Journal of Personalized Medicine最新文献

{"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}

{"title":"Navigating the Uncertainty of B3 Breast Lesions: Diagnostic Challenges and Evolving Management Strategies.","authors":"Sabatino D'Archi, Beatrice Carnassale, Alejandro Martin Sanchez, Cristina Accetta, Paolo Belli, Flavia De Lauretis, Enrico Di Guglielmo, Alba Di Leone, Antonio Franco, Stefano Magno, Francesca Moschella, Maria Natale, Lorenzo Scardina, Marta Silenzi, Riccardo Masetti, Gianluca Franceschini","doi":"10.3390/jpm15010036","DOIUrl":"10.3390/jpm15010036","url":null,"abstract":"<p><p>B3 breast lesions, classified as lesions of uncertain malignant potential, present a significant diagnostic and therapeutic challenge due to their heterogeneous nature and variable risk of progression to malignancy. These lesions, which include atypical ductal hyperplasia (ADH), papillary lesions (PLs), flat epithelial atypia (FEA), radial scars (RSs), lobular neoplasia (LN), and phyllodes tumors (PTs), occupy a \"grey zone\" between benign and malignant pathologies, making their management complex and often controversial. This article explores the diagnostic difficulties associated with B3 lesions, focusing on the limitations of current imaging techniques, including mammography, ultrasound, and magnetic resonance imaging (MRI), as well as the challenges in histopathological interpretation. Core needle biopsy (CNB) and vacuum-assisted biopsy (VAB) are widely used for diagnosis, but both methods have inherent limitations, including sampling errors and the inability to determine malignancy in some cases definitively. The therapeutic approach to B3 lesions is nuanced, with treatment decisions strongly influenced by factors such as the lesion size, radiological findings, histopathological characteristics, and patient factors. While some lesions can be safely monitored with watchful waiting, others may require vacuum-assisted excision (VAE) or surgical excision to rule out malignancy. The decision-making process is further complicated by the discordance between the BI-RADS score and biopsy results, as well as the presence of additional risk factors, such as microcalcifications. This review provides an in-depth analysis of the current diagnostic challenges and treatment strategies for B3 lesions, emphasizing the importance of a multidisciplinary approach to management. By synthesizing the most recent research, this article aims to provide clinicians with a clearer understanding of the complexities involved in diagnosing and treating B3 breast lesions while highlighting areas for future research, such as artificial intelligence and genomics, to improve the diagnostic accuracy and patient outcomes.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 1","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11766555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143033244","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":"Musculoskeletal Diseases: Aetiology, Clinical Implications, Rehabilitation and Treatment.","authors":"Giacomo Farì, Andrea Bernetti","doi":"10.3390/jpm15010035","DOIUrl":"10.3390/jpm15010035","url":null,"abstract":"<p><p>Musculoskeletal diseases (MDs) are a wide range of conditions affecting bones, muscles, joints, and connective tissues and are among the leading causes of disability worldwide [...].</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 1","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11766573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143033157","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":"Concussion and the Autonomic, Immune, and Endocrine Systems: An Introduction to the Field and a Treatment Framework for Persisting Symptoms.","authors":"Jon L Pertab, Tricia L Merkley, Holly Winiarski, Kelly M J Cramond, Alex J Cramond","doi":"10.3390/jpm15010033","DOIUrl":"10.3390/jpm15010033","url":null,"abstract":"<p><p>A significant proportion of patients who sustain a concussion/mild traumatic brain injury endorse persisting, lingering symptoms. The symptoms associated with concussion are nonspecific, and many other medical conditions present with similar symptoms. Medical conditions that overlap symptomatically with concussion include anxiety, depression, insomnia, chronic pain, chronic fatigue, fibromyalgia, and cervical strain injuries. One of the factors that may account for these similarities is that these conditions all present with disturbances in the optimal functioning of the autonomic nervous system and its intricate interactions with the endocrine system and immune system-the three primary regulatory systems in the body. When clinicians are working with patients presenting with persisting symptoms after concussion, evidence-based treatment options drawn from the literature are limited. We present a framework for the assessment and treatment of persisting symptoms following concussion based on the available evidence (treatment trials), neuroanatomical principles (research into the physiology of concussion), and clinical judgment. We review the research supporting the premise that behavioral interventions designed to stabilize and optimize regulatory systems in the body following injury have the potential to reduce symptoms and improve functioning in patients. Foundational concussion rehabilitation strategies in the areas of sleep stabilization, fatigue management, physical exercise, nutrition, relaxation protocols, and behavioral activation are outlined along with practical strategies for implementing intervention modules with patients.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 1","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11766534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143032845","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":"Robotic Versus Sternotomy, Thoracotomy and Video-Thoracoscopy Approaches for Thymoma Resection: A Comparative Analysis of Short-Term Results.","authors":"Beatrice Trabalza Marinucci, Matteo Tiracorrendo, Camilla Vanni, Fabiana Messa, Giorgia Piccioni, Alessandra Siciliani, Silvia Fiorelli, Mohsen Ibrahim, Erino A Rendina, Antonio D'Andrilli","doi":"10.3390/jpm15010034","DOIUrl":"10.3390/jpm15010034","url":null,"abstract":"<p><p><b>OBJECTIVE</b>. The optimal surgical approach for thymoma resection is still an object of debate. The increasing experience in robotic-assisted thoracic surgery (RATS) has led to the progressive affirmation of this technique as a valid alternative to Sternotomy, Thoracotomy and Video-Assisted Thoracic Surgery (VATS) in this setting. The present study aims to compare the post-operative and short-term results of RATS Thymectomy for thymoma with those of other main surgical approaches (sternotomy, thoracotomy and VATS) from a high-volume single center. <b>METHODS</b>. Between May 2021 and September 2023, 40 consecutive patients underwent RATS Thymectomy for stage I to limited-stage III thymoma in our center. Three homogenous groups of patients who received thymoma resection through main alternative approaches (sternotomy, thoracotomy, VATS) over the last 5 years, were identified in order to perform a comparative analysis. Data including surgery duration, associated resections, conversion rate, overall morbidity, tumor size, radicality of resection, post-operative pain, length of hospital stay and cosmetic results were retrospectively collected and compared between the RATS and each control group. <b>RESULTS.</b> Mean tumor size was higher in the sternotomy group, but not significantly. The mean operative time of RATS interventions was significantly lower than that of sternotomy and VATS. It was significantly shorter compared to thoracotomy if excluding docking-undocking time. A higher rate of associated adjacent structures resection was reported in the sternotomy group (<i>p</i> = 0.005). Conversion rate was significantly higher in the VATS group (<i>p</i> = 0.026) compared to RATS. Post-operative pain at 24 and 48 h was significantly lower in the RATS group compared to the others. Improved cosmetics results were reported after RATS compared to sternotomy (<i>p</i> = 0.0001) and thoracotomy (<i>p</i> = 0.001) groups, with a trend towards better results compared to VATS (<i>p</i> = 0.05). Length of hospital stay was shorter in the RATS group with a significant difference vs. the sternotomy group (<i>p</i> < 0.001). <b>CONCLUSIONS.</b> These results from a single center confirm the safety and efficacy of RATS for the treatment of limited stage thymoma. An advantage in terms of operative outcomes, post-operative pain, cosmetic results and hospital stay was observed if compared to the alternative approaches. The short-term oncologic outcome was excellent based on the high complete resection rate of the tumor.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 1","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11767127/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143033215","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":"Causes of Sleep Disturbance in Early ASAS Spondyloarthritis: A Retrospective Long-Term Experience.","authors":"Francesca Bandinelli, Andrea Delle Sedie, Ilenia Mallia, Ilaria Mauro, Nikita Pecani, Linda Carli, Lorenzo Esti, Marco Di Carlo, Marina Carotti, Fausto Salaffi","doi":"10.3390/jpm15010031","DOIUrl":"10.3390/jpm15010031","url":null,"abstract":"<p><p><b>Introduction:</b> Sleep disturbance (SD) in the second half of the night due to inflammatory pain was included in the 2009 ASAS classification criteria of Spondyloarthritis (SpA), even though its definition is uncertain. <b>Aim:</b> We aimed to investigate SD in early-SpA (e-SpA) patients at T1 (2010-2013), comparing them to long-term SpA (l-SpA) patients at T2 (2023-2024) after at least 10 years of follow-up. <b>Methods:</b> At T1, in e-SpA and l-SpA cases, SD, classified as \"difficulty in initiating sleep\" (DIS), \"difficulty in maintaining sleep\" (DMS) and \"early awakening\" (EA), was compared to clinical parameters (ASDAS-CRP, BASDAI, m-HAQ-S, BASMI, MASES, 68/66 joint count, tenderness of sacroiliac joints, fatigue [FACIT] and HADS for anxiety [A] and depression [D]). At T2, e-SpA patients were re-evaluated using the Pittsburgh Sleep Quality Index (PSQI). <b>Results:</b> At T1, 45% of 166 SpA patients had SD; in e-SpA patients (60), SD correlated with sacroiliac pain (DMS) BASDAI, FACIT and HADS-D (EA); in l-SpA patients (106), it correlated with HADS-A (DIS), BASDAI and FACIT (DMS). At T2, e-SpA patients showed a high PSQI in 51.5% of cases, correlated with T2-ASDAS-CRP and T2-BASDAI. Moreover, T1-ASDAS-CRP was predictive of T2-PSQI. <b>Conclusions:</b> SD is more specific for inflammatory pain in e-SpA and might be influenced by disease activity also in long-term disease.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 1","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11767170/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143032693","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}