دانلود ترجمه مقاله شناسایی اختلالات شفت مو با شیوه الگوریتمی عملی – نشریه NCBI

• فهرست مطالب:

 چکیده
مقدمه
شيوۀ برخورد با بیمار
بهترین راه بررسی و آزمایش مو چست؟
اختلالات شفت موی اکتسابی همراه با افزایش شکنندگی و شکستگی
اختلالات شفت موی اکتسابی بدون افزایش شکنندگی
اختلالات شفت موی مادرزادی توام با افزایش تردی و شکستگی
TN مادرزادی در بیماران مبتلا به arginosuccinic aciduria:
نتيجه گيري
پرسش ها

• بخشی از ترجمه:

بيماران مبتلا به اختلالات شفت مو بايد با شيوۀ منظم آزمايش و بررسي شوند(شكل ۴؛جدول ۲).چنانچه بمار با نابهنجاري و تغيير بافت، كيفيت يا شكنندگي مو مواجه باشد،م توان ادعا كرد كه به اختلال شفت مو دچار شده است.بعد ازگرفته سابقۀ بماري، انجام آزمايش و آزمايش مانت مو، بايد مو را به به صورت”بدون شكنندگي افزايش يافته”يا “همراه با شكنندگي افزايش يافته” دسته بندي كرد.با تكنيك هاي آزمايشي كامل و يك شيوۀ سيستمي مي توان اختلالات شفت مو را ارزيابي و تشخيص داد.

• بخشی از مقاله انگلیسی:

Introduction The production of the hair shaft in humans occurs through a complex orchestration of biological signals in the pilosebaceous unit. These signals result in cyclic periods of growth and rest in the hair follicle. Many different cell types are incorporated during the hair cycle to form the inner root sheath, hair cuticle, cortex and, in large fibers, the medulla. This cell differentiation results from the expression of major hair keratin genes. During the growth phase of the follicle, or anagen, the actively dividing cells of the matrix start the process of hair shaft formation. The main structural component of the hair shaft, the hair cortex, is composed of interdigitating keratinocytes oriented in a parallel fashion, and held together by the intercellular matrix protein. The hair shaft is protected by the cuticle layer with its overlapping cells that resemble shingles on a roof. If there is damage to the cuticle, the exposed hair cortex still holds together but is more susceptible to environmental damage and fracture. The hair shaft is a unique structure in terms of its strength, resilience, flexibility, and resistance to the environment. Any defects in this normal structure due to genetics or the environment can lead to variations in physical properties, such as optics, shape, and strength. An alteration in these properties is clinically noticed as a change in strength (fragility, or inability to grow hair long), texture, appearance, and manageability. Thus, when a patient presents in the clinic with a chief complaint of ‘‘hair loss’’, the possible causes may be vast, but a thoughtful and stepwise approach will quickly uncover clues that will lead the clinician to suspect a hair shaft disorder. Approach to patients • When should one suspect that a patient has a hair shaft disorder? Patients with hair shaft disorders will often present with one of the following complaints: ‘‘My hair (or my child’s hair) does not grow long’’ or ‘‘My child has never had a haircut.’’ ‘‘My hair (or my child’s hair) has an unusual appearance and/or texture.’’ ‘‘My hair (or my child’s hair) suddenly started breaking.’’ • What are pertinent questions to ask the patient? Directed questions will help the clinician narrow the differential diagnosis. When did the problem first start (has the problem been present since birth or was it acquired later in life)? Are there any problems with the nails or teeth? How does the patient style or process the hair? Ask about brushing technique, frequency of shampooing, use of heat and chemicals. Do other family members have similar findings? • What is the best way to examine the hair? Evaluate for ‘‘general appearance’’, length, luster, curl, and color. Note the ‘‘distribution’’ of the hair abnormality – diffuse or focal. Determine if there is hair breakage: for the close-up examination of individual hair shafts, a contrasting paper (white for dark hair, black for light hair) can be used to improve visibility. By placing the card near the scalp and behind the hair being examined, one can determine if there are blunt or broken hair distal tips that would suggest breakage. These broken hairs can be differentiated from newly growing hairs that have tapered or pointed distal tips (Fig. 1). If fragility or breakage is suspected, it can be confirmed by performing a tug test (Fig. 2). This test consists of holding the hair several centimeters from the hair tip then tugging at the ends. If the hair is fragile, short 2–۴mm hair fragments will easily break off. When these small fragments of hair are mounted on a glass slide with a mounting medium and cover slip (Fig. 3), characteristic changes of hair shaft disorders may be seen. The scalp and the rest of the skin should also be examined for any changes. If a clinician determines that a hair shaft disorder is likely, further classification and diagnosis can often be done in the office with a hair mount. An algorithmic Figure approach to making the diagnosis of a hair shaft disorder is presented (Fig. 4). This algorithm should be used as a guide and not an absolute, as variations and overlaps in hair shaft disorders are seen. Disorders of the hair shaft are typically segregated by those that are congenital or acquired; further classification is based on the presence or absence of hair shaft fragility that can lead to breakage (Table 1). A review of the most common hair shaft disorders is presented below. Although our emphasis is on the clinical presentation and diagnosis of the hair shaft disorder, we have included a summary of the molecular defects where known. Not only is an understanding of these molecular defects critical in understanding and correlating clinical findings, it is helpful in counseling patients and potentially offering treatment options.

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