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1.
Clin Neurol Neurosurg ; 190: 105651, 2020 03.
Article in English | MEDLINE | ID: mdl-31896489

ABSTRACT

Wilson's disease is an inherited autosomal-recessive disorder of biliary copper excretion. It is characterized by hepatic, neurological and ophthalmic manifestations related to the accumulation of copper in the liver, the lenticular nuclei of brain and cornea. The authors present the case of a 29-year-old female with primarily depression manifestation of Wilson's disease. The patient also reported agitation, difficulties with concentration, slowdown of speech, and stuttering. In magnetic resonance imaging, in putamen, the globus pallidus, claustrum, the heads of caudate nucleus and thalamus areas demonstrated the increased signal in T2. A high copper content was obtained in daily urine collection and reduced level in serum. Similarly, ceruloplasmin level was decreased. Despite the antidepressant treatment with venlafaxine, no improvement was observed. Within a week of psychomotor slowdown, symptoms such as Parkinson's syndrome appeared. Due to the rapid progression of the disease symptoms, the patient was referred for further treatment at a specialistic center. After six month, despite the treatment, the progress of disease was so advanced that patient was transferred to the hospice. Two weeks later patient died. Wilson's disease might be consider in differential diagnosis of depression in young patients, especially if they present additional extrapyramidal symptoms and unspecific changes in magnetic resonance imaging.


Subject(s)
Brain/diagnostic imaging , Depressive Disorder/psychology , Hepatolenticular Degeneration/diagnosis , Hepatolenticular Degeneration/psychology , Liver/diagnostic imaging , Adult , Atrophy , Brain/pathology , Corpus Striatum/diagnostic imaging , Depressive Disorder/etiology , Diffusion Magnetic Resonance Imaging , Fatal Outcome , Female , Hepatolenticular Degeneration/complications , Hepatolenticular Degeneration/physiopathology , Humans , Magnetic Resonance Imaging
2.
Transplant Proc ; 50(7): 1939-1945, 2018 Sep.
Article in English | MEDLINE | ID: mdl-30177084

ABSTRACT

BACKGROUND: Although transplantation has gained more support and acceptance, there are still many ethical, moral, and legal barriers associated with this form of treatment. The demand for organs is higher than what can be accommodated. Current medical students are forming their views about transplantation. METHODS: The aim of this study was to investigate the perspectives of 569 students from the Faculty of Medicine, Medical University of Bialystok, Poland, with regard to their beliefs about organ donation. RESULTS: Respondents included in this study were 21.77 ± 2.03 years of age (73.6% female, 80.1% living in an urban setting). Organ procurement and transplantation from living donors was found to be acceptable by 97.54% of respondents, and 98.77% found deceased donor procurement to be acceptable. More than 90% of respondents agreed with organ donation from family members after death, and agreed to donation after their own death. However, only 54.77% indicated an agreement to donate in their lifetime for nonrelatives. It was found that 70.74% believe the final decision on cadaveric organ donation should be made by the family. A positive attitude toward organ transplantation was expressed by 96.47% of respondents, but 2% submitted an objection to placement on a central registry. Refusals for organ donation included emotions associated with death (88%), religious beliefs (42%), and lack of knowledge of medical terminology (24.78%). According to respondents, the concept of transplantation should be managed by patients and donors (65.38%), universities (49.56%), or the media (44.64%). CONCLUSION: Medical students generally agree on procurement of organs from deceased and living donors. However, their enthusiasm for organ donation after death diminished with regard to their family members. An educational campaign promoting organ transplantation should be considered.


Subject(s)
Health Knowledge, Attitudes, Practice , Organ Transplantation/psychology , Students, Medical/psychology , Tissue and Organ Procurement , Adult , Attitude , Decision Making , Female , Humans , Male , Morals , Poland , Religion , Surveys and Questionnaires , Young Adult
3.
Transplant Proc ; 50(7): 1946-1952, 2018 Sep.
Article in English | MEDLINE | ID: mdl-30177085

ABSTRACT

In 2016 the total number of solid organ transplantations in Poland was 1469; the number of patients on waiting lists was approximately 1600 every month, and demand for organs is increasing every year. Transplantation has achieved increasing support and acceptance among Polish people; however, there are still many ethical, moral, and legal barriers related to this form of treatment of end-stage organ failure. MATERIAL AND METHODS: The research method is a diagnostic survey of 347 law students from the Faculty of Law, University of Bialystok, Poland. The research tool was the authors' questionnaire. RESULTS: Responders were 21.172 ± 1.34 years old (67.4% female, 74.4% urban residence). Organ procurement and transplantation from living donors are accepted by 95.6% of respondents; 97.4% are accepted from deceased donors. More than 80.4% of the respondents would agree to organ donation from their family members after death and to be donors after their death. The majority of students (80.1%) believe that the final decision of deceased organ donation should be made by the family. Despite positive attitude towards transplantation (97%), about 2% have submitted their objection to the central registry. Refusal of organ donation was associated mainly with emotions related to death (89%) and religion (47.6%). According to responders, the transplantation should be managed by patients and donors (42.1%) and universities (31.7%). CONCLUSIONS: Law students generally accept procurement of organs from deceased and living donors, but in situations related to family members, their acceptance rates drop significantly. According to future lawyers, patients, donors, and universities should educate society about issues related to organ transplantation.


Subject(s)
Health Knowledge, Attitudes, Practice , Lawyers/psychology , Organ Transplantation/psychology , Students/psychology , Female , Humans , Male , Morals , Poland , Religion , Surveys and Questionnaires , Tissue Donors/psychology , Tissue and Organ Procurement , Young Adult
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