Journal of Personalized Medicine最新文献

{"title":"Predictive Value of First Amniotic Sac IL-6 and Maternal Blood CRP for Emergency Cerclage Success in Twin Pregnancies.","authors":"Diana María Diago-Muñoz, Alicia Martínez-Varea, Ricardo Alonso-Díaz, Alfredo Perales-Marín, Vicente José Diago-Almela","doi":"10.3390/jpm15010037","DOIUrl":"https://doi.org/10.3390/jpm15010037","url":null,"abstract":"<p><p><b>Objectives:</b> To assess the usefulness of first amniotic sac Interleukin-6 (IL-6) to rule out intra-amniotic inflammation (IAI), as well as maternal blood c-reactive protein (CRP), to select patients with a twin pregnancy who may benefit from an emergency cerclage. <b>Materials and Methods</b>: Retrospective, descriptive study among all patients with a twin pregnancy and mid-trimester bulging membranes admitted to a tertiary Hospital from January 2012 to September 2023. According to the Hospital's Protocol, all patients received a vaginal and abdominal ultrasound, a maternal blood test, and an amniocentesis of the first sac to rule out IAI, defined by IL-6 ≥ 2.6 ng/dL. <b>Results:</b> A total of 28 patients with a twin pregnancy and mid-trimester bulging membranes were included. Among them, 18 patients (64.28%) had IL-6 levels ≥ 2.6 ng/dL. Cerclage was placed in 10 patients with IL-6 < 2.6 ng/dL. Perinatal mortality in pregnancies with IL-6 ≥ 2.6 ng/dL was 77.22%. The gestational age at delivery of patients with IL-6 < 2.6 ng/dL was 34 ± 3 weeks, compared to 23 ± 4 weeks when IL-6 was ≥2.6 ng/dL (<i>p</i> < 0.001). The latency to delivery with IL-6 < 2.6 ng/dL was 88.1 ±31.56 days, compared to 13.11 ± 20.43 days when IL-6 was ≥2.6 ng/dL (<i>p</i> < 0.001). Significant differences were found in maternal blood CRP levels in both study groups (no IAI 4.32 ± 3.67 vs. IAI 13.32 ± 15.07, <i>p</i> < 0.05). The area under the curve with an ROC curve was 0.799 (IC 95% 0.596-0.929), with a cut-off of 3.9 mg/L (S 94.4%, % E 62.5%). The gestational age at delivery with CRP < 3.9 mg/L was 33 ± 5 weeks, while in cases with CRP ≥ 3.9 mg/L, it was 24 ± 5 weeks (<i>p</i> < 0.001). The latency days to delivery were 86.5 ± 44.88 and 21.95 ± 30.97 days (<i>p</i> < 0.01), respectively. A positive correlation between the IL-6 values of both amniotic sacs was obtained, along with the Spearman coefficient correlation rank (rho = 0.835, <i>p</i> < 0.001). <b>Conclusions:</b> Compared to those with IAI, patients with a twin pregnancy and mid-trimester bulging membranes without IAI who underwent emergency cerclage had a significantly higher interval from diagnosis to delivery, as well as a significantly lower incidence of preterm birth < 34 weeks and perinatal death. Further studies are needed to assess whether the IL-6 of the first amniotic sac and maternal blood CRP might constitute a useful parameter to select patients who may benefit from an emergency cerclage.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 1","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143033254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fundus Photography-Based Distribution of Retinal Hemorrhages in Newborns: Implications for Underlying Mechanisms.","authors":"Gwon Hui Jo, Mi Young Choi, Kibum Lee, Kyung Tae Kim, Dong Yoon Kim, Ju Byung Chae, Eoi Jong Seo","doi":"10.3390/jpm15010038","DOIUrl":"https://doi.org/10.3390/jpm15010038","url":null,"abstract":"<p><p><b>Introduction:</b> The aim of this study was to investigate the locational distribution and potential mechanisms of retinal hemorrhages in newborns using fundus photography. <b>Methods:</b> A retrospective analysis of 98 consecutive newborns with retinal hemorrhages in at least one eye and 30 control newborns without retinal hemorrhages after uneventful delivery was conducted. Retinal hemorrhages were diagnosed and characterized using fundus photography and indirect ophthalmoscopy. The location, grade, and features of the hemorrhages were analyzed, alongside their association with delivery mode. Visual function was assessed at a mean follow-up of 7.8 months to evaluate the long-term implications. <b>Results:</b> Retinal hemorrhages were significantly associated with normal spontaneous vaginal delivery (NSVD) compared to cesarean section (<i>p</i> = 0.004). Bilateral involvement was observed in 87.8% of cases, with hemorrhages predominantly located around the major vascular arcade (MVA) and near the optic disc. Higher grades of hemorrhages were linked to increased involvement of the macula and retinal capillary area (RCA) (<i>p</i> < 0.001). All hemorrhages resolved spontaneously within 45.6 ± 15.9 days. No significant differences in refractive errors or strabismus development were identified between the hemorrhage and control groups at follow-up. <b>Conclusions</b>: Neonatal retinal hemorrhages are commonly observed near the MVA and optic disc, with greater severity associated with macular and RCA involvement. These findings, along with the significant association with NSVD, support a mechanism related to elevated central venous pressure. Retinal hemorrhages resolve spontaneously without impacting refractive error or strabismus development in the short term follow-up.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 1","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143032971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Hepatic Function and Chemotherapy-Induced Side Effects Between Pegylated Liposomal Doxorubicin (PLD), Topotecan (TOPO), and Gemcitabine in Platinum-Resistant Ovarian Cancer (PROC).","authors":"Radu-Dumitru Dragomir, Marina Adriana Mercioni, Șerban Negru, Dorel Popovici, Sorin Săftescu, Andiana Roxana Blidari, Ioan Sas","doi":"10.3390/jpm15010039","DOIUrl":"https://doi.org/10.3390/jpm15010039","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Platinum-resistant ovarian cancer (PROC) is a major therapeutic challenge, as it responds poorly to standard platinum-based treatment, has limited treatment options, and offers a generally unfavorable prognosis. Chemotherapeutic agents like pegylated liposomal doxorubicin (PLD), topotecan (TOPO), and gemcitabine (GEM) are used for this setting, but with varying efficacy and toxicity profiles, leading to an increasing need to understand the optimal balance between treatment effectiveness and tolerability for improving patient outcomes. This study evaluates the efficacy and side effects of PLD, TOPO, and GEM, focusing on progression-free survival (PFS), overall survival (OS), and safety profiles. <b>Methods</b>: We conducted a retrospective observational study that included 856 PROC patients treated with PLD (<i>n</i> = 383), TOPO (<i>n</i> = 352), or GEM (<i>n</i> = 121) at the OncoHelp Oncology Center from January 2018 to December 2023. Inclusion criteria encompass diagnosis, prior platinum therapy, and Eastern Cooperative Oncology Group (ECOG) status (0-2). Treatment protocols followed standard dosing, with adjustments for toxicity. Primary endpoints included PFS and OS, with safety assessed by incidence of grade 3 and 4 toxicities per CTCAE v5.0. Kaplan-Meier analysis and Cox regression were used to compare survival, and statistical significance was set at <i>p</i> < 0.05. <b>Results</b>: TOPO showed higher toxicity than PLD and GEM, including liver damage, hematological and non-hematological side effects, while PLD induced more skin toxicity. In terms of survival, minor differences were seen between the three chemotherapeutic agents, with a slight advantage for PLD for better disease control. <b>Conclusions</b>: Given the comparable results in OS across the regimens, treatment decisions should be based on other factors such as patient tolerance and quality of life.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 1","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143032770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Navigating the Uncertainty of B3 Breast Lesions: Diagnostic Challenges and Evolving Management Strategies.","authors":"Sabatino D'Archi, Beatrice Carnassale, Alejandro Martin Sanchez, Cristina Accetta, Paolo Belli, Flavia De Lauretis, Enrico Di Guglielmo, Alba Di Leone, Antonio Franco, Stefano Magno, Francesca Moschella, Maria Natale, Lorenzo Scardina, Marta Silenzi, Riccardo Masetti, Gianluca Franceschini","doi":"10.3390/jpm15010036","DOIUrl":"https://doi.org/10.3390/jpm15010036","url":null,"abstract":"<p><p>B3 breast lesions, classified as lesions of uncertain malignant potential, present a significant diagnostic and therapeutic challenge due to their heterogeneous nature and variable risk of progression to malignancy. These lesions, which include atypical ductal hyperplasia (ADH), papillary lesions (PLs), flat epithelial atypia (FEA), radial scars (RSs), lobular neoplasia (LN), and phyllodes tumors (PTs), occupy a \"grey zone\" between benign and malignant pathologies, making their management complex and often controversial. This article explores the diagnostic difficulties associated with B3 lesions, focusing on the limitations of current imaging techniques, including mammography, ultrasound, and magnetic resonance imaging (MRI), as well as the challenges in histopathological interpretation. Core needle biopsy (CNB) and vacuum-assisted biopsy (VAB) are widely used for diagnosis, but both methods have inherent limitations, including sampling errors and the inability to determine malignancy in some cases definitively. The therapeutic approach to B3 lesions is nuanced, with treatment decisions strongly influenced by factors such as the lesion size, radiological findings, histopathological characteristics, and patient factors. While some lesions can be safely monitored with watchful waiting, others may require vacuum-assisted excision (VAE) or surgical excision to rule out malignancy. The decision-making process is further complicated by the discordance between the BI-RADS score and biopsy results, as well as the presence of additional risk factors, such as microcalcifications. This review provides an in-depth analysis of the current diagnostic challenges and treatment strategies for B3 lesions, emphasizing the importance of a multidisciplinary approach to management. By synthesizing the most recent research, this article aims to provide clinicians with a clearer understanding of the complexities involved in diagnosing and treating B3 breast lesions while highlighting areas for future research, such as artificial intelligence and genomics, to improve the diagnostic accuracy and patient outcomes.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 1","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143033244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Musculoskeletal Diseases: Aetiology, Clinical Implications, Rehabilitation and Treatment.","authors":"Giacomo Farì, Andrea Bernetti","doi":"10.3390/jpm15010035","DOIUrl":"https://doi.org/10.3390/jpm15010035","url":null,"abstract":"<p><p>Musculoskeletal diseases (MDs) are a wide range of conditions affecting bones, muscles, joints, and connective tissues and are among the leading causes of disability worldwide [...].</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 1","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143033157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Concussion and the Autonomic, Immune, and Endocrine Systems: An Introduction to the Field and a Treatment Framework for Persisting Symptoms.","authors":"Jon L Pertab, Tricia L Merkley, Holly Winiarski, Kelly M J Cramond, Alex J Cramond","doi":"10.3390/jpm15010033","DOIUrl":"https://doi.org/10.3390/jpm15010033","url":null,"abstract":"<p><p>A significant proportion of patients who sustain a concussion/mild traumatic brain injury endorse persisting, lingering symptoms. The symptoms associated with concussion are nonspecific, and many other medical conditions present with similar symptoms. Medical conditions that overlap symptomatically with concussion include anxiety, depression, insomnia, chronic pain, chronic fatigue, fibromyalgia, and cervical strain injuries. One of the factors that may account for these similarities is that these conditions all present with disturbances in the optimal functioning of the autonomic nervous system and its intricate interactions with the endocrine system and immune system-the three primary regulatory systems in the body. When clinicians are working with patients presenting with persisting symptoms after concussion, evidence-based treatment options drawn from the literature are limited. We present a framework for the assessment and treatment of persisting symptoms following concussion based on the available evidence (treatment trials), neuroanatomical principles (research into the physiology of concussion), and clinical judgment. We review the research supporting the premise that behavioral interventions designed to stabilize and optimize regulatory systems in the body following injury have the potential to reduce symptoms and improve functioning in patients. Foundational concussion rehabilitation strategies in the areas of sleep stabilization, fatigue management, physical exercise, nutrition, relaxation protocols, and behavioral activation are outlined along with practical strategies for implementing intervention modules with patients.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 1","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143032845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic Versus Sternotomy, Thoracotomy and Video-Thoracoscopy Approaches for Thymoma Resection: A Comparative Analysis of Short-Term Results.","authors":"Beatrice Trabalza Marinucci, Matteo Tiracorrendo, Camilla Vanni, Fabiana Messa, Giorgia Piccioni, Alessandra Siciliani, Silvia Fiorelli, Mohsen Ibrahim, Erino A Rendina, Antonio D'Andrilli","doi":"10.3390/jpm15010034","DOIUrl":"https://doi.org/10.3390/jpm15010034","url":null,"abstract":"<p><p><b>OBJECTIVE</b>. The optimal surgical approach for thymoma resection is still an object of debate. The increasing experience in robotic-assisted thoracic surgery (RATS) has led to the progressive affirmation of this technique as a valid alternative to Sternotomy, Thoracotomy and Video-Assisted Thoracic Surgery (VATS) in this setting. The present study aims to compare the post-operative and short-term results of RATS Thymectomy for thymoma with those of other main surgical approaches (sternotomy, thoracotomy and VATS) from a high-volume single center. <b>METHODS</b>. Between May 2021 and September 2023, 40 consecutive patients underwent RATS Thymectomy for stage I to limited-stage III thymoma in our center. Three homogenous groups of patients who received thymoma resection through main alternative approaches (sternotomy, thoracotomy, VATS) over the last 5 years, were identified in order to perform a comparative analysis. Data including surgery duration, associated resections, conversion rate, overall morbidity, tumor size, radicality of resection, post-operative pain, length of hospital stay and cosmetic results were retrospectively collected and compared between the RATS and each control group. <b>RESULTS.</b> Mean tumor size was higher in the sternotomy group, but not significantly. The mean operative time of RATS interventions was significantly lower than that of sternotomy and VATS. It was significantly shorter compared to thoracotomy if excluding docking-undocking time. A higher rate of associated adjacent structures resection was reported in the sternotomy group (<i>p</i> = 0.005). Conversion rate was significantly higher in the VATS group (<i>p</i> = 0.026) compared to RATS. Post-operative pain at 24 and 48 h was significantly lower in the RATS group compared to the others. Improved cosmetics results were reported after RATS compared to sternotomy (<i>p</i> = 0.0001) and thoracotomy (<i>p</i> = 0.001) groups, with a trend towards better results compared to VATS (<i>p</i> = 0.05). Length of hospital stay was shorter in the RATS group with a significant difference vs. the sternotomy group (<i>p</i> < 0.001). <b>CONCLUSIONS.</b> These results from a single center confirm the safety and efficacy of RATS for the treatment of limited stage thymoma. An advantage in terms of operative outcomes, post-operative pain, cosmetic results and hospital stay was observed if compared to the alternative approaches. The short-term oncologic outcome was excellent based on the high complete resection rate of the tumor.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 1","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143033215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Causes of Sleep Disturbance in Early ASAS Spondyloarthritis: A Retrospective Long-Term Experience.","authors":"Francesca Bandinelli, Andrea Delle Sedie, Ilenia Mallia, Ilaria Mauro, Nikita Pecani, Linda Carli, Lorenzo Esti, Marco Di Carlo, Marina Carotti, Fausto Salaffi","doi":"10.3390/jpm15010031","DOIUrl":"https://doi.org/10.3390/jpm15010031","url":null,"abstract":"<p><p><b>Introduction:</b> Sleep disturbance (SD) in the second half of the night due to inflammatory pain was included in the 2009 ASAS classification criteria of Spondyloarthritis (SpA), even though its definition is uncertain. <b>Aim:</b> We aimed to investigate SD in early-SpA (e-SpA) patients at T1 (2010-2013), comparing them to long-term SpA (l-SpA) patients at T2 (2023-2024) after at least 10 years of follow-up. <b>Methods:</b> At T1, in e-SpA and l-SpA cases, SD, classified as \"difficulty in initiating sleep\" (DIS), \"difficulty in maintaining sleep\" (DMS) and \"early awakening\" (EA), was compared to clinical parameters (ASDAS-CRP, BASDAI, m-HAQ-S, BASMI, MASES, 68/66 joint count, tenderness of sacroiliac joints, fatigue [FACIT] and HADS for anxiety [A] and depression [D]). At T2, e-SpA patients were re-evaluated using the Pittsburgh Sleep Quality Index (PSQI). <b>Results:</b> At T1, 45% of 166 SpA patients had SD; in e-SpA patients (60), SD correlated with sacroiliac pain (DMS) BASDAI, FACIT and HADS-D (EA); in l-SpA patients (106), it correlated with HADS-A (DIS), BASDAI and FACIT (DMS). At T2, e-SpA patients showed a high PSQI in 51.5% of cases, correlated with T2-ASDAS-CRP and T2-BASDAI. Moreover, T1-ASDAS-CRP was predictive of T2-PSQI. <b>Conclusions:</b> SD is more specific for inflammatory pain in e-SpA and might be influenced by disease activity also in long-term disease.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 1","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143032693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A First Diastolic Function Evaluation in the Personalized Exercise Prescription Program for Solid Organs Transplanted Subjects: Is Atrial Strain Useful?","authors":"Melissa Orlandi, Marco Corsi, Vittorio Bini, Roberto Palazzo, Stefano Gitto, Claudia Fiorillo, Matteo Becatti, Marco Maglione, Laura Stefani","doi":"10.3390/jpm15010032","DOIUrl":"https://doi.org/10.3390/jpm15010032","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Solid organ transplant recipients (OTR) have been recently involved in exercise prescription programs in order to reduce the high prevalence of cardiovascular diseases. The normal systolic and diastolic cardiac function is fundamental to personalizing the prescription. Diastolic dysfunction can be associated to a higher risk of cardiovascular events and left atrial (LA) strain is an emerging parameter in the evaluation of diastolic compromising, especially in subjects with preserved ejection fraction. Left atrial (LA) strain has never been explored in this category. The study aimed to evaluate the contribution of the LA strain in the assessment of diastolic function of OTR and its potential contribution in the exercise program. <b>Methods</b>: 54 solid OTR (liver and kidney transplants) regularly trained for at least 12 months in a home-based, partially supervised model at moderate intensity estimated by cardiopulmonary exercise test, underwent a complete echocardiographic analysis. The measured variables included left ventricle systolic function (ejection fraction, EF), diastolic function (E/A and E/E'), LA indexed volumes, LA peak atrial longitudinal strain (PALS) and LA peak atrial contraction strain (PACS). The data were compared to those of 44 healthy subjects (HS). <b>Results</b>: The OTR showed an overweight condition (BMI: 25.79 ± 2.92 vs. 22.25 ± 2.95; <i>p</i> < 0.01). Both groups showed a preserved systolic function (EF: OTR 63.1 ± 3.5% vs. HS 66.9 ± 6.1; <i>p</i> < 0.001), while diastolic standard parameters were significantly different (E/A, 1.01 ± 0.4 vs. 1.96 ± 0.74; <i>p</i> < 0.001; E/E', 9.2 ± 2.7 vs. 6.9 ± 1.3; <i>p</i> < 0.001, in OTR and HS respectively) despite being normal. LA strain was significantly lower in OTR vs. HS (4C PALS, 33.7 ± 9.7 vs. 45.4 ± 14.19; <i>p</i> < 0.001; 4C PACS, 15.9 ± 6.7 vs. 11.6 ± 7.5; <i>p</i> = 0.006; 2C PALS, 35.3 ± 11.1 vs. 47.6 ± 14.9; <i>p</i> < 0.001; 2C PALS, 17.4 ± 4.9 vs. 13.2 ± 14.97; <i>p</i> = 0.001; in OTR and HS respectively). A specific correlation of two- and four-chamber PACs and PALs with BMI has been observed (R for 4C PALS -0.406 ** and 2C PALS -0.276 *). <b>Conclusions</b>: These findings suggest that the coexistence of increased bodyweight in asymptomatic OTR patients can exacerbate the impairment of LA strains. LA strain detection could be useful in the development of a personalized exercise program for OTRs, especially for asymptomatic subjects and those with elevated cardiovascular risk profile, to potentially manage the exercise program in the long term. Larger studies will confirm the role via an eventual structured clinical score index.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 1","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143033405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Remote-Customized Telecontrol for Patients with Rheumatoid Arthritis: The iARPlus (Innovative Approach in Rheumatology) Initiative.","authors":"Fausto Salaffi, Sonia Farah, Eleonora Di Donato, Massimo Sonnati, Emilio Filippucci, Rossella De Angelis, Francesco Gabbrielli, Marco Di Carlo","doi":"10.3390/jpm15010030","DOIUrl":"https://doi.org/10.3390/jpm15010030","url":null,"abstract":"<p><p><b>Objective</b>. Telecontrol approaches for rheumatoid arthritis (RA) management aim to enhance patient outcomes. This pilot study assessed whether the Rheumatoid Arthritis Impact of Disease (RAID) approach could be used during teleconsultations to monitor RA disease activity through a web-based platform called iARPlus (Innovative Approach in Rheumatology). <b>Methods</b>. Forty RA patients participated in two in-person visits (baseline and 12 months) and seven teleconsultations over 12 months, collected via the iARPlus portal and accessible through an internet browser. Disease activity, at baseline and follow-up, was measured using the Clinical Disease Activity Index (CDAI) and self-reported RAID scores throughout the study. The RAID approach, developed by the European Alliance of Associations for Rheumatology (EULAR), combines key patient-reported outcomes (PROs). <b>Results</b>. Nineteen patients (mean age: 49.3 years) were treated with Janus kinase inhibitors (JAKis), and 21 patients (mean age: 48.1 years) received adalimumab. All patients had active disease (mean CDAI 27.9 ± 4.8). Strong correlations were found between CDAI and RAID scores at baseline (ρ = 0.809, <i>p</i> < 0.0001) and at follow-up (ρ = 0.789, <i>p</i> < 0.0001). JAKi-treated patients showed greater reductions in RAID scores, pain relief, and higher rates of disease remission compared to adalimumab-treated patients. <b>Conclusions</b>. RAID scores were effective in teleconsultations for assessing RA disease activity. JAKi treatment resulted in better pain control and disease activity improvement compared to adalimumab. Further studies are needed to confirm the clinical and economic benefits of telecontrol for RA management.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 1","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143033208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}