Journal of Personalized Medicine

18 pages, 3642 KiB

Open AccessArticle

Subjective Perception and Psychoacoustic Aspects of the Laryngectomee Voice: The Impact on Quality of Life

by Massimo Mesolella, Salvatore Allosso, Roberto D’aniello, Emanuela Pappalardo, Vincenzo Catalano, Giuseppe Quaremba, Gaetano Motta and Grazia Salerno

J. Pers. Med. 2023, 13(3), 570; https://doi.org/10.3390/jpm13030570 - 22 Mar 2023

Cited by 2 | Viewed by 1231

Abstract

Purpose: A retrospective study is presented to correlate the inter-judge consistency for the different psycho-perceptual parameters of the recently proposed Impression Noise Fluency Voicing (INFVo) perceptual rating scale for substitution voices, and the vocal function as perceived by the patient. Methods: The scale [...] Read more.

Purpose: A retrospective study is presented to correlate the inter-judge consistency for the different psycho-perceptual parameters of the recently proposed Impression Noise Fluency Voicing (INFVo) perceptual rating scale for substitution voices, and the vocal function as perceived by the patient. Methods: The scale Voice-Related Quality of Life (V-RQoL) and the Self Evaluation of Communication Experiences After Laryngectomy scale (SECEL)—a self-evaluation questionnaire of communicative experience after laryngectomy surgery—were administered to 89 total laryngectomees, subdivided in four groups depending on their type of alaryngeal voice (i.e., tracheoesophageal and esophageal speakers, electro larynx users, voiceless patients), in order to evaluate the impact of the impairment of the phonatory function on the quality of life. Results: No significant differences exist among the various groups on their perception of QoL using subjective questionnaires, whereas the INFVo scale has proven to be a useful tool for the description and analysis of the psychoacoustic characteristics of the vocal signal and a reliable instrument to correctly classify the patients. It is also notable that the judgement of the patients on their own voice and those of the referees are highly significant. Conclusion: Although speech rehabilitation for the acquisition of a substitution voice offers a new way of communication for the laryngectomized patients, nonetheless, their QoL is not significantly related to the type of substitution voice. Therefore, improving the patient’s adaptation to the new phonatory condition is mandatory. Full article

(This article belongs to the Special Issue Personalized Medicine in Otorhinolaryngology)

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4 pages, 559 KiB

Open AccessEditorial

Special Issue “Plastic and Reconstructive Surgery in Personalized Medicine”

by Raymund E. Horch and Andreas Arkudas

J. Pers. Med. 2023, 13(3), 569; https://doi.org/10.3390/jpm13030569 - 22 Mar 2023

Viewed by 825

Abstract

With an ever-growing knowledge in various disciplines of medicine and with rapidly evolving new techniques and operative methods in plastic surgery, it is obvious that it becomes more and more difficult to keep up with all the developments in this field at any [...] Read more.

With an ever-growing knowledge in various disciplines of medicine and with rapidly evolving new techniques and operative methods in plastic surgery, it is obvious that it becomes more and more difficult to keep up with all the developments in this field at any time [...] Full article

(This article belongs to the Special Issue Plastic and Reconstructive Surgery in Personalized Medicine)

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2 pages, 159 KiB

Open AccessEditorial

Robotic Gastrointestinal Surgery: State of the Art and Future Perspectives

by Marco Milone and Paolo Pietro Bianchi

J. Pers. Med. 2023, 13(3), 568; https://doi.org/10.3390/jpm13030568 - 22 Mar 2023

Cited by 1 | Viewed by 829

Abstract

Since its inception, robotic surgery has made incredible progress and has undergone significant development in an extremely short period of time [...] Full article

(This article belongs to the Special Issue Update on Robotic Gastrointestinal Surgery)

8 pages, 1541 KiB

Open AccessCase Report

The Association of Four Natural Molecules—EGCG, Folic Acid, Vitamin B12, and HA—To Counteract HPV Cervical Lesions: A Case Report

by Giovanni Grandi, Laura Botticelli, Pietro Di Fraia, Carla Babalini, Meris Masini and Vittorio Unfer

J. Pers. Med. 2023, 13(3), 567; https://doi.org/10.3390/jpm13030567 - 22 Mar 2023

Viewed by 1654

Abstract

Precancerous lesions of the uterine cervix, due to HPV infections, are still today a great medical challenge. This clinical case highlighted the effectiveness of epigallocatechin gallate (EGCG), vitamin B12, folic acid, and hyaluronic acid (HA) in counteracting HPV lesions in a 39-year-old patient [...] Read more.

Precancerous lesions of the uterine cervix, due to HPV infections, are still today a great medical challenge. This clinical case highlighted the effectiveness of epigallocatechin gallate (EGCG), vitamin B12, folic acid, and hyaluronic acid (HA) in counteracting HPV lesions in a 39-year-old patient with a long history of viral persistence, cervical lesions of various degree, and several unsuccessful surgical approaches. After eight weeks of treatment, both the histological and cytological analyses revealed only a chronic cervicitis without any malignant lesions or cellular dysplasia, thus reducing the urgency of an invasive surgery, a total hysterectomy. Full article

(This article belongs to the Special Issue Personalized Prevention, Diagnosis, and Treatment of HPV Associated Cancers)

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8 pages, 714 KiB

Open AccessBrief Report

Comparison of Transforaminal Lumbar Interbody Fusion in the Ambulatory Surgery Center and Traditional Hospital Settings, Part 2: Assessment of Surgical Safety in Medicare Beneficiaries

by Scott M. Schlesinger, Dominic Maggio, Morgan P. Lorio, Kai-Uwe Lewandrowski and Jon E. Block

J. Pers. Med. 2023, 13(3), 566; https://doi.org/10.3390/jpm13030566 - 22 Mar 2023

Cited by 1 | Viewed by 1664

Abstract

(1) Background: The clinical benefits and procedural efficiencies of performing minimally invasive fusion procedures, such as transforaminal lumbar interbody fusion (TLIF), in the ambulatory surgery center (ASC) are becoming increasingly well established. Currently, Medicare does not provide reimbursement for its beneficiaries eligible for [...] Read more.

(1) Background: The clinical benefits and procedural efficiencies of performing minimally invasive fusion procedures, such as transforaminal lumbar interbody fusion (TLIF), in the ambulatory surgery center (ASC) are becoming increasingly well established. Currently, Medicare does not provide reimbursement for its beneficiaries eligible for TLIF in the ASC due to a lack of evidence regarding procedural safety. However, the initiation of the Hospital Without Walls program allowed for traditional hospital procedures to be relocated to other facilities such as ASCs, providing a unique opportunity to evaluate the utility of TLIF in the ASC in Medicare-age patients. (2) Methods: This single-center, retrospective study compared baseline characteristics, intraoperative variables, and 30-day postoperative safety outcomes between 48 Medicare-age patients undergoing TLIF in the ASC and 48 patients having the same procedure as hospital in-patients. All patients had a one-level TLIF using the VariLift^®-LX expandable lumbar interbody fusion device. (3) Results: There were similar patient characteristics, procedural efficiency, and occurrence of clinical 30-day safety events between the two study groups. However, there was a marked and statistically significant difference in the median length of stay favoring TLIF patients treated in the ASC (23.9 h vs. 1.6 h, p = 0.001). All ASC-treated patients were discharged on the day of surgery. Postoperative visits to address adverse events were rare in either group. (4) Conclusions: These findings provide evidence that minimally invasive TLIF can be performed safely and efficiently in the ASC in Medicare-age patients. With same-day discharge, fusion procedures performed in the ASC offer a similar safety and more attractive cost–benefit profile for older patients than the same surgery undertaken in the traditional hospital setting. The Centers for Medicare and Medicaid Services should strongly consider extending the appropriate reimbursement codes (CPT ^® 22630, 22633) for minimally invasive TLIF and PLIF to the ASC Covered Procedure List so that Medicare-age patients can realize the clinical benefits of surgeries performed in this setting. Full article

(This article belongs to the Special Issue The Path to Personalized Pain Management)

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13 pages, 1635 KiB

Open AccessReview

Targeted Therapy for Orofacial Pain: A Novel Perspective for Precision Medicine

by Swarnalakshmi Raman, Daisuke Ikutame, Kazuo Okura and Yoshizo Matsuka

J. Pers. Med. 2023, 13(3), 565; https://doi.org/10.3390/jpm13030565 - 22 Mar 2023

Cited by 2 | Viewed by 1563

Abstract

Orofacial pain (OFP) is a dental specialty that includes the diagnosis, management and treatment of disorders of the jaw, mouth, face, head and neck. Evidence-based understanding is critical in effectively treating OFPs as the pathophysiology of these conditions is multifactorial. Since OFP impacts [...] Read more.

Orofacial pain (OFP) is a dental specialty that includes the diagnosis, management and treatment of disorders of the jaw, mouth, face, head and neck. Evidence-based understanding is critical in effectively treating OFPs as the pathophysiology of these conditions is multifactorial. Since OFP impacts the quality of life of the affected individuals, treating patients successfully is of the utmost significance. Despite the therapeutic choices available, treating OFP is still quite challenging, owing to inter-patient variations. The emerging trends in precision medicine could probably lead us to a paradigm shift in effectively managing the untreatable long-standing pain conditions. Precision medicine is designed based on the patient’s genetic profile to meet their needs. Several significant relationships have been discovered based on the genetics and genomics of pain in the past, and some of the notable targets are discussed in this review. The scope of this review is to discuss preclinical and clinical trials that include approaches used in targeted therapy for orofacial pain. Future developments in pain medicine should benefit from current trends in research into novel therapeutic approaches. Full article

(This article belongs to the Special Issue Precision Medicine for Oral Diseases)

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10 pages, 253 KiB

Open AccessArticle

Balloon Dacryocystoplasty with Pushed Monocanalicular Intubation as a Primary Management for Primary Acquired Nasolacrimal Duct Obstruction

by Chun-Chieh Lai, Cheng-Ju Yang, Chia-Chen Lin and Yi-Chun Chi

J. Pers. Med. 2023, 13(3), 564; https://doi.org/10.3390/jpm13030564 - 21 Mar 2023

Cited by 2 | Viewed by 1073

Abstract

Given the improvement in the instrument and techniques, novel surgical interventions emerged to avoid the osteotomy from the gold standard dacryocystorhinostomy (DCR) for treating primary acquired nasolacrimal duct obstruction (PANDO). This study’s aim is to compare the surgical outcomes of antegrade balloon dacryocystoplasty [...] Read more.

Given the improvement in the instrument and techniques, novel surgical interventions emerged to avoid the osteotomy from the gold standard dacryocystorhinostomy (DCR) for treating primary acquired nasolacrimal duct obstruction (PANDO). This study’s aim is to compare the surgical outcomes of antegrade balloon dacryocystoplasty (DCP) with pushed monocanalicular intubation (MCI) to balloon DCP alone in patients with complete PANDO. Adult patients with complete PANDO receiving balloon DCP followed by pushed MCI or balloon DCP alone from December 2014 to May 2019 were retrospectively reviewed. A total of 37 eyes of 29 patients were treated with balloon DCP with pushed MCI for 1 month, whereas 35 eyes of 28 patients were treated with balloon DCP alone. The success rates at 1 month, 3 months, and 6 months after operation were 89.2%, 73.0%, and 70.2%, respectively, in balloon DCP with MCI group, and 62.9%, 62.9%, and 60.0%, respectively, in the balloon DCP alone group. The balloon DCP with pushed MCI group had a better success rate but only reached statistical significance at 1 month postoperatively (p < 0.01). Subgroup analysis was performed based on age. The success rate in those under 65 in the combined balloon DCP with MCI group was significantly higher than in balloon DCP alone group (72.7% vs. 9.1%, p = 0.004), whereas there was no significant difference between those aged at least 65 in the combined group and the balloon DCP alone group (69.2% vs. 83.3%, p = 0.2). Conclusively, there was no significant difference in the success rate between antegrade balloon DCP with and without pushed MCI in general. Nevertheless, the former procedure was associated with significantly higher surgical success rate than the latter in younger patients. Full article

(This article belongs to the Special Issue The Challenges and Therapeutic Prospects in Eye Disease)

11 pages, 1327 KiB

Open AccessArticle

Impact of COVID-19 Pandemic on Women’s Health and Obstetric Outcomes after Assisted Reproduction: A Survey from an Italian Fertility Center

by Michela Cirillo, Valentina Basile, Letizia Mazzoli, Maria Elisabetta Coccia and Cinzia Fatini

J. Pers. Med. 2023, 13(3), 563; https://doi.org/10.3390/jpm13030563 - 21 Mar 2023

Cited by 2 | Viewed by 1310

Abstract

Background: the restrictive measures that were adopted during three waves of the COVID-19 pandemic had an impact on both the emotional state and lifestyle of the general population. We evaluated the impact of COVID-19 pandemic on lifestyles and emotional states of women planning [...] Read more.

Background: the restrictive measures that were adopted during three waves of the COVID-19 pandemic had an impact on both the emotional state and lifestyle of the general population. We evaluated the impact of COVID-19 pandemic on lifestyles and emotional states of women planning assisted reproductive technology (ART), and whether these changes affected ART outcomes. Methods: quantitative research, using a web-based survey, was performed on 289 Caucasian women. Results: In preconception, we observed higher percentage of women with positive obstetric outcomes who reduced body weight (52.4% vs. 27.2%, p = 0.09). Over 60% of women with positive outcomes practiced physical activity vs. 47% of women with negative outcomes (p = 0.03), as well as having better quality of sleep (45% vs. 35%), and a more solid relationships with their partners (65.1% vs. 51.7%, p = 0.03). Women who increased their intake of whole grains, fruits, vegetables, and legumes (p < 0.05), according to the Mediterranean diet, showed positive outcomes. We observed that participants who experienced “very much” or “extreme” anxiety, sadness, and fear (p < 0.05) during pandemic were clearly more numerous in the group with negative pregnancy outcomes. Conclusions: healthy lifestyle together with a positive emotional state in preconception can positively influence the obstetric outcomes after ART. Full article

(This article belongs to the Special Issue Effects of COVID-19 on Pregnancy)

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10 pages, 10590 KiB

Open AccessArticle

Cochlear Implantation in Pediatrics: The Effect of Cochlear Coverage

by Noura Alothman, Fida Almuhawas, Reem Badghaish, Al Hanouf Alotaibi, Salman F. Alhabib, Farid Alzhrani and Abdulrahman Hagr

J. Pers. Med. 2023, 13(3), 562; https://doi.org/10.3390/jpm13030562 - 21 Mar 2023

Cited by 2 | Viewed by 1169

Abstract

The effect of insertion depth and position of cochlear implant (CI) electrode arrays on speech perception remains unclear. This study aimed to determine the relationship between cochlear coverage and speech performance in children with prelingual hearing loss with CI. Pure tone audiometry (PTA) [...] Read more.

The effect of insertion depth and position of cochlear implant (CI) electrode arrays on speech perception remains unclear. This study aimed to determine the relationship between cochlear coverage and speech performance in children with prelingual hearing loss with CI. Pure tone audiometry (PTA) and speech audiometry, including speech reception threshold (SRT) using spondee words and speech discrimination score (SDS) using phonetically balanced monosyllabic words, were tested. The Categories of Auditory Performance (CAP) and Speech Intelligibility Rating (SIR) scales were also used. Thirty-one ears were implanted with the FLEX 28 electrode array, and 54 with the FORM 24 were included in the current study. For the studied ear, the mean cochlear duct length was 30.82 ± 2.24 mm; the mean cochlear coverage was 82.78 ± 7.49%. Cochlear coverage was a significant negative predictor for the mean pure tone threshold across frequecnies of 0.5, 1, 2, and 4 kHz (PTA4) (p = 0.019). Cochlear coverage was a significant positive predictor of SDS (p = 0.009). In children with cochlear coverage ≥ 82.78%, SDS was significantly better than in those with coverage < 82.78% (p = 0.04). Cochlear coverage was not a significant predictor of the SRT, CAP, or SIR. In conclusion, the cochlear coverage of the CI electrode array has an impact on the users’ SDS. Further long-term studies with larger sample sizes should be conducted to address the most critical factors affecting CI recipients’ outcomes. Full article

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10 pages, 575 KiB

Open AccessReview

The Role of Folic Acid in SARS-CoV-2 Infection: An Intriguing Linkage under Investigation

by Nikolaos D. Karakousis, Konstantinos I. Gourgoulianis and Ourania S. Kotsiou

J. Pers. Med. 2023, 13(3), 561; https://doi.org/10.3390/jpm13030561 - 21 Mar 2023

Cited by 2 | Viewed by 1967

Abstract

Background: SARS-CoV-2 is a life-threatening RNA virus that may cause an acute respiratory syndrome associated with extremely high morbidity and mortality rates. Folic acid (FA), also known as folate, is an essential vitamin vital for human homeostasis, participating in many biochemical pathways, and [...] Read more.

Background: SARS-CoV-2 is a life-threatening RNA virus that may cause an acute respiratory syndrome associated with extremely high morbidity and mortality rates. Folic acid (FA), also known as folate, is an essential vitamin vital for human homeostasis, participating in many biochemical pathways, and its deficiency has been associated with viral infection vulnerability. In this review, we investigated the association between FA intake and SARS-CoV-2 infection, along with the existence of any potential impact of FA on the health outcome of patients suffering from this new viral infection. Methods: Studies included were patients’ and in silico and molecular docking studies. Results: Data from in silico studies and molecular docking support that FA inhibits SARS-CoV-2 entry into the host and viral replication, binding at essential residues. Accordingly, in patients’ studies, a protective role of FA supplementation against SARS-CoV-2 infection is indicated. However, contradictory data from observational studies indicate that FA supplementation, often linked to deficits during systemic inflammation due to SARS-CoV-2, increases the risk of post-infection mortality. Conclusions: Future randomized controlled trial studies, including the FA pharmacological group, are needed to better understand the role of FA as a potential protective or mortality risk indicator in COVID-19 patients. Full article

(This article belongs to the Section Personalized Critical Care)

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18 pages, 39695 KiB

Open AccessArticle

Screening of Differentially Expressed Genes Based on the ACRG Molecular Subtypes of Gastric Cancer and the Significance and Mechanism of AGTR1 Gene Expression

by Haoran Zhang, Shuman Zhen, Pingan Ding, Bibo Tan, Hongyan Wang, Wenbo Liu, Yuan Tian and Qun Zhao

J. Pers. Med. 2023, 13(3), 560; https://doi.org/10.3390/jpm13030560 - 20 Mar 2023

Viewed by 1462

Abstract

Background: The Asian Cancer Research Group (ACRG) classification is a molecular classification established based on the tissues of gastric cancer (GC) patients in Asia. Patients with different ACRG subtypes differ significantly with regard to treatment response and prognosis, which indicates that the ACRG [...] Read more.

Background: The Asian Cancer Research Group (ACRG) classification is a molecular classification established based on the tissues of gastric cancer (GC) patients in Asia. Patients with different ACRG subtypes differ significantly with regard to treatment response and prognosis, which indicates that the ACRG molecular classification is more valuable than the traditional pathological classification. However, the specific differentially expressed genes (DEGs) and the value of the ACRG molecular subtypes of GC have not been studied in depth. Methods: Through the analysis of the GEO database, the DEGs in GC tissues of different ACRG molecular subtypes were investigated. The expression and mechanism of the screened angiotensin II receptor type 1 (AGTR1) gene were bioinformatically analyzed and experimentally verified. The role of AGTR1 in GC cells was mainly investigated using CCK-8, wound-healing, transwell invasion assays, qRT-PCR, and Western blotting. Results: The bioinformatics results showed the presence of multiple DEGs in GC tissues with different ACRG molecular subtypes. Certain DEGs in GC tissues of different ACRG molecular subtypes have prognostic significance. AGTR1 levels in tumor tissues were significantly higher than in paired paracancerous tissues. The prognosis of GC patients with high expression of AGTR1 was poor (p < 0.05). The AGTR1 gene in GC samples was associated with the expression of immune pathways and immune checkpoint genes. After modifying AGTR1 expression in cell lines, cells’ proliferation, invasion, and migration abilities and the expression of related genes changed. Conclusions: There were significant DEGs in GC tissues with different ACGR molecular types, among which the increased expression of AGTR1 was a molecular feature of MSS/EMT type gastric cancer. Further study found that AGTR1 was closely related to tumor immune infiltration and invasion and may be a new therapeutic target gene for gastric cancer. Full article

(This article belongs to the Special Issue Gastric Cancer: Innovations in Screening, Diagnosis and Treatment)

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15 pages, 2782 KiB

Open AccessArticle

Comparison between Cardiac Output and Pulmonary Vascular Pressure Measured by Indirect Fick and Thermodilution Methods

by Igor Volodarsky, Katerina Kerzhner, Dan Haberman, Valeri Cuciuc, Lion Poles, Alex Blatt, Elena Kirzhner, Jacob George and Gera Gandelman

J. Pers. Med. 2023, 13(3), 559; https://doi.org/10.3390/jpm13030559 - 20 Mar 2023

Cited by 1 | Viewed by 1371

Abstract

Introduction: Right heart catheterization (RHC) is a diagnostic procedure, the main purpose of which is to diagnose pulmonary hypertension and investigate its etiology and treatability. In addition to measuring blood pressure in heart chambers, it includes estimating cardiac output (CO) and calculation of [...] Read more.

Introduction: Right heart catheterization (RHC) is a diagnostic procedure, the main purpose of which is to diagnose pulmonary hypertension and investigate its etiology and treatability. In addition to measuring blood pressure in heart chambers, it includes estimating cardiac output (CO) and calculation of pulmonary vascular resistance (PVR) derived from the CO. There are two common methods to evaluate the CO—the indirect Fick method and the thermodilution method. Depending on the clinical conditions, either of the two may be considered better. Several studies have showed that, in most cases, there is no difference between measurements rendered by the two methods. Other studies have raised suspicion of a discrepancy between the two methods in a substantial number of patients. A clear opinion on this matter is missing. Aim: To evaluate the agreement between the values of the CO and PVR found by the thermodilution and indirect Fick methods. Methods: We retrospectively included patients that underwent RHC in Kaplan Medical Center during the last two years with a measurement of the CO using both the thermodilution and the indirect Fick methods. The measurements obtained upon RHC and the clinical data of the patients were collected. The values of the CO and PVR measured or calculated using the two methods were compared for each patient. Results: We included 55 patients that met the inclusion criteria in this study. The mean CO measured by the thermodilution method was 4.94 ± 1.17 L/min and the mean CO measured by the indirect Fick method was 5.82 ± 1.97 L/min. The mean PVR calculated using the thermodilution method was 3.33 ± 3.04 Woods’ units (WU) and the mean PVR calculated using the indirect Fick method was 2.71 ± 2.76 WU. Among the patients with normal mPAP, there was a strong and statistically significant correlation between the PVR values calculated by the two methods (Peasron’s R² = 0.78, p-value = 0.004), while among the patients with elevated mPAP, the correlation between the PVR values calculated by the two methods was not statistically significant. Conclusion: The findings of this small study demonstrate that, in a proportion of patients, the indirect Fick method and thermodilution method classify the PVR value differently. In our experience, it seems that, in these patients, the indirect Fick method misclassified patients with a pathological finding as normal. We, therefore, recommend that upon performing RHC, at least in patients with mPAP > 25 mmHg, both the thermodilution and indirect Fick methods be performed and, whenever they disagree, the values obtained from the thermodilution method should be preferred. Full article

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24 pages, 845 KiB

Open AccessReview

Impact of Sex and Gender on Clinical Management of Patients with Advanced Chronic Liver Disease and Type 2 Diabetes

by Anna Licata, Giuseppina T. Russo, Annalisa Giandalia, Marcella Cammilleri, Clelia Asero and Irene Cacciola

J. Pers. Med. 2023, 13(3), 558; https://doi.org/10.3390/jpm13030558 - 20 Mar 2023

Cited by 1 | Viewed by 1719

Abstract

Gender differences in the epidemiology, pathophysiological mechanisms and clinical features in chronic liver diseases that may be associated with type 2 diabetes (T2D) have been increasingly reported in recent years. This sexual dimorphism is due to a complex interaction between sex- and gender-related [...] Read more.

Gender differences in the epidemiology, pathophysiological mechanisms and clinical features in chronic liver diseases that may be associated with type 2 diabetes (T2D) have been increasingly reported in recent years. This sexual dimorphism is due to a complex interaction between sex- and gender-related factors, including biological, hormonal, psychological and socio-cultural variables. However, the impact of sex and gender on the management of T2D subjects with liver disease is still unclear. In this regard, sex-related differences deserve careful consideration in pharmacology, aimed at improving drug safety and optimising medical therapy, both in men and women with T2D; moreover, low adherence to and persistence of long-term drug treatment is more common among women. A better understanding of sex- and gender-related differences in this field would provide an opportunity for a tailored diagnostic and therapeutic approach to the management of T2D subjects with chronic liver disease. In this narrative review, we summarized available data on sex- and gender-related differences in chronic liver disease, including metabolic, autoimmune, alcoholic and virus-related forms and their potential evolution towards cirrhosis and/or hepatocarcinoma in T2D subjects, to support their appropriate and personalized clinical management. Full article

(This article belongs to the Special Issue Cirrhosis and Complication: Treatment and Prognosis)

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3 pages, 171 KiB

Open AccessEditorial

Synchrony 2022: Epilepsy and Seizures in Autism Spectrum Disorder Roundtable

by Richard E. Frye, Heer Nanda, Samuel J. Pleasure, Manuel F. Casanova, Richard G. Boles, Jeffrey Lewine, John Gaitanis and James B. Adams

J. Pers. Med. 2023, 13(3), 557; https://doi.org/10.3390/jpm13030557 - 20 Mar 2023

Viewed by 1878

Abstract

The BRAIN Foundation (Pleasanton, CA, USA) hosted Synchrony 2022, a translational medicine conference focused on research into treatments for individuals with neurodevelopmental disorders (NDD), including those with autism spectrum disorders (ASD) [...] Full article

(This article belongs to the Special Issue Autism Spectrum Disorder and Epilepsy)

11 pages, 1391 KiB

Open AccessArticle

Diagnostic Value of the Combined Measurement of Serum HCY and NRG4 in Type 2 Diabetes Mellitus with Early Complicating Diabetic Nephropathy

by Sheng Ding, Yi Yang, Yuming Zheng, Jinling Xu, Yangyang Cheng, Wei Wei, Fuding Yu, Li Li, Menglan Li, Mengjie Wang, Zhongjing Wang and Guangda Xiang

J. Pers. Med. 2023, 13(3), 556; https://doi.org/10.3390/jpm13030556 - 20 Mar 2023

Cited by 2 | Viewed by 1330

Abstract

Purpose: This study aimed to investigate the value of combined detection of HCY and NRG4 in the diagnosis of early diabetic kidney disease (DKD) and to explore the association between the ratio of HCY/NRG4 and DKD. Methods: A total of 140 diabetic patients [...] Read more.

Purpose: This study aimed to investigate the value of combined detection of HCY and NRG4 in the diagnosis of early diabetic kidney disease (DKD) and to explore the association between the ratio of HCY/NRG4 and DKD. Methods: A total of 140 diabetic patients and 43 healthy people were prospectively enrolled. The plasma HCY level, NRG4 level and HCY/NRG4 of them were measured to compare their differences and analyze the correlation with DKD. The independent influencing factors of patients with DKD were screened, and the nomograph of DKD occurrence was constructed. Results: The levels of HCY and HCY/NRG4 in diabetic patients were significantly increased, while the level of NRG4 was significantly decreased (p < 0.01). The AUCs of HCY/NRG4 predicted for DKD were 0.961. HCY/NRG4 and the course of DM were independent risk factors for DKD. A predictive nomograph of DKD was constructed, and decision curve analysis (DCA) showed good clinical application value. HCY/NRG4 was positively correlated with Scr, UACR, TG, UA, BUN, TCHOL and LDL and negatively correlated with eGFR and HDL (p < 0.05). Conclusions: The level of HCY and NRG4 is closely related to the severity of DM, and combined detection of HCY/NRG4 can identify patients with DKD at an early stage. Full article

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16 pages, 570 KiB

Open AccessArticle

Challenges of E-Learning: Behavioral Intention of Academicians to Use E-Learning during COVID-19 Crisis

by Mohammad Jamal Khan, Lingala Kalyan Viswanath Reddy, Javed Khan, Bayapa Reddy Narapureddy, Sunil Kumar Vaddamanu, Fahad Hussain Alhamoudi, Rajesh Vyas, Vishwanath Gurumurthy, Abdelrhman Ahmed Galaleldin Altijani and Saurabh Chaturvedi

J. Pers. Med. 2023, 13(3), 555; https://doi.org/10.3390/jpm13030555 - 20 Mar 2023

Cited by 4 | Viewed by 1820

Abstract

The COVID-19 crisis demanded that all educational activities should be performed virtually to follow social distancing guidelines. Therefore, there was a need to perform a research study to assess the effects of external factors on the perceived usefulness, ease of use of e-learning, [...] Read more.

The COVID-19 crisis demanded that all educational activities should be performed virtually to follow social distancing guidelines. Therefore, there was a need to perform a research study to assess the effects of external factors on the perceived usefulness, ease of use of e-learning, and the further effect of these perceptions on attitude and intent to use e-learning by using the technology acceptance model (TAM) among academicians at higher education institutions in the Kingdom of Saudi Arabia. Methods: A cross-sectional study was conducted, and data were collected from 263 academicians across Saudi Arabia through an online survey questionnaire using a non-probability purposive sampling technique and analyzed and tested using the SPSS and Smart PLS software. Results: This study found that self-efficacy was positively associated with perceived usefulness at β = 0.143 and p < 0.05, but it had no association with perceived ease of use at β = 0.057 at p > 0.05. System accessibility had a significant and positive relationship with perceived usefulness and perceived ease of use at β = 0.283, β = 0.247, and p < 0.01, respectively. Self-efficacy had a positive effect on perceived usefulness, whereas the subjective norm had no relationship with perceived usefulness and perceived ease of use at β = −0.065 and β = −0.012 at p > 0.05, respectively. Perceived ease of use and perceived usefulness were positively related to attitude towards use, which has a significant influence on intention to use e-learning. Conclusion: Perceived ease of application is the most significant factor (β = 0.556) in developing the attitude among academicians to practice e-learning, followed by perceived usefulness (β = 0.262). Moreover, it can be concluded that system accessibility has a stronger influence on developing perception among academicians about the expediency and ease of application of e-learning than self-efficacy. Full article

(This article belongs to the Special Issue Recent Advances in COVID-19 Pandemic: Challenges and Opportunities)

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13 pages, 2471 KiB

Open AccessArticle

Association of Diabetes Mellitus with All-Cause and Cause-Specific Mortality among Patients with Metabolic-Dysfunction-Associated Fatty Liver Disease: A Longitudinal Cohort Study

by Yixuan Zhu, Chuan Liu, Xiaoming Xu, Xiaoyan Ma, Jiacheng Liu, Zhiyi Zhang, Fuchao Li, Danny Ka-Ho Wong, Zhiwen Fan, Chao Wu, Xiaolong Qi and Jie Li

J. Pers. Med. 2023, 13(3), 554; https://doi.org/10.3390/jpm13030554 - 20 Mar 2023

Viewed by 1539

Abstract

Background: Diabetes mellitus (DM) is a comorbidity commonly presenting with metabolic-dysfunction-associated fatty liver disease (MAFLD); however, few tests for interaction have been reported. Our target was to evaluate the prognostic implications of DM in patients with different forms of MAFLD. Methods: Using data [...] Read more.

Background: Diabetes mellitus (DM) is a comorbidity commonly presenting with metabolic-dysfunction-associated fatty liver disease (MAFLD); however, few tests for interaction have been reported. Our target was to evaluate the prognostic implications of DM in patients with different forms of MAFLD. Methods: Using data from the Third National Health and Nutrition Examination Survey (NHANES III) in the United States, we screened 14,797 participants aged 20–74 who received ultrasound examinations from 1988–1994. Among them, 4599 patients met the diagnosis of MAFLD, and we defined mortality as the outcome event. Survival analysis of competitive risk events was performed using Cox regression and sub-distributed risk ratio (SHR). Results: During 21.1 years of follow-up, cardiovascular diseases seemed to be the most common cause of death among MAFLD patients. Of them, DM was present in 25.48% and was independently associated with increased risk of all-cause mortality (HRs: 1.427, 95% CIs: 1.256–1.621, p < 0.001) and cause-specific mortality (cardiovascular-related mortality (HRs: 1.458, 95% CIs: 1.117–1.902, p = 0.005), non-cardiovascular-related mortality (HRs: 1.423, 95% CIs: 1.229–1.647, p < 0.001), and non-cancer-related mortality (HRs: 1.584, 95% CIs: 1.368–1.835, p < 0.001), respectively). Surprisingly, this association was more significant for young patients (p-value for interaction <0.001). Moreover, DM had a greater risk of all-cause and cause-specific mortality among overweight and obese MAFLD patients (p-value for interaction <0.001). Conclusions: DM increased the risk of all-cause and cause-specific mortality (cardiovascular-related, non-cardiovascular-related, and non-cancer-related) in MAFLD patients, especially in younger patients with excess obesity. Full article

(This article belongs to the Section Mechanisms of Diseases)

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15 pages, 3561 KiB

Open AccessArticle

Prognostic Factors and the Role of Adjuvant Chemotherapy in Pathological Node-Negative T3 Gastric Cancer

by Yi-Fu Chen, Ming-Yang Chen, Puo-Hsien Le, Tsung-Hsing Chen, Chia-Jung Kuo, Shang-Yu Wang, Shih-Chiang Huang, Wen-Chi Chou, Ta-Sen Yeh and Jun-Te Hsu

J. Pers. Med. 2023, 13(3), 553; https://doi.org/10.3390/jpm13030553 - 20 Mar 2023

Cited by 3 | Viewed by 1477

Abstract

The role of adjuvant chemotherapy in pathological T3N0M0 (pT3N0M0) gastric cancer (GC) remains unclear. The aim of this study was to analyze the prognostic factors of patients with pT3N0M0 GC and to clarify which ones could benefit from adjuvant chemotherapy. A total of [...] Read more.

The role of adjuvant chemotherapy in pathological T3N0M0 (pT3N0M0) gastric cancer (GC) remains unclear. The aim of this study was to analyze the prognostic factors of patients with pT3N0M0 GC and to clarify which ones could benefit from adjuvant chemotherapy. A total of 137 patients with pT3N0M0 GC were recruited between 1994 and 2020. Clinicopathological factors and adjuvant chemotherapy regimens were retrospectively collected. Prognostic factors of disease-free survival (DFS) and cancer-specific survival (CSS) were determined using univariate and multivariate analyses. The chemotherapy group was younger (p = 0.012), had had more lymph nodes retrieved (p = 0.042) and had higher percentages of vascular invasion (p = 0.021) or perineural invasion (p = 0.030) than the non-chemotherapy group. There were no significant differences in DFS (p = 0.222) and CSS (p = 0.126) between patients treated with or without adjuvant chemotherapy. Stump cancer, tumor size and perineural invasion were associated with higher rates of recurrence. Tumor size was an independent prognostic factor for DFS (hazard ratio, 4.55; confidence interval, 1.59–12.99; p = 0.005) and CSS (hazard ratio, 3.97; confidence interval, 1.38–11.43; p = 0.011). Tumor size independently influenced survival outcomes in pT3N0M0 patients who underwent radical surgery with and without adjuvant chemotherapy. Full article

(This article belongs to the Special Issue Upper Digestive Surgical Oncology)

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12 pages, 2799 KiB

Open AccessArticle

Clinical Characteristics of Minimal Lumbar Disc Herniation and Efficacy of Percutaneous Endoscopic Lumbar Discectomy via Transforaminal Approach: A Retrospective Study

by Feifei Chen, Guihe Yang, Jinjin Wang, Zhongpeng Ge, Heran Wang, Yifei Guo, Heng Yang, Xingzhi Jing, Xiaoyang Liu and Xingang Cui

J. Pers. Med. 2023, 13(3), 552; https://doi.org/10.3390/jpm13030552 - 20 Mar 2023

Cited by 1 | Viewed by 2046

Abstract

Objective: To define the characteristics of Mini LDH, develop new diagnostic references and examine the clinical efficacy of percutaneous endoscopic lumbar discectomy via a transforaminal approach (TF-PELD) for it. Methods: A total of 72 patients who underwent TF-PELD with Mini LDH from September [...] Read more.

Objective: To define the characteristics of Mini LDH, develop new diagnostic references and examine the clinical efficacy of percutaneous endoscopic lumbar discectomy via a transforaminal approach (TF-PELD) for it. Methods: A total of 72 patients who underwent TF-PELD with Mini LDH from September 2019 to October 2022 were enrolled in this retrospective study. The patients’ basic information, symptoms, number of outpatient visits, duration of conservative treatment, physical examination findings and so on were obtained from the medical records. Clinical effects of TF-PELD for Mini LDH were assessed by means of the following: the Visual Analog Scale (VAS) for low back pain (LBP) and leg pain, Oswestry Disability Index (ODI) for functional status assessment and Modified Mac Nab criteria for patient satisfaction. Results: Mini LDH have specific clinical characteristics and imaging features. All included patients achieved obvious pain relief after TF-PELD surgery. Pain scores were repeated at postoperative day 1 and 1, 3, 6, 12 and 24 months later. Results were statistically analyzed. The average VAS-Back, VAS-Leg and ODI scores were all significantly reduced at the first postoperative day and gradually decreased with the follow-up time continuing. In total, 66 out of 72 patients received an excellent or good recovery and no poor result was reported according to the Modified Mac Nab criteria. Conclusions: Mini LDH is a type of LDH with special characteristics and in need of correct diagnosis and active treatment in clinical work. TF-PELD was also found to be an effective procedure for the treatment of Mini LDH. Full article

(This article belongs to the Special Issue The Path to Personalized Pain Management)

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9 pages, 3392 KiB

Open AccessTechnical Note

Early Reduction of the Posterior Column: A Surgical Technique in AO/OTA C3 Tibial Pilon Fractures

by Yanchun Gao, Hongyi Zhu, Yanjie Guo and Xingang Yu

J. Pers. Med. 2023, 13(3), 551; https://doi.org/10.3390/jpm13030551 - 20 Mar 2023

Cited by 1 | Viewed by 1677

Abstract

Staged treatment for pilon fractures is widely accepted. It remains to be discussed how to reduce and fix posterior column fractures while avoiding clinical complications. We provided a staged treatment protocol with detailed surgical techniques for closed AO Foundation/Orthopaedic Trauma Association (AO/OTA) C3 [...] Read more.

Staged treatment for pilon fractures is widely accepted. It remains to be discussed how to reduce and fix posterior column fractures while avoiding clinical complications. We provided a staged treatment protocol with detailed surgical techniques for closed AO Foundation/Orthopaedic Trauma Association (AO/OTA) C3 tibial pilon fractures with fibular fractures. In the first stage, the internal fixation of the fibula and distal tibial posterior column is accompanied by an external fixator. After swelling, the medial and anterior columns were fixed via the posteromedial approach in the second stage. We advocate early reduction and fixation of the posterior column and lateral column. The right timing of surgery can ensure well-reduced articular surface and alignment while minimizing soft tissue complications. Full article

(This article belongs to the Special Issue Personalized Management in Orthopedics and Traumatology)

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16 pages, 6919 KiB

Open AccessArticle

High-Throughput Sequencing Reveals That Rotundine Inhibits Colorectal Cancer by Regulating Prognosis-Related Genes

by Lingyu Huang, Tongxiang Zou, Wenken Liang, Chune Mo, Jianfen Wei, Yecheng Deng and Minglin Ou

J. Pers. Med. 2023, 13(3), 550; https://doi.org/10.3390/jpm13030550 - 20 Mar 2023

Cited by 1 | Viewed by 1513

Abstract

Background: Rotundine is an herbal medicine with anti-cancer effects. However, little is known about the anti-cancer effect of rotundine on colorectal cancer. Therefore, our study aimed to investigate the specific molecular mechanism of rotundine inhibition of colorectal cancer. Methods: MTT and cell scratch [...] Read more.

Background: Rotundine is an herbal medicine with anti-cancer effects. However, little is known about the anti-cancer effect of rotundine on colorectal cancer. Therefore, our study aimed to investigate the specific molecular mechanism of rotundine inhibition of colorectal cancer. Methods: MTT and cell scratch assay were performed to investigate the effects of rotundine on the viability, migration, and invasion ability of SW480 cells. Changes in cell apoptosis were analyzed by flow cytometry. DEGs were detected by high-throughput sequencing after the action of rotundine on SW480 cells, and the DEGs were subjected to function enrichment analysis. Bioinformatics analyses were performed to screen out prognosis-related DEGs of COAD. Followed by enrichment analysis of prognosis-related DEGs. Furthermore, prognostic models were constructed, including ROC analysis, risk curve analysis, PCA and t-SNE, Nomo analysis, and Kaplan–Meier prognostic analysis. Results: In this study, we showed that rotundine concentrations of 50 μM, 100 μM, 150 μM, and 200 μM inhibited the proliferation, migration, and invasion of SW480 cells in a time- and concentration-dependent manner. Rotundine does not induce SW480 cell apoptosis. Compared to the control group, high-throughput results showed that there were 385 DEGs in the SW480 group. And DEGs were associated with the Hippo signaling pathway. In addition, 16 of the DEGs were significantly associated with poorer prognosis in COAD, with MEF2B, CCDC187, PSD2, RGS16, PLXDC1, HELB, ASIC3, PLCH2, IGF2BP3, CLHC1, DNHD1, SACS, H1-4, ANKRD36, and ZNF117 being highly expressed in COAD and ARV1 being lowly expressed. Prognosis-related DEGs were mainly enriched in cancer-related pathways and biological functions, such as inositol phosphate metabolism, enterobactin transmembrane transporter activity, and enterobactin transport. Prognostic modeling also showed that these 16 DEGs could be used as predictors of overall survival prognosis in COAD patients. Conclusions: Rotundine inhibits the development and progression of colorectal cancer by regulating the expression of these prognosis-related genes. Our findings could further provide new directions for the treatment of colorectal cancer. Full article

(This article belongs to the Special Issue Bioinformatics and Medicine)

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10 pages, 2301 KiB

Open AccessCase Report

The Flipping-Wedge Osteotomy: How 3D Virtual Surgical Planning (VSP) Suggested a Simple and Promising Type of Osteotomy in Pediatric Post-Traumatic Forearm Deformity

by Alessandro Depaoli, Grazia Chiara Menozzi, Giovanni Luigi Di Gennaro, Marco Ramella, Giulia Alessandri, Leonardo Frizziero, Alfredo Liverani, Daniela Martinelli, Gino Rocca and Giovanni Trisolino

J. Pers. Med. 2023, 13(3), 549; https://doi.org/10.3390/jpm13030549 - 19 Mar 2023

Cited by 1 | Viewed by 1959

Abstract

(1) Background: The application of computer-aided planning in the surgical treatment of post-traumatic forearm deformities has been increasingly widening the range of techniques over the last two decades. We present the “flipping-wedge osteotomy”, a promising geometrical approach to correct uniapical deformities defined during [...] Read more.

(1) Background: The application of computer-aided planning in the surgical treatment of post-traumatic forearm deformities has been increasingly widening the range of techniques over the last two decades. We present the “flipping-wedge osteotomy”, a promising geometrical approach to correct uniapical deformities defined during our experience with virtual surgical planning (VSP); (2) Methods: a case of post-traumatic distal radius deformity (magnitude 43°) treated with a flipping-wedge osteotomy in an 11-year-old girl is reported, presenting the planning rationale, its geometrical demonstration, and the outcome of the procedure; (3) Results: surgery achieved correction of both the angular and rotational deformities with a neutral ulnar variance; (4) Conclusions: flipping-wedge osteotomy may be a viable option to achieve correction in forearm deformities, and it deserves further clinical investigation. Full article

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13 pages, 2115 KiB

Open AccessCase Report

Multiple Metastases of Parathyroid and Papillary Thyroid Carcinoma in a Female Patient Treated with Long-Term Hemodialysis

by Julia Krupinova, Ekaterina Kim, Anna Eremkina, Lilia Urusova, Iya Voronkova, Konstantin Slaschuk, Ekaterina Dobreva and Natalia Mokrysheva

J. Pers. Med. 2023, 13(3), 548; https://doi.org/10.3390/jpm13030548 - 19 Mar 2023

Cited by 1 | Viewed by 1596

Abstract

Parathyroid cancer is a rare, clinically aggressive malignancy with a prevalence of approximately 0.005% relative to all carcinoma cases and 1–5% among patients with primary hyperparathyroidism. Prognosis largely depends on the extent of the primary surgery. Non-radical surgical treatment increases the risk of [...] Read more.

Parathyroid cancer is a rare, clinically aggressive malignancy with a prevalence of approximately 0.005% relative to all carcinoma cases and 1–5% among patients with primary hyperparathyroidism. Prognosis largely depends on the extent of the primary surgery. Non-radical surgical treatment increases the risk of local and distant metastases of the parathyroid cancer associated with limited treatment options. The combination of thyroid and parathyroid disorders has been described rather well for the general population; however, cases of parathyroid and thyroid carcinoma in the same patient are extremely rare (1 case per 3000 patients with parathyroid disorders). We present a rare clinical case of combination of parathyroid and thyroid cancers with metastases of both tumors to the neck lymph nodes in a woman with a mutation in the MEN1 gene (NM_130799.2): c.658T > C p.Trp220Arg (W220R), who has been exposed to radiation for 20 years before diagnosis of thyroid cancer and received renal replacement therapy with long-term hemodialysis before the diagnosis of parathyroid cancer. The patient underwent several surgeries because of metastases of the parathyroid cancer in the neck lymph nodes. Surgeons used intraoperative navigation methods (single-channel gamma detection probe, Gamma Probe 2, and fluorescence angiography with indocyanine green (ICG)) to clarify the volume of surgery. Currently, the patient is still in laboratory remission, despite the structural recurrence of tumors. Full article

(This article belongs to the Special Issue Biomarkers, Therapeutic Opportunities and Tumor Microenvironment in Solid and Hematological Tumors: Past, Present, and Future)

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12 pages, 1814 KiB

Open AccessEditor’s ChoiceArticle

Generative Adversarial Networks Can Create High Quality Artificial Prostate Cancer Magnetic Resonance Images

by Isaac R. L. Xu, Derek J. Van Booven, Sankalp Goberdhan, Adrian Breto, Joao Porto, Mohammad Alhusseini, Ahmad Algohary, Radka Stoyanova, Sanoj Punnen, Anton Mahne and Himanshu Arora

J. Pers. Med. 2023, 13(3), 547; https://doi.org/10.3390/jpm13030547 - 18 Mar 2023

Cited by 4 | Viewed by 2711

Abstract

The recent integration of open-source data with machine learning models, especially in the medical field, has opened new doors to studying disease progression and/or regression. However, the ability to use medical data for machine learning approaches is limited by the specificity of data [...] Read more.

The recent integration of open-source data with machine learning models, especially in the medical field, has opened new doors to studying disease progression and/or regression. However, the ability to use medical data for machine learning approaches is limited by the specificity of data for a particular medical condition. In this context, the most recent technologies, like generative adversarial networks (GANs), are being looked upon as a potential way to generate high-quality synthetic data that preserve the clinical variability of a condition. However, despite some success, GAN model usage remains largely minimal when depicting the heterogeneity of a disease such as prostate cancer. Previous studies from our group members have focused on automating the quantitative multi-parametric magnetic resonance imaging (mpMRI) using habitat risk scoring (HRS) maps on the prostate cancer patients in the BLaStM trial. In the current study, we aimed to use the images from the BLaStM trial and other sources to train the GAN models, generate synthetic images, and validate their quality. In this context, we used T2-weighted prostate MRI images as training data for Single Natural Image GANs (SinGANs) to make a generative model. A deep learning semantic segmentation pipeline trained the model to segment the prostate boundary on 2D MRI slices. Synthetic images with a high-level segmentation boundary of the prostate were filtered and used in the quality control assessment by participating scientists with varying degrees of experience (more than ten years, one year, or no experience) to work with MRI images. Results showed that the most experienced participating group correctly identified conventional vs. synthetic images with 67% accuracy, the group with one year of experience correctly identified the images with 58% accuracy, and the group with no prior experience reached 50% accuracy. Nearly half (47%) of the synthetic images were mistakenly evaluated as conventional. Interestingly, in a blinded quality assessment, a board-certified radiologist did not significantly differentiate between conventional and synthetic images in the context of the mean quality of synthetic and conventional images. Furthermore, to validate the usability of the generated synthetic images from prostate cancer MRIs, we subjected these to anomaly detection along with the original images. Importantly, the success rate of anomaly detection for quality control-approved synthetic data in phase one corresponded to that of the conventional images. In sum, this study shows promise that high-quality synthetic images from MRIs can be generated using GANs. Such an AI model may contribute significantly to various clinical applications which involve supervised machine-learning approaches. Full article

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

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11 pages, 1411 KiB

Open AccessArticle

Anti-VEGF Treatment of Diabetic Macular Edema in Denmark: Incidence, Burden of Therapy, and Forecasting Analyses

by Yousif Subhi, Ivan Potapenko, Javad Nouri Hajari and Morten la Cour

J. Pers. Med. 2023, 13(3), 546; https://doi.org/10.3390/jpm13030546 - 18 Mar 2023

Cited by 1 | Viewed by 1121

Abstract

Background: The aim of this study was to analyze demographically stratified incidence rates of patients with diabetic macular edema (DME) commenced in anti-VEGF therapy, to study temporal trends, to report the proportion of patients in active therapy over time, and to develop a [...] Read more.

Background: The aim of this study was to analyze demographically stratified incidence rates of patients with diabetic macular edema (DME) commenced in anti-VEGF therapy, to study temporal trends, to report the proportion of patients in active therapy over time, and to develop a model to forecast the future number of patients in active treatment. Methods: This was a retrospective registry-based study of all patients with DME who received at least one intravitreal anti-VEGF treatment from 1 January 2007 to 30 June 2022. Population data were extracted from Statistics Denmark. Results: This study included 2220 patients with DME who were commenced in anti-VEGF therapy. Demographic analyses revealed higher incidence rates among males than females and among those aged 60–80 years. The number of patients in active treatment followed an exponential decay curve; hence, this was used to mathematically model the number of patients in active therapy. The number of patients in active treatment is expected to stay relatively stable with a minimal increase until the year 2023. Conclusions: This study provides insight into the practical aspects of the anti-VEGF treatment of DME that allow the planning of adequate health services. Full article

(This article belongs to the Special Issue Diagnostics and Therapeutics in Ophthalmology)

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10 pages, 569 KiB

Open AccessCommunication

Anthropometric Features and Third-Fourth Degree Perineal Tears

by Arrigo Fruscalzo, Alice Novak, Camilla Somma, Anjeza Xholli, Virginia Michelerio, Federico Prefumo, Ambrogio P. Londero and Angelo Cagnacci

J. Pers. Med. 2023, 13(3), 545; https://doi.org/10.3390/jpm13030545 - 18 Mar 2023

Cited by 1 | Viewed by 1280

Abstract

The main objective of this study was to evaluate the association between maternal and fetal anthropometric characteristics and third- and fourth-degree perineal tears. This retrospective cohort study considered all consecutive pregnancies from 2011 to 2017 at a single Institution. The inclusion criteria were: [...] Read more.

The main objective of this study was to evaluate the association between maternal and fetal anthropometric characteristics and third- and fourth-degree perineal tears. This retrospective cohort study considered all consecutive pregnancies from 2011 to 2017 at a single Institution. The inclusion criteria were: singletons who delivered vaginally during the study period, the presence of information on maternal pre-pregnancy weight, maternal height, and weight of the newborn. The feto-maternal body-mass index (BMI) was calculated as neonatal weight in kg on maternal height in squared meters (kg/m²). In total, 5397 singleton-term pregnancies were included; the prevalence of third-fourth-degree perineal tears was 0.47%. The most predictive factors were: nulliparity, feto-maternal BMI, neonatal weight, gestational age at delivery, and neonatal head circumference. After adjustment in multivariate analysis, the only independent predictors were nulliparity and fetomaternal BMI. The AUC of the final multivariate model was 73.54% (95% CI 65.65–81.42). Furthermore, feto-maternal BMI and gestational age had a significant direct correlation. Nulliparity and feto-maternal BMI are the two best predictors for third and fourth-degree perineal tears in our setting. Confirming this association in future research and integrating it into a decision algorithm on delivery timing could reduce obstetric damage to the anal sphincter. Full article

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

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13 pages, 1592 KiB

Open AccessArticle

The Association of Intravitreal Injections of Different Anti-Vascular Endothelial Growth Factor with Systemic Outcomes in Diabetic Patients

by Eugene Yu-Chuan Kang, Tzu-Yi Lin, Sunir J. Garg, Nan-Kai Wang, Lee-Jen Chen, Pei-Wei Huang, Ming-Jen Chan, Kuan-Jen Chen, Wei-Chi Wu, Chi-Chun Lai and Yih-Shiou Hwang

J. Pers. Med. 2023, 13(3), 544; https://doi.org/10.3390/jpm13030544 - 18 Mar 2023

Cited by 1 | Viewed by 1511

Abstract

This retrospective cohort study aimed to assess the systemic effects of three commonly available anti-vascular endothelial growth factor intravitreal injections in patients with diabetes, using data taken from a multi-institutional database in Taiwan. Patient data were sourced from the multi-institutional Chang Gung Research [...] Read more.

This retrospective cohort study aimed to assess the systemic effects of three commonly available anti-vascular endothelial growth factor intravitreal injections in patients with diabetes, using data taken from a multi-institutional database in Taiwan. Patient data were sourced from the multi-institutional Chang Gung Research Database. Participants were divided into groups based on treatment with bevacizumab, ranibizumab, or aflibercept. Baseline characteristics were matched among the groups by the inverse probability of treatment weighting. The incidence rate of outcome events was calculated as the number of events divided by 100 person-years of follow-up. The cumulative incidence function was used to estimate the incidence rate of the outcome events among groups. The incidence of ischemic stroke was higher in the ranibizumab group than the bevacizumab and aflibercept groups (1.65, 0.92, and 0.61 per 100 person-years, respectively). The incidence of major adverse lower-limb events was higher in the bevacizumab group (2.95), followed by ranibizumab (2.00) and aflibercept (0.74). Major bleeding was relatively higher in bevacizumab (12.1) compared to ranibizumab (4.3) and aflibercept (3.8). All-cause death was higher for both bevacizumab (3.26) and aflibercept (2.61) when compared to ranibizumab (0.55), and all-cause admission was found to be highest with bevacizumab (58.6), followed by aflibercept (30.2), and ranibizumab (27.6). The bevacizumab group demonstrated a greater decrease in glycated hemoglobin compared to the baseline level (−0.33%). However, a few differences in the clinical condition between the groups were still observed after matching. In conclusion, this study suggests that different anti-vascular endothelial growth factor agents may be associated with various and differing systemic adverse events. The differences might also be attributed to differences in patient characteristics and clinical status. Full article

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

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12 pages, 5402 KiB

Open AccessArticle

Assessing the Impact of Transcutaneous Maxillary Distraction Osteogenesis on Pharyngeal Airway Volume in Children with Cleft Lip and Palate: A 3D Evaluation Study

by Chia-Hsuan Chan, Chi-Yu Tsai, Jui-Pin Lai, Shiu-Shiung Lin and Yu-Jen Chang

J. Pers. Med. 2023, 13(3), 543; https://doi.org/10.3390/jpm13030543 - 18 Mar 2023

Viewed by 1357

Abstract

Cleft lip and cleft palate (CLCP) patients often have a retrusive maxilla and a severe skeletal Class III malocclusion, which can result in velopharyngeal insufficiency (VPI). The aim of this study was to evaluate the changes in the volume of the 3D airway [...] Read more.

Cleft lip and cleft palate (CLCP) patients often have a retrusive maxilla and a severe skeletal Class III malocclusion, which can result in velopharyngeal insufficiency (VPI). The aim of this study was to evaluate the changes in the volume of the 3D airway in CLCP children after maxilla distraction using the transcutaneous maxillary distraction osteogenesis (TMDO) method. 15 children with bilateral or unilateral CLCP were included in the study. 3D CBCT images were taken before and after distraction and were segmented and reconstructed to create a 3D airway model. The airway was divided into three regions: the upper, oropharyngeal, and hypopharyngeal airway. Pearson correlation tests were used to assess correlations between volume changes and corresponding skeletal and dental landmark movements (Point N, ANS, A, B, Pog, U1, and L1). The results showed that the ANS point advanced 9.85 ± 3.60 mm, and the A point advanced 14.22 ± 4.57 mm. The total airway volume change increased by 2535.06 ± 2791.80 mm³. However, there was no significant correlation between the A/ANS/U1 and the three different airway regions. Only B/Pog/L1 showed a positive correlation with these airway regions, with a high correlation between B/Pog/L1 and the hypopharyngeal airway region. TMDO can result in greater anterior advancement of the maxilla and an increase in airway volume, but the changes in bony landmarks did not show a strong positive correlation with the increase in airway volume as expected. Further investigation is needed to analyze the influence of surrounding soft tissue on the changes in airway volume. Full article

(This article belongs to the Special Issue Epidemiology: An Important Science of Public Health and Disease)

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9 pages, 1691 KiB

Open AccessArticle

Bibliometric Analysis of Research Relating to Perineal Pain Reported over the Period 1981 to 2021

by Huang Ding, Qin Chen, Huiming Zhan, Yifan Jia, Juan Ren and Jishi Ye

J. Pers. Med. 2023, 13(3), 542; https://doi.org/10.3390/jpm13030542 - 17 Mar 2023

Cited by 1 | Viewed by 1197

Abstract

Background: Perineal pain is a painful neuropathic condition, which does not have a standard diagnostic or treatment approach. As such, we sought to evaluate the global scientific output of research into perineal pain and explore trends from 1981 to 2021 using bibliometric methods. [...] Read more.

Background: Perineal pain is a painful neuropathic condition, which does not have a standard diagnostic or treatment approach. As such, we sought to evaluate the global scientific output of research into perineal pain and explore trends from 1981 to 2021 using bibliometric methods. Methods: Articles on perineal pain were retrieved from the Web of Science (WoS) database. We analyzed the content and quality of publications from within the specified timeframe. We also utilized VOSviewer to mine and cluster data from retrieved articles. Results: A total of 1917 articles were collected. The number of related papers published increased year by year. Articles were most frequently published by authors in the United States and France. Although the US remains at the center of this field, publications from China have become more frequent in recent years. We also found that French academic institutions dominate the field of perineal pain, and Jean-Jacques Labat from Nantes Universite is the most published author in the field. “Episiotomy”, “pain”, “management”, “prostatectomy”, “pelvic pain”, and “complication” were frequently cited as keywords. Conclusion: The increasing number of publications each year indicates that perineal pain has gained more attention as an important research topic. Full article

(This article belongs to the Special Issue The Path to Personalized Pain Management)

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14 pages, 1796 KiB

Open AccessArticle

Intraoperative Hypertension Is Associated with Postoperative Acute Kidney Injury after Laparoscopic Surgery

by Yongzhong Tang, Bo Li, Wen Ouyang, Guiping Jiang, Hongjia Tang and Xing Liu

J. Pers. Med. 2023, 13(3), 541; https://doi.org/10.3390/jpm13030541 - 17 Mar 2023

Cited by 2 | Viewed by 1380

Abstract

Background: It is well demonstrated that intraoperative blood pressure is associated with postoperative acute kidney injury (AKI); however, the association between severity and duration of abnormal intraoperative blood pressure (BP) with AKI in patients undergoing laparoscopic surgery remains unknown. Methods: This retrospective cohort [...] Read more.

Background: It is well demonstrated that intraoperative blood pressure is associated with postoperative acute kidney injury (AKI); however, the association between severity and duration of abnormal intraoperative blood pressure (BP) with AKI in patients undergoing laparoscopic surgery remains unknown. Methods: This retrospective cohort study included 12,414 patients aged ≥ 18 years who underwent a single elective laparoscopic abdominal surgery during hospitalization between October 2011 and April 2017. Multivariate stepwise logistic regressions were applied to determine the correlation between the severity and duration of intraoperative mean arterial pressure (MAP, (systolic BP + 2 × diastolic BP)/3), acute intraoperative hypertension (IOTH) and postoperative AKI, in different periods of surgery. Results: A total of 482 hospitalized patients (3.9%) developed surgery-related AKI. Compared with those without IOTH or with preoperative mean MAP (80–85 mmHg), acute elevated IOTH (odds ratio, OR, 1.4, 95% CI, 1.1 to 1.7), mean MAP 95–100 mmHg (OR, 1.8; 95% CI, 1.3 to 2.7), MAP 100–105 mmHg (OR, 2.4; 95% CI, 1.6 to 3.8), and more than 105 mmHg (OR, 1.9; 95% CI, 1.1 to 3.3) were independent of other risk factors in a diverse cohort undergoing laparoscopic surgery. In addition, the risk of postoperative AKI appeared to result from long exposure (≥20 min) to IOTH (OR, 1.9; 95% CI, 1.5 to 2.5) and MAP ≥ 115 mmHg (OR, 2.2; 95% CI, 1.6 to 3.0). Intraoperative hypotension was not found to be associated with AKI in laparoscopic surgery patients. Conclusions: Postoperative AKI correlates positively with intraoperative hypertension in patients undergoing laparoscopic surgery. These findings provide an intraoperative evaluation criterion to predict the occurrence of postoperative AKI. Full article

(This article belongs to the Special Issue Novel Challenges and Advances in Anesthesiology and Pain Management)

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