Journal of Personalized Medicine最新文献

(1) Background: This study investigates the tumor immune microenvironment, focusing on immune cell distribution in lung adenocarcinoma. (2) Methods: We evaluated fifty cases of lung adenocarcinoma, and suitable areas for further studies were annotated on the histological slides. Two tumor cores per case were obtained, one from the tumor's center and another from its periphery, and introduced into three paraffin receptor blocks for optimized processing efficiency. The 4-micrometer-thick tissue microarray sections were stained for H&E and for CD68, CD163, CD8, CD4, and PD-L1; (3) Results: Our investigation revealed significant correlations between PD-L1 expression in tumor cells and the presence of CD163+ macrophages, between CD4+ cells and CD8+, CD68+, and CD163+ cells, and also between CD8+ T cells and CD163+ cells. Additionally, while we observed some differences in cellular components and densities between the tumor center and periphery, these differences were not statistically significant. However, distinct correlations between PD-L1 and immune cells in these regions were identified, suggesting spatial heterogeneity in the immune landscape. (4) Conclusions: These results emphasize the intricate interactions between immune cells and tumor cells in lung adenocarcinoma. Understanding patient spatial immune profile could improve patient selection for immunotherapy, ensuring that those most likely to benefit are identified.

The AI-MIRACLE Study investigates the efficacy of using ChatGPT 4.0, a large language model (LLM), for translating and simplifying radiology reports into multiple languages, aimed at enhancing patient comprehension. The study assesses the model's performance across the most spoken languages in the U.S., emphasizing the accuracy and clarity of translated and simplified radiology reports for non-medical readers. This study employed ChatGPT 4.0 to translate and simplify selected radiology reports into Vietnamese, Tagalog, Spanish, Mandarin, and Arabic. Hindi was used as a preliminary test language for validation of the questionnaire. Performance was assessed via Google form surveys distributed to bilingual physicians, which assessed the translation accuracy and clarity of simplified texts provided by ChatGPT 4. Responses from 24 participants showed mixed results. The study underscores the model's varying success across different languages, emphasizing both potential applications and limitations. ChatGPT 4.0 shows promise in breaking down language barriers in healthcare settings, enhancing patient comprehension of complex medical information. However, the performance is inconsistent across languages, indicating a need for further refinement and more inclusive training of AI models to handle diverse medical contexts and languages. The study highlights the role of LLMs in improving healthcare communication and patient comprehension, while indicating the need for continued advancements in AI technology, particularly in the translation of low-resource languages.

Background: The aim of this study was to understand how neurological development of preterm infants can be predicted at earlier stages and explore the possibility of applying personalized approaches.

Methods: Our study included a cohort of 64 preterm infants, between 24 and 34 weeks of gestation. Linear and nonlinear models were used to evaluate feature predictability to Bayley outcomes at the corrected age of 2 years. The outcomes were classified into motor, language, cognitive, and socio-emotional categories. Pediatricians' opinions about the predictability of the same features were compared with machine learning.

Results: According to our linear analysis sepsis, brain MRI findings and Apgar score at 5th minute were predictive for cognitive, Amiel-Tison neurological assessment at 12 months of corrected age for motor, while sepsis was predictive for socio-emotional outcome. None of the features were predictive for language outcome. Based on the machine learning analysis, sepsis was the key predictor for cognitive and motor outcome. For language outcome, gestational age, duration of hospitalization, and Apgar score at 5th minute were predictive, while for socio-emotional, gestational age, sepsis, and duration of hospitalization were predictive. Pediatricians' opinions were that cardiopulmonary resuscitation is the key predictor for cognitive, motor, and socio-emotional, but gestational age for language outcome.

Conclusions: The application of machine learning in predicting neurodevelopmental outcomes of preterm infants represents a significant advancement in neonatal care. The integration of machine learning models with clinical workflows requires ongoing education and collaboration between data scientists and healthcare professionals to ensure the models' practical applicability and interpretability.

Introduction: This study aimed to evaluate the efficacy of mindfulness therapy compared to traditional physiotherapy and usual care in alleviating postoperative pain and improving functional outcomes in patients undergoing lumbar spine surgery during the COVID-19 pandemic.

Methods: Ninety patients undergoing lumbar decompression and fusion (LDF) who presented persistent low back pain after surgery were prospectively followed for one year. They were randomly divided into three groups: mindfulness therapy, physiotherapy, and medical therapy. The primary outcome was the improvement of the Oswestry Disability Index (ODI) score postoperatively and at six months follow-up.

Results: Both mindfulness and physiotherapy groups showed significant improvement in ODI scores compared to the control group, with mean variations of 10.6 and 11.6 points, respectively, versus 4.9 points in the control group. There was no significant difference between mindfulness and physiotherapy (p = 0.52), but both were superior to medical care (p < 0.0001 for physiotherapy and p = 0.0007 for mindfulness).

Conclusions: This study demonstrated that mindfulness therapy is more effective than usual care in improving postoperative outcomes for patients undergoing lumbar spine surgery. In our cohort, its efficacy was comparable to that of physiotherapy, making it a viable alternative, especially when access to healthcare services is restricted, as seen during the COVID-19 pandemic. Future research should validate the findings of this study and examine the long-term effects on surgical patient populations.

Objective: This randomized, single-blind controlled study aimed to investigate the QoL and satisfaction of patients wearing complete dentures with lingualized (LO) and bilaterally balanced occlusion (BBO). Participants were stratified based on their prior experience with complete dentures.

Methods: The study involved 131 complete denture wearers who were categorized into four groups: G1-first-time prosthesis wearers treated with LO (n = 33); G2-first-time prosthesis wearers treated with BBO (n = 31); G3-participants with prior prosthesis experience treated with LO (n = 34); G4-participants with prior prosthesis experience treated with BBO (n = 33). After wearing the prosthesis for one month, all participants completed the Oral Health Impact Profile (OHIP-14) questionnaire. A statistical analysis was conducted using the χ² test, Kruskal-Wallis analysis and Mann-Whitney test, with significance determined at p < 0.05.

Results: After dividing the respondents into two groups, a statistically significant difference was observed in the distribution of scores for three questions related to oral pain severity, anxiety, and difficulty relaxing. However, the distribution of scores for all other questions did not show a statistically significant difference between the groups studied (p < 0.05). The total OHIP-14 score was also not statistically different (z = 0.469; p = 0.639). However, when respondents were divided into four groups, the median score for first-time denture wearers was 3.9 points higher in respondents who received dentures with BBO compared to those with LO (p < 0.001). Furthermore, the median score for first-time denture wearers who received BBO was higher than for those in the second group who received BBO (p = 0.013).

Conclusion: Patients wearing complete dentures for the first time demonstrated significantly higher satisfaction with the LO scheme compared to the BBO scheme. In contrast, satisfaction levels between occlusal schemes did not significantly differ among patients with prior denture-wearing experience. Novice denture wearers reported heightened sensations of oral discomfort, anxiety, and difficulty relaxing regardless of the occlusal scheme compared to experienced wearers, likely due to the unrealistic expectations that first-time wearers often have about complete dentures.

This study aimed to retrospectively analyze the follow-up results of cases in which the adjacent joint was preserved using a custom-made uncemented short-stem design (hollow stem) with optional external flanches in tumor endoprosthetic replacement due to bone sarcomas in 13 patients (with an average age of 9.6 years) between 2017 and 2023. Reconstructions were proximal femur (n = 6), intercalary femur (n = 4), intercalary tibia (n = 2), and proximal humerus (n = 1) tumor prostheses. The hollow body was used distally in 10 of the megaprotheses, proximally in 1, and both proximally and distally in 2 of them. The average distance from the joints was 6 cm in stems with flanches and 11.8 cm in stems without flanches. No aseptic loosening or deep infection was observed during an average follow-up of 34 months. Except for one case with a tibial intercalary prosthesis that needed a revision, all cases were well osteointegrated and all lower extremity cases could bear full weight without pain. In cases where the remaining bone stock after bone resection is insufficient for a standard stem implantation, reconstruction with a patient-specific short hollow-stem design appears to be a good alternative to protect healthy joints with high prosthesis survival and low revision rates in the short-term follow-up.

Background: Colorectal cancer peritoneal carcinomatosis (CRC PC) necessitates preoperative assessment of inflammatory markers to predict postoperative outcomes and guide treatment. This study aims to evaluate the prognostic value of preoperative Neutrophil-Lymphocyte Ratio (NLR), Platelet-Lymphocyte Ratio (PLR), and Mean Platelet Volume (MPV) in predicting complications for CRC PC patients undergoing surgery.

Methods: Calculating NLR, PLR, and MPV from patient data: NLR = absolute neutrophil count/total lymphocyte count, PLR = total lymphocyte count/total platelet count × 100, and MPV = platelet crit (PCT)/total platelet count.

Result: The study included 196 CRC PC patients and found significant relationships between these markers and overall survival (OS). Patients with an NLR of 3.77 had a median OS of 22.1 months, compared to 58.3 months for those with lower NLR (HR 2.7, 95% CI 1.1-5.3, p < 0.001).

Conclusions: For CRC PC patients undergoing CRS+HIPEC, preoperative assessment of NLR, PLR, and MPV can serve as independent prognostic markers for OS. Incorporating these markers into preoperative evaluations may improve patient selection and outcome prediction.

Background: Endometriosis and uterine fibroids are benign conditions frequently linked to subfertility/infertility. Recent research has highlighted the importance of epithelial-mesenchymal transition between embryonic and endometrial cells in the context of embryo implantation. Additionally, the adverse endometrial environment during implantation has been proposed as a mechanism contributing to infertility in endometriosis. Nevertheless, the role of cadherin molecule alterations in relation to endometrial receptivity and embryo invasion remains a subject of controversy.

Methods: We investigated the expression patterns of E-cadherin and N-cadherin in the endometria of women with ovarian endometrioma or uterine fibroids and assessed whether they differed from those of healthy women. We enrolled 17 women with ovarian endometrioma, 16 with uterine fibroids, and 6 healthy women. Endometrial tissues were obtained at the mid-secretory phase on days 19-24 of the menstrual cycle. The E-cadherin and N-cadherin mRNA and protein expression levels were measured using quantitative reverse transcriptase polymerase chain reaction and Western blot analysis, respectively.

Results: The E-cadherin and N-cadherin mRNA expression levels were higher and lower, respectively, in the endometrium of women with ovarian endometrioma than in those of the controls. In the endometrium of women with uterine fibroids, similar patterns with higher E-cadherin and lower N-cadherin levels were observed compared with that of the controls. Protein expression showed similar patterns.

Conclusions: Our findings revealed higher E-cadherin expression and lower N-cadherin expression in the endometria of women with infertility-related diseases than in those of healthy women in the mid-secretory phase. This suggests a resistance to endometrial receptivity, potentially reflecting mesenchymal-epithelial transition properties.

This study aimed to assess the effectiveness of vortioxetine for improving depressive symptoms, cognitive performance, daily and global functioning in patients with Alzheimer's disease (AD) and major depressive disorder (MDD) in real-world clinical practice. We retrospectively identified 46 AD patients who had received treatment for 12 months with vortioxetine. Drug effects were evaluated at baseline, 4, 8, and 12 months. The primary endpoint was change from baseline in the Hamilton Depression Rating Scale (HDRS) and in the Cornell Scale for Depression in Dementia (CSDD) to month 12. Cognitive and daily and global functioning changes were also evaluated. Significant baseline-to-endpoint improvement in depressive symptom severity was observed (p < 0.0001). At month 12, the least-square mean (standard error) change score from baseline was -10.48 (±0.42) on the HDRS and -9.04 (±0.62) on the CSDD. Significant improvements in cognitive performance were observed for the Rey Auditory Verbal Learning Test, the Symbol Digit Modalities Test, the Letter Fluency Test, the Category Fluency Test, and the Trail Making Test-A. Patients also experienced significant improvements in daily and global functioning. Vortioxetine was safe and well tolerated. Patients with AD and MDD receiving vortioxetine showed meaningful improvements in depressive symptoms, cognitive performance, and daily and global functioning over the 12-month treatment period.

Background: The COVID-19 pandemic has caused severe health issues worldwide and contributed to huge financial losses. Key comorbidities linked to an increased risk of severe COVID-19 and higher mortality rates include cardio-metabolic disorders such as type 1 and type 2 diabetes mellitus (T1DM and T2DM), atherosclerotic cardiovascular disease, chronic kidney disease, hypertension, heart failure, and obesity. The persistence of symptoms even after the acute phase is over is termed long COVID-19 syndrome. This study aimed to evaluate the relationship between long COVID-19 syndrome and the development of insulin resistance in previously non-diabetic patients. Methods: A prospective observational study was performed on 143 non-diabetic patients who had tested positive for SARS-CoV-2 infection by a PCR test and were hospitalized in our hospital between January 2020 and December 2022. The clinical and para-clinical data at 0, 4, and 12 months of hospital admission for post-COVID-19 infection follow-up was collected and labeled as t0, t4, and t12. Blood glucose, insulin, and C-peptide levels were measured at the beginning and further at 2, 5, 10, and 30 min after the intravenous arginine stimulation test. Similarly, BMI was calculated, and hs-CRP and ESR levels were noted. The results obtained were statistically analyzed. Results: More than one-third (30.7%) of the included patients developed long COVID-19 syndrome. It was found that 75% of patients with long COVID-19 hospitalized in our clinic developed diabetes within a year of acute infection with COVID-19; therefore, it can be said that the presence of long COVID-19 is a major risk for an altered metabolic status, which can cause diabetes. When comparing the glycemia levels (106 mg/dL) with the BMI at t0, t4, and t12 time intervals, the p-values were found to be 0.214, 0.042, and 0.058, respectively. Almost 62% of the patients having BMI > 30 kg/m² were found to have an increase in blood glucose levels at 1 year. Similarly, insulin resistance was noted during this interval. A negative correlation of 0.40 for hsCRP and 0.38 for ESR was noted when compared with acute infection with COVID-19. Conclusions: The association between long COVID-19 and insulin resistance highlights the varied and widespread impacts of SARS-CoV-2 infection. Addressing the complexities of long COVID-19 requires a holistic strategy that encompasses both respiratory and metabolic considerations, which is crucial for enhancing the well-being of those enduring this persistent condition.