Journal of Personalized Medicine

8 pages, 250 KiB

Open AccessCommunication

Contrast-Induced Acute Kidney Injury and Endothelial Dysfunction: The Role of Vascular and Biochemical Parameters

by Adolfo Marco Perrotta, Antonietta Gigante, Silverio Rotondi, Paolo Menè, Adriano Notturni, Stefano Schiavetto, Gaetano Tanzilli, Chiara Pellicano, Giuseppe Guaglianone, Francesca Tinti, Paolo Palange, Sandro Mazzaferro, Rosario Cianci and Silvia Lai

J. Pers. Med. 2023, 13(4), 701; https://doi.org/10.3390/jpm13040701 - 21 Apr 2023

Cited by 2 | Viewed by 1352

Abstract

Introduction: Contrast-induced acute kidney injury (CIAKI) is one of the main causes of acute renal failure in hospitalized patients, following the administration of iodinated contrast medium used for CT scans and angiographic procedures. CIAKI determines a high cardiovascular risk and appears to be [...] Read more.

Introduction: Contrast-induced acute kidney injury (CIAKI) is one of the main causes of acute renal failure in hospitalized patients, following the administration of iodinated contrast medium used for CT scans and angiographic procedures. CIAKI determines a high cardiovascular risk and appears to be one of the most feared complications of coronary angiography, causing a notable worsening of the prognosis with high morbidity and mortality. Aim: To evaluate a possible association between the renal resistive index (RRI) and the development of CIAKI, as well as an association with the main subclinical markers of atherosclerosis and the main cardiovascular risk factors. Materials and Methods: We enrolled 101 patients with an indication for coronary angiography. Patients underwent an assessment of renal function (serum nitrogen and basal creatinine, 48 and 72 h after administration of contrast medium), inflammation (C reactive protein (CRP), serum calcium and phosphorus, intact parathormone (iPTH), 25-hydroxyvitaminD (25-OH-VitD), serum uric acid (SUA), total cholesterol, serum triglycerides, serum glucose and insulin). All patients also carried out an evaluation of RRI, intima-media thickness (IMT), interventricular septum (IVS) and the ankle-brachial index (ABI). Results: 101 patients (68 male), with a mean age of 73.0 ± 15.0 years, were enrolled for the study; 35 are affected by type 2 diabetes mellitus. A total of 19 cases of CIAKI were reported (19%), while among diabetic patients we reported an incidence of 23% (8 patients). In our study, patients with CIAKI had significantly higher RRI (p < 0.001) and IMT (p < 0.001) with respect to the patients who did not develop CIAKI. Furthermore, patients with CIAKI had significantly higher CRP (p < 0.001) and SUA (p < 0.006). Conclusions: We showed a significant difference in RRI, IMT, SUA and CRP values between the population developing CIAKI and patients without CIAKI. This data appears relevant considering that RRI and IMT are low-cost, non-invasive and easily reproducible markers of endothelial dysfunction and atherosclerosis. Full article

(This article belongs to the Special Issue New Biomarkers for Diagnosis and Therapy in Civilization Diseases)

13 pages, 1604 KiB

Open AccessArticle

Transcription Factor ATF3 Participates in DeltaNp63-Mediated Proliferation of Corneal Epithelial Cells

by Yi-Jen Hsueh, Yaa-Jyuhn James Meir, Hui-Yi Hsiao, Chao-Min Cheng, Hui-Kang David Ma, Wei-Chi Wu and Hung-Chi Chen

J. Pers. Med. 2023, 13(4), 700; https://doi.org/10.3390/jpm13040700 - 21 Apr 2023

Cited by 1 | Viewed by 1427

Abstract

Understanding the regulatory mechanisms underlying corneal epithelial cell (CEC) proliferation in vitro may provide the means to boost CEC production in cell therapy for ocular disorders. The transcription factor ΔNp63 plays a crucial role in the proliferation of CECs, but the underlying mechanisms [...] Read more.

Understanding the regulatory mechanisms underlying corneal epithelial cell (CEC) proliferation in vitro may provide the means to boost CEC production in cell therapy for ocular disorders. The transcription factor ΔNp63 plays a crucial role in the proliferation of CECs, but the underlying mechanisms is yet to be elucidated. TP63 and ΔNp63 are encoded by the TP63 gene via alternative promoters. We previously reported that both ΔNp63 and activating transcription factor (ATF3) are substantially expressed in cultured CECs, but the regulatory relationship between ΔNp63 and ATF3 is unknown. In the present study, we found that ΔNp63 increased ATF3 expression and ATF3 promoter activity in cultured CECs. The deletion of the p63 binding core site reduced ATF3 promoter activity. CECs overexpressing ATF3 exhibited significantly greater proliferation than control CECs. ATF3 knockdown suppressed the ΔNp63-induced increase in cell proliferation. Overexpression of ATF3 in CECs significantly elevated protein and mRNA levels of cyclin D. The protein levels of keratin 3/14, integrin β1, and involucrin did not differ between ATF3-overexpressing CECs, ATF3-downregulated CECs, and control cells. In conclusion, our results suggest that ΔNp63 increases CEC proliferation via the ΔNp63/ATF3/CDK pathway. Full article

(This article belongs to the Special Issue Clinical and Translational Research in Ophthalmology)

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11 pages, 1646 KiB

Open AccessReview

SARS-CoV-2 Footprints in the Placenta: What We Know after Three Years of the Pandemic

by Valentina Tosto, Arun Meyyazhagan, Malek Alqasem, Valentina Tsibizova and Gian Carlo Di Renzo

J. Pers. Med. 2023, 13(4), 699; https://doi.org/10.3390/jpm13040699 - 21 Apr 2023

Cited by 4 | Viewed by 2960

Abstract

As the COVID-19 pandemic continues into its third year, there is accumulating evidence on the consequences of maternal infection. Emerging data indicate increased obstetrics risks, including maternal complications, preterm births, impaired intrauterine fetal growth, hypertensive disorders, stillbirth, gestational diabetes, and a risk of [...] Read more.

As the COVID-19 pandemic continues into its third year, there is accumulating evidence on the consequences of maternal infection. Emerging data indicate increased obstetrics risks, including maternal complications, preterm births, impaired intrauterine fetal growth, hypertensive disorders, stillbirth, gestational diabetes, and a risk of developmental defects in neonates. Overall, controversial concerns still exist regarding the potential for vertical transmission. Histopathological examination of the placenta can represent a useful instrument for investigation and can contribute significant information regarding the possible immunohistopathological mechanisms involved in developing unfavorable perinatal outcomes. Based on current evidence, SARS-CoV-2 infection can affect placental tissue by inducing several specific changes. The level of placental involvement is considered one of the determining factors for unfavorable outcomes during pregnancy due to inflammation and vascular injuries contributing to complex cascade immunological and biological events; however, available evidence does not indicate a strong and absolute correlation between maternal infection, placental lesions, and obstetric outcomes. As existing studies are still limited, we further explore the placenta at three different levels, using histology, immunohistochemistry, and molecular genetics to understand the epidemiological and virological changes observed in the ongoing pandemic. Full article

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

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11 pages, 1703 KiB

Open AccessArticle

MRI Characteristics and Alterations in Patellar Height in Patients with Patellar Tendinopathy—A Retrospective Study

by Kim Loose, Sophie Pennekamp, Wolfgang Hitzl, Maximilian Willauschus, Johannes Rüther, Sandeep Silawal, Philipp Schuster, Hermann Josef Bail, Michael Millrose and Markus Geßlein

J. Pers. Med. 2023, 13(4), 698; https://doi.org/10.3390/jpm13040698 - 21 Apr 2023

Cited by 1 | Viewed by 1674

Abstract

(1) Background: Patellar tendinopathy (PT) is an overuse condition of the knee extensor mechanism characterized by ventral knee pain at the lower pole of the patella and limited functionality. (2) Methods: In this retrospective study, a group of patients with PT (n [...] Read more.

(1) Background: Patellar tendinopathy (PT) is an overuse condition of the knee extensor mechanism characterized by ventral knee pain at the lower pole of the patella and limited functionality. (2) Methods: In this retrospective study, a group of patients with PT (n = 41) was compared with a control group (n = 50) in terms of patient-related data and magnetic resonance imaging (MRI) characteristics. (3) Results: Patellar height was higher in the PT patient group and there was a significant difference in Caton–Deschamps index (CD) compared to the control group (p = 0.021). Patients with PT showed a lower patella–patellar tendon angle (PPTA) (p = 0.011). The patellar tendon thickness (PTT) in the proximal (PTTprox), middle (PTTmid) and distal (PTTdistal) part of the tendon was significantly thickened (p < 0.001). Increased signal intensity in MRI was detected in symptomatic tendons over 6 months compared to a duration of less than 6 months (p = 0.025). A significant relationship between the PTTprox and an increased signal intensity was observed (p < 0.001). (4) Conclusions: Patients with PT showed a significant difference in the patellar height and PPTA. With persistence of symptoms over 6 months, MRI seems suitable to detect the morphologic tendon changes and further identify patients suitable for surgical procedures. Full article

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

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19 pages, 811 KiB

Open AccessEditor’s ChoiceSystematic Review

Investigating the Role of Maintenance TMS Protocols for Major Depression: Systematic Review and Future Perspectives for Personalized Interventions

by Giacomo d’Andrea, Gianluca Mancusi, Maria Chiara Santovito, Carlotta Marrangone, Fabrizio Martino, Mario Santorelli, Andrea Miuli, Francesco Di Carlo, Maria Salvina Signorelli, Massimo Clerici, Mauro Pettorruso and Giovanni Martinotti

J. Pers. Med. 2023, 13(4), 697; https://doi.org/10.3390/jpm13040697 - 21 Apr 2023

Cited by 6 | Viewed by 2664

Abstract

Repetitive Transcranial Magnetic Stimulation (rTMS) has been approved by the FDA as an effective intervention for Treatment-Resistant Depression (TRD). However, there is little evidence about maintenance protocol necessity. The aim of this systematic review is to identify, characterize, and evaluate the current maintenance [...] Read more.

Repetitive Transcranial Magnetic Stimulation (rTMS) has been approved by the FDA as an effective intervention for Treatment-Resistant Depression (TRD). However, there is little evidence about maintenance protocol necessity. The aim of this systematic review is to identify, characterize, and evaluate the current maintenance TMS protocols for MDD and TRD patients who have received acute treatment. A literature search was conducted following the PRISMA guidelines of 2015 on PubMed, Scopus, and Web of Science databases for publications up to March 2022. Fourteen articles were included. High protocol heterogeneity was observed. Most studies highlighted significant efficacy of maintenance protocols in decreasing relapse risk, suggesting that administering two or fewer stimulations per month is ineffective in sustaining an antidepressant effect or in reducing the risk of relapse in responder patients. The risk of relapse was most pronounced after five months from the acute treatment. Maintenance TMS appears to be a resourceful strategy to maintain acute antidepressant treatment effects, significantly reducing relapse risk. The ease of administering and the ability to monitor treatment adherence should be considered when evaluating the future use of maintenance TMS protocols. Further studies are needed to clarify the clinical relevance of overlapping acute TMS effects with maintenance protocols and to evaluate their long-term effectiveness. Full article

(This article belongs to the Special Issue Biomarkers in Psychiatric Disorders)

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8 pages, 2658 KiB

Open AccessCase Report

Uroperitoneum as a Complication of Laparoscopic Cholecystectomy: A Case Report

by Charalampos Kefalas, Alexandra Menni, Eleni Karlafti, Stavros Panidis, Georgios Chatziantoniou, Konstantina Katsiafliaka, Despina Krokou, Aristeidis Ioannidis, Patroklos Goulas, Smaro Netta and Daniel Paramythiotis

J. Pers. Med. 2023, 13(4), 696; https://doi.org/10.3390/jpm13040696 - 21 Apr 2023

Viewed by 1490

Abstract

Background: Bladder rupture is more frequently encountered in blunt pelvic trauma, but can also be spontaneous or iatrogenic. Laparoscopic repair has been widely used during the last few years as a treatment for intraperitoneal bladder perforation. The bladder is the genitourinary organ most [...] Read more.

Background: Bladder rupture is more frequently encountered in blunt pelvic trauma, but can also be spontaneous or iatrogenic. Laparoscopic repair has been widely used during the last few years as a treatment for intraperitoneal bladder perforation. The bladder is the genitourinary organ most often affected by iatrogenic injury. The purpose of this article is to report what is, to our knowledge, the first documented case of bladder rupture as a complication of laparoscopic cholecystectomy. Case description: A 51-year-old female presented to the emergency department complaining about generalized abdominal pain on the sixth postoperative day after laparoscopic cholecystectomy. Laboratory results highlighted a significant impact on renal function while the abdominal CT scan demonstrated free intraperitoneal fluid collection and surgical clips in the anatomic region of the liver and in an ectopic position near the ileocecal valve. An explorative laparoscopy revealed a 2 cm defect in the superior bladder wall, which was repaired in one layer in a continuous-locking fashion. The patient was discharged home on the fifth postoperative day having an uneventful recovery. Conclusion: Bladder rupture frequently presents with non-specific clinical signs; as a result, it is easily misdiagnosed, especially when it occurs with a non-typical mechanism of injury. Pseudorenal failure is a relatively obscure entity that may help the clinician suspect a bladder perforation. Laparoscopic repair with a single-layer continuous suture technique is a safe and feasible treatment in hemodynamically stable patients. Prospective research is required to specify the optimal timing of catheter removal after bladder repair. Full article

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

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13 pages, 646 KiB

Open AccessReview

Bortezomib Pharmacogenetic Biomarkers for the Treatment of Multiple Myeloma: Review and Future Perspectives

by Antonio Sanz-Solas, Jorge Labrador, Raquel Alcaraz, Beatriz Cuevas, Raquel Vinuesa, María Victoria Cuevas and Miriam Saiz-Rodríguez

J. Pers. Med. 2023, 13(4), 695; https://doi.org/10.3390/jpm13040695 - 20 Apr 2023

Cited by 1 | Viewed by 1477

Abstract

Multiple myeloma (MM) is a hematological neoplasm for which different chemotherapy treatments are used with several drugs in combination. One of the most frequently used drugs for the treatment of MM is the proteasome inhibitor bortezomib. Patients treated with bortezomib are at increased [...] Read more.

Multiple myeloma (MM) is a hematological neoplasm for which different chemotherapy treatments are used with several drugs in combination. One of the most frequently used drugs for the treatment of MM is the proteasome inhibitor bortezomib. Patients treated with bortezomib are at increased risk for thrombocytopenia, neutropenia, gastrointestinal toxicities, peripheral neuropathy, infection, and fatigue. This drug is almost entirely metabolized by cytochrome CYP450 isoenzymes and transported by the efflux pump P-glycoprotein. Genes encoding both enzymes and transporters involved in the bortezomib pharmacokinetic pathway are highly polymorphic. The response to bortezomib and the incidence of adverse drug reactions (ADRs) vary among patients, which could be due to interindividual variations in these possible pharmacogenetic biomarkers. In this review, we compiled all pharmacogenetic information relevant to the treatment of MM with bortezomib. In addition, we discuss possible future perspectives and the analysis of potential pharmacogenetic markers that could influence the incidence of ADR and the toxicity of bortezomib. It would be a milestone in the field of targeted therapy for MM to relate potential biomarkers to the various effects of bortezomib on patients. Full article

(This article belongs to the Special Issue Precision Medicine Genomics: Pharmacogenomics)

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19 pages, 349 KiB

Open AccessReview

Utilization of Circulating Tumor Cells in the Management of Solid Tumors

by Peter C. Kurniali, Michael H. Storandt and Zhaohui Jin

J. Pers. Med. 2023, 13(4), 694; https://doi.org/10.3390/jpm13040694 - 20 Apr 2023

Cited by 2 | Viewed by 1694

Abstract

Circulating tumor cells (CTCs) are tumor cells shed from the primary tumor into circulation, with clusters of CTCs responsible for cancer metastases. CTC detection and isolation from the bloodstream are based on properties distinguishing CTCs from normal blood cells. Current CTC detection techniques [...] Read more.

Circulating tumor cells (CTCs) are tumor cells shed from the primary tumor into circulation, with clusters of CTCs responsible for cancer metastases. CTC detection and isolation from the bloodstream are based on properties distinguishing CTCs from normal blood cells. Current CTC detection techniques can be divided into two main categories: label dependent, which depends upon antibodies that selectively bind cell surface antigens present on CTCs, or label-independent detection, which is detection based on the size, deformability, and biophysical properties of CTCs. CTCs may play significant roles in cancer screening, diagnosis, treatment navigation, including prognostication and precision medicine, and surveillance. In cancer screening, capturing and evaluating CTCs from peripheral blood could be a strategy to detect cancer at its earliest stage. Cancer diagnosis using liquid biopsy could also have tremendous benefits. Full utilization of CTCs in the clinical management of malignancies may be feasible in the near future; however, several challenges still exist. CTC assays currently lack adequate sensitivity, especially in early-stage solid malignancies, due to low numbers of detectable CTCs. As assays improve and more trials evaluate the clinical utility of CTC detection in guiding therapies, we anticipate increased use in cancer management. Full article

10 pages, 779 KiB

Open AccessArticle

Voiding Dysfunction Due to Urethral Sphincter Dysfunction Might Be an Early Neurological Presentation of Central Nervous System Disorders in Aged Patients

by Guan-Ru Ho, Chiao-Wen Wei and Hann-Chorng Kuo

J. Pers. Med. 2023, 13(4), 693; https://doi.org/10.3390/jpm13040693 - 20 Apr 2023

Cited by 2 | Viewed by 1384

Abstract

Purpose: To investigate the incidence of central nervous system (CNS) diseases in adult patients with voiding dysfunction and videourodynamics (VUDS) proven urethral sphincter dysfunction. Methods: This retrospective analysis reviewed the medical charts of patients aged > 60 years who underwent VUDS for non-prostatic [...] Read more.

Purpose: To investigate the incidence of central nervous system (CNS) diseases in adult patients with voiding dysfunction and videourodynamics (VUDS) proven urethral sphincter dysfunction. Methods: This retrospective analysis reviewed the medical charts of patients aged > 60 years who underwent VUDS for non-prostatic voiding dysfunction from 2006 to 2021. A chart review was performed to search for the occurrence and treatment of CNS diseases after the VUDS examination up to 2022. The diagnosis of CNS disease, such as cerebrovascular accidents (CVA), Parkinson’s disease (PD), and dementia, by neurologists was also retrieved from the charts. Based on the VUDS findings, patients were divided into the following subgroups: dysfunctional voiding (DV), poor relaxation of the external sphincter (PRES), and hypersensitive bladder (HSB) and coordinated sphincter subgroups. The incidence of CVA, PD, and dementia in each subgroup was recorded and compared among them using one-way analysis of variance (ANOVA). Results: A total of 306 patients were included. VUDS examinations revealed DV in 87 patients, PRES in 108, and HSB in 111. Among them, 36 (11.8%) patients had CNS disease, including CVA in 23 (7.5%), PD in 4 (1.3%), and dementia in 9 (2.9%). Among the three subgroups, the DV group had the highest incidence rate of CNS disease (n = 16, 18.4%), followed by PRES (n = 12, 11.1%) and HSB (n = 8, 7.2%). However, no significant difference was noted in the incidence of CNS disease across the three subgroups. Nevertheless, the incidence of CNS disease was higher in patients with DV and PRES than that in the general population. Conclusions: The incidence of CNS diseases was high in patients aged > 60 years with voiding dysfunction due to urethral sphincter dysfunction. Patients with VUDS-confirmed DV had the highest incidence of CNS disease among the three subgroups. Full article

(This article belongs to the Topic Clinical, Translational, Basic Researches, and Application of Bacterial Toxins on Bladder Diseases and Lower Urinary Tract Dysfunctions)

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12 pages, 3998 KiB

Open AccessArticle

Radiation Exposure and Frequency of Dental, Bitewing and Occlusal Radiographs in Children and Adolescents

by Ina Manuela Schüler, Christoph-Ludwig Hennig, Rika Buschek, Rebecca Scherbaum, Collin Jacobs, Marcel Scheithauer and Hans-Joachim Mentzel

J. Pers. Med. 2023, 13(4), 692; https://doi.org/10.3390/jpm13040692 - 20 Apr 2023

Cited by 4 | Viewed by 3583

Abstract

Dental radiographs are valuable diagnostic aids for oral healthcare, but exposure to ionizing radiation carries health risks, especially in children due to their high radio-sensitivity. Valid reference values for intraoral radiographs in children and adolescents are still missing. This study aimed to investigate [...] Read more.

Dental radiographs are valuable diagnostic aids for oral healthcare, but exposure to ionizing radiation carries health risks, especially in children due to their high radio-sensitivity. Valid reference values for intraoral radiographs in children and adolescents are still missing. This study aimed to investigate the radiation dose values and underlying justifications of dental, bitewing and occlusal X-rays in children and adolescents. Data from routinely executed intraoral radiographs between 2002 and 2020 with conventional and digital tube-heads were extracted from the Radiology Information System. The effective exposure was calculated from technical parameters and statistical tests performed. A total number of 4455 intraoral (3128 dental, 903 bitewing and 424 occlusal) radiographs were investigated. For dental and bitewing radiographs, the dose area product (DAP) was 2.57 cGy × cm² and the effective dose (ED) 0.77 µSv. For occlusal radiographs, the DAP was 7.43 cGy × cm² and the ED 2.22 µSv. Overall, 70.2% of all intraoral radiographs were dental, 20.3% bitewing and 9.5% occlusal radiographs. The most frequent indication for intraoral radiographs was trauma (28.7%), followed by caries (22.7%) and apical diagnostics (22.7%). Moreover, 59.7% of all intraoral radiographs were taken in boys, especially for trauma (66.5%) and endodontics (67.2%) (p ≤ 0.00). Girls were significantly more frequently X-rayed for caries diagnostics than boys (28.1% vs. 19.1%, p ≤ 0.00). The average ED of 0.77 µSv for intraoral dental and bitewing radiographs in this study was within the range of other reported values. The technical parameters of the X-ray devices were found at the lowest recommended levels to best limit the radiation exposure and to assure acceptable diagnostic efficacy. Intraoral radiographs were performed predominantly for trauma, caries and apical diagnostics—reflecting general recommendations for the use of X-rays in children. For improved quality assurance and radiation protection, further studies are necessary to determine the meaningful dose reference level (DRL) for children. Full article

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15 pages, 1770 KiB

Open AccessFeature PaperArticle

Early and Late Response and Glucocorticoid-Sparing Effect of Belimumab in Patients with Systemic Lupus Erythematosus with Joint and Skin Manifestations: Results from the Belimumab in Real Life Setting Study—Joint and Skin (BeRLiSS-JS)

by Margherita Zen, Mariele Gatto, Roberto Depascale, Francesca Regola, Micaela Fredi, Laura Andreoli, Franco Franceschini, Maria Letizia Urban, Giacomo Emmi, Fulvia Ceccarelli, Fabrizio Conti, Alessandra Bortoluzzi, Marcello Govoni, Chiara Tani, Marta Mosca, Tania Ubiali, Maria Gerosa, Enrica P. Bozzolo, Valentina Canti, Paolo Cardinaletti, Armando Gabrielli, Giacomo Tanti, Elisa Gremese, Ginevra De Marchi, Salvatore De Vita, Serena Fasano, Francesco Ciccia, Giulia Pazzola, Carlo Salvarani, Simone Negrini, Andrea Di Matteo, Rossella De Angelis, Giovanni Orsolini, Maurizio Rossini, Paola Faggioli, Antonella Laria, Matteo Piga, Alberto Cauli, Salvatore Scarpato, Francesca Wanda Rossi, Amato De Paulis, Enrico Brunetta, Angela Ceribelli, Carlo Selmi, Marcella Prete, Vito Racanelli, Angelo Vacca, Elena Bartoloni, Roberto Gerli, Elisabetta Zanatta, Maddalena Larosa, Francesca Saccon, Andrea Doria and Luca Iaccarino Show full author list Hide full author list

J. Pers. Med. 2023, 13(4), 691; https://doi.org/10.3390/jpm13040691 - 20 Apr 2023

Cited by 2 | Viewed by 2956

Abstract

Aim. To assess the efficacy of belimumab in joint and skin manifestations in a nationwide cohort of patients with SLE. Methods. All patients with skin and joint involvement enrolled in the BeRLiSS cohort were considered. Belimumab (intravenous, 10 mg/kg) effectiveness in joint and [...] Read more.

Aim. To assess the efficacy of belimumab in joint and skin manifestations in a nationwide cohort of patients with SLE. Methods. All patients with skin and joint involvement enrolled in the BeRLiSS cohort were considered. Belimumab (intravenous, 10 mg/kg) effectiveness in joint and skin manifestations was assessed by DAS28 and CLASI, respectively. Attainment and predictors of DAS28 remission (<2.6) and LDA (≥2.6, ≤3.2), CLASI = 0, 1, and improvement in DAS28 and CLASI indices ≥20%, ≥50%, and ≥70% were evaluated at 6, 12, 24, and 36 months. Results. DAS28 < 2.6 was achieved by 46%, 57%, and 71% of patients at 6, 12, and 24 months, respectively. CLASI = 0 was achieved by 36%, 48%, and 62% of patients at 6, 12, and 24 months, respectively. Belimumab showed a glucocorticoid-sparing effect, being glucocorticoid-free at 8.5%, 15.4%, 25.6%, and 31.6% of patients at 6, 12, 24, and 36 months, respectively. Patients achieving DAS-LDA and CLASI-50 at 6 months had a higher probability of remission at 12 months compared with those who did not (p = 0.034 and p = 0.028, respectively). Conclusions. Belimumab led to clinical improvement in a significant proportion of patients with joint or skin involvement in a real-life setting and was associated with a glucocorticoid-sparing effect. A significant proportion of patients with a partial response at 6 months achieved remission later on during follow-up. Full article

(This article belongs to the Special Issue Rheumatism in 2023: New Challenges and Perspectives)

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10 pages, 642 KiB

Open AccessArticle

Do you Hear what I Hear? A Qualitative Study Examining Psychological Associations Underlying Evaluations of Everyday Sounds in Patients with Chronic Tinnitus

by Christina Baniotopoulou, Benjamin Boecking and Birgit Mazurek

J. Pers. Med. 2023, 13(4), 690; https://doi.org/10.3390/jpm13040690 - 20 Apr 2023

Viewed by 872

Abstract

Tinnitus is a multifactorial phenomenon and psychological, audiological, or medical factors can facilitate its onset or maintenance. A growing body of research investigates individuals’ perceptions, associations, and experiences of living with tinnitus. This body of research examines tinnitus as a condition rather than [...] Read more.

Tinnitus is a multifactorial phenomenon and psychological, audiological, or medical factors can facilitate its onset or maintenance. A growing body of research investigates individuals’ perceptions, associations, and experiences of living with tinnitus. This body of research examines tinnitus as a condition rather than a symptom. We examine a sample of chronic tinnitus patients in terms of associations that are induced by neutral sounds. In particular, we investigate how patients with chronic tinnitus ascribe meaning to those neutral sounds. The present study uses Mayring’s content analysis to explore the content of psychological associations underlying valence ratings of everyday neutral sounds. Nine tinnitus patients completed a hearing exercise, during which they listened to seven neutral sounds, following which we examined their sound-induced associations using semi-structured interviews. Three groups of factors influenced patients’ associations and valence ratings of neutral sounds: affect, episodic memory, and ‘other’. The former two factors further comprised two subcategories. In line with previous psychoaudiological research designs, our findings suggest that neutral, everyday auditory stimuli evoke strong affective reactions—possibly through serving as retrieval cues for episodic memories. Based on these findings, we discuss our results in the context of previous psychoaudiological findings and propose further research concerning psychological associations that may specifically underlie the tinnitus sound. Full article

(This article belongs to the Section Evidence Based Medicine)

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13 pages, 1125 KiB

Open AccessArticle

Immune Response and Transplacental Antibody Transfer in Pregnant Women after COVID-19 Vaccination

by Chiara Lubrano, Alessandro Mancon, Gaia Maria Anelli, Gloria Gagliardi, Roberta Corneo, Micol Bianchi, Chiara Coco, Giulia Dal Molin, Michele Vignali, Irene Schirripa, Nicoletta Di Simone, Giulia Pavone, Antonio Pellegrino, Maria Rita Gismondo, Valeria Maria Savasi and Irene Cetin

J. Pers. Med. 2023, 13(4), 689; https://doi.org/10.3390/jpm13040689 - 20 Apr 2023

Cited by 1 | Viewed by 1341

Abstract

COVID-19 infection is associated with increased risk of pregnancy complications, making vaccination during pregnancy critical for mother-neonate dyads. Few data, often with an unrepresentative sample size, are available on SARS-CoV-2 vaccine-induced humoral and cell-mediated response. Here, we evaluated anti-S antibody and interferon-gamma (IFN-γ) [...] Read more.

COVID-19 infection is associated with increased risk of pregnancy complications, making vaccination during pregnancy critical for mother-neonate dyads. Few data, often with an unrepresentative sample size, are available on SARS-CoV-2 vaccine-induced humoral and cell-mediated response. Here, we evaluated anti-S antibody and interferon-gamma (IFN-γ) production elicited by SARS-CoV-2 immunization in maternal and neonatal plasma. Pregnant women (n = 230) were prospectively enrolled and classified as unvaccinated (n = 103) and vaccinated (n = 127); after serological screening for previous infections, assays were performed on 126 dyads, 15 mothers and 17 newborns. Positive anti-S antibodies were found in most of the vaccinated subjects, regardless of timespan between immunization and delivery (range: 7–391 days). A total of 89 of 92 vaccinated women showed a broad response to COVID-19 immunization and highly effective placental transfer, as attested by anti-S positive rates (maternal = 96.7%, cord = 96.6%). Most of our subjects had indeterminate results in an IGRA assay, preventing a conclusive evaluation of IFN-γ production. Indeed, pregnancy-related hormonal changes may influence T-cell response with an impact on IFN-γ production. Positive pregnancy and perinatal outcomes reinforce the evidence that the anti-SARS-CoV-2 immunization is effective and well-tolerated in pregnant women and also protective for the fetus/neonate, even though it was not possible to define the related IFN-γ production and role. Full article

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

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12 pages, 659 KiB

Open AccessReview

Soluble Urokinase Plasminogen Activator Receptor (suPAR) in Autoimmune Rheumatic and Non Rheumatic Diseases

by Mariangela Manfredi, Lieve Van Hoovels, Maurizio Benucci, Riccardo De Luca, Carmela Coccia, Pamela Bernardini, Edda Russo, Amedeo Amedei, Serena Guiducci, Valentina Grossi, Xavier Bossuyt, Carlo Perricone and Maria Infantino

J. Pers. Med. 2023, 13(4), 688; https://doi.org/10.3390/jpm13040688 - 19 Apr 2023

Cited by 1 | Viewed by 1882

Abstract

The soluble urokinase plasminogen activator receptor (suPAR) is the bioactive form of uPAR, a membrane-bound glycoprotein, and it is primarily expressed on the surface of immunologically active cells. Mirroring local inflammation and immune activation, suPAR has gained interest as a potential prognostic biomarker [...] Read more.

The soluble urokinase plasminogen activator receptor (suPAR) is the bioactive form of uPAR, a membrane-bound glycoprotein, and it is primarily expressed on the surface of immunologically active cells. Mirroring local inflammation and immune activation, suPAR has gained interest as a potential prognostic biomarker in several inflammatory diseases. Indeed, in many diseases, including cancer, diabetes, cardiovascular diseases, kidney diseases, and inflammatory disorders, higher suPAR concentrations have been associated with disease severity, disease relapse, and mortality. Our review describes and discusses the supporting literature concerning the promising role of suPAR as a biomarker in different autoimmune rheumatic and non-rheumatic diseases. Full article

(This article belongs to the Special Issue Rheumatism in 2023: New Challenges and Perspectives)

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14 pages, 265 KiB

Open AccessFeature PaperArticle

Nasal Cytology on 241 Children: From Birth to the First 3 Years of Life and Association with Common Airways Diseases

by Cecilia Rosso, Federica Turati, Alberto Maria Saibene, Elvira Verduci, Emanuela Fuccillo, Maria Chiara Tavilla, Mauro Magnani, Giuseppe Banderali, Monica Ferraroni, Eugenio De Corso, Giovanni Felisati and Carlotta Pipolo

J. Pers. Med. 2023, 13(4), 687; https://doi.org/10.3390/jpm13040687 - 19 Apr 2023

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Abstract

Background: Nasal cytology at birth and in the pediatric age is barely investigated regarding its association with the onset of common pediatric diseases. Methods: We enrolled 241 newborns within their first 24 h of life, studying their nasal cellular composition and repeating this [...] Read more.

Background: Nasal cytology at birth and in the pediatric age is barely investigated regarding its association with the onset of common pediatric diseases. Methods: We enrolled 241 newborns within their first 24 h of life, studying their nasal cellular composition and repeating this at 1 and 3 years of life. We collected anamneses of perinatal factors and external factors (parental smoking, passive smoking, breastfeeding), and the prevalence of otitis, rhinosinusitis, bronchitis, asthma, and allergy at all timepoints. Results: 204 children completed the study. At birth, there was a prevalence of ciliated cells and rare neutrophils. At 1 and 3 years, ciliated cells started reducing in favor of muciparous cells and neutrophils. We found that caesarian delivery and nasogastric tube usage for choanal patency are significantly related to a certain cellular nasal composition. Additionally, development of upper respiratory tract infections, AOM (acute otitis media) and allergy correlates with specific cytological compositions which may predict those pathologies. Conclusions: Our study is the first to show the normal nasal mucosa cellular composition and development in the first 3 years of life in a large cohort. Nasal cytology may be a tool for early risk assessment in the occurrence of upper airway disease. Full article

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

8 pages, 246 KiB

Open AccessBrief Report

Eosinopenia as a Prognostic Biomarker for Noninvasive Ventilation Use in COPD Exacerbations

by Konstantinos Bartziokas, Evgenia Papathanasiou, Andriana I. Papaioannou, Ilias Papanikolaou, Emmanouil Antonakis, Ioanna Makou, Georgios Hillas, Theodoros Karampitsakos, Ourania Papaioannou, Katerina Dimakou, Vasiliki Apollonatou, Galateia Verykokou, Spyros Papiris, Petros Bakakos, Stelios Loukides and Konstantinos Kostikas

J. Pers. Med. 2023, 13(4), 686; https://doi.org/10.3390/jpm13040686 - 19 Apr 2023

Cited by 2 | Viewed by 1068

Abstract

Background: In recent years, blood eosinophils have been evaluated as a surrogate biomarker for eosinophilic airway inflammation and as a prognostic indicator of the outcomes of hospitalized COPD subjects. During an exacerbation of COPD, eosinopenia has been proposed as a prognostic marker of [...] Read more.

Background: In recent years, blood eosinophils have been evaluated as a surrogate biomarker for eosinophilic airway inflammation and as a prognostic indicator of the outcomes of hospitalized COPD subjects. During an exacerbation of COPD, eosinopenia has been proposed as a prognostic marker of adverse outcomes. Objectives: The aim of the present post hoc analysis was to elucidate the effectiveness of blood eosinophils for predicting the need of NIV in subjects with COPD exacerbation. Methods: Consecutive subjects admitted to a hospital for COPD exacerbation were included in the analysis. The eosinophil count from the first complete blood count was used to designate the eosinophil groups. The relationship between the clinical characteristics and blood eosinophil counts, as dichotomized using 150 cells/μL, was evaluated. Results Subjects with blood eosinophil number < 150 k/μL had a more severe disease on admission compared to subjects with ≥150 k/μL, regarding pH 7.400 (7.36, 7.44) vs. 7.42 (7.38, 7.45), p = 0.008, PO₂/FiO₂ levels 238.1 (189.8, 278.6) vs. 276.2 (238.2, 305.6), p < 0.001, CRP (mg/L) levels 7.3 (3.1, 19.9) vs. 3.5 (0.7, 7.8), p < 0.001 and required a longer hospital stay (days) 10.0 (8.0, 14.0) vs. 5.0 (3.0, 7.0) p < 0.001 respectively. The number of blood eosinophils correlated with the levels of CRP upon admission (p < 0.001, r = −0.334), with arterial pH upon admission (p < 0.030, r = 0.121), with PO₂/FiO₂ (p < 0.001, r = −0.248), and with duration of hospital stay (p < 0.001, r = −0.589). In the multinomial logistic regression analysis, blood eosinophil count < 150 k/μL was an independent predictor of the use of NIV during hospital stay. Conclusion: During COPD exacerbation, low blood eosinophil levels upon admission are related to more severe disease and can be used as a predictor of the need of NIV. Further prospective studies are needed to identify the use of blood eosinophil levels as a predictor of unfavorable outcomes. Full article

(This article belongs to the Topic Diagnosis, Management, and Prognostic Assessment of Chronic Disease)

17 pages, 3753 KiB

Open AccessArticle

Imaging-Based Patterns of Failure following Re-Irradiation for Recurrent/Progressive High-Grade Glioma

by Debanjali Datta, Archya Dasgupta, Abhishek Chatterjee, Arpita Sahu, Kajari Bhattacharya, Lilawati Meena, Kishore Joshi, Ameya Puranik, Indraja Dev, Aliasgar Moiyadi, Prakash Shetty, Vikas Singh, Vijay Patil, Nandini Menon, Epari Sridhar, Ayushi Sahay and Tejpal Gupta

J. Pers. Med. 2023, 13(4), 685; https://doi.org/10.3390/jpm13040685 - 19 Apr 2023

Viewed by 1264

Abstract

Background: Re-irradiation (ReRT) is an effective treatment modality in appropriately selected patients with recurrent/progressive high-grade glioma (HGG). The literature is limited regarding recurrence patterns following ReRT, which was investigated in the current study. Methods: Patients with available radiation (RT) contours, dosimetry, and imaging-based [...] Read more.

Background: Re-irradiation (ReRT) is an effective treatment modality in appropriately selected patients with recurrent/progressive high-grade glioma (HGG). The literature is limited regarding recurrence patterns following ReRT, which was investigated in the current study. Methods: Patients with available radiation (RT) contours, dosimetry, and imaging-based evidence of recurrence were included in the retrospective study. All patients were treated with fractionated focal conformal RT. Recurrence was detected on imaging with magnetic resonance imaging (MRI) and/ or amino-acid positron emission tomography (PET), which was co-registered with the RT planning dataset. Failure patterns were classified as central, marginal, and distant if >80%, 20–80%, or <20% of the recurrence volumes were within 95% isodose lines, respectively. Results: Thirty-seven patients were included in the current analysis. A total of 92% of patients had undergone surgery before ReRT, and 84% received chemotherapy. The median time to recurrence was 9 months. Central, marginal, and distant failures were seen in 27 (73%), 4 (11%), and 6 (16%) patients, respectively. None of the patient-, disease-, or treatment-related factors were significantly different across different recurrence patterns. Conclusion: Failures are seen predominantly within the high-dose region following ReRT in recurrent/ progressive HGG. Full article

(This article belongs to the Special Issue The Application of Medical Imaging in Brain Tumors)

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15 pages, 1820 KiB

Open AccessArticle

The Composition of Small Extracellular Vesicles (sEVs) in the Blood Plasma of Colorectal Cancer Patients Reflects the Presence of Metabolic Syndrome and Correlates with Angiogenesis and the Effectiveness of Thermoradiation Therapy

by Natalia V. Yunusova, Dmitry A. Svarovsky, Artem I. Konovalov, Dmitry N. Kostromitsky, Zhanna A. Startseva, Olga V. Cheremisina, Sergey G. Afanas’ev, Irina V. Kondakova, Alina E. Grigor’eva, Sergey V. Vtorushin, Elena E. Sereda, Anna V. Usova and Svetlana N. Tamkovich

J. Pers. Med. 2023, 13(4), 684; https://doi.org/10.3390/jpm13040684 - 19 Apr 2023

Cited by 1 | Viewed by 1369

Abstract

The majority of colorectal cancer patients (CRCPs) develop tumors on the background of “metabolically healthy obesity” or metabolic syndrome. The aim of the work was to study the levels of matrix metalloproteinases (MMPs) and heat shock proteins (HSPs) on the surface of blood [...] Read more.

The majority of colorectal cancer patients (CRCPs) develop tumors on the background of “metabolically healthy obesity” or metabolic syndrome. The aim of the work was to study the levels of matrix metalloproteinases (MMPs) and heat shock proteins (HSPs) on the surface of blood plasma CD9-positive and FABP4-positive small extracellular vesicles (sEVs) from CRCPs depending on metabolic status and tumor angiogenesis, as well as to evaluate the sEVs markers as predictors of the effectiveness of thermoradiotherapy. In CRCPs, compared with patients with colorectal polyps (CPPs), the proportion of triple positive EVs and EVs with the MMP9+MMP2-TIMP1+ phenotype increased significantly among FABP4-positive EVs (adipocyte-derived EVs), which in general may indicate the overexpression of MMP9 and TIMP1 by adipocytes or adipose tissue macrophages in CRCPs. The results obtained have prospects for use as markers to clarify cancer risk in CPPs. One can assume that for CRCPs with metabolic syndrome or metabolically healthy obesity, it is the FABP4+MMP9+MMP2-TIMP1- population of circulating sEVs that is the most optimal biomarker reflecting tumor angiogenesis. Determining this population in the blood will be useful in monitoring patients after treatment for the early detection of tumor progression. CD9+MMP9+MMP2-TIMP1- and MMP9+MMP2-TIMP1+ subpopulations of circulating sEVs are the most promising predictors of the efficacy of thermoradiation therapy because their levels at baseline differ significantly in CRCPs with different tumor responses. Full article

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

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12 pages, 844 KiB

Open AccessArticle

Mediation Effects of Social Cognition on the Relationship between Neurocognition and Social Functioning in Major Depressive Disorder and Schizophrenia Spectrum Disorders

by Takashi Uchino, Ryo Okubo, Youji Takubo, Akiko Aoki, Izumi Wada, Naoki Hashimoto, Satoru Ikezawa and Takahiro Nemoto

J. Pers. Med. 2023, 13(4), 683; https://doi.org/10.3390/jpm13040683 - 19 Apr 2023

Cited by 2 | Viewed by 1548

Abstract

Background: In schizophrenia spectrum disorders (SSD), social cognition mediates the relationship between neurocognition and social functioning. Although people with major depressive disorder (MDD) also exhibit cognitive impairments, which are often prolonged, little is known about the role of social cognition in MDD. Methods: [...] Read more.

Background: In schizophrenia spectrum disorders (SSD), social cognition mediates the relationship between neurocognition and social functioning. Although people with major depressive disorder (MDD) also exhibit cognitive impairments, which are often prolonged, little is known about the role of social cognition in MDD. Methods: Using data obtained through an internet survey, 210 patients with SSD or MDD were selected using propensity score matching based on their demographics and illness duration. Social cognition, neurocognition, and social functioning were evaluated using the Self-Assessment of Social Cognition Impairments, Perceived Deficits Questionnaire, and Social Functioning Scale, respectively. The mediation effects of social cognition on the relationship between neurocognition and social functioning were examined in each group. Invariances of the mediation model across the two groups were then analyzed. Results: The SSD and MDD groups had mean ages of 44.49 and 45.35 years, contained 42.0% and 42.8% women, and had mean illness durations of 10.76 and 10.45 years, respectively. In both groups, social cognition had significant mediation effects. Configural, measurement, and structural invariances across the groups were established. Conclusion: The role of social cognition in patients with MDD was similar to that in SSD. Social cognition could be a common endophenotype for various psychiatric disorders. Full article

(This article belongs to the Special Issue Personalized Medicine of Cognitive Impairments Associated with Psychiatric Disorders)

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11 pages, 1014 KiB

Open AccessArticle

Overweight/Obesity Increases the Risk of Overt Hepatic Encephalopathy after Transjugular Intrahepatic Portosystemic Shunt in Cirrhotic Patients

by Lihong Gu, Xiaochun Yin, Yang Cheng, Xixuan Wang, Ming Zhang, Xiaoping Zou, Lei Wang, Yuzheng Zhuge and Feng Zhang

J. Pers. Med. 2023, 13(4), 682; https://doi.org/10.3390/jpm13040682 - 19 Apr 2023

Cited by 2 | Viewed by 1015

Abstract

The purpose of this study was to investigate the effect of body mass index (BMI) on the prevalence of overt hepatic encephalopathy (OHE) after the transjugular intrahepatic portosystemic shunt (TIPS) procedure in decompensated cirrhotic patients. A retrospective observational cohort study of 145 cirrhotic [...] Read more.

The purpose of this study was to investigate the effect of body mass index (BMI) on the prevalence of overt hepatic encephalopathy (OHE) after the transjugular intrahepatic portosystemic shunt (TIPS) procedure in decompensated cirrhotic patients. A retrospective observational cohort study of 145 cirrhotic patients receiving TIPS was carried out in our department from 2017 to 2020. The relationships between BMI and clinical outcomes including OHE, as well as risk factors of developing post-TIPS OHE, were analyzed. BMI was categorized as normal weight (18.5 ≤ BMI < 23.0 kg/m²), underweight (BMI < 18.5 kg/m²), and overweight/obese (BMI ≥ 23.0 kg/m²). Among the 145 patients, 52 (35.9%) were overweight/obese and 50 (34%) had post-TIPS OHE. Overweight/obese patients more frequently had OHE compared with normal weight patients (OR: 2.754, 95% CI: 1.236–6.140; p = 0.013). Overweight/obesity (p = 0.013) and older age (p = 0.030) were independent risk factors for post-TIPS OHE according to the logistic regression analysis. Kaplan–Meier curve analysis suggested that overweight/obese patients had the highest cumulative incidence of OHE (log-rank p = 0.0118). In conclusion, overweight/obesity and older age may raise the risk of post-TIPS OHE in cirrhotic patients. Full article

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9 pages, 897 KiB

Open AccessFeature PaperCommunication

A New Treatment Option in Incomplete Partition Type III: The Varese Bone–Air Stimulation (B.A.S.)

by Flavia Di Maro, Vittoria Sykopetrites, Annalisa Meli, Davide Cocozza, Greta Albanese, Maria Teresa Antonietta Miccoli, Annalisa De Candia, Mario Picozzi, Francesca Greco and Eliana Cristofari

J. Pers. Med. 2023, 13(4), 681; https://doi.org/10.3390/jpm13040681 - 19 Apr 2023

Cited by 1 | Viewed by 1404

Abstract

The incomplete partition type III is a severe cochlear malformation present in X-linked deafness. It is a rare, non-syndromic cause of severe to profound mixed hearing loss, often progressive. The complete absence of bony modiolus and the wide communication between the cochlea and [...] Read more.

The incomplete partition type III is a severe cochlear malformation present in X-linked deafness. It is a rare, non-syndromic cause of severe to profound mixed hearing loss, often progressive. The complete absence of bony modiolus and the wide communication between the cochlea and the internal auditory canal make cochlear implantation challenging, with still no consensus on the management of these patients. To the best of our knowledge, no results have ever been published in the literature on the treatment of these patients with hybrid stimulation (bone and air). We present three cases in which this hybrid stimulation gave better audiological results then air stimulation alone. A literature review on audiological results of the current treatment options in children affected by IPIII malformation was conducted independently by two researchers. Ethical considerations on the treatment of these patients were conducted by the Bioethics department of the University of Insubria. In two of the patients, the bone–air stimulation, associated with prosthetic–cognitive rehabilitation, meant that surgery was avoided, obtaining similar communication performances of those present in the literature. We believe that, when the bone threshold appears partially preserved, a stimulation through the bone or hybrid modality, such as the Varese B.A.S. stimulation, should be attempted. Full article

(This article belongs to the Special Issue Recent Advances in Diagnosis, Treatment and Observation in Otorhinolaryngology)

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11 pages, 257 KiB

Open AccessArticle

Physicians’ Perspectives on a Multi-Dimensional Model for the Roles of Electronic Health Records in Approaching a Proper Differential Diagnosis

by Abdullah Alanazi, Amal Almutib and Bakheet Aldosari

J. Pers. Med. 2023, 13(4), 680; https://doi.org/10.3390/jpm13040680 - 19 Apr 2023

Viewed by 1109

Abstract

Many healthcare organizations have adopted Electronic Health Records (EHRs) to improve the quality of care and help physicians make proper clinical decisions. The vital roles of EHRs can support the accuracy of diagnosis, suggest, and rationalize the provided care to patients. This study [...] Read more.

Many healthcare organizations have adopted Electronic Health Records (EHRs) to improve the quality of care and help physicians make proper clinical decisions. The vital roles of EHRs can support the accuracy of diagnosis, suggest, and rationalize the provided care to patients. This study aims to understand the roles of EHRs in approaching proper differential diagnosis and optimizing patient safety. This study utilized a cross-sectional survey-based descriptive research design to assess physicians’ perceptions of the roles of EHRs on diagnosis quality and safety. Physicians working in tertiary hospitals in Saudi Arabia were surveyed. Three hundred and fifty-one participants were included in the study, of which 61% were male. The main participants were family/general practice (22%), medicine, general (14%), and OB/GYN (12%). Overall, 66% of the participants ranked themselves as IT competent, most of the participants underwent IT self-guided learning, and 65% of the participants always used the system. The results generally reveal positive physicians’ perceptions toward the roles of the EHR system on diagnosis quality and safety. There was a statistically significant relationship between user characteristics and the roles of the EHR by enhancing access to care, patient–physician encounter, clinical reasoning, diagnostic testing and consultation, follow-up, and diagnostic safety functionality. The study participants demonstrate positive perceptions of physicians toward the roles of the EHR system in approaching differential diagnosis. Yet, areas of improvement in the design and using EHRs are emphasized. Full article

12 pages, 2142 KiB

Open AccessArticle

A Novel Risk Calculator to Predict Erectile Dysfunction in HIV-Positive Men

by Narcis Chirca, Anca Streinu-Cercel, Marius Stefan, Justin Aurelian and Cristian Persu

J. Pers. Med. 2023, 13(4), 679; https://doi.org/10.3390/jpm13040679 - 18 Apr 2023

Viewed by 1244

Abstract

HIV infection is considered to be a lifelong medical condition, requiring follow-up and treatment for decades. HIV-positive men are reported to have erectile dysfunction more often than age-matched healthy controls, and improving sexuality is known to potentially improve overall health-related quality of life. [...] Read more.

HIV infection is considered to be a lifelong medical condition, requiring follow-up and treatment for decades. HIV-positive men are reported to have erectile dysfunction more often than age-matched healthy controls, and improving sexuality is known to potentially improve overall health-related quality of life. The aim of this paper is to evaluate the presence of ED in HIV-positive men and the associated contributing factors and to create a statistical model to assess the risk to develop ED in this population. In a prospective study, we analyzed a group of HIV-positive men in a cross-sectional manner, looking at demographics, blood test results, and smoking habits. Data were statistically analyzed using the Kruskal–Wallis test. In our series, the overall incidence of ED was 48.5%, increasing with age. Our analysis showed no correlation with blood sugar level, but a very strong correlation with total serum lipids. We were able to develop and validate a risk calculator for ED in HIV-positive men. Full article

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

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11 pages, 1591 KiB

Open AccessArticle

The Clinical Significance of Serum Biomarkers of the Intestinal Barrier in Systemic Sclerosis: A Cross-Sectional Study

by Albert Stec, Magdalena Maciejewska, Michał Zaremba, Karolina Paralusz-Stec, Milena Michalska, Lidia Rudnicka and Mariusz Sikora

J. Pers. Med. 2023, 13(4), 678; https://doi.org/10.3390/jpm13040678 - 18 Apr 2023

Cited by 1 | Viewed by 1387

Abstract

Systemic sclerosis (SSc) is an immune-mediated connective tissue disease. Recent studies reported differences in the composition of intestinal microbiota (dysbiosis) in patients with SSc compared to nonsclerodermic subjects. Dysbiosis may disrupt the intestinal barrier, which leads to immunological activation via microbial antigen and [...] Read more.

Systemic sclerosis (SSc) is an immune-mediated connective tissue disease. Recent studies reported differences in the composition of intestinal microbiota (dysbiosis) in patients with SSc compared to nonsclerodermic subjects. Dysbiosis may disrupt the intestinal barrier, which leads to immunological activation via microbial antigen and metabolite translocation. The study aimed to assess the differences in intestinal permeability between SSc patients and controls and to examine the correlation between intestinal permeability and complications of SSc. The study comprised 50 patients with SSc and 30 matched subjects. Serum intestinal permeability markers: intestinal fatty acid binding protein, claudin-3, and lipopolysaccharides (LPS) were determined using an enzyme-linked immunosorbent assay. SSc patients had a significantly increased concentration of LPS compared to control subjects (232.30 [149.00–347.70] versus 161.00 [83.92–252.20] pg/mL, p < 0.05). The patients with shorter SSc duration (≤6 years) had an increased concentration of LPS and claudin-3 compared to the subgroup with longer disease length: LPS (280.75 [167.30–403.40] versus 186.00 [98.12–275.90] pg/mL, p < 0.05), and claudin-3 (16.99 [12.41–39.59] versus 13.54 [10.29–15.47] ng/mL, p < 0.05). The patients with esophageal dysmotility had a decreased LPS level compared to those without this complication (188.05 [102.31–264.40] versus 283.95 [203.20–356.30] pg/mL, p < 0.05). Increased intestinal permeability in SSc may exacerbate the course of the disease and increase the risk of developing complications. Lower LPS levels in SSc might be a hallmark of esophageal dysmotility. Full article

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

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15 pages, 649 KiB

Open AccessReview

Asthma-COPD Overlap in Clinical Practice (ACO_CP 2023): Toward Precision Medicine

by Ahmad R. Alsayed, Mahmoud S. Abu-Samak and Mohammad Alkhatib

J. Pers. Med. 2023, 13(4), 677; https://doi.org/10.3390/jpm13040677 - 18 Apr 2023

Cited by 6 | Viewed by 3277

Abstract

Asthma and COPD have characteristic symptoms, yet patients with both are prevalent. Despite this, there is currently no globally accepted definition for the overlap between asthma and COPD, commonly referred to as asthma–COPD overlap (ACO). Generally, ACO is not considered a distinct disease [...] Read more.

Asthma and COPD have characteristic symptoms, yet patients with both are prevalent. Despite this, there is currently no globally accepted definition for the overlap between asthma and COPD, commonly referred to as asthma–COPD overlap (ACO). Generally, ACO is not considered a distinct disease or symptom from either clinical or mechanistic perspectives. However, identifying patients who present with both conditions is crucial for guiding clinical therapy. Similar to asthma and COPD, ACO patients are heterogeneous and presumably have multiple underlying disease processes. The variability of ACO patients led to the establishment of multiple definitions describing the condition’s essential clinical, physiological, and molecular characteristics. ACO comprises numerous phenotypes, which affects the optimal medication choice and can serve as a predictor of disease prognosis. Various phenotypes of ACO have been suggested based on host factors including but not limited to demographics, symptoms, spirometric findings, smoking history, and underlying airway inflammation. This review provides a comprehensive clinical guide for ACO patients to be used in clinical practice based on the available limited data. Future longitudinal studies must evaluate the stability of ACO phenotypes over time and explore their predictive powers to facilitate a more precise and effective management approach. Full article

(This article belongs to the Special Issue Personalized Medicine in Asthma: Current Approach and Future Perspectives)

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9 pages, 1219 KiB

Open AccessBrief Report

Effects and Safety of Wearable Exoskeleton for Robot-Assisted Gait Training: A Retrospective Preliminary Study

by Gwang-Min Park, Su-Hyun Cho, Jun-Taek Hong, Dae-Hyun Kim and Ji-Cheol Shin

J. Pers. Med. 2023, 13(4), 676; https://doi.org/10.3390/jpm13040676 - 18 Apr 2023

Cited by 3 | Viewed by 1530

Abstract

Background: Wearable devices for robot-assisted gait training (RAGT) provide overground gait training for the rehabilitation of neurological injuries. We aimed to evaluate the effectiveness and safety of RAGT in patients with a neurologic deficit. Methods: Twenty-eight patients receiving more than ten sessions of [...] Read more.

Background: Wearable devices for robot-assisted gait training (RAGT) provide overground gait training for the rehabilitation of neurological injuries. We aimed to evaluate the effectiveness and safety of RAGT in patients with a neurologic deficit. Methods: Twenty-eight patients receiving more than ten sessions of overground RAGT using a joint-torque-assisting wearable exoskeletal robot were retrospectively analyzed in this study. Nineteen patients with brain injury, seven patients with spinal cord injury and two patients with peripheral nerve injury were included. Clinical outcomes, such as the Medical Research Council scale for muscle strength, Berg balance scale, functional ambulation category, trunk control tests, and Fugl–Meyer motor assessment of the lower extremities, were recorded before and after RAGT. Parameters for RAGT and adverse events were also recorded. Results: The Medical Research Council scale scores for muscle strength (36.6 to 37.8), Berg balance scale (24.9 to 32.2), and functional ambulation category (1.8 to 2.7) significantly improved after overground RAGT (p < 0.05). The familiarization process was completed within six sessions of RAGT. Only two mild adverse events were reported. Conclusions: Overground RAGT using wearable devices can improve muscle strength, balance, and gait function. It is safe in patients with neurologic injury. Full article

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15 pages, 3672 KiB

Open AccessArticle

Needs and Demands for eHealth Pain Management Interventions in Chronic Pain Patients

by Paula Stoppok, Anna-Lena Frewer, Adam Schweda, Sheila Geiger, Eva-Maria Skoda, Diana Müßgens, Ulrike Bingel, Martin Teufel and Alexander Bäuerle

J. Pers. Med. 2023, 13(4), 675; https://doi.org/10.3390/jpm13040675 - 17 Apr 2023

Cited by 3 | Viewed by 1262

Abstract

Although chronic pain is a global health problem, the current care situation is often inadequate. eHealth offers many advantages as an additional option for treating chronic pain. Yet, an intervention’s efficacy can only be fully exhausted if patients intend to use it. This [...] Read more.

Although chronic pain is a global health problem, the current care situation is often inadequate. eHealth offers many advantages as an additional option for treating chronic pain. Yet, an intervention’s efficacy can only be fully exhausted if patients intend to use it. This study aims to identify the needs and demands of patients with chronic pain regarding intervention concepts and frameworks to develop specifically tailored eHealth pain management interventions. A cross-sectional study was conducted, including 338 individuals with chronic pain. Within the cohort, a distinction between a high- and a low-burden group was made. Respondents generally preferred a permanently accompanying mobile app, but the preferred content varied with group. According to the majority, interventions should be made available on smartphones, offer sessions once per week with a duration from 10 to 30 min, and be recommended by experts. These results can provide the basis for future eHealth pain management interventions tailored to the patients’ needs and demands. Full article

(This article belongs to the Special Issue Personalized Therapy and Clinical Outcomes for Chronic Pain)

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11 pages, 528 KiB

Open AccessArticle

Hidden Blood Loss and Its Possible Risk Factors in Full Endoscopic Lumbar Interbody Fusion

by Zhilin Ge, Wenhua Zhao, Zhihua Wu, Jiahui He, Guangye Zhu, Zefeng Song, Jianchao Cui, Xiaobing Jiang and Weibo Yu

J. Pers. Med. 2023, 13(4), 674; https://doi.org/10.3390/jpm13040674 - 17 Apr 2023

Cited by 1 | Viewed by 1146

Abstract

Background: Full endoscopic lumbar interbody fusion (Endo-LIF) is a representative recent emerging minimally invasive operation. The hidden blood loss (HBL) in an Endo-LIF procedure and its possible risk factors are still unclear. Methods: The blood loss (TBL) was calculated by Gross formula. Sex, [...] Read more.

Background: Full endoscopic lumbar interbody fusion (Endo-LIF) is a representative recent emerging minimally invasive operation. The hidden blood loss (HBL) in an Endo-LIF procedure and its possible risk factors are still unclear. Methods: The blood loss (TBL) was calculated by Gross formula. Sex, age, BMI, hypertension, diabetes, ASA classification, fusion levels, surgical approach type, surgery time, preoperative RBC, HGB, Hct, PT, INR, APTT, Fg, postoperative mean arterial pressure, postoperative heart rate, Intraoperative blood loss (IBL), patient blood volume were included to investigate the possible risk factors by correlation analysis and multiple linear regression between variables and HBL. Results:Ninety-six patients (23 males, 73 females) who underwent Endo-LIF were retrospective analyzed in this study. The HBL was 240.11 (65.51, 460.31) mL (median [interquartile range]). Fusion levels (p = 0.002), age (p = 0.003), hypertension (p = 0.000), IBL (p = 0.012), PT (p = 0.016), preoperative HBG (p = 0.037) were the possible risk factors. Conclusion: Fusion levels, younger age, hypertension, prolonged PT, preoperative HBG are possible risk factors of HBL in an Endo-LIF procedure. More attention should be paid especially in multi-level minimally invasive surgery. The increase of fusion levels will lead to a considerable HBL. Full article

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

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17 pages, 1109 KiB

Open AccessReview

Familial CCM Genes Might Not Be Main Drivers for Pathogenesis of Sporadic CCMs-Genetic Similarity between Cancers and Vascular Malformations

by Jun Zhang, Jacob Croft and Alexander Le

J. Pers. Med. 2023, 13(4), 673; https://doi.org/10.3390/jpm13040673 - 17 Apr 2023

Cited by 4 | Viewed by 1772

Abstract

Cerebral cavernous malformations (CCMs) are abnormally dilated intracranial capillaries that form cerebrovascular lesions with a high risk of hemorrhagic stroke. Recently, several somatic “activating” gain-of-function (GOF) point mutations in PIK3CA (phosphatidylinositol-4, 5-bisphosphate 3-kinase catalytic subunit p110α) were discovered as a dominant mutation in [...] Read more.

Cerebral cavernous malformations (CCMs) are abnormally dilated intracranial capillaries that form cerebrovascular lesions with a high risk of hemorrhagic stroke. Recently, several somatic “activating” gain-of-function (GOF) point mutations in PIK3CA (phosphatidylinositol-4, 5-bisphosphate 3-kinase catalytic subunit p110α) were discovered as a dominant mutation in the lesions of sporadic forms of cerebral cavernous malformation (sCCM), raising the possibility that CCMs, like other types of vascular malformations, fall in the PIK3CA-related overgrowth spectrum (PROS). However, this possibility has been challenged with different interpretations. In this review, we will continue our efforts to expound the phenomenon of the coexistence of gain-of-function (GOF) point mutations in the PIK3CA gene and loss-of-function (LOF) mutations in CCM genes in the CCM lesions of sCCM and try to delineate the relationship between mutagenic events with CCM lesions in a temporospatial manner. Since GOF PIK3CA point mutations have been well studied in reproductive cancers, especially breast cancer as a driver oncogene, we will perform a comparative meta-analysis for GOF PIK3CA point mutations in an attempt to demonstrate the genetic similarities shared by both cancers and vascular anomalies. Full article

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13 pages, 282 KiB

Open AccessArticle

Influence of the Psychological Effect of COVID-19 on Saudi Student Nurses’ Attitudes toward Nursing and Their Future Career Plans

by Khalaf Aied Alotaibi, Ejercito Mangawa Balay-odao, Jonas Preposi Cruz, Jazi Shaydied Alotaibi, Junel Bryan Bajet, Nahed Alquwez, Jennifer Mesde, Ahmed Mansour Almansour, Ahmed Almoghairi and Abdulrhman Saad Albougami

J. Pers. Med. 2023, 13(4), 672; https://doi.org/10.3390/jpm13040672 - 17 Apr 2023

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Abstract

Background: The effects of COVID-19 on the attitude of student nurses toward the nursing profession remain unclear because few studies have been conducted on this topic. Thus, this study examines the influence of the psychological effects of COVID-19 on student nurses’ attitudes toward [...] Read more.

Background: The effects of COVID-19 on the attitude of student nurses toward the nursing profession remain unclear because few studies have been conducted on this topic. Thus, this study examines the influence of the psychological effects of COVID-19 on student nurses’ attitudes toward the nursing profession and their desire to become nurses. Method: The study utilised a quantitative, cross-sectional, and observational design. It surveyed a convenience sample of 726 student nurses in Saudi Arabia during the first semester of the 2021–2022 academic year. Results: The students reported low levels of COVID-19 fear, anxiety, stress, phobia, and obsession. The students reported positive attitudes toward the nursing profession and 86.0% highlighted their desire to continue with nursing as their future profession. Gender, knowing someone infected with COVID-19, confidence in the government’s pandemic response, fear, anxiety, and phobia were significant predictors of the nurses’ attitudes. Community, family members in the profession, “COVID-19-related anxiety”, and “preference for the nursing profession” were significant predictors of the student’s desire to continue nursing. Conclusions: Living in a rural community, having family members in the nursing profession, having low levels of COVID-19-related anxiety, and having positive attitudes toward nursing increased the likelihood of nursing students continuing their nursing careers during the COVID-19 pandemic. Full article

(This article belongs to the Special Issue Personalized Medicine and Management of COVID-19)

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J. Pers. Med., Volume 13, Issue 4 (April 2023) – 131 articles

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