He aha ka Hereditary Hemorrhagic Telangiectasia (HHT)? Nā hōʻailona, nā kumu, a me ka mālama

ʻO ka Hereditary Hemorrhagic Telangiectasia, a i ʻole HHT, he kūlana genetic ia e pili ana i kou mau kīʻaha koko ma kou kino holoʻokoʻa. Loaʻa i nā kānaka me HHT nā kīʻaha koko i hana ʻole ʻia i ka wā e ulu ana, e hana ana i nā pilina pololei ma waena o nā arteries a me nā veins me ka ʻole o nā capillaries liʻiliʻi ma waena.

Ua kapa ʻia kēia kūlana ma mua ʻo Osler-Weber-Rendu syndrome, i kapa ʻia ma hope o nā kauka i wehewehe mua ia. ʻOiai ua manaʻo ʻia he mea maʻamau ʻole ka HHT, e pili ana i ka 1 i 5,000 mau kānaka ma ka honua holoʻokoʻa, hiki iā ʻoe ke kahaha ke ʻike ʻoe he nui nā kānaka e noho ana me ia me ka ʻike ʻole ʻana iā lākou.

He aha maoli ka HHT?

Hana ka HHT i nā pilina kīʻaha koko kūpono ʻole i kapa ʻia ʻo arteriovenous malformations, a i ʻole AVMs no ka pōkole. E noʻonoʻo i kou mau kīʻaha koko maʻamau e like me kahi ʻōnaehana ala nui i hoʻonohonoho maikaʻi ʻia kahi e kahe ai ke koko mai nā arteries nui, ma o nā alanui liʻiliʻi i kapa ʻia ʻo capillaries, a laila i nā veins e lawe i ke koko i kou naʻau.

Me ka HHT, kekahi o kēia mau pilina e lele i nā “alanui” capillary āpau, e hana ana i nā ala pōkole pololei ma waena o nā arteries a me nā veins. Hiki i kēia mau ala pōkole ke liʻiliʻi ma kou ʻili a me nā membrane mucous, a i ʻole hiki iā lākou ke lilo i nā hana nui i loko o nā ʻōnaehana e like me kou māmā, ate, a i ʻole lolo.

ʻO nā pilina kūpono ʻole liʻiliʻi e ʻike ʻia e like me nā kiko ʻulaʻula a ʻōmaʻomaʻo paha i kapa ʻia ʻo telangiectasias. E ʻike maʻamau ʻoe i kēia ma kou lehelehe, alelo, manamanalima, a me loko o kou ihu. ʻO nā pilina nui, i kapa ʻia ʻo AVMs, e ulu pinepine ana i nā ʻōnaehana kūloko a hiki ke ʻokoʻa nui i ka nui a me ka hopena.

He aha nā hōʻailona o HHT?

ʻO ka hōʻailona maʻamau a pinepine hoʻi ka mea mua āu e ʻike ai ʻo ka ihu kahe pinepine, i kapa ʻia ʻo epistaxis. ʻAʻole kēia nā ihu kahe maʻamau i kēlā me kēia manawa akā ʻo nā mea hoʻi hou e hiki ke hana i nā manawa he nui i ka hebedoma a i ʻole i kēlā me kēia lā.

Eia nā hōʻailona nui a nā kānaka me HHT e ʻike pinepine ai:

• Nā ihu kahe pinepine e hiki ke kaumaha a paʻakikī ke hoʻōki
• Nā kiko ʻulaʻula a ʻōmaʻomaʻo paha ma kou lehelehe, alelo, manamanalima, a i ʻole maka
• Pōkole o ka hanu i ka wā o ka hana kino
• Luhi e like ʻole me kou pae hana
• Anemia nele hao mai ka nalowale koko mau

Hiki i kekahi poʻe ke ʻike pū i nā hōʻailona e pili ana i nā AVMs i nā ʻōnaehana kikoʻī. Inā loaʻa iā ʻoe nā lung AVMs, hiki iā ʻoe ke manaʻo i ka pōkole o ka hanu a i ʻole ke ʻeha umauma. ʻO nā lolo AVMs, ʻoiai he mea maʻamau ʻole, hiki ke hana i nā poʻo ʻeha, nā hoʻoulu ʻana, a i ʻole nā ​​​​wahi liʻiliʻi.

He mea nui e hoʻomaopopo he hiki i nā hōʻailona HHT ke ʻokoʻa nui ma waena o nā lālā o ka ʻohana, ʻoiai ʻo nā mea me ka ʻano genetic like. Loaʻa i kekahi poʻe nā hōʻailona māmā e pili iki i ko lākou ola i kēlā me kēia lā, ʻoiai ʻo nā mea ʻē aʻe e pono ai ka mālama lapaʻau nui aʻe.

He aha nā ʻano o HHT?

Loaʻa ka HHT i kekahi mau ʻano genetic, me nā mea maʻamau ʻelua ʻo HHT1 a me HHT2. Hoʻokumu ʻia kēlā me kēia ʻano e nā mutations i nā gene like ʻole, akā hana lākou i nā hōʻailona holoʻokoʻa like me kekahi mau ʻokoʻa.

ʻO HHT1, i hana ʻia e nā mutations i ka gene ENG, e hoʻokumu pinepine ana i nā lung a me nā lolo AVMs. ʻIke pinepine nā kānaka me kēia ʻano i nā hōʻailona hanu koʻikoʻi aʻe a loaʻa iā lākou ka nui o ka ulu ʻana o nā pulmonary AVMs e pono ai ka nānā a me ka mālama.

ʻO HHT2, e pili ana i nā mutations i ka gene ACVRL1, e pili pinepine ana i ka ate a e hoʻokumu pinepine ana i nā ate AVMs. Eia naʻe, hiki i nā kānaka me HHT2 ke ulu mau i nā lung AVMs, ʻaʻole pinepine e like me nā mea me HHT1.

Aia nō hoʻi nā ʻano maʻamau ʻole, me HHT3 a me HHT4, a me kekahi mau hihia kahi i ʻike ʻole ʻia ai ke kumu genetic kikoʻī. Hoʻokumu kēia i kahi hapa liʻiliʻi o nā hihia HHT akā hiki iā lākou ke loaʻa ko lākou mau ʻano kūikawā.

He aha ka mea e hoʻokumu ai i HHT?

Hoʻokumu ʻia ka HHT e nā mutations i nā genes e kōkua i ka kaohi ʻana i ka ulu ʻana o nā kīʻaha koko a mālama iā lākou iho. Hana maʻamau kēia mau genes e like me nā puke kuhikuhi no ka kūkulu ʻana i nā pilina kīʻaha koko olakino, akā i ka wā e hoʻololi ʻia ai, e hui pū ʻia nā kuhikuhi.

Ke hahai nei ke kūlana i ka mea a nā kauka i kapa ai he autosomal dominant inheritance pattern. ʻO ia hoʻi, pono ʻoe e hoʻoilina i hoʻokahi kope o ka gene i hoʻololi ʻia mai hoʻokahi makua e hoʻomohala i ka HHT. Inā loaʻa i hoʻokahi o kou mau mākua ka HHT, loaʻa iā ʻoe ka 50% manawa e hoʻoilina ai.

I kekahi manawa, hiki i ka HHT ke hana ma ke ʻano he mutation hou, ʻo ia hoʻi ʻaʻohe makua i loaʻa ke kūlana akā ua hana ʻia kahi hoʻololi genetic i ka wā e ulu ana. ʻOi aku ka maʻamau ʻole o kēia mau hihia kūlohelohe akā e hana ia, e helu ana i ka 20% o nā hihia HHT.

ʻO nā genes i hoʻohana pinepine ʻia e komo pū me ENG, ACVRL1, a me SMAD4. Kūkulu maʻamau kēia mau genes i nā cell e kamaʻilio pono i ka wā o ka hana ʻana o nā kīʻaha koko, e hōʻoia ana i ka hoʻohui pono ʻana o nā arteries, capillaries, a me nā veins.

I ka wā hea ʻoe e ʻike ai i ke kauka no HHT?

Pono ʻoe e noʻonoʻo e ʻike i ke kauka inā ʻoe e ʻike ana i nā ihu kahe pinepine, ʻoi aku inā e lilo ana i mea koʻikoʻi aʻe a i ʻole e hana ana i nā manawa he nui i ka hebedoma. ʻOiai he mea maʻamau nā ihu kahe i kēlā me kēia manawa, pono ka nānā ʻana o ke kauka i nā mea mau e hoʻopilikia i kou ola i kēlā me kēia lā.

E ʻimi i ka mālama lapaʻau inā ʻike ʻoe i nā kiko ʻulaʻula a ʻōmaʻomaʻo paha e ulu ana ma kou lehelehe, alelo, a i ʻole manamanalima, ʻoi aku inā loaʻa iā ʻoe kahi mōʻaukala ʻohana o nā hōʻailona like. ʻO kēia mau telangiectasias, me nā ihu kahe hou, he mau hōʻailona mua maʻamau o HHT.

Pono ʻoe e ʻimi i ka nānā lapaʻau koke inā ʻike ʻoe i ka pōkole o ka hanu, ke ʻeha umauma, nā poʻo ʻeha koʻikoʻi, a i ʻole nā ​​​​hōʻailona neurological e like me nā loli ʻike a i ʻole nāwaliwali. Hiki i kēia ke hōʻike i nā pilikia mai nā AVMs i kou māmā a i ʻole lolo e pono ai ka loiloi wikiwiki.

Inā loaʻa iā ʻoe kahi mōʻaukala ʻohana o HHT, he mea kūpono ke kūkākūkā i ka ʻōlelo aʻo genetic a me ka nānā ʻana me kāu mea hoʻolako mālama ola, ʻoiai inā ʻaʻohe ou hōʻailona maopopo. Hiki i ka ʻike mua ke kōkua i ka pale ʻana i nā pilikia ma o ka nānā pono a me ka mālama pale.

He aha nā mea pilikia no HHT?

ʻOiai he nui nā kānaka me HHT e ola ana i nā ola maʻamau, hiki i ke kūlana ke alakaʻi i kekahi mau pilikia e pono ai ka nānā lapaʻau mau. Hiki i ka hoʻomaopopo ʻana i kēia mau mea hiki ke kōkua iā ʻoe e hana pū me kāu hui mālama ola e pale a mālama paha iā lākou me ka maikaʻi.

ʻO nā pilikia maʻamau loa e komo pū me:

• Anemia nele hao mai ka nalowale koko mau ma o nā ihu kahe
• Pulmonary AVMs e hiki ke hana i ka pōkole o ka hanu a i ʻole, maʻamau ʻole, ka hahau
• Liver AVMs e hiki ke hoʻopilikia i ka hana ate ma hope o kekahi manawa
• Brain AVMs e hiki ke hana i nā poʻo ʻeha, nā hoʻoulu ʻana, a i ʻole nā ​​​​hōʻailona neurological
• High-output heart failure mai nā liver AVMs i nā hihia koʻikoʻi

Pono nā Pulmonary AVMs i ka nānā kūikawā no ka mea hiki iā lākou ke ʻae i nā clots koko a i ʻole nā ​​​​bacteria e hala i ka ʻōnaehana kānana maʻamau o nā māmā. Hana kēia i kahi pilikia liʻiliʻi o ka hahau a i ʻole ka lolo abscess, ʻo ia ke kumu e loaʻa pinepine ai i nā kānaka me nā lung AVMs nā antibiotics pale ma mua o nā kaʻina hana niho.

I nā hihia maʻamau ʻole, hiki i nā liver AVMs nui ke hana i ka hana ʻana o ka naʻau ikaika, e alakaʻi ana i ka naʻau nele ma hope o nā makahiki he nui. ʻO nā Brain AVMs, ʻoiai he mea maʻamau ʻole, hiki ke haki i kekahi manawa a hana i ke kahe koko i loko o ka lolo, ʻoiai he mea maʻamau ʻole kēia.

Pehea e hiki ai ke pale ʻia ka HHT?

ʻOiai he kūlana genetic ka HHT, ʻaʻole hiki iā ʻoe ke pale aku iā ia mai ka hana ʻana inā hoʻoilina ʻoe i nā genes i hoʻololi ʻia. Eia naʻe, hiki iā ʻoe ke lawe i nā hana e pale ai i nā pilikia a mālama pono i nā hōʻailona ke ʻike ʻoe i loaʻa iā ʻoe ke kūlana.

Inā ʻoe e hoʻolālā ana e loaʻa nā keiki a loaʻa iā ʻoe ka HHT a i ʻole kahi mōʻaukala ʻohana o ia mea, hiki i ka ʻōlelo aʻo genetic ke kōkua iā ʻoe e hoʻomaopopo i nā pilikia a me nā koho. Loaʻa ka hoʻokolokolo genetic prenatal inā makemake ʻoe e ʻike inā e hoʻoilina kāu pēpē i ke kūlana.

No ka mālama ʻana i ka HHT i loaʻa, pili ka pale ʻana i ka pale ʻana i nā hana e hiki ke hoʻoulu i nā ihu kahe koʻikoʻi a mālama i ka olakino holoʻokoʻa maikaʻi. E komo pū kēia i ka hoʻohana ʻana i ka humidifier, ka pale ʻana i ka ʻiʻo ihu, a me ka mālie i ka wā e puhi ai i kou ihu.

He mea nui ka nānā lapaʻau maʻamau no ka pale ʻana i nā pilikia koʻikoʻi. E komo pinepine kēia i nā haʻawina kiʻi manawa e nānā ai no nā AVMs hou a me ka nānā ʻana i nā pae hao e pale ai i ka anemia koʻikoʻi.

Pehea ka hōʻoia ʻana o HHT?

Hoʻomaopopo nā kauka i ka HHT me ka hoʻohana ʻana i ka hui ʻana o nā kūlana lapaʻau a me ka hoʻokolokolo genetic. Hoʻomaka pinepine ka hōʻoia ʻana me ka ʻike ʻana i kahi ʻano o nā hōʻailona, ʻoi aku ka hui ʻana o nā ihu kahe hou a me nā telangiectasias hiʻohiʻona.

Hoʻohana ʻia nā Curacao Criteria e hōʻoia i ka HHT ma muli o ʻehā mau hiʻohiʻona nui: nā ihu kahe hou kūlohelohe, nā telangiectasias i nā wahi hiʻohiʻona, nā visceral AVMs, a me kahi mōʻaukala ʻohana o HHT. ʻO ka loaʻa ʻana o ʻekolu a ʻoi aku paha nā kūlana e hoʻomaopopo i ka hōʻoia.

Hiki i ka hoʻokolokolo genetic ke hōʻoia i ka hōʻoia a ʻike i ke ʻano kikoʻī o HHT āu i loaʻa ai. Kūkulu kēia ʻike i nā kauka e hoʻomaopopo i nā pilikia āu e ʻike pinepine ai a hoʻolālā i nā papa hana nānā kūpono.

Hiki i kāu kauka ke kauoha pū i nā haʻawina kiʻi e like me nā CT scans a i ʻole MRI e nānā ai no nā AVMs i kou māmā, ate, a i ʻole lolo. Hoʻohana pinepine ʻia kahi echocardiogram me ka haʻawina pūpū e nānā ai no nā lung AVMs, ʻoiai he mea palekana a maikaʻi ia no ka ho'āʻo mua.

He aha ka mālama no HHT?

Hoʻokumu ka mālama ʻana no HHT i ka mālama ʻana i nā hōʻailona a me ka pale ʻana i nā pilikia ma mua o ka ho'ōla ʻana i ke kūlana kumu. E hoʻopilikino ʻia kāu papahana mālama i kāu mau hōʻailona kikoʻī a me nā wahi o nā AVMs āu e loaʻa ai.

No nā ihu kahe, ʻokoʻa nā mālama mai nā hana hoʻomehana maʻalahi a hiki i nā kaʻina hana holomua. Loaʻa nā koho e komo pū me nā rinses saline ihu, humidification, nā mālama topical, laser therapy, a i ʻole nā ​​​​kaʻina hana pani ihu i nā hihia koʻikoʻi.

Eia nā ala mālama nui:

• Hoʻopili ʻana i ka hao a me nā transfusion koko no ka anemia
• Nā kaʻina hana embolization e kāohi i nā AVMs pilikia
• Hoʻoneʻe ʻana i nā AVMs hiki ke loaʻa ke kūpono
• Nā lāʻau lapaʻau e ho'ēmi i nā manaʻo kahe koko
• Nā antibiotics pale ma mua o nā kaʻina hana niho a i ʻole nā ​​​​kaʻina hana ʻoki

Mālama pinepine ʻia nā lung AVMs nui me ka embolization, kahi kaʻina hana kahi i waiho ʻia ai nā coils a i ʻole nā ​​​​plugs liʻiliʻi e kāohi i ka pilina kūpono ʻole. Hana pinepine ʻia kēia ma ke ʻano he kaʻina hana outpatient a hiki ke ho'ēmi nui i ka pilikia o ka hahau a i ʻole nā ​​​​pilikia ʻē aʻe.

Nānā pinepine ʻia nā liver AVMs ma mua o ka mālama ʻana ke hana ʻole nei lākou i nā pilikia naʻau. Pono nā Brain AVMs i ka loiloi akahele e nā loea neurosurgical e hoʻoholo inā pono a palekana paha ka mālama.

Pehea ʻoe e mālama ai i ka HHT ma ka home?

ʻO ka ola maikaʻi me HHT e komo pū ana i ka hoʻomohala ʻana i nā maʻamau i kēlā me kēia lā e ho'ēmi ai i nā hōʻailona a ho'ēmi i kou pilikia o nā pilikia. ʻIke ka hapa nui o nā kānaka he hiki i nā hoʻololi ola maʻalahi ke hana i kahi ʻokoʻa nui i ko lākou ola.

No ka mālama ʻana i ka ihu kahe, e mālama i kou mau ala ihu i ka pulu me nā sprays saline a i ʻole ka humidifier, ʻoi aku hoʻi i ka wā maloʻo. E kau i kahi papa lahilahi o ka petroleum jelly a i ʻole ka gel ihu i loko o kou mau puka ihu ma mua o ka moe ʻana e pale ai i ka maloʻo a me ka haki.

Ke hana ka ihu kahe, e kūlou iki i mua a pīpī i ka ʻāpana palupalu o kou ihu no 10-15 mau minuke. E pale i ka hoʻohuli ʻana i kou poʻo i hope, no ka mea hiki i kēia ke hana i ke kahe koko i lalo i kou ʻāʻī a hiki ke hana i ka nausea.

E nānā i kou mau pae ikehu a e nānā i nā hōʻailona o ka anemia e like me ka luhi maʻamau ʻole, ka pōkole o ka hanu, a i ʻole ka ʻili ʻōmaʻomaʻo. E mālama i ka pinepine a me ka koʻikoʻi o kou ihu kahe e kūkākūkā me kāu hui mālama ola i ka wā e kipa ai.

E noho hou me ka mālama pale, me nā hoʻomaʻemaʻe niho a me nā haʻawina kiʻi i manaʻo ʻia. Inā loaʻa iā ʻoe nā lung AVMs, e hoʻomanaʻo e lawe i nā antibiotics i kuhikuhi ʻia ma mua o nā kaʻina hana niho e pale aku i nā maʻi hiki.

Pehea ʻoe e hoʻomākaukau ai no kāu kauka hālāwai?

Hiki i ka hoʻomākaukau ʻana no kāu mau hālāwai lapaʻau e pili ana i HHT ke kōkua i ka hōʻoia ʻana e loaʻa iā ʻoe ka mālama holoʻokoʻa loa. E hoʻomaka me ka mālama ʻana i kahi puke hōʻailona e mālama i kou mau ihu kahe, me ko lākou pinepine, lōʻihi, a me ka koʻikoʻi.

E hōʻiliʻili i kāu mōʻaukala lapaʻau ʻohana, ʻoi aku ka hoʻomaopopo ʻana i nā hoahānau i loaʻa nā ihu kahe pinepine, anemia wehewehe ʻole, nā pilikia māmā, a i ʻole nā ​​​​hahau i ka wā ʻōpio. Hiki i kēia ʻike ke lilo i mea nui no ka hōʻoia ʻana a me ka ʻōlelo aʻo genetic.

E lawe mai i kahi papa inoa o kāu mau lāʻau lapaʻau āpau, me nā mea hoʻohui over-the-counter a me nā huaora. Hiki i kekahi mau lāʻau lapaʻau ke hoʻopilikia i nā manaʻo kahe koko, no laila pono i kāu kauka kahi kiʻi piha o kāu mea e lawe nei.

E kākau i nā nīnau āpau āu e loaʻa ai e pili ana i kou kūlana, nā koho mālama, a i ʻole nā ​​​​hoʻololi ola. Mai kānalua e nīnau e pili ana i ka ʻōlelo aʻo genetic inā ʻoe e hoʻolālā ana e loaʻa nā keiki a i ʻole inā hiki ke pili nā lālā ʻohana ʻē aʻe.

He aha ka mea nui e pili ana i HHT?

ʻO HHT kahi kūlana genetic hiki ke mālama ʻia e hoʻopilikia i ka hana ʻana o nā kīʻaha koko ma kou kino holoʻokoʻa. ʻOiai hiki iā ia ke hana i nā hōʻailona pilikia e like me nā ihu kahe pinepine a pono i ka nānā lapaʻau mau, ola ka hapa nui o nā kānaka me HHT i nā ola piha, hana me ka mālama pono.

ʻO ke kī i ka ola maikaʻi me HHT ʻo ia ka hōʻoia mua, ka nānā mau ʻana no nā pilikia, a me ka hana pili me kahi hui mālama ola e kamaʻāina i ke kūlana. Hiki ke mālama maikaʻi ʻia nā hōʻailona he nui me nā mālama kūpono a me nā hoʻololi ola.

Inā manaʻo ʻoe he HHT paha ʻoe ma muli o nā hōʻailona a i ʻole ka mōʻaukala ʻohana, mai kānalua e kūkākūkā me kāu mea hoʻolako mālama ola. Hiki i ka ʻike mua a me ka mālama pono ke pale i nā pilikia koʻikoʻi a hoʻomaikaʻi nui i kou ola.

E hoʻomanaʻo ʻaʻole e hoʻomaopopo ka loaʻa ʻana o HHT i nā palena o kou ola. Me ka mālama lapaʻau pono a me nā hoʻolālā mālama ponoʻī, hiki iā ʻoe ke alualu i kou mau pahuhopu a mālama i ka olakino holoʻokoʻa maikaʻi ʻoiai e mālama ana i kēia kūlana.

Nā nīnau i nīnau pinepine ʻia e pili ana i HHT

He mea weliweli i ke ola anei ka HHT?

No ka hapa nui o nā kānaka, ʻaʻole he mea weliweli koke i ke ola ka HHT, akā pono ia i ka mālama lapaʻau mau. ʻO nā pilikia nui e hele mai ana mai nā pilikia hiki ke like me nā lung AVMs nui a i ʻole nā ​​​​lolo AVMs, kahi e hoʻopilikia ai i kahi ʻāpana o nā kānaka me HHT. Me ka nānā pono a me ka mālama, loaʻa i ka hapa nui o nā kānaka me HHT nā manaʻolana ola maʻamau.

Hiki i nā hōʻailona HHT ke ʻoi aku ka maikaʻi ma hope o kekahi manawa?

ʻAe, pinepine nā hōʻailona HHT e holomua mālie ma hope o kekahi manawa. Hiki i nā ihu kahe ke lilo i mea pinepine a koʻikoʻi paha me ka makahiki, a hiki ke ulu nā AVMs hou i nā ʻōnaehana like ʻole. ʻO ia ke kumu he mea nui ka nānā mau ʻana, no ka mea hiki i ka ʻike mua ʻana o nā AVMs hou ke ʻae i ka mālama manawa inā pono.

Pono anei wau e pale i kekahi mau hana inā loaʻa iaʻu HHT?

Hiki i ka hapa nui o nā kānaka me HHT ke komo i nā hana maʻamau, akā hiki ke manaʻo ʻia kekahi mau palekana. Inā loaʻa iā ʻoe nā lung AVMs, hiki i kāu kauka ke ʻōlelo aʻo e pale aku i ka scuba diving ma muli o nā loli kaomi. Hiki ke hoʻomaopopo ʻia nā haʻuki pili inā loaʻa iā ʻoe nā lolo AVMs, akā hoʻopilikino ʻia kēia mau palena ma muli o kāu kūlana kikoʻī.

Hiki i ka hāpai ke hoʻopilikia i nā hōʻailona HHT?

Hiki i ka hāpai ke hoʻopilikia i nā hōʻailona HHT no kekahi manawa ma muli o ka nui o ke koko a me nā loli hormonal. Hiki i nā ihu kahe ke lilo i mea pinepine, a hiki ke ulu nui nā AVMs i loaʻa. Eia naʻe, me ka mālama prenatal pono a me ka nānā ʻana, loaʻa i ka hapa nui o nā wāhine me HHT nā hāpai holomua.

He mea pono anei ka hoʻokolokolo genetic no nā lālā ʻohana?

Hiki i ka hoʻokolokolo genetic ke kōkua i nā lālā ʻohana, ʻoi aku inā ʻike lākou i nā hōʻailona a i ʻole e hoʻolālā ana e loaʻa nā keiki. Eia naʻe, he mea pilikino ka hoʻoholo a pono e komo pū me ka ʻōlelo aʻo genetic e hoʻomaopopo i nā pono a me nā palena o ka hoʻokolokolo. Makemake kekahi poʻe e kau i ka nānā ʻana i nā hōʻailona ma mua o ka hoʻokolokolo genetic.