Overview of Pancreatic Cancer Epidemiology in Europe and Recommendations for Screening in High-Risk Populations.

Pancreatic cancer is the seventh most common cause of death in the group of oncological diseases. Due to the asymptomatic course, early diagnosis is difficult. Currently, early detection methods are only used in high-risk groups. A literature review based on the available results of observational studies on patients with pancreatic cancer and people from high-risk groups was used to summarize the knowledge on risk factors. The GLOBOCAN 2020 data were used to assess the epidemiological situation in Europe. A summary of screening recommendations was prepared based on the available documents from medical organizations and associations. Pancreatic cancer risk factors are divided into two main groups: non-modifiable factors, e.g., hereditary factors and age, which increase the risk of developing this disease, and modifiable factors-BMI, smoking, and alcohol consumption. Hereditary factors account for 10% of pancreatic cancer cases. The highly specialized methods of early detection, (MRI, CT, or EUS) are used for screening high-risk populations. Of all the imaging methods, EUS is considered the most sensitive for pancreatic cancer and allows an accurate assessment of the size of even small lesions (<30 mm) and the extent of tumour infiltration into blood vessels. The available studies vary on the level of sensitivity and specificity of these methods for the diagnosis of pancreatic cancer. EUS, MRI, and CT are also expensive procedures and in some patients can be invasive, which is one of the arguments against the introduction of population screening programs based on imaging methods. Therefore, it is important to look for viable solutions that would improve early detection. This is important from the point of view of healthcare systems in Europe, where almost 29% of all global pancreatic cancer cases are reported.

The Impact of Whey Protein Supplementation on Sarcopenia Progression among the Elderly: A Systematic Review and Meta-Analysis.

We conducted a systematic literature review and meta-analysis to investigate the role of whey protein supplementation in the functioning of the elderly with sarcopenia. The aim was to investigate the available scientific evidence and determine the best recommendations with respect to whey protein supplementation in sarcopenic patients. Methods: Databases, including CINAHL, Embase PubMed, and Web of Science, were searched from database inception until 31 December 2022 for randomised controlled trials (RCTs) comparing the efficacy of whey protein supplementation in the elderly with sarcopenia. Data on study design, risk of bias, patient, illness, and treatment characteristics from each study were independently extracted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The tool "assessing risk of bias" from the Cochrane Handbook was used to evaluate the quality of the included papers. Results: The search identified 629 records; 590 articles were excluded as duplicates or after evaluation at the title or abstract level. Out of 39 full-text articles that were reviewed, 29 were excluded for not fulfilling the inclusion criteria. There is some evidence that whey protein supplementation combined with age-appropriate physical exercise might improve muscle mass and lower limb function in the elderly with sarcopenia. The present meta-analysis demonstrated overall that whey supplementation does not improve any of the tested sarcopenia-linked parameters. However, we found that study duration (weeks) and age significantly affect the handgrip strength rate and the chair and stand test rate, respectively, so consideration should be given to oral supplementation combined with the age of participants and an appropriate physical activity as a form of sarcopenia prevention in the high-risk group.

Relationships of Body Mass Index, Relative Fat Mass Index, and Waist Circumference with Serum Concentrations of Parameters of Chronic Inflammation.

(1) Background: Obesity in the perimenopausal period is associated with hormonal changes, lifestyle, and environment. In obesity, elevated levels of IL-6 and TNF-α and reduced levels of adiponectin are observed, and the associated chronic inflammation favors the development of cardiometabolic diseases. Therefore, the aim of our study was to assess the relationship between selected measures of obesity (BMI, WC, RFM, VAI, WHtR) and parameters of chronic inflammation (CRP, TNF-α, IL-6) in perimenopausal women. (2) Methods: The study involved 172 perimenopausal women. The methods used in this study were diagnostic surveys, anthropometric measurements, blood pressure measurements, and venous blood sampling. (3) Results: Preliminary multivariate linear regression analysis showed that CRP moderately positively correlated with IL-6 (ß = 0.25; p = 0.001) and weakly negatively correlated with adiponectin (ß = -0.23; p = 0.002). Similar associations were noted in preliminary multivariate linear regression analysis adjusted for age, menopausal status, and smoking status. Preliminary multivariate linear regression analysis also showed that BMI positively correlated with IL-6 (ß = 0.16; p = 0.033). VAI weakly positively correlated with CRP (ß = 0.25; p = 0.001) and negatively correlated with adiponectin (ß = -0.43; p = 0.000). (4) BMI, WC, RFM, VAI, and WHtR are clearly related to selected parameters of chronic inflammation. Our study suggests that each of the anthropometric variables provides distinct information on metabolic processes associated with inflammatory parameters.

Factors Associated with Insomnia and Aggression among Healthcare Workers during COVID-19 Pandemic.

(1) Healthcare workers are exposed to increased risks of insomnia and aggression during the COVID-19 pandemic. The aim of the study was to assess insomnia, sleep disturbances, and aggression and identify the associated risk factors among healthcare workers during the COVID-19 pandemic. (2) A total of 264 healthcare workers participated in the study. The study was conducted with the diagnostic survey method, using the Buss−Perry Aggression Questionnaire, the Athens Insomnia Scale, the Pittsburgh Sleep Quality Index, and a self-administered questionnaire. (3) The vast majority of the respondents (81.06%) suffered from insomnia and had poor sleep quality (78.03%). Education (p = 0.038), marital status (p = 0.043), and working with patients suffering from COVID-19 (p = 0.024) were statistically significant contributors to insomnia. Age was found to significantly correlate with total aggression (r = −0.133 p = 0.031), verbal aggression (r = −0.138 p = 0.025), and anger (r = −0.151 p = 0.014). The analysis demonstrated statistically significant relationships between gender and physical aggression (p = 0.017), anger (p = 0.032), and hostility (p = 0.002). A statistically significant positive correlation between the quality of sleep as per the PSQI and all subscales of the BPAQ was found (p < 0.001). (4) A considerable proportion of HCWs experienced sleep disturbances during the outbreak, stressing the need to establish ways to reduce long-term adverse outcomes associated with chronic insomnia and mental health problems and adjust interventions under pandemic conditions.

Personality traits and the degree of work addiction among Polish women: the mediating role of depressiveness.

Objectives: Workaholism is an addiction, however the obsessive-compulsive components alone may prove insufficient in determining its nature. The aim of the following study was to determine the mediating role of depressiveness in the relationships between workaholism and personality traits according to the five-factor model among Polish women. Methods: The research study was carried out among 556 women residing in the West Pomerania Voivodeship in Poland. The research was based on a survey performed using a questionnaire technique. The following research instruments adapted to Polish conditions were employed to assess the incidence of work addiction among female adults: The NEO Five-Factor Inventory (NEO-FFI), The Work Addiction Risk Test (WART) Questionnaire, and The Beck Depression Inventory-BDI I-II. Results: A positive correlation between the intensity of neuroticism and the work addiction risk was revealed (ß = 0.204, p < 0.001). A partial mediation (35%) with the severity of depression symptoms as a mediating factor was observed (ß = 0.110, p < 0.001). Respondents characterized by high neuroticism showed a greater severity of the symptoms of depression (ß = 0.482, p < 0.001), which is a factor increasing the work addiction risk (ß = 0.228, p < 0.001). No effect of extraversion intensity on the work addiction risk was found (ß = 0.068, p = 0.081). Respondents characterized by a high level of extraversion displayed lower severity of the symptoms of depression (ß = -0.274, p < 0.001). A negative correlation between the intensity of agreeableness and the work addiction risk was revealed (ß = -0.147, p < 0.001). A partial mediation (27.8%) was observed. A positive correlation between the intensity of conscientiousness and the work addiction risk was revealed (ß = 0.082, p = 0.047). Respondents characterized by a high level of conscientiousness showed a lower severity of depression symptoms (ß = -0.211, p < 0.001). Conclusion: Depressiveness plays the role of a mediator between neuroticism, extraversion, agreeableness as well as conscientiousness, and work addiction. Depressiveness is a factor which increases the risk of work addiction.

Analysis of Nurses' Attitudes toward Patient Death.

(1) The aim of the study was to analyze nurses' attitudes toward a patient's death, taking into account the emotions they experience and the general perception of death. (2) The study involved 516 nurses from the West Pomeranian Voivodeship in Poland. The research was carried out using the diagnostic survey method using The Death Attitudes Profile Revisited (DAP-R-PL), the Scale of Fear and Fascination with Death, and a demographic questionnaire. (3) Research has shown that nurses accept the phenomenon of death as a natural process of human life; however, they adopt the attitude of fear of death. Most of the respondents experienced: sadness (73.4%), helplessness (58.5%), and regret (43.6%) due to the patient's death. (4) Both age, sex, marital status, and place of residence significantly influenced the attitudes of nurses toward the patient's death. Therefore, it is important to provide psychological support or special education in the case of dealing with the fear of death.

Analysis of Factors Related to Mental Health, Suppression of Emotions, and Personality Influencing Coping with Stress among Nurses.

(1) The specificity of a nurse's work, apart from performing medical procedures, is characterized by intensive contacts with other people. Stress is an inevitable part of a nurse's job and can affect their physical and mental health. Thus, strategies for coping with stress play an important role in improving health or well-being by reducing the level of stress. (2) The aim of the study was to evaluate the impact of coping strategies in predicting the overall health of nurses. The study also assessed the impact of personality traits and emotional control (anger, depression, anxiety) on the choice of coping with stress among nurses. (3) The study included 811 nurses from the West Pomeranian Voivodeship, with an average age of 40 (SD = 9.8), working mainly in hospitals (82%). The research was carried out with a diagnostic survey method, using the Coping Inventory for Stressful Situations questionnaire, NEO-Five Factor Inventor, Courtland Emotional Control Care Scale, General Health Questionnaire 30, and a demographic questionnaire. (4) Among the surveyed nurses, the dominant style of coping with stress was the style focused on emotions (MT 0.43), followed by the style focused on avoidance (MT 0.42). There were mental problems among 46.1% of the respondents. Nurses with mental problems according to GHQ-30 were characterized by a high intensity of coping styles focused on emotions (30.2%), avoiding (18.7%), and engaging in alternative activities (32.3%) (p = 0.000). (5) Most of the surveyed nurses have a tendency to cope with stress through an emotional-focused style, which may be associated with a higher level of occupational stress.

CCL18 Expression Is Higher in a Glioblastoma Multiforme Tumor than in the Peritumoral Area and Causes the Migration of Tumor Cells Sensitized by Hypoxia.

Glioblastoma multiforme (GBM) is a brain tumor with a very poor prognosis. For this reason, researchers worldwide study the impact of the tumor microenvironment in GBM, such as the effect of chemokines. In the present study, we focus on the role of the chemokine CCL18 and its receptors in the GBM tumor. We measured the expression of CCL18, CCR8 and PITPNM3 in the GMB tumor from patients (16 men and 12 women) using quantitative real-time polymerase chain reaction. To investigate the effect of CCL18 on the proliferation and migration of GBM cells, experiments were performed using U-87 MG cells. The results showed that CCL18 expression was higher in the GBM tumor than in the peritumoral area. The women had a decreased expression of PITPNM3 receptor in the GBM tumor, while in the men a lower expression of CCR8 was observed. The hypoxia-mimetic agent, cobalt chloride (CoCl2), increased the expression of CCL18 and PITPNM3 and thereby sensitized U-87 MG cells to CCL18, which did not affect the proliferation of U-87 MG cells but increased the migration of the test cells. The results indicate that GBM cells migrate from hypoxic areas, which may be important in understanding the mechanisms of tumorigenesis.

Epidemiology of Glioblastoma Multiforme-Literature Review.

Glioblastoma multiforme (GBM) is one of the most aggressive malignancies, with a median overall survival of approximately 15 months. In this review, we analyze the pathogenesis of GBM, as well as epidemiological data, by age, gender, and tumor location. The data indicate that GBM is the higher-grade primary brain tumor and is significantly more common in men. The risk of being diagnosed with glioma increases with age, and median survival remains low, despite medical advances. In addition, it is difficult to determine clearly how GBM is influenced by stimulants, certain medications (e.g., NSAIDs), cell phone use, and exposure to heavy metals.

The impact of the last ten minutes of surgery on hemorrhagic complications after laparoscopic sleeve gastrectomy. Case-control study.

INTRODUCTION: Hemorrhagic complications after laparoscopic sleeve gastrectomy (LSG) are among the most common adverse events. The last 10 min of LSG are essential in terms of hemostasis. AIM: To assess the blood pressure profile in the last 10 min of LSG in patients who experienced hemorrhagic complications after laparoscopic sleeve gastrectomy. MATERIAL AND METHODS: We performed a retrospective case-control study. The medical records of 867 patients who underwent primary LSG were analyzed. Cases were defined as patients who required surgical revision due to hemorrhagic complications within 72 h. Controls were matched (1 : 1) with cases by age, body mass index, gender, staple line reinforcement, comorbidities and surgeon's experience. Comparison of the last three intraoperative blood pressure measurements at the end of surgery was made. RESULTS: The bleeding rate was 3.0%. A total of 24 subjects (12 matched pairs) were included in the study. Cases had statistically significant increased mean arterial blood pressure (mm Hg) 5 min before the end of surgery (87.8 ±11.9 vs. 79.4 ±8.8 mm Hg, p = 0.049) and at the end of surgery (89.2 ±11.7 vs. 77.5 ±11.8 mm Hg, p = 0.011). Higher diastolic blood pressure measurements were observed 5 min before the end (72.1 ±10.7 vs. 62.8 ±8.1 mm Hg, p = 0.023) and at the end of surgery (74.2 ±10.0 vs. 60.8 ±11.2 mm Hg, p = 0.004). CONCLUSIONS: Compared with closely matched control subjects, patients with HC after LSG have increased mean arterial pressure in the last 5 min of surgery. This phenomenon has not been reported in the literature before.

Are cadmium and lead levels linked to the development of anxiety and depression? - A systematic review of observational studies.

The aim of this systematic review was to assess if cadmium and lead levels are linked to anxiety and depression. A systematic literature search was conducted to identify observational trials evaluating the impact of cadmium and lead on the incidence and phenotype of depression and anxiety. The search identified 1059 records. Overall eighteen studies comprising 28,304 participants with a female predominance (n = 19,483; 69%) were included. Cadmium and lead levels were analyzed in eight and thirteen studies, respectively. Five studies found an association between blood cadmium levels and depression, among them three trials which reported that individuals in the highest quartile of blood cadmium had higher odds of showing depressive symptoms. Sex and smoking status were found to be potential confounders of cadmium impact on the depressive phenotype. None of the studies found association between the level of anxiety and blood cadmium levels. Nine studies demonstrated association between depressive symptoms and blood lead concentration. High lead levels may be associated with anxiety and neurobehavioral deficits. There are many factors that influence both the levels of cadmium and lead, and the severity of depression and anxiety in the respondents. There is no clear evidence for the impact of cadmium and lead levels on the development of depressive symptoms but a lot of indirect evidence points to this.

CC Chemokines in a Tumor: A Review of Pro-Cancer and Anti-Cancer Properties of Receptors CCR5, CCR6, CCR7, CCR8, CCR9, and CCR10 Ligands.

CC chemokines (or ß-chemokines) are 28 chemotactic cytokines with an N-terminal CC domain that play an important role in immune system cells, such as CD4+ and CD8+ lymphocytes, dendritic cells, eosinophils, macrophages, monocytes, and NK cells, as well in neoplasia. In this review, we discuss human CC motif chemokine ligands: CCL1, CCL3, CCL4, CCL5, CCL18, CCL19, CCL20, CCL21, CCL25, CCL27, and CCL28 (CC motif chemokine receptor CCR5, CCR6, CCR7, CCR8, CCR9, and CCR10 ligands). We present their functioning in human physiology and in neoplasia, including their role in the proliferation, apoptosis resistance, drug resistance, migration, and invasion of cancer cells. We discuss the significance of chemokine receptors in organ-specific metastasis, as well as the influence of each chemokine on the recruitment of various cells to the tumor niche, such as cancer-associated fibroblasts (CAF), Kupffer cells, myeloid-derived suppressor cells (MDSC), osteoclasts, tumor-associated macrophages (TAM), tumor-infiltrating lymphocytes (TIL), and regulatory T cells (Treg). Finally, we show how the effect of the chemokines on vascular endothelial cells and lymphatic endothelial cells leads to angiogenesis and lymphangiogenesis.

Fractalkine/CX3CL1 in Neoplastic Processes.

Fractalkine/CX3C chemokine ligand 1 (CX3CL1) is a chemokine involved in the anticancer function of lymphocytes-mainly NK cells, T cells and dendritic cells. Its increased levels in tumors improve the prognosis for cancer patients, although it is also associated with a poorer prognosis in some types of cancers, such as pancreatic ductal adenocarcinoma. This work focuses on the 'hallmarks of cancer' involving CX3CL1 and its receptor CX3CR1. First, we describe signal transduction from CX3CR1 and the role of epidermal growth factor receptor (EGFR) in this process. Next, we present the role of CX3CL1 in the context of cancer, with the focus on angiogenesis, apoptosis resistance and migration and invasion of cancer cells. In particular, we discuss perineural invasion, spinal metastasis and bone metastasis of cancers such as breast cancer, pancreatic cancer and prostate cancer. We extensively discuss the importance of CX3CL1 in the interaction with different cells in the tumor niche: tumor-associated macrophages (TAM), myeloid-derived suppressor cells (MDSC) and microglia. We present the role of CX3CL1 in the development of active human cytomegalovirus (HCMV) infection in glioblastoma multiforme (GBM) brain tumors. Finally, we discuss the possible use of CX3CL1 in immunotherapy.