Journal of Personalized Medicine

16 pages, 510 KiB

Open AccessReview

Enhancing Adult Asthma Management: A Review on the Utility of Remote Home Spirometry and Mobile Applications

by Norbert Wellmann, Monica Steluta Marc, Emil Robert Stoicescu, Camelia Corina Pescaru, Ana Adriana Trusculescu, Flavia Gabriela Martis, Ioana Ciortea, Alexandru Florian Crisan, Madalina Alexandra Balica, Diana Raluca Velescu and Ovidiu Fira-Mladinescu

J. Pers. Med. 2024, 14(8), 852; https://doi.org/10.3390/jpm14080852 (registering DOI) - 11 Aug 2024

Abstract

Asthma is a prevalent chronic disease, contributing significantly to the global burden of disease and economic costs. Despite advances in treatment, inadequate disease management and reliance on reliever medications lead to preventable deaths. Telemedicine, defined as the use of information and communication technology [...] Read more.

Asthma is a prevalent chronic disease, contributing significantly to the global burden of disease and economic costs. Despite advances in treatment, inadequate disease management and reliance on reliever medications lead to preventable deaths. Telemedicine, defined as the use of information and communication technology to improve healthcare access, has gained global attention, especially during the COVID-19 pandemic. This systematic review examines the effectiveness of home monitoring systems in managing severe asthma. A systematic literature search was conducted in PubMed, Web of Science, Scopus, and Cochrane Library, focusing on studies from 2014 to 2024. Fourteen studies involving 9093 patients were analyzed. The results indicate that telemedicine, through tools such as mobile applications and portable spirometers, positively impacts asthma control, self-management, and quality of life. Home spirometry, in particular, shows strong agreement with clinic spirometry, offering a feasible alternative for continuous monitoring. Digital coaching and machine learning-based telemedicine applications also demonstrate significant potential in improving asthma outcomes. However, challenges such as technology accessibility, data privacy, and the need for standardized protocols remain. This review highlights the promise of telemedicine in asthma management and calls for further research to optimize its implementation and address existing barriers. Full article

(This article belongs to the Special Issue Treatment, Prevention and Multidisciplinarity of Respiratory Problems)

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13 pages, 2184 KiB

Open AccessArticle

RNA-Seq Analysis in Non-Small Cell Lung Cancer: What Is the Best Sample from Clinical Practice?

by Lorenzo Nibid, Giovanna Sabarese, Luca Andreotti, Benedetta Canalis, Daniela Righi, Filippo Longo, Margherita Grazi, Pierfilippo Crucitti and Giuseppe Perrone

J. Pers. Med. 2024, 14(8), 851; https://doi.org/10.3390/jpm14080851 (registering DOI) - 11 Aug 2024

Abstract

RNA-based next-generation sequencing (RNA-seq) represents the gold standard for detecting gene fusion in non-small cell lung cancer (NSCLC). Despite this, RNA instability makes the management of tissue samples extremely complex, resulting in a significant number of test failures with missing data or the [...] Read more.

RNA-based next-generation sequencing (RNA-seq) represents the gold standard for detecting gene fusion in non-small cell lung cancer (NSCLC). Despite this, RNA instability makes the management of tissue samples extremely complex, resulting in a significant number of test failures with missing data or the need to switch to other techniques. In the present study, we analyzed pre-analytical variables in 140 tumor tissue samples from patients affected by NSCLC to detect features that increase the chances of successful RNA-seq. We found that the success rate of the analysis positively correlates with the RNA concentration and fragmentation index. Interestingly, small biopsies were more suitable samples than surgical specimens and cell blocks. Among surgical specimens, wedge resections demonstrated better results than lobectomy. Moreover, samples stored for less than 30 days (1 month) had a better chance of success than older samples. Defining the role of pre-analytical variables in RNA-seq allows the detection of more suitable samples for analysis and more effective planning of molecular-based diagnostic approaches in NSCLC. Full article

(This article belongs to the Special Issue New Insights into Personalized Surgical Oncology)

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14 pages, 2626 KiB

Open AccessArticle

Perioperative Modulation of Left Ventricular Systolic Performance: A Retrospective Study on Ionized Calcium and Vitamin D in Cardiac Surgery Patients

by Adrian Ștef, Constantin Bodolea, Ioana Corina Bocșan, Alexandru Achim, Nadina Tintiuc, Raluca Maria Pop, Aurelia Georgeta Solomonean, Alexandru Manea and Anca Dana Buzoianu

J. Pers. Med. 2024, 14(8), 850; https://doi.org/10.3390/jpm14080850 (registering DOI) - 10 Aug 2024

Abstract

Background: The perioperative impact of calcium and vitamin D on left ventricular (LV) performance during major cardiac surgery remains unexplored. We aimed to assess the relation of calcium and vitamin D measured at different time points with the LV ejection fraction (EF), [...] Read more.

Background: The perioperative impact of calcium and vitamin D on left ventricular (LV) performance during major cardiac surgery remains unexplored. We aimed to assess the relation of calcium and vitamin D measured at different time points with the LV ejection fraction (EF), and to investigate whether changes in EF correlate with postoperative outcomes. Methods: We enrolled 83 patients, in whom ionized calcium was measured before, during, and after surgery (until discharge), vitamin D preoperatively, and EF pre- and postoperatively at 24 h. The postoperative outcomes were cardiopulmonary bypass (CPB) time, aortic cross-clamp time, mechanical ventilation time, vasoactive inotropic score (VIS) (intraoperative, day 0, day 1), and ICU stay time. Results: The mean age was 64.9 ± 8.5 years, with 21 of the patients (25%) having an EF < 50%. The median change from preoperative to postoperative EF was −2.0 (−10.0–0.0) % (p < 0.001). At the baseline, the EF < 50% group had significantly lower preoperative vitamin D levels than the EF ≥ 50% group (p = 0.048). The calcium trend did not differ across the groups. Preoperative EF was significantly associated with CPB time (r = 0.22, p = 0.044) and aortic cross-clamp time (r = 0.24, p = 0.031). Postoperative EF was significantly and inversely associated with intraoperative VIS (r = −0.28, p = 0.009), VIS day 0 (r = −0.25, p = 0.020), VIS day 1 (r = −0.23, p = 0.036), and ICU length of stay (r = −0.22, p = 0.047). Finally, the change in ejection fraction was significantly and inversely associated with CPB time (r = −0.23, p = 0.037), aortic cross-clamp time (r = −0.22, p = 0.044), intraoperative VIS (r = −0.42, p < 0.001), VIS day 0 (r = −0.25, p = 0.024), mechanical ventilation time (r = −0.22, p = 0.047), and ICU length of stay (r = −0.23, p = 0.039). Conclusions: The fluctuations in perioperative ionized calcium levels were not associated with the evolution of LVEF, although preoperative vitamin D levels may affect those with low EF. Correspondingly, a reduced EF significantly impacted all the studied postoperative outcomes. Further investigation into biomarkers affecting cardiac inotropic function is warranted to better understand their significance. Full article

(This article belongs to the Section Disease Biomarker)

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Study flow chart. Full article ">Figure 2
Change in ejection fraction from preoperative to day 1. Full article ">Figure 3
Trend in ionized calcium during the study period, according to preoperative ejection fraction (EF) group. Full article ">Figure 4
Spearman’s correlation coefficients for the associations of ejection fraction with vitamin D, ionized calcium, and outcomes. Correlation coefficients are given. Statistically significant correlation coefficients (p < 0.05) are indicated by *. Full article ">Figure 5
Significant correlations between EF and outcomes (preoperative EF sub-figures (A,B), postoperative EF subfigures (C–F), and change in EF subfigures (G–L)). EF, ejection fraction; CPB, cardiopulmonary bypass; VIS, vasoinotropic score. Full article ">Figure 6
Correlations between preoperative (first panel), postoperative (middle panel), and differences in ejection fraction and calcium levels (last panel). There is no linear relationship between the calcium levels and LVEF before and after surgery, but the decrease in calcium values is weakly to moderately directly proportional to the decrease in LVEF values (r = 0.26, p = 0.01). Full article ">

12 pages, 1457 KiB

Open AccessArticle

Cranio-Maxillo-Facial Reconstruction with Polyetheretherketone Patient-Specific Implants: Aesthetic and Functional Outcomes

by Ylenia Gugliotta, Emanuele Zavattero, Guglielmo Ramieri, Claudia Borbon and Giovanni Gerbino

J. Pers. Med. 2024, 14(8), 849; https://doi.org/10.3390/jpm14080849 (registering DOI) - 10 Aug 2024

Abstract

Background: Reconstructing cranio-maxillo-facial defects presents significant challenges. This study evaluates the results of polyetheretherketone patient-specific implants (PEEK PSIs) in primary and secondary cranio-maxillo-facial reconstructions, with a focus on aesthetic and functional outcomes and long-term complications. Methods: From October 2009 to February 2023, 45 [...] Read more.

Background: Reconstructing cranio-maxillo-facial defects presents significant challenges. This study evaluates the results of polyetheretherketone patient-specific implants (PEEK PSIs) in primary and secondary cranio-maxillo-facial reconstructions, with a focus on aesthetic and functional outcomes and long-term complications. Methods: From October 2009 to February 2023, 45 patients underwent cranio-maxillo-facial reconstructions with PSIs. Patients aged 18 years or older, with a minimum follow-up period of 12 months, were included. The morpho-functional outcome was evaluated through a modified Katsuragy Scale, the Visual Analogue Scale (VAS) for pain, and four FACE-Q|Aesthetics© scales. Results: In total, 44 PSIs were placed in 37 patients (51.3% males; mean age 45.1 years). The main cause of the defect was the resection of a tumor (55.4%). Mean follow-up was 78.6 months. Clinical evaluations showed an improvement in the postoperative period both in patient’s and surgeon’s scores (p: 0.01 and p: 0.002, respectively). Subgroup analysis confirmed a significant improvement in patients undergoing cranioplasty (p = 0.02) and mandible reconstruction (p = 0.03). No cases of prosthesis dislocation, rupture, or long-term infection were recorded. Conclusions: PEEK PSIs offer significant advantages in craniofacial reconstructions. Despite challenges in predicting soft tissue adaptation, overall patient satisfaction was high with no long-term complications. Future improvements should focus on predicting and enhancing soft tissue adaptations. Full article

(This article belongs to the Section Clinical Medicine, Cell, and Organism Physiology)

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Resection and primary reconstruction of a fronto-orbital osteoma. (a) Preoperative CT scan revealing a heterogeneous fronto-orbital expansive process extending to the roof of the orbit and frontal sinus. (b) Customized cutting guide implant digital planning. (c) Intraoperative placement of the cutting guide for executing the osteotomy and subsequent fixation of the implant. (d) Postoperative CT scan. (e) Aesthetic outcome at the 3-month follow-up. (f) Aesthetic outcome at the 24-month follow-up. Full article ">Figure 2
Resection and primary reconstruction of intraosseous meningioma. (a) Preoperative facial views of right exophthalmos and dystopia. (b) Preoperative coronal computed tomogram displays hyperostotic bone owing to intraosseous meningioma. (c) Three-dimensional model based on data from computed tomogram (green, cutting guide; red, custom-made implant, red and light blue, planned resection). (d) Intraoperative use of cutting guide to outline the area of resection that matches the size of the polyetheretherketone implant (m, meningioma; Or, right orbit) and reconstruction of bone defect with a polyetheretherketone patient-specific implant fixed in position with plate and screws. (e) Postoperative facial views show good functional globe position and excellent postoperative cosmetic appearance at 12-month follow-up. (f) Aesthetic outcome at the 36-month follow-up. Full article ">Figure 3
Correction of congenital mandibular asymmetry using two PEEK implants. (a) Patient with congenital asymmetry of the lower third of the face. (b) Planned correction of the asymmetry. Given the good occlusal compensation achieved through orthodontic therapy, a decision was made for a camouflage intervention using a patient-specific implant instead of opting for orthognathic surgery, which would have necessitated a new orthodontic treatment. (c) Intraoperative positioning of patient-specific implant. (d) Patient at 3-month follow-up after surgery. Full article ">

9 pages, 268 KiB

Open AccessArticle

Subclinical Ocular Motility Dysfunction and Extraocular Muscle Changes in Inactive Graves’ Orbitopathy

by Filippo Lixi, Alberto Cuccu, Giuseppe Giannaccare, Matteo Onnis, Mihaela Madalina Timofte Zorila, Stefano Mariotti, Rosanna Vacca, Paola Elisa Meloni, Michela Pisu, Chiara Mura and Francesco Boi

J. Pers. Med. 2024, 14(8), 848; https://doi.org/10.3390/jpm14080848 (registering DOI) - 10 Aug 2024

Abstract

This study aimed to investigate the presence of structural and functional changes in extraocular muscles (EMs) among patients with inactive Graves’ orbitopathy (GO) classified according to the Clinical Activity Score (CAS). Sixty-seven patients with Graves’ disease (GD) and inactive GO were included. The [...] Read more.

This study aimed to investigate the presence of structural and functional changes in extraocular muscles (EMs) among patients with inactive Graves’ orbitopathy (GO) classified according to the Clinical Activity Score (CAS). Sixty-seven patients with Graves’ disease (GD) and inactive GO were included. The data collected included clinical parameters, thyroid function, autoantibody levels, EOM morphology via orbital ultrasound (US), and ocular motility. Patients were stratified into Red Filter Test (RFT)-positive or RFT-negative groups based on the presence or absence of latent diplopia during the RFT examination. Thirty-three patients (49.25%) exhibited latent diplopia on the RFT, despite not reporting double vision during standard ocular motility tests. Significant differences were observed between the two groups in terms of age, disease duration, intraocular pressure (IOP) elevation in up-gaze, and medial rectus muscle thickness (p < 0.05). No significant differences were found in thyroid status, TRAb and ATA levels, CASs, exophthalmos, or lateral rectus thickness between the two groups. This study revealed that in inactive GO, subclinical EM dysfunction and morphological changes may be present, which might not be apparent through routine ocular examinations. The RFT is effective in detecting latent diplopia, highlighting its utility in identifying subtle ocular motility issues and subclinical muscle involvement. Comprehensive evaluations combining functional tests like the RFT and imaging are essential for early detection of GO-related abnormalities, enabling tailored and prompt management and improving patient outcomes. Full article

(This article belongs to the Special Issue New Advances and Perspectives in Ophthalmology: Progress and Modern Challenges)

13 pages, 8455 KiB

Open AccessArticle

Starvation and Inflammation Modulate Adipose Mesenchymal Stromal Cells’ Molecular Signature

by Simona Piccolo, Giulio Grieco, Caterina Visconte, Paola De Luca, Michela Taiana, Luigi Zagra, Enrico Ragni and Laura de Girolamo

J. Pers. Med. 2024, 14(8), 847; https://doi.org/10.3390/jpm14080847 (registering DOI) - 9 Aug 2024

Abstract

Mesenchymal stromal cells (MSCs) and their released factors (secretome) are intriguing options for regenerative medicine approaches based on the management of inflammation and tissue restoration, as in joint disorders like osteoarthritis (OA). Production strategy may modulate cells and secretome fingerprints, and for the [...] Read more.

Mesenchymal stromal cells (MSCs) and their released factors (secretome) are intriguing options for regenerative medicine approaches based on the management of inflammation and tissue restoration, as in joint disorders like osteoarthritis (OA). Production strategy may modulate cells and secretome fingerprints, and for the latter, the effect of serum removal by starvation used in clinical-grade protocols has been underestimated. In this work, the effect of starvation on the molecular profile of interleukin 1 beta (IL1β)-primed adipose-derived MSCs (ASCs) was tested by assessing the expression level of 84 genes related to secreted factors and 84 genes involved in defining stemness potential. After validation at the protein level, the effect of starvation modulation in the secretomes was tested in a model of OA chondrocytes. IL1β priming in vitro led to an increase in inflammatory mediators’ release and reduced anti-inflammatory potential on chondrocytes, features reversed by subsequent starvation. Therefore, when applying serum removal-based clinical-grade protocols for ASCs’ secretome production, the effects of starvation must be carefully considered and investigated. Full article

(This article belongs to the Special Issue Prospectives in Regenerative Medicine and Surgery: Stem Cells and Beyond)

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ASCs’ immunophenotype: (A) ASCs were positive for MSC markers CD44, CD73, CD90, and CD105, and tissue-resident/early-passage ASC marker CD34. Plots illustrate the results from a representative donor. (B) No difference was observed under the analyzed conditions (N = 3). Full article ">Figure 2
Correlation between samples and conditions: (A) Intra-group and (B) inter-group correlation analyses for the expression of inflammation-related genes; N = 3, mean ± SD. “r” Pearson values are shown. (C) PCA performed on normalized Ct values for inflammation genes. The X and Y axes show principal component 1 and principal component 2, which explain 47.3% and 15.3% of the total variance. (D) Hierarchical clustering performed on normalized Ct values for inflammation genes. Higher Ct means lower amount, and lower Ct means higher amount. (E) Intra-group and (F) inter-group correlation analyses for the expression of mesenchymal stem cell-related genes; N = 3, mean ± SD. “r” Pearson values are shown. (G) PCA performed on normalized Ct values for mesenchymal genes. The X and Y axes show principal component 1 and principal component 2, which explain 35.8% and 13.0% of the total variance. (H) Hierarchical clustering performed on normalized Ct values for mesenchymal genes. Higher Ct means lower amount, and lower Ct means higher amount. Full article ">Figure 3
Correlation between samples and conditions for significantly modulated genes: (A) PCA performed on ln(FC + 1) values, with FC calculated vs. condition F. The X and Y axes show principal component 1 and principal component 2, which explain 87.7% and 9.7% of the total variance. (B) Hierarchical clustering performed on ln(FC + 1) values, with FC calculated vs. condition F. Full article ">Figure 4
Quantitative analysis of factors modulated by IL1β and reversed by subsequent starvation. CCL2, CXCL2, IL6, IL8, CSF2, and CSF3 levels detected as pg/mL were measured by ELISA assays. In the absence of plots, the proteins were undetectable or below the lower limit of detection of the assay. Under ANOVA analysis, significance was set for p-value ≤ 0.05 (§ for p-value ≤ 0.1, * ≤ 0.05, ** ≤ 0.01, *** ≤ 0.001 and **** ≤ 0.0001. N = 3). Full article ">Figure 5
Correlation between conditions for significantly modulated genes in inflamed chondrocytes treated with secretomes: (A) Inter-group correlation analysis of the modulation of OA-related genes in chondrocytes treated with IL1β alone or with IL1β and secretomes with respect to untreated (CTRL) cells. “r” Pearson values are shown. (B) PCA performed on ln(FC + 1) values, with FC calculated vs. condition CTRL. The X and Y axes show principal component 1 and principal component 2, which explain 91.6% and 6.6% of the total variance, respectively. (C) Hierarchical clustering performed on ln(FC + 1) values, with FC calculated vs. condition CTRL. The scale bar’s maximum for ln(FC + 1) values was set to 2.5. Full article ">

12 pages, 1308 KiB

Open AccessArticle

Reduced Clavicle Length Indicates the Severity of Scapular Misalignment in Obstetric Brachial Plexus Lesions

by Rudolf Rosenauer, Antal Nógrádi, Stefan Quadlbauer, Markus Schmidhammer, Robert Schmidhammer and Savas Tsolakidis

J. Pers. Med. 2024, 14(8), 846; https://doi.org/10.3390/jpm14080846 (registering DOI) - 9 Aug 2024

Abstract

(1) Background: Although most brachial plexus birth palsies show some spontaneous recovery, secondary operations are likely to follow. Accordingly, due to the loss of muscle innervation, the growth of the affected limb and the shoulder girdle is reduced. This is associated with pathological [...] Read more.

(1) Background: Although most brachial plexus birth palsies show some spontaneous recovery, secondary operations are likely to follow. Accordingly, due to the loss of muscle innervation, the growth of the affected limb and the shoulder girdle is reduced. This is associated with pathological scapula positioning and rotation. The objective of this work was to clarify the relationship between length differences of the two clavicles and different types of scapular dyskinesia. (2) Methods: Twenty-five patients suffering from brachial plexus birth palsy were included in this retrospective study. There were eighteen female and seven male patients with a mean age of 10 years (2 to 23 years). CT scans of the thoracic cage, including both shoulder joints and both clavicles, were obtained preoperatively between 2010 and 2012. Radiographic measurements were taken of the axial plane and 3D reconstructions were produced. Functional evaluations of possible movement and scapular dyskinesia were performed. (3) Results: We found an increasing difference in the length of the clavicle (both in absolute and relative terms) in the children with more pronounced scapular dyskinesia. Additionally, with increasing clavicle length differences, the scapula was positioned in a deteriorated angle compared to the healthy side. Significant positive correlations were identified for the age and absolute difference of the clavicle length and the length and width of the scapula on the affected side. (4) Conclusion: Scapular dyskinesia, which is a common finding in brachial plexus birth palsy, is strongly related to reduced clavicle growth. Reduced clavicle length (which is a relatively easily examinable parameter) compared to the healthy side can be used to estimate the extent of scapular malpositioning on the thoracic cage. The extent and severity of scapular dyskinesia increases with augmented differences in the length of the clavicle. Full article

(This article belongs to the Section Clinical Medicine, Cell, and Organism Physiology)

13 pages, 486 KiB

Open AccessArticle

Emergency Awake Laparotomy Using Neuraxial Anaesthesia: A Case Series and Literature Review

by Matteo Luigi Giuseppe Leoni, Tommaso Rossi, Marco Mercieri, Giorgia Cerati, David Michael Abbott, Giustino Varrassi, Gaetano Cattaneo, Patrizio Capelli, Manuela Mazzoni and Ruggero Massimo Corso

J. Pers. Med. 2024, 14(8), 845; https://doi.org/10.3390/jpm14080845 - 9 Aug 2024

Abstract

Emergency laparotomy is a surgical procedure associated with significantly higher mortality rates compared to elective surgeries. Awake laparotomy under neuraxial anaesthesia has recently emerged as a promising approach in abdominal surgery to improve patient outcomes. This study aims to evaluate the feasibility and [...] Read more.

Emergency laparotomy is a surgical procedure associated with significantly higher mortality rates compared to elective surgeries. Awake laparotomy under neuraxial anaesthesia has recently emerged as a promising approach in abdominal surgery to improve patient outcomes. This study aims to evaluate the feasibility and potential benefits of using neuraxial anaesthesia as the primary anaesthetic technique in emergency laparotomies. We conducted a case series involving 16 patients who underwent emergency laparotomy for bowel ischemia, perforation, or occlusion. Neuraxial anaesthesia was employed as the main anaesthetic technique. We analysed patient demographics, clinical characteristics, intraoperative details, and postoperative outcomes. The primary outcome measures included the adequacy of postoperative pain control, the incidence of postoperative complications, and mortality rates. Among the 16 patients, adequate postoperative pain control was achieved, with only 2 patients requiring additional analgesia. Postoperative complications, including sepsis, wound dehiscence, and pneumonia, were observed in seven patients (44%). The observed mortality rate was relatively low at 6% (one patient). Notably, conversion to general anaesthesia was not necessary in any of the cases, and no early readmissions were reported. Our findings highlight the feasibility and potential benefits of using neuraxial anaesthesia in emergency laparotomies. The observed low mortality rate and the avoidance of conversion to general anaesthesia suggest that neuraxial anaesthesia may be a useful alternative in emergency settings. However, the occurrence of postoperative complications in 44% of patients indicates the need for cautious patient selection and close monitoring. Further research with larger sample sizes is warranted to fully elucidate the efficacy, safety, and potential impact of this technique on patient outcomes in emergency laparotomies. Full article

(This article belongs to the Special Issue Towards Precision Anesthesia and Pain Management)

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16 pages, 2923 KiB

Open AccessArticle

Effects of Dance-Based Aerobic Training on Mental Health and Quality of Life in Older Adults with Mild Cognitive Impairment

by Marcelina Sánchez-Alcalá, Agustín Aibar-Almazán, Fidel Hita-Contreras, Yolanda Castellote-Caballero, María del Carmen Carcelén-Fraile, Aday Infante-Guedes and Ana María González-Martín

J. Pers. Med. 2024, 14(8), 844; https://doi.org/10.3390/jpm14080844 - 9 Aug 2024

Abstract

(1) Background: Mild cognitive impairment in older adults is a condition characterized by a decrease in mental abilities that affects their quality of life. The aim of this study is to evaluate the effects of an aerobic training program based on dance on [...] Read more.

(1) Background: Mild cognitive impairment in older adults is a condition characterized by a decrease in mental abilities that affects their quality of life. The aim of this study is to evaluate the effects of an aerobic training program based on dance on depression, sleep quality, and quality of life in older adults with mild cognitive impairment. (2) Methods: This study employed a randomized controlled trial design with a total of 92 older adults with cognitive impairment, randomly assigned to an experimental group (n = 47) undergoing dance-based aerobic training and a control group (n = 45) who did not receive any intervention. Depression was assessed using the Yesavage Geriatric Depression Scale, sleep quality through the Pittsburgh Sleep Quality Index (PSQI), and quality of life through the SF-36 questionnaire. (3) Results: Statistically significant improvements were observed in depression (t(46) = 4.783, p = 0.000) and in the PSQI domains: subjective sleep quality (t(46) = 3.333, p = 0.002, and Cohen’s d = 0.35), sleep duration (t(46) = 5.511, p = 0.000, and Cohen’s d = 0.73) and PSQI total score (t(46) = 2.116, p = 0.040, and Cohen’s d = 0.20). Regarding quality of life, improvements were observed in all domains of the questionnaire: the general health (t(46) = −9.374, p = 0.000, and Cohen’s d = 0.03), physical function (t(46) = −9.374, p = 0.000, and Cohen’s d = 0.03), the physical role (t(46) = −5.954, p = 0.000, and Cohen’s d = 1.06), the emotional role (t(46) = −6.200, p = 0.000, and Cohen’s d = 0.80), social function (t(46) = −5.585, p = 0.000, and Cohen’s d = 0.53), physical pain, (t(46) = −9.224, p = 0.000, and Cohen’s d = 1.04), vitality (t(46) = 2.289, p = 0.027, and Cohen’s d = 1.27), mental health, (t(46) = −7.985, p = 0.000, and Cohen’s d = 1.33), the physical summary component, (t(46) = −13.532, p = 0.000, and Cohen’s d = 1.81), and in the mental summary component (t(46) = −10.6 81, p = 0.000, and Cohen’s d = 0.06); (4) Conclusions: The results of the present study showed that they suggest that a dance-based aerobic training program improves mental health and quality of life in older people with mild cognitive impairment, providing a non-pharmacological approach to improve general well-being in this population. Full article

(This article belongs to the Special Issue New Insight into Aging and Geriatric Syndromes: Clinical Updates and Perspectives)

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Flowchart of participants in this process. Full article ">Figure 2
Inter- and intra-group comparisons regarding depression. * p < 0.05; *** p < 0.001. Full article ">Figure 3
Inter- and intra-group comparisons regarding sleep quality. * p < 0.05; ** p < 0.01; *** p < 0.001. Full article ">Figure 4
Inter- and intra-group comparisons regarding general health and physical function. * p < 0.05; *** p < 0.001. Full article ">Figure 5
Inter- and intra-group comparisons regarding physical role and emotional role. * p < 0.05, *** p < 0.001. Full article ">Figure 6
Inter- and intra-group comparisons regarding social function and emotional role. ** p < 0.01; *** p < 0.001. Full article ">Figure 7
Inter- and intra-group comparisons regarding sleep quality. * p < 0.05; ** p < 0.01; *** p < 0.001. Full article ">Figure 8
Inter- and intra-group comparisons regarding sleep quality. ** p < 0.01; *** p < 0.001. Full article ">

11 pages, 573 KiB

Open AccessArticle

The Utility of Radiomorphometric Mandibular Indices on Cone Beam Computer Tomography in the Assessment of Bone Mass in Postmenopausal Women: A Cross-Sectional Study

by Ioana Ruxandra Poiană, Ramona Dobre, Silviu-Mirel Pițuru and Alexandru Bucur

J. Pers. Med. 2024, 14(8), 843; https://doi.org/10.3390/jpm14080843 - 9 Aug 2024

Abstract

Background: The present study examined the potential use of computed tomography radiomorphometric mandibular indices on cone beam CT (CBCT) for the assessment of bone density in postmenopausal women with low bone mass. Methods: We included 104 postmenopausal women who received dual-energy X-ray absorptiometry [...] Read more.

Background: The present study examined the potential use of computed tomography radiomorphometric mandibular indices on cone beam CT (CBCT) for the assessment of bone density in postmenopausal women with low bone mass. Methods: We included 104 postmenopausal women who received dual-energy X-ray absorptiometry (DXA) using a DXA scanner and mental foramen (MF) region CBCT using a NewTom VGi EVO Cone Beam 3D system. We assessed the relationships between the following DXA parameters: lumbar, femoral neck, and total hip T-scores, bone mineral density (BMD), lumbar trabecular bone score (TBS), and mandibular inferior cortical bone thickness at 4 sites. The cross-sectional images were obtained, as follows: anterior (A)—10 mm anterior from the MF; molar (M)—10 mm posterior from the MF; posterior (P)—25 mm posterior from the MF; symphysis (S)—equidistant from the centers of the right and left MF. Results: We found that A and M indices showed statistically significant moderate positive correlations with lumbar spine, femoral neck, and total hip BMD, as well as TBS. The P index demonstrated moderate positive correlations with these measurements, while the S index did not show significant correlations with BMD or TBS in postmenopausal women. Conclusions: These findings support the potential usefulness of CBCT-derived radiomorphometric mandibular indices for non-invasive bone health assessment in clinical practice. Full article

(This article belongs to the Topic Advances in Dental Health)

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13 pages, 5702 KiB

Open AccessArticle

Does Treatment of Adolescent Fractures Differ between Specialties? A Survey among Pediatric and Trauma Surgeons

by Alexander Hanke, Eva Scheerer-Harbauer, Christian Wulbrand and Clemens Memmel

J. Pers. Med. 2024, 14(8), 842; https://doi.org/10.3390/jpm14080842 - 9 Aug 2024

Abstract

From a traumatological point of view, adolescents (12–18 years) represent a special group of patients. This is due to their biomechanical characteristics being between pediatric and adult fracture types. In Germany, they are treated by both pediatric and trauma surgeons. For this survey, [...] Read more.

From a traumatological point of view, adolescents (12–18 years) represent a special group of patients. This is due to their biomechanical characteristics being between pediatric and adult fracture types. In Germany, they are treated by both pediatric and trauma surgeons. For this survey, seven cases of adolescent fractures were evaluated by both pediatric and trauma surgeons and their preferred treatment options were raised. The questionnaires were completed anonymously. Additionally, information on the specialty and years of experience were asked. In total, 126 valid questionnaires were obtained (from 78 pediatric and 48 trauma surgeons). The respondents’ mean clinical experience was high (71.5% stated more than 10 years of surgical experience). For every single exemplary case, a significant difference in therapy decisions between the groups could be found. For the demonstrated seven cases, a tendency toward more operative and more invasive treatments was found with trauma surgeons compared to pediatric surgeons. On the other hand, there was a risk of underestimating the severity of fracture entities similar to adult fractures in pediatric surgeons. Overall, a continuous interdisciplinary exchange between both surgical specialties is necessary to ensure optimal treatment for adolescent fractures and to develop guidelines in the future. Full article

(This article belongs to the Special Issue Personalized Management in Orthopedics and Traumatology)

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(a) Anterior–posterior and (b) lateral X-rays of a proximal subcapital humeral fracture (f, 13 y, 150 cm, 48 kg). (c) Descriptive data of the survey results, indicated in percentages. Full article ">Figure 2
(a) Anterior–posterior and (b) lateral X-rays of a distal lower leg fracture (m, 15 y, 170 cm, 60 kg). Descriptive data of the survey results for the (c) distal tibia and (d) fibula, indicated in percentages. Full article ">Figure 3
(a) Anterior–posterior X-ray of a dislocated clavicle shaft fracture (m, 13 y, 160 cm, 40 kg). (b) Descriptive data of the survey results, indicated in percentages. Full article ">Figure 4
(a) X-ray of a multifragmentary femoral fracture (f, 17 y, 165 cm, 55 kg). (b) Descriptive data of the survey results, indicated in percentage. Full article ">Figure 5
(a) Anterior–posterior and (b) lateral X-rays of a dislocated forearm shaft fracture (f, 14 y, 155 cm, 45 kg). (c) Descriptive data of the survey results, indicated in percentages. Full article ">Figure 6
(a) Anterior–posterior and (b) lateral X-rays of a distal radial fracture with concomitant non-dislocated fracture of the styloid process of the distal ulna (m, 17 y, 185 cm, 85 kg). (c) Descriptive data of the survey results, indicated in percentages. Full article ">Figure 7
(a,b) X-rays and (c–f) representative CT layers of a bimalleolar fracture with concomitant a Tillaux fracture and free joint body (m, 14 y, 175 cm, 55 kg). (g–j) Descriptive data of the survey results, indicated in percentages. Full article ">

16 pages, 841 KiB

Open AccessArticle

Innovative Implementation Strategies for Familial Hypercholesterolemia Cascade Testing: The Impact of Genetic Counseling

by Kelly M. Morgan, Gemme Campbell-Salome, Nicole L. Walters, Megan N. Betts, Andrew Brangan, Alicia Johns, H. Lester Kirchner, Zoe Lindsey-Mills, Mary P. McGowan, Eric P. Tricou, Alanna Kulchak Rahm, Amy C. Sturm and Laney K. Jones

J. Pers. Med. 2024, 14(8), 841; https://doi.org/10.3390/jpm14080841 - 9 Aug 2024

Abstract

The IMPACT-FH study implemented strategies (packet, chatbot, direct contact) to promote family member cascade testing for familial hypercholesterolemia (FH). We evaluated the impact of genetic counseling (GC) on medical outcomes, strategy selection, and cascade testing. Probands (i.e., patients with FH) were recommended to [...] Read more.

The IMPACT-FH study implemented strategies (packet, chatbot, direct contact) to promote family member cascade testing for familial hypercholesterolemia (FH). We evaluated the impact of genetic counseling (GC) on medical outcomes, strategy selection, and cascade testing. Probands (i.e., patients with FH) were recommended to complete GC and select sharing strategies. Comparisons were performed for both medical outcomes and strategy selection between probands with or without GC. GEE models for Poisson regression were used to examine the relationship between proband GC completion and first-degree relative (FDR) cascade testing. Overall, 46.3% (81/175) of probands completed GC. Probands with GC had a median LDL-C reduction of −13.0 mg/dL (−61.0, 4.0) versus −1.0 mg/dL (−16.0, 17.0) in probands without GC (p = 0.0054). Probands with and without GC selected sharing strategies for 65.3% and 40.3% of FDRs, respectively (p < 0.0001). Similarly, 27.1% of FDRs of probands with GC completed cascade testing, while 12.0% of FDRs of probands without GC completed testing (p = 0.0043). Direct contact was selected for 47 relatives in total and completed for 39, leading to the detection of 18 relatives with FH. Proband GC was associated with improved medical outcomes and increased FDR cascade testing. Direct contact effectively identified FH cases for the subset who participated. Full article

(This article belongs to the Section Epidemiology)

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11 pages, 914 KiB

Open AccessArticle

Intraoperative Iris Behavior during Phacoemulsification Maneuvers in Rabbits Treated with Selective α1-Blocker, 5α-Reductase Inhibitor, or Anxiolytic Medication

by Karin Ursula Horvath, Florina Vultur, Septimiu Voidazan, Valentin Simon and Alexandra Cristina Rusu

J. Pers. Med. 2024, 14(8), 840; https://doi.org/10.3390/jpm14080840 - 9 Aug 2024

Abstract

This prospective, experimental study aims to evaluate the association between administration of α-blocker, 5α-reductase inhibitor, or anxiolytic medications and intraoperative floppy iris syndrome (IFIS) using a rabbit animal model. A total of 31 Metis rabbits were distributed into four groups as follows: 10 [...] Read more.

This prospective, experimental study aims to evaluate the association between administration of α-blocker, 5α-reductase inhibitor, or anxiolytic medications and intraoperative floppy iris syndrome (IFIS) using a rabbit animal model. A total of 31 Metis rabbits were distributed into four groups as follows: 10 rabbits given tamsulosin, 10 rabbits given finasteride, 5 rabbits who received lorazepam, and 6 treatment-naive animals in the control group. Dosing was calculated according to body surface area ratio of man to rabbit, with a dosing duration of 43 days for all groups. Phacoemulsification maneuvers were performed by a single surgeon, who was blinded to group allocation. Any intraoperative billowing of the iris was noted and subsequently graded from 0 to 3. Higher incidences of iris billowing were found in the tamsulosin-dosed animals [OR = 8.33 (CI 95% 0.63–110.09)], (p = 0.13), the finasteride group [OR = 11.6 (CI 95% 0.92–147.6)], (p = 0.11), and the lorazepam group [OR = 7.5 (CI 95% 0.45–122.8)], (p = 0.24), as opposed to the control. Administration of α-blocker tamsulosin, 5α-reductase inhibitor finasteride, or anxiolytic medication lorazepam induces altered intraoperative iris behavior. These results correspond with previous studies and further solidify the hypothesis that systemic medication, administered both long and short-term, influences surgical parameters in cataract surgery. The present study can become the basis for further clinical or experimental research. Full article

(This article belongs to the Section Evidence Based Medicine)

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14 pages, 2199 KiB

Open AccessArticle

Is There a Link between Chronic Obstructive Pulmonary Disease and Lung Adenocarcinoma? A Clinico-Pathological and Molecular Study

by Francesca Lunardi, Giorgia Nardo, Elisabetta Lazzarini, Sofia-Eleni Tzorakoleftheraki, Giovanni Maria Comacchio, Eugenio Fonzi, Michela Tebaldi, Luca Vedovelli, Federica Pezzuto, Francesco Fortarezza, Marco Schiavon, Federico Rea, Stefano Indraccolo and Fiorella Calabrese

J. Pers. Med. 2024, 14(8), 839; https://doi.org/10.3390/jpm14080839 - 8 Aug 2024

Abstract

Chronic Obstructive Pulmonary Disease (COPD) and lung cancer are strictly related. To date, it is unknown if COPD-associated cancers are different from the tumors of non-COPD patients. The main goal of the study was to compare the morphological/molecular profiles of lung adenocarcinoma (LUAD) [...] Read more.

Chronic Obstructive Pulmonary Disease (COPD) and lung cancer are strictly related. To date, it is unknown if COPD-associated cancers are different from the tumors of non-COPD patients. The main goal of the study was to compare the morphological/molecular profiles of lung adenocarcinoma (LUAD) samples of COPD, non-COPD/smokers and non-COPD/non-smokers, and to investigate if a genetic instability also characterized non-pathological areas. This study included 110 patients undergoing surgery for a LUAD, divided into three groups: COPD/smoker LUAD (38), non-COPD/smoker LUAD (54) and non-COPD/non-smoker LUAD (18). The tissue samples were systemically evaluated by pathologists and analyzed using a 30-gene Next Generation Sequencing (NGS) panel. In a subset of patients, tissues taken far from the neoplasia were also included. The non-COPD/smoker LUAD were characterized by a higher proliferative index (p = 0.001), while the non-COPD/non-smoker LUAD showed higher percentages of lepidic pattern (p = 0.008), lower necrosis, higher fibrosis, and a significantly lower mutation rate in the KRAS and PIK3CA genes. Interestingly, the same gene mutations were found in pathological and normal areas exclusively in the COPD/smokers and non-COPD/smokers. COPD/smoker LUAD seem to be similar to non-COPD/smoker LUAD, particularly for the genetic background. A less aggressive cancer phenotype was confirmed in non-COPD/non-smokers. The genetic alterations detected in normal lungs from smokers with and without COPD reinforce the importance of screening to detect early neoplastic lesions. Full article

(This article belongs to the Special Issue Pathology and Molecular Diagnostics in the Personalized Treatment of Lung Diseases)

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CONSORT diagram. Abbreviations: LUAD: lung adenocarcinoma; COPD: chronic obstructive pulmonary disease; pts: patients. Full article ">Figure 2
Explanatory images of a non-COPD/non-smoker LUAD and a non-COPD/smoker LUAD. Explanatory images showing a non-COPD/non-smoker LUAD with a lepidic pattern ((A), hematoxylin and eosin, scale bar: 300 µm) and a low proliferative index ((B), Ki67 immunostaining, scale bar: 300 µm). In contrast, a LUAD with solid pattern ((C), hematoxylin and eosin, scale bar: 300 µm) with a high proliferative index ((D), Ki67 immunostaining, scale bar: 300 µm) was detected in a non-COPD/smoker patient. Full article ">Figure 3
Histogram showing mutated genes in the three study groups. COPD (N = 38), smokers without COPD (N = 54) and non-smokers (N = 18) are represented by filled, light-gray and dark-gray columns, respectively. Genes on the x axis have been ordered according to their mutation rate in the COPD population. Full article ">Figure 4
Boruta feature selection output. Important features are marked in green while non-important features are in red. This process was repeated five times and only variables identified in all the five processes were retained. Along with genes, we allowed the algorithm to consider deamination weight, filtered total variants and possible deamination to assess a possible bias in our filtering. Full article ">

13 pages, 1049 KiB

Open AccessArticle

Impact of Vaginal Dilator Use and 68 Gy EQD2_(α/β=3) Dose Constraint on Vaginal Complications in External Beam Irradiation Followed by Brachytherapy in Post-Operative Endometrial Cancer

by Faegheh Noorian, Rosa Abellana, Yaowen Zhang, Antonio Herreros, Valentina Lancellotta, Luca Tagliaferri, Sebastià Sabater, Aureli Torne, Eduard Agusti-Camprubi and Angeles Rovirosa

J. Pers. Med. 2024, 14(8), 838; https://doi.org/10.3390/jpm14080838 - 8 Aug 2024

Abstract

Background: This study evaluated the clinical outcomes of applying a 68 Gy EQD2_(α/β=3) dose constraint to the most exposed 2 cm³ area of the vagina in post-operative endometrial cancer patients treated with vaginal-cuff brachytherapy after external beam irradiation and the impact [...] Read more.

Background: This study evaluated the clinical outcomes of applying a 68 Gy EQD2_(α/β=3) dose constraint to the most exposed 2 cm³ area of the vagina in post-operative endometrial cancer patients treated with vaginal-cuff brachytherapy after external beam irradiation and the impact of vaginal dilator use on late vaginal complications. Material and methods: We analyzed 131 patients treated with vaginal-cuff brachytherapy after external beam irradiation. Group-1 (65 patients) received one fraction of 7 Gy, and Group-2 (66 patients) received one fraction of between 5.5 and 7.0 Gy after applying a 68 Gy EQD2_(α/β=3) dose constraint. Vaginal-cuff relapse, late toxicity, clinical target volume, vaginal dilator use, D90, and EQD2_(α/β=3) at 2 cm³ of the most exposed part of the clinical target volume were evaluated. Descriptive analysis, the chi-squared test, Student’s t-test, and the Cox proportional and Kaplan–Meier models were used for the statistical analysis. Results: With a median follow-up of 60 months, the vaginal-cuff relapse rate was 1/131 (0.8%). Late vaginal complications appeared in 36/65 (55.4%) Group-1 patients and 17/66 (25.8%) Group-2 patients (p = 0.003). Multivariate analysis showed that belonging to Group-1 and vaginal dilator use of <9 months were independent prognostic factors of late vaginal complications with hazard ratios of 1.99 (p = 0.021) and 3.07 (p = 0.010), respectively. Conclusions: A 68 Gy EQD2_(α/β=3) constraint at 2 cm³ of clinical target volume and vaginal dilator use of ≥9 months were independent prognostic factors, having protective effects on late vaginal complications. Full article

(This article belongs to the Special Issue Obstetrics and Gynecology and Women's Health—2nd Edition)

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11 pages, 2392 KiB

Open AccessPerspective

Clinical Implementation of Tissue-Sparing Posterior Cervical Fusion: Addressing Market Access Challenges

by Morgan P. Lorio, Pierce D. Nunley, Joshua E. Heller, Bruce M. McCormack, Kai-Uwe Lewandrowski and Jon E. Block

J. Pers. Med. 2024, 14(8), 837; https://doi.org/10.3390/jpm14080837 - 7 Aug 2024

Abstract

Background: The traditional open midline posterior cervical spine fusion procedure has several shortcomings. It can cause soft tissue damage, muscle atrophy, compromise of the lateral masses and painful prominent posterior cervical instrumentation or spinous process if there is dehiscence of the fascia. Additionally, [...] Read more.

Background: The traditional open midline posterior cervical spine fusion procedure has several shortcomings. It can cause soft tissue damage, muscle atrophy, compromise of the lateral masses and painful prominent posterior cervical instrumentation or spinous process if there is dehiscence of the fascia. Additionally, patients frequently experience the rapid development of adjacent segment disease, which can result in the reemergence of debilitating pain and functional impairment. Clinical relevance: Tissue-sparing posterior cervical fusion is an alternative method for treating patients with symptomatic cervical degenerative disc disease. However, widespread clinical adoption has been challenged by ambiguity, misunderstandings and misinterpretations regarding appropriate procedural reimbursement coding. Technological advancement: The tissue-sparing posterior cervical fusion procedure was approved by the US Food and Drug Administration (FDA) in 2018 (CORUS™ Spinal System and CAVUX^® Facet Fixation System (CORUS/CAVUX); Providence™ Medical Technology). This technique addresses the concerns with traditional spine fusion methods by achieving the stability and outcomes of posterior cervical fusion without the morbidity associated with significant muscle stripping in the traditional approach. This technology uses specialized implants and instrumentation to perform all of the steps required to facilitate bone fusion and provide stability while minimizing tissue disruption. The technique involves extensive bone preparation for fusion and placement of specialized stabilization implants that span the facet joint, promoting natural bone growth and fusion while reducing the need for extensive exposure. This procedure provides an effective, less invasive solution for patients with cervical degenerative disc disease. Reimbursement and coding clarity: The article provides a comprehensive rationale for appropriate reimbursement coding for tissue-sparing posterior cervical fusion. This is a critical aspect for the adoption and accessibility of medical technologies. This information is crucial for practitioners and healthcare administrators, ensuring that innovative procedures are accurately coded and reimbursed. Procedural details and clinical evidence: By detailing the procedural steps, instruments used and the physiological basis for the procedure, this article serves as a valuable educational resource for spine surgeons and payers to appropriately code for this procedure. Conclusions: The description of work for CORUS/CAVUX is equivalent to the current surgical standard of lateral mass screw fixation with decortication and onlay posterior grafting to facilitate posterior fusion. Thus, it is recommended that CPT codes 22600/22840 be used, as they best reflect the surgical approach, instrumentation, decortication, posterior cervical fusion and bone grafting procedures. Full article

(This article belongs to the Special Issue Personalized Approaches to Spine Surgery: Innovations and Future Directions)

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Shown are the CORUS/CAVUX surgical steps: (a) minimally invasive posterior access to the cervical spine docking the access chisel at the facet joint complex, (b) decortication of the lateral mass with the trephine decorticator, (c) removal of the facet capsule and decortication of the articular surfaces with the rasp decorticator, (d) application of the rotatory decorticator, (e) delivery of the CAVUX cage, (f) delivery of the ALLY® bone screw, (g) bone graft placement with the bone graft applicator and (h) oblique view of the posterior cervical spine with bridging bone indicating successful fusion. Full article ">Figure 2
The tissue-sparing posterior cervical fusion procedure involves the implantation of the (a) CORUS™ PCSS, an integrated construct comprising a cage and two fixation screws, (b) placed bilaterally through a posterior surgical approach, (c) spanning the interspace and including additional screw fixation points at each end of the construct to provide trans-facet stabilization. Full article ">Figure 3
Shown are (a) the sagittal view two years after 3-level posterior cervical fusion demonstrating abundant ossification and bridging trabecular bone across the C3/4, C4/5 and C5/6 facet joints confirmed by multiplanar computed tomography scan and (b) a tri-force of fixation and support that leverages the stability of the anterior implant coupled with inter-facet cages to create three points of fixation for fusion of the anterior and posterior columns. Full article ">

12 pages, 1366 KiB

Open AccessArticle

Whole-Body Cryostimulation: An Effective Complementary Treatment in Fibromyalgia? A Follow Up Study

by Federica Verme, Neža Majdič, Giuseppe Modaffari, Angelo Alito, Alessandra Scarpa, Paolo Piterà, Amelia Brunani, Jacopo Maria Fontana and Paolo Capodaglio

J. Pers. Med. 2024, 14(8), 836; https://doi.org/10.3390/jpm14080836 - 7 Aug 2024

Abstract

Recent evidence suggests that whole-body cryostimulation (WBC) may be beneficial for patients with fibromyalgia (FM), but little is known about the duration of such effects. The purpose of this study was to verify the duration of clinical–functional benefits after one cycle of WBC. [...] Read more.

Recent evidence suggests that whole-body cryostimulation (WBC) may be beneficial for patients with fibromyalgia (FM), but little is known about the duration of such effects. The purpose of this study was to verify the duration of clinical–functional benefits after one cycle of WBC. We conducted a follow-up study on the medium and long-term effects of WBC on well-being, use of pain-relieving/anti-inflammatory medications, pain level, fatigue, sleep quality, and psychological aspects such as mood and anxiety. Twelve months after discharge, we administered a 10 min follow-up telephone interview with FM patients with obesity who had undergone ten 2 min WBC sessions at −110 °C as part of a multidisciplinary rehabilitation program (n = 23) and with patients who had undergone rehabilitation alone (n = 23). Both groups reported positive changes after the rehabilitation program, and similar results regarding fatigue, mood, and anxiety scores; however, the implementation of ten sessions of WBC over two weeks produced additional benefits in pain, general well-being status, and sleep quality with beneficial effects lasting 3–4 months. Therefore, our findings suggest that adding WBC to a rehabilitation program could exert stronger positive effects to improve key aspects of FM such as general well-being, pain level, and sleep quality. Full article

(This article belongs to the Special Issue Cold Perspectives: Advancements and Applications of Cryotherapy in Clinical Settings)

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9 pages, 1220 KiB

Open AccessArticle

Efficacy and Safety of Urethral Catheter with Continuous Infusion of Ropivacaine after Urologic Surgery: A Pilot Prospective Randomized Controlled Trial

by Kwang Taek Kim, Myungsun Shim, Kookjin Huh, Sang Hoon Song, Young Jun Uhm, Il Tae Son, Kyung Jin Chung, Dae-Kyung Kwak, Yi Hwa Choi and Hwanik Kim

J. Pers. Med. 2024, 14(8), 835; https://doi.org/10.3390/jpm14080835 - 6 Aug 2024

Abstract

Background: Catheter-related bladder discomfort (CRBD) has been found in many patients with urologic surgery. The authors investigated the effect of analgesic-eluting urethral catheters on postoperative CRBD. Methods: 60 subjects scheduled for urologic surgery requiring urethral catheterization were randomized prospectively to one of three [...] Read more.

Background: Catheter-related bladder discomfort (CRBD) has been found in many patients with urologic surgery. The authors investigated the effect of analgesic-eluting urethral catheters on postoperative CRBD. Methods: 60 subjects scheduled for urologic surgery requiring urethral catheterization were randomized prospectively to one of three groups (control arm, 0.5% ropivacaine 1 mL/h arm [Study 1 arm] and 0.5% ropivacaine 2 mL/h arm [Study 2 arm]; n = 20 each). The incidence and severity of CRBD were evaluated postoperatively at 24 h as primary outcomes. The incidence of adverse events regarding urethral catheter utilization was assessed as a secondary outcome. Results: The CRBD incidence at 24 h postoperatively in the control, study 1 and study 2 arms was 50.0%, 10.0%, and 15.0%, respectively (p = 0.002). The CRBD severity at 24 h postoperatively showed that patients in the study 1 and study 2 arms had significantly less postoperative CRBD than those in the control arm (visual analog score [VAS]; the mean VAS of the control, study 1, and study 2 arms: 2.1 vs. 1.6 vs. 0.9, p = 0.045). Urethral pain regarding catheter was significantly less severe in the study arms than in the control (VAS score: 6.2 vs. 1.5 vs. 1.4, p < 0.001). The severity and incidence of adverse events did not differ significantly among groups (p = 0.287). Peri-catheter leakage was more frequent in the study 2 arm (p = 0.057). Conclusion: The proper usage of a ropivacaine-eluting catheter can not only alleviate CRBD but reduce catheter-related urethral pain in patients with urologic surgery followed by catheterization, without major adverse events. Full article

(This article belongs to the Section Clinical Medicine, Cell, and Organism Physiology)

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11 pages, 7623 KiB

Open AccessFeature PaperArticle

Comparing Optical Coherence Tomography Angiography Metrics in Healthy Chinese and Caucasian Adults

by Inna Bujor, Jacqueline Chua, Bingyao Tan, Raluca Iancu, Ruxandra Pirvulescu, Aida Geamanu, Mihai Bostan, Eduard Toma, Diana Ionescu, Leopold Schmetterer and Alina Popa-Cherecheanu

J. Pers. Med. 2024, 14(8), 834; https://doi.org/10.3390/jpm14080834 - 6 Aug 2024

Abstract

Background: The goal of the present study was to identify differences in retinal microvasculature between healthy Caucasians and healthy Asians in order to provide a better understanding of the variability between different ethnic groups. Methods: In this cross-sectional study, 191 healthy Chinese and [...] Read more.

Background: The goal of the present study was to identify differences in retinal microvasculature between healthy Caucasians and healthy Asians in order to provide a better understanding of the variability between different ethnic groups. Methods: In this cross-sectional study, 191 healthy Chinese and Caucasian participants were enrolled. They underwent optical coherence tomography angiography (OCTA) scans with Zeiss Cirrus HD-5000 Spectral-Domain with AngioPlex. Linear regression models were used to investigate the association of OCTA metrics with potential risk factors. Results: Whereas participants in both groups are comparable in age and sex, Chinese participants had a longer axial length, higher spherical equivalent, higher intraocular pressure (p < 0.001), and a significantly higher perfusion density of large vessels in the superficial capillary plexus (p < 0.001). Regarding the foveolar avascular area (FAZ), Chinese participants had a larger superficial FAZ, a wider superficial FAZ perimeter, and a more circular deep FAZ shape (p < 0.001). Conclusions: There are significant differences in the retinal vasculature between Caucasian and Asian eyes as measured using OCTA. This needs to be considered when developing normative databases. Whether such findings relate to inter-racial differences in the incidence of retinal vascular disease remains to be shown. Full article

(This article belongs to the Special Issue Retinal Diseases: Mechanisms, Diagnosis and Treatments)

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The framework of optical coherence tomography angiography (OCTA) image post-processing. (A–C) Raw OCTA images extracted from the OCTA machine. (D) Large vessels (LVs) segmented and binarized from the superficial capillary plexus. (E,F) Foveal avascular zones (FAZs) manually delineated from the superficial and deep capillary plexuses. (G) Choriocapillaris flow deficits (FDs) binarized from the OCTA image. Large vessel artefacts were masked prior to binarization. (H,I) Vessels binarized from the superficial and deep capillary plexuses. FAZ regions were masked from the binarized images. (J) A magnification-corrected fovea-centered annulus mask with an inner diameter of 1.0 mm and an outer diameter of 2.5 mm. (K) Binarized choriocapillaris FDs overlaid with annulus mask to perform regional quantification of FDs. (L–O) Binarized vascular images overlaid with an annulus mask to perform regional quantification of perfusion density (PD). Full article ">Figure 2
Optical coherence tomography angiography (OCTA) images of a healthy Chinese participant (A–C) and healthy Caucasian participant (D–F) of the superficial capillary plexus (SCP; (A,D)), deep capillary plexus (DCP; (B,E)), and choriocapillaris (CC; (C,F)). The eye of the Chinese participant demonstrated significantly higher SCP (42% vs. 40%), a larger superficial FAZ area (0.60 mm2 vs. 0.37 mm2), wider superficial FAZ perimeter (3.0 mm vs. 2.6 mm), more circular deep FAZ (1.09 vs. 1.11), and higher CC FD density (17% vs. 15%) compared to the Caucasian participant. Full article ">

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