Journal of Personalized Medicine最新文献

{"title":"Personalized Medicine, Storied Past, Contentious Present, Promising Future.","authors":"Kenneth P H Pritzker, Arash Samari","doi":"10.3390/jpm16040217","DOIUrl":"https://doi.org/10.3390/jpm16040217","url":null,"abstract":"<p><p>Personalized Medicine has been a central aspiration of medical practice and has guided the direction of medical advances from ancient times to the present. This narrative review highlights some of the most significant past advances and present practices, discusses issues currently limiting Personalized Medicine and proposes activities necessary for Personalized Medicine to have a promising future. Throughout history, Personalized Medicine has developed along with the evolution of science and societal concepts. Notable advances paralleled the growth in what an individual person is and how experimental science can apply to medical practice. In the twentieth century, the study of inborn errors of metabolism and pharmacogenetics broadened the horizons of what Personalized Medicine could be. Presently, Personalized Medicine is challenged by different perspectives on its scope, by the various clinical scientific activities which can inadvertently or by misinterpretation serve to depersonalize medicine, and by the difficulties involved in integrating the massive amount of available scientific data to optimize medical practice centered on the individual. The conditions necessary for Personalized Medicine to have a promising future include developing broader, deeper, and more dynamic knowledge of disease processes, new methods to identify anomalous, singular disease-contributing characteristics in individuals, and improving data quality in research and medical practice. Advancing Personalized Medicine requires developing new perspectives for research, healthcare education, medical practice, and healthcare governance, as well as deploying medical advances at scale across populations.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 4","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13117741/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774515","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":"Beyond the Gut: Extra-Enteric Digestive Manifestations of Inflammatory Bowel Disease-A Personalized Medicine Perspective and Comprehensive Review.","authors":"Maria Rogalidou, Maria-Veatriki Christodoulou, Alexandros Skamnelos, Dimitrios K Christodoulou","doi":"10.3390/jpm16040219","DOIUrl":"https://doi.org/10.3390/jpm16040219","url":null,"abstract":"<p><p>Inflammatory bowel disease (IBD)-including Crohn's disease, ulcerative colitis, and indeterminate colitis-is a chronic immune-mediated condition that primarily affects the intestinal mucosa but often presents with extraintestinal digestive manifestations, which are important yet frequently underrecognized sources of morbidity. These heterogeneous manifestations reflect diverse genetic, microbial, immunologic, and environmental influences, highlighting the value of a personalized medicine approach. Hepatobiliary involvement affects IBD adults patients and is even more common in children, ranging from mild liver enzyme elevations to severe complications such as liver failure, with autoimmune disorders, cholelithiasis, portal vein thrombosis, and non-alcoholic fatty liver disease as key considerations. Pancreatic manifestations may include autoimmune or acute pancreatitis, often linked to gallstones, thiopurine exposure, or duodenal Crohn's disease, while splenic abnormalities, such as granulomatous lesions, splenomegaly, or functional hyposplenism, reflect systemic immune dysregulation. Oral findings-including aphthous ulcers, periodontitis, pyostomatitis vegetans, and granulomatous cheilitis-can serve as early, patient-specific indicators of disease activity. Personalized approaches, encompassing investigations tailored to the individual profile and selected targeted therapies, are essential for improving diagnostic accuracy, preventing complications, and optimizing multidisciplinary care in patients with IBD.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 4","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13118048/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774367","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":"Upper Tract Urothelial Carcinoma: An Update on Current Diagnostic Modalities and Emerging Biomarkers.","authors":"Konstantinos Kapriniotis, Ioannis Loufopoulos, Mohammad U Sharif, Ioannis Manolitsis, Lazaros Tzelves, Amy Nagle, James S A Green","doi":"10.3390/jpm16040220","DOIUrl":"https://doi.org/10.3390/jpm16040220","url":null,"abstract":"<p><p><b>Introduction:</b> Upper tract urothelial carcinoma is a rare disease with variable prognosis depending on the stage and grade at diagnosis. Current modalities are far from perfect in diagnosis and risk stratification. In this setting, there is an urgent need for diagnostic and prognostic biomarkers to overcome these limitations. <b>Methods:</b> We carried out a narrative review of the literature searching for research articles on diagnostic and prognostic biomarkers for upper tract urothelial carcinoma (UC) and underlined the limitations of current diagnostic modalities. <b>Results:</b> CT urogram (CTU) is the imaging modality of choice in suspected upper tract UC with sensitivity and specificity exceeding 90% but with limitations in smaller lesions. Urine cytology has an excellent specificity for high-grade UC but is limited by low sensitivity leading to a high number of diagnostic ureteroscopies with significant associated risks. Adjuncts such as Fluorescence In Situ Hybridization (FISH) technology and urine DNA methylation markers have shown promising results but need further validation in large cohorts of upper tract UC. Finally, circulation tumour DNA (ctDNA) is a novel approach with great potential in risk stratification and monitoring of minimal residual disease post radical surgery; however, larger prospective studies are required to validate its role similarly to the recent bladder UC trials. <b>Conclusions:</b> There is an urgent need for non-invasive biomarkers that can reliably replace diagnostic ureteroscopies, identify high-risk/invasive disease and select patients for radical surgery or kidney sparing procedures.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 4","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13117324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Decade of Artificial Intelligence in Stroke Care (2015-2025): Trends, Clinical Translation, and the Precision Medicine Frontier-A Narrative Review.","authors":"Mian Urfy, Mariam Tariq Mir","doi":"10.3390/jpm16040218","DOIUrl":"https://doi.org/10.3390/jpm16040218","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Stroke generates 157 million disability-adjusted life-years (DALYs) annually, making it the leading neurological cause of global disease burden. Artificial intelligence (AI) and machine learning (ML) have emerged as transformative technologies across the stroke care continuum. This narrative review maps the trajectory of AI in stroke medicine over the decade from 2015 to 2025. <b>Methods:</b> We conducted a narrative review with a structured, pre-specified search strategy across eight pre-specified thematic clusters using PubMed/MEDLINE (January 2015-December 2025), identifying 8549 records and including 1335 studies after screening. Inclusion criteria encompassed primary research articles, systematic reviews, meta-analyses, and RCTs reporting quantitative performance metrics or clinical outcome data for AI/ML in stroke. <b>Results:</b> Stroke imaging AI is the most commercially mature domain, with over 30 FDA-cleared tools. Automated ASPECTS scoring reduced radiologist reading time by 74.8% (AUC 84.97%; 95% CI: 83.1-86.8%). The only triage AI RCT demonstrated an 11.2 min reduction in door-to-groin time without significant improvement in 90-day functional independence (OR 1.3, 95% CI 0.42-4.0). Brain-computer interface rehabilitation showed significant upper limb recovery in a 17-center RCT (FMA-UE mean difference +3.35 points, 95% CI 1.05-5.65; <i>p</i> = 0.0045). AF detection AI is FDA-cleared and RCT-validated. LLMs and federated learning are pre-regulatory but growing exponentially. <b>Conclusions:</b> AI in stroke has achieved diagnostic maturity but therapeutic immaturity. Bridging algorithmic performance to patient outcomes, addressing equity gaps, and building the economic evidence base for scalable deployment are the defining challenges of the next decade.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 4","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13117140/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Risk Management and Postoperative Outcomes After Colorectal Resection: A Retrospective Observational Study.","authors":"Laura Ambrosi, Giorgio Ammerata, Maurizio Mastrapasqua, Gianmarco Sirago, Valentina Cianci, Biagio Solarino, Alessandro Dell'Erba, Davide Ferorelli, Michele Simone","doi":"10.3390/jpm16040216","DOIUrl":"https://doi.org/10.3390/jpm16040216","url":null,"abstract":"<p><p><b>Background</b>: Postoperative complications after colorectal cancer surgery imply challenges to patient safety, recovery, and healthcare resources. Clinical Risk Management (CRM) is vital for reducing complications. This study aims to provide a comprehensive overview of short-term outcomes in a high-volume hospital over four years, evaluating the impact of complications through the lens of CRM. <b>Methods</b>: A retrospective cohort study was conducted on 483 patients (332 colon tumors, 151 rectal tumors) who underwent surgical resection. Data were extracted from the internal database, including demographic characteristics, diagnoses, surgical approaches, types of anastomoses, histological grades, and postoperative outcomes. Complications were categorized using the Clavien-Dindo system (grades I-V). Statistical analyses examined the link between clinical variables and complications. <b>Results</b>: Postoperative complications occurred in 44 (9.1%) patients in 483 cases. Among the 44 patients with postoperative complications, the most frequent events were anastomotic leakage (AL) (9/44, 20.5%; 9/483, 1.9% of the total cohort) and postoperative hemorrhage (POH) (8/44, 18.2%; 8/483, 1.7% of the total cohort). Moreover, complications were accompanied by an extended hospital stay and a higher in-hospital mortality (15.9% vs. 0%). The number of recorded postoperative follow-up visits differed significantly across complication severity categories. The overall in-hospital survival rate was 98.6%. <b>Conclusions</b>: The low rates of complications and in-hospital mortality observed in this cohort were documented within a hospital operating under a mandatory institutional CRM framework. However, due to the retrospective single-arm design, these findings should be interpreted as descriptive and hypothesis-generating rather than causal. The Clavien-Dindo system provided a useful tool for grading complication severity and supporting postoperative management. These findings support continued refinement of perioperative care pathways and further comparative studies on CRM implementation.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 4","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13117567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774528","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":"Toward Personalized Psychoeducational Interventions for Psychophysical Health: A Systematic Review and Meta-Analysis for Tailored Intervention Selection.","authors":"Evgenia Gkintoni, Apostolos Vantarakis","doi":"10.3390/jpm16040215","DOIUrl":"https://doi.org/10.3390/jpm16040215","url":null,"abstract":"<p><p><b>Background</b>: Psychoeducational interventions are increasingly implemented to promote psychological and physical health, yet evidence guiding personalized intervention selection remains limited. This systematic review and meta-analysis quantifies the effectiveness of psychoeducational interventions across five settings and identifies empirically derived moderator patterns to inform the selection of tailored interventions. <b>Methods</b>: Systematic searches of PubMed/MEDLINE, PsycINFO, Scopus, Web of Science, ERIC, the Cochrane Library, and Google Scholar were conducted to identify eligible studies published between January 2015 and December 2024. A two-tier analytical approach was employed: a random-effects meta-analysis of k = 53 studies reporting extractable effect-size data, and a direction-of-effect narrative synthesis of all 186 included studies (<i>N</i> = 50,328 verified from 124 studies reporting sample sizes), following SWiM guidelines. <b>Results</b>: The quantitative meta-analysis yielded a significant medium-to-large pooled effect (g = 0.66, 95% CI [0.50, 0.82], <i>p</i> < 0.001) with substantial heterogeneity (I² = 96.1%). Effects varied across settings: clinical/vulnerable populations showed the largest effect (g = 0.91), followed by university programs (g = 0.62), school-based (g = 0.60), mindfulness/positive psychology (g = 0.55), and community-based (g = 0.49). The broader narrative synthesis confirmed near-universal effectiveness: 131 studies (70.4%) reported significant positive effects, 51 (27.4%) reported mixed results, and none reported null effects-yielding 97.8% favorable outcomes across the full evidence base. Direction-of-effect moderator patterns indicated a stepped severity gradient (indicated 100% favorable, selective 98.6%, universal 95.6%), and that programs exceeding 8 weeks (99.0% vs. 96.6%), theory-based interventions (98.2% vs. 95.2%), and guided digital delivery were consistently associated with the most favorable outcomes. Publication bias assessment confirmed robustness (fail-safe N = 22,942; leave-one-out range: 0.61-0.67). GRADE evidence quality was rated Moderate for four of five research questions. <b>Conclusions</b>: This systematic review and meta-analysis provide converging quantitative and direction-of-effect evidence supporting the effectiveness of psychoeducational interventions. The near-universal favorable direction across 186 studies, combined with a medium-to-large pooled effect in the quantitative subset, provides a preliminary empirical foundation for personalized intervention matching. A preliminary four-phase implementation framework is proposed as a hypothesis-generating heuristic; prospective validation through a meta-analysis of individual participant data is needed before prescriptive application.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 4","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13117039/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774656","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":"Personalized Vestibular Rehabilitation in Persistent Postural-Perceptual Dizziness (PPPD), Unilateral and Bilateral Vestibular Dysfunction: A Comparative Study.","authors":"Pasqualina Maria Picciotti, Rolando Rolesi, Giorgia Rossi, Giuseppe Oliveto, Jacopo Galli","doi":"10.3390/jpm16040214","DOIUrl":"https://doi.org/10.3390/jpm16040214","url":null,"abstract":"<p><p><b>Background:</b> In the last few decades, a growing body of evidence has confirmed that vestibular rehabilitation (VR) can improve the symptoms of many unilateral and bilateral vestibular disorders, by facilitating vestibular compensation mechanisms, such as adaptation, substitution, and habituation. However, the usefulness of the vestibular rehabilitation approach in Persistent Postural-Perceptual Dizziness (PPPD) is currently highly debated and unclear. The aim of the present study was to evaluate the efficacy of VR using computerized dynamic posturography in PPPD patients as a single treatment and without other associated psychological or pharmacological therapies. Results were compared with patients with unilateral and bilateral vestibular disfunction, in order to define the role of our rehabilitation model within a framework of personalized therapy for different disorders. <b>Methods</b>: We evaluated 44 patients (23 F, 21 M; ranged from 28 to 82 years; mean age 63.72) affected by unilateral vestibular vestibulopathy (UVP) (<i>n</i> = 19), bilateral vestibular vestibulopathy (BVP) (<i>n</i> = 10) and PPPD (<i>n</i> = 15). For each patient, a comprehensive clinical bedside vestibular assessment was carefully performed by expert clinicians, as well as Bithermal caloric tests with videonystagmography (VNG), Video Head Impulse Test (vHIT) and Computed Dynamic Posturography (CDP). The impact of dizziness on quality of life (QoL) was assessed by the Italian Dizziness Handicap Inventory (DHI). All subjects evaluated in this study underwent five rehabilitative therapy sessions in our centre, once a week for 45 min and exercised daily for 30 min at home. All the exercises progressively became more difficult each week. <b>Results</b>: Our study showed that vestibular rehabilitation improved quality of life and reduced the level of self-perceived handicap in patients affected by unilateral and bilateral vestibular dysfunction, with significant improvement in DHI total score and posturographic parameters. In PPPD patients, rehabilitation did not significantly modify posturographic performances and the improvement in total DHI score did not reach statistical significance, although a significant change was observed in the functional sub-score. <b>Conclusions</b>: Vestibular rehabilitation confirmed its effectiveness in unilateral and bilateral peripheral vestibulopathies. In patients with PPPD, rehabilitation performed with computerized dynamic posturography may reduce subjective handicap and improve some aspects of daily functioning, although the small sample size and the absence of a control group do not allow definitive conclusions about its efficacy.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 4","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13117376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774531","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":"Personalised Approach to the Management of Older People with Type 2 Diabetes Mellitus-A Comprehensive Narrative Review.","authors":"Alan Sinclair, Mohammed Al-Banna, Roxana Tutunariu, Ahmed H Abdelhafiz","doi":"10.3390/jpm16040213","DOIUrl":"https://doi.org/10.3390/jpm16040213","url":null,"abstract":"<p><p>The global population is ageing due to increased life expectancy, and the prevalence of diabetes is proportionally increasing. With advancing age, diabetes in older people is a complex condition due to associated morbidities and geriatric syndromes. As a result, the management of diabetes in old age is challenging. Due to the wide heterogeneity of older people, diabetes management in this age group should be personalised. While strict targets are accepted in fit individuals, relaxed targets should be considered in patients with multiple morbidities and a high risk of hypoglycaemia. The development of frailty changes the metabolic profile of older people, and their insulin resistance and diabetes trajectory, which will have an impact on the choice of glucose-lowering agents and the goals of therapy. For example, intensive therapy, the use of SGLT-2 inhibitors and GLP-1RA, and tight targets should be continued in frail, sarcopenic, obese individuals due to their increased insulin resistance and cardiovascular risk. On the other hand, relaxed targets and deintensification of therapy should be considered in anorexic, malnourished, frail individuals with significant weight loss due to their low insulin resistance, low prevalence of cardiovascular risk factors, and high risk of hypoglycaemia. Annual reviews of older people with diabetes should include screening for frailty, depression and dementia for early diagnosis, and appropriate interventions. The introduction of continuous glucose monitoring is increasingly used in older people with diabetes and has the potential to reduce the incidence of hypoglycaemia. With the expectation of a continued increase in the prevalence of older people with diabetes, the use of mobile health may allow care delivery on a wider scale without the need for face-to-face appointments. In addition, there is a promising scope for artificial intelligence to achieve better diabetes outcomes. Future research is still required to expand the use of these technologies in older age groups.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 4","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13117061/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774706","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":"Early Postnatal Hypocapnia and Hypercapnia in Ventilated Preterm Infants: Incidence and Associations with Adverse Outcomes.","authors":"Ilias Chatziioannidis, Angeliki Kontou, Eleni Agakidou, Theodora Stathopoulou, Kostantia Tsoni, Christos Paschaloudis, William Chotas, Kosmas Sarafidis","doi":"10.3390/jpm16040212","DOIUrl":"https://doi.org/10.3390/jpm16040212","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Abnormalities in the partial pressure of carbon dioxide (PCO₂) can occur during respiratory support and may contribute to adverse neonatal outcomes. This study aimed to assess the incidence of early hypocapnia and hypercapnia in mechanically ventilated preterm infants and their major associated outcomes. <b>Methods:</b> A single-center retrospective cohort study (2017-2024) was conducted in preterm infants < 32 weeks' gestation who required > 24 h of invasive ventilation within the first 3 days of life. Perinatal-neonatal data were retrieved from the medical database. Admission blood gas values (arterial and capillary-venous) and the maximum and minimum PCO₂ in the first 72 h were evaluated. Normocapnia was defined as PCO₂ 35-45 mmHg, hypocapnia as < 35 mmHg, and hypercapnia as > 45 mmHg. Primary outcomes were the incidence of PCO₂ abnormalities; secondary outcomes included death or severe brain injury (SBI), SBI alone, and bronchopulmonary dysplasia (BPD) among survivors. Logistic regression identified independent predictors of the secondary outcomes. <b>Results:</b> Among the 134 infants evaluated, most experienced both hypercapnia and hypocapnia. Hypercapnia occurred in 81.3% of infants, and hypocapnia in 93.2%. Death or SBI was observed in 51.5%, and SBI alone in 42.5%. Gestational age < 28 weeks, air-leak syndromes, and pulmonary hemorrhage were independent predictors of death or SBI. Among survivors, hypercapnia and gestational age < 28 weeks independently predicted BPD. Infants with adverse outcomes had higher maximum PCO₂ values and greater PCO₂ variability, although these were not independent predictors of SBI or death. <b>Conclusions:</b> PCO₂ instability is highly prevalent in ventilated preterm infants, underscoring the need for individualized ventilation strategies. Extreme prematurity emerged as the primary risk factor for adverse outcomes, while hypercapnia was independently associated with BPD.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 4","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13118081/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Impact of Rare Subtypes of Parathyroid Adenoma: A Systematic Review.","authors":"Maurizio Martiradonna, Rossella Mazzilli, Virginia Zamponi, Daniela Prosperi, Massimiliano Mancini, Antongiulio Faggiano","doi":"10.3390/jpm16040211","DOIUrl":"https://doi.org/10.3390/jpm16040211","url":null,"abstract":"<p><p><b>Background:</b> Parathyroid lipoadenoma, oncocytic parathyroid adenoma, and water-clear cell parathyroid adenoma (WCCA) are exceptionally rare subtypes of parathyroid adenoma, whose real clinical impact remains unclear. <b>Methods</b>: We performed a literature review and comparison of these uncommon subtypes of parathyroid adenoma, as these lesions may be associated with distinct clinical, pathological and radiological phenotypes. <b>Results</b>: The three groups were comparable in terms of age and gender, mainly affecting middle-aged women. As for the biochemical findings, although PTH level did not show statistically significant differences among the three adenomas, in the two-tail comparison between WCCAs and lipoadenomas, there was a trend towards higher PTH values (<i>p</i> = 0.058). However, serum calcium levels differed significantly, with higher levels in WCCAs than in lipoadenomas (12.1 vs. 11.3 mg/dL; <i>p</i> = 0.002). From a preoperative point of view, ultrasound positivity was significantly higher in WCCAs than in lipoadenomas and oncocytic adenomas (97% vs. 50% vs. 55.3%, <i>p</i> < 0.001), compared to scintigraphy positivity, which was comparable between subtypes and relatively suboptimal (66.7% vs. 64.3% vs. 61.3%; <i>p</i> = 0.825); WCCAs also had an overall more voluminous morphological phenotype. <b>Conclusions</b>: This review, although limited by its reliance primarily on case reports and small case series, confirms that lipoadenoma, oxyphilic adenoma, and WCCAs are rare but clinically relevant subtypes of parathyroid adenoma. These entities may be associated with atypical presentations of primary hyperparathyroidism (including difficult preoperative localization and clinicopathological features raising suspicion of malignancy) and should be recognized as a potential source of diagnostic difficulty. A better understanding of these rare subtypes may improve clinicopathological interpretation, increase awareness of potential diagnostic pitfalls and support a more personalized diagnostic and surgical approach in the future.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 4","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13117124/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774482","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}