo lukaJohnson & Johnson.)

Okukwintsusa? Iindaba zamva nje akufuneki zikuyekise ukubhukisha ixesha lokugonya okanye ukuthetha ngazo zonke iindlela ozikhethayo zolawulo nogqirha wakho. Kodwa kuhlawula ukufundiswa kuyo yonke imingcipheko enokubakho kuzo zombini, ukuze ukwazi ukugcina ngokufanelekileyo iithebhu kwimpilo yakho.

Ulwazi kweli bali luchanekile ngexesha lokushicilelwa. Njengoko uhlaziyo malunga ne-coronavirus ye-COVID-19 luqhubeka nokuvela, kunokwenzeka ukuba ezinye iinkcukacha kunye nezindululo kweli bali zitshintshile ukusukela ekupapashweni kwayo. Siyakukhuthaza ukuba ujonge rhoqo ngezixhobo ezinjenge-CDC, i-WHO, kunye nesebe lezempilo likarhulumente kwindawo yakho yokufumana olona lwazi lwanamhlanje kunye neengcebiso.

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