Journal of Personalized Medicine最新文献

{"title":"Increased Frequency of the Non-Dipper Blood Pressure Pattern in Patients with Systemic Sclerosis: Insights from 24-Hour Ambulatory Monitoring.","authors":"Oğuzhan Zengin, Gülşah Soytürk, Burak Göre, Mustafa Yürümez, Ali Can Kurtipek, Emra Asfuroğlu Kalkan, Hatice Ecem Konak, Şükran Erten, Ihsan Ateş","doi":"10.3390/jpm15060253","DOIUrl":"10.3390/jpm15060253","url":null,"abstract":"<p><p><b>Background:</b> In systemic sclerosis (SSc), endothelial dysfunction, inflammation, and reduced nitric oxide levels may disrupt circadian blood pressure (BP) regulation. There are studies showing that inflammatory and certain other cells in diseases like SSc exhibit diurnal rhythms. In our study, we examined the effect of SSc on BP. In particular, the frequency of the non-dipper pattern (lack of nighttime BP reduction) in SSc patients has not been adequately investigated. The aim of this study was to evaluate the 24 h BP profile in SSc patients and to compare the frequency of the non-dipper pattern with that of the non-scleroderma group. Additionally, the identification of disrupted circadian BP patterns in SSc patients aims to contribute to the development of personalized, time-sensitive BP monitoring strategies in the future and to support the applicability of personalized medicine in this context. <b>Methods:</b> A total of 31 SSc patients diagnosed according to the 2013 ACR/EULAR classification criteria and 30 age- and sex-matched individuals without SSc were included in this prospective study. BP changes between day and night were evaluated by measuring BP every 30 min with a 24 h ambulatory blood pressure monitoring (ABPM) device. The non-dipper pattern was defined as a decrease in BP of less than 10% during the night compared to the day. To better assess BP fluctuations during the night, nighttime measurements were divided into two time periods: first, 24:00-04:00, and then 04:00-08:00. Additionally, laboratory and clinical parameters and SSc subtypes were compared between the groups. <b>Results:</b> The ABPM findings were compared between the groups with and without SSc. The non-dipper pattern was significantly more common in the SSc group at all time intervals. The non-dipper pattern was observed in 25.8% of the non-SSc group and 83.9% of SSc patients (<i>p</i> < 0.001). In the period between 24:00 and 04:00, the prevalence was 25.8% in the control group and 71.0% in SSc patients (<i>p</i> < 0.001), and between 04:00 and 08:00, it was 35.5% in the control group and 80.6% in SSc patients (<i>p</i> < 0.001). No significant difference was found in non-dipper patterns between individuals with diffuse and limited cutaneous forms of systemic sclerosis. <b>Conclusions:</b> The non-dipper BP pattern is significantly more common in patients with SSc, indicating the disruption of the circadian rhythm affecting BP. Analysis performed by dividing the night into specific time periods revealed that this deterioration continued throughout the night. The findings highlight the importance of circadian BP monitoring in SSc patients and may contribute to future risk stratification and treatment strategies. Circadian BP analysis in SSc may help to develop strategies that are personalized for these patients and tailored to their physiological rhythm.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12194108/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484822","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":"Overcoming Challenges in Learning Prerequisites for Adaptive Functioning: Tele-Rehabilitation for Young Girls with Rett Syndrome.","authors":"Rosa Angela Fabio, Samantha Giannatiempo, Michela Perina","doi":"10.3390/jpm15060250","DOIUrl":"10.3390/jpm15060250","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Rett Syndrome (RTT) is a rare neurodevelopmental disorder that affects girls and is characterized by severe motor and cognitive impairments, the loss of purposeful hand use, and communication difficulties. Children with RTT, especially those aged 5 to 9 years, often struggle to develop the foundational skills necessary for adaptive functioning, such as eye contact, object tracking, functional gestures, turn-taking, and basic communication. These abilities are essential for cognitive, social, and motor development and contribute to greater autonomy in daily life. This study aimed to explore the feasibility of a structured telerehabilitation program and to provide preliminary observations of its potential utility for young girls with RTT, addressing the presumed challenge of engaging this population in video-based interactive training. <b>Methods:</b> The intervention consisted of 30 remotely delivered sessions (each lasting 90 min), with assessments at baseline (A), after 5 weeks (B1), and after 10 weeks (B2). Quantitative outcome measures focused on changes in eye contact, object tracking, functional gestures, social engagement, and responsiveness to visual stimulus. <b>Results:</b> The findings indicate that the program was feasible and well-tolerated. Improvements were observed across all measured domains, and participants showed high levels of engagement and participation throughout the intervention. While these results are preliminary, they suggest that interactive digital formats may be promising for supporting foundational learning processes in children with RTT. <b>Conclusions:</b> This study provides initial evidence that telerehabilitation is a feasible approach for engaging young girls with RTT and supporting adaptive skill development. These findings may inform future research and the design of controlled studies to evaluate the efficacy of technology-assisted interventions in this population.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12194260/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484841","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":"Tailoring Evaluations of Chronic Rhinosinusitis: Understanding Sleep and Its Effect on Memory Through Actigraphy.","authors":"Donyea Moore, Rachel Nolte, Yitong Huang, Shreya Maharana, Pavan Nataraj, Bichun Ouyang, Mahboobeh Mahdavinia","doi":"10.3390/jpm15060249","DOIUrl":"10.3390/jpm15060249","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Chronic rhinosinusitis (CRS) is a persistent inflammatory condition of the sinonasal mucosa lasting for at least three months. For patients, CRS-related sleep disturbances can significantly disrupt circadian rhythms, leading to further health complications such as cognitive impairment. Despite the well-documented sleep disturbances associated with CRS, there is limited research on objective assessment methods. Additionally, the severity of these issues can vary among patients. This study aims to assess sleep quality and timing in CRS patients and investigate their impact on cognition, providing guidance for personalized and tailored assessment and management of CRS. <b>Methods:</b> Our case-control study compares sleep patterns and cognitive function between CRS patients and healthy controls utilizing actigraphy, a non-invasive device for measuring sleep-wake cycles and circadian rhythms. The actigraphy-derived sleep variables include inter-daily variability, intra-daily variability, highest 10 h activity (M10), lowest 5 h activity (L5), relative amplitude (RA), sleep onset latency, sleep efficiency, sleep and wake time, time spent in bed, total sleep time, and wakefulness after sleep onset. We also used a standard questionnaire assessing sleep quality, the Pittsburgh Sleep Quality Index (PSQI). <b>Results:</b> Our study enrolled 44 CRS and 43 control participants. Our findings indicate that the actigraphy-derived sleep variables were comparable between groups, all with a <i>p</i>-value > 0.05. However, CRS patients exhibited greater early morning activity and significantly lower PSQI-reported sleep quality compared to controls (8.78 ± 3.45, 4.71 ± 2.96, respectively; adjusted <i>p</i> < 0.001). Actigraphy-derived sleep variables showed trends towards significance in association with episodic memory (<i>p</i> = 0.051) and executive function (<i>p</i> = 0.15). <b>Conclusions:</b> Actigraphy-derived sleep outcomes revealed associations with episodic and executive function, underscoring the potential of actigraphy in understanding the individualized sleep-related cognitive impacts in CRS patients. This highlights the importance of personalized assessment and management strategies to address the unique sleep and cognitive challenges faced by each patient.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12194002/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484860","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":"Phenotype-Driven Variability in Longitudinal Body Composition Changes After a Very Low-Calorie Ketogenic Intervention: A Machine Learning Cluster Approach.","authors":"Victor de la O, Begoña de Cuevillas, Miksa Henkrich, Barbara Vizmanos, Maitane Nuñez-Garcia, Ignacio Sajoux, Daniel de Luis, J Alfredo Martínez","doi":"10.3390/jpm15060251","DOIUrl":"10.3390/jpm15060251","url":null,"abstract":"<p><p><b>Background</b>: Obesity is a major global public health issue with no fully satisfactory solutions. Most nutritional interventions rely on caloric restriction, with varying degrees of success. Very low-calorie ketogenic diets (VLCKD) have demonstrated rapid and sustained weight loss by inducing ketone bodies through lipolysis, reducing appetite, and preserving lean mass while maintaining metabolic health. <b>Methods</b>: A prospective clinical study analyzed sociodemographic, anthropometric, and adherence data from 7775 patients undergoing a multidisciplinary nutritional single-arm intervention based on a commercial weight-loss program. This method, using protein preparations with a specific balanced nutritional profile, aimed to identify key predictors of weight-loss success and classify population phenotypes with shared baseline characteristics and weight-loss patterns to optimize treatment personalization. <b>Results</b>: Statistical and machine learning analyses revealed that male gender (-9.2 kg vs. -5.9 kg) and higher initial body weight (-8.9 kg vs. -4.0 kg) strongly predict greater weight loss on a VLCKD, while age has a lesser impact. Two distinct population clusters emerged, differing in age, sex, follow-up duration, and medical visits, demonstrating unique weight-loss success patterns. These clusters help define individualized strategies for optimizing outcomes. <b>Conclusions</b>: These findings translationally support associations with the efficacy of a multidisciplinary VLCK weight-loss program and highlight predictors of success. Recognizing variables such as sex, age, and initial weight enhances the potential for a precision-based approach in obesity management, enabling more tailored and effective treatments for diverse patient profiles and prescribe weight loss personalized recommendations.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12193932/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484845","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":"Associations Between Chemotherapy-Induced Peripheral Neuropathy and Distress in Patients Assigned to Adjuvant Irradiation for Non-Metastatic Breast Cancer.","authors":"Dirk Rades, Tobias Bartscht, Achim Rody, Martin Ballegaard","doi":"10.3390/jpm15060248","DOIUrl":"10.3390/jpm15060248","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Many patients assigned to adjuvant radiotherapy for non-metastatic breast cancer already received taxane-based chemotherapy, which can cause peripheral neuropathy (PNP). This study investigated potential associations between moderate-to-severe or mild PNP and distress. <b>Methods:</b> Ninety-eight breast cancer patients who received taxane-based chemotherapy and completed the National Comprehensive Cancer Network Distress Thermometer were included in this retrospective study. The severity of PNP plus 17 factors were evaluated for associations with distress. <b>Results:</b> Mean distress scores (higher scores representing higher levels of distress) were 6.17 (SD ± 2.41) in patients with moderate-to-severe PNP, 4.21 (SD ± 2.54) in patients with mild PNP and 4.04 (SD ± 2.24) in patients without PNP. On univariable analyses, higher distress scores were significantly associated with moderate-to-severe PNP (vs. mild or no PNP, <i>p</i> < 0.001), Karnofsky performance score ≤ 80 (<i>p</i> = 0.001), history of autoimmune disease (<i>p</i> = 0.035), and hypertension (<i>p</i> = 0.002). Trends were found for age ≥65 years (<i>p</i> = 0.056), type of chemotherapy (<i>p</i> = 0.078), and beta-blocker medication (<i>p</i> = 0.072). On multivariable analysis, moderate-to-severe PNP (<i>p</i> = 0.036), Karnofsky performance score ≤ 80 (<i>p</i> = 0.013), and hypertension (<i>p</i> = 0.045) were significant. <b>Conclusions</b>: Since moderate-to-severe chemotherapy-induced PNP was associated with a significantly higher level of distress when compared to mild or nor PNP, these patients should be offered early psychological support and personalized monitoring.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12194417/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484793","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":"Assessing the Impact of Simplified Language on a Patient-Facing Pharmacogenetic Report: A User Comprehension Study.","authors":"Russell Amato, Nicole M Del Toro-Pagan, Harris Nguyen, Jordan Plummer, Katie Pizzolato, David Krause, Daniel Dowd","doi":"10.3390/jpm15060247","DOIUrl":"10.3390/jpm15060247","url":null,"abstract":"<p><p><b>Background:</b> Pharmacogenetics (PGx) is the science of assessing how genetic variation affects drug efficacy, tolerability, and safety. While PGx is an emerging discipline which is becoming standard of care, many providers have misunderstandings about its utility. This is even more of a problem for patients, who may perceive that there is a single drug that is \"right\" for them. The primary objective of this study was to evaluate consumer comprehension of a newly developed patient-facing PGx report. <b>Methods:</b> In this study, we adapted a commercial pharmacogenetic test (Genomind Professional PGx) into a report intended to be more comprehensible to the consumer. The initial translation of the clinical terminology used in the PGx report, into lay terminology was conducted by PharmDs and PhDs who have collectively provided over 20,000 PGx consults to date. These reports were then evaluated with readability scoring software to ensure each translation's complexity remained ≤8th-grade reading level. A total of 107 participants were recruited to conduct the initial analysis with a goal of achieving a 90% comprehension rate using the Genomind consumer comprehension survey. These participants were also given a modified Minnesota Assessment of Pharmacogenomic Literacy (MAPL™) both before and after the Genomind comprehension survey to assess overall PGx literacy. <b>Results:</b> Ninety-eight (98) out of 107 research participants scored one or zero questions incorrectly, translating to >90% comprehension score on the Genomind consumer comprehension survey. These participants also demonstrated a significant increase in overall pharmacogenetic literacy, as assessed by MAPL after viewing the consumer report and survey. <b>Conclusions:</b> This study found that translating pharmacogenetic test results into lay language may provide individuals with a greater understanding of how their DNA may impact prescribed medications.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12194072/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484766","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":"Morphology of Macular Neovascularization in Age-Related Macular Degeneration Influences Treatment Requirement and Visual Outcome After 1 Year.","authors":"Michael Grün, Kai Rothaus, Martin Ziegler, Albrecht Lommatzsch, Clemens Lange, Henrik Faatz","doi":"10.3390/jpm15060246","DOIUrl":"10.3390/jpm15060246","url":null,"abstract":"<p><p><b>Background/Objectives</b>: To evaluate the potential of Optical Coherence Tomography (OCT) and OCT angiography parameters in predicting treatment requirements and visual outcomes after one year in therapy-naïve eyes with neovascular age-related macular degeneration (nAMD). <b>Methods</b>: A retrospective study of 96 therapy-naïve eyes newly diagnosed with nAMD was carried out. All eyes received baseline OCT and OCTA. Follow-up OCT after initial upload was then carried out, involving three intravitreal injections (IVIs) with anti-Vascular Endothelial Growth Factor (anti-VEGF) at four-week intervals. OCT parameters, including intraretinal fluid (IRF), subretinal fluid (SRF), pigment epithelium detachment (PED), and central retinal thickness (CRT), were assessed qualitatively and quantitatively. Macular Neovascularization (MNV) morphology at baseline was described in terms of area, total vessel length, flow density, and fractal dimension. OCT and OCTA parameters were correlated with best corrected visual acuity (BCVA) and number of administered IVIs after 1 year of treatment. <b>Results</b>: Eyes with persistent subretinal fluid (SRF) or both intraretinal fluid (IRF) and SRF after upload showed a significantly higher need for IVIs (<i>p</i> < 0.01). Also, pigment epithelium detachment (PED) presence at baseline (<i>p</i> < 0.05), PED height at baseline (<i>p</i> < 0.01), PED presence after upload (<i>p</i> < 0.01), and PED height after upload (<i>p</i> < 0.01) were each correlated with a greater number of IVIs. Decrease in PED height during upload was accompanied by a lower number of IVIs (<i>p</i> < 0.01). All the aforementioned parameters had no influence on BCVA after 1 year (<i>p</i> > 0.05). Baseline central retinal thickness (CRT) was linked to worse BCVA at 12 months (<i>p</i> < 0.05), but not the number of IVIs. Follow-up CRT correlated with worse BCVA (<i>p</i> < 0.01) and more IVIs (<i>p</i> < 0.01), while CRT decrease was associated with better BCVA (<i>p</i> < 0.05) and fewer IVIs (<i>p</i> < 0.01) at 1 year. In OCTA, area and total vessel length of MNVs were correlated with BCVA after 1 year (<i>p</i> < 0.01) but had no influence on number of IVIs (<i>p</i> > 0.05). Flow density had no influence on either outcome parameter (<i>p</i> > 0.05). Fractal dimension was associated with BCVA (<i>p</i> < 0.01) and number of IVIs (<i>p</i> < 0.05) after 1 year. <b>Conclusions</b>: MNV area, vessel length, and fractal dimension in OCTA, along with fluid distribution in OCT at baseline and after follow-up, may serve as indicators of treatment needs and visual outcomes after one year. Further studies with longer observation periods and the use of deep learning models are needed to improve analyses and to verify the applicability of these findings to clinical practice.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12194689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484838","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":"Evaluation of Perioperative Risk Factors for Infection by Multidrug-Resistant Bacteria in Patients Undergoing Liver Transplantation.","authors":"Rafael Ramos Fernández, Alberto Calvo García, Ainhoa Fernández Yunkera, Silvia Ramos Cerro, Ignacio Garutti, Javier Hortal Iglesias, Patricia Muñoz García, Sergio García Ramos, Adoración Elvira Rodríguez, Mercedes Power Esteban, Patricia Duque González, Patricia Piñeiro","doi":"10.3390/jpm15060240","DOIUrl":"10.3390/jpm15060240","url":null,"abstract":"<p><p><b>Background:</b> Liver transplantation (LT) is a critical intervention for patients with end-stage liver disease. Infections caused by multidrug-resistant bacteria (MDRB) significantly worsen post-transplant outcomes. The main objective of this study was to analyze perioperative risk factors associated with MDRB infections within six months following LT. <b>Methods:</b> A retrospective analysis was conducted on 133 medical records of patients who underwent liver transplantation between October 2018 and May 2022. Data collected included the presence of MDRB colonization and infection, as well as various perioperative variables. These were analyzed to identify potential risk factors for MDRB infection and colonization. <b>Results:</b> Univariate analysis identified several perioperative variables associated with MDRB infection within six months after LT. Multivariate logistic regression revealed that pre-transplant MDRB colonization (OR 5.72, 95% CI 1.7-18.7, <i>p</i> = 0.005) and the requirement for dialysis during postoperative ICU stay (OR 6.42, 95% CI 1.7-23.4, <i>p</i> = 0.009) were independent risk factors for developing MDRB infections. MDRB infection occurred in 9.4% of patients and was not significantly associated with increased mortality (<i>p</i> = 0.126). <b>Conclusions:</b> These findings contribute to a better understanding of the epidemiology and pathophysiology of MDRB infections in the postoperative period of liver transplantation. This knowledge is essential for developing effective prevention and treatment strategies that may improve outcomes in this patient population.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12194424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484817","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":"Indocyanine Green Angiography to Predict Complications in Subcutaneous Mastectomy: A Single-Center Experience.","authors":"Letizia Cuniolo, Raquel Diaz, Dafne Anastasia, Federica Murelli, Chiara Cornacchia, Francesca Depaoli, Marco Gipponi, Cecilia Margarino, Chiara Boccardo, Simonetta Franchelli, Marianna Pesce, Amandine Causse D'agraives, Rebecca Allievi, Martina Cossu, Franco De Cian, Piero Fregatti","doi":"10.3390/jpm15060242","DOIUrl":"10.3390/jpm15060242","url":null,"abstract":"<p><p><b>Background/Objectives</b>: In the setting of breast surgery, indocyanine green angiography (ICGA) allows estimating the perfusion of cutaneous tissues during surgical interventions, in order to reduce vascularization-related complications. This study has a dual objective: to evaluate the correlation between preoperative factors and the level of skin vascularization, measured by ICGA, in patients undergoing subcutaneous mastectomy for breast cancer; and to establish any relationship between low intraoperative vascularization and the onset of postoperative complications. <b>Methods</b>: This is a preliminary, non-randomized, prospective clinical study that includes 46 female patients undergoing subcutaneous mastectomy with reconstruction for breast cancer between February 2022 and July 2024. The relationship between vascularization and the following preoperative variables was assessed: smoking, previous breast surgeries, prior radiotherapy, neoadjuvant or prior chemotherapy/anti-Her2 therapy, and the thickness of breast subcutaneous tissue evaluated through mammography. For the analysis, three ICGA procedures were performed, using 0.125 mg/kg of indocyanine green (ICG) for each procedure before the surgical incision (V1), at the end of the demolition phase (V2), and at the end of the reconstruction phase (V3). The results of this analysis were finally correlated with the occurrence of any postoperative complications. <b>Results</b>: Vascularization was conventionally classified as \"low\" and \"good\" using a cutoff of 33%. Previous surgeries on the ipsilateral breast and neoadjuvant or prior chemotherapy/anti-Her2 therapy were found to be predictive factors of \"low\" vascularization (<i>p</i> = 0.031). Patients with \"low\" vascularization at time V3 showed a significantly higher risk of developing complications (<i>p</i> = 0.038). Incision length emerged as an independent predictor of complications, with a 23% increase in risk per additional centimeter (<i>p</i> = 0.006), independent of perfusion level. <b>Conclusions</b>: This study supports the use of ICGA as a useful tool to improve outcomes in patients undergoing subcutaneous mastectomy with prosthetic reconstruction for breast cancer. The results of this preliminary work are encouraging, and recruiting a larger number of patients could provide more significant data.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12194276/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Ventricular Assist Devices in Patients with Ischemic vs. Non-Ischemic Cardiomyopathy.","authors":"Eglė Rumbinaitė, Dainius Karčiauskas, Grytė Ramantauskaitė, Dovydas Verikas, Gabrielė Žūkaitė, Liucija Rancaitė, Barbora Jociutė, Gintarė Šakalytė, Remigijus Žaliūnas","doi":"10.3390/jpm15060241","DOIUrl":"10.3390/jpm15060241","url":null,"abstract":"<p><p><b>Background</b>: The HeartMate 3 (HM3) left ventricular assist device (LVAD) has demonstrated improved clinical outcomes in patients with advanced heart failure (HF). However, the influence of underlying HF etiology-ischemic cardiomyopathy (ICM) versus dilated cardiomyopathy (DCM)-on post-implantation outcomes remains insufficiently characterized. <b>Objectives:</b> This paper aims to evaluate early postoperative outcomes following HM3 LVAD implantation in patients with ICM versus DCM and to identify the preoperative hemodynamic and clinical predictors of early mortality and hemodynamic instability. <b>Methods</b>: We conducted a retrospective single-center cohort study of 30 patients who underwent HM3 LVAD implantation between 2017 and 2024. Patients were stratified by HF etiology (ICM, <i>n</i> = 17; DCM, <i>n</i> = 13), and preoperative clinical, echocardiographic, and right heart catheterization data were analyzed. The primary endpoint was 30-day postoperative survival. Secondary endpoints included postoperative hemodynamic stability and the need for vasopressor support. <b>Results</b>: Non-survivors (<i>n</i> = 13) demonstrated elevated central venous pressure (>16.5 mmHg), mean right ventricular pressure (>31.5 mmHg), and pulmonary vascular resistance (>7.5 Wood units), in addition to higher preoperative creatinine levels and longer cardiopulmonary bypass times. Vasopressor requirement postoperatively was associated with elevated pre-implant systolic pulmonary artery pressure. <b>Conclusions</b>: Preoperative right-sided pressures and renal dysfunction are strong predictors of early mortality following HM3 LVAD implantation. Patients with ICM exhibit greater early left ventricular recovery compared to those with DCM. These findings underscore the importance of comprehensive and personalized preoperative risk stratification-particularly in patients with DCM and pulmonary hypertension-to optimize postoperative outcomes and guide patient selection for durable LVAD support.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12193741/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484861","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}