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J. Pers. Med., Volume 14, Issue 3 (March 2024) – 110 articles

Cover Story (view full-size image): Sepsis is one of the most common causes of morbidity and mortality worldwide. Despite the remarkable advances in modern medicine throughout the last century, the mortality rates associated with sepsis have remained significantly elevated, both in high- and low-income countries. The main difficulty in the diagnosis and treatment of septic patients is the tremendous heterogeneity of this condition. The vast heterogeneity that characterizes sepsis ranges from its clinical presentation to the biological aspects of the disease. Evidence-based medicine approaches sepsis as a homogenous syndrome and does not consider the individual discrepancies between septic patients. This approach may contribute to the poor outcomes of such patients. In recent years, personalized medicine has gained significant interest. View this paper
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14 pages, 2040 KiB  
Article
Functional Status Correlates of Change and Stability in Appraisal after Spine Surgery: Earlier versus Later Effects
by Carolyn E. Schwartz, Katrina Borowiec, Bruce D. Rapkin and Joel A. Finkelstein
J. Pers. Med. 2024, 14(3), 329; https://doi.org/10.3390/jpm14030329 - 21 Mar 2024
Viewed by 536
Abstract
Spine surgery generally yields a notable improvement in patients’ health state, and there is variability in measured patient outcomes after spine surgery. The present work aimed to describe for clinicians how appraisal underlies their patients’ experience of healthcare interventions. This prospective longitudinal cohort [...] Read more.
Spine surgery generally yields a notable improvement in patients’ health state, and there is variability in measured patient outcomes after spine surgery. The present work aimed to describe for clinicians how appraisal underlies their patients’ experience of healthcare interventions. This prospective longitudinal cohort study (n = 156) included adults undergoing spine surgery for degenerative spinal conditions. The analysis was a descriptive illustration of the relationship between change in the spine-related disability using the Oswestry Disability Index and change in cognitive-appraisal processes using the Quality-of-Life Appraisal Profilev2-Short Form, early versus later during the recovery trajectory (i.e., between baseline and 3 months post-surgery; and between 3 and 12 months post-surgery). Cognitive-appraisal processes related to Sampling of Experience showed greater change soon after surgery, whereas Standards of Comparison appraisals changed more later in the recovery trajectory. Different appraisal processes were emphasized by patients who reported worsening of the spine-related disability, as compared to those who reported no change or improvement. These findings suggest that changes in appraisal differ depending on the individual’s experience of the impact of spine surgery. Appraisal processes thus reflect an ongoing dynamic in adaptation to changing function. Full article
(This article belongs to the Section Clinical Medicine, Cell, and Organism Physiology)
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23 pages, 6644 KiB  
Article
Concatenated Modified LeNet Approach for Classifying Pneumonia Images
by Dhayanithi Jaganathan, Sathiyabhama Balsubramaniam, Vidhushavarshini Sureshkumar and Seshathiri Dhanasekaran
J. Pers. Med. 2024, 14(3), 328; https://doi.org/10.3390/jpm14030328 - 21 Mar 2024
Viewed by 628
Abstract
Pneumonia remains a critical health concern worldwide, necessitating efficient diagnostic tools to enhance patient care. This research proposes a concatenated modified LeNet classifier to classify pneumonia images accurately. The model leverages deep learning techniques to improve the diagnosis of Pneumonia, leading to more [...] Read more.
Pneumonia remains a critical health concern worldwide, necessitating efficient diagnostic tools to enhance patient care. This research proposes a concatenated modified LeNet classifier to classify pneumonia images accurately. The model leverages deep learning techniques to improve the diagnosis of Pneumonia, leading to more effective and timely treatment. Our modified LeNet architecture incorporates a revised Rectified Linear Unit (ReLU) activation function. This enhancement aims to boost the discriminative capacity of the features learned by the model. Furthermore, we integrate batch normalization to stabilize the training process and enhance performance within smaller, less complex, CNN architectures like LeNet. Batch normalization addresses internal covariate shift, a phenomenon where the distribution of activations within a network alter during training. These modifications help to prevent overfitting and decrease computational time. A comprehensive dataset is used to evaluate the model’s performance, and the model is benchmarked against relevant deep-learning models. The results demonstrate a high recognition rate, with an accuracy of 96% in pneumonia image recognition. This research suggests that the Concatenated Modified LeNet classifier has the potential to be a highly useful tool for medical professionals in the diagnosis of pneumonia. By offering accurate and efficient image classification, our model could contribute to improved treatment decisions and patient outcomes. Full article
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18 pages, 700 KiB  
Review
Prophylactic Antibiotics before Gynecologic Surgery: A Comprehensive Review of Guidelines
by Stamatios Petousis, Panagiota Angelou, Aristarchos Almperis, Antonio Simone Laganà, Gerasimos Titilas, Chrysoula Margioula-Siarkou and Konstantinos Dinas
J. Pers. Med. 2024, 14(3), 327; https://doi.org/10.3390/jpm14030327 - 21 Mar 2024
Viewed by 1500
Abstract
Surgical site infections (SSIs) refer to infections in the incision, organ, or postoperative space. As common healthcare-associated infections, SSIs correlate with prolonged hospital stay, additional procedures, ICU stay, and higher mortality rates. Around 8–10% of gynecologic surgery patients may experience infectious complications, influenced [...] Read more.
Surgical site infections (SSIs) refer to infections in the incision, organ, or postoperative space. As common healthcare-associated infections, SSIs correlate with prolonged hospital stay, additional procedures, ICU stay, and higher mortality rates. Around 8–10% of gynecologic surgery patients may experience infectious complications, influenced by microbial contamination, surgical nature, and patient factors. The goal of this narrative review is to compare and merge recommendations from globally published guidelines concerning the utilization of antibiotics in the perioperative phase. A comparative descriptive/narrative review of the guidelines issued by the American College of Obstetrics and Gynecology (ACOG), Society of Obstetricians and Gynecologists of Canada (SOGC), Royal College of Obstetricians and Gynecologists (RCOG), National Institute for Health and Care Excellence (NICE), Royal Australian and New Zealand College of Obstetricians and Gynecologists (RANZCOG), European Society of Gynecologic Oncology (ESGO), Société Française d’ Anésthesie et de Réanimation (SFAR), Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC), and Hellenic Society of Obstetrics and Gynecology (HSOG) was conducted. For hysterectomy, first/second-generation cephalosporins are suggested, with metronidazole as an option. Laparoscopy without entering the bowel or vagina typically does not require prophylaxis. Uterine evacuation and hysteroscopy may involve doxycycline or azithromycin based on risk factors, whereas, for vulvectomy, cefazolin is recommended. Urogynecology procedures may include cefazolin with metronidazole. In cases of penicillin allergy, cephalosporins are suggested, and, for obese patients, adjusted doses are advised. Additional doses may be needed for prolonged procedures or excessive blood loss. Timing recommendations are 15–60 min before incision, adjusting for specific antibiotics. Clear indications exist for certain surgeries like hysterectomy, termination of pregnancy, and urogynecologic procedures. Conversely, procedures such as intrauterine device insertion, hysteroscopy, and laparoscopy typically do not necessitate antibiotic prophylaxis. For several other procedures, the evidence is inconclusive, while considering dose, timing, and indications can mitigate infectious complications and provide benefits for the healthcare system. Full article
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14 pages, 479 KiB  
Review
Oxygen–Ozone Therapy of Musculoskeletal Neck Pain: A Review
by Jiri Jandura, Milan Vajda, Michal Cech and Pavel Ryska
J. Pers. Med. 2024, 14(3), 326; https://doi.org/10.3390/jpm14030326 - 21 Mar 2024
Viewed by 696
Abstract
Minimally invasive oxygen–ozone (O2-O3) therapy utilizing the biochemical effects of O2-O3 mixture is commonly used in the treatment of musculoskeletal pain. The literature dealing with O2-O3 therapy of spinal pain focuses mainly on [...] Read more.
Minimally invasive oxygen–ozone (O2-O3) therapy utilizing the biochemical effects of O2-O3 mixture is commonly used in the treatment of musculoskeletal pain. The literature dealing with O2-O3 therapy of spinal pain focuses mainly on the lumbosacral region. The aim of this review is to evaluate the efficacy of O2-O3 therapy in musculoskeletal pain in the neck region. The Medline (PubMed), SCOPUS, Web of Science, and Google Scholar databases were searched for clinical studies, using the free text terms: ozone, neck, cervical, spine, pain, disc, hernia, nucleolysis, paravertebral, treatment, and various combinations of them. In total, seven studies (two randomized controlled trials and five observational studies) were found. These studies dealt with the intradiscal or intramuscular paravertebral application of O2-O3 mixture in patients with myofascial pain syndrome, cervical disc hernias, and chronic neck pain. All these studies proved a significant decrease in neck pain (evaluated by Visual Analog Scale or Numerical Rating Scale), and most of them showed improvement in functional status (measured by Oswestry Disability Index or Neck Disability Index). In addition, other pain assessment scales and function and quality of life measures (DN4 questionnaire, pain pressure threshold, cervical lateral flexion range of motion, Japanese Orthopedic Association scale, 12- and 36-Item Short Form Surveys, modified MacNab criteria, and analgesic drug intake reduction) were used. Changes in these measurements also mostly supported the efficacy of O2-O3 treatment. No significant complications of the treatment were reported. The available evidence is sparse, but despite this, the O2-O3 treatment of musculoskeletal neck pain can be considered potentially beneficial and relatively safe. Full article
(This article belongs to the Topic Pathology and Current State of Treatment of Chronic Pain)
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12 pages, 282 KiB  
Article
Clinical Variables and Peripheral Biomarkers Associated with Substance-Induced Psychotic Disorder: Differences Related to Alcohol, Cannabis, and Psychostimulant Abuse
by Martina Di Paolo, Antonia Calabrese, Guido Nosari, Valentina Ciappolino, Luisa Cirella, Alice Caldiroli, Enrico Capuzzi, Massimo Clerici and Massimiliano Buoli
J. Pers. Med. 2024, 14(3), 325; https://doi.org/10.3390/jpm14030325 - 21 Mar 2024
Viewed by 643
Abstract
Background: The present retrospective observational study aims to identify differences in clinical features and peripheral biomarkers among patients affected by substance-induced psychotic disorder (SIPD) according to the primary substance of abuse. Methods: A sample of 218 patients was divided into three groups according [...] Read more.
Background: The present retrospective observational study aims to identify differences in clinical features and peripheral biomarkers among patients affected by substance-induced psychotic disorder (SIPD) according to the primary substance of abuse. Methods: A sample of 218 patients was divided into three groups according to the type of consumed substance: alcohol, cannabis, and psychostimulants. The three groups were compared using one-way analyses of variance (ANOVAs) for continuous variables and χ2 tests for qualitative variables. After excluding the alcohol-induced psychotic disorder group, the same analyses were repeated. The statistically significant variables from these subsequent analyses were included in a binary logistic regression model to confirm their reliability as predictors of cannabis- or psychostimulant-induced psychotic disorder. Results: Psychotic cannabis abusers were younger (p < 0.01), with illness onset at an earlier age (p < 0.01). Alcohol consumers presented a longer duration of illness (p < 0.01), more frequent previous hospitalizations (p = 0.04) and medical comorbidities (p < 0.01), and higher mean Modified Sad Persons Scale scores (p < 0.01). Finally, psychostimulant abusers had a higher frequency of lifetime history of poly-substance use disorders (p < 0.01). A binary logistic regression analysis revealed that higher mean Brief Psychiatric Rating Scale scores (p < 0.01) and higher sodium (p = 0.012) and hemoglobin (p = 0.040) plasma levels were predictors of cannabis misuse in SIPD patients. Conclusions: Different clinical factors and biochemical parameters con be associated with SIPD according to the main substance of abuse, thus requiring specific management by clinicians. Full article
(This article belongs to the Section Disease Biomarker)
14 pages, 3260 KiB  
Article
Assessment of a New Medical Device (PirifixTM) for Positioning and Maintaining the Upper Dental Arch during Le Fort I Osteotomy
by Pierre-Etienne Serree, Eugénie Bertin, Camille Coussens, Eleonore Brumpt, Jean-François Devoti and Aurélien Louvrier
J. Pers. Med. 2024, 14(3), 324; https://doi.org/10.3390/jpm14030324 - 20 Mar 2024
Viewed by 604
Abstract
Introduction: Several medical devices (MDs) are used to assist surgeons in positioning the upper dental arch (UDA) during Le Fort I osteotomies (LFIOs). Some only allow holding, others only positioning. This study aimed to assess the accuracy of a new MD (PirifixTM [...] Read more.
Introduction: Several medical devices (MDs) are used to assist surgeons in positioning the upper dental arch (UDA) during Le Fort I osteotomies (LFIOs). Some only allow holding, others only positioning. This study aimed to assess the accuracy of a new MD (PirifixTM) coupling these two functions during LFIO on 3D-printed models. Materials and Methods: DICOM data were selected from patients who underwent surgical planning for LFIO between 27 July 2020 and 1 December 2022. Their anatomy was reproduced after segmentation, planning, and stereolithography in two models. Each model was assigned to one of two surgical groups: the control group (positioning by occlusal splint) and the PirifixTM group. Each patient’s model was planned with the objective of horizontalizing and recentering the UDA. After positioning, models were digitalized using Einscan Pro 2X and compared to the planned model with CloudCompare. The statistical analysis was performed using the Wilcoxon Mann–Whitney test. The result was considered significant if the p-value was less than 0.05. Results: Twenty-one patients were selected. Forty-two anatomical models were 3D-printed. The mean difference compared to the planned and corrected positions was 0.69 mm for the control group and 0.84 mm for the PirifixTM group (p = 0.036). Conclusion: PirifixTM may be a new alternative to available MDs. Further investigations are needed to describe the relationship between the device and facial soft tissues. Full article
(This article belongs to the Special Issue New Updates in Oral and Maxillofacial Surgery)
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13 pages, 283 KiB  
Article
Genetic Factors Contributing to the Pathogenesis of Essential Hypertension in Two African Populations
by Kusha Kalideen, Brian Rayner and Raj Ramesar
J. Pers. Med. 2024, 14(3), 323; https://doi.org/10.3390/jpm14030323 - 20 Mar 2024
Viewed by 646
Abstract
The African continent has the highest prevalence of hypertension globally, with South Africa reporting the highest prevalence in Southern Africa. While the influence of genetic variability in the pathogenesis of hypertension is well described internationally, limited reports are available for African populations. This [...] Read more.
The African continent has the highest prevalence of hypertension globally, with South Africa reporting the highest prevalence in Southern Africa. While the influence of genetic variability in the pathogenesis of hypertension is well described internationally, limited reports are available for African populations. This study aimed to assess the association of genetic variants and essential hypertension in a cohort of two ethnic South African population groups. Two hundred and seventy-seven hypertensive and one hundred and seventy-six normotensive individuals were genotyped for 78 variants. Genotyping was performed using the Illumina GoldenGate Assay and allele-specific polymerase chain reaction. The association of variants was assessed using the Fisher Exact test under the additive and allelic genetic models, while multivariate logistic regression was used to predict the development of hypertension. Five variants (CYP11B2 rs179998, AGT rs5051 and rs699, AGTR1 rs5186, and ACE rs4646994) were significantly associated with essential hypertension in the cohort under study. Furthermore, AGTR1 rs5186 and AGT rs699 were identified as risk factors for the development of hypertension in both ethnic groups. In two ethnic South African populations, an association was observed between renin–angiotensin–aldosterone system (RAAS)-related genes and the development of hypertension. Full article
(This article belongs to the Special Issue Pharmacogenomics and Hypertension: Problems and Prospects)
24 pages, 1087 KiB  
Review
Exploring Costimulatory Blockade-Based Immunologic Strategies in Transplantation: Are They a Promising Immunomodulatory Approach for Organ and Vascularized Composite Allotransplantation?
by Andreea Grosu-Bularda, Florin-Vlad Hodea, Dragos Zamfirescu, Alexandru Stoian, Răzvan Nicolae Teodoreanu, Ioan Lascăr and Cristian Sorin Hariga
J. Pers. Med. 2024, 14(3), 322; https://doi.org/10.3390/jpm14030322 - 20 Mar 2024
Viewed by 591
Abstract
The field of transplantation, including the specialized area of vascularized composite allotransplantation (VCA), has been transformed since the first hand transplant in 1998. The major challenge in VCA comes from the need for life-long immunosuppressive therapy due to its non-vital nature and a [...] Read more.
The field of transplantation, including the specialized area of vascularized composite allotransplantation (VCA), has been transformed since the first hand transplant in 1998. The major challenge in VCA comes from the need for life-long immunosuppressive therapy due to its non-vital nature and a high rate of systemic complications. Ongoing research is focused on immunosuppressive therapeutic strategies to avoid toxicity and promote donor-specific tolerance. This includes studying the balance between tolerance and effector mechanisms in immune modulation, particularly the role of costimulatory signals in T lymphocyte activation. Costimulatory signals during T cell activation can have either stimulatory or inhibitory effects. Interfering with T cell activation through costimulation blockade strategies shows potential in avoiding rejection and prolonging the survival of transplanted organs. This review paper aims to summarize current data on the immunologic role of costimulatory blockade in the field of transplantation. It focuses on strategies that can be applied in vascularized composite allotransplantation, offering insights into novel methods for enhancing the success and safety of these procedures. Full article
(This article belongs to the Section Methodology, Drug and Device Discovery)
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15 pages, 6019 KiB  
Article
Characterization of Plastic Scintillator Detector for In Vivo Dosimetry in Gynecologic Brachytherapy
by Antonio Herreros, José Pérez-Calatayud, Facundo Ballester, Rosa Abellana, Joana Neves, Joana Melo, Luis Moutinho, Jordi Tarrats-Rosell, Sergi Serrano-Rueda, Luca Tagliaferri, Elisa Placidi and Angeles Rovirosa
J. Pers. Med. 2024, 14(3), 321; https://doi.org/10.3390/jpm14030321 - 20 Mar 2024
Viewed by 612
Abstract
(1) Background: High dose gradients and manual steps in brachytherapy treatment procedures can lead to dose errors which make the use of in vivo dosimetry (IVD) highly recommended for verifying brachytherapy treatments. A new procedure was presented to obtain a calibration factor which [...] Read more.
(1) Background: High dose gradients and manual steps in brachytherapy treatment procedures can lead to dose errors which make the use of in vivo dosimetry (IVD) highly recommended for verifying brachytherapy treatments. A new procedure was presented to obtain a calibration factor which allows fast and robust calibration of plastic scintillation detector (PSD) probes for the geometry of a compact phantom using Monte Carlo simulations. Additionally, characterization of PSD energy, angular, and temperature dependences was performed. (2) Methods: PENELOPE/PenEasy code was used to obtain the calibration factor. To characterize the energy dependence of the PSD, the signal was measured at different radial and transversal distances. The sensitivity to the angular position was characterized in axial and azimuthal planes. (3) Results: The calibration factor obtained allows for an absorbed dose to water determination in full scatter conditions from ionization measured in a mini polymethylmethacrylate (PMMA) phantom. The energy dependence of the PSD along the radial distances obtained was (2.3 ± 2.1)% (k = 1). The azimuthal angular dependence measured was (2.6 ± 3.4)% (k = 1). The PSD response decreased by (0.19 ± 0.02)%/°C with increasing detector probe temperature. (4) Conclusions: The energy, angular, and temperature dependence of a PSD is compatible with IVD. Full article
(This article belongs to the Special Issue Application of Brachytherapy in Clinical Practice (Volume II))
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11 pages, 277 KiB  
Article
Influence of Pelvic Floor Disorders on Sleep Quality in Women
by Rocío Adriana Peinado-Molina, Sergio Martínez-Vázquez, Antonio Hernández-Martínez and Juan Miguel Martínez-Galiano
J. Pers. Med. 2024, 14(3), 320; https://doi.org/10.3390/jpm14030320 - 20 Mar 2024
Viewed by 561
Abstract
Pelvic floor disorders, the impact of their symptoms, and their association with sleep quality and sleep disorders is a little studied area. The aim of this study was to determine if an association exists between pelvic floor disorders in women and sleep disorders. [...] Read more.
Pelvic floor disorders, the impact of their symptoms, and their association with sleep quality and sleep disorders is a little studied area. The aim of this study was to determine if an association exists between pelvic floor disorders in women and sleep disorders. An observational study was conducted among women in Spain during 2021 and 2022. A self-developed questionnaire was used to collect sociodemographic and employment data, previous medical history and health status, lifestyle and habits, obstetric history, and health problems. A validated questionnaire, the Pittsburgh Sleep Quality Index (PSQI), was used to assess the quality of sleep. The presence and impact of pelvic floor problems was assessed with the Pelvic Floor Distress Inventory (PFDI-20). Odds ratios (OR) and adjusted odds ratios (aOR) with their respective 95% confidence intervals were calculated using logistic regression. A total of 1396 women participated in the study. The total PSQI indicated that 75.36% (1052) of women have altered general sleep quality. Women with pelvic floor disorders have a higher probability of developing sleep alterations (aOR: 1.32; 95% CI: 1.22–1.42; for every 20 points). A high BMI (aOR: 1.04; 95% CI: 1.01–1.07; for each point) and the presence of musculoskeletal disorders (aOR: 3.14; 95% CI: 1.20–8.27) are also associated with sleep quality in women. Women with pelvic floor disorders are more likely to develop sleep disorders, probably due to all the discomfort they entail. Full article
(This article belongs to the Section Epidemiology)
13 pages, 2158 KiB  
Article
A Genetic Analysis of Current Medication Use in the UK Biobank
by Palle Duun Rohde
J. Pers. Med. 2024, 14(3), 319; https://doi.org/10.3390/jpm14030319 - 20 Mar 2024
Viewed by 677
Abstract
Genomics has been forecasted to revolutionise human health by improving medical treatment through a better understanding of the molecular mechanisms of human diseases. Despite great successes of the last decade’s genome-wide association studies (GWAS), the results have been translated to genomic medicine to [...] Read more.
Genomics has been forecasted to revolutionise human health by improving medical treatment through a better understanding of the molecular mechanisms of human diseases. Despite great successes of the last decade’s genome-wide association studies (GWAS), the results have been translated to genomic medicine to a limited extent. One route to get closer to improved medical treatment could be by understanding the genetics of medication use. Current medication profiles from 335,744 individuals from the UK Biobank were obtained, and a GWAS was conducted to identify common genetic variants associated with current medication use. In total, 59 independent loci were identified for medication use, and approximately 18% of the total variation was attributable to common genetic variation. The largest fraction of genetic variance for current medication use was captured by variants with low-to-medium minor allele frequency, with coding, conserved genomic regions and transcription start sites being enriched for associated variants. The average correlation (R) between medication use and the polygenic score was 0.14. The results further demonstrated that individuals with higher polygenic burden for medication use were, on average, sicker and had a higher risk for adverse drug reactions. These results provide an insight into the genetic contribution of medication use and pave the way for developments of novel multiple trait polygenic scores, which include the genetically informed medication use. Full article
(This article belongs to the Section Omics/Informatics)
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14 pages, 441 KiB  
Review
Opioids in Treatment of Refractory Dyspnea in Chronic Obstructive Pulmonary Disease: Yes, No or Maybe
by Ruxandra-Mioara Rajnoveanu, Antonia Harangus, Doina Adina Todea, Milena Adina Man, Corina Eugenia Budin and Armand-Gabriel Rajnoveanu
J. Pers. Med. 2024, 14(3), 318; https://doi.org/10.3390/jpm14030318 - 19 Mar 2024
Viewed by 751
Abstract
Chronic Obstructive Pulmonary Disease (COPD) is a complex condition with significant impact on prognosis, especially in advanced stages where symptom burden becomes critical. Breathlessness affects patients’ quality of life, and despite various therapeutic strategies, the role of opioids in palliative care for COPD [...] Read more.
Chronic Obstructive Pulmonary Disease (COPD) is a complex condition with significant impact on prognosis, especially in advanced stages where symptom burden becomes critical. Breathlessness affects patients’ quality of life, and despite various therapeutic strategies, the role of opioids in palliative care for COPD remains under investigation. The acceptance of a therapeutic trial of different types of opioids is increasing not only in end-of-life situations but also for stable COPD patients experiencing intolerable refractory breathlessness despite optimal conventional therapy. Recent clinical trials have raised questions about the overall clinical benefit of opioids in addressing breathlessness in COPD, prompting the need to clarify inconsistencies and identify specific subgroups that may benefit from opioid therapy. In the clinical setting, it is crucial to understand the attributes of patients who exhibit positive responses to opioids and what type of opioids could have a positive impact. This research paper aims to offer an update of the most recent evidence of opioid treatment in managing breathlessness among individuals with COPD with a head-to-head evaluation of the supporting and opposing proof in the medical literature. Full article
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11 pages, 909 KiB  
Article
Implications of the Matrix Metalloproteinases, Their Tissue Inhibitors and Some Other Inflammatory Mediators Expression Levels in Children Obesity-Related Phenotypes
by Aldona Wierzbicka-Rucińska, Izabela Kubiszewska, Renata Grzywa-Czuba, Lidia Gackowska, Mieczysław Szalecki, Jacek Michałkiewicz and Joanna Beata Trojanek
J. Pers. Med. 2024, 14(3), 317; https://doi.org/10.3390/jpm14030317 - 19 Mar 2024
Viewed by 688
Abstract
Objectives: Matrix metalloproteinases (MMPs) are calcium-dependent zinc-containing endo-peptidases engaged in many biological processes including adipogenesis, angiogenesis, and tissue remodeling. Fat tissue infiltration by peripheral leukocytes plays an important role in transition of fat tissue residual, non-inflammatory status into the pro-inflammatory one, resulting in [...] Read more.
Objectives: Matrix metalloproteinases (MMPs) are calcium-dependent zinc-containing endo-peptidases engaged in many biological processes including adipogenesis, angiogenesis, and tissue remodeling. Fat tissue infiltration by peripheral leukocytes plays an important role in transition of fat tissue residual, non-inflammatory status into the pro-inflammatory one, resulting in fat tissue inflammation and expansion as well as production of many mediators like adipokines and cytokines. The aim of this study was to investigate the expression of MMPs, their endogenous tissue inhibitors (TIMPs), and selected inflammatory mediators in leukocytes and plasma of children with simple obesity to find their associations with obesity-related phenotypes. Material and methods: Twenty-six overweight/obese children and twenty-three healthy volunteers participated in the study. The leukocyte mRNA expression levels of MMP-2, -9, -12 -14, TIMP-1, -2, and IL-6 were analyzed by the real time quantitative PCR. Plasma MMP-9/TIMP-1 and MMP-2/TIMP-2 ratios as well as the concentrations of MMP-9, TIMP-1, IL-1 beta, IL-6, TNF- alpha, leptin and resistin were tested by ELISA assays. Gelatin zymography was used to assess the activity of the leukocyte MMPs proteins. Results: The obese children showed the following: a) increased expression of leukocyte TIMP-1 and slight elevation (close to statistical significance) of leukocyte MMP-9 (p = 0.054), the decline in MMP-2, b) elevation of plasma MMP-9, leptin, and MMP9/TIMP1 ratio, c) reduced expression of plasma TNF-alpha and MMP-2/TIMP-2 ratio. Several negative correlations were found: TIMP2 vs. ALT (r = −0.536), AST (r = −0.645) and TTG (r = −0.438), IL-6 vs. GGTP (r = −0.815), and MMP12 vs. TTG (r = −0.488), leptin vs. ALT (r = −0.569), MMP-9 vs. total cholesterol (r = −0.556). The only positive correlation was that of plasma leptin level vs. GGTP (r = 0.964). Conclusions: At the beginning of obesity development (children), possibly compensatory reactions prevail, reflected here by an increase in the expression of leukocyte MMPs inhibitor TIMP-1, decrease in the level of leukocyte MMP-2 and plasma MMP-2, MMP2/TIMP-2 ratio, low plasma TNF-alpha and negative correlations between the expression of TIMP-2 and liver (AST, ALT) or fat (TTG) inflammatory markers. Full article
(This article belongs to the Section Disease Biomarker)
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19 pages, 1358 KiB  
Article
Lowering Barriers to Health Risk Assessments in Promoting Personalized Health Management
by Hayoung Park, Se Young Jung, Min Kyu Han, Yeonhoon Jang, Yeo Rae Moon, Taewook Kim, Soo-Yong Shin and Hee Hwang
J. Pers. Med. 2024, 14(3), 316; https://doi.org/10.3390/jpm14030316 - 18 Mar 2024
Viewed by 700
Abstract
This study investigates the feasibility of accurately predicting adverse health events without relying on costly data acquisition methods, such as laboratory tests, in the era of shifting healthcare paradigms towards community-based health promotion and personalized preventive healthcare through individual health risk assessments (HRAs). [...] Read more.
This study investigates the feasibility of accurately predicting adverse health events without relying on costly data acquisition methods, such as laboratory tests, in the era of shifting healthcare paradigms towards community-based health promotion and personalized preventive healthcare through individual health risk assessments (HRAs). We assessed the incremental predictive value of four categories of predictor variables—demographic, lifestyle and family history, personal health device, and laboratory data—organized by data acquisition costs in the prediction of the risks of mortality and five chronic diseases. Machine learning methodologies were employed to develop risk prediction models, assess their predictive performance, and determine feature importance. Using data from the National Sample Cohort of the Korean National Health Insurance Service (NHIS), which includes eligibility, medical check-up, healthcare utilization, and mortality data from 2002 to 2019, our study involved 425,148 NHIS members who underwent medical check-ups between 2009 and 2012. Models using demographic, lifestyle, family history, and personal health device data, with or without laboratory data, showed comparable performance. A feature importance analysis in models excluding laboratory data highlighted modifiable lifestyle factors, which are a superior set of variables for developing health guidelines. Our findings support the practicality of precise HRAs using demographic, lifestyle, family history, and personal health device data. This approach addresses HRA barriers, particularly for healthy individuals, by eliminating the need for costly and inconvenient laboratory data collection, advancing accessible preventive health management strategies. Full article
(This article belongs to the Special Issue Precision Medicine for Epidemiology and Public Health)
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12 pages, 816 KiB  
Article
Significant Increase in Oxidative Stress Indices in Erythrocyte Membranes of Obese Patients with Metabolically-Associated Fatty Liver Disease
by Valeria Tutino, Valentina De Nunzio, Rossella Donghia, Emanuela Aloisio Caruso, Anna Maria Cisternino, Palma Aurelia Iacovazzi, Anna Margherita Mastrosimini, Elizabeth Alicia Fernandez, Vito Giannuzzi and Maria Notarnicola
J. Pers. Med. 2024, 14(3), 315; https://doi.org/10.3390/jpm14030315 - 18 Mar 2024
Viewed by 624
Abstract
Metabolic dysfunction-associated hepatic steatosis (MAFLD) indicates the metabolic risk associated with hepatic steatosis, overweight and obesity, and clinical evidence of metabolic dysregulation. Since MAFLD is one of the diseases that show a high frequency of alterations in the lipid content of cell membranes, [...] Read more.
Metabolic dysfunction-associated hepatic steatosis (MAFLD) indicates the metabolic risk associated with hepatic steatosis, overweight and obesity, and clinical evidence of metabolic dysregulation. Since MAFLD is one of the diseases that show a high frequency of alterations in the lipid content of cell membranes, the aim of this study was to evaluate the indices of oxidative damage of erythrocyte membranes in overweight and obese MAFLD subjects. The study was conducted on serum samples and red blood cell membranes of overweight and obese MAFLD subjects. For each patient, biochemical measurements and lipidomic analyses of erythrocytes membranes were performed. Significant differences in fatty acid profiles of RBC membranes were found between overweight and obese patients. In particular, the Peroxidation Index (PI) was higher in the erythrocyte membranes of obese subjects than in overweight subjects. The same behavior was observed for Unsaturation Index (UI) and Free Radical Stress Index (Free RSI), supporting the fact that the systemic increase in oxidative stress was associated with obesity. The study shows that there is a different susceptibility to erythrocyte membrane peroxidation for overweight and obese subjects, and the increased values of oxidative stress indices observed in the erythrocyte membranes of obese patients with MAFLD may be a possible indicator of pro-oxidative events occurring in obesity-related diseases. Full article
(This article belongs to the Section Disease Biomarker)
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13 pages, 1502 KiB  
Article
Hemidouble Stapling Technique versus Ghosting Double Stapling Technique for Esophagojejunostomy after Laparoscopic Total Gastrectomy
by Serdar Senol and Servet Karagul
J. Pers. Med. 2024, 14(3), 314; https://doi.org/10.3390/jpm14030314 - 18 Mar 2024
Viewed by 586
Abstract
The hemidouble stapler technique (HDST) in laparoscopic intracorporeal esophagojejunostomy has aspects that pose risks to the safety of the anastomosis. We developed a new esophagojejunostomy technique that converts a double-stapled anastomosis to a single-stapled anastomosis in laparoscopic total gastrectomy (LTG). The aim of [...] Read more.
The hemidouble stapler technique (HDST) in laparoscopic intracorporeal esophagojejunostomy has aspects that pose risks to the safety of the anastomosis. We developed a new esophagojejunostomy technique that converts a double-stapled anastomosis to a single-stapled anastomosis in laparoscopic total gastrectomy (LTG). The aim of this study is to compare the results of two techniques. Patients who underwent LTG for gastric cancer in our hospital between October 2016 and May 2022 were included in the study. Patients were retrospectively reviewed in two groups: those who underwent HDST and the ghosting double stapling technique (GDST). Both groups were analysed in terms of demographics, perioperative findings, and postoperative outcomes. The GDST was used in 14 patients. The HDST was used on 16 patients. Two patients in the HDST group whose esophagojejunal anastomosis was not assessed on endoscopic imaging were excluded. The mean total operative times were 292.6 ± 43.7 and 224.3 ± 36.1 min (p < 0.001). The mean times for esophagojejunostomy were 38.6 ± 4.3 and 26.8 ± 6.4 min (p < 0.001). One case of anastomotic stenosis was observed in the HDST group. Anastomotic leakage was not observed in both groups. However, there was no significant difference in overall morbidity between the groups (p > 0.05). Both HDST and GDST can be safely performed in the esophagojejunostomy for LTG. Full article
(This article belongs to the Section Methodology, Drug and Device Discovery)
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13 pages, 810 KiB  
Article
A Prospective Study on Neural Biomarkers in Patients with Long-COVID Symptoms
by Charikleia S. Vrettou, Alice G. Vassiliou, Chrysi Keskinidou, Panagiotis Mourelatos, Andreas Asimakos, Stavroula Spetsioti, Aristidis Diamantopoulos, Edison Jahaj, Archontoula Antonoglou, Paraskevi Katsaounou, Dimitra A. Vassiliadi, Anastasia Kotanidou and Ioanna Dimopoulou
J. Pers. Med. 2024, 14(3), 313; https://doi.org/10.3390/jpm14030313 - 16 Mar 2024
Viewed by 890
Abstract
Background: this prospective observational study aims to assess serum levels of glial fibrillary acidic protein (GFAP), s100b, and total Tau in long-COVID patients, exploring correlations with symptoms, cognitive decline, mental health, and quality of life. Methods: Long-COVID patients visiting our outpatient clinic (February [...] Read more.
Background: this prospective observational study aims to assess serum levels of glial fibrillary acidic protein (GFAP), s100b, and total Tau in long-COVID patients, exploring correlations with symptoms, cognitive decline, mental health, and quality of life. Methods: Long-COVID patients visiting our outpatient clinic (February 2021–December 2022) were screened alongside age- and sex-matched controls. GFAP, s100b, and total Tau in serum were measured with ELISA. Cognitive function, depression, anxiety, post-traumatic stress disorder, and quality of life were evaluated using MoCA, HADS (depression and anxiety), IES-R, and SF-36, respectively. Results: Sixty-five long-COVID patients and 20 controls were included. GFAP levels were significantly higher in long-COVID patients (p = 0.031), though not correlating with the presence of long-COVID symptoms. S100b and total Tau showed no significant differences between patients and controls. Nervous system-related symptoms were reported in 47% of patients. High rates of cognitive decline (65.9%), depression (32.2%), anxiety (47.5%), and post-traumatic stress disorder (44.1%) were observed. Over 80% of the study population scored below normative cutoffs for SF-36, indicating a significant impact on quality of life. Conclusions: in this long-COVID cohort with substantial psychological and cognitive symptoms, GFAP levels were elevated compared to controls, though not correlating with the presence of long-COVID symptoms. Full article
(This article belongs to the Section Disease Biomarker)
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16 pages, 8663 KiB  
Article
Digital Validation in Breast Cancer Needle Biopsies: Comparison of Histological Grade and Biomarker Expression Assessment Using Conventional Light Microscopy, Whole Slide Imaging, and Digital Image Analysis
by Ji Eun Choi, Kyung-Hee Kim, Younju Lee and Dong-Wook Kang
J. Pers. Med. 2024, 14(3), 312; https://doi.org/10.3390/jpm14030312 - 16 Mar 2024
Viewed by 639
Abstract
Given the widespread use of whole slide imaging (WSI) for primary pathological diagnosis, we evaluated its utility in assessing histological grade and biomarker expression (ER, PR, HER2, and Ki67) compared to conventional light microscopy (CLM). In addition, we explored the utility of digital [...] Read more.
Given the widespread use of whole slide imaging (WSI) for primary pathological diagnosis, we evaluated its utility in assessing histological grade and biomarker expression (ER, PR, HER2, and Ki67) compared to conventional light microscopy (CLM). In addition, we explored the utility of digital image analysis (DIA) for assessing biomarker expression. Three breast pathologists assessed the Nottingham combined histological grade, its components, and biomarker expression through the immunohistochemistry of core needle biopsy samples obtained from 101 patients with breast cancer using CLM, WSI, and DIA. There was no significant difference in variance between the WSI and CLM agreement rates for the Nottingham grade and its components and biomarker expression. Nuclear pleomorphism emerged as the most variable histologic component in intra- and inter-observer agreement (kappa ≤ 0.577 and kappa ≤ 0.394, respectively). The assessment of biomarker expression using DIA achieved an enhanced kappa compared to the inter-observer agreement. Compared to each observer’s assessment, DIA exhibited an improved kappa coefficient for the expression of most biomarkers with CLM and WSI. Using WSI to assess prognostic and predictive factors, including histological grade and biomarker expression in breast cancer, is acceptable. Furthermore, incorporating DIA to assess biomarker expression shows promise for substantially enhancing scoring reproducibility. Full article
(This article belongs to the Special Issue Digital Pathology in Translational Medicine and Clinical Practice)
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14 pages, 3468 KiB  
Systematic Review
Safety and Efficacy of the Use of Supraglottic Airway Devices in Children and Adolescents Undergoing Adenotonsillectomy—A Systematic Review and Meta-Analysis
by Abhijit Nair, Nitinkumar Borkar, Sunil Subhash Murke and Ujjwalraj Dudhedia
J. Pers. Med. 2024, 14(3), 311; https://doi.org/10.3390/jpm14030311 - 16 Mar 2024
Viewed by 1193
Abstract
(1) Background: Supraglottic airway devices (SAD) have been used in children and adolescents undergoing adenotonsillectomies under general anesthesia. This systematic review and meta-analysis investigate the safety and efficacy of using SADs when compared to an endotracheal tube (ETT). (2) Methods: After registering with [...] Read more.
(1) Background: Supraglottic airway devices (SAD) have been used in children and adolescents undergoing adenotonsillectomies under general anesthesia. This systematic review and meta-analysis investigate the safety and efficacy of using SADs when compared to an endotracheal tube (ETT). (2) Methods: After registering with PROSPERO, databases like PubMed, Scopus, OviD, CINAHL, and Cochrane Library were searched using relevant keywords from the year 2000. We used RoB-2 for risk-of-bias assessment, GRADE for assessing the quality of evidence, RevMan 5.2 for qualitative meta-analysis, and trial sequential analysis (TSA) to corroborate the significant findings of meta-analysis. (3) Results: Out of 200 studies, 5 randomized-controlled trials fulfilled inclusion criteria. The quality of evidence was moderate for laryngospasm, low for airway device failure, and very low for recovery time. The incidence of laryngospasm was comparable between SADs and ETT (RR: 0.80, 95% CI-0.36, 1.80, p = 0.59). The incidence of airway device failure was significantly higher with SADs than ETT (RR: 11.29, 95% CI: 2.73, 46.66, p = 0.0008). The postoperative recovery time was significantly less with SADs than with ETT use (MD: −4.33, 95% CI: −5.28, −3.39, p < 0.0001), which was confirmed by the TSA. (4) Conclusions: The results of this review suggests that use of SADs can provide a lesser postoperative recovery time and comparable incidence of laryngospasm, with a higher incidence of failure of SAD when compared to ETT. Use of SAD for pediatric and adolescent adenotonsillectomies should be individualized based on patient characteristics, and on the expertise of the anesthesiologist and the surgeons involved. Full article
(This article belongs to the Section Evidence Based Medicine)
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19 pages, 10031 KiB  
Review
Artificial Intelligence-Supported Ultrasonography in Anesthesiology: Evaluation of a Patient in the Operating Theatre
by Sławomir Mika, Wojciech Gola, Monika Gil-Mika, Mateusz Wilk and Hanna Misiołek
J. Pers. Med. 2024, 14(3), 310; https://doi.org/10.3390/jpm14030310 - 15 Mar 2024
Viewed by 799
Abstract
Artificial intelligence has now changed regional anesthesia, facilitating, therefore, the application of the regional block under the USG guidance. Innovative technological solutions make it possible to highlight specific anatomical structures in the USG image in real time, as needed for regional block. This [...] Read more.
Artificial intelligence has now changed regional anesthesia, facilitating, therefore, the application of the regional block under the USG guidance. Innovative technological solutions make it possible to highlight specific anatomical structures in the USG image in real time, as needed for regional block. This contribution presents such technological solutions as U-Net architecture, BPSegData and Nerveblox and the basis for independent assisting systems in the use of regional blocks, e.g., ScanNav Anatomy PNB or the training system NeedleTrainer. The article describes also the systems integrated with the USG devices, such as Mindray SmartNerve or GE cNerve as well as the robotic system Magellan which substantially increases the patient’s safety, time needed for the regional block and quality of the procedure. All the solutions presented in this article facilitate the performance of regional blocks by less experienced physicians and appear as an excellent educational tool which, at the same time, improves the availability of the more and more popular regional anesthesia. Will, therefore, artificial intelligence replace physicians in regional block procedures? This seems unlikely. It will, however, assist them in a significant manner, contributing to better effectiveness and improved safety of the patient. Full article
(This article belongs to the Special Issue Personalized Medicine in Anesthesia and Anesthetics)
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13 pages, 2302 KiB  
Article
The First Prospective Study Investigating the Safety and Feasibility of a Spray-Type Adhesion Barrier (AdSpray™) in Minimally Invasive Hepatectomy: An Analysis of 124 Cases at Our Institution
by Masayuki Kojima, Atsushi Sugioka and Yutaro Kato
J. Pers. Med. 2024, 14(3), 309; https://doi.org/10.3390/jpm14030309 - 15 Mar 2024
Viewed by 586
Abstract
(1) Background: With the increasing demand for repeat hepatectomy, preventing perihepatic adhesion formation following initial hepatectomy is crucial. Adhesion-preventative barriers, like the new spray-type AdSprayTM (Terumo Corporation, Tokyo, Japan), have been proposed to reduce adhesion risk. However, data on their safety in [...] Read more.
(1) Background: With the increasing demand for repeat hepatectomy, preventing perihepatic adhesion formation following initial hepatectomy is crucial. Adhesion-preventative barriers, like the new spray-type AdSprayTM (Terumo Corporation, Tokyo, Japan), have been proposed to reduce adhesion risk. However, data on their safety in minimally invasive hepatectomy (MIH) remain scarce. This is the first prospective study to evaluate the safety and feasibility of AdSprayTM in MIH. (2) Methods: A total of 124 patients who underwent MIH with AdSprayTM and 20 controls were analyzed. Subgroup analysis according to the AdSpray™ application area was conducted. Major complications were assessed using the Clavien–Dindo classification. Moreover, intraperitoneal pressure during AdSpray™ application was monitored in 20 cases. (3) Results: Major complications occurred in 6.4% of the patients, which was comparable to that in open hepatectomy. Intraperitoneal pressure remained stable below 12 mmHg during AdSpray™ application without any complications. No significant difference in complication rates was observed among subgroups. However, a potential increase in intra-abdominal abscess formation was suspected with AdSpray™ application to the resected liver surfaces. (4) Conclusions: AdSpray™ can be safely used in MIH; however, further research is needed to confirm the appropriacy of using AdSpray™, particularly over resected liver surfaces. Overall, AdSpray™ is a promising tool for enhancing the safety of MIH. Full article
(This article belongs to the Special Issue Minimally Invasive Liver Resection)
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3 pages, 171 KiB  
Editorial
Special Issue—Diabetes Mellitus: Current Research and Future Perspectives
by Roberto Franceschi
J. Pers. Med. 2024, 14(3), 308; https://doi.org/10.3390/jpm14030308 - 15 Mar 2024
Viewed by 754
Abstract
The Special Issue “Diabetes Mellitus: Current Research and Future Perspectives” is focused on the importance of customized medicine in monogenic diabetes of the young (MODY) and type 2 diabetes (T2D) [...] Full article
(This article belongs to the Special Issue Diabetes Mellitus: Current Research and Future Perspectives)
4 pages, 186 KiB  
Editorial
Pressure Never Lies, but It Should Be Interpreted Thoughtfully: The Role of Hydrostatic Pressure in Coronary Physiology
by Zsolt Kőszegi and Gábor Tamás Szabó
J. Pers. Med. 2024, 14(3), 307; https://doi.org/10.3390/jpm14030307 - 14 Mar 2024
Viewed by 611
Abstract
Personalized medicine shows promise for the management of patients with coronary artery disease (CAD) [...] Full article
10 pages, 656 KiB  
Article
A Seasonal Variation of Clinical and Neurological Outcomes in Patients with Out-of-Hospital Cardiac Arrest Treated with Extracorporeal Cardiopulmonary Resuscitation: A Secondary Data Analysis of the SaveJ II Study
by Kei Ito, Wataru Takayama, Yasuhiro Otomo, Akihiko Inoue, Toru Hifumi, Tetsuya Sakamoto, Yasuhiro Kuroda and on behalf of the SAVE-J II Study Group
J. Pers. Med. 2024, 14(3), 306; https://doi.org/10.3390/jpm14030306 - 14 Mar 2024
Viewed by 706
Abstract
The prognosis for patients with out-of-hospital cardiac arrest (OHCA) has been reported to be worse in the cold season. On the other hand, it is unclear whether a similar trend exists in OHCA patients who are treated with extracorporeal cardiopulmonary resuscitation (ECPR). This [...] Read more.
The prognosis for patients with out-of-hospital cardiac arrest (OHCA) has been reported to be worse in the cold season. On the other hand, it is unclear whether a similar trend exists in OHCA patients who are treated with extracorporeal cardiopulmonary resuscitation (ECPR). This study was a retrospective multicenter registry study. We examined the association between ECPR and season. We compared the prognosis in four seasonal groups according to the day of occurrence. Multivariable logistic regression analysis was performed for the assessment of clinical and neurological outcomes. A total of 2024 patients with OHCA who received ECRP were included. There were no significant differences in in-hospital mortality (p = 0.649) and in the rate of favorable neurological outcome (p = 0.144). In the multivariable logistic regression, the seasonal factor was not significantly associated with worse in-hospital mortality (p = 0.855) and favorable neurological outcomes (p = 0.807). In this study, there was no seasonal variation in OHCA patients with ECPR. Full article
(This article belongs to the Section Clinical Medicine, Cell, and Organism Physiology)
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44 pages, 1384 KiB  
Review
Personalizing Nutrition Strategies: Bridging Research and Public Health
by Vicente Javier Clemente-Suárez, Helia Carmen Peris-Ramos, Laura Redondo-Flórez, Ana Isabel Beltrán-Velasco, Alexandra Martín-Rodríguez, Susana David-Fernandez, Rodrigo Yáñez-Sepúlveda and José Francisco Tornero-Aguilera
J. Pers. Med. 2024, 14(3), 305; https://doi.org/10.3390/jpm14030305 - 13 Mar 2024
Viewed by 1047
Abstract
In recent years, although life expectancy has increased significantly, non-communicable diseases (NCDs) continue to pose a significant threat to the health of the global population. Therefore, eating habits have been recognized as key modifiable factors that influence people’s health and well-being. For this [...] Read more.
In recent years, although life expectancy has increased significantly, non-communicable diseases (NCDs) continue to pose a significant threat to the health of the global population. Therefore, eating habits have been recognized as key modifiable factors that influence people’s health and well-being. For this reason, it is interesting to study dietary patterns, since the human diet is a complex mixture of macronutrients, micronutrients, and bioactive compounds, and can modulate multiple physiological processes, including immune function, the metabolism, and inflammation. To ensure that the data we acquired were current and relevant, we searched primary and secondary sources, including scientific journals, bibliographic indexes, and databases in the last 15 years with the most relevant articles. After this search, we observed that all the recent research on NCDs suggests that diet is a critical factor in shaping an individual’s health outcomes. Thus, cardiovascular, metabolic, mental, dental, and visual health depends largely on the intake, habits and patterns, and nutritional behaviors. A diet high in processed and refined foods, added sugars, and saturated fats can increase the risk of developing chronic diseases. On the other hand, a diet rich in whole, nutrient-dense foods, such as vegetables, fruits, nuts, legumes, and a high adherence to Mediterranean diet can improve health’s people. Full article
(This article belongs to the Special Issue Mechanism of Endocrine and Metabolic Diseases)
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12 pages, 3173 KiB  
Article
Rapid and Label-Free Histopathology of Oral Lesions Using Deep Learning Applied to Optical and Infrared Spectroscopic Imaging Data
by Matthew P. Confer, Kianoush Falahkheirkhah, Subin Surendran, Sumsum P. Sunny, Kevin Yeh, Yen-Ting Liu, Ishaan Sharma, Andres C. Orr, Isabella Lebovic, William J. Magner, Sandra Lynn Sigurdson, Alfredo Aguirre, Michael R. Markiewicz, Amritha Suresh, Wesley L. Hicks, Jr., Praveen Birur, Moni Abraham Kuriakose and Rohit Bhargava
J. Pers. Med. 2024, 14(3), 304; https://doi.org/10.3390/jpm14030304 - 13 Mar 2024
Viewed by 947
Abstract
Oral potentially malignant disorders (OPMDs) are precursors to over 80% of oral cancers. Hematoxylin and eosin (H&E) staining, followed by pathologist interpretation of tissue and cellular morphology, is the current gold standard for diagnosis. However, this method is qualitative, can result in errors [...] Read more.
Oral potentially malignant disorders (OPMDs) are precursors to over 80% of oral cancers. Hematoxylin and eosin (H&E) staining, followed by pathologist interpretation of tissue and cellular morphology, is the current gold standard for diagnosis. However, this method is qualitative, can result in errors during the multi-step diagnostic process, and results may have significant inter-observer variability. Chemical imaging (CI) offers a promising alternative, wherein label-free imaging is used to record both the morphology and the composition of tissue and artificial intelligence (AI) is used to objectively assign histologic information. Here, we employ quantum cascade laser (QCL)-based discrete frequency infrared (DFIR) chemical imaging to record data from oral tissues. In this proof-of-concept study, we focused on achieving tissue segmentation into three classes (connective tissue, dysplastic epithelium, and normal epithelium) using a convolutional neural network (CNN) applied to three bands of label-free DFIR data with paired darkfield visible imaging. Using pathologist-annotated H&E images as the ground truth, we demonstrate results that are 94.5% accurate with the ground truth using combined information from IR and darkfield microscopy in a deep learning framework. This chemical-imaging-based workflow for OPMD classification has the potential to enhance the efficiency and accuracy of clinical oral precancer diagnosis. Full article
(This article belongs to the Special Issue Clinical Applications of Biospectroscopy and Imaging)
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12 pages, 1833 KiB  
Review
Do Patients with Benign Paroxysmal Positional Vertigo Have a Higher Prevalence of Osteoporosis? A Systematic Review and Meta-Analysis
by Chul-Ho Kim, Keunho Kim and Yeonjoo Choi
J. Pers. Med. 2024, 14(3), 303; https://doi.org/10.3390/jpm14030303 - 13 Mar 2024
Viewed by 745
Abstract
Benign paroxysmal positional vertigo (BPPV) is a common vestibular disorder characterized by episodic vertigo. BPPV primarily affects older adults. Thus, understanding the potential relationship between BPPV and osteoporosis is clinically important. We performed a systematic search of MEDLINE (PubMed), Embase, and Cochrane Library [...] Read more.
Benign paroxysmal positional vertigo (BPPV) is a common vestibular disorder characterized by episodic vertigo. BPPV primarily affects older adults. Thus, understanding the potential relationship between BPPV and osteoporosis is clinically important. We performed a systematic search of MEDLINE (PubMed), Embase, and Cochrane Library databases for studies on the risk of osteoporosis between BPPV (+) and BPPV (−) groups up until 17 April 2023. We compared osteoporosis prevalence between groups and performed subgroup analyses for male, female, and older patients (aged ≥ 55 years). The 12 studies included 32,460 patients with BPPV and 476,304 controls. Pooled analysis showed that the BPPV (+) group had a significantly higher osteoporosis risk than the control group (odds ratio [OR], 1.73; 95% confidence interval [CI], 1.45–2.06; p < 0.01). Subgroup analyses also presented similar trends as male (OR, 2.41; 95% CI, 1.18–4.90; p = 0.02), female (OR, 2.14; 95% CI, 1.57–2.92; p < 0.001), and older patient subgroups (OR, 1.91; 95% CI, 1.47–2.49; p < 0.01) showed a higher osteoporosis risk in the BPPV (+) group than in the control group. This meta-analysis supports the hypothesis that patients with BPPV have a higher osteoporosis prevalence than those without. Full article
(This article belongs to the Topic Metabolic Syndrome, Biomarkers and Lifestyles)
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10 pages, 810 KiB  
Review
Personalized Approach in Transcatheter Palliation of Congenital Heart Disease with Duct-Dependent Pulmonary Circulation: Right Ventricular Outflow Tract Stenting vs. Arterial Duct Stenting
by Silvia Teresa Scalera, Alessandra Pizzuto, Pietro Marchese, Massimiliano Cantinotti, Eliana Franchi, Chiara Marrone, Nadia Assanta and Giuseppe Santoro
J. Pers. Med. 2024, 14(3), 302; https://doi.org/10.3390/jpm14030302 - 12 Mar 2024
Viewed by 668
Abstract
Despite significant improvements in techniques, the treatment of neonates and infants with congenital heart disease resulting in duct-dependent pulmonary circulation is still significantly challenging. Despite current trends toward early primary surgical repair, temporary palliation is still necessary in those patients who are at [...] Read more.
Despite significant improvements in techniques, the treatment of neonates and infants with congenital heart disease resulting in duct-dependent pulmonary circulation is still significantly challenging. Despite current trends toward early primary surgical repair, temporary palliation is still necessary in those patients who are at high surgical risk for complete correction due to unfavorable clinical or anatomic characteristics. Recent advances in interventional cardiology have led to the emergence of right ventricular outflow tract and arterial duct stenting as cost-effective alternatives to surgical palliation in high-risk surgical candidates or whenever short-term pulmonary blood flow support is anticipated. This review aims to explore the evolving landscape of these transcatheter approaches, highlighting their role, efficacy and potential complications in the context of duct-dependent pulmonary circulation anatomies. Full article
(This article belongs to the Special Issue Personalized Diagnosis and Treatment for Congenital Heart Disease)
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13 pages, 2671 KiB  
Article
Assessment of Muscle Stiffness Using the MyotonPro: Effects of Fatigue on Vastus Lateralis and Medialis Muscles
by Jonathan Lettner, Lars Graventein, Hassan Tarek Hakam, Nikolai Ramadanov, Roland Becker and Robert Prill
J. Pers. Med. 2024, 14(3), 301; https://doi.org/10.3390/jpm14030301 - 12 Mar 2024
Viewed by 615
Abstract
Background: The investigation of soft tissue stiffness has garnered increasing interest due to its potential applications in detecting tissue conditions, monitoring therapy effects, and preventing sports injuries. This study utilized the MyotonPro as a reliable measurement device to assess muscle stiffness and muscle [...] Read more.
Background: The investigation of soft tissue stiffness has garnered increasing interest due to its potential applications in detecting tissue conditions, monitoring therapy effects, and preventing sports injuries. This study utilized the MyotonPro as a reliable measurement device to assess muscle stiffness and muscle frequency in the vastus lateralis and medialis muscles of both the dominant and non-dominant legs. Methods: Sixteen young, healthy subjects (seven males and nine females, age 25 ± 3.46 years) participated in this study. To induce maximal muscle fatigue, the vastus lateralis and vastus medialis muscles were subjected to a 30 kg load using a single-leg leg press. Pre- and post-fatigue measurements were conducted by two testers on the dominant and non-dominant legs, respectively, employing the MyotonPro. Results: We revealed a significant increase in muscle stiffness after maximal muscle fatigue. Specifically, on the dominant side, the vastus lateralis exhibited a stiffness increase of 6.5%, while the vastus medialis showed a 6.3% increase. On the non-dominant side, the vastus lateralis demonstrated a 7.6% increase, and the vastus medialis exhibited a 6.7% increase in muscle stiffness. Furthermore, muscle frequency increased by 8.6% (vastus lateralis) and 13.5% (vastus medialis) on the dominant side and by 15.1% (vastus lateralis) and 6.3% (vastus medialis) on the non-dominant side. The reliability of the measurements varied, with Cronbach’s alpha values ranging from inadequate 0.49 to very good 0.88. Conclusion: This study affirms the efficacy of the MyotonPro as a measurement device for assessing muscle stiffness and establishes its reliability. The observed increase in muscle stiffness after maximal muscle fatigue, accompanied by changes in muscle frequency, underscores the device’s utility. However, further research is warranted to validate the reproducibility of these findings and explore additional facets of the muscular response to fatigue. Full article
(This article belongs to the Section Methodology, Drug and Device Discovery)
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24 pages, 402 KiB  
Review
The High Rates of Comorbidity among Neurodevelopmental Disorders: Reconsidering the Clinical Utility of Distinct Diagnostic Categories
by Eleni Bonti, Irini K. Zerva, Christiana Koundourou and Maria Sofologi
J. Pers. Med. 2024, 14(3), 300; https://doi.org/10.3390/jpm14030300 - 11 Mar 2024
Viewed by 1275
Abstract
The boundaries between neurodevelopmental disorders are often indistinct, even among specialists. But do these boundaries exist, or do experts struggle to distinguish and categorize symptoms in order to arrive at a dominant diagnosis while comorbidity continually leaves questions about where each disorder ends [...] Read more.
The boundaries between neurodevelopmental disorders are often indistinct, even among specialists. But do these boundaries exist, or do experts struggle to distinguish and categorize symptoms in order to arrive at a dominant diagnosis while comorbidity continually leaves questions about where each disorder ends and begins? What should be reconsidered? The introduction of the term ‘spectrum of neurodevelopmental disorders’ could pave the way for a re-appraisal of the clinical continuum of neurodevelopmental disorders. This study aims to highlight the problems that emerge in the field of the differential diagnosis of neurodevelopmental disorders and propose a renegotiation of the distinctiveness criteria. Full article
(This article belongs to the Section Mechanisms of Diseases)
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