Journal of Personalized Medicine最新文献

{"title":"An Assessment of Real-World Evidence and Other Sources Supporting Payer Coverage Decisions for Pharmacogenomic Testing in Psychiatry.","authors":"Sandra E Yankah, Maryam Nafie, Rachele M Hendricks-Sturrup, Christine Y Lu","doi":"10.3390/jpm15060232","DOIUrl":"10.3390/jpm15060232","url":null,"abstract":"<p><p><b>Background:</b> Sources and evidence cited to inform payer coverage decisions on pharmacogenomic (PGx) testing in psychiatry are presently underexplored. <b>Methods:</b> We conducted a qualitative and quantitative assessment of publicly available coverage policies from 14 US payers, examining the number and both the type and source of citations across policies and coverage decisions. Payers were classified as for-profit or mutual fund versus non-profit or government, and their coverage decisions were categorized as either coverage (limited or specified) or no coverage. <b>Results:</b> Among 32 unique sources cited, peer-reviewed literature as a single source was most frequently cited across all policies. Of 207 peer-reviewed papers cited across all policies, 40% (<i>n</i> = 83) were psychiatry-specific real-world evidence (RWE) studies. No statistically significant relationships were observed when comparing variance in the number of citations per policy by payer type (<i>p</i> = 0.22) or coverage decision (<i>p</i> = 0.75; unadjusted variance of 61.25 and an adjusted variance of 60.98 for both comparisons). For-profit or mutual fund payers and/or payers providing no coverage cited systematic reviews and non-randomized controlled cohort RWE studies most often. Non-profit or government payers and/or payers providing coverage cited case series or case-control RWE studies most often. Six psychiatry-specific RWE studies and contributions from 13 distinct sources were often cited, regardless of payer type or coverage decision. <b>Conclusions:</b> RWE, among several sources, are cited in many forms and to varying degrees among payers providing coverage decisions for PGx testing in psychiatry, with coverage determinations being largely based on how certain payers interpret evidence on the clinical value of testing.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12194790/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484763","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":"Comprehensive Management of Cocaine-Induced Midline Destructive Lesions: A Young-IfOS Consensus.","authors":"Alberto Maria Saibene, Letizia Nitro, Florent Carsuzaa, Mihaela Alexandru, Vincent Bedarida, Matteo Di Bari, Léa Fath, Ainhoa Garcia-Lliberos, Margaux Legré, David Lobo-Duro, Antonino Maniaci, Thomas Radulesco, Leigh Sowerby, Neil Tan, Manuel Tucciarone, Clair Vandersteen, Valentin Favier, Maxime Fieux","doi":"10.3390/jpm15060231","DOIUrl":"10.3390/jpm15060231","url":null,"abstract":"<p><p><b>Background:</b> Recreational nasal cocaine use (RNCU) presents a significant challenge for rhinologists due to cocaine-induced midline destructive lesions (CIMDLs). This clinical consensus statement (CCS) offers guidelines for diagnosing, assessing, and managing both proven and suspected cases of CIMDL (including those without a prior RNCU history). It aims to support clinicians in addressing these complex cases effectively. <b>Methods:</b> An international, multidisciplinary panel of 18 specialists employed a three-round modified Delphi-method survey to evaluate statements covering CIMDL management issues such as definition, clinical evaluation and diagnosis, initial management approaches, and surgical management of complications and reconstructions. This study primarily targets otorhinolaryngologists. <b>Results:</b> Out of 44 evaluated statements, 20 achieved strong consensus, 20 reached consensus, 3 approached near-consensus, and 1 failed to achieve consensus. Consensus-covered areas included the definition of CIMDL, clinical evaluations, first-line management, and management of complications. However, reconstructive techniques remained a contentious topic. <b>Conclusions:</b> In the absence of extensive data, this CCS establishes a management framework for CIMDL, significantly bridging a knowledge gap. It highlights the need for standardized assessments, multidisciplinary cooperation, and customized follow-up care for patients with CIMDL. Considering the widespread use of cocaine, physicians should consistently consider the possibility of RNCU when encountering chronic inflammatory lesions in the sinonasal tract.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12193749/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484797","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":"Pericapsular Nerve Group (PENG) Associated with Lateral Femoral Cutaneous Nerve (LFCN) Block Versus Fascia Iliaca Compartment Block (FICB) for Total Hip Replacement Surgery: Double-Blind Randomized Controlled Trial.","authors":"Francesco Vetrone, Stefano Marelli, Andrea Galimberti, Michele Umbrello, Miriam Gotti, Angelo Pezzi, Alessandro Girombelli","doi":"10.3390/jpm15060230","DOIUrl":"10.3390/jpm15060230","url":null,"abstract":"<p><p><b>Background:</b> Total hip arthroplasty (THA) improves the quality of life by alleviating pain and restoring function. The optimal pain control with minimal muscle weakness is paramount for early rehabilitation and for reducing complications. Although PROSPECT and ICAROS guidelines recommend the Fascia Iliaca Compartment Block (FICB), it is associated with insufficient pain relief and a prolonged quadriceps motor block. The association of the PENG (Pericapsular Nerve Group) with LFCN (lateral femoral cutaneous nerve) blocks may address these limitations, provide improved motor-sparing pain control, and offer a more tailored approach that enhances both an early postoperative recovery and patient satisfaction. <b>Methods:</b> A randomized controlled trial (November 2023-July 2024) compared the PENG + LFCN to the FICB in patients undergoing elective THAs under spinal anesthesia. The primary outcome was quadriceps weakness at 6 h post-block. Secondary outcomes included the degree of hip flexion and pain scores at 6, 24, and 48 h post-block, opioid consumption, and time to ambulation. <b>Results:</b> Fifty-eight patients were randomized (twenty-nine per group). The PENG + LFCN group achieved a significantly greater muscle strength (MRC: 4 [4; 4] vs. 3 [3; 4], <i>p</i> < 0.0001) and better hip flexion at all measured moments (6 h: 45° [37; 60] vs. 30° [25; 43], 24h: 59° [49; 66] vs. 47° [36; 50], 48 h: 62° [55; 70] vs. 50° [40; 55], all <i>p</i> < 0.0001). Resting pain was lower in the PENG + LFCN group (0 [0; 1], 0 [0; 2], and 0 [0; 1] vs. 2 [0; 3], 1 [0; 3], 1 [0; 3]), as was the dynamic pain during movement (1 [0; 2], 2 [2; 4], and 2 [1; 2] vs. 3 [2; 5], 3 [2; 4], and 3 [1; 3]; all <i>p</i> < 0.001), along with a lower total opioid consumption (0 [0; 0] vs. 7.5 [7.5; 22.5] MME, <i>p</i> < 0.001). <b>Conclusions:</b> The PENG + LFCN block outperformed the FICB in muscle strength, hip flexion, pain control, and opioid use, suggesting it may be a more effective option for THAs.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12193918/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484844","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":"Correlations Between Novel Adiposity Indices and Electrocardiographic Evidence of Left Ventricular Hypertrophy in Individuals with Arterial Hypertension.","authors":"Giulio Geraci, Pietro Ferrara, Francesco Pallotti, Rosario Le Moli, Vincenzo Calabrese, Valentina Paternò, Luca Zanoli, Antonina Giammanco, Alessandra Bellavia, Liliana Naro, Alessandra Sorce, Luigi La Via, Jacob George, Riccardo Polosa, Giuseppe Mulè, Caterina Carollo","doi":"10.3390/jpm15060229","DOIUrl":"10.3390/jpm15060229","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Obesity is a key driver of cardiovascular disease (CVD), with central adiposity directly involved in adverse cardiac remodeling. Body mass index (BMI) is limited in capturing fat distribution and associated cardiovascular risk. Novel anthropometric indices, including A Body Shape Index (ABSI) and Body Roundness Index (BRI), may offer greater clinical value, but their relationship with electrocardiographic markers of left ventricular hypertrophy (LVH) remains underexplored. This study aims to assess the correlation between novel adiposity indices (ABSI and BRI) and electrocardiographic evidence of LVH, as measured by the Sokolow-Lyon Index (SLI), in individuals with arterial hypertension. <b>Methods</b>: 274 hypertensive patients were recruited, and BMI, ABSI, and BRI were calculated. LVH was assessed via SLI on 12-lead ECG. Participants were stratified by the SLI (≤35 mm vs. >35 mm) for statistical analyses. <b>Results</b>: Patients with a lower SLI showed significantly higher values of ABSI and BRI compared to those in higher SLI group, without differences in BMI. In the entire population, SLI was significantly and inversely correlated with both ABSI (r = -0.296, <i>p</i> < 0.001) and BRI (r = -0.238, <i>p</i> < 0.01), but not with BMI. Multivariate regression analysis confirmed ABSI (<i>p</i> = 0.013) and BRI (<i>p</i> = 0.038) as independent predictors of SLI, even after adjusting for age, blood pressure, renal function, and metabolic parameters. <b>Conclusions</b>: ABSI and BRI are inversely and independently associated with ECG-derived SLI in hypertensive individuals, suggesting that central adiposity may attenuate ECG voltages and obscure LVH detection. Incorporating novel adiposity indices into ECG interpretation may enhance diagnostic accuracy and risk stratification in obese and hypertensive populations. Longitudinal studies are needed to validate these findings and refine clinical algorithms.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12194296/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484799","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":"Thromboembolic Risk and High Prothrombotic Factors in Childhood Acute Lymphoblastic Leukemia with Ischemic Stroke: A Literature Review of Personalized and Institutional Approaches to Prophylaxis.","authors":"Marta Malczewska, Ewa Dudkiewicz, Joanna Zawitkowska, Monika Lejman","doi":"10.3390/jpm15060228","DOIUrl":"10.3390/jpm15060228","url":null,"abstract":"<p><p><b>Background</b>: Although thromboembolic complications are recognized in the treatment of acute lymphoblastic leukemia (ALL), ischemic strokes are rare but severe events. These life-threatening complications not only pose an immediate risk but can also result in long-term neurological deficits, significantly impacting a patient's quality of life. Identifying high-risk patients and implementing effective prophylaxis strategies are crucial for improving patient outcomes. In addition to strokes, these patients are also at risk of other embolic and thrombotic events, which can occur in up to 35% of patients. Despite this, there are still no clear guidelines for prophylactic management in pediatric patients treated for oncologic diseases. <b>Results</b>: Using the example of a 14-year-old male treated for ALL who suffered an ischemic stroke, we conducted a review of the literature on embolic and thrombotic events, neurological complications, methods of prevention, and ways to monitor and detect patients with an increased risk of such difficulties. We outlined our approach to the monitoring of prothrombotic factors, the interpretation of their levels, and the subsequent adjustment to prophylactic management based on these findings. As a result of this review, we reached two basic conclusions. First, thromboembolic episodes are not uncommon complications in pediatric patients and can cause long-lasting consequences, even after the cancer is cured. Secondly, despite such an urgent problem, clinicians are still struggling with the question of monitoring prothrombotic factors, the choice of drug, and the duration of prophylaxis. Their decisions depend on the experience of the treating center. <b>Conclusions:</b> The pediatric population being treated for malignant disease urgently requires the establishment of guidelines that standardize the management of thromboembolic events.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12193809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484862","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":"Novel Biomarkers for SARS-CoV-2 Infection: A Systematic Review and Meta-Analysis.","authors":"Sara Weronika Snopkowska Lesniak, Diego Maschio, Fernando Neria, Beatriz Rey-Delgado, Victor Moreno Cuerda, Cesar Henriquez-Camacho","doi":"10.3390/jpm15060225","DOIUrl":"10.3390/jpm15060225","url":null,"abstract":"<p><p><b>Background:</b> COVID-19, caused by SARS-CoV-2, has posed significant challenge to global healthcare systems, necessitating reliable biomarkers to predict disease severity and mortality. This systematic review and meta-analysis evaluated the prognostic value of novel biomarkers in COVID-19 patients. The aim of this study was to identify and prioritize the most prognostically relevant novel biomarkers associated with COVID-19 outcomes. <b>Methods:</b> We conducted a systematic review and meta-analysis of the available evidence. A systematic search of PubMed and Web of Science was performed to identify studies on the COVID-19 biomarkers. Observational studies that compared poor (severe disease/mortality) and good outcomes were included. For continuous measures, standard mean differences (SMDs) with 95% confidence intervals (CIs) were calculated. Pooled sensitivity, specificity, diagnostic odds ratio (DOR), and summary receiver operating characteristic (SROC) curve analyses for the biomarkers were used. The risk of bias was assessed using the Newcastle-Ottawa scale. <b>Results:</b> Of the 2907 screened studies, 38 were included (21 in the meta-analysis). MR-proADM showed higher levels of prediction for poor outcomes (SMD = 1.40, 95% CI: 1.11-1.69; AUC 0.74-0.96; sensitivity, 85%; specificity, 71%). The neutrophil-to-lymphocyte ratio (NLR) showed a high correlation with disease severity (SMD = 1.07, 95% CI: 0.79-1.35; AUC 0.73-0.98; sensitivity, 86%; specificity, 78%). Increased KL-6 levels were associated with lung injury (SMD = 1.22, 95% CI: 0.24-2.19; AUC 0.85-0.95). Other biomarkers (suPAR, miR-155, Galectin-3) showed promise but lacked sufficient data for pooled analysis. Heterogeneity was observed among the included studies in terms of diagnostic accuracy. These findings indicate that elevated levels of MR-proADM, NLR, and KL-6 are significantly associated with COVID-19 prognostic accuracy to guide patient management. <b>Conclusions:</b> MR-proADM, NLR, and KL-6 levels demonstrated strong prognostic value for COVID-19 severity and mortality. These biomarkers can enhance clinical decision-making.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12194655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484840","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":"Advanced Basal Cell Carcinoma: A Narrative Review on Current Systemic Treatments and the Neoadjuvant Approach.","authors":"Andrea Paradisi, Maria Mannino, Francesco Brunetti, Enrico Bocchino, Alessandro Di Stefani, Ketty Peris","doi":"10.3390/jpm15060226","DOIUrl":"10.3390/jpm15060226","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Systemic therapy with hedgehog pathway inhibitors (HHIs) and anti-programmed cell death protein 1 (PD-1) antibodies represent the first- and second-line treatment options for advanced basal cell carcinoma (aBCC), respectively. A shift in the treatment paradigms toward the neoadjuvant approach is gaining increasing interest in aBCC management, whereby prior systemic therapy followed by surgery is likely to yield more favorable outcomes. The aim of this narrative review is to summarize the current evidence on systemic treatment options and the neoadjuvant approach for aBCC management. <b>Methods:</b> We performed a non-systematic review of the literature based on PubMed as search engine. <b>Results:</b> The pivotal phase II trials ERIVANCE and BOLT investigated the efficacy and safety profile of vismodegib and sonidegib, respectively, with reported objective response rates (ORRs) of 60.3% and 56% in laBCC patients, respectively. The pivotal phase II trial NCT03132636 investigated the efficacy and safety profile of cemiplimab in patients who progressed or were intolerant to prior HHI therapy, with an ORR of 32.1% in laBCC patients. Real-life studies confirmed the effectiveness and safety profile of HHI and anti-PD-1 immunotherapy. Several phase I/II clinical trials are currently investigating HHIs and immune-checkpoint inhibitors in the neoadjuvant setting followed by surgery for aBCC patients, with the aim of providing more favorable treatment outcomes, especially when upfront surgery would result in functional and/or aesthetic sequelae. <b>Conclusions:</b> Advanced BCC treatment is challenging, and the neoadjuvant approach followed by surgery is expected to reduce surgical complexity, increase tissue preservation, and improve patients' satisfaction.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12194520/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484780","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":"Prospective Evaluation of Adverse Drug Reactions in Hospitalized Older Adults in Ethiopia.","authors":"Mengist Awoke Yizengaw, Behailu Terefe Tesfaye, Dula Dessalegn Bosho, Gebremichael Tesfay Desta, Mohammed S Salahudeen","doi":"10.3390/jpm15060227","DOIUrl":"https://doi.org/10.3390/jpm15060227","url":null,"abstract":"<p><p><b>Background:</b> Older adults are vulnerable to adverse drug reactions (ADRs), particularly in low-income settings, yet data on ADR prevalence in Africa, including Ethiopia, remain limited. <b>Objective:</b> This study aimed to evaluate the incidence, severity, and preventability of ADRs among hospitalized older adults, as well as all-cause inpatient mortality. <b>Methods:</b> A cross-sectional observational study was conducted at Jimma Medical Center, located in Jimma town, Ethiopia, from 6 September 2021 to 26 December 2022. The study participants were older adults (n = 162) admitted to the medical wards. ADRs were assessed using the Naranjo ADR probability scale, severity was classified according to the modified Hartwig and Siegel criteria, and preventability was determined using the Schumock and Thornton criteria. <b>Results:</b> The median age of participants was 65 years (interquartile range: 60-70). During their hospital stay, 84 patients (51.9%) experienced at least one ADR. A total of 123 ADRs (76 ADRs per 100 admissions) were captured. Most ADRs (93.5%) were classified as mild to moderate in severity, and 84.5% (n = 105) were considered preventable. Endocrine and metabolic systems (48.8%) and diuretics (43.9%) were the most frequently affected organ systems and drug class linked to ADRs, respectively. Furosemide (41.5%) and aspirin (10.6%) were the most frequently implicated medications, commonly causing hypokalemia (35.3%) and dyspepsia (53.8%), respectively. The observed all-cause in-patient mortality rate was 6.8% (5 deaths per 1000 patient-days). The use of potentially inappropriate medications (PIMs) (aOR: 4.747, <i>p</i> = 0.003) and presence of digestive system disorders (aOR: 8.784, <i>p</i> = 0.038) were associated with an increased risk of ADRs, while a history of recent traditional medicine use (aOR: 0.285, <i>p</i> = 0.042) was linked to a lower risk. <b>Conclusions:</b> More than half of the hospitalized older adults experienced ADRs, most of which were mild to moderate in severity and considered preventable. Regular medication review for screening and minimizing PIM use in older adults may play a crucial role in lowering ADR occurrence. The borderline but statistically significant association between a history of traditional medicine use and lower occurrence of ADRs requires cautious interpretation and further investigation to explore possible explanations. Nearly seven deaths per hundred hospitalized patients were recorded.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Right Ventricular Strain by Echocardiography: Current Clinical Applications and Future Directions for Mechanics Assessment of the Forgotten Ventricle.","authors":"Mahmoud Abdelnabi, Ramzi Ibrahim, Hoang Nhat Pham, Bobbi Jo Heon, George Bcharah, Girish Pathangey, Milagros Pereyra Pietri, Juan M Farina, Ian C Chang, Reza Arsanjani, Chadi Ayoub","doi":"10.3390/jpm15060224","DOIUrl":"10.3390/jpm15060224","url":null,"abstract":"<p><p>Myocardial deformation imaging has emerged as a valuable clinical tool for assessing right ventricular (RV) systolic function, providing additional diagnostic and prognostic insights compared to traditional indices of RV function. Two-dimensional speckle-tracking echocardiography is currently the standardized method of choice for measuring RV longitudinal strain (RVLS) in clinical practice. RVLS provides a more sensitive indicator of subtle myocardial dysfunction than conventional parameters for RV function assessment (i.e., tricuspid annular plane systolic excursion, tissue Doppler systolic velocity, fractional area change, or RV ejection fraction), with utility for the risk stratification and surveillance of conditions affecting the right heart. However, accurate interpretation of RVLS requires a comprehensive understanding of RV mechanics, pathology, and loading conditions across various cardiovascular conditions, as well as the effects of image quality and technical aspects of image acquisition and tracking in RV strain measurements. This review provides an updated overview of current practical guidelines for RV strain analysis, current clinical applications, and future directions for its potential use in clinical practice.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12194349/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484857","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":"Developing a Risk Stratification Tool to Predict Patients with Gestational Diabetes Mellitus at Risk of Insulin Treatment: A Cohort Study.","authors":"Xi Yang, Hannah L Nathan, Ebruba E Oyekan, Tim I M Korevaar, Doaa Ahmed, Katherine Pacifico, Aisha Hameed, Manju Chandiramani, Anita Banerjee, Caroline Ovadia","doi":"10.3390/jpm15060223","DOIUrl":"10.3390/jpm15060223","url":null,"abstract":"<p><p><b>Objectives:</b> We aimed to develop and validate a simple, easy-to-use risk stratification tool to use in the diagnosis of gestational diabetes mellitus (GDM) to triage those more likely to require insulin treatment. <b>Methods</b>: Using an audit of patients with GDM in 2019, multivariable logistic regression was used to select variables and develop a prediction model for insulin requirement. A stratification tool was developed by dichotomising these selected variables; its performance was assessed with an internal cohort from 2021 and externally from patients managed at a separate hospital. <b>Results</b>: Patients with a higher fasting blood glucose concentration (OR 2.41, 95% CI 1.84-3.15) and higher booking body mass index (OR 1.48, 95% CI 1.07-2.03) were more likely to require insulin therapy whilst a later gestational-weeks-at-diagnosis value gave a lower risk of insulin therapy (OR 0.71, 95% CI 0.62-0.81 per week). The low-risk group for insulin requirement was defined thus: fasting blood glucose < 5.6 mmol/L, booking BMI < 30 kg/m², and gestational weeks at diagnosis ≥ 24 weeks. This classification had a negative predictive value (NPV) of 94% for insulin requirement, with a sensitivity of 84% and specificity of 56% in the development cohort. Similarly, in the internal and external validation cohorts, the NPVs were 93 and 90%, with sensitivity values of 77 and 78%, respectively. <b>Conclusions</b>: This study developed a pragmatic tool with three criteria for stratifying the GDM group not requiring insulin treatment, with successful validation for clinical use.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12194323/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484800","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}