TEYXOS 172 3/17/09 11:13 AM Page 3 - μ. πιτσιλιδης α.ε.
TEYXOS 172 3/17/09 11:13 AM Page 3 - μ. πιτσιλιδης α.ε.
TEYXOS 172 3/17/09 11:13 AM Page 3 - μ. πιτσιλιδης α.ε.
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<strong>TEYXOS</strong> <strong><strong>17</strong>2</strong> 3/<strong>17</strong>/<strong>09</strong> <strong>11</strong>:14 <strong>AM</strong> <strong>Page</strong> 60<br />
Σ Υ Ν Τ Ο Μ Η Ε Ν Η Μ Ε Ρ Ω Σ Η<br />
Είν<strong>α</strong>ι ση<strong>μ</strong><strong>α</strong>ντικό οι<br />
γι<strong>α</strong>τροί ν<strong>α</strong> ρωτούν<br />
<strong>μ</strong>ήπως υπάρχουν<br />
<strong>ε</strong>νδ<strong>ε</strong>ίξ<strong>ε</strong>ις <strong>α</strong>κράτ<strong>ε</strong>ι<strong>α</strong>ς<br />
κοπράνων σ<strong>ε</strong> <strong>ε</strong>ξ<strong>ε</strong>τάσ<strong>ε</strong>ις<br />
<strong>μ</strong><strong>ε</strong>τά τον τοκ<strong>ε</strong>τό<br />
κ<strong>α</strong>ι ν<strong>α</strong> π<strong>α</strong>ρ<strong>α</strong>κολουθού<strong>μ</strong><strong>ε</strong><br />
τις <strong>α</strong>σθ<strong>ε</strong>ν<strong>ε</strong>ίς<br />
ώστ<strong>ε</strong> ν<strong>α</strong> δι<strong>α</strong>β<strong>ε</strong>β<strong>α</strong>ιωθού<strong>μ</strong><strong>ε</strong><br />
ότι η<br />
<strong>α</strong>κράτ<strong>ε</strong>ι<strong>α</strong> θ<strong>α</strong> υποχωρήσ<strong>ε</strong>ι.<br />
60 / MEDICAL EXPRESS / TEYXOΣ <strong><strong>17</strong>2</strong> / ΜΑΡΤΙΟΣ 20<strong>09</strong><br />
τ<strong>α</strong>ς στον <strong>α</strong>υτοκινητόδρο<strong>μ</strong>ο σ<strong>ε</strong> π<strong>α</strong>ιδιά<br />
που δ<strong>ε</strong>ν <strong>ε</strong>ίχ<strong>α</strong>ν ποτέ άσθ<strong>μ</strong><strong>α</strong> ούτ<strong>ε</strong> κάπνιζ<strong>α</strong>ν.<br />
Αν κ<strong>α</strong>ι η <strong>μ</strong>όλυνση του <strong>α</strong>έρ<strong>α</strong> στην<br />
π<strong>ε</strong>ριοχή συσχ<strong>ε</strong>τίσθηκ<strong>ε</strong> <strong>ε</strong>πίσης <strong>μ</strong><strong>ε</strong> τη <strong>μ</strong><strong>ε</strong>ιω<strong>μ</strong>ένη<br />
λ<strong>ε</strong>ιτουργί<strong>α</strong> των πν<strong>ε</strong>υ<strong>μ</strong>όνων, η<br />
<strong>ε</strong>πίδρ<strong>α</strong>ση της <strong>ε</strong>γγύτητ<strong>α</strong>ς στον <strong>α</strong>υτοκινητόδρο<strong>μ</strong>ο<br />
ήτ<strong>α</strong>ν <strong>α</strong>ν<strong>ε</strong>ξάρτητη της ποιότητ<strong>α</strong>ς<br />
του <strong>α</strong>έρ<strong>α</strong> στην π<strong>ε</strong>ριοχή.<br />
Σχόλιο: Επ<strong>ε</strong>ιδή η λ<strong>ε</strong>ιτουργί<strong>α</strong> των πν<strong>ε</strong>υ<strong>μ</strong>όνων<br />
συνήθως <strong>α</strong>ν<strong>α</strong>πτύσσ<strong>ε</strong>τ<strong>α</strong>ι πλήρως<br />
ως την ηλικί<strong>α</strong> των 18, προβλή<strong>μ</strong><strong>α</strong>τ<strong>α</strong><br />
όπως <strong>α</strong>υτά που συν<strong>α</strong>ντήσ<strong>α</strong><strong>μ</strong><strong>ε</strong> στη <strong>μ</strong><strong>ε</strong>λέτη<br />
<strong>ε</strong>ίν<strong>α</strong>ι πιθ<strong>α</strong>νό ν<strong>α</strong> συν<strong>ε</strong>χίσουν ν<strong>α</strong> υφίστ<strong>α</strong>ντ<strong>α</strong>ι<br />
κ<strong>α</strong>ι στην <strong>ε</strong>νήλικο ζωή. Οι προσπάθ<strong>ε</strong>ι<strong>ε</strong>ς<br />
<strong>μ</strong><strong>ε</strong>ίωσης των <strong>α</strong>ν<strong>α</strong>πν<strong>ε</strong>υστικών<br />
προβλη<strong>μ</strong>άτων που προκ<strong>α</strong>λούντ<strong>α</strong>ι <strong>α</strong>πό<br />
τη <strong>μ</strong>όλυνση του <strong>α</strong>έρ<strong>α</strong> δ<strong>ε</strong> θ<strong>α</strong> πρέπ<strong>ε</strong>ι ν<strong>α</strong><br />
<strong>ε</strong>στιάσουν <strong>μ</strong>όνο στην ποιότητ<strong>α</strong> του <strong>α</strong>έρ<strong>α</strong><br />
της π<strong>ε</strong>ριοχής, <strong>α</strong>λλά <strong>ε</strong>πίσης κ<strong>α</strong>ι σ<strong>ε</strong> πιο<br />
τοπικής ση<strong>μ</strong><strong>α</strong>σί<strong>α</strong>ς π<strong>α</strong>ράγοντ<strong>ε</strong>ς, όπως<br />
η δι<strong>α</strong><strong>μ</strong>ονή κοντά σ<strong>ε</strong> <strong>α</strong>υτοκινητόδρο<strong>μ</strong>ους<br />
τ<strong>α</strong>χ<strong>ε</strong>ί<strong>α</strong>ς κυκλοφορί<strong>α</strong>ς.<br />
Βιβλιογρ<strong>α</strong>φί<strong>α</strong>: Gauderman WJ et al.<br />
Effect of exposure to traffic on lung<br />
development from 10 to 18 years of<br />
age: A cohort study. Lancet 2007 Feb<br />
<strong>17</strong>; 369: 571 – 7.<br />
Ακράτ<strong>ε</strong>ι<strong>α</strong> κοπράνων<br />
<strong>μ</strong><strong>ε</strong>τά τον τοκ<strong>ε</strong>τό<br />
Ο φυσικός τοκ<strong>ε</strong>τός θ<strong>ε</strong>ωρ<strong>ε</strong>ίτ<strong>α</strong>ι β<strong>α</strong>σική<br />
<strong>α</strong>ιτί<strong>α</strong> πρόκλησης <strong>α</strong>κράτ<strong>ε</strong>ι<strong>α</strong>ς κοπράνων.<br />
Ερ<strong>ε</strong>υνητές <strong>ε</strong>ξέτ<strong>α</strong>σ<strong>α</strong>ν όλ<strong>ε</strong>ς τις γυν<strong>α</strong>ίκ<strong>ε</strong>ς<br />
που γέννησ<strong>α</strong>ν στο Όρ<strong>ε</strong>γκον κ<strong>α</strong>τά τη<br />
διάρκ<strong>ε</strong>ι<strong>α</strong> <strong>μ</strong>ι<strong>α</strong>ς <strong>ε</strong>ξ<strong>α</strong><strong>μ</strong>ηνι<strong>α</strong>ί<strong>α</strong>ς π<strong>ε</strong>ριόδου,<br />
το 2002, προκ<strong>ε</strong>ι<strong>μ</strong>ένου ν<strong>α</strong> υπολογίσουν<br />
τ<strong>α</strong> συ<strong>μ</strong>βά<strong>μ</strong><strong>α</strong>τ<strong>α</strong> <strong>α</strong>κράτ<strong>ε</strong>ι<strong>α</strong>ς κοπράνων<br />
στους 3 έως 6 <strong>μ</strong>ήν<strong>ε</strong>ς <strong>μ</strong><strong>ε</strong>τά τον τοκ<strong>ε</strong>τό.<br />
Από τις π<strong>ε</strong>ρισσότ<strong>ε</strong>ρ<strong>ε</strong>ς <strong>α</strong>πό 8700 γυν<strong>α</strong>ίκ<strong>ε</strong>ς<br />
που ολοκλήρωσ<strong>α</strong>ν την έρ<strong>ε</strong>υν<strong>α</strong><br />
(ποσοστό <strong>α</strong>ντ<strong>α</strong>πόκρισης 40%), το 29%<br />
<strong>α</strong>νέφ<strong>ε</strong>ρ<strong>ε</strong> ότι π<strong>α</strong>ρουσί<strong>α</strong>ζ<strong>ε</strong> <strong>α</strong>κράτ<strong>ε</strong>ι<strong>α</strong> κοπράνων<br />
– που ορίσθηκ<strong>ε</strong> ως τ<strong>α</strong> <strong>ε</strong>π<strong>α</strong>ν<strong>α</strong>λ<strong>α</strong><strong>μ</strong>β<strong>α</strong>νό<strong>μ</strong><strong>ε</strong>ν<strong>α</strong><br />
<strong>ε</strong>π<strong>ε</strong>ισόδι<strong>α</strong> <strong>α</strong>πώλ<strong>ε</strong>ι<strong>α</strong>ς κοπράνων<br />
ή <strong>α</strong><strong>ε</strong>ρίων – <strong>μ</strong><strong>ε</strong>τά τον τοκ<strong>ε</strong>τό. Το<br />
46% των γυν<strong>α</strong>ικών <strong>μ</strong><strong>ε</strong> <strong>α</strong>κράτ<strong>ε</strong>ι<strong>α</strong> <strong>α</strong>νέφ<strong>ε</strong>ρ<strong>ε</strong><br />
<strong>α</strong>κράτ<strong>ε</strong>ι<strong>α</strong> κοπράνων. Η συχνότητ<strong>α</strong><br />
της <strong>α</strong>κράτ<strong>ε</strong>ι<strong>α</strong>ς κυ<strong>μ</strong><strong>α</strong>ινότ<strong>α</strong>ν <strong>α</strong>πό κ<strong>α</strong>θη<strong>μ</strong><strong>ε</strong>ρινή<br />
έως <strong>ε</strong><strong>μ</strong>φ<strong>α</strong>νιζό<strong>μ</strong><strong>ε</strong>νη <strong>μ</strong>όνο κ<strong>α</strong>τά<br />
τη διάρκ<strong>ε</strong>ι<strong>α</strong> της συνουσί<strong>α</strong>ς. Μ<strong>ε</strong>τά <strong>α</strong>πό<br />
προσ<strong>α</strong>ρ<strong>μ</strong>ογή των δ<strong>ε</strong>δο<strong>μ</strong>ένων σύ<strong>μ</strong>φων<strong>α</strong><br />
<strong>μ</strong><strong>ε</strong> τις φορές που <strong>ε</strong>ίχ<strong>ε</strong> γ<strong>ε</strong>ννήσ<strong>ε</strong>ι η<br />
κάθ<strong>ε</strong> γυν<strong>α</strong>ίκ<strong>α</strong>, οι συγγρ<strong>α</strong>φ<strong>ε</strong>ίς δι<strong>α</strong>πίστωσ<strong>α</strong>ν<br />
ότι ο δ<strong>ε</strong>ίκτης <strong>μ</strong>άζ<strong>α</strong>ς σώ<strong>μ</strong><strong>α</strong>τος >30,<br />
η <strong>α</strong>υξη<strong>μ</strong>ένη διάρκ<strong>ε</strong>ι<strong>α</strong> των ωθήσ<strong>ε</strong>ων του<br />
<strong>μ</strong>ωρού πριν τον τοκ<strong>ε</strong>τό, οι <strong>α</strong><strong>μ</strong>υχές τρίτου<br />
ή τ<strong>ε</strong>τάρτου β<strong>α</strong>θ<strong>μ</strong>ού κ<strong>α</strong>τά τη γένν<strong>α</strong><br />
κ<strong>α</strong>ι το ν<strong>α</strong> <strong>ε</strong>ίν<strong>α</strong>ι η <strong>μ</strong>ητέρ<strong>α</strong> κ<strong>α</strong>πνίστρι<strong>α</strong><br />
συσχ<strong>ε</strong>τίζοντ<strong>α</strong>ν σ<strong>ε</strong> στ<strong>α</strong>τιστικά ση<strong>μ</strong><strong>α</strong>ντικό<br />
β<strong>α</strong>θ<strong>μ</strong>ό <strong>μ</strong><strong>ε</strong> την <strong>α</strong>κράτ<strong>ε</strong>ι<strong>α</strong> κοπράνων.<br />
Η κ<strong>α</strong>ισ<strong>α</strong>ρική το<strong>μ</strong>ή δ<strong>ε</strong>ν <strong>ε</strong>πέφ<strong>ε</strong>ρ<strong>ε</strong> κ<strong>α</strong><strong>μ</strong>ί<strong>α</strong><br />
προστ<strong>α</strong>σί<strong>α</strong> έν<strong>α</strong>ντι της <strong>α</strong>κράτ<strong>ε</strong>ι<strong>α</strong>ς.<br />
Σχόλιο: Επ<strong>ε</strong>ιδή <strong>α</strong>ρκ<strong>ε</strong>τές γυν<strong>α</strong>ίκ<strong>ε</strong>ς διστάζουν<br />
ν<strong>α</strong> <strong>μ</strong>οιρ<strong>α</strong>στούν την <strong>α</strong>νησυχί<strong>α</strong> τους<br />
σχ<strong>ε</strong>τικά <strong>μ</strong><strong>ε</strong> την <strong>α</strong>κράτ<strong>ε</strong>ι<strong>α</strong> <strong>μ</strong><strong>ε</strong> το γι<strong>α</strong>τρό<br />
τους, <strong>ε</strong>ίν<strong>α</strong>ι ση<strong>μ</strong><strong>α</strong>ντικό οι γι<strong>α</strong>τροί ν<strong>α</strong> ρωτούν<br />
<strong>μ</strong>ήπως υπάρχουν <strong>ε</strong>νδ<strong>ε</strong>ίξ<strong>ε</strong>ις <strong>α</strong>κράτ<strong>ε</strong>ι<strong>α</strong>ς<br />
κοπράνων σ<strong>ε</strong> <strong>ε</strong>ξ<strong>ε</strong>τάσ<strong>ε</strong>ις <strong>μ</strong><strong>ε</strong>τά τον τοκ<strong>ε</strong>τό<br />
κ<strong>α</strong>ι ν<strong>α</strong> π<strong>α</strong>ρ<strong>α</strong>κολουθού<strong>μ</strong><strong>ε</strong> τις <strong>α</strong>σθ<strong>ε</strong>ν<strong>ε</strong>ίς<br />
ώστ<strong>ε</strong> ν<strong>α</strong> δι<strong>α</strong>β<strong>ε</strong>β<strong>α</strong>ιωθού<strong>μ</strong><strong>ε</strong> ότι η<br />
<strong>α</strong>κράτ<strong>ε</strong>ι<strong>α</strong> θ<strong>α</strong> υποχωρήσ<strong>ε</strong>ι. Η έρ<strong>ε</strong>υν<strong>α</strong> δ<strong>ε</strong>ν<br />
προέβη σ<strong>ε</strong> <strong>ε</strong>κτί<strong>μ</strong>ηση της διάρκ<strong>ε</strong>ι<strong>α</strong>ς της<br />
<strong>ε</strong>πιλόχ<strong>ε</strong>ι<strong>α</strong>ς <strong>α</strong>κράτ<strong>ε</strong>ι<strong>α</strong>ς, <strong>α</strong>λλά <strong>ε</strong>ίν<strong>α</strong>ι πιθ<strong>α</strong>νό<br />
ότι θ<strong>α</strong> <strong>α</strong>ποτ<strong>ε</strong>λ<strong>ε</strong>ί χρόνιο πρόβλη<strong>μ</strong><strong>α</strong><br />
<strong>μ</strong>όνο σ<strong>ε</strong> έν<strong>α</strong> <strong>μ</strong>ικρό ποσοστό γυν<strong>α</strong>ικών.<br />
Βιβλιογρ<strong>α</strong>φί<strong>α</strong>: Guise JM et al.<br />
Incidence of faecal incontinence after<br />
childbirth. Obstet Gynecol. 2007 Feb<br />
1<strong>09</strong>: 281 – 8.<br />
Αν<strong>α</strong>στολ<strong>ε</strong>ίς COX-2<br />
κ<strong>α</strong>ι γ<strong>α</strong>στρ<strong>ε</strong>ντ<strong>ε</strong>ρικό<br />
Μ<strong>ε</strong> έν<strong>α</strong>ν <strong>ε</strong>κλ<strong>ε</strong>κτικό <strong>α</strong>ν<strong>α</strong>στολέ<strong>α</strong> της<br />
κυκλοοξυγ<strong>ε</strong>νάσης 2 (COX-2), τη σ<strong>ε</strong>λ<strong>ε</strong>κοξί<strong>μ</strong>πη,<br />
ν<strong>α</strong> δι<strong>α</strong>τίθ<strong>ε</strong>τ<strong>α</strong>ι <strong>α</strong>κό<strong>μ</strong><strong>α</strong> στις ΗΠΑ<br />
κ<strong>α</strong>ι έν<strong>α</strong>ν <strong>α</strong>κό<strong>μ</strong><strong>α</strong>, την <strong>ε</strong>τορικοξί<strong>μ</strong>πη, ν<strong>α</strong><br />
βρίσκ<strong>ε</strong>τ<strong>α</strong>ι υπό <strong>α</strong>ξιολόγηση (JW 15 / 3<br />
/ 2007, σ.48 κ<strong>α</strong>ι Lancet 2007 369: 465)<br />
το προφίλ των γ<strong>α</strong>στρ<strong>ε</strong>ντ<strong>ε</strong>ρικών <strong>α</strong>ν<strong>ε</strong>πιθύ<strong>μ</strong>ητων<br />
<strong>ε</strong>ν<strong>ε</strong>ργ<strong>ε</strong>ιών <strong>α</strong>υτών των φ<strong>α</strong>ρ<strong>μ</strong>άκων<br />
<strong>ε</strong>ξ<strong>α</strong>κολουθ<strong>ε</strong>ί ν<strong>α</strong> προσ<strong>ε</strong>λκύ<strong>ε</strong>ι το<br />
<strong>ε</strong>νδι<strong>α</strong>φέρον όλων.<br />
Σ<strong>ε</strong> <strong>μ</strong>ι<strong>α</strong> ένθ<strong>ε</strong>τη <strong>α</strong>ν<strong>α</strong>δρο<strong>μ</strong>ική συγκριτική<br />
<strong>μ</strong><strong>ε</strong>λέτη, οι <strong>ε</strong>ρ<strong>ε</strong>υνητές χρησι<strong>μ</strong>οποίησ<strong>α</strong>ν<br />
<strong>μ</strong>ι<strong>α</strong> βάση δ<strong>ε</strong>δο<strong>μ</strong>ένων πληθυσ<strong>μ</strong>ού <strong>α</strong>πό<br />
το Ηνω<strong>μ</strong>ένο Β<strong>α</strong>σίλ<strong>ε</strong>ιο γι<strong>α</strong> ν<strong>α</strong> συγκρίνουν<br />
1561 <strong>α</strong>σθ<strong>ε</strong>ν<strong>ε</strong>ίς <strong>μ</strong><strong>ε</strong> <strong>ε</strong>πιπλοκές του <strong>α</strong>νώτ<strong>ε</strong>ρου<br />
γ<strong>α</strong>στρ<strong>ε</strong>ντ<strong>ε</strong>ρικού σωλήν<strong>α</strong> (<strong>α</strong>ι<strong>μ</strong>ορρ<strong>α</strong>γί<strong>α</strong><br />
<strong>μ</strong>η οφ<strong>ε</strong>ιλό<strong>μ</strong><strong>ε</strong>νη σ<strong>ε</strong> κιρσούς οισοφάγου<br />
ή διάτρηση) <strong>μ</strong><strong>ε</strong> 10.000 άτο<strong>μ</strong><strong>α</strong><br />
ίδι<strong>α</strong>ς ηλικί<strong>α</strong>ς κ<strong>α</strong>ι φύλου που <strong>α</strong>ποτέλ<strong>ε</strong>σ<strong>α</strong>ν<br />
την ο<strong>μ</strong>άδ<strong>α</strong> <strong>ε</strong>λέγχου. Μ<strong>ε</strong>τά την προσ<strong>α</strong>ρ<strong>μ</strong>ογή<br />
σύ<strong>μ</strong>φων<strong>α</strong> <strong>μ</strong><strong>ε</strong> πιθ<strong>α</strong>νούς συγχυτικούς<br />
π<strong>α</strong>ράγοντ<strong>ε</strong>ς, ο σχ<strong>ε</strong>τικός κίνδυνος
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