Journal of Personalized Medicine最新文献

{"title":"Understanding the Lymph Node Microenvironment in Metastatic and Non-Metastatic Head and Neck Squamous Cell Carcinoma: A Systematic Review.","authors":"Antoine Yanni, Géraldine Descamps, Fabrice Journe, Edward Boutremans, Isabelle Loeb, Sven Saussez, Didier Dequanter","doi":"10.3390/jpm16090444","DOIUrl":"10.3390/jpm16090444","url":null,"abstract":"<p><p><b>Background:</b> The immune landscape in head and neck squamous cell carcinoma (HNSCC) has been widely investigated. However, the crucial role played by the lymph node microenvironment in metastatic and non-metastatic HNSCC remains unknown. This systematic review aims to discuss the immunological crosstalk between the tumor and the nodal microenvironment and to describe the distribution of immune cells in metastatic and non-metastatic lymph nodes. <b>Methods:</b> A systematic review was conducted according to the PRISMA guidelines. PubMed, Scopus, and the Cochrane Library were searched for studies published between 1990 and 2025, with the final search performed in December 2025. Prospective and retrospective studies evaluating immune cell infiltration in metastatic and non-metastatic cervical lymph nodes were included, whereas studies focusing exclusively on non-cellular biomarkers and non-English publications were excluded. The risk of bias was assessed using the Newcastle-Ottawa Scale. The results were synthesized narratively, and no meta-analysis was performed. <b>Results:</b> The screening process identified 608 articles, of which 27 met our predefined inclusion criteria. These studies focused on macrophages, dendritic cells, neutrophils, natural killer cells, T helper cells, cytotoxic T cells, regulatory T cells, B cells, total lymphocytes, and surface markers. This systematic review provides a well-structured analysis of current knowledge on the impact of the innate and adaptive immune systems on the response against cancer cells and the recruitment of immune cells in lymph nodes. The most significant findings highlight the crucial role of antigen presentation in the antitumor response, particularly through the recruitment and activation of dendritic cells and subcapsular sinus macrophages in tumor-draining lymph nodes. It also presents in a fairly comprehensible manner that the density of mature dendritic cells, cytotoxic T cells, and B cells is higher in non-metastatic lymph nodes. <b>Discussion:</b> The lymph node microenvironment is highly enriched with immune cell infiltration, and their distribution between metastatic and non-metastatic lymph nodes can contribute to a better understanding of the underlying pathological processes. Particular attention should be given to the innate immune system cells and their implication in antigen presentation. Our findings suggest that identifying immunological profiles of lymph nodes may provide a rationale for treatment de-escalation protocols and raise the question of lymph node preservation in antitumor immune responses. However, the heterogeneity and bias assessment of the included studies warrant a cautious interpretation of these findings. Another important limitation is the limited number of studies comparing the immune microenvironment of primary tumors and lymph nodes.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13608288/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039379","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":"Primary Biliary Neuroendocrine Tumors: A Systematic Review of Surgical Management, Oncologic Outcomes and Implications for Personalized Care.","authors":"Anna Paspala, Dimitrios K Vlachos, Dionysios Prevezanos, Panagiotis Dorovinis, Nikolaos Machairas, Stylianos Kykalos, Evangelos Tagkalos, Georgios C Sotiropoulos","doi":"10.3390/jpm16090445","DOIUrl":"10.3390/jpm16090445","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Primary biliary neuroendocrine tumors (PBilNETs) are exceptionally rare biliary tract neoplasms that are frequently misdiagnosed preoperatively as cholangiocarcinoma because of overlapping clinical and radiological findings. This systematic review aimed to summarize overall evidence regarding presentation, diagnostic evaluation, surgical management, and outcomes of PBilNETs. <b>Methods</b>: A systematic search of PubMed, Scopus, and Embase databases was performed according to PRISMA guidelines for studies published between January 2000 and December 2025. Studies including adult patients with histologically confirmed and surgically treated PBilNETs were eligible. Data regarding demographics, symptoms, imaging findings, surgical treatment, histopathology, immunohistochemistry, and outcomes were extracted and analyzed. <b>Results</b>: Fifty-eight studies involving 79 patients met the inclusion criteria. Median age at diagnosis was 49 years, with female predominance. Obstructive jaundice, abdominal pain, and pruritus were the most common presenting symptoms. Most tumors originated from the hilar or extrahepatic bile ducts. Preoperative diagnosis was challenging, as most lesions were initially considered cholangiocarcinomas. Surgical resection was the main therapeutic approach and included bile duct excision with biliary reconstruction, pancreaticoduodenectomy, or hepatic resection according to tumor location. Histopathological analysis demonstrated predominantly well- or moderately differentiated neuroendocrine neoplasms with frequent chromogranin A and synaptophysin positivity. Favorable long-term outcomes were reported, with high postoperative survival and limited recurrence during follow-up. <b>Conclusions</b>: PBilNETs remain diagnostically challenging because of their rarity and nonspecific presentation; however, they appear to exhibit a less aggressive biological behavior than conventional biliary adenocarcinomas. Surgical resection remains the cornerstone of treatment, while further multicenter studies are required to optimize diagnostic and therapeutic strategies. The findings also support an individualized multidisciplinary approach integrating clinical presentation, advanced imaging, histopathological grading, and immunohistochemical profiling to optimize personalized management of these rare tumors.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13608694/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039388","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":"Cannabis and Wound Healing: A Narrative Review of Current Evidence and Applications to Facial Plastic Surgery.","authors":"Bita Rashed Naimi, David B Hom","doi":"10.3390/jpm16090442","DOIUrl":"10.3390/jpm16090442","url":null,"abstract":"<p><p>Cannabis use has increased substantially in the United States, driven by broader legalization, decriminalization, and expanding medical and recreational availability. For facial plastic surgeons, the clinical implications remain difficult to define because \"cannabis use\" encompasses heterogeneous products and routes, including smoked flower, vaping, concentrates, edibles, pharmaceutical cannabinoids, topical cannabidiol (CBD), and frequent co-use with tobacco or nicotine. Current evidence suggests that systemic cannabis use, particularly inhaled or heavy perioperative use, may be associated with increased surgical complications in selected populations; however, existing studies are limited by retrospective design, inconsistent exposure definitions, inadequate dose and route characterization, and confounding by tobacco use and comorbidities. Cannabinoids exert biologic effects through the endocannabinoid system, particularly CB1 and CB2 receptors, which are expressed in the central nervous system, immune cells, vasculature, and skin. These pathways influence inflammation, keratinocyte proliferation, fibroblast activity, angiogenesis, immune surveillance, pain signaling, and tissue remodeling. The net effect of cannabinoid exposure on wound healing is likely context dependent, varying based on receptor expression, wound-healing phase, route of administration, cannabinoid composition, local tissue environment, and patient-specific risk factors. Preclinical and early dermatologic literature suggests potential therapeutic roles for topical cannabinoids, especially CBD, in modulating inflammation and epithelial repair. In contrast, systemic perioperative cannabis use has been associated in several surgical cohorts with infection, delayed healing, hematoma, nonunion, and reoperation. Evidence specific to facial plastic surgery remains sparse. The most directly relevant study evaluated cannabis and tobacco use in patients undergoing operative mandibular fracture repair. Cannabis-only use was not associated with increased complications, although the cohort was small; concurrent cannabis and tobacco use was associated with higher rates of surgical site infection, facial nonunion, abscess, debridement, and malocclusion. To date, no published studies address cannabis-associated outcomes in rhinoplasty, rhytidectomy, blepharoplasty, browlift, or facial rejuvenation. This review summarizes the biologic rationale, available surgical evidence, and clinical considerations for incorporating cannabis use into individualized perioperative risk assessment in facial plastic surgery.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13608392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039515","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":"Posterior-Only Sagittal Correction in Degenerative Lumbar Kyphosis Using Posterior Interpedicular Osteotomy (PIO) and Bilateral Discectomy with Hyperlordotic Cages: A Retrospective Case Series.","authors":"Andrea Franchini, Giuseppe Rovere, Felice Barletta, Franco Lucio Gorgoglione, Giovanni Noia, Giuseppe Maccagnano, Andrea Perna","doi":"10.3390/jpm16090443","DOIUrl":"10.3390/jpm16090443","url":null,"abstract":"<p><p><b>Introduction</b>: Degenerative lumbar kyphosis (DLK) is a common cause of sagittal imbalance, pain, and functional disability. While three-column osteotomies provide powerful correction, they are associated with substantial morbidity. We evaluated the radiographic and clinical outcomes of a novel posterior-based correction strategy combining Posterior Interpedicular Osteotomy (PIO), bilateral discectomy, and hyperlordotic transforaminal lumbar interbody fusion (TLIF) in patients with DLK. <b>Materials and Methods</b>: A retrospective single-center case series was conducted including 215 consecutive patients with symptomatic DLK and pelvic incidence-lumbar lordosis (PI-LL) mismatch >10° treated between 2019 and 2023. All patients underwent PIO combined with bilateral discectomy and insertion of a 20° hyperlordotic TLIF cage. Radiographic parameters, including lumbar lordosis (LL), pelvic tilt (PT), and sacral slope (SS), were assessed preoperatively and up to 24 months postoperatively. Clinical outcomes were evaluated using the Visual Analog Scale (VAS), Oswestry Disability Index (ODI), and Short Form-36 (SF-36). Complications were systematically recorded. <b>Results</b>: Mean lumbar lordosis improved from 15.7° ± 8.3° preoperatively to 45.4° ± 11.6° at 24 months, corresponding to a mean correction of 29.7° ± 10.1° and 12.4° ± 2.9° per treated level (<i>p</i> < 0.001). Significant improvements were observed in PT, SS, VAS, ODI, and SF-36 scores (all <i>p</i> < 0.001), with maintenance of correction throughout follow-up. Mean operative time was 218.4 ± 47.3 min and mean blood loss was 483.2 ± 195.7 mL. The overall complication rate was 16.3%, with incidental durotomy being the most common event (14.9%). No cases of cage migration, deep infection, neurological deterioration, or radiographic pseudarthrosis were identified among patients who underwent CT evaluation. <b>Conclusions</b>: PIO combined with bilateral discectomy and hyperlordotic TLIF achieved substantial and durable sagittal correction with significant clinical improvement and an acceptable safety profile. By combining extensive posterior release with preservation of the anterior tension band, this technique may represent an effective intermediate alternative between conventional posterior column osteotomies and more invasive three-column deformity correction procedures.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13608052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039410","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":"Association Between the GGT/HDL-C Ratio and Ultrasonography-Defined NAFLD in Vietnamese Adults: A Cross-Sectional Study.","authors":"Truc Thanh Nguyen, Huong Tu Lam, Thong Duy Vo","doi":"10.3390/jpm16090441","DOIUrl":"10.3390/jpm16090441","url":null,"abstract":"<p><p><b>Background and aims.</b> Nonalcoholic fatty liver disease (NAFLD) is a prevalent chronic liver disease associated with cirrhosis, hepatocellular carcinoma, and increased risks of liver-related and cardiovascular mortality. Many patients, however, remain asymptomatic until advanced stages. The gamma-glutamyl transferase to high-density lipoprotein cholesterol (GGT/HDL-C) ratio is a simple, noninvasive marker reflecting hepatic dysfunction and cardiometabolic imbalance. This study assessed its association with NAFLD and determined an optimal cutoff for identifying NAFLD. <b>Methods.</b> We conducted a cross-sectional analysis of 575 adults undergoing routine health examinations at the University of Medicine and Pharmacy Hospital in Ho Chi Minh City between 2021 and 2023. Participants with significant alcohol intake, viral hepatitis, or other chronic liver diseases were excluded. NAFLD was diagnosed by standardized abdominal ultrasonography based on increased hepatic echogenicity relative to the renal cortex or spleen. Associations between GGT/HDL-C and NAFLD were assessed by logistic regression (both as a continuous variable and by quartiles), and diagnostic performance was evaluated using receiver operating characteristic (ROC) analysis. Statistical significance was defined as a two-tailed <i>p</i>-value < 0.05. <b>Results.</b> Individuals with NAFLD showed significantly higher BMI, prevalence of hypertension and diabetes, and elevated glucose, HbA1c, AST, ALT, GGT, cholesterol, triglycerides, and LDL-C, along with lower HDL-C. Each unit increase in the GGT/HDL-C ratio was associated with a 2% increase in the odds of NAFLD based on univariate logistic regression analysis. However, after adjustment for demographic and metabolic covariates, the GGT/HDL-C ratio was no longer independently associated with NAFLD. The highest quartile had an odds ratio of 7.05 (95% CI: 4.2-11.83) compared to the lowest. The area under the ROC curve for GGT/HDL-C was 0.72, outperforming GGT or HDL-C alone. A cutoff of 32.47 UI/mmol had 72.4% sensitivity and 63.3% specificity. <b>Conclusions.</b> The GGT/HDL-C ratio showed a significant unadjusted association with NAFLD and moderate discriminatory performance. However, because the association was no longer significant after full adjustment, the ratio should currently be considered a simple laboratory-based screening marker that requires further validation before routine clinical application.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13608547/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039436","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":"Decompressive Laminectomy for Neurological Complications of Spondylodiscitis: A Case Series of 15 Patients.","authors":"Andrea Bruno, Antonio Meola, Stefano Di Bella, Leonello Tacconi","doi":"10.3390/jpm16090440","DOIUrl":"10.3390/jpm16090440","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Surgical indications for spondylodiscitis are controversial, particularly when epidural extension and evolving neurological compromise are present. This study aimed to describe the clinical, neurological, pain-related, and inflammatory outcomes of patients with spondylodiscitis treated with decompressive laminectomy without spinal stabilization, at a single tertiary center. <b>Methods</b>: We retrospectively reviewed 15 consecutive patients with spondylodiscitis who underwent decompressive laminectomy at the University Hospital of Trieste between January 2017 and December 2023. Inclusion required at least 6 months of clinical and laboratory follow-up. Patients treated with acute vertebral stabilization were excluded. Collected data included spinal level, timing from diagnosis to surgery, visual analog scale (VAS) pain score, Cooper Scale grade, modified Japanese Orthopedic Association score (mJOA), white blood cell count, and C-reactive protein (CRP). Assessments were performed preoperatively (T0), 1 week after surgery (T1), and at 6 months (T2). Imaging findings from representative cases were reviewed to illustrate the radiographic evolution after decompression combined with antibiotic therapy and orthotic support. <b>Results</b>: The cohort included 8 women and 7 men with a mean age of 57.33 years. Twelve patients (80%) underwent surgery within 48 h because of neurological deterioration or urgent compressive findings. Thoracic involvement was predominant (11 cases, 73%), whereas cervical and lumbar disease accounted for 1 and 3 cases, respectively. Intraoperative cultures were positive in 9 patients (60%), and <i>Staphylococcus aureus</i> was isolated in 7 of these 9 cases (77.8%). Mean VAS pain score improved from 6.3 at T0 to 4.3 at T1 and 1.4 at T2. Mean lower-extremity Cooper Scale grade improved from 2.7 to 2.1 to 0.6; mean upper-extremity Cooper Scale grade improved from 1.3 to 1.0 to 0. Mean mJOA improved from 10.3 to 11.4 to 16.0. Mean white blood cell count declined from 11.58 to 8.35 to 6.14 × 10³/µL, and mean CRP declined from 123.9 to 72.81 to 19.44 mg/L. No patient worsened neurologically after surgery. No patient required acute stabilization or delayed arthrodesis during follow-up. <b>Conclusions</b>: In our case series of patients with compressive or progressive neurological spondylodiscitis, decompressive laminectomy combined with antibiotic treatment, bracing, and rehabilitation was associated with early neurological stabilization, substantial pain relief, and marked reduction in inflammatory markers, without subsequent need for instrumented stabilization. These data support the role of spinal decompression as part of a personalized, effective treatment strategy in patients with neurological decline.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13608500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039454","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":"Structural and Functional Characteristics of the Liver After Fractionated Local Electron Irradiation and Against the Background of Ascorbic Acid Administration.","authors":"Grigory Demyashkin, Anastasiia Buianova, Nathalia Pyatigorskaya, Olga Filippova, Galina Brkich, Zhanna Aladysheva, Vasiliy Belyaev, Vladimir Shchekin","doi":"10.3390/jpm16090439","DOIUrl":"10.3390/jpm16090439","url":null,"abstract":"<p><p>Radiation-induced liver disease (RILD) remains a clinically significant complication of radiotherapy for malignant neoplasms of the liver and upper abdomen, restricting achievable therapeutic doses and adversely affecting patient outcomes. Conventional photon-based radiotherapy (X-rays/γ-rays) exposes substantial volumes of healthy liver parenchyma and adjacent organs to ionizing radiation, increasing the risk of hepatocellular damage, inflammation, and progressive fibrosis. Electron irradiation (β-particles) represents a promising alternative owing to its limited tissue penetration (~2-3 cm) and steep dose fall-off, which significantly reduces exit dose and may reduce exit dose and limit exposure of paratumoral healthy tissues compared with photon therapy. However, the molecular mechanisms underlying electron-induced hepatic damage and strategies for its prevention remain insufficiently characterized. This review systematically analyzes the pathogenesis of radiation-induced liver damage, encompassing direct DNA damage, oxidative stress, mitochondrial dysfunction, NF-κB-mediated inflammation, cellular senescence, and TGF-β/Smad-driven fibrosis. The comparative dosimetric and radiobiological advantages of electron irradiation over photon therapy are discussed, with particular attention to intraoperative radiotherapy, FLASH, and very high-energy electron techniques. Current radioprotective strategies are critically evaluated, with emphasis on the limitations of amifostine and the multifunctional radioprotective potential of ascorbic acid, including free radical scavenging, attenuation of lipid peroxidation, stimulation of endogenous antioxidant defense, and direct inhibition of radiation-induced DNA strand breaks. Existing gaps in the evidence base are identified, and recommendations for future experimental and clinical research are proposed.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13608792/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039400","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":"Contemporary Challenges and Strategies for Diagnosing and Managing in Type 2 Myocardial Infarction: A Narrative Review.","authors":"Julia Kościanek, Natalia Zabawa, Anna Stanaszek, Michał Maślanka, Hubert Mączka, Martyna Pniaczek, Aleksandra Bołoz, Jadwiga Nessler, Jarosław Zalewski, Konrad Stępień","doi":"10.3390/jpm16080438","DOIUrl":"10.3390/jpm16080438","url":null,"abstract":"<p><p>Type 2 myocardial infarction (T2MI) occurs secondary to an imbalance between myocardial oxygen supply and demand, with systemic conditions serving as the primary precipitating factors. T2MI predominantly affects older adults and is frequently accompanied by multiple chronic comorbidities. Therefore, it often has an atypical clinical course and remains a significant diagnostic and therapeutic challenge, particularly given the lack of standardized clinical guidelines. Furthermore, the diagnosis of T2MI in women is especially challenging due to sex-related differences in biomarker kinetics and atypical symptom presentation. The aim of this review is to summarize current knowledge on T2MI, discuss modern diagnostic tools, and analyze sex-related differences in this context in order to identify future directions for the development of therapeutic guidelines. The review emphasizes the need for a multimodal approach, integrating biomarkers, individualized clinical decision-making and advanced cardiac imaging, as differentiation between T2MI and T1MI remains a significant challenge. Therefore, both non-invasive and invasive diagnostic strategies may be required to accurately identify patients with T2MI. Although routine coronary angiography in T2MI is not clearly supported by current evidence, it may be useful as a decisive tool for reclassification, particularly when the clinical presentation is ambiguous.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 8","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13514624/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148829497","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":"Clinical Outcomes Associated with GLP-1 Receptor Agonist Exposure in Non-Diabetic Patients with Chronic Pancreatitis: A Retrospective Cohort Study.","authors":"Arkadeep Dhali, Jyotirmoy Biswas, Fayaz Khan, Dushyant Singh Dahiya, Saikat Mandal","doi":"10.3390/jpm16080437","DOIUrl":"10.3390/jpm16080437","url":null,"abstract":"<p><p><b>Background</b>: GLP-1 receptor agonists (GLP-1 RAs) are increasingly used for obesity and metabolic disease, but their use in people with chronic pancreatitis is not a chronic pancreatitis-directed indication and direct evidence is limited. We described recorded outcomes among non-diabetic adults carrying a chronic pancreatitis diagnosis who did or did not have recorded GLP-1 RA exposure. <b>Methods</b>: We performed a retrospective propensity score-matched cohort study using the TriNetX Collaborative Network. Chronic pancreatitis was identified from a recorded diagnosis; supporting imaging, histological, functional, or specialist-confirmation criteria were unavailable. The exposed cohort included patients receiving dulaglutide, semaglutide, or tirzepatide (<i>n</i> = 1441 before matching), and the comparator cohort included patients without recorded GLP-1 RA exposure (<i>n</i> = 142,047 before matching). One-to-one propensity score matching generated 1422 patients in each cohort. Outcomes were assessed from 1 to 1095 days after the index date using risk comparisons and time-to-event analyses. <b>Results</b>: Mean follow-up after matching was 458.8 days in the exposed cohort and 664.4 days in the comparator cohort. Recurrent acute pancreatitis was recorded in 19/799 (2.4%) versus 76/704 (10.8%) patients (HR 0.247, 95% CI 0.149-0.409), pancreatic cancer in 10/1373 (0.7%) versus 40/1345 (3.0%) (HR 0.255, 95% CI 0.128-0.511), and all-cause mortality in 21/1419 (1.5%) versus 157/1416 (11.1%) (HR 0.167, 95% CI 0.105-0.263). A similar direction was observed across several coded outcomes. Vitamin D deficiency showed a higher hazard (HR 1.556, 95% CI 1.129-2.145), although its risk comparison was not significant. <b>Conclusions</b>: These estimates describe outcomes in a selected treatment-exposed phenotype of chronic pancreatitis. The findings are hypothesis-generating and should not guide prescribing decisions. Further prospective studies are required to confirm this hypothesis.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 8","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13514437/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148829471","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":"Disease Characteristics and Management of Intrabiliary Colorectal Liver Metastasis: An Updated Systematic Review.","authors":"Panagiotis Dorovinis, Konstantinos Kossenas, Anna Paspala, Dimitrios Papaconstantinou, Myrto D Keramida, Dimitrios K Vlachos, Dionysios Prevezanos, Stylianos Kykalos, Nikolaos Machairas, Georgios C Sotiropoulos","doi":"10.3390/jpm16080436","DOIUrl":"10.3390/jpm16080436","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Liver metastasis develops in approximately 50% of patients with colorectal cancer. Invasion of the biliary tract from colorectal liver metastasis (CRLM) is rarely reported. Preoperative diagnosis remains elusive, prohibiting optimal surgical management. The objective of this systematic review was to summarize the clinical, radiological, pathological, and treatment characteristics of ibCRLM and describe the reported outcomes. <b>Methods</b>: A systematic literature search of the Medline, Embase, Web of Science, CENTRAL, and CINAHL databases was undertaken for studies reporting clinical outcomes of patients with ibCRLM, up to May 2026. An individual patient data analysis approach was utilized. <b>Results</b>: Thirty-eight case reports and 10 case-series, incorporating 228 patients with biliary involvement from CRLM, were identified. Mean age was 62.4 ± 10.9 years, with a male-to-female ratio of 3.2:1. The majority of metastatic lesions were metachronous in 71.1% and solitary in 59.1% of patients. Surgical treatment was implemented in 89.2% of patients. Major hepatectomy was the most common procedure, being performed in 46.2% of patients, followed by minor hepatectomy in 38.7% and pancreatoduodenectomy in 4.3%. After a median follow-up of 52.5 months (range 2-164 months), the survival rate was 60.5%. Non-survivors were found to have significantly more synchronous CRLM (50% versus 0, <i>p</i> = 0.008), while a single patient did not receive any curative-intent treatment and died 20 days following CRLM presentation. <b>Conclusions</b>: IbCRLM is a distinct clinicopathological presentation of CRLM with characteristic radiological and pathological features. The available evidence suggests that selected patients may achieve favorable long-term outcomes following complete surgical resection, although these findings should be interpreted with caution given the limitations of the available literature.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 8","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13514391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148829526","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}