Journal of Personalized Medicine

16 pages, 938 KiB

Open AccessEditor’s ChoiceReview

Three-Dimensional Printing Technology in Drug Design and Development: Feasibility, Challenges, and Potential Applications

by Maria C. Simon, Konstantinos Laios, Ioannis Nikolakakis and Theodore G. Papaioannou

J. Pers. Med. 2024, 14(11), 1080; https://doi.org/10.3390/jpm14111080 - 29 Oct 2024

Cited by 4 | Viewed by 2713

Abstract

Background/Objectives: The present investigation evaluates the impact of 3D-printing technology on the design of pharmaceutical drugs, considering the feasibility issues and problems concerning technological, pharmaceutical, and clinical matters. This paper aims to review how 3D printing can modify the traditional manufacturing of drugs [...] Read more.

Background/Objectives: The present investigation evaluates the impact of 3D-printing technology on the design of pharmaceutical drugs, considering the feasibility issues and problems concerning technological, pharmaceutical, and clinical matters. This paper aims to review how 3D printing can modify the traditional manufacturing of drugs with personalized medicine-therapy outcomes being individualized and optimized, hence improving patients’ compliance. Methods: The historical development of 3D printing from rapid prototyping to advanced pharmaceutical applications is discussed. A comparison is then made between traditional drug manufacturing approaches and the different techniques of 3D printing, including stereolithography, material extrusion, and binder jetting. Feasibility is assessed based on clinical trials and studies evaluating the efficacy, safety, bioavailability, and cost-effectiveness of 3D-printed drugs. Results: Current evidence indicates that material selection, regulatory barriers, and scalability issues are some of the major challenges to be overcome for wider acceptance. Other matters, such as ethical issues concerning patient data privacy, the misuse of 3D-printing technology, and technical complexities related to pharmaceutical 3D printing, are discussed further. Future applications also include bioprinting and in situ printing together with their implications for personalized drug delivery, which will also be discussed. Conclusions: This review stresses that intersectoral collaboration and the updating of regulatory frameworks are a must to overcome the barriers that confront 3D-printing applications in drug development. can could be an opportunity for innovative licensing and manufacturing techniques in pharmaceutical product development that can change the paradigm of personalized medicine through modern printing techniques. Full article

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

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29 pages, 1103 KiB

Open AccessEditor’s ChoiceReview

Integrating Machine Learning with Multi-Omics Technologies in Geroscience: Towards Personalized Medicine

by Nikolaos Theodorakis, Georgios Feretzakis, Lazaros Tzelves, Evgenia Paxinou, Christos Hitas, Georgia Vamvakou, Vassilios S. Verykios and Maria Nikolaou

J. Pers. Med. 2024, 14(9), 931; https://doi.org/10.3390/jpm14090931 - 31 Aug 2024

Cited by 12 | Viewed by 4658

Abstract

Aging is a fundamental biological process characterized by a progressive decline in physiological functions and an increased susceptibility to diseases. Understanding aging at the molecular level is crucial for developing interventions that could delay or reverse its effects. This review explores the integration [...] Read more.

Aging is a fundamental biological process characterized by a progressive decline in physiological functions and an increased susceptibility to diseases. Understanding aging at the molecular level is crucial for developing interventions that could delay or reverse its effects. This review explores the integration of machine learning (ML) with multi-omics technologies—including genomics, transcriptomics, epigenomics, proteomics, and metabolomics—in studying the molecular hallmarks of aging to develop personalized medicine interventions. These hallmarks include genomic instability, telomere attrition, epigenetic alterations, loss of proteostasis, disabled macroautophagy, deregulated nutrient sensing, mitochondrial dysfunction, cellular senescence, stem cell exhaustion, altered intercellular communication, chronic inflammation, and dysbiosis. Using ML to analyze big and complex datasets helps uncover detailed molecular interactions and pathways that play a role in aging. The advances of ML can facilitate the discovery of biomarkers and therapeutic targets, offering insights into personalized anti-aging strategies. With these developments, the future points toward a better understanding of the aging process, aiming ultimately to promote healthy aging and extend life expectancy. Full article

(This article belongs to the Special Issue The Intersection of Multi-Omics Data and Machine Learning in Medicine)

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25 pages, 655 KiB

Open AccessEditor’s ChoiceReview

Systematic Review and Clinical Insights: The Role of the Ketogenic Diet in Managing Glioblastoma in Cancer Neuroscience

by Jose Valerio, Matteo Borro, Elisa Proietti, Livia Pisciotta, Immanuel O. Olarinde, Maria Fernandez Gomez and Andres Mauricio Alvarez Pinzon

J. Pers. Med. 2024, 14(9), 929; https://doi.org/10.3390/jpm14090929 - 31 Aug 2024

Cited by 4 | Viewed by 5869

Abstract

Recent scientific research has shown that the ketogenic diet may have potential benefits in a variety of medical fields, which has led to the diet receiving a substantial amount of attention. Clinical and experimental research on brain tumors has shown that the ketogenic [...] Read more.

Recent scientific research has shown that the ketogenic diet may have potential benefits in a variety of medical fields, which has led to the diet receiving a substantial amount of attention. Clinical and experimental research on brain tumors has shown that the ketogenic diet has a satisfactory safety profile. This safety profile has been established in a variety of applications, including the management of obesity and the treatment of drug-resistant epileptic cases. However, in human studies, the impact of ketogenic therapy on the growth of tumors and the life expectancy of patients has not provided results that are well characterized. Consequently, our purpose is to improve the comprehension of these features by succinctly presenting the developments and conclusions that have been gained from the most recent study that pertains to this non-pharmacological technique. According to the findings of our study, patients with brain tumors who stick to a ketogenic diet are more likely to experience improved survival rates. However, it is required to conduct additional research on humans in order to more accurately define the anti-tumor efficiency of this diet as well as the underlying processes that support the therapeutic effects of this dieting regimen. Full article

(This article belongs to the Special Issue Advancements in Neurosurgical Oncology: Bridging Neurosurgery and Cancer Neuroscience)

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19 pages, 1888 KiB

Open AccessEditor’s ChoiceReview

Chatbots in Cancer Applications, Advantages and Disadvantages: All that Glitters Is Not Gold

by Georgios Goumas, Theodoros I. Dardavesis, Konstantinos Syrigos, Nikolaos Syrigos and Effie Simou

J. Pers. Med. 2024, 14(8), 877; https://doi.org/10.3390/jpm14080877 - 19 Aug 2024

Cited by 6 | Viewed by 4139

Abstract

The emergence of digitalization and artificial intelligence has had a profound impact on society, especially in the field of medicine. Digital health is now a reality, with an increasing number of people using chatbots for prognostic or diagnostic purposes, therapeutic planning, and monitoring, [...] Read more.

The emergence of digitalization and artificial intelligence has had a profound impact on society, especially in the field of medicine. Digital health is now a reality, with an increasing number of people using chatbots for prognostic or diagnostic purposes, therapeutic planning, and monitoring, as well as for nutritional and mental health support. Initially designed for various purposes, chatbots have demonstrated significant advantages in the medical field, as indicated by multiple sources. However, there are conflicting views in the current literature, with some sources highlighting their drawbacks and limitations, particularly in their use in oncology. This state-of-the-art review article seeks to present both the benefits and the drawbacks of chatbots in the context of medicine and cancer, while also addressing the challenges in their implementation, offering expert insights on the subject. Full article

(This article belongs to the Section Personalized Therapy and Drug Delivery)

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12 pages, 894 KiB

Open AccessEditor’s ChoiceReview

Physician-Modified Endografts for Repair of Complex Abdominal Aortic Aneurysms: Clinical Perspectives and Medico-Legal Profiles

by Giovanna Ricci, Filippo Gibelli, Ascanio Sirignano, Maurizio Taurino and Pasqualino Sirignano

J. Pers. Med. 2024, 14(7), 759; https://doi.org/10.3390/jpm14070759 - 17 Jul 2024

Cited by 4 | Viewed by 2329

Abstract

Standard endovascular aortic repair (EVAR) has become the standard of care for treating infrarenal abdominal aortic aneurysms (AAAs) in patients with favorable anatomies, while patients with challenging AAA anatomies, and those with suprarenal or thoraco-abdominal aneurysms, still need alternative, more complex, solutions, including [...] Read more.

Standard endovascular aortic repair (EVAR) has become the standard of care for treating infrarenal abdominal aortic aneurysms (AAAs) in patients with favorable anatomies, while patients with challenging AAA anatomies, and those with suprarenal or thoraco-abdominal aneurysms, still need alternative, more complex, solutions, including custom-made branched or fenestrated grafts, which are constrained by production delay and costs. To address urgent needs and complex cases, physicians have proposed modifying standard endografts by manually creating graft fenestrations. This allows for effective aneurysm exclusion and satisfactory patency of visceral vessels. Although physician-modified grafts (PMEGs) have demonstrated high technical success, standardized creation processes and long-term safety data are still lacking, necessitating further study to validate their clinical and legal standing. The aim of this article is to illustrate the state of the art with regard to this surgical technique, summarizing its origin, evolution, and the main clinical evidence supporting its effectiveness. The paper also aims to discuss the main medico-legal issues related to the use of PMEGs, with particular reference to the issue of safety related to the standardization of the surgical technique, medical liability profiles, and informed consent. Full article

(This article belongs to the Special Issue Precision Medicine in Vascular Disease)

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18 pages, 2135 KiB

Open AccessEditor’s ChoiceReview

Emerging Applications of Nanoparticles in the Diagnosis and Treatment of Breast Cancer

by Josephine B. Oehler, Weranga Rajapaksha and Hugo Albrecht

J. Pers. Med. 2024, 14(7), 723; https://doi.org/10.3390/jpm14070723 - 4 Jul 2024

Cited by 20 | Viewed by 7301

Abstract

Breast cancer remains the most prevalent cancer among women worldwide, driving the urgent need for innovative approaches to diagnosis and treatment. This review highlights the pivotal role of nanoparticles in revolutionizing breast cancer management through advancements of interconnected approaches including targeted therapy, imaging, [...] Read more.

Breast cancer remains the most prevalent cancer among women worldwide, driving the urgent need for innovative approaches to diagnosis and treatment. This review highlights the pivotal role of nanoparticles in revolutionizing breast cancer management through advancements of interconnected approaches including targeted therapy, imaging, and personalized medicine. Nanoparticles, with their unique physicochemical properties, have shown significant promise in addressing current treatment limitations such as drug resistance and nonspecific systemic distribution. Applications range from enhancing drug delivery systems for targeted and sustained release to developing innovative diagnostic tools for early and precise detection of metastases. Moreover, the integration of nanoparticles into photothermal therapy and their synergistic use with existing treatments, such as immunotherapy, illustrate their transformative potential in cancer care. However, the journey towards clinical adoption is fraught with challenges, including the chemical feasibility, biodistribution, efficacy, safety concerns, scalability, and regulatory hurdles. This review delves into the current state of nanoparticle research, their applications in breast cancer therapy and diagnosis, and the obstacles that must be overcome for clinical integration. Full article

(This article belongs to the Special Issue Nanomedicine in Cancer Therapy: What's New)

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18 pages, 1027 KiB

Open AccessEditor’s ChoiceReview

Revolutionizing Pathology with Artificial Intelligence: Innovations in Immunohistochemistry

by Diana Gina Poalelungi, Anca Iulia Neagu, Ana Fulga, Marius Neagu, Dana Tutunaru, Aurel Nechita and Iuliu Fulga

J. Pers. Med. 2024, 14(7), 693; https://doi.org/10.3390/jpm14070693 - 27 Jun 2024

Cited by 6 | Viewed by 2561

Abstract

Artificial intelligence (AI) is a reality of our times, and it has been successfully implemented in all fields, including medicine. As a relatively new domain, all efforts are directed towards creating algorithms applicable in most medical specialties. Pathology, as one of the most [...] Read more.

Artificial intelligence (AI) is a reality of our times, and it has been successfully implemented in all fields, including medicine. As a relatively new domain, all efforts are directed towards creating algorithms applicable in most medical specialties. Pathology, as one of the most important areas of interest for precision medicine, has received significant attention in the development and implementation of AI algorithms. This focus is especially important for achieving accurate diagnoses. Moreover, immunohistochemistry (IHC) serves as a complementary diagnostic tool in pathology. It can be further augmented through the application of deep learning (DL) and machine learning (ML) algorithms for assessing and analyzing immunohistochemical markers. Such advancements can aid in delineating targeted therapeutic approaches and prognostic stratification. This article explores the applications and integration of various AI software programs and platforms used in immunohistochemical analysis. It concludes by highlighting the application of these technologies to pathologies such as breast, prostate, lung, melanocytic proliferations, and hematologic conditions. Additionally, it underscores the necessity for further innovative diagnostic algorithms to assist physicians in the diagnostic process. Full article

(This article belongs to the Section Clinical Medicine, Cell, and Organism Physiology)

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13 pages, 300 KiB

Open AccessEditor’s ChoiceArticle

Assessing Nutritional Deficiencies in Bariatric Surgery Patients: A Comparative Study of Roux-en-Y Gastric Bypass versus Sleeve Gastrectomy

by José P. Vieira de Sousa, Hugo Santos-Sousa, Sofia Vieira, Rita Nunes, Jorge Nogueiro, André Pereira, Fernando Resende, André Costa-Pinho, John Preto, Bernardo Sousa-Pinto, Silvestre Carneiro and Eduardo Lima-da-Costa

J. Pers. Med. 2024, 14(6), 650; https://doi.org/10.3390/jpm14060650 - 18 Jun 2024

Cited by 11 | Viewed by 4504

Abstract

Obesity is a worldwide epidemic, and bariatric surgery is considered the primary treatment for long-term weight loss and managing obesity-related health issues. Sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) are the most performed procedures. Nutritional deficiencies are a significant concern following bariatric [...] Read more.

Obesity is a worldwide epidemic, and bariatric surgery is considered the primary treatment for long-term weight loss and managing obesity-related health issues. Sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) are the most performed procedures. Nutritional deficiencies are a significant concern following bariatric surgery and can have serious consequences. This study aims to compare the incidence of nutritional deficiencies in patients undergoing RYGB and SG. A retrospective analysis was conducted on the nutritional status of 505 consecutive patients who underwent either RYGB or SG between January and December 2019. Data were collected regarding vitamin B12, folic acid, vitamin D, calcium, PTH, magnesium, hemoglobin, iron, ferritin, and transferrin at preoperative, 6-month, and 12-month intervals post-surgery. The RYGB group showed significantly higher excess weight loss. Vitamin B12, hemoglobin, and ferritin levels were consistently higher in the SG group throughout the study. Vitamin D deficiency was prevalent, with no significant difference between the groups. Vitamin B12 deficiency was significantly more common in the RYGB group (6 months: 17.46% vs. 4.69%, p < 0.001; 12 months: 16.74% vs. 0.93%, p < 0.001). Despite differences in their mechanisms, bariatric surgeries were associated with nutritional deficiencies. It is crucial to efficiently assess, prevent, and manage these deficiencies tailored to each surgical procedure. Full article

(This article belongs to the Special Issue New Advances and Challenges in Metabolic and Bariatric Surgery)

12 pages, 1410 KiB

Open AccessEditor’s ChoiceArticle

Comparative Analysis of Large Language Models in Emergency Plastic Surgery Decision-Making: The Role of Physical Exam Data

by Sahar Borna, Cesar A. Gomez-Cabello, Sophia M. Pressman, Syed Ali Haider and Antonio Jorge Forte

J. Pers. Med. 2024, 14(6), 612; https://doi.org/10.3390/jpm14060612 - 8 Jun 2024

Cited by 6 | Viewed by 2141

Abstract

In the U.S., diagnostic errors are common across various healthcare settings due to factors like complex procedures and multiple healthcare providers, often exacerbated by inadequate initial evaluations. This study explores the role of Large Language Models (LLMs), specifically OpenAI’s ChatGPT-4 and Google Gemini, [...] Read more.

In the U.S., diagnostic errors are common across various healthcare settings due to factors like complex procedures and multiple healthcare providers, often exacerbated by inadequate initial evaluations. This study explores the role of Large Language Models (LLMs), specifically OpenAI’s ChatGPT-4 and Google Gemini, in improving emergency decision-making in plastic and reconstructive surgery by evaluating their effectiveness both with and without physical examination data. Thirty medical vignettes covering emergency conditions such as fractures and nerve injuries were used to assess the diagnostic and management responses of the models. These responses were evaluated by medical professionals against established clinical guidelines, using statistical analyses including the Wilcoxon rank-sum test. Results showed that ChatGPT-4 consistently outperformed Gemini in both diagnosis and management, irrespective of the presence of physical examination data, though no significant differences were noted within each model’s performance across different data scenarios. Conclusively, while ChatGPT-4 demonstrates superior accuracy and management capabilities, the addition of physical examination data, though enhancing response detail, did not significantly surpass traditional medical resources. This underscores the utility of AI in supporting clinical decision-making, particularly in scenarios with limited data, suggesting its role as a complement to, rather than a replacement for, comprehensive clinical evaluation and expertise. Full article

(This article belongs to the Special Issue Artificial Intelligence for Personalized Medicine: Bridging Innovative Technologies and Patient-Centric Care)

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19 pages, 306 KiB

Open AccessEditor’s ChoiceReview

Shoulder Dystocia: A Comprehensive Literature Review on Diagnosis, Prevention, Complications, Prognosis, and Management

by Panagiotis Tsikouras, Sonia Kotanidou, Konstantinos Nikolettos, Nektaria Kritsotaki, Anastasia Bothou, Sotiris Andreou, Theopi Nalmpanti, Kyriaki Chalkia, Vlassios Spanakis, Panagiotis Peitsidis, George Iatrakis and Nikolaos Nikolettos

J. Pers. Med. 2024, 14(6), 586; https://doi.org/10.3390/jpm14060586 - 30 May 2024

Cited by 4 | Viewed by 7060

Abstract

The term dystocia refers to labor characterized by a slow progression with delayed rates or even pauses in the dilation of the cervix or the descent of the fetus. Dystocia describes the deviation from the limits that define a normal birth and is [...] Read more.

The term dystocia refers to labor characterized by a slow progression with delayed rates or even pauses in the dilation of the cervix or the descent of the fetus. Dystocia describes the deviation from the limits that define a normal birth and is often used as a synonym for the term pathological birth. Shoulder dystocia, also known as the manual exit of the shoulders during vaginal delivery on cephalic presentation, is defined as the “failure of the shoulders to spontaneously traverse the pelvis after delivery of the fetal head”. This means that obstetric interventions are necessary to deliver the fetus’s body after the head has been delivered, as gentle traction has failed. Abnormal labor (dystocia) is expressed and represented in partograms or by the prolongation of the latent phase or by slowing and pausing in the phases of cervical dilatation and fetal descent. While partograms are helpful in visualizing the progress of labor, regular use of them has not been shown to enhance obstetric outcomes considerably, and no partogram has been shown to be superior to others in comparative trials. Dystocia can, therefore, appear in any phase of the evolution of childbirth, so it is necessary to simultaneously assess all the factors that may contribute to its abnormal evolution, that is, the forces exerted, the weight, the shape, the presentation and position of the fetus, the integrity and morphology of the pelvis, and its relation to the fetus. When this complication occurs, it can result in an increased incidence of maternal morbidity, as well as an increased incidence of neonatal morbidity and mortality. Although several risk factors are associated with shoulder dystocia, it has proven impossible to recognize individual cases of shoulder dystocia in practice before they occur during labor. Various guidelines have been published for the management of shoulder dystocia, with the primary goal of educating the obstetrician and midwife on the importance of a preplanned sequence of maneuvers, thereby reducing maternal and neonatal morbidity and mortality. Full article

(This article belongs to the Special Issue Clinical Updates on Reproductive Medicine)

13 pages, 375 KiB

Open AccessEditor’s ChoiceSystematic Review

A Systematic Review of Congenital Insensitivity to Pain, a Rare Disease

by Raquel Rodríguez-Blanque, Laura Maria Nielsen, Beatriz Piqueras-Sola, Juan Carlos Sánchez-García, Celia Cortés-Martín, Andrés Reinoso-Cobo and Jonathan Cortés-Martín

J. Pers. Med. 2024, 14(6), 570; https://doi.org/10.3390/jpm14060570 - 26 May 2024

Cited by 5 | Viewed by 6182

Abstract

Introduction: Pain perception, far from being a pathological mechanism, is a crucial protective stimulus to prevent additional injuries. Any disturbance in this complex system poses significant risks to individuals, affecting their quality of life and even their survival. Objective: This review aims to [...] Read more.

Introduction: Pain perception, far from being a pathological mechanism, is a crucial protective stimulus to prevent additional injuries. Any disturbance in this complex system poses significant risks to individuals, affecting their quality of life and even their survival. Objective: This review aims to explore congenital insensitivity to pain, an extremely rare genetic disorder with an autosomal recessive pattern that results in the inability to perceive pain. We will focus on the well-known subtype, congenital insensitivity to pain with anhidrosis (CIPA). Our research seeks to update existing knowledge through a comprehensive literature review. Methodology: The review employs a systematic literature review, analyzing various sources and scientific documents, primarily emphasizing CIPA. The review follows the PROSPERO protocol, registered under CRD42023394489. The literature search was performed on the Scopus, PubMed, and Cinahl databases. Results: Our review reveals secondary complications associated with CIPA, such as recurrent bone fractures, temperature insensitivity, self-mutilation, and, occasionally, intellectual disabilities. The limited available information underscores the need for expanding our knowledge. Conclusions: In summary, CIPA, particularly, presents a significant medical challenge with adverse impacts on quality of life. Early diagnosis, education for families and healthcare professionals, and appropriate nursing care are essential for effective management. This review highlights the necessity of further research and awareness to enhance support for those affected. Full article

(This article belongs to the Section Mechanisms of Diseases)

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13 pages, 251 KiB

Open AccessEditor’s ChoiceArticle

Exploring Inflammatory Parameters in Lung Cancer Patients: A Retrospective Analysis

by Catalin Vladut Ionut Feier, Calin Muntean, Alaviana Monique Faur, Vasile Gaborean, Ioan Adrian Petrache and Gabriel Veniamin Cozma

J. Pers. Med. 2024, 14(6), 552; https://doi.org/10.3390/jpm14060552 - 22 May 2024

Cited by 8 | Viewed by 1774

Abstract

Inflammation-related parameters serve as pivotal indicators in the prognosis and management of lung cancer. This retrospective investigation aimed to explore the relationship between inflammatory markers and diverse clinical variables in non-small-cell lung cancer patients. A cohort of 187 individuals undergoing elective lobectomy for [...] Read more.

Inflammation-related parameters serve as pivotal indicators in the prognosis and management of lung cancer. This retrospective investigation aimed to explore the relationship between inflammatory markers and diverse clinical variables in non-small-cell lung cancer patients. A cohort of 187 individuals undergoing elective lobectomy for lung cancer was retrospectively analyzed, spanning an 11-year data collection period. Six inflammation ratios derived from complete peripheral blood counts were assessed. Significantly elevated levels of neutrophil-to-lymphocyte ratio (NLR) (p = 0.005), platelet-to-lymphocyte ratio (PLR) (p = 0.001), Aggregate Index of Systemic Inflammation (AISI) (p = 0.015), Systemic Inflammation Response Index (SIRI) (p = 0.004), and Systemic Immune Inflammation Index (SII) (p = 0.004) were observed in patients with advanced T stages. Significantly, elevated values (p < 0.05) of these parameters were observed in the study’s smoker patients compared to non-smokers. A statistically significant correlation was identified between the NLR parameter and tumor size (p = 0.07, r = 0.204), alongside a significant elevation in SIRI (p = 0.041) among patients experiencing postoperative complications. Inflammatory biomarkers emerge as invaluable prognostic indicators for patients with non-small-cell lung cancer, offering potential utility in forecasting their prognosis. Full article

(This article belongs to the Special Issue Respiratory Health and Chronic Disease Management)

15 pages, 1291 KiB

Open AccessEditor’s ChoiceReview

Sudden Cardiac Death, Post-Mortem Investigation: A Proposing Panel of First Line and Second Line Genetic Tests

by Fabio Del Duca, Alessandro Ghamlouch, Alice Chiara Manetti, Gabriele Napoletano, Elena Sonnini, Biancamaria Treves, Alessandra De Matteis, Raffaele La Russa, Mary N. Sheppard, Vittorio Fineschi and Aniello Maiese

J. Pers. Med. 2024, 14(5), 544; https://doi.org/10.3390/jpm14050544 - 20 May 2024

Cited by 4 | Viewed by 2452

Abstract

Investigating the causes of Sudden cardiac death (SCD) is always difficult; in fact, genetic cardiac conditions associated with SCD could be “silent” even during autopsy investigation. In these cases, it is important to exclude other aetiology and assist to ask for genetic investigations. [...] Read more.

Investigating the causes of Sudden cardiac death (SCD) is always difficult; in fact, genetic cardiac conditions associated with SCD could be “silent” even during autopsy investigation. In these cases, it is important to exclude other aetiology and assist to ask for genetic investigations. Herein, the purpose of this review is to collect the most-implicated genes in SCD and generate a panel with indications for first line and second line investigations. A systematic review of genetic disorders that may cause SCD in the general population was carried out according to the Preferred Reporting Item for Systematic Review (PRISMA) standards. We subsequently listed the genes that may be tested in the case of sudden cardiac death when the autopsy results are negative or with no evidence of acquired cardiac conditions. To make genetic tests more specific and efficient, it is useful and demanded to corroborate autopsy findings with the molecular investigation as evident in the panel proposed. The genes for first line investigations are HCM, MYBPC3, MYH7, TNNT2, TNNI3, while in case of DCM, the most implicated genes are LMNA and TTN, and in second line for these CDM, ACTN2, TPM1, C1QPB could be investigated. In cases of ACM/ARVC, the molecular investigation includes DSP, DSG2, DSC2, RYR2, PKP2. The channelopathies are associated with the following genes: SCN5A, KCNQ1, KCNH2, KCNE1, RYR2. Our work underlines the importance of genetic tests in forensic medicine and clinical pathology; moreover, it could be helpful not only to assist the pathologists to reach a diagnosis, but also to prevent other cases of SCD in the family of the descendant and to standardise the type of analysis performed in similar cases worldwide. Full article

(This article belongs to the Special Issue Clinical Advances in Functional Genomics)

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13 pages, 2579 KiB

Open AccessEditor’s ChoiceArticle

Ellipsoid Zone Integrity and Visual Function in Dry Age-Related Macular Degeneration

by Sari Yordi, Yavuz Cakir, Gagan Kalra, Hasan Cetin, Ming Hu, Joseph Abraham, Jamie Reese, Sunil K. Srivastava and Justis P. Ehlers

J. Pers. Med. 2024, 14(5), 543; https://doi.org/10.3390/jpm14050543 - 19 May 2024

Cited by 12 | Viewed by 2620

Abstract

In this longitudinal retrospective image analysis, conducted on patients diagnosed with dry age-related macular degeneration (AMD) and 5 years of follow-up imaging data, the study aimed to investigate the relationship between ellipsoid zone (EZ) integrity on spectral domain optical coherence tomography (SD-OCT) and [...] Read more.

In this longitudinal retrospective image analysis, conducted on patients diagnosed with dry age-related macular degeneration (AMD) and 5 years of follow-up imaging data, the study aimed to investigate the relationship between ellipsoid zone (EZ) integrity on spectral domain optical coherence tomography (SD-OCT) and visual acuity (VA). Using a machine learning-enabled feature extraction tool, quantitative EZ parameters were derived from SD-OCT images. The analysis revealed significant correlations between EZ integrity metrics and VA. Eyes with excellent VA (≥20/25 Snellen) exhibited higher EZ integrity, including less EZ attenuation, thicker ellipsoid zone-retinal pigment epithelium (EZ-RPE) thickness, and higher EZ intensity, in contrast to eyes with worse VA (≤20/40 Snellen). Additionally, eyes with geographic atrophy (GA) in the foveal region displayed compromised EZ integrity compared to those without GA. Notably, baseline EZ integrity metrics were predictive of future VA loss. These findings suggest that quantitative SD-OCT measurements of EZ integrity could potentially detect early changes in dry AMD and serve as valuable indicators for predicting future functional outcomes. Furthermore, these measurements hold promise for use in clinical trial screenings, offering insights into the progression of the disease and its impact on visual acuity. This study underscores the importance of EZ integrity assessment in understanding and managing dry AMD. Full article

(This article belongs to the Section Disease Biomarker)

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13 pages, 3416 KiB

Open AccessEditor’s ChoiceArticle

Long-Term Clinical Outcomes of 3D-Printed Subperiosteal Titanium Implants: A 6-Year Follow-Up

by Neculai Onică, Dana Gabriela Budală, Elena-Raluca Baciu, Cezara Andreea Onică, Gabriela Luminița Gelețu, Alice Murariu, Mihail Balan, Mihaela Pertea and Carmen Stelea

J. Pers. Med. 2024, 14(5), 541; https://doi.org/10.3390/jpm14050541 - 18 May 2024

Cited by 13 | Viewed by 3824

Abstract

As an alternative to regenerative therapies, numerous authors have recently proposed bringing back subperiosteal implants. The aim of the study was to present our clinical experience with a subperiosteal jaw implant that needs minimal bone preparation and enables the rapid implantation of prosthetic [...] Read more.

As an alternative to regenerative therapies, numerous authors have recently proposed bringing back subperiosteal implants. The aim of the study was to present our clinical experience with a subperiosteal jaw implant that needs minimal bone preparation and enables the rapid implantation of prosthetic teeth in edentulous, atrophic alveolar bone. The research included 36 complete or partial edentulous patients (61 subperiostal implants) over a period of 6 years. To create the patient-specific subperiostal implants design, DentalCAD 3.0 Galway software (exocad GmbH, Darmstadt, Germany) was used and fabricated with a Mysint 100 (Sisma S.p.A., Piovene Rocchette, Italy) by titanium alloy powder. The results showed that only 9 of the 36 cases were successful at 6-year follow-up, while 27 cases had complications, including exposure of the metal frame (early or delayed), mobility of the device prior to the first 4–6 months, and late mobility due to recurrent infections and progressive structure exposure; 1 case failed for reasons unrelated to the device. This study indicated that the prudent application of fully customized subperiosteal jaw implants is a dependable alternative for the dental rehabilitation of atrophic edentulous cases that necessitate bone grafts for traditional fixed dental implant solutions. Full article

(This article belongs to the Special Issue New Updates in Oral and Maxillofacial Surgery)

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32 pages, 840 KiB

Open AccessEditor’s ChoiceReview

Interactions and Trends of Interleukins, PAI-1, CRP, and TNF-α in Inflammatory Responses during the Perioperative Period of Joint Arthroplasty: Implications for Pain Management—A Narrative Review

by Arabela-Codruta Cocea and Cristian Ioan Stoica

J. Pers. Med. 2024, 14(5), 537; https://doi.org/10.3390/jpm14050537 - 17 May 2024

Cited by 4 | Viewed by 2130

Abstract

Inflammation during the perioperative period of joint arthroplasty is a critical aspect of patient outcomes, influencing both the pathophysiology of pain and the healing process. This narrative review comprehensively evaluates the roles of specific cytokines and inflammatory biomarkers in this context and their [...] Read more.

Inflammation during the perioperative period of joint arthroplasty is a critical aspect of patient outcomes, influencing both the pathophysiology of pain and the healing process. This narrative review comprehensively evaluates the roles of specific cytokines and inflammatory biomarkers in this context and their implications for pain management. Inflammatory responses are initiated and propagated by cytokines, which are pivotal in the development of both acute and chronic postoperative pain. Pro-inflammatory cytokines play essential roles in up-regulating the inflammatory response, which, if not adequately controlled, leads to sustained pain and impaired tissue healing. Anti-inflammatory cytokines work to dampen inflammatory responses and promote resolution. Our discussion extends to the genetic and molecular influences on cytokine production, which influence pain perception and recovery rates post-surgery. Furthermore, the role of PAI-1 in modulating inflammation through its impact on the fibrinolytic system highlights its potential as a therapeutic target. The perioperative modulation of these cytokines through various analgesic and anesthetic techniques, including the fascia iliac compartment block, demonstrates a significant reduction in pain and inflammatory markers, thus underscoring the importance of targeted therapeutic strategies. Our analysis suggests that a nuanced understanding of the interplay between pro-inflammatory and anti-inflammatory cytokines is required. Future research should focus on individualized pain management strategies. Full article

(This article belongs to the Special Issue Challenges and Opportunities in Personalized Management of Bone and Joint Infections)

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21 pages, 1072 KiB

Open AccessEditor’s ChoiceReview

Review: A Contemporary, Multifaced Insight into Psoriasis Pathogenesis

by Rucsandra Cristina Dascălu, Andreea Lili Bărbulescu, Loredana Elena Stoica, Ștefan Cristian Dinescu, Cristina Elena Biță, Horațiu Valeriu Popoviciu, Răzvan Adrian Ionescu and Florentin Ananu Vreju

J. Pers. Med. 2024, 14(5), 535; https://doi.org/10.3390/jpm14050535 - 16 May 2024

Cited by 9 | Viewed by 4454

Abstract

Psoriasis is a chronic recurrent inflammatory autoimmune pathology with a significant genetic component and several interferences of immunological cells and their cytokines. The complex orchestration of psoriasis pathogenesis is related to the synergic effect of immune cells, polygenic alterations, autoantigens, and several other [...] Read more.

Psoriasis is a chronic recurrent inflammatory autoimmune pathology with a significant genetic component and several interferences of immunological cells and their cytokines. The complex orchestration of psoriasis pathogenesis is related to the synergic effect of immune cells, polygenic alterations, autoantigens, and several other external factors. The major act of the IL-23/IL-17 axis, strongly influencing the inflammatory pattern established during the disease activity, is visible as a continuous perpetuation of the pro-inflammatory response and keratinocyte activation and proliferation, leading to the development of psoriatic lesions. Genome-wide association studies (GWASs) offer a better view of psoriasis pathogenic pathways, with approximately one-third of psoriasis’s genetic impact on psoriasis development associated with the MHC region, with genetic loci located on chromosome 6. The most eloquent genetic factor of psoriasis, PSORS1, was identified in the MHC I site. Among the several factors involved in its complex etiology, dysbiosis, due to genetic or external stimulus, induces a burst of pro-inflammatory consequences; both the cutaneous and gut microbiome get involved in the psoriasis pathogenic process. Cutting-edge research studies and comprehensive insights into psoriasis pathogenesis, fostering novel genetic, epigenetic, and immunological factors, have generated a spectacular improvement over the past decades, securing the path toward a specific and targeted immunotherapeutic approach and delayed progression to inflammatory arthritis. This review aimed to offer insight into various domains that underline the pathogenesis of psoriasis and how they influence disease development and evolution. The pathogenesis mechanism of psoriasis is multifaceted and involves an interplay of cellular and humoral immunity, which affects susceptible microbiota and the genetic background. An in-depth understanding of the role of pathogenic factors forms the basis for developing novel and individualized therapeutic targets that can improve disease management. Full article

(This article belongs to the Special Issue Immune-Mediated Diseases)

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12 pages, 1128 KiB

Open AccessEditor’s ChoiceSystematic Review

Misdiagnosis and Clinical Insights into Acral Amelanotic Melanoma—A Systematic Review

by Fortunato Cassalia, Andrea Danese, Enrico Cocchi, Elisabetta Danese, Francesca Ambrogio, Gerardo Cazzato, Marcodomenico Mazza, Anna Zambello, Anna Belloni Fortina and Davide Melandri

J. Pers. Med. 2024, 14(5), 518; https://doi.org/10.3390/jpm14050518 - 13 May 2024

Cited by 6 | Viewed by 2426

Abstract

Background: Acral amelanotic melanomas (AAMs), a rare subset of melanomas located on acral sites such as the palms, soles, and subungual areas, are diagnostically challenging due to their lack of typical pigmentation and often benign clinical appearance. Misdiagnosis is common, leading to delays [...] Read more.

Background: Acral amelanotic melanomas (AAMs), a rare subset of melanomas located on acral sites such as the palms, soles, and subungual areas, are diagnostically challenging due to their lack of typical pigmentation and often benign clinical appearance. Misdiagnosis is common, leading to delays in treatment and potentially worse outcomes. This systematic review aims to synthesise evidence on cases of AAM initially misdiagnosed as other conditions, to better understand their clinical and epidemiological characteristics, diagnostic pitfalls, and management strategies. Methods: A comprehensive search of the MEDLINE/PubMed, EMBASE, and SCOPUS databases was conducted up to March 2024. Case reports and small case series of AAMs initially misdiagnosed as other conditions were included. Data on patient demographics, clinical presentation, and diagnostic methods were collected and analyzed. Results: Of the 152 records identified, 26 cases from 23 articles met the inclusion criteria. A demographic analysis revealed that the gender distribution appears to be perfectly balanced, with an age range of 38 to 91 years. Misdiagnoses included non-healing ulcers or traumatic lesions (37.5%), benign proliferative lesions (29.2%) and infectious lesions (20.8%). The foot was the most affected site (53.8%). Notably, a histological evaluation was performed in 50% of cases involving the upper extremities, in contrast to only 7.1% of cases involving the foot and 0% of cases of the heel. This discrepancy suggests a reluctance to perform biopsies in the lower extremities, which may contribute to a higher misdiagnosis rate in these areas. Conclusions: The underutilization of biopsy in the diagnosis of lower extremity lesions contributes significantly to the misdiagnosis and delay in treatment of AAMs. Especially when the clinical assessment and dermoscopy are inconclusive, biopsies of suspicious lesions are essential. Immunohistochemistry and markers such as PRAME are critical in differentiating melanoma from other malignancies such as clear cell sarcoma. This review highlights the need for increased vigilance and a proactive diagnostic approach to increase early detection rates and improve prognostic outcomes. Full article

(This article belongs to the Special Issue Advances in Personalized Diagnosis and Treatment in Dermatology)

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18 pages, 1020 KiB

Open AccessEditor’s ChoiceReview

Exploring the Gut Microbiome’s Role in Inflammatory Bowel Disease: Insights and Interventions

by Despoina Gyriki, Christos Nikolaidis, Elisavet Stavropoulou, Ioanna Bezirtzoglou, Christina Tsigalou, Stergios Vradelis and Eugenia Bezirtzoglou

J. Pers. Med. 2024, 14(5), 507; https://doi.org/10.3390/jpm14050507 - 11 May 2024

Cited by 9 | Viewed by 5221

Abstract

Inflammatory Bowel Disease (IBD), encompassing Crohn’s disease (CD) and ulcerative colitis (UC), is a chronic and relapsing inflammatory condition of the intestine that significantly impairs quality of life and imposes a heavy burden on healthcare systems globally. While the exact etiology of IBD [...] Read more.

Inflammatory Bowel Disease (IBD), encompassing Crohn’s disease (CD) and ulcerative colitis (UC), is a chronic and relapsing inflammatory condition of the intestine that significantly impairs quality of life and imposes a heavy burden on healthcare systems globally. While the exact etiology of IBD is unclear, it is influenced by genetic, environmental, immunological, and microbial factors. Recent advances highlight the gut microbiome’s pivotal role in IBD pathogenesis. The microbial dysbiosis characteristic of IBD, marked by a decline in beneficial bacteria and an increase in pathogenic microbes, suggests a profound connection between microbial imbalance and disease mechanisms. This review explores diagnostic approaches to IBD that integrate clinical assessment with advanced microbiological analyses, highlighting the potential of microbiome profiling as a non-invasive diagnostic tool. In addition, it evaluates conventional and emerging treatments and discusses microbiome-targeted intervention prospects, such as probiotics, symbiotics, and faecal microbiota transplantation. The necessity for future research to establish their efficacy and safety is emphasised. Full article

(This article belongs to the Special Issue Gut Microbiome and Its Impact on Human Health)

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18 pages, 967 KiB

Open AccessEditor’s ChoiceReview

Non-Invasive Retinal Vessel Analysis as a Predictor for Cardiovascular Disease

by Raluca Eugenia Iorga, Damiana Costin, Răzvana Sorina Munteanu-Dănulescu, Elena Rezuș and Andreea Dana Moraru

J. Pers. Med. 2024, 14(5), 501; https://doi.org/10.3390/jpm14050501 - 9 May 2024

Cited by 6 | Viewed by 2815

Abstract

Cardiovascular disease (CVD) is the most frequent cause of death worldwide. The alterations in the microcirculation may predict the cardiovascular mortality. The retinal vasculature can be used as a model to study vascular alterations associated with cardiovascular disease. In order to quantify microvascular [...] Read more.

Cardiovascular disease (CVD) is the most frequent cause of death worldwide. The alterations in the microcirculation may predict the cardiovascular mortality. The retinal vasculature can be used as a model to study vascular alterations associated with cardiovascular disease. In order to quantify microvascular changes in a non-invasive way, fundus images can be taken and analysed. The central retinal arteriolar (CRAE), the venular (CRVE) diameter and the arteriolar-to-venular diameter ratio (AVR) can be used as biomarkers to predict the cardiovascular mortality. A narrower CRAE, wider CRVE and a lower AVR have been associated with increased cardiovascular events. Dynamic retinal vessel analysis (DRVA) allows the quantification of retinal changes using digital image sequences in response to visual stimulation with flicker light. This article is not just a review of the current literature, it also aims to discuss the methodological benefits and to identify research gaps. It highlights the potential use of microvascular biomarkers for screening and treatment monitoring of cardiovascular disease. Artificial intelligence (AI), such as Quantitative Analysis of Retinal vessel Topology and size (QUARTZ), and SIVA–deep learning system (SIVA-DLS), seems efficient in extracting information from fundus photographs and has the advantage of increasing diagnosis accuracy and improving patient care by complementing the role of physicians. Retinal vascular imaging using AI may help identify the cardiovascular risk, and is an important tool in primary cardiovascular disease prevention. Further research should explore the potential clinical application of retinal microvascular biomarkers, in order to assess systemic vascular health status, and to predict cardiovascular events. Full article

(This article belongs to the Special Issue New Advances in Diagnostic and Surgical Treatment of Ocular Diseases)

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12 pages, 1486 KiB

Open AccessEditor’s ChoiceArticle

Assessment of the Quality and Readability of Information Provided by ChatGPT in Relation to the Use of Platelet-Rich Plasma Therapy for Osteoarthritis

by Stephen Fahy, Marcel Niemann, Peter Böhm, Tobias Winkler and Stephan Oehme

J. Pers. Med. 2024, 14(5), 495; https://doi.org/10.3390/jpm14050495 - 8 May 2024

Cited by 8 | Viewed by 2204

Abstract

Objective: This study aimed to evaluate the quality and readability of information generated by ChatGPT versions 3.5 and 4 concerning platelet-rich plasma (PRP) therapy in the management of knee osteoarthritis (OA), exploring whether large language models (LLMs) could play a significant role [...] Read more.

Objective: This study aimed to evaluate the quality and readability of information generated by ChatGPT versions 3.5 and 4 concerning platelet-rich plasma (PRP) therapy in the management of knee osteoarthritis (OA), exploring whether large language models (LLMs) could play a significant role in patient education. Design: A total of 23 common patient queries regarding the role of PRP therapy in knee OA management were presented to ChatGPT versions 3.5 and 4. The quality of the responses was assessed using the DISCERN criteria, and readability was evaluated using six established assessment tools. Results: Both ChatGPT versions 3.5 and 4 produced moderate quality information. The quality of information provided by ChatGPT version 4 was significantly better than version 3.5, with mean DISCERN scores of 48.74 and 44.59, respectively. Both models scored highly with respect to response relevance and had a consistent emphasis on the importance of shared decision making. However, both versions produced content significantly above the recommended 8th grade reading level for patient education materials (PEMs), with mean reading grade levels (RGLs) of 17.18 for ChatGPT version 3.5 and 16.36 for ChatGPT version 4, indicating a potential barrier to their utility in patient education. Conclusions: While ChatGPT versions 3.5 and 4 both demonstrated the capability to generate information of moderate quality regarding the role of PRP therapy for knee OA, the readability of the content remains a significant barrier to widespread usage, exceeding the recommended reading levels for PEMs. Although ChatGPT version 4 showed improvements in quality and source citation, future iterations must focus on producing more accessible content to serve as a viable resource in patient education. Collaboration between healthcare providers, patient organizations, and AI developers is crucial to ensure the generation of high quality, peer reviewed, and easily understandable information that supports informed healthcare decisions. Full article

(This article belongs to the Special Issue Personalized Medicine in Orthopaedics, 2nd Edition)

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34 pages, 1308 KiB

Open AccessEditor’s ChoiceReview

IL-8 (CXCL8) Correlations with Psychoneuroimmunological Processes and Neuropsychiatric Conditions

by Anton Shkundin and Angelos Halaris

J. Pers. Med. 2024, 14(5), 488; https://doi.org/10.3390/jpm14050488 - 3 May 2024

Cited by 5 | Viewed by 3285

Abstract

Interleukin-8 (IL-8/CXCL8), an essential CXC chemokine, significantly influences psychoneuroimmunological processes and affects neurological and psychiatric health. It exerts a profound effect on immune cell activation and brain function, suggesting potential roles in both neuroprotection and neuroinflammation. IL-8 production is stimulated by several factors, [...] Read more.

Interleukin-8 (IL-8/CXCL8), an essential CXC chemokine, significantly influences psychoneuroimmunological processes and affects neurological and psychiatric health. It exerts a profound effect on immune cell activation and brain function, suggesting potential roles in both neuroprotection and neuroinflammation. IL-8 production is stimulated by several factors, including reactive oxygen species (ROS) known to promote inflammation and disease progression. Additionally, CXCL8 gene polymorphisms can alter IL-8 production, leading to potential differences in disease susceptibility, progression, and severity across populations. IL-8 levels vary among neuropsychiatric conditions, demonstrating sensitivity to psychosocial stressors and disease severity. IL-8 can be detected in blood circulation, cerebrospinal fluid (CSF), and urine, making it a promising candidate for a broad-spectrum biomarker. This review highlights the need for further research on the diverse effects of IL-8 and the associated implications for personalized medicine. A thorough understanding of its complex role could lead to the development of more effective and personalized treatment strategies for neuropsychiatric conditions. Full article

(This article belongs to the Section Disease Biomarker)

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37 pages, 6817 KiB

Open AccessEditor’s ChoiceArticle

A Multidisciplinary Hyper-Modeling Scheme in Personalized In Silico Oncology: Coupling Cell Kinetics with Metabolism, Signaling Networks, and Biomechanics as Plug-In Component Models of a Cancer Digital Twin

by Eleni Kolokotroni, Daniel Abler, Alokendra Ghosh, Eleftheria Tzamali, James Grogan, Eleni Georgiadi, Philippe Büchler, Ravi Radhakrishnan, Helen Byrne, Vangelis Sakkalis, Katerina Nikiforaki, Ioannis Karatzanis, Nigel J. B. McFarlane, Djibril Kaba, Feng Dong, Rainer M. Bohle, Eckart Meese, Norbert Graf and Georgios Stamatakos

J. Pers. Med. 2024, 14(5), 475; https://doi.org/10.3390/jpm14050475 - 29 Apr 2024

Cited by 8 | Viewed by 3095

Abstract

The massive amount of human biological, imaging, and clinical data produced by multiple and diverse sources necessitates integrative modeling approaches able to summarize all this information into answers to specific clinical questions. In this paper, we present a hypermodeling scheme able to combine [...] Read more.

The massive amount of human biological, imaging, and clinical data produced by multiple and diverse sources necessitates integrative modeling approaches able to summarize all this information into answers to specific clinical questions. In this paper, we present a hypermodeling scheme able to combine models of diverse cancer aspects regardless of their underlying method or scale. Describing tissue-scale cancer cell proliferation, biomechanical tumor growth, nutrient transport, genomic-scale aberrant cancer cell metabolism, and cell-signaling pathways that regulate the cellular response to therapy, the hypermodel integrates mutation, miRNA expression, imaging, and clinical data. The constituting hypomodels, as well as their orchestration and links, are described. Two specific cancer types, Wilms tumor (nephroblastoma) and non-small cell lung cancer, are addressed as proof-of-concept study cases. Personalized simulations of the actual anatomy of a patient have been conducted. The hypermodel has also been applied to predict tumor control after radiotherapy and the relationship between tumor proliferative activity and response to neoadjuvant chemotherapy. Our innovative hypermodel holds promise as a digital twin-based clinical decision support system and as the core of future in silico trial platforms, although additional retrospective adaptation and validation are necessary. Full article

(This article belongs to the Special Issue Mathematical Models of Personalized Medicine)

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16 pages, 3036 KiB

Open AccessEditor’s ChoiceArticle

Protection against Oxidative Stress by Coenzyme Q10 in a Porcine Retinal Degeneration Model

by Leonie Deppe, Ana M. Mueller-Buehl, Teresa Tsai, Carl Erb, H. Burkhard Dick and Stephanie C. Joachim

J. Pers. Med. 2024, 14(4), 437; https://doi.org/10.3390/jpm14040437 - 22 Apr 2024

Cited by 4 | Viewed by 2119

Abstract

Oxidative stress plays an important role in neurodegenerative diseases, including glaucoma. Therefore, we analyzed if the antioxidant coenzyme Q10 (CoQ10), which is also commercially available, can prevent retinal degeneration induced by hydrogen peroxide (H₂O₂) in a porcine organ culture [...] Read more.

Oxidative stress plays an important role in neurodegenerative diseases, including glaucoma. Therefore, we analyzed if the antioxidant coenzyme Q10 (CoQ10), which is also commercially available, can prevent retinal degeneration induced by hydrogen peroxide (H₂O₂) in a porcine organ culture model. Retinal explants were cultivated for eight days, and H₂O₂ (500 µM, 3 h) induced the oxidative damage. CoQ10 therapy was applied (700 µM, 48 h). Retinal ganglion cells (RGCs) and microglia were examined immunohistologically in all groups (control, H₂O₂, H₂O₂ + CoQ10). Cellular, oxidative, and inflammatory genes were quantified via RT-qPCR. Strong RGC loss was observed with H₂O₂ (p ≤ 0.001). CoQ10 elicited RGC protection compared to the damaged group at a histological (p ≤ 0.001) and mRNA level. We detected more microglia cells with H₂O₂, but CoQ10 reduced this effect (p = 0.004). Cellular protection genes (NRF2) against oxidative stress were stimulated by CoQ10 (p ≤ 0.001). Furthermore, mitochondrial oxidative stress (SOD2) increased through H₂O₂ (p = 0.038), and CoQ10 reduced it to control level. Our novel results indicate neuroprotection via CoQ10 in porcine retina organ cultures. In particular, CoQ10 appears to protect RGCs by potentially inhibiting apoptosis-related pathways, activating intracellular protection and reducing mitochondrial stress. Full article

(This article belongs to the Special Issue Glaucoma Management in the Era of Personalized Medicine)

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17 pages, 551 KiB

Open AccessEditor’s ChoiceReview

Precision Medicine—Are We There Yet? A Narrative Review of Precision Medicine’s Applicability in Primary Care

by William Evans, Eric M. Meslin, Joe Kai and Nadeem Qureshi

J. Pers. Med. 2024, 14(4), 418; https://doi.org/10.3390/jpm14040418 - 15 Apr 2024

Cited by 8 | Viewed by 6009

Abstract

Precision medicine (PM), also termed stratified, individualised, targeted, or personalised medicine, embraces a rapidly expanding area of research, knowledge, and practice. It brings together two emerging health technologies to deliver better individualised care: the many “-omics” arising from increased capacity to understand the [...] Read more.

Precision medicine (PM), also termed stratified, individualised, targeted, or personalised medicine, embraces a rapidly expanding area of research, knowledge, and practice. It brings together two emerging health technologies to deliver better individualised care: the many “-omics” arising from increased capacity to understand the human genome and “big data” and data analytics, including artificial intelligence (AI). PM has the potential to transform an individual’s health, moving from population-based disease prevention to more personalised management. There is however a tension between the two, with a real risk that this will exacerbate health inequalities and divert funds and attention from basic healthcare requirements leading to worse health outcomes for many. All areas of medicine should consider how this will affect their practice, with PM now strongly encouraged and supported by government initiatives and research funding. In this review, we discuss examples of PM in current practice and its emerging applications in primary care, such as clinical prediction tools that incorporate genomic markers and pharmacogenomic testing. We look towards potential future applications and consider some key questions for PM, including evidence of its real-world impact, its affordability, the risk of exacerbating health inequalities, and the computational and storage challenges of applying PM technologies at scale. Full article

(This article belongs to the Section Personalized Critical Care)

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13 pages, 750 KiB

Open AccessEditor’s ChoiceReview

Challenges in Diagnosis and Therapeutic Strategies in Late-Onset Multiple Sclerosis

by Viviana Nociti, Marina Romozzi and Massimiliano Mirabella

J. Pers. Med. 2024, 14(4), 400; https://doi.org/10.3390/jpm14040400 - 10 Apr 2024

Cited by 5 | Viewed by 2702

Abstract

Multiple sclerosis (MS) is a chronic inflammatory and degenerative demyelinating disease of the central nervous system of unknown etiology, which affects individuals in their early adulthood. However, nearly 5–10% of people with MS can be diagnosed at ages above 50 years old, referred [...] Read more.

Multiple sclerosis (MS) is a chronic inflammatory and degenerative demyelinating disease of the central nervous system of unknown etiology, which affects individuals in their early adulthood. However, nearly 5–10% of people with MS can be diagnosed at ages above 50 years old, referred to as late-onset multiple sclerosis (LOMS). Some studies have reported a distinctive presentation, clinical course, and prognosis for LOMS, implicating a different diagnostic and therapeutic approach for this population. Furthermore, similar manifestations between LOMS and other age-related conditions may lead to potential misdiagnosis and diagnostic delays, and a higher burden of multimorbidity associated with aging can further complicate the clinical picture. This review aims to explore the clinical characteristics, the disease course, and the differential diagnosis of LOMS and addresses therapeutic considerations for this population. Full article

(This article belongs to the Section Clinical Medicine, Cell, and Organism Physiology)

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17 pages, 922 KiB

Open AccessEditor’s ChoiceReview

Role of Oral Microbiota Dysbiosis in the Development and Progression of Oral Lichen Planus

by Alessandro Lavoro, Giovanni Cultrera, Giuseppe Gattuso, Cinzia Lombardo, Luca Falzone, Candido Saverio, Massimo Libra and Mario Salmeri

J. Pers. Med. 2024, 14(4), 386; https://doi.org/10.3390/jpm14040386 - 3 Apr 2024

Cited by 4 | Viewed by 2894

Abstract

Oral lichen planus (OLP) is a chronic inflammatory autoimmune disease of the oral cavity with malignant potential affecting 1.01% of the worldwide population. The clinical patterns of this oral disorder, characterized by relapses and remissions of the lesions, appear on buccal, lingual, gingival, [...] Read more.

Oral lichen planus (OLP) is a chronic inflammatory autoimmune disease of the oral cavity with malignant potential affecting 1.01% of the worldwide population. The clinical patterns of this oral disorder, characterized by relapses and remissions of the lesions, appear on buccal, lingual, gingival, and labial mucosa causing a significant reduction in the quality of life. Currently, there are no specific treatments for this disease, and the available therapies with topical and systemic corticosteroids only reduce symptoms. Although the etiopathogenesis of this pathological condition has not been completely understood yet, several exogenous and endogenous risk factors have been proposed over the years. The present review article summarized the underlying mechanisms of action involved in the onset of OLP and the most well-known triggering factors. According to the current data, oral microbiota dysbiosis could represent a potential diagnostic biomarker for OLP. However, further studies should be undertaken to validate their use in clinical practice, as well as to provide a better understanding of mechanisms of action and develop novel effective intervention strategies against OLP. Full article

(This article belongs to the Special Issue Novel Biomarkers in the Diagnostics of Cancer)

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12 pages, 643 KiB

Open AccessEditor’s ChoiceArticle

Longterm Outcome of Therapeutic Vaccination with a Third Generation Pre-S/S HBV Vaccine (PreHevbrio^R) of Chronically HBV Infected Patients

by Hedwig Roggendorf, Daniel Shouval, Michael Roggendorf and Guido Gerken

J. Pers. Med. 2024, 14(4), 364; https://doi.org/10.3390/jpm14040364 - 29 Mar 2024

Cited by 5 | Viewed by 1630

Abstract

Several antiviral treatment regimens for chronic hepatitis B (CHB) virus infection have been shown to be effective in suppressing viral load and reducing the risk of hepatocellular injury and its complications. It has been hypothesized that high levels of circulating HBV surface antigen(s) [...] Read more.

Several antiviral treatment regimens for chronic hepatitis B (CHB) virus infection have been shown to be effective in suppressing viral load and reducing the risk of hepatocellular injury and its complications. It has been hypothesized that high levels of circulating HBV surface antigen(s) may lead to immune tolerance against HBV and contribute to chronic carriership. Conversely, low-level HBsAg may create a window for the reconstitution of an HBV-specific immune response through vaccination and control of infection. Previous studies in non-responders to yeast-derived HBV vaccines, using a third-generation pre-S/S vaccine, have led to up to 95% anti-HBs seroconversion. This report evaluates the long-term outcome after experimental vaccination with a pre-S/S HBV vaccine intended as a therapeutic intervention in chronic HBV carriers. Four low-level HBsAg carriers (<500 IU/mL) were vaccinated three to seven times with 20 μg PreHevbrio^R. Three out of four carriers eliminated HBsAg completely and seroconverted to anti-HBs. One patient seroconverted to anti-HBs but remained with a borderline HBsAg titer (10 IU/mL). Serum anti-HBs levels following repeated vaccination varied between 27 and >1000 IU/L, respectively. Long-term observation (>6 years) showed that after discontinuing NUC treatment for at least two years, HBsAg and HBV DNA remained negative with anti-HBs positive titers ranging between 80 and >1000 IU/L. Based on our preliminary observations, there is a rationale to further evaluate the role of this vaccine as a therapeutic agent. Full article

(This article belongs to the Special Issue Novel Challenges and Therapeutic Options for Liver Diseases)

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13 pages, 2880 KiB

Open AccessEditor’s ChoiceArticle

Personalized Diabetes Management with Digital Twins: A Patient-Centric Knowledge Graph Approach

by Fatemeh Sarani Rad, Rasha Hendawi, Xinyi Yang and Juan Li

J. Pers. Med. 2024, 14(4), 359; https://doi.org/10.3390/jpm14040359 - 28 Mar 2024

Cited by 13 | Viewed by 5121

Abstract

Diabetes management requires constant monitoring and individualized adjustments. This study proposes a novel approach that leverages digital twins and personal health knowledge graphs (PHKGs) to revolutionize diabetes care. Our key contribution lies in developing a real-time, patient-centric digital twin framework built on PHKGs. [...] Read more.

Diabetes management requires constant monitoring and individualized adjustments. This study proposes a novel approach that leverages digital twins and personal health knowledge graphs (PHKGs) to revolutionize diabetes care. Our key contribution lies in developing a real-time, patient-centric digital twin framework built on PHKGs. This framework integrates data from diverse sources, adhering to HL7 standards and enabling seamless information access and exchange while ensuring high levels of accuracy in data representation and health insights. PHKGs offer a flexible and efficient format that supports various applications. As new knowledge about the patient becomes available, the PHKG can be easily extended to incorporate it, enhancing the precision and accuracy of the care provided. This dynamic approach fosters continuous improvement and facilitates the development of new applications. As a proof of concept, we have demonstrated the versatility of our digital twins by applying it to different use cases in diabetes management. These include predicting glucose levels, optimizing insulin dosage, providing personalized lifestyle recommendations, and visualizing health data. By enabling real-time, patient-specific care, this research paves the way for more precise and personalized healthcare interventions, potentially improving long-term diabetes management outcomes. Full article

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

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19 pages, 1358 KiB

Open AccessEditor’s ChoiceArticle

Lowering Barriers to Health Risk Assessments in Promoting Personalized Health Management

by Hayoung Park, Se Young Jung, Min Kyu Han, Yeonhoon Jang, Yeo Rae Moon, Taewook Kim, Soo-Yong Shin and Hee Hwang

J. Pers. Med. 2024, 14(3), 316; https://doi.org/10.3390/jpm14030316 - 18 Mar 2024

Cited by 4 | Viewed by 2467

Abstract

This study investigates the feasibility of accurately predicting adverse health events without relying on costly data acquisition methods, such as laboratory tests, in the era of shifting healthcare paradigms towards community-based health promotion and personalized preventive healthcare through individual health risk assessments (HRAs). [...] Read more.

This study investigates the feasibility of accurately predicting adverse health events without relying on costly data acquisition methods, such as laboratory tests, in the era of shifting healthcare paradigms towards community-based health promotion and personalized preventive healthcare through individual health risk assessments (HRAs). We assessed the incremental predictive value of four categories of predictor variables—demographic, lifestyle and family history, personal health device, and laboratory data—organized by data acquisition costs in the prediction of the risks of mortality and five chronic diseases. Machine learning methodologies were employed to develop risk prediction models, assess their predictive performance, and determine feature importance. Using data from the National Sample Cohort of the Korean National Health Insurance Service (NHIS), which includes eligibility, medical check-up, healthcare utilization, and mortality data from 2002 to 2019, our study involved 425,148 NHIS members who underwent medical check-ups between 2009 and 2012. Models using demographic, lifestyle, family history, and personal health device data, with or without laboratory data, showed comparable performance. A feature importance analysis in models excluding laboratory data highlighted modifiable lifestyle factors, which are a superior set of variables for developing health guidelines. Our findings support the practicality of precise HRAs using demographic, lifestyle, family history, and personal health device data. This approach addresses HRA barriers, particularly for healthy individuals, by eliminating the need for costly and inconvenient laboratory data collection, advancing accessible preventive health management strategies. Full article

(This article belongs to the Special Issue Precision Medicine for Epidemiology and Public Health)

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12 pages, 553 KiB

Open AccessEditor’s ChoiceArticle

Long-Term Perspectives on Chronic Rhinosinusitis with Nasal Polyps: Evaluating Recurrence Rates after Functional Endoscopic Sinus Surgery in the Biologics Era—A 5-Year Follow-Up Study

by Carlo Cavaliere, Simonetta Masieri, Elona Begvarfaj, Antonella Loperfido, Silvia Baroncelli, Francesca Cascone and Andrea Ciofalo

J. Pers. Med. 2024, 14(3), 297; https://doi.org/10.3390/jpm14030297 - 10 Mar 2024

Cited by 10 | Viewed by 3981

Abstract

Introduction: Chronic rhinosinusitis with nasal polyps (CRSwNP) is an inflammatory disease with multifactorial etiopathogenesis. This study investigated the recurrence rate and risk factors predicting recurrence in patients subjected to Functional Endoscopic Sinus Surgery (FESS) for CRSwNP. Methods: Patients affected by CRSwNP who underwent [...] Read more.

Introduction: Chronic rhinosinusitis with nasal polyps (CRSwNP) is an inflammatory disease with multifactorial etiopathogenesis. This study investigated the recurrence rate and risk factors predicting recurrence in patients subjected to Functional Endoscopic Sinus Surgery (FESS) for CRSwNP. Methods: Patients affected by CRSwNP who underwent FESS between January 2015 and March 2020 were enrolled. The recurrence rate and the influence of risk factors were assessed. Results: A total of 154 patients were included, 100 males and 54 females, aged 14–82 years (mean age 51.96 ± 16.27; median 52 years). Of 154 patients, 28 presented CRSwNP recurrence in a follow-up period ranging from 6 months to 69 months, with a recurrence rate of 18.2%. The recurrence rate was higher in patients aged between 31 and 50 years and between 51 and 70 years at the time of surgery than in those aged between 14 and 30 years and over 70 years. Furthermore, most patients with recurrence were men (61%), while 39% were women. A higher recurrence rate was observed between non-smokers (50%) and ex-smokers (36%), while only 14% declared themselves habitual smokers. Only four subjects (14%) had a positive family history of CRSwNP. Conclusion: To date, no specific biomarkers have been identified in order to determine the appropriate therapy for the patients affected by CRSwNP. Based on our results, we suggest that it is necessary for an accurate assessment of the CRSwNP patients to identify which phenotype/endotype each subject manifests based on medical history, endoscopy, computed tomography, and a laboratory evaluation. Full article

(This article belongs to the Section Epidemiology)

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12 pages, 1498 KiB

Open AccessFeature PaperEditor’s ChoiceArticle

Assessment of Arterial Stiffness and Biochemical Markers in Systemic Lupus Erythematosus in the Diagnosis of Subclinical Atherosclerosis

by Dominika Blachut, Brygida Przywara-Chowaniec, Michalina Mazurkiewicz and Andrzej Tomasik

J. Pers. Med. 2024, 14(3), 289; https://doi.org/10.3390/jpm14030289 - 8 Mar 2024

Cited by 4 | Viewed by 1781

Abstract

Patients with systemic lupus erythematosus (SLE) are 2–10 times more likely to develop cardiovascular disease (CVD) than the general population. The assessment of the risk of developing CVD is an important direction for further clinical management. The study was conducted retrospectively and included [...] Read more.

Patients with systemic lupus erythematosus (SLE) are 2–10 times more likely to develop cardiovascular disease (CVD) than the general population. The assessment of the risk of developing CVD is an important direction for further clinical management. The study was conducted retrospectively and included patients with SLE. The aim of the study was to assess the measurements of pulse wave velocity (PWV), carotid intima-media thickness (CIMT), ankle–brachial index (ABI) and biochemical parameters. Subclinical atherosclerosis was also assessed. The study included 98 patients with SLE with an age- and sex-matched control group of 68 healthy adults. Statistical significance was found in the SLE group and the controls for N-terminal fragment of pro-B-type natriuretic peptide (NT proBNP) (144.87 vs. 36.41 pg/mL, p = 0.0018), high-sensitivity cardiac troponin (hs-cTn) (25.43 vs. 6.38 ng/L, p = 0.0303) and D-Dimer levels (0.73 vs. 0.36 µg/mL, p = 0.0088), left CIMT (1.03 vs. 0.62 mm, p < 0.0001), right CIMT (0.93 vs. 0.63 mm, p < 0.0001) and PWV CF (9.74 vs. 7.98 m/s, p = 0.0294). A positive correlation was found between NT proBNP and PWV CF (r = 0.6880, p = 0.0498) and hs-cTn and PVW carotid-femoral (CF) (r = 0.8862, p = 0.0499) in SLE. A positive correlation was reported between PWV CF and systolic blood pressure (r = 0.5025, p = 0.0487). The measurement of carotid–femoral PWV is a simple, non-invasive, and reproducible method and may independently predict future CVD events and their cause. Further studies are warranted to establish the prognostic value of PWV in patients with SLE, as it may be superior to CIMT measurements in the early stages of vascular disorders. Full article

(This article belongs to the Special Issue Cardiology and Vascular Health: Pathophysiology, Therapeutics and Epidemiology)

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44 pages, 1953 KiB

Open AccessEditor’s ChoiceReview

Patient-Generated Health Data (PGHD): Understanding, Requirements, Challenges, and Existing Techniques for Data Security and Privacy

by Pankaj Khatiwada, Bian Yang, Jia-Chun Lin and Bernd Blobel

J. Pers. Med. 2024, 14(3), 282; https://doi.org/10.3390/jpm14030282 - 3 Mar 2024

Cited by 20 | Viewed by 10040

Abstract

The evolution of Patient-Generated Health Data (PGHD) represents a major shift in healthcare, fueled by technological progress. The advent of PGHD, with technologies such as wearable devices and home monitoring systems, extends data collection beyond clinical environments, enabling continuous monitoring and patient engagement [...] Read more.

The evolution of Patient-Generated Health Data (PGHD) represents a major shift in healthcare, fueled by technological progress. The advent of PGHD, with technologies such as wearable devices and home monitoring systems, extends data collection beyond clinical environments, enabling continuous monitoring and patient engagement in their health management. Despite the growing prevalence of PGHD, there is a lack of clear understanding among stakeholders about its meaning, along with concerns about data security, privacy, and accuracy. This article aims to thoroughly review and clarify PGHD by examining its origins, types, technological foundations, and the challenges it faces, especially in terms of privacy and security regulations. The review emphasizes the role of PGHD in transforming healthcare through patient-centric approaches, their understanding, and personalized care, while also exploring emerging technologies and addressing data privacy and security issues, offering a comprehensive perspective on the current state and future directions of PGHD. The methodology employed for this review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and Rayyan, AI-Powered Tool for Systematic Literature Reviews. This approach ensures a systematic and comprehensive coverage of the available literature on PGHD, focusing on the various aspects outlined in the objective. The review encompassed 36 peer-reviewed articles from various esteemed publishers and databases, reflecting a diverse range of methodologies, including interviews, regular articles, review articles, and empirical studies to address three RQs exploratory, impact assessment, and solution-oriented questions related to PGHD. Additionally, to address the future-oriented fourth RQ for PGHD not covered in the above review, we have incorporated existing domain knowledge articles. This inclusion aims to provide answers encompassing both basic and advanced security measures for PGHD, thereby enhancing the depth and scope of our analysis. Full article

(This article belongs to the Special Issue Selected Papers from the pHealth 2022 Conference, Oslo, Norway, 8–10 November 2022)

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17 pages, 1496 KiB

Open AccessEditor’s ChoiceReview

Remimazolam for Procedural Sedation in Older Patients: A Systematic Review and Meta-Analysis with Trial Sequential Analysis

by Myeongjong Lee, Cheol Lee, Guen Joo Choi and Hyun Kang

J. Pers. Med. 2024, 14(3), 276; https://doi.org/10.3390/jpm14030276 - 29 Feb 2024

Cited by 9 | Viewed by 2973

Abstract

This systematic review and meta-analysis with trial sequential analysis (TSA) aimed to evaluate the efficacy and safety of remimazolam compared to other sedatives for procedural sedation in older patients. We registered the protocol of this systematic review and meta-analysis with TSA in the [...] Read more.

This systematic review and meta-analysis with trial sequential analysis (TSA) aimed to evaluate the efficacy and safety of remimazolam compared to other sedatives for procedural sedation in older patients. We registered the protocol of this systematic review and meta-analysis with TSA in the PROSPERO network (CRD42023441209). Two investigators performed a systematic, comprehensive, and independent search of the PubMed, EMBASE, and Cochrane Central Register of Controlled Trials databases to identify randomized controlled trials (RCTs) comparing remimazolam with other sedatives in older patients undergoing procedural sedation. Conventional meta-analysis and TSA were also performed. Seven RCTs (1502 patients) were included. Pooled results demonstrated that remimazolam was associated with a low incidence of hypoxemia, hypotension, bradycardia, respiratory depression, and injection pain. Remimazolam also required a long time to cause loss of consciousness. There were no differences in rates of sedation success, dizziness/headache, postoperative nausea and vomiting, or recovery time. Older patients receiving procedural sedation with remimazolam had a lower risk of hypoxemia, hypotension, bradycardia, respiratory depression, and injection pain than those receiving other sedatives, suggesting that remimazolam may be more suitable for procedural sedation in older patients. Full article

(This article belongs to the Special Issue State of the Art of Anesthesia and Perioperative Medicine)

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30 pages, 1541 KiB

Open AccessEditor’s ChoiceReview

Digital Anti-Aging Healthcare: An Overview of the Applications of Digital Technologies in Diet Management

by Tagne Poupi Theodore Armand, Hee-Cheol Kim and Jung-In Kim

J. Pers. Med. 2024, 14(3), 254; https://doi.org/10.3390/jpm14030254 - 27 Feb 2024

Cited by 9 | Viewed by 5106

Abstract

Diet management has long been an important practice in healthcare, enabling individuals to get an insight into their nutrient intake, prevent diseases, and stay healthy. Traditional methods based on self-reporting, food diaries, and periodic assessments have been used for a long time to [...] Read more.

Diet management has long been an important practice in healthcare, enabling individuals to get an insight into their nutrient intake, prevent diseases, and stay healthy. Traditional methods based on self-reporting, food diaries, and periodic assessments have been used for a long time to control dietary habits. These methods have shown limitations in accuracy, compliance, and real-time analysis. The rapid advancement of digital technologies has revolutionized healthcare, including the diet control landscape, allowing for innovative solutions to control dietary patterns and generate accurate and personalized recommendations. This study examines the potential of digital technologies in diet management and their effectiveness in anti-aging healthcare. After underlining the importance of nutrition in the aging process, we explored the applications of mobile apps, web-based platforms, wearables devices, sensors, the Internet of Things, artificial intelligence, blockchain, and other technologies in managing dietary patterns and improving health outcomes. The research further examines the effects of digital dietary control on anti-aging healthcare, including improved nutritional monitoring, personalized recommendations, and behavioral and sustainable changes in habits, leading to an expansion of longevity and health span. The challenges and limitations of digital diet monitoring are discussed, and some future directions are provided. Although many digital tools are used in diet control, their accuracy, effectiveness, and impact on health outcomes are not discussed much. This review consolidates the existing literature on digital diet management using emerging digital technologies to analyze their practical implications, guiding researchers, healthcare professionals, and policy makers toward personalized dietary management and healthy aging. Full article

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

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14 pages, 3666 KiB

Open AccessEditor’s ChoiceArticle

The Interplay between Dyslipidemia and Neighboring Developments in Coronary Artery Disease Progression: A Personalized Approach

by Tomasz Urbanowicz, Krzysztof Skotak, Anna Olasińska-Wiśniewska, Krzysztof J. Filipiak, Jakub Bratkowski, Beata Krasińska, Zbigniew Krasiński, Andrzej Tykarski and Marek Jemielity

J. Pers. Med. 2024, 14(3), 237; https://doi.org/10.3390/jpm14030237 - 23 Feb 2024

Cited by 4 | Viewed by 1564

Abstract

(1) Background: Estimates suggest that up to 10% of global annual cardiovascular deaths could be related to environmental factors. Not only air pollution components, but also noise exposure and climate changes, are highlighted as nontraditional causes of cardiovascular morbidity. The aim of this [...] Read more.

(1) Background: Estimates suggest that up to 10% of global annual cardiovascular deaths could be related to environmental factors. Not only air pollution components, but also noise exposure and climate changes, are highlighted as nontraditional causes of cardiovascular morbidity. The aim of this study was to identify possible urbanization risk factors for the progression of coronary artery disease in a group of patients with chronic coronary syndrome. (2) Method: There were 77 patients (50 (65%) males and 27 (35%) females) with a median age of 70 (60–74) years who underwent repetitive angiography due to chronic coronary syndrome between 2018 and 2022. The Gensini score was calculated for assessment of coronary artery disease advancement. Environmental factors including neighboring developments were taken into account in this analysis, including housing, commercial, and industrial developments within 300, 500, and 700 m distances (buffer) from the place of habitation. (3) Results: The multivariable analysis results for prediction of Gensini score progression in relation to 700 m buffer urbanization pointed out the significance of hyperlipidemia (OR: 4.24, 95% CI 1.34–13.39, p = 0.014), initial Gensini score (OR: 1.02, 95% CI 1.00–1.05, p = 0.112), and neighborhood housing (OR: 0.03, 95% CI 0.01–0.49, p = 0.025). (4) Conclusions: Hyperlipidemia and housing neighborhood can be regarded as possible factors for coronary disease progression in patients with chronic coronary syndrome with the use of optimal medical therapy. Full article

(This article belongs to the Special Issue Advances in Personalized Medicine for Cardiovascular Care)

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15 pages, 333 KiB

Open AccessFeature PaperEditor’s ChoiceReview

Cardiac Troponin Serum Concentration Measurement Is Useful Not Only in the Diagnosis of Acute Cardiovascular Events

by Grzegorz K. Jakubiak

J. Pers. Med. 2024, 14(3), 230; https://doi.org/10.3390/jpm14030230 - 21 Feb 2024

Cited by 23 | Viewed by 3312

Abstract

Cardiac troponin serum concentration is the primary marker used for the diagnosis of acute coronary syndrome. Moreover, the measurement of cardiac troponin concentration is important for risk stratification in patients with pulmonary embolism. The cardiac troponin level is also a general marker of [...] Read more.

Cardiac troponin serum concentration is the primary marker used for the diagnosis of acute coronary syndrome. Moreover, the measurement of cardiac troponin concentration is important for risk stratification in patients with pulmonary embolism. The cardiac troponin level is also a general marker of myocardial damage, regardless of etiology. The purpose of this study is to conduct a literature review and present the most important information regarding the current state of knowledge on the cardiac troponin serum concentration in patients with chronic cardiovascular disease (CVD), as well as on the relationships between cardiac troponin serum concentration and features of subclinical cardiovascular dysfunction. According to research conducted to date, patients with CVDs, such as chronic coronary syndrome, chronic lower extremities’ ischemia, and cerebrovascular disease, are characterized by higher cardiac troponin concentrations than people without a CVD. Moreover, the literature data indicate that the concentration of cardiac troponin is correlated with markers of subclinical dysfunction of the cardiovascular system, such as the intima–media thickness, pulse wave velocity, ankle–brachial index, coronary artery calcium index (the Agatston score), and flow-mediated dilation. However, further research is needed in various patient subpopulations and in different clinical contexts. Full article

(This article belongs to the Special Issue Cardiology and Vascular Health: Pathophysiology, Therapeutics and Epidemiology)

31 pages, 4329 KiB

Open AccessEditor’s ChoiceArticle

Assessing the Impact of Organ Failure and Metastases on Quality of Life in Breast Cancer Patients: A Prospective Study Based on Utilizing EORTC QLQ-C30 and EORTC QLQ-BR45 Questionnaires in Romania

by Andreea-Iuliana Ionescu (Miron), Alexandra-Valentina Anghel, Ionuț-Lucian Antone-Iordache, Dimitrie-Ionuț Atasiei, Cătălin-Alexandru Anghel, Andrei-Alexandru Barnonschi, Alexandra-Maria Bobolocu, Catinca Verga, Florica Șandru and Horia-Dan Lișcu

J. Pers. Med. 2024, 14(2), 214; https://doi.org/10.3390/jpm14020214 - 16 Feb 2024

Cited by 9 | Viewed by 3581

Abstract

Breast cancer (BC) significantly impacts the quality of life (QoL) of affected individuals. This study, conducted at Colțea Clinical Hospital, Bucharest, aimed to assess the impact of organ failures and metastases on QoL in breast cancer patients using EORTC QLQ-C30 and EORTC QLQ-BR45 [...] Read more.

Breast cancer (BC) significantly impacts the quality of life (QoL) of affected individuals. This study, conducted at Colțea Clinical Hospital, Bucharest, aimed to assess the impact of organ failures and metastases on QoL in breast cancer patients using EORTC QLQ-C30 and EORTC QLQ-BR45 questionnaires and the survival rate to understand the clinical journey and the quality of life status in breast cancer patients. From January 2019 to October 2022, a prospective, observational study surveyed 874 patients, revealing 201 fatalities, 66 refusals, and 607 eligible participants. Results indicated statistically significant differences in various QoL aspects for patients experiencing heart failure, including physical functioning, pain, insomnia, global health status, and overall summary score. Kidney failure exhibited significance in physical functioning for QLQ-C30 and body image, sexual functioning, and endocrine sexual symptoms for QLQ-BR45. Respiratory failure demonstrated significant differences across multiple QoL domains. Patients with bone metastases reported lower physical functioning (p = 0.006) and increased pain (p = 0.002). This study has revealed an overall 5-year life expectancy of 68.8%, with survival rates of 93.8% for Stage I, 86.3% for Stage II, and 77.2% for Stage III breast cancer. Metastatic cancer patients have shown a 35.6% survival rate over 45 months, with a median survival duration of 36 months. A significant limitation of our study was the administration of the questionnaire only once, preventing us from quantifying the impact of specific treatment types on quality of life. This study emphasizes the necessity of using standardized QoL assessments in clinical practice from the initial presentation to ongoing follow-up. Full article

(This article belongs to the Special Issue Interdisciplinary Approach and Personalized Therapy for Gynecological Disease)

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16 pages, 5398 KiB

Open AccessEditor’s ChoiceArticle

Exploring an Innovative Approach: Integrating Negative-Pressure Wound Therapy with Silver Nanoparticle Dressings in Skin Graft Procedures

by Abdalah Abu-Baker, Andrada-Elena Țigăran, Teodora Peligrad, Daniela-Elena Ion, Daniela-Elena Gheoca-Mutu, Adelaida Avino, Cristian-Sorin Hariga, Oriana Elena Moraru, Laura Răducu and Radu-Cristian Jecan

J. Pers. Med. 2024, 14(2), 206; https://doi.org/10.3390/jpm14020206 - 14 Feb 2024

Cited by 11 | Viewed by 2606

Abstract

Background: Skin grafting is a helpful instrument in a plastic surgeon’s arsenal. Several types of dressings were designed to facilitate the process of graft integration. Negative-pressure wound therapy is a proven dressing method, enhancing graft survival through several mechanisms: aspiration of secretions, stimulation [...] Read more.

Background: Skin grafting is a helpful instrument in a plastic surgeon’s arsenal. Several types of dressings were designed to facilitate the process of graft integration. Negative-pressure wound therapy is a proven dressing method, enhancing graft survival through several mechanisms: aspiration of secretions, stimulation of neoangiogenesis, and promotion of an anti-inflammatory environment. Silver nanoparticle dressings also bring multiple benefits by bearing an antimicrobial effect and providing a humid medium, which are favorable for epithelialization. The combination of NPWT (negative-pressure wound therapy) with AgNPs (silver nanoparticles) has not been widely studied. Materials and methods: This study aimed to compare the outcomes of silver nanoparticle sheets with the combination of negative-pressure wound therapy and silver nanoparticle dressings. We conducted a comparative prospective study on 80 patients admitted to the Plastic Surgery Department of “Prof. Dr. Agrippa Ionescu” Emergency Clinical Hospital between 1st of January 2020 and 31st of December 2022. The study population was randomized to receive either silver nanoparticle dressings or negative-pressure wound therapy (NPWT) combined with silver nanoparticle dressings. Various parameters were monitored, including patient comorbidities and graft-related data such as defect etiology, graft integration, and graft size. Dressings were changed, and graft status was evaluated at 7, 10, and 14 days postoperatively. Additionally, baseline C-reactive protein (CRP) levels were measured before surgery and 7, 10, and 14 days postoperatively. Results: The study demonstrated an enhanced integration of skin grafts at all evaluation stages when employing NPWT combined with AgNPs, particularly evident 10 days post operation. Significant variations in graft integration were also observed based on factors such as diabetes, cardiovascular disease, graft size, or the origin of the grafted defect. Moreover, dynamic C-reactive protein monitoring showed a statistically significant decrease in CRP levels 10 days post operation among patients treated with NPWT in conjunction with silver dressing, consistent with the nearly complete integration of skin grafts at this evaluation threshold. Conclusion: Several factors influence the postoperative evolution of split-skin grafts. Postoperative dressings target local factors to enhance graft integration further. Our research demonstrated that the innovative combination of NPWT-assisted dressings, complemented by a silver nanoparticle sheet, resulted in improved benefits for graft integration and the alleviation of systemic inflammation. Full article

(This article belongs to the Special Issue Implications for Personalized Plastic, Aesthetic and Reconstructive Surgery)

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30 pages, 27177 KiB

Open AccessEditor’s ChoiceArticle

The Role of Cone Beam Computed Tomography in Periodontology: From 3D Models of Periodontal Defects to 3D-Printed Scaffolds

by Styliani Verykokou, Charalabos Ioannidis, Sofia Soile, Christos Angelopoulos, Konstantinos Theodoridis, Athanasios S. Arampatzis, Andreana N. Assimopoulou, Dimitrios Christofilos, Afroditi Kapourani, Ioannis Pantazos, Panagiotis Barmpalexis, Argyro-Maria Boutsi and Chryssy Potsiou

J. Pers. Med. 2024, 14(2), 207; https://doi.org/10.3390/jpm14020207 - 14 Feb 2024

Cited by 6 | Viewed by 2852

Abstract

The treatment of osseous defects around teeth is a fundamental concern within the field of periodontology. Over the years, the method of grafting has been employed to treat bone defects, underscoring the necessity for custom-designed scaffolds that precisely match the anatomical intricacies of [...] Read more.

The treatment of osseous defects around teeth is a fundamental concern within the field of periodontology. Over the years, the method of grafting has been employed to treat bone defects, underscoring the necessity for custom-designed scaffolds that precisely match the anatomical intricacies of the bone cavity to be filled, preventing the formation of gaps that could allow the regeneration of soft tissues. In order to create such a patient-specific scaffold (bone graft), it is imperative to have a highly detailed 3D representation of the bone defect, so that the resulting scaffold aligns with the ideal anatomical characteristics of the bone defect. In this context, this article implements a workflow for designing 3D models out of patient-specific tissue defects, fabricated as scaffolds with 3D-printing technology and bioabsorbable materials, for the personalized treatment of periodontitis. The workflow is based on 3D modeling of the hard tissues around the periodontal defect (alveolar bone and teeth), scanned from patients with periodontitis. Specifically, cone beam computed tomography (CBCT) data were acquired from patients and were used for the reconstruction of the 3D model of the periodontal defect. The final step encompasses the 3D printing of these scaffolds, employing Fused Deposition Modeling (FDM) technology and 3D-bioprinting, with the aim of verifying the design accuracy of the developed methodοlogy. Unlike most existing 3D-printed scaffolds reported in the literature, which are either pre-designed or have a standard structure, this method leads to the creation of highly detailed patient-specific grafts. Greater accuracy and resolution in the macroarchitecture of the scaffolds were achieved during FDM printing compared to bioprinting, with the standard FDM printing profile identified as more suitable in terms of both time and precision. It is easy to follow and has been successfully employed to create 3D models of periodontal defects and 3D-printed scaffolds for three cases of patients, proving its applicability and efficiency in designing and fabricating personalized 3D-printed bone grafts using CBCT data. Full article

(This article belongs to the Section Regenerative Medicine and Therapeutics)

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18 pages, 22167 KiB

Open AccessEditor’s ChoiceSystematic Review

Laparoscopic Management of Multiple Liver, Omental, Mesenteric, Peritoneal, and Round Ligament Hydatid Cysts—A Rare Report of a Case and a Systematic Literature Review

by Alin Mihetiu, Dan Georgian Bratu, Ciprian Tanasescu, Bogdan Ioan Vintilă, Alexandra Sandu, Mariana Sandu, Dragos Serban, Dan Sabau and Adrian Hasegan

J. Pers. Med. 2024, 14(2), 205; https://doi.org/10.3390/jpm14020205 - 14 Feb 2024

Cited by 7 | Viewed by 2486

Abstract

Hydatid cyst disease is a parasitic ailment with an endemic nature, predominantly affecting geographical areas with a tradition in animal husbandry. The most common localization of hydatid disease is in the liver (60%), followed by the lungs, with other organ localizations comprising less [...] Read more.

Hydatid cyst disease is a parasitic ailment with an endemic nature, predominantly affecting geographical areas with a tradition in animal husbandry. The most common localization of hydatid disease is in the liver (60%), followed by the lungs, with other organ localizations comprising less than 10%. The surgical approach to this condition can be carried out through open surgery or laparoscopy. The coexistence of hepatic and intraperitoneal hydatidosis often leads to the preference for open surgery. We performed a literature review aiming to retrieve data regarding demographic characteristics, clinical features, preoperative management, and surgical approach concerning these unusual localizations of hydatid disease. It was observed that the mesenteric localization frequently presented with acute abdominal pain (p = 0.038) and that the open approach was preferred in 85.71% of cases. Furthermore, an interdependence was identified between the localization of the cysts and the type of surgical approach (p = 0.001), with mesenteric localizations being approached through laparotomy and excision (p = 0.037), while omental localizations, due to the easier approach, benefited from laparoscopy with excision in 14.29% of cases. Overall, the laparoscopic approach was less frequently used, but its utilization resulted in a lower number of complications and faster recovery. Additionally, we present a rare case of hepatic and intra-abdominal hydatidosis, resolved exclusively through a laparoscopic approach, including a review of the literature for these uncommon localizations of hydatid disease. A 45-year-old patient diagnosed with multiple hydatid cysts, both hepatic and intraperitoneal, underwent surgical intervention with exploratory laparoscopy. Laparoscopic excision of peritoneal, epiploic, mesenteric cysts, and round ligament, along with laparoscopic inactivation, evacuation, and pericystectomy of hepatic hydatid cysts, was performed. The patient’s recovery was uneventful, and she was reevaluated at 3 and 9 months without signs of recurrence. The association of hepatic hydatid cysts with multiple intra-abdominal localizations is not commonly encountered. The treatment of choice is surgical and is predominantly conducted through open surgery. The presented case is unique due to the exclusive laparoscopic approach in the management of mixed hepatic and intra-abdominal hydatidosis. Full article

(This article belongs to the Section Clinical Medicine, Cell, and Organism Physiology)

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21 pages, 2042 KiB

Open AccessEditor’s ChoiceReview

Leveraging Machine Learning for Personalized Wearable Biomedical Devices: A Review

by Ali Olyanasab and Mohsen Annabestani

J. Pers. Med. 2024, 14(2), 203; https://doi.org/10.3390/jpm14020203 - 13 Feb 2024

Cited by 13 | Viewed by 11042

Abstract

This review investigates the convergence of artificial intelligence (AI) and personalized health monitoring through wearable devices, classifying them into three distinct categories: bio-electrical, bio-impedance and electro-chemical, and electro-mechanical. Wearable devices have emerged as promising tools for personalized health monitoring, utilizing machine learning to [...] Read more.

This review investigates the convergence of artificial intelligence (AI) and personalized health monitoring through wearable devices, classifying them into three distinct categories: bio-electrical, bio-impedance and electro-chemical, and electro-mechanical. Wearable devices have emerged as promising tools for personalized health monitoring, utilizing machine learning to distill meaningful insights from the expansive datasets they capture. Within the bio-electrical category, these devices employ biosignal data, such as electrocardiograms (ECGs), electromyograms (EMGs), electroencephalograms (EEGs), etc., to monitor and assess health. The bio-impedance and electro-chemical category focuses on devices measuring physiological signals, including glucose levels and electrolytes, offering a holistic understanding of the wearer’s physiological state. Lastly, the electro-mechanical category encompasses devices designed to capture motion and physical activity data, providing valuable insights into an individual’s physical activity and behavior. This review critically evaluates the integration of machine learning algorithms within these wearable devices, illuminating their potential to revolutionize healthcare. Emphasizing early detection, timely intervention, and the provision of personalized lifestyle recommendations, the paper outlines how the amalgamation of advanced machine learning techniques with wearable devices can pave the way for more effective and individualized healthcare solutions. The exploration of this intersection promises a paradigm shift, heralding a new era in healthcare innovation and personalized well-being. Full article

(This article belongs to the Special Issue Application of Deep and Machine Learning in Personalized Medicine and Individualized Bioinstruments)

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12 pages, 284 KiB

Open AccessEditor’s ChoiceReview

How Sex Hormones Affect Migraine: An Interdisciplinary Preclinical Research Panel Review

by Frederick Godley III, John Meitzen, Hadas Nahman-Averbuch, Mary Angela O’Neal, David Yeomans, Nanette Santoro, Nina Riggins and Lars Edvinsson

J. Pers. Med. 2024, 14(2), 184; https://doi.org/10.3390/jpm14020184 - 7 Feb 2024

Cited by 11 | Viewed by 12957

Abstract

Sex hormones and migraine are closely interlinked. Women report higher levels of migraine symptoms during periods of sex hormone fluctuation, particularly during puberty, pregnancy, and perimenopause. Ovarian steroids, such as estrogen and progesterone, exert complex effects on the peripheral and central nervous systems, [...] Read more.

Sex hormones and migraine are closely interlinked. Women report higher levels of migraine symptoms during periods of sex hormone fluctuation, particularly during puberty, pregnancy, and perimenopause. Ovarian steroids, such as estrogen and progesterone, exert complex effects on the peripheral and central nervous systems, including pain, a variety of special sensory and autonomic functions, and affective processing. A panel of basic scientists, when challenged to explain what was known about how sex hormones affect the nervous system, focused on two hormones: estrogen and oxytocin. Notably, other hormones, such as progesterone, testosterone, and vasopressin, are less well studied but are also highlighted in this review. When discussing what new therapeutic agent might be an alternative to hormone therapy and menopause replacement therapy for migraine treatment, the panel pointed to oxytocin delivered as a nasal spray. Overall, the conclusion was that progress in the preclinical study of hormones on the nervous system has been challenging and slow, that there remain substantial gaps in our understanding of the complex roles sex hormones play in migraine, and that opportunities remain for improved or novel therapeutic agents. Manipulation of sex hormones, perhaps through biochemical modifications where its positive effects are selected for and side effects are minimized, remains a theoretical goal, one that might have an impact on migraine disease and other symptoms of menopause. This review is a call to action for increased interest and funding for preclinical research on sex hormones, their metabolites, and their receptors. Interdisciplinary research, perhaps facilitated by a collaborative communication network or panel, is a possible strategy to achieve this goal. Full article

(This article belongs to the Special Issue New Challenges and Perspectives in Neurology and Autonomic Disorders)

22 pages, 1979 KiB

Open AccessEditor’s ChoiceSystematic Review

Safety and Efficacy of Ultrasound-Guided Perineural Hydrodissection as a Minimally Invasive Treatment in Carpal Tunnel Syndrome: A Systematic Review

by Valerio Sveva, Giacomo Farì, Annatonia Fai, Alessio Savina, Mattia Giuseppe Viva, Francesco Agostini, Maurizio Ranieri, Marisa Megna, Massimiliano Mangone, Marco Paoloni and Andrea Bernetti

J. Pers. Med. 2024, 14(2), 154; https://doi.org/10.3390/jpm14020154 - 30 Jan 2024

Cited by 7 | Viewed by 4358

Abstract

Ultrasound-guided perineural hydrodissection (HD) is a novel technique that has been found to be effective in providing mechanical release of perineural adhesions and decompression of the nerve, reducing inflammation and edema and restoring its physiological function. It has a significant impact on chronic [...] Read more.

Ultrasound-guided perineural hydrodissection (HD) is a novel technique that has been found to be effective in providing mechanical release of perineural adhesions and decompression of the nerve, reducing inflammation and edema and restoring its physiological function. It has a significant impact on chronic neuropathic pain (20 ± 4 weeks with VAS < 5 or VAS diminished by 2 points after the procedure). Carpal tunnel syndrome (CTS) is a common entrapment mononeuropathy, and its distribution is typically innervated by the median nerve. Patients with mild or moderate CTS may benefit from nonsurgical treatments or conservative therapies. This review was conducted following the preferred reporting items for systematic reviews and meta-analysis (PRISMA) statement guidelines. Four investigators assessed each title, abstract, and full-text article for eligibility, with disagreements being resolved by consensus with two experienced investigators. The qualitative assessment of the studies was carried out using the modified Oxford quality scoring system, also known as the modified Jadad score. Furthermore, risk of possible biases was assessed using the Cochrane collaboration tool. The results of this review suggest that US-guided HD is an innovative, effective, well-tolerated, and safe technique (11 out of 923 patients had collateral or side effects after the procedure). However, further studies comparing all drugs and with a larger sample population are required to determine the most effective substance. Full article

(This article belongs to the Special Issue Personalized Treatment for Musculoskeletal Diseases)

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12 pages, 1166 KiB

Open AccessEditor’s ChoiceReview

The Reciprocal Relationship between Sleep and Epilepsy

by Yana Krutoshinskaya, Kelly Coulehan, Galyna Pushchinska and Rebecca Spiegel

J. Pers. Med. 2024, 14(1), 118; https://doi.org/10.3390/jpm14010118 - 20 Jan 2024

Cited by 9 | Viewed by 3597

Abstract

The relationship between sleep and epilepsy is bidirectional. Certain epilepsy syndromes predominantly or exclusively manifest during sleep, with seizures frequently originating from non-rapid eye movement (NREM) sleep. Interictal epileptiform discharges observed on electroencephalograms are most likely to be activated during the deep NREM [...] Read more.

The relationship between sleep and epilepsy is bidirectional. Certain epilepsy syndromes predominantly or exclusively manifest during sleep, with seizures frequently originating from non-rapid eye movement (NREM) sleep. Interictal epileptiform discharges observed on electroencephalograms are most likely to be activated during the deep NREM sleep stage known as N3. Conversely, epileptiform discharges, anti-seizure medications (ASMs), as well as other anti-seizure therapies can exert detrimental effects on sleep architecture. Moreover, the co-occurrence of sleep disorders has the potential to exacerbate seizure control. Understating the relationship between sleep and epilepsy is crucial for healthcare providers. Addressing and managing sleep-related problems in individuals with epilepsy can potentially contribute to improved seizure control and overall well-being. At the same time, improving seizure control can improve sleep quality and quantity, thus further improving the health of individuals with epilepsy. Full article

(This article belongs to the Section Clinical Medicine, Cell, and Organism Physiology)

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18 pages, 1452 KiB

Open AccessEditor’s ChoiceReview

The Relationship between Fine Particle Matter (PM2.5) Exposure and Upper Respiratory Tract Diseases

by Łukasz Zaręba, Katarzyna Piszczatowska, Karolina Dżaman, Karolina Soroczynska, Parham Motamedi, Mirosław J. Szczepański and Nils Ludwig

J. Pers. Med. 2024, 14(1), 98; https://doi.org/10.3390/jpm14010098 - 16 Jan 2024

Cited by 15 | Viewed by 4294

Abstract

PM2.5 is one of the most harmful components of airborne pollution and includes particles with diameters of less than 2.5 μm. Almost 90% of the world’s population lives in areas with poor air quality exceeding the norms established by the WHO. PM2.5 exposure [...] Read more.

PM2.5 is one of the most harmful components of airborne pollution and includes particles with diameters of less than 2.5 μm. Almost 90% of the world’s population lives in areas with poor air quality exceeding the norms established by the WHO. PM2.5 exposure affects various organs and systems of the human body including the upper respiratory tract which is one of the most prone to its adverse effects. PM2.5 can disrupt nasal epithelial cell metabolism, decrease the integrity of the epithelial barrier, affect mucociliary clearance, and alter the inflammatory process in the nasal mucosa. Those effects may increase the chance of developing upper respiratory tract diseases in areas with high PM2.5 pollution. PM2.5’s contribution to allergic rhinitis (AR) and rhinosinusitis was recently thoroughly investigated. Numerous studies demonstrated various mechanisms that occur when subjects with AR or rhinosinusitis are exposed to PM2.5. Various immunological changes and alterations in the nasal and sinonasal epithelia were reported. These changes may contribute to the observations that exposure to higher PM2.5 concentrations may increase AR and rhinosinusitis symptoms in patients and the number of clinical visits. Thus, studying novel strategies against PM2.5 has recently become the focus of researchers’ attention. In this review, we summarize the current knowledge on the effects of PM2.5 on healthy upper respiratory tract mucosa and PM2.5’s contribution to AR and rhinosinusitis. Finally, we summarize the current advances in developing strategies against PM2.5 particles’ effects on the upper respiratory tract. Full article

(This article belongs to the Section Epidemiology)

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24 pages, 709 KiB

Open AccessEditor’s ChoiceArticle

DeepBiomarker2: Prediction of Alcohol and Substance Use Disorder Risk in Post-Traumatic Stress Disorder Patients Using Electronic Medical Records and Multiple Social Determinants of Health

by Oshin Miranda, Peihao Fan, Xiguang Qi, Haohan Wang, M. Daniel Brannock, Thomas R. Kosten, Neal David Ryan, Levent Kirisci and Lirong Wang

J. Pers. Med. 2024, 14(1), 94; https://doi.org/10.3390/jpm14010094 - 14 Jan 2024

Cited by 6 | Viewed by 2953

Abstract

Prediction of high-risk events amongst patients with mental disorders is critical for personalized interventions. We developed DeepBiomarker2 by leveraging deep learning and natural language processing to analyze lab tests, medication use, diagnosis, social determinants of health (SDoH) parameters, and psychotherapy for outcome prediction. [...] Read more.

Prediction of high-risk events amongst patients with mental disorders is critical for personalized interventions. We developed DeepBiomarker2 by leveraging deep learning and natural language processing to analyze lab tests, medication use, diagnosis, social determinants of health (SDoH) parameters, and psychotherapy for outcome prediction. To increase the model’s interpretability, we further refined our contribution analysis to identify key features by scaling with a factor from a reference feature. We applied DeepBiomarker2 to analyze the EMR data of 38,807 patients from the University of Pittsburgh Medical Center diagnosed with post-traumatic stress disorder (PTSD) to determine their risk of developing alcohol and substance use disorder (ASUD). DeepBiomarker2 predicted whether a PTSD patient would have a diagnosis of ASUD within the following 3 months with an average c-statistic (receiver operating characteristic AUC) of 0.93 and average F1 score, precision, and recall of 0.880, 0.895, and 0.866 in the test sets, respectively. Our study found that the medications clindamycin, enalapril, penicillin, valacyclovir, Xarelto/rivaroxaban, moxifloxacin, and atropine and the SDoH parameters access to psychotherapy, living in zip codes with a high normalized vegetative index, Gini index, and low-income segregation may have potential to reduce the risk of ASUDs in PTSD. In conclusion, the integration of SDoH information, coupled with the refined feature contribution analysis, empowers DeepBiomarker2 to accurately predict ASUD risk. Moreover, the model can further identify potential indicators of increased risk along with medications with beneficial effects. Full article

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

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20 pages, 3764 KiB

Open AccessEditor’s ChoiceSystematic Review

Sex Bias in Diagnostic Delay: Are Axial Spondyloarthritis and Ankylosing Spondylitis Still Phantom Diseases in Women? A Systematic Review and Meta-Analysis

by Francesca Bandinelli, Bianca Martinelli-Consumi, Mirko Manetti and Maria Sole Vallecoccia

J. Pers. Med. 2024, 14(1), 91; https://doi.org/10.3390/jpm14010091 - 13 Jan 2024

Cited by 7 | Viewed by 2061

Abstract

Diagnostic delay (DD) is associated with poor radiological and quality of life outcomes in axial spondyloarthritis (ax-SpA) and ankylosing spondylitis (AS). The female (F) population is often misdiagnosed, as classification criteria were previously studied mostly in males (M). We conducted a systematic review [...] Read more.

Diagnostic delay (DD) is associated with poor radiological and quality of life outcomes in axial spondyloarthritis (ax-SpA) and ankylosing spondylitis (AS). The female (F) population is often misdiagnosed, as classification criteria were previously studied mostly in males (M). We conducted a systematic review to investigate (i) the difference in DD between the sexes, the impact of HLA*B27 and clinical and social factors (work and education) on this gap, and (ii) the possible influence of the year of publication (before and after the 2009 ASAS classification criteria), geographical region (Europe and Israel vs. extra-European countries), sample sources (mono-center vs. multi-center studies), and world bank (WB) economic class on DD in both sexes. We searched, in PubMed and Embase, studies that reported the mean or median DD or the statistical difference in DD between sexes, adding a manual search. Starting from 399 publications, we selected 26 studies (17 from PubMed and Embase, 9 from manual search) that were successively evaluated with the modified Newcastle–Ottawa Scale (m-NOS). The mean DD of 16 high-quality (m-NOS > 4/8) studies, pooled with random-effects meta-analysis, produces results higher in F (1.48, 95% CI 0.83–2.14, p < 0.0001) but with significant results at the second analysis only in articles published before the 2009 ASAS classification criteria (0.95, 95% CI 0.05–1.85, p < 0.0001) and in extra-European countries (3.16, 95% CI 2.11–4.22, p < 0.05). With limited evidence, some studies suggest that DD in F might be positively influenced by HLA*B27 positivity, peripheral involvement, and social factors. Full article

(This article belongs to the Section Sex, Gender and Hormone Based Medicine)

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Graphical abstract

12 pages, 2164 KiB

Open AccessEditor’s ChoiceSystematic Review

Health Policy for Prostate Cancer Early Detection in the European Union and the Impact of Opportunistic Screening: PRAISE-U Consortium

by Katharina Beyer, Renée Leenen, Lionne D. F. Venderbos, Jozien Helleman, Frederique Denijs, Wichor Bramer, Vera Vasilyeva, Erik Briers, Juan Gomez Rivas, Renata Chloupkova, Ondrej Majek, Lieven Annemans, Pieter Vynckier, Partha Basu, Arunah Chandran, Roderick van den Bergh, Sarah Collen, Hendrik van Poppel, Monique J. Roobol and on behalf of the PRAISE-U Consortium

J. Pers. Med. 2024, 14(1), 84; https://doi.org/10.3390/jpm14010084 - 11 Jan 2024

Cited by 11 | Viewed by 3903

Abstract

With the new policy recommendation in 2022 to explore the possibilities of screening for prostate cancer by the European Commission, the landscape for prostate cancer early detection is evolving. In line with this recommendation, the PRAISE-U project aims to evaluate the early detection [...] Read more.

With the new policy recommendation in 2022 to explore the possibilities of screening for prostate cancer by the European Commission, the landscape for prostate cancer early detection is evolving. In line with this recommendation, the PRAISE-U project aims to evaluate the early detection and diagnosis of prostate cancer through customised and risk-based screening programmes, with the goal to align protocols across European Union member states. This systematic review is part of the PRAISE-U project, with the goal to review the policy, medical guideline recommendations, and the current level of opportunistic screening presented in the scientific literature on prostate cancer early detection from 2016 to 2023 in European Union member states. An extensive literature search was performed on 1 June 2023 in a large number of databases, including Embase.com, Medline (Ovid), Web of Science Core Collection, Google Scholar, and Policy Commons. We identified 318 articles (qualitative, quantitative, and reviews), of which 41 were included in the full-text screening. Seventeen articles were ultimately identified as eligible for inclusion. The included articles revealed significant variations towards PSA-based early detection policies for prostate cancer in nine European countries. Despite official recommendations, opportunistic screening was prevalent across all nine countries regardless of recommendations for or against PSA-based early detection. This systematic review suggests that the current early detection policies are not fit for purpose. High levels of opportunistic screening and overdiagnosis persist, prompting policy recommendations for standardised guidelines, informed decision making, and increased awareness to improve efficiency and effectiveness in early detection. Full article

(This article belongs to the Section Epidemiology)

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23 pages, 4335 KiB

Open AccessEditor’s ChoiceReview

Inhibitors of Immune Checkpoints: Small Molecule- and Peptide-Based Approaches

by Natalie Fuchs, Longfei Zhang, Laura Calvo-Barreiro, Katarzyna Kuncewicz and Moustafa Gabr

J. Pers. Med. 2024, 14(1), 68; https://doi.org/10.3390/jpm14010068 - 4 Jan 2024

Cited by 9 | Viewed by 5756

Abstract

The revolutionary progress in cancer immunotherapy, particularly the advent of immune checkpoint inhibitors, marks a significant milestone in the fight against malignancies. However, the majority of clinically employed immune checkpoint inhibitors are monoclonal antibodies (mAbs) with several limitations, such as poor oral bioavailability [...] Read more.

The revolutionary progress in cancer immunotherapy, particularly the advent of immune checkpoint inhibitors, marks a significant milestone in the fight against malignancies. However, the majority of clinically employed immune checkpoint inhibitors are monoclonal antibodies (mAbs) with several limitations, such as poor oral bioavailability and immune-related adverse effects (irAEs). Another major limitation is the restriction of the efficacy of mAbs to a subset of cancer patients, which triggered extensive research efforts to identify alternative approaches in targeting immune checkpoints aiming to overcome the restricted efficacy of mAbs. This comprehensive review aims to explore the cutting-edge developments in targeting immune checkpoints, focusing on both small molecule- and peptide-based approaches. By delving into drug discovery platforms, we provide insights into the diverse strategies employed to identify and optimize small molecules and peptides as inhibitors of immune checkpoints. In addition, we discuss recent advances in nanomaterials as drug carriers, providing a basis for the development of small molecule- and peptide-based platforms for cancer immunotherapy. Ongoing research focused on the discovery of small molecules and peptide-inspired agents targeting immune checkpoints paves the way for developing orally bioavailable agents as the next-generation cancer immunotherapies. Full article

(This article belongs to the Special Issue Nanomedicine in Cancer Therapy: What's New)

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