Saratov JOURNAL of Medical and Scientific Research

Volga District Medical Center of FMBA

Oculomotor abnormalities in Huntington's disease patients and premanifest gene carriers

Year: 2018, volume 14 Issue: №4 Pages: 922-928
Heading: Ophtalmology Article type: Original article
Authors: Svetozarskiy S.N., Kopishinskaya S.V., Smetankin I.G.
Organization: Privolzhskiy Research Medical University, Volga District Medical Center of FMBA
Summary:

Purpose: to establish oculomotor features in manifest Huntington's disease (HD) patients and premanifest gene carriers compared with controls. Material and Methods. The study involved 23 manifest HD patients, 21 premanifest gene carriers and 31 healthy volunteers. Binocular vision was evaluated using the four-point test. Direct and indirect pupil light reaction, convergence and accommodation response, head position, eye mobility and deviation were assessed. Slow eye movements, saccades and convergence were assessed. The criterion for clinical convergence insufficiency was defined as the near point of convergence of more than 5 cm. Patients from the target groups underwent DNA testing with an estimation of the CAG-repeats (cytosine-adenine-guanine) length in the huntingtin gene, an examination on the UHDRS motor scale (Unified Huntington's Disease Rating Scale) and had the duration of their disease determined. Results. The study showed that slow eye movements, initiation, speed and volume of saccades are disturbed in more than a half of manifest HD group. A high frequency (33%) of vertical slow eye movements disturbances was revealed in the premanifest HD group. Convergence insufficiency was found in manifest patients and HD carriers significantly more often than in the control group (p<0.001). Convergent eye movements were interrupted by uncontrolled saccades in 35% of manifest patients. A positive correlation was found between the distance to the near point of convergence and the UHDRS motor score, as well as with the number of CAG repeats. Conclusion. The study added new insights to the well-known picture of oculomotor disturbances in manifest HD patients, especially considering convergence characteristic. The leading symptoms of oculomotor abnormalities in premanifest HD carriers were identified. To designate the discussed complex of symptoms, a descriptive term "hyperkinetic oculomotor disorder" was proposed.

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Transplantation tourism as an international problem: prerequisites and ways of prevention

Year: 2018, volume 14 Issue: №4 Pages: 683-685
Heading: Sociology of Medicine Article type: Author's opinion
Authors: Romanov S.V., Abaeva O.P.
Organization: I.M. Sechenov First Moscow State Medical University, Volga District Medical Center of FMBA
Summary:

The purpose of scientific work was to substantiate the relevance ofthe problem of transplant tourism, which is a way for a recipient to obtain an organ for transplantation bypassing national wait lists by finding a donor in a foreign country on a commercial basis. The authors have performed analysis of literary sources related to issues ofthe development of transplant tourism around the world, origins of its existence as well as possible ways to prevent the following practive. In conclusion, authors underline the necessity to establish the development of transplantology based on principles of gracious organ donations and fairness in terms of recipient election.

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Application of financial motivation factors for organ donors: foreign experience and Russian attitude

Year: 2018, volume 14 Issue: №3 Pages: 448-450
Heading: Sociology of Medicine Article type: Author's opinion
Authors: Romanov S.V.
Organization: Volga District Medical Center of FMBA
Summary:

The purpose of the article was to analyze the world practice of the means of financial motivation for organ donors as well as the attitude of Russians towards it. As the results have shown, means of financial stimulation are widely applied to living organ donors in the world. Such means are mainly illegal, most often targeting the most vulnerable social groups and current attempts to stop such practices are not successful. Among all nations, Iran is the only one country whose system of organ transplantation includes the idea of rewarding a living donor. Such practice has been supported by several specialists, some of them from the US. In the world, the ways of financial support of the families of posthumous donors also exist. Such practice has evoked controversial responses in Russia. In conclusion, it has been highlighted the necessity to conduct more informative works with different social groups with the aim to develop and support the principles of humanity and altruism of organ donation.

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