Journal of Personalized Medicine最新文献

{"title":"Mid-Regional Pro-Adrenomedullin Is Associated with Adverse Cardiovascular Outcomes After Cardiac Surgery.","authors":"Ulrike Baumer, Niema Kazem, Andreas Hammer, Felix Hofer, Eva Steinacher, Lorenz Koller, Daniel Zimpfer, Martin Andreas, Barbara Steinlechner, Christian Hengstenberg, Alexander Niessner, Patrick Sulzgruber","doi":"10.3390/jpm15020047","DOIUrl":"10.3390/jpm15020047","url":null,"abstract":"<p><p><b>Background:</b> In the era of personalized medicine, tools for risk stratification after cardiovascular interventions are crucial to reduce mortality and morbidity, especially in the aging population. Biomarker-based approaches, in particular, have gained significant importance. Mid-regional pro-adrenomedullin (MR-proADM) represents an easily assessable biomarker that mirrors cardiac function and fibrosis. Therefore, we aimed to investigate the prognostic potential of MR-proADM in patients undergoing elective cardiac surgery. <b>Methods:</b> Patients undergoing elective cardiac bypass and/or valve surgery were prospectively enrolled between May 2013 and August 2018. The primary endpoint was the composite of hospitalization for heart failure (HHF) or cardiovascular (CV) mortality. <b>Results:</b> In total, 500 patients (146 female [29.2%]; median age 69.8 years (IQR 60.6-75.5 years) were included. Individuals were stratified into risk categories based on their MR-proADM values (Low Risk ≤ 0.63 nmol/L, Intermediate Risk > 0.63 and ≤0.84, High Risk > 0.84). A significant increase in 5-year event rates for HHF/CV mortality in patients in the high-risk category (Low Risk 8.6% vs. High Risk 37.7%, <i>p</i> < 0.001) was observed. MR-pro ADM showed an independent association with HHF/ CV mortality (adjusted HR of 3.43, 95% CI 1.83-6.42; <i>p</i> < 0.001 comparing the High-Risk group to the Low-Risk group). <b>Conclusions:</b> MR-pro ADM was found to be a strong and independent predictor for HHF/CV mortality in patients undergoing elective cardiac surgery. Considering a personalized diagnostic and prognostic work-up, a standardized preoperative evaluation of MR-proADM levels might help to identify patients at risk for major adverse events and early re-hospitalization.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 2","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11856237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143492176","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":"Urinary Bladder Acute Inflammations and Nephritis of the Renal Pelvis: Diagnosis Using Fine-Tuned Large Language Models.","authors":"Mohammad Khaleel Sallam Ma'aitah, Abdulkader Helwan, Abdelrahman Radwan","doi":"10.3390/jpm15020045","DOIUrl":"10.3390/jpm15020045","url":null,"abstract":"<p><p><b>Background:</b> Large language models (LLMs) have seen a significant boost recently in the field of natural language processing (NLP) due to their capabilities in analyzing words. These autoregressive models prove robust in classification tasks where texts need to be analyzed and classified. <b>Objectives:</b> In this paper, we explore the power of base LLMs such as Generative Pre-trained Transformer 2 (GPT-2), Bidirectional Encoder Representations from Transformers (BERT), Distill-BERT, and TinyBERT in diagnosing acute inflammations of the urinary bladder and nephritis of the renal pelvis. <b>Materials and Methods:</b> the LLMs were trained and tested using supervised fine-tuning (SFT) on a dataset of 120 examples that include symptoms that may indicate the occurrence of these two conditions. <b>Results:</b> By employing a supervised fine-tuning method and carefully crafted prompts to present the data, we demonstrate the feasibility of using minimal training data to achieve a reasonable diagnostic, with overall testing accuracies of 100%, 100%, 94%, and 79%, for GPT-2, BERT, Distill-BERT, and TinyBERT, respectively.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 2","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11856954/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143492495","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":"Implementation and Feasibility of Mechanomyography in Minimally Invasive Spine Surgery.","authors":"Fabian Sommer, Ibrahim Hussain, Noah Willett, Mousa K Hamad, Chibuikem A Ikwuegbuenyi, Rodrigo Navarro-Ramirez, Sertac Kirnaz, Lynn McGrath, Jacob Goldberg, Amanda Ng, Catherine Mykolajtchuk, Sam Haber, Vincent Sullivan, Pravesh S Gadjradj, Roger Härtl","doi":"10.3390/jpm15020042","DOIUrl":"10.3390/jpm15020042","url":null,"abstract":"<p><p><b>Background</b>: Mechanomyography (MMG) is a neurodiagnostic technique with a documented ability to evaluate the compression of nerve roots. Its utility in degenerative spine surgery is unknown. <b>Objective</b>: To assess the utility of intraoperative MMG during cervical posterior foraminotomy, minimally invasive transforaminal interbody fusion (MIS-TLIF), and tubular lumbar far lateral discectomy. <b>Methods</b>: A prospective feasibility study was conducted during which MMG was applied during three procedures. Adhesive accelerometers were placed on two muscle groups per procedure. Stimulus threshold in mA was recorded before and after the decompression of the nerve root. Differences in stimulation thresholds were correlated with operative findings. <b>Results</b>: In total, 22 patients were included in this study; 5 patients underwent cervical foraminotomies, 3 underwent MIS-TLIFs, and 14 underwent tubular far lateral discectomies. For the foraminotomies, all cases showed a reduction in stimulation threshold (mean of 3.4 mA) after decompression. For MIS-TLIF cases, there was a limited reduction in the stimulation threshold after decompression (mean 1.7 mA). For far lateral discectomy, there was a mean reduction of 4.3 mA in the stimulation threshold following decompression. <b>Conclusions</b>: MMG is a method that may provide intraoperative feedback on the decompression of nerve roots. In the context of MIS-TLIF, MMG showed a limited decrease in stimulus threshold. This may be due to the identification of the nerve occurring after decompression is already underway. For cervical foraminotomies and far lateral discectomies, MMG showed promising results in determining adequate decompression of the nerve root.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 2","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11856354/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143492573","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":"Dupilumab Effectiveness in Patients with Severe Allergic Asthma Non-Responsive to Omalizumab.","authors":"Diego Bagnasco, Benedetta Bondi, Luisa Brussino, Stefania Nicola, Paolo Cameli, Angelica Tiotiu, Giuseppe Guida, Chiara Gollinucci, Dina Visca, Antonio Spanevello, Laura Pini, Marco Caminati, Gianenrico Senna, Cristiano Caruso, Rikki Frank Canevari, Melania Bertolini, Sara Fedele, Marcello Mincarini, Giorgio Walter Canonica, Fulvio Braido, On Behalf Of The Sani Group","doi":"10.3390/jpm15020043","DOIUrl":"10.3390/jpm15020043","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Severe allergic asthma is usually treated with omalizumab; however, this drug may not be effective for every patient. By its action, dupilumab could be an alternative in these patients. The objective of this study was to evaluate the efficacy of dupilumab in patients with severe allergic asthma, non-responsive to omalizumab, according to the maintenance of their oral corticosteroid (OCS) dose, an exacerbation rate decrease, or poor control of the disease, despite optimized treatment. <b>Methods</b>: A retrospective analysis of data from severe asthma clinics was performed, observing the efficacy of the switch to dupilumab in patients who experienced a failed treatment with omalizumab. <b>Results</b>: Forty-two patients were included. Dupilumab proved to be effective in patients who experienced a failed omalizumab treatment, with a significant reduction in the exacerbation number and OCS use. Furthermore, remission of the disease, according to the Severe Asthma Network of Italy (SANI) criteria, was achieved in 35 patients, with complete remission in 19 (45%) and partial remission in 16 (38%). The analysis of the predictors of the success of dupilumab therapy in achieving clinical remission, through univariate analysis of the data at baseline, showed that complete remission was more easily reached in patients with concomitant aspirin (ASA) intolerance or in those with nasal polyposis. <b>Conclusions</b>: Dupilumab is an effective drug for the treatment of patients with severe asthma with an allergic component, with better benefits in patients with an ASA intolerance or nasal polyposis.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 2","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11856950/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143492496","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 Use of the Great Toe Pulp Free Flap in Dystrophic Fingertips.","authors":"Alessandro Crosio, Mauro Magnani, Simona Odella, Matilde Cacianti, Francesco Maria Locatelli, Pierluigi Tos","doi":"10.3390/jpm15020044","DOIUrl":"10.3390/jpm15020044","url":null,"abstract":"<p><p><b>Background</b>: Lesions of the digital apices are common, and several treatment strategies can be considered for them. Among these, the free great toe pulp flap can be used. <b>Methods</b>: This is a retrospective report in which five patients undergoing hallux free flap surgery for loss of pulpal substance at the level of the hand were evaluated. They were re-evaluated by using both clinical testing to assess sensitivity and the use of questionnaires to estimate function. <b>Results</b>: None of the performed flaps failed. The mean follow-up was 36 months (range 16-66 months). With SW-MF, the mean value was 3.734 compared to 2.986 for the same contralateral finger. The S2-PD test attested a mean value of 6.8 mm (range 6-8 mm) in contrast to the contralateral finger, which showed a mean result of 3.2 mm (range 3-5 mm), while the D-2PD indicated lower values for both the operated finger, with a mean value of 6.4 mm (range 4-8 mm), and the healthy finger. <b>Conclusions</b>: When a dystrophic fingertip results from an inappropriate acute management, the GTP flap appears to be an excellent strategy to restore the specialized tissue of finger pulp and to bring supple tissue to the correct PIP flexion contracture or the small first web space contracture. It is mostly required for thumb and radial fingers' reconstruction, especially in young patients or those who need high functional demands and/or present an extensive loss of substance that cannot be resolved with local flaps.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 2","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11856036/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143492491","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":"Meningeal Metastasis from Naso-Ethmoidal Malignancies: Pathogenesis, Risk Factors, and Prognostic Impact.","authors":"Remo Accorona, Isabelle Dohin, Davide Mattavelli, Marco Ferrari, Marco Ravanelli, Vittorio Rampinelli, Davide Farina, Piero Nicolai, Cesare Piazza, Alberto Schreiber","doi":"10.3390/jpm15020041","DOIUrl":"10.3390/jpm15020041","url":null,"abstract":"<p><p><b>Introduction:</b> Meningeal metastasis (MM) from naso-ethmoidal malignancies (NEMs) is rare, its metastatic route is still debated, and its prognostic impact remains unclear. Our aim is to analyze a retrospective series of NEMs with non-contiguous MM to study the possible route of spread and the prognostic value of MM. <b>Materials and methods:</b> The institutional database of SNC treated at the University of Brescia between 1995 and 2021 was reviewed. Clinical-pathological data were collected, and survivals were estimated with Kaplan-Meier. Univariate and multivariate logistic regression analysis were run to identify predictors of MM. <b>Results:</b> Among 296 patients, 17 experienced non-contiguous MM, all located along the dura. Intestinal-type adenocarcinoma (10/17) and olfactory neuroblastoma (3/17) were the most frequent histologies. At univariate analysis, brain edema (<i>p</i> < 0.0001), resection (<i>p</i> = 0.026) or invasion (<i>p</i> = 0.006) of brain parenchyma, and local (<i>p</i> = 0.0004) and nodal (<i>p</i> = 0.021) recurrence were predictors of MM. At multivariate analysis, local recurrence was confirmed as an independent factor (odds ratio: 11.88, <i>p</i> = 0.0005). Dural surgical resection was not a risk factor. The five-year disease-specific survival was longer in patients with exclusive MM compared with patients with distant metastasis at other sites (64.3% vs. 30.1% <i>p</i> = 0.046). <b>Conclusions:</b> Dural venous shunt is the most likely pathway of spread of MM. Local recurrence is the only independent risk factor. Exclusive MM has a better prognosis than extrameningeal metastasis.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 2","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11856435/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143492070","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":"Strabismus and Strabismus Surgery in the U.S. Veterans Health Administration: Foundational Analyses of Electronic Health Record Data from 2000 to 2022.","authors":"John H Lillvis, Michael Feehan, Treefa Shwani, Amy E Millen, Gregory E Wilding, Karen M Allison, Leah A Owen, Margaret M DeAngelis","doi":"10.3390/jpm15020040","DOIUrl":"10.3390/jpm15020040","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Strabismus, or eye misalignment, has not been well-described in U.S. military Veterans. This study was undertaken to characterize Veterans with a strabismus diagnosis as well as those who underwent strabismus surgery. <b>Methods:</b> A retrospective analysis of electronic health records (EHR) from the Veterans Health Administration (VHA) was conducted using patient data from 2000 to 2022. VHA-enrolled Veterans ≥ 18 years with strabismus-related International Classification of Diseases (ICD) codes and/or Current Procedural Terminology (CPT) codes were identified. Total and demographic (age group, sex, race, and ethnicity) stratified prevalence and incidence rates were calculated, as well as sex-stratified residual lifetime risk. <b>Results:</b> A total of 321,639 patients had a strabismus diagnosis, with most (320,107) identified by ICD code (CPT code only = 1532). The peak prevalence was 2.29% in the 2022 VHA fiscal year (1 October 2021 to 30 September 2022) with a median annual age-adjusted incidence rate of 168.9/100 000 enrollees. Age-adjusted lifetime risk was 10.19% for males and 11.03% for females. Significant differences by age group, sex, race, and ethnicity were identified for strabismus prevalence (<i>p</i> < 0.001), strabismus diagnosis types (<i>p</i> < 0.001), and between patients with strabismus who either did or did not have surgery (sex <i>p</i> < 0.05, all others <i>p</i> < 0.001). Compared with other U.S. adult populations, VHA Veterans have similar or higher prevalence, annual incidence rates, and lifetime risk of a strabismus diagnosis, with demographic factors significantly affecting the rates and types of strabismus. Notably, despite lower prevalence and incidence than other racial groups, a higher percentage of African American patients with strabismus underwent surgery, contrasting with published Medicare data. Inconsistencies between ICD and CPT codes highlight potential miscoding and/or missing codes, with reliance on ICD code diagnoses potentially underestimating strabismus prevalence. <b>Conclusions:</b> Further characterization of factors affecting strabismus risk among these patients may help improve strabismus diagnosis and management for many US Veterans. This foundational study serves as a platform for detailed predictive analyses in determining risk outcomes for individuals. This includes better identification of at-risk individuals, informing effective resource allocation for treatment.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 2","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11855967/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143492476","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":"Predictive Value of First Amniotic Sac IL-6 and Maternal Blood CRP for Emergency Cerclage Success in Twin Pregnancies.","authors":"Diana María Diago-Muñoz, Alicia Martínez-Varea, Ricardo Alonso-Díaz, Alfredo Perales-Marín, Vicente José Diago-Almela","doi":"10.3390/jpm15010037","DOIUrl":"10.3390/jpm15010037","url":null,"abstract":"<p><p><b>Objectives:</b> To assess the usefulness of first amniotic sac Interleukin-6 (IL-6) to rule out intra-amniotic inflammation (IAI), as well as maternal blood c-reactive protein (CRP), to select patients with a twin pregnancy who may benefit from an emergency cerclage. <b>Materials and Methods</b>: Retrospective, descriptive study among all patients with a twin pregnancy and mid-trimester bulging membranes admitted to a tertiary Hospital from January 2012 to September 2023. According to the Hospital's Protocol, all patients received a vaginal and abdominal ultrasound, a maternal blood test, and an amniocentesis of the first sac to rule out IAI, defined by IL-6 ≥ 2.6 ng/dL. <b>Results:</b> A total of 28 patients with a twin pregnancy and mid-trimester bulging membranes were included. Among them, 18 patients (64.28%) had IL-6 levels ≥ 2.6 ng/dL. Cerclage was placed in 10 patients with IL-6 < 2.6 ng/dL. Perinatal mortality in pregnancies with IL-6 ≥ 2.6 ng/dL was 77.22%. The gestational age at delivery of patients with IL-6 < 2.6 ng/dL was 34 ± 3 weeks, compared to 23 ± 4 weeks when IL-6 was ≥2.6 ng/dL (<i>p</i> < 0.001). The latency to delivery with IL-6 < 2.6 ng/dL was 88.1 ±31.56 days, compared to 13.11 ± 20.43 days when IL-6 was ≥2.6 ng/dL (<i>p</i> < 0.001). Significant differences were found in maternal blood CRP levels in both study groups (no IAI 4.32 ± 3.67 vs. IAI 13.32 ± 15.07, <i>p</i> < 0.05). The area under the curve with an ROC curve was 0.799 (IC 95% 0.596-0.929), with a cut-off of 3.9 mg/L (S 94.4%, % E 62.5%). The gestational age at delivery with CRP < 3.9 mg/L was 33 ± 5 weeks, while in cases with CRP ≥ 3.9 mg/L, it was 24 ± 5 weeks (<i>p</i> < 0.001). The latency days to delivery were 86.5 ± 44.88 and 21.95 ± 30.97 days (<i>p</i> < 0.01), respectively. A positive correlation between the IL-6 values of both amniotic sacs was obtained, along with the Spearman coefficient correlation rank (rho = 0.835, <i>p</i> < 0.001). <b>Conclusions:</b> Compared to those with IAI, patients with a twin pregnancy and mid-trimester bulging membranes without IAI who underwent emergency cerclage had a significantly higher interval from diagnosis to delivery, as well as a significantly lower incidence of preterm birth < 34 weeks and perinatal death. Further studies are needed to assess whether the IL-6 of the first amniotic sac and maternal blood CRP might constitute a useful parameter to select patients who may benefit from an emergency cerclage.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 1","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11767201/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143033254","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":"Fundus Photography-Based Distribution of Retinal Hemorrhages in Newborns: Implications for Underlying Mechanisms.","authors":"Gwon Hui Jo, Mi Young Choi, Kibum Lee, Kyung Tae Kim, Dong Yoon Kim, Ju Byung Chae, Eoi Jong Seo","doi":"10.3390/jpm15010038","DOIUrl":"10.3390/jpm15010038","url":null,"abstract":"<p><p><b>Introduction:</b> The aim of this study was to investigate the locational distribution and potential mechanisms of retinal hemorrhages in newborns using fundus photography. <b>Methods:</b> A retrospective analysis of 98 consecutive newborns with retinal hemorrhages in at least one eye and 30 control newborns without retinal hemorrhages after uneventful delivery was conducted. Retinal hemorrhages were diagnosed and characterized using fundus photography and indirect ophthalmoscopy. The location, grade, and features of the hemorrhages were analyzed, alongside their association with delivery mode. Visual function was assessed at a mean follow-up of 7.8 months to evaluate the long-term implications. <b>Results:</b> Retinal hemorrhages were significantly associated with normal spontaneous vaginal delivery (NSVD) compared to cesarean section (<i>p</i> = 0.004). Bilateral involvement was observed in 87.8% of cases, with hemorrhages predominantly located around the major vascular arcade (MVA) and near the optic disc. Higher grades of hemorrhages were linked to increased involvement of the macula and retinal capillary area (RCA) (<i>p</i> < 0.001). All hemorrhages resolved spontaneously within 45.6 ± 15.9 days. No significant differences in refractive errors or strabismus development were identified between the hemorrhage and control groups at follow-up. <b>Conclusions</b>: Neonatal retinal hemorrhages are commonly observed near the MVA and optic disc, with greater severity associated with macular and RCA involvement. These findings, along with the significant association with NSVD, support a mechanism related to elevated central venous pressure. Retinal hemorrhages resolve spontaneously without impacting refractive error or strabismus development in the short term follow-up.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 1","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11766510/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143032971","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":"Comparison of Hepatic Function and Chemotherapy-Induced Side Effects Between Pegylated Liposomal Doxorubicin (PLD), Topotecan (TOPO), and Gemcitabine in Platinum-Resistant Ovarian Cancer (PROC).","authors":"Radu-Dumitru Dragomir, Marina Adriana Mercioni, Șerban Negru, Dorel Popovici, Sorin Săftescu, Andiana Roxana Blidari, Ioan Sas","doi":"10.3390/jpm15010039","DOIUrl":"10.3390/jpm15010039","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Platinum-resistant ovarian cancer (PROC) is a major therapeutic challenge, as it responds poorly to standard platinum-based treatment, has limited treatment options, and offers a generally unfavorable prognosis. Chemotherapeutic agents like pegylated liposomal doxorubicin (PLD), topotecan (TOPO), and gemcitabine (GEM) are used for this setting, but with varying efficacy and toxicity profiles, leading to an increasing need to understand the optimal balance between treatment effectiveness and tolerability for improving patient outcomes. This study evaluates the efficacy and side effects of PLD, TOPO, and GEM, focusing on progression-free survival (PFS), overall survival (OS), and safety profiles. <b>Methods</b>: We conducted a retrospective observational study that included 856 PROC patients treated with PLD (<i>n</i> = 383), TOPO (<i>n</i> = 352), or GEM (<i>n</i> = 121) at the OncoHelp Oncology Center from January 2018 to December 2023. Inclusion criteria encompass diagnosis, prior platinum therapy, and Eastern Cooperative Oncology Group (ECOG) status (0-2). Treatment protocols followed standard dosing, with adjustments for toxicity. Primary endpoints included PFS and OS, with safety assessed by incidence of grade 3 and 4 toxicities per CTCAE v5.0. Kaplan-Meier analysis and Cox regression were used to compare survival, and statistical significance was set at <i>p</i> < 0.05. <b>Results</b>: TOPO showed higher toxicity than PLD and GEM, including liver damage, hematological and non-hematological side effects, while PLD induced more skin toxicity. In terms of survival, minor differences were seen between the three chemotherapeutic agents, with a slight advantage for PLD for better disease control. <b>Conclusions</b>: Given the comparable results in OS across the regimens, treatment decisions should be based on other factors such as patient tolerance and quality of life.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 1","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11766750/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143032770","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}