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1.
Tanya L. Kowalczyk Mullins Caitlyn R. Idoine Gregory D. Zimet Jessica A. Kahn 《The Journal of adolescent health》2019,64(5):581-588
Purpose
Understanding the attitudes of physicians toward the use of pre-exposure prophylaxis (PrEP) for HIV prevention among youth is critical to improving access to PrEP. We examined PrEP-related attitudes among physicians who provide primary care to 13- to 21-year-old adolescents.Methods
Individual, in-depth, semistructured interviews were conducted with 38 physicians from adolescent medicine, family practice, internal medicine/medicine-pediatrics, obstetrics/gynecology, and pediatrics who care for any adolescents younger than 18 years. Interviews assessed familiarity with PrEP, perceived benefits and barriers to providing PrEP to adolescents, facilitating factors for prescribing PrEP, and likelihood of recommending and prescribing PrEP to adolescents.Results
Mean age was 44.6 years (standard deviation 10.9). Fourteen physicians (37%) reported being somewhat or very familiar with PrEP. Perceived benefits of prescribing PrEP included decreased acquisition/rates of HIV, improved provision of sexual health services, and improved patient awareness of HIV risk. Barriers to PrEP were reported at the patient (e.g., lack of acceptability to patients), provider (e.g., concerns about patient adherence, safety/side effects, parents as a barrier to PrEP use), and system (e.g., high cost) levels. Facilitating factors for prescribing PrEP included low cost/coverage by insurance, physician education about PrEP, patient educational materials, and clinical guidelines for PrEP use in youth. A higher proportion of physicians reported being highly or somewhat likely to recommend (N = 16, 42%) than prescribe PrEP (N = 13, 34%).Conclusions
In this study of primary care physician attitudes toward PrEP prescribing for adolescents, physicians identified numerous barriers to providing PrEP. Addressing these barriers may increase adolescents' access to PrEP. 相似文献2.
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Gustaw Lech Wojciech Korcz Emilia Kowalczyk Tomasz Guzel Marcin Radoch Ireneusz Wojciech Krasnodebski 《World journal of gastroenterology : WJG》2015,21(11):3388-3393
Gastrointestinal stromal tumours(GISTs) are the most common mesenchymal tumours of the gastrointestinal tract,but they represent less than 3% of all gastrointestinal tract malignancies.This is a detailed case study of a 52-yearold male patient treated for very uncommon histological subtype of gastric GIST with atypical clinical presentation,asymptomatic progress and late diagnosis.The resected tumour,giant in diameters,was confirmed to represent the most rare histopathologic subtype of GISTs- sarcomatoid epithelioid GIST.We report this case and review the literature with a special focus on pathomorphological evaluation,biological aggressiveness and prognostic factors.To our knowledge this is the first report of giant GIST of very uncommon sarcomatoid epithelioid subtype.It is concluded that clinicians should pay attention to the fact that initial diagnosis may be delayed due to mildly asymptomatic and non-specific clinical presentation.Asymptomatic tumours diagnosed at a late stage,which is often the case,can be large on presentation.Prognosis for patients diagnosed with GIST depend on tumour size,mitotic rate,histopathologic subtype and tumour location.That is why early diagnosis and R0 resection,which is usually feasible and safe even in giant gastric sarcomatoid epithelioid subtype of GISTs,are the key factors for further treatment and good prognosis. 相似文献
5.
Kondzior Eliza Tokarska Małgorzata Kowalczyk Rafał Ruczyńska Iwona Sobociński Wojciech Kołodziej-Sobocińska Marta 《Parasitology research》2018,117(11):3659-3662
Parasitology Research - Sparganosis is a zoonosis caused by the spargana (larvae) of Spirometra sp. (Diphyllobothriidae). Reptiles are particularly important vectors for the transmission of this... 相似文献
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Z. Jabiry-Zieniewicz B. Suchońska R. Kowalczyk E. Nowacka B. Kociszewska-Najman 《The journal of maternal-fetal & neonatal medicine》2015,28(2):177-181
Aim: Retrospective analysis of the course of pregnancy, labor and mode of anesthesia in women with portal hypertension and esophageal varices induced by portal vein thrombosis.Material: From 2000 to 2012 seven pregnant were admitted. None had liver transplantation (Ltx), the varicose have been in the 1st stage. Each of them has been consulted by the obstetrician, transplant surgeon and anesthetist. The patient condition during pregnancy, labor and postpartum period was analyzed.Results: Pregnancy in five cases proceeded physiologically. In one threatening miscarriage was diagnosed and treated with gestagens, two patients had tocolytic. One required variceal banding twice. In three thrombocytopenia worsened, with platelet count 70?g/L (up to 59?g/L). They received platelet transfusion before delivery. In one case, significant hipoproteinemia (4.7?g/L) occurred. In a case, GDM G1 and oligohydramnios were found. All women delivered at term (37–40?Hbd). In all general anesthesia with the use of remifentanil was done. There were no fluctuations in MAP and HR. Incision to delivery time was 2.5?min. Time from opioid administration to birth was <4?min. All children were born in good condition, weight 10–90 percentile. Regional anesthesia is contraindicated in patients with thrombocytopenia. In patients with esophageal varices sudden increase in heart rate and blood pressure can cause hemorrhage.Conclusion: Patients with portal hypertension can deliver at term. It is a high-risk pregnancy. In this group it is desirable to shorten the second stage of labor or complete it by c-section under general anesthesia with remifentanyl which allows getting desired analgesia without complications in the newborn. Surveillance of pregnant with portal hypertension must include monitoring of liver function and coagulation disorders. 相似文献
8.
Robert Kowalczyk Krzysztof Nowosielski Ida Cedrych Marek Krzystanek Iwona Glogowska Joanna Streb Jakub Kucharz Zbigniew Lew-Starowicz 《Clinical breast cancer》2019,19(1):e30-e39
Introduction
Knowing the important factors influencing sexual function and body image might facilitate the recovery process of breast cancer survivors. Surgery type, relationship quality, and partner support might be modified to create a space for psychosexual intervention.Patients and Methods
This retrospective questionnaire-based study was performed on 128 women aged 18 to 65 years who were free of disease at time of study entry and who underwent surgical treatment for breast cancer. Diagnostic and Statistical Manual of Mental Disorders criteria were used to assessed female sexual dysfunction (FSD). Changes in Sexual Functioning Questionnaire (CSFQ) were used to measure sexual function, whereas the Body Image After Breast Cancer Questionnaire (BIBCQ) was used to assess body image. The support of the partner was evaluated by the Provisions of Social Relation Scale (PSRS).Results
The median age of the studied respondents was 52.5 ± 10.1 years. FSD was diagnosed in 27.3% women. Lower physical satisfaction in relationship (odds ratio [OR] = 2.3), undergoing mastectomy (OR = 4.1) higher level of anxiety (OR = 4.2), and shorter duration of relationship (OR = 1.1) as well as not receiving adjuvant chemotherapy (F = 3.54), higher level of emotional satisfaction in relationship (F = 20.32), longer time after completion of oncologic treatment (F = 8.76), undergoing breast-conserving therapy (compared to mastectomy) (F = 13.21), and lower level of anxiety (F = 31,25) were important factors for the prevalence of FSD and positive body image, respectively.Conclusion
Type of surgery, time after completion of treatment, level of anxiety, adjuvant chemotherapy, partner support, and satisfying quality of relationship are important factors for sexual function, sexual quality of life, and body image in female breast cancer survivors. 相似文献9.
Oral mucosa lesions and gingival bleeding can indicate the progression of liver disease in children and adolescents aged two to 18 years 下载免费PDF全文
10.
Monika D. Kraszewska Małgorzata Dawidowska Maria Kosmalska Łukasz Sędek Władysław Grzeszczak Jerzy R. Kowalczyk Tomasz Szczepański Michał Witt 《Blood cells, molecules & diseases》2013,50(1):33-38
T‐cell acute lymphoblastic leukemia is a heterogeneous malignancy originating from developing lymphocyte precursors likely due to mutations in genes regulating thymocyte differentiation. Here, we characterized mutation status of BCL11B and FLT3 genes, presumably involved in T-ALL, together with FBXW7 and NOTCH1 as known players in T-ALL in 65 pediatric T-cell acute lymphoblastic leukemia patients. We also aimed at the assessment of prognostic value of NOTCH1 and FBXW7 mutations in ALL-IC BFM 2002 protocol.FLT3 and BCL11B mutations were detected in 3% and 2% of patients, respectively. FBXW7 mutations were observed in 8% of patients, while NOTCH1 was mutated in 40%. No correlation was found between NOTCH1 and FBXW7 mutations and traditionally used clinical factors or molecular features. In total we have detected nine mutations, which have not been previously described by others. Eight of them were found in NOTCH1 and one in BCL11B gene.Observed frequencies of NOTCH1 and FBXW7 are in line with previous reports, thus confirming postulated participation of these two genes in T-ALL pathomechanism. Moreover, we report on mutation frequency of FLT3 and BCL11B, not extensively studied in T-ALL so far. Finally, we suggest a putative role of BLC11B as an oncogene in T-ALL pathogenesis. 相似文献