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Current Updates into Personalized Medicine for Anesthesia, Emergency Medicine, Disaster...
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Current Updates into Personalized Medicine for Anesthesia, Emergency Medicine, Disaster Medicine, Mass Gathering Events

A special issue of Journal of Personalized Medicine (ISSN 2075-4426). This special issue belongs to the section "Clinical Medicine, Cell, and Organism Physiology".

Deadline for manuscript submissions: closed (25 April 2025) | Viewed by 3392

Special Issue Editors

Dr. Bruno Romanò

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Guest Editor
Dipartimento di Scienze dell’Emergenza, Anestesiologiche e della Rianimazione, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
Interests: anesthesia; mass gathering events; pain; intensive care; hemodynamic monitoring
Prof. Dr. Fabio Guarracino

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Guest Editor
Department of Anaesthesia and Critical Care Medicine, Azienda Ospedaliero Universitaria Pisana, 56126 Pisa, Italy
Interests: anesthesia; critical care; hemodynamic monitoring; perioperative echocardiography; acute heart failure and the design of intensive care pathways to improve the effectiveness of the patient’s journey

Special Issue Information

Dear Colleagues,

The increasing development of technology and the advent of artificial intelligence in medicine allow us to personalize the care we can offer our patients. Technology applied to medicine, such as advanced hemodynamic monitoring systems, brain activity monitoring, and many other systems, is being used in the ERAS or Fast-Track programs and stands among the various consolidated methods to optimize the perioperative path of patients. The implementation of these multimodal strategies aims to speed up recovery after surgery.

With this Special Issue, we aim to emphasize and highlight how technology and new discoveries in anesthesia, resuscitation, and emergency medicine can enable clinicians to apply precision medicine and ensure patients achieve a personalized pathway. Personalized medicine covers the processes of disease development, such as disease risk factors, disease epidemiology and prevention, disease diagnosis, disease treatment, and disease prognosis after treatment. In this Special Issue, we also want to highlight how personalized medicine can be applied not only to patients but also to large events or disaster medicine. In particular pre-hospital scenarios, the use of specific protocols or particular procedures ensures better management and quality of care.

In this Special Issue, original research articles and reviews are welcome. Research areas may include (but are not limited to) the following: hemodynamic monitoring, artificial intelligence for the prevention of hypotensive events, brain activity monitoring, artificial intelligence, multiparametric operating room monitoring, mass gathering events, disaster medicine, CBRN (chemical, biological, radiological, and nuclear), and public health preparedness.

I look forward to receiving your contributions.

Dr. Bruno Romanò
Prof. Dr. Fabio Guarracino
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Personalized Medicine is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • hemodynamic monitoring
  • artificial intelligence for the prevention of hypotensive events
  • brain activity monitoring
  • artificial intelligence
  • multiparametric operating room monitoring
  • mass gathering events
  • disaster medicine
  • CBRN (chemical, biological, radiological, and nuclear)
  • public health preparedness

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (2 papers)

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Research

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13 pages, 1494 KiB  
Article
First Clinical Application of Aztreonam–Avibactam in Treating Carbapenem-Resistant Enterobacterales: Insights from Therapeutic Drug Monitoring and Pharmacokinetic Simulations
by Oliver Hölsken, Keno Sponheuer, Franz Weber, Jens Martens-Lobenhoffer, Stefanie M. Bode-Böger, Charlotte Kloft, Sascha Treskatsch and Stefan Angermair
J. Pers. Med. 2024, 14(12), 1135; https://doi.org/10.3390/jpm14121135 - 30 Nov 2024
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Abstract
Background: A novel fixed combination of aztreonam (ATM) and avibactam (AVI) offers promising potential to treat infections with carbapenem-resistant Enterobacterales (CRE) producing metallo-β-lactamases (MBL). This study aimed to assess the accuracy of population pharmacokinetic (PK) models for ATM-AVI in predicting in vivo [...] Read more.
Background: A novel fixed combination of aztreonam (ATM) and avibactam (AVI) offers promising potential to treat infections with carbapenem-resistant Enterobacterales (CRE) producing metallo-β-lactamases (MBL). This study aimed to assess the accuracy of population pharmacokinetic (PK) models for ATM-AVI in predicting in vivo concentrations in a critically ill patient with CRE infection during its first clinical use. Methods: A 70-year-old male with septic shock due to hospital-acquired pneumonia (HAP) caused by MBL-producing Klebsiella pneumoniae was treated with ATM-AVI. Trough and peak serum concentrations (32 samples over 7 days) were measured using liquid chromatography–tandem mass spectrometry (LC-MS/MS). Population PK models were used to simulate complete concentration–time profiles. Bland–Altman analysis assessed model performance by comparing predicted and measured concentrations. Results: Median ATM trough concentrations (18.4 mg/L) remained above the minimum inhibitory concentration (MIC) of 1 mg/L for the pathogen. The Bland–Altman analysis demonstrated reasonable agreement between predicted and observed concentrations, with a relative bias (rBias) of −50.5% for ATM and −14.4% for AVI. ATM-AVI ratios remained stable. Clinical improvement and sterile blood cultures within 12 days led to intensive care unit (ICU) discharge. Conclusions: Population PK models for ATM-AVI accurately predicted in vivo concentrations in a severely ill patient with HAP. Therapeutic drug monitoring (TDM) with PK modeling ensured optimal antimicrobial exposure and contributed to clinical recovery. Full article
(This article belongs to the Special Issue Current Updates into Personalized Medicine for Anesthesia, Emergency Medicine, Disaster Medicine, Mass Gathering Events)
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Review

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17 pages, 960 KiB  
Review
The Need for Standardized Guidelines for the Use of Monocyte Distribution Width (MDW) in the Early Diagnosis of Sepsis
by Andrea Piccioni, Fabio Spagnuolo, Silvia Baroni, Gabriele Savioli, Federico Valletta, Maria Chiara Bungaro, Gianluca Tullo, Marcello Candelli, Antonio Gasbarrini and Francesco Franceschi
J. Pers. Med. 2025, 15(1), 5; https://doi.org/10.3390/jpm15010005 - 27 Dec 2024
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Abstract
Sepsis is a complex and potentially life-threatening syndrome characterized by an abnormal immune response to an infection, which can lead to organ dysfunction, septic shock, and death. Early diagnosis is crucial to improving prognosis and reducing hospital management costs. This narrative review aims [...] Read more.
Sepsis is a complex and potentially life-threatening syndrome characterized by an abnormal immune response to an infection, which can lead to organ dysfunction, septic shock, and death. Early diagnosis is crucial to improving prognosis and reducing hospital management costs. This narrative review aims to summarize and evaluate the current literature on the role of monocyte distribution width (MDW) as a diagnostic biomarker for sepsis, highlighting its advantages, limitations, and potential clinical applications. MDW measures the volumetric distribution width of monocytes, reflecting monocytic anisocytosis, and is detected using advanced hematological analyzers. In 2019, it was approved by the FDA as a biomarker for sepsis due to its ability to identify systemic inflammatory response at an early stage. Thirty-one studies analyzed by us have shown that an increased MDW value is associated with a higher risk of sepsis and that its combination with clinical parameters (such as qSOFA) and other biomarkers (CRP, PCT) can enhance diagnostic sensitivity and risk stratification capacity. Despite its high sensitivity, MDW has lower specificity compared to more established biomarkers such as procalcitonin, thus requiring a multimodal integration for an accurate diagnosis. The use of MDW in emergency and intensive care settings represents an opportunity to improve early sepsis diagnosis and critical patient management, particularly when combined with other markers and clinical tools. However, further studies are needed to define a universal cut-off and confirm its validity in different clinical contexts and pathological scenarios. Full article
(This article belongs to the Special Issue Current Updates into Personalized Medicine for Anesthesia, Emergency Medicine, Disaster Medicine, Mass Gathering Events)
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