Y pedwar uchaf lladdwyr modern yn y gorllewin

The top four modern killers in the west

 

Powered by Guardian.co.ukMae'r erthygl hon yn dwyn y teitl “Y pedwar uchaf lladdwyr modern yn y gorllewin” Ysgrifennwyd gan Robin McKie, ar gyfer The Observer ar ddydd Sadwrn 6 Mehefin 2015 23.05 UTC

CANSER

Ble rydym ni
Mae'r frwydr yn erbyn canser wedi profi i fod yn un o'r heriau deallusol ac ymarferol mwyaf yn y cyfnod modern. Gan mlynedd yn ôl, ymyriadau llawfeddygol a gefnogir gan ffurfiau cynnar o therapi ymbelydredd oedd yr unig arfau at wasanaeth meddygon. Ers hynny, mae nifer o chwyldroadau allweddol wedi newid hynny.

Y cyntaf oedd cyflwyno cemotherapi, ar ffurf cyffuriau a oedd yn deillio, yn eironig, oddi wrth y nwy mwstard a gafodd ei ddefnyddio fel arf yn ystod y rhyfel byd cyntaf. Meddygon sy'n cynnal awtopsïau ar ddioddefwyr nwy nodi ei fod yn atal cellraniad, a fersiynau datblygu sy'n helpu i atal celloedd tiwmor rhag amlhau. Mae'r rhain daeth triniaethau rheolaidd yn y 1950au.

Beth nawr?
Gan fod ymchwil genomig symud ymlaen yn y 20fed ganrif, mae gwyddonwyr wedi defnyddio'r wybodaeth honno i ddatblygu triniaethau newydd. Mae datblygiadau diweddar wedi cynnwys therapïau a dargedir. Mae'r rhain yn fwy penodol yn eu gweithredu yn erbyn tiwmorau oherwydd eu bod yn gweithredu ar dargedau moleciwlaidd sy'n gysylltiedig â chelloedd canser penodol, tra bod y rhan fwyaf o chemotherapies safonol yn gweithredu ar yr holl gelloedd gyflym rannu, boed yn arferol neu ganseraidd.

Er enghraifft,, mewn tua un o bob pum claf canser y fron, celloedd tiwmor yn cael gormod o brotein twf-hyrwyddo a elwir yn HER2 ar eu harwyneb. ganserau'r fron gyda gormod o brotein hwn yn arbennig o ymosodol, Canfu gwyddonwyr. Mae nifer o gyffuriau, megis Herceptin, wedi cael eu datblygu i dargedu protein hwn a bloc lledaeniad celloedd tiwmor. Mae'r therapïau hyn wedi'u targedu yn awr yn brif yn y frwydr yn erbyn canser.

Beth yw'r problemau mawr?
cynnydd mawr yn cael ei wneud, ond efallai y bydd y broblem yn dod i'r amlwg yn ariannol yn hytrach na thechnegol. Mae'r genhedlaeth newydd o gyffuriau sy'n cael eu datblygu yn ddrud iawn, gan godi cwestiynau fforddiadwyedd.

Cymerwch y dechnoleg egin o imiwnotherapi. Mae celloedd canser yn meddu ar fath o ysgwyd llaw gyfrinach bod perswadio T-gelloedd, yn rhan allweddol o amddiffynfeydd gwrth-clefyd y corff, i beidio â ymosod arnynt. Yn y 1990au, gwyddonwyr darganfod moleciwl ar T-gelloedd a oedd yn rhan o ysgwyd llaw hon. Mae'n cael ei adnabod fel marwolaeth raglennu 1 (PD1) ac, ers ei darganfod, ymchwilwyr wedi bod yn ceisio tarfu ar ei swyddogaeth.

Mae'r cyffuriau newydd a ddadorchuddiwyd yn Chicago wythnos diwethaf yn ganlyniad y gwaith hwn. Treialon ar gleifion sydd â melanoma datblygedig, sydd â chyfradd marwolaethau uchel, eisoes wedi cynhyrchu canlyniadau calonogol, ond mae gwyddonwyr yn rhybuddio y gallai fod sgîl-effeithiau difrifol mewn rhai cleifion.

sleid ymennydd
Ffotograff: Alamy

DEMENTIA

Ble rydym ni?
Nid yw Dementia mewn gwirionedd yn glefyd. Mae'n ganlyniad llawer o wahanol gyflyrau. Clefyd Alzheimer yw'r mwyaf cyffredin o'r rhain ond mae eraill yn cynnwys dementia fasgwlaidd a dementia frontotemporal. Mae pob un o'r ffurflenni hyn yn rhannu symptomau cyffredin, Fodd bynnag,. Mae'r rhain yn cynnwys colli cof, dryswch a phersonoliaeth newid.

Er nad yw demensia yn sicr yn ganlyniad anochel o gael hen, y tebygolrwydd o ddatblygu'r cyflwr yn ddi-os yn cynyddu gydag oedran. Felly, fel clefydau heintus yn cael eu vanquished yn y DU, a chyfraddau marwolaethau ar gyfer canser a'r galon amodau eu gorfodi i lawr, mwy a mwy o bobl wedi gallu byw â henaint. (Mae disgwyliad oes yn y DU bellach 79 ar gyfer dynion a 83 ar gyfer menywod.)

heddiw, cyfrifwyd fod yna bellach yn fwy na 850,000 pobl â dementia yn y DU.

Beth nawr?
erbyn 2025, mae nifer yr achosion o ddementia yn y DU disgwylir i hyn godi i fwy na 1 miliwn. erbyn 2050, rhagwelir i fod yn fwy na 2 miliwn. yn ychwanegol, y cyflwr wedi cael ei ganfod i fod yn arbennig o gyffredin mewn merched. o blith y 850,000 cleifion dementia ym Mhrydain, 500,000 yn fenywod. Fel canlyniad, menywod dros 60 yn awr yn ddwywaith yn fwy tebygol o gael dementia fel canser y fron.

Mae gwyddonwyr yn awr yn gweithio ar ffyrdd o ddefnyddio technolegau genetig a bôn-gelloedd i ddeall achosion manwl o'r gwahanol fathau o ddemensia a, Yn y hir dymor, i ddatblygu cyffuriau a allai arafu colli cyfadrannau yn y rhai yr effeithir arnynt gan y cyflwr.

Mae gwyddonwyr yn rhybuddio bod y dyhead hwn yn parhau i fod yn nod tymor hir ac yn rhybuddio bod llawer o waith sy'n dal angen ei wneud.

Beth yw'r problemau?
A key problem for those trying to tackle dementia is a lack of resources. There have been major investments in heart disease and cancer research in recent years and these have helped bring down death rates.

But that has not happened with dementia, said Matthew Norton, head of policy for Alzheimer’s Research UK. “Just look at the figures,"Meddai.

“Total spend in the UKfrom charities and the governmenton dementia in 2013 was £73.8m. Ar y llaw arall, for cancer, that figure was £503m.” This underfunding means reduced manpower, say campaigners. There are some 3,600 dementia researchers working in the UK –about 19,000 fewer than those working on cancer, even though dementia costs the UK economy more. felly, prospects of finding treatments to slow or halt the loss of faculties associated with dementia will be limited, say researchers.

Heart attack, conceptual computer artwork
Ffotograff: PASIEKA/SPL/Getty Images/Brand X

HEART DISEASE

Ble rydym ni?
Over the past 50 flynyddoedd, there has been an impressive improvement in mortality rates from cardiovascular disease in Britain. This point was precisely summed up by Peter Weissberg, medical director of the British Heart Foundation. “The foundation was established in 1961, when heart disease was ravaging the country. It caused nearly half of all deaths in the UK in that year.”

With hindsight, it is not hard to see why. Smoking levels were four times higher than today, while eating foods high in saturated fatswhole milk, butter and red meatwas the norm.

heddiw, those foods have been replaced by lower-fat options, vegetable oils, skimmed milk and poultry. We have medicines to reduce blood pressure and cholesterol levels, and it is possible to open blocked or narrowed arteries without major surgery.

Beth nawr?
Devising drugs to treat damaged hearts suffers from a key problem: they are difficult to test. “We cannot keep cutting patients open to remove heart-tissue samples. That is just not practical or ethical,” said Chris Denning of Nottingham University.

A solution for scientists in recent years has been to turn to the use of stem cells. At Nottingham University researchers have taken cells from patients’ skin and bathed them in nutrients in order to transform them into stem cells, a type of cell that can be turned into any tissue. These cells are then developed into heart cells, which are kept in Petri dishes for testing purposes.

“That means they are ideal for trying new drugs on. It is an incredibly important development,” added Denning.

Other scientists believe that it may be possible to use stem cells to directly repair, damaged hearts in the near future.

Beth yw'r problemau?
Although medical procedures continue to improve prospects for saving the lives of those who suffer from cardiovascular disease, there are a host of epidemiological issues that threaten to offset these benefits.

Er enghraifft,, the rate of smoking declined sharply between 1972 ac 1994 but the fall-off has since slowed down. And the prevalence of heavy drinking has not changed substantially since the 1970s. Yn waeth, childhood obesity has been increasing in both boys and girls since the mid-1980s, while adult obesity rates are also continuing to rise – as is the incidence of diabetes in the UK. All these factors increase the risk that heart disease mortality rates could rise again in the near future.

Weissberg has warned that these factors “threaten to derail the decreasing trends in heart disease and death rates that we are now experiencing”.

Antibodies attacking flu virus, artwork
Ffotograff: SCIEPRO/Getty Images/Brand X

INFECTIOUS DISEASE

Ble rydym ni?
Defeating the scourge of infectious disease in the western world is generally attributed to the development of vaccine programmes and antibiotics, although improved sanitation and health education have also been key factors.

“In fact, death rates from tuberculosis, a pernicious killer, had begun to drop by the mid-19th century,” said Carsten Timmermann of Manchester University. “In 1838, there were around 4,000 deaths per million as a result of TB, but this had dropped to around 1,000 gan 1900. Vaccines and antibiotics had nothing to do with that. Yn wir, it is not clear why the decline occurred at all. But it is also evident that programmes such as the BCG vaccine project had really stopped tuberculosis being a serious killer by the middle of the 20th century.”

Beth nawr?
In the west, most infectious diseases are now kept at bay. Fodd bynnag, the balance is an uneasy one. “In the 1960s, a US surgeon-general was alleged to have claimed that infectious diseases had been completely defeated,” said Jeremy Farrar, who is head of the UK Wellcome Trust.

“The story may be apocryphal but it certainly sums up attitudes at the time. yna, a couple of decades later, we had the arrival of HIV in the west and a very clear lesson about the ever-present danger of infectious diseases, sy'n can spread very quickly from other parts of the world.”

yn ychwanegol, the rise of antibiotic resistancea result, in part, of overusehas led to growing fears that one of the west’s key defences against infectious disease may be lost in the near future, unless pharmaceutical companies speed up the development of new versions.

Beth yw'r problemau?
In an increasingly connected world, it’s more and more difficult to contain infectious diseases. Changes in weather patterns and increased migrations from areas affected by rising sea levels or spreading deserts will also intensify the risk of new diseases or new strains of existing conditions arriving in the west.

“In developing nations, we have replaced the problems of infectious disease with health issues such as diabetes and obesity,” said Farrar. “But in developing nations, they still have major problems with infectious diseasesmalaria, TB and HIV, er enghraifft – but are also being affected by obesity and diabetes. Countries such as theseVietnam is a good exampleneed considerable help from global agencies such as the World Health Organisation. Fodd bynnag, these agencies are not getting the support they need from the west any more.”

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