Publications by authors named "Anna Horbaczewska"

10 Publications

  • Page 1 of 1

Magnetic resonance imaging of the fetal central nervous system: Timing and consistency between pre- and postnatal diagnoses.

Eur J Paediatr Neurol 2020 Nov 29;29:62-65. Epub 2020 Sep 29.

Jagiellonian University Medical College, Department of Obstetrics and Perinatology, 23 Kopernika str, 31-501, Krakow, Poland.

Introduction: It has been shown that a proper comparison of prenatal ultrasound and magnetic resonance imaging (MRI) is possible only in the case of a short interval between tests. However, it is worth noting that the reference test is a postnatal examination. The aim of our study was to evaluate the effect of time between prenatal MRI (pMRI) and postnatal examinations on the consistency of diagnoses.

Material And Methods: The prospective observational study was carried out between 2014 and 2017 at the Department of Obstetrics and Perinatology of Krakow University Hospital. In total, 60 patients with fetuses suspected of central nervous system (CNS) defects were included in the study group. PMRI examinations were conducted in the third trimester of pregnancy.

Results: The median gestational age of pMRI was 35 weeks and median of the time interval between carrying out pre- and postnatal test was 34.5 days. In the group of nonconcordant diagnoses, the interval was longer. The analysis did not show a statistically significant relationship between consistency of diagnoses and timing of pMRI. The median time of pregnancy at which pMRI was performed was similar in both groups. A prolongation of the interval between examinations reduced the probability of consistency of diagnoses.

Conclusions: The number of inaccurate results increased with the prolongation of the interval between pre- and postnatal tests.

Key Message: Prolongation of the interval between pre- and postnatal increases number of inaccurate results.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ejpn.2020.08.009DOI Listing
November 2020

Survey of Fertility Preservation Options Available to Patients With Cancer Around the Globe.

JCO Glob Oncol 2020 2;6. Epub 2020 Mar 2.

Northwestern University, Chicago, IL.

Purpose: Oncofertility focuses on providing fertility and endocrine-sparing options to patients who undergo life-preserving but gonadotoxic cancer treatment. The resources needed to meet patient demand often are fragmented along disciplinary lines. We quantify assets and gaps in oncofertility care on a global scale.

Methods: Survey-based questionnaires were provided to 191 members of the Oncofertility Consortium Global Partners Network, a National Institutes of Health-funded organization. Responses were analyzed to measure trends and regional subtleties about patient oncofertility experiences and to analyze barriers to care at sites that provide oncofertility services.

Results: Sixty-three responses were received (response rate, 25%), and 40 were analyzed from oncofertility centers in 28 countries. Thirty of 40 survey results (75%) showed that formal referral processes and psychological care are provided to patients at the majority of sites. Fourteen of 23 respondents (61%) stated that some fertility preservation services are not offered because of cultural and legal barriers. The growth of oncofertility and its capacity to improve the lives of cancer survivors around the globe relies on concentrated efforts to increase awareness, promote collaboration, share best practices, and advocate for research funding.

Conclusion: This survey reveals global and regional successes and challenges and provides insight into what is needed to advance the field and make the discussion of fertility preservation and endocrine health a standard component of the cancer treatment plan. As the field of oncofertility continues to develop around the globe, regular assessment of both international and regional barriers to quality care must continue to guide process improvements.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1200/JGO.2016.008144DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7853877PMC
July 2021

Survey of Third-Party Parenting Options Associated With Fertility Preservation Available to Patients With Cancer Around the Globe.

JCO Glob Oncol 2020 2;6. Epub 2020 Mar 2.

Northwestern University, Chicago, IL.

Purpose: In the accompanying article, "Survey of Fertility Preservation Options Available to Patients With Cancer Around the Globe," we showed that specific fertility preservation services may not be offered at various sites around the world because of cultural and legal barriers. We assessed global and regional experiences as well as the legal status of third-party reproduction and adoption to serve as a comprehensive international data set and resource for groups that wish to begin oncofertility interventions.

Methods: We provide data on the legalities of third-party assisted reproductive technologies and other family-building options in the 28 oncofertility-practicing countries surveyed.

Results: We found regional and country differences that will be important in the development of tailored resources for physicians and for patient brochures that are sensitive to these local restrictions and cultural norms.

Conclusion: Because many patients first consult Web-based materials, the formal assessment of the availability of these options provides members of the global oncofertility community with data to which they might otherwise not have ready access to better serve their patients.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1200/JGO.2017.009944DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7853875PMC
July 2021

Cesarean scar pregnancy - various methods of treatment.

Folia Med Cracov 2019 ;59(2):5-14

Department of Gynaecological Endocrinology and Gynaecology, Jagiellonian University Medical College Kraków, Poland.

Ectopic pregnancy constitutes 2% of all pregnancies. In the last decades, due to the rising amount of caesarean sections, new localization of ectopic pregnancy has been observed - caesarean scar pregnancy (CSP). Cesarean scar pregnancy is an iatrogenic disease and a life-threatening condition which frequency will systematically rise. Because of possible serious complications, CSP should be swiftly diagnosed and treated. The purpose of this retrospective study was to demonstrate different methods of CSP treatment performed between 2015-2018 in the Clinic of Endocrinological Gynaecology and Gynaecology Jagiellonian University Medical College in Cracow. The clinical characteristics, diagnosis, various methods of treatment and clinical outcomes were analysed. Definitive algorithm of CSP treatment is still not established. Pharmacological and operative methods are approved while expectant observation is considered unsafe due to possible risk of complications for the patient, including death.
View Article and Find Full Text PDF

Download full-text PDF

Source
April 2020

Challenging iatrogenic menopause. Oncofertility programme in Poland - a single-centre experience.

Prz Menopauzalny 2019 Jun 14;18(2):63-67. Epub 2019 Jun 14.

Clinic of Gynaecological Oncology, Jagiellonian University Medical College, Krakow, Poland.

Introduction: Menopause is defined as a 12-month period of time when menstruation permanently ceases. In some cases, menopause may be caused by external factors - for example gonadotoxic treatment that irreversibly damages ovarian tissue leading to loss of its hormonal and reproductive function. Oncofertility is a discipline that merges oncology and reproductive medicine, giving patients a chance to experience parenthood after gonadotoxic treatment is finished.

Aim Of The Study: The purpose of the study is to present the implementation and first outcomes of the Oncofertility Programme in the University Clinic of Endocrinological Gynaecology and Gynaecology, University Hospital in Krakow, Poland.

Material And Methods: Patients interested in fertility preservation have been consulted in the University Clinic of Endocrinological Gynaecology and Gynaecology in Krakow since April 2016. Preliminary qualification to one of the available methods (embryo cryopreservation, oocyte cryopreservation, ovarian tissue cryopreservation) was conducted. Patients declaring a wish to join the programme were then referred to one of the three infertility treatment centres cooperating with the University Clinic, in order to undergo the chosen procedure.

Results: During a period of 24 months, 18 patients were consulted. The youngest consulted patient was 20 years old, the oldest 39. Two years after the first consultation, a telephone survey among consulted patients was carried out to verify whether the patients finally underwent oncofertility procedures, and to ask about their reproductive status.

Conclusions: The problem of fertility issues being inadequately addressed results in low referral rates to oncofertility programmes. Attempts to raise awareness of oncofertility possibilities among oncologists should be undertaken because critically few patients are being referred to oncofertility centres.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5114/pm.2019.85787DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6719631PMC
June 2019

Current management of cervical cancer in Poland-Analysis of the questionnaire trial for the years 2002-2014 in relation to ASCO 2016 recommendations.

PLoS One 2019 31;14(1):e0209901. Epub 2019 Jan 31.

Department of Gynecology and Obstetrics, Jagiellonian University Medical College, Krakow, Poland.

Objectives: To assess the survival of patients with cervical cancer (CC). Since the recommendations concerning cervical cancer management adopted by Polish medical societies do not differ significantly from the ESGO or non-European guidelines, and the fact that evaluation of the system for CC treatment in Poland, as well as the mortality rate of Polish women with CC, which is 70% higher than the average for European Union (EU) countries, justifies the hypothesis that treatment of CC in Poland deviates from the Polish and international recommendations. This article puts forward the current management of cervical cancer in Poland and discusses it in the context of ASCO guidelines.

Material And Methods: A survey retrospective multicenter analysis of the medical records of 1247 patients with cervical cancer who underwent treatment for disease and who had completed at least two years of follow-up.

Results: Although concurrent radiotherapy and chemotherapy is a standard treatment of FIGO IB to IVA cervical cancer patients in enhanced- and maximum-resources settings, in our analysis, we found that the percentage of women subjected to chemotherapy was lower than in countries where total survival rates were lower.

Conclusion: Within the IA to II A cervical cancer patients studied group, the methods of treatment remained in line with ASCO guidelines for countries with the highest standard of care. Although concurrent radiotherapy and chemotherapy is a standard treatment of FIGO IB to IVA cervical cancer patients in enhanced- and maximum-resources settings, in our analysis, we found that the percentage of women subjected to chemotherapy was lower than in countries where total survival rates were lower. Our findings, together with the inconsistencies within the cervical cancer screening program, may be one of the explanations of poorer survival rate of women with cervical cancer in Poland.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0209901PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6354992PMC
September 2019

[The role of cytologic-colposcopic diagnostics in qualification to LEEP (loop electrical excision procedure)].

Przegl Lek 2016;73(7):472-8

Loop electrosurgical excision procedurę (LEEP) is both a diagnostic and a therapeutic method in cervical intraepithelial neoplasia (CIN). The key for the therapeutic effect is accurate diagnostics, in particular precise colposcopic localisation of CIN in the cervical area. It enables localising a lesion highly suspected of neoplasmatic character, excising a sample for histopathologic examination and making a pre-therapeutical diagnosis, as well as choosing optimal way of treatment. Colposcopic examination conducted in 115 women with inapropriate cytologic exam, i.e. HGSIL, revealed CIN-suspected image in all cases. Highly positive and statistically relevant correlation between results of colposcopic examination and histologial examination of samples excised with the use of high frequency electrosurgical loop in examined group was stated. Due to its efficiency, easy implementation, great tolerance and wide acceptance the procedure is widespread.
View Article and Find Full Text PDF

Download full-text PDF

Source
May 2018

Acute kidney injury in a single pediatric intensive care unit in Poland: a retrospective study.

Kidney Blood Press Res 2014 9;39(1):28-39. Epub 2014 May 9.

Department of Pediatric Nephrology, Jagiellonian University Medical College, Kraków, Poland.

Background/aims: The recent improvements of management of patients in pediatric intensive care units (PICU) are associated with improved outcome. However, this decrease in mortality is associated with an increased number of children with acute kidney injury (AKI), especially in patients with multiorgan failure.

Methods: The report presents a retrospective analysis of 25 cases of AKI (assessed based on the pRIFLE criteria) in PICU within 7 years.

Results: AKI was diagnosed in 1.24% of all hospitalized children. AKI percentage duration (as compared to the total hospitalization time) in the children who died vs. the survivors was 79.55% vs. 46.19%, respectively (p<0.05). The mortality rate of AKI patients was 40% which was 4.4-times higher as compared to the total mortality rate in PICU. The final cumulative survival ratio (FCSR) of patients meeting the oliguria criterion (which was met in 48% of AKI patients) was 37% vs. 49% in non-oliguric children. Averaged urine output values in the first week of hospitalization in the deceased vs. survivors were 1.49 vs. 2.57 ml/kg/h, respectively (p<0.05).

Conclusions: Oliguria should not be considered as a sensitive parameter for AKI diagnosing in children below one year of age. A decreased mean urine output in the first week of PICU hospitalization (less than 1.4 ml/kg/h) should be considered as a poor prognostic factor. In many cases AKI was diagnosed too infrequently and too late.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1159/000355774DOI Listing
March 2015

Prevalence of HPV-DNA in Pap smears containing ASC and AGC performed within Population Programme of Prophylaxis and Early Detection of Early Cervical Cancer.

Przegl Lek 2012 ;69(11):1189-93

Katedra Połoznictwa i Ginekologii, Klinika Ginekologii i Onkologii, Uniwersytet Jagielloński, Collegium Medicum, Kraków.

Aim: to assess the incidence of HPV -DNA in women with ASC/AGC compared to patients with normal Pap smears.

Material And Methods: The study group consisted of 242 women (207 ASC and 35 AGC cases). The control group counted 200 age-matched women with negative Pap smears. Cervical samples collected from all the participants were tested for the presence of HPV-DNA using the Hybrid Capture-2 test.

Results: Total HPV infection was significantly higher in the study than in the control group (43.0% vs.14.0%) (p=0.005). There was no difference in the incidence of HPV -DNA between ASC and AGC groups. Prevalence of HPV-DNA ASC-H was significantly higher in ASC-US group (83.3% vs. 40.5%) (p=0.004). HPV positive endometrial AGC significantly outnumbered HPV positive endocervical AGC (88.9% vs. 26.9%) (p=0.003). Similar trends were observed for the high-risk type of HPV (p<0.001).

Conclusions: The significant difference in HPV -DNA incidence between the study and control groups suggests that HPV plays a role in the development of ASC and AGC. The implementation of HPV testing in all women diagnosed with ASC or AGC can lead to tailored therapeutic management and more careful follow-up care.
View Article and Find Full Text PDF

Download full-text PDF

Source
May 2013

Dissecting aortic aneurysm in computed tomography.

Ann Univ Mariae Curie Sklodowska Med 2003 ;58(1):61-6

2nd Department of Radiology, Medical University of Lublin, Lublin, Poland.

The dissecting aortic aneurysm (DAA) is an emergency, and because of that it requires urgent diagnosis and treatment. Many methods may by used to diagnose dissection, including aortography, CT, MRI, traditional and transesophageal ultrasonography. The computed tomography is often used in diagnostic of DAA, thus the knowledge of morphological characteristic of dissection is very important. The most important features of dissection in CT are presence of dissection of intima and two lumens, true and false. Nevertheless, the CT pictures of dissection not always appears like this, and sometimes the two lumens are identified only by their different rates of opacification with contrast material.
View Article and Find Full Text PDF

Download full-text PDF

Source
November 2004
-->