Journal Description
Journal of Personalized Medicine
Journal of Personalized Medicine
is an international, peer-reviewed, open access journal on personalized medicine, published monthly online by MDPI.
- Open Access— free for readers, with article processing charges (APC) paid by authors or their institutions.
- High Visibility: indexed within Scopus, SCIE (Web of Science), PubMed, PMC, Embase, and other databases.
- Journal Rank: JCR - Q2 (Medicine, General & Internal) CiteScore - Q2 (Medicine (miscellaneous))
- Rapid Publication: manuscripts are peer-reviewed and a first decision is provided to authors approximately 17.8 days after submission; acceptance to publication is undertaken in 2.6 days (median values for papers published in this journal in the second half of 2023).
- Recognition of Reviewers: reviewers who provide timely, thorough peer-review reports receive vouchers entitling them to a discount on the APC of their next publication in any MDPI journal, in appreciation of the work done.
Impact Factor:
3.4 (2022);
5-Year Impact Factor:
3.5 (2022)
Latest Articles
Longterm Outcome of Therapeutic Vaccination with a Third Generation Pre-S/S HBV Vaccine (PreHevbrioR) of Chronically HBV Infected Patients
J. Pers. Med. 2024, 14(4), 364; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm14040364 (registering DOI) - 29 Mar 2024
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)
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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 PreHevbrioR. 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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Open AccessArticle
Assessment of Relative Energy Deficiency in Sport (REDs) Risk among Adolescent Acrobatic Gymnasts
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Omri Besor, Noam Redlich, Naama Constantini, Michal Weiler-Sagie, Efrat Monsonego Ornan, Shira Lieberman, Lea Bentur and Ronen Bar-Yoseph
J. Pers. Med. 2024, 14(4), 363; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm14040363 (registering DOI) - 29 Mar 2024
Abstract
Energy imbalance exposes athletes to relative energy deficiency in sports (REDs) syndrome. Data on energy consumption, REDs, and bone mineral density (BMD) in adolescent acrobatic gymnasts, especially in males, are scarce. Our aim was to examine the eating habits, energy balance, body composition,
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Energy imbalance exposes athletes to relative energy deficiency in sports (REDs) syndrome. Data on energy consumption, REDs, and bone mineral density (BMD) in adolescent acrobatic gymnasts, especially in males, are scarce. Our aim was to examine the eating habits, energy balance, body composition, and BMD of these athletes. In this study, 18 healthy adolescents participating in competitive acrobatic gymnastics completed a questionnaire, underwent a dual-energy X-ray absorptiometry scan (DXA), received a food log, and had their activities monitored for 3 days. Eighteen acrobats were enrolled (mean age: 14.3 ± 1.2 years; males: 6/18). The mean total body BMD Z-score was 0.4 ± 1.0. Top-position acrobats (7/18) had significantly lower total body BMD Z-scores than base-positioned acrobats (−0.2 ± 0.3 vs. 0.8 ± 0.3, p = 0.032), though their forearms were not significantly different (0.2 ± 0.5 vs. 0.8 ± 0.7, p = 0.331). No sex differences were found for BMD Z-scores, BMI, or energy availability. The BMD parameters of the acrobats were within the normal range for a healthy pediatric population, although three had low BMDs (<−1 SD) for healthy athletes. Total body and LS BMD Z-scores were significantly lower in top-position athletes compared to base-position athletes. These findings suggest personalized (top vs. base) training programs (high-impact training) that may achieve better health outcomes.
Full article
(This article belongs to the Section Epidemiology)
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Open AccessArticle
Sex Differences in Albumin Quotient and Cerebrospinal Fluid Total Protein Content Do Not Depend on Anthropometric Factors
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Massimiliano Castellazzi, Raffaella Candeloro, Caterina Trevisan, Samantha Permunian, Gaia Buscemi, Sara Ghisellini, Giovanna Negri, Giada Gilli, Caterina Ferri, Tiziana Bellini, Stefano Pizzicotti and Maura Pugliatti
J. Pers. Med. 2024, 14(4), 362; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm14040362 (registering DOI) - 29 Mar 2024
Abstract
(1) Background: Cerebrospinal fluid (CSF)/serum albumin quotient (QAlb) and CSF total protein (TP) are more elevated in males than females, and this has been hypothesised to be due to anthropometric differences between the sexes. This study aimed to investigate QAlb and CSF TP
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(1) Background: Cerebrospinal fluid (CSF)/serum albumin quotient (QAlb) and CSF total protein (TP) are more elevated in males than females, and this has been hypothesised to be due to anthropometric differences between the sexes. This study aimed to investigate QAlb and CSF TP as a function of body height, weight, and body mass index (BMI). (2) Methods: A total of 207 patients were included in the study and analysed blinded to clinical diagnosis. (3) Results: Multivariable linear regressions were run to predict log-transformed Qalb and log-transformed CSF TP value from age, sex, weight, and height (first model) or from age, sex, and BMI (second model). In both models, age (β = 0.004, 95% CI = 0.002 to 0.006) and sex (β = −0.095, 95% CI = −0.169 to −0.021, and β = −0.135, 95% CI = −0.191 to −0.079) were significant predictors for QAlb, but weight, height, and BMI were not. Similarly, age (β = 0.004, 95% CI = 0.003 to 0.006) and sex (β = −0.077, 95% CI = −0.142 to −0.013, and β = −0.109, 95% CI = −0.157 to −0.060) were significant predictors for CSF TP, while anthropometric characteristics were not. No differences in QAlb and CSF TP were found when grouping males and females by BMI status. (4) Conclusions: Our data suggest that anthropometric characteristics could not explain the sex-related differences in QAlb and CSF TP.
Full article
(This article belongs to the Special Issue Sex and Gender-Related Issues in the Era of Personalized Medicine)
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Open AccessArticle
HBCR_DMR: A Hybrid Method Based on Beta-Binomial Bayesian Hierarchical Model and Combination of Ranking Method to Detect Differential Methylation Regions in Bisulfite Sequencing Data
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Maryam Yassi, Ehsan Shams Davodly, Saeedeh Hajebi Khaniki and Mohammad Amin Kerachian
J. Pers. Med. 2024, 14(4), 361; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm14040361 (registering DOI) - 29 Mar 2024
Abstract
DNA methylation is a key epigenetic modification involved in gene regulation, contributing to both physiological and pathological conditions. For a more profound comprehension, it is essential to conduct a precise comparison of DNA methylation patterns between sample groups that represent distinct statuses. Analysis
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DNA methylation is a key epigenetic modification involved in gene regulation, contributing to both physiological and pathological conditions. For a more profound comprehension, it is essential to conduct a precise comparison of DNA methylation patterns between sample groups that represent distinct statuses. Analysis of differentially methylated regions (DMRs) using computational approaches can help uncover the precise relationships between these phenomena. This paper describes a hybrid model that combines the beta-binomial Bayesian hierarchical model with a combination of ranking methods known as HBCR_DMR. During the initial phase, we model the actual methylation proportions of the CpG sites (CpGs) within the replicates. This modeling is achieved through beta-binomial distribution, with parameters set by a group mean and a dispersion parameter. During the second stage, we establish the selection of distinguishing CpG sites based on their methylation status, employing multiple ranking techniques. Finally, we combine the ranking lists of differentially methylated CpG sites through a voting system. Our analyses, encompassing simulations and real data, reveal outstanding performance metrics, including a sensitivity of 0.72, specificity of 0.89, and an F1 score of 0.76, yielding an overall accuracy of 0.82 and an AUC of 0.94. These findings underscore HBCR_DMR’s robust capacity to distinguish methylated regions, confirming its utility as a valuable tool for DNA methylation analysis.
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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Open AccessSystematic Review
Efficacy and Safety of Anti-CD38 Monoclonal Antibodies in Patients with Relapsed or Refractory Multiple Myeloma: A Meta-Analysis of Randomized Clinical Trials
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Francisco Cezar Aquino de Moraes, Vitor Kendi Tsuchiya Sano, Artur de Oliveira Macena Lôbo, Francinny Alves Kelly, Victória Morbach, Eric Pasqualotto and Rommel Mario Rodríguez Burbano
J. Pers. Med. 2024, 14(4), 360; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm14040360 (registering DOI) - 29 Mar 2024
Abstract
The benefit of associating anti-CD38 monoclonal antibodies to proteasome inhibitor (PI)/immunomodulatory agent (IA) and dexamethasone in the treatment of patients with relapsed or refractory multiple myeloma (MM) remains unclear. PubMed, Embase, and Cochrane Library databases were searched for randomized controlled trials that investigated
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The benefit of associating anti-CD38 monoclonal antibodies to proteasome inhibitor (PI)/immunomodulatory agent (IA) and dexamethasone in the treatment of patients with relapsed or refractory multiple myeloma (MM) remains unclear. PubMed, Embase, and Cochrane Library databases were searched for randomized controlled trials that investigated the addition of anti-CD38 monoclonal antibodies to a therapy composed of PI/IA and dexamethasone versus PI/IA and dexamethasone alone for treating relapsed or refractory MM. Hazard ratios (HRs) or risk ratios (RRs) were computed for binary endpoints, with 95% confidence intervals (CIs). Six studies comprising 2191 patients were included. Anti-CD38 monoclonal antibody significantly improved progression-free survival (HR 0.52; 95% CI 0.43–0.61; p < 0.001) and overall survival (HR 0.72; 95% CI 0.63–0.83; p < 0.001). There was a significant increase in hematological adverse events, such as neutropenia (RR 1.41; 95% CI 1.26–1.58; p < 0.01) and thrombocytopenia (RR 1.14; 95% CI 1.02–1.27; p = 0.02), in the group treated with anti-CD38 monoclonal antibody. Also, there was a significant increase in non-hematological adverse events, such as dyspnea (RR 1.72; 95% CI 1.38–2.13; p < 0.01) and pneumonia (RR 1.34; 95% CI 1.13–1.59; p < 0.01), in the group treated with anti-CD38 monoclonal antibody. In conclusion, the incorporation of an anti-CD38 monoclonal antibody demonstrated a promising prospect for reshaping the established MM treatment paradigms.
Full article
(This article belongs to the Section Personalized Therapy and Drug Delivery)
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Open AccessArticle
Personalized Diabetes Management with Digital Twins: A Patient-Centric Knowledge Graph Approach
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Fatemeh Sarani Rad, Rasha Hendawi, Xinyi Yang and Juan Li
J. Pers. Med. 2024, 14(4), 359; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm14040359 - 28 Mar 2024
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.
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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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Open AccessArticle
Delta Variant in the COVID-19 Pandemic: A Comparative Study on Clinical Outcomes Based on Vaccination Status
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Damiana-Maria Vulturar, Liviu-Ștefan Moacă, Maria Adriana Neag, Andrei-Otto Mitre, Teodora-Gabriela Alexescu, Diana Gherman, Iulia Făgărășan, Ioana Maria Chețan, Claudia Diana Gherman, Oana-Elena Melinte, Antigona Carmen Trofor and Doina-Adina Todea
J. Pers. Med. 2024, 14(4), 358; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm14040358 - 28 Mar 2024
Abstract
Background: As the global battle against the COVID-19 pandemic endures, the spread of the Delta variant has introduced nuanced challenges, prompting a nuanced examination. Materials and Methods: We performed a multilevel logistic regression analysis encompassing 197 patients, comprising 44 vaccinated individuals (V group)
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Background: As the global battle against the COVID-19 pandemic endures, the spread of the Delta variant has introduced nuanced challenges, prompting a nuanced examination. Materials and Methods: We performed a multilevel logistic regression analysis encompassing 197 patients, comprising 44 vaccinated individuals (V group) and 153 unvaccinated counterparts (UV). These patients, afflicted with the Delta variant of SARS-CoV-2, were hospitalized between October 2021 and February 2022 at the COVID-19 department of a University Centre in Cluj-Napoca, Romania. We compared patient characteristics, CT lung involvement, Padua score, oxygen saturation (O2 saturation), ventilation requirements, dynamics of arterial blood gas (ABG) parameters, ICU admission rates, and mortality rates between the two groups. Results: The UV group exhibited a statistically significant (p < 0.05) proclivity toward developing a more severe form of infection, marked by elevated rates of lung involvement, oxygen requirement, ICU admission, and mortality. Conclusion: Our findings underscore the substantial efficacy of the vaccine in diminishing the incidence of severe disease, lowering the rates of ICU admissions, and mitigating mortality among hospitalized patients.
Full article
(This article belongs to the Special Issue Personalized Medicine for COVID-19)
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Open AccessBrief Report
Combination of Tractography, Intraoperative Computed Tomography and 5-Aminolevulinic Acid Fluorescence in Stereotactic Brain Biopsies: A Case Series
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Edoardo Mazzucchi, Gianluca Galieri, Fabrizio Pignotti, Pierluigi Rinaldi, Giovanni Sabatino and Giuseppe La Rocca
J. Pers. Med. 2024, 14(4), 357; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm14040357 - 28 Mar 2024
Abstract
Stereotactic needle biopsy (SNB) may be performed to collect tissue samples from lesions not amenable to open surgery. Integration of tractography, intraoperative imaging and fluorescence has been applied to reduce risk of complications and confirm the adequacy of bioptic specimens. Clinical and radiological
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Stereotactic needle biopsy (SNB) may be performed to collect tissue samples from lesions not amenable to open surgery. Integration of tractography, intraoperative imaging and fluorescence has been applied to reduce risk of complications and confirm the adequacy of bioptic specimens. Clinical and radiological data from patients who underwent stereotactic needle biopsy with the use of intraoperative CT, tractography and 5-aminolevulinic acid (5-ALA) fluorescence in a single Hospital were retrospectively reviewed to evaluate the accuracy and safety of the procedure. Seven patients were included in the study, and all the collected specimens showed red fluorescence. In six of them, the final histopathological diagnosis was grade 4 glioblastoma IDH-wt and in the other case it was Diffuse large B-Cell Lymphoma. The integration of tractography, intraoperative CT and 5-ALA as an intraoperative marker of diagnostic samples may be suggested in biopsies of suspect gliomas and lymphomas. The cost-effectiveness of the procedure should be evaluated in future studies.
Full article
(This article belongs to the Special Issue Clinical Research of Precision Neuro-Oncology)
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Open AccessArticle
Associations between Chronic Kidney Disease and Migraine Incidence: Findings from a Korean Longitudinal Big Data Study
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Mi Jung Kwon, Jwa-Kyung Kim, Min-Jeong Kim, Dae Myoung Yoo, Na-Eun Lee, Kyeong Min Han, Nan Young Kim, Ho Suk Kang, Hyo Geun Choi and Eun Soo Kim
J. Pers. Med. 2024, 14(4), 356; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm14040356 - 28 Mar 2024
Abstract
While headaches frequently occur in individuals with chronic kidney disease (CKD), there are few statistical evaluations of their connection to migraines in population-based studies. In this nationwide longitudinal follow-up study of Korean health examination data (2002–2019), a total of 15,443 participants with CKD
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While headaches frequently occur in individuals with chronic kidney disease (CKD), there are few statistical evaluations of their connection to migraines in population-based studies. In this nationwide longitudinal follow-up study of Korean health examination data (2002–2019), a total of 15,443 participants with CKD and 61,772 matched controls were enrolled. We applied overlap-weighted Cox proportional hazard regression models to assess hazard ratios, examining the correlation between CKD and the development of migraines. After accounting for various factors, we observed a modest reduction of approximately 11% in the likelihood of migraine occurrence among CKD patients (95% confidence intervals = 0.81–0.97) during the 16-year monitoring period. Subgroup analysis revealed a significant association among specific demographic and health conditions, including individuals aged 70 or older, females, overweight individuals, nonsmokers, and those without hypertension or diabetes. Our research may indicate a potential relationship between CKD and the onset of migraines in Korean adults, suggesting a slight reduction in the probability of the occurrence of migraines among those with CKD. These findings emphasize the need for attentive follow-up and preventive management in individuals without the identified protective factors, particularly in male CKD patients under the age of 70 with hypertension.
Full article
(This article belongs to the Special Issue Precision Medicine for Epidemiology and Public Health)
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Open AccessReview
Posterior Tibial Nerve Stimulation for the Treatment of Detrusor Overactivity in Multiple Sclerosis Patients: A Narrative Review
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Vaia Sapouna, Athanasios Zikopoulos, Sofia Thanopoulou, Dimitrios Zachariou, Ioannis Giannakis, Aris Kaltsas, Bou Sopheap, Nikolaos Sofikitis and Athanasios Zachariou
J. Pers. Med. 2024, 14(4), 355; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm14040355 - 28 Mar 2024
Abstract
Bladder dysfunction, particularly neurogenic detrusor overactivity (DO), poses a substantial challenge in multiple sclerosis (MS) patients, detrimentally impacting their quality of life (QoL). Conventional therapies often fall short, necessitating alternative approaches like posterior tibial nerve stimulation (PTNS) for effective management. This narrative review
[...] Read more.
Bladder dysfunction, particularly neurogenic detrusor overactivity (DO), poses a substantial challenge in multiple sclerosis (MS) patients, detrimentally impacting their quality of life (QoL). Conventional therapies often fall short, necessitating alternative approaches like posterior tibial nerve stimulation (PTNS) for effective management. This narrative review critically examines the application of PTNS in treating DO among MS patients, aiming to provide a comprehensive synthesis of its efficacy, underlying mechanisms, and clinical outcomes. By evaluating a spectrum of studies, including randomized controlled trials and long-term follow-up research, the review elucidates PTNS’s role in enhancing bladder control and ameliorating symptoms of urgency and incontinence, thereby improving patient well-being. Despite its potential, the review acknowledges the limited scope of existing research specific to MS-induced neurogenic DO and calls for further investigation to optimize PTNS protocols and understand its long-term benefits. Highlighting PTNS’s minimal invasiveness and favorable safety profile, the review advocates for its consideration as a viable third-line treatment option in MS-related bladder dysfunction management. Through this analysis, the review contributes to the broader narrative of seeking effective, patient-centered therapeutic strategies for MS-related complications, underscoring the importance of personalized care in improving patient outcomes.
Full article
(This article belongs to the Special Issue Clinical Updates and Challenges of Multiple Sclerosis and Related Disorders)
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Open AccessArticle
A Comprehensive Evaluation of AI-Assisted Diagnostic Tools in ENT Medicine: Insights and Perspectives from Healthcare Professionals
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Sarah Alshehri, Khalid A. Alahmari and Areej Alasiry
J. Pers. Med. 2024, 14(4), 354; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm14040354 - 28 Mar 2024
Abstract
The integration of Artificial Intelligence (AI) into healthcare has the potential to revolutionize medical diagnostics, particularly in specialized fields such as Ear, Nose, and Throat (ENT) medicine. However, the successful adoption of AI-assisted diagnostic tools in ENT practice depends on the understanding of
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The integration of Artificial Intelligence (AI) into healthcare has the potential to revolutionize medical diagnostics, particularly in specialized fields such as Ear, Nose, and Throat (ENT) medicine. However, the successful adoption of AI-assisted diagnostic tools in ENT practice depends on the understanding of various factors; these include influences on their effectiveness and acceptance among healthcare professionals. This cross-sectional study aimed to assess the usability and integration of AI tools in ENT practice, determine the clinical impact and accuracy of AI-assisted diagnostics in ENT, measure the trust and confidence of ENT professionals in AI tools, gauge the overall satisfaction and outlook on the future of AI in ENT diagnostics, and identify challenges, limitations, and areas for improvement in AI-assisted ENT diagnostics. A structured online questionnaire was distributed to 600 certified ENT professionals with at least one year of experience in the field. The questionnaire assessed participants’ familiarity with AI tools, usability, clinical impact, trust, satisfaction, and identified challenges. A total of 458 respondents completed the questionnaire, resulting in a response rate of 91.7%. The majority of respondents reported familiarity with AI tools (60.7%) and perceived them as generally usable and clinically impactful. However, challenges such as integration with existing systems, user-friendliness, accuracy, and cost were identified. Trust and satisfaction levels varied among participants, with concerns regarding data privacy and support. Geographic and practice setting differences influenced perceptions and experiences. The study highlights the diverse perceptions and experiences of ENT professionals regarding AI-assisted diagnostics. While there is general enthusiasm for these tools, challenges related to integration, usability, trust, and cost need to be addressed for their widespread adoption. These findings provide valuable insights for developers, policymakers, and healthcare providers aiming to enhance the role of AI in ENT practice.
Full article
(This article belongs to the Special Issue Artificial Intelligence Applied to Clinical Practice)
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Open AccessBrief Report
Diabetic Neuropathy and Minimum Effective Anesthetic Concentration of Mepivacaine for Axillary Brachial Plexus Block: A Prospective Observational Study
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Na-Eun Kim, Woo-Joo Lee, Jong-Kwon Jung, Jang-Ho Song, Kyung-Lim Joa, Chun-Woo Yang, Eui-Chan Jung, Soo-Man Jo and Yeong-Seung Ko
J. Pers. Med. 2024, 14(4), 353; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm14040353 - 27 Mar 2024
Abstract
Nerves in patients with diabetic neuropathy (DN) show increased susceptibility to local anesthetics, potentially requiring a decreased dose. We investigated whether the minimum effective anesthetic concentration (MEAC) of mepivacaine for successful axillary block is lower in patients with DN than in those without.
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Nerves in patients with diabetic neuropathy (DN) show increased susceptibility to local anesthetics, potentially requiring a decreased dose. We investigated whether the minimum effective anesthetic concentration (MEAC) of mepivacaine for successful axillary block is lower in patients with DN than in those without. This prospective observational study included patients with DN (n = 22) and without diabetes (n = 22) at a tertiary care center. Patients received an ultrasound-guided axillary block with 30 mL of mepivacaine for anesthesia. The mepivacaine concentration used in each patient was calculated using Dixon’s up-and-down method. A block was considered successful if all four sensory nerves had a score of 1 or 2 within 30 min with no pain during surgery. The primary outcome was the MEAC of mepivacaine, and the secondary outcomes included the minimal nerve stimulation intensity for the musculocutaneous nerve and the occurrence of adverse events. The MEAC50 was 0.55% (95% CI 0.33–0.77%) in patients without diabetes and 0.58% (95% CI 0.39–0.77%) in patients with DN (p = 0.837). The MEAC90 was 0.98% (95% CI 0.54–1.42%) in patients without diabetes and 0.96% (95% CI 0.57–1.35%) in patients with DN (p = 0.949). The stimulation threshold for the musculocutaneous nerve was significantly different between groups (0.49 mA vs. 0.19 mA for patients with vs. without diabetes; p = 0.002). In conclusion, the MEAC of mepivacaine for a successful axillary block is not lower in patients with DN.
Full article
(This article belongs to the Section Clinical Medicine, Cell, and Organism Physiology)
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Open AccessArticle
Non-Union Treatment in the Foot, Ankle, and Lower Leg: A Multicenter Retrospective Study Comparing Conventional Treatment with the Human Allogeneic Cortical Bone Screw (Shark Screw®)
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Viktor Labmayr, Elisabeth Huber, Florian Wenzel-Schwarz, Patrick Holweg, Martin Ornig, Gerd Jakob, Wolfgang Palle, Gudrun H. Borchert and Klaus Pastl
J. Pers. Med. 2024, 14(4), 352; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm14040352 - 27 Mar 2024
Abstract
Addressing non-unions involves stabilizing the affected area through osteosynthesis and improving bone biology using bone grafts. However, there is no consensus on the optimal treatment method. This study aims to compare outcomes of non-union surgery using conventional treatment methods (metal hardware ± graft)
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Addressing non-unions involves stabilizing the affected area through osteosynthesis and improving bone biology using bone grafts. However, there is no consensus on the optimal treatment method. This study aims to compare outcomes of non-union surgery using conventional treatment methods (metal hardware ± graft) versus osteosynthesis with the human allogeneic cortical bone screw (Shark Screw®) alone or in combination with a metallic plate. Thirty-four patients underwent conventional treatment, while twenty-eight cases received one or more Shark Screws®. Patient demographics, bone healing, time to bone healing, and complications were assessed. Results revealed a healing rate of 96.4% for the Shark Screw® group, compared to 82.3% for the conventionally treated group. The Shark Screw® group exhibited a tendency for faster bone healing (9.4 ± 3.2 vs. 12.9 ± 8.5 weeks, p = 0.05061). Hardware irritations led to six metal removals in the conventional group versus two in the Shark Screw® group. The Shark Screw® emerges as a promising option for personalized non-union treatment in the foot, ankle, and select lower leg cases, facilitating effective osteosynthesis and grafting within a single construct and promoting high union rates, low complications, and a rapid healing process.
Full article
(This article belongs to the Section Clinical Medicine, Cell, and Organism Physiology)
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Open AccessSystematic Review
Exploring the Relationship between Ovarian Cancer and Genital Microbiota: A Systematic Review and Meta-Analysis
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Vito Andrea Capozzi, Giosuè Giordano Incognito, Elisa Scarpelli, Marco Palumbo, Cinzia Lucia Randazzo, Alessandra Pino, Marco La Verde, Carlo Ronsini, Gaetano Riemma, Michela Gaiano, Paola Romeo, Vittorio Palmara, Roberto Berretta and Stefano Cianci
J. Pers. Med. 2024, 14(4), 351; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm14040351 - 27 Mar 2024
Abstract
Ovarian cancer (OC) remains a significant health challenge globally, with high mortality rates despite advancements in treatment. Emerging research suggests a potential link between OC development and genital dysbiosis, implicating alterations in the microbiome composition as a contributing factor. To investigate this correlation,
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Ovarian cancer (OC) remains a significant health challenge globally, with high mortality rates despite advancements in treatment. Emerging research suggests a potential link between OC development and genital dysbiosis, implicating alterations in the microbiome composition as a contributing factor. To investigate this correlation, a meta-analysis was conducted following PRISMA and MOOSE guidelines, involving eight studies encompassing 3504 patients. Studies investigating the role of upper and inferior genital tract dysbiosis were included, with particular reference to HPV infection and/or history of pelvic inflammatory disease. The analysis revealed no significant difference in genital dysbiosis prevalence between OC patients and healthy controls. Although previous literature suggests associations between dysbiosis and gynecologic cancers, such as cervical and endometrial cancers, the findings regarding OC are inconclusive. Methodological variations and environmental factors may contribute to these discrepancies, underscoring the need for standardized methodologies and larger-scale studies. Despite the limitations, understanding the microbiome’s role in OC development holds promise for informing preventive and therapeutic strategies. A holistic approach to patient care, incorporating microbiome monitoring and personalized interventions, may offer insights into mitigating OC risk and improving treatment outcomes. Further research with robust methodologies is warranted to elucidate the complex interplay between dysbiosis and OC, potentially paving the way for novel preventive and therapeutic approaches.
Full article
(This article belongs to the Special Issue Gynecological Oncology: From Pathogenesis to Therapy)
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Open AccessCase Report
Personalized and Complex Esthetic Oral Rehabilitation in a Case of Non-Syndromic Oligodontia
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Silvia Izabella Pop, Ana Procopciuc, Mihai Mițariu, Loredana Mițariu and Radu Vasile Pop
J. Pers. Med. 2024, 14(4), 350; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm14040350 - 27 Mar 2024
Abstract
Dental agenesis is one of the most common developmental anomalies in humans and it is frequently associated with several other oral abnormalities. The present case describes non-familial agenesis of permanent teeth in a twenty-one-year-old boy with no apparent systemic abnormalities. The treatment included
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Dental agenesis is one of the most common developmental anomalies in humans and it is frequently associated with several other oral abnormalities. The present case describes non-familial agenesis of permanent teeth in a twenty-one-year-old boy with no apparent systemic abnormalities. The treatment included a personalized and interdisciplinary approach involving endodontics, orthodontics, implant-supported restorations and prosthetic treatments. The treatment plan was thoroughly elaborated using photographic analysis, study models, orthopantomogram, CBCT and cephalograms. Virtual smile design, diagnostic waxing and mock-ups previsualized the treatment objectives. The edentulous spaces were reconstructed by inserting dental implants and monolithic zirconia implant-supported restorations. The final results showed a highly esthetic and functional rehabilitation. Periodic check-ups have shown that the stability of the result is well maintained and that the implant-supported restorations are an optimal solution for patients with multiple anodontia.
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(This article belongs to the Section Disease Biomarker)
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Open AccessArticle
Critical Steps and Common Mistakes during Temporal Bone Dissection: A Survey among Residents and a Step-by-Step Guide Analysis
by
Giovanni Motta, Eva Aurora Massimilla, Salvatore Allosso, Massimo Mesolella, Pietro De Luca, Domenico Testa and Gaetano Motta
J. Pers. Med. 2024, 14(4), 349; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm14040349 - 27 Mar 2024
Abstract
Background: Given that the temporal bone is one of the most complex regions of the human body, cadaveric dissection of this anatomical area represents the first necessary step for the learning and training of the young oto-surgeon in order to perform middle ear
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Background: Given that the temporal bone is one of the most complex regions of the human body, cadaveric dissection of this anatomical area represents the first necessary step for the learning and training of the young oto-surgeon in order to perform middle ear surgery, which includes the management of inflammatory pathology, hearing rehabilitation, and also cognitive decline prevention surgery. The primary objective of this study was to identify common mistakes and critical passages during the initial steps of temporal bone dissection, specifically cortical mastoidectomy and posterior tympanotomy. Methods: A survey among 100 ENT residents was conducted, gathering insights into the most prevalent errors encountered during their training to uncover the most challenging aspects faced by novice surgeons during these procedures. Results: The most common mistakes included opening the dura of the middle cranial fossa (MCF), injury of the sigmoid sinus (SS), chorda tympani (CT), and facial nerve (FN) injury while performing the posterior tympanotomy. The most important critical steps to prevent mistakes are related to the absence of wide exposure during cortical mastoidectomy and the consequent impossibility of identifying the landmarks of the facial recess before performing posterior tympanotomy. Injury of these structures was more common in younger surgeons and in the ones who performed less than five temporal bone dissection courses. Conclusions: Numerous temporal bone dissections on cadavers are mandatory for ENT residents looking forward to performing middle ear surgery.
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(This article belongs to the Section Clinical Medicine, Cell, and Organism Physiology)
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Open AccessArticle
Outcomes of Endoscopic Endonasal Dacryocystorhinostomy in Glaucoma Patients
by
Gian Marco Pace, Francesco Giombi, Giovanna Muci, Gianmarco Giunta, Francesca Pirola, Egidio Serra, Jessica Zuppardo, Fabio Ferreli, Paolo Vinciguerra, Giuseppe Mercante, Alessandra Di Maria, Giuseppe Spriano and Luca Malvezzi
J. Pers. Med. 2024, 14(4), 348; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm14040348 - 27 Mar 2024
Abstract
Background: Anti-glaucoma eye drops have been investigated due to their production of fibrotic changes on the conjunctival surface, undermining the functioning of the upper lacrimal drainage system. We aimed to assess whether these effects may impair the effectiveness of endoscopic endonasal dacryocystorhinostomy (EE-DCR).
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Background: Anti-glaucoma eye drops have been investigated due to their production of fibrotic changes on the conjunctival surface, undermining the functioning of the upper lacrimal drainage system. We aimed to assess whether these effects may impair the effectiveness of endoscopic endonasal dacryocystorhinostomy (EE-DCR). Methods: This is a single-center observational retrospective study on EE-DCR via a posterior approach. Resolution of epiphora and dacryocystitis were analyzed after 1 (T1) and 6-months (T2) from surgery. Surgical success was defined as anatomical (patency at irrigation, no recurring dacryocystitis) or complete (zeroing of Munk score). Results: Twenty patients (32 sides) were enrolled. Preoperatively, 93.75% (n = 30/32) presented severe (Munk 3–4) epiphora and 68.75% (n = 22/32) recurrent dacryocystitis. At T1, 50.0% (n = 16/32) were referred with residual epiphora (Munk ≥ 1) and 18.75% (n = 6/32) dacryocystitis. At T2, 31.25% (n = 10/32) still complained of epiphora (Munk ≥ 1) and 6.25% (n = 2/32) dacryocystitis. Difference of outcomes at aggregate and paired timepoints (except for T1 versus T2) resulted in statistical significance (p < 0.05). At T2, 22 (68.75%) complete, 8 (25.0%) anatomical successes and 2 (6.25%) surgical failures were observed. Conclusions: Despite the chronic uptake of anti-glaucoma eye drops, EE-DCR guaranteed high rates of clinical relief from epiphora and remarkable decreases in the rates of recurrent dacryocystitis.
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(This article belongs to the Section Personalized Therapy and Drug Delivery)
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Multidimensional Impact of Dupilumab on Chronic Rhinosinusitis with Nasal Polyps: A Complete Health Technology Assessment of Clinical, Economic, and Non-Clinical Domains
by
Ignazio La Mantia, Giancarlo Ottaviano, Martina Ragusa, Matteo Trimarchi, Emanuela Foglia, Fabrizio Schettini, Daniele Bellavia and Elena Cantone
J. Pers. Med. 2024, 14(4), 347; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm14040347 - 27 Mar 2024
Abstract
Chronic RhinoSinusitis with Nasal Polyps (CRSwNP) represents a condition mainly caused by the type 2 inflammation presence and marked by the existence of polyps within the nasal and paranasal sinuses. The standard of care includes intranasal steroids, additional burst of systemic steroids, if
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Chronic RhinoSinusitis with Nasal Polyps (CRSwNP) represents a condition mainly caused by the type 2 inflammation presence and marked by the existence of polyps within the nasal and paranasal sinuses. The standard of care includes intranasal steroids, additional burst of systemic steroids, if needed, and surgery. However, recurrence is common, especially among patients with comorbid type 2 inflammatory diseases. Recently, biological drugs, addressing the underlying cause of the disease, have been approved in Italy (dupilumab, omalizumab, and mepolizumab). A Health Technology Assessment was conducted to define multidimensional impact, assuming Italian NHS perspective and a 12-month time horizon. The EUnetHTA Core Model was deployed, using the following methods to analyze the domains: (i) literature evidence; (ii) administration of semi-structured questionnaires to 17 healthcare professionals; (iii) health economics tools to define the economic sustainability for the system. Evidence from NMA and ITC showed a more favorable safety profile and better efficacy for dupilumab compared with alternative biologics. All the analyses, synthesizing cost and efficacy measures, showed that dupilumab is the preferable alternative. Specifically, the cost per responder analysis for dupilumab, exhibiting a 67.0% response rate at Week 52, is notably economical at 14,209EUR per responder. This presents a more economical profile compared with the cost per responder for omalizumab (36.2% response rate) at 24,999EUR and mepolizumab (28.5% response rate) at 31,863EUR. These results underscore dupilumab’s potential, not merely in terms of clinical outcomes, but also in terms of economic rationality, thereby solidifying its status as a valid and preferrable alternative in the management of CRSwNP, in the context of the Italian NHS.
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(This article belongs to the Section Methodology, Drug and Device Discovery)
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Open AccessReview
Investigating ABO Blood Groups and Secretor Status in Relation to SARS-CoV-2 Infection and COVID-19 Severity
by
Stefanos Ferous, Nikolaos Siafakas, Fotini Boufidou, George P. Patrinos, Athanasios Tsakris and Cleo Anastassopoulou
J. Pers. Med. 2024, 14(4), 346; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm14040346 - 26 Mar 2024
Abstract
The ABO blood groups, Lewis antigens, and secretor systems are important components of transfusion medicine. These interconnected systems have been also shown to be associated with differing susceptibility to bacterial and viral infections, likely as the result of selection over the course of
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The ABO blood groups, Lewis antigens, and secretor systems are important components of transfusion medicine. These interconnected systems have been also shown to be associated with differing susceptibility to bacterial and viral infections, likely as the result of selection over the course of evolution and the constant tug of war between humans and infectious microbes. This comprehensive narrative review aimed to explore the literature and to present the current state of knowledge on reported associations of the ABO, Lewis, and secretor blood groups with SARS-CoV-2 infection and COVID-19 severity. Our main finding was that the A blood group may be associated with increased susceptibility to SARS-CoV-2 infection, and possibly also with increased disease severity and overall mortality. The proposed pathophysiological pathways explaining this potential association include antibody-mediated mechanisms and increased thrombotic risk amongst blood group A individuals, in addition to altered inflammatory cytokine expression profiles. Preliminary evidence does not support the association between ABO blood groups and COVID-19 vaccine response, or the risk of developing long COVID. Even though the emergency state of the pandemic is over, further research is needed especially in this area since tens of millions of people worldwide suffer from lingering COVID-19 symptoms.
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(This article belongs to the Special Issue Personalized Medicine for COVID-19)
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The Impact of Periodontal Disease on Preterm Birth and Preeclampsia
by
Panagiotis Tsikouras, Efthymios Oikonomou, Konstantinos Nikolettos, Sotiris Andreou, Dimitrios Kyriakou, Christos Damaskos, Nikolaos Garmpis, Vassiliki Monastiridou, Theopi Nalmpanti, Anastasia Bothou, George Iatrakis and Nikolaos Nikolettos
J. Pers. Med. 2024, 14(4), 345; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm14040345 - 26 Mar 2024
Abstract
This review delves into the possible connection between periodontitis and negative pregnancy outcomes, such as preeclampsia and preterm birth. It highlights the potential influence of an unidentified microbial factor on preeclampsia and the effects of inflammatory responses on the rate of preterm births.
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This review delves into the possible connection between periodontitis and negative pregnancy outcomes, such as preeclampsia and preterm birth. It highlights the potential influence of an unidentified microbial factor on preeclampsia and the effects of inflammatory responses on the rate of preterm births. Furthermore, it underscores the prevalent occurrence of oral ailments within the populace and their significant repercussions on quality of life. Hormonal fluctuations during pregnancy may exacerbate oral conditions such as pregnancy gingivitis and periodontitis, necessitating bespoke therapeutic approaches that take into account potential fetal ramifications. Periodontal disease, characterized by microbial attack and inflammatory response, results in tissue destruction and tooth loss. The oral cavity’s susceptibility to bacterial colonization, which is primarily due to its role as a site for food intake, is highlighted. Furthermore, research indicates a correlation between inflammatory responses and factors such as prostaglandin E2 and IL-1β, and preterm birth. Therapeutic interventions are a focus of international research, with efforts being aimed at optimizing outcomes through larger studies involving pregnant women.
Full article
(This article belongs to the Section Clinical Medicine, Cell, and Organism Physiology)
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