Journal of Personalized Medicine

13 pages, 821 KB

Open AccessArticle

Venous Cannulation Pain as a Marker of Postoperative Pain Vulnerability: A Pre-Specified Secondary Analysis of a Randomized Controlled Trial

by Anna K. M. Persson and Krister Mogianos

J. Pers. Med. 2026, 16(1), 58; https://doi.org/10.3390/jpm16010058 - 22 Jan 2026

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Abstract

Background: Identification of patients at risk and prevention of acute postoperative pain (APOP) are central to individualized anesthesia and analgesia. Venous cannulation pain (VCP) has shown promise as a predictor of APOP. In the PeriOPerative Individualization Trial (POPIT), VCP was evaluated as [...] Read more.

Background: Identification of patients at risk and prevention of acute postoperative pain (APOP) are central to individualized anesthesia and analgesia. Venous cannulation pain (VCP) has shown promise as a predictor of APOP. In the PeriOPerative Individualization Trial (POPIT), VCP was evaluated as a pain-sensitivity stratification method to guide anesthesia and reduce postoperative pain. This report presents a predefined secondary analysis with the primary aim to evaluate VCP as a method for postoperative pain prediction. As a secondary aim, we sought to explore factors that influence VCP. Methods: 271 patients were stratified into two cohorts, high-risk (VCP ≥ 2.0) and low-risk (VCP < 2.0), for APOP, based on their VCP. Within each group, patients were randomized to receive either: standard care or opioid-free anesthesia (low-risk cohort), and standard care or multimodal anesthesia with opioids (high-risk cohort). Differences in acute and persistent pain, quality of recovery, postoperative opioid consumption, and proportion of patients experiencing moderate to severe APOP depending on VCP levels were investigated. The predictive capacity of VCP was evaluated and adjusted for in terms of potential confounders. Results: High-risk patients, grading VCP ≥ 2.0 (VAS units) experienced more APOP on the day of surgery (difference 0.9 NRS-units, 95% CI 0.2–1.6, p = 0.009) and after 24 h during movement (difference 0.6 NRS-units, 95% CI 0.0–1.3, p = 0.048). Patients grading VCP < 2.0 had better quality of recovery after 24 hr (difference 7, 95% 1–13, p = 0.002) and lower postoperative opioid consumption (difference 7.5 mg, 95% 5.7–9.3, p < 0.001). The OR for VCP ≥ 2.0 to predict APOP in PACU was 1.76 (95% CI 1.02–3.04, p = 0.043), but in a multivariate model, adjusted for age, VCP ≥ 2, gender, pain catastrophizing, preoperative pain, and pain on the day of surgery, female gender was the only independent predictor of APOP (OR 2.65 (95% CI 1.33–5.29), p = 0.006). Conclusions: Pain during venous cannulation as a predictor of acute pain after surgery was significant in univariate regression, but the results were lost when adjusting for confounders like gender and current pain. However, VCP continues to show potential in associated postoperative recovery outcomes such as opioid consumption. The level of pain associated with venous cannulation is influenced by gender, preoperative pain, and current pain on the day of surgery. Pain sensitivity stratification needs refinement before implementation in clinical practice. Full article

(This article belongs to the Section Diagnostics in Personalized Medicine)

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3 pages, 887 KB

Open AccessCorrection

Correction: Althenayyan et al. Alternatively Spliced Isoforms of MUC4 and ADAM12 as Biomarkers for Colorectal Cancer Metastasis. J. Pers. Med. 2023, 13, 135

by Saleh Althenayyan, Mohammed H. AlMuhanna, Abdulkareem AlAbdulrahman, Bandar Alghanem, Suliman A. Alsagaby, Abdulaziz Alfahed, Glowi Alasiri and Mohammad Azhar Aziz

J. Pers. Med. 2026, 16(1), 57; https://doi.org/10.3390/jpm16010057 - 22 Jan 2026

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Abstract

Error in Figure 3 [...] Full article

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10 pages, 650 KB

Open AccessArticle

Sex-Specific Differences in Patients with Hypertrophic Cardiomyopathy: A Cohort Study from Vienna

by Christopher Mann, Rodi Tosun, Shehroz Masood, Theresa M. Dachs, Franz Duca, Christina Binder-Rodriguez, Christian Hengstenberg, Marianne Gwechenberger, Thomas A. Zelniker and Daniel Dalos

J. Pers. Med. 2026, 16(1), 56; https://doi.org/10.3390/jpm16010056 - 21 Jan 2026

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Abstract

Background: Hypertrophic cardiomyopathy (HCM) is the most common inherited cardiovascular disease and affects male patients more often than women. Prior studies, however, suggested that women are diagnosed later and at advanced stages of the disease, present with more pronounced symptoms, and experience [...] Read more.

Background: Hypertrophic cardiomyopathy (HCM) is the most common inherited cardiovascular disease and affects male patients more often than women. Prior studies, however, suggested that women are diagnosed later and at advanced stages of the disease, present with more pronounced symptoms, and experience worse outcomes. Objectives: To investigate sex-specific differences in clinical, laboratory, and comprehensive imaging characteristics in a contemporary cohort of HCM patients from a tertiary referral center in Austria. Methods: We retrospectively analyzed 321 HCM patients enrolled in a prospective registry (2018–2024). All patients underwent a comprehensive baseline evaluation, including medical history, laboratory assessment, transthoracic echocardiography, and cardiac magnetic resonance imaging. Results: At diagnosis, women were significantly older (62 vs. 53 years, p < 0.001) and presented with more advanced functional class (NYHA ≥ II: 80% vs. 49%, p < 0.001). Six-minute walking distance was lower and obstructive HCM was more prevalent in women (425 vs. 505 m, p < 0.001, and 55% vs. 32%, p < 0.001, respectively). Echocardiographic assessment revealed higher diastolic filling pressures (E/E′ 18 vs. 10, p < 0.001), larger indexed atrial volumes (29.5 vs. 26.6 mL/m², p < 0.001), a higher left ventricular ejection fraction (70% vs. 62%, p < 0.001), and a larger indexed interventricular septal thickness in women (10.2 vs. 9.3 mm/m², p = 0.004). Moreover, serum levels of NT-proBNP were significantly higher in women (760 vs. 338 pg/L, p < 0.001). Conclusions: Female patients with HCM were diagnosed at an older age, presented with more advanced symptoms, had higher rates of obstructive physiology, and a phenotype characterized by diastolic dysfunction and elevated biomarkers, closely resembling heart failure with preserved ejection fraction. Recognizing these sex-specific disparities is crucial in improving diagnostic awareness and individualized therapeutic management. Full article

(This article belongs to the Section Personalized Medical Care)

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3 pages, 163 KB

Open AccessReply

Reply to Mammadov et al. Comment on “Catanzaro et al. Risk Factors for Recurrence of Primary Sclerosing Cholangitis after Liver Transplantation: Single-Center Data. J. Pers. Med. 2024, 14, 222”

by Elisa Catanzaro and Martina Gambato

J. Pers. Med. 2026, 16(1), 55; https://doi.org/10.3390/jpm16010055 - 21 Jan 2026

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Abstract

We thank Dr [...] Full article

(This article belongs to the Section Personalized Therapy in Clinical Medicine)

4 pages, 165 KB

Open AccessComment

Comment on Catanzaro et al. Risk Factors for Recurrence of Primary Sclerosing Cholangitis after Liver Transplantation: Single-Center Data. J. Pers. Med. 2024, 14, 222

by Ruslan A. Mammadov, Henk P. Roest, Maikel P. Peppelenbosch and Luc J. W. van der Laan

J. Pers. Med. 2026, 16(1), 54; https://doi.org/10.3390/jpm16010054 - 21 Jan 2026

Cited by 1 | Viewed by 233

Abstract

Primary sclerosing cholangitis (PSC) is a chronic cholestatic liver disease characterized by progressive inflammation and fibrosis of the intra- and extrahepatic bile ducts, and is often associated with inflammatory bowel disease (IBD) [...] Full article

(This article belongs to the Section Personalized Therapy in Clinical Medicine)

18 pages, 924 KB

Open AccessReview

Beyond Oral Health: Personalized Strategies for Managing Oral Infections in Neutropenic Patients

by Anca Elena Duduveche, Luminita Ocroteala and Adina Andreea Mirea

J. Pers. Med. 2026, 16(1), 53; https://doi.org/10.3390/jpm16010053 - 16 Jan 2026

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Abstract

Oral infections in neutropenic patients are an underestimated but likely fatal cause of infectious complications, with clinical manifestations often diminished or absent due to immune deficiency. The evaluation and management of these infections requires a personalized multidisciplinary strategy, including prevention through pre-therapy dental [...] Read more.

Oral infections in neutropenic patients are an underestimated but likely fatal cause of infectious complications, with clinical manifestations often diminished or absent due to immune deficiency. The evaluation and management of these infections requires a personalized multidisciplinary strategy, including prevention through pre-therapy dental assessment, individualized oral hygiene protocols, and rapid treatment of dental lesions. Antimicrobial strategies should be adapted not only to the local resistance profile and individual risk, with a priority on antibiotic stewardship and rapid de-escalation when possible, but also to individual patterns of colonization and comorbidities. Dental procedures can be performed without risk in neutropenic patients with a low complication rate, but further studies are key to stratifying risk. Future research directions include the application of artificial intelligence for infectious risk stratification, the use of salivary or microbiome biomarkers for early detection, and the development of innovative technologies for targeted antimicrobial delivery. This narrative review aims to provide an overview of the common clinical manifestations in neutropenic patients and also the potential progression of dental infections into sepsis in this category of patients. Full article

(This article belongs to the Special Issue Advances in Oral Health: Innovative and Personalized Approaches)

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21 pages, 2127 KB

Open AccessSystematic Review

Comparative Meta-Analysis: Salivary, Plasma, and Serum miRNA Profiles for Oral Squamous Cell Carcinoma Detection

by Arbi Wijaya, Vera Julia, Nurtami Soedarsono, Turmidzi Fath, Bayu Brahma, Alif Rizqy Soeratman, Denni Joko Purwanto, Yutaro Higashi, Masaaki Miyakoshi and Tsuyoshi Sugiura

J. Pers. Med. 2026, 16(1), 52; https://doi.org/10.3390/jpm16010052 - 16 Jan 2026

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Abstract

Background: MiRNAs have emerged as minimally invasive biomarkers with considerable potential for the early detection of oral squamous cell carcinoma (OSCC). Although numerous studies have evaluated circulating miRNAs across different biofluids, the comparative diagnostic performance of saliva-, serum-, and plasma-derived miRNAs has not [...] Read more.

Background: MiRNAs have emerged as minimally invasive biomarkers with considerable potential for the early detection of oral squamous cell carcinoma (OSCC). Although numerous studies have evaluated circulating miRNAs across different biofluids, the comparative diagnostic performance of saliva-, serum-, and plasma-derived miRNAs has not been systematically clarified. Methods: A meta-analysis was performed by screening PubMed, MEDLINE, Scopus, CINAHL, and related databases. Nineteen eligible studies evaluating miRNA-based assays in saliva, serum, or plasma were included. A random-effects bivariate model was used to calculate pooled sensitivity, specificity, and area under the HSROC curve. Meta-regression using log diagnostic odds ratio (lnDOR) examined whether biofluid type significantly influenced diagnostic performance. Results: Salivary miRNAs showed a pooled sensitivity of 0.76 (95% CI: 0.68–0.82; I² = 84.69%), specificity of 0.79 (95% CI: 0.70–0.85; I² = 70.41%), and an AUC of 0.84 (95% CI: 0.80–0.87). Plasma miRNAs produced comparable results with a pooled sensitivity of 0.77 (95% CI: 0.61–0.88; I² = 90.45%), specificity of 0.79 (95% CI: 0.63–0.89; I² = 80.20%), and an AUC of 0.85 (95% CI: 0.81–0.89). Serum-derived miRNAs demonstrated the highest accuracy with a pooled sensitivity of 0.82 (95% CI: 0.70–0.90; I² = 76.92%), specificity of 0.88 (95% CI: 0.75–0.95; I² = 74.87%), and an AUC of 0.91 (95% CI: 0.89–0.94). Despite serum’s numerically superior performance, meta-regression revealed no significant matrix effect (Wald χ² = 0.20, p = 0.903). Conclusions: Although serum-derived miRNAs performed best overall, biofluid type was not a statistically significant determinant of diagnostic performance. Full article

(This article belongs to the Special Issue Personalized Diagnosis and Treatment for Head and Neck Cancer)

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13 pages, 2180 KB

Open AccessArticle

Functional, Cohort-Level Assessment of CFTR Modulator Responses Using Biobanked Nasal Epithelial Cells from Individuals with Cystic Fibrosis

by Bente L. Aalbers, Gimano D. Amatngalim, Ellen M. Aarts, Lisa W. Rodenburg, Loes A. den Hertog-Oosterhoff, Harry G. M. Heijerman and Jeffrey M. Beekman

J. Pers. Med. 2026, 16(1), 51; https://doi.org/10.3390/jpm16010051 - 15 Jan 2026

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Abstract

Background/Objectives: Individual responses to CFTR modulators vary widely among people with cystic fibrosis (pwCF), underscoring the need for functional approaches that provide biological context alongside genotype-based therapy selection. Nasal epithelial cultures provide an individual-specific model for theratyping, but most studies rely on [...] Read more.

Background/Objectives: Individual responses to CFTR modulators vary widely among people with cystic fibrosis (pwCF), underscoring the need for functional approaches that provide biological context alongside genotype-based therapy selection. Nasal epithelial cultures provide an individual-specific model for theratyping, but most studies rely on freshly isolated cells, restricting repeated testing and long-term sample use. In this study, we tested whether CFTR modulator responses measured in biobanked nasal cells were associated with real-world clinical outcomes. Methods: Cryopreserved nasal epithelial cells from 23 pwCF were differentiated at the air–liquid interface and assessed for CFTR modulator-responsive ion transport using Ussing chambers. In vitro responses were correlated with 6-month changes in sweat chloride concentration (SCC), FEV₁, and BMI. Results: Cryopreserved cultures retained donor-specific CFTR modulator responsiveness. Modulator-induced forskolin/IBMX-stimulated currents correlated with changes in SCC (R = −0.512). CFTR inhibitor-sensitive currents correlated with FEV₁ (R = 0.564). Associations between forskolin/IBMX-stimulated currents and FEV₁ were positive but did not reach statistical significance using two-tailed analysis. BMI changes showed no significant association. Conclusions: Biobanked nasal epithelial cultures preserve clinically relevant CFTR modulator responses at the cohort level, supporting their use as functional assays for population-level assessment in cystic fibrosis. This cryopreservation-based strategy enables repeated testing and may expand access to theratyping beyond freshly obtained samples. Full article

(This article belongs to the Section Diagnostics in Personalized Medicine)

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13 pages, 541 KB

Open AccessReview

Occupational Radiation Risk Stratification and Protection in Fluoroscopy-Guided Surgeons and Interventionalists: A Multispecialty Structured Narrative Review

by Nana Kwadwo Okraku-Yirenkyi, Sri Snehita Reddy Bonthu, Hanisha Bhakta, Oluwatoyin O. Duyile and Michael Bernas

J. Pers. Med. 2026, 16(1), 50; https://doi.org/10.3390/jpm16010050 - 13 Jan 2026

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Abstract

Background/Objectives: Fluoroscopy-guided procedures are widely used across surgical and interventional specialties but expose operators to ionizing radiation with associated stochastic and deterministic effects. The aim is to characterize occupational radiation exposure, evaluate the effectiveness of shielding strategies, assess long-term cancer risks, and identify [...] Read more.

Background/Objectives: Fluoroscopy-guided procedures are widely used across surgical and interventional specialties but expose operators to ionizing radiation with associated stochastic and deterministic effects. The aim is to characterize occupational radiation exposure, evaluate the effectiveness of shielding strategies, assess long-term cancer risks, and identify compliance patterns. Methods: This structured narrative review summarizes evidence on operator dose, shielding effectiveness, compliance with protective practices, and long-term cancer risk. A search of PubMed, Scopus, Embase, and Web of Science (limited to January 2000–March 2024) identified 62 records; 27 full texts were reviewed, and 16 studies met the inclusion criteria. Results: Across studies, unshielded chest exposure averaged 0.08–0.11 mSv per procedure, and eye exposure averaged 0.04–0.05 mSv. Lead aprons reduced exposure by about 90% at 0.25 mm and 99% at 0.5 mm, thyroid collars reduced neck dose by 60–70%, and lead glasses reduced ocular dose 2.5–4.5-fold. Compliance with aprons and thyroid collars was high, whereas lead glasses and lower-body shielding were inconsistently used. Limited epidemiologic data suggested a higher cancer burden in exposed surgeons, and Biologic Effects of Ionizing Radiation (BEIR) VII–based modeling projected increased lifetime risks of solid cancers in chronically exposed operators. Conclusions: Protective equipment substantially reduces operator dose, but exposure variability and inconsistent shielding practices persist and justify standardized monitoring, stronger enforcement of radiation safety protocols, and longitudinal studies. Full article

(This article belongs to the Special Issue Review Special Issue: Recent Advances in Personalized Medicine)

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18 pages, 450 KB

Open AccessReview

Post-NAC Microcalcifications in Breast Cancer: Rethinking Surgical Indications in the Era of Precision Oncology

by Sabatino D’Archi, Beatrice Carnassale, Lorenzo Scardina, Cristina Accetta, Flavia De Lauretis, Alba Di Leone, Antonio Franco, Federica Gagliardi, Stefano Magno, Francesca Moschella, Maria Natale, Alejandro Martin Sanchez, Marta Silenzi, Pierluigi Maria Rinaldi and Gianluca Franceschini

J. Pers. Med. 2026, 16(1), 49; https://doi.org/10.3390/jpm16010049 - 12 Jan 2026

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Abstract

Residual microcalcifications after neoadjuvant chemotherapy (NAC) in breast cancer remain a complex diagnostic and therapeutic challenge. Although NAC has significantly improved pathologic complete response (pCR) rates and transformed surgical approaches, the persistence or evolution of microcalcifications may not accurately reflect residual disease. This [...] Read more.

Residual microcalcifications after neoadjuvant chemotherapy (NAC) in breast cancer remain a complex diagnostic and therapeutic challenge. Although NAC has significantly improved pathologic complete response (pCR) rates and transformed surgical approaches, the persistence or evolution of microcalcifications may not accurately reflect residual disease. This discrepancy complicates radiologic interpretation, impacts surgical decision-making, and may lead to overtreatment or unnecessary mastectomies. This review synthesizes current evidence on the radiologic–pathologic correlation of post-NAC microcalcifications, their prognostic value, and their relevance to guiding surgical management in contemporary precision oncology. A narrative review of the literature was performed, focusing on imaging evolution after NAC, pathologic correlations, predictive and prognostic implications, and the role of microcalcifications in defining optimal surgical strategies, ranging from breast-conserving surgery to mastectomy. Emerging contributions from digital breast tomosynthesis, contrast-enhanced mammography (CEM), Magnetic Resonance (MR) and radiomics are also examined. Studies consistently demonstrate that residual microcalcifications are often poor predictors of viable tumor tissue after NAC. Up to half of cases with persistent calcifications may reflect minimal or absent residual invasive cancer, whereas calcifications may also persist in areas of treatment-induced necrosis or fibrosis. Reliance on calcifications alone may therefore lead to unnecessary extensive resections. Conversely, specific morphologic patterns, especially fine pleomorphic or branching calcifications, are more strongly associated with residual malignancy. Advanced imaging and radiomics show promise in improving predictive accuracy. Residual microcalcifications after NAC should not be interpreted as a direct surrogate of residual disease. A multimodal assessment integrating imaging evolution, tumor biology, and treatment response is essential to optimize surgical planning and avoid overtreatment. Precision surgery in the NAC era increasingly requires individualized decision-making supported by advanced imaging and robust radiologic–pathologic correlation. Full article

(This article belongs to the Special Issue Breast Cancer: New Advances in Diagnosis and Personalized Therapies)

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28 pages, 3242 KB

Open AccessReview

Comprehensive Landscape of Diagnostic, Prognostic and Predictive Biomarkers in Colorectal Cancer: From Genomics to Multi-Omics Integration in Precision Medicine

by Alfonso Agüera-Sánchez, Emilio Peña-Ros, Irene Martínez-Martínez and Francisco García-Molina

J. Pers. Med. 2026, 16(1), 48; https://doi.org/10.3390/jpm16010048 - 12 Jan 2026

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Abstract

Colorectal cancer (CRC) remains one of the leading causes of cancer-related morbidity and mortality worldwide. Despite advances in screening and therapeutic strategies, early detection and individualized treatment remain major challenges. In recent years, an expanding repertoire of biomarkers has emerged, spanning genomic, transcriptomic, [...] Read more.

Colorectal cancer (CRC) remains one of the leading causes of cancer-related morbidity and mortality worldwide. Despite advances in screening and therapeutic strategies, early detection and individualized treatment remain major challenges. In recent years, an expanding repertoire of biomarkers has emerged, spanning genomic, transcriptomic, proteomic, and metabolomic signatures. Epigenetic features, such as DNA methylation panels, as well as non-coding RNAs and the gut microbiome, hold potential not only for improving early diagnosis but also for refining prognosis and predicting therapeutic responses within the framework of precision oncology. This narrative review provides an updated, integrative overview of CRC diagnostic, prognostic, and predictive biomarkers. We distinguish established markers already in clinical practice, such as RAS and BRAF mutations, HER2 amplification, microsatellite instability/mismatch repair deficiency (MSI/dMMR), and widely investigated molecular alterations including TP53 mutations and immune-checkpoint-related markers, from novel biomarkers with growing translational potential. We also discuss the implementation challenges of these biomarkers in clinical practice, including issues related to validation, standardization, and cost-effectiveness, as well as the multi-modal approach for the development of composite diagnostic panels. Full article

(This article belongs to the Special Issue Advances in Colorectal Cancer: Diagnosis and Personalized Treatment)

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18 pages, 624 KB

Open AccessArticle

Insulin Resistance in Bipolar Disorder: A Real-World Cross-Sectional Study

by Andrea Aguglia, Matteo Meinero, Valentina Aprile, Tommaso Cerisola, Giuditta Mazzarello, Angelo Oggianu, Alessandra Costanza, Mario Amore, Andrea Amerio and Gianluca Serafini

J. Pers. Med. 2026, 16(1), 47; https://doi.org/10.3390/jpm16010047 - 12 Jan 2026

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Abstract

Background/Objectives: Bipolar disorder (BD) is increasingly recognized as a multisystem condition in which metabolic abnormalities, particularly insulin resistance (IR), may be linked to illness severity and neuroprogression. Despite growing evidence linking IR to adverse clinical outcomes, the data is heterogeneous and preliminary, and [...] Read more.

Background/Objectives: Bipolar disorder (BD) is increasingly recognized as a multisystem condition in which metabolic abnormalities, particularly insulin resistance (IR), may be linked to illness severity and neuroprogression. Despite growing evidence linking IR to adverse clinical outcomes, the data is heterogeneous and preliminary, and its specific association in hospitalized patients with BD remains underexplored. Methods: This cross-sectional study included 86 inpatients with a primary diagnosis with BD at the IRCCS Ospedale Policlinico San Martino, Genoa, Italy, between July 2023 and January 2024. Sociodemographic, clinical, and metabolic characteristics were systematically investigated. IR was defined as a HOMA-IR index ≥ 2.5. Results: Twenty-eight patients met criteria for IR. Insulin resistant patients showed a significantly longer illness duration, more frequent residual symptoms, and higher rates of ≥5 lifetime psychiatric hospitalizations. They also exhibited greater polypharmacy (≥4 psychotropics at discharge) and daily alcohol use. Furthermore, the IR subgroup was significantly associated with higher body mass index and triglycerides, lower HDL cholesterol and physical activity levels. Conclusions: Our findings indicate that IR is associated with markers of greater illness burden in BD. While these results are consistent with emerging hypotheses on metabolic dysfunction in BD, longitudinal studies are required to clarify temporal and causal relationships. These associations suggest that IR may represent a clinically relevant component of BD rather than a secondary metabolic consequence. Routine metabolic screening and the preferential use of metabolically neutral agents may improve long-term outcomes and align with the emerging paradigm of precision psychiatry. Full article

(This article belongs to the Section Personalized Therapy in Clinical Medicine)

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1 pages, 137 KB

Open AccessRetraction

RETRACTED: Kebede et al. Determinants of Disease Progression in Autosomal Dominant Polycystic Kidney Disease. J. Pers. Med. 2024, 14, 936

by Molla Asnake Kebede, Yewondwosen Tadesse Mengistu, Biruk Yacob Loge, Misikr Alemu Eshetu, Erkihun Pawlos Shash, Amenu Tolera Wirtu and Jickssa Mulissa Gemechu

J. Pers. Med. 2026, 16(1), 46; https://doi.org/10.3390/jpm16010046 - 9 Jan 2026

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Abstract

The journal retracts the article entitled “Determinants of Disease Progression in Autosomal Dominant Polycystic Kidney Disease“ [...] Full article

(This article belongs to the Special Issue Kidney Disease: From Basic Research to Clinical Practice)

13 pages, 1172 KB

Open AccessReview

Hypoglycaemia and Cardiac Arrhythmias in Type 1 Diabetes Mellitus: A Mechanistic Review

by Kyriaki Mavromoustakou, Christos Fragoulis, Kyriaki Cholidou, Zoi Sotiropoulou, Nektarios Anagnostopoulos, Ioannis Gastouniotis, Stavroula-Panagiota Lontou, Kyriakos Dimitriadis, Anastasia Thanopoulou, Christina Chrysohoou and Konstantinos Tsioufis

J. Pers. Med. 2026, 16(1), 45; https://doi.org/10.3390/jpm16010045 - 9 Jan 2026

Cited by 1 | Viewed by 836

Abstract

Hypoglycaemia in patients with type 1 diabetes mellitus (T1DM) remains a major clinical burden and, beyond its metabolic complications, can cause serious cardiac arrhythmias. Multiple mechanisms lead to different types of arrhythmias during hypoglycaemia. However, existing studies often involve mixed diabetes populations, small [...] Read more.

Hypoglycaemia in patients with type 1 diabetes mellitus (T1DM) remains a major clinical burden and, beyond its metabolic complications, can cause serious cardiac arrhythmias. Multiple mechanisms lead to different types of arrhythmias during hypoglycaemia. However, existing studies often involve mixed diabetes populations, small cohorts, or limited monitoring during nocturnal periods, leaving a critical gap in understanding the links between glucose fluctuations and arrhythmic events. This review provides an updated combination of experimental and clinical evidence describing how autonomic dysfunction and ionic imbalances lead to electrophysiological instability and structural remodelling of the myocardium during hypoglycaemia. Continuous glucose monitoring (CGM) combined with electrocardiographic or wearable rhythm tracking may enable early detection of glycemic and cardiac disturbances and help identify high-risk individuals. Future prospective studies using combined CGM–ECG monitoring, particularly during sleep, are essential to clarify the relationship between hypoglycaemia and arrhythmic events. Full article

(This article belongs to the Special Issue Diabetes and Its Complications: From Research to Clinical Practice)

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13 pages, 830 KB

Open AccessArticle

Outcomes of Minimally Invasive Mitral Valve Surgery Using a Multidisciplinary Team Approach: A Single-Center Experience

by Nicolas Mourad, Durr Al-Hakim, Rosalind Groenewoud, Bader Al-Zeer, Neil Wu, Amy Myring, Julie Nakahara, David Wood, Travis Schisler and Richard C. Cook

J. Pers. Med. 2026, 16(1), 44; https://doi.org/10.3390/jpm16010044 - 9 Jan 2026

Viewed by 390

Abstract

Background: The advantage of employing multidisciplinary heart teams (MDHT) for the selection process of minimally invasive (MIS) mitral valve repair (MVr) and mitral valve replacement (MVR) has been previously substantiated. Here, we outline the contributions each member of the MDHT at our [...] Read more.

Background: The advantage of employing multidisciplinary heart teams (MDHT) for the selection process of minimally invasive (MIS) mitral valve repair (MVr) and mitral valve replacement (MVR) has been previously substantiated. Here, we outline the contributions each member of the MDHT at our institution made during the intra-operative and peri-operative periods and describe their impacts on short-term outcomes. Patients and Methods: This is a single-center retrospective review of all 278 adult patients who underwent MIS MVR or MVr by a single surgeon at our institution between 2006 and 2023. The repair’s efficacy was assessed intraoperatively and at 1 year post-operation. The surgical technique involved a mini-thoracotomy and valve repair or replacement. Outcomes included post-operative mortality, complications, operative time, repair success rate, hospital length of stay (LOS), and post-operative ejection fraction. There was no control group, as all patients undergoing MIS MVR/MVr were treated within an MDHT model. Results: Delivery of regional anesthesia via paravertebral catheter (PVC) was associated with a statistically significant shorter hospital LOS (6.52 vs. 7.81 days, p = 0.028). Enhanced Recovery After Surgery (ERAS) implementation by nurses was associated with a potentially clinically important, although not statistically significant, reduction in LOS (6.7 vs. 10.1 days, p = 0.168). Introduction of the COR-KNOT^® DEVICE for securing annuloplasty sutures was associated with a statistically significant reduction in operative time (288 vs. 326 min, p < 0.001). Percutaneous cannulation, proctored by interventional cardiology in 2019, was associated with a decrease in lymphocele rate from 6.2% before 2019 to 0% after 2019. Conclusions: Initiatives implemented by our MDHT were associated with reduced post-operative LOS, shorter operative times, and lower incidence of post-operative complications. Full article

(This article belongs to the Special Issue Clinical Progress in Personalized Management of Cardiac Surgery)

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12 pages, 466 KB

Open AccessReview

The Evolving Role of Artificial Intelligence in Pediatric Asthma Management: Opportunities and Challenges for Modern Healthcare

by Valentina Fainardi, Carlo Caffarelli and Susanna Esposito

J. Pers. Med. 2026, 16(1), 43; https://doi.org/10.3390/jpm16010043 - 8 Jan 2026

Viewed by 550

Abstract

Asthma is a common chronic disease in children, contributing to significant morbidity and healthcare utilization worldwide. The integration of artificial intelligence (AI) and machine learning (ML) into pediatric asthma care is rapidly advancing, offering new opportunities for early diagnosis, risk stratification, and personalized [...] Read more.

Asthma is a common chronic disease in children, contributing to significant morbidity and healthcare utilization worldwide. The integration of artificial intelligence (AI) and machine learning (ML) into pediatric asthma care is rapidly advancing, offering new opportunities for early diagnosis, risk stratification, and personalized management. AI-driven tools can analyze complex clinical, genetic, and environmental data to identify asthma phenotypes and endotypes, predict exacerbations, and support timely interventions. In pediatric populations, these technologies enable non-invasive diagnostic approaches, remote monitoring through wearable devices, and improved medication adherence via smart inhalers and digital health platforms. Despite these advances, challenges remain, including the need for pediatric-specific datasets, transparency in AI decision-making, and careful attention to data privacy and equity. The integration of AI in pediatric asthma care and into the clinical decision system can offer personalized treatment plans, reducing the burden of the disease both for patients and health professionals. This is a narrative review on the applications of AI and ML in pediatric asthma care. Full article

(This article belongs to the Section Personalized Medical Care)

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23 pages, 821 KB

Open AccessSystematic Review

Pain and Suicide Behavior in Cancer Patients: Implications for Personalized Treatment—A Systematic Review

by Alessio Simonetti, Davide Tripaldella, Francesca Bardi, Mario Pinto, Romina Caso, Gianmarco Stella, Leonardo Monacelli, Giovanni Camardese, Antonio Maria D’Onofrio, Silvia Montanari, Delfina Janiri and Gabriele Sani

J. Pers. Med. 2026, 16(1), 42; https://doi.org/10.3390/jpm16010042 - 8 Jan 2026

Viewed by 481

Abstract

Objective: Pain is among the most common and debilitating symptoms experienced by oncology patients and has been associated with adverse mental health outcomes, including depression and suicide. Nevertheless, the relationship between pain and suicide in oncology populations remains insufficiently characterized. A clearer understanding [...] Read more.

Objective: Pain is among the most common and debilitating symptoms experienced by oncology patients and has been associated with adverse mental health outcomes, including depression and suicide. Nevertheless, the relationship between pain and suicide in oncology populations remains insufficiently characterized. A clearer understanding of this interplay is essential to guide personalized approaches aimed at reducing cancer-related burden and improving quality of life. Methods: We searched PubMed and PsycInfo without imposing limits regarding publication date using pain* AND (suicid* OR “self-harm” OR “self-injurious behavior” OR “self-inflicted injury” or “self-killing”) AND (cancer* OR oncolog* OR tumor* OR neoplasm* OR metasta*). A total of 832 articles were identified, and 15 of them were included in our review. Results: Inadequately managed pain in cancer patients is associated with a significantly elevated risk of suicidal ideation. This association is further exacerbated in individuals presenting with depressive symptoms, advanced-stage disease, or limited access to timely psychological support. These factors may interact synergistically, intensifying the emotional and cognitive burden of pain, thereby increasing vulnerability in cancer patients. Conclusions: Cancer-related pain should be conceptualized as a highly variable indicator of psychological vulnerability. Factors influencing this variability include cancer type and severity, as well as the presence of past psychopathology. These findings support the need for a personalized medicine approach, whereby pain management and psychosocial interventions are tailored to patient-specific factors such as disease stage, psychological comorbidity, and access to supportive care. Full article

(This article belongs to the Special Issue New Insights into Personalized Medicine for Anesthesia and Pain)

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13 pages, 1862 KB

Open AccessTechnical Note

Beyond Strict Physics: Using Poiseuille’s Law as a Practical Framework to Optimize and Personalize Cementoplasty

by Sylvain Grange, Rémi Grange, Vincent Habouzit, Maxime Pastor, Louis-Martin Boucher, Jean-Pierre Pelage, Natalia Gorelik and Nicolas Stacoffe

J. Pers. Med. 2026, 16(1), 41; https://doi.org/10.3390/jpm16010041 - 8 Jan 2026

Viewed by 390

Abstract

Background/Objectives: Poiseuille’s law describes the influence of radius, length, viscosity, and pressure on the flow of Newtonian fluids. Although bone cement is a non-Newtonian, shear-thinning, and polymerizing material that does not comply with this law in any predictive or quantitative sense, its qualitative [...] Read more.

Background/Objectives: Poiseuille’s law describes the influence of radius, length, viscosity, and pressure on the flow of Newtonian fluids. Although bone cement is a non-Newtonian, shear-thinning, and polymerizing material that does not comply with this law in any predictive or quantitative sense, its qualitative principles may offer a didactic framework for understanding factors that affect injectability during cementoplasty. The objective of this Technical Note is to provide an educational and conceptual interpretation of Poiseuille’s law as it relates to trocar selection, cement behavior, and procedural planning. Methods: This work presents theoretical calculations based on the r⁴/L component of Poiseuille’s equation, using manufacturer-specified internal radii for commonly used trocars. Relative flow rates were computed as r⁴/L ratios normalized to a 13-gauge, 15 cm trocar. Conceptual viscosity profiles illustrate qualitative differences among cements over time. A representative, fully anonymized clinical example is provided to illustrate the integration of these conceptual principles into practice. No experimental measurements were performed. Results: Theoretical calculations show that trocar radius has the strongest influence on theoretical flow, with an exponential effect (r⁴), whereas increasing trocar length proportionally reduces flow. Conceptual viscosity curves demonstrate the rapid rise in viscosity during polymerization and highlight the importance of timing and cement selection. The clinical example illustrates how trocar choice, access planning, and cement viscosity are adapted to lesion morphology and cortical integrity. Conclusions: Poiseuille’s law cannot model or predict bone cement behavior and has no procedural or clinical validity in cementoplasty. Its use in this Technical Note is strictly educational, providing a qualitative framework to illustrate general relationships between equipment characteristics, viscosity evolution, and resistance during injection, without offering clinical guidance or implying any impact on procedural planning, safety, or outcomes. Full article

(This article belongs to the Special Issue Exploring Interventional Radiology: New Advances and Prospects)

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15 pages, 1298 KB

Open AccessSystematic Review

Preventing Parastomal Hernias After Radical Cystectomy with Ileal Conduit: A Systematic Review Regarding Surgical Prophylactic Techniques

by Giulio Rossin, Arianna Biasatti, Ioana Alexandra Iachimovsky, Luca Braulin, Alessandro Zucchi, Tommaso Cai, Antonio Vitarelli, Michele Rizzo, Paolo Umari and Giovanni Liguori

J. Pers. Med. 2026, 16(1), 40; https://doi.org/10.3390/jpm16010040 - 8 Jan 2026

Viewed by 324

Abstract

Background/Objective: Parastomal hernia (PSH) following radical cystectomy (RC) with ileal conduit represents a significant late complication. Preventive strategies have been described but are not yet routinely incorporated into clinical practice. We conducted a systematic review of the current literature to assess the [...] Read more.

Background/Objective: Parastomal hernia (PSH) following radical cystectomy (RC) with ileal conduit represents a significant late complication. Preventive strategies have been described but are not yet routinely incorporated into clinical practice. We conducted a systematic review of the current literature to assess the efficacy of PSH preventive techniques for ileal conduit. Methods: A literature search of PubMed/MEDLINE, Scopus, CENTRAL, and Web of Science databases was conducted from 2010 to December 2024 following PRISMA guidelines. Inclusion criteria were patients undergoing RC with ileal conduit, evaluation of at least one PSH preventive strategy and reporting of PSH incidence or relevant postoperative outcomes. Eligible designs included RCTs and non-randomized cohort studies. Exclusion criteria included urinary diversions other than ileal conduit, non-bladder-related indications, non-extractable outcome data, and non-original publications. Results: Three randomized controlled trials (RCTs) and nine non-randomized studies were included in the analysis. Studies investigating both mesh and non-mesh preventive techniques were considered. Clinical PSH recurrence rates following mesh placement ranged from 0.0% to 11.1% among the included studies. RCTs using mesh placement reported conflicting conclusions regarding its protective effects. For non-mesh preventive strategies, clinical PSH recurrence rates ranged from 0.0% to 11.5%. The only RCT focusing on non-mesh approaches reported positive protective effects for the experimental group. All procedures were safe, with no significant increase in complication rates compared to conventional interventions. Conclusions: The low quality of current evidence prevents definitive conclusions regarding the protective effects of both mesh and non-mesh preventive approaches. High-quality evidence is needed to make conclusive statements on this topic. Patients at high risk for PSH development should be offered personalized preoperative counselling and the opportunity to participate in ongoing RCTs. Full article

(This article belongs to the Special Issue Personalized Urologic Surgery: Innovation and Strategies)

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7 pages, 168 KB

Open AccessEditorial

Special Issue “Current Trends and Future Challenges in Assisted Reproduction”

by Stefano Canosa

J. Pers. Med. 2026, 16(1), 39; https://doi.org/10.3390/jpm16010039 - 7 Jan 2026

Viewed by 463

Abstract

As the Special Issue on Current Trends and Future Challenges in Assisted Reproduction comes to a close, it is worth revisiting the rationale behind its conception [...] Full article

(This article belongs to the Special Issue Current Trends and Future Challenges in Assisted Reproduction)

38 pages, 2813 KB

Open AccessArticle

Long COVID Does Not Impair Hemodynamic, Vascular, or Autonomic Responses to Maximal Exercise: Sex-Stratified Study in Young Adults

by Carla Nascimento dos Santos Rodrigues, Fernanda Rico Angelotto, Vitória Luiz Diotto, Daniel da Motta Cristofoletti, Tatiana Oliveira Passos de Araújo, Marco Antonio de Lima, José Campanholi Neto, Jonato Prestes, James Navalta and Guilherme Borges Pereira

J. Pers. Med. 2026, 16(1), 38; https://doi.org/10.3390/jpm16010038 - 7 Jan 2026

Viewed by 715

Abstract

Background/Objectives: Long COVID (LC) has been linked to fatigue, exercise intolerance, and autonomic dysfunction, but sex-stratified data on cardiovascular responses to maximal exercise—an essential component of personalized medicine—are scarce. This study aimed to examine hemodynamic, autonomic, and functional responses during and up [...] Read more.

Background/Objectives: Long COVID (LC) has been linked to fatigue, exercise intolerance, and autonomic dysfunction, but sex-stratified data on cardiovascular responses to maximal exercise—an essential component of personalized medicine—are scarce. This study aimed to examine hemodynamic, autonomic, and functional responses during and up to 24 h after a cardiopulmonary exercise test (CPET) in young adults with and without Long COVID (LC). Methods: In this cross-sectional study, we assessed 38 physically active adults, who were allocated into four subgroups stratified by clinical condition (LC or control) and biological sex: control–female (CON-F; n = 10), LC–female (LC-F; n = 10), control–male (CON-M; n = 10), and LC–male (LC-M; n = 8). Outcomes included systolic (SBP) and diastolic blood pressure (DBP), heart rate (HR), cardiac output (CO), total (TPR) and peripheral vascular resistance (PVR), pulse wave velocity (PWV), augmentation index (AIx@75), and heart rate variability (HF, LF, LF/HF), assessed at rest, peak effort, recovery (1, 3, 5, 10, 30, and 60 min), and through 24 h ambulatory blood pressure monitoring (ABPM) after CPET. Results: SBP increase appropriately during exercise, with higher peaks in males (p < 0.01), and returned to baseline within 5 min across all groups. HR recovery was preserved; however, LC-F showed lower values than CON-F at 3, 5, and 10 min (126 vs. 144 bpm, p = 0.020; 119 vs. 136 bpm, p = 0.020; 94 vs. 109 bpm, p = 0.011), though all groups normalized by 60 min. PWV, AIx@75, TPR and PVR exhibited expected sex-related patterns without LC-related impairments. HRV indices showed transient post-exercise shifts (HF↓, LF↑, LF/HF↑). Ambulatory monitoring confirmed preserved circadian modulation, with normal systolic dipping (11–13%) and no abnormal nocturnal patterns. Conclusions: Young physically active adults with LC showed preserved hemodynamic, autonomic, and vascular responses during and after maximal exercise. These findings contribute to personalized medicine by showing that individualized, sex-stratified cardiovascular assessments reveal no clinically relevant impairments in this population, supporting tailored clinical decision making and exercise prescription. Full article

(This article belongs to the Special Issue Sports Cardiology and Health Promotion Through Personalized Exercise Prescription)

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13 pages, 413 KB

Open AccessArticle

Associations Between Binge-Eating Symptoms and Chronotype Among Bariatric Surgery Candidates: Clinical Implications for Preoperative Assessment—A Cross-Sectional Study

by Giovanna Lira Rosa Ciutti, Andréia Gomes Bezerra, Marcos Mônico-Neto, Lia Rita Bittencourt, Sergio Tufik, Gabriel Natan Pires and José Carlos Fernandes Galduróz

J. Pers. Med. 2026, 16(1), 37; https://doi.org/10.3390/jpm16010037 - 7 Jan 2026

Viewed by 413

Abstract

The prevalence of binge-eating behavior among individuals with obesity is reported to be higher than in the overall population. Previous studies have suggested that chronotype (more specifically, eveningness) is associated with binge-eating symptoms; however, this association remains unclear among individuals with obesity. Background/Objectives [...] Read more.

The prevalence of binge-eating behavior among individuals with obesity is reported to be higher than in the overall population. Previous studies have suggested that chronotype (more specifically, eveningness) is associated with binge-eating symptoms; however, this association remains unclear among individuals with obesity. Background/Objectives: To evaluate the association between chronotype and binge-eating symptoms in adults with severe obesity undergoing preoperative evaluation for bariatric surgery. Methods: This cross-sectional study evaluated 100 adults with severe obesity undergoing multidisciplinary preoperative assessment at a bariatric surgery clinic. Binge-eating symptoms were assessed using the Binge-Eating Scale. Chronotype was evaluated using the Morningness–Eveningness Questionnaire. Other sleep parameters were subjectively assessed using the Insomnia Severity Index, the Epworth Sleepiness Scale, the Pittsburgh Sleep Quality Index, the Functional Outcomes of Sleep Questionnaire, and the Berlin questionnaire. Psychological aspects were assessed using the Depression, Stress, and Anxiety Scale (DASS-21). Results: Clinically relevant binge-eating symptoms were identified in 50% of the patients. Regarding chronotype, 16 patients were evening-types, 45 were intermediate types, and 39 were morning-types. The proportion of the clinical sample with moderate or severe binge-eating symptoms was equivalent among the three chronotypes (p = 0.794), with patients with no binge-eating symptoms accounting for around 50% of each group. There was no association between chronotype and the binge-eating score (p = 0.702). Conclusions: Despite the high prevalence of binge-eating symptoms and an overall negative sleep profile (composed of excessively daytime sleepiness, poor sleep quality, and a high risk of sleep apnea), chronotype does not appear to influence binge-eating symptoms in this clinical sample of adults with severe obesity evaluated for bariatric surgery. These findings suggest a limited utility of chronotype assessment for identifying vulnerability to binge-eating symptoms in the preoperative setting. Full article

(This article belongs to the Special Issue Personalized Medicine of Obesity and Metabolic Disorders)

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38 pages, 1867 KB

Open AccessReview

Radiolabeled Vitamins and Nanosystems as Potential Agents in Oncology Theranostics: Developed Approaches and Future Perspectives

by Ghazal Basirinia, Albert Comelli, Pierpaolo Alongi, Muhammad Ali, Giuseppe Salvaggio, Costanza Longo, Domenico Di Raimondo, Antonino Tuttolomondo and Viviana Benfante

J. Pers. Med. 2026, 16(1), 36; https://doi.org/10.3390/jpm16010036 - 5 Jan 2026

Viewed by 586

Abstract

Theranostic approaches employing radioactive materials have emerged as innovative strategies that integrate molecular imaging with targeted therapy using nanosystems, thereby advancing the paradigm of precision medicine in oncology. Each year, substantial research efforts are dedicated to developing molecular probes capable of detecting early-stage [...] Read more.

Theranostic approaches employing radioactive materials have emerged as innovative strategies that integrate molecular imaging with targeted therapy using nanosystems, thereby advancing the paradigm of precision medicine in oncology. Each year, substantial research efforts are dedicated to developing molecular probes capable of detecting early-stage tumors, with improved efficacy and reduced toxicity to the surrounding healthy tissues. Radiopharmaceuticals based on vitamins and nanoparticles are among the most promising developments in this field, as they possess a high level of specificity and low toxicity. Vitamin B9 and vitamin B12 represent notable examples, as their targeting properties exploit the overexpression of corresponding receptors in tumor cells. In this context, future directions may include the radiolabeling of nanoparticles functionalized with these vitamins using isotopes such as [⁶⁸Ga] and [¹⁷⁷Lu], thereby enabling both diagnostic imaging and therapeutic applications. Despite the encouraging preclinical evidence, many in vitro and in vivo studies employing these strategies do not sufficiently address their translational applicability to radiotheranostics. This review highlights the most promising advances in the diagnostic and therapeutic potential of vitamin and nanoparticle-based systems. It aims to critically evaluate current findings and propose hypotheses for further study in the emerging field of radiopharmaceutical theranostics. Full article

(This article belongs to the Special Issue Cancer Immunotherapy: Current Advancements and Future Perspectives)

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15 pages, 755 KB

Open AccessSystematic Review

Prosthetic Joint Infections in Trapeziometacarpal Arthroplasty: A Comprehensive Systematic Review

by Guido Bocchino, Silvia Pietramala, Stella La Rocca, Giulia Di Pietro, Alessandro El Motassime, Giacomo Capece, Domenico De Mauro, Camillo Fulchignoni, Giulio Maccauro and Raffaele Vitiello

J. Pers. Med. 2026, 16(1), 35; https://doi.org/10.3390/jpm16010035 - 5 Jan 2026

Viewed by 543

Abstract

Background: Osteoarthritisof the first trapeziometacarpal (TMC) joint (rhizarthrosis) is a degenerative condition causing pain, reduced mobility, and functional limitations, particularly in older adults and postmenopausal women. Though conservative treatments offer symptomatic relief, advanced cases often require trapeziectomy or total joint replacement. The choice [...] Read more.

Background: Osteoarthritisof the first trapeziometacarpal (TMC) joint (rhizarthrosis) is a degenerative condition causing pain, reduced mobility, and functional limitations, particularly in older adults and postmenopausal women. Though conservative treatments offer symptomatic relief, advanced cases often require trapeziectomy or total joint replacement. The choice of prosthesis is tailored to patient-specific factors such as age, functional demands, and comorbidities. Despite the benefits of TMC joint replacements, prosthetic infections remain underexplored. Materials and Methods: This systematic review (covering 2000–2024) adhered to PRISMA guidelines, searching Medline, Cochrane, and Google Scholar for randomized controlled trials and case series. Data on demographics, prosthesis types, infection rates, and management strategies were extracted and analyzed. Results: Among 4165 TMC joint procedures reported in 63 studies, 15 cases (0.36%) involved superficial or deep infections, with Staphylococcus aureus identified in two instances. Management ranged from antibiotic therapy and debridement to prosthesis removal with or without reimplantation. Conclusions: Variability in diagnostic criteria and reporting limited uniform conclusions. Although infections are infrequent, they pose significant management challenges due to inconsistent diagnostic criteria and treatments. Early identification and tailored interventions remain critical. This review underscores the need for standardized protocols and highlights gaps in current research. Future studies should focus on multicenter trials and robust methodologies to improve outcomes and advance infection management in TMC prosthesis surgery. Full article

(This article belongs to the Special Issue Arthroplasty and Personalized Medicine: Updates and Challenges)

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11 pages, 383 KB

Open AccessArticle

Can Hertel Criteria Reliably Predict Avascular Necrosis After Intracapsular Proximal Humerus Fractures in the Elderly? A Retrospective Analysis

by Marco Simone Vaccalluzzo, Marco Sapienza, Alberto Giardina, Mirko Giuseppe Sicurella, Fabio Raciti, Andrea Vescio, Vito Pavone and Gianluca Testa

J. Pers. Med. 2026, 16(1), 34; https://doi.org/10.3390/jpm16010034 - 5 Jan 2026

Viewed by 662

Abstract

Background/Objectives: Avascular necrosis (AVN) of the humeral head is a severe complication after intracapsular proximal humerus fractures in the elderly. Hertel’s radiographic classification is widely used to estimate ischemic risk, yet its real-world accuracy remains debated. Methods: We retrospectively analyzed 204 patients aged [...] Read more.

Background/Objectives: Avascular necrosis (AVN) of the humeral head is a severe complication after intracapsular proximal humerus fractures in the elderly. Hertel’s radiographic classification is widely used to estimate ischemic risk, yet its real-world accuracy remains debated. Methods: We retrospectively analyzed 204 patients aged ≥65 years treated between 2019 and 2022 for intracapsular proximal humerus fractures. Fractures were classified according to Hertel’s criteria and the LEGO system. The incidence of AVN and its association with radiographic predictors were assessed. Diagnostic performance metrics (sensitivity, specificity, predictive values, accuracy) were calculated for Hertel’s classification. Results: AVN developed in 22 patients (10.8%). High-risk fractures according to Hertel’s criteria showed a 24.7% AVN rate versus 0.8% in low-risk fractures (p < 0.001; OR = 38.7). Hertel’s model demonstrated high sensitivity (95.5%) and negative predictive value (99.2%) but low positive predictive value (24.7%). Medial hinge disruption and calcar extension < 8 mm were the strongest radiographic predictors (p < 0.001). Conclusions: Hertel’s classification effectively identifies elderly patients at low risk for AVN, given its high sensitivity and NPV. However, its limited positive predictive value highlights the need for integrative models combining radiographic and clinical parameters to improve ischemic risk stratification. Full article

(This article belongs to the Section Diagnostics in Personalized Medicine)

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15 pages, 6023 KB

Open AccessArticle

Imaging Assessment of Complex Renal Cysts: Comparative Value of Superb Microvascular Imaging and Contrast-Enhanced Ultrasound

by Fabrizio Urraro, Nicoletta Giordano, Vittorio Patanè, Roberto Calbi, Alfredo Clemente, Maria Chiara Brunese, Salvatore Cappabianca and Alfonso Reginelli

J. Pers. Med. 2026, 16(1), 33; https://doi.org/10.3390/jpm16010033 - 5 Jan 2026

Viewed by 540

Abstract

Background: Accurate characterization of complex renal cystic lesions is essential for individualized patient management, as enhancement patterns of septa and walls determine Bosniak classification, malignancy risk, and tailored follow-up strategies. While contrast-enhanced ultrasound (CEUS) is widely used to assess enhancement, Superb Microvascular [...] Read more.

Background: Accurate characterization of complex renal cystic lesions is essential for individualized patient management, as enhancement patterns of septa and walls determine Bosniak classification, malignancy risk, and tailored follow-up strategies. While contrast-enhanced ultrasound (CEUS) is widely used to assess enhancement, Superb Microvascular Imaging (SMI) offers a non-contrast alternative that is capable of detecting slow-flow microvascular signals. This study aimed to evaluate the diagnostic concordance, accuracy, and reproducibility of SMI compared with CEUS in the Bosniak 2019 classification, and to explore its role in personalized imaging pathways for patients with contraindications to contrast media. Methods: Eighty patients (92 cystic renal lesions) who underwent both SMI and CEUS between January 2024 and July 2025 were retrospectively analyzed. Lesions were categorized using the Bosniak 2019 criteria. CEUS served as the reference standard. Concordance between modalities was evaluated using Cohen’s κ, and diagnostic accuracy was determined by ROC analysis. Inter- and intra-reader agreement were assessed with κ and intraclass correlation coefficients (ICC), respectively. Histopathologic confirmation was available for resected Bosniak III–IV lesions. Results: SMI showed excellent concordance with CEUS (κ = 0.84, 95% CI 0.76–0.91; overall agreement 83.7%). Concordance was perfect for Bosniak I–II, good for IIF (85%), and moderate for III (68%) and IV (64%) categories. Using CEUS as the reference, SMI achieved a sensitivity of 88.5%, specificity of 90.0%, and AUC of 0.94 for distinguishing low- from high-risk lesions. Inter-reader (κ = 0.83) and intra-reader (ICC = 0.91) agreements were excellent. Among 18 surgically resected Bosniak III–IV lesions, 14 (77.8%) were malignant; SMI correctly identified 12/14 malignant and 3/4 benign cases. Conclusions: SMI shows high diagnostic accuracy and reproducibility in the assessment of complex renal cystic lesions, with strong concordance to CEUS within the Bosniak 2019 system. By providing vascular characterization without contrast administration, SMI supports more personalized renal cyst management, enabling safer imaging for patients at risk from contrast agents and potentially reducing unnecessary interventions. Further multicenter validation is warranted to define its integration into precision-oriented multiparametric renal ultrasound protocols. Full article

(This article belongs to the Section Diagnostics in Personalized Medicine)

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11 pages, 1320 KB

Open AccessArticle

A Categorical ANCOVA Approach to Severity Endophenotype-Specific Genome-Wide Association Studies in Childhood Asthma

by Shraddha Piparia, Parham Hadikhani, John Ziniti, Julian Hecker, Alvin T. Kho, Rinku Sharma, Juan C. Celedón, Michael J. McGeachie, Scott T. Weiss and Kelan G. Tantisira

J. Pers. Med. 2026, 16(1), 32; https://doi.org/10.3390/jpm16010032 - 5 Jan 2026

Viewed by 382

Abstract

Objective: Asthma is a complex and heterogeneous syndrome, making it hard to predict disease progression and suitable treatments. One strategy for reducing this uncertainty is to define genetic subtypes, or endophenotypes, that capture shared biological mechanisms. Most genome-wide studies, however, compare one subgroup [...] Read more.

Objective: Asthma is a complex and heterogeneous syndrome, making it hard to predict disease progression and suitable treatments. One strategy for reducing this uncertainty is to define genetic subtypes, or endophenotypes, that capture shared biological mechanisms. Most genome-wide studies, however, compare one subgroup against all others within a single cohort and rarely replicate their findings. We aimed to determine whether simultaneously modeling all asthma endophenotypes improves the discovery and replication of genetic associations compared with the standard one-versus-rest approach. Methods: We analyzed common single-nucleotide polymorphisms (SNPs) in the Childhood Asthma Management Program (CAMP) using an analysis of covariance (ANCOVA) across all severity-related endophenotypes, adjusting for age, sex, and ancestry principal components. SNPs showing genome-wide significance were tested for replication in the Genetics of Asthma in Costa Rican Children Study (GACRS). For comparison, we performed traditional one-versus-rest logistic regression analyses within each cohort, using identical covariates and endophenotype labels. Results: The ANCOVA identified 244 genome-wide significant SNPs in CAMP, of which six unique loci replicated in GACRS. In contrast, logistic regression recovered only four significant contrasts from those six loci in CAMP and replicated just one in GACRS. Conclusions: Our findings highlight genetic variants that are associated with asthma severity endophenotypes and demonstrate that modeling all clinical subtypes simultaneously can reveal biologically meaningful signals that are missed by standard pairwise design. Full article

(This article belongs to the Special Issue Mechanisms of Airway Inflammation in Asthma)

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11 pages, 783 KB

Open AccessArticle

Investigation of Biomarkers in Allergic Patients with Long COVID

by Fabio Romano Selvi, David Longhino, Gabriele Lucca, Ilaria Baglivo, Maria Antonietta Zavarella, Chiara Laface, Laura Bruno, Sara Gamberale, Ludovica Fabbroni, Angela Rizzi, Arianna Aruanno, Rosa Buonagura, Marina Curci, Alessandro Buonomo, Marinella Viola, Gianluca Ianiro, Francesco Landi, Matteo Tosato, Antonio Gasbarrini and Cristiano Caruso

J. Pers. Med. 2026, 16(1), 31; https://doi.org/10.3390/jpm16010031 - 5 Jan 2026

Viewed by 370

Abstract

Background: Long COVID remains a challenging and heterogeneous condition, with mechanisms that are still incompletely understood. Emerging evidence suggests that patients with allergic disease may experience more persistent post-COVID symptoms, possibly due to immune dysregulation and epithelial barrier fragility. Methods: We [...] Read more.

Background: Long COVID remains a challenging and heterogeneous condition, with mechanisms that are still incompletely understood. Emerging evidence suggests that patients with allergic disease may experience more persistent post-COVID symptoms, possibly due to immune dysregulation and epithelial barrier fragility. Methods: We carried out an observational, single-center study at the Allergy and Clinical Immunology Unit of Policlinico Universitario A. Gemelli IRCCS (Rome, Italy). Seventeen adults with confirmed allergic disease and long COVID were evaluated between July and December 2024. Biomarkers reflecting allergic inflammation and barrier integrity, blood eosinophil count, total immunoglobulin E (IgE), eosinophil cationic protein (ECP), and serum free light chains (FLCs), were measured and analyzed for interrelationships and symptom correlations. Results: Participants (10 men, 7 women; mean age 43.7 years) showed variable biomarker profiles, consistent with the heterogeneity of allergic inflammation. Mean eosinophil count was 179 ± 72 cells/µL, total IgE 165.4 ± 140.6 kU/L, ECP 64.2 ± 48.5 ng/mL, and the kappa/lambda FLC ratio 1.20 ± 0.69. Notably, elevated kappa FLC levels (>19.4 mg/L) were significantly associated with high ECP (>20 ng/mL) (χ² = 10.6, p = 0.001) and increased IgE (>200 kU/L) (χ² = 6.0, p = 0.015). Individuals with higher ECP and FLCs more often reported respiratory and systemic symptoms, especially fatigue, dyspnea, and cognitive fog, that persisted beyond six months. Conclusions: These findings suggest that biomarkers of allergic inflammation and barrier dysfunction, particularly ECP and FLCs, may contribute to the persistence of long-COVID symptoms in allergic patients. The observed links between humoral activation, eosinophilic activity, and prolonged symptom burden support a model of sustained inflammation and delayed epithelial recovery. Larger, longitudinal studies including non-allergic controls are warranted to confirm these associations and to explore whether restoring barrier integrity could shorten recovery trajectories in this vulnerable population. Full article

(This article belongs to the Special Issue Biomarkers and Pathogenesis of Infectious Diseases: From Research to Personalized Medicine)

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14 pages, 252 KB

Open AccessArticle

Personalised Psychological Care in Hospitals: An Organisational Model of Integrated, Patient- and Staff-Centred Services (2019–2024)

by Daniela Pia Rosaria Chieffo, Valentina Massaroni, Valentina Delle Donne, Letizia Lafuenti, Laura Monti, Valentina Arcangeli, Federica Moriconi, Daniele Ferrarese, Roberta Galluzzi, Eugenio Maria Mercuri, Gabriele Sani, Giampaolo Tortora and Antonio Gasbarrini

J. Pers. Med. 2026, 16(1), 30; https://doi.org/10.3390/jpm16010030 - 5 Jan 2026

Viewed by 419

Abstract

Background: Psychological services within hospitals are essential to delivering integrated, patient-centred care, yet in many health systems they remain fragmented, variably organised, or confined to specific medical specialties. The Clinical Psychology Unit of the Fondazione Policlinico Universitario Agostino Gemelli, Istituto di Ricerca [...] Read more.

Background: Psychological services within hospitals are essential to delivering integrated, patient-centred care, yet in many health systems they remain fragmented, variably organised, or confined to specific medical specialties. The Clinical Psychology Unit of the Fondazione Policlinico Universitario Agostino Gemelli, Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS), represents one of the few examples of a hospital-wide psychological governance model in Italy, but its organisational structure and longitudinal activity have not previously been systematically described. Objective: This study (I) describes the organisational design and operational components of the Gemelli Unit; (II) compares it with international organisational models using a typological framework; and (III) examines its resilience and adaptive capacity during the coronavirus disease 2019 (COVID-19) pandemic. Methods: A descriptive–narrative approach was adopted, integrating institutional documentation, routinely collected service data (2019–2024), anonymised case vignettes, and a structured comparison with national and international psychological care structures. The analysis was informed by theoretical models of integrated health-care delivery and by Donabedian’s structure–process–outcome framework. Results: Between 2019 and 2024, psychological interventions increased from 28,878 to 47,076 (+63%), with a post-pandemic average of 41,868 annual interventions. In 2024, the Unit supported 2150 patients and 340 healthcare professionals, with psycho-oncology accounting for approximately one-third of all activities. The model integrates clinical activity, staff support, conflict management, research, and training under a centralised governance structure, ensuring hospital-wide coverage and coordinated referral pathways. The comparative analysis identified four international organisational types—department-based, liaison/specialty-based, structured health-system, and academic–clinical hybrid—highlighting the hybrid and transversal nature of the Gemelli Unit and its capacity to maintain and adapt services during the COVID-19 emergency. Conclusions: The Gemelli Unit represents a distinctive hospital-wide organisational model that combines centralised governance, transversal deployment, personalised care, and structured support for healthcare professionals. These characteristics position it as a potentially transferable benchmark for health systems seeking to integrate psychological care into core organisational and clinical processes. Future work should prioritise the development of standardised outcome indicators and national frameworks to support the evaluation and harmonisation of hospital-based psychological services. Full article

(This article belongs to the Special Issue Personalized Medicine for Clinical Psychology)

17 pages, 805 KB

Open AccessReview

Genetic Variants in Liver Cirrhosis: Classifications, Mechanisms, and Implications for Clinical Practice

by Roshni Pushpa Raghavan, Kirti Theresa Alexander, Shine Sadasivan, Chetan Parmar and Manikandan Kathirvel

J. Pers. Med. 2026, 16(1), 29; https://doi.org/10.3390/jpm16010029 - 5 Jan 2026

Viewed by 696

Abstract

Background: Cirrhosis represents the final common pathway of chronic liver injury, arising from diverse etiologies such as metabolic, viral, autoimmune, and alcohol-related liver diseases. Despite similar exposures, disease progression varies considerably among individuals, suggesting a genetic contribution to susceptibility and outcome. Objective: This [...] Read more.

Background: Cirrhosis represents the final common pathway of chronic liver injury, arising from diverse etiologies such as metabolic, viral, autoimmune, and alcohol-related liver diseases. Despite similar exposures, disease progression varies considerably among individuals, suggesting a genetic contribution to susceptibility and outcome. Objective: This narrative review examines how specific genetic variants influence the risk, progression, and phenotypic expression of cirrhosis. It provides a structured synthesis of established and emerging gene associations, emphasizing their biological mechanisms and potential clinical relevance. Methods: This narrative review synthesizes evidence from all major biomedical and scientific databases, including PubMed, Scopus, Web of Science, and Google Scholar, as well as reference lists of relevant articles, covering literature published between 2005 and 2025 on genetic polymorphisms associated with cirrhosis and its etiological subtypes. Content: Variants are categorized into four mechanistic domains—metabolic regulation, immune modulation, liver enzyme activity, and ancestry-linked expression patterns—representing a novel integrative framework for understanding genetic risk in cirrhosis. Well-characterized variants such as PNPLA3, TM6SF2, HSD17B13, and MBOAT7, along with less commonly studied loci and chromosomal alterations, are discussed in relation to major etiologies, including MASLD/MASH, viral hepatitis, alcohol-related liver disease, and autoimmune conditions. Conclusions: Genetic insights into cirrhosis offer pathways toward early risk stratification and personalized disease management. While polygenic risk scores and multi-omic integration show promise, their clinical translation remains exploratory and requires further validation through large-scale prospective studies. Full article

(This article belongs to the Special Issue Liver Diseases: Diagnosis and Treatment in the Era of Personalized Medicine)

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J. Pers. Med., Volume 16, Issue 1 (January 2026) – 58 articles

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