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qalis tvinisqalis tvinisqalis tvinisqalis tvinisqalis tvinis

TaviseburebaniTaviseburebaniTaviseburebaniTaviseburebaniTaviseburebani

Teimuraz kuxalaSvili

TbilisiTbilisiTbilisiTbilisiTbilisi20092009200920092009

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recenzentebi:

irakli mWedliSvili _ medicinis mecnierebaTa doqtori,sruli profesori

sergo rigvava _ biologiis mecnierebaTa doqtori,profesori, saqarTvelos mediko-biologiur mecnierebaTaakademiis akademikosi

amiran meifariani _ medicinis mecnierebaTa doqtori,profesori, saqarTvelos medicinis mecnierebaTa akademiisvice-prezidenti, akademikosi

ISBN 978-9941-0-1374-4

wignSi Tavmoyrilia sxvadasxva droisa da sxvadasxva period-uli gamocemebis rCeuli publikaciebi. zogi maTgani ucxouriliteraturis damuSavebis Sedegadaa Seqmnili, zogi saistorioarqivSi mikvleul pirvelwyaros efuZneba, ramdenime aqtualursakiTxebze ki Tanamedroe gamoxmaurebaa.

naSromi gamiznulia, rogorc samedicino sazogadoebis, isemkiTxvelTa farTo wrisaTvis.

medicinis doqtori T. kuxalaSvili

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s a r C e v i

qalis tvinis Taviseburebani ............................................................. 5

simsuqne da misi genetika .................................................................. 11

janmrTelobis saTaveebi ................................................................... 16

dayovneba sikvdilis tolfasia ...................................................... 23

Wama yovelTvis rodia `didad Sesargi~ ....................................... 27

agresia kacobriobis winaaRmdeg.................................................... 33

brucelozi saSiSi infeqciaa ........................................................... 37

jilexis `afeTqeba~ .............................................................................. 40

Savi Wiri _ wyevlis sinonimi .......................................................... 42

epidemiam arc mSveniereba daindo ................................................. 51

ilia WavWavaZe _ sanitaruli meurve ........................................... 54

sisxliani warsulis mogoneba ........................................................ 62

istoriis foliantebi ........................................................................ 65

WavWavaZiaanT ojaxuri saidumlo ................................................. 69

Sesavali wignidan `jilexis kerebi saqarTveloSi~ ............... 71

avtobiografiis magivrad ................................................................. 87

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vuZRvni SviliSvilsTornike kuxalaSvils

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qalis tvinis Taviseburebani

rusTaveli brZanebs `lekvi lomisa sworia, Zu iyos Tun-da xvadia~-o, magram didi msgavsebis miuxedavad, qalis tvi-ni mainc gansxvavdeba mamakacis tvinisagan zomiT (qalis tvi-ni 9 kv.sm-iT mcirea da 10-15%-iT naklebi mamakacis tvinze),struqturiTa da mgrZnobelobiT. mecnierebs uWirT am mo-nacemebis ganzogadeba, magram erTi ram cxadia, mamakacistvini da qalis tvini orive erTnair samuSaos asrulebs, oR-ond gansxvavebuli xerxebiTa da meTodebiT. qalisa da mama-kacis gansxvavebuli azrovneba, emociebi da sxva uamraviamoucnobi movlena, didi xania ipyrobs neirobiologiaSimomuSave mecnierebis yuradRebas.

fiqris (azrovnebis) dros qalis tvini ufro meti mocu-lobiT itvirTeba. Carstonis universitetis (samxreT ka-rolinis) fsiqiatrma da nevrologma mark jorjma rTulineirowarmosaxviTi teqnikis (MRI) gamoyenebiT naxa: rocamamakaci iwyebda raime saganze fiqrs, neironebi ganimuxte-boda Zalze specifikur ubnebSi. qalis SemTxvevaSi ki imde-ni neironi iwyebda ganmuxtvas, rom MRI-is ekranze miRebu-li gamosaxuleba mecniers Ramis gaCaxCaxebul las-vegassagonebda.mkvlevarebi fiqroben, rom am gansxvavebis erT-erTi SesaZlo mizezTagania is, rom tvinis ori naxevarsf-eros damakavSirebeli nervuli boWkoebisagan agebuli xidiufro msxvilia qalebSi, vidre mamakacebSi, es ki zrdis in-formaciis urTierTgacvlis unars marjvena `emociur~ damarcxena `gonier~ hemisferoebs Soris.

mamakacis tvini ufro datixrulia, amitom misTvis ioliaerT garkveul sakiTxze yuradRebis koncentrireba. amiTaixsneba is garemoeba, Tu ratom SeuZlia qmars guldasmiTikiTxos sportuli gazeTi maSin, roca bavSvi tiris, tele-foni gauTaveblad rekavs an ZaRli yefs. tradiciulad, ma-makacis ZiriTadi funqcia iyo teritoriis dacva, sakvebismopoveba, mdedris `monadireba~. mas yuradReba gamaxvile-buli hqonda TviTgadarCenaze. qali ki, rogorc deda, yve-la SemTxvevaSi mobilizebuli iyo bavSvis dasacavad. qalis

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tvinis aseTi modusi mSvenivrad esadageba dRevandeli cxo-vrebis nirsa da wess. mxolod naxevari tviniT SeuZlebeliiqneboda im uamravi saqmis keTeba, rac Tanamedrove qalebsuwevT.

qalis tvini meti intensivobiT pasuxobs emociebs. amaTiode wlis winaT mark jorjma emociuri gancdebisSesafaseblad skanirebis meTodiT Seiswavla qalisa da ma-makacis tvini. gansxvaveba imdenad didi iyo, rom mecnierididxans yoymanobda _ gamoeqveynebina Tu ara miRebuliSedegebi? mowyenilobis an melanqoliis dros tvinis Sesa-bamis ubnebSi neironuli aqtivoba qalebSi 8-jer didi iyo,vidre mamakacebSi. neirobiologiaSi momuSave mecnierebiiziareben fsiqologTa Sexedulebas: qali ufro metad gan-icdis urTierTkavSirs, xolo am kavSirebis gawyveta 2-jerufro xSirad iwvevs maTSi depresias. garda amisa, qalebiufro ukeTesad afaseben sxva adamianis emociur mdgomare-obas. erT-erT eqsperimentSi sakvlev pirebs unda Seefasebi-naT fotoebze aRbeWdil msaxiobTa saxeebis emociuri mdgo-mareoba. orive sqesis warmomadgeneli iolad gansazRvra-vda bednier gamometyvelebas. mowyenili da dardiani saxe-ebis Sefaseba ki mamakacebs sakmaod gauWirdaT, gansakuT-rebiT, qalebis fotoebze.

qalis tvini organi-zebulia warmosaxvisa-Tvis da ara agresiisa-Tvis.

adamianis emociurmdgomareobas marTavs(ganagebs) tvinis lim-buri sistema. mSvid md-gomareobaSi orive sqe-sis adamianTa kvlevamgamoavlina gansxvaveba

am sistemaSi. mamakacebis limbur sistemaSi `mudmiv saqmi-anobaSia~ uZvelesi ubani _ struqturebis jaWvi, saidanacaRmocendeba emociebis aqtiuri formebi _ agresia da Zal-

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adoba. qalis tvinSi ki aqtiurad funqcionirebs limburisistemis gvian ganviTarebuli nawili _ sartyliseburi xve-ulebi, romlebic gamoxatvis simboluri formebis (Jesti-kulacia, sityva) meqanizmebs emsaxureba. am gansxvavebiTSeiZleba aixsnas mamakacebis midrekileba emociis fizikurigamoxatvisadmi, maSin, rodesac qali upiratesobas sity-vier taqtikas aniWebs. evoluciuri TvalsazrisiT qalebierTi nabijiT win dganan mamakacebTan SedarebiT, radgan emo-ciebis gamosaxatavad tvinis axal struqturebs iyeneben.

qalis tvini da metyveleba. yvelasaTvis cnobilia, romgogonebi laparaks adreul asakSi iwyeben, kiTxvasac swra-fad swavloben da swavlaSi darRvevebic ufro iSviaTadaqvT gamoxatuli. neirobiologebis sali Saivitas da benet-tis azriT, amis mizezia tvinis orive hemisferos gamoyene-ba kiTxvisa da verbaluri savarjiSoebis Sesrulebis dros.mamakacebi mxolod marcxena hemisferos Sesabamis ubnebsiyeneben. bilateraluri midgoma upiratesobas aZlevs qa-lebs, rom gamoiyenon `emociebisa da gancdebis mareguli-rebeli~ marjvena hemisfero iseve kargad, rogorc `goni-eri~ marcxena hemisfero. verbaluri amocanebis Sesruleba-Si asakovan qalebs ukeTesi maCvenebeli aqvT, vidre igive asa-kis mamakacebs. drois erTsa da imave monakveTSi isini erTida imave asoTi dawyebul met sityvas ixseneben, weren metsinonims, ufro swrafad sazRvraven fersa da formebs. qa-lis am dualur-hemisferul SesaZleblobebs Zalian didimniSvneloba aqvs insultis Sedegad verbaluri ubnis dazia-nebis mqone pacientebSi. isini ufro swrafad aRidgenen met-yvelebas, radgan cnobilia, rom qalebSi kiTxvisa da lapar-akis dros neironebis didi raodenobaa gaaqtiurebuli damaTi reabilitacia ufro swrafad xdeba.

qalis seqsualur gancdebSi monawileobas iRebs tvinissxvadasxva ubani. bolodroindeli samedicino xasiaTis is-toriebidan gansakuTrebul yuradRebas imsaxurebs Sot-landieli qalis mier SemCneuli ucnauri movlena: ukont-rolo (uneblie) orgazmi, romelic mas emarTeboda manqanismarTvis an saubris drosac. es ̀ seqsualuri Seteva~ ewyebo-

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da Tavis tkivilTan erTad, amitom misma eqimma ivarauda,rom problema dakavSirebuli iyo tvinis muSaobasTan. gamo-kvlevebiT dadginda, rom mas aReniSneboda hemodinamikisdarRveva marjvena hemisferos safeTqlis wilSi. mamakace-bSi msgavsi simptomebis gamovlena dakavSirebulia mxolodda mxolod hipoTalamusis funqcionirebasTan. amgvarad,qalis tvinSi seqsualur qcevasTan dakavSirebuli nervu-li aqtivoba SeiZleba aRmocendes tvinis sxvadasxva ubanSi.

qalebi garemoSi saorientaciod irCeven moqmedebis gan-sxvavebul strategias. quCaSi moZraobis dros an ama Tu imadgilis gaxsenebisaTvis qalebi yuradRebas aqceven da imax-sovreben garkveul orientirebs, kerZod, kuTxeSi arisyavis maRazia, eklesia aris saTamaSo moednis sapirispiromxares da sxva. mamakacebi am gzas imaxsovreben mimarTuleb-isa da distanciis gamoyenebiT. mecnierTa azriT sivrcisada distanciis aRqma aris mamakacebis biologiuri memkvi-dreoba. marTlac, samganzomilebiani mentaluri rotaci-is testebSi mamakacebi sagrZnoblad met qulebs agroveben.qalebisaTvis qulebi izrdeba asakisa da gamocdilebis zr-dis Sesabamisad. Suaxnis qalebi mamakacebis msgavsad pasux-oben sivrciT amocanebs da garkveul asakSi zogjer ukeTe-si maCveneblebiTac gamoirCevian.

qalebi gamoirCevian ukeTesi mxedvelobiT da ufromgrZnobiare smenis aparatiT. qalisa da mamakacis tvini si-naTlesa da bgerebs gansxvavebulad aRiqvams. qals esmisiseTi CurCulic ki, romelic mamakacis yurisaTvis miuwv-domelia, xolo misi mxedveloba imdenadaa ganviTarebuli,rom Tavisuflad dadis rTul da Cabnelebul gzaze, maSin,roca mamakacs aseT gzaze erTi nabijis gadadgmac ki gau-Wirdeboda. miuxedavad amisa, mamakaci sibereSi ufro xangr-Zlivad inarCunebs karg mxedvelobas, maSin roca qalis mxe-dveloba ufro adre (35-45 w.) qveiTdeba. meore mxriv, qalsesmis ufro farTo speqtris bgerebi da darRvevebic 50wlamde ar SeimCneva, mamakacebs ki smena uqveiTdebaT 40 wlisasakidan.

qals ufro maxvili mexsiereba aqvs. fsiqologma tomas

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krukma 50 000 qalisa da mamakacis mexsierebis SemowmebisSemdeg gamoaqveyna naSromi `yvela asakSi qalis mexsierebaukeTesia mamakacTan SedarebiT~, qalebs aqvT gansakuTre-buli unari saxelebis dakavSirebisa saxeebTan, aseve kargadixseneben sagnebis sias, personaluri gamocdilebis deta-lebsa da sxva. orive sqesis adamianebSi mexsiereba qveiTde-ba asakis matebasTan dakavSirebiT. 55-65 wlisTvis 50%-iTiklebs saxelebisa da sityvebis gaxsenebis albaToba. miuxe-davad amisa, kruki Tvlis, rom `movlenebi, romlebsac CvenvixsenebT, dakavSirebulia Cvens emociebTan. radganac qaliemociis gasakontroleblad marjvena hemosferos ukeTe-sad iyenebs, amitom faqtebisa da emociebis dakavSireba av-tomaturad xdeba~.

qalis tvini ufro nela berdeba, vidre mamakacis. nevro-logebma daadgines, rom mamakacis tvinis qsovilis gadag-vareba samjer ufro swrafad xdeba, vidre qalisa. amitommamakacis tvini, romelic ufro didi da mZimea, axalgazr-dobaSive imdenad `iWmuxneba~, rom qerqis wilebidan yve-laze mniSvnelovani _ Sublis wili _ 40 wlis asakSi orivesqesSi erTnair zomas aRwevs. aseve, ufro swrafad xdebamamakacebSi tvinis sxva nawilebis atrofia. es faqtori ga-napirobebs mexsierebis daqveiTebas, yuradRebis koncen-traciis unaris Semcirebas da siberis sxva movlenebs. yove-live amas safuZvlad udevs organizmis mier glukozis ara-efeqtiani gamoyeneba. qalis tvins aqvs unari Seamciros me-tabolizmis siCqare maSin, roca mamakacis tvini asakTan er-Tad glukozis moxmarebis siCqares zrdis. sxva sityvebiTrom vTqvaT, qalebSi glukozis moxmarebis margi qmedebiskoeficienti mcirdeba, mamakacebSi ki izrdeba. amis mizeziSesaZloa iyos organizmSi testosteronis odenobis sxvao-ba. zemoT TqmuliT SeiZleba aixsnas gavrcelebuli azri,rom qalebi ufro didxans cocxloben, vidre mamakacebi.

qalis tvini ufro metad intuiciuria. marjvena _ `emo-ciur~ da marcxena _ `gonier~ tvins Soris mudmivi urT-ierTgacvliTi `saubris~ gamo, qalis tvinSi SeiZleba dam-yardes iseTi kontaqtebi, romlebic mamakacis tvinSi ar

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ganviTardeba. erTni intuicias uwodeben `emociis in-teligentur formas~, sxvani ki `qalis intuicias~. `intui-cia moicavs qalis tvinsa da sxeuls~, _ ambobs fsiqiatrimonaliza Sulci. qalis tvini naklebad lateralizebulia,amitom orive naxevarsfero informacias ukeT moixmars, risgamoc is arasodes anawevrebs sagnebsa da movlenebs,rogorc mamakaci da erT mTlianobaSi aRiqvams maT.

zemoT ganxiluli gansxvavebebi SeiZleba CaiTvalos pa-suxad im kiTxvaze, Tu rogor axerxebs qali swrafadgaerkves situaciaSi da imoqmedos Sesabamisad.

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simsuqne da misi genetika

mTel msoflioSi (rogorc ganviTarebul, ise ganviTare-bad qveynebSi) simsuqne adamianis janmrTelobis farTodgavrcelebul problemas warmoadgens. igi rTuli, mravalfaqtorze damokidebuli davadebaa, romlisadmi interesisul ufro da ufro izrdeba. ganviTarebul qveynebSi sim-suqne yvelaze gavrcelebuli kvebiTi darRvevaa da dakav-Sirebulia iseT mniSvnelovan qronikul daavadebebTan,rogoricaa: hipertenzia, arainsulindamokidebuli Saqria-ni diabeti, hiperqolesterinemia, sisxlCaqcevebi, zogier-Ti saxis simsivneebi. simsuqnis mkurnaloba (dieta, varjiSi,wamlebi) Tumca sakmaod efeqtiania da mravali adamiani ikl-ebs wonaSi (5-10%), magram amgvarad daklebuli wonis xangrZ-livad SenarCuneba, samwuxarod, iSviaTia. amrigad, simsuqneZnelad marTvadi samedicino problemaa, romelic xSir avad-myofobasa da sikvdilianobas iwvevs.

simsuqnis gansazRvra: sxeulis wona Tu misi idealuriwonis 120%-s aRemateba _ laparakoben simsuqneze. igi gan-pirobebulia cximovani qsovilis Warbi dagrovebiT. simsu-qne anu sxeulis masis indeqsi gamoiangariSeba sxeulis wo-nis (kilogramebSi) SefardebiT, metrebSi gamosaxul gaor-magebul simaRlesTan. Tu indeqsi 27 da 30 Soris meryeobs_ laparakoben msubuq simsuqneze. Tu indeqsi 30-35-is far-

glebSia, maSin zomiersimsuqnesTan gvaqvssaqme, xolo Tu indeqs-ma 35-s gadaaWarba, maSinudavoa mkacri simsu-qne. aRwerili meTodiaris yvelaze metadgavrcelebuli simsuq-nis gansasazRvrav sxvaanTropomorful inde-qsTa Soris. msofliosmraval kuTxeSi warmoe-

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buli mecnieruli kvleva miuTiTebs imaze, rom cximis mo-mateba janmrTelobisTvis araxelsayreli movlenaa. qron-ikuli daavadebebis ganviTarebis TvalsazrisiT, sxeuliszemo nawilebis simsuqne (`visceraluri~ anu `mamakacuri~anu ̀ sartylis zemo~ nawilebis simsuqne anu cximis gavrce-lebis ̀ vaSliseburi paterni~) ufro saSiSia, vidre sxeulisqveda nawilebis simsuqne (`kanqveSa~ anu `qaluri~ anu `sar-tylis qvemo~ anu ̀ msxliseburi paterni~). cximis gavrcele-bas afaseben welis da TeZoebis garSemowerilobis mixedviT.`visceralurs~ _ welis garSemowerilobiT, xolo ̀ kanqve-Sas~ – TeZoebis garSemowerilobiT. fiziologiuri Tval-sazrisiT simsuqne xasiaTdeba ramdenime paTofiziologiu-ri alternativiT: 1. cximovan qsovilSi lipoidebis dagro-vebis maRali sixSire; 2. sakvebisadmi insulinis gazrdilimgrZnobeloba; 3. hiperinsulinemiaa; 4. OB proteinis (anuleptinis) koncentraciis momateba.

genetikis mniSvneloba adamianis simsuqneSi: didi xaniadadgenilia, rom mosaxleobaSi simsuqne vrceldeba ojax-urad (msuqani ojaxebi). aseve cnobilia, rom energetikulisubstratis (sakvebis) didi raodenobiT miReba da Semcire-buli fizikuri aqtivoba, genetikisagan damoukidebladiwvevs gasuqebas. simsuqnis genetikuri komponentebis kla-sikur gamokvlevebSi Seiswavles monozigoturi (erTi gana-yofierebuli kvercxujredidan) da dizigoturi (ori gana-yofierebuli kvercxujredidan) tyupebi, ris gamoc erT-maneTis gverdiT gadaiRes mravali wyvilis suraTi. gansa-kuTrebiT saintereso aRmoCnda monozigoturi tyupebissuraTebi, radgan aSkara iyo didi msgavseba sxeulis forma-sa da zomaSi. tyupiscali iseTive msuqani iyo, rogorc meo-re. dizigotur tyupebSi ki piriqiT sxeulis zomisa da for-mis msgavseba gamonaklisis saxiT iyo warmodgnili.

Tanamedrove pirobebSi adamianis simsuqnis genetikisSeswavlisaTvis yvelaze miRebuli modeli aris genetikuriganwyobisa da garemo faqtorebis urTierTmoqmedebis ana-lizi. mkvlevarTa Soris gabatonebulia azri, rom adamianissimsuqne xasiaTdeba adipozuri qsovilis masis zrdiT, rac

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ganpirobebulia ori faqtoris urTierTmoqmedebiT: 1. ge-netikuri ganwyoba, romlis gamovlinebaa cximovan qsovil-Si trigliceridebis saxiT energiis dagroveba. am faqto-rze modis 35-50%. 2. garemo an cxovrebis wesis faqtori,romelzec modis 50-65%. sadReisod miiCneven, rom sxeuliscximis 35% modis memkvidreobiT faqtorze, Tu genetikurimemkvidreobis wils mivumatebT darCenil 15%-s, roca wonaimatebs imis gamo, rom individi Rebulobs gemriel, maRalikaloriulobis sakvebs (rogorc es xdeba ganviTarebul qve-ynebSi), maSin, genetikuri memkvidreoba SeiZleba SevafasoT58%-iT (Baumhardi-is da Peims-is mixedviT). zemoT Tqmuliadasturebs genetikuri faqtoris did mniSvnelobas da ase-ve ar uaryofs imas, rom simsuqnis etiologiasa da ganviTa-rebaSi garemo da qceviTi faqtorebi mniSvnelovan rolsasrulebs.

simsuqne biologiuri disregulaciis daavadebaa. bolo-droindeli gamokvlevebi cxadyofs, rom simsuqne aris bio-logiuri disregulaciis daavadeba. organizmi sxeulis mu-dmiv wonas inarCunebs mravali biologiuri faqtoris er-TobliobiT, romlebic nawilobriv mainc genetikiTaa gan-pirobebuli. orive mimarTulebiT (momateba da dakleba)sxeulis wonis mouwesrigeblobas organizmi ewinaaRmdege-ba da awesrigebs Zlieri fiziologiuri meqanizmebiT. esmeqanizmebi ewinaaRmdegeba sxeulSi cximis raodenobis cv-lilebebs da ganapirobebs sxeulis wonis im arasasurvelkvlavmomatebas, romelic daklebas axlavs Tan. cximovanqsovilSi simsuqnis genis produqti OB proteini, romelicmocirkulire sisxlSi gadadis da moqmedebs Tavis tvinze,SesaZloa mniSvnelovan rols asrulebdes im ̀ rezistentulpasuxSi~, romelic gamoixateba sxeulis wonis momatebiT _wonis daklebis Semdeg.

organizmis energiis balansis regulireba. energiis bal-ansi aris energiis miRebis (Wamis), energiis xarjvisa da cxi-movan qsovilSi energiis dagrovebis (momaragebis) kontro-lis Sedegi. mozrdilTa umravlesobaSi, rogorc sxeuliswona, aseve sxeulis cximebis raodenoba mudmivi rCeba mrava-

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li wlis ganmavlobaSi. miuxedavad energiis miRebasa da misxarjvas Soris didi sxvaobisa. energiis miReba aris diskre-tuli (wyvetili) procesi (individualuri kveba iyofa Wa-mebs Soris intervalebiT), maSin, roca amavdroulad ganu-wyvetlad mimdinareobs energiis xarjva da misi dagrovebacximovan qsovilSi. jerjerobiT gamoucnobi rCeba is rTu-li molekuluri meqanizmebi, romliTac xdeba zemoT CamoT-vlili procesebis (Wama, energiis xarjva da misi dagrove-ba) gaerTianeba _ integracia, magram sadReisod mkvle-varTaTvis erTi ram cxadia _ am movlenebSi gadamwyvetimniSvneloba aqvs 2 nivTierebas _ insulinsa da OB pro-teins.

OB proteini sekretirdeba cximovani qsovilidan. cirku-lirebs sisxlSi, moqmedebs garkveul nervul badeze, rome-lic aregulirebs ylapviT funqcias (kvebas) da energiisbalanss. igi aris mocirkulire cilovani signali. OB pro-teini miCneulia simsuqnis genis produqtad. misi eqsperi-mentuli miReba moxerxda 1994 wels rokfeleris univer-sitetSi fridmanisa da misi kolegebis mier.

adamianis organizmSi OB proteinis sasignalo mniSvne-lobis aRmoCenasa da daxasiaTebas udidesi mniSvneloba aqvsramdenime TvalsazrisiT: 1. igi iZleva imis damatebiT samx-ils, rom simsuqne aris biologiur safuZvelze ganviTare-buli daavadeba; 2. molekuluri biologiis mecnierebam aiT-visa simsuqnisa da kvebis gamokvlevis meTodika da es saki-Txi radikalurad Secvala; 3. OB proteinis gamovlena aCve-nebs, rom gamokvlevebis TvalsazrisiT monelebis proce-sis da energiis balansis neirobiologia swrafi nabijebiTwavida win.

daskvna: simsuqnisa da misi genetikis safuZvlebis gageb-is saqmeSi Cven vdgavarT axali eris dasawyisTan. sxeuliswonis daklebis Semdeg misi kvlavmomatebis meqanizmebisSeswavlis saqmeSi aqtiuradaa CarTuli mecnieruli mona-povrebi genebis identifikaciisa da misi Sesabamisi genuriproduqtebis Sesaxeb monacemebi. es axali informacia iZl-eva im axali algoriTmebis amoxsnis saSualebas, romliTac

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tvini `sargeblobs~ sxeulis cximis Semcvelobis regula-ciaSi. molekuluri biologia ukeT xsnis am amocanebs da ex-mareba farmakologiur industrias Tavisi gamocdilebis,teqnologiisa da eqspertizis daxmarebiT miiRos ufro sai-medo da efeqtiani preparatebi. identificirebuli geneb-is genetikuri testireba gamoyenebuli iqneba simsuqnis ma-Rali riskis dasadgenad, rac saSualebas mogvcems qceviTada farmakologiuri saSualebebiT Tavidan aviciloT wonismomateba an piriqiT. adamianis simsuqnis genetikaze dafuZ-nebuli axali kombinirebuli moqmedeba (qceva) da farmako-logiuri mkurnalobis strategia daexmareba msuqan adami-anebs ufro advilad SeinarCunon sxeulis daklebuli wonada gaiumjobeson janmrTeloba.

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janmrTelobis saTaveebi

80 wlis winaT, roca londonis CrdiloeTiT mdebareqalaq uelsSi daibada jon karteri, samSobiaros eqimi-meaninamdvilad ar moeloda axalSobilis gadarCenas, is xom mx-olod erT kilogramsa da 190 grams iwonida, magram is ga-darCa, gaizarda, davaJkacda da muSaobac daiwyo. janmrTe-lobis deficits saerTod ar ganicdida, vidre 50 wels armiaRwia. maSin eqimebma daadgines, rom karters sisxlis wne-

va Zalian maRali hqon-da, sxva testebma kiinsulindamoukidebe-li diabeti daudastu-ra. karters araviTariCivilebi ar hqonia, romTavi avadmyofad CaeTv-ala. amasTanave, paTo-logiuri gadaxrebi saS-vilosnoSi gatarebulperiods ukavSirdebo-da. mecnierebi fiqro-ben, rom mucladyofni-sas, rodesac dedis ho-

rmonebi aregulirebs placentaSi sakvebi nivTierebebisganvladobis intensivobas, yalibdeba nayofis momavali zr-dasrulobis periodis janmrTeloba.

am sakiTxs eZRvneba kornelis universitetis doqtorispiter naTanielsis axali wigni _ ̀ cxovreba saSvilosnoSi~.avtori wers: ̀ Zalze STambeWdavia bolodroindeli gamokv-levebis Sedegebi, romlis Tanaxmadac Cveni janmrTeloba(romelsac ase veloliavebiT) yalibdeba im pirobebis zegav-leniT, romelSic embrioni viTardeba da romelic RviZlis,gulis, Tirkmelebisa da Tavis tvinis funqciebis Camoyali-bebas ganapirobebs. aseT aRmoCenas ̀ revoluciuri~ rom vu-wodoT, gazviadebuli ar iqneba. zrdasrulobis periodisdaavadebebze saSvilosnos pirobebis zegavlena, upirispir-

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deba sneulebaTa ganviTarebis genur moZRvrebas (radgan,rasac adre mecnierebi genetikur gavlenas uwodebdnen,SesaZloa mucladyofnis periodis gamoxatuleba iyos) damiuTiTebs, rom zrdasrulobis daavadebani, romelTac cxo-vrebis mankier pirobebs ukavSirebdnen (magaliTad Warbikveba) sxva ara aris ra, Tu ara ̀ nayofis programirebis”, moz-rdilobaSi gamovlineba, rac harvardis samedicino skolisdoqtoris meTiu jilmenis sityvebiT, 4 wlis winaT es azra-dac ar mouvidoda vinmes.

es aRmoCena mxolod imas rodi amtkicebs, rom muclady-ofnis periodi did zegavlenas axdens bavSvis momavalze,metsac gvidasturebs. sayovelTaod cnobilia, rom alkoho-li uaryofiTad moqmedebs nayofze, iwvevs gonebriv Camor-Cenasa da gulis daavadebebs, Tambaqos toqsini zeda sasunT-qi gzebisa da sasmeni aparatis paTologiuri gadaxrebissaTavea. axali aRmoCenebiT, mucladyofnis periodSi Tavi-danve xdeba nayofis programireba _ Camoyalibeba (feter-is programireba). dasaxelebuli toqsinebis (alkoholi, ni-kotini) zegavlenisagan gansxvavebiT feteris programi-rebis Sedegebis gamovlinebas SedarebiT naklebi dro sWi-rdeba.

nayofis fiziologia isea mowyobili, rom dedis organiz-midan miRebul sakvebs cximebad gardaqmnis da, Tu gogona Ta-vidan janmrTeli daibada, 4 kilogrami woniT, igive ̀ zrdisfaqtori~ (romelmac mas cximebi daugrova) miaRwevs misisarZeve jirkvlebis qsovils, xolo mowifulobis periodSi,estrogenebis zemoqmedeba mamilarul qsovilze, iseT cv-lilebebs gamoiwvevs, rom es individi 46 wlis asakSi Sesa-Zlebelia mkerdis kiboTi daavadebis kandidati gaxdes.

zemoT Tqmuli ise ar unda gavigoT, TiTqos bediswerismorCilebas vqadagebdeT. raki mucladyofnis periodi gan-sazRvravs janmrTelobas zrdasrulobisas, am periodisgamokvleva (maT Soris, axalSobilis sigrZis, wonis, welisgarSemowerilobisa da Tavis zomebi) winaswar gvamcnobs, rariskis matareblad viTvlebiT. magaliTad Tu axalSobil-is muceli uCveulod pataraa, maSin RviZlic, Sesabamisad,

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metismetad mcire iqneba da ver SeZlebs sisxlis srulyofi-lad gawmendas qolesterinisagan, ris gamoc 50 wlis asakSimisi done sagrZnoblad iqneba momatebuli.

nayofis programireba SesaZloa kidev didxans yofiliyosaidumloebiT moculi, rom ara doqtori devid barkeri,romelmac 1984 wels yuradReba miaqcia inglisisa da uel-sis mosaxleobis janmrTelobis mdgomareobis nusxebs. manSeniSna, rom 1900-ani wlebis dasawyisSi axalSobilTa sikv-dilianoba im regionebSi iyo maRali, sadac maRali iyo gu-lis daavadebebiT gamowveuli letaloba. aRsaniSnavia, rombavSvTa sikvdilianoba siRaribis bralia, gulis daavadebaki simdidrisa da fufunebis (magaliTad, karaqis, xorcis dasxva amgvari produqtebis didi raodenobiT miReba iwvevsgulis daavadebas). ra saerTo unda hqondes am or garemoe-bas? maSin barkerma ieWva rom gulis daavadebis saTave mu-cladyofnis periodSi iwyeboda, ris dasadgenadac mas sam-Sobiaros arqivebi sWirdeboda, raTa erTmaneTisaTvis dae-kavSirebina sicocxlis Tavdapirveli pirobebi da im zrdas-rulTa janmrTeloba, romelTac ikvlevda. britaneTissamedicino kvlevis sakonsulos daxmarebiT mravali aseTiCanaweri Seugrovda. saukeTeso aRmoCnda hertfordSirelaxalSobilTa arqivebi, romlebic bebiaqalebs CauweriaT1911 wlidan 1945 wlamde. maT Soris iyo jon karteric. bark-eris jgufma Seiswavla 13249 kaci da daadgina, rom, Tu bav-Svi dabadebisas 2,5 kilogramze naklebs iwonida, zrdasru-lobaSi maTgan 50%-Si iyo riski imisa, rom gulis daavadeb-iT gardacvliliyo.

1996 wels igive jgufma Seiswavla indoeTidan miRebulimonacemebi. iqac, zemoT Tqmulis msgavsad, axalSobilis da-bali wona, Suaxnis asakSi gulis daavadebiT sikvdils winas-warmetyvelebda. 1997 wels doqtor Janet riCedvardsmagamoikvlia 70257 amerikeli qali da daadgina, rom maT Soris2,5 kilogramze naklebi woniT dabadebulebis 23%-s aReniS-nebodaT kardiovaskuluri sistemis paTologia. saintere-soa, ra meqanizmi udevs safuZvlad zrdasrulobis period-Si daavadebis gamovlenas. naTanielsis azriT, es mcire zo-

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mis Tirkmelebis bralia. dasaxelebuli organo areguli-rebs organizmis sisxlis wnevas, Tu maTi funqcia mwyobri-dan gamova, ganviTardeba hipertonia, rac Tavis mxriv gu-lis daavadebas gamoiwvevs, cxovelebze gamokvlevebma aCve-na, rom, Tu nayofi cilebis sakmao raodenobas ar Rebulobs,maSin placentis fermentebi kargavs moqmedebis Zalas daver uvnebelyofs damazianebel hormonebs, romlebic nayo-fisken miiltvis. erT-erTi aseTi hormonia kortizoli _stresis hormoni, romelic zrdis wnevas da aganierebs ven-ebs.amrigad, Tu deda orsulobisas normalurad ar ikvebe-ba, placentis fermentebis moqmedebis Zala mcirdeba dakortizoli aRwevs nayofis tvins, rac ganapirobebs zrdas-rulobaSi individis stresebisadmi daucvelobas.

mecnierebi daavadebaTa saTaves mucladyofnis periodsukavSireben. 1999 wlis ianvarSi janmrTelobis nacionalu-rma institutma mucladyofnis pirobebsa da kibos ganviTa-rebis urTierTkavSirs miuZRvna konferencia, xolo imavewlis seqtemberSi ganixiles kardiovaskuluri sistemisa daTirkmlis daavadebis kavSiri xsenebul pirobebTan.

did interess iwvevs mkerdis kibos SemTxvevebi. es daava-deba iseT qalebsac emarTebaT, romelTac ara aqvT riskisfaqtori (aq igulisxmeba asaki an fexmZimobisaTvis Tavisarideba 30 wlis asakamde) harvardis janmrTelobis skoliswarmomadgenelma karin miSelsma moaxdina erTi, aqamdemxedvelobidan gamorCenili faqtis identificireba. mandaadgina, rom axalSobilis didi wona mianiSnebs saSvilos-nos pirobebis im gavlenaze, romelic `amzadebs~ zrdasru-lobaSi, nayofis mamilaruli qsovilis kibos qsovilad gar-daqmnis riskis faqtors. zrdis faqtori, rogorc saxel-wodeba mianiSnebs, nayofis zrdas ganapirobebs. aseTi faq-torebia: insulini, leptini da estrogeni. Tu dedis orga-nizmSi am nivTierebebis done maRalia (magaliTad, simsuq-nis dros estrogenis done momatebulia), is miaRwevs nayofsda Taviseburad Secvlis Camoyalibebis procesSi myof sar-Zeve qsovils, rasac zrdasrulobaSi avTvisebian qsoviladgardaqmna mohyveba.

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axalSobilis fizikurma monacemebma SesaZloa SeadginosTaviseburi ruka, sadac individis personalur daavadeba-Ta riskis sabado iqneba CaniSnuli. es monacemebia: sxeuliswona, sigrZe, welis garSemoweriloba, Tavis zoma da pla-centis wona.

qolesteroli: rac ufro pataraa axalSobilis muceli,zrdasrulobaSi mis organizmSi miT meti iqneba qolester-olis done. Tu orsulobis periodSi deda cudad ikvebebaan placenturi xarvezebi xels uSlis nayofs Sesabamisisakvebis miRebaSi, maSin nayofi gadairTveba sagangebo mdgo-mareobaSi _ sisxls ZiriTadad Tavis tvinisaken gadagzav-nis, ris gamoc muclis organoebs sisxli daakldeba da Sew-yveten zrdas. patara RviZli ki qolesterolisagan sisxlsver gaasufTavebs. janmrTel adamians, romelic uxvad Reb-ulobs cximiTa da qolesteroliT mdidar sakvebs, aravi-Tari safrTxe ar emuqreba, radgan misi RviZli efeqturadamuSavebs am nivTierebebs. barkeris azriT, saSvilosnoSimomxdari adaptacia individs mTeli sicocxlis manZilzemihyveba permanentulad.

simsuqne: es is fenomenia, romelmac warmoSva mosazreba,rom mucladyofnis periodi did gavlenas axdens cxovreb-is Semdgom wlebze. meore msoflio omis periodSi, 1944 wlisseqtembridan momdevno wlis maisamde, germaneli naciste-bi aiZulebdnen dasavleT holandiis mosaxleobas eSimSi-la. didi interesi gamoiwvia im mamakacebis janmrTelobismonacemebma, romlebmac dedis mucelSi gaatares es perio-di an misi nawili mainc. Tu maTi dedebi SimSiliT itanje-bodnen orsulobis pirvel sam Tves, e. i. 1945 wlis martidanmaisamde, xolo mogvianebiT daiwyes normaluri kveba, axal-Sobili biWebi normasTan SedarebiT mets iwonidnen, zomi-Tac didebi iyvnen da Tavic ufro didi hqondaT, zrdasru-lobaSi ki ufro gasuqdnen. xolo Tu mSoblebi SimSilobd-nen bolo sam Tves, e. i. 1944 wlis noemberSi, dabadebulibiWebi kafandara agebulebis kacebad Camoyalibdnen. ai,rogor aixsneba es garemoeba: Tu nayofi sakvebis naklebobasganicdis mucladyofnis pirvel sam Tves, maSin igi yalib-

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deba xelmomWirne fenotipad anu misi metabolizmi iseamowyobili, rom yoveli SesaZlo kaloria organizms emate-ba. sakvebis arseboba Tu ararseboba moqmedebs nayofis tvi-nSi arsebul madis centrze. im nayofs, romelic sakvebisnaklebobas gvian ganicdida, cximovani qsovili ar uviTar-deba, radgan cximovani ujredebis momateba orsulobisbolo TveebSi xdeba. amitomacaa, rom dabadebis Semdeg maTuWirT gasuqeba.

diabeti: bavSvi Tu Zalze gamxdari daibada, Suaxnis asak-Si mas diabetis maRali riski eqneba. am debulebis erT-erTiaxsna aseTia: arasakmarisi sakvebi nayofis metabolur pro-cesebs aiZulebs iyos xelmomWirne, e. i. insulin-rezisten-tuli, ris gamoc organizmSi grovdeba glukoza (pur-fun-TuSeuli da Semwvari kartofili, romelic asuqebs dedisorganizms, energias ki naklebad aZlevs, rwyavs nayofis sx-euls glukoziT, ris gamoc is diabetiani xdeba). diabetikargi magaliTia imisa, Tu rogor SeiZleba SevcvaloT mu-cladyofnis periodSi momxdari programireba. marTalia,axalSobilis sigamxdre zrdasrulobaSi diabetis riskismauwyebelia, magram es riski mniSvnelovnad Semcirdeba, Tuindividi gasuqebas Tavs aaridebs.

tvini: nayofis tvinze orsulobis periodis zegavlenajerac kvlevis procesSia. Tumca gairkva rom fexis terfe-bis, xelis TiTebis, yurebisa da idayvebis asimetriuloba_ dabali inteleqtualuri koeficientis mauwyebelia. mu-cladyofnis periodSi momxdari zogierTi saxis stresiSesaZloa iwvevdes asimetriulobas, zogi ki – nervuli sis-temis ganviTarebis anomaliebs. asimetriuloba imis niSania,rom raRac arasworad mimdinareobda mucladyofnis peri-odSi.

naTanielsis azriT, nayofis programireba iseTive mniS-vnelovani momentia (Tu meti ara), rogorc genebis zegav-lena. mxolod genebis arseboba sakmarisi ar aris masTan aso-cirebuli niSan-Tvisebebis gamosavlenad. genma SesaZloagamoavlinos efeqti, an miCumebul mdgomareobaSi darCes.magaliTad, stresis hormonis siWarbem SeiZleba gamoTiSos

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is geni, romelic streszea pasuxismgebeli, aseT SemTxveva-Si reagireba naklebefeqtiani iqneba da Sedegad bavSvi iseCamoyalibdeba, rom zrdasrulobaSi stresebs Tavs ver gaa-rTmevs. ̀ genebis did mniSvnelobas dRes muclad yofnis pe-riodis didi mniSvneloba daupirispirda,~ _ ambobs naTani-elsi.

roca nayofis programirebis arss ufro ukeT gaarkveven,SesaZloa kvlav aRdges didi xnis win diskreditebuli lama-rkizmis Teoria, romlis Tanaxmadac sicocxlis manZilzeSeZenili niSan-Tvisebebi SeiZleba Svils gadaeces. magali-Tad, Tu qali orsulobamde 10 wlis ganmavlobaSi intensi-urad varjiSobda, misi vaJiSvili did kunTebs memkvidreo-biT miiRebs. Tanamedrove genetika aseT memkvidreobas arcnobs, nayofis programirebis Teoria ki piriqiT, amtkic-ebs, rom magaliTad, Tu momavali deda diabetiT daavadda,nayofi ganicdis glukoziT gadajerebas, rac xels uSlispankreasis ganviTarebas. Sedegad bavSvi diabetianad Camoy-alibdeba. Tu igi mdedrobiTi sqesisaa, momavalSi orsulo-bis dros nayofs aseve `moamaragebs~ glukoziT da `diabe-tiT~ daasaCuqrebs. es qali (SviliSvili) wina or TaobaSimomxdari darRvevebis msxverpli iqneba. aseTi SemTxvevamecnierebaSi `bebiis efeqtis~ saxelwodebiT moixsenieba.

daskvna: unda gvaxsovdes, rom Cveni janmrTelobis marc-vali manam daiTesa, sanam pirvelad CavisunTqavT haers daswored saSvilosnoSi gatarebuli 9 Tve _ sicocxlis esmokle periodi gansazRvravs Cvens janmrTelobas mTeli ar-sebobis manZilze.

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dayovneba sikvdilis tolfasia

dRes kacobrioba ar icnobs sxva daavadebas, gavrceleb-is iseTi farTo speqtriT, rogoric cofia. cofiT avadde-ba yvela cocxali, Tbilsisxliani arseba (adamiani, frin-veli, cxoveli). igi mwvave infeqciuri sneulebaa, romelicaucileblad sikvdiliT mTavrdeba. cofi mTel msoflio-Sia gavrcelebuli, garda im qveynebisa, romlebic kunZule-bzea ganlagebuli (didi britaneTi, iaponia, kviprosi dasxva).

cofis gamomwvevi virusi gansakuTrebiT paTogenuriaZuZumwovarTaTvis. igi azianebs tvinis sisxlZarRvebs, ri-Tac gapirobebulia specifikuri CanarTebis warmoqmna. amCanarTebs pouloben cofiT daRupuli adamianisa da cxove-lis Tavis tvinis calkeul nawilSi. maT, aRmomCenTa pativ-sacemad, babeS-negris sxeulakebi ewoda da aqvs sadiagnos-tiko mniSvneloba. dReisaTvis cofis laboratoriuli dia-gnostika emyareba virusis antigenis aRmoCenas fluores-ciuli meTodiT, cofis virusis gamoyofas ujredovan kul-turaze an biocdaSi da cofis sawinaaRmdego antisxeulebistitris gansazRvras.

cofis virusi organiz-midan gamoiyofa nerwyvissaSualebiT. misi gamZleo-ba mcirea, 60 graduszeixoceba 5-10 wuTSi, adu-Rebisas – 2 wuTSi. swrafadixoceba iseTi sadezinfeq-cio saSualebebis moqme-debiT, rogoricaa 3%-ianilizoli, 3%-iani qlora-mini, 5%-iani karbolismJava.

bunebaSi cofis virusisZiriTadi rezervuari dainfeqciis wyaroa ZaRlis-

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ebrTa ojaxi mtacebelTa gvaridan (mgeli, tura, mela).evropis qveynebSi amJamad cofis virusis ZiriTad rezer-vuars warmoadgens wiTeli mela, aRmosavleTis qveynebSi _mgeli, afrikaSi _ tura. amierkavkasiaSi ukanasknel wleb-Si gamovlinda meliebis bunebrivi kerebi.

gareul cxovelebSi cofis gavrceleba da am epizotiurprocesSi Sinauri cxovelebis (ZaRlebi, katebi) aqtiuriCarTva zrdis adamianTa daavadebis SesaZleblobas.

cofiani cxovelisagan dakbenili yvela adamiani ar xde-ba avad. es nawilobriv damokidebulia kbenis lokaliza-ciaze. ase magaliTad, saxeze kbenisas avaddebian 90% SemTx-vevaSi, xelis mtevanze kbenisas _ 63% SemTxvevaSi, xoloxelisa da fexis proqsimalur nawilebSi (tansacmliT dafa-rul) kbenisas – 23% SemTxvevaSi.

adamianTa daavadeba umetesad dakavSirebulia antirabi-uli daxmarebisaTvis dagvianebul mimarTvasTan, acrebisdros reJimis darRvevasTan da imunizaciis ciklis daum-TavreblobasTan.

cofis virusi organizmSi SeiWreba kbeniT dazianebulikanidan, raime naWdevidan an nakawridan, maTze cofiani cxo-velis nerwyvis moxvedris SemTxvevaSi. avadmyofobis gamov-lena xdeba maSin, roca virusi miaRwevs Tavis tvins da iqgamravldeba garkveul odenobamde. manamde virusma undaganvlos sakmaod grZeli gza nervuli gamtarebis gaswvrivperinevraluri sivrceebiT, romlis sigrZem organizmSi(adamiani, cxeni, ZaRli) SesaZloa 1-2 metrs miaRwios. amito-maa inkubaciuri periodis xangrZlivobis aseTi sxvadasxva-oba (12 dRidan ramdenime Tvemde). ufro xSirad adamianebSidaavadeba kbenidan pirveli sami Tvis farglebSi gamovlin-deba.

erTi da igive organizmSi virusis Tavis tvinamde miRwe-vis dro ganpirobebulia misi SeWris adgiliT. ase magali-Tad, cofiani cxovelis mier fexze nakben adamians eqnebagacilebiT xangrZlivi inkubaciuri periodi, vidre Tavzean saxeze nakbens.

miaRwevs ra Tavis tvins, virusi nawilobriv kvlav ganagr-

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Zobs gavrcelebas, amjerad centridanuli mimarTulebiT,aRwevs sanerwyve jirkvlebamde da didi raodenobiT gamoiy-ofa nerwyvTan erTad. am procesma SesaZloa gauswros kidecvirusis gamravlebisa da dagrovebis process Tavis tvinSi.amitom inficirebuli cxovelis nerwyvSi cofis virusiSesaZloa daavadebis pirveli niSnebis gamovlinebamde 12-15 dRiT adre aRmoCndes. es niSnebia: mousvenroba, aradamax-asiaTebeli qceva, sakvebis miuRebloba, arasaWmeli sagnebis(nafotebi, Cvrebi, qvebi da sxva) ylapva, Zlieri, ymuilSigardamavali yefa, wyals ar svams, gaZlierebulad mosdisnerwyvi, am dros cxoveli (ZaRli) Zalze saSiSia, radgan aRg-znebulia, garbis saxlidan da umizezod ikbineba. adamianiscofiT daavadebis erT-erTi adreuli niSania yru tkivilisSegrZneba, kbenis adgilas (Tundac Wriloba didi xnis Sex-orcebuli iyos) tkivils male emateba ̀ wvis~ SegrZneba Wri-lobis irgvliv da `TrTolva~. tkivili vrceldeba cen-triskenulad. irRveva avadmyofis nervul-fsiqikuri sfe-ro, guneba-ganwyoba daTrgunulia, Zili mSfoTvare, xSir-ia muqaris xasiaTis halucinaciebi. SemdgomSi yalibdebaavadmyofobis ZiriTadi klinikuri niSnebi: agresiuloba,saylapavi muskulaturis krunCxvebi, wylis SiSi, ofliano-ba, gaZlierebuli nerwyvis dena. avadmyofoba grZeldeba 5-7 dRe da yovelTvis sikvdiliT mTavrdeba.

cofis profilaqtika ori gziT SeiZleba. ar davuSvaTadamianis inficireba da Tu moxda inficireba, CavataroTcofis sawinaaRmdego samkurnalo-profilaqtikuri imuni-zacia (rac SeiZleba adre).

pirvelis Sesasruleblad saWiroa cofis virusis Ziri-Tadi populaciis kontrolireba da epizootiis aRkveTaZaRlebsa da katebSi. amisTvis aucilebelia mudmivi veter-inaluri meTvalyureoba da mkacri administracia, vaqcina-cia da upatrono, mawanwala cxovelTa TareSis aRkveTa.

cofiani cxovelis mier dakbenil an danerwyvil yvelaadamians aucilebelia Cautardes cofis sawinaaRmdegoacrebis mTliani kursi. amiT xerxdeba inficirebul orga-nizmSi imunitetis warmoqmna manamde, sanam daiwyeba paTo-

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logiuri movlenebis ganviTareba. amis gaTvaliswinebiTsaWiroa adamians dakbenidan rac SeiZleba male davuwyoTacrebi. cofis sawinaaRmdego vaqcina mTel msoflioSi aRi-arebulia, rogorc profilaqtikis saimedo saSualeba. ac-rilTa imunitetis xangrZlivobis Sesaxeb zusti monaceme-bi ar arsebobs.

cxovelisagan dakbenilTa antirabiuli daxmareba Sedge-ba ori komponentisagan: 1. adgilobrivi Wrilobis damuSave-ba; 2. vaqcinis Seyvana an erTdroulad antirabiuli imuno-globulinisa da vaqcinis gamoyeneba.

Wrilobis damuSaveba unda xdebodes dauyovnebliv darac SeiZleba male, kbenis an dazianebis Semdeg. Wrilobakargad unda Cairecxos sapniani wyliT da Semdeg damuSavdes70%-iani spirtiT an iodis xsnariT. imunoglobulinis Sey-vanis saWiroebisas, rekomendebuli doziT unda gakeTdesinfiltracia Wrilobis irgvliv. agreTve, imunoglobuli-ni unda SeviyvanoT Wrilobis siRrmeSi, Tu ukiduresmasaWiroebam ar moiTxova, nakerebis dadebas unda veridoT.Wrilobis damuSavebis Semdeg, iwyeba samkurnalo-profi-laqtikuri imunizacia (Cvenebebi: cofiani, cofze saeWvo,an ucnobi cxovelis (ZaRlis) kbena an masTan kontaqti).

samkurnalo-profilaqtikuri imunizaciis ukuCveneba ararsebobs.

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Wama yovelTvis rodia `didad Sesargi~

gasuli saukunis miwurulisaTvis amerikis SeerTebuliStatebis daavadebaTa kontrolisa da prevenciis centre-bis (CDC) monacemebiT botulizmiT daavadebis mxriv (100000 sul mosaxleze) msoflioSi saqarTvelos pirveli adg-ili ekava. TvalsaCinoebisTvis movitan erT konkretul ma-galiTs: 1998 wels saqarTveloSi dafiqsirda botulizmiTdaavadebis 53 SemTxveva, maSin, roca iseT did qveyanaSirogoricaa amerikis SeerTebuli Statebi, saSualod yovel-wliurad botulizmiT avaddeba 110 adamiani. mainc ratomgamovirCeviT ase, am mxriv da ra aris amis mizezi? xSirad`mimtvrevia Tavi~ am sakiTxze da garkveuli cxovrebiseu-li daskvnac gamovitane.

2003 wlis Semodgomaze, amerikelTa xelSewyobiT (sa-transporto da samivlinebo xarjebi), TiTqmis mTeli sa-qarTvlos qalaqebi da soflebi Semoviare kardakar (eqs-pediciis sxva monawileebTan erTad) da davrwmundi _saqarTvelos mosaxleobis umravlesoba, ganurCevladerovnebisa da qonebrivi cenzis, sakvebad intensiurad moix-

mars Sin, kustaruli we-siT dakonservebulbostneuls (albaT, sxvaqveynebis mosaxleobazegacilebiT metad). amfaqts ki udidesi mniS-vneloba aqvs botuliz-mis epidemiologiaSi.ase magaliTad, 2001-2004 wlebSi, saqarTve-loSi dafiqsirebulibotulizmis 100 SemTx-vevidan 92 avad gaxdadakonservebuli bost-

neulis miRebiT, 7 SemTxvevaSi daavadebis mizezi SeboliliTevzi iyo, xolo erTi, Sebolilma Zexvma gaxada avad. (Zexvs

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laTinurad `Botulus~-i hqvia, ZexviT mowamvlas _ botuli-zmi. es termini pirvelad 1820 wels ixmara viurtembergel-ma eqimma iustinius kernerma germaniaSi da mas Semdeg dam-kvidrda samedicino literaturaSi).

uaxlesi monacemebiT, arsebobs sami saxis botulizmi: 1)sakvebismieri botulizmi, romelic gamowveulia botuliz-mis toqsinis Semcveli produqtis miRebiT; 2) Wrilobisbotulizms iwvevs WrilobaSi moxvedrili botulizmis mik-robebis mier gamomuSavebuli toqsini; 3) axalSobilebisbotulizmiT daavadeba SesaZloa gamoiwvios TviT mikrobe-bis moxvedram sakvebTan erTad nawlavebSi da iq gamomuSave-bulma toqsinma.

saqarTveloSi jerjerobiT dafiqsirebulia mxolodsakvebismieri botulizmi. igi kvebiTi mowamvlis erT-erTimZime formaa da xasiaTdeba centraluri nervuli sistemisdazianebiT. avadmyofobis ZiriTadi meqanizmi sakveb pro-duqtSi warmoqmnili toqsiniT mowamvlaa, magram ar SeiZle-ba misi, rogorc marto toqsemiis ganxilva. inficirebulsakvebTan erTad organizmSi xvdeba ukve gamomuSavebulitoqsini da botulizmis mikrobebi. toqsinis moqmedebiTSeqmnili paTologiuri foni ganapirobebs organizmSi mik-robebis gamravlebasa da toqsinis axali porciebis warmo-qmnas, ris gamoc intoqsikacia da organizmis mowamvlaufro da ufro Zlierdeba.

inkubaciuri periodi. sakvebiT gamowveuli botulizmisdros pirveli simptomebis gamovlineba xdeba inficirebu-li sakvebis miRebidan 18-36 saaTis Semdg, Tumca SesaZloagamovlindes 6 saaTidan 10 dRemde.

daavadebis simptomebi. daavadeba iwyeba gulisreviT,zogjer RebinebiT, temperatura normaluria an Cerdebasubfebrilur cifrebze. faRaraToba, rogorc wesi gamor-icxulia, xSirad aRiniSneba yabzoba da muclis Seberva.avadmyofebi uCivian saerTo sisustes, Tavbrusxvevas, Tavistkivils, mxedvelobis dabindvas da gaorebas. obieqturigamokvlevebiT avadmyofebs aReniSnebaT zeda quTuTosdaSveba (ftozi), sielme, gugebis gafarToeba da sxvadasxva

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zoma. aRsaniSnavia, agreTve laparakisa da ylapvis gaZnele-ba, piris simSrale. pulsi dasawyisSi Senelebulia, Semdgom-Si _ xSirdeba. daavadebis mogvianebiT stadiaSi zemoTCamoTvlils emateba sunTqvis moSla. Cvil bavSvebSi gamoxa-tulia uCveulo Zilianoba, cudi mada, yabzoba, bavSvi Cu-mad, sustad tiris, daqveiTebulia kunTebis tonusi. yvelaes CamoTvlili simptomi gamoxatavs baqteriuli toqsiniTganviTarebul kunTebis damblas.

botulizmis garTulebebi. botulizmi SesaZloa leta-lurad damTavrdes, risi uSualo mizezi sasunTqi sistemisukmarisoba da damblaa. am daavadebisagan gamojanmrTele-bul pacients ramdenime wlis ganmavlobaSi aReniSneba hae-ris ukmarisoba, daRliloba da a. S. sruli gamojanmrTeleb-isaTvis SesaZloa saWiro gaxdes xangrZlivi mkurnaloba.

botulizmis diagnostika. SesaZloa eqimma dasvas botu-lizmis winaswari diagnozi avadmyofobis simptomebisa daepidanamnezis mixedviT, Tumca zogjr es sakmarisi ar aris,msgavsi simptomebi SesaZloa hqondes iseT daavadebebs,rogoricaa gien-bares sindromi, sisxlis mimoqcevis moSlaTavis tvinSi, miasTenia. diagnozis dadasturebis ZiriTa-di saSualebaa botulizmis toqsinis an TviT baqteriis aR-moCena daavadebulis ganavalSi, sisxlSi an moxmarebulisakvebi produqtis darCenil ulufaSi. mniSvnelovani faq-toria aseve erTdroulad daavadebis ramdenime SemTxvevadakavSirebuli erTi da igive produqtis miRebasTan.

botulizmis mkurnaloba. mkurnaloba Cveulebriv iwye-ba kuWis amorecxviT 5%-iani sodiani xsnariT. ukeTdebaTpenicilini Cveulebrivi doziTa da sqemiT. radikaluri sa-Sualebaa polivalenturi antibotulinuri Srati 500 000antitoqsikuri erTeuli kunTebSi (mZime SemTxvevaSi me-tic). Sratis adreuli SeyvaniT daavadebis yvela simptomiswrafad mcirdeba da SemdgomSi qreba. ylapvis moSlasTandakavSirebiT aucilebelia parenteralurad fiziolo-giuri xsnarisa da 5-procentiani glukozis Seyvana, agreT-ve, striqnini da adrenalini kunTebSi. yabzobisas iyenebensifonur oynas.

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daavadebis iseTi Sorswasuli SemTxvevebi, rogoricaasasunTqi sistemis dambla, saWiroebs reanimaciul Carevas_ avadmyofis xelovnuri sunTqvis aparatze CarTvas (zog-jer SesaZloa ramdenime kviriTac) da Sesabamis movlas. sak-maod xangrZlivi periodis gavlisas TandaTanobiT iwyebaavadmyofis mdgomareobis gaumjobeseba. adreuli diagnos-tikis SemTxvevaSi samkurnalod gamoiyeneba antitoqsikuriSrati, romelic axdens avadmyofis sisxlSi mocirkulacietoqsinis blokirebas, es ki icavs pacients mdgomareobisSemdgomi gauarsebisagan. saboloo gamojanmrTelebas kiramdenime kvira sWirdeba. sasurvelia, avadmyofis nawla-vebSi jer kidev arsebuli inficirebuli sakvebis mocile-ba, Rebinebis gamowveviT an gamwmendi oynis saSualebiT.

epidsawinaaRmdego RonisZiebebi. aucilebelia botu-lizmze saeWvo yvela avadmyofis saswrafo hospitalizaciada diagnozis dazustebamde dauyovnebliv mkurnalobisdawyeba polivalnturi SratiT. yvela subieqtze, romleb-mac botulizmze saeWvo produqti miiRes, aucileblia same-dicino meTvalyureobis daweseba 10-12 dRiT. saeWvo pro-duqti aucileblad unda ganadgurdes.

bunebaSi botulizmis mikrobTa rezervuari Tbilsis-xlian arsebaTa (maT Soris, adamianTa) nawlavebia, sadac isi-ni saprofitebis saxiT binadroben da drodadro ganaval-Tan erTad gamoiyofian gareT.

organizmis gareT (niadagSi) sicocxlis SesanarCuneb-lad es mikrobebi qmnian Zalian gamZle formebs _ sporebs,romelTa dasaxasiaTebladac sakmarisia aRvniSnoT TundacerTi faqti – isini duRils uZleben 5 saaTs. am xangrZlivo-bis Termuli damuSaveba ki mogexsenebaT arc erT sakvebproduqts ar sWirdeba. aqedan gamomdinare, Tu produqtibotulizmis mikrobiT dainficirda, mas veraviTari kusta-ruli gasterileba da Sebolva ver uSvelis. maT gasauvne-blad mizanSewonilia avtoklavireba (parametrebi: temper-atura 120 gradusi celsiusiT, wneva _ 2 atmosfero, dro_ 20 wuTi), magram avtoklavi ar Sedis sayofacxovrebo apa-raturis nusxaSi – ojaxebs da wvril kustarul sawarmoebs

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igi ara aqvT, amdenad, maT ar ZaluZT srulyofili steril-izaciis Catareba. aRniSnulidan gamomdinare, gasagebi xde-ba, ratom imata am bolo wlebSi botulizmiT daavadebisSemTxvevebma.

saxlSi, konservebis kustaruli wesiT warmoeba ver iZl-eva botulizmiT daavadebis Tavidan acilebis garantias.inficirebulma produqtma botulizmiT daavadeba rom gam-oiwvios, aucilebelia ori piroba: garkveuli dro (sulmcire ori kvira mainc) da uhaero anu uJangbado are. pirve-li saWiroa mikrobTa gasamravleblad da produqtSi maTmier warmoqmnili toqsinis dasagroveblad, meore ki TviTbotulizmis mikrobTa bunebidan gamomdinareobs _ igiaris mkacri anaerobi e. i. izrdeba da toqsins gamoimuSavbsmxolod uhaero sivrceSi.

amdenad, Semodgomaze daxuful-dakonservebuli sxva-dasxva saxis bostneuli da Sebolili Zexveul-Tevzeuli,Tuki igi inficirebulia botulizmis sporebiT, zamTri-saTvis warmoadgens botulizmiT daavadebis ucilobelmizezs. aRsaniSnavia, rom am dros produqtis organolep-tikuri Tvisebebi (suni, feri, gemo) ar icvleba da adamianiver sazRvravs misi Wamis saSiSroebas (Tu igi Zalian didixnis Senaxuli ar aris. didi xnis Senaxvis SemTxvevaSi igiicvlis fers, edeba mZaRe karaqis suni, icvleba konsisten-ciac). sagulisxmoa is viTarebac, rom, Tu inficirebuliproduqti mkvrivia (erTi cali Sebolili Tevzi, an erTicali Zexvi) misi Wamis SemTxvevaSi SesaZloa erTi adamianimoiwamlos, meore ki uvneblad gadarCes, rac imiTaa ganpi-robebuli – vis ulufaSi moxvdeba gamravlebuli mikrobe-bi da maT mier gamomuSavebuli toqsini. Txieri produqtisSemTxvevaSi es SesaZlebloba gamoricxulia.

aqve unda aRiniSnos, rom Tu produqti Seicavs 8%-ze metsufris marils an 45%-ze met Saqars, masSi botulizmis mik-robebi ver ganviTardeba e. i. toqsinic ar warmoiqmneba dadaavadebasac ver gamoiwvevs. amitomacaa, rom murabebisa-gan, Taflisagan, kanfetebisagan an kitris, pamidvris, ko-mbostos mwnilisagan, ra xangrZlivobisac ar unda iyos is

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da ra pirobebSic ar unda iyos Senaxuli (daxufuli Tudauxufavi), adamiani ar avaddeba.

amrigad, botulizmi kvebiTi mowamvlis erT-erTi umZi-mesi formaa. mis paTogenezSi gadamwyveti mniSvneloba aqvssawamlavs anu toqsins, romelsac gamoimuSavebs mikrobi dagrovdeba sakveb produqtSi, amitom profilaqtikis sakiTx-is gadawyvetisas yuradReba unda gamaxvildes botuloto-qsinis im Tvisebaze, rom igi ar aris Termostabiluri – gacx-elebas uZlebs mxolod 80 gradusamde celsiusiT, metze ki(duRilisas) swrafad iSleba da kargavs toqsikur Tvise-bebs. amitom zamTrisaTvis kustarulad damzadebuli pro-duqtis miRebisas, aucilebelia, Wamis win Termuli damu-Saveba (10 wuTi duRili), riTac uzrunvelyofili iqnebausafrTxoeba.

am statiaze muSaobisas, rakiRa kvebasa da produqtebzeiyo saubari, Zalauneburad fiqrebSi amotivtivda am Temazerostevan mefis sentencia vefxistyaosnidan:

`sma-Wama-didad Sesargi, deba ra savargulia?! rasaca gascem, Senia, rac ara dakargulia!~

mkiTxvelis yuradRebas mivapyrob sityvebs _ `deba rasavargulia?!~ e.i. Senaxva, momarageba, gamozogva (Tanamed-rove gagebiT _ dakonserveba, daxufva, Sebolva da sxva) arvargao. ver avukrZalavT Cvens Tanamemamuleebs am proce-durebis Catarebas, magram survili ki miCndeba xmamaRla vi-yviro mTeli saqarTvelos gasagonad _ ar WamoT auduReb-lad Sin dakonservebuli produqti!

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agresia kacobriobis winaaRmdeg

msoflios masobrivi informaciis saSualebebSi atexiliiyo didi xmauri da miTqma-moTqma imasTan dakavSirebiT,rom 2001 wlis seqtemberis TveSi teroristebma amerikisSeerTebuli Statebisa da sxva qveynebis winaaRmdeg gam-oiyenes baqteriologiuri iaraRi, kerZod, jilexis (cimbi-ruli wylulis) sporebi. sporebi fxvnilis saxiT, safostogzavnilebis saSualebiT gaavrceles floridaSi, niu-iork-Si, vaSingtonsa da sxva qalaqebSi, ramac ukve gamoiwvia ram-denime adamianis daavadeba jilexiT, aris letaluri SemTx-vevac. 30 adamianis analizSi aRmoCnda jilexis CxirebTankontaqtis kvali. gamokvleulia aTasobiT adamiani, visacSesaZloa kontaqti hqonda aRniSnul werilebTan. aaS-s mTa-vroba acxadebs premias 1 mln dolaris odenobiT maTTvis,vinc aRmoaCens da saaSkaraoze gamoiyvans am saSineli bo-rotmoqmedebis CamdenT. radganac Cveni qveyanac Sedis mso-flio Tanamegobrobis samyaroSi da gamoricxuli araa, romteroristebis gamogzavnilma werilebma rogorc sxva qvey-nebSi, CvenTanac SemoaRwios. amitomac mizanSewonilad mig-vaCnia detalurad SeviswavloT, ganvmartoT, Tu ra Tvise-bebis gamo airCies borotmoqmedebma es mikroorganizmebibaqteriologiur iaraRad da rogor davicvaT Tavi misgan.

jilexis anu, rogorc mas xSirad eZaxian, cimbiruli wy-lulis gamomwvevi mikroorganizmi aris sakmaod didi (mik-

robis pirobebze,Torem ise umikrosk-opod arc dainaxeba)da tlanqi Cxiri. igisazrdos mimarT up-retenzioa (izrdebaubralo bulionze anCveulebriv agarze),Zalze mgrZnobiareapenicilinisa da misirigis antibiotike-

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bis mimarT. organizmis gareT, garemoSi, Jangbadis zemoq-medebiT, swrafad gadadis sporul formaSi (sporulaciaiwyeba me-12 wuTidan). spora mikrobis damcavi formaa, ro-melic xasiaTdeba didi gamZleobiT. is erTi saaTis ganmav-lobaSi duRiliT ar kvdeba, gayinva mis cxovelmyofeloba-ze saerTod ar moqmedebs, kargad uZlebs gamoSrobas. amTvisebebis gamo, jilexis spora garemoSi (Tundac miwaSi),Zalze didxans (aTeuli wlobiT) inarCunebs sicocxlisu-narianobasa da paTogenobas. jilexis sporis dasnebovnebisindeqsi adamianTaTvis, Cveni monacemebiT, udris 23%-s.

jilexi zoonozuri daavadebaa, is, ZiriTadad, balaxism-Wamel cxovelTa avadmyofobaa. adamiani jilexis epidemio-logiuri procesis ciklSi Cixs warmoadgens, rac imas gu-lisxmobs rom adamiani meore adamianisTvis infeqciis wya-ros ar warmoadgens. am Tvisebis gamo, jilexi, sxva paToge-nebTan SedarebiT, bioiaraRad nakleb saSiSia. samagirod mi-si `damzadeba~, gamoyeneba da gavrceleba SedarebiT advi-lia da mosaxleobaSi did panikas iwvevs.

adamianis organizmSi jilexis sporis moxvedris ramde-nime forma arsebobs: kanis 99% da darCenili 1% Semdegformebze: abdominuri, filtvis. es ukanaskneli formebi Za-lian mZimed mimdinareobs da umTavresad sikvdiliT mTavr-deba. rogor gamovicnoT yvelaze ufro gavrcelebuli _kanis forma? amisaTvis mivyveT daavadebis ganviTarebisdinamikas: inkubaciuri periodis (9 saaTidan 14 dRemde) gas-vlis Semdeg mikrobis SeWris adgilas (aq aucilebeli pi-robaa _ kani dazianebuli unda iyos Wrilobis, nakawris,naxeTqis an mikrotramvis saxiT mainc) viTardeba molur-jo – mowiTalo feris laqa, romelic erT-or dReSi papu-lad gardaiqmneba, ris Semdeg (kidev erTi-ori dRe) masSidgeba serozuli siTxe da gadaiqceva vezikulad, romelicmale skdeba da viTardeba wyluli Savi feris fufxiT. undagvaxsovdes, rom es procesi nekrozul-hemoragiulia daCirqi damaxasiaTebeli ar aris. wylulis irgvliv mdebareqsovilebi Zalze SeSupebulia da umtkivneulo (jilexistoqsiniT nervuli daboloebebis parezis gamo). am daavade-

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bisTvis damaxasiaTebelia, agreTve, gamoxatuli linfan-goiti da uaxloesi limfuri jirkvlis limfadeniti. racSeexeba zemoT CamoTvlil jilexis sxva formebs, isini Zal-ian swrafad, mwvaved mimdinareobs da avadmyofi klinikuridiagnozis dasmamde (Tu epidemiologiuri anamnezi ar dag-vexmara) iRupeba.

jilexi kargad emorCileba antibiotikoTerapias (maTSoris, penicilinTerapiasac), riTac Cven mier zemoT aRwe-rili procesebi swrafad ganicdis ukuganviTarebas da ava-dmyofi droulad ikurneba. aSS-Si jilexis SemTxvevebismkurnalobisa da kontaqtSi myofTaTvis profilaqtikismizniT, farTod gamoiyenes ciprofloqsacini.

aRsaniSnavia erTi garemoebac: msoflios aTze met qveya-naSi, maT Soris, yofil sabWoTa kavSirSi, baqteriologiuriaraRad gamosayeneblad miRebuli iyo jilexis antibi-otikebis mimarT rezistentuli Stamebic, rac am daavadebismkurnalobas did problemas uqmnida. Tanamedrove tero-ristebs etyoba, xeli ver miuwvdebodaT amgvari Stamebi-sadmi. maT mier gamoyenebuli jilexis Stamebi antibiotike-bis mimarT mgrZnobiarea. sad SeeZloT teroristebs moe-povebinaT jilexis kulturis Stamebi? amerikeli kolege-bis kvlevis SedegebiT, pirvel SemTxvevaSi gamoyenebuliStamebi erTmaneTis identuri da bunebrivi warmoSobis iyo,rac ar gamoricxavs maT gamotanas romelime laboratori-idan. ra Tqma unda, maTi miReba, momzadeba da gamoyeneba spe-cialur codnas moiTxovs.

rogor davicvaT Tavi teroristTa SesaZlo agresiisa-gan? saeWvo safosto gzavnilebi, romlebSic moTeTro fe-ris fxvnili SeiZleba iyos, ar unda gaixsnas. saqarTvelosfostas miRebuli aqvs Sesabamisi instruqciebi. aseT kon-vertebTan Sexeba SeiZleba mxolod rezinis xelTaTmanebisgamoyenebiT, xolo gaxsna _ sasunTqi gzebis respiratoriTan 4-feniani dolbandis gamoyenebiT, Tu konvertSi aRmoCn-da saeWvo nivTiereba, misi mikareba ar SeiZleba. daavadeba-Ta kontrolis erovnuli centris specialistebs, Sesabam-isi organoebis miwveviT, SeuZliaT saeWvo nivTierebis us-

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afrTxo aReba da laboratoriuli gamokvleva. sifrTxil-is dacvisas daavadebis riski minimaluria.

unda gvaxsovdes, rom saWiroebis dros, xelis kargad da-bana sapniT (gansakuTrebiT sarecxis sapniT) profilaq-tikis saukeTeso saSualebaa. jilexis sporebs saimedodklavs 1%-iani lizoformi, 8%-iani wyalbadis zeJangi daqloriani kiris xsnari, sadac aqtiuri qloris Semcveloba5%-ze naklebi ar unda iyos.

bioteroristuli aqtebis yvelaze damangreveli efeqtimosaxleobaSi SiSiTa da panikiT gamomJRavndeba, gansakuT-rebiT im qveynebSi, sadac jilexi bunebrivad TiTqmis ar gvx-vdeba. amitom mosaxleobis sanitariul ganaTlebas, elemen-tarul pirad profilaqtikas, masobrivi informaciis saSu-alebebiT informaciis droul da swor gaSuqebas gadamwy-veti mniSvneloba aqvs.

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brucelozi saSiSi infeqciaa

brucelozi CvenSi gavrcelebul infeqciur daavadebaswarmoadgens. igi xasiaTdeba retikulur-endoTeluri sis-temis dazianebiT: procesSi CairTveba nervuli, sisxlZar-RvTa da sxva sistemebic. daavadebisTvis damaxasiaTebliaagreTve sayrden-samoZrao aparatis dazianeba da midreki-leba qronikuli mimdinareobisken.

saqarTveloSi adamianTa Soris bruceloziT avadobissistematuri aRricxva daiwyo 1939 wlidan. Semdgom wlebSiam daavadebis klinikuri da laboratoriuli diagnostikissrulyofam ganapiroba daavadebulTa gamovlenis mateba,romelmac maqsimums 50-ian wlebSi miaRwia. Sesabamisi pro-filaqtikuri RonisZiebis gatarebam gamoiwvia mosaxleoba-Si daavadebis kleba, rac 1978 wlamde gagrZelda. Semdgomiwlebidan bruceloziT avadoba garkveul stabilur donesinarCunebs, weliwadSi saSualod 200 axali SemTxveva aRi-ricxeba.

ukanasknel periodSi, didi socialur-ekonomikuri cv-lilebebis gamo (sazogadoebrivi meurneobis adgilze wv-ril-wvrili kerZo fermeruli warmoebis gaCena), mniSvne-lovnad gaizarda brucelozis problemis aqtualoba, ram-denadac garTulda veterinaruli samsaxuris mier rigiprofilaqtikuri RonisZiebebis masStaburad ganxorcie-leba. amdenad, miuxedavad bruceloziT adamianTa daavade-bis SemTxvevebis aRricxvis arasrulyofilebisa (pacienti,daavadebis msubuqi formiT xSirad ar mimarTavs eqims), mo-salodnelia am daavadebis SemTxvevebis garkveuli zrda.

Tumca daavadeba ZiriTadad mecxoveleobaSi dasaqmebulpirTa Sorisaa gavrcelebuli, saTanado wesebis ugulebel-yofis pirobebSi, arc mosaxleobaa dazRveuli dasnebova-nebisagan.

brucelozis rezervuars bunebaSi ZiriTadad sasoflo-sameurneo cxovelebi warmoadgenen, upirveles yovlisa,wvrilfexa da msxvilfexa rqosani pirutyvi. avadmyofi ada-miani infeqciis wyaro ar aris. daavadebuli pirutyvi bru-

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celebs gamohyofs daavadebis mTel periodSi rZiT, SardiT,ganavliT da sanayofe wylebiT. adamiani avad xdeba avadmy-ofi cxovelis xorcis an rZis produqtebis gamoyenebisas,an avadmyof cxovelTan kontaqtis (upiratesad profesiu-li xasiaTis) Sedegad. aqedan gamomdinare, gadacemis gzebialimentaruli da kontaqturia.

brucelozis gamomwvevTagan adamianTa daavadebaSi upi-ratesi epidemiologiuri mniSvneloba aqvs Txa-cxvris bru-celozis gamomwvevs _ Brucella melitensis .

gadacemis faqtori ufro xSirad auduRari rZe an misiproduqtebia, agreTve xorci. SedarebiT iSviaTad matyli,tyavi.

mecxoveleTa inficirebaSi mniSvnelovan rols TamaSobsplacenta da avadmyofi pirutyvis sxva gamonayofebi. bru-celebi bunebaSi sakmaod maRali gamZleobiT xasiaTdeba.magaliTad, rZeSi macivris temperaturaze or kviras Zlebs,yvelSi – 45-60 dRemde. duRilisas swrafad iRupeba.

adamianTa amTvisebloba brucelozis mimarT maRalia daganisazRvreba brucelas saxeobiT. ase magaliTad, Zroxisbrucelozis kerebSi 20 inficirebulidan avad xdeba erTi,maSin, roca Txa-cxvris brucelozis keraSi avad xdeba TiT-qmis yvela inficirebuli. daavadebis Semdgomi imunitetixanmoklea.

daavadebis klinikuri gamovlineba mravalferovania,avadmyofoba iwyeba TandaTanobiT (zogjer mwvaved), aRin-iSneba gamoxatuli cxeleba (39_40ºC), romlic grZeldeba3-7 dRe, SesaZloa ganviTardes angina, faringiti, mSralibronqiti. damaxasiaTebelia kunTebis, saxsrebis tkivili,zogjer SeiZleba Camoyalibdes mwvave morecidive bruce-lozi. am SemTxvevaSi cxelebian Setevebs enacvleba usicxoperiodebi 1-2 Tvis ganmavlobaSi. cxelebian periodSi avad-myofi aRgznebulia, uCivis uZilobas, Zlier oflianobas.usicxo periodSi avadmyofs unarCundeba kunTebis sisuste,adinamia, kidurebis tkivili. daaxloebiT 6 Tvis Semdegavadmyofoba gadadis qronikul formaSi, romlis drosacxdeba sxvadasxva organosa da sistemis perioduli kero-

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brivi dazianeba: SesaZloa ganviTardes arTriti, nefriti,pleqsiti, radikuliti, orqiti, endometriti. bruceloz-is dros letaloba 2% ar aRemateba.

brucelozis laboratoriuli diagnostika emyareba se-rologiur da baqteriologiur gamokvlevebs, agreTve ka-nis alergiul sinjs.

brucelozis samkurnalod gamoiyeneba: antibiotikebi,zogjer vaqcina, mastimulirebeli da sadesensibilizaciosaSualebebi.

aRsaniSnavia, rom saqarTveloSi brucelozi yvelganerTnairad araa gavrcelebuli. Cvens qveyanaSi adamianTabruceloziT avadobis 95 %-ze meti aRmosavleT saqarTve-loze modis. aq daavadebis intensivobis mixedviT gamoirCe-va 14 raioni: sagarejo, yazbegi, aspinZa, duSeTi, axmeta, de-dofliswyaro, ninowminda, TianeTi, TeTriwyaro, siRnaRi,gardabani, Telavi, dmanisi, lagodexi.

brucelozis sawinaaRmdego acrebi adamianebisaTvis re-komendebulia mxolod wvrilfexa rqiani pirutyvis aqti-ur kerebSi momuSave personalisTvis (vaqcinacia SedarebiTnakleb efeqtiania).

brucelozis profilaqtikaSi udidesi mniSvneloba aqvsmosaxleobisaTvis imis codnas, Tu ra saSiSroebas warmoad-gens Seumowmebeli, auduRari rZis, umarilo yvelisa daTermiulad arasakmarisad damuSavebuli xorcis sakvebadxmareba.

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jilexis `afeTqeba~

infeqciur sneulebaTa Soris, jilexi erT-erTi iseTiavadobaa, romlis epidemia yumbarasaviT afeTqdeba xolmeda mosaxleobaSi SiSsa da dabneulobas iwvevs. es ki am daa-vadebis ramdenime TaviseburebiTaa ganpirobebuli. pirve-li _ is ZiriTadad dakavSirebulia kvebis iseT produqt-Tan, rogoricaa xorci. meore _ misi gamomwvevi mikrobebissporebi gamZlea da duRils uZlebs zustad erT saaTs. aqe-dan gamomdinare, inficirebuli xorciani sakvebi, romlisTermiul damuSavebas erT saaTze naklebi duRili sWirde-ba, qmnis sikvdilis saSiSroebas. albaT amitomac iyo 1999wlis seqtembris pirveli naxevari Tbilisis bazrebSi saqon-lis xorcis gasayidi daxlebi dacarielebuli. xalxs eSino-da xorcis yidva (mogexsenebaT andaza _ `SiSs didi Tvale-bi aqvso~). gaWra radioTi da televiziiT gavrcelebulmainformaciam jilexis epidemiuri afeTqebis Sesaxeb gar-dabnisa da dedofliswyaros raionebSi (soflebSi: aqtag-lia, kalinino, meurneobis dasaxleba, sabaTlo), qalaqebSi:rusTavi, Tbilisi, samtredia.

ramdenime dReSi aRniSnul regionebSi Cacxra jilexisepidemiuri afeTqeba (gavida daavadebis inkubaciuri _faruli periodis maqsimumi 12_14 dRe ukanaskneli SemTx-vevidan). masobrivi informaciis saSualebebma kargi samsax-uri gauwia Cvens Tanamemamuleebs (gangaSis wyalobiT xalxigafrTxilda, ar yofila registrirebuli nawlavuri for-ma, yvela SemTxveva kanis forma iyo da arc sikvdilianobadafiqsirebula).

sainteresoa, ram ganapiroba jilexis esoden mZlavri epi-demiuri afeTqeba. jilexi, ZiriTadad, sasoflo-sameurneopirutyvis daavadebaa da adamianebi maTgan xdebian avad (re-gistrirebuli 47 avadmyofidan erTis garda yvela daavad-da dacemuli pirutyvis dakvlisa da gatyavebisgan an xor-cis damuSavebisagan). jilexisagan pirutyvis dasacavad sa-Wiroa maTi yovelwliuri acra, rac ver moxerxda ekonomi-uri siZneleebis gamo. amasTanave, angariSgasawevia maSinde-

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li uCveulod cxeli da gvalviani zafxuli (gadamxmari ba-laxis gamo, pirutyvi iZulebulia, ufro mWidrod Seexosmiwas drunCiT, riTac izrdeba misi inficirebis Sansi jile-xis sporebiT).

momavalSi jilexidan gamowveuli garTulebebis Tavidanasacileblad saWiroa, gaZlierdes veterinaruli momsaxu-reba. pirutyvi unda ikvlebodes mxolod erTsa da imaveadgilze – sasaklaoze. meti yuradReba unda daeTmos cxo-velsamarxebis mowyobas (jilexiT dacemuli pirutyvis le-Si jer unda daiwvas da mere ferfli daimarxos), saWiroaadgilebze gamovlindes axali da Zveli cxovelsamarxi dadawesdes maTze veterinaruli zedamxedveloba (pirvelrigSi gaukeTdes maT izolireba e. i. SemoiRobos), rac mciregamonaklisis garda arsad ar xdeba, rac SeiZleba pirutyvismet raodenobas Cautardes jilexis sawinaaRmdego acrebi.gasayidad gamotanili xorci aucileblad damowmebuliunda iyos specialistis mier (Cvens Tanamoqalaqeebs Tavi-suflad da uSiSrad SeuZliaT ivaWron bazrebis saqonlisxorcis gasayid daxlebTan).

Cems TanamemamuleT (imaT, vinc mecxoveleobas misdevs)ki erTi andaziT Sevexmianebodi _ `vinc davardnil saqo-nels ar daklavs, is arc avaddeba jilexiTo~.

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Savi Wiri – wyevlis sinonimi

Savi Wiri. imdeni ubedureba moutania am ori sityviT sax-eldebul daavadebas kacTa modgmisTvis, rom igi wyevlissinonimad iqca. qarTul matianeSi Savi Wiris epidemiebi Ja-mianobis saxelwodebiTaa cnobili. dRevandeli axalgazr-da eqimi am daavadebas mxolod wignis saSualebiT Tu icn-obs, magram arc ise didi xania, rac Savi Wiris gamoCena SiSiszars scemda mosaxleobas, romelic Tavis gadarCenis miz-niT tovebda saxl-kars, sarCo-sabadebels da garboda sai-Tac SeeZlo. Tavis gadarCenas yvela ver axerxebda, bevridawyebul avadmyofobas versad gaurboda da mas yvelganavrcelebda, amitom XIX saukuneSi CvenSi xSiri iyo Savi Wi-ris mZvinvare epidemiebi. maTi Seswavlis mizniT gavecani sa-xelmwifo centralur saistorio arqivSi dacul dokumen-tebs, movZebne da davamuSave 24 fondis 287 saqme, ramac gar-dasul JamTa siavis uSualo mowmeni gagvxada.

Savi Wiri gansakuTrebiT saSiSi infeqciuri daavadebaa.bunebaSi Savi Wiris gamomwvevi mikrobebis rezervuaria sx-vadasxva saxis mRrRneli, xolo gadamtani _ rwyilebi. amde-nad, igi bunebrivkerovani, transmisiuli daavadebaa. bune-briv keraSi dasnebovanebisas adamians Savi Wiris bubonuri(jirkvlovani) an septikuri forma uviTardeba, romelic Se-saZloa garTuldes filtvis meoradi formiT. es ki udidessaSiSrobas qmnis irgvliv myofTaTvis, radgan Savi WirismikrobTa gavrceleba haerovan-wveTovani gziT iwvevs ada-mianTa daavadebas filtvis pirveladi formiT. avadmyofo-bis yvela formis inkubaciuri periodi meryeobs 1-5 dRisfarglebSi.

arCeven Savi Wiris `velur~ (bunebriv) da `saporto~ ker-ebs. maT Soris damakavSirebeli rgolia sinantropuli (ada-mianTan mcxovrebi) mRrRnelebi.

adamiani Savi WiriT SeiZleba daavaddes sxvadasxva piro-bebSi: uSualod bunebriv kerebSi, intensiuri epizootiis(daavadebis gavrceleba cxovelebSi) fonze, SemTxveviT ansameurneo saqmianobisas. daavadebis wyaroa sinantropuli

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mRrRnelebi, Sinauri cxovelebi, avadmyofi adamiani an misigvami. daavadebis gza ZiriTadad transmisiulia _ inficir-ebuli rwyilebisagan adamianis dakbena. aseT SemTxvevaSi Sa-vi Wiris bubonuri forma viTardeba, romelTa diagniosti-kisaTvis bubonis SigTavsis baqteriologiur gamokvlevasgadamwyveti mniSvneloba aqvs.

daavadeba, rogorc wesi iwyeba uecrad, SemcivnebiTa daTavis tkiviliT. sxeulis temperatura ramdenime saaTisganmavlobaSi matulobs 39-40 gradusamde, avadmyofis saxesisxlsavsea da SeSupebuli, gamoxatavs SeSfoTebas. koniun-qtivebi hiperemiulia, ena – TeTri nadebiT, kankalebs daZnelad gamodis piris Rrudan, nestoebi gafarToebuli,tuCebi mSrali. avadmyofi agznebulia, bodavs.

aRwerili saerTo simptomebis fonze avadmyofs uviTar-deba adgilobrivi dazianebebi, rac gansazRvravs Savi WiriTdaavadebis formas, romelic ZiriTadad sami saxisaa: bubo-nuri, septikuri da filtvis.

aris Tu ara saqarTveloSi adamianTa Savi WiriT daavade-bis saSiSroeba?

aris! es ki imiT aixsneba, rom garda damoukidebeli bune-brivi kerebisa, saqarTvelos teritoria garemoculia SaviWiris moqmedi kerebiT. ase magaliTad, aRmosavleTiT dasamxreTiT Cven vemijnebiT azerbaijanis teritoriaze gan-lagebul Savi Wiris vrcel bunebriv keras, sadac am sneu-lebis gamomwvevis rezervuars warmoadgens wiTelkuda meq-viSia (gareuli mRrRneli) 1966 wlis gazafxulze mosazRvrededofliswyaros raionSi, xolo 1968, 1969, 1970 da 1971wlebSi gardabnis raionSi, swored am saxeobis mRrRnele-bidan da maTi rwyilebidan Savi Wiris gamomwvevi mikrobebiiqna gamoyofili.

samxreTiT Cveni momijnavea somxeTSi arsebuli Savi Wi-ris bunebrivi kera (aq am sneulebis rezervuaria Cveuleb-rivi memindvria). samocdaaTiani wlebis bolos, oTxmocianida oTxmocdaaTiani wlebis dasawyisSi, ninowmindis raionSidadasturda zemoT aRniSnul mRrRnelebSi Savi Wiris epi-zootia.

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kavkasionis CrdiloeT kalTebze registrirebulia SaviWiris bunebrivi kerebi (yabardo-balyareTi, daRestani), ma-Ti zegavlena Cvens teritoriebze, marTalia, jerjerobT,daudgenelia, magram arcTu ise Soreuli warsuli, am mxrivfriad sagulisxmo monacemebs Seicavs.

ganvixiloT saqarTvelos centralur saistorio arqivSidaculi dokumentebi:

_ «Ëîìàòü, à áóäå ìîæíî ñæèãàòü òå ñàêëè, ãäå áûë ÷óìíîé, àáóäå íà òî íóæíî âîéñêîâîé ïîìîùè òî òðåáîâàòü ñèëîþ åãî îò áëè-æàéøåé âîéñêîâîé êîìàíäû». (fondi_2, anaweri_1, saqme_79,gv._58).

es saqarTvelosmTavarmarTeblis1804 wlis 2 Teber-vlis # 13 dadge-nilebaa. aRniSnu-li RonisZieba, ud-avod, calmxriviiyo da bevrad verSezRudavda SaviWiris epidemias,romelmac gansa-

kuTrebiT imZlavra 1806 wels sofel stefanwmindaSi daqvemo qobaanSi, xolo «â Êèñòèéñêèõ óùåëúÿõ æèòåëè îò ñèëúíîãîñâèðåïñòâîâàíèÿ çàðàçèòåëúíîé áîëåçíè ïî÷òè âñå âûìåðëè» (fon-di 16, anaweri-1, saqm 452, gv. 1-5). aq albaT, Savi Wiris fil-tvis formazea laparaki.

1807 wels Savi WiriT daavadeba daiwyo larsis simagreSiganlagebul samxedro mosamsaxurTa Soris da gavrceldamTeli kavkasiis samxedro xazze.

6 TveSi (28 maisidan 12 dekembramde) am ubanze Savi WiriT1596 kaci daavadda. romelTagan mokvda 1144 e.i 71% ( fon-di 2. anaweri 1, saqme – 158, gv. 137).

male Jamianoba Tbilissac moedo.«Æèòåëè ãîðîäà Òèôëèñà, áîÿñü çàðàçèòåëüíîé áîëåçíè, âûõîäÿò

èç ãîðîäó â ïðåäìåñòüÿ îíîãî, ÿ íóæíûì íàõîæó ïðåäïèñàòú âàøåìó

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Ïðåâîñõîäèòåëúñòâó, ÷òîáû ïîçâîëèòü òîëüêî äâîðÿíàì è ïî÷òåííûìãðàæäàíàì âûõîäèòü èç ãîðîäó è ðàñïîëîãàòüñÿ â ïðåäìåñòüÿõ îíîãîèëè â ñàäàõ , íî íå èíà÷å, êàê ïî áèëåòàì Âàøèì, ñî âçèÿòèåì îò íèõoáÿçàòåëüñòâà, ÷òîá îíè ëþäåé ïðè íèõ íàõîäÿùèåõñÿ, îòíþäü íèêóäàîò ñåáÿ íå îòïóñêàëè äà è ñàìè áû íå ðàñõîäèëèñü â äðóãèå ìåñòà,÷òîæ êàñàåòñÿ äî ÷åðíîãî íàðîäó Òèôëèñå íàõîäÿùèåõñÿ, òî îíûéíèêàê âûñåëÿòüñÿ èç ãîðîäà íå äîëæíû, èáî ÷åðåç òî ìîãóò ïðîèçîéòèãèáåëüíàÿ äëÿ ïðî÷èõ ìåñò ïî Ãðóçèè ïîñëåäñòâèÿ, òàê êàê íàðîä ñåéïîâñþäó ðàçîéäåòñÿ, à îñòàâÿ îíûé â Òèôëèñå ðàñïîðÿäèòå òîëüêî,÷òîáû â ãîðîäå íå áûëî íåäîñòàòêó â ñúåñòíûõ ïðèïàñàõ, ïðèêàæèòåâíóøèòü âñåì âîîáùå ïèñàòåëÿì, ÷òîáû îíè ê ñîõðàíåíèþ ñåáÿ îòçàðàçû ïðèíèìàëè âñå ìåðû ïðåäîñòîðîæíîñòè, íàòèðàëè áû ñåáÿóêñóñîì è ïåðåìåíÿëè ÷àùå áåëüå, ïåðåìûâàÿ åãî õîðîøåíüêî. Óìåð-øèõ çàðàçîþ èìóùåñòâî ïðåäîâàòü îãíþ. Âîêðóã ãîðîäà ÷èñëî ïîñòîâïàòðóëåé óâåëè÷èòü, ÷òîáû øàòàþùèõñÿ áåç áèëåòà ïðåïðîâîäèòü âkàðàíòèí.» (fondi 16, anaweri _1, saqme _ 1237, gv. 17)

es pataki saqarTvelos mTavarmarTeblisadmi Tbilisiskomendantis mier wardgenilia 1811 wlis 11 ivliss.

am droisaTvis TbilisSi funqcionirebda sakarantino sa-guSagoebi. magaliTad, avlabris karantinSi aRniSnuli wlis27 agvistosaTvis iyo 78 avadmyofi, xolo orTaWalis karan-tinSi 124 (f.-16, anaw.-1, saqme.-1256, gv-60,64). male Savi Wirisepidemia Tbilisidan gavrcelda maxlobel soflebSi: Cu-RureTi, yarajala, diRomi, martyofi.

saqarTvelos saeqimo mmarTvelobis operatori 1811 w. 8ivliss upatakebda xelisufalT, rom sof. martyofSi dai-wyo Savi Wiris epidemia, ris sawinaaRmdegodac man SemdegiRonisZiebebi ganaxorciela: soflis garSemo daayena gu-Sagebi, raTa maT aravin gamoeSvaT soflidan, garda mind-vris muSebisa. mcxovrebTagan gamoyo 4 kaci daxocilTa da-samarxavad. avadmyofebi gaacalkeva soflis moSorebiT ca-lke SenobaSi. mravalricxovani ojaxebi (mWidrod rom aryofiliyvnen) dayo ramdenime nawilad da daasaxla baRebSi.SemoiRo daxocilTa tansacmlisa da nivTebis sajaro dawva.daasufTavebina soflis quCebi da orRobeebi. soflis gle-xobas sistematurad STaagonebda, rom xSir-xSirad See-

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bolaT, Semdeg ki gaeniavebinaT TavianTi saxlebi, Savi Wi-riT daavadebis acilebis mizniT ( f._16, anaw._1, saqme_1254, gv. 9).

zemonaTqvamidan Cans, rom imdroindeli mmarTvelobaeyrdnoboda sakarantino RonisZiebaTa elementarul wes-ebs da krZalavda epidemiis keridan mosaxleobis ganTesvas.zogjer adgilobrivi mebatoneebi ewinaaRmdegebodnen amRonisZiebebis gatarebas.amaze metyvelebs arqivSi moZebni-li erTi dokumenti (f._16, anaw._1, saqme-1092, gv. .27. iqveamisi rusuli Targmanic gv. 20). es aris saqarTvelos mTavar-marTebelis saxelze gagzavnili Txovna, romlis Sinaarsicmogvyavs sityvasityviT:

`Cems sofel diRomSi ramdenime kacs Wiri kvlav gamosCe-nia, romelic iqaurma mouravma da mamasaxlisma gamomicxa-da, amisTvis maqvs pativi moxsenebad, rom Tumca aqvT maTsoflis moSorebiT saxlebi imgvari avadmyofis gansacal-keveblad, magram imiT didad SeuZlebeli aris am sneuleb-is gardavardna, Tu srulad is sofeli ar aiyreba da cal-calke ar dadgeba. amisaTvis gTxovT umorCilesad raTaubrZanoT iq mdgom russ, rom imisgan ayra ar daeSalos, manamsarwmuno Seiqmnebodnen da rodesac sarwmuno Seiqmnebianim sneulebis gadavardnisa, maSin isev TavTavis saxlebSidadgnen. sxveb davSTebi da Cemi da Tqvendami pativiscemi-Ta da samudamo SevrdomiT.

Tqvenis aRmatebulebis morCili msaxuri da Reneral-maiori muxran batoni ivlisi 17 1811 wlisa~.

Cven jerjerobiT ver vnaxeT iseTi dokumenti, sadac aR-niSnuli iqneba Tu ra pasuxi miiRo muxran batonma mTavar-marTeblisagan. erTSi darwmunebuli varT _ uaryofiTisjobda uciloblad, rogorc diRmelebisaTvis, ise maTi me-zobeli soflebisTvisac.

mogvianebiT, Savi Wiris epidemiam Tavi iCina qalaq gor-Si, sadac im droisaTvis arsebobda sakarantino saguSago,

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magaliTad 1811 wlis 21 agvistosTvis goris karantinSi iyoSavi WiriT daavadebuli 15 kaci, romelTagan erTi kvirisganmavlobaSi mokvda 3 (fondi_16, anaw. -1, saqme_1258,gv._74). miuxedavad miRebuli sakarantino RonisZiebebisa,Savi Wiris epidemia mainc gavrcelda goris mazris sofleb-Si: surami, ali, breTi, saRoraSeni, dirbi, kemperti, osiau-ri, Cala, bekami, tirZnisi, qinZaTi, vake, advisi, Ceronisi,Zagini, Zagla. aRniSnul soflebSi Savi WiriT mokvda 308adamiani (f._16, anaw._1, saq._1092, gv._4).

1811 wlis 10 ivliss qalaq Telavis komendanti ityobine-boda, rom qalaqSi daiwyo Savi Wiris epidemia, ris gamoc mo-saxleobam miatova saxl-kari da gaiqca sxvadasxva mimarTu-lebiTo (f._16, anaw._1, saq._1237, gv._65). amas male moh-yva epidemiis gavrceleba soflebSi: kurdRelauri, xodaSe-ni, sagarejo, ruispiri, vardisubani, yarabulaxi, Silda dawinandali.

imave wlis agvistoSi mosaxleobis Savi WiriT daavadebaaRiniSna siRnaRis mazris soflebSi: yarajala, vejini, gur-jaani. im saxlebSi, sadac avadmyofebi iyvnen, daayenes dara-jebi, raTa maTTan Sewyvetiliyo yovelgvari urTierToba(f.-16, anaw.-1, saq.-1254, gv.-10). miuxedavad amisa, Savi Wirisepidemia mainc gavrcelda da moedo sof. bodbisxevis mo-saxleobas, ris gamoc siRnaRis mazris ufrosi Txovda xeli-sufalT saeqimo daxmarebas da sofelSi sakarantino sagu-Sagoebis mowyobas (f.-16, anaw.-1, saq.-1237, gv._23)..

Savi Wiris epidemiis Semdegi talRa gamoCnda 1829 wels.wina wlis miwuruls goris mosaxleobaSi registrirebuliiyo daavadebis ramdenime SemTxveva, xolo 1829w. dasawyi-sSi daavadeba xanZariviT moedo mTel qalaqs da gavrceldamezobel soflebSi: dirbi, wveri, breTi. amasTan dakavSire-biT goris mazraSi daarsda sakarantino saguSagoebi (f.1491, anaw.-1, saq.-322 da 323), xolo mazris eqimad dainiSnagamocdili specialisti p. klapitonaSvili, romelmac didida Tavdauzogavi Sroma gaswia Savi Wiris epidemiis salikvi-daciod. epidemia marTlac likvidirebuli iqna, risTvisacmogvianebiT goris mazris ufrosi i. menkovi, daajiloves

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warCinebis niSniT, masve mieniWa podpolkovnikis wodeba (f.-26, anaw.-1, saq._773).

1829 w. mais-seqtemberSi Savi Wiris epidemia gansakuTre-buli ZaliT boboqrobda borCalos mazris soflebSi: kaza-nCi, Sulaveri, aq sxva epidsawinaaRmdego RonisZiebebTanerTad farTod gamoiyenes ukiduresi RonisZieba _ Savi Wi-riT daavadebulTa da daxocilTa saxlebis dawva, ris gamocam soflebis mravali mkvidris bina cecxlis als misces (f.-504, anaw.-1, saq._5).

mecxramete saukunis 40-ian wlebSi somxeTis teritori-aze farTod gavrcelda Savi Wiris epidemia. aq, gogCis maz-raSi, epidsawinaaRmdego RonisZiebebis ganxorcielebaSiaqtiur monawileobas iRebda Cveni sasiqadulo poeti da ma-muliSvili aleqsandre WavWavaZe, romelic ̀ amierkavkasiismxaris Savi Wiris epidemiebisgan dacvis komitetis~ Tavmj-domare iyo, saarqivo dokumentebSi daculia misi avtog-rafi. (f.-2, anaw.-1, saq.-7, gv.-391).

erT-erTi saarqivo masalidan (f.-2, anaw.-1, saq.-7395)irkveva, rom 1841 w. dasawyisSi Savi Wiris epidemia aleqsan-dropolis (somxeTi) mazridan SemoiWra borCalos (marneu-li) mazraSi, swrafad gavrcelda qvemo qarTlis soflebSida miaRwia Tbiliss, sadac pirvelad gamovlinda s. Saxnaza-rovis sikvdilis SemTxveva, romelic eWvmitanili iyo SaviWiriT daavadebaze (f.-2, anaw._1, saq.-7388). Semdeg Tanda-TanobiT gaxSirda aRniSnuli daavadebiT sikvdilis SemTx-vevebi da sul male Tbiliss cecxlis aliviT moedo SaviWiris epidemia, ris gamoc mas sakmaod didi xnis ganmavloba-Si samxedro nawilebiT alya hqonda Semortymuli (f._378,anaw.-1, saq.-6013).

im xanebSi Tbilisis mazris eqimad muSaobda z. zubalaS-vili, romelsac didi Rvawli miuZRvis TbilisSi Savi Wirisepidemiis sawinaaRmdego RonisZiebebis SemuSavebasa daganxorcielebaSi, ris gamoc is waradgines wminda stanisla-vis III xarisxis ordeniT dasajildoeblad (f.-2, anaw._1,saq.-12058).

aRsaniSnavia agreTve meore qarTveli eqimis, s. basta-

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maSvilis moRvaweoba TbilisSi Savi Wiris epidemiis dros.is imxanad muSaobda, qalaqis samxedro hospitalSi da bev-ris sicocxle gadaarCina ulmobeli senisagan. s. bastama-Svili amave dros aqtiurad monawileobda profilaqtikuriRonisZiebebis gatarebaSi Tbilisis mosaxleobis dasacavad.(f.-5, anaw.-1, saq. -2464).

1841 w. seqtemberSe Telavis mazris soflebSi gaxSirda ga-damdebi sneulebiT adamianTa sikvdilis SemTxvevebi. erT-erTi aseTi SemTxvevis gamosakvlevad sof. tularSi miav-lines Telavis mazris eqimi g. davriSvili. gamokvlevam daa-dastura, rom sikvdili gamowveuli iyo Savi WiriT, mazriseqimis iniciativiT miRebuli iqna zomebi Telavis mazraSiSavi Wiris gavrcelebis SesazRudavad (f.- 2, anaw.-1, saq.-7386).miRebuli epidsawinaaRmdego RonisZiebebis miuxedavad epi-demia mazraSi mainc gavrcelda. Savi WiriT daavadebis uka-naskneli SemTxvevebi likvidirebuli iqna mxolod 1843w.sof. sabuesa da axmetaSi. (f.-2, anaw.-1, saq. 10552 da 10553).

saarqivo masalebSi moZebnilia dokumenti, romliTacdasturdeba, rom samurzayanos okrugSi (afxazeTi) 1849wels mosaxleobaSi gavrcelebuli iyo avadmyofoba ZalianmaRali kontagiozobiTa (gadamdebloba) da sikvdiliano-biT (fondi-4, anaw.-6, saq._83). Cveni azriT, aq albaT, SaviWiris epidemia mimdinareobda.

saqarTvelos teritoriaze Savi Wiris ukanaskneli SemTx-veva registrirebulia 1910 wels qalaq baTumSi. am drois-aTvis mecnierul doneze ukve damuSavebuli iyo epidsawi-naaRmdego da profilaqtikuri RonisZiebebi, romelTa gan-xorcielebis Sedegad avadmyofoba qalaqis farglebs ar ga-scilebia da mokle droSi iqna likvidirebuli.

naSromSi dasaxelebulia mravali dasaxlebuli punqti(soflebi, qalaqebi), sadac mecxramete saukunis pirvel na-xevarSi mZvinvarebda Savi Wiris epidemia. rogorc analizmagviCvena isini Semotanili unda iyos. mizanSewonilad mig-vaCnia Seswavlil iqnas maTi ekologiuri da fizikur- geog-rafiuli pirobebi, rom gamoiricxos Savi Wiris bunebrivikeris arsebobis SesaZlebloba.

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moZebnili da damuSavebuli saarqivo pirvelwyaroebinaTels fens zogierTi qarTveli eqimis moRvaweobas Znel-bedobis periodSi, rac saintereso masalaa am dargSi momu-Save mkvlevarTaTvis.

Cveni dRevandeloba did socialur gardaqmnaTa epoqaa.gadavediT ra erTi sazogadoebrivi formaciidan meoreze,epidsawinaaRmdego muSaobaSi Tavi iCina arsebiTma siZne-leebma (ZiriTadad usaxsrobis gamo), ris Sedegadac mogve-Zala iseTi gansakuTrebiT saSiSi infeqciuri daavadebebi,rogoricaa jilexi, cofi. epidemiologiuri situaciis uf-ro garTulebis Tavidan asacileblad gadaudebeli amoca-naa ganvaxorcieloT mudmivi meTvalyureoba im regioneb-Si, sadac SesaZlebelia gareul mRrRnelebSi gavrceldesSavi Wiris epizootia.

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epidemiam arc mSveniereba daindoSen mogayares miwa beltebad,mkerdze rom vardsac Zlivs ikarebdi.

giorgi leoniZe

adamiani qoleras uZvelesi droidan icnobs. berZeni is-torikosebi, romlebmac aRweres aleqsandre makedonelislaSqrobebi, adastureben, rom sored qoleris umZimesmaepidemiam aiZula dampyrobeli, ar SeWriliyo indoeTSi daukan mobrunebuliyo. evropam es avadmyofoba mxolod XIXsaukuneSi gaicno, roca 1817 wlidan daiwyo qoleris cno-bili pandemiebi, TiTqmis yvela pandemiis gza amierkavkasi-asa da saqarTveloze gadioda, amitom bevrjer yofila qvey-ana am sneulebisagan iavarqmnili. qolera CvenSi gansakuT-rebuli siZlieriT mesame pandemiis wlebSi (1846-1862) bob-oqrobda. erTi saintereso detali am pandemiidan.

1857 wels indoeTsa da filipinebze daZrulma qolerisepidemiis talRam aaoxra avRaneTi, Sua aziis qveynebi da

gavrcelda iransa da amier-kavkasiaSi. saqarTveloSiqolera zemoT aRniSnuliwlis maisis miwuruls ga-moCnda siRnaRis mazraSi daepidemiis xasiaTi rom mii-Ro, gza swrafad gaikvliaTbilisisaken. TbilisSi da-avadebis pirveli SemTxve-vebi aRiricxa 12 ivniss, qa-laqSi epidemia gagrZelda28 agvistomde da moicva 854mosaxle, romelTagan 224imsxverpla. msxverplTa So-ris erT maTganze SevaCerebmkiTxvelis yuradRebas saa-rqivo dokumentis moSveli-ebiT: ̀ 1857 wlis 28 ivniss, 44

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wlisa, xoleriT gardaicvala statski sovetnikis gribo-edovis qvrivi, nina aleqsandres asuli WavWavaZe. aRsarebaaTqmevina da aziara dekanozma ioseb grigorevma~ (saqarTve-los centraluri saistorio arqivi. fondi _ 489, anaw. 7,saq. 10, gv. 157).

qoleris epidemia weliwadis Tbil Tveebze modis, amit-om gadamwyveti mniSvneloba aqvs wylis faqtors, uaRresadmniSvnelovania piradi higienac. Zveli avtorebi qoleras`WuWyiani xelebis daavadebas~ uwodebdnen, magram martoxelebis sisufTave ver dagvicavs daavadebisagan, Tu qvey-nis saerTo sanitariul-higienuri done saTanado simaR-leze ar dgas.

qolera aris anTroponozuli, sakonvencio, gansakuTre-biT saSiSi infeqciuri daavadeba, gamomwvevis gadacema xde-ba fekalur-oraluri meqanizmebiT. igi xasiaTdeba wyal-ma-rilovani da cilovani cvlis moSliT, gauwylovanebiT, to-qsikoziTa da gastroenteritiT. am daavadebis gamomwvevibaqtriebi vibrionTa gvars ekuTvnis. aqamde cnobili iyo 2saxis vibrioni; klasikuri qoleris da el-toris, axlaxanaRmoaCines qoleris gamomwvevi mesame saxis _ ̀ 0 139~ _ vib-rionic.

meoce saukunis samocdaaTian wlebSi el-toris vibrion-iT gamowveuli qoleris gavrcelebam pandemiis xasiaTi mi-iRo (meSvide pandemia). igi SeiWra yvela kontinentis mravalqveyanaSi, maT Soris saqarTveloSic (1970 wels, sam qala-qSi: baTumi, rusTavi, Tbilisi dafiqsirda qoleris SemTx-vevebi). ukanasknel wlebSi CvenSi aRiniSneba mxolod Semo-tanili qoleris erTeuli SemTxveva. sayuradReboa 1994wlis qoleris epidemiis sakmaod didi afeTqeba Cven mezo-bel daRestanSi sadac avad gaxda 1600 –ze meti adamiani.

el-toris vibrioni garemoSi gamZlea: Ria wyalsacaveb-Si ramdenime Tve Zlebs, sakanalizacio wylebSi – 30 saaTs;kargad mravldeba axal rZeSi, xorcis produqtebSi; uZlebsdabal temperaturas, swrafad ixoceba gamoSrobisas, mzissxivebis pirdapiri moqmedebiT da mJave areSi; aduReba myi-sierad xocavs; swrafad ixoceba qloris Semcvel sadezin-

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feqcio saSualebebis zemoqmedebiTac. el-toris vibrionsunari aqvs ara marto SeinarCunos sicocxlisunarianobaTevzebsa da kiborCxalebis organizmSi, aramed gamravldeskidec.

daavadebis gamomwvevi mikrobis rezervuari da infeqci-is wyaro avadmyofi an vibriomatarebeli adamiania. vibri-omatarebeli SeiZleba iyos rekonvalescenti (daavadebam-oxdili), romelic vibrions gamoyofs saSualod 2-4 kvirisganmavlobaSi, tranzitoruli (janmrTeli) matarebeli 9-14 dRis ganmavlobaSi da qronikuli matarebeli, romelicvibrionebs gamoyofs ramdenime Tvis ganmavlobaSi.

qoleris inkubaciuri periodi meryeobs ramdenime saaTi-dan 6 dRemde, ufro xSirad 1-2 dRe.

miuxedavad qoleris mimarT adamianTa maRali mgrZnobe-lobisa, erT klinikurad gamoxatul daavadebulze modis10-dan 1000-mde janmrTeli vibromatarebeli. ufro xSiradavad xdebian kuWis wvenis mJavadaqveiTebuli adamianebi (ana-ciduri gastriti, anemiis zogierTi forma, Wiebis invazia).

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ilia WavWavaZe _ sanitariuli meurve

saarqivo wyaroebi mow-mobs, rom XIX saukuneSi,qoleris pandemiebis dros,es daavadeba saqarTvelo-Sic iCenda Tavs da gark-veul daRs asvamda Cvenixalxis yofa-cxovrebas.statiaSi gvinda SevCer-deT im dokumentze, ro-melsac respublikis sax-elmwifo centralur sai-storio arqivSi mivakvli-eT (fondi_504, anaw._1,saqme -634, gv. 33_40). esaris pataki Tbilisis gu-bernatorisadmi, romelicSeadgina Cvenma didma Tan-amemamulem ilia WavWava-Zem da daTariRebulia1892 wlis ivlis_agvis-

toTi (im dros ilia daniSnuli iyo Tbilisisa da duSeTismazrebis sanitariul meurved).

dokuments adevs Tbilisis gubernatoris giorgi Serva-SiZis rezolucia, romelic mogvyavs sityvasityviT:

_ «Ñåðäå÷íî îáðàäîâàí ñòîëü óìåëûì âûïîëíåíèåì ÊíèÿçåìÈëüåþ Ãðèãîðüèåâè÷åì âîçëîæåííûõ ìíîþ íà íåãî îáÿçàííîñòåé ïîáîðüáå ñ åïèäåìèåé è çà íàñòîÿùèé îò÷¸ò, äîñòîéíûé âñåì èçâåñåòûõäàðîâàíèèÿ è äîáðîñîâåñòíîñòè ïî÷¸òíîãî àâòîðà. Ïîëàãàþ âåñüìàïîëåçíûì íàïå÷àòàíèå â ãàçåòå «Êàâêàç» èçâëå÷åíèÿ èç íåãî»

albaT, cenzuram dokumenti TiTqmis mTlianad gadaxaza(safiqrebelia Cinovnikma mizanSeuwonlad CaTvala teqstisgamoqveyneba). didi Zalisxmevis Sedegad SevZeli teqstisamokiTxva, riTac saSualeba momeca, gavcnobodi ilia Wav-WavaZis moRvaweobas saqarTveloSi qoleris epidemiis dros.

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es dRemde ucnobi, sakmaod saintereso faqtia ilias biogra-fiaSi.

ilias pataki gazeT `kavkazSi~ ar dabeWdila. igi arc miskrebulSia gamoqveynebuli. masalebis gamoqveynebis mcde-loba mqonda 70-ian wlebSi gazeT ̀ literaturul saqarTve-loSi~, magram uSedegod. maSindelma redaqtorma zrdilo-biani uariT gamomistumra. iZulebuli gavxdi dokumentisfotoasli qarTuli literaturis s/k institutis teqs-tologiis ganyofilebaSi mimetana. institutis eqspertiz-is Sedegad, saSualeba momeca 1981 wels gazeT `komunist-Si~ nawilobriv gamomeqveynebina saarqivo dokumenti saTau-riT `Tavi Wirsa ar damridad~. 1987 wels mecnierebaTa aka-demiis centraluri samecniero biblioTekis mier gamoce-mul wignSi (avt. i. giorgaZe, n. gurgeniZe) `ilia WavWavaZe_ cxovrebisa da Semoqmedebis matiane~ citirebulia mxo-lod gubernatoris rezolucia.

mecxramete saukuneSi kacTa modgmas ramdenjerme daat-yda Tavs qoleris didi epidemia (pandemia), romelic gavr-celebis masStabebiT zogjer mTel dedamiwas moicavda xo-lme. amjerad, mexuTe pandemiaze minda SevaCero mkiTxvelisyuradReba. (1883 – 1896 ww). roca es daavadeba sam kontinen-tze mZvinvarebda (azia, afrika, evropa). saqarTveloSi qol-eriT daavadebis pirveli SemTxveva TbilisSi dafiqsirda1892 wlis 14 ivniss. avadmyofi im dRes baqodan Camosulijariskaci _ iakob txorui iyo. qolera swrafad gavrcelda(xuT TveSi avad gaxda 531 adamiani, gardaicvala 316), Tanda-Tan moedo mTlianad Tbilisis mazras, xolo ivnisis bolo-saTvis duSeTis mazraSic gadavida. am mazris sofel jiRau-rSi 24 komlidan erT dRSi avad gaxda 28 adamiani. aman miiq-cia ilia WavWavaZis yuradReba, da igi dauyovnebliv gamocx-adda SemTxvevis adgilze, raTa exelmZRvanela epidsawina-aRmdego RonisZiebebisaTvis.

am droisaTvis medicinisa da epidemiologiis ganviTare-bis done SedarebiT dabali iyo. gardamavali periodis Se-saxeb (1801-1860 ww.) prof. mixeil Sengelia wignSi ̀ qarTulimedicinis istoria~ aRniSnavs – `qoleris epidemiologiis

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sakiTxebSi bevri ram gaugebari iyo, rogorc Cans, ar icod-nen qolera haeriT vrceldeboda Tu SexebiT, ris gamocuamrav Secdomebs uSvebdnen epidsawinaaRmdego RonisZie-bebis gatarebisa da mkurnalobisas~.

ilia WavWavaZis xelmZRvanelobiT sof. jiRauri sanitar-iulad moawesriges. yvela saxlsa da nagebobebSi sagul-dagulod Catarda dezinfeqcia, yvela avadmyofma drou-lad miiRo samedicino daxmareba. aq ilia gansakuTrebiTgamoarCevs eqimis Tavdadebas:

«.... Ñïðàâåäëèâîñòü âûíóæäàåò ìåíÿ çàÿâèòü, ÷òî ã. Ãåäåâàíîâûì ñäå-ëàíî áûëî âñ¸, ÷òî âîçìîæíî òðåáîâàòü îò ÷åëîâåêà, ñâÿòî ñîçíàþùåãîñâîé äîëã è ñàìîîòâåðæåííî ïðåäàííîãî èñïîëíåíèþ ñâîåé îáÿçàííîñòè.Áûâàëè ñëó÷àé, î÷åâèäöåì êîòîðûõ áûë ÿ, ÷òî áåç âñÿêîãî ñòðàõà èîïàñåíèÿ áûòü çàðàæ¸ííûì, îí ñàì ëè÷íî íàòèðàë òðóäíî áîëüíîãî»

naxsenebi gedevanoviiyo cnobili eqimi daviTaleqsandres Ze gedevani-Svili.