Journal Description
Journal of Clinical Medicine
Journal of Clinical Medicine
is an international, peer-reviewed, open access journal of clinical medicine, published semimonthly online by MDPI. The International Bone Research Association (IBRA), Italian Resuscitation Council (IRC), Spanish Society of Hematology and Hemotherapy (SEHH), Japan Association for Clinical Engineers (JACE), European Independent Foundation in Angiology/ Vascular Medicine (VAS) and others are all affiliated with JCM, and their members receive a discount on article processing charges.
- Open Access— free for readers, with article processing charges (APC) paid by authors or their institutions.
- High Visibility: indexed within Scopus, SCIE (Web of Science), PubMed, PMC, Embase, CAPlus / SciFinder, and other databases.
- Journal Rank: JCR - Q2 (Medicine, General & Internal) / CiteScore - Q1 (General Medicine)
- Rapid Publication: manuscripts are peer-reviewed and a first decision is provided to authors approximately 17.9 days after submission; acceptance to publication is undertaken in 2.6 days (median values for papers published in this journal in the second half of 2023).
- Recognition of Reviewers: reviewers who provide timely, thorough peer-review reports receive vouchers entitling them to a discount on the APC of their next publication in any MDPI journal, in appreciation of the work done.
- Companion journals for JCM include: Epidemiologia, Transplantology, Uro, Sinusitis, Rheumato, Journal of Clinical & Translational Ophthalmology, Journal of Vascular Diseases, Osteology, Complications, Therapeutics, and Sclerosis.
Impact Factor:
3.9 (2022);
5-Year Impact Factor:
4.1 (2022)
Latest Articles
A Review of Key Regulators of Steady-State and Ineffective Erythropoiesis
J. Clin. Med. 2024, 13(9), 2585; https://doi.org/10.3390/jcm13092585 (registering DOI) - 27 Apr 2024
Abstract
Erythropoiesis is initiated with the transformation of multipotent hematopoietic stem cells into committed erythroid progenitor cells in the erythroblastic islands of the bone marrow in adults. These cells undergo several stages of differentiation, including erythroblast formation, normoblast formation, and finally, the expulsion of
[...] Read more.
Erythropoiesis is initiated with the transformation of multipotent hematopoietic stem cells into committed erythroid progenitor cells in the erythroblastic islands of the bone marrow in adults. These cells undergo several stages of differentiation, including erythroblast formation, normoblast formation, and finally, the expulsion of the nucleus to form mature red blood cells. The erythropoietin (EPO) pathway, which is activated by hypoxia, induces stimulation of the erythroid progenitor cells and the promotion of their proliferation and survival as well as maturation and hemoglobin synthesis. The regulation of erythropoiesis is a complex and dynamic interaction of a myriad of factors, such as transcription factors (GATA-1, STAT5), cytokines (IL-3, IL-6, IL-11), iron metabolism and cell cycle regulators. Multiple microRNAs are involved in erythropoiesis, mediating cell growth and development, regulating oxidative stress, erythrocyte maturation and differentiation, hemoglobin synthesis, transferrin function and iron homeostasis. This review aims to explore the physiology of steady-state erythropoiesis and to outline key mechanisms involved in ineffective erythropoiesis linked to anemia, chronic inflammation, stress, and hematological malignancies. Studying aberrations in erythropoiesis in various diseases allows a more in-depth understanding of the heterogeneity within erythroid populations and the development of gene therapies to treat hematological disorders.
Full article
(This article belongs to the Section Hematology)
Open AccessSystematic Review
Laparoscopic Ligation of the Inferior Mesenteric Artery: A Systematic Review of an Emerging Trend for Addressing Type II Endoleak Following Endovascular Aortic Aneurysm Repair
by
Konstantinos Roditis, Paraskevi Tsiantoula, Nikolaos-Nektarios Giannakopoulos, Afroditi Antoniou, Vasileios Papaioannou, Sofia Tzamtzidou, Dimitra Manou, Konstantinos G. Seretis, Theofanis T. Papas and Nikolaos Bessias
J. Clin. Med. 2024, 13(9), 2584; https://doi.org/10.3390/jcm13092584 (registering DOI) - 27 Apr 2024
Abstract
Background/Objectives: this systematic review aims to explore the efficacy and safety of the laparoscopic ligation of the inferior mesenteric artery (IMA) as an emerging trend for addressing a type II endoleak following endovascular aortic aneurysm repair (EVAR). Methods: A comprehensive literature
[...] Read more.
Background/Objectives: this systematic review aims to explore the efficacy and safety of the laparoscopic ligation of the inferior mesenteric artery (IMA) as an emerging trend for addressing a type II endoleak following endovascular aortic aneurysm repair (EVAR). Methods: A comprehensive literature search was conducted across several databases including Medline, Scopus, and the Cochrane Central Register of Controlled Trials, adhering to the PRISMA guidelines. The search focused on articles reporting on the laparoscopic ligation of the IMA for the treatment of a type II endoleak post-EVAR. Data were extracted regarding study characteristics, patient demographics, technical success rates, postoperative outcomes, and follow-up results. Results: Our analysis included ten case studies and two retrospective cohort studies, comprising a total of 26 patients who underwent a laparoscopic ligation of the IMA between 2000 and 2023. The mean age of the cohort was 72.3 years, with a male predominance (92.3%). The mean AAA diameter at the time of intervention was 69.7 mm. The technique demonstrated a high technical success rate of 92.3%, with a mean procedure time of 118.4 min and minimal blood loss. The average follow-up duration was 19.9 months, with 73% of patients experiencing regression of the aneurysmal sac, and no reports of an IMA-related type II endoleak during the follow-up period. Conclusions: The laparoscopic ligation of the IMA for a type II endoleak following EVAR presents a promising, minimally invasive alternative with high technical success rates and favorable postoperative outcomes. Despite its potential advantages, including reduced contrast agent use and radiation exposure, its application remains limited to specialized centers. The findings suggest the need for further research in larger prospective studies to validate the effectiveness of this procedure and potentially broaden its clinical adoption.
Full article
(This article belongs to the Special Issue Vascular Surgery: Recent Developments and Emerging Trends)
►▼
Show Figures
Figure 1
Open AccessArticle
The Relationship between Tumor Budding and Tumor Deposits in Patients with Stage III Colorectal Carcinoma
by
Zdenko Bilić, Mario Zovak, Goran Glavčić, Dubravka Mužina, Amir Ibukić, Andro Košec, Davor Tomas and Alma Demirović
J. Clin. Med. 2024, 13(9), 2583; https://doi.org/10.3390/jcm13092583 (registering DOI) - 27 Apr 2024
Abstract
TDs appear more often in patients with higher TB grades in stage III CRC. A higher TB grade and a growing number of TDs were statistically significantly associated with shorter overall survival. These results could give additional emphasis to the importance of TB
[...] Read more.
TDs appear more often in patients with higher TB grades in stage III CRC. A higher TB grade and a growing number of TDs were statistically significantly associated with shorter overall survival. These results could give additional emphasis to the importance of TB as an adverse prognostic factor since a strong relationship with TDs has been demonstrated.
Full article
(This article belongs to the Special Issue Advances in the Diagnosis, Treatment of Intestinal Cancer)
Open AccessArticle
Systemic Inflammatory Response Index (SIRI) as a Predictive Marker for Adverse Outcomes in Children with New-Onset Type 1 Diabetes Mellitus
by
Alexandra-Cristina Scutca, Iulius Jugănaru, Delia-Maria Nicoară, Giorgiana-Flavia Brad, Meda-Ada Bugi, Raluca Asproniu, Lucian-Ioan Cristun and Otilia Mărginean
J. Clin. Med. 2024, 13(9), 2582; https://doi.org/10.3390/jcm13092582 (registering DOI) - 27 Apr 2024
Abstract
(1) Background: Although most cases of new-onset type 1 diabetes mellitus (T1DM) are managed without serious events, life-threatening complications do arise in a subset of patients. Our objective was to assess the correlation between elevated SIRI values and adverse events related to
[...] Read more.
(1) Background: Although most cases of new-onset type 1 diabetes mellitus (T1DM) are managed without serious events, life-threatening complications do arise in a subset of patients. Our objective was to assess the correlation between elevated SIRI values and adverse events related to the onset of T1DM. (2) Methods: This retrospective study, spanning ten years, included 187 patients with new-onset T1DM divided into three groups based on SIRI tertiles. The primary outcome was the occurrence of acute complications during hospital admission, while the secondary outcome was prolonged Intensive Care Unit (ICU) admission. (3) Results: Patients with high SIRI values were more likely to experience higher disease activity, leading to longer ICU admission times and more frequent complications. Multivariate logistic regression analysis revealed that the SIRI was independently associated with acute complications (p = 0.003) and prolonged ICU length of stay (p = 0.003). Furthermore, receiver operating characteristic analysis demonstrated the SIRI’s superior predictive accuracy compared to venous pH (AUC = 0.837 and AUC = 0.811, respectively) and to the individual component cell lineages of the SIRI. (4) Conclusions: These findings emphasize the potential utility of the SIRI as a prognostic marker in identifying patients at increased risk during T1DM hospital admissions.
Full article
(This article belongs to the Special Issue Biomarkers for Diagnosis, Complications and Therapy Effects in the Management of Endocrine and Metabolic Disorders)
►▼
Show Figures
Figure 1
Open AccessReview
Biochemical Changes in Anterior Chamber of the Eye in Diabetic Patients—A Review
by
Joanna Dolar-Szczasny, Agnieszka Drab and Robert Rejdak
J. Clin. Med. 2024, 13(9), 2581; https://doi.org/10.3390/jcm13092581 (registering DOI) - 27 Apr 2024
Abstract
This article aims to provide a comprehensive review of the biochemical changes observed in the anterior chamber of the eye in diabetic patients. The increased levels of inflammatory markers, alterations in antioxidant defense mechanisms, and elevated levels of advanced glycation end products (AGEs)
[...] Read more.
This article aims to provide a comprehensive review of the biochemical changes observed in the anterior chamber of the eye in diabetic patients. The increased levels of inflammatory markers, alterations in antioxidant defense mechanisms, and elevated levels of advanced glycation end products (AGEs) in the aqueous humor (AH) are explored. Additionally, the impact of these biochemical changes on diabetic retinopathy progression, increased intraocular pressure, and cataract formation is discussed. Furthermore, the diagnostic and therapeutic implications of these findings are presented. This study explores potential biomarkers for detecting diabetic eye disease at an early stage and monitoring its progression. An investigation of the targeting of inflammatory and angiogenic pathways as a potential treatment approach and the role of antioxidant agents in managing these biochemical changes is performed.
Full article
(This article belongs to the Special Issue Diabetic Retinopathy: Current Concepts and Future Directions)
Open AccessSystematic Review
Clival Metastases: Single-Center Retrospective Case Series and Literature Review
by
Alessandro Carretta, Giacomo Sollini, Federica Guaraldi, Arianna Rustici, Marcello Magnani, Sofia Asioli, Marco Faustini-Fustini, Ernesto Pasquini, Matteo Zoli and Diego Mazzatenta
J. Clin. Med. 2024, 13(9), 2580; https://doi.org/10.3390/jcm13092580 (registering DOI) - 27 Apr 2024
Abstract
Background/Objectives: Clivus metastases from distant neoplasms are uncommon occurrences both in clinical practice and the neurosurgical literature. Surgical management is debated, particularly about the role of surgery and the preferable approach. The aim of this study was to report our surgical experience
[...] Read more.
Background/Objectives: Clivus metastases from distant neoplasms are uncommon occurrences both in clinical practice and the neurosurgical literature. Surgical management is debated, particularly about the role of surgery and the preferable approach. The aim of this study was to report our surgical experience and review the concerning literature. Methods: Our institutional registry was retrospectively reviewed, and patients who underwent surgical treatment for clival metastasis from 1998 to 2023 were included. A PRISMA systematic review of the literature was performed. Results: Four patients were enrolled, and all of them underwent an endoscopic endonasal approach (EEA). Three presented with cranial nerve (CN) VI palsy. The aim of surgery was biopsy in all cases. No complications were reported. Mean overall survival (OS) was 6 ± 1 months. The systematic review retrieved 27 papers reporting 39 patients who underwent the surgical treatment of clivus metastases. Most of them (79.5%) presented with CN palsies, and EEA was the preferred approach in 92.3% of the cases, to perform a biopsy in most patients (59%). Two hemorrhagic complications (5.1%) were reported, and the mean OS was 9.4 ± 5.6 months. Conclusions: Clival metastases are uncommonly observed, in most cases, during advanced stages of oncological disease. The aim of surgery should be the confirmation of diagnosis and symptomatic relief, balancing the risk–benefit ratio in a multidisciplinary context. EEA is the approach of choice, and it should be carried out in experienced tertiary skull base centers.
Full article
(This article belongs to the Special Issue Emerging Treatment Options for Skull Base Tumors and Related Diseases)
►▼
Show Figures
Figure 1
Open AccessArticle
Aspergillus Sinusitis: Risk Factors and Phenotyping
by
Lena Hafrén, Riitta Saarinen, Rane Kurimo, Milla Viljanen and Marie Lundberg
J. Clin. Med. 2024, 13(9), 2579; https://doi.org/10.3390/jcm13092579 (registering DOI) - 27 Apr 2024
Abstract
Background: Aspergillus can cause fungal rhinosinusitis (FRS). We aimed to identify risk factors for sinonasal Aspergillus disease. Methods: Patients with a positive sinonasal mycological culture for Aspergillus species diagnosed in our hospital located in a continental climate were included in the 9-year
[...] Read more.
Background: Aspergillus can cause fungal rhinosinusitis (FRS). We aimed to identify risk factors for sinonasal Aspergillus disease. Methods: Patients with a positive sinonasal mycological culture for Aspergillus species diagnosed in our hospital located in a continental climate were included in the 9-year retrospective study. Results: Of the 86 patients, 3 had invasive FRS (IFRS), 51 had fungal ball (FB) disease, and 32 had chronic rhinosinusitis with fungus (CFRS). In the IFRS group, all patients had a malignancy and were immunocompromised. Allergies, allergic rhinitis, asthma, nasal polyps, and the use of inhaled and nasal steroids were more common in the CFRS group, and IgE levels were greater than those in the FB and IRFS groups (p < 0.05). Conclusion: FB disease is a relatively symptom-free single-sinus disease among elderly individuals, and IFRS is dominant among immunocompromised patients. We discovered a third patient group, predominantly with nasal polyps, atopy, asthma, and elevated blood IgE and eosinophils, that did not fulfill the allergic FRS (AFRS) criteria. It is possible that a less fulminant category of underdiagnosed AFRS exists in cold climates. Treatment with local debridement is usually sufficient for FRS, apart from IFRS, and relapses are not common in cold climates.
Full article
(This article belongs to the Section Otolaryngology)
►▼
Show Figures
Figure 1
Open AccessArticle
Sonographic Characterization of the Pericruciate Fat Pad with the Use of Compression Elastography—A Cross-Sectional Study among Healthy and Post-Injured Patients
by
Michał Kanak, Natalia Pawłuś, Marcin Mostowy, Marcin Piwnik, Marcin Domżalski and Jędrzej Lesman
J. Clin. Med. 2024, 13(9), 2578; https://doi.org/10.3390/jcm13092578 (registering DOI) - 27 Apr 2024
Abstract
Background: The pericruciate fat pad (PCFP) in the knee joint is still insufficiently studied despite its potential role in knee pathologies. This is the first reported study which aimed to clarify the characteristics of the PCFP in healthy individuals and contrast them with
[...] Read more.
Background: The pericruciate fat pad (PCFP) in the knee joint is still insufficiently studied despite its potential role in knee pathologies. This is the first reported study which aimed to clarify the characteristics of the PCFP in healthy individuals and contrast them with cases of post-traumatic injuries. Methods: Conducted as a retrospective cross-sectional study (n = 110 knees each) following STROBE guidelines, it employed grayscale ultrasound with echogenicity measurement, compression elastography with elasticity measurement, and Color Doppler for blood flow assessment. Results: PCFP showed a homogenic and hyperechoic echostructure. The echogenicity of the PCFP was higher than that of the posterior cruciate ligament (PCL) (p < 0.001, z-score = 8.97) and of the medial head of gastrocnemius (MHG) (p = 0.007, z-score = 2.72) in healthy knees, but lower than subcutaneous fat (SCF) (p < 0.001, z-score = −6.52). Post-injury/surgery, PCFP echogenicity surpassed other structures (p < 0.001; z-score for PCL 12.2; for MHG 11.65 and for SCF 12.36) and notably exceeded the control group (p < 0.001, z-score = 8.78). PCFP elasticity was lower than MHG and SCF in both groups, with significantly reduced elasticity in post-traumatic knees (ratio SCF/PCFP 15.52 ± 17.87 in case group vs 2.26 ± 2.4 in control group; p < 0.001; z-score = 9.65). Blood flow was detected in 71% of healthy PCFPs with three main patterns. Conclusions: The main findings, indicating increased echogenicity and reduced elasticity of PCFP post-trauma, potentially related to fat pad fibrosis, suggest potential applications of echogenicity and elasticity measurements in detecting and monitoring diverse knee pathologies. The description of vascularity variations supplying the PCFP adds additional value to the study by emphasizing the clinically important role of PCFP as a bridge for the middle genicular artery on its way to the inside of the knee joint.
Full article
(This article belongs to the Special Issue Clinical Advances in Musculoskeletal Disorders)
Open AccessArticle
Vitamin D and Albumin Deficiency in a Swiss Orthopaedic Surgery In-Patient Cohort
by
Craig David Kingston, Simone Santini, Dorian Hauke and Victor Valderrabano
J. Clin. Med. 2024, 13(9), 2577; https://doi.org/10.3390/jcm13092577 (registering DOI) - 27 Apr 2024
Abstract
Background: Vitamin D and protein deficiencies are common conditions in the general population. In Orthopaedic surgery, they can result in wound complications or poor bone healing. The goal of this study was, therefore, to determine the prevalence of vitamin D and albumin deficiencies
[...] Read more.
Background: Vitamin D and protein deficiencies are common conditions in the general population. In Orthopaedic surgery, they can result in wound complications or poor bone healing. The goal of this study was, therefore, to determine the prevalence of vitamin D and albumin deficiencies in patients scheduled for elective Orthopaedic procedures. Methods: We performed an observational, noninterventional study using the demographic characteristics via means chart analysis of in-patients with an elective surgery in a single Swiss Orthopaedic centre. The following variables were collected and analysed: age, gender, BMI, ASA score, rate of vitamin D supplementation before surgery, and serum preoperative levels of vitamin D, albumin, Haemoglobin, calcium, and phosphate. Results: A total of 336 patients were analysed; there were 218 women (64.9%) and 118 men (35.1%). The average age was 59.4 years (17–89 years). The average BMI was 26.8 kg/m2 (17.8–37.6) and the average ASA score was II (I–III). The overall prevalence of vitamin D deficiency was 82.1%, being more common in the male (89.8%) than female patients (77.9%). Patients who received vitamin D supplements before surgery had an average vitamin D level in the normal range. Of the subgroup of 170 patients who were over 60 years of age, 78.8% of the patients were Vitamin D deficient, with deficiency once again being more common in men (93.3%) than in women (92%). Albumin deficiency was documented in 58.9% of the cases. A total of 62.8% of all the female patients were albumin deficient, and 51.7% of all male patients were. Of the subgroup of 170 patients who were over 60 years of age, 71.8% of the patients were albumin deficient, with the deficiency being practically identical in men (71.1%) and women (72%). Conclusions: Despite increased awareness in the medical community, vitamin D and albumin deficiencies remain highly prevalent in elective Orthopaedic patients. Pre/perioperative screening and addressing possible vitamin D and albumin deficiencies are of great importance for good outcomes in Orthopaedic surgery.
Full article
(This article belongs to the Section Orthopedics)
Open AccessArticle
The Short-Term Efficacy of a Three-Week Pulmonary Rehabilitation Program among Patients with Obstructive Lung Diseases
by
Magdalena K. Klimczak, Hubert A. Krzepkowski, Wojciech J. Piotrowski and Adam J. Białas
J. Clin. Med. 2024, 13(9), 2576; https://doi.org/10.3390/jcm13092576 (registering DOI) - 27 Apr 2024
Abstract
Introduction: The recommended duration for pulmonary rehabilitation stands at a minimum of six weeks; however, this stipulation may pose constraints in various countries due to financial limitations imposed by insurance companies and/or national health funds, as is the case in Poland. Consequently,
[...] Read more.
Introduction: The recommended duration for pulmonary rehabilitation stands at a minimum of six weeks; however, this stipulation may pose constraints in various countries due to financial limitations imposed by insurance companies and/or national health funds, as is the case in Poland. Consequently, our study endeavors to analyze the short-term outcomes stemming from a condensed three-week PR regimen administered to patients diagnosed with chronic obstructive pulmonary disease (COPD), asthma, and the concomitance of these conditions (COPD-A)—this is an approach that is standard in the rehabilitation protocols endorsed by our national health fund. Methods: Patients diagnosed with COPD, asthma, and COPD-A, referred to the PR program, underwent retrospective analysis to evaluate the short-term efficacy of a three-week PR program. Patients underwent comprehensive assessment by respiratory physicians and rehabilitation consultants, leading to individualized PR programs. Clinical evaluations occurred at program onset and completion. Results: 125 patients participated: 37 COPD, 61 asthma, and 27 COPD-A. Significant improvements were observed in the COPD Assessment Test (CAT), the consensus-based GINA symptom control tool (GINA-SCT), the Modified Medical Research Council (mMRC) scale, forced expiratory volume in the first second (FEV1), forced vital capacity (FVC), and the 6-min walk test (6 MWT) distance, as well as in the St. George’s Respiratory Questionnaire (SGRQ) scores. All groups experienced reduced dyspnea severity and improved exercise tolerance. FEV1 and FVC improved in asthma and COPD-A, but not significantly in COPD. Multivariable logistic regression identified predictive factors for PR response. Conclusions: The study supports the short-term efficacy of the three-week PR program in improving clinical outcomes, exercise tolerance, and quality of life in COPD and asthma patients. Tailoring interventions based on predictors of PR response can optimize outcomes. Further research, particularly of the COPD-A group, is needed for individualized approaches. Larger sample sizes are necessary to confirm our findings.
Full article
(This article belongs to the Special Issue Advances in Pulmonary Rehabilitation)
►▼
Show Figures
Figure 1
Open AccessArticle
Comparison of Fetal Crown-Rump Length Measurements between Thawed and Fresh Embryo Transfer
by
Kyriaki Mitta, Ioannis Tsakiridis, Evaggelia Giougi, Apostolos Mamopoulos, Ioannis Kalogiannidis, Themistoklis Dagklis and Apostolos Athanasiadis
J. Clin. Med. 2024, 13(9), 2575; https://doi.org/10.3390/jcm13092575 (registering DOI) - 27 Apr 2024
Abstract
Background and Objectives: Neonates born from thawed embryo transfers tend to have a significantly higher birthweight compared to those from fresh embryo transfers. The aim of this study was to compare the crown-rump length (CRL) between thawed and fresh embryos to investigate the
[...] Read more.
Background and Objectives: Neonates born from thawed embryo transfers tend to have a significantly higher birthweight compared to those from fresh embryo transfers. The aim of this study was to compare the crown-rump length (CRL) between thawed and fresh embryos to investigate the potential causes of different growth patterns between them. Materials and Methods: This was a retrospective study (July 2010–December 2023) conducted at the Third Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece. In total, 3082 assisted reproductive technology (ART) pregnancies (4044 embryos) underwent a routine scan at 11+0–13+6 gestational weeks and were included in the study. Maternal age, the type of embryo transfer (thawed vs. fresh, donor vs. their own oocytes), CRL, twin and singleton gestations were analyzed. Results: The mean maternal age in thawed was significantly higher than in fresh embryos (39.8 vs. 35.8 years, p-value < 0.001). The mean CRL z-score was significantly higher in thawed compared to fresh embryo transfers (0.309 vs. 0.199, p-value < 0.001). A subgroup analysis on singleton gestations showed that the mean CRL z-score was higher in thawed blastocysts compared to fresh (0.327 vs. 0.215, p-value < 0.001). Accordingly, an analysis on twins revealed that the mean CRL z-score was higher in thawed blastocysts (0.285 vs. 0.184, p-value: 0.015) and in oocytes’ recipients compared to own oocytes’ cases (0.431 vs. 0.191, p-value: 0.002). Conclusions: The difference in CRL measurements between thawed and fresh embryos may be a first indication of the subsequent difference in sonographically estimated fetal weight and birthweight. This finding highlights the need for additional research into the underlying causes, including maternal factors and the culture media used.
Full article
(This article belongs to the Special Issue Clinical Risks and Perinatal Outcomes in Pregnancy and Childbirth)
►▼
Show Figures
Figure 1
Open AccessEditorial
Special Issue “Diagnosis and Treatment of Rare Diseases”
by
Álvaro Hermida-Ameijeiras
J. Clin. Med. 2024, 13(9), 2574; https://doi.org/10.3390/jcm13092574 (registering DOI) - 27 Apr 2024
Abstract
Rare diseases (RDs) represent a large and heterogeneous group of low-prevalence conditions, and 473 million people could be affected worldwide [...]
Full article
(This article belongs to the Special Issue Diagnosis and Treatment of Rare Diseases)
Open AccessArticle
Intra-Examiner Reliability and Validity of Sagittal Cervical Spine Mensuration Methods Using Deep Convolutional Neural Networks
by
Mohammad Mehdi Hosseini, Mohammad H. Mahoor, Jason W. Haas, Joseph R. Ferrantelli, Anne-Lise Dupuis, Jason O. Jaeger and Deed E. Harrison
J. Clin. Med. 2024, 13(9), 2573; https://doi.org/10.3390/jcm13092573 (registering DOI) - 27 Apr 2024
Abstract
Background: The biomechanical analysis of spine and postural misalignments is important for surgical and non-surgical treatment of spinal pain. We investigated the examiner reliability of sagittal cervical alignment variables compared to the reliability and concurrent validity of computer vision algorithms used in the
[...] Read more.
Background: The biomechanical analysis of spine and postural misalignments is important for surgical and non-surgical treatment of spinal pain. We investigated the examiner reliability of sagittal cervical alignment variables compared to the reliability and concurrent validity of computer vision algorithms used in the PostureRay® software 2024. Methods: A retrospective database of 254 lateral cervical radiographs of patients between the ages of 11 and 86 is studied. The radiographs include clearly visualized C1–C7 vertebrae that were evaluated by a human using the software. To evaluate examiner reliability and the concurrent validity of the trained CNN performance, two blinded trials of radiographic digitization were performed by an extensively trained expert user (US) clinician with a two-week interval between trials. Then, the same clinician used the trained CNN twice to reproduce the same measures within a 2-week interval on the same 254 radiographs. Measured variables included segmental angles as relative rotation angles (RRA) C1–C7, Cobb angles C2–C7, relative segmental translations (RT) C1–C7, anterior translation C2–C7, and absolute rotation angle (ARA) C2–C7. Data were remotely extracted from the examiner’s PostureRay® system for data collection and sorted based on gender and stratification of degenerative changes. Reliability was assessed via intra-class correlations (ICC), root mean squared error (RMSE), and R2 values. Results: In comparing repeated measures of the CNN network to itself, perfect reliability was found for the ICC (1.0), RMSE (0), and R2 (1). The reliability of the trained expert US was in the excellent range for all variables, where 12/18 variables had ICCs ≥ 0.9 and 6/18 variables were 0.84 ≤ ICCs ≤ 0.89. Similarly, for the expert US, all R2 values were in the excellent range (R2 ≥ 0.7), and all RMSEs were small, being 0.42 ≤ RMSEs ≤ 3.27. Construct validity between the expert US and the CNN network was found to be in the excellent range with 18/18 ICCs in the excellent range (ICCs ≥ 0.8), 16/18 R2 values in the strong to excellent range (R2 ≥ 0.7), and 2/18 in the good to moderate range (R2 RT C6/C7 = 0.57 and R2 Cobb C6/C7 = 0.64. The RMSEs for expert US vs. the CNN network were small, being 0.37 ≤ RMSEs ≤ 2.89. Conclusions: A comparison of repeated measures within the computer vision CNN network and expert human found exceptional reliability and excellent construct validity when comparing the computer vision to the human observer.
Full article
(This article belongs to the Special Issue Structural Rehabilitation of the Spine and Posture: Analysis, Techniques, and Outcomes in Clinical Research)
►▼
Show Figures
Figure 1
Open AccessFeature PaperArticle
Elasticity of the Cervix in Relation to Uterus Position
by
Anjeza Xholli, Ambrogio Pietro Londero, Umberto Scovazzi and Angelo Cagnacci
J. Clin. Med. 2024, 13(9), 2572; https://doi.org/10.3390/jcm13092572 (registering DOI) - 27 Apr 2024
Abstract
Strain elastography allows the evaluation of tissue elasticity. Background/Objectives: Tissue elasticity depends on the content and distribution of collagen fibers and is shaped by the applied tensile forces that may differ in uteri with a different angle of flexion of the corpus on
[...] Read more.
Strain elastography allows the evaluation of tissue elasticity. Background/Objectives: Tissue elasticity depends on the content and distribution of collagen fibers and is shaped by the applied tensile forces that may differ in uteri with a different angle of flexion of the corpus on the cervix. The objective was to investigate whether the angle of uterine flexion is related to cervical tissue elasticity. Methods: The anterior angle between the longitudinal axis of the uterus corpus and that of the cervix was measured in 275 non-pregnant young women by transvaginal ultrasonography and considered both as an absolute value or categorized as ≤150°, between >150° and ≤210°, and >210°. Strain elastography was used to assess tissue elasticity by placing the probe in the anterior vaginal fornix. Tissue elasticity was evaluated in the middle of the anterior cervical compartment (ACC), in the middle of the posterior cervical compartment (PCC), in the middle portion of the cervical canal (MCC), and at the internal cervical os (ICO). In a sagittal plane MCC was evaluated across the cervical canal, and ACC and PCC at a distance equal between the cervical canal and the outer anterior or posterior part of the cervix. MCC, ACC and PCC were evaluated at equal distance between the ICO and the external cervical os. Elasticity was expressed as a color score ranging from 0.1 (low elasticity) to 3 (high elasticity). Results: The angle of uterine flexion show a negative linear relation with the elasticity of the ACC (p = 0.001) and MCC (p = 0.002) and a positive relation with the elasticity of the PCC (p = 0.054). In comparison to uteri with an angle of flexion of <150°, those with an angle of flexion of >210° had lower elasticity of the ACC (p = 0.001) and MCC (p = 0.001) and higher elasticity of the PCC (p = 0.004). The ACC/PCC and PCC/MCC elasticity ratios were also significantly different (p = 0.001). Conclusions: The angle of uterine flexion is associated with changes in cervix elasticity. Retroflexion is associated with stiffer ACC and MCC and a more elastic PCC. Differences in tissue elasticity suggest structural changes of the cervix that may have implication in variate obstetric and gynecological conditions.
Full article
(This article belongs to the Section Obstetrics & Gynecology)
►▼
Show Figures
Figure 1
Open AccessArticle
Sex Disparity in the Association of Metabolic Syndrome with Cognitive Impairment
by
Yi-Min Chang, Chia-Lin Lee and Jun-Sing Wang
J. Clin. Med. 2024, 13(9), 2571; https://doi.org/10.3390/jcm13092571 (registering DOI) - 27 Apr 2024
Abstract
Background/Objectives: Metabolic syndrome (MS) is a constellation of several cardiometabolic risk factors. We investigated sex disparity in the associations between MS and cognitive impairment using cross-sectional data from Taiwan Biobank. Methods: We determined the associations of MS and its five components with cognitive
[...] Read more.
Background/Objectives: Metabolic syndrome (MS) is a constellation of several cardiometabolic risk factors. We investigated sex disparity in the associations between MS and cognitive impairment using cross-sectional data from Taiwan Biobank. Methods: We determined the associations of MS and its five components with cognitive impairment (mini-mental state examination, MMSE < 24) and the five domains of MMSE using logistic regression analyses. Results: A total of 7399 men and 11,546 women were included, and MS was significantly associated with cognitive impairment only in women (adjusted OR 1.48, 95% CI 1.29–1.71, p = 0.001) (p for interaction 0.005). In women, the association with MS was significant in orientation (adjusted OR 1.21, 95% CI 1.07–1.37, p = 0.003), memory (adjusted OR 1.12, 95% CI 1.01–1.25, p = 0.034) and design copying (adjusted OR 1.41, 95% CI 1.23–1.62, p = 0.001) (p value for interaction 0.039, 0.023, and 0.093, respectively). Among the components of MS, a large waist circumference (adjusted OR 1.25, 95% CI 1.08–1.46, p = 0.003), high fasting glucose (adjusted OR 1.16, 95% CI 1.00–1.34, p = 0.046), and low HDL cholesterol (adjusted OR 1.16, 95% CI 1.00–1.34, p = 0.049) were significantly associated with cognitive impairment in women. Conclusions: Our findings suggest that sex has a significant influence on the association between MS and cognitive dysfunction, especially in orientation and memory.
Full article
(This article belongs to the Section Endocrinology & Metabolism)
►▼
Show Figures
Figure 1
Open AccessArticle
Contemporary Prevalence of Oral Clefts in the US: Geographic and Socioeconomic Considerations
by
Hilliard T. Brydges, Matteo Laspro, Alexandra N. Verzella, Andre Alcon, Jill Schechter, Michael F. Cassidy, Bachar F. Chaya, Eduardo Iturrate and Roberto L. Flores
J. Clin. Med. 2024, 13(9), 2570; https://doi.org/10.3390/jcm13092570 (registering DOI) - 27 Apr 2024
Abstract
Background: Socio-economic status, living environments, and race have been implicated in the development of different congenital abnormalities. As orofacial clefting is the most common anomaly affecting the face, an understanding of its prevalence in the United States and its relationship with different determinants
[...] Read more.
Background: Socio-economic status, living environments, and race have been implicated in the development of different congenital abnormalities. As orofacial clefting is the most common anomaly affecting the face, an understanding of its prevalence in the United States and its relationship with different determinants of health is paramount. Therefore, the purpose of this study is to determine the modern prevalence of oral–facial clefting in the United States and its association with different social determinants of health. Methods: Utilizing Epic Cosmos, data from approximately 180 US institutions were queried. Patients born between November 2012 and November 2022 were included. Eight orofacial clefting (OC) cohorts were identified. The Social Vulnerability Index (SVI) was used to assess social determinants of health. Results: Of the 15,697,366 patients identified, 31,216 were diagnosed with OC, resulting in a prevalence of 19.9 (95% CI: 19.7–20.1) per 10,000 live births. OC prevalence was highest among Asian (27.5 CI: 26.2–28.8) and Native American (32.8 CI: 30.4–35.2) patients and lowest among Black patients (12.96 CI: 12.5–13.4). Male and Hispanic patients exhibited higher OC prevalence than female and non-Hispanic patients. No significant differences were found among metropolitan (20.23/10,000), micropolitan (20.18/10,000), and rural populations (20.02/10,000). SVI data demonstrated that OC prevalence was positively associated with the percentage of the population below the poverty line and negatively associated with the proportion of minority language speakers. Conclusions: This study examined the largest US cohort of OC patients to date to define contemporary US prevalence, reporting a marginally higher rate than previous estimates. Multiple social determinants of health were found to be associated with OC prevalence, underscoring the importance of holistic prenatal care. These data may inform clinicians about screening and counseling of expectant families based on socio-economic factors and direct future research as it identifies potential risk factors and provides prevalence data, both of which are useful in addressing common questions related to screening and counseling.
Full article
(This article belongs to the Special Issue Cleft Lip and Palate: Current Treatment and Future Options)
►▼
Show Figures
Figure 1
Open AccessArticle
Coronary Calcium Is Elevated in Patients with Myocardial Infarction without Standard Modifiable Risk Factors
by
Jeffrey L. Anderson, Stacey Knight, Li Dong, Heidi T. May, Viet T. Le, Tami L. Bair and Kirk U. Knowlton
J. Clin. Med. 2024, 13(9), 2569; https://doi.org/10.3390/jcm13092569 (registering DOI) - 27 Apr 2024
Abstract
Objectives: Recent reports have highlighted myocardial infarction (MI) patients without standard modifiable risk factors (SMRF), noting them to be surprisingly common and to have a substantial risk of adverse outcomes. The objective of this study was to address the challenge of identifying
[...] Read more.
Objectives: Recent reports have highlighted myocardial infarction (MI) patients without standard modifiable risk factors (SMRF), noting them to be surprisingly common and to have a substantial risk of adverse outcomes. The objective of this study was to address the challenge of identifying at-risk patients without SMRF and providing preventive therapy. Methods: Patients presenting between 2001 and 2021 to Intermountain Health catheterization laboratories with a diagnosis of MI were included if they also had a coronary artery calcium (CAC) scan by computed tomography within 2 years. SMRF were defined as a clinical diagnosis or treatment of hypertension, hyperlipidemia, diabetes, or smoking. The co-primary endpoints in SMRF-less patients were: (1) proportion of patients with an elevated (>50%ile) CAC score, and (2) an indication for statin therapy (i.e., CAC ≥ 100 AU or ≥75%ile). The 60-day and long-term major adverse cardiovascular events were determined. A comparison set included MI patients with SMRF. Results: We identified 429 MI patients with a concurrent CAC scan, of which 60 had no SMRF. SMRF status did not distinguish most risk factors or interventions. No-SMRF patients had a high CAC prevalence and percentile (82% ≥ 50%ile; median, 80%ile), and 77% met criteria for preventive therapy. As expected, patients with SMRF had high CAC scores and percentiles. Outcomes were more favorable for No-SMRF status and for lower CAC scores. Conclusions: Patients without SMRF presenting with an MI have a high prevalence and percentile of CAC. Wider application of CAC scans, including in those without SMRF, is promising as a method to identify an additional at-risk population for MI and to provide primary preventive therapy.
Full article
(This article belongs to the Section Cardiology)
►▼
Show Figures
Figure 1
Open AccessArticle
Differential Expression of LMNA/C and Insulin Receptor Transcript Variants in Peripheral Blood Mononuclear Cells of Leukemia Patients
by
Khalid Saud Alshaalan, Turki Khalid Albawardi, Mahmoud Zhra, Norah Bin Sulaiman, Osama Yaheia Jnied, Rimah Abdullah Saleem and Ahmad Aljada
J. Clin. Med. 2024, 13(9), 2568; https://doi.org/10.3390/jcm13092568 (registering DOI) - 27 Apr 2024
Abstract
Background: Recent research has identified alternative transcript variants of LMNA/C (LMNA, LMNC, LMNAΔ10, and LMNAΔ50) and insulin receptors (INSRs) as potential biomarkers for various types of cancer. The objective of this study was to assess the expression of LMNA/C and INSR transcript
[...] Read more.
Background: Recent research has identified alternative transcript variants of LMNA/C (LMNA, LMNC, LMNAΔ10, and LMNAΔ50) and insulin receptors (INSRs) as potential biomarkers for various types of cancer. The objective of this study was to assess the expression of LMNA/C and INSR transcript variants in peripheral blood mononuclear cells (PBMCs) of leukemia patients to investigate their potential as diagnostic biomarkers. Methods: Quantitative TaqMan reverse transcriptase polymerase chain reaction (RT-qPCR) was utilized to quantify the mRNA levels of LMNA/C (LMNA, LMNC, LMNAΔ10, and LMNAΔ50) as well as INSR (IR-A and IR-B) variants in PBMCs obtained from healthy individuals (n = 32) and patients diagnosed with primary leukemias (acute myeloid leukemia (AML): n = 17; acute lymphoblastic leukemia (ALL): n = 8; chronic myeloid leukemia (CML): n = 5; and chronic lymphocytic leukemia (CLL): n = 15). Results: Only LMNA and LMNC transcripts were notably present in PBMCs. Both exhibited significantly decreased expression levels in leukemia patients compared to the healthy control group. Particularly, the LMNC:LMNA ratio was notably higher in AML patients. Interestingly, IR-B expression was not detectable in any of the PBMC samples, precluding the calculation of the IR-A:IR-B ratio as a diagnostic marker. Despite reduced expression across all types of leukemia, IR-A levels remained detectable, indicating its potential involvement in disease progression. Conclusions: This study highlights the distinct expression patterns of LMNA/C and INSR transcript variants in PBMCs of leukemia patients. The LMNC:LMNA ratio shows promise as a potential diagnostic indicator for AML, while further research is necessary to understand the role of IR-A in leukemia pathogenesis and its potential as a therapeutic target.
Full article
(This article belongs to the Special Issue Acute Myeloid Leukemia: Latest Advances in the Diagnostics, Therapeutic Strategies and Clinical Management)
►▼
Show Figures
Figure 1
Open AccessReview
Treatment-Free Remission in Chronic Myeloid Leukemia
by
Garrett Bourne, Ravi Bhatia and Omer Jamy
J. Clin. Med. 2024, 13(9), 2567; https://doi.org/10.3390/jcm13092567 (registering DOI) - 27 Apr 2024
Abstract
With the discovery of tyrosine kinase inhibitors (TKIs), overall survival in patients with chronic myeloid leukemia (CML) now approaches that of the general population. While these TKIs have proven to be lifesaving, remaining on them lifelong creates both physical and financial burdens for
[...] Read more.
With the discovery of tyrosine kinase inhibitors (TKIs), overall survival in patients with chronic myeloid leukemia (CML) now approaches that of the general population. While these TKIs have proven to be lifesaving, remaining on them lifelong creates both physical and financial burdens for patients. Recently, multiple trials have begun looking into the efficacy of trialing patients off these TKIs to see if they can sustain treatment-free remission (TFR). TFR eligibility is currently limited to a small population of patients with both robust and sustained responses to TKIs. Currently, for those who attempt a trial of TFR, the average success rates are promising, with anywhere from 38 to 54% of patients experiencing sustained TFR. For those who fail to maintain sustained TFR, safety results to date are reassuring, with almost all patients successfully responding to the re-initiation of TKIs, with death and disease progression being very rare complications. Moving forward, research is being conducted to more accurately risk stratify patients at diagnosis and pair them with optimized upfront treatment regimens aimed at increasing candidacy for the trial of TFR.
Full article
(This article belongs to the Section Hematology)
►▼
Show Figures
Figure 1
Open AccessArticle
The Effect of a Cognitive Dual Task on Gait Parameters among Healthy Young Adults with Good and Poor Sleep Quality: A Cross-Sectional Analysis
by
Jood Dalbah, Shima A. Mohammad Zadeh and Meeyoung Kim
J. Clin. Med. 2024, 13(9), 2566; https://doi.org/10.3390/jcm13092566 (registering DOI) - 27 Apr 2024
Abstract
Background: Sleep quality is known to affect automatic and executive brain functions such as gait control and cognitive processing. This study aimed to investigate the effect of dual tasks on gait spatiotemporal parameters among young adults with good and poor sleep quality.
[...] Read more.
Background: Sleep quality is known to affect automatic and executive brain functions such as gait control and cognitive processing. This study aimed to investigate the effect of dual tasks on gait spatiotemporal parameters among young adults with good and poor sleep quality. Methods: In total, 65 young adults with a mean age of 21.1 ± 2.5 were assessed for gait analysis during single-task and dual-task conditions. The participants’ sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) and gait was assessed using the BTS Gaitlab System. The participants were asked to walk at natural speed as a single-task condition, followed by walking while performing a cognitive task as a dual-task condition. The parameters assessed included the gait velocity (m/s), cadence (steps/min), step width (m), and stride length (m). The dual-task cost (DTC) on each gait parameter was calculated. The Mann–Whitney U test was used to compare the differences in the DTC on gait variables between the good and poor sleep quality groups and the Spearman correlation test was used to assess the correlation between total PSQI scores and the DTC. Results: At a significance level of p < 0.05, a significant difference in cadence between the two sleep quality groups was observed, in addition to a positive correlation between sleep quality and the DTC effect on gait mean velocity, cadence, and stride length. Our findings also revealed a greater DTC in participants with poorer sleep quality. Conclusions: These findings contribute to our perception of the significance of sleep quality in gait performance while multitasking in younger populations.
Full article
(This article belongs to the Special Issue New Insights into Sleep Medicine)
►▼
Show Figures
Figure 1
Journal Menu
► ▼ Journal Menu-
- JCM Home
- Aims & Scope
- Editorial Board
- Reviewer Board
- Topical Advisory Panel
- Instructions for Authors
- Special Issues
- Topics
- Sections & Collections
- Article Processing Charge
- Indexing & Archiving
- Editor’s Choice Articles
- Most Cited & Viewed
- Journal Statistics
- Journal History
- Journal Awards
- Society Collaborations
- Conferences
- Editorial Office
Journal Browser
► ▼ Journal BrowserHighly Accessed Articles
Latest Books
E-Mail Alert
News
Topics
Topic in
Biology, Cancers, Current Oncology, Diseases, JCM, Pathogens
Pathogenetic, Diagnostic and Therapeutic Perspectives in Head and Neck Cancer
Topic Editors: Shun-Fa Yang, Ming-Hsien ChienDeadline: 20 June 2024
Topic in
Cancers, Cells, JCM, Radiation, Pharmaceutics, Applied Sciences, Nanomaterials, Current Oncology
Innovative Radiation Therapies
Topic Editors: Gérard Baldacchino, Eric Deutsch, Marie Dutreix, Sandrine Lacombe, Erika Porcel, Charlotte Robert, Emmanuelle Bourneuf, João Santos Sousa, Aurélien de la LandeDeadline: 30 June 2024
Topic in
Cancers, IJERPH, JCM
Bridging Oral Medicine and Systemic Disease
Topic Editors: Pia Lopez-Jornet, Ivan Alajbeg, Rui Amaral Mendes, Eduardo Pons-FusterDeadline: 7 July 2024
Topic in
Biomedicines, JCM, Membranes, Metabolites, Reports
Nephrology and Dialysis: From Bench to Bedside
Topic Editors: Eiichi Sato, Tsukasa NakamuraDeadline: 31 July 2024
Conferences
Special Issues
Special Issue in
JCM
Living with a Hereditary Anemia—Diagnosis and Clinical ManagementGuest Editors: Roberto Gambari, Eleni KatsantoniDeadline: 28 April 2024
Special Issue in
JCM
Acute Coronary Syndrome (ACS): Guidelines and Evolving Concepts in the Diagnosis, Treatment and Management
Guest Editors: Giuseppe Andò, Francesco Costa, Antonio MicariDeadline: 17 May 2024
Special Issue in
JCM
Clinical Diagnosis and Management of Pregnancy Complications
Guest Editor: Rinat Gabbay-BenzivDeadline: 31 May 2024
Special Issue in
JCM
Oral Pharmacologic Treatment of Type 2 Diabetes
Guest Editor: Juan José Gorgojo-MartínezDeadline: 15 June 2024
Topical Collections
Topical Collection in
JCM
Clinical Research and Advances in Hemodialysis
Collection Editors: Mariusz Kusztal, Kultigin Turkmen
Topical Collection in
JCM
Current Advances and Future Directions for Antithrombotic Treatment Strategies
Collection Editor: Giulio Francesco Romiti
Topical Collection in
JCM
Impact of COVID-19 on the Dental Community
Collection Editors: Hans-Peter Howaldt, Sameh Attia
Topical Collection in
JCM
Pediatric and Adolescent Gynecology
Collection Editor: Panagiotis Christopoulos