{"id":37169,"date":"2025-10-27T08:35:15","date_gmt":"2025-10-27T07:35:15","guid":{"rendered":"https:\/\/semaxpolska.com\/?p=37169"},"modified":"2026-04-01T04:13:24","modified_gmt":"2026-04-01T02:13:24","slug":"ivermektins-pret-kaski","status":"publish","type":"post","link":"https:\/\/bioevidencehub.com\/lv\/iwermektyna-na-swierzb\/","title":{"rendered":"ivermekt\u012bns pret ka\u0161\u0137i \u2013 K\u0101p\u0113c ivermekt\u012bns ir lab\u0101ka izv\u0113le nek\u0101 permetr\u012bns"},"content":{"rendered":"

Ivermekt\u012bna iesp\u0113jam\u0101s iedarb\u012bbas apraksts, pamatojoties uz literat\u016bras datiem. (Tas nav produkta apraksts, atruna lapas apak\u0161\u0101)<\/h2>\n

Ka\u0161\u0137is ir lip\u012bga paraz\u012btiska \u0101das infekcija, ko izraisa \u0113rces. Sarcoptes scabiei var. hominis<\/i>. Lai gan tie ir mikroskopiski organismi, to ietekme uz cilv\u0113ka vesel\u012bbu neb\u016bt nav niec\u012bga. \u0112rces iek\u013c\u016bst \u0101das virspus\u0113j\u0101 sl\u0101n\u012b, izd\u0113j olas un izraisa sp\u0113c\u012bgu im\u016bnreakciju, kas izraisa past\u0101v\u012bgu niezi, aps\u0101rtumu un rakstur\u012bgos pavedienveida tune\u013cus. (1<\/sup><\/a>)<\/sup><\/a>T\u0101 k\u0101 ka\u0161\u0137is ir \u013coti infekciozs, tas joproj\u0101m ir izplat\u012bta sabiedr\u012bbas vesel\u012bbas probl\u0113ma vis\u0101 pasaul\u0113, kas skar gan att\u012bst\u012btos, gan jaunatt\u012bst\u012bbas re\u0123ionus, un tiek l\u0113sts, ka gad\u0101 ir 200-300 miljoni saslim\u0161anas gad\u012bjumu. Slim\u012bba nevienu nediskrimin\u0113; t\u0101 ir sastopama visu vecumu, etnisko grupu un soci\u0101lekonomisko sl\u0101\u0146u cilv\u0113kiem, lai gan saslimst\u012bba ar \u0161o slim\u012bbu ir augst\u0101ka p\u0101rpild\u012bt\u0101 vid\u0113, kur bie\u017ei notiek cie\u0161s personisks kontakts. (2)<\/sup><\/a><\/p>\n

Rakstur\u012bgs ka\u0161\u0137a simptoms ir sp\u0113c\u012bga nieze, \u012bpa\u0161i nakt\u012bs, kas trauc\u0113 miegu un iev\u0113rojami pasliktina dz\u012bves kvalit\u0101ti. Niezi bie\u017ei pavada izsitumi, kas var atg\u0101din\u0101t ekz\u0113mu vai aler\u0123iskas reakcijas, t\u0101p\u0113c bez r\u016bp\u012bgas anamn\u0113zes un izmekl\u0113\u0161anas kl\u012bnisko diagnozi ir gr\u016bti noteikt. Rakstur\u012bgas niezei rakstur\u012bg\u0101s vietas ir plaukstas starp pirkstiem, plaukstas, elko\u0146i, paduses, jostasvieta un dzimumorg\u0101nu zona. Z\u012bdai\u0146iem un gados vec\u0101kiem pacientiem var rasties neparasti simptomi, piem\u0113ram, galvas \u0101das vai nagu boj\u0101jumi. Lai gan ka\u0161\u0137is pats par sevi nav n\u0101v\u0113jo\u0161s, t\u0101 komplik\u0101cijas var b\u016bt nopietnas. Past\u0101v\u012bga skr\u0101p\u0113\u0161an\u0101s var izrais\u012bt \u0101das boj\u0101jumus, kas paver ce\u013cu bakteri\u0101l\u0101m superinfekcij\u0101m, kuras visbie\u017e\u0101k izraisa Streptococcus pyogenes <\/i>vai Staphylococcus aureus. <\/i>Resursu zi\u0146\u0101 ierobe\u017eot\u0101 vid\u0113 \u0161\u012bs infekcijas var izv\u0113rsties par celul\u012btu, septic\u0113miju un pat netie\u0161i veicin\u0101t hronisku slim\u012bbu, piem\u0113ram, reimatisko sirds slim\u012bbu, att\u012bst\u012bbu. (3)<\/sup><\/a>\u00a0 (4)<\/sup><\/a><\/p>\n

Ka\u0161\u0137is galvenok\u0101rt izplat\u0101s ilgsto\u0161a \u0101das kontakta laik\u0101, t\u0101p\u0113c m\u0101jsaimniec\u012bbas, pansion\u0101ti, cietumi un b\u0113g\u013cu nometnes ir vietas, kur slim\u012bbas uzliesmojumi ir visbie\u017e\u0101k sastopami. Ar\u012b koplietoti ap\u0123\u0113rbi, dvie\u013ci un gultas ve\u013ca veicina slim\u012bbas izplat\u012b\u0161anos, lai gan maz\u0101k\u0101 m\u0113r\u0101 nek\u0101 tie\u0161ais kontakts. Probl\u0113mu bie\u017ei saasina ar ka\u0161\u0137i saist\u012bt\u0101 soci\u0101l\u0101 stigma, kas liek slimniekiem vilcin\u0101ties mekl\u0113t \u0101rst\u0113\u0161anu, l\u012bdz simptomi k\u013c\u016bst nepanesami. Ne\u0101rst\u0113ta infic\u0113\u0161an\u0101s var saglab\u0101ties nenoteiktu laiku un izplat\u012bties nepaman\u012bta sabiedr\u012bb\u0101. (5)<\/sup><\/a><\/p>\n

Sabiedr\u012bbas vesel\u012bbai svar\u012bgo ka\u0161\u0137a noz\u012bmi starptautisk\u0101 m\u0113rog\u0101 atzina tikai nesen. 2017. gad\u0101. Pasaules Vesel\u012bbas organiz\u0101cija (PVO) iek\u013c\u0101va ka\u0161\u0137i nov\u0101rt\u0101 atst\u0101to tropisko slim\u012bbu sarakst\u0101, uzsverot t\u0101s rad\u012bto slogu vesel\u012bbas apr\u016bpes sist\u0113m\u0101m un steidzamo nepiecie\u0161am\u012bbu p\u0113c efekt\u012bv\u0101k\u0101m p\u0101rvald\u012bbas strat\u0113\u0123ij\u0101m. Slim\u012bbas iek\u013cau\u0161ana sarakst\u0101 atspogu\u013co pieaugo\u0161o izpratni par to, ka ka\u0161\u0137is ir ne tikai trauc\u0113klis, bet ar\u012b b\u016btisks saslimst\u012bbas faktors, jo \u012bpa\u0161i tropu re\u0123ionos un re\u0123ionos ar nepietiekamiem resursiem. (6)<\/sup><\/a><\/p>\n

Pa\u0161reiz\u0113j\u0101 pirm\u0101s l\u012bnijas \u0101rst\u0113\u0161ana ir balst\u012bta uz lok\u0101lu permetr\u012bnu un peror\u0101lu ivermekt\u012bnu, kas iedarbojas tie\u0161i uz \u0113rc\u0113m. Tom\u0113r aizvien bie\u017e\u0101ki zi\u0146ojumi par to, ka \u0101rst\u0113\u0161ana ar permetr\u012bnu ir bijusi neveiksm\u012bga, ir izrais\u012bju\u0161i kl\u012bnicistu un p\u0113tnieku ba\u017eas. \u0160\u012b jaun\u0101 probl\u0113ma uzsver, cik svar\u012bgi ir p\u0101rskat\u012bt ka\u0161\u0137a \u0101rst\u0113\u0161anas iesp\u0113jas un mekl\u0113t alternat\u012bvas terapijas, kas nodro\u0161ina lab\u0101kus rezult\u0101tus, jo \u012bpa\u0161i pacientiem ar atk\u0101rtot\u0101m vai rezistent\u0101m infekcij\u0101m. Izpratne par ka\u0161\u0137i vis\u0101s t\u0101 dimensij\u0101s - biolo\u0123ij\u0101, kl\u012bniskaj\u0101s iez\u012bm\u0113s, transmisijas dinamik\u0101 un komplik\u0101cij\u0101s - nodro\u0161ina pamatu, lai saprastu, k\u0101p\u0113c da\u017eas \u0101rst\u0113\u0161anas metodes var izr\u0101d\u012bties neveiksm\u012bgas, bet citas, piem\u0113ram, ivermekt\u012bns, k\u013c\u016bst arvien atz\u012bt\u0101kas k\u0101 dro\u0161\u0101ki risin\u0101jumi. Ka\u0161\u0137is nav tikai \u0101das slim\u012bba; t\u0101 ir sabiedr\u012bbas vesel\u012bbas probl\u0113ma, kuras past\u0101v\u012bbai un komplik\u0101cij\u0101m ir j\u0101piev\u0113r\u0161 pastiprin\u0101ta uzman\u012bba un j\u0101izmanto inovat\u012bvas terapeitisk\u0101s pieejas. (6)<\/sup><\/a><\/p>\n

Standarta apstr\u0101de: permetr\u012bns<\/h2>\n

Vair\u0101kas desmitgades permetr\u012bna kr\u0113ms (5%) ir bijis galvenais l\u012bdzeklis, ko lieto ka\u0161\u0137a \u0101rst\u0113\u0161anai vis\u0101 pasaul\u0113. Permetr\u012bns, klasific\u0113ts k\u0101 sint\u0113tisks piretro\u012bds, darbojas, trauc\u0113jot n\u0101trija transporta kan\u0101lu darb\u012bbu ka\u0161\u0137a \u0113r\u010du nervu sist\u0113m\u0101, izraisot paral\u012bzi un galu gal\u0101 n\u0101vi. T\u0101 m\u0113r\u0137tiec\u012bg\u0101s iedarb\u012bbas, sal\u012bdzino\u0161i zem\u0101s toksicit\u0101tes un vieglas lok\u0101las lieto\u0161anas d\u0113\u013c tas \u0101tri vien ir k\u013cuvis par zelta standartu gan individu\u0101lai \u0101rst\u0113\u0161anai, gan slim\u012bbas uzliesmojumu ierobe\u017eo\u0161anai sabiedrisk\u0101s viet\u0101s un iest\u0101d\u0113s. (7)<\/sup><\/a><\/p>\n

Standarta \u0101rst\u0113\u0161ana sast\u0101v no permetr\u012bna kr\u0113ma uzkl\u0101\u0161anas uz visa \u0137erme\u0146a, s\u0101kot no kakla uz leju, t\u0101 iedarb\u012bbas ilgums ir 8-14 stundas, p\u0113c tam tas tiek nomazg\u0101ts. Z\u012bdai\u0146iem un maziem b\u0113rniem apstr\u0101d\u0101 ar\u012b galvas \u0101du un seju (iz\u0146emot acis un muti), jo \u0161\u012bs vietas bie\u017ei vien ir skartas. Lai nodro\u0161in\u0101tu tikko iz\u0161\u0137\u012blu\u0161os \u0113r\u010du izn\u012bcin\u0101\u0161anu, parasti p\u0113c ned\u0113\u013cas ieteicams lietot atk\u0101rtoti, jo permetr\u012bnam ir ierobe\u017eota insektic\u012bda aktivit\u0101te. Pareizi lietojot kop\u0101 ar m\u0101jas apstr\u0101di un ap\u0123\u0113rba un gultas ve\u013cas dezinfekciju, permetr\u012bns v\u0113sturiski ir nodro\u0161in\u0101jis vair\u0101k nek\u0101 90% iz\u0101rst\u0113to \u0113r\u010du skaitu. (7)<\/sup><\/a><\/p>\n

Tom\u0113r ir aizvien vair\u0101k pier\u0101d\u012bjumu, ka rezistence pret permetr\u012bnu var k\u013c\u016bt par realit\u0101ti. Kl\u012bniskajos zi\u0146ojumos no da\u017e\u0101d\u0101m pasaules da\u013c\u0101m aprakst\u012bti gad\u012bjumi, kad pacientiem nav att\u012bst\u012bjusies adekv\u0101ta reakcija, neraugoties uz pareizu lieto\u0161anu, adekv\u0101tu devu un vienlaic\u012bgu to personu \u0101rst\u0113\u0161anu, kas bija saskar\u0113 ar pacientu. Laboratorijas p\u0113t\u012bjumi nor\u0101da uz iesp\u0113jam\u0101m mut\u0101cij\u0101m \u0113r\u010du n\u0101trija kan\u0101lu g\u0113nos, kas var samazin\u0101t permetr\u012bna saist\u012b\u0161an\u0101s afinit\u0101ti un t\u0101d\u0113j\u0101di mazin\u0101t t\u0101 efektivit\u0101ti. Turkl\u0101t k\u0101 v\u0113l viens meh\u0101nisms ir ierosin\u0101ta metabolisk\u0101 rezistence, kad \u0113rces palielina detoksik\u0101cijas enz\u012bmu daudzumu, lai no\u0101rd\u012btu z\u0101les. Lai gan pla\u0161a m\u0113roga molekul\u0101rie p\u0113t\u012bjumi joproj\u0101m ir ierobe\u017eoti, \u0161\u012bs ba\u017eas ir liku\u0161as p\u0113tniekiem un kl\u012bnicistiem ap\u0161aub\u012bt permetr\u012bna k\u0101 vien\u012bg\u0101s pirm\u0101s izv\u0113les terapijas ilgtermi\u0146a efektivit\u0101ti. (8)<\/sup><\/a><\/p>\n

V\u0113l viens permetr\u012bna izmanto\u0161anas ierobe\u017eojums ir lo\u0123istikas un praktiskie \u0161\u0137\u0113r\u0161\u013ci. Nepiecie\u0161am\u012bba uzkl\u0101t l\u012bdzekli uz visa \u0137erme\u0146a, jo \u012bpa\u0161i gados vec\u0101kiem pacientiem vai pacientiem ar invalidit\u0101ti, bie\u017ei vien ir ne\u0113rta. Lai gan sal\u012bdzino\u0161i reti, var rasties \u0101das kairin\u0101jums, kas v\u0113l vair\u0101k attur no z\u0101\u013cu lieto\u0161anas. End\u0113miskos re\u0123ionos \u0161\u0137\u0113rslis var b\u016bt ar\u012b permetr\u012bna kr\u0113ma cena un pieejam\u012bba, kas ierobe\u017eo t\u0101 lietder\u012bbu pla\u0161a m\u0113roga sabiedr\u012bbas vesel\u012bbas programm\u0101s. T\u0101 k\u0101 ka\u0161\u0137is joproj\u0101m tiek atz\u012bts par nopietnu glob\u0101lu vesel\u012bbas probl\u0113mu, pa\u013cau\u0161an\u0101s tikai uz permetr\u012bnu k\u013c\u016bst arvien problem\u0101tisk\u0101ka. Arvien vair\u0101k zi\u0146ojumu par neveiksm\u012bgu \u0101rst\u0113\u0161anu rezistences, atk\u0101rtotas infic\u0113\u0161an\u0101s vai lieto\u0161anas gr\u016bt\u012bbu d\u0113\u013c liecina par steidzamu nepiecie\u0161am\u012bbu mekl\u0113t alternat\u012bvas vai papildu terapeitisk\u0101s strat\u0113\u0123ijas. Pieaugo\u0161\u0101 neatbilst\u012bba starp kl\u012bnisko nepiecie\u0161am\u012bbu un terapeitisko efektivit\u0101ti ir novedusi pie t\u0101, ka peror\u0101lais ivermekt\u012bns tiek uzskat\u012bts ne tikai par otr\u0101s izv\u0113les iesp\u0113ju, bet daudzos gad\u012bjumos par praktisk\u0101ku un efekt\u012bv\u0101ku pirm\u0101s izv\u0113les risin\u0101jumu. (8)<\/sup><\/a><\/p>\n

K\u0101p\u0113c permetr\u012bns da\u017ereiz neizdodas<\/h2>\n

Lai gan permetr\u012bns jau gadu desmitiem ir bijis galvenais ka\u0161\u0137a \u0101rst\u0113\u0161anas l\u012bdzeklis, t\u0101 efektivit\u0101te re\u0101los apst\u0101k\u013cos ir k\u013cuvusi aizvien nevienm\u0113r\u012bg\u0101ka. Gan pacienti, gan kl\u012bnicisti zi\u0146o par situ\u0101cij\u0101m, kad simptomi saglab\u0101jas vai atk\u0101rtojas, neraugoties uz \u0161\u0137ietami pareizu lieto\u0161anu. Lai saprastu, k\u0101p\u0113c permetr\u012bns da\u017ek\u0101rt neizdodas, ir j\u0101izp\u0113ta biolo\u0123isko, kl\u012bnisko un lo\u0123istikas faktoru kombin\u0101cija, kas kop\u0101 mazina t\u0101 efektivit\u0101ti.<\/p>\n

Nepiln\u012bgs vai nepareizs pieteikums<\/h3>\n

Viens no visbie\u017e\u0101k sastopam\u0101kajiem \u0101rst\u0113\u0161anas neveiksmju iemesliem ir nepiln\u012bga vai nepareiza lieto\u0161ana. Lai permetr\u012bns iedarbotos, tas r\u016bp\u012bgi j\u0101uzkl\u0101j uz visas \u0137erme\u0146a virsmas, aptverot pat maz\u0101k paman\u0101mas vietas, piem\u0113ram, p\u0113du p\u0113das, vietas zem nagiem un \u0101das krokas. Praks\u0113 pacienti var izlaist da\u017eas vietas, uzkl\u0101t p\u0101r\u0101k pl\u0101nu k\u0101rtu vai nomazg\u0101t kr\u0113mu pirms ieteicam\u0101 8-14 stundu kontakta laika. Ja netiek nodro\u0161in\u0101ts piln\u012bgs p\u0101rkl\u0101jums, da\u017eas \u0113rces izdz\u012bvo, vairojas un uztur infekciju. \u0160\u012b probl\u0113ma saasin\u0101s m\u0101jsaimniec\u012bb\u0101s, kur\u0101s \u0101rst\u0113 tikai slimnieku, kuram ir simptomi; ne\u0101rst\u0113ti cilv\u0113ki, kas ir cie\u0161\u0101 kontakt\u0101 ar slimnieku, var viegli atk\u0101rtoti infic\u0113t citus, radot iespaidu, ka z\u0101les neiedarbojas. (9)<\/sup><\/a><\/p>\n

Pacientu atbilst\u012bba<\/h3>\n

V\u0113l viens svar\u012bgs faktors ir pacienta atbilst\u012bba. Permetr\u012bna lieto\u0161ana ir darbietilp\u012bga, jo \u012bpa\u0161i b\u0113rniem, vec\u0101ka gadag\u0101juma cilv\u0113kiem vai cilv\u0113kiem ar ierobe\u017eot\u0101m p\u0101rvieto\u0161an\u0101s sp\u0113j\u0101m, kuri nesp\u0113j pa\u0161i uzkl\u0101t l\u012bdzekli uz visa \u0137erme\u0146a. Bie\u017ei vien tiek atst\u0101ta nov\u0101rt\u0101 atk\u0101rtota prepar\u0101ta lieto\u0161ana p\u0113c vienas ned\u0113\u013cas, kas ir nepiecie\u0161ama, lai kontrol\u0113tu no izdz\u012bvoju\u0161\u0101m ol\u0101m iz\u0161\u0137\u012blu\u0161\u0101s \u0113rces. Pat kl\u012bniskajos p\u0113t\u012bjumos, kuros instrukcijas ir r\u016bp\u012bgi izskaidrotas, to iev\u0113ro\u0161anas r\u0101d\u012bt\u0101ji nav ide\u0101li, un re\u0101los apst\u0101k\u013cos to ir v\u0113l gr\u016bt\u0101k nodro\u0161in\u0101t. (9)<\/sup><\/a><\/p>\n

Biolo\u0123isk\u0101 iztur\u012bba<\/h3>\n

Papildus atbilst\u012bbas jaut\u0101jumiem, biolo\u0123isk\u0101 rezistence, kas par\u0101d\u0101s attiec\u012bb\u0101 uz Sarcoptes scabiei<\/i>. L\u012bdz\u012bgi k\u0101 bakt\u0113rijas, kas izstr\u0101d\u0101 rezistenci pret antibiotik\u0101m, ar\u012b ka\u0161\u0137a \u0113rces, \u0161\u0137iet, sp\u0113j piel\u0101goties \u0137\u012bmiskajiem l\u012bdzek\u013ciem. Mut\u0101cijas n\u0101trija kan\u0101lu olbaltumviel\u0101s, kas ir galvenais permetr\u012bna m\u0113r\u0137is, var samazin\u0101t z\u0101\u013cu saist\u012b\u0161an\u0101s sp\u0113ju, t\u0101d\u0113j\u0101di samazinot to efektivit\u0101ti. Turkl\u0101t \u0113rc\u0113m var att\u012bst\u012bties metaboliskas adapt\u0101cijas, palielinot detoksik\u0101cijas enz\u012bmu aktivit\u0101ti, kas no\u0101rda permetr\u012bnu, pirms tas s\u0101k iedarboties. Lai gan pla\u0161a m\u0113roga \u0123en\u0113tisk\u0101s uzraudz\u012bbas p\u0113t\u012bjumi joproj\u0101m ir ierobe\u017eoti, vair\u0101kos re\u0123ionos ir zi\u0146ots par rezistences gad\u012bjumu kop\u0101m, kas liecina, ka tas nav teor\u0113tisks jaut\u0101jums, bet gan main\u012bga kl\u012bnisk\u0101 realit\u0101te. (9)<\/sup><\/a><\/p>\n

Bez insektic\u012bda iedarb\u012bbas<\/h3>\n

V\u0113l viens permetr\u012bna ierobe\u017eojums ir insektic\u012bd\u0101s iedarb\u012bbas tr\u016bkums. Lai gan tas efekt\u012bvi izn\u012bcina pieaugu\u0161\u0101s \u0113rces un k\u0101purus, olas bie\u017ei paliek neskartas. Ja apstr\u0101di neatk\u0101rto p\u0113c ned\u0113\u013cas, lai izn\u012bcin\u0101tu tikko izper\u0113ju\u0161\u0101s \u0113rces, inv\u0101zija var atgriezties. Pacienti, kuri neizprot \u0161o pras\u012bbu, var uzskat\u012bt, ka ar vienu lieto\u0161anas reizi ir pietiekami, un p\u0113c tam piedz\u012bvot slim\u012bbas atjauno\u0161anos. \u0160o da\u013c\u0113jas \u0101rst\u0113\u0161anas un atk\u0101rtotas infic\u0113\u0161an\u0101s ciklu var viegli k\u013c\u016bdaini interpret\u0113t k\u0101 rezistenci pret z\u0101l\u0113m. (9)<\/sup><\/a><\/p>\n

Soci\u0101lekonomiskie \u0161\u0137\u0113r\u0161\u013ci<\/h3>\n

Visbeidzot, liela noz\u012bme ir ar\u012b soci\u0101lekonomiskajiem \u0161\u0137\u0113r\u0161\u013ciem. Ierobe\u017eotu resursu apst\u0101k\u013cos piek\u013cuve permetr\u012bnam var b\u016bt ierobe\u017eota, k\u0101 rezult\u0101t\u0101 \u0101rst\u0113\u0161anas cikli tiek at\u0161\u0137aid\u012bti vai nepabeigti. \u0122imenes var dal\u012bt vienu m\u0113\u0123eni starp vair\u0101kiem locek\u013ciem, t\u0101d\u0113j\u0101di samazinot efekt\u012bvu devu katrai personai. Turkl\u0101t ar ka\u0161\u0137i saist\u012bt\u0101 stigma da\u017ek\u0101rt attur pacientus no t\u016bl\u012bt\u0113jas \u0101rst\u0113\u0161anas, padarot infekcijas smag\u0101kas un gr\u016bt\u0101k \u0101rst\u0113jamas.<\/p>\n

Kopum\u0101 \u0161ie faktori liecina, ka permetr\u012bna neveiksmes iemesls reti ir viens vien\u012bgs c\u0113lonis. T\u0101 dr\u012bz\u0101k atspogu\u013co sare\u017e\u0123\u012btu mijiedarb\u012bbu starp cilv\u0113ku uzved\u012bbu, \u0113r\u010du biolo\u0123iskaj\u0101m adapt\u0101cij\u0101m un vesel\u012bbas apr\u016bpes snieg\u0161anas struktur\u0101laj\u0101m probl\u0113m\u0101m. \u0160o ierobe\u017eojumu atz\u012b\u0161ana ir b\u016btiska, lai p\u0101rdom\u0101tu ka\u0161\u0137a \u0101rst\u0113\u0161anu, un uzsver nepiecie\u0161am\u012bbu p\u0113c alternat\u012bv\u0101m pieej\u0101m, piem\u0113ram, peror\u0101l\u0101 ivermekt\u012bna, kas var p\u0101rvar\u0113t daudzus no \u0161iem \u0161\u0137\u0113r\u0161\u013ciem. (9)<\/sup><\/a><\/p>\n

Ivermekt\u012bns: darb\u012bbas meh\u0101nisms un ieguvumi<\/h2>\n

Darb\u012bbas meh\u0101nisms<\/h3>\n

Ivermekt\u012bns ir pla\u0161a spektra pretparaz\u012btisks l\u012bdzeklis, kas ir ieguvis noz\u012bmi ka\u0161\u0137a \u0101rst\u0113\u0161an\u0101. Tas iedarbojas, saistoties ar glutam\u0101ta regul\u0113tiem hlor\u012bdu kan\u0101liem \u0113r\u010du nervu sist\u0113m\u0101. \u0160\u012b saist\u012b\u0161an\u0101s palielina hlor\u012bda jonu pl\u016bsmu caur \u0161\u016bnu membr\u0101n\u0101m, izraisot paraz\u012btu paral\u012bzi un galu gal\u0101 n\u0101vi. At\u0161\u0137ir\u012bb\u0101 no permetr\u012bna, kas paliek uz \u0101das virsmas, ivermekt\u012bns tiek lietots iek\u0161\u0137\u012bgi un izplat\u0101s organism\u0101, padarot to efekt\u012bvu pret \u0113rc\u0113m, kas atrodas dzi\u013c\u0101k epiderm\u0101. \u0160\u012b sist\u0113misk\u0101 iedarb\u012bba ir \u012bpa\u0161i svar\u012bga smagos gad\u012bjumos, piem\u0113ram, ka\u0161\u0137a gad\u012bjum\u0101, kad \u0113r\u010du skaits ir \u013coti liels. ((1)\u00a0 (1)\u00a0 ())<\/sup><\/a><\/p>\n

Administr\u0113\u0161anas vieglums<\/h3>\n

Viena no iev\u0113rojam\u0101kaj\u0101m ivermekt\u012bna priek\u0161roc\u012bb\u0101m ir vienk\u0101r\u0161a doz\u0113\u0161ana. \u0100rst\u0113\u0161ana parasti sast\u0101v no vienreiz\u0113jas peror\u0101las 200 \u03bcg\/kg devas, kam seko otr\u0101 deva p\u0113c 7-14 dien\u0101m, lai izn\u012bcin\u0101tu \u0113rces, kas iz\u0161\u0137\u012blu\u0161\u0101s no izdz\u012bvoju\u0161aj\u0101m ol\u0101m. \u0160\u0101da vienk\u0101r\u0161a lieto\u0161ana nov\u0113r\u0161 daudzas probl\u0113mas, kas saist\u012btas ar terapeitisko ieteikumu iev\u0113ro\u0161anu, kuri saist\u012bti ar lok\u0101lo terapiju. Gados vec\u0101kiem pacientiem, cilv\u0113kiem ar fiziskiem ierobe\u017eojumiem un tiem, kas atrodas apr\u016bpes iest\u0101d\u0113s vai p\u0101rbl\u012bv\u0113t\u0101 vid\u0113, peror\u0101la lieto\u0161ana ir \u013coti izdev\u012bga, jo t\u0101 nov\u0113r\u0161 gr\u016bt\u012bbas, kas saist\u012btas ar kr\u0113ma uzkl\u0101\u0161anu uz visa \u0137erme\u0146a. ((1)\u00a0 (2)\u00a0 ())<\/sup><\/a><\/p>\n

Efektivit\u0101te kl\u012bniskaj\u0101 praks\u0113<\/h3>\n

Daudzi kl\u012bniskie p\u0113t\u012bjumi liecina, ka ivermekt\u012bns nodro\u0161ina sal\u012bdzin\u0101mus vai pat lab\u0101kus iz\u0101rst\u0113\u0161anas r\u0101d\u012bt\u0101jus sal\u012bdzin\u0101jum\u0101 ar permetr\u012bnu. \u012apa\u0161i liela noz\u012bme ir bijusi t\u0101 noz\u012bme masveida z\u0101\u013cu lieto\u0161anas programm\u0101s (MDA). Ir pier\u0101d\u012bts, ka ivermekt\u012bna lieto\u0161ana vis\u0101 sabiedr\u012bb\u0101 pal\u012bdz p\u0101rtraukt infekcijas ciklus, samazin\u0101t atk\u0101rtotas infic\u0113\u0161an\u0101s gad\u012bjumu skaitu un kontrol\u0113t slim\u012bbas uzliesmojumus apr\u016bpes namos, skol\u0101s un b\u0113g\u013cu nometn\u0113s. Turkl\u0101t peror\u0101l\u0101 \u0101rst\u0113\u0161ana \u013cauj viegli \u0101rst\u0113t asimptom\u0101tiskus infekcijas p\u0101rn\u0113s\u0101t\u0101jus, kas bie\u017ei vien ir klusie atk\u0101rtotas infic\u0113\u0161an\u0101s avoti, bet ne\u0113rt\u012bbu vai soci\u0101l\u0101s stigmatiz\u0101cijas d\u0113\u013c var pretoties viet\u0113jai terapijai. (12)<\/sup><\/a><\/p>\n

Dro\u0161\u012bbas profils<\/h3>\n

Ivermekt\u012bna dro\u0161uma reput\u0101cija ir labi zin\u0101ma, jo gadu desmitiem vis\u0101 pasaul\u0113 tas tiek lietots parazit\u0101ro slim\u012bbu, piem\u0113ram, onhocerc\u012bzes un limf\u0101tisk\u0101s filarozes, apkaro\u0161anai. Liel\u0101k\u0101 da\u013ca blakuspar\u0101d\u012bbu ir vieglas un p\u0101rejo\u0161as, ietver galvass\u0101pes, reiboni vai ku\u0146\u0123a un zarnu trakta darb\u012bbas trauc\u0113jumus. Lietojot standarta devas, nopietnas blakuspar\u0101d\u012bbas ir retas. Tom\u0113r ieteicams iev\u0113rot piesardz\u012bbu attiec\u012bb\u0101 uz \u012bpa\u0161\u0101m grup\u0101m: b\u0113rniem, kas sver maz\u0101k nek\u0101 15 kg, gr\u016btniec\u0113m un z\u012bd\u012bt\u0101j\u0101m, par kuru dro\u0161umu joproj\u0101m ir ierobe\u017eoti dati. (12)<\/sup><\/a><\/p>\n

Rezistences probl\u0113mu p\u0101rvar\u0113\u0161ana<\/h3>\n

Ivermekt\u012bns atrisina ar\u012b vienu no aktu\u0101l\u0101kaj\u0101m probl\u0113m\u0101m ka\u0161\u0137a \u0101rst\u0113\u0161an\u0101 - aizdomas par rezistenci pret permetr\u012bnu. T\u0101 k\u0101 ivermekt\u012bns iedarbojas caur piln\u012bgi at\u0161\u0137ir\u012bgu molekul\u0101ro m\u0113r\u0137i, savstarp\u0113ja rezistence starp ab\u0101m z\u0101l\u0113m ir maz ticama. Tas padara to \u012bpa\u0161i v\u0113rt\u012bgu re\u0123ionos vai kopien\u0101s, kur \u0101rst\u0113\u0161ana ar permetr\u012bnu ir bie\u017ei neveiksm\u012bga. Smagos vai refrakt\u012bvos gad\u012bjumos peror\u0101l\u0101 ivermekt\u012bna kombin\u0101cija ar lok\u0101li lietojamo permetr\u012bnu ir izr\u0101d\u012bjusies v\u0113l efekt\u012bv\u0101ka, t\u0101d\u0113j\u0101di uzsverot to potenci\u0101lo siner\u0123iju. (13)<\/sup><\/a><\/p>\n

Lab\u0101ka alternat\u012bva<\/h3>\n

Kopum\u0101 ivermekt\u012bnam ir vair\u0101kas priek\u0161roc\u012bbas, kas tie\u0161i p\u0101rsp\u0113j permetr\u012bna tr\u016bkumus. Peror\u0101la lieto\u0161ana nodro\u0161ina lab\u0101ku atbilst\u012bbu, sist\u0113miska izplat\u012b\u0161ana nodro\u0161ina pla\u0161\u0101ku p\u0101rkl\u0101jumu, un efektivit\u0101te rezistences gad\u012bjumos pastiprina t\u0101 noz\u012bmi ilgtermi\u0146a c\u012b\u0146\u0101 pret ka\u0161\u0137i. \u0145emot v\u0113r\u0101 pieaugo\u0161o pier\u0101d\u012bjumu skaitu un pasaules pieredzi, ivermekt\u012bns arvien vair\u0101k tiek atz\u012bts ne tikai k\u0101 rezerves variants, bet ar\u012b k\u0101 pirm\u0101s izv\u0113les terapija gan individu\u0101liem pacientiem, gan k\u0101 da\u013ca no pla\u0161a m\u0113roga sabiedr\u012bbas vesel\u012bbas intervences pas\u0101kumiem.<\/p>\n

K\u0101p\u0113c ivermekt\u012bns ir lab\u0101ks par permetr\u012bnu ka\u0161\u0137a \u0101rst\u0113\u0161an\u0101<\/h2>\n

Da\u017e\u0101di lieto\u0161anas meh\u0101nismi un veidi<\/h3>\n

5% permetr\u012bna kr\u0113ms iedarbojas, saistoties ar \u0113r\u010du nervu \u0161\u016bnu n\u0101trija kan\u0101liem, izraisot paral\u012bzi un n\u0101vi. Lai gan tas ir \u013coti efekt\u012bvs kontrol\u0113tos apst\u0101k\u013cos, t\u0101 lok\u0101l\u0101 lieto\u0161ana padara veiksm\u012bgu \u0101rst\u0113\u0161anu atkar\u012bgu no pareizas lieto\u0161anas. P\u0113t\u012bjumi liecina, ka visbie\u017e\u0101kie \u0101rst\u0113\u0161anas neveiksmju iemesli ir nepietiekams \u0137erme\u0146a laukumu p\u0101rkl\u0101jums, priek\u0161laic\u012bga nomazg\u0101\u0161ana vai devu izlai\u0161ana. Turpretim ivermekt\u012bns ir peror\u0101li lietojams l\u012bdzeklis, kas izplat\u0101s sist\u0113miski. Tas iedarbojas uz glutam\u0101ta regul\u0113tiem hlor\u012bdu kan\u0101liem \u0113r\u010du nervu sist\u0113m\u0101, izraisot hiperpolariz\u0101ciju un n\u0101vi. T\u0101 k\u0101 z\u0101les iedarbojas no saimnieka organisma iek\u0161ienes, t\u0101s iedarbojas uz \u0113rc\u0113m gr\u016bti sasniedzam\u0101s viet\u0101s (zem nagiem, galvas \u0101d\u0101 vai ekz\u0113mas zv\u012b\u0146\u0101s), kur lok\u0101l\u0101 terapija bie\u017ei vien ir neveiksm\u012bga. \u0160\u012b sist\u0113misk\u0101 darb\u012bba ir \u012bpa\u0161i v\u0113rt\u012bga pacientiem ar pla\u0161iem \u0101das boj\u0101jumiem vai ierobe\u017eot\u0101m iesp\u0113j\u0101m lietot tikai kr\u0113mus. (14)<\/sup><\/a><\/p>\n

Sal\u012bdzino\u0161\u0101 efektivit\u0101te: kl\u012bnisko p\u0113t\u012bjumu dati<\/h3>\n

Randomiz\u0113tos kontrol\u0113tos p\u0113t\u012bjumos ir konsekventi sal\u012bdzin\u0101tas abas z\u0101les. Noz\u012bm\u012bg\u0101 daudzcentru p\u0113t\u012bjum\u0101, kas public\u0113ts \u017eurn\u0101l\u0101 New England Journal of Medicine (1995) <\/i>par\u0101d\u012bja, ka ar vienu peror\u0101li lietota ivermekt\u012bna devu p\u0113c div\u0101m lieto\u0161anas reiz\u0113m var pan\u0101kt iz\u0101rst\u0113\u0161anas r\u0101d\u012bt\u0101jus, kas ir sal\u012bdzin\u0101mi ar permetr\u012bnu, jo \u012bpa\u0161i, ja to kombin\u0113 ar otru ivermekt\u012bna devu, kas lietota 7-14 dienas v\u0113l\u0101k. (15)<\/sup><\/a>\u00a0 Jaun\u0101kajos p\u0101rskatos, tostarp 2018. gad\u0101 public\u0113taj\u0101 Cochrane sistem\u0101tiskaj\u0101 p\u0101rskat\u0101 par ka\u0161\u0137a \u0101rst\u0113\u0161anu, ir konstat\u0113ts, ka permetr\u012bns joproj\u0101m ir nedaudz efekt\u012bv\u0101ks ka\u0161\u0137a \u0101rst\u0113\u0161anai bez komplik\u0101cij\u0101m, ja ir nodro\u0161in\u0101ta ide\u0101la lieto\u0161anas prakse. Tom\u0113r kl\u012bniskaj\u0101 praks\u0113 ivermekt\u012bna peror\u0101la lieto\u0161ana dod lab\u0101kus ilgtermi\u0146a rezult\u0101tus, jo pacientu iev\u0113ro\u0161ana ir iev\u0113rojami lab\u0101ka..<\/sup><\/a> (16)<\/sup><\/a><\/p>\n

Priek\u0161roc\u012bbas epid\u0113miju un kopienas kontroles gad\u012bjum\u0101<\/h3>\n

Slim\u012bbas uzliesmojumi apr\u016bpes iest\u0101d\u0113s uzsver ivermekt\u012bna lo\u0123istikas priek\u0161roc\u012bbas. Austr\u0101lijas pamatiedz\u012bvot\u0101ju kopien\u0101s, masveid\u0101 lietojot ivermekt\u012bnu (200 \u03bcg\/kg dev\u0101s, atk\u0101rtojot katru ned\u0113\u013cu), da\u017eu m\u0113ne\u0161u laik\u0101 saslimst\u012bba ar ka\u0161\u0137i samazin\u0101j\u0101s no vair\u0101k nek\u0101 50% l\u012bdz maz\u0101k nek\u0101 5%, kas ir gr\u016bti sasniedzams ar lok\u0101liem kr\u0113miem. L\u012bdz\u012bgi ar\u012b Francijas pansion\u0101tos slim\u012bbas uzliesmojumu kontrole ar ivermekt\u012bnu deva \u0101tr\u0101kus rezult\u0101tus nek\u0101 permetr\u012bns, galvenok\u0101rt t\u0101p\u0113c, ka visus iem\u012btniekus var\u0113ja \u0101rst\u0113t vienlaic\u012bgi. (17)<\/sup><\/a><\/p>\n

Ieteikumu iev\u0113ro\u0161ana un pacientu pieredze<\/h3>\n

Pacientu atbilst\u012bbai ir b\u016btiska noz\u012bme, lai noteiktu faktiskos pan\u0101kumus. Permetr\u012bnu nepiecie\u0161ams r\u016bp\u012bgi uzkl\u0101t uz visa \u0137erme\u0146a, atst\u0101jot to iedarb\u012bb\u0101 8-14 stundas un bie\u017ei vien atk\u0101rtoti uzkl\u0101jot p\u0113c ned\u0113\u013cas. Z\u012bdai\u0146iem, gados vec\u0101kiem pacientiem vai pacientiem ar invalidit\u0101ti \u0161is process var b\u016bt nogurdino\u0161s un saist\u012bts ar k\u013c\u016bdu iesp\u0113jam\u012bbu.<\/p>\n

Turpret\u012b ivermekt\u012bnam nepiecie\u0161ama tikai viena peror\u0101la deva, ko atk\u0101rto p\u0113c 7-14 dien\u0101m. P\u0113t\u012bjumi liecina, ka ivermekt\u012bna lieto\u0161anas saist\u012bbu l\u012bmenis p\u0101rsniedz 90%, sal\u012bdzinot ar daudz zem\u0101ku permetr\u012bna lieto\u0161anas l\u012bmeni, kad pacienti bie\u017ei izlai\u017e lok\u0101l\u0101s terapijas posmus. \u0160\u012b praktiski vienk\u0101r\u0161\u0101 lieto\u0161ana veicina ivermekt\u012bna augst\u0101ku visp\u0101r\u0113jo efektivit\u0101ti \u0101rpus stingri uzraudz\u012btiem kl\u012bniskiem p\u0113t\u012bjumiem. (18)<\/sup><\/a><\/p>\n

Dro\u0161\u012bba, pielaide un ierobe\u017eojumi<\/h3>\n

Abas z\u0101les parasti ir dro\u0161as. Permetr\u012bns da\u017ek\u0101rt izraisa \u0101das kairin\u0101jumu, niezi vai dedzin\u0101\u0161anu, ko var sajaukt ar infekcijas saasin\u0101\u0161anos. Ivermekt\u012bns tiek labi panests, un visbie\u017e\u0101k sastopam\u0101s blakuspar\u0101d\u012bbas ir viegli ku\u0146\u0123a-zarnu trakta darb\u012bbas trauc\u0113jumi, reibonis vai nogurums. Nopietnas nev\u0113lamas blakuspar\u0101d\u012bbas sastopamas reti. Tom\u0113r ivermekt\u012bna lieto\u0161ana ir ierobe\u017eota b\u0113rniem, kas sver maz\u0101k par 15 kg, un nav ieteicama gr\u016btniec\u012bbas laik\u0101, jo dati par dro\u0161\u012bbu ir ierobe\u017eoti. \u0160aj\u0101s grup\u0101s permetr\u012bns joproj\u0101m ir pirm\u0101s izv\u0113les l\u012bdzeklis. Pieaugu\u0161ajiem, tostarp pacientiem ar nov\u0101jin\u0101tu imunit\u0101ti un pacientiem ar ka\u0161\u0137i, ivermekt\u012bns bie\u017ei vien ir lab\u0101ka izv\u0113le. (18)<\/sup><\/a><\/p>\n

Ivermekt\u012bna lieto\u0161ana augsta riska pacientiem un ietekme uz sabiedr\u012bbas vesel\u012bbu<\/h2>\n

Ka\u0161\u0137is un im\u016bnkompromit\u0113ti pacienti<\/h3>\n

Ka\u0161\u0137is, paz\u012bstams ar\u012b k\u0101 Norv\u0113\u0123ijas ka\u0161\u0137is, ir vissmag\u0101k\u0101 infic\u0113\u0161an\u0101s forma, kam rakstur\u012bga p\u0101rm\u0113r\u012bga \u0101das keratiniz\u0101cija un miljoniem \u0113r\u010du kl\u0101tb\u016btne. T\u0101 bie\u017ei sastopama im\u016bnkompromit\u0113tiem cilv\u0113kiem, tostarp HIV\/AIDS slimniekiem, transplant\u0101tu sa\u0146\u0113m\u0113jiem vai pacientiem, kuri ilgsto\u0161i sa\u0146em kortikostero\u012bdu terapiju. Viet\u0113j\u0101 permetr\u012bna lieto\u0161ana, lai gan teor\u0113tiski t\u0101 ir efekt\u012bva, \u0161ajos gad\u012bjumos bie\u017ei vien ir neveiksm\u012bga, jo \u0113r\u010du daudzums ir \u013coti liels un gr\u016bti iek\u013c\u016bt biezos kraupjos. (19)<\/sup><\/a>\u00a0 (<\/sup>20)<\/sup><\/a><\/p>\n

\u0160\u0101d\u0101s situ\u0101cij\u0101s peror\u0101lajam ivermekt\u012bnam ir nep\u0101rprotamas priek\u0161roc\u012bbas. T\u0101 k\u0101 tas iedarbojas sist\u0113miski, tas apiet ierobe\u017eojumus, kas saist\u012bti ar lok\u0101lu uzs\u016bk\u0161anos, un tie\u0161i kontrol\u0113 \u0113rces vis\u0101 organism\u0101. Austr\u0101lijas un Francijas kl\u012bniskaj\u0101s vadl\u012bnij\u0101s k\u0101 v\u0113lamo ka\u0161\u0137a \u0101rst\u0113\u0161anas strat\u0113\u0123iju iesaka lietot vair\u0101kas ivermekt\u012bna devas kombin\u0101cij\u0101 ar keratol\u012btiskiem l\u012bdzek\u013ciem un da\u017ek\u0101rt ar\u012b lok\u0101li lietojamiem l\u012bdzek\u013ciem. \u0160\u0101da \u0101rst\u0113\u0161anas sh\u0113ma ne tikai uzlabo pacientu \u0101rst\u0113\u0161anas rezult\u0101tus, bet ar\u012b mazina augstu infic\u0113\u0161an\u0101s risku, ko var izrais\u012bt \u0161ie cilv\u0113ki, kuri bie\u017ei vien ir \"superplat\u012bt\u0101ji\" slim\u012bbas uzliesmojumu gad\u012bjumos sabiedr\u012bb\u0101. (19)<\/sup><\/a>\u00a0 (<\/sup>20)<\/sup><\/a><\/p>\n

Ka\u0161\u0137is k\u0101 nov\u0101rt\u0101 atst\u0101ta tropu slim\u012bba<\/h3>\n

Papildus atsevi\u0161\u0137iem gad\u012bjumiem ka\u0161\u0137is arvien bie\u017e\u0101k tiek atz\u012bts par glob\u0101lu vesel\u012bbas slogu. 2017. gad\u0101. Pasaules Vesel\u012bbas organiz\u0101cija ofici\u0101li iek\u013c\u0101va ka\u0161\u0137i nov\u0101rt\u0101 atst\u0101to tropisko slim\u012bbu (NTD) sarakst\u0101. \u0160\u012b slim\u012bba nesam\u0113r\u012bgi skar resursiem ierobe\u017eotus apst\u0101k\u013cus, jo \u012bpa\u0161i Subsah\u0101ras \u0100frik\u0101, Dienvid\u0101zij\u0101 un noma\u013c\u0101s pamatiedz\u012bvot\u0101ju kopien\u0101s, kur t\u0101s izplat\u012bba b\u0113rnu vid\u016b var p\u0101rsniegt 30%. Ka\u0161\u0137a komplik\u0101cijas - sekund\u0101r\u0101s bakteri\u0101l\u0101s infekcijas, sekas p\u0113c streptokoku infekcijas, piem\u0113ram, reimatisk\u0101 sirds slim\u012bba un nieru boj\u0101jumi - palielina t\u0101s ietekmi uz sabiedr\u012bbas vesel\u012bbu. (21)<\/sup><\/a><\/p>\n

Masveida z\u0101\u013cu lieto\u0161ana un papildu priek\u0161roc\u012bbas<\/h2>\n

Masveida z\u0101\u013cu lieto\u0161anas (MDA) pieredze \u0100frik\u0101 un Klus\u0101 oke\u0101na valst\u012bs liecina par ivermekt\u012bna potenci\u0101lu sabiedr\u012bbas vesel\u012bbas jom\u0101. Gan\u0101, Tanz\u0101nij\u0101 un Z\u0101lamana sal\u0101s ivermekt\u012bna izplat\u012b\u0161ana vis\u0101 kopien\u0101, lai kontrol\u0113tu filarizes izplat\u012bbu, izrais\u012bja nejau\u0161u un iev\u0113rojamu ka\u0161\u0137a izplat\u012bbas samazin\u0101\u0161anos. Fid\u017ei randomiz\u0113ts kl\u012bnisks p\u0113t\u012bjums par\u0101d\u012bja, ka MDA ar ivermekt\u012bnu samazin\u0101ja ka\u0161\u0137a izplat\u012bbu par vair\u0101k nek\u0101 90% \u0101rst\u0113tajos ciematos viena gada laik\u0101. \u0160ie rezult\u0101ti liecina, ka ivermekt\u012bnu var izmantot gan k\u0101 m\u0113r\u0137tiec\u012bgu terapiju, gan k\u0101 kopienas l\u012bme\u0146a kontroles l\u012bdzekli. (22)<\/sup><\/a><\/p>\n

Secin\u0101jumi<\/h2>\n
    \n
  1. Kopum\u0101 pier\u0101d\u012bjumi liecina, ka ivermekt\u012bns ir ne tikai b\u016btisks smagos gad\u012bjumos, piem\u0113ram, ka\u0161\u0137a gad\u012bjum\u0101, bet ar\u012b ir pamats glob\u0101l\u0101m ka\u0161\u0137a izskau\u0161anas strat\u0113\u0123ij\u0101m. Izmantojot eso\u0161\u0101s z\u0101\u013cu pieg\u0101des platformas cit\u0101m tropu slim\u012bb\u0101m, ivermekt\u012bns pied\u0101v\u0101 rentablu un praktisku veidu, k\u0101 samazin\u0101t \u0161\u012bs nov\u0101rt\u0101 atst\u0101t\u0101s slim\u012bbas glob\u0101lo slogu.<\/li>\n<\/ol>\n

    Atruna<\/h3>\n

    \u0160is raksts ir rakst\u012bts izgl\u012btojo\u0161iem nol\u016bkiem, un t\u0101 m\u0113r\u0137is ir veicin\u0101t izpratni par apl\u016bkojamo vielu. Ir svar\u012bgi atz\u012bm\u0113t, ka raksts ir par vielu kopum\u0101 - tas nav konkr\u0113ta produkta (\u0137\u012bmisk\u0101 rea\u0123enta) apraksts. M\u0113s neiesak\u0101m lietot \u0137\u012bmiskos rea\u0123entus uz cilv\u0113kiem - tas ir aizliegts ar likumu. Lai produktu var\u0113tu izmantot \u0101rst\u0113\u0161anai, tam j\u0101b\u016bt re\u0123istr\u0113tam k\u0101 z\u0101l\u0113m. Tekst\u0101 ietvert\u0101 inform\u0101cija ir balst\u012bta uz pieejamajiem zin\u0101tniskajiem p\u0113t\u012bjumiem, un t\u0101 nav paredz\u0113ta k\u0101 medic\u012bnisks padoms vai pa\u0161\u0101rst\u0113\u0161an\u0101s veicin\u0101\u0161anai. Las\u012bt\u0101jam par visiem vesel\u012bbas un \u0101rst\u0113\u0161anas l\u0113mumiem j\u0101konsult\u0113jas ar kvalific\u0113tu vesel\u012bbas apr\u016bpes speci\u0101listu.<\/p>\n

    Atsauces<\/h2>\n
      \n
    1. Talaga-\u0106wiertnia, K. (2021). Sarcoptes inv\u0101zija. Kas jau zin\u0101ms un kas jauns par ka\u0161\u0137i 21. gadsimta tre\u0161\u0101s desmitgades s\u0101kum\u0101? Patog\u0113ni<\/i>, 10<\/i>(7), 868.<\/li>\n
    2. Dela\u0161 A\u017edaji\u0107, M., Be\u0161li\u0107, I., Ga\u0161i\u0107, A., Ferara, N., Pedi\u0107, L. un Lugovi\u0107-Mihi\u0107, L. (2022). Palielin\u0101ta ka\u0161\u0137a izplat\u012bba 21. gadsimta s\u0101kum\u0101: ko liecina zi\u0146ojumi no Eiropas un pasaules? Life, 12(<\/i>10), 1598.<\/li>\n
    3. Jannic, A., Bernigaud, C., Brenaut, E. un Khosidov, O. (2018). Ka\u0161\u0137a izrais\u012bta nieze. Dermatolo\u0123ijas kl\u012bnikas<\/i>, 36<\/i>(3), 301-308.<\/li>\n<\/ol>\n

      Banerji, A. (2015). Scabies. Pediatrija un b\u0113rnu vesel\u012bba<\/i>, 20<\/i>(7), 395-398.<\/p>\n

        \n
      1. Hussain, A. H., Hussain, N. M. un Ali, S. (2021). P\u0101rskats par ka\u0161\u0137a epidemiolo\u0123iju, transmisiju, pato\u0123en\u0113zi un \u0101rst\u0113\u0161anu. Britu studentu \u0101rstu \u017eurn\u0101ls<\/i>, 5<\/i>(1), 54-61.<\/li>\n
      2. El-Moamly, A. A. (2021). K\u0101rpu ka\u0161\u0137is k\u0101 da\u013ca no Pasaules Vesel\u012bbas organiz\u0101cijas 2021-2030. gada Nov\u0101rt\u0101 atst\u0101to tropisko slim\u012bbu r\u012bc\u012bbas pl\u0101na: ko m\u0113s zin\u0101m un kas mums j\u0101dara, lai nodro\u0161in\u0101tu glob\u0101lu kontroli. Tropu medic\u012bna un vesel\u012bba<\/i>, 49<\/i>(1), 64.<\/li>\n
      3. Ranjkesh, M. R., Naghili, B., Goldust, M. and Rezaee, E. (2013). Permetr\u012bna 5% efektivit\u0101te pret peror\u0101li lietojamo ivermekt\u012bnu ka\u0161\u0137a \u0101rst\u0113\u0161an\u0101. Parazitolo\u0123ijas gadagr\u0101matas<\/i>, 59<\/i>(4).<\/li>\n
      4. Y\u00fcrekli, A. (2022). Vai tie\u0161\u0101m past\u0101v rezistence pret ka\u0161\u0137a \u0101rst\u0113\u0161anu ar permetr\u012bnu? Permetr\u012bna in vitro nogalino\u0161\u0101 iedarb\u012bba uz Sarcoptes scabiei pacientiem ar rezistentu ka\u0161\u0137i. Dermatolo\u0123isk\u0101 terapija<\/i>, 35<\/i>(3), e15260.<\/li>\n
      5. Mbuagbaw, L., Sadeghirad, B., Morgan, R. L., Mertz, D., Motaghi, S., Ghadimi, M., ... & Reichert, F. (2024). Neveiksm\u012bga \u0101rst\u0113\u0161ana ka\u0161\u0137a gad\u012bjum\u0101: sistem\u0101tisks p\u0101rskats un metaanal\u012bze. British Journal of Dermatology<\/i>, 190<\/i>(2), 163-173.<\/li>\n
      6. Martin, R. J., Robertson, A. P., & Choudhary, S. (2021). Ivermekt\u012bns: prets\u0113n\u012b\u0161u l\u012bdzeklis, insektic\u012bds un v\u0113l vair\u0101k. Parazitolo\u0123ijas tendences<\/i>, 37<\/i>(1), 48-64.<\/li>\n
      7. Martin, R. J., Robertson, A. P. un Choudhary, S. (2021). Ivermekt\u012bns: prets\u0113n\u012b\u0161u l\u012bdzeklis, insektic\u012bds un v\u0113l vair\u0101k. Parazitolo\u0123ijas tendences<\/i>, 37<\/i>(1), 48-64.<\/li>\n
      8. Chhaiya, S. B., Mehta, D. S. un Kataria, B. C. (2012). Ivermekt\u012bns: farmakolo\u0123ija un terapeitiskie lietojumi. Int J Basic Clin Pharmacol<\/i>, 1<\/i>(3), 132-139.<\/li>\n
      9. Simonart, T. un Lam Hoai, X. L. (2024). Arvien pieaugo\u0161ie pret z\u0101l\u0113m rezistentas cilv\u0113ku ka\u0161\u0137a slim\u012bbas draudi: pa\u0161reiz\u0113j\u0101s zin\u0101\u0161anas un n\u0101kotnes virzieni. Kl\u012bnisk\u0101s medic\u012bnas \u017eurn\u0101ls<\/i>, 13<\/i>(18), 5511.<\/li>\n
      10. Lobo, Y. un Wheller, L. (2021). Viet\u0113j\u0101 permetr\u012bna un peror\u0101l\u0101 ivermekt\u012bna lomas b\u0113rnu ka\u0161\u0137a \u0101rst\u0113\u0161an\u0101 apraksto\u0161s p\u0101rskats. Australasian Journal of Dermatology<\/i>, 62<\/i>(3), 267-277.<\/li>\n
      11. Meinking, T. L., Taplin, D., Herminda, J. L., Pardo, R. un Kerdel, F. A. (1995). Ka\u0161\u0137a \u0101rst\u0113\u0161ana ar ivermekt\u012bnu. New England Journal of Medicine<\/i>, 333<\/i>(1), 26-30.<\/li>\n
      12. Rosumeck, S., Nast, A., Dressler, C. un Cochrane Infectious Diseases Group. (1996). Ivermekt\u012bns un permetr\u012bns ka\u0161\u0137a \u0101rst\u0113\u0161an\u0101. Cochrane sistem\u0101tisko p\u0101rskatu datub\u0101ze<\/i>, 2018<\/i>(4).<\/li>\n
      13. Middleton, J., Walker, S. L., House, T., Head, M. G. un Cassel, J. A. (2019). Ivermekt\u012bns ka\u0161\u0137a uzliesmojumu kontrol\u0113 Apvienotaj\u0101 Karalist\u0113. The Lancet<\/i>, 394<\/i>(10214), 2068-2069.<\/li>\n
      14. Genuino, R. F., Batac, M. C. F. R., Capule, F. R., Ednalino, K. A. G., Garcia Jr, F. B., Ladia, M. A. J., ... un Cagayan, M. S. F. S. (2022). Peror\u0101li lietojam\u0101 ivermekt\u012bna, lok\u0101li lietojam\u0101 permetr\u012bna un to kombin\u0101cijas sal\u012bdzino\u0161\u0101 efektivit\u0101te un dro\u0161\u012bba ka\u0161\u0137a \u0101rst\u0113\u0161an\u0101: sistem\u0101tisks literat\u016bras apskats. Filip\u012bnu Dermatologu biedr\u012bbas \u017eurn\u0101ls, 31(<\/i>1), 7-19.<\/li>\n
      15. Hall, M., Forsyth, A., Du, W., Carletti, M., & Weis, S. (2025). Sabiedr\u012bbas vesel\u012bbas probl\u0113mas: ka\u0161\u0137a diagnostika un \u0101rst\u0113\u0161ana.<\/li>\n
      16. Salvador, F., Lucas-Dato, A., Roure, S., Arsuaga, M., P\u00e9rez-Jacoiste, A., Garc\u00eda-Rodr\u00edguez, M., ... and Molina, I. (2021). Vienreiz\u0113jas ivermekt\u012bna devas efektivit\u0101te un dro\u0161\u012bba nekomplic\u0113tas strongiloidozes \u0101rst\u0113\u0161an\u0101 pacientiem ar pav\u0101jin\u0101tu im\u016bnsist\u0113mu (ImmunoStrong p\u0113t\u012bjums): p\u0113t\u012bjuma protokols. Patog\u0113ni, 10(<\/i>7), 812.<\/li>\n
      17. Cox, V., Fuller, L. C., Engelman, D., Steer, A., & Hay, R. J. (2021). Glob\u0101l\u0101 ka\u0161\u0137a sloga nov\u0113rt\u0113\u0161ana: kas v\u0113l mums ir vajadz\u012bgs? British Journal of Dermatology<\/i>, 184<\/i>(2), 237-242.<\/li>\n<\/ol>\n

        Mutono, N., Bas\u00e1\u00f1ez, M. G., James, A., Stolk, W. A., Makori, A., Kimani, T. N., ... & Thumbi, S. M. (2024). Elimination of onchocerciasis (river blindness) transmission by long-term mass administration of ivermectin with or without vector control in sub-Saharan Africa: a systematic review and meta-analysis. The Lancet Global Health, 12(<\/i>5), e771-e782.<\/p>","protected":false},"excerpt":{"rendered":"

        Ivermekt\u012bna iesp\u0113jam\u0101s iedarb\u012bbas apraksts, pamatojoties uz literat\u016bru. (\u0160is nav produkta apraksts, atruna lapas apak\u0161\u0101) Ka\u0161\u0137is ir lip\u012bga parazit\u0101ra \u0101das infekcija, ko izraisa \u0113rc\u012btes\u2026<\/p>","protected":false},"author":7908,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-37169","post","type-post","status-publish","format-standard","hentry","category-bez-kategorii","beh-no-thumb"],"_links":{"self":[{"href":"https:\/\/bioevidencehub.com\/lv\/wp-json\/wp\/v2\/posts\/37169","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/bioevidencehub.com\/lv\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/bioevidencehub.com\/lv\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/bioevidencehub.com\/lv\/wp-json\/wp\/v2\/users\/7908"}],"replies":[{"embeddable":true,"href":"https:\/\/bioevidencehub.com\/lv\/wp-json\/wp\/v2\/comments?post=37169"}],"version-history":[{"count":0,"href":"https:\/\/bioevidencehub.com\/lv\/wp-json\/wp\/v2\/posts\/37169\/revisions"}],"wp:attachment":[{"href":"https:\/\/bioevidencehub.com\/lv\/wp-json\/wp\/v2\/media?parent=37169"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/bioevidencehub.com\/lv\/wp-json\/wp\/v2\/categories?post=37169"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/bioevidencehub.com\/lv\/wp-json\/wp\/v2\/tags?post=37169"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}