Journal of Personalized Medicine

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.

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.

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.