Search

Introduction and purpose: Acute pancreatitis remains a clinically significant problem worldwide and in Poland, where its incidence is observed to be twice as high as in the global population. The aim of this study is to describe the latest available guidelines for managing patients diagnosed with acute pancreatitis, including diagnostic methods, radiological approaches, as well as conservative and invasive therapeutic treatment. Materials and Methods: The literature available on PubMed, Scopus, Google Scholar databases, and guidelines from the Polish Society of Gastroenterology was reviewed using the words: „acute pancreatitis”, „pancreas", "AP treatment", and „acute pancreatitis management”. Description of the state of knowledge: Patients with suspicion of acute pancreatitis are mainly diagnosed based on their symptoms using the Revised Atlanta Classification comprising of clinical symptoms, elevated pancreatic enzymes level, and imaging test results. The recommended therapeutic management for patients with acute pancreatitis underlines the importance of conservative treatment before the implementation of invasive procedures, the choice of which should be based on the severity and form of the condition. Summary: The existing recommendations regarding the diagnostic approach in acute pancreatitis emphasize the importance of correlating symptoms with radiological findings obtained through ultrasound, which is a quick and widely accessible diagnostic tool. In therapeutic management, conservative treatment remains significant with the early implementation of nutritional support, along with the appropriate method and timing of surgical intervention depending on the form of acute pancreatitis and the presence of infection.

Introduction and purpose The treatment of acute pancreatitis remains a clinically significant problem worldwide, as well as in Poland, where the incidence of the condition is nearly twice as high as in the global population. The aim of this study is to present the latest available guidelines regarding conservative management of patients diagnosed with acute pancreatitis, focusing on nutritional management and treatment methods. Materials and methods: The literature available in PubMed, Scopus, Google Scholar databases, and guidelines from the European Society for Clinical Nutrition and Metabolism (ESPEN) was reviewed using the following keywords: "acute pancreatitis," "AP treatment," "nutritional treatment of acute pancreatitis," "enteral nutrition," "parenteral nutrition." Description of the state of knowledge: The approach to conservative treatment for acute pancreatitis has evolved over the years. Previously, the preferred route of feeding was parenteral with limited lipid content, aimed at reducing the stress on the pancreas. Current guidelines emphasize the superiority of enteral nutrition using a complete nutritional composition. Conclusions: The latest guidelines highlight the advantage of enteral nutrition over parenteral nutrition, with implementation within 48 hours of diagnosis. This approach reduces mortality, the risk of complications, and the duration of hospital stay for patients. The appropriate caloric intake should be adjusted to the individual needs of the patient, considering the severity of the disease and coexisting conditions. Meeting the patient's energy requirements, along with the choice of administration method and precise composition of nutritional formulas, play a crucial role in therapy.

Introduction: Xenotransplantology, the field of transplantation involving organs or tissues between different species, holds great promise for addressing the global organ shortage crisis. However, the development of new technologies without proper legislative preparation raises significant moral and ethical considerations. This paper provides an overview of the current state of xenotransplantology, highlighting its revolutionary potential alongside the moral dilemmas it entails. Aim of the study: The aim of this study is to assess current social, ethical, religious, and legal trends regarding the issue of xenotransplantation. Materials and methods: To obtain up-to-date information concerning trends in xenotransplantation, a review of the PubMed and Google Scholar databases, along with the latest legislative reports in both Europe and Poland, was performed. Conclusions: Firstly, the authors briefly report on the current situation concerning transplantology and the widely spread organ donor crisis. Next, the issue of species boundaries and the moral status of non-human animals is addressed. The assessment of ethical implications of utilizing animals as organ donors is examined, along with the legal acts regulating this issue. Moreover, the authors attempt to evaluate the cultural and religious differences related to this concern. Furthermore, this study discusses the allocation and distribution of xenotransplants, considering issues of justice, fairness, and access to this innovative medical technology. Lastly, the paper delves into the risks and uncertainties associated with xenotransplantation, including the possibility of cross-species disease transmission and intensified course of organ rejection disease.

Introduction and purpose: Oral cavity diseases are a common problem in everyday clinical practice, particularly important in the context of elderly people affected by numerous chronic diseases, on the verge of frailty. These patients are often characterized by an increased risk of cardiovascular events, but also an increased risk of bleeding, which is the reason for dentists' doubts regarding the maintenance or suspension of chronic antiplatelet therapy in the periprocedural period. The aim of our work is to present the risks of untreated oral diseases and to summarize the current knowledge and recommendations on the use of antiplatelet drugs during surgical dental treatment. Description of the state of knowledge: It has been proven that the ongoing disease processes in the oral cavity exacerbate the course of chronic diseases by several different mechanisms, the best known of which are: opening the gates to the bloodstream, blood circulation of inflammatory mediators and direct colonization of the respiratory tract by microorganisms from the focal point in the oral cavity. According to current research, standard dental surgeries can be safely performed in patients taking antiplatelet drug(s) chronically without the need to discontinue therapy in the periprocedural period. The risk of prolonged or excessive bleeding in such patients is not significantly increased, and bleeding complications that occur can be managed with local haemostasis measures. Conclusions: Prevention and early treatment of oral diseases can protect against their negative global impact on health. There is no indication to interrupt chronic antiplatelet therapy with one or two drugs prior to standard dental procedures.

Eosinophilic esophagitis (EoE) is a chronic inflammatory disease, which in recent years has shown a clear upward trend of incidence and prevalence in the general population. The symptoms of EoE are very heterogeneous as well as therapy management of this entity which often causes problems in the clinical approach to the patient. Adults most often suffer from dysphagia, while children usually present non-specific symptoms such as food refusal, vomiting, nausea, etc.. Currently, we have many therapeutic paths that change the course of the disease, but high expectations are also placed on new biological drugs. This publication attempts to summarize the current state of knowledge about epidemiology, age-related clinical presentation, and therapeutic strategy of eosinophilic esophagitis.

Introduction and purpose: Obesity remains an urgent problem, both worldwide and in Poland. Approximately 25% of people in Poland are obese. Therefore, anti-obesity drugs are gaining clinical importance. The aim of this work is to describe new methods of pharmacotherapy of obesity and to give short description of the most promising research being currently conducted in the topic. Description of the state of knowledge There are four drugs currently approved for the treatment of obesity in Poland. One of them, semaglutide is not practically available yet. While flozins probably will not be used in the therapy of obesity in patients without diabetes, there are some reseach showing their usefulness in combination with GLP-1 analogs. Tirzepatide, glucose-dependent insulinotropic peptide receptor agonist, has been recently approved in the EU and seems to be an effective anti-obesity agent. New substances extending its mechanism of action and further increasing effectiveness are during research. FGF21 is a catabolic peptide hormone, showing a beneficial pleiotropic effect. Gene therapy that increases endogenous FGF21 levels is being researched. Pharmacotherapy of obesity in Poland is not financed from the general health insurance, which makes the economical aspect an important one. While inhibitors of lipid absorption and tesofensine are two drugs which had been previously classified as unsuitable for the treatment of obesity, new research show that they may be effective; along with methylphenidate these three drugs may be more accessible in financial terms. Conclusions There are many new and emerging ant-obesity agents, which will be possibly used in Poland. Tirzepatide seems to be the most promising one so far. The usefulness of new agents must be considered in terms of economic availability.