Journal of Personalized Medicine最新文献

{"title":"Binocular Summation in Healthy Presbyopic Adults: Contrast Sensitivity and Defocus Curves.","authors":"Vanesa García-Del-Castillo, Mónica Alamo-Peña, César Albarrán-Diego, Cecilia Arnaiz-Schmitz, Nuria Garzón, María García-Montero","doi":"10.3390/jpm16090465","DOIUrl":"10.3390/jpm16090465","url":null,"abstract":"<p><p><b>Background/Objective:</b> Binocular summation, the improvement in visual performance under binocular compared with monocular viewing, depends on the visual task and the degree of optical degradation of the retinal image. Its behavior across the full defocus curve in presbyopia remains poorly characterized. The purpose is to quantify binocular summation in healthy presbyopic adults by assessing contrast sensitivity (CS) at intermediate and near distances and by comparing monocular and binocular defocus curves to evaluate the effect of binocularity on depth of focus, the area under the curve (AUC), and the binocular summation ratio (BSR). <b>Methods:</b> Thirty healthy presbyopic participants (mean age 53.7 ± 5.7 years, range 45-64) were included in this observational, cross-sectional study. CS was measured with the Pelli-Robson chart at 1 m and 40 cm, and monocular and binocular defocus curves were obtained from -3.50 D to +1.50 D in 0.50 D steps. BSR, AUC and depth of focus at the 0.2 and 0.1 logMAR thresholds were calculated. Monocular and binocular values were compared with paired <i>t</i>-tests, applying a Bonferroni correction. <b>Results:</b> Binocular CS was significantly higher than monocular CS at both distances (adjusted <i>p</i> < 0.025), with a large, distance-independent BSR (1.68 at 1 m, 1.69 at 40 cm). BSR exceeded unity at every defocus level (10-21% gain), but after correction the binocular advantage in visual acuity remained significant only within the central range (-0.50 D to +1.00 D). At the participant level, binocularity increased the AUC at the 0.1 logMAR threshold (+50.5%, <i>p</i> = 0.037, d = 0.40), whereas the increase at the 0.2 logMAR threshold (+52.2%) did not reach statistical significance (<i>p</i> = 0.107). <b>Conclusions:</b> Binocularity consistently enhances visual performance in presbyopic adults, for contrast sensitivity and, with a pattern of significant improvement concentrated in the central defocus range, for visual acuity, supporting a more personalized evaluation of presbyopia.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13608484/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039495","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":"Metabolic Dysfunction-Associated Steatotic Liver Disease in Childhood: From Disease Heterogeneity to Personalized Care.","authors":"Maria Rogalidou, Christina Kanaka-Gantenbein","doi":"10.3390/jpm16090464","DOIUrl":"10.3390/jpm16090464","url":null,"abstract":"<p><p>Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) has become the most common chronic liver disease in childhood, paralleling the global increase in pediatric obesity and metabolic dysfunction. Once considered a benign condition, pediatric MASLD is now recognized as a heterogeneous and potentially progressive disease that may advance from simple steatosis to steatohepatitis, fibrosis, and, rarely, cirrhosis, with lifelong hepatic and cardiometabolic consequences. Its pathogenesis is multifactorial, involving insulin resistance, adipose tissue dysfunction, chronic low-grade inflammation, genetic and epigenetic susceptibility, environmental factors, and alterations in the gut microbiome. Most affected children are asymptomatic, and diagnosis is often prompted by elevated liver enzymes or incidental imaging findings. Noninvasive tools, including ultrasonography, elastography, serum biomarkers, and emerging multi-omics approaches, are improving disease detection and risk stratification, although liver biopsy remains the reference standard in selected cases. Lifestyle modification, including dietary optimization, increased physical activity, and gradual weight reduction, remains the cornerstone of management, while pharmacological therapies are still under investigation in pediatric populations. The marked variability in disease susceptibility; progression; and treatment response underscores the need for a personalized medicine approach. Integrating clinical characteristics with genomic, epigenomic, metabolomic, and microbiome data may enable early identification of high-risk children, more accurate prognostic assessment, and individualized preventive and therapeutic strategies. Early detection and multidisciplinary care involving pediatricians, hepatologists, endocrinologists, dietitians, and families may help reduce disease progression and the risk of long-term hepatic and cardiometabolic complications. This review summarizes current evidence on the epidemiology, pathophysiology, clinical presentation, diagnosis, and management of pediatric MASLD, with a particular emphasis on precision diagnostics, biomarker discovery, and personalized therapeutic approaches. It also discusses current challenges and future directions for implementing personalized medicine to improve outcomes and reduce the lifelong burden of pediatric MASLD.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13608809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039407","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":"Left Bundle Branch Area Pacing in Heart Failure: A Physiological Alternative to Conventional Biventricular Cardiac Resynchronization Therapy and a Step Towards Personalized Device Therapy.","authors":"Ioanna Koniari, Andreas Gerakaris, Efthimia Kapsali, Stamatios Kanellopoulos, Georgia Xygka, Asimenia Katsea, Eftychia Petropoulou, Anastasia Mavromati, Rafail Koros, Georgios Leventopoulos, Angelos Perperis, Georgios Kollias, Periklis Davlouros","doi":"10.3390/jpm16090463","DOIUrl":"10.3390/jpm16090463","url":null,"abstract":"<p><p>Heart failure remains a major cause of morbidity and mortality despite advances in guideline-directed medical therapy and device-based treatment. Cardiac resynchronization therapy delivered by conventional biventricular pacing constitutes an established therapeutic strategy for selected patients with heart failure with reduced ejection fraction and electrical desynchrony. Left bundle branch area pacing has emerged as a physiological pacing strategy that directly engages the conduction system, providing more effective electrical and mechanical resynchronization. Current evidence from observational studies, randomized pilot trials, and recent multicentre data suggest that left bundle branch pacing may achieve greater QRS narrowing, more favourable pacing thresholds, improved left ventricular ejection fraction, and reduced heart failure hospitalizations compared with conventional biventricular pacing in selected patients. This review summarizes the rationale, implantation criteria, patient selection, and current clinical evidence supporting left bundle branch pacing as an alternative pacing modality in heart failure patients. Despite encouraging available data, larger randomized trials with longer follow-up and broader patient populations are required to clarify long-term safety and to determine whether left bundle branch pacing should be adopted as a routine alternative to conventional cardiac resynchronization therapy. From a personalized medicine perspective, the choice between conduction system pacing and conventional biventricular pacing should be guided by individual patient characteristics, including conduction phenotype, QRS morphology and duration, myocardial scar burden, heart failure aetiology, coronary venous anatomy, and the chance of achieving confirmed conduction-system capture. This review therefore renders left bundle branch pacing within an individualized, phenotype-guided resynchronization strategy rather than as a universal replacement for biventricular pacing.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13608650/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039397","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":"Prenatal Diagnosis and Perinatal Management Considerations in Congenital Abdominal Wall Defects: A Case Series and Narrative Review.","authors":"Nikola Popovski, Nikoleta Stoyanova, Rebecca Caiulo","doi":"10.3390/jpm16090460","DOIUrl":"10.3390/jpm16090460","url":null,"abstract":"<p><p><b>Background</b>: Congenital abdominal wall defects (CAWDs), primarily gastroschisis and omphalocele, result from disturbances in early embryonic folding and midgut development and are routinely detected during prenatal ultrasound screening. Despite advances in prenatal imaging, considerable heterogeneity in clinical presentation, severity, and outcomes necessitates structured risk stratification to optimize prenatal and perinatal management. <b>Objectives</b>: We aimed to present a series of prenatally diagnosed congenital abdominal wall defects and integrate current evidence into a clinically applicable, risk-adapted framework for prenatal assessment and perinatal management. <b>Materials and Methods</b>: Three pathological cases of CAWDs diagnosed between 2025 and 2026 were retrospectively analyzed. Two additional first-trimester ultrasound examinations demonstrating physiological midgut herniation were included as illustrative examples of an important differential diagnosis during early pregnancy. Prenatal assessment included systematic evaluation of bowel dilatation, bowel wall thickness, liver herniation, and associated structural anomalies. Established risk stratification systems-including the distinction between simple and complex gastroschisis and the classification of omphalocele according to defect size and associated anomalies-were applied. A narrative review of the literature was performed to contextualize the clinical findings and support the development of a practical ultrasound-based diagnostic and management algorithm. <b>Results</b>: The pathological cases illustrated the broad clinical spectrum of CAWDs, ranging from isolated omphalocele to lethal body stalk anomaly, while the illustrative examples emphasized the importance of distinguishing physiological midgut herniation from pathological abdominal wall defects during the first trimester. Prenatal risk stratification based on ultrasound findings may inform surveillance strategies, delivery planning, and parental counseling. In particular, associated anomalies and liver herniation in omphalocele, as well as progressive bowel abnormalities in gastroschisis, were identified as key determinants of prognosis and clinical management. Based on the literature review and the illustrative institutional cases, an educational ultrasound-based diagnostic and management framework was proposed to summarize the current evidence and support a structured diagnostic approach. <b>Conclusions</b>: Congenital abdominal wall defects should be considered a spectrum of disorders with varying embryological origins, clinical manifestations, and prognostic implications. A standardized prenatal assessment combined with risk-adapted management can improve prognostic accuracy, optimize perinatal planning, and support informed parental counseling. Implementation of structured diagnostic frameworks may enhance clinical decision making and improve outcomes in affected pregnancies.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13608570/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039363","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":"Neurological and Neuropsychiatric Manifestations of Pediatric Inflammatory Multisystem Syndrome (PIMS/MIS-C): A Narrative Review.","authors":"Wiktor Śliwiński, Weronika Pura, Dominika Matecka, Mateusz Kosowski, Daniel Chołuj, Jakub Marciniak, Jakub Mazur, Karolina Zarówna, Laavanya Damodaran, Natalia Szejko","doi":"10.3390/jpm16090461","DOIUrl":"10.3390/jpm16090461","url":null,"abstract":"<p><p><b>Background:</b> Pediatric inflammatory multisystem syndrome (PIMS), also referred to as multisystem inflammatory syndrome in children (MIS-C), is a rare but serious post-infectious complication of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection characterized by systemic hyperinflammation and multiorgan involvement. New-onset neurological and psychiatric symptoms have emerged as critical clinical features, occurring in approximately 12-27% of pediatric patients aged 2-15 years (median age, 10 years) and often indicating a more severe disease course. This narrative review aims to provide a comprehensive overview of the current literature regarding the neurological and psychiatric manifestations of PIMS/MIS-C, focusing on epidemiology, pathophysiology, clinical presentation, neuroimaging findings, biomarkers, treatment strategies, and outcomes. <b>Methods:</b> A narrative literature review was conducted to synthesize current evidence on the neurological and psychiatric spectrum of PIMS/MIS-C. Evaluated parameters included clinical presentations ranging from common symptoms (such as headache, encephalopathy, altered mental status, and seizures) to rare complications (such as ischemic stroke, acute disseminated encephalomyelitis, Guillain-Barré syndrome, and cerebral edema), alongside associated psychiatric disturbances, diagnostic findings, and therapeutic approaches. <b>Results:</b> Neurological and psychiatric manifestations significantly impact the clinical trajectory of PIMS/MIS-C. Acute symptoms include headache, encephalopathy, seizures, and psychiatric disturbances like behavioral changes, hallucinations, delirium, anxiety, and sleep disorders. Neuroimaging in many cases reveals reversible lesions of the splenium of the corpus callosum, while electroencephalography typically demonstrates diffuse slowing consistent with encephalopathy. Early recognition and prompt administration of immunomodulatory therapy-primarily intravenous immunoglobulin and corticosteroids-correlate with favorable neurological recovery in the majority of patients. However, current evidence remains largely observational and heterogeneous, precluding definitive causal conclusions regarding this treatment-outcome relationship. Affected children more frequently require intensive care unit admission and remain at risk for persistent cognitive, behavioral, and psychiatric sequelae. <b>Conclusions:</b> Neurological and psychiatric complications in PIMS/MIS-C are clinically significant indicators of disease severity that require vigilant monitoring and early immunomodulatory intervention. Continued multidisciplinary follow-up and prospective studies are essential to elucidate the long-term neurodevelopmental and psychiatric consequences and to optimize therapeutic strategies for these patients.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13608028/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039437","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":"Flexor Tendon Rupture Following Collagenase <i>Clostridium histolyticum</i> Versus Percutaneous Needle Fasciotomy in the Management of Dupuytren's Disease: A Systematic Review and Meta-Analysis.","authors":"Sherlyn Chng, Omar Shadid, Ishith Seth, Warren M Rozen","doi":"10.3390/jpm16090459","DOIUrl":"10.3390/jpm16090459","url":null,"abstract":"<p><p><b>Background:</b> Flexor tendon rupture is a rare but potentially disabling complication following minimally invasive treatment of Dupuytren's disease. This meta-analysis compared rupture incidence after collagenase <i>Clostridium histolyticum</i> (CCH) injection and percutaneous needle fasciotomy/aponeurotomy (PNF/PNA). <b>Methods:</b> PubMed, MEDLINE, and Embase were systematically searched for randomised trials, cohort studies, clinical trials, and case series reporting complications after CCH or PNF for Dupuytren's disease. Case reports and secondary evidence were excluded from incidence calculations, although reference lists of reviews were screened for eligible primary studies. Flexor tendon rupture events and study denominators were extracted as reported. Pooled incidence was estimated using random-effects proportional meta-analysis with logit transformation and continuity correction. Separate pooled estimates were generated for CCH and PNF, followed by subgroup comparison. <b>Results:</b> Forty-one studies were included. Across eligible studies, 68 flexor tendon ruptures were identified, including 62 after CCH and 6 after PNF. Ruptures most commonly involved the flexor digitorum profundus, affected the small finger, and occurred early, with a median time to rupture of 8 days, where reported. Fourteen PNF cohorts comprising 6058 treated units reported 6 ruptures, producing a pooled incidence of 0.32% (95% CI: 0.18-0.55%) with no observed heterogeneity. Twenty-nine CCH cohorts comprising 60,949 treated units reported 62 ruptures, producing a pooled incidence of 0.83% (95% CI: 0.42-1.64%) with substantial heterogeneity. Subgroup comparison demonstrated a higher pooled rupture incidence following CCH than PNF. <b>Conclusions:</b> Flexor tendon rupture is uncommon after both CCH and PNF. Characterisation of anatomical and treatment-related patterns of rupture may support more individualised risk counselling and treatment selection in Dupuytren's disease. Future studies are required to develop clinically meaningful risk-stratification strategies.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13608378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039286","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":"Ruptured Isolated Posterior Spinal Artery Aneurysm: A rare case and systematic literature review.","authors":"Elisa Garbin, Nicola Cavasin, Luca Basaldella, Salima Magrini","doi":"10.3390/jpm16090462","DOIUrl":"10.3390/jpm16090462","url":null,"abstract":"<p><p><b>Background:</b> Ruptured isolated spinal artery aneurysms (SAAs) are not common. Posterior spinal artery aneurysms (PSAAs) are less common. Either is rarely the cause of spontaneous spinal subarachnoid hemorrhage (sSAH). Due to a few published reports, the natural course, diagnosis and optimal therapeutic strategy remain debatable and challenging. We report the case of a 60-year-old male presenting with lumbar and abdominal pain, which swiftly became associated with headache, photophobia and worsening neck pain. Spinal MRI revealed an intradural hemorrhage collection from the T9 level to the T10 level; the spinal DSA confirmed a fusiform dissecting PSAA originating from the T11 level. He was managed conservatively and recovered completely. We have reviewed the few cases reported in the literature. <b>Results</b>: Except for the present case, there are 29 reported cases of isolated PSAAs and 69 cases of isolated SAAs. The patients' ages ranged from 16 to 88 years, and common presenting symptoms were headache and back/abdominal pain. The PSAAs were commonly located at the lower thoracic level or lumbar level. The most common PSAA treatment was surgery; among the 29 cases, 85% reported favorable outcomes regardless of the type of treatment. <b>Conclusions:</b> Ruptured spinal artery aneurysms are prone to spontaneous thrombosis. Given the lack of standardized guidelines, a personalized medicine approach is essential, requiring a detailed, patient-specific risk assessment. Conservative management could be an appropriate treatment option with a favorable outcome. Further understanding may help guide future clinical decision-making and tailored treatment planning according to patient-specific features.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13608540/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039393","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":"Optimising Autologous Breast Reconstruction: Pneumothorax and Pneumomediastinum-A Literature Review and First Reported Case of Pneumomediastinum Following Bilateral DIEP Flap Reconstruction.","authors":"Akshay Soni, Ishith Seth, Kaiyang Lim, Alexander Phan, Richard J Ross, Mathew Lee, Warren M Rozen","doi":"10.3390/jpm16090458","DOIUrl":"10.3390/jpm16090458","url":null,"abstract":"<p><p><b>Background</b>: Thoracic air complications after autologous breast reconstruction (ABR) are uncommon and incompletely characterised. A personalised perioperative approach requires integration of patient anatomy, reconstructive technique, anaesthetic exposures and the postoperative clinical trajectory rather than reliance on population-level estimates alone. <b>Methods</b>: We report a 41-year-old woman in whom pneumomediastinum was identified after bilateral DIEP flap reconstruction and performed a focused literature review restricted to primary studies of pneumothorax or pneumomediastinum following autologous flap breast reconstruction. Searches across MEDLINE-Ovid, PubMed and Wiley Online Library using predefined MeSH terms were conducted. Data extraction focused on study characteristics, incidence, mechanism of injury, perioperative factors, and management. <b>Results</b>: The patient developed postoperative hypotension and persistent tachycardia, followed by pleuritic chest pain. CT excluded pulmonary embolism and oesophageal perforation but demonstrated Moderate volume pneumomediastinum without pneumothorax. She was managed conservatively and discharged on postoperative day 7. Five primary studies met the eligibility criteria. Study-specific pneumothorax frequencies were 1/463 (0.22%) after rib-sparing free-flap reconstruction, 3/749 (0.4%) after extended latissimus dorsi reconstruction, and 4/180 patients (2.2%; 1.4 per 100 internal mammary vessel dissections). Reported mechanisms included pleural injury during internal mammary vessel dissection, inadvertent puncture during regional anaesthesia, barotrauma under positive-pressure ventilation, and drain-related barotrauma. No previous primary report of pneumomediastinum after autologous flap breast reconstruction was identified. <b>Conclusions</b>: Pneumothorax and pneumomediastinum are uncommon but potentially serious complications of ABR. They are rarely documented postoperatively; however, surgeons and anaesthetists must remain vigilant, particularly during exposure of the internal mammary vessels and airway management. Patient-specific assessment, symptom-directed imaging and multidisciplinary management may support early recognition to prevent morbidity and preserve the outcomes of reconstructive procedures.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13608144/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039422","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":"Nurses' Knowledge of Insensible Water Loss and the Evolution of a Digital Decision-Support Tool for Personalized Fluid Balance Assessment: A Cross-Sectional Study.","authors":"Anna Grimaldi, Diego Lopane, Stefano Mancin, Orsola Agorini, Vincenzo Di Nuzzo, Giuseppe Frattolillo, Domenico Di Sivo, Giovanni Gavarro, Incoronata Chiusolo, Ciro Pozzuoli, Sara Morales Palomares, Italian Society Of Nephrology Nurses Sian Board Of Directors Group, Giovanni Cangelosi, Alessandro Stievano","doi":"10.3390/jpm16090456","DOIUrl":"10.3390/jpm16090456","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Fluid balance management is a core nursing competency, particularly in high-acuity settings. However, the assessment of insensible water loss remains challenging due to the lack of standardized methods, which may increase variability in clinical reasoning. In this context, digital tools may support a more structured and personalized approach. This study aimed to assess nurses' knowledge of fluid balance and insensible water loss [perspiratio insensibilis (PI)] and to evaluate the usability and perceived quality of a pilot digital clinical decision-support tool (CareBalance-N). Secondary analyses explored differences across clinical settings and the association between knowledge level and app evaluation. <b>Methods:</b> A cross-sectional observational study was conducted among 50 nurses working in three clinical settings: hemodialysis (n = 20; 40%), internal medicine (n = 15; 30%), and intensive care (n = 15; 30%). Knowledge was assessed using a structured questionnaire (score range: 0-100), while the usability and perceived quality of the digital application for fluid balance were evaluated using the User Version of the Mobile App Rating Scale (uMARS). Differences between settings were analyzed using ANOVA, and correlations were assessed using Pearson's correlation coefficient. <b>Results:</b> The mean knowledge score was 67.6 ± 7.7, with significant differences across clinical settings [F(2, 47) = 28.4; <i>p</i> < 0.001]: hemodialysis 73.6 ± 6.0, intensive care 66.9 ± 4.7, and internal medicine 60.3 ± 5.1. The mean uMARS score was 3.91 ± 0.17, with particularly high ratings for functionality (4.19 ± 0.17) and perceived impact (4.17 ± 0.16). A strong positive correlation was found between knowledge scores and app evaluation (r = 0.943; <i>p</i> < 0.001). <b>Conclusions:</b> These findings highlight variability in nursing knowledge across clinical settings and suggest that digital tools such as CareBalance-N may represent a promising approach to facilitate more structured clinical reasoning and fluid balance assessment. However, these potential benefits require validation in real-world clinical settings. Further studies are needed to evaluate their impact on decision-making processes, the accuracy of fluid balance assessment, patient safety, and clinical outcomes.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13608302/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039440","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":"Body Mass Index and Body Fat Percentage Are Associated with Clinical Outcomes in Patients Receiving PD-1/PD-L1 Inhibitors: A Prospective Exploratory Study.","authors":"Ángela Morell, Alberto Morell, Ainhoa Aranguren, Jacobo Rogado, Miguel Sampedro, Rebeca Mondéjar, Ramón Colomer, M Paz Lorenzo, Esther Ramírez","doi":"10.3390/jpm16090457","DOIUrl":"10.3390/jpm16090457","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Immunotherapy using immune checkpoint inhibitors has transformed the treatment of multiple solid tumours. However, the clinical response to programmed death receptor (PD-1) and its ligand (PD-L1) inhibitors remains heterogeneous. We have previously shown that host-related factors such as body mass index (BMI) may modulate the efficacy of immunotherapy. The aim of this study was to determine whether body composition, measured with bioelectrical impedance analysis (BIA) before treatment initiation, is a prognostic factor for survival outcomes in patients treated with PD-1/PD-L1 inhibitors, independently of tumour type and stage. <b>Methods</b>: In this prospective, single-centre observational study, patients with solid tumours underwent baseline body composition assessment using multifrequency bioelectrical impedance analysis (BIA) before initiation of PD-1/PD-L1 inhibitor therapy. Overall survival (OS), progression-free survival (PFS), and treatment-related adverse events were evaluated using Kaplan-Meier analyses and multivariable Cox regression models adjusted for tumour stage and metastatic status. <b>Results</b>: A total of 80 patients with solid tumours were included in the study. The median age was 67 years, and 48 (60.0%) were male. Higher BMI (≥25 kg/m²) and elevated body fat percentage (%BF) were associated with more favourable survival outcomes. After adjustment for tumour stage and metastatic status, BMI ≥ 25 kg/m² was associated with a lower risk of death (HR 0.286, 95% CI 0.087-0.941; <i>p</i> = 0.039). Similar results were observed for elevated %BF (HR 0.289, 95% CI 0.087-0.963; <i>p</i> = 0.036). Neither BMI nor %BF was significantly associated with the occurrence of confirmed immune-related adverse events. <b>Conclusions</b>: Baseline BMI and body fat percentage were associated with survival outcomes in this exploratory cohort of patients receiving PD-1/PD-L1 inhibitors. These findings should be considered exploratory and hypothesis-generating and require confirmation in larger, tumour-specific prospective studies.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13608239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039500","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}