{"id":53381,"date":"2020-04-05T16:17:32","date_gmt":"2020-04-05T15:17:32","guid":{"rendered":"https:\/\/fjala.info\/?p=53381"},"modified":"2020-04-11T01:55:03","modified_gmt":"2020-04-11T00:55:03","slug":"si-sillet-koronavirusi-brenda-nje-pacienti","status":"publish","type":"post","link":"https:\/\/jehonashqiptare.al\/fjala\/si-sillet-koronavirusi-brenda-nje-pacienti\/","title":{"rendered":"Si sillet koronavirusi brenda nj\u00eb pacienti?"},"content":{"rendered":"

Matja do t\u00eb ndihmoj\u00eb n\u00eb identifikimin e faktor\u00ebve q\u00eb ndikojn\u00eb n\u00eb ashp\u00ebrsin\u00eb e rasteve t\u00eb Covid-19. Ilustrimi nga Alexander Glandien<\/em><\/span><\/p>\n

Kronikat Coronavirus<\/em>, Botimi – 6 prill 2020<\/em> – NewYorker.com<\/a><\/p>\n

Ne kemi llogaritur p\u00ebrhapjen virale n\u00ebp\u00ebr popuj; tani duhet ta llogarisim at\u00eb brenda njer\u00ebzve.<\/p><\/blockquote>\n

Nga Siddhartha Mukherjee<\/strong>, 26 mars 2020<\/em><\/p>\n

P\u00ebrktheu Arben \u00c7okaj<\/strong><\/p><\/blockquote>\n

N\u00eb jav\u00ebn e tret\u00eb t\u00eb shkurtit, pasi epidemia e Covid-19<\/a> ishte akoma e ndezur n\u00eb Kin\u00eb, un\u00eb mb\u00ebrrita n\u00eb Kolkata, Indi. U zgjova nga pik\u00eb t\u00eb m\u00ebngjesit – kuajt e zi jasht\u00eb dhom\u00ebs sime t\u00eb hotelit ishin duke u ngritur lart, t\u00eb ngritur nga rrymat e ngrohjes s\u00eb ajrit – dhe shkova t\u00eb vizitoja nj\u00eb faltore t\u00eb per\u00ebndesh\u00ebs Shitala. Emri i saj do t\u00eb thot\u00eb “i ftohti”; pasi miti tregon, se ajo u ngrit nga hiri i ftoht\u00eb i nj\u00eb zjarri sakrifikues. Nxeht\u00ebsia q\u00eb ajo supozohet t\u00eb shp\u00ebrndaj\u00eb nuk \u00ebsht\u00eb vet\u00ebm t\u00ebrbimi i ver\u00ebs, q\u00eb godet qytetin n\u00eb mesin e qershorit, por edhe nxeht\u00ebsin\u00eb e brendshme t\u00eb inflamacionit. Ajo ka p\u00ebr q\u00ebllim t\u00eb mbroj\u00eb f\u00ebmij\u00ebt nga lia e vog\u00ebl, t\u00eb sh\u00ebroj\u00eb dhembjen e atyre, q\u00eb e kontraktojn\u00eb at\u00eb dhe t\u00eb lag\u00ebshtoj\u00eb t\u00ebrbimin e nj\u00eb epidemie t\u00eb s\u00ebmundjes.<\/p>\n

Faltorja ishte nj\u00eb struktur\u00eb e vog\u00ebl brenda nj\u00eb tempulli – disa blloqe larg nga Kolegji Mjek\u00ebsor Kolkata. Brenda, kishte nj\u00eb figur\u00eb t\u00eb per\u00ebndesh\u00ebs, e ulur mbi nj\u00eb gomar dhe mbante kavanozin e saj t\u00eb l\u00ebngut ftoh\u00ebs – m\u00ebnyr\u00ebn se si ajo \u00ebsht\u00eb p\u00ebrshkruar p\u00ebr nj\u00eb mij\u00ebvje\u00e7ar. Tempulli ishte dyqind e pes\u00ebdhjet\u00eb vje\u00e7, m\u00eb njoftoi sh\u00ebrb\u00ebtori. Kjo do t\u00eb datoj\u00eb rreth or\u00ebs kur llogarit\u00eb u shfaq\u00ebn p\u00ebr her\u00eb t\u00eb par\u00eb nga nj\u00eb sekt misterioz i Brahmans, q\u00eb endej lart e posht\u00eb n\u00eb fush\u00ebn Gangetic, p\u00ebr t\u00eb popullarizuar praktik\u00ebn e tika<\/em>, nj\u00eb p\u00ebrpjekje e hershme p\u00ebr inokulim<\/em> (vaksinim<\/em>). Kjo p\u00ebrfshinte marrjen e materialit nga pu\u00e7rra e nj\u00eb pacienti t\u00eb lis\u00eb – nj\u00eb pickim gjarpri nga virusi i gjall\u00eb – dhe zbatimin e saj n\u00eb l\u00ebkur\u00ebn e shpuar t\u00eb nj\u00eb personi t\u00eb pa infektuar, duke mbuluar m\u00eb pas vendin me nj\u00eb leck\u00eb prej liri.<\/p>\n

Mbulimi dhe analiza e lajmeve t\u00eb koronavirusit t\u00eb New Yorker jan\u00eb falas p\u00ebr t\u00eb gjith\u00eb lexuesit.<\/p><\/blockquote>\n

Praktikant\u00ebt indian\u00eb t\u00eb tik\u00ebs<\/em> e kishin m\u00ebsuar at\u00eb nga mjek\u00ebt arab\u00eb, t\u00eb cil\u00ebt e kishin m\u00ebsuar at\u00eb nga kinez\u00ebt. Qysh n\u00eb vitin 1100, sh\u00ebruesit mjek\u00ebsor\u00eb n\u00eb Kin\u00eb kishin kuptuar, q\u00eb ata q\u00eb mbijetuan nga lia e vog\u00ebl nuk i kapi s\u00ebmundja p\u00ebrs\u00ebri (t\u00eb mbijetuarit e s\u00ebmundjes, u regjistruan p\u00ebr t’u kujdesur p\u00ebr viktimat e reja), dhe nxorr\u00ebn n\u00eb p\u00ebrfundim se ekspozimi i trupit ndaj nj\u00eb s\u00ebmundje, e mbronte at\u00eb nga rastet e ardhshme t\u00eb asaj s\u00ebmundjeje. Mjek\u00ebt kinez\u00eb bluanin vrag\u00ebt e lis\u00eb s\u00eb vog\u00ebl n\u00eb pluhur dhe ia ngulnin n\u00eb flegr\u00ebn e hund\u00ebs f\u00ebmij\u00ebs me nj\u00eb tub t\u00eb gjat\u00eb argjendi.<\/p>\n

Vaksinimi me virus t\u00eb gjall\u00eb ishte nj\u00eb ecje m\u00eb e ngusht\u00eb: n\u00ebse sasia e inokulimit viral n\u00eb pluhur ishte shum\u00eb e madhe, f\u00ebmija do t’i n\u00ebnshtrohej nj\u00eb versioni t\u00eb plot\u00eb t\u00eb s\u00ebmundjes – nj\u00eb fatkeq\u00ebsi, q\u00eb ndodhi ndoshta nj\u00eb n\u00eb nj\u00ebqind her\u00eb. N\u00ebse t\u00eb gjitha shkuan mir\u00eb, f\u00ebmija do t\u00eb kishte nj\u00eb p\u00ebrvoj\u00eb t\u00eb but\u00eb t\u00eb s\u00ebmundjes dhe do t\u00eb imunizohej p\u00ebr jet\u00ebn. Nga nj\u00ebmij\u00eb e shtat\u00ebqinda, praktika ishte p\u00ebrhapur n\u00eb t\u00eb gjith\u00eb bot\u00ebn arabe. N\u00eb vitet nj\u00ebmij\u00eb e shtat\u00ebqind e gjasht\u00ebdhjet\u00eb, grat\u00eb n\u00eb Sudan ushtruan praktik\u00ebn tishteree el jidderee<\/em> (“blerja e lis\u00eb<\/em>“): nj\u00eb n\u00ebn\u00eb merrej me nj\u00eb tjet\u00ebr, rreth asaj se sa pu\u00e7rra t\u00eb pjekura t\u00eb f\u00ebmij\u00ebs s\u00eb s\u00ebmur\u00eb do t’i blinte ajo p\u00ebr djalin ose vajz\u00ebn e saj. Ishte nj\u00eb art i matur n\u00eb m\u00ebnyr\u00eb t\u00eb jasht\u00ebzakonshme: sh\u00ebruesit tradicional\u00eb m\u00eb t\u00eb men\u00e7ur njoh\u00ebn lezione, q\u00eb ka t\u00eb ngjar\u00eb t\u00eb japin mjaftuesh\u00ebm material viral, por jo shum\u00eb. Emri evropian p\u00ebr s\u00ebmundjen, variola, vjen nga Latinishtja p\u00ebr “ndotur” ose “ngritje p\u00ebrpjet\u00eb”. Procesi i imunizimit kund\u00ebr lis\u00eb, u quajt “variolation”.<\/p>\n

Zonja Mary Wortley Montagu, gruaja e Ambasadorit Britanik n\u00eb Kostandinopoj\u00eb, ishte prekur nga s\u00ebmundja, m\u00eb 1715, duke e l\u00ebn\u00eb l\u00ebkur\u00ebn e saj t\u00eb p\u00ebrsosur q\u00eb t’i griset me plag\u00eb. M\u00eb von\u00eb, n\u00eb fshatin turk, ajo d\u00ebshmoi praktik\u00ebn e ndryshimit dhe u shkroi miqve t\u00eb saj me habi, duke p\u00ebrshkruar pun\u00ebn e nj\u00eb specialisti: “Gruaja e vjet\u00ebr vjen me nj\u00eb guask\u00eb arre plot me materialin e llojit m\u00eb t\u00eb mir\u00eb t\u00eb lis\u00eb s\u00eb vog\u00ebl, dhe pyet se cil\u00ebn ven\u00eb ju lutem doni t\u00eb hapni<\/em>“, pas k\u00ebsaj ajo “fut n\u00eb ven\u00eb aq shum\u00eb material sa mund t\u00eb shtrihet mbi kok\u00ebn e gjilp\u00ebr\u00ebs s\u00eb saj<\/em>“. Pacient\u00ebt t\u00ebrhiq\u00ebn n\u00eb shtrat p\u00ebr disa dit\u00eb me ethe dhe, vuri n\u00eb dukje Zonja Montagu, ngriheshin jasht\u00ebzakonisht t\u00eb pad\u00ebmtuar.<\/p>\n

“Ata kan\u00eb shum\u00eb rrall\u00eb mbi nj\u00ebzet apo tridhjet\u00eb n\u00eb fytyrat e tyre, t\u00eb cilat kurr\u00eb nuk v\u00ebrehen; dhe n\u00eb tet\u00eb dit\u00eb, ata jan\u00eb aq mir\u00eb, si dhe para s\u00ebmundjes s\u00eb tyre.<\/em>” Ajo raportoi se mij\u00ebra njer\u00ebz iu n\u00ebnshtronin t\u00eb sigurt\u00eb vaksinimit \u00e7do vit, dhe se s\u00ebmundja ishte p\u00ebrmir\u00ebsuar kryesisht n\u00eb rajon. “Mund ta besoni se jam e k\u00ebnaqur mjaft nga siguria e k\u00ebtij eksperimenti<\/em>,” shtoi ajo, “pasi un\u00eb synoj ta provoj k\u00ebt\u00eb edhe me djalin tim t\u00eb dashur t\u00eb vog\u00ebl<\/em>.” Djalin e saj nuk e preku kurr\u00eb lia.<\/p>\n

N\u00eb shekujt q\u00eb kur Zonja Montagu u mrekullua me efikasitetin e vaksinimit, ne kemi b\u00ebr\u00eb zbulime t\u00eb paimagjinueshme n\u00eb biologji dhe epidemiologji t\u00eb s\u00ebmundjes infektive, dhe sidoqoft\u00eb, pandemia e Covid-19 nuk paraqet munges\u00eb enigmash. Pse u p\u00ebrhap<\/a> si zjarri i eg\u00ebr n\u00eb Itali, mij\u00ebra milje nga epiqendra e tij fillestare, n\u00eb Wuhan, nd\u00ebrsa India duket se deri m\u00eb tani kryesisht \u00ebsht\u00eb kursyer? Cilat specie shtazore e transmetuan infeksionin origjinal te njer\u00ebzit?<\/p>\n

Por tre pyetje meritojn\u00eb v\u00ebmendje t\u00eb ve\u00e7ant\u00eb, sepse p\u00ebrgjigjet e tyre mund t\u00eb ndryshojn\u00eb m\u00ebnyr\u00ebn e izolimit, trajtimit dhe menaxhimit t\u00eb pacient\u00ebve. S\u00eb pari<\/em>, \u00e7far\u00eb mund t\u00eb m\u00ebsojm\u00eb n\u00eb lidhje me “kurb\u00ebn e p\u00ebrgjigjes s\u00eb doz\u00ebs” p\u00ebr infeksionin fillestar – dometh\u00ebn\u00eb, a mund ta vler\u00ebsojm\u00eb rritjen e rrezikut t\u00eb infeksionit pasi njer\u00ebzit i ekspozohen dozave m\u00eb t\u00eb larta t\u00eb virusit? S\u00eb dyti<\/em>, a ka ndonj\u00eb marr\u00ebdh\u00ebnie midis asaj “doze” fillestare t\u00eb virusit dhe ashp\u00ebrsis\u00eb s\u00eb s\u00ebmundjes – dometh\u00ebn\u00eb, a sjell m\u00eb shum\u00eb ekspozim n\u00eb s\u00ebmundje m\u00eb t\u00eb r\u00ebnd\u00eb? Dhe, e treta<\/em>, a ka masa sasiore sesi sjellja e virusit te pacient\u00ebt e infektuar (p.sh., kulmi i ngarkes\u00ebs virale t\u00eb trupit tuaj, modelet e ngritjes dhe r\u00ebnies s\u00eb tij), q\u00eb parashikojn\u00eb ashp\u00ebrsin\u00eb e s\u00ebmundjes s\u00eb tyre dhe sa infektive jan\u00eb ndaj t\u00eb tjer\u00ebve? Deri m\u00eb tani, n\u00eb fazat e hershme t\u00eb pandemis\u00eb Covid-19, ne kemi matur p\u00ebrhapjen e virusit te njer\u00ebzit. Nd\u00ebrsa ritmi i pandemis\u00eb p\u00ebrshkall\u00ebzohet, gjithashtu duhet t\u00eb fillojm\u00eb matjen e virusit brenda njer\u00ebzve.<\/p>\n

Shumica e epidemiolog\u00ebve, duke pasur parasysh pak\u00ebsin\u00eb e t\u00eb dh\u00ebnave, jan\u00eb detyruar t\u00eb modelojn\u00eb p\u00ebrhapjen e koronavirusit t\u00eb ri sikur t\u00eb ishte nj\u00eb fenomen binar: individ\u00ebt jan\u00eb ose t\u00eb ekspozuar ose t\u00eb pa ekspozuar, t\u00eb infektuar ose t\u00eb pa infektuar, pacient\u00eb simptomatik\u00eb ose bart\u00ebs asimptomatik\u00eb. Koh\u00ebt e fundit, Washington Post publikoi nj\u00eb simulim<\/a> ve\u00e7an\u00ebrisht t\u00eb mrekulluesh\u00ebm n\u00eb internet, n\u00eb t\u00eb cilin njer\u00ebzit n\u00eb nj\u00eb qytet p\u00ebrshkruheshin si pika q\u00eb l\u00ebviznin lirsh\u00ebm n\u00eb hap\u00ebsir\u00eb \u200b\u200b- ato t\u00eb pa infektuara n\u00eb gri, ato t\u00eb infektuara me t\u00eb kuqe (at\u00ebher\u00eb duke u zhvendosur n\u00eb roz\u00eb, pasi kishin fituar imuniteti). Sa her\u00eb q\u00eb nj\u00eb pik\u00eb e kuqe prekte nj\u00eb pik\u00eb gri, infeksioni transmetohej. Pa nd\u00ebrhyrje, e gjith\u00eb fusha e pikave u kthye n\u00eb m\u00ebnyr\u00eb t\u00eb q\u00ebndrueshme nga gri n\u00eb t\u00eb kuqe. Distancimi dhe izolimi shoq\u00ebror i mbanin pikat t\u00eb trokisnin n\u00eb nj\u00ebra-tjetr\u00ebn dhe ngadal\u00ebsuan p\u00ebrhapjen e kuqe n\u00eb ekran.<\/p>\n

Kjo ishte pamja e syrit t\u00eb nj\u00eb zogu e nj\u00eb virusi, q\u00eb rrezatonte p\u00ebrmes nj\u00eb popullate, q\u00eb shihet si nj\u00eb fenomen \u201ci menj\u00ebhersh\u00ebm\u201d. Doktori dhe studiuesi mjek\u00ebsor tek un\u00eb – si studente i diplomuar, un\u00eb isha e trajnuar n\u00eb imunologji virale – desha t\u00eb dija se \u00e7far\u00eb po ndodhte brenda pikave. Sa virus ishte n\u00eb at\u00eb pik\u00eb t\u00eb kuqe? Sa shpejt ishte duke replikuar n\u00eb k\u00ebt\u00eb pik\u00eb? Si ishte i lidhur ekspozimi – koha e prekjes – e lidhur me mund\u00ebsin\u00eb e transmetimit? Sa koh\u00eb nj\u00eb pik\u00eb e kuqe mbeti e kuqe – dometh\u00ebn\u00eb, si ndryshoi infektiviteti i nj\u00eb individi me kalimin e koh\u00ebs? Dhe cila ishte ashp\u00ebrsia e s\u00ebmundjes n\u00eb secilin rast?<\/p>\n

Ajo q\u00eb kemi m\u00ebsuar n\u00eb lidhje me viruset e tjera – p\u00ebrfshir\u00eb ato q\u00eb shkaktojn\u00eb SIDA, SARS dhe Lia e vog\u00ebl – sugjeron nj\u00eb pamje m\u00eb komplekse t\u00eb s\u00ebmundjes, shkall\u00ebn e p\u00ebrparimit t\u00eb saj dhe strategjit\u00eb e kontrollit. N\u00eb vitet nj\u00ebmij\u00eb e n\u00ebnt\u00ebqind e n\u00ebnt\u00ebdhjet\u00eb, pasi studiuesit m\u00ebsuan t\u00eb matin sa HIV ishte n\u00eb gjakun e nj\u00eb pacienti, u shfaq nj\u00eb model i ve\u00e7ant\u00eb. Pas nj\u00eb infeksioni, num\u00ebrimi i virusit n\u00eb gjak do t\u00eb rritet n\u00eb nj\u00eb zenit, i njohur si “viremia e pikut<\/em>“, dhe pacient\u00ebt me viremin\u00eb m\u00eb t\u00eb lart\u00eb tipike u s\u00ebmur\u00ebn m\u00eb shpejt; ata ishin m\u00eb pak n\u00eb gjendje t’i rezistonin virusit. Edhe m\u00eb parashikuese se ngarkesa virale e pikut ishte e ashtuquajtura pik\u00eb e caktuar – niveli n\u00eb t\u00eb cilin num\u00ebrimi i virusit t\u00eb dikujt u vendos pas pikut fillestar t\u00eb tij.<\/p>\n

Ajo p\u00ebrfaq\u00ebsonte nj\u00eb ekuilib\u00ebr dinamik, q\u00eb u arrit midis virusit dhe prit\u00ebsit t\u00eb tij njer\u00ebzor. Njer\u00ebzit me nj\u00eb set pik\u00ebsh t\u00eb lart\u00eb ishin m\u00eb t\u00eb prirur t\u00eb p\u00ebrparojn\u00eb m\u00eb shpejt n\u00eb AIDS; njer\u00ebzit me nj\u00eb set pik\u00ebsh m\u00eb t\u00eb vog\u00ebl t\u00eb caktuar shpesh provohen t\u00eb jen\u00eb “p\u00ebrparimtar\u00eb t\u00eb ngadalt\u00eb”. Ngarkesa virale – nj\u00eb vazhdim\u00ebsi, dhe jo nj\u00eb vler\u00eb binare – ndihmoi n\u00eb parashikimin e natyr\u00ebs, kursit dhe transmetueshm\u00ebris\u00eb s\u00eb s\u00ebmundjes. P\u00ebr t\u00eb qen\u00eb t\u00eb sigurt, \u00e7do virus ka personalitetin e tij, edhe HIV ka tipare, q\u00eb e b\u00ebjn\u00eb ve\u00e7an\u00ebrisht t\u00eb zbulueshme ngarkes\u00ebn virale: ajo shkakton nj\u00eb infeksion kronik, dhe at\u00eb q\u00eb posa\u00e7\u00ebrisht synon qelizat e sistemit imunitar. Megjithat\u00eb, modele t\u00eb ngjashme jan\u00eb v\u00ebrejtur edhe me viruse t\u00eb tjera…<\/p>\n

( Vijon shkrimi m\u00eb tej n\u00eb anglisht n\u00eb The New Yorker<\/a> )<\/p>\n","protected":false},"excerpt":{"rendered":"

Matja do t\u00eb ndihmoj\u00eb n\u00eb identifikimin e faktor\u00ebve q\u00eb ndikojn\u00eb n\u00eb ashp\u00ebrsin\u00eb e rasteve t\u00eb Covid-19. Ilustrimi nga Alexander Glandien Kronikat Coronavirus, Botimi – 6 prill 2020 – NewYorker.com Ne kemi llogaritur p\u00ebrhapjen virale n\u00ebp\u00ebr popuj; tani duhet ta llogarisim at\u00eb brenda njer\u00ebzve. Nga Siddhartha Mukherjee, 26 mars 2020 P\u00ebrktheu Arben \u00c7okaj N\u00eb jav\u00ebn e […]<\/p>\n","protected":false},"author":1,"featured_media":53382,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2,173],"tags":[],"class_list":["post-53381","post","type-post","status-publish","format-standard","has-post-thumbnail","category-artikuj","category-covid-19"],"yoast_head":"\nSi sillet koronavirusi brenda nj\u00eb pacienti? - FJALA e LIR\u00cb<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/jehonashqiptare.al\/fjala\/si-sillet-koronavirusi-brenda-nje-pacienti\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Si sillet koronavirusi brenda nj\u00eb pacienti? - FJALA e LIR\u00cb\" \/>\n<meta property=\"og:description\" content=\"Matja do t\u00eb ndihmoj\u00eb n\u00eb identifikimin e faktor\u00ebve q\u00eb ndikojn\u00eb n\u00eb ashp\u00ebrsin\u00eb e rasteve t\u00eb Covid-19. Ilustrimi nga Alexander Glandien Kronikat Coronavirus, Botimi – 6 prill 2020 – NewYorker.com Ne kemi llogaritur p\u00ebrhapjen virale n\u00ebp\u00ebr popuj; tani duhet ta llogarisim at\u00eb brenda njer\u00ebzve. 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