{"id":107224,"date":"2020-02-19T08:45:29","date_gmt":"2020-02-19T07:45:29","guid":{"rendered":"https:\/\/sdk.mk\/?p=107224"},"modified":"2020-02-19T08:45:29","modified_gmt":"2020-02-19T07:45:29","slug":"ju-njoftojme-me-semundjet-e-rralla-semundja-e-kushing","status":"publish","type":"post","link":"https:\/\/sdk.mk\/index.php\/uncategorized-sq\/ju-njoftojme-me-semundjet-e-rralla-semundja-e-kushing\/","title":{"rendered":"JU NJOFTOJM\u00cb ME S\u00cbMUNDJET E RRALLA: S\u00cbMUNDJA E KUSHING"},"content":{"rendered":"<div class=\"f52428582a4b906b2d2e2a7d733c7d27\" data-index=\"7\" style=\"float: none; margin:10px 0 10px 0; text-align:center;\">\n<!-- MSP Ads Asynchronous JS Tag - Generated with Revive Adserver v5.4.1 -->\r\n<ins data-revive-zoneid=\"167\" data-revive-id=\"060fdb01f6430ec164d3519234aa4967\"><\/ins>\r\n<script async src=\"\/\/panel.ads.com.mk\/www\/delivery\/asyncjs.php\"><\/script>\n<\/div>\n<p><a href=\"https:\/\/www.youtube.com\/watch?v=7ajYnqP8LTg&amp;list=PLPGcigDEy-qj0I1um2ByEqy4a1IdVRjzf&amp;index=20&amp;t=0s\" target=\"_blank\" rel=\"noopener noreferrer\"><em><strong>S\u00ebmundja e Kushing<\/strong><\/em><\/a><\/p>\n<p>MKB D35.2 E24.0<\/p>\n<p>Cushings Disease<br \/>\nMjeku dhe pionieri amerikan i neurologjis\u00eb, Harvi Uillijams Kushing, n\u00eb vitin 1932, e p\u00ebrshkroi k\u00ebt\u00eb s\u00ebmundje si sindrom\u00eb klinike q\u00eb p\u00ebrfshin munges\u00ebn e menstruacioneve, dukuri me mavijosje dhe strija, presion i lart\u00eb i gjakut, hirzutiz\u00ebm dhe miopati, si edhe e lidh s\u00ebmundjen me adenom\u00eb bazofile t\u00eb adenohipofiz\u00ebs.<br \/>\nS\u00ebmundja Kushing vler\u00ebsohet se nuk \u00ebsht\u00eb e trash\u00ebgueshme, por shfaqet p\u00ebr shkak t\u00eb tumorit t\u00eb hipofiz\u00ebs, q\u00eb shkaktohet si pasoj\u00eb e medikamenteve, stresit dhe faktor\u00ebve t\u00eb ngjash\u00ebm. Ekzistojn\u00eb s\u00ebmundje t\u00eb caktuara t\u00eb rralla t\u00eb trash\u00ebgueshme, q\u00eb e rrisin rrezikun e tumoreve t\u00eb hipofiz\u00ebs, prej s\u00eb cil\u00ebs zhvillohet edhe s\u00ebmundja Kushing.<br \/>\nK\u00ebto tumore jan\u00eb beninje, rriten me ngadal\u00eb dhe jan\u00eb prezent tek m\u00eb shum\u00eb se 70% e pacient\u00ebve n\u00eb mosh\u00eb dhe 60-70% tek f\u00ebmij\u00ebt dhe adoleshent\u00ebt me s\u00ebmundjen Kushing. Adenomat zhvillohen n\u00eb hipofiz\u00eb kur qeliza t\u00eb caktuara formojn\u00eb tumorin q\u00eb sekreton m\u00eb shum\u00eb hormone. Kjo zakonisht \u00ebsht\u00eb edhe shkaktari i s\u00ebmundjes Kushing sepse hipofiza sekreton m\u00eb shum\u00eb ACTH, (hormonin adrenokortikotrop), i cili sjell edhe rritjen e sekretimit t\u00eb kortizolit.<\/p>\n<p>Kortizoli, n\u00eb rrethana normale sekretohet gjat\u00eb dit\u00ebs, sipas nj\u00eb radhitje t\u00eb caktuar: niveli m\u00eb i lart\u00eb i kortizolit \u00ebsht\u00eb n\u00eb m\u00ebngjes, n\u00eb or\u00ebn tet\u00eb, nd\u00ebrsa gjat\u00eb dit\u00ebs niveli i tij bie gradualisht, dhe \u00ebsht\u00eb m\u00eb i ul\u00ebt n\u00eb or\u00ebt e mbr\u00ebmjes dhe rreth mesnat\u00ebs.<br \/>\nKur ai sekreton n\u00eb m\u00ebnyr\u00eb t\u00eb vazhdueshme, krijohen probleme me m\u00eb shum\u00eb organe dhe kur ndryshimet do t\u00eb p\u00ebrfshijn\u00eb t\u00eb gjitha organet, b\u00ebhet fjal\u00eb p\u00ebr s\u00ebmundje multisistematike.<\/p>\n<p>Niveli i rritur i kortizolit shpeshher\u00eb shoq\u00ebrohet edhe me nivele t\u00eb larta t\u00eb hormoneve mashkullore gjenitale, t\u00eb cilat krahas n\u00eb testitet e burrave prodhohen edhe n\u00eb gj\u00ebndrat mbi veshka tek t\u00eb dy gjinit\u00eb. Simptomat zhvillohen gradualisht, k\u00ebshtu q\u00eb s\u00ebmundja diagnostikohet relativisht me vones\u00eb. Niveli i lart\u00eb i kortizolit, i lidhur edhe me prodhimin n\u00eb rritje t\u00eb hormoneve mashkullore gjinore tek femrat shkakton sterilitetin, menstruacione t\u00eb \u00e7rregullta, pu\u00e7rra dhe qime, nd\u00ebrsa tek meshkujt s\u00ebmundja Kushing shkakton impotenc\u00ebn, anien e testiseve dhe prodhimin e reduktuar t\u00eb testosteronit prej tyre.<\/p>\n<p>Shpeshher\u00eb simptoma e par\u00eb e s\u00ebmundjes \u00ebsht\u00eb rritja e pesh\u00ebs trupore, me depozitimin e shtresave dhjamore n\u00eb fytyr\u00eb, qaf\u00eb dhe abdomen. Pasi q\u00eb kortizoli sjell edhe shp\u00ebrb\u00ebrjen e madhe t\u00eb proteinave, muskujt e k\u00ebmb\u00ebve dhe duarve dob\u00ebsohen, l\u00ebkura b\u00ebhet m\u00eb e holl\u00eb, mavijosje n\u00eb trup q\u00eb shfaqen edhe gjat\u00eb l\u00ebndimeve m\u00eb t\u00eb vogla. Sprijat shfaqen n\u00eb l\u00ebkur\u00eb, n\u00eb pjes\u00ebn e poshtme t\u00eb k\u00ebmb\u00ebve dhe tek gjoksi, si rezultat i defektit tek indi n\u00ebn l\u00ebkur\u00eb.<\/p>\n<p>Var\u00ebsisht nivelit t\u00eb kortizozlit tek t\u00eb s\u00ebmur\u00ebt zakonisht ndodh edhe \u00e7rregullimi psikiatrik, q\u00eb manifestohet me depresion, pagjum\u00ebsi, koncentrim i dob\u00ebt dhe ndonj\u00ebher\u00eb jan\u00eb prezent\u00eb edhe halucinacionet dhe tendencat p\u00ebr vet\u00ebvrasje.<\/p>\n<p>Diabeti \u00ebsht\u00eb zbuluar tek nj\u00eb e kat\u00ebrta e pacient\u00ebve, nd\u00ebrsa hipertensioni \u00ebsht\u00eb shpesh prezent, q\u00eb \u00ebsht\u00eb edhe nj\u00eb prej shkaktar\u00ebve kryesor\u00eb t\u00eb vdekjeve tek s\u00ebmundja Kushing.<\/p>\n<p>Diagnoza e s\u00ebmundjes jepet pas testeve laboratorike t\u00eb gjakut dhe urin\u00ebs, t\u00eb cilat tregojn\u00eb nivel t\u00eb rritur kronik t\u00eb kortizolit.<\/p>\n<p>Skaneri (tomografia kompjuterike ) dhe rezonanca nukleare magnetike e abdomenit dhe strukturave t\u00eb trurit mund\u00ebson q\u00eb t\u00eb gjenden ndryshimet strukturore n\u00eb gj\u00ebndrat mbi veshkat dhe hipofiz\u00eb.<\/p>\n<p>Tumori, i identifikuar me analizat e RM \u00ebsht\u00eb n\u00eb korelacion me konkluzioni kirurgjikal prej 75-98%.<br \/>\nZbatohet edhe ultrasonografia intraoperative p\u00ebr p\u00ebrmir\u00ebsimin e lokalizimit t\u00eb tumorit. Kjo teknik\u00eb nuk sjell komplikime, por \u00ebsht\u00eb subjektive dhe varet nga kirurgu.<br \/>\nTerapia<\/p>\n<p>Kirurgjia transfenoide e hipofiz\u00ebs \u00ebsht\u00eb tipi i par\u00eb i mjekimit p\u00ebr mikrohenomet e aksesueshme dhe joinvazive t\u00eb hipofiz\u00ebs (tumoret m\u00eb t\u00eb vogla se 1\u0441\u043c). Kur operacioni nuk \u00ebsht\u00eb i suksessh\u00ebm, mund t\u00eb sugjerohet reintegrimi (m\u00ebnjanimi i tumorit mund t\u00eb sjell\u00eb sh\u00ebrimin e plot\u00eb, por ekziston rreziku 15-25% nga shfaqja e tij e serishme dhe nj\u00eb rrezik prej 20-30% i ekzistimit t\u00eb tumorit edhe pas operacionit). N\u00ebse nuk \u00ebsht\u00eb e mundur kirurgjia e hipofiz\u00ebs ose e nj\u00ebjta nuk del me sukses, opsionet alternative duhet t\u00eb merren parasysh n\u00eb nivel individual, mes t\u00eb cilave edhe terapi medicinave, adrenalektomia bilaterale ose radioterapia e hipofiz\u00ebs.<\/p>\n<p>&nbsp;<\/p>\n\n<div style=\"font-size: 0px; height: 0px; line-height: 0px; margin: 0; padding: 0; clear: both;\"><\/div>","protected":false},"excerpt":{"rendered":"<p>S\u00ebmundja e Kushing MKB D35.2 E24.0 Cushings Disease Mjeku dhe pionieri amerikan i neurologjis\u00eb, Harvi Uillijams Kushing, n\u00eb vitin 1932, [&hellip;]<\/p>\n","protected":false},"author":24,"featured_media":107222,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_mo_disable_npp":"","inline_featured_image":false},"categories":[1794],"tags":[],"imageURL":"https:\/\/sdk.mk\/wp-content\/uploads\/2020\/02\/19-Cushings-Disease-650x366.png","thumbURL":"https:\/\/sdk.mk\/wp-content\/uploads\/2020\/02\/19-Cushings-Disease-250x141.png","categoryNames":["Uncategorized"],"feature_caption":"","subtitle":"","views":"2300","source":"\u0421\u043a\u043e\u043f\u0458\u0435, (\u0421\u0410\u041a\u0410\u041c\u0414\u0410\u041a\u0410\u0416\u0410\u041c.\u041c\u041a)","yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v15.0 - 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