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UNIFLECA-Flecainide Effect on Idiopathic Premature Ventricular Contractions and the Associated Cardiomyopathy
The Uncommon Phenomenon of Short QT Syndrome: A Scoping Review of the Literature

Journal Description

Journal of Personalized Medicine

Journal of Personalized Medicine is an international, peer-reviewed, open access journal on personalized medicine, published monthly online by MDPI. The Inter-American Society for Minimally Invasive Spine Surgery (SICCMI), Korean Society of Brain Neuromodulation Therapy (KBNT) and American Board of Precision Medicine (ABOPM) are affiliated with JPM, 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, PubMed, PMC, Embase, and other databases.
Journal Rank: CiteScore - Q1 (Medicine (miscellaneous))
Rapid Publication: manuscripts are peer-reviewed and a first decision is provided to authors approximately 21.5 days after submission; acceptance to publication is undertaken in 3.5 days (median values for papers published in this journal in the first half of 2025).
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.

Imprint Information Journal Flyer Open Access ISSN: 2075-4426

Latest Articles

14 pages, 784 KiB

Open AccessArticle

Resting-State EEG Alpha Asymmetry as a Potential Marker of Clinical Features in Parkinson’s Disease

by Thalita Frigo da Rocha, Valton Costa, Lucas Camargo, Elayne Borges Fernandes and Anna Carolyna Gianlorenço

J. Pers. Med. 2025, 15(7), 291; https://doi.org/10.3390/jpm15070291 - 4 Jul 2025

Background: Asymmetrical brain oscillations may be characteristic of Parkinson’s disease (PD). We investigated differences in oscillation asymmetry between individuals with PD and healthy controls and explored associations between the asymmetry and clinical features. Methods: Clinical and resting-state EEG data from 37 [...] Read more.

Background: Asymmetrical brain oscillations may be characteristic of Parkinson’s disease (PD). We investigated differences in oscillation asymmetry between individuals with PD and healthy controls and explored associations between the asymmetry and clinical features. Methods: Clinical and resting-state EEG data from 37 patients and 24 controls were cross-sectionally analyzed. EEG asymmetry indices were calculated for the delta, theta, alpha, and beta frequencies in the frontal, central, and parietal regions. Independent t-tests and linear regression models were employed. Results: Patients exhibited lower alpha asymmetry than controls in the parietal region (t(59) = 2.12, p = 0.03). In the frontal alpha asymmetry models, there were associations with time since diagnosis (β = −0.042) and attention/orientation (β = 0.061), and with Movement Disorder Society-Unified Parkinson’s Disease Rating Scale (MDS-UPDRSIII)-posture (β = 0.136) and MDS-UPDRSIII-rest-tremor persistence (β = −0.111). In the central alpha model, higher asymmetry was associated with the physical activity levels (International Physical Activity Questionnaire) IPAQ-active (β = 0.646) and IPAQ-very active (β = 0.689), (Timed Up and Go) TUG dual-task cost (β = 0.023), MDS-UPDRSII-freezing (β = 0.238), and being male (β = 0.535). In the parietal alpha asymmetry model, MDS-UPDRSII-gait/balance was inversely associated with alpha asymmetry (β = −0.156), while IPAQ-active (β = −0.247) and being male (β = −0.191) were associated with lower asymmetry. Conclusions: Our findings highlight the potential role of alpha asymmetry as a neurophysiological marker of PD’s motor symptoms, mainly rest tremor, gait/balance, freezing, and specific cognitive domains such as attention/orientation. The models stressed the relationship between disease progression and reduced alpha asymmetry. Brazilian Registry of Clinical Trials (RBR-7zjgnrx, 9 June 2022). Full article

(This article belongs to the Section Disease Biomarker)

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14 pages, 389 KiB

Open AccessReview

Relationship Between Vitamin D Deficiency and Postpartum Depression

by Ioanna Apostolidou, Marios Baloukas and Ioannis Tsamesidis

J. Pers. Med. 2025, 15(7), 290; https://doi.org/10.3390/jpm15070290 - 4 Jul 2025

Background/Objectives: Postpartum depression (PPD) affects approximately 10–20% of women during and after pregnancy, posing significant risks to maternal health, infant development, and family dynamics. Identifying modifiable risk factors is essential for prevention. Emerging evidence suggests that vitamin D, a neuroactive steroid hormone involved [...] Read more.

Background/Objectives: Postpartum depression (PPD) affects approximately 10–20% of women during and after pregnancy, posing significant risks to maternal health, infant development, and family dynamics. Identifying modifiable risk factors is essential for prevention. Emerging evidence suggests that vitamin D, a neuroactive steroid hormone involved in neurotransmitter synthesis, neuroinflammation regulation, and calcium homeostasis, may play a protective role against mood disorders, including PPD. Methods: The search was conducted through a comprehensive search of the PubMed, Scopus, and Web of Science databases using a combination of Medical Subject Headings (MeSH) and free-text terms including “vitamin D”, “25-hydroxyvitamin D”, “deficiency”, “pregnancy”, “postpartum”, “depression”, “antenatal depression”, “maternal mental health”, and “perinatal mood disorders”. Results: Numerous observational studies and systematic review reports around the world reinforce the potential global relevance of vitamin D insufficiency. This study advances personalized and precision medicine approaches by emphasizing the importance of individualized screening for vitamin D deficiency during pregnancy and postpartum, enabling tailored interventions that could mitigate the risk of postpartum depression. Conclusions: In conclusion, while a definitive causal relationship between vitamin D deficiency and perinatal depression remains unproven, screening for vitamin D levels during pregnancy could serve as a low-risk intervention to support maternal mental health. Future research should focus on well designed, large-scale randomized trials and standardization of diagnostic criteria to clarify vitamin D’s role in preventing perinatal depression. Recognizing vitamin D status as a modifiable biomarker allows for targeted nutritional and pharmacological strategies to optimize maternal mental health. Full article

(This article belongs to the Special Issue Hormone Therapies for Women)

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10 pages, 449 KiB

Open AccessArticle

Accuracy of Lower Extremity Alignment Correction Using Patient-Specific Cutting Guides and Anatomically Contoured Plates

by Julia Matthias, S Robert Rozbruch, Austin T. Fragomen, Anil S. Ranawat and Taylor J. Reif

J. Pers. Med. 2025, 15(7), 289; https://doi.org/10.3390/jpm15070289 - 4 Jul 2025

Background/Objectives: Limb malalignment disrupts physiological joint forces and predisposes individuals to the development of osteoarthritis. Surgical interventions such as distal femur or high tibial osteotomy aim to restore mechanical balance on weight-bearing joints, thereby reducing long-term morbidity. Accurate alignment is crucial since [...] Read more.

Background/Objectives: Limb malalignment disrupts physiological joint forces and predisposes individuals to the development of osteoarthritis. Surgical interventions such as distal femur or high tibial osteotomy aim to restore mechanical balance on weight-bearing joints, thereby reducing long-term morbidity. Accurate alignment is crucial since it cannot be adjusted after stabilization with plates and screws. Recent advances in personalized medicine offer the opportunity to tailor surgical corrections to each patient’s unique anatomy and biomechanical profile. This study evaluates the benefits of 3D planning and patient-specific cutting guides over traditional 2D planning with standard implants for alignment correction procedures. Methods: We assessed limb alignment parameters pre- and postoperatively in patients with varus and valgus lower limb malalignment undergoing acute realignment surgery. The cohort included 23 opening-wedge high tibial osteotomies and 28 opening-wedge distal femur osteotomies. We compared the accuracy of postoperative alignment parameters between patients undergoing traditional 2D preoperative X-ray planning and those using 3D reconstructions of CT data. Outcome measures included mechanical axis deviation and tibiofemoral angles. Results: 3D reconstructions of computerized tomography data and patient-specific cutting guides significantly reduced the variation in postoperative limb alignment parameters relative to preoperative goals. In contrast, traditional 2D planning with standard non-custom implants resulted in higher deviations from the targeted alignment. Conclusions: Utilizing 3D CT reconstructions and patient-specific cutting guides enhances the accuracy of postoperative limb realignment compared to traditional 2D X-ray planning with standard non-custom implants. Patient-specific instrumentation and personalized approaches represent a key step toward precision orthopedic surgery, tailoring correction strategies to individual patient anatomy and potentially improving long-term joint health. This improvement may reduce the morbidity associated with lower limb malalignment and delay the onset of osteoarthritis. Level of Evidence: Therapeutic Level III. Full article

(This article belongs to the Special Issue Orthopedic Diseases: Advances in Limb Reconstruction)

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8 pages, 1411 KiB

Open AccessBrief Report

Computational Fluid Dynamics Simulations to Personalize Nasal Irrigations

by Thomas Radulesco, Dario Ebode, Ralph Haddad, Jerome R. Lechien, Lionel Meister, Stephane Gargula and Justin Michel

J. Pers. Med. 2025, 15(7), 288; https://doi.org/10.3390/jpm15070288 - 3 Jul 2025

Background/Objectives: Proper nasal irrigation techniques are essential for treating nasal and sinus conditions, influencing drug delivery efficiency and patient comfort. This study evaluates how different head positions—upright, right-tilted, and left-tilted—affect the distribution of saline solution in the nasal cavity and maxillary sinus [...] Read more.

Background/Objectives: Proper nasal irrigation techniques are essential for treating nasal and sinus conditions, influencing drug delivery efficiency and patient comfort. This study evaluates how different head positions—upright, right-tilted, and left-tilted—affect the distribution of saline solution in the nasal cavity and maxillary sinus using computational fluid dynamics (CFD). Methods: CFD simulations were conducted on a CT-based model of a healthy adult. A 4 mL saline solution was administered into the right nostril over three seconds. Fluid distribution and percentage of nasal mucosa coverage was analyzed in the inferior, middle, and superior thirds of the nasal cavity and the right maxillary sinus. Results: In the upright position, fluid primarily accumulated in the inferior (0.075 mL) and middle (0.015 mL) nasal regions, with minimal sinus penetration (0.002 mL). Right-tilting improved maxillary sinus coverage (0.028 mL) and increased irrigation of the inferior region (0.086 mL), while left-tilting enhanced central nasal coverage with only slight sinus penetration improvement. Irrigation patterns exhibited a rapid initial wetting phase followed by a slower, steady increase. Conclusions: Head position significantly influences the distribution achieved by nasal irrigation. These findings can guide clinical recommendations for specific conditions or postoperative care. Full article

(This article belongs to the Special Issue Personalized Medicine in Otolaryngology—Head and Neck Surgery: Updates and Challenges)

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14 pages, 700 KiB

Open AccessArticle

The Association Between Psychosocial Stress and Perinatal Maternal Depressive Symptoms: A Case–Control Study in a Regional Medical Center in Hungary

by Anita Sisák, Evelin Polanek, Regina Molnár, Andrea Szabó, Ferenc Rárosi, Armita Hosseini, Gábor Németh, Hajnalka Orvos and Edit Paulik

J. Pers. Med. 2025, 15(7), 287; https://doi.org/10.3390/jpm15070287 - 3 Jul 2025

Perinatal depression is one of the most common mental illnesses in women. The aim of this study was to assess the association of life stressors, perceived stress, obstetric and neonatal complications, and depressive symptoms in the early postpartum period and to compare these [...] Read more.

Perinatal depression is one of the most common mental illnesses in women. The aim of this study was to assess the association of life stressors, perceived stress, obstetric and neonatal complications, and depressive symptoms in the early postpartum period and to compare these variables in two groups of women (preterm and term deliveries). Methods: A case–control study was conducted among 300 women who gave birth in 2019 at the University of Szeged. Cases included women with preterm deliveries (<37 weeks, n = 100), and the controls included women with term deliveries (≥37 weeks, n = 200). Data were collected during postpartum hospital stays through a self-administered questionnaire (containing validated questionnaires: the Holmes–Rahe Life Stress Inventory, the Perceived Stress Scale (PSS-14), and the Edinburgh Postnatal Depression Scale (EPDS)) and the medical records of women and newborns. A descriptive statistical analysis and logistic regression were used to identify predictors of high EPDS scores (≥10). Results: Perceived stress levels were significantly higher among cases than controls (p < 0.001). Higher perceived stress was associated with a higher risk of depression in cases (OR: 1.31, 95% CI: 1.17–1.48, p < 0.001) and controls (OR: 1.33, 95% CI: 1.21–1.45, p < 0.001), too. Newborn complications were associated with an increased perinatal depression risk in the controls (OR: 2.48, 95% CI: 1.05–5.91; p = 0.039) but not in the cases (OR: 2.79, 95% CI: 0.79–9.85; p = 0.111). It is supposed that premature birth was stressful itself, and women with preterm babies were less sensitive to any complications occurring in their newborns compared to women with term newborns. Neither maternal age, education, nor obstetric complications predicted depressive symptoms. Conclusions: Our findings highlight the impact of maternal perceived stress and newborns’ health status on the risk of developing depression during the early postpartum period. These results emphasize the need for ongoing screening and follow-up measures, especially for women with higher EPDS scores. Full article

(This article belongs to the Section Epidemiology)

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12 pages, 519 KiB

Open AccessArticle

Cardiac Autonomic Measures Predict Clinician-Rated Anxiety and Behavioral Response to Propranolol in Autistic Children and Young Adults

by Carrina Appling, Nanan Nuraini, Ryan Holem, Samantha Hunter, Kathy Hirst, Nicole Takahashi, Micah O. Mazurek, Stephen M. Kanne, Bradley Ferguson and David Q. Beversdorf

J. Pers. Med. 2025, 15(7), 286; https://doi.org/10.3390/jpm15070286 - 3 Jul 2025

Propranolol, a nonselective beta-adrenergic antagonist, has shown potential for improving anxiety in autistic individuals. Heart rate variability (HRV), a noninvasive cardiac marker of autonomic nervous system functioning, may help identify individuals most likely to benefit from propranolol. Objectives: Determine if baseline resting [...] Read more.

Propranolol, a nonselective beta-adrenergic antagonist, has shown potential for improving anxiety in autistic individuals. Heart rate variability (HRV), a noninvasive cardiac marker of autonomic nervous system functioning, may help identify individuals most likely to benefit from propranolol. Objectives: Determine if baseline resting HRV and other cardiac measures predict the response to propranolol for anxiety and core autism symptomology in autistic children and young adults. Methods: Sixty-two autistic individuals (ages 7–24) participated in a two-phase (i.e., a 12-week randomized controlled trial and a 12-week open-label extension) trial of propranolol. Baseline (i.e., resting state, prior to treatment) HRV and other cardiac measures were obtained from an electrocardiogram. Clinical global impression for anxiety symptoms and overall behavioral treatment impact were assessed after the 12-week trial period. Group-level (i.e., all participants) and responder groups (i.e., strong, minimal, and non-responders to propranolol) were analyzed for treatment effects. Results: HRV variables predicted group-level anxiety response to propranolol, particularly for strong responders. Also, lower baseline values of parasympathetic HRV indices were significantly correlated with greater behavioral improvement after treatment with propranolol. Last, several baseline cardiac variables were associated with improvement in multiple behavioral domains after treatment with propranolol. Conclusions: HRV may be a potential biomarker for predicting reduced anxiety and behavioral symptoms in response to propranolol in autistic children and young adults. Identifying autonomic profiles associated with positive treatment outcomes could guide future personalized interventions in autism. The results presented herein should be regarded as preliminary until the findings are replicated in future clinical trials. Full article

(This article belongs to the Special Issue Personalized Medicine for Autism Spectrum Disorder)

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35 pages, 4138 KiB

Open AccessArticle

Shoulder and Scapular Function Before and After a Scapular Therapeutic Exercise Program for Chronic Shoulder Pain and Scapular Dyskinesis: A Pre–Post Single-Group Study

by Ana S. C. Melo, Ana L. Soares, Catarina Castro, Ricardo Matias, Eduardo B. Cruz, J. Paulo Vilas-Boas and Andreia S. P. Sousa

J. Pers. Med. 2025, 15(7), 285; https://doi.org/10.3390/jpm15070285 - 2 Jul 2025

Background/Objectives: Scapular adaptations have been associated with shoulder pain. However, conflicting findings have been reported after scapular-focused interventions. The present study aims to evaluate scapula-related outcomes before and after a scapular therapeutic exercise program. Methods: Eighteen adult volunteers with chronic shoulder [...] Read more.

Background/Objectives: Scapular adaptations have been associated with shoulder pain. However, conflicting findings have been reported after scapular-focused interventions. The present study aims to evaluate scapula-related outcomes before and after a scapular therapeutic exercise program. Methods: Eighteen adult volunteers with chronic shoulder pain participated in an 8-week scapular therapeutic exercise program that was personalized according to their pain condition and the presence of scapular dyskinesis. This program included preparation and warm-up, scapular neuromotor control, and strengthening and stretching exercises. Both self-reported (shoulder pain and function, psychosocial factors, and self-impression of change) and performance-based outcomes (scapular muscular stiffness and activity level, tridimensional motion, rhythm, and movement quality, measured while participants drank a bottle of water) were used for analysis. Results: After the intervention, participants presented reduced shoulder pain (p < 0.0001) and pain catastrophizing (p = 0.004) and increased shoulder function (p < 0.0001). Additionally, the participants presented changes in scapular winging (p < 0.0001 to p = 0.043), increased scapular downward rotation (p < 0.0001) and depression (p = 0.038), and decreased global movement smoothness (p = 0.003). These were associated with changes in serratus anterior activity (p = 0.016 to p = 0.035), decreased middle (p < 0.0001 to p = 0.002) and lower trapezius (p < 0.0001) and levator scapulae (p = 0.048) activity levels, and decreased middle trapezius muscle stiffness (p = 0.014). Patients’ self-perception of change was rated favorably. Conclusions: After a scapular therapeutic exercise program, changes were observed in both self-reported and performance-based outcomes. These results need to be confirmed by a randomized controlled trial. Full article

(This article belongs to the Special Issue Personalized Medicine in Physical Medicine and Rehabilitation: Pediatrics, Adolescents and the Elderly)

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30 pages, 4082 KiB

Open AccessSystematic Review

Prostate MRI Using Deep Learning Reconstruction in Response to Cancer Screening Demands—A Systematic Review and Meta-Analysis

by Stephan Ursprung, Georgios Agrotis, Petra J. van Houdt, Leon C. ter Beek, Thierry N. Boellaard, Regina G. H. Beets-Tan, Derya Yakar, Anwar R. Padhani and Ivo G. Schoots

J. Pers. Med. 2025, 15(7), 284; https://doi.org/10.3390/jpm15070284 - 2 Jul 2025

Background/Objectives: There is a growing need for efficient prostate MRI protocols due to their increasing use in managing prostate cancer (PCa) and potential inclusion in screening. Deep learning reconstruction (DLR) may enhance MR acquisitions and improve image quality compared to conventional acceleration [...] Read more.

Background/Objectives: There is a growing need for efficient prostate MRI protocols due to their increasing use in managing prostate cancer (PCa) and potential inclusion in screening. Deep learning reconstruction (DLR) may enhance MR acquisitions and improve image quality compared to conventional acceleration techniques. This systematic review examines DLR approaches to prostate MRI. Methods: A search of PubMed, Web of Science, and Google Scholar identified eligible studies comparing DLR to conventional reconstruction for prostate imaging. A narrative synthesis was performed to summarize the impact of DLR on acquisition time, image quality, and diagnostic performance. Results: Thirty-three studies showed that DLR can reduce acquisition times for T₂w and DWI imaging while maintaining or improving image quality. It did not significantly affect clinical tasks, such as biopsy decisions, and performed comparably to human readers in PI-RADS scoring and the detection of extraprostatic extension. However, AI models trained on conventional data might be less accurate with DLR images. The heterogeneity in image quality metrics among the studies prevented quantitative synthesis. Discussion: DLR has the potential to achieve substantial time savings in prostate MRI while maintaining image quality, which is especially relevant because of increased MRI demands. Future research should address the effect of DLR on clinically relevant downstream tasks, including AI algorithms’ performances and biopsy decisions, and explore task-specific accelerated protocols for screening, image-guided biopsy, and treatment. Full article

(This article belongs to the Special Issue Diagnosis of Prostate Cancer: Population-Based Early Detection, Risk Stratification and Imaging)

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13 pages, 941 KiB

Open AccessReview

How to Establish the Baseline for Non-Invasive Technological Regenerative Esthetic Medicine in the Face and Neck Region: A Literature Review

by Ornella Rossi, Giovanna Perrotti, Riccardo Scaini, Massimo Del Fabbro, Giovanni Damiani and Tiziano Testori

J. Pers. Med. 2025, 15(7), 283; https://doi.org/10.3390/jpm15070283 - 2 Jul 2025

(1) Background: Esthetic regenerative medicine is increasingly in demand for facial and neck rejuvenation due to its proven efficacy, safety profile, and minimal downtime. This study aimed to evaluate the role of standardized assessment tools in optimizing the outcomes of non-invasive regenerative [...] Read more.

(1) Background: Esthetic regenerative medicine is increasingly in demand for facial and neck rejuvenation due to its proven efficacy, safety profile, and minimal downtime. This study aimed to evaluate the role of standardized assessment tools in optimizing the outcomes of non-invasive regenerative esthetic technologies, both during the treatment course and in follow-up. (2) Methods: A literature review of the main articles published in peer-reviewed journals was conducted to identify high-quality studies addressing the use of validated esthetic scales and questionnaires (patient-reported outcomes) for evaluating the effectiveness of non-invasive regenerative treatments for the face and neck using accessible clinical tools such as photographs and 3D facial scanning. (3) Results: Clinician-reported outcomes (CROs) can be collected using standardized and reproducible photographic documentation and facial scans. The esthetic scales and classifications target both specific facial areas (e.g., upper third, perioral, periorbital) and overall skin appearance. Furthermore, advanced software allows overlay facial scan analysis and wrinkle mapping for precise quantification of improvements. In addition to objective CROs, patient-reported outcomes (PROs) offer essential insights into perceived esthetic changes, satisfaction, and emotional well-being, completing a multidimensional evaluation of treatment efficacy. (4) Conclusions: Standardized evaluation protocols based on accessible tools such as clinical photographs, 3D facial scans, and validated PRO questionnaires are essential for guiding effective, personalized regenerative treatments. Their integration into routine practice enhances clinical decision-making and patient satisfaction. While advanced tools like dermal probes may further refine assessments, they require specific expertise and resources and may be less practical for daily clinical use. Full article

(This article belongs to the Special Issue Prospectives in Regenerative Medicine and Surgery: Stem Cells and Beyond)

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16 pages, 4039 KiB

Open AccessReview

Management of Acetabular Fractures with Total Hip Replacement: A Narrative Literature Review

by Domenico Tigani, Luigigiuseppe Lamattina, Andrea Assenza, Giuseppe Melucci, Alex Pizzo and Cesare Donadono

J. Pers. Med. 2025, 15(7), 282; https://doi.org/10.3390/jpm15070282 - 1 Jul 2025

Open reduction and internal fixation (ORIF) is widely regarded as the primary treatment for acetabular fractures, but limitations arise in complex cases, leading to non-anatomical reductions and increased risk of post-traumatic osteoarthritis. Given the high incidence of secondary arthritis (12–57%) following ORIF, total [...] Read more.

Open reduction and internal fixation (ORIF) is widely regarded as the primary treatment for acetabular fractures, but limitations arise in complex cases, leading to non-anatomical reductions and increased risk of post-traumatic osteoarthritis. Given the high incidence of secondary arthritis (12–57%) following ORIF, total hip arthroplasty (THA) is often necessitated, particularly in scenarios unsuitable for ORIF, such as extensive comminution or combined femoral head and neck fractures. The surgical landscape has shifted from a traditional “fix or replace” to a more integrated “fix and replace” approach, especially beneficial in managing elderly patients with osteoporotic bones. THA is applied across various timelines, including acute (0–3 weeks), delayed (3 weeks to 3 months), and late (beyond 3 months), each presenting distinct challenges and requiring specific strategies to optimize outcomes. The importance of precise bone defect classifications and the role of dual mobility cups in reducing dislocation risks are highlighted, alongside the use of modern surgical and fixation techniques to improve stability and patient outcomes. Enhanced recovery protocols and meticulous postoperative management are critical to addressing complications, such as infections and hardware interference, tailoring treatment approaches to each patient’s needs, and advancing care for complex acetabular fractures. Full article

(This article belongs to the Special Issue Orthopedic Trauma: New Perspectives and Innovative Techniques)

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18 pages, 1014 KiB

Open AccessSystematic Review

The Impact of Preoperative Risk Factors on Unplanned Readmission After Day Surgery: A Meta-Analysis

by Hanqing Zhang, Xinglian Gao and Zhen Chen

J. Pers. Med. 2025, 15(7), 281; https://doi.org/10.3390/jpm15070281 - 1 Jul 2025

Objective: This research seeks to explore and determine the principal pre-surgical risk elements associated with unplanned readmissions following day surgery, providing evidence-based guidance for clinical practice to optimize preoperative evaluations and reduce the incidence of readmissions. Background: As day surgery becomes [...] Read more.

Objective: This research seeks to explore and determine the principal pre-surgical risk elements associated with unplanned readmissions following day surgery, providing evidence-based guidance for clinical practice to optimize preoperative evaluations and reduce the incidence of readmissions. Background: As day surgery becomes increasingly common across global healthcare systems, ensuring effective postoperative recovery and preventing readmissions have become critical challenges. Numerous studies have explored the impact of various preoperative risk factors on postoperative readmissions. This study synthesizes existing evidence through a meta-analysis to identify the key preoperative factors associated with increased readmission risk. Methods: An extensive literature review was conducted across various databases, such as Web of Science, PubMed, CINAHL, Scopus, Embase, the Cochrane Library, and CNKI, to gather all relevant clinical research on pre-surgical risk elements for day surgery procedures, with studies included up to 15 January 2025. A structured analysis was undertaken, and the findings were integrated using a random-effects approach to assess the influence of key preoperative risk factors on subsequent readmissions in day surgery environments. Results: A total of 12 studies, involving 704,568 patients, were incorporated into the final analysis. The findings identified several preoperative factors that were significantly associated with an increased risk of postoperative readmission. These risk factors included: age ≥ 60 years (OR = 2.38, 95% CI: 1.74–3.26, p < 0.00001), ASA classification ≥ 3 (OR = 1.96, 95% CI: 1.61–2.38, p < 0.00001), presence of chronic diseases (OR = 11.78, 95% CI: 9.99–13.90, p < 0.00001), general anesthesia (OR = 2.42, 95% CI: 1.51–3.86, p = 0.0002), infection risk (OR = 1.68, 95% CI: 1.35–2.10, p < 0.00001), gender (OR = 2.45, 95% CI: 2.21–2.71, p < 0.00001), complex surgery type (OR = 2.83, 95% CI: 2.03–3.93, p < 0.00001), and bleeding disorders (OR = 1.82, 95% CI: 1.53–2.17, p < 0.00001). Conclusions: This study highlights several key preoperative risk factors associated with unexpected readmissions following day surgery. These factors include age, ASA classification, presence of chronic diseases, general anesthesia, infection risk, gender, complex surgery type, and bleeding disorders. These findings provide valuable insights for preoperative assessments. Clinicians should focus on these high-risk factors during preoperative assessment and management to minimize postoperative readmission rates and improve surgical safety and recovery outcomes for patients. Full article

(This article belongs to the Section Evidence Based Medicine)

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15 pages, 4918 KiB

Open AccessReview

Ultrasonographic Assessment of Calcium Pyrophosphate Deposition Disease: A Comprehensive Review

by Lissiane Karine Noronha Guedes, Letícia Queiroga de Figueiredo, Fernanda Oliveira de Andrade Lopes, Luis Fernando Fernandes Ferrari and Karina Rossi Bonfiglioli

J. Pers. Med. 2025, 15(7), 280; https://doi.org/10.3390/jpm15070280 - 1 Jul 2025

Calcium pyrophosphate deposition disease (CPPD) is a common crystal arthropathy characterized by the deposition of calcium pyrophosphate crystals in joints and soft tissues. Ultrasonography (US) has emerged as a valuable imaging modality for diagnosing CPPD, offering real-time visualization of crystal deposits and joint [...] Read more.

Calcium pyrophosphate deposition disease (CPPD) is a common crystal arthropathy characterized by the deposition of calcium pyrophosphate crystals in joints and soft tissues. Ultrasonography (US) has emerged as a valuable imaging modality for diagnosing CPPD, offering real-time visualization of crystal deposits and joint inflammation. In the context of personalized medicine, US plays a critical role in enabling individualized patient assessment, facilitating early and accurate diagnosis, and supporting tailored therapeutic decisions based on specific imaging findings. This article reviews the ultrasonographic features of CPPD, their diagnostic utility, and clinical applications, emphasizing the relevance of US in stratifying patients and guiding personalized management approaches. Full article

(This article belongs to the Special Issue Personalized Medicine for Rheumatic Diseases)

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12 pages, 418 KiB

Open AccessArticle

Comparing Multigene Molecular Testing Results of MRI-Target Versus Systematic Prostate Needle Biopsies of Candidates for and Under Active Surveillance

by Nicholas J. Lanzotti, Chris Du, Julia Hall, Joseph Saba, Maria M. Picken and Gopal N. Gupta

J. Pers. Med. 2025, 15(7), 279; https://doi.org/10.3390/jpm15070279 - 1 Jul 2025

Introduction: The multigene molecular testing of prostate cancer tissue after biopsy provides individualized information to guide further management. The utility of selective genetic testing for MRI-visible target versus systematic cancer in patients as well as during different time points of active surveillance (AS) [...] Read more.

Introduction: The multigene molecular testing of prostate cancer tissue after biopsy provides individualized information to guide further management. The utility of selective genetic testing for MRI-visible target versus systematic cancer in patients as well as during different time points of active surveillance (AS) is unknown. The objective of this study was to compare Prolaris^TM results of MRI-target cancers versus systematic cancers on prostate needle biopsy as well as both during consideration for initial AS candidacy and candidacy for remaining on AS. Methods: Our prospectively maintained institutional multiparametric (mp) MRI prostate cancer active surveillance database (2013–2024) was queried for patients that underwent Prolaris^TM genetic testing of positive biopsy cores. Baseline information for PSA, PSA density, and Prolaris^TM calculated data were collected. Information on the timing of the Prolaris testing, defined as during the initial cancer diagnostic biopsy or on a subsequent confirmatory biopsy was collected. SPSS v29.0 was used to compare the selective Prolaris^TM results of MRI-target cancers versus systematic cancers during different points of AS. Results: 264 patients with a Prolaris^TM test were identified, 86 with MRI-target and 178 on systematic cancers. 182 Prolaris^TM tests were sent on a diagnostic biopsy and 81 on a subsequent biopsy. Overall, MRI-target cancers had similar risk scores (3.23 vs. 3.14, p = 0.18). Prolaris^TM scores were higher for GG2 systematic than GG1 target cancers (3.40 vs. 3.18, p = 0.023). The GG2 systematic lesion cohort also had higher predicted the 10-year disease-specific mortality (DSM) (3.40% vs. 2.30%, p < 0.01) and 10-year metastasis risk (1.90% vs. 1.20%, p = 0.013), and more aggressive recommended treatment. Analyses of the Prolaris^TM results sent during a diagnostic biopsy yielded similar results. Finally, on an analysis of the Prolaris^TM results sent during subsequent biopsy, a systematic GG2 biopsy was noted to have a higher 10-year DSM and metastasis rate, but similar risk scores and treatment recommendations. Conclusions: Prolaris^TM tests can be sent at multiple time points of AS, and selectively for MRI-visible versus higher grade cancers. There is no consistent association between MRI-visible cancer and Prolaris risk profile. When utilizing multigene molecular testing in prostate cancer, each individual patient must be evaluated to decide the appropriate level of care. Full article

(This article belongs to the Special Issue Urological Cancer: Clinical Advances in Personalized Therapy)

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10 pages, 3215 KiB

Open AccessReview

Endoscopic vs. External Dacryocystorhinostomy in Granulomatosis with Polyangiitis: A Scoping Review of the Literature and Our Experience with Endoscopic Dacryocystorhinostomy

by Nitish Kumar, Lisa A. Marks, Pedro Lança Gomes and Devyani Lal

J. Pers. Med. 2025, 15(7), 278; https://doi.org/10.3390/jpm15070278 - 1 Jul 2025

Background/Objectives: Although endoscopic dacryocystorhinostomy (DCR) has been widely accepted as the procedure of choice for nasolacrimal duct obstruction (NLDO) management due to most etiologies, concerns regarding the reactivation of disease and involvement of surrounding structures add to hesitation in its utilization for [...] Read more.

Background/Objectives: Although endoscopic dacryocystorhinostomy (DCR) has been widely accepted as the procedure of choice for nasolacrimal duct obstruction (NLDO) management due to most etiologies, concerns regarding the reactivation of disease and involvement of surrounding structures add to hesitation in its utilization for granulomatosis with polyangiitis (GPA) patients. No study has directly compared outcomes of external vs. endoscopic DCR in GPA patients. This information can be helpful for patient counselling and choosing a personalized surgical approach for the best results. Methods: A scoping review of the literature was performed in January 2024. The following databases were searched using a combination of MeSH (Medical Subject Headings) and keywords: Ovid MEDLINE, Ovid EMBASE, Scopus, and Web of Science. This scoping review is not registered. Medical records of two GPA patients who underwent endoscopic DCR at our center were reviewed. Results: The search yielded 96 articles; 15 articles met the inclusion criteria for a full review. Six studies with 22 procedures reported 100% success with endoscopic DCR. Nine studies with 122 procedures reported success in 88.5% of cases with external DCRs. Additional perioperative immunosuppression was recommended in patients with severe mucosal inflammation. The case series presents the disease course, details of surgery, and perioperative management in two GPA patients with NLDO who underwent endoscopic DCR successfully. Conclusions: Endoscopic DCR was associated with equivalent or better success rates and lower complications compared to external DCR in GPA patients. Ensuring disease remission state and appropriate immunomodulatory therapy can help prevent the proposed risk of endonasal disease reactivation with endoscopic DCR. Full article

(This article belongs to the Special Issue Clinical Diagnosis and Treatment in Otorhinolaryngology)

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12 pages, 1170 KiB

Open AccessArticle

Simultaneous Evaluation of Shear Wave Elastography and C-Peptide Index for Predicting Need of Insulin Therapy in Type 2 Diabetes: A Pilot Study

by Moeno Sugita-Hamada, Takeshi Yokoo, Nao Nakajima, Yoshifumi Takahashi, Akihiko Osaki, Masaki Maruyama, Masaaki Takamura, Nobuo Waguri, Osamu Isokawa and Shuji Terai

J. Pers. Med. 2025, 15(7), 277; https://doi.org/10.3390/jpm15070277 - 1 Jul 2025

Background/Objectives: Recently, shear wave elastography (SWE) and dispersion (SWD) targeting the pancreas have been attempted as noninvasive procedures to evaluate personalized conditions. This study aimed to analyze the feasibility of utilizing them for evaluating the individual need of introducing insulin therapy, combined [...] Read more.

Background/Objectives: Recently, shear wave elastography (SWE) and dispersion (SWD) targeting the pancreas have been attempted as noninvasive procedures to evaluate personalized conditions. This study aimed to analyze the feasibility of utilizing them for evaluating the individual need of introducing insulin therapy, combined with the C-peptide index (CPI), in patients with type 2 diabetes mellitus (T2DM). Methods: This study involved 51 patients with T2DM aged ≥20 years old and 20 control subjects without impaired glucose tolerance (CTRL). T2DM were divided into non-insulin-treated (non-INS) and insulin-treated (INS) groups. Their background data, shear wave speed (SWS), and dispersion slope (DS) of the pancreas were obtained on the same day. Results: Pancreatic SWS was higher in T2DM than in CTRL (p < 0.0001), with an AUC of 0.840, sensitivity of 89.1%, and specificity of 70.6%, using a Youden index cutoff of 1.31 m/s. INS and non-INS were discriminated with the cutoff value of 1.70 m/s (p = 0.031, AUC 0.736, sensitivity 55.6% and specificity 89.2%). Pancreatic DS of INS and non-INS was 13.52 and 12.16 (m/s)/kHz, respectively (p = 0.046). Using 12.38 (m/s)/kHz as the cutoff, AUC was 0.718, with sensitivity of 88.9%, specificity of 56.8% and negative predictive value of 95.5%. CPI had AUC of 0.724, sensitivity of 66.7% and specificity of 83.3% with the cutoff of 0.63. With combination of SWS and CPI, all patients with SWS < 1.70 m/s and CPI > 0.476 belonged to non-INS. Conclusions: Simultaneous non-invasive SWE and CPI evaluation showed the feasibility for estimating personalized insulin initiation needs in T2DM, integrating biophysical and hormonal perspectives. Further investigation with a larger, multi-center study population is warranted to enhance the level of evidence. Full article

(This article belongs to the Special Issue Medical Imaging and Interventional Radiology: Current Updates and Clinical Challenges)

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18 pages, 1117 KiB

Open AccessReview

Surgical Management of Mediastinal Ectopic Parathyroids

by Giacomo Rabazzi, Gianmarco Elia, Vittorio Aprile, Stylianos Korasidis, Maria Giovanna Mastromarino, Diana Bacchin, Alessandra Lenzini, Marcello Carlo Ambrogi, Greta Alì, Filomena Cetani, Gabriele Materazzi and Marco Lucchi

J. Pers. Med. 2025, 15(7), 276; https://doi.org/10.3390/jpm15070276 - 30 Jun 2025

Primary hyperparathyroidism is commonly caused by parathyroid adenomas, hyperplasia, or, rarely, carcinoma. In up to 20% of cases, parathyroid tissue may be ectopic, often located in the mediastinum due to aberrant embryologic migration. Ectopic parathyroid glands pose a diagnostic and therapeutic challenge, and [...] Read more.

Primary hyperparathyroidism is commonly caused by parathyroid adenomas, hyperplasia, or, rarely, carcinoma. In up to 20% of cases, parathyroid tissue may be ectopic, often located in the mediastinum due to aberrant embryologic migration. Ectopic parathyroid glands pose a diagnostic and therapeutic challenge, and an accurate preoperative localization is essential for an effective and safe resection. Imaging modalities such as CT scan, TC-sestamibi scintigraphy, PET/CT, ultrasonography and MRI are routinely employed, whereas combined techniques offer improved diagnostic accuracy. Emerging approaches, however, including PET/CT with choline tracers, have shown promise in enhancing sensitivity in complex or recurrent cases. When ectopic glands are in the mediastinum, thoracic surgical intervention is required. Traditional open approaches, such as sternotomy or thoracotomy, are associated with significant morbidity. The development and evolution of minimally invasive surgery (MIS) has become the preferred approach in selected cases. When MIS is performed, intraoperative assessment and parathyroid identification are crucial to ensure complete gland removal. Intraoperative parathyroid hormone (ioPTH) monitoring provides real-time confirmation of surgical success. The integration of advanced imaging, intraoperative monitoring, and minimally invasive techniques significantly improves surgical outcomes while minimizing complications and accelerating patient recovery. Ultimately, the effective treatment of ectopic parathyroid glands relies on a personalized approach, adapting both diagnostic and surgical strategies to the unique anatomical and clinical context of each patient. Integration of advanced imaging, intraoperative monitoring, and minimally invasive techniques, combined with a multidisciplinary team involving endocrinologists, radiologists, and thoracic surgeons, is key to optimizing outcomes and reducing patient morbidity. Full article

(This article belongs to the Section Methodology, Drug and Device Discovery)

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23 pages, 1050 KiB

Open AccessArticle

Quantitative Method for Monitoring Tumor Evolution During and After Therapy

by Paolo Castorina, Filippo Castiglione, Gianluca Ferini, Stefano Forte and Emanuele Martorana

J. Pers. Med. 2025, 15(7), 275; https://doi.org/10.3390/jpm15070275 - 28 Jun 2025

Objectives: The quantitative analysis of tumor progression—monitored during and immediately after therapeutic interventions—can yield valuable insights into both long-term disease dynamics and treatment efficacy. Methods: We used a computational approach designed to support clinical decision-making, with a focus on personalized patient care, [...] Read more.

Objectives: The quantitative analysis of tumor progression—monitored during and immediately after therapeutic interventions—can yield valuable insights into both long-term disease dynamics and treatment efficacy. Methods: We used a computational approach designed to support clinical decision-making, with a focus on personalized patient care, based on modeling therapy effects using effective parameters of the Gompertz law. Results: The method is applied to data from in vivo models undergoing neoadjuvant chemoradiotherapy, as well as conventional and FLASH radiation treatments. Conclusions: This user-friendly, phenomenological model captures distinct phases of treatment response and identifies a critical dose threshold distinguishing complete response from partial response or tumor regrowth. These findings lay the groundwork for real-time quantitative monitoring of disease progression during therapy and contribute to a more tailored and predictive clinical strategy. Full article

(This article belongs to the Special Issue Integrating Mathematical Modeling and Data Analysis in Personalized Medical Research)

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17 pages, 627 KiB

Open AccessReview

Major Allele Frequencies in CYP2C9 and CYP2C19 in Asian and European Populations: A Case Study to Disaggregate Data Among Large Racial Categories

by Horng-Ee Vincent Nieh and Youssef Malak Roman

J. Pers. Med. 2025, 15(7), 274; https://doi.org/10.3390/jpm15070274 - 27 Jun 2025

CYP2C9 and CYP2C19 are major CYP450 enzymes that heavily influence the hepatic metabolism and bioactivation of many medications, including over-the-counter and narrow therapeutic index drugs. Compared to the wild-type alleles, genetic variants in either gene could potentially alter the pharmacokinetics of widely used [...] Read more.

CYP2C9 and CYP2C19 are major CYP450 enzymes that heavily influence the hepatic metabolism and bioactivation of many medications, including over-the-counter and narrow therapeutic index drugs. Compared to the wild-type alleles, genetic variants in either gene could potentially alter the pharmacokinetics of widely used medications, affect the desired therapeutic outcomes of a drug therapy, or increase the risk of undesired adverse events. The frequency of genetic polymorphisms associated with CYP450 enzymes can widely differ across and between racial and ethnic groups. This narrative review highlights the differences in CYP2C9 and CYP2C19 allele frequencies among European and Asian population subgroups, using published literature. Identifying the substantial differences across European and Asian populations, as well as within Asian subgroups, indicates the need to further scrutinize general population data. Clinical scientists and healthcare providers should advocate for more inclusive clinical pharmacogenomic data and racially and ethnically diverse pharmacogenomic databases. Clinical trials of limited racial and geographical diversity may not necessarily have strong external generalizability for all populations. Furthermore, clinical trials that designate an all-inclusive Asian population consisting of multiple ethnicities may not be adequate due to the perceived genetic differences among Asian subgroups. Gravitating towards a more comprehensive approach to utilizing pharmacogenomic data necessitates granular population-level genetic information which can be leveraged to improve how drug therapies are prescribed, achieve health equity, and advance the future of precision medicine. Full article

(This article belongs to the Special Issue New Trends and Challenges in Pharmacogenomics Research)

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10 pages, 841 KiB

Open AccessArticle

The Insufficient Number of Informative SNPs in a Preclinical Karyomapping Test for PGT-M Depends on the Reference Selected

by Min Jee Kim, Yeseul Hong, Gaeul Han, Hyoung-Song Lee, Eun A. Park, Kyung-Ah Lee, Eun Jeong Yu and Inn Soo Kang

J. Pers. Med. 2025, 15(7), 273; https://doi.org/10.3390/jpm15070273 - 26 Jun 2025

Background/Objectives: Karyomapping, a genome-wide SNP analysis, has drastically changed the approach to preimplantation genetic testing for monogenic disorders (PGT-M). However, there are cases in which karyomapping cannot be applied due to an insufficient number of informative SNPs. In this study, we aimed [...] Read more.

Background/Objectives: Karyomapping, a genome-wide SNP analysis, has drastically changed the approach to preimplantation genetic testing for monogenic disorders (PGT-M). However, there are cases in which karyomapping cannot be applied due to an insufficient number of informative SNPs. In this study, we aimed to analyze for the first time whether an insufficient number of informative SNPs is related to the family member used as a reference. Methods: For the karyomapping pre-clinical test, in addition to the couple, one of the DNA samples from an additional family member (children, parent, sibling) is used as a reference for phasing the SNP allele. We analyzed 263 couples who underwent karyomapping for PGT-M at the CHA Fertility Center from May 2020 to December 2022. karyomapping data was scanned on an Illumina NextSeq and analyzed through the BlueFuse Multi software version 4.5. Results: Preclinical karyomapping tests were performed in 263 couples with 58 monogenic diseases. Karyomapping was applicable to PGT-M for 241 (91.6%) couples and not applicable for 22 (8.4%) couples. The percentages of “not applicable” cases according to the reference family member were 1.3% (1/80) in the children group, 5.4% (8/148) in the parent group, and 37.1% (13/35) in the sibling group. Among the genetic diseases studied, couples with neurofibromatosis type 1 (6/27, 22.2%) and Kennedy disease (5/5, 100%) had the highest rate of non-applicable cases. Conclusions: Our results suggest that a child or parent may be better than the sibling for karyomapping in PGT-M. These data provide useful information for selecting a reference among the family members for preclinical karyomapping tests. Full article

(This article belongs to the Section Omics/Informatics)

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16 pages, 267 KiB

Open AccessReview

Neuroendocrine Neoplasms in Pregnancy: A Narrative Review of Clinical Challenges and Therapeutic Limitations in the Absence of Established Safe Treatments

by Mauro Daniel Spina Donadio, Maria Cecília Mathias-Machado, Danielly Scaranello Nunes Santana and Renata D’Alpino Peixoto

J. Pers. Med. 2025, 15(7), 272; https://doi.org/10.3390/jpm15070272 - 25 Jun 2025

Cancer during pregnancy is a rare but complex clinical scenario that affects approximately 0.1% of pregnant individuals and is associated with increased maternal morbidity. With the trend of delayed childbearing, the incidence of pregnancy-associated cancers is expected to rise. Neuroendocrine neoplasms (NENs), although [...] Read more.

Cancer during pregnancy is a rare but complex clinical scenario that affects approximately 0.1% of pregnant individuals and is associated with increased maternal morbidity. With the trend of delayed childbearing, the incidence of pregnancy-associated cancers is expected to rise. Neuroendocrine neoplasms (NENs), although rare in pregnancy, present unique diagnostic and therapeutic challenges due to their hormonal activity, histological diversity, and limited data on management in the gestational context. Objectives: This manuscript reviews the current evidence on the diagnosis, staging, and management of NENs during pregnancy, focusing on maternal–fetal safety, therapeutic limitations, and multidisciplinary care strategies. Methods: A comprehensive narrative review was conducted using relevant case reports, retrospective studies, clinical guidelines, and expert consensus documents addressing cancer in pregnancy and NEN-specific management. Results: Pregnancy complicates the evaluation and treatment of NENs due to overlapping symptoms, contraindications to standard imaging and systemic therapies, and unreliable biomarkers such as chromogranin A and 5-HIAA. Most systemic therapies for NENs, including somatostatin analogs, tyrosine kinase inhibitors, and peptide receptor radionuclide therapy, are contraindicated or lack safety data in pregnancy. Surgical interventions and supportive care require careful planning. Decisions regarding pregnancy continuation or termination must be individualized and supported by a multidisciplinary team. Conclusions: The management of NENs during pregnancy demands a highly individualized approach, coordinated among oncology, maternal–fetal medicine, and supportive care teams. Given the paucity of robust data, future research is essential to establish evidence-based guidelines and improve outcomes for both mother and fetus. Full article

(This article belongs to the Section Evidence Based Medicine)

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