Journal of Personalized Medicine最新文献

{"title":"Combined Assessment of Gastrointestinal Hormones and Metabolomic Profiling Following Mixed-Meal Tolerance Tests in Patients at Increased Risk of Refeeding Syndrome: Study Protocol.","authors":"Gonçalo Nunes, Marta Guimarães, Sofia S Pereira, Ivo Mendes, Francisco Vara-Luiz, Cátia Oliveira, Marta Gonçalves, Patrícia Mendes, Rute Santos, Tânia Meira, Jorge Fonseca","doi":"10.3390/jpm16090452","DOIUrl":"10.3390/jpm16090452","url":null,"abstract":"<p><p><b>Introduction:</b> Refeeding syndrome (RS) is a life-threatening metabolic complication of nutritional support. Prolonged fasting, frequently observed in malnourished patients referred for percutaneous endoscopic gastrostomy (PEG), may induce histological and ultrastructural changes in the intestinal mucosa, potentially influencing metabolic adaptation during nutritional reintroduction. Mixed-Meal Tolerance Tests (MMTT) combined with targeted metabolic profiling allow dynamic assessment of serum glucose, gastrointestinal hormones and metabolites, which may help to elucidate the metabolic adaptations associated with fasting and refeeding. <b>Objective:</b> The present study aims to perform MMTT in PEG patients to characterize enteroendocrine hormone responses and metabolomic profiles following a prolonged period of reduced nutritional intake and subsequent enteral refeeding. <b>Methods:</b> This prospective, single-center study includes adults referred for PEG after at least one month of oral intake below 50% of energy needs. The MMTT will be performed at PEG placement and after 3-6 months of enteral nutrition. Serial blood samples will be collected from baseline up to 120 minutes post-meal to measure serum glucose, insulin, C-peptide, electrolytes and gastrointestinal hormones (GLP-1, GIP, ghrelin and PYY), and for targeted metabolomic profiling by spectroscopy. Clinical and nutritional data will be prospectively recorded. Exploratory analyses will assess metabolic and hormonal changes over time and their potential associations with relevant clinical characteristics. The study was approved by the institutional ethics committee, and patient informed consent will be obtained. <b>Conclusion:</b> This study integrates MMTT and targeted metabolomic profiling to characterize hormonal and metabolic responses during fasting and refeeding in PEG patients considered at increased risk of RS due to prolonged markedly reduced oral intake. The findings may improve understanding of metabolic adaptations associated with nutritional reintroduction and may identify candidate hormonal and metabolic signatures to support future studies on RS pathophysiology and risk assessment.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13608184/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039443","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":"AI-Enabled Digital Phenotyping for Personalized Risk Stratification in Internet Gaming Disorder: A Privacy-Preserving Simulation Study.","authors":"Athanasios Kranas, Evgenia Paxinou, Ioannis Bazakidis, Christina Koufopoulou, Petros Koufopoulos, Georgios Feretzakis, Vassilios S Verykios","doi":"10.3390/jpm16090447","DOIUrl":"10.3390/jpm16090447","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Assessment of Internet Gaming Disorder (IGD) relies on retrospective self-reports and clinical interviews, which may be affected by recall and social desirability biases and may be insensitive to behavioral change. This study evaluated an artificial intelligence (AI)-enabled, privacy-preserving digital phenotyping framework for personalized IGD risk stratification under controlled simulation assumptions. <b>Methods</b>: A synthetic dataset of 1000 virtual user profiles was generated with a 20% elevated-risk prevalence and 5% balanced stochastic label noise. Four aggregated telemetry features were modeled: average session duration, sessions per week, Late-Night Index, and application-switching rate. Random Forest, Logistic Regression, and Gradient Boosting classifiers were evaluated using a stratified 80:20 hold-out split, five-fold cross-validation, playtime-only baselines, label-noise sensitivity analysis, and 200 synthetic realizations. <b>Results</b>: The primary Random Forest model achieved a balanced accuracy of 0.850, a sensitivity of 0.800, a specificity of 0.900, an area under the receiver operating characteristic curve (ROC-AUC) of 0.909, an average precision (AP) of 0.779, and a Brier score of 0.089. As an internal consistency check under the pre-specified synthetic signal structure, all-feature models showed higher performance than playtime-only baselines, and feature importance analyses recovered the encoded signal hierarchy. Performance declined with increasing label noise. Across 200 realizations, mean ROC-AUC values for the three all-feature models ranged from 0.888 to 0.904, with overlapping empirical 95% intervals. <b>Conclusions</b>: The framework demonstrates the methodological feasibility of transforming aggregated telemetry into interpretable risk signals while avoiding content-level monitoring. These findings are hypothesis-generating and do not establish clinical validity or diagnostic performance. Longitudinal validation in clinically characterized cohorts is required before deployment.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13608727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039371","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":"Knowledge, Attitudes, and Perceived Barriers to Genetics and Precision Medicine Among Rural Participants in a Large Academic Biobank: A Mixed-Methods Study.","authors":"Meghan MacNeal, Nathan A Bihlmeyer, Susanne B Haga","doi":"10.3390/jpm16090446","DOIUrl":"10.3390/jpm16090446","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Rural populations remain underrepresented in genomic research and may face unique barriers to accessing genetic and precision medicine services. This study evaluated knowledge, attitudes, beliefs, and perceived barriers related to genetics and precision medicine among rural participants enrolled in OneDukeGen (ODG), a large academic biobank and precision medicine research initiative. <b>Methods:</b> This mixed-methods study included rural ODG participants identified using U.S. Census Bureau rural classification code. Participants completed an online survey assessing genetics knowledge, attitudes toward genetic testing and precision medicine, healthcare utilization, and internet use. Semi-structured interviews were conducted with a subset of survey participants to further explore perceptions of genetics research, barriers to care, privacy concerns, and educational needs. <b>Results:</b> Among 10,305 ODG participants, 3268 (31.7%) were classified as rural, representing 97 of North Carolina's 100 counties. A total of 111 rural participants completed surveys and 14 participated in qualitative interviews. Participants generally demonstrated favorable attitudes toward genetics and precision medicine despite moderate genetics knowledge scores. Most participants believed genetic testing could improve disease prevention and treatment selection, particularly for cancer care and pharmacogenomics applications. Qualitative interviews identified three major thematic domains: (1) perceived value and promise of genetics, (2) concerns regarding privacy, trust, and misuse of genetic information, and (3) barriers and facilitators to accessing genetic services. Participants generally viewed genetics research positively but expressed concerns regarding cost, insurance coverage, privacy, and genetic discrimination. <b>Conclusions:</b> Rural participants generally expressed positive attitudes toward genetics and precision medicine; however, substantial barriers related to cost, trust, privacy, awareness, and digital access remain. Community-engaged approaches emphasizing accessibility, provider education, and culturally appropriate communication may be critical for equitable implementation of precision medicine in rural communities.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13608115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039383","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":"Understanding the Lymph Node Microenvironment in Metastatic and Non-Metastatic Head and Neck Squamous Cell Carcinoma: A Systematic Review.","authors":"Antoine Yanni, Géraldine Descamps, Fabrice Journe, Edward Boutremans, Isabelle Loeb, Sven Saussez, Didier Dequanter","doi":"10.3390/jpm16090444","DOIUrl":"10.3390/jpm16090444","url":null,"abstract":"<p><p><b>Background:</b> The immune landscape in head and neck squamous cell carcinoma (HNSCC) has been widely investigated. However, the crucial role played by the lymph node microenvironment in metastatic and non-metastatic HNSCC remains unknown. This systematic review aims to discuss the immunological crosstalk between the tumor and the nodal microenvironment and to describe the distribution of immune cells in metastatic and non-metastatic lymph nodes. <b>Methods:</b> A systematic review was conducted according to the PRISMA guidelines. PubMed, Scopus, and the Cochrane Library were searched for studies published between 1990 and 2025, with the final search performed in December 2025. Prospective and retrospective studies evaluating immune cell infiltration in metastatic and non-metastatic cervical lymph nodes were included, whereas studies focusing exclusively on non-cellular biomarkers and non-English publications were excluded. The risk of bias was assessed using the Newcastle-Ottawa Scale. The results were synthesized narratively, and no meta-analysis was performed. <b>Results:</b> The screening process identified 608 articles, of which 27 met our predefined inclusion criteria. These studies focused on macrophages, dendritic cells, neutrophils, natural killer cells, T helper cells, cytotoxic T cells, regulatory T cells, B cells, total lymphocytes, and surface markers. This systematic review provides a well-structured analysis of current knowledge on the impact of the innate and adaptive immune systems on the response against cancer cells and the recruitment of immune cells in lymph nodes. The most significant findings highlight the crucial role of antigen presentation in the antitumor response, particularly through the recruitment and activation of dendritic cells and subcapsular sinus macrophages in tumor-draining lymph nodes. It also presents in a fairly comprehensible manner that the density of mature dendritic cells, cytotoxic T cells, and B cells is higher in non-metastatic lymph nodes. <b>Discussion:</b> The lymph node microenvironment is highly enriched with immune cell infiltration, and their distribution between metastatic and non-metastatic lymph nodes can contribute to a better understanding of the underlying pathological processes. Particular attention should be given to the innate immune system cells and their implication in antigen presentation. Our findings suggest that identifying immunological profiles of lymph nodes may provide a rationale for treatment de-escalation protocols and raise the question of lymph node preservation in antitumor immune responses. However, the heterogeneity and bias assessment of the included studies warrant a cautious interpretation of these findings. Another important limitation is the limited number of studies comparing the immune microenvironment of primary tumors and lymph nodes.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13608288/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039379","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":"Primary Biliary Neuroendocrine Tumors: A Systematic Review of Surgical Management, Oncologic Outcomes and Implications for Personalized Care.","authors":"Anna Paspala, Dimitrios K Vlachos, Dionysios Prevezanos, Panagiotis Dorovinis, Nikolaos Machairas, Stylianos Kykalos, Evangelos Tagkalos, Georgios C Sotiropoulos","doi":"10.3390/jpm16090445","DOIUrl":"10.3390/jpm16090445","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Primary biliary neuroendocrine tumors (PBilNETs) are exceptionally rare biliary tract neoplasms that are frequently misdiagnosed preoperatively as cholangiocarcinoma because of overlapping clinical and radiological findings. This systematic review aimed to summarize overall evidence regarding presentation, diagnostic evaluation, surgical management, and outcomes of PBilNETs. <b>Methods</b>: A systematic search of PubMed, Scopus, and Embase databases was performed according to PRISMA guidelines for studies published between January 2000 and December 2025. Studies including adult patients with histologically confirmed and surgically treated PBilNETs were eligible. Data regarding demographics, symptoms, imaging findings, surgical treatment, histopathology, immunohistochemistry, and outcomes were extracted and analyzed. <b>Results</b>: Fifty-eight studies involving 79 patients met the inclusion criteria. Median age at diagnosis was 49 years, with female predominance. Obstructive jaundice, abdominal pain, and pruritus were the most common presenting symptoms. Most tumors originated from the hilar or extrahepatic bile ducts. Preoperative diagnosis was challenging, as most lesions were initially considered cholangiocarcinomas. Surgical resection was the main therapeutic approach and included bile duct excision with biliary reconstruction, pancreaticoduodenectomy, or hepatic resection according to tumor location. Histopathological analysis demonstrated predominantly well- or moderately differentiated neuroendocrine neoplasms with frequent chromogranin A and synaptophysin positivity. Favorable long-term outcomes were reported, with high postoperative survival and limited recurrence during follow-up. <b>Conclusions</b>: PBilNETs remain diagnostically challenging because of their rarity and nonspecific presentation; however, they appear to exhibit a less aggressive biological behavior than conventional biliary adenocarcinomas. Surgical resection remains the cornerstone of treatment, while further multicenter studies are required to optimize diagnostic and therapeutic strategies. The findings also support an individualized multidisciplinary approach integrating clinical presentation, advanced imaging, histopathological grading, and immunohistochemical profiling to optimize personalized management of these rare tumors.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13608694/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039388","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":"Cannabis and Wound Healing: A Narrative Review of Current Evidence and Applications to Facial Plastic Surgery.","authors":"Bita Rashed Naimi, David B Hom","doi":"10.3390/jpm16090442","DOIUrl":"10.3390/jpm16090442","url":null,"abstract":"<p><p>Cannabis use has increased substantially in the United States, driven by broader legalization, decriminalization, and expanding medical and recreational availability. For facial plastic surgeons, the clinical implications remain difficult to define because \"cannabis use\" encompasses heterogeneous products and routes, including smoked flower, vaping, concentrates, edibles, pharmaceutical cannabinoids, topical cannabidiol (CBD), and frequent co-use with tobacco or nicotine. Current evidence suggests that systemic cannabis use, particularly inhaled or heavy perioperative use, may be associated with increased surgical complications in selected populations; however, existing studies are limited by retrospective design, inconsistent exposure definitions, inadequate dose and route characterization, and confounding by tobacco use and comorbidities. Cannabinoids exert biologic effects through the endocannabinoid system, particularly CB1 and CB2 receptors, which are expressed in the central nervous system, immune cells, vasculature, and skin. These pathways influence inflammation, keratinocyte proliferation, fibroblast activity, angiogenesis, immune surveillance, pain signaling, and tissue remodeling. The net effect of cannabinoid exposure on wound healing is likely context dependent, varying based on receptor expression, wound-healing phase, route of administration, cannabinoid composition, local tissue environment, and patient-specific risk factors. Preclinical and early dermatologic literature suggests potential therapeutic roles for topical cannabinoids, especially CBD, in modulating inflammation and epithelial repair. In contrast, systemic perioperative cannabis use has been associated in several surgical cohorts with infection, delayed healing, hematoma, nonunion, and reoperation. Evidence specific to facial plastic surgery remains sparse. The most directly relevant study evaluated cannabis and tobacco use in patients undergoing operative mandibular fracture repair. Cannabis-only use was not associated with increased complications, although the cohort was small; concurrent cannabis and tobacco use was associated with higher rates of surgical site infection, facial nonunion, abscess, debridement, and malocclusion. To date, no published studies address cannabis-associated outcomes in rhinoplasty, rhytidectomy, blepharoplasty, browlift, or facial rejuvenation. This review summarizes the biologic rationale, available surgical evidence, and clinical considerations for incorporating cannabis use into individualized perioperative risk assessment in facial plastic surgery.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13608392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039515","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":"Posterior-Only Sagittal Correction in Degenerative Lumbar Kyphosis Using Posterior Interpedicular Osteotomy (PIO) and Bilateral Discectomy with Hyperlordotic Cages: A Retrospective Case Series.","authors":"Andrea Franchini, Giuseppe Rovere, Felice Barletta, Franco Lucio Gorgoglione, Giovanni Noia, Giuseppe Maccagnano, Andrea Perna","doi":"10.3390/jpm16090443","DOIUrl":"10.3390/jpm16090443","url":null,"abstract":"<p><p><b>Introduction</b>: Degenerative lumbar kyphosis (DLK) is a common cause of sagittal imbalance, pain, and functional disability. While three-column osteotomies provide powerful correction, they are associated with substantial morbidity. We evaluated the radiographic and clinical outcomes of a novel posterior-based correction strategy combining Posterior Interpedicular Osteotomy (PIO), bilateral discectomy, and hyperlordotic transforaminal lumbar interbody fusion (TLIF) in patients with DLK. <b>Materials and Methods</b>: A retrospective single-center case series was conducted including 215 consecutive patients with symptomatic DLK and pelvic incidence-lumbar lordosis (PI-LL) mismatch >10° treated between 2019 and 2023. All patients underwent PIO combined with bilateral discectomy and insertion of a 20° hyperlordotic TLIF cage. Radiographic parameters, including lumbar lordosis (LL), pelvic tilt (PT), and sacral slope (SS), were assessed preoperatively and up to 24 months postoperatively. Clinical outcomes were evaluated using the Visual Analog Scale (VAS), Oswestry Disability Index (ODI), and Short Form-36 (SF-36). Complications were systematically recorded. <b>Results</b>: Mean lumbar lordosis improved from 15.7° ± 8.3° preoperatively to 45.4° ± 11.6° at 24 months, corresponding to a mean correction of 29.7° ± 10.1° and 12.4° ± 2.9° per treated level (<i>p</i> < 0.001). Significant improvements were observed in PT, SS, VAS, ODI, and SF-36 scores (all <i>p</i> < 0.001), with maintenance of correction throughout follow-up. Mean operative time was 218.4 ± 47.3 min and mean blood loss was 483.2 ± 195.7 mL. The overall complication rate was 16.3%, with incidental durotomy being the most common event (14.9%). No cases of cage migration, deep infection, neurological deterioration, or radiographic pseudarthrosis were identified among patients who underwent CT evaluation. <b>Conclusions</b>: PIO combined with bilateral discectomy and hyperlordotic TLIF achieved substantial and durable sagittal correction with significant clinical improvement and an acceptable safety profile. By combining extensive posterior release with preservation of the anterior tension band, this technique may represent an effective intermediate alternative between conventional posterior column osteotomies and more invasive three-column deformity correction procedures.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13608052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039410","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":"Association Between the GGT/HDL-C Ratio and Ultrasonography-Defined NAFLD in Vietnamese Adults: A Cross-Sectional Study.","authors":"Truc Thanh Nguyen, Huong Tu Lam, Thong Duy Vo","doi":"10.3390/jpm16090441","DOIUrl":"10.3390/jpm16090441","url":null,"abstract":"<p><p><b>Background and aims.</b> Nonalcoholic fatty liver disease (NAFLD) is a prevalent chronic liver disease associated with cirrhosis, hepatocellular carcinoma, and increased risks of liver-related and cardiovascular mortality. Many patients, however, remain asymptomatic until advanced stages. The gamma-glutamyl transferase to high-density lipoprotein cholesterol (GGT/HDL-C) ratio is a simple, noninvasive marker reflecting hepatic dysfunction and cardiometabolic imbalance. This study assessed its association with NAFLD and determined an optimal cutoff for identifying NAFLD. <b>Methods.</b> We conducted a cross-sectional analysis of 575 adults undergoing routine health examinations at the University of Medicine and Pharmacy Hospital in Ho Chi Minh City between 2021 and 2023. Participants with significant alcohol intake, viral hepatitis, or other chronic liver diseases were excluded. NAFLD was diagnosed by standardized abdominal ultrasonography based on increased hepatic echogenicity relative to the renal cortex or spleen. Associations between GGT/HDL-C and NAFLD were assessed by logistic regression (both as a continuous variable and by quartiles), and diagnostic performance was evaluated using receiver operating characteristic (ROC) analysis. Statistical significance was defined as a two-tailed <i>p</i>-value < 0.05. <b>Results.</b> Individuals with NAFLD showed significantly higher BMI, prevalence of hypertension and diabetes, and elevated glucose, HbA1c, AST, ALT, GGT, cholesterol, triglycerides, and LDL-C, along with lower HDL-C. Each unit increase in the GGT/HDL-C ratio was associated with a 2% increase in the odds of NAFLD based on univariate logistic regression analysis. However, after adjustment for demographic and metabolic covariates, the GGT/HDL-C ratio was no longer independently associated with NAFLD. The highest quartile had an odds ratio of 7.05 (95% CI: 4.2-11.83) compared to the lowest. The area under the ROC curve for GGT/HDL-C was 0.72, outperforming GGT or HDL-C alone. A cutoff of 32.47 UI/mmol had 72.4% sensitivity and 63.3% specificity. <b>Conclusions.</b> The GGT/HDL-C ratio showed a significant unadjusted association with NAFLD and moderate discriminatory performance. However, because the association was no longer significant after full adjustment, the ratio should currently be considered a simple laboratory-based screening marker that requires further validation before routine clinical application.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13608547/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039436","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":"Decompressive Laminectomy for Neurological Complications of Spondylodiscitis: A Case Series of 15 Patients.","authors":"Andrea Bruno, Antonio Meola, Stefano Di Bella, Leonello Tacconi","doi":"10.3390/jpm16090440","DOIUrl":"10.3390/jpm16090440","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Surgical indications for spondylodiscitis are controversial, particularly when epidural extension and evolving neurological compromise are present. This study aimed to describe the clinical, neurological, pain-related, and inflammatory outcomes of patients with spondylodiscitis treated with decompressive laminectomy without spinal stabilization, at a single tertiary center. <b>Methods</b>: We retrospectively reviewed 15 consecutive patients with spondylodiscitis who underwent decompressive laminectomy at the University Hospital of Trieste between January 2017 and December 2023. Inclusion required at least 6 months of clinical and laboratory follow-up. Patients treated with acute vertebral stabilization were excluded. Collected data included spinal level, timing from diagnosis to surgery, visual analog scale (VAS) pain score, Cooper Scale grade, modified Japanese Orthopedic Association score (mJOA), white blood cell count, and C-reactive protein (CRP). Assessments were performed preoperatively (T0), 1 week after surgery (T1), and at 6 months (T2). Imaging findings from representative cases were reviewed to illustrate the radiographic evolution after decompression combined with antibiotic therapy and orthotic support. <b>Results</b>: The cohort included 8 women and 7 men with a mean age of 57.33 years. Twelve patients (80%) underwent surgery within 48 h because of neurological deterioration or urgent compressive findings. Thoracic involvement was predominant (11 cases, 73%), whereas cervical and lumbar disease accounted for 1 and 3 cases, respectively. Intraoperative cultures were positive in 9 patients (60%), and <i>Staphylococcus aureus</i> was isolated in 7 of these 9 cases (77.8%). Mean VAS pain score improved from 6.3 at T0 to 4.3 at T1 and 1.4 at T2. Mean lower-extremity Cooper Scale grade improved from 2.7 to 2.1 to 0.6; mean upper-extremity Cooper Scale grade improved from 1.3 to 1.0 to 0. Mean mJOA improved from 10.3 to 11.4 to 16.0. Mean white blood cell count declined from 11.58 to 8.35 to 6.14 × 10³/µL, and mean CRP declined from 123.9 to 72.81 to 19.44 mg/L. No patient worsened neurologically after surgery. No patient required acute stabilization or delayed arthrodesis during follow-up. <b>Conclusions</b>: In our case series of patients with compressive or progressive neurological spondylodiscitis, decompressive laminectomy combined with antibiotic treatment, bracing, and rehabilitation was associated with early neurological stabilization, substantial pain relief, and marked reduction in inflammatory markers, without subsequent need for instrumented stabilization. These data support the role of spinal decompression as part of a personalized, effective treatment strategy in patients with neurological decline.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13608500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039454","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":"Structural and Functional Characteristics of the Liver After Fractionated Local Electron Irradiation and Against the Background of Ascorbic Acid Administration.","authors":"Grigory Demyashkin, Anastasiia Buianova, Nathalia Pyatigorskaya, Olga Filippova, Galina Brkich, Zhanna Aladysheva, Vasiliy Belyaev, Vladimir Shchekin","doi":"10.3390/jpm16090439","DOIUrl":"10.3390/jpm16090439","url":null,"abstract":"<p><p>Radiation-induced liver disease (RILD) remains a clinically significant complication of radiotherapy for malignant neoplasms of the liver and upper abdomen, restricting achievable therapeutic doses and adversely affecting patient outcomes. Conventional photon-based radiotherapy (X-rays/γ-rays) exposes substantial volumes of healthy liver parenchyma and adjacent organs to ionizing radiation, increasing the risk of hepatocellular damage, inflammation, and progressive fibrosis. Electron irradiation (β-particles) represents a promising alternative owing to its limited tissue penetration (~2-3 cm) and steep dose fall-off, which significantly reduces exit dose and may reduce exit dose and limit exposure of paratumoral healthy tissues compared with photon therapy. However, the molecular mechanisms underlying electron-induced hepatic damage and strategies for its prevention remain insufficiently characterized. This review systematically analyzes the pathogenesis of radiation-induced liver damage, encompassing direct DNA damage, oxidative stress, mitochondrial dysfunction, NF-κB-mediated inflammation, cellular senescence, and TGF-β/Smad-driven fibrosis. The comparative dosimetric and radiobiological advantages of electron irradiation over photon therapy are discussed, with particular attention to intraoperative radiotherapy, FLASH, and very high-energy electron techniques. Current radioprotective strategies are critically evaluated, with emphasis on the limitations of amifostine and the multifunctional radioprotective potential of ascorbic acid, including free radical scavenging, attenuation of lipid peroxidation, stimulation of endogenous antioxidant defense, and direct inhibition of radiation-induced DNA strand breaks. Existing gaps in the evidence base are identified, and recommendations for future experimental and clinical research are proposed.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13608792/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039400","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}