The relationship between diabetes mellitus (DM) and pancreatic cancer is complex—DM is both a risk factor and early sign of pancreatic cancer. DM is a risk factor for pancreatic cancer because it increases insulin resistance, intrapancreatic concentrations of insulin, and the bioavailability of IGF, subsequently promoting ductal cell proliferation. Accordingly, treatment targeting the insulin/IGF pathway is the focus of many researchers. Antidiabetic drugs modify the risk for pancreatic cancer—metformin's antineoplastic effect being most notable and indicating potential clinical use in pancreatic cancer. New-onset DM can also be the first manifestation of pancreatic cancer. There are several theories for the pathogenesis of DM in pancreatic cancer, the most important being that DM is a paraneoplastic syndrome caused by diabetogenic factors. As a consequence of this intricate relationship, new-onset DM after the age of 50 is considered a red flag for pancreatic cancer, prompting the need for screening in this patient population. Multiple clinical studies are currently underway exploring this matter. A better understanding of the relationship between DM and pancreatic cancer could aid in developing novel screening and treatment strategies for pancreatic cancer. This could ultimately improve the prognosis and quality of life of patients with pancreatic cancer.

Objective: To present a case of relapsing and resistant Sweet’s syndrome that developed during pregnancy together with an onset of Crohn’s disease, showing complete resolution with the use of infliximab. Clinical Presentation and Intervention: A 30-year-old pregnant woman presented with fever, skin lesions, and diarrhea. Skin biopsy confirmed neutrophilic dermatosis and she was diagnosed with Crohn’s disease after endoscopy. There was no recurrence of Sweet’s syndrome outside of her pregnancy. During a previous pregnancy, while corticosteroids were ineffective, complete regression of skin lesions was achieved using infliximab. Conclusion: The “off-label” use of infliximab is beneficial for relapsing and resistant Sweet’s syndrome.

Background: According to the Global Cancer Observatory 2020 report, pancreatic cancer occupies the 11th position among the leading causes of cancer-related mortality in both sexes, with nearly 500,000 deaths annually worldwide. This study aimed to evaluate the trend of mortality due to pancreatic cancer in Montenegro from 1990 to 2018 and to contribute to the effective planning of preventive strategies for pancreatic cancer as well as future health policies and initiatives. Methods: We utilized national data on the causes of death from pancreatic cancer and codes 157 from the 9th and C25 from the 10th revision of the International Classification of Diseases. The trend was described by using Joinpoint, Poisson, and linear regression. Results: Mortality rates of pancreatic cancer in Montenegro consistently increased (P < 0.05) for the overall level for both men and women, with the average annual percentage change (AAPC) in the AAPC order (95% confidence interval): 1.7% (0.9%–2.5%) overall, 1.3% (0.4%–2.1%) in men, and 2.2% (0.9%–3.5%) in women. The majority of those who died from pancreatic cancer were aged 65–74 years (32.7%), 55–64 years (26.3%), and 75–84 years (24.1%). Conclusions: The persistent increase in pancreatic cancer mortality rates in Montenegro, observed in both men and women, highlights a concerning public health trend. With the highest proportion of deaths occurring among individuals aged 55–84 years, these findings underscore the urgent need for policymakers to implement a national strategy targeting early detection, prevention, and improved management, especially among the most affected age groups.

Background/Objectives: Vedolizumab (VDZ), a monoclonal antibody targeting α4β7 integrin, is used in Crohn’s disease (CD) management, yet patients’ responses vary, underscoring the need for pharmacogenomic (PGx) markers. This study aimed to identify PGx pathways associated with suboptimal VDZ response using a rare-variant analytical framework. Methods: DNA from 63 CD patients treated with VDZ as first-line advanced therapy underwent whole-exome sequencing. Clinical response at week 14 classified patients as optimal responders (ORs) or suboptimal responders (SRs). Sequencing data were processed using GATK Best Practices, annotated with variant effect predictors, and filtered for rare damaging variants (damaging missense and high-confidence loss-of-function; minor allele frequency < 0.05). Variants were mapped to genes specific for SRs and ORs, and analyzed for pathway enrichment using the Reactome database. Rare-variant burden and composition differences were assessed with Fisher’s exact test and SKAT-O gene-set association analysis. Results: Suboptimal VDZ response was associated with pathways related to membrane transport (ABC-family proteins, ion channels), L1–ankyrin interactions, and bile acid recycling, while optimal response was associated with pathways involving MET signaling. SKAT-O identified lipid metabolism-related pathways as significantly different—SRs harbored variants in pro-inflammatory lipid signaling and immune cell trafficking genes (e.g., PIK3CG, CYP4F2, PLA2R1), whereas ORs carried variants in fatty acid oxidation and detoxification genes (e.g., ACADM, CYP1A1, ALDH3A2, DECR1, MMUT). Conclusions: This study underscores the potential of exome-based rare-variant analysis to stratify CD patients and guide precision medicine approaches. The identified genes and pathways are potential PGx markers for CD patients treated with VDZ.

Introduction. Nonsteroidal anti-inflammatory drug-induced colopathy is an uncommon condition associated with the long-term use of enteric-coated and slow-release nonsteroidal anti-inflammatory drugs. This paper presents a case of colopathy showing no symptoms or signs, discovered by a positive immunochemical faecal occult blood test. Case report. Performed within the framework of the National Program for Screening of Colorectal Cancer, the immunochemical faecal occult blood test was positive in a 56-year-old female patient. The colonoscopy revealed three lesions in the right colon: one erosion-ulceration and two concentric "diaphragm-like" strictures passable by the endoscope. The patient reported that she had been taking diclofenac 100 mg twice a day for the past seven years. After withdrawing the offending drug, the second colonoscopy indicated a marked improvement in the colonic mucosa while the "diaphragm-like" strictures persisted. Conclusion. The cases of nonsteroidal anti-inflammatory drug-induced colopathy are likely to become more frequent. It would be, therefore, advisable to consider the long-term u se of such d rugs as being a possible f actor that leads to mucosal injury, particularly in the right colon, as well as being a rare reason for a positive immunochemical faecal occult blood test.

Introduction While the COVID-19 pandemic disrupted everyday life for all individuals, its impact was especially pronounced in patients with chronic illnesses. Among them, individuals undergoing biological therapy experienced additional difficulties related to continuity of care and access to...