Peb suav nrog kev txhaj tshuaj tiv thaiv. Part 15. Rubella

2024 Tus sau: Seth Attwood | [email protected]. Kawg hloov kho: 2023-12-16 16:06

1. Rubella nyob rau hauv cov menyuam yaus yog ib yam kab mob tseem ceeb tshaj li kab mob qog. Txawm li cas los xij, rubella tuaj yeem ua rau muaj kev phom sij rau cov poj niam cev xeeb tub hauv thawj peb lub hlis twg.

Tsis zoo li tus hnoos hawb pob, qhov twg cov neeg laus thiab menyuam yaus tau txhaj tshuaj tiv thaiv menyuam mos, nyob rau hauv rooj plaub ntawm rubella, qhov sib txawv, cov menyuam mos tau txhaj tshuaj tiv thaiv cov poj niam cev xeeb tub. Lossis, cov menyuam mos tau txhaj tshuaj tiv thaiv menyuam mos.

2. CDC Pinkbook

Rubella yog asymptomatic hauv 50% ntawm cov neeg mob. Hauv cov poj niam laus, rubella feem ntau yog nrog kev mob caj dab (mob pob qij txha) thiab mob caj dab.

Rubella tsis tshua muaj teeb meem. Cov teeb meem tshwm sim hauv cov neeg laus dua li cov menyuam yaus.

Rubella nyob rau hauv thawj peb lub hlis twg ntawm cev xeeb tub tuaj yeem ua rau muaj kev tsis haum xeeb ntawm tus menyuam hauv plab los yog rho menyuam tawm.

Hauv xyoo 1980, 30% ntawm tus mob rubella tau tshaj tawm rau cov neeg laus (15-39 xyoo). Tom qab txhaj tshuaj tiv thaiv, 60% ntawm cov neeg mob tau sau tseg hauv 20-49 xyoo (hnub nyoog nruab nrab 32 xyoo).

35% ntawm cov poj niam tom qab yug me nyuam muaj mob caj dab tom qab txhaj tshuaj tiv thaiv, thiab 10% tsim mob caj dab.

Txawm hais tias ib koob tshuaj tiv thaiv yog txaus rau kev tiv thaiv rubella, cov menyuam yaus yuav tsum tau txais ob koob tshuaj MMR. Zoo, tsuas yog vim tsis muaj tshuaj tiv thaiv rubella cais.

Muaj pov thawj tsis txaus ntawm kev tiv thaiv kab mob li cas rau qhov koob thib ob ntawm cov kab mob qog thiab cov tshuaj tiv thaiv rubella.

3. Rubella (Banatvala, 2004, Lancet)

Rubella feem ntau yog qhov txawv ntawm parvovirus B19, herpes simplex type 6, dengue fever, group A streptococcus, qhua pias, thiab lwm yam kab mob kis. Yog li ntawd, kev kuaj pom tseeb yog qhov tsim nyog rau kev kuaj mob kom raug.

Rubella tuaj yeem cog lus dua. Qhov kev pheej hmoo rov kis mob tom qab txhaj tshuaj tiv thaiv yog siab dua tom qab muaj kab mob.

Hom RA27 / 3, uas tau siv rau hauv txhua qhov tshuaj tiv thaiv rubella txij li xyoo 1979 (tshwj tsis yog Nyiv thiab Tuam Tshoj, uas siv lawv tus kheej hom), raug cais tawm hauv xyoo 1965 los ntawm kev rho menyuam hauv plab. RA stands rau Rubella Abortus (piv txwv li fetus rho tawm vim leej niam rubella), 27/3 txhais tau tias peb cov ntaub so ntswg (lub raum) ntawm 27th fetus. Nyob rau yav dhau los 26 fetuses rho tawm vim rubella, tus kab mob no tsis pom. Tus kab mob cais tawm tsis muaj zog los ntawm kev hla nws serially 25-30 zaug los ntawm lub ntsws rho tawm (WI-38).

4. Kev tshawb fawb txog kev txhaj tshuaj tiv thaiv kab mob rubella nyob. Kev sim hauv cov menyuam yaus uas muaj kab mob kis los ntawm tus menyuam hauv plab. (Plotkin, 1965, Am J Dis Child)

Nws mus rau qhov nthuav dav ntxiv txog seb tus kab mob no raug cais li cas, tshuaj tiv thaiv li cas, thiab nws tau sim li cas rau cov menyuam ntsuag nyob hauv Philadelphia.

Ntxiv nrog rau kev tswj hwm subcutaneous ntawm cov tshuaj tiv thaiv, kev tswj xyuas qhov ntswg kuj tau sim, tab sis nws tsis zoo.

Kev sim tshuaj tiv thaiv qhov ntswg kuj tau tshaj tawm ntawm no, ntawm no thiab ntawm no. Txoj kev subcutaneous ntawm kev tswj hwm tshuaj tiv thaiv zoo li tau xaiv thaum kawg vim tias cov tshuaj tiv thaiv qhov ntswg xav tau tus kab mob ntau dua thiab vim tias cov tshuaj tiv thaiv subcutaneous yooj yim dua rau kev tswj hwm.

5. Cov tshuaj tiv thaiv kab mob rubella: yav dhau los, tam sim no thiab yav tom ntej. (Zoo tshaj, 1991, Epidemiol Infect)

Thawj qhov tshuaj tiv thaiv kab mob rubella, HPV77. DE5, tau tshwm sim xyoo 1961. Thiab nws tau hu ua qhov ntawd vim tias nws tsis muaj zog los ntawm 77 serial dhau los ntawm lub raum hlwb ntawm liab liab, thiab tom qab ntawd 5 zaug ntxiv los ntawm fibroblasts ntawm duck embryos. Duck fibroblasts tau ntxiv vim nws ntseeg tias muaj tsawg dua cov kab mob txawv teb chaws thiab lwm yam kab mob hauv avian embryos dua li ntawm ob lub raum liab. Cov tshuaj tiv thaiv no tau siv dav hauv Tebchaws Meskas thiab Europe hauv xyoo 1970s, thiab thawj koob tshuaj tiv thaiv MMR (MMR1) muaj cov kab mob no. Niaj hnub no MMR-II yog siv, uas tau tso cai nyob rau hauv 1988.

Lwm hom kab mob rubella, HPV77. DK12, tau ua kom qis dua duck fibroblasts los ntawm 12 serial kis los ntawm cov kab mob hauv lub raum. Cov tshuaj tiv thaiv no tau tso cai nyob rau xyoo 1969, tab sis tau txiav tawm tom qab ob peb xyoos vim tias nws ua rau muaj kev phiv ntau dhau (mob mob caj dab hauv cov menyuam yaus ntev txog peb xyoos).

Cov kab mob RA27 / 3 ua rau mob arthropathy (kev puas tsuaj sib koom ua ke) uas kav ntev tshaj 18 lub hlis hauv 5% ntawm cov poj niam, mob pob qij txha hauv 42%, thiab pob khaus hauv 25%. Ib txoj kev tshawb nrhiav pom tias mob pob qij txha tsis tshua muaj tshwm sim hauv cov neeg uas tau txhaj tshuaj li ntawm 6-24 hnub ntawm qhov pib ntawm kev coj khaub ncaws, thiab lwm txoj kev tshawb nrhiav pom tias mob pob qij txha tshwm sim feem ntau hauv cov neeg uas tau txhaj tshuaj li ntawm xya hnub ntawm qhov pib ntawm cev xeeb tub…Cov kws sau ntawv pom zoo kom txhaj tshuaj tiv thaiv hauv 7 hnub kawg ntawm lub voj voog.

Kev tshawb fawb me me tau ua tiav ntawm lub luag haujlwm ntawm kev tiv thaiv cellular hauv rubella. Kev hloov pauv ntawm lymphocytes qis dua tom qab inoculation dua tom qab ntuj rubella.

Rubella boosters tsis muaj txiaj ntsig tshwj xeeb. Hauv cov neeg uas muaj cov tshuaj tiv thaiv qis qis, kev txhaj tshuaj tiv thaiv tsuas yog nce me ntsis hauv cov tshuaj tiv thaiv kab mob, thaum 28% tsis muaj qhov nce ntxiv.

6. Kev nyab xeeb, kev tiv thaiv kab mob thiab qhov mob tam sim ntawm intramuscular piv rau subcutaneous tswj hwm ntawm cov tshuaj tiv thaiv kab mob qhua pias-mob-rubella-varicella rau cov menyuam hnub nyoog 11-21 lub hlis. (Knuf, 2010, Eur J Pediatr)

MMR thiab MMRV, tsis zoo li cov tshuaj tiv thaiv uas tsis muaj sia nyob, yuav tsum tau muab subcutaneously, tsis yog intramuscularly. Tab sis txij li ob peb tus neeg paub yuav ua li cas txhaj tshuaj subcutaneous, qhov kev tshawb fawb no tau sim seb yuav ua li cas yog tias MMRV tau txhaj tshuaj intramuscularly, thiab xaus lus tias qhov no kuj ua tau. Zoo, txawm li cas los xij, thawj 42 hnub tom qab txhaj tshuaj, txhua yam zoo.

7. Kev kis kab mob thaum cev xeeb tub. (Silasi, 2015, Am J Reprod Immunol)

Muaj ntau cov kab mob thiab cov kab mob uas tsis yog rubella, yog tias kis tau thaum cev xeeb tub, ua rau muaj kev pheej hmoo ntawm kev yug menyuam los yog rho menyuam tawm. Piv txwv li, kab mob herpes, kab mob qhua pias, cytomegalovirus, kab mob siab, mob khaub thuas, parvovirus B19, syphilis, listeria, toxoplasma, chlamydia, Trichomonas, thiab lwm yam. Tab sis lawv feem ntau tsis txhaj tshuaj tiv thaiv, yog li ob peb ntshai lawv.

8. Rubella nyob teb chaws Europe. (Galazka, 1991, Epidemiol Infect)

Xyoo 1984, WHO European Office tau txiav txim siab tshem tawm rubella los ntawm xyoo 2000 (nrog rau qhua pias, polio, neonatal tetanus thiab diphtheria).

Txij li thaum pib ntawm MMR nyob rau hauv teb chaws Poland, Finland thiab lwm lub teb chaws, rubella tshwm sim tau hloov ntawm cov me nyuam mus rau cov hluas thiab cov neeg laus.

Muaj peb txoj kev txhaj tshuaj tiv thaiv:

1) Ib koob tshuaj MMR ntawm 15 lub hlis rau txhua tus menyuam yaus (US)

2) Ib koob tshuaj tiv thaiv rubella tsuas yog rau cov ntxhais hnub nyoog 10-14 xyoo uas tsis tau mob (UK)

3) Ob koob tshuaj MMR ntawm 18 lub hlis thiab 12 xyoos rau txhua tus menyuam yaus (Sweden)

Txoj kev xaiv txhaj tshuaj tiv thaiv (xws li hauv tebchaws Askiv), txawm hais tias nws tau ua rau txo qis ntawm rubella tshwm sim hauv cov poj niam cev xeeb tub, tawm 3% ntawm cov poj niam tsis muaj kev tiv thaiv. Yog li ntawd, WHO tau txiav txim siab kom tshem tawm rubella tag nrho, thiab rau qhov no txhawm rau txhaj tshuaj tiv thaiv menyuam mos.

Cov qauv lej kwv yees tias tsawg dua 60-70% kev tiv thaiv cov tshuaj tiv thaiv yuav ua rau cov neeg laus rubella ntau dua.

9. Kev nce hauv qhov tshwm sim ntawm tus kab mob rubella tshwm sim tom qab txhaj tshuaj tiv thaiv hauv tebchaws Greece: kev soj ntsuam rov qab thiab kev tshuaj xyuas zoo. (Panagiotopoulos, 1999, BMJ)

Kev txhaj tshuaj Rubella tau pib hauv tebchaws Greece xyoo 1975, tab sis kev pab them nqi qis dua 50%. Qhov no tau ua rau lub fact tias tus naj npawb ntawm cov poj niam cev xeeb tub uas raug rau rubella yog tas li nce. Raws li qhov tshwm sim, xyoo 1993 tau muaj tus kabmob rubella nyob rau tim Nkij teb chaws, thiab 6-7 lub hlis tom qab, kev kis tus kabmob loj tshaj plaws ntawm tus kabmob rubella hauv keeb kwm ntawm lub tebchaws (25 kis). Ua ntej ntawd, congenital rubella syndrome yog tsawg heev nyob rau hauv tim Nkij teb chaws.

Tsis tas li ntawd, cov neeg laus pib mob rubella. Yog tias ua ntej pib txhaj tshuaj, qhov nruab nrab hnub nyoog ntawm cov neeg mob yog 7 xyoo, ces xyoo 1993 lub hnub nyoog nruab nrab yog 17 xyoo. Txawm hais tias tag nrho cov neeg mob rubella hauv xyoo 1993 qis dua xyoo 1983, cov neeg mob hnub nyoog 15 xyoo thiab laus dua tau nce.

10. Evolution of surveillance of measles, mumps, and rubella in England and Wales: muab lub platform rau pov thawj txoj cai txhaj tshuaj tiv thaiv. (Vyse, 2002, Epidemiol Rev)

Ntawm no, ntawm lwm yam, muaj ib daim duab ntawm tus naj npawb ntawm rubella cov poj niam uas muaj hnub nyoog yug menyuam hauv tebchaws Askiv los ntawm 1985 txog 1998, uas qhia tau tias tus lej tsis hloov ntau. Cov kab mob yog cov poj niam uas tseem tsis tau yug los, thiab cov kab dotted yog cov uas tau yug los.

Kev txhaj tshuaj tiv thaiv kab mob rubella hauv tebchaws Askiv tau qhia hauv xyoo 1970 rau cov menyuam ntxhais hnub nyoog 11-13 xyoos, thiab MMR tau qhia hauv xyoo 1988.

11. Global seroprevalence ntawm rubella ntawm cov poj niam cev xeeb tub thiab cov menyuam muaj hnub nyoog: ib qho kev tshuaj ntsuam xyuas. (Pandolfi, 2017, Eur J Public Health)

Xyoo 2012, WHO tau txiav txim siab tshem tawm rubella los ntawm 2020.

Txij li thaum rubella, nrog rau cov kab mob rubella hauv lub cev, yog qhov nyuaj heev rau kev kuaj mob, tus naj npawb ntawm cov neeg mob tuaj yeem yog 10-50 npaug ntau dua.

Cov kws sau ntawv tau ua qhov kev tshuaj ntsuam xyuas meta ntawm 122 rubella kev tshawb fawb hauv cov poj niam cev xeeb tub thiab cov poj niam uas muaj hnub nyoog yug me nyuam.

Hauv Africa, 10.7% ntawm cov poj niam tsis muaj tshuaj tiv thaiv kab mob rubella, hauv Asmeskas - 9.7%, Middle East - 6.9%, Europe - 7.6%, Southeast Asia - 19.4%, Far East - 9%. Nyob rau hauv tag nrho, 9.4% ntawm cov poj niam cev xeeb tub thiab 9.5% ntawm cov poj niam ntawm lub hnub nyoog yug me nyuam nyob rau hauv lub ntiaj teb no tsis muaj tshuaj tiv thaiv rau rubella, thaum lub hom phiaj ntawm WHO yog ib tug susceptibility ntawm 5% los yog tsawg dua.

Nyob rau tib lub sijhawm, hauv Africa, txog rau xyoo 2011, tsis muaj lub tebchaws tau txhaj tshuaj tiv thaiv tus kabmob rubella, hauv Asmeskas, los ntawm 2008, yuav luag txhua lub tebchaws tau txhaj tshuaj, thiab hauv Tebchaws Europe, txhua lub tebchaws tau txhaj tshuaj.

Tsoomfwv Meskas tseem tabtom siv $ 4 nphom hauv ib xyoos txhawm rau txhawm rau txhawm rau txhaj tshuaj tiv thaiv rau cov tub ntxhais hluas thiab cov neeg laus.

12. Immunogenicity ntawm koob thib ob koob tshuaj tiv thaiv kab mob qhua pias-mob-rubella (MMR) thiab cuam tshuam rau serosurveillance. (Pebody, 2002, Vaccine)

2-4 xyoos tom qab MMR, 19.5% ntawm cov menyuam yaus muaj cov tshuaj tiv thaiv kab mob qhua pias qis dua qib tiv thaiv, 23.4% ntawm cov menyuam yaus muaj kab mob qog noj ntshav qis dua qib tiv thaiv, thiab 4.6% ntawm cov menyuam yaus muaj cov tshuaj tiv thaiv kab mob rubella qis dua qib tiv thaiv.

41% ntawm cov menyuam yaus tsis muaj kev tiv thaiv tsawg kawg ib tus kab mob, uas txhais tau hais tias yuav tsum tau txhaj tshuaj tiv thaiv thib ob. Cov txiaj ntsig zoo sib xws tau pom hauv lwm cov kev tshawb fawb hauv UK thiab Canada.

Kev txhaj tshuaj MMR rov qab ua rau nce qib ntawm cov tshuaj tiv thaiv kab mob qhua pias thiab rubella, tab sis tom qab 2-3 xyoos nws txo qis mus rau qib tshuaj tiv thaiv ua ntej. Cov txiaj ntsig zoo sib xws tau tshaj tawm hauv lwm qhov kev tshawb fawb hauv Finland thiab lwm qhov.

Cov kws sau ntawv xaus lus tias qib ntawm cov tshuaj tiv thaiv kab mob hauv cov ntshav cuam tshuam tsis zoo nrog rau qib kev tiv thaiv kab mob.

13. Kev kis mob ntawm qhua pias, mumps thiab rubella hauv Ltalis. (Gabutti, 2002, Epidemiol Infect)

Hauv tebchaws Ltalis, txij li xyoo 70 txog rau 90s, tus naj npawb ntawm tus mob qhua pias tau txo qis ntawm cov menyuam yaus thiab nce ntxiv ntawm cov tub ntxhais hluas thiab cov neeg laus.

Qhov tshwm sim ntawm mumps tau nce ntau ntawm cov menyuam yaus hnub nyoog qis dua 14 xyoo, thiab tseem tsis tau hloov pauv ntawm cov neeg laus. Tej zaum qhov no yog vim lub fact tias nyob rau hauv ltalis lub Rubini strain tau siv, uas tau hloov mus ua tsis tau zoo heev. Cov kab mob no tau hloov pauv hauv xyoo 2001.

Tus naj npawb ntawm tus mob rubella ntawm cov menyuam yaus tau nce hauv xyoo 1980 thiab tom qab ntawd tsis kam dua. Ntawm cov tub ntxhais hluas thiab cov neeg laus, qhov tshwm sim ntawm rubella tau nce ntau hauv xyoo 1980s thiab tseem siab tom qab ntawd.

Ntawm cov menyuam yaus hnub nyoog 2-4 xyoos, 59% muaj cov tshuaj tiv thaiv kab mob qhua pias thiab rubella, tab sis tsuas yog 32% muaj cov tshuaj tiv thaiv rau tag nrho peb cov kab mob. Ntawm cov menyuam yaus hnub nyoog 14 xyoos, tsuas yog 46% muaj cov tshuaj tiv thaiv rau tag nrho peb cov kab mob. Ntawm cov hnub nyoog 20 xyoo thiab laus dua, 6.1% tsis muaj cov tshuaj tiv thaiv kab mob qhua pias, 11.7% mumps, thiab 8.8% cov hnub nyoog 15 xyoo thiab laus dua tsis muaj cov tshuaj tiv thaiv kab mob rubella.

Qhov xwm txheej ntawm rubella tsis tau hloov pauv hauv kaum xyoo tsis ntev los no, txawm tias qhov tseeb tias kev txhaj tshuaj tiv thaiv rubella tau qhia hauv tebchaws Ltalis rau cov ntxhais thaum ntxov xyoo 1970. Ntawm qhov tsis sib xws, tsis txaus txhaj tshuaj tiv thaiv siab, uas tsis ua rau kev tshem tawm ntawm tus kab mob, ua rau, xws li mob qhua pias, mus rau qhov tseeb tias tus kab mob hloov mus rau hauv cov neeg laus, uas nyob rau hauv rooj plaub ntawm rubella yog qhov txaus ntshai ntau dua., vim muaj kev pheej hmoo kis tus kab mob thaum cev xeeb tub.

Cov kws sau ntawv xaus lus tias WHO lub hom phiaj ntawm kev tshem tawm tus mob qhua pias, mumps thiab rubella tsis tau ua tiav, thiab kev txhaj tshuaj tsis txaus hauv tebchaws Ltalis tsuas yog ua rau muaj tus mob qhua pias thiab rubella ntau ntxiv, thiab hauv cov kab mob qog, kev txhaj tshuaj tsis tau ua haujlwm txhua..

14. Humoral tiv thaiv kab mob nyob rau hauv congenital rubella. (Hayes, 1967, Clin Exp Immunol)

Tsis muaj kev sib raug zoo ntawm tus nqi ntawm cov tshuaj tiv thaiv thiab kev tshem tawm tus kab mob hauv cov neeg mob uas muaj tus kab mob rubella hauv lub cev.

15. Congenital rubella kab mob tom qab kev tiv thaiv ntawm leej niam yav dhau los. (Saule, 1988, Eur J Pediatr)

Kev txhaj tshuaj ntawm leej niam tsis yog ib txwm muab kev tiv thaiv ntawm congenital rubella syndrome rau tus menyuam. Ntawm no yog cov ntaub ntawv ntawm leej niam uas tau txhaj tshuaj tiv thaiv 7 xyoo ua ntej cev xeeb tub thiab muaj cov tshuaj tiv thaiv txaus 3 xyoos ua ntej cev xeeb tub, tab sis txawm li cas los xij tau cog lus rubella thaum cev xeeb tub.

Nov yog qee qhov xwm txheej zoo sib xws:

16. Tshuaj tiv thaiv kab mob qhua pias, mumps thiab rubella rau cov me nyuam. (Demicheli, 2012, Cochrane Database Syst Rev)

Hauv kev tshuaj xyuas los ntawm Cochrane, cov kws sau ntawv xaus lus tias tsis muaj kev tshawb fawb uas qhia tau hais tias kev siv tshuaj tiv thaiv kab mob rubella.

MMR kev nyab xeeb tau tham txog hauv qhov chaw hais txog kab mob qhua pias thiab mumps. Nov yog qee qhov kev tshawb fawb ntxiv ntsig txog rubella:

17. Anaphylaxis tom qab txhaj tshuaj tiv thaiv kab mob rubella ib leeg. (Erlewyn-Lajeunesse, 2008, Arch Dis Child)

Qhov kev pheej hmoo ntawm anaphylactic poob siab vim kev txhaj tshuaj yog 1.89 ntawm 10,000 rau tshuaj tiv thaiv kab mob qhua pias thiab 2.24 hauv 10,000 rau tshuaj tiv thaiv rubella. Cov kws sau ntawv ntseeg hais tias cov nuj nqis no yog qhov tsawg heev, txij li tus naj npawb ntawm cov tshuaj tiv thaiv tsis paub meej, thiab cov nuj nqis tiag tiag yuav yog 3-5 npaug ntau dua.

Qhov kev pheej hmoo ntawm anaphylactic shock vim MMR tau kwv yees nyob rau xyoo 2004 ntawm 1.4 rau 100,000. Txawm li cas los xij, xyoo 2003, qhov kev pheej hmoo ntawm kev poob siab anaphylactic los ntawm tag nrho cov tshuaj tiv thaiv tau kwv yees li ntawm 0.65 ib lab.

18. Puas yog kev txhaj tshuaj RA27/3 rubella ua rau qaug zog ntev? (Allen, 1988, Med Hypotheses)

Xyoo 1979, lawv pib txhaj tshuaj tiv thaiv kab mob rubella nrog RA27/3 hom. Nyob rau hauv peb lub xyoos, ib tug kab mob tshiab tshwm sim nyob rau hauv cov ntaub ntawv kho mob - chronic fatigue syndrome, uas yog pib los ntawm tus kab mob Epstein-Barr.

Feem ntau ntawm cov neeg mob nkees nkees yog cov poj niam laus uas tsim cov tsos mob tom qab txhaj tshuaj tiv thaiv rubella.

Cov neeg mob uas muaj tus mob no tau nce qib ntawm cov tshuaj tiv thaiv los ntawm ntau tus kab mob.

Qhov ntau rubella cov tshuaj tiv thaiv tau pom, qhov hnyav dua cov tsos mob ntawm kev qaug zog ntev.

19. Mob caj dab ntev tom qab txhaj tshuaj tiv thaiv rubella. (Howson, 1992, Clin Infect Dis)

Ib tsab ntawv ceeb toom los ntawm pawg neeg tshwj xeeb ntawm Lub Tsev Haujlwm Saib Xyuas Tshuaj, uas tau ntsib rau 20 lub hlis thiab xaus lus tias RA27 / 3 strain ua rau mob caj dab ntev hauv cov poj niam.

Nov yog lwm daim ntawv tshaj tawm uas txuas cov tshuaj tiv thaiv rubella rau mob caj dab.

20. Kev soj ntsuam ib xyoos ntawm kev mob caj dab ntev tom qab txhaj tshuaj tiv thaiv kab mob rubella thiab kab mob siab B raws li kev txheeb xyuas ntawm Vaccine Adverse Events Reporting System (VAERS) database. (Geier, 2002, Clin Exp Rheumatol)

VAERS tsom xam. Cov tshuaj tiv thaiv rubella ua rau muaj kev pheej hmoo ntawm mob caj dab ntev 32-59 zaug, thiab tshuaj tiv thaiv kab mob siab B ua rau muaj kev pheej hmoo ntawm mob caj dab ntev 5.1-9 zaug.

21. Kev txhaj tshuaj tiv thaiv kab mob qhua pias-mob-rubella rau kev ua haujlwm ntawm polymorphonuclear neutrophil hauv menyuam yaus. (Toraldo, 1992, Acta Paediatr)

MMR txo qis kev ua haujlwm ntawm neutrophilic leukocytes (piv txwv li ua rau muaj kev kis kab mob ntau ntxiv). Qhov no feem ntau yuav yog vim cov tshuaj tiv thaiv kab mob tsis loj hlob hauv cov ntaub so ntswg lymphatic zoo li cov tsiaj qus.

22. Txij li thaum MMR yog contraindicated rau cov poj niam cev xeeb tub (nrog rau 1-3 lub hlis ua ntej xeeb tub), CDC pom zoo kom cov poj niam cev xeeb tub uas tsis muaj cov tshuaj tiv thaiv rubella tau txhaj tshuaj tiv thaiv tam sim tom qab yug menyuam.

Txawm li cas los xij, CDC tsis pom zoo kom kuaj cev xeeb tub ua ntej txhaj tshuaj tiv thaiv rubella.

23. Cov nyhuv ntawm kev txhaj tshuaj tiv thaiv kab mob rubella ntawm cov khoom lactation. I. Kev txhim kho thiab ua tus yam ntxwv ntawm kev tiv thaiv kab mob tiv thaiv kab mob hauv cov mis nyuj. (Losonsky, 1982, J Infect Dis)

Hauv 69% ntawm cov poj niam txhaj tshuaj tiv thaiv kab mob rubella tom qab yug menyuam, tus kab mob no tau tawm hauv cov kua mis. Ntawm cov neeg uas tau txais RA27 / 3 hom, 87.5% cais tus kab mob.

24. Cov nyhuv ntawm kev txhaj tshuaj tiv thaiv kab mob rubella ntawm cov khoom lactation. II. Kev sib cuam tshuam ntawm niam-txiv. (Losonsky, 1982, J Infect Dis)

56% ntawm cov menyuam mos hauv niam mis uas nws niam tau txhaj tshuaj tiv thaiv kab mob rubella tom qab yug menyuam.

25. Kev txhaj tshuaj tiv thaiv kab mob rubella tom qab yug me nyuam: koom nrog kev txhim kho ntawm kev mob caj dab ntev, kab mob paj hlwb, thiab mob rubella viremia. (Tingle, 1985, J Infect Dis)

Rau tus poj niam tau txhaj tshuaj tiv thaiv kab mob rubella tom qab yug me nyuam. Tag nrho cov ntawm lawv tsim mob caj dab, thiab tom qab ntawd mob caj dab, uas kav ntev li 2-7 xyoo tom qab txhaj tshuaj. Peb muaj cov kab mob neurological sequelae (carpal tunnel syndrome, paresthesia, qhov muag tsis pom kev, thiab lwm yam). Hauv tsib ntawm lawv, tus kab mob no tau kuaj pom hauv cov ntshav mus txog 6 xyoo tom qab txhaj tshuaj. Hauv ib qho ntawm lawv, tus kab mob no tau pom hauv cov kua mis 9 lub hlis tom qab txhaj tshuaj. Tus kab mob rubella tau pom nyob rau hauv cov ntshav ntawm ob ntawm plaub tus menyuam mos noj mis niam.

26. Kev txhaj tshuaj tiv thaiv kab mob tom qab yug me nyuam: cov lus qhia los ntawm cov kws kho tsiaj. (Yazbak, 2002, Med Hypotheses)

Ntawm 62 leej niam uas tau txhaj tshuaj tiv thaiv kab mob rubella lossis MMR tom qab yug menyuam, 47 muaj tsawg kawg yog ib tus menyuam autistic, thiab lwm tus 10 muaj menyuam yaus uas xav tias muaj kev puas hlwb lossis kev loj hlob qeeb.

Tus kab mob rubella tau paub tias yuav raug tso tawm hauv cov kua mis tom qab txhaj tshuaj, tab sis nws tsis paub tias kab mob qhua pias thiab kab mob qog noj ntshav kuj raug tawm.

Hauv cov kws kho tsiaj, ntau cov tshuaj tiv thaiv tsis pom zoo tom qab yug menyuam thiab thaum lactation, ntawm lawv cov tshuaj tiv thaiv kab mob canine distemper.

Aub distemper feem ntau ua rau tuag taus, thiab thaum tsis tuag, nws muaj qhov tshwm sim neurological. Tus kab mob canine distemper zoo ib yam li tus kab mob qhua pias. Cov tshuaj tiv thaiv kab mob qhua pias tiv thaiv dev thiab distemper, thiab feem ntau yog ob tus kab mob sib xyaw ua ke hauv ib qho tshuaj tiv thaiv.

Muaj cov ntaub ntawv tshaj tawm txog 5 xyoos Labrador bitch uas tau txhaj tshuaj tiv thaiv 3 hnub tom qab yug menyuam rau 10 tus menyuam dev. Tom qab 19 hnub, cov menyuam dev tau kuaj pom tias muaj kev ntxhov siab, thiab tsib ntawm lawv yuav tsum tau euthanized. Aub distemper tsis tau pom nyob rau hauv cheeb tsam no ua ntej, thiab feem ntau lawv yuav kis tau los ntawm kev txhaj tshuaj tiv thaiv niam txiv, los ntawm qhov nws tuaj yeem txiav txim siab tias cov kab mob ntawm cov neeg mob qhua pias tau tawm hauv cov kua mis.

27. Fulminant encephalitis txuam nrog tshuaj tiv thaiv kab mob rubella. (Gualberto, 2013, J Clin Virol)

Ib tug txiv neej noj qab nyob zoo 31 xyoo tau txhaj tshuaj tiv thaiv kab mob qhua pias thiab rubella. Tom qab 10 hnub, nws tau mus pw hauv tsev kho mob nrog kev kuaj mob ntawm tus kab mob encephalitis, thiab tom qab 3 hnub nws tuag. Nws tau txhaj tshuaj tiv thaiv rubella RA27/3 hauv nws lub hlwb thiab cov kua dej cerebrospinal.

Ob qhov xwm txheej zoo sib xws tau piav qhia ntawm no.

28. Mob tom qab txhaj tshuaj tiv thaiv kab mob qhua pias-mob-rubella. (Freeman, 1993, CMAJ)

23.8% ntawm cov me nyuam mos tom qab MMR muaj lymphadenopathy, 3.3% muaj otitis media, 4.6% muaj pob liab liab, thiab 3.3% muaj conjunctivitis.

29. Kev ntsuam xyuas qhov muaj peev xwm tshwm sim ntawm peb cov tshuaj tiv thaiv kab mob qhua pias-mob-rubella ua ke. (Dos Santos, 2002, Rev Panam Salud Publica)

Kev sib piv ntawm peb hom tshuaj tiv thaiv MMR sib txawv. Kev txhaj tshuaj tau nce qhov kev pheej hmoo ntawm lymphadenopathy los ntawm 3.11 / 2.22 / 1.4 zaug, thiab kev pheej hmoo ntawm mumps los ntawm 5.72 / 2.33 / 2.46 zaug.

30. Rubella persistence nyob rau hauv epidermal keratinocytes thiab granuloma M2 macrophages nyob rau hauv cov neeg mob uas muaj thawj immunodeficiencies. (Perelygina, 2016, J Allergy Clin Immun)

Cov tshuaj tiv thaiv rubella RA27/3 tsis ntev los no tau kuaj pom hauv daim tawv nqaij granulomas hauv peb cov neeg mob tiv thaiv kab mob.

31. Ib qho ntawm cov khoom ntawm MMR thiab MMRV, nrog rau qee yam tshuaj tiv thaiv, yog gelatin. Tshuaj tiv thaiv gelatin yog tsim los ntawm cov pob txha ntawm npua.

Qhov no, ntawm chav kawm, yog ib qho teeb meem me ntsis rau cov neeg Yudais thiab Muslims.

Cov neeg Yudais muaj kev daws teeb meem yooj yim heev rau qhov teeb meem no. Nqaij npuas yog txwv tsis pub noj hauv qhov ncauj, thiab Torah tsis hais dab tsi txog kev noj cov nqaij npuas intramuscular. Cov sages ntawm Talmud kuj tsis tau sau ib yam dab tsi tawm tsam intramuscular los yog subcutaneous noj nqaij npuas, tab sis dab tsi yog txwv tsis pub.

Cov neeg Muslims coj qhov teeb meem no hnyav dua, thiab tuav lub rooj sib tham tshwj xeeb hauv Kuwait hauv 1995 txog qhov teeb meem no, nrog kev koom tes ntawm Middle East ceg ntawm WHO. Lawv xaus lus tias nyob rau hauv tus txheej txheem ntawm kev ua, gelatin tau hloov los ntawm ib yam khoom tsis huv (haram) mus rau hauv ib yam khoom ntshiab (halal), thiab nyob rau hauv tus txheej txheem ntawm ua gelatin, cov pob txha, tendons thiab daim tawv nqaij ntawm tus tsiaj tsis huv tig mus rau hauv cov ntshiab gelatin, uas tuaj yeem noj tau. Txawm li cas los xij, tsis yog txhua tus pom zoo nrog qhov kev txiav txim siab no.

Zoo, kuv tsis paub yuav ua li cas muaj kev nyab xeeb nws yog ua si xws li kev ua si nrog Allah. Tseem muaj 72 lub qhov muag dub qhov muag ntawm ceg txheem ntseeg.

32. Feem ntau ntawm cov tshuaj tiv thaiv gelatin IgE cov tshuaj tiv thaiv hauv cov neeg uas muaj anaphylaxis tom qab txhaj tshuaj tiv thaiv kab mob qhua pias-mob rubella hauv Tebchaws Meskas. (Pool, 2002, Pediatrics)

Txawm hais tias MMR muaj cov qe dawb, cov tshuaj tiv thaiv no tsis yog contraindicated rau cov qe ua xua, vim tias cov khoom ua rau anaphylactic poob siab los ntawm MMR ntseeg tau tias yog gelatin.

Xav paub ntau ntxiv txog qhov no: [1], [2], [3].

33. Cov ntseeg tsis txaj muag los ntawm cov tshuaj tiv thaiv nqaij npuas, tab sis rho tawm cov hlwb ua. Lub Vatican rau txim rau kev siv cov hlwb rho tawm thiab cov kab mob los ntawm cov menyuam hauv plab, thiab hu rau Catholics los tos txais kev tsim cov tshuaj tiv thaiv, thiab tiv thaiv txhua txoj hauv kev muaj peev xwm txhaj tshuaj tiv thaiv nrog cov hlwb rho tawm. Rau qhov tsis muaj lwm txoj hauv kev, Vatican tso cai siv cov tshuaj tiv thaiv no, txawm li cas los xij, nws hais tias nws yog lub luag haujlwm ntawm txhua tus Catholic los tawm tsam los hloov cov xwm txheej. Lub Vatican tso cai tsis kam txhaj tshuaj tiv thaiv yog tias qhov no tsis ua rau muaj kev pheej hmoo loj.

34. Cov tshuaj tiv thaiv keeb kwm ntawm kev rho menyuam. (Furton, 1999, Ethics Medical)

Txawm hais tias txoj haujlwm kho mob yuav raug mob los ntawm kev tsis kam txhaj tshuaj tiv thaiv, tsis kam txhaj tshuaj tiv thaiv nrog cov ntaub ntawv rho tawm yog qhov ua yeeb yam rau Catholic.

35. Cinnamon as a prophylactic in measles and German measles (Drummond, 1917, BMJ)

Cinnamon tseem ceeb roj yog ib qho kev kho mob zoo tshaj plaws rau rhinitis. Nws yog qhov ua tau zoo dua thiab siv tau zoo dua li kev kho mob ntau dua rau cov mob khaub thuas, amoniated quinine tincture.

Ob peb xyoos dhau los, BMJ tau luam tawm ib tsab xov xwm hais tias nws tau siv cinnamon ua tiav los tiv thaiv qhua pias. Thaum ib tug neeg hauv tsev neeg tau mob qhua pias, lawv yuav muab tshuaj cinnamon rau lwm tus menyuam hauv tsev neeg, thiab lawv tsis tau mob lossis lawv muaj mob hnyav heev. Kuv kuj muaj kev paub zoo sib xws.

Tsis ntev los no, txawm li cas los xij, kuv tau siv cinnamon los tiv thaiv rubella. Ib tug ntawm peb tus kws saib xyuas neeg mob, uas tau ntsib nrog ntau tus menyuam, kis tus kab mob rubella. Kuv tau qhia txhua tus menyuam yaus uas tau ntsib nrog nws (20 tus neeg) noj cinnamon thaum sawv ntxov thiab yav tsaus ntuj rau peb lub lis piam (nyob rau hauv tus nqi uas haum rau ib lub npib sixpence). Cov cinnamon tau ntxiv rau cov zaub mov thiab cov menyuam nyiam qhov tsw tshiab. Tsis muaj leej twg mob.

Rubella, tau kawg, tsis yog mob hnyav, thiab kuv sau qhov no los qhia siv cinnamon tsis ntau rau rubella li tiv thaiv kab mob qhua pias.

(Los ntawm txoj kev, lo lus "coryza" yog ib lub npe rau khaub thuas.)

36. Ua ntej txhaj tshuaj tiv thaiv, muaj 22-67 tus neeg mob ntawm tus mob rubella hauv ib xyoos hauv Tebchaws Meskas (1 ntawm 5 lab). Qhov ntawd yog, txhawm rau tiv thaiv ntau lub kaum ob, yim lab tus menyuam raug txhaj tshuaj txhua xyoo. Qhov no, nyob rau hauv lem, muab txog 400 tus me nyuam ib xyoos nrog encephalopathy, thiab lwm 400 nrog anaphylactic shock (1 ntawm 20 txhiab). Thiab qhov no yog yam tsis tau hais txog qhov tshwm sim neurological ntawm MMR, uas peb yuav tham txog lwm qhov.

VAERS tau sau tseg 916 tus neeg tuag lossis xiam oob qhab tom qab MMR thiab MMRV txij li xyoo 2000 (piv txwv li qhov nruab nrab ntawm 50 ib xyoos). Xav txog tias 1-10% ntawm tag nrho cov xwm txheej tau tshaj tawm hauv VAERS, tsis yog 50 tus neeg mob ntawm tus mob rubella, peb tau txais los ntawm 500 mus rau 5,000 tus neeg tuag lossis kev xiam oob qhab hauv ib xyoos.