Journal of Personalized Medicine最新文献

{"title":"Optimising Autologous Breast Reconstruction: Pneumothorax and Pneumomediastinum-A Literature Review and First Reported Case of Pneumomediastinum Following Bilateral DIEP Flap Reconstruction.","authors":"Akshay Soni, Ishith Seth, Kaiyang Lim, Alexander Phan, Richard J Ross, Mathew Lee, Warren M Rozen","doi":"10.3390/jpm16090458","DOIUrl":"10.3390/jpm16090458","url":null,"abstract":"<p><p><b>Background</b>: Thoracic air complications after autologous breast reconstruction (ABR) are uncommon and incompletely characterised. A personalised perioperative approach requires integration of patient anatomy, reconstructive technique, anaesthetic exposures and the postoperative clinical trajectory rather than reliance on population-level estimates alone. <b>Methods</b>: We report a 41-year-old woman in whom pneumomediastinum was identified after bilateral DIEP flap reconstruction and performed a focused literature review restricted to primary studies of pneumothorax or pneumomediastinum following autologous flap breast reconstruction. Searches across MEDLINE-Ovid, PubMed and Wiley Online Library using predefined MeSH terms were conducted. Data extraction focused on study characteristics, incidence, mechanism of injury, perioperative factors, and management. <b>Results</b>: The patient developed postoperative hypotension and persistent tachycardia, followed by pleuritic chest pain. CT excluded pulmonary embolism and oesophageal perforation but demonstrated Moderate volume pneumomediastinum without pneumothorax. She was managed conservatively and discharged on postoperative day 7. Five primary studies met the eligibility criteria. Study-specific pneumothorax frequencies were 1/463 (0.22%) after rib-sparing free-flap reconstruction, 3/749 (0.4%) after extended latissimus dorsi reconstruction, and 4/180 patients (2.2%; 1.4 per 100 internal mammary vessel dissections). Reported mechanisms included pleural injury during internal mammary vessel dissection, inadvertent puncture during regional anaesthesia, barotrauma under positive-pressure ventilation, and drain-related barotrauma. No previous primary report of pneumomediastinum after autologous flap breast reconstruction was identified. <b>Conclusions</b>: Pneumothorax and pneumomediastinum are uncommon but potentially serious complications of ABR. They are rarely documented postoperatively; however, surgeons and anaesthetists must remain vigilant, particularly during exposure of the internal mammary vessels and airway management. Patient-specific assessment, symptom-directed imaging and multidisciplinary management may support early recognition to prevent morbidity and preserve the outcomes of reconstructive procedures.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13608144/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039422","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":"Nurses' Knowledge of Insensible Water Loss and the Evolution of a Digital Decision-Support Tool for Personalized Fluid Balance Assessment: A Cross-Sectional Study.","authors":"Anna Grimaldi, Diego Lopane, Stefano Mancin, Orsola Agorini, Vincenzo Di Nuzzo, Giuseppe Frattolillo, Domenico Di Sivo, Giovanni Gavarro, Incoronata Chiusolo, Ciro Pozzuoli, Sara Morales Palomares, Italian Society Of Nephrology Nurses Sian Board Of Directors Group, Giovanni Cangelosi, Alessandro Stievano","doi":"10.3390/jpm16090456","DOIUrl":"10.3390/jpm16090456","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Fluid balance management is a core nursing competency, particularly in high-acuity settings. However, the assessment of insensible water loss remains challenging due to the lack of standardized methods, which may increase variability in clinical reasoning. In this context, digital tools may support a more structured and personalized approach. This study aimed to assess nurses' knowledge of fluid balance and insensible water loss [perspiratio insensibilis (PI)] and to evaluate the usability and perceived quality of a pilot digital clinical decision-support tool (CareBalance-N). Secondary analyses explored differences across clinical settings and the association between knowledge level and app evaluation. <b>Methods:</b> A cross-sectional observational study was conducted among 50 nurses working in three clinical settings: hemodialysis (n = 20; 40%), internal medicine (n = 15; 30%), and intensive care (n = 15; 30%). Knowledge was assessed using a structured questionnaire (score range: 0-100), while the usability and perceived quality of the digital application for fluid balance were evaluated using the User Version of the Mobile App Rating Scale (uMARS). Differences between settings were analyzed using ANOVA, and correlations were assessed using Pearson's correlation coefficient. <b>Results:</b> The mean knowledge score was 67.6 ± 7.7, with significant differences across clinical settings [F(2, 47) = 28.4; <i>p</i> < 0.001]: hemodialysis 73.6 ± 6.0, intensive care 66.9 ± 4.7, and internal medicine 60.3 ± 5.1. The mean uMARS score was 3.91 ± 0.17, with particularly high ratings for functionality (4.19 ± 0.17) and perceived impact (4.17 ± 0.16). A strong positive correlation was found between knowledge scores and app evaluation (r = 0.943; <i>p</i> < 0.001). <b>Conclusions:</b> These findings highlight variability in nursing knowledge across clinical settings and suggest that digital tools such as CareBalance-N may represent a promising approach to facilitate more structured clinical reasoning and fluid balance assessment. However, these potential benefits require validation in real-world clinical settings. Further studies are needed to evaluate their impact on decision-making processes, the accuracy of fluid balance assessment, patient safety, and clinical outcomes.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13608302/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039440","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":"Body Mass Index and Body Fat Percentage Are Associated with Clinical Outcomes in Patients Receiving PD-1/PD-L1 Inhibitors: A Prospective Exploratory Study.","authors":"Ángela Morell, Alberto Morell, Ainhoa Aranguren, Jacobo Rogado, Miguel Sampedro, Rebeca Mondéjar, Ramón Colomer, M Paz Lorenzo, Esther Ramírez","doi":"10.3390/jpm16090457","DOIUrl":"10.3390/jpm16090457","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Immunotherapy using immune checkpoint inhibitors has transformed the treatment of multiple solid tumours. However, the clinical response to programmed death receptor (PD-1) and its ligand (PD-L1) inhibitors remains heterogeneous. We have previously shown that host-related factors such as body mass index (BMI) may modulate the efficacy of immunotherapy. The aim of this study was to determine whether body composition, measured with bioelectrical impedance analysis (BIA) before treatment initiation, is a prognostic factor for survival outcomes in patients treated with PD-1/PD-L1 inhibitors, independently of tumour type and stage. <b>Methods</b>: In this prospective, single-centre observational study, patients with solid tumours underwent baseline body composition assessment using multifrequency bioelectrical impedance analysis (BIA) before initiation of PD-1/PD-L1 inhibitor therapy. Overall survival (OS), progression-free survival (PFS), and treatment-related adverse events were evaluated using Kaplan-Meier analyses and multivariable Cox regression models adjusted for tumour stage and metastatic status. <b>Results</b>: A total of 80 patients with solid tumours were included in the study. The median age was 67 years, and 48 (60.0%) were male. Higher BMI (≥25 kg/m²) and elevated body fat percentage (%BF) were associated with more favourable survival outcomes. After adjustment for tumour stage and metastatic status, BMI ≥ 25 kg/m² was associated with a lower risk of death (HR 0.286, 95% CI 0.087-0.941; <i>p</i> = 0.039). Similar results were observed for elevated %BF (HR 0.289, 95% CI 0.087-0.963; <i>p</i> = 0.036). Neither BMI nor %BF was significantly associated with the occurrence of confirmed immune-related adverse events. <b>Conclusions</b>: Baseline BMI and body fat percentage were associated with survival outcomes in this exploratory cohort of patients receiving PD-1/PD-L1 inhibitors. These findings should be considered exploratory and hypothesis-generating and require confirmation in larger, tumour-specific prospective studies.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13608239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039500","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":"Molecular Residual Disease in Non-Small Cell Lung Cancer: Technology or Patient Outcomes?","authors":"Paul R Walker","doi":"10.3390/jpm16090454","DOIUrl":"10.3390/jpm16090454","url":null,"abstract":"<p><p>Molecular residual disease (MRD) testing approaches with plasma next-generation sequencing (NGS) testing to identify circulating tumor DNA (ctDNA) in resectable-stage non-small cell lung cancer (NSCLC) are evolving. The MRD concept is to better guide perioperative systemic treatment and identify recurrent NSCLC before symptomatic radiographic recurrences. Multiple tumor-informed assays are available with technology driving lower levels of ctDNA detection. However, it remains unclear that individual patients derive survival outcome benefit from MRD testing. NSCLC tumor biology of spatial heterogeneity, early parallel metastases, and recurrence clonal evolution can impact tumor-informed approaches irrespective of specific assay level of ctDNA detection. Clinical decision making guided by tumor-informed MRD testing to date have been limited by recurrence risks of up to 20% when landmark MRD-negative, improved outcomes benefit of adjuvant treatment even when landmark MRD-negative, and lead times with longitudinal MRD-positive conversion of several months or longer before overt radiographic recurrences with no proven strategy of survival benefit with intervening treatment. Cautionary tumor biology and clinical issues remain in the clinical utility of tumor-informed MRD testing in resected NSCLC. These need to be clarified with certainty before MRD testing should step beyond a technology-driven prognostic recurrence risk indicator before becoming an absolute clinical guide to meaningfully impact individual patient management and outcomes.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13608606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039390","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":"Personalizing Peri-Intubation Oxygenation in Patients at Risk of Acute Hypoxemic Respiratory Failure: A Phenotype-Driven Narrative Review of High-Flow Nasal Oxygen and Non-Invasive Ventilation.","authors":"Daniele Salvatore Paternò, Luigi La Via, Rossella Moltisanti, Antonio Putaggio, Angela Maria Piccolo, Giorgia Maria Noce, Roberta Scuto, Gilberto Duarte-Medrano, Natalia Nuño-Lámbarri, Emilia Concetta Lo Giudice, Massimiliano Sorbello","doi":"10.3390/jpm16090455","DOIUrl":"10.3390/jpm16090455","url":null,"abstract":"<p><p>Tracheal intubation in patients at risk of acute hypoxemic respiratory failure (AHRF) carries a high risk of life-threatening desaturation, and the choice of peri-intubation oxygenation strategy critically influences patient safety. This narrative review synthesizes current evidence on non-invasive oxygenation techniques-high-flow nasal oxygen (HFNO), non-invasive ventilation (NIV), and their combination-across the pre-oxygenation, apneic, and awake-intubation phases of airway management. We examine the physiological mechanisms underlying each modality, appraise landmark randomized trials and meta-analyses (including PREOXI, OPTINIV, and OPTIMASK), and address disease-specific considerations in chronic obstructive pulmonary disease, heart failure, interstitial lung disease, severe obesity, obstructive sleep apnea, and obstetric, pediatric, and trauma populations. The evidence supports a phenotype-driven hierarchy rather than a single dominant technique: NIV-optionally combined with HFNO for apneic oxygenation-is preferred in severely hypoxemic critically ill patients, whereas HFNO alone is adequate for many moderately hypoxemic or non-hypoxemic patients. Progressive hypercapnia limits apneic oxygenation, particularly in chronic CO₂ retainers, underscoring the value of continuous CO₂ monitoring. Persistent under-implementation of NIV-based pre-oxygenation reveals a gap between evidence and practice. Individualized, physiology-guided oxygenation-aligned with the goals of personalized peri-procedural medicine-offers the greatest potential to reduce peri-intubation morbidity.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13608045/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039419","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 Decision-Making Regarding the Added Value of Postoperative Chemotherapy After Complete Secondary Cytoreductive Surgery in Unifocal First Recurrent Epithelial Ovarian Cancer-An International Expert Survey.","authors":"Renée E W M van de Vorst, Sophie S M Pelk, Eelke H Gort, Petronella O Witteveen, Ronald P Zweemer, Cornelis G Gerestein","doi":"10.3390/jpm16090449","DOIUrl":"10.3390/jpm16090449","url":null,"abstract":"<p><p><b>Background</b>: Secondary cytoreductive surgery (SCS) followed by postoperative chemotherapy is a recognized option for select patients with platinum-sensitive first recurrent epithelial ovarian cancer (EOC), supported by the DESKTOP-III and SOC-1 trials. Neither trial reported chemotherapy rates stratified by lesion number or resection status. As a result, the added value of postoperative chemotherapy after complete resection of a unifocal recurrence remains unclear. This study aimed to evaluate current clinical practice and factors influencing this decision. <b>Methods</b>: A cross-sectional survey was conducted among gynecological and medical oncologists from international expert oncological centers, assessing definitions of unifocal recurrence, current postoperative chemotherapy practice after complete SCS, perceived clinical value and strength of the supporting evidence, and factors influencing decision-making. <b>Results</b>: Twenty of 48 invited experts responded (41.7%). Respondents applied different definitions of unifocal recurrence, leading to variable estimates of the annual number of patients undergoing SCS. Respondents perceived postoperative chemotherapy to have meaningful clinical value, despite rating the supporting evidence as weak. A proportion did not routinely administer postoperative chemotherapy after complete SCS, managing patients with observation alone. Decisions to omit chemotherapy were influenced by institutional, clinical, and patient-related factors. Overall, 82% of respondents considered a randomized trial comparing chemotherapy with observation clinically valuable. <b>Conclusions</b>: Clinical practice regarding postoperative chemotherapy after complete SCS for a first unifocal recurrence of EOC varies among international expert oncological centers. The absence of a uniform definition of unifocal recurrence and lack of direct evidence regarding postoperative chemotherapy omission highlight the need for standardized definitions and prospective randomized evaluation of chemotherapy versus observation.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13608701/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039512","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":"Social Status and Clinical Resource Allocation by a Large Language Model: An Evaluation of 30,618 Decisions.","authors":"Siddharth Gandhi, Michael Balas","doi":"10.3390/jpm16090448","DOIUrl":"10.3390/jpm16090448","url":null,"abstract":"<p><p><b>Objective</b>: The objective was to quantify whether demographic and social attributes that were irrelevant to stated clinical need, prognosis, and expected benefit altered resource-allocation decisions made by a general-purpose large language model (LLM). <b>Methods</b>: We conducted a cross-sectional audit of the gpt-5-chat-latest API model alias on 8 October 2025, across seven clinical vignettes, generating 30,618 forced-choice comparisons between patient profiles. Profiles varied across a full-factorial combination of eight demographic and social attributes while clinical need, prognosis, and expected benefit were held constant. Forced choices were analyzed using pooled logistic regression with separate Patient A and Patient B attribute terms and vignette-specific position effects; position-averaged odds ratios and position-balanced absolute probabilities were derived from this model. Priority-score differences were analyzed using an analogous linear model. <b>Results</b>: The model showed large position-averaged associations between non-clinical patient attributes and allocation decisions. Indigenous and Black race were associated with substantially higher odds of selection relative to White race (Indigenous: OR 16.48, 95% CI 14.85-18.28; Black: OR 8.07, 95% CI 7.32-8.90), corresponding to position-balanced absolute increases in selection probability of 30.7 and 16.3 percentage points, respectively. Conversely, high-status occupation (OR 0.064, 95% CI 0.058-0.071), friendship with institutional leadership (OR 0.121, 95% CI 0.111-0.131), and major donor status (OR 0.092, 95% CI 0.084-0.101) were associated with markedly lower odds of selection. Choice-score concordance was 95.1%. <b>Conclusions</b>: In this controlled audit, the LLM's allocation decisions varied substantially according to demographic and social characteristics despite identical stated clinical need, prognosis, and expected benefit. Although some patterns could be interpreted differently under competing ethical frameworks, their implicit and unexplained incorporation into resource-allocation decisions raises concerns regarding transparency, accountability, and clinical governance. Clinical use of LLM-based allocation support should therefore require explicit safeguards and systematic auditing for non-clinical influences.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13608446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039368","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":"Incidence and Risk Factors for Acute and Persistent Postoperative Pediatric Pain: The 4P Prospective Observational Multicenter Study.","authors":"Johanna Broman, Niklas Nielsen, Anna K M Persson","doi":"10.3390/jpm16090450","DOIUrl":"10.3390/jpm16090450","url":null,"abstract":"<p><p><b>Background:</b> Large prospective studies on the prevalence of acute and persistent pain in children are limited, and risk factors associated with post-surgical pain in children remain unclear. <b>Objective:</b> To examine the incidence of pediatric acute (APOP) and persistent postoperative pain (PPOP) and to determine whether factors such as age, sex, preoperative anxiety/sleep disturbance, preoperative pain and parental stress are associated with increased risk. <b>Design:</b> Prospective observational multicenter study. <b>Setting:</b> Hospitals performing pediatric surgery in southern Sweden. <b>Patients:</b> 601 children aged 1-17 years planned for one of the European Society of Pediatric Anesthesia (ESPA) pre-defined surgical procedures: inguinal hernia, circumcision/hypospadias/retentio testis, adenoidectomy/tonsillectomy/tonsillotomy, appendectomy and orthopedic acute fracture surgery. <b>Main outcome measures:</b> Postoperative pain in PACU after 24 h and 3, 6 and 12 months, level and description of the pain and effect on the child. <b>Results:</b> The incidence of APOP in the postoperative care unit was 0-27%, increasing to 13-58% after 24 h depending on surgery type. The incidences of PPOP were 4-24%, 4-30%, and 0-19% at 3, 6, and 12 months, respectively, depending on surgery type. Older age was a risk factor for APOP_PACU (OR 1.2, <i>p</i> < 0.001) and APOP_24h (OR 1.3, <i>p</i> < 0.001), whereas female sex was a risk factor only for PPOP_6months (OR 2.1, <i>p</i> = 0.028). Self-reported parental stress was a significant risk factor for postoperative pain at all follow-ups, exhibiting increasing influence (APOP_24h OR 1.2, <i>p</i> = 0.001; 3_months OR 1.5, <i>p</i> < 0.001; 6_months OR 1.3, <i>p</i> < 0.001; 12_months OR 1.5, <i>p</i> < 0.001). Preoperative anxiety/sleep disturbance only affected APOP_PACU (OR 2.0, <i>p</i> = 0.008), whereas preoperative pain was not a risk factor. <b>Conclusions:</b> The incidences of APOP and PPOP were lower than in previous studies. Possible risk factors for acute pain include older age and preoperative anxiety/sleep disturbance. Only self-reported parental stress was a consistent risk factor for persistent pain.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13608878/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039434","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":"Telemedicine in Pediatric Cardiology: Current Applications, Clinical Impact, and Future Perspectives.","authors":"Luisa M Rizzo, Matilde Petz, Federico Carlini, Susanna Esposito","doi":"10.3390/jpm16090453","DOIUrl":"10.3390/jpm16090453","url":null,"abstract":"<p><p>Telemedicine is increasingly transforming pediatric cardiology by expanding access to specialized care, supporting early diagnosis, and improving longitudinal monitoring of children with cardiovascular disease. This narrative review summarizes current applications of digital health in pediatric cardiology, with emphasis on congenital heart disease, pediatric hypertension, and arrhythmia management. Tele-echocardiography represents one of the most established telehealth tools, enabling remote interpretation of fetal, neonatal, and pediatric echocardiographic images and improving referral appropriateness, particularly in peripheral or resource-limited settings. In infants with complex congenital heart disease, especially those with single-ventricle physiology during the interstage period, home monitoring programs using mobile applications, pulse oximeters, digital scales, and structured caregiver reporting may facilitate early recognition of clinical deterioration and reduce avoidable transfers. In non-congenital cardiovascular disease, home blood pressure monitoring can improve diagnostic accuracy by reducing white-coat effects and supporting repeated measurements in real-life settings. Smartphone-enabled electrocardiographic devices and wearable technologies may enhance detection of intermittent arrhythmias and strengthen outpatient management. Despite these advantages, challenges remain, including data fragmentation, limited pediatric validation of consumer devices, interoperability issues, privacy concerns, and socioeconomic disparities in technology access. Properly integrated telemedicine may promote more timely, equitable, and patient-centered pediatric cardiovascular care.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13608622/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039345","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 Proenkephalin in Predicting Renal Dysfunction and Mortality in Septic Patients Admitted to the Emergency Department and Intensive Care Unit: A Narrative Review.","authors":"Christos Verras, Ioannis Ventoulis, Sofia Bezati, John Parissis, Effie Polyzogopoulou","doi":"10.3390/jpm16090451","DOIUrl":"10.3390/jpm16090451","url":null,"abstract":"<p><p>Prompt diagnosis and treatment of sepsis and septic shock is crucial due to the persistently high rates of morbidity and mortality associated with the disease. Recently, research efforts have focused on identifying novel biomarkers that would detect, classify, and assess the severity of sepsis in a timely manner, thereby allowing for expeditious and precise treatment of sepsis and septic shock. Among these biomarkers, proenkephalin (PENK) has gained considerable attention. Accordingly, this narrative review aims to consolidate current evidence on the clinical utility of PENK in patients with sepsis and septic shock, with emphasis on its role as a biomarker of renal dysfunction and as a predictor of sepsis-associated acute kidney injury (AKI) and mortality in both the emergency department (ED) and intensive care unit (ICU) settings.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13608850/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039432","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}