Journal of Personalized Medicine最新文献

{"title":"Ultrasound-Guided Regional Block in Renal Transplantation: Towards Personalized Pain Management.","authors":"Ahmad Mirza, Munazza Khan, Zachary Massey, Usman Baig, Imran Gani, Shameem Beigh","doi":"10.3390/jpm15090411","DOIUrl":"10.3390/jpm15090411","url":null,"abstract":"<p><p><b>Introduction:</b> The management of peri-operative pain significantly impacts the post-operative recovery following kidney transplant. For decades, regional blocks have been utilized for post-operative pain management following abdominal surgery. The data on the routine use of regional blocks peri-operatively during kidney transplants are limited. We aim to review our current clinical practice of peri-operative use of regional blocks during kidney transplants and management of peri-operative pain up to 24 h. <b>Methods:</b> A consecutive series of 100 patients who underwent kidney transplant was reviewed. All demographic data including patient's age, gender, race, and body mass index were collected. Pre-transplant co-morbidities were summarized for all patients and included the American Society of Anesthesiologists (ASA) score. Patients were divided into two groups based on whether they received a transversus abdominis plane (TAP) block. Group A consisted of patients who received an ultrasound-guided TAP block, while Group B included patients who did not receive any form of TAP block. The intra-operative and post-operative use of analgesia was recorded for up to 24 h post kidney transplant. All peri-operative complications were reviewed. The chi-square test and Fisher's exact test was used to compare symptoms (nausea, vomiting, and pruritus) between the two groups. Similarly, the use of analgesia was also compared. <b>Results:</b> A total of 100 patients were identified and equally distributed between the two groups [Group A = 50 (TAP block), Group B = 50 (non-TAP block)]. There was a statistically significant reduction in the use of intraoperative fentanyl (<i>p</i> = 0.04) in Group A. There was no difference in the post-operative use of hydromorphone (<i>p</i> = 0.665), oxycodone (<i>p</i> = 0.75), and acetaminophen (<i>p</i> = 0.64) up to 24 h after the kidney transplant procedure. There was no difference between post-operative nausea (<i>p</i> = 0.766), vomiting (<i>p</i> = 0.436), and pruritus. There were no complications recorded secondary to the use of regional blocks in Group A. <b>Conclusions:</b> The use of regional anesthesia in kidney transplant recipients is a safe approach without complications. The study concluded that regional blocks decrease the use of intra-operative opioids. However, there was no difference in the use of post-operative requirements for analgesia or side effects up to 24 h after kidney transplant.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12470380/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149442","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":"Microsatellite Instability and Myometrial Infiltration in Low-Grade Endometrial Cancer: A Focus on MMR Heterodimer Dysfunction by a Retrospective Multicentric Italian Study.","authors":"Carlo Ronsini, Stefano Restaino, Mariano Catello Di Donna, Giuseppe Cucinella, Maria Cristina Solazzo, Pasquale De Franciscis, Giuseppe Vizzielli, Manuela Ludovisi, Vito Chiantera","doi":"10.3390/jpm15090417","DOIUrl":"10.3390/jpm15090417","url":null,"abstract":"<p><p><b>Background:</b> Recent studies highlight the role of microsatellite instability (MSI) in tumor progression. This study examines the link between MSI, type of loss of function, and disease progression in low-grade endometrial carcinoma clinically confined to the uterus, focusing on myometrial infiltration. <b>Materials and Methods:</b> This retrospective case-control study analyzed data from 144 women treated for clinical stage I low-grade endometrial carcinoma at two university hospitals. Patients were divided into two groups based on microsatellite status: 118 with microsatellite stability (MSS) and 26 with MSI. Immunohistochemical profiling assessed MMR proteins (MLH1, PMS2, MSH2, MSH6). The primary outcome was the presence of myometrial infiltration, and the secondary outcome was the deepness of infiltration. Data were statistically analyzed using Fisher's exact, Chi-square, and Wilcoxon tests, with logistic regression applied to evaluate the impact of MSI on these outcomes. <b>Results:</b> Myometrial infiltration was present in 96% of MSS and 98% of MSI cases (<i>p</i> = 0.5). However, deep infiltration (≥50%) was more frequent in patients with MSI (38% vs. 19%, <i>p</i> = 0.042). Stratification by heterodimer loss revealed that loss of MLH1/PMS2 was associated with a higher rate of deep infiltration (47%), while loss of MSH2/MSH6 correlated with lower infiltration risk (14%). In multivariate analysis, MSH2/MSH6 loss remained negatively associated with infiltration (OR 0.88; 95% CI 0.80-0.98; <i>p</i> = 0.020), independent of grade and LVSI. <b>Conclusions:</b> In low-grade endometrial carcinomas clinically confined to the uterus, MSI does not increase the overall prevalence of myometrial infiltration but is associated with deeper invasion, especially in cases with MLH1/PMS2 loss. MSI profiling could aid in risk stratification and therapeutic planning, particularly in candidates for fertility-sparing treatment.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12471136/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149672","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":"Long-Term Outcomes in Aortic Stenosis: Mortality Analysis in a Selected Patient Group.","authors":"Olga Irtyuga, Mary Babakekhyan, Oleg Metsker, Anna Starshinova, Dmitry Kudlay, Georgy Kopanitsa","doi":"10.3390/jpm15090410","DOIUrl":"10.3390/jpm15090410","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Background:&lt;/b&gt; Aortic stenosis (AS) is a prevalent acquired heart valve disease with increasing incidence, particularly among older adults. Gender-specific differences in AS presentation, comorbidities, and outcomes remain underexplored, necessitating further investigation to optimize personalized treatment strategies. &lt;b&gt;Objective:&lt;/b&gt; To evaluate the clinical and demographic characteristics, comorbidities, and survival outcomes of patients with AS, stratified by gender and aortic valve morphology. &lt;b&gt;Methods:&lt;/b&gt; A retrospective analysis of 145,454 echocardiographic examinations (2009-2018) at the Federal State Budgetary Institution \"V.A. Almazov National Medical Research Centre\" identified 84,851 patients meeting the inclusion criteria (Vmax ≥ 2.0 m/s, age ≥ 18 years). Patients were stratified by gender and valve morphology (bicuspid aortic valve [BAV] vs. tricuspid aortic valve [TAV]). Survival was assessed in 475 pts with AS over a 16-year period (2009-2025) using Kaplan-Meier analysis. Statistical comparisons utilized STATISTICA v. 10.0, with &lt;i&gt;p&lt;/i&gt;-values derived from P-tests. &lt;b&gt;Results:&lt;/b&gt; Of the cohort, 4998 men and 6322 women had AS. Men with AS were older (median 64 vs. 57 years, &lt;i&gt;p&lt;/i&gt; &lt; 0.0001) and had higher systolic blood pressure (140 vs. 130 mmHg, &lt;i&gt;p&lt;/i&gt; &lt; 0.0001) than men without AS. Women with AS were also older (median 70 vs. 58 years, &lt;i&gt;p&lt;/i&gt; &lt; 0.0001) with higher systolic (140 vs. 130 mmHg, &lt;i&gt;p&lt;/i&gt; &lt; 0.0001) and diastolic blood pressure (80 vs. 80 mmHg, &lt;i&gt;p&lt;/i&gt; &lt; 0.0001). Men with AS had higher rates of hyperlipidemia (HLP) (26.3% vs. 10.3%, &lt;i&gt;p&lt;/i&gt; &lt; 0.0001), while women with AS had increased coronary artery disease (CAD) (35.7% vs. 26.4%, &lt;i&gt;p&lt;/i&gt; &lt; 0.0001), diabetes mellitus (DM) (13.4% vs. 10.2%, &lt;i&gt;p&lt;/i&gt; &lt; 0.0001), and obesity (10.9% vs. 10.2%, &lt;i&gt;p&lt;/i&gt; = 0.06). Chronic heart failure (CHF) was more frequently reported in patients with AS, regardless of gender, compared to patients without AS (in men 53.4% vs. 41.8%, &lt;i&gt;p&lt;/i&gt; &lt; 0.0001; in women 54.5% vs. 37.5%, &lt;i&gt;p&lt;/i&gt; &lt; 0.0001). BAV was associated with higher AS prevalence (54.5% in men, 66.4% in women). Survival analysis revealed higher mortality. Over the 16-year follow-up period, the mortality rate was 21.7%. &lt;b&gt;Conclusions:&lt;/b&gt; Mortality in a representative AS cohort reached 21.7%, underscoring the progressive nature of the disease and its long-term impact. Survival was negatively affected by age over 68.5 years, as well as the presence of aortic regurgitation (AR), increased peak aortic jet velocity, and enlarged maximum aortic diameter. Aortic valve replacement demonstrates an insignificant effect on patient survival rates. Beta-blocker therapy in patients with varying degrees of aortic AS severity has not only demonstrated its safety but has also shown a positive effect on reducing mortality (improving survival). In contrast, the combination of angiotensin II receptor blockers (ARBs) with calcium channel blockers (CCBs) is quite dangerous f","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12471443/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149616","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 Orbital Atherectomy for Complex Coronary Calcium Modification: Has It Been Eclipsed?","authors":"Natasha Khullar, Trisha Singh, Peter O'Kane, Jonathan Hinton","doi":"10.3390/jpm15090414","DOIUrl":"10.3390/jpm15090414","url":null,"abstract":"<p><p>Severe coronary artery calcification (CAC) is a frequent finding in patients undergoing percutaneous coronary intervention (PCI) and represents a significant procedural challenge. CAC is commonly associated with ageing and comorbidities such as diabetes, hypertension, and chronic kidney disease, and contributes to vessel rigidity, impaired device delivery, and suboptimal stent expansion. These factors increase the risk of angiographic complications, as well as major adverse cardiac events compared with non-calcified lesions, negatively impacting both immediate and long-term clinical outcomes. In cases of severe calcification, traditional balloon angioplasty is often inadequate, necessitating the use of dedicated calcium modification techniques. Devices such as rotational atherectomy (RA), orbital atherectomy (OA), excimer laser coronary atherectomy (ELCA), and intravascular lithotripsy (IVL) have been developed to address these challenges. Among these, orbital atherectomy offers a potential unique dual mechanism of action and has shown promise in enhancing lesion preparation and facilitating optimal stent deployment. This review provides an overview of the role of orbital atherectomy in the management of calcified coronary lesions, evaluates current evidence on its safety and efficacy, and discusses how it may be positioned in the future, underscoring the need for a personalised, lesion-specific approach to optimise PCI outcomes.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12471242/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149472","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":"Repurposing SGLT-2 Inhibitors as a Novel Therapeutic Strategy for Treatment-Resistant Meniere's Disease.","authors":"Sun-Uk Lee, Euyhyun Park","doi":"10.3390/jpm15090412","DOIUrl":"10.3390/jpm15090412","url":null,"abstract":"<p><p><b>Background:</b> Meniere's disease (MD) is a chronic inner ear disorder affecting approximately 0.2% of the population, with 30% of patients remaining refractory to conventional treatments. The pathophysiology involves endolymphatic hydrops, suggesting that agents affecting fluid homeostasis might provide therapeutic benefit. Sodium-glucose cotransporter 2 (SGLT-2) inhibitors, originally developed for diabetes, offer unique mechanisms including natriuresis and osmotic diuresis that may address the underlying fluid imbalance in MD. <b>Methods</b>: We conducted a retrospective observational study at the Korea University Anam Hospital, analyzing the medical records of patients with definite MD (Bárány Society criteria) who received off-label empagliflozin 10 mg daily between January 2023 and December 2023. Six patients (3 men, 3 women; mean age 55.8 years) with treatment-resistant MD were identified who had failed conventional therapy for at least 3 months. Primary outcomes included changes in pure tone threshold average (PTA), low-frequency threshold average (LFA), vertigo episode frequency, and vertigo severity using visual analog scale (VAS) scores, assessed at baseline and after 3 months of treatment. <b>Results:</b> All patients demonstrated clinically significant improvements in both auditory and vestibular symptoms. Mean PTA improved from 31.4 dB to 20.8 dB (improvement of 10.6 dB, <i>p</i> < 0.05). Low-frequency hearing showed more substantial recovery, with LFA improving from 37.2 dB to 15.6 dB (improvement of 21.6 dB, <i>p</i> < 0.01). Vertigo frequency decreased dramatically from 1.6 episodes per month to 0.1 episodes per month, with four patients experiencing a complete resolution of vertigo episodes. VAS scores for vertigo severity decreased from 5.2 to 0.5. Treatment was well-tolerated, with only minor adverse effects reported in two patients: transient polyuria in one patient and 5 kg weight loss in another, both consistent with the known pharmacological profile of SGLT-2 inhibitors. <b>Conclusions</b>: This preliminary study suggests a potential clinical benefit of repurposing SGLT-2 inhibitors for treatment-resistant MD. However, the retrospective design and inherent limitations prevent definitive conclusions about causality. The significant improvements observed in both hearing thresholds and vestibular symptoms warrant further investigation through randomized controlled trials with objective outcome measures to establish the true efficacy of this therapeutic approach.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12470965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149640","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":"Female Sexual Function After Radical Treatment for MIBC: A Systematic Review.","authors":"Francesco Pio Bizzarri, Marco Campetella, Salvatore Marco Recupero, Fabrizio Bellavia, Lorenzo D'Amico, Francesco Rossi, Filippo Gavi, Giovanni Battista Filomena, Pierluigi Russo, Giuseppe Palermo, Nazario Foschi, Angelo Totaro, Mauro Ragonese, Maria Chiara Sighinolfi, Marco Racioppi, Emilio Sacco, Bernardo Rocco","doi":"10.3390/jpm15090415","DOIUrl":"10.3390/jpm15090415","url":null,"abstract":"<p><p><b>Background:</b> Sexuality in women with muscle-invasive bladder cancer (MIBC) undergoing radical treatment represents a crucial aspect of their overall quality of life, which is increasingly recognized as a key component of patient-centered care and long-term well-being. This review aimed to analyze the available literature to provide a comprehensive overview of the effects of treatments on female sexual function. <b>Methods:</b> We included all qualitative and quantitative studies addressing sexual function in patients treated for MIBC. Excluded were narrative reviews, case reports, conference abstracts, systematic reviews, and meta-analyses. The included studies involved women undergoing either robot-assisted radical cystectomy (RARC) or open RC (ORC), often with nerve-sparing, vaginal-sparing, or pelvic organ-preserving techniques. Data on oncological and functional outcomes were collected. <b>Results:</b> A systematic review of 29 studies including 1755 women was conducted. RC was performed via robotic/laparoscopic approaches in 39% of cases and open techniques in 61%. Urinary diversions included orthotopic neobladders (48%), ileal conduits (42%), ureterocutaneostomies (3%), and Indiana pouches (7%). Radiotherapy, used in 6% of patients, was mainly applied in a curative, trimodal setting. Sexual function was evaluated using various pre- and/or postoperative questionnaires, most commonly the EORTC QLQ-C22, FACT-BL, Bladder Cancer Index (BCI), LENT SOMA, and Female Sexual Function Index (FSFI). Radiotherapy was associated with reduced sexual function, though outcomes were somewhat better than with surgery. Among surgical approaches, no differences in sexual outcomes were observed. <b>Conclusions:</b> Further qualitative research is essential to better understand the experience of FSD after treatment. Incorporating both patient and clinician perspectives will be key to developing tailored interventions. In addition, efforts should be made to standardize the questionnaires used to assess female sexual dysfunction, in order to improve comparability across studies and ensure consistent evaluation.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12471525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149593","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":"Longitudinal Ellipsoid Zone Dynamics During Hydroxychloroquine Use.","authors":"Karen Matar, Katherine E Talcott, Obinna Ugwuegbu, Ming Hu, Sunil K Srivastava, Jamie L Reese, Justis P Ehlers","doi":"10.3390/jpm15090416","DOIUrl":"10.3390/jpm15090416","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Hydroxychloroquine (HCQ) retinopathy can be underrecognized early, as structural changes in OCT may precede symptoms and are often subtle. Early detection is crucial to prevent irreversible damage. This study evaluated longitudinal OCT changes preceding overt HCQ toxicity using ellipsoid zone (EZ) mapping. <b>Methods</b>: Patients on long-term HCQ underwent two macular cube scans at least one year apart using Cirrus HD-OCT. Scans were analyzed with an EZ-mapping platform and manually validated. Patients with baseline OCT signs of toxicity or co-existing macular disease were excluded based on masked expert review. <b>Results</b>: Three hundred and seventy-three eyes of 373 patients were included. The mean age was 57.0 ± 12.6 years, the mean HCQ dose was 379.4 ± 59.4 mg, the treatment duration was 5.6 ± 3.7 years, and the OCT interval was 3.1 ± 0.9 years. Outer retinal metrics remained stable across the cohort. The mean en face EZ attenuation increased from 3.3% to 3.9% (<i>p</i> = 0.24). Thirty-four eyes (9.1%) experienced an absolute increase of ≥4% (~1.5 mm²) in EZ attenuation. This increase was significantly associated with age at HCQ initiation (<i>p</i> < 0.001), age at the time of the first and second OCT (<i>p</i> < 0.001), and baseline visual acuity (<i>p</i> = 0.01), and demonstrated changes in other outer retinal metrics (<i>p</i> < 0.01). Only 3/34 eyes (8.9%) were diagnosed by the managing clinician with HCQ toxicity at the time of the second OCT. However, 26 of these eyes (76.5%) had signs of HCQ toxicity by expert review, suggesting the overall greater sensitivity of these quantitative outer retinal metrics for detecting toxicity compared with clinician review. <b>Conclusions</b>: Longitudinal OCT assessment revealed overall stability in outer retinal metrics in eyes on HCQ, but a subset showed increased EZ attenuation, which correlated with age at the time of HCQ initiation, baseline visual acuity, and expert OCT review. These changes may help identify at-risk eyes and eyes with early toxicity and warrant further validation as potential screening biomarkers.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12470658/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149548","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":"Utilizing Mobile Health Technology to Enhance Brace Compliance: Feasibility and Effectiveness of an App-Based Monitoring System for Adolescents with Idiopathic Scoliosis.","authors":"Judith Sánchez-Raya, Judith Salat-Batlle, Diana Castilla, Irene Zaragozá, Azucena García-Palacios, Carlos Suso-Ribera","doi":"10.3390/jpm15090405","DOIUrl":"10.3390/jpm15090405","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Adolescent idiopathic scoliosis (AIS) often requires prolonged brace use to prevent curve progression. However, adherence is challenging due to discomfort, mobility restrictions, and psychosocial stressors. This study evaluated the feasibility and clinical utility of a mobile health (mHealth) system for real-time tracking of brace adherence and treatment-related experiences in adolescents with AIS. <b>Methods:</b> Thirty adolescents with AIS (mean age = 12.9, SD = 1.8) undergoing brace treatment at a tertiary care center used a custom app for 90 days. The app collected daily self-reports on brace wear duration, discomfort, movement limitations, emotional distress, and social challenges. A clinical alarm system alerted providers when patient input indicated potential concerns. Primary outcomes were feasibility (adherence to daily use and usability ratings) and brace adherence. Secondary outcomes included the app's capacity to identify treatment-related challenges and its association with changes in stress, quality of life, anxiety, and depression. <b>Results:</b> Participants reported meeting recommended brace wear time (≥16 h/day) on 84.8% of days. The app triggered 186 clinical alarms, with the most frequent related to emotional distress (23.1%) and pain (15.6%). Alarm frequency declined over time. Improvements of ≥20% in psychological outcomes were observed in 20-26.7% of participants, while group-level changes were nonsignificant. <b>Conclusions:</b> mHealth-based monitoring appears feasible and acceptable for digitally engaged adolescents with AIS. The app supported early detection of treatment barriers and prompted timely clinical responses. Despite limitations, it shows promise as a tool to improve treatment engagement and address psychosocial challenges in scoliosis care.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12470586/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149521","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":"Objective Evaluation of Nasal Obstruction in Cleft Lip and Palate Patients: A Preliminary Study.","authors":"Nicolas Pachebat, Jiad N Mcheik, Maxime Fieux, Valentin Favier, Aurélien Binet, Xavier Dufour, Florent Carsuzaa","doi":"10.3390/jpm15090403","DOIUrl":"10.3390/jpm15090403","url":null,"abstract":"<p><p><b>Introduction</b>: Cleft lip and/or palate (CLP) is frequently associated with persistent nasal obstruction, often due to structural deformities unaddressed by primary surgical repair. While subjective assessment tools are commonly used to evaluate nasal patency, they underestimate functional impairment, particularly nasal valve collapse. This study aims to objectively evaluate nasal obstruction and identify its anatomical causes in CLP patients after primary rhinoplasty. <b>Methods</b>: We conducted an observational study involving 21 children aged 8-16 with CLP who had undergone primary cheilorhinoplasty but not secondary nasal surgery. Each participant underwent clinical evaluation, nasal endoscopy, acoustic rhinometry, and active anterior rhinomanometry (AAR), both before and after nasal decongestion. The Nasal Obstruction Symptom Evaluation (NOSE) scale was used to assess subjective symptoms. Obstructive sites were diagnosed based on established criteria combining endoscopic and functional findings. <b>Results</b>: Objective nasal obstruction was identified in 80.9% of patients, with nasal valve collapse observed in 66.7%, most commonly among unilateral and bilateral CLP subtypes. External nasal valve collapse was the predominant form (57.1%), followed by internal valve involvement (38.1%). Notably, the NOSE score did not reliably correlate with the AAR results, underlining the limitations of subjective assessment tools. Structural anomalies such as septal deviation (52.5%) and turbinate hypertrophy (23.8%) were also prevalent. <b>Conclusions</b>: This study highlights nasal valve collapse as a major, underrecognized contributor to persistent nasal obstruction in CLP patients after primary repair. Objective assessment methods like AAR and targeted endoscopy should be routinely integrated into secondary rhinoplasty planning. These findings advocate for a personalized approach to secondary nasal reconstruction in CLP patients, integrating objective functional data into surgical planning. Such strategies align with personalized medicine principles by tailoring interventions to individual anatomical and physiological characteristics.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12471402/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149711","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":"Weekend Effect and Predictors of Mortality for Patients Presenting to Emergency Department with COVID-19 Infection.","authors":"Amteshwar Singh, Jerome Gnanaraj, Evani Jain, Japleen Kaur, Waseem Khaliq","doi":"10.3390/jpm15090402","DOIUrl":"10.3390/jpm15090402","url":null,"abstract":"<p><p><b>Background:</b> Weekend presentation to the emergency department (ED) has been associated with increased morbidity and mortality in various clinical settings. However, the literature is scant whether such an effect exists for patients presenting with COVID-19 infection. Additionally, comparative analyses of mortality predictors in COVID-19 patients evaluated at the emergency department need further exploration. <b>Methods:</b> This retrospective cohort study examined factors associated with mortality among adult patients (aged ≥ 18 years) who presented with COVID-19 to the emergency departments of five hospitals within the Johns Hopkins Health System (combined capacity: 2513 beds) between March 1 and 4 May 2020. Data were extracted from electronic health records. Multivariable logistic regression was utilized to assess the relationship between mortality and a range of variables, including sociodemographic characteristics, clinical presentation, laboratory parameters, pre-existing comorbidities, and weekend versus weekday presentation. <b>Results:</b> Of the 2767 patients, 685 (25%) presented to the emergency department on weekends. Compared to weekday presenters, weekend patients were more likely to be hospitalized (64%), and these patients had a mean symptom duration of 5 days (SD ± 6). Weekend presenters also exhibited higher rates of clinical frailty, dehydration, hypoxia, and respiratory distress upon arrival. In multivariable logistic regression analysis adjusting for sociodemographic characteristics, clinical risk factors, and laboratory findings, independent predictors of increased mortality included absence of a primary care provider (OR 3.47; 95% CI: 2.37-5.07), peripheral oxygen saturation (SpO₂) < 95% at presentation (OR 1.46; 95% CI: 1.001-2.12), and hyperglycemia (OR 2.13; 95% CI: 1.25-3.65). Notably, the presence of crackles on physical examination demonstrated a trend toward reduced mortality (OR 0.47; 95% CI: 0.24-0.92). <b>Conclusions:</b> While weekend presentation was associated with higher hospitalization rates among patients with COVID-19, it did not independently predict increased mortality. Absence of a primary care provider, hypoxia, and hyperglycemia at presentation emerged as strong, independent predictors of mortality in the ED setting. Race, gender, and obesity were not significantly associated with mortality in this cohort, warranting further investigation. These findings may support more effective triage and risk stratification strategies in current and future public health emergencies.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12470697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149461","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}