Management of Metastatic Pancreatic Cancer-Comparison of Global Guidelines over the Last 5 Years.

Pancreatic cancer (PC) is usually diagnosed at an advanced stage of its development, which results in lower overall survival (OS). Prognosis is also poor even with curative-intent surgery. Approximately 80% of patients with localized PDAC have micrometastases at the time of diagnosis, which leads to a worse prognosis than in other cancers. The objective of this study is to present the progress in the treatment of metastatic pancreatic cancer based on the recommendations of oncological scientific societies, such as ESMO, NCCN, ASCO, NICE and SEOM, over the last 5 years. Combined FOLFIRINOX therapy is mostly a recommended therapy among patients with good performance statuses, while gemcitabine is recommended for more fragile patients as a first-line treatment. The newest guidelines suggest that molecular profiling of the tumor should be the first step in determining the course of treatment. The use of modern molecular therapies in patients with specific gene mutations should extend the survival of patients with this disease.

Comparison between the American and the European Systems of Monitoring Adverse Effects of Dietary Supplements and Their Usefulness on the Polish Market.

Many Polish patients do not inform physicians about supplements they use in addition to prescribed medicines. This may be because they consider dietary supplements as being rather natural products that cannot cause health problems. Although dietary supplements may produce side effects, Poland's food safety system and medical statistics do not recognise the necessity of reporting such cases. However, a different approach is observed in France and the United States where adverse effects of food supplements as well as drugs are reported. The aim of this study was to determine the need for creating in Poland a general model of a register monitoring dietary supplements and their adverse effects. In order to achieve this goal, a detailed comparison between the American and European monitoring systems was made. It showed the relationship between negative symptoms caused by specific components in supplements and t profiles of patients who reported side effects. Additionally, it was found that there is a real risk associated with side effects caused by dietary supplements. Therefore, it necessary to establish in Poland a special system for recording such cases as it should be beneficial to patients, including polypragmatic patients.

Admissions to the Emergency Department Due to Atrial Fibrillation/Atrial Flutter Incidents during the Third Wave of COVID-19 Pandemic.

(1) Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection increases the risk of atrial fibrillation/flutter (AF/AFL) incident. The study aimed to present the characteristics of admissions to the emergency department (ED) due to AF/AFL incidents during the third COVID-19 pandemic wave. (2) Methods: A retrospective analysis of the medical records of the ED patients: 8399 during 3 months of the second and 11,144 during the 3 months of the third pandemic wave. (3) Results: SARS-CoV-2 positive patients there were 295 (3.5%) during the second wave and 692 (6.2%) during the third wave (p < 0.001). Among patients with SARS-CoV-2 infection, there were 44 (14.9%) patients with known AF/AFL during the second wave and 75 (10.8%) during the third wave, respectively (0.07). There were 116 visits with a diagnosis of AF/AFL incident during the third wave (study group) and 76 visits during the second wave (control group). The SARS-CoV-2 test was positive in 11 (9.5%) visits in the study group and in 1 (1.3%) visit in the control group p = 0.047. During the third wave, the patients with AF/AFL incidents with positive tests were older and more often had new-onset AF/AFL than those with negative tests: 76.3 (13.2) years vs. 71.8 (12.6) years; and 4 (36.4%) patients vs. 7 (7.6%) patients, respectively. (5) Conclusions: During the third pandemic wave, the number of patients with SARS-CoV-2 infection increased in comparison to the second wave. Additionally, among patients with AF/AFL incidents, the percentage of SARS-CoV-2-positive patients increased. During the third wave, the patients with positive tests and AF/AFL incident were older and more often had new-onset AF/AFL than those with AF/AFL incident and negative test which indicate the arrhythmogenic effect at the onset of the disease, especially in the older population.

Dietary Supplements Questioned in the Polish Notification Procedure upon the Basis of Data from the National Register of Functional Foods and the European System of the RASFF.

Dietary supplements (DS) in the countries of the European Union falls within the scope of the food law. DS may, however, contain substances that are simultaneously applied in medicinal products as defined in the pharmaceutical law. The presence of such ingredients may cause problems with the product qualification. The phenomenon of applying such borderline ingredients in dietary supplements may require additional regulations, and ensuring them may be problematic. We conducted an analysis aiming to identify dishonest market practices resorted to by the producers and distributors of non-conforming dietary supplements. We examined mostly questioned DS and compared them with data from the RASFF system and registers of medicinal substances and pharmaceutical entities. The results show that some operators tend to re-notify the same products in response to the initiation of official control procedures. Products in the form of capsules or powders were the most common re-notifications within the 50-100 days. Based on the data obtained, it can be concluded that some entities are obliged to document the safety of the product or its compliance with the regulations, use the imperfection of the notification procedure, and re-notify the questioned product in order to keep it on the market despite potential non-compliance.

Assessment of the Impact of Scientific Reports Published by EFSA and GIS on Functional Foods Newly Placed on the Market in Poland.

Dietary supplements are health-promoting products. The legal categorization of dietary supplements as foods does not raise concerns, but a general understanding of how they work in the human body seems to deviate from the official definition. Thus, it is necessary to establish effective methods of market control related to dietary supplements. This research aims at assessing the impact of recommendations by various food safety authorities on ingredients used in newly registered products. It probes how the proportions of utilized product ingredients were modified after the European Food Safety Authority (EFSA) and Chief Sanitary Inspector in Poland (GIS) published their recommendations. Research data on the composition of products comes from the Polish national register of dietary supplements and covers the period from 2012 to 28 November 2021. Note that 103,102 products were analysed for the presence of thirty-seven ingredients, and the joinpoint regression method was applied to assess changing trends related to the use of ingredients. As our research points out, most often, changes in the trend appeared in product ingredients for which the European Food Safety Authority and Chief Sanitary Inspector in Poland issued the recommendation of having the safest level of consumption. However, these changes seem to emerge randomly and should not be unquestionably considered as the result of the published recommendations.

The Impact of the COVID-19 Pandemic on the Composition of Dietary Supplements and Functional Foods Notified in Poland.

The COVID-19 pandemic has exerted a strong impact on numerous areas of everyday life. The aim of this study was to check how the pandemic influenced the composition of dietary supplements and other functional food products placed on the market till March 2021, compared to 2019. For this purpose, data concerning the registered products and reports of popularity of online searches of terms connected with vitamins and minerals were used. The results of the study made it possible to determine the group of ingredients especially popular during the pandemic. Their use in products after the announcement of the pandemic was significantly higher than in the preceding period. In conclusion, it can be shown that the pandemic changed the ingredients used in functional foods-mainly as far as vitamins and minerals are concerned. The highest proportional increase in its use in dietary supplements was noted for potassium. Personalized therapy has also become more popular, promoted by one of the manufacturers of dietary supplements active during the pandemic. Moreover, different phases of the pandemic were characterized by the popularity of different ingredients among the consumers-first, these were immunity-boosting ingredients, then those that improved psychological functions, and finally mixtures with universal health effects.

The Effectiveness of Active Rehabilitation Camp on Physical Performance of Disabled People Moving in Wheelchairs.

(1) Background: Regular participation in physical activity (PA) prevents many medical complications and improves the physical fitness of people with spinal cord injury, and in turn improves the functional independence, psychosocial status and quality of life. The goal of Active Rehabilitation Camps (ARCs) is to use various forms of PA in order for the participants to obtain the greatest efficiency and independence in everyday life. (2) Purpose: To evaluate the improvement in physical performance of people with chronic spinal cord disabilities moving in wheelchairs taking part in the Active Rehabilitation Camp depending on (a) sex, (b) type of disability, (c) the level of injury and (d) the type of wheelchair. (3) Methods: The study included 42 wheelchair users: 28 men and 14 women aged 18-65 years (34.7 ± 14.9 years) taking part in the Active Rehabilitation Camp. Finally, the study involved 27 paraplegics, 9 tetraplegics and 6 individuals with myelomeningocele. The participants took part in four fitness tests: (1) sprint test (SP)-individual time to cover a distance of 15 m in the wheelchair; (2) slalom test (SL)-time to ride between four cones front and back; (3) basketball ball throw at a distance (BT), (4) zig-zag test (ZZ)-riding continuously for 6 min on the designated track. The tests were performed at the beginning and at the end of the ACR. Active wheelchairs were used by 32 participants, and 10 participants used the classic wheelchairs. (4) Results: Paraplegics achieved the best average results in all the tests and the best improvement in physical performance in comparison to individuals with myelomeningocele and tetraplegics. People in active wheelchairs achieved a statistically significant improvement in the results of SL and ZZ (p < 0.001). People with injury above Th-9 level of the spinal cord achieved a statistically significant improvement in the results of SP (p < 0.01), SL and ZZ (p < 0.01). People with injury below Th6 achieved a statistically significant improvement (p < 0.05) in SP, SL and ZZ. (5) Conclusions: Regular PA during the Active Rehabilitation Camp improves the physical performance of disabled people in wheelchairs, but the scale of improvement of physical performance fitness depends on the type of wheelchair used and the level and the type of injury.