Journal of Personalized Medicine最新文献

{"title":"Artificial Intelligence for Personalized Management of Acute Myeloid Leukemia.","authors":"Pasquale Niscola, Valentina Gianfelici, Roberta Laureana, Marco Giovannini, Carla Mazzone, Fabio Efficace, Maria Ilaria Del Principe","doi":"10.3390/jpm16080397","DOIUrl":"10.3390/jpm16080397","url":null,"abstract":"<p><p>Acute Myeloid Leukemia (AML) is a heterogeneous group of aggressive blood-related cancers that arise from the hematopoietic system, requiring specific treatments due to their genetic diversity and complexity. Artificial intelligence (AI) has emerged as a transformative technology in healthcare, with considerable potential to help manage AML. The application of AI approaches, such as Machine Learning (ML) models and Deep Learning (DL) algorithms, has been shown to aid risk stratification, diagnosis, treatment planning, and surveillance. This review highlights recent developments in AI applications for the personalized management of AML. We focus specifically on three major axes of personalization in AML: (1) the use of predictive models combining different data sources to improve prognostic assessment and guide risk-adaptive treatments; (2) prediction of treatment responses to various therapies based on data analysis; and (3) the use of AI for monitoring and adaptive trials in AML patients.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 8","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13514554/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148829502","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":"Hormones, Sexual Function, and Dysfunctional Sexual Beliefs in Postmenopausal Women: A Cross-Sectional Study.","authors":"Clayton Peixoto, Melanie Navarro, Carolina Gomes Carrilho, Antonio José Grande, Antonio Egidio Nardi, Adriana Cardoso, André Barciela Veras","doi":"10.3390/jpm16070394","DOIUrl":"10.3390/jpm16070394","url":null,"abstract":"<p><p><b>Background:</b> Sexual function in postmenopausal women is influenced by both hormonal and psychological factors. This study investigates the associations between sex hormones, sexual function, and sexual beliefs in this population. <b>Objective:</b> This research seeks to assess the relationship between sex hormones, sexual function, and dysfunctional sexual beliefs in postmenopausal women. <b>Methods:</b> A cross-sectional study was conducted with 42 postmenopausal women aged 45-65 years. Instruments included the FSFI and SDBQ. Hormones assessed were testosterone, estradiol, progesterone, prolactin, DHEA, SHBG, and LH. Blood samples were collected in the morning and analyzed using chemiluminescence or radioimmunoassay. Pearson correlation tests were used, with Bonferroni adjustment applied to control for multiple comparisons. <b>Results:</b> Free testosterone was positively correlated with sexual desire and negatively associated with dysfunctional beliefs regarding sexual desire. Estradiol also showed a positive correlation with desire, while prolactin was negatively associated. No other FSFI domains showed significant hormonal associations. <b>Conclusions:</b> Findings suggest that testosterone may influence both sexual desire and the internalization of dysfunctional sexual beliefs in postmenopausal women, highlighting the interplay between biological and psychological dimensions of sexuality, which may be relevant for a more comprehensive clinical assessment of sexual function in this population.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 7","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13412903/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148592421","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":"Scratching the Surface: Lipidomic Profiling of the Stratum Corneum in the Search for Pruritogens in Cholestatic Liver Diseases.","authors":"Rebecca L Beres, Kenneth D R Setchell, Marialena Mouzaki, Xueheng Zhao","doi":"10.3390/jpm16070391","DOIUrl":"10.3390/jpm16070391","url":null,"abstract":"<p><p>Pruritus is a debilitating symptom frequently affecting patients with cholestatic liver disease, often resistant to conventional antipruritic therapies. The pathogenesis of cholestatic pruritus (CP) is multifactorial, implicating not only bile acids but also a complex array of other potential pruritogenic mediators and neural signaling pathways. Identification of the exact pruritogen has been elusive, and gaps remain in understanding the pathogenesis of pruritus, so developing targeted treatments is critical. The stratum corneum (SC), the outermost lipid-rich layer of the skin, may act as a reservoir for circulating pruritogens, offering a novel window to explore the pathogenesis of CP. Recent advancements in lipidomics and non-invasive tape stripping have enabled detailed profiling of SC lipid alterations in disease states. In this review, we synthesize the current understanding of CP and its candidate pruritogens and describe state-of-the-art approaches for SC lipid analysis, combining tape stripping to sample the skin surface with mass spectrometry-based lipidomics. Finally, we summarize cutaneous molecular findings and discuss how these techniques are facilitating biomarker discovery and informing therapeutic development. This review discusses the paradigm shift from a single-molecule perspective to a more integrated view of CP as a product of complex mediator interactions and highlights the potential of SC profiling to uncover novel targets for intervention strategies.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 7","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13412514/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148592271","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":"From One-Size-Fits-All to Data-Driven Recovery: A Narrative Review of Wearable Technologies Toward Personalized Rehabilitation After Total Hip and Knee Arthroplasty.","authors":"Stefano Pagano, Sebastian Dendorfer, Tobias Renkawitz","doi":"10.3390/jpm16070393","DOIUrl":"10.3390/jpm16070393","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Commercial wearables are increasingly used after total hip and knee arthroplasty (THA/TKA) to record activity and gait outside the clinic and may help tailor recovery pathways. We reviewed the evidence on commercial devices, digital phenotyping, and data-informed rehabilitation after arthroplasty. <b>Methods</b>: We performed a structured narrative search of PubMed and Google Scholar. Of 916 records, 63 duplicates were removed, 853 were screened, 245 full texts were assessed, and 76 publications were included. Findings were synthesized thematically; no formal risk-of-bias assessment or evidence grading was undertaken. <b>Results</b>: Recovery differed by outcome and procedure. PROMs commonly improved within 1-3 months, while gait-quality measures recovered over about 7-13 weeks after THA and 13-24 weeks after TKA. Frequency-domain gait features, sample entropy, and machine-learning models provided information beyond step counts. Tracker-based interventions most consistently increased postoperative steps when introduced early and combined with behavior-change support, while digital rehabilitation was generally non-inferior to conventional rehabilitation. Wrist-worn consumer devices remained inaccurate with gait aids, compliance definitions varied, and higher step counts did not consistently correspond to better PROMs. <b>Conclusions</b>: Commercial wearables already support phenotyping and remote follow-up of individual recovery trajectories, but evidence for fully adaptive rehabilitation remains limited.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 7","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13413271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148592371","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":"Uterine Leiomyosarcoma Incidentally Diagnosed After Sigmoid Colon Perforation: A Case Report and Review of the Literature Highlighting Individualized Surgical and Oncologic Decision-Making.","authors":"Theodora Palyvou, Ioannis Stefanou, Sotirios Kympouris, Theodora Imant, Dionysia Thermou, Stavriella Seferli, Vasiliki Kanellopoulou, Despoina Chatzopoulou, Katrin Spyropoulou, Nikolaos Kardaras, Milena Iotova, Asimina Ntotsika, Maria-Christina Kapoutsi, Iasonas Priftis, Mara Bouga, Christina Bolanou, Georgios Sygkounas, Spyridon Volteas","doi":"10.3390/jpm16070392","DOIUrl":"10.3390/jpm16070392","url":null,"abstract":"<p><p><b>Introduction:</b> Uterine leiomyosarcoma (uLMS) is a rare, highly aggressive malignancy arising from the smooth muscle tissue of the uterine wall. It typically presents with abnormal vaginal bleeding, pelvic pain, or a pelvic mass. In rare instances, symptoms may result from local invasion or metastasis. We report a case of uLMS initially diagnosed following colonic perforation due to direct tumor invasion, accompanied by a comprehensive narrative review of the literature on the incidental identification of uterine sarcomas during emergency general surgery to further emphasize the diagnostic challenges, treatment approaches, and need for individualized care in these complex cases. <b>Case Presentation:</b> A 45-year-old woman presented to the Emergency Department with acute abdominal pain of several hours' duration, in the absence of other associated symptoms. An emergency exploratory laparotomy was performed, revealing feculent peritonitis secondary to sigmoid colon rupture, resulting from local invasion by a large uterine mass. A total abdominal hysterectomy with bilateral salpingo-oophorectomy was undertaken, followed by en bloc resection of the sigmoid colon, appendectomy and construction of a terminal colostomy. Her postoperative course was uneventful, and she was discharged on postoperative day eight. Histopathological examination of the specimen revealed a high-grade uterine leiomyosarcoma. Following evaluation by a multidisciplinary oncology board, the patient received adjuvant chemotherapy. <b>Methods and Results:</b> A narrative review of the literature was performed to identify cases of uterine sarcomas incidentally diagnosed during emergency surgery performed by general surgeons. Including the present case, six cases were identified. Most patients presented with acute abdomen mimicking gastrointestinal pathology, with diagnosis established intraoperatively or postoperatively. Definitive surgical management was achieved during the initial emergency procedure in all cases. <b>Conclusion:</b> Although exceptionally rare, uterine sarcoma should be considered in the differential diagnosis of acute abdomen in female patients undergoing emergency surgery. Awareness of this atypical presentation, the appropriate diagnostic approach, real-time intraoperative adaptability, and individualized multidisciplinary management are essential for ensuring appropriate surgical management and optimizing patient care.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 7","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13412596/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148592344","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":"Managing Secondary Findings from Germline Pharmacogenomic Testing.","authors":"Yee Ming Lee, Elizabeth Kearney, David F Kisor, Christopher L Farrell","doi":"10.3390/jpm16070390","DOIUrl":"10.3390/jpm16070390","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Germline pharmacogenomics (PGx) testing performed by clinical laboratories and companies can reveal secondary findings (SF) related to gene-disease risk that clinicians must appropriately manage. This study evaluated PGx panel content for potential SF using the Clinical Pharmacogenomics (ClinPGx) resource, the Clinical Genome Resource (ClinGen), and the American College of Medical Genetics and Genomics (ACMG). <b>Methods</b>: A cross-sectional review of PGx panels offered by laboratories and companies was assessed for ClinPGx PGx annotation, ClinGen's gene-disease validity and clinical actionability classifications, Clinical Pharmacogenetics Implementation Consortium (CPIC) incidental finding (IF) comments, and ACMG SF v3.3 inclusion. <b>Results/Discussion</b>: Forty-four testing sites provided panel content, yielding 125 genes, alleles, and variants. Of these, 26.4% (33/125) had PGx annotations while 73.6% (92/125) did not. A small subset of genes-<i>CACNA1S</i>, <i>CFTR</i>, <i>G6PD</i>, <i>LDLR</i>, <i>MT-RNR1</i>, and <i>RYR1</i>-had actionable recommendations based on CPIC and ACMG. Additional genes such as <i>ATM</i>, <i>F5</i>, <i>ITGB3</i>, and <i>SCN1A</i> may require consultation with genetics professionals. These findings underscore the need for a centralized resource for identifying gene-specific SF from germline PGx testing and guidance on their clinical management. <b>Conclusions</b>: PGx panels often include genes with and without established PGx annotations, some of which have potential SF implications. ClinGen's PGx Working Group, which aims to integrate PGx into the broader context of genomic medicine, may be well-positioned to facilitate the development of a standardized framework for managing potential SF from panel-based PGx testing as the field evolves.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 7","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13412467/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148592066","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":"True Left Bundle Branch Block by Strauss Criteria: Impact on CRT Response and Conduction System Pacing Trial Design-A Systematic Evidence Synthesis Toward Personalized Patient Selection.","authors":"Athanasios Saplaouras, Panagiotis Mililis, Stavroula Koskina, Athanasios Makris, Sokratis Oikonomou, Vasileios Cheilas, Theodoros Efremidis, Athena Batsouli, Ourania Kariki, George Bazoukis, Sotirios Xydonas, Theodoros Karamitsos, Christodoulos Papadopoulos, Nikolaos Fragakis, Michael Efremidis, Konstantinos P Letsas","doi":"10.3390/jpm16070389","DOIUrl":"10.3390/jpm16070389","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Background/Objectives&lt;/b&gt;: About one-third of patients who receive cardiac resynchronization therapy (CRT) do not show meaningful clinical improvement. One possible reason is that current criteria for diagnosing left bundle branch block (LBBB) do not clearly separate true conduction block from other conditions that can produce a similar QRS pattern, since they rely mainly on surface ECG features. The Strauss criteria have been proposed as a stricter alternative. They include sex-specific QRS duration thresholds and require a mid-QRS notch or slur, with the goal of better identifying patients whose conduction abnormality may be correctable. Selecting candidates on this basis reflects a personalized-medicine approach that matches resynchronization to the individual conduction substrate rather than applying a single wide-QRS threshold to all patients. In this review, we assess whether LBBB defined by the Strauss criteria is linked to better CRT outcomes, and we examine how these criteria have been used in the design of randomized clinical trials investigating conduction system pacing (CSP). &lt;b&gt;Methods&lt;/b&gt;: A systematic search of PubMed, EMBASE, and the Cochrane Library was conducted (last updated April 2026) in accordance with PRISMA 2020 guidelines. Evidence was drawn from two groups of studies: (1) observational studies comparing CRT outcomes in Strauss-positive versus Strauss-negative patients, and (2) randomized CSP trials conducted in populations enriched using either Strauss-type or typical LBBB morphology. &lt;b&gt;Results&lt;/b&gt;: A total of 17 comparative studies (&lt;i&gt;n&lt;/i&gt; ≈ 4200) were included in Part 1; most (14 of 17) reported outcomes favouring Strauss-defined LBBB, with the greatest signal in non-ischemic cardiomyopathy, although these were mostly small retrospective studies with heterogeneous outcome definitions. However, two large registry analyses found no incremental benefit of strict over conventional criteria. In Part 2, six randomized controlled trials were analyzed. The HeartSync-LBBP trial (&lt;i&gt;n&lt;/i&gt; = 200, 36-month follow-up) demonstrated significantly lower rates of mortality or heart failure hospitalization with LBBP compared to BiVP (8% vs. 28%; HR 0.26; 95% CI 0.12-0.57), with 98% technical success for LBBP. In contrast, the PhysioSync-HF trial (&lt;i&gt;n&lt;/i&gt; = 173) showed superiority of BiVP, with CSP success of only 69% and 42.8% of procedures performed by less experienced operators. Similarly, the LEFT-BUNDLE-CRT trial (&lt;i&gt;n&lt;/i&gt; = 176) found that LBBAP did not meet non-inferiority criteria compared to BiVP (RR 0.95; 95% CI 0.88-1.02). &lt;b&gt;Conclusions&lt;/b&gt;: Strauss-defined LBBB is associated with improved CRT outcomes in observational studies, particularly in non-ischemic cardiomyopathy; this reflects an association rather than established superiority or causal benefit, and no randomized trial has yet compared Strauss-guided against guideline-based patient selection. In randomized CSP trials, both operator experience and patient","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 7","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13413429/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148592272","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":"Cardiorenal Effects of Switching from Eplerenone to Esaxerenone in Patients with Chronic Heart Failure and Hypertension: A Prospective Clinical Study.","authors":"Akira Sezai, Masanori Abe, Takashi Maruyama, Makoto Taoka, Hisakuni Sekino, Masashi Tanaka","doi":"10.3390/jpm16070388","DOIUrl":"10.3390/jpm16070388","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Esaxerenone is a non-steroidal mineralocorticoid receptor antagonist (MRA) with potent cardiorenal protective effects. However, the clinical effects of switching from eplerenone to esaxerenone in patients with chronic heart failure complicated by hypertension remain unclear. This study investigated the effects of switching from eplerenone to esaxerenone on blood pressure, heart failure biomarkers, renal function, and the renin-angiotensin-aldosterone system (RAAS). <b>Methods:</b> A total of 156 patients with chronic heart failure and hypertension who had been receiving eplerenone for more than one year were prospectively enrolled. Eplerenone was switched to esaxerenone, and the patients were followed for 6 months. Blood pressure, heart rate, brain natriuretic peptide (BNP), renal function, urinary albumin-to-creatinine ratio (UACR), plasma renin activity (PRA), plasma aldosterone concentration (PAC), and urinary osmolality (U-OSM) were evaluated. <b>Results:</b> Following the switch to esaxerenone, systolic and diastolic blood pressure significantly decreased (both <i>p</i> < 0.001), whereas heart rate remained unchanged. BNP levels significantly decreased at 3 and 6 months (<i>p</i> = 0.008 and <i>p</i> = 0.002, respectively). Serum creatinine decreased (<i>p</i> = 0.017), estimated glomerular filtration rate increased (<i>p</i> = 0.028), and UACR significantly decreased at both time points (both <i>p</i> < 0.001). PRA and PAC significantly increased after switching (both <i>p</i> < 0.05), whereas angiotensin II levels remained unchanged. U-OSM significantly decreased (<i>p</i> = 0.01 and <i>p</i> = 0.002 at 3 and 6 months, respectively). No major cardiovascular events or severe adverse events were observed. <b>Conclusions:</b> In patients with chronic heart failure and hypertension, switching from eplerenone to esaxerenone was associated with reductions in blood pressure, BNP, UACR, and urinary osmolality, together with improvements in renal function. These findings suggest favorable physiological changes following the switch from a steroidal to a non-steroidal mineralocorticoid receptor antagonist, although confirmation in randomized controlled studies with clinical outcome measures is warranted.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 7","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13412516/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148592204","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":"Expanded Indications for Hybrid Spinal Fixation Systems; Combined Percutaneous Pedicle Screw Fixation and Open Approaches.","authors":"Thomas Repantis, Ioanna Lianou, Ioannis Papaioannou, Maria Papathanasiou, Lexi de Jager, Andreas Filippopoulos, Andreas Baikousis","doi":"10.3390/jpm16070387","DOIUrl":"10.3390/jpm16070387","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Minimally invasive (percutaneous) pedicle screw fixation (PPSF) was initially introduced for the treatment of degenerative spinal deformities. Since then, its indications have progressively expanded to a broad spectrum of spinal pathologies. This method has gained increasing acceptance in spinal surgery due to lower morbidity when compared with conventional open procedures. This study presents a comprehensive review of the recent literature on hybrid minimally invasive spinal instrumentation techniques, focusing on the combined use of PPSF with open or mini-open approaches and their roles in personalized surgical management. <b>Methods</b>: A literature search was conducted in PubMed and Web of Science to identify studies reporting expanded indications of percutaneous pedicle screw fixation (combined with other approaches), novel surgical techniques, and their clinical outcomes. <b>Results</b>: Thirty-five studies met the inclusion criteria and were categorized according to pathology. Most included studies were retrospective observational investigations corresponding to Oxford CEBM Levels III-IV evidence, with a smaller number of prospective studies and systematic reviews. <b>Conclusions</b>: The findings from this review highlight the expanding role of hybrid methods in the management of complex spinal disorders. These approaches provide adequate stability and enable decompression or deformity correction, while minimizing tissue trauma, blood loss, and perioperative morbidity, thereby facilitating improved recovery and functional outcomes. The included literature predominantly represents moderate levels of evidence, supporting a patient-specific, pathology-driven surgical strategy that optimizes individualized outcomes in spinal surgery.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 7","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13413084/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148592239","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":"Use of Sedation During Non-Invasive Ventilation in Intensive Care Unit: A Systematic Review and Meta-Analysis.","authors":"Carmine Iacovazzo, Andrea Uriel de Siena, Katarzyna Kotfis, Pasquale Buonanno, Serena Nappi, Raffaele Merola, Maria Vargas, Giuseppe Servillo, Pratik P Pandharipande, Annachiara Marra","doi":"10.3390/jpm16070385","DOIUrl":"10.3390/jpm16070385","url":null,"abstract":"<p><p><b>Background</b>: Non-invasive ventilation (NIV) is a well-established approach for preventing endotracheal intubation (ETI) in critically ill patients with acute respiratory failure (ARF). Sedation is frequently used to improve comfort. This study aimed to analyze the impact of sedation during NIV on ETI rates and NIV success in critically ill patients. <b>Methods</b>: We systematically searched in PubMed, EMBASE, MEDLINE, Web of Science, and CENTRAL up to September 2023, including prospective observational studies, retrospective cohort studies (nRCTs), and randomized controlled trials (RCTs). Primary outcomes were NIV success and ETI rates; secondary outcomes were hypotension, bradycardia, 28-day mortality, delirium, and oversedation. Proportions were used for observational studies, odds ratios (OR) for retrospective studies, and risk ratios (RR) for RCTs. Retrospective studies compared intermittent and continuous analgosedation, while RCTs evaluated dexmedetomidine versus other sedatives, including direct comparisons. <b>Results</b>: Four observational studies, 2 retrospective studies, and 7 RCTs (738 patients) were selected. Dexmedetomidine showed increased NIV success (RR = 1.167, 95%C.I. 1.014-1.343, <i>p</i> = 0.032) and reduced ETI rate (RR = 0.553, 95%C.I. 0.405-0.755, <i>p</i> < 0.001), but higher rate of bradycardia (RR = 2.172, 95%C.I. 1.819-4.042, <i>p</i> < 0.001) and hypotension (RR = 2.441, 95%C.I. 1.608-3.706, <i>p</i> < 0.001). nRCTs revealed higher NIV success (Proportion = 0.694, 95%C.I. 0.528-0.912, <i>p</i> = 0.009), moderate ETI rates (Proportion = 0.379, 95%C.I. 0.282-0.511, <i>p</i> < 0.001), and low bradycardia and hypotension rates. <b>Conclusions</b>: Our findings suggest that sedation, particularly dexmedetomidine-based strategies, may enhance NIV success and lower ETI rates. However, dexmedetomidine was also associated with higher rates of bradycardia and hypotension, especially compared with midazolam. To establish the correct sedation strategy, it is important to tailor the drug to the patient, considering its hemodynamic instability, delirium risk, and mortality risk.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 7","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13412897/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148592357","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}