Journal of Clinical Medicine最新文献

{"title":"Effectiveness of Tralokinumab Across Atopic Dermatitis Phenotypes.","authors":"Francesca Barei, Paolo Calzari, Elena Pezzolo, Maddalena Napolitano, Mariateresa Rossi, Mario Bruno Guanti, Francesca Caroppo, Anna Belloni Fortina, Cataldo Patruno, Anna Campanati, Tommaso Bianchelli, Giovanni Marco D'Agostino, Eustachio Nettis, Francesco Pugliese, Francesca di Vico, Ilaria Trave, Emanuele Cozzani, Luca Stingeni, Katharina Hansel, Matilde Dall'Olio, Laura Grigolato, Rosa Coppola, Vincenzo Panasiti, Martina Maurelli, Giampiero Girolomoni, Michela Ortoncelli, Simone Ribero, Angelo Valerio Marzano, Silvia Mariel Ferrucci","doi":"10.3390/jcm14062077","DOIUrl":"10.3390/jcm14062077","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Tralokinumab, a fully human monoclonal antibody targeting IL-13, has shown efficacy and safety in clinical trials and real-life studies for atopic dermatitis (AD). However, data on its effectiveness across AD phenotypes are limited. <b>Methods</b>: A multicentric study evaluated tralokinumab's efficacy over 52 weeks in 416 severe AD patients. EASI (Eczema Area and Severity Index), P-NRS (Pruritus Numerical Rating Scale), DLQI (Dermatology Life Quality Index), and ADCT (Atopic Dermatitis Control Tool) were recorded up to 52 weeks of treatment. <b>Results</b>: The EASI, P-NRS, DLQI, and ADCT trends across phenotypes showed significant improvement in all phenotype subgroups. By week 16, classical and generalized lichenoid phenotypes showed the highest EASI improvements compared to the generalized inflammatory (75.0 vs. 45.5 [<i>p</i> < 0.001] and 79.3 vs. 45.5 [<i>p</i> < 0.001]), with most achieving EASI-75 (<i>p</i> < 0.001, χ² = 25.96). By week 24, generalized lichenoid reached 100% EASI improvement, significantly outperforming other phenotypes. The highest EASI-75 rates were seen in classical, generalized lichenoid, and portrait/head and neck phenotypes (<i>p</i> = 0.016, χ² = 13.85). No significant differences were observed at weeks 32, 40, or 52. <b>Conclusions</b>: Our results suggest that tralokinumab's durability and tolerability are consistent across the various phenotypes. The classical and generalized lichenoid were the fastest phenotypes to improve. However, given the uneven distribution of phenotypes and the gradual reduction in patient numbers over time, larger prospective studies are essential to confirm the observed trends.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11942799/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spirit Interim Analysis: A Multicenter Prospective Observational Study of Outpatients with CKD and Decreased eGFR to Assess Therapeutic Algorithms, Disease Management and Quality of Life in Greece.","authors":"Dimitrios Petras, Smaragdi Marinaki, Stylianos Panagoutsos, Ioannis Stefanidis, Kostantinos Stylianou, Evangelia Ntounousi, Sofia Lionaki, Ioannis Tzanakis, Ioannis Griveas, Dimitrios Xidakis, Eleni Theodoropoulou, Dimitris Gourlis, Argyris Andreadellis, Dimitrios Goumenos, Vassilios Liakopoulos","doi":"10.3390/jcm14062079","DOIUrl":"10.3390/jcm14062079","url":null,"abstract":"<p><p><b>Background:</b> Chronic Kidney Disease (CKD) affects 8-16% of the population worldwide and is characterized by an estimated Glomerular Filtration Rate (eGFR) of less than 60 mL/min/1.73 m² for more than 3 months. The main purpose of the study is to record the treatment algorithms and disease management of patients presenting for the first time to hospital-based nephrologists with a reduced eGFR and CKD diagnosis, under real-world clinical practice in Greece. <b>Methods:</b> This is the 6-month interim analysis of an ongoing, multicenter, observational, prospective, national study, which included 178 patients, with an eGFR between <60 and 15 mL/min/1.73 m², presenting for the first time to nephrologists at 15 public hospital units. <b>Results:</b> The median age of the patients was 71 years old, with 39.6% of them categorized as CKD stage G3b. Of these patients, 71.6% and 33.7% suffered from arterial hypertension and type 2 diabetes mellitus, respectively; 78.7% of patients received antihypertensive and 38.5% antidiabetic medications. Calcium channel blocker usage increased with disease progression (from 52.2% at G3a, to 67.9% and 67.6% at G3b and G4, respectively), while that of angiotensin II receptor antagonists decreased (from 78.3% at G3a, to 41.5% and 17.6% at G3b and G4, respectively). A decrease in metformin usage and an increase in Dipeptidyl peptidase-4 inhibitor (DPP4i) usage was also observed upon disease progression. Furthermore, 18.5%, 32.0% and 7.7% of patients received Sodium-glucose cotransporter-2 inhibitors (SGLT2i) at the G3a, G3b and G4 stages, respectively. <b>Conclusions</b>: The interim analysis results contributed to the collection of real-world data for the therapeutic patterns and the management of CKD in Greece.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943387/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Complications Related to Cardiac Implantable Electronic Devices.","authors":"Jamie Simpson, Mason Yoder, Nathaniel Christian-Miller, Heather Wheat, Boldizsar Kovacs, Ryan Cunnane, Michael Ghannam, Jackson J Liang","doi":"10.3390/jcm14062058","DOIUrl":"10.3390/jcm14062058","url":null,"abstract":"<p><p>Cardiac implantable electronic devices (CIEDs) are commonly used for a number of cardiac-related conditions, and it is estimated that over 300,000 CIEDs are placed annually in the US. With advances in technology surrounding these devices and expanding indications, CIEDs can remain implanted in patients for long periods of time. Although the safety profile of these devices has improved over time, both the incidence and prevalence of long-term complications are expected to increase. This review highlights pertinent long-term complications of CIEDs, including lead-related issues, device-related arrhythmias, inappropriate device therapies, and device-related infections. We also explore key clinical aspects of each complication, including common presentations, patient-specific and non-modifiable risk factors, diagnostic evaluation, and recommended management strategies. Our goal is to help spread awareness of CIED-related complications and to empower physicians to manage them effectively.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11942853/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacokinetic-Pharmacodynamic Simulation of Muscle Relaxation Antagonistic Conditions for Post-Operative Recurarization Prevention.","authors":"Fumiyo Yasuma, Osamu Nagata, Yuka Matsuki, Kenji Shigemi","doi":"10.3390/jcm14062043","DOIUrl":"10.3390/jcm14062043","url":null,"abstract":"<p><p><b>Background/Objectives:</b> No study has simulated rocuronium (Rb) effect-site concentrations (Ce_Rb) using real-time data-such as Rb concentrations, train-of-four (TOF) count (TOFC), and TOF ratio (TOFR)-under mechanical Rb administration. Therefore, we aimed to investigate post-operative recurarization and changes in the Ce_Rb after sugammadex (SGX) administration under conditions where Rb dosing was strictly administered using an automated delivery system for total intravenous anesthesia. <b>Methods:</b> This non-interventional, retrospective, observational study included 74 patients from an existing clinical trial who met the study criteria. Rb was automatically administered during surgery to maintain a TOFC of 1. SGX (2 mg/kg) was manually administered post-surgery, and the time until the TOFR reached ≥0.9 (if the time exceeded 3 min, 0.5 mg/kg SGX was added every minute). The results were analyzed using a pharmacokinetic (PK)-pharmacodynamic (PD) simulation model of the Rb-SGX complex. <b>Results:</b> The average total dose of administered SGX was 2.2 ± 0.4 mg/kg (mean ± standard deviation). The time from SGX administration till the TOFR reached ≥0.9 was 2.9 ± 1.1 min. Furthermore, Ce_Rb at recovery (Ce_r) was 0.3 ± 0.2 μg/mL. Notably, no cases showed post-operative recurarization within 24 h of surgery. PK-PD model simulations revealed that Ce_Rb increased again after reaching the lowest Ce_Rb in 72 cases, although no increase was recorded beyond Ce_r, suggesting no numerical risk of recurarization. <b>Conclusions:</b> Our results show that if TOFC of 1 is strictly maintained intraoperatively and SGX is administered till the TOFR reaches ≥0.9, post-operative recurarization does not occur.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943233/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Practice Preferences for Glaucoma Surgery in Japan in 2024.","authors":"Kentaro Iwasaki, Shogo Arimura, Yoshihiro Takamura, Masaru Inatani","doi":"10.3390/jcm14062039","DOIUrl":"10.3390/jcm14062039","url":null,"abstract":"<p><p><b>Objectives:</b> This study evaluated the clinical preferences of glaucoma specialists regarding glaucoma surgery and postoperative management in Japan in 2024. <b>Methods:</b> A survey about clinical practice preferences regarding glaucoma surgery and postoperative care was administered among 50 glaucoma specialists who were councilors in the Japan Glaucoma Society. <b>Results:</b> Minimally invasive glaucoma surgery (MIGS) plus phacoemulsification was the most preferred procedure for nonoperated mild to moderate cases of primary open-angle glaucoma (POAG) (94.6%) and normal tension glaucoma (NTG) (67.3%) associated with cataract. Microhook surgery was the most preferred among the MIGS procedures. Meanwhile, PreserFlo MicroShunt (PMS) surgery is emerging as a popular option for cases of POAG and NTG, especially in advanced-stage pseudophakic eyes that underwent prior corneal incision phacoemulsification (40.1%). Long-tube shunt surgeries were predominantly preferred for POAG after two failed trabeculectomies (69.4%) and for neovascular glaucoma with prior vitrectomy after a failed trabeculectomy (73.0%). Among long-tube shunt surgeries, the Ahmed glaucoma valve (AGV) was preferred over the Baerveldt glaucoma implant. Trabeculectomy required the most frequent follow-up visits within the first postoperative year, whereas PMS and long-tube shunt surgeries required comparatively fewer follow-up visits. Overall, MIGS involved less frequent follow-up visits versus filtering surgeries. <b>Conclusions:</b> MIGS is currently the procedure of choice for primary glaucoma surgery in Japan. Among glaucoma specialists of the Japan Glaucoma Society, PMS surgery is becoming popular for cases of POAG and NTG. Refractory glaucoma is commonly treated with long-tube shunt surgeries, especially the AGV.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11942949/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Features and Patient-Reported Outcomes in a Cohort of Patients with Sjögren's Disease.","authors":"Rossana Izzetti, Chiara Cinquini, Giovanni Fulvio, Marco Nisi, Chiara Baldini, Antonio Barone","doi":"10.3390/jcm14062027","DOIUrl":"10.3390/jcm14062027","url":null,"abstract":"<p><p><b>Background</b>: Sjögren's disease (SD) is an autoimmune condition causing progressive salivary and lacrimal glands dysfunction following lymphocytic infiltration in the glandular tissue. SD patients are more prone to oral health impairment due to a reduction in salivary flow. This study evaluated the relationship between oral health, functional tests, and patient reported outcomes in a cohort of SD patients. <b>Methods</b>: Patients diagnosed with SD underwent complete dental examination, with the recording of the decayed-missing-filled teeth index (DMFT), probing pocket depth (PPD), full mouth bleeding score (FMBS), and full mouth plaque score (FMPS). Hyposalivation was assessed using the unstimulated whole saliva flow rate (UWS). Patients were administered the European League Against Rheumatism (EULAR) Sjögren's Syndrome Patient Reported Index, EULAR Sjögren's syndrome disease activity index, Oral Health Impact Profile-14 (OHIP-14), Patient Acceptable Symptom State questionnaires, and a visual analog scale for xerostomia (VASx). <b>Results</b>: Fifty patients in total were enrolled. Reduced UWS was associated with higher DMFT, FMBS, and FMPS. Significant correlation was observed for UWS with VASx and OHIP-14 (<i>p</i> < 0.05). <b>Conclusions</b>: Quality of life and oral health appear mildly impaired in SD patients as an effect of reduced salivary flow, with higher DMFT and tendency towards gingival inflammation and plaque accumulation.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11942638/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Breathomics Profile of Volatile Sulfur Compounds in the Bipolar Spectrum, Does It Represent a Potential Tool for Early Diagnosis?","authors":"Federica Sancassiani, Mauro Giovanni Carta, Diego Primavera, Massimo Tusconi, Antonio Urban, Laura Atzori, Caterina Ferreli, Elisa Cantone, Gloria Virginia Cuccu, Goce Kalcev, Germano Orrù, Flavio Cabitza, Serdar M Dursun, Cesar Ivan Aviles Gonzalez, Pedro José Fragoso Castilla, Shellsyn Giraldo Jaramillo, Giulia Cossu, Alessandra Scano","doi":"10.3390/jcm14062025","DOIUrl":"10.3390/jcm14062025","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Emerging laboratory technologies, such as breathomics, may enhance the early diagnosis of psychiatric disorders, including Bipolar Disorder (BD). This study investigates the detection of volatile sulfur compounds (VSCs) in exhaled breath as potential biomarkers for BD, comparing VSC levels between individuals with BD, healthy controls, and individuals with non-pathological hyperactivity. <b>Methods:</b> A matched case-control study was conducted involving 24 patients with BD and 95 healthy controls recruited at the University Hospital of Cagliari. Controls were selected using a matched-pair design based on age (±5 years) and sex through a block-matching technique to ensure comparability with cases. Participants underwent psychiatric interviews, completed the Mood Disorder Questionnaire (MDQ), and had their exhaled breaths analyzed for VSCs using a gas chromatograph (OralChroma™). Controls were selected and randomized for age and sex. <b>Results:</b> Patients with BD exhibited significantly higher levels of methyl mercaptan (CH₃SH) compared to healthy controls (18.62 ± 5.04 vs. 9.45 ± 18.64 ppb, <i>p</i> = 0.022). Among individuals without BD, those with positive MDQ scores showed lower levels of CH₃SH than those with negative scores (9.17 ± 5.42 vs. 15.05 ± 18.03); however, this difference did not reach statistical significance (<i>p</i> = 0.254), highlighting how the deep connection between some clinical and laboratory aspects needs to be investigated more thoroughly. <b>Conclusions:</b> The results suggest a correlation between oral dysbiosis and metabolic alterations in patients with BD, with CH₃SH levels being higher in cases compared to controls. Further studies are needed to validate the use of VSCs as potential biomarkers for BD and to investigate their role in individuals with non-pathological hyperactivity.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11942791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Comparison of Physical Characteristics in Different Brands and Staining Techniques in a Brand of Lissamine Green Strips.","authors":"Neema Ghorbani-Mojarrad, James S Wolffsohn, Jennifer P Craig, Debarun Dutta, Byki Huntjens, Raheel Hussain, Zarghona Khan, Shoaib Raja, Mohammed Ibrahim, Thomas Godfrey, Alison Alderson, Katharine Evans, Mahesh Joshi, Carole Maldonado-Codina, Manbir Nagra, Elidh Martin, Laura Sweeney, Louise Terry, Dean Dunning, Marta Vianya-Estopa","doi":"10.3390/jcm14062022","DOIUrl":"10.3390/jcm14062022","url":null,"abstract":"<p><p><b>Backgrounds/Objectives:</b> The aim of this study was to compare differences in the physical characteristics of lissamine green (LG) strips and the outcomes of using different staining techniques. <b>Methods:</b> Two separate complementary investigations were conducted. Physical study: Differences between four LG strips were evaluated in terms of material, dye concentration, and dye absorption. In vivo study: Bulbar conjunctival staining was compared for four application methods of I-DEW LG strips presented in a randomized order for twenty-two participants: (1) single application 5 s after wetting (also repeated using GreenGlo for comparison), (2) single application using two strips held together, 5 s after wetting, (3) two applications using a single LG strip 5 s after wetting, 1 minute apart, (4) the same as method 3, with a single fluorescein strip in between LG applications. White light imaging was performed immediately following application and after 30, 60, 90, and 300 s. Three masked practitioners independently evaluated the randomized staining images for spot count and staining intensity. <b>Results:</b> Physical study: Strip paper fibres demonstrated visible similarities, with no difference in saline absorption (<i>p</i> > 0.05). LG concentration increased as saline retention duration increased (F = 964.1, <i>p</i> < 0.001), and GreenGlo tips were significantly darker (F = 2775.2, <i>p</i> < 0.001). In vivo study: I-DEW application resulted in less conjunctival staining than GreenGlo (<i>p</i> < 0.001). Amongst I-DEW application techniques, staining levels were similar (<i>p</i> > 0.05); however, staining intensity was significantly higher following two applications of I-DEW, 1 min apart, compared to a single application (<i>p</i> = 0.042). Both spot count and staining intensity decreased with time (<i>p</i> < 0.001). <b>Conclusions:</b> Two applications of I-DEW using a single strip, 1 min apart, after wetting with a single drop of saline provided maximal staining. There was also a significant difference in staining intensity observed between LG products.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943145/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender Differences in Alexithymia, Emotion Regulation, and Impulsivity in Young Individuals with Mood Disorders.","authors":"Luca Di Benedetto, Mario Pinto, Valentina Ieritano, Francesco Maria Lisci, Laura Monti, Elisa Marconi, Daniela Pia Rosaria Chieffo, Silvia Montanari, Georgios D Kotzalidis, Gabriele Sani, Delfina Janiri","doi":"10.3390/jcm14062030","DOIUrl":"10.3390/jcm14062030","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Alexithymia, emotion regulation, and impulsivity are key factors in youths with mood disorders. However, gender differences within these dimensions remain insufficiently studied in this population. This study seeks to explore these dimensions in a sample of adolescents and young adults with mood disorders, aiming to identify gender-specific characteristics with important clinical implications. <b>Methods:</b> We assessed 115 outpatients aged 13 to 25 years with a DSM-5 diagnosis of mood disorder. The evaluation included the Toronto Alexithymia Scale (TAS-20), the Difficulties in Emotion Regulation Scale (DERS), and the UPPS-P Impulsive Behavior Scale. The associations with suicidal ideation were tested using two different multivariate models. Results were controlled for age and intelligence measures. <b>Results:</b> The first model (Wilks' Lambda = 0.720, <i>p</i> < 0.001) revealed significantly higher scores in women than men for TAS-20 (<i>p</i> < 0.001), DERS (<i>p</i> < 0.001), and the UPPS-P subscales \"Lack of Premeditation\" (<i>p</i> = 0.004) and \"Lack of Perseverance\" (<i>p</i> = 0.001). Regression analyses confirmed gender as a significant predictor of these variables, also controlling for age and intelligence. Furthermore, intelligence measure influenced Lack of Premeditation and age influenced Lack of Perseverance. <b>Conclusions:</b> Women with mood disorders exhibit greater alexithymia, emotional dysregulation, and impulsivity, particularly in difficulties with planning and task persistence. These findings highlight the need for gender-sensitive interventions that address emotional awareness and impulse control to improve clinical outcomes.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11942885/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinically Evident Portal Hypertension Is an Independent Risk Factor of Hepatocellular Carcinoma Recurrence Following Liver Transplantation.","authors":"Arno Kornberg, Nick Seyfried, Helmut Friess","doi":"10.3390/jcm14062032","DOIUrl":"10.3390/jcm14062032","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Clinically evident portal hypertension (CEPH) is a major risk factor for the development and poor outcomes of hepatocellular carcinoma (HCC). The aim of this study was to determine the impact of CEPH on the risk of HCC recurrence following liver transplantation (LT). <b>Methods</b>: A total of 129 HCC patients were included in this retrospective analysis. The definition of CEPH was based on indirect clinical features without hepatic venous pressure gradient measurement. The impact of CEPH on the post-LT risk of HCC recurrence was determined by uni- and multivariate analysis. <b>Results:</b> Evidence of manifest portal hypertension (PH) was associated with a higher ¹⁸F-fluorodeoxy-glucose (FDG) uptake of HCC on positron emission tomography (PET; <i>p</i> < 0.001) and increased serum levels of C-reactive protein (<i>p</i> = 0.008) and interleukin-6 (IL-6; <i>p</i> = 0.001). The cumulative risk of HCC recurrence at 5 years post-LT was significantly higher in the CEPH group (38.1% vs. 10.6%, <i>p</i> < 0.001). The eligibility for neoadjuvant transarterial chemoembolization (TACE) was comparable between both study cohorts (71.4% vs. 74.2%; <i>p</i> = 0.719). However, the post-interventional pathologic response rate was significantly lower in the case of PH (15.6% vs. 53.1%; <i>p</i> < 0.001). In addition to the Milan criteria (MC), ¹⁸F-FDG avidity on PET and serum values of IL-6 and alfa-fetoprotein, we identified CEPH as another significant and independent predictor of HCC recurrence (<i>p</i> = 0.008). <b>Conclusions</b>: CEPH correlates with an unfavorable tumor phenotype, TACE refractoriness and a risk of post-LT HCC recurrence. Therefore, the clinical features of PH should be implemented in pre-transplant risk assessment and decision-making processes.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11942807/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}