Uphuhliso olutsha lwe-5 olunokuthi lunciphise ukusetyenziswa kweOpioid

Umxholo

• IiLaser zamazinyo
• Ukukhupha kancinci ii-Anesthetics zaseKhaya
• ITekhnoloji yeCandelo le-C eNtsha
• Uvavanyo lweDNA
• Unyango lokuhlaziya
• Uphengululo lwe

IMelika iphakathi kwengxaki ye-opioid. Ngelixa kubonakala ngathi ayisiyonto ekufuneka ukhathazekile ngayo, kubalulekile ukuba uqaphele ukuba abasetyhini banokuba semngciphekweni omkhulu wokuba likhoboka leepilisi zentlungu, ezihlala zimiselwe emva kotyando oluqhelekileyo. Kwaye nangona zisetyenziselwa ukunyanga iintlungu ezingapheliyo, uphando lubonisa ukuba i-opioids ayinakunceda ukuhambisa intlungu kwixesha elide. Ngaphezu koko, nangona ingengabo bonke abantu abasebenzisa i-opioids baba likhoboka, uninzi lwenzayo, kwaye ixesha lokuphila e-US liye lehla njengoko abantu abaninzi besifa ngenxa ye-opioid overdoses.

Inxalenye enkulu yomzamo wokulwa nalo bhubhane kukumisela xa ii-opioids zingafuneki kwaye zifumana ezinye iindlela zonyango. Sekunjalo, oogqirha abaninzi bayaqiniseka ukuba i-opioids ibalulekile kwiimeko ezithile zentlungu-zombini ezingapheliyo kunye nezibuhlungu. "Kuba iintlungu ezingapheliyo yimeko entsonkothileyo ye-biopsychosocial-intsingiselo yokuba ibandakanya ukudibana kwezinto eziphilayo, ezengqondo nezentlalo-zizodwa kwaye zichaphazela umntu ngamnye ngokwahlukileyo," ucacisa uShai Gozani, MD, Ph.D., umongameli kunye ne-CEO NeuroMetrix. IiOpioids nazo ngamanye amaxesha ziyafuneka xa umntu enentlungu ebukhali, nje emva kotyando okanye ukwenzakala. "Ngenxa yokuba iintlungu zinjalo ngamava, iindlela zonyango kufuneka zenziwe ngumntu." Ngamanye amaxesha, oko kubandakanya ukusetyenziswa kweeopioid, kwaye ngamanye amaxesha ayenzi njalo.

Iingcali ziyavuma ukuba zininzi nezinye iindlela zonyango ezinokunyangwa ezinomngcipheko omncinci wokuba likhoboka. Ayinakutsho into yokuba unyango lomzimba, unyango olulolunye olufana ne-acupuncture, kunye nonyango lwengqondo lunokunceda ukunciphisa ukusetyenziswa kwe-opioids, kodwa omnye umgca wokuzikhusela kwindyikityha ye-opioid bubugcisa obuvelayo obufezekiswayo kwaye bube buyamkeleka ngokubanzi. Nazi ezintlanu ezinokunceda ukunciphisa ukusetyenziswa kwe-opioid.

IiLaser zamazinyo

Uphando lubonisa ukuba abantu ngokubanzi banamayeza eentlungu ashiyekileyo emva kotyando lomlomo, njengokukhupha izinyo lobulumko, okushiya umnyango uvulelekile ekusebenziseni gwenxa. Xa ucinga ukuba ngaphezu kweepesenti ze-90 zezigulane zenze utyando oluqhelekileyo lomlomo (cinga: ukukhupha izinyo, utyando lwentsini olubandakanya ukuthungwa) lumiselwe i-opioids, ngokutsho kukaRobert H. Gregg, DDS, umseki weMillennium Dental Technologies kunye ne-Institute for Advanced Laser amazinyo, loo nto uhlobo into enkulu.

Leyo yinxalenye yesizathu sokuba enze i-LANAP laser, enokusetyenziselwa ukwenza utyando lwamazinyo kunye nokunciphisa iintlungu, ukopha kunye nexesha lokubuyisela. UGqirha uGregg uthi abaguli abakhetha ukhetho lwe-laser bamiselwe kuphela i-opioids 0.5 yepesenti yexesha-umahluko omkhulu.

Okwangoku, ii-lasers zisetyenziswa kwii-2,200 iiofisi zamazinyo ezahlukeneyo kwilizwe liphela, kwaye uGqirha Gregg uthi ulindele ukuba eli nani likhule ngokuzinzileyo njengoko abantu befunda ngakumbi ngamazinyo e-laser kwaye baqonde ukwehla kokumisela i-opioids zotyando lomlomo.

Ukukhupha kancinci ii-Anesthetics zaseKhaya

Ezi ntlobo zamayeza bezikho kangangesithuba seminyaka embalwa, kodwa ziya zisanda ukunikezelwa kuluhlu olubanzi lweentlobo zotyando. Esona sixhaphakileyo sibizwa ngokuba yi-Exparel, eyindlela yokukhulula kade yeyeza lendawo elibizwa ngokuba yi-bupivacaine. UJoe Smith, M.D., ugqirha obulala iintlungu kwiSibhedlele i-Inova Loudon eLeesburg, eVirginia uthi: “Liyeza elisebenza ixesha elide lokunyanga iintlungu elitofelwa ngexesha lotyando elinokulawula iintlungu kwiintsuku ezimbalwa zokuqala emva kotyando, xa izigulana zilifuna kakhulu. "Oku kunciphisa, okanye kwezinye iimeko kuphelisa, isidingo se-opioids. Ayisi kunceda nje abaguli ukuba baphephe umngcipheko ocacileyo wokuxhomekeka, kodwa kunye neziphumo ebezingalindelekanga ezinje ngoxinzelelo lokuphefumla, isicaphucaphu kunye nokugabha, ukuqhina, isiyezi nokudideka, ukubalula ezimbalwa."

Enye yezona zinto zilungileyo malunga nesi sisombululo kukuba ingasetyenziselwa iintlobo ezininzi ezahlukeneyo zotyando, kubandakanywa utyando lwamathambo afana noqhaqho lwamagxa, ukulungiswa kwe-ACL, kunye nabanye abaninzi, uDkt Smith uthi. Isetyenziswe kwakhona kutyando lweenyawo, c-amacandelo, utyando lweplastiki, utyando ngomlomo, kunye nokuninzi. Uninzi lwabantu lubalungeleyo, ngaphandle kwalawo aleji ye-anesthetics yendawo kunye nabo banesifo sesibindi, ngokukaGqirha Smith.

Icala elisezantsi kuphela? "Ngelixa esebenza ixesha elide i-anesthetics yendawo efana ne-Exparel inokunceda ukunciphisa isidingo se-opioid yasemva kokusebenza, ezi ziyabiza kwaye uninzi lwezigulana zikhetha uqoqosho lwenketho ye-opioid," utshilo u-Adam Lowenstein, MD, ugqirha weplastikhi kunye ne-migraine. Ezinye izicwangciso zeinshurensi zingayigubungela okanye ziyigubungele ngokuyinxenye, kodwa ngokuqinisekileyo ayisiyonto iqhelekileyo. Sekunjalo, ibonelela ngokhetho oluluncedo kwabo baqinisekileyo ukuba abafuni i-opioids post-op.

ITekhnoloji yeCandelo le-C eNtsha

"C-candelo lutyando olukhulu, ke phantse bonke abantu basetyhini bafumana iopioids post cesarean," utshilo uRobert Phillips Heine, MD, ob-gyn eDuke University Medical Center. "Ngenxa yokuba ukuhanjiswa okwexeshana yeyona nkqubo iqhelekileyo eyenziwa e-United States, kuya kuba luncedo ukunciphisa inani le-narcotic efunekayo, njengoko utyando olukhulu luyindlela eyaziwayo yokuxhomekeka kwe-opioid," uyongeza. (Idibeneyo: Ngaba i-Opioids iyimfuneko ngokwenene emva kweC-C?)

Ukongeza kukhetho lwe-anesthetic njenge-Exparel, kukho into ebizwa ngokuba luvavanyo olungenasiphelo kunyango olunokuthi lunciphise isidingo seopioids emva kwecandelo le-c. Ugqirha Heine uthi: "Unyango oluvaliweyo loxinzelelo olubi oluvaliweyo lukhusela ukutsalwa kungcoliseko lwangaphandle, lunceda ukubamba imiphetho ye-incision kunye, kwaye lususe ulwelo kunye nezinto zosulelo," utshilo uGqr. "Kukunxiba okungenazintsholongwane okusetyenziselwa ukusikwa kotyando kwaye kuqhotyoshelwe kwimpompo ehambisa uxinzelelo olubi oluqhubekayo kwaye ihlala ikho iintsuku ezintlanu ukuya kwezisixhenxe." Oku kwaqaliswa okokuqala ukuthintela usulelo emva kotyando, kodwa oogqirha bafumanisa ukuba ikwabangele nokwehliswa kwemali yamayeza eentlungu afunwa ngabasetyhini ababenayo. Okwangoku, le ndlela isetyenziswa ikakhulu kwizigulana ezinomngcipheko omkhulu wosulelo, njengaleyo ine-BMI engaphezulu kwama-40, kuba ezo zizigulana zophando ezibonisa izibonelelo, utshilo uGqirha Heine. "Ukuba idatha eninzi ifumaneka ecebisa ukuba ithintele usulelo kunye / okanye inciphise ukusetyenziswa kwe-narcotic kwizigulana ezisengozini esezantsi, iya kusetyenziswa nakwabemi."

Uvavanyo lweDNA

Siyazi ukuba umlutha uyinxalenye yemfuza, kwaye abaphandi bakholelwa ukuba bazikhethele ezinye zofuzo ezinokuxela kwangaphambili ukuba umntu uza kuba likhoboka leeopioid okanye hayi. Ngoku, kukho uvavanyo lwasekhaya onokuthi uluthathe ukuvavanya umngcipheko wakho. Enye yezona zidumileyo ibizwa ngokuba yiLifeKit Predict, eyenziwe yiPrescient Medicine. Ngokophando olupapashwe kwi- Izibhengezo zeNzululwazi yeLabhoratri yeNzululwazi, Iindlela ezintsha zokuvavanya ezisetyenziswa yi-Prescient inokuqikelela nge-97 yepesenti ngokuqinisekileyo ukuba umntu unomngcipheko ophantsi wokuba likhoboka le-opioid. Nangona olu phononongo lwaluluncinci kwaye abanye oogqirha ababandakanyeka kwinkampani babeyinxalenye yesifundo, kubonakala ngathi lubonisa ukuba uvavanyo lunokuba luncedo kumntu ochaphazelekayo ngomngcipheko wokulutha.

Kubaluleke kakhulu ukuba uqaphele ukuba olu vavanyo ngokuqinisekileyo alunakuqinisekisa ukuba umntu uza kuba okanye angayi kuba likhoboka leeopioid, kodwa unokubonelela ngolwazi oluluncedo kwabo bathatha isigqibo sokuba bayazisebenzisa. Uvavanyo lugqunywe zizicwangciso ezithile zeinshurensi, kwaye nangona ungayidingi into yokuyithatha, iPrescient icebisa kakhulu ukuba ubonane nogqirha wakho malunga novavanyo kunye neziphumo wakube uzifumene. (Eyeleleneyo: Ngaba uVavanyo lwezonyango eKhaya luyakunceda okanye luyakwenzakalisa?)

Unyango lokuhlaziya

Ukuba uke weva kuphela malunga neeseli ze-stem ngokubhekiselele kwi-cloning, unokumangaliswa ukufumanisa ukuba zisetyenziswa kakhulu kumayeza njengendlela yokujongana neentlungu. Unyango lwe-stem cell yinxalenye yonyango olukhulu olubizwa ngokuba liyeza lokuhlaziya. "Iyeza lokuvuselela liyindlela yokuguqula ukunyanga izifo ezininzi kunye nokulimala," kuchaza uKristin Comella, Ph.D., iGosa eliyiNtloko leSayensi ye-American Stem Cell Centres of Excellence. "Iyaqhubeka ukukhula, kwaye ibandakanya iindlela ngeendlela ezahlukeneyo, ezinje ngonyango lwe-stem cell, ukubopha umzimba wakho ngendlela yokunyanga yendalo." Ngelixa amayeza e-opioid ajongana neempawu zentlungu, unyango lwe-stem cell lujonge ukujongana nonobangela wentlungu. Ngale ndlela, unyango lwesiqu se-stem lulawula kakuhle iintlungu kwaye lunokunciphisa isidingo sokuthomalalisa iintlungu nge-opioids, utshilo uComella.

Ke lubandakanya ntoni kanye kanye unyango? Iiseli ze-Stem zikhona kuzo zonke izicubu emizimbeni yethu kwaye umsebenzi wazo ophambili kukugcina kunye nokulungisa izicubu ezonakalisiweyo, utshilo uComella. "Banokwahlulwa kwindawo enye emzimbeni wakho kwaye bafuduselwe kwenye indawo efuna ukuphiliswa, ukujongana neentlungu kwiindawo ezahlukeneyo." Okubaluleke kakhulu, iiseli ze-stem zisetyenziswa kuphela kwisixhobo sakho yeyakho Umzimba kolu nyango, osusa ezinye zeendlela zokuziphatha eziza kunye negama elithi "iiseli zeziqu."

Ngamanye amaxesha, unyango lwe-stem cell ludibaniswa ne-platelet-rich plasma therapy (PRP), ethi uComella yenza njengesichumiso seeseli ze-stem. "I-PRP ngabantu abatyebileyo bezinto zokukhula kunye neeproteni ezifunyenwe kwigazi lomntu. Iyakwenyusa ukuphiliswa kwecascade eveliswa ziiseli ezinxamnye nokudumba," ucacisa. "I-PRP iphumelele kakhulu ekunyangeni iintlungu ezibangelwe kukonzakala okutsha kuba inyusa iiseli zokuphilisa esele zikhulisile njengoko zihlala ziya kwindawo eyonzakeleyo." Kwaye, unyango lungasetyenziselwa ukukhawulezisa ukuphelisa iintlungu ezichasayo kwimicimbi engapheliyo njenge-osteoarthritis, utshilo uComella.

Kubalulekile ukuqaphela ukuba unyango lwe-stem cell alukho ngokuchanekileyo eqhelekileyo, kwaye ayivunywanga yi-FDA. Ngelixa i-FDA (kunye nabaphandi abaninzi bezonyango, kulo mbandela) ivuma ukuba unyango lwe-stem cell luyathembisa, abakholelwa ukuba kukho uphando olwaneleyo malunga nalo ukuba luvume njengonyango. Ibali elifutshane: Ayisiyo kangako ukuba i-FDA ayicingi ukuba unyango lwe-stem yeseli luyasebenza, ngaphezulu kukuba asinalo ulwazi olwaneleyo lokuyisebenzisa ngokukhuselekileyo okanye ngokuthembekileyo.Ngokwenza kuphela isigulana, iinkqubo ze-anesthesia-free elawulwa ngoogqirha besebenzisa iiseli zezigulana, nangona kunjalo, iiklinikhi zeseli ezinamanzi ziyakwazi ukusebenza ngaphakathi kwezikhokelo ze-FDA.

Ngelixa amayeza okuzihlaziya engenakucetyiswa ngugqirha-kwaye ngokuqinisekileyo ayizukugutyungelwa yi-inshurensi yakho-isekukukhangela okukhangelekileyo phambili nokuba loluphi unyango olunokuba lunjengamashumi eminyaka ukusukela ngoku.

Uphengululo lwe