Rakesh Jalali, Aleksandra Bieniecka, Marek Jankowski, Patryk Stanisław Michel, Marta Popielarczyk, Mariusz Krzysztof Majewski, Jacek Zwiernik, Joanna Maria Harazny
Background: Stroke is one of the most misdiagnosed conditions that causes serious medical disabilities. Its early and accurate diagnosis by the emergency team is crucial for the patient's survival. This study aimed to determine the percentage of brain strokes incorrectly diagnosed by paramedic teams and to analyze the factors influencing incorrect diagnoses.
Methods: The data of 103 patients, mean age of 68.4 ± 14.96 years, admitted in 2019 to hospital emergency departments of the two hospitals in Olsztyn, Poland, were analyzed retrospectively. All patient data were obtained from their information cards. The parameters of the patients misdiagnosed and accurately diagnosed by paramedics were analyzed with Odds Ratio (OR) calculations using IBM SPSS version 23 software.
Results: Stroke and transient ischemic attack were recognized in 77 cases (74.8%). In 26 patients (25.2%), the diagnosis made in the ambulance differed from that made in the hospital ward. The analysis of the Odds Ratio (OR) has shown that typical stroke risk factors, if present in a patient, facilitate the correct diagnosis. The greatest source of misdiagnosis of stroke by the paramedic team was the lack of hemiplegia (OR = 6.0).
Conclusions: The absence of typical stroke risk factors and neurological stroke symptoms, such as smoking, hemiplegia, aphasia, hypercholesterolemia, arrhythmia, diabetes or a drooping corner of the mouth, constitutes a high risk of misdiagnosing stroke by the paramedic team.
{"title":"The Absence of Typical Stroke Symptoms and Risk Factors Represents the Greatest Risk of an Incorrect Diagnosis in Stroke Patients.","authors":"Rakesh Jalali, Aleksandra Bieniecka, Marek Jankowski, Patryk Stanisław Michel, Marta Popielarczyk, Mariusz Krzysztof Majewski, Jacek Zwiernik, Joanna Maria Harazny","doi":"10.3390/jpm14090964","DOIUrl":"https://doi.org/10.3390/jpm14090964","url":null,"abstract":"<p><strong>Background: </strong>Stroke is one of the most misdiagnosed conditions that causes serious medical disabilities. Its early and accurate diagnosis by the emergency team is crucial for the patient's survival. This study aimed to determine the percentage of brain strokes incorrectly diagnosed by paramedic teams and to analyze the factors influencing incorrect diagnoses.</p><p><strong>Methods: </strong>The data of 103 patients, mean age of 68.4 ± 14.96 years, admitted in 2019 to hospital emergency departments of the two hospitals in Olsztyn, Poland, were analyzed retrospectively. All patient data were obtained from their information cards. The parameters of the patients misdiagnosed and accurately diagnosed by paramedics were analyzed with Odds Ratio (OR) calculations using IBM SPSS version 23 software.</p><p><strong>Results: </strong>Stroke and transient ischemic attack were recognized in 77 cases (74.8%). In 26 patients (25.2%), the diagnosis made in the ambulance differed from that made in the hospital ward. The analysis of the Odds Ratio (OR) has shown that typical stroke risk factors, if present in a patient, facilitate the correct diagnosis. The greatest source of misdiagnosis of stroke by the paramedic team was the lack of hemiplegia (OR = 6.0).</p><p><strong>Conclusions: </strong>The absence of typical stroke risk factors and neurological stroke symptoms, such as smoking, hemiplegia, aphasia, hypercholesterolemia, arrhythmia, diabetes or a drooping corner of the mouth, constitutes a high risk of misdiagnosing stroke by the paramedic team.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11433094/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348842","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}
Carlos Fernández Baltar, María Elena Martínez Corral, Daniel Pérez Fentes
Background: Percutaneous nephrolithotomy (PCNL) is associated with a wide range of complications. This review aims to explore how recent technological advancements and personalized medicine can help prevent or predict these complications.
Methods: A scoping review was conducted according to the PRISMA-SCR guidelines and registered on the Open Science Framework in April 2024. A literature search was performed on PUBMED, Web of Science, and Scopus databases. This review focused on predictive AI models, 3D surgical models, intrasurgical image guidance, and biomarkers. Articles meeting the following criteria were included: publication between 2019 and 2024, written in English, involving human participants, and discussing technological advancements or personalized medicine in the context of complications in PCNL.
Results: Of the 11,098 articles searched, 35 new studies were included. We identified a few articles on predictive AI models. Several studies demonstrated that 3D presurgical models and virtual models could enhance surgical planning and reduce complications. New intrasurgical image and guidance systems showed the potential in reducing bleeding and radiation exposure. Finally, several biomarkers were identified as predictors of sepsis and other complications.
Conclusion: This scoping review highlights the potential of emerging technologies in reducing and predicting PCNL complications. However, larger prospective studies are required for validation.
{"title":"Predicting and Avoiding Complications in Percutaneous Nephrolithotomy in the Era of Personalized Medicine: A Scoping Review.","authors":"Carlos Fernández Baltar, María Elena Martínez Corral, Daniel Pérez Fentes","doi":"10.3390/jpm14090962","DOIUrl":"https://doi.org/10.3390/jpm14090962","url":null,"abstract":"<p><strong>Background: </strong>Percutaneous nephrolithotomy (PCNL) is associated with a wide range of complications. This review aims to explore how recent technological advancements and personalized medicine can help prevent or predict these complications.</p><p><strong>Methods: </strong>A scoping review was conducted according to the PRISMA-SCR guidelines and registered on the Open Science Framework in April 2024. A literature search was performed on PUBMED, Web of Science, and Scopus databases. This review focused on predictive AI models, 3D surgical models, intrasurgical image guidance, and biomarkers. Articles meeting the following criteria were included: publication between 2019 and 2024, written in English, involving human participants, and discussing technological advancements or personalized medicine in the context of complications in PCNL.</p><p><strong>Results: </strong>Of the 11,098 articles searched, 35 new studies were included. We identified a few articles on predictive AI models. Several studies demonstrated that 3D presurgical models and virtual models could enhance surgical planning and reduce complications. New intrasurgical image and guidance systems showed the potential in reducing bleeding and radiation exposure. Finally, several biomarkers were identified as predictors of sepsis and other complications.</p><p><strong>Conclusion: </strong>This scoping review highlights the potential of emerging technologies in reducing and predicting PCNL complications. However, larger prospective studies are required for validation.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11432793/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348810","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}
Nunzia Balzano, Annamaria Mascolo, Raffaella Di Napoli, Federica Colapietra, Marina Di Domenico, Annalisa Capuano, Francesca Gargano
Dexmedetomidine, a selective α2-adrenergic agonist, is favoured in intensive care for its minimal respiratory depression. This study evaluated the reporting frequency of rhabdomyolysis with dexmedetomidine compared to midazolam and propofol using the European pharmacovigilance database Eudravigilance. We conducted an observational, retrospective analysis of Individual Case Safety Reports (ICSRs) from 1 January 2013, to 31 December 2023. Primary and secondary outcomes included the reporting frequencies of rhabdomyolysis and its indicative signs and symptoms, respectively. We retrieved 19,268 ICSRs, of which 364 reported rhabdomyolysis associated with dexmedetomidine (3.8%), midazolam (10.2%), propofol (76.9%), or combinations thereof (9.1%). Dexmedetomidine showed a significantly lower reporting frequency of rhabdomyolysis compared to propofol (ROR, 0.32; 95% CI, 0.19-0.55) but no significant difference compared to midazolam. Subgroup analyses revealed higher frequencies in males, especially with propofol. Despite limitations such as underreporting, our findings suggest dexmedetomidine poses a lower rhabdomyolysis risk than propofol, supporting its safe use for sedation in high-risk patients. It is important to note that due to the retrospective design of this study our findings are indicative of correlations rather than causation. Continuous monitoring and further studies are recommended to validate these results.
{"title":"Risk of Rhabdomyolysis Associated with Dexmedetomidine Use over the Past 10 Years: Insights from the EudraVigilance Database.","authors":"Nunzia Balzano, Annamaria Mascolo, Raffaella Di Napoli, Federica Colapietra, Marina Di Domenico, Annalisa Capuano, Francesca Gargano","doi":"10.3390/jpm14090961","DOIUrl":"https://doi.org/10.3390/jpm14090961","url":null,"abstract":"<p><p>Dexmedetomidine, a selective α2-adrenergic agonist, is favoured in intensive care for its minimal respiratory depression. This study evaluated the reporting frequency of rhabdomyolysis with dexmedetomidine compared to midazolam and propofol using the European pharmacovigilance database Eudravigilance. We conducted an observational, retrospective analysis of Individual Case Safety Reports (ICSRs) from 1 January 2013, to 31 December 2023. Primary and secondary outcomes included the reporting frequencies of rhabdomyolysis and its indicative signs and symptoms, respectively. We retrieved 19,268 ICSRs, of which 364 reported rhabdomyolysis associated with dexmedetomidine (3.8%), midazolam (10.2%), propofol (76.9%), or combinations thereof (9.1%). Dexmedetomidine showed a significantly lower reporting frequency of rhabdomyolysis compared to propofol (ROR, 0.32; 95% CI, 0.19-0.55) but no significant difference compared to midazolam. Subgroup analyses revealed higher frequencies in males, especially with propofol. Despite limitations such as underreporting, our findings suggest dexmedetomidine poses a lower rhabdomyolysis risk than propofol, supporting its safe use for sedation in high-risk patients. It is important to note that due to the retrospective design of this study our findings are indicative of correlations rather than causation. Continuous monitoring and further studies are recommended to validate these results.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11432986/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348828","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}
Andrea Lastrucci, Yannick Wandael, Angelo Barra, Vittorio Miele, Renzo Ricci, Lorenzo Livi, Graziano Lepri, Rosario Alfio Gulino, Giovanni Maccioni, Daniele Giansanti
(Background) Over the years, there has been increasing interest in adopting a quality approach in radiology, leading to the strategic pursuit of specific and key performance indicators (KPIs). These indicators in radiology can have significant impacts ranging from radiation protection to integration into digital healthcare. (Purpose) This study aimed to conduct a narrative review on the integration of key performance indicators (KPIs) in radiology with specific key questions. (Methods) This review utilized a standardized checklist for narrative reviews, including the ANDJ Narrative Checklist, to ensure thoroughness and consistency. Searches were performed on PubMed, Scopus, and Google Scholar using a combination of keywords related to radiology and KPIs, with Boolean logic to refine results. From an initial yield of 211 studies, 127 were excluded due to a lack of focus on KPIs. The remaining 84 studies were assessed for clarity, design, and methodology, with 26 ultimately selected for detailed review. The evaluation process involved multiple assessors to minimize bias and ensure a rigorous analysis. (Results and Discussion) This overview highlights the following: KPIs are crucial for advancing radiology by supporting the evolution of imaging technologies (e.g., CT, MRI) and integrating emerging technologies like AI and AR/VR. They ensure high standards in diagnostic accuracy, image quality, and operational efficiency, enhancing diagnostic capabilities and streamlining workflows. KPIs are vital for radiological safety, measuring adherence to protocols that minimize radiation exposure and protect patients. The effective integration of KPIs into healthcare systems requires systematic development, validation, and standardization, supported by national and international initiatives. Addressing challenges like CAD-CAM technology and home-based radiology is essential. Developing specialized KPIs for new technologies will be key to continuous improvement in patient care and radiological practices. (Conclusions) In conclusion, KPIs are essential for advancing radiology, while future research should focus on improving data access and developing specialized KPIs to address emerging challenges. Future research should focus on expanding documentation sources, improving web search methods, and establishing direct connections with scientific associations.
{"title":"Precision Metrics: A Narrative Review on Unlocking the Power of KPIs in Radiology for Enhanced Precision Medicine.","authors":"Andrea Lastrucci, Yannick Wandael, Angelo Barra, Vittorio Miele, Renzo Ricci, Lorenzo Livi, Graziano Lepri, Rosario Alfio Gulino, Giovanni Maccioni, Daniele Giansanti","doi":"10.3390/jpm14090963","DOIUrl":"https://doi.org/10.3390/jpm14090963","url":null,"abstract":"<p><p>(<i>Background</i>) Over the years, there has been increasing interest in adopting a quality approach in radiology, leading to the strategic pursuit of specific and key performance indicators (KPIs). These indicators in radiology can have significant impacts ranging from radiation protection to integration into digital healthcare. (<i>Purpose</i>) This study aimed to conduct a narrative review on the integration of key performance indicators (KPIs) in radiology with specific key questions. (<i>Methods</i>) This review utilized a standardized checklist for narrative reviews, including the ANDJ Narrative Checklist, to ensure thoroughness and consistency. Searches were performed on PubMed, Scopus, and Google Scholar using a combination of keywords related to radiology and KPIs, with Boolean logic to refine results. From an initial yield of 211 studies, 127 were excluded due to a lack of focus on KPIs. The remaining 84 studies were assessed for clarity, design, and methodology, with 26 ultimately selected for detailed review. The evaluation process involved multiple assessors to minimize bias and ensure a rigorous analysis. (<i>Results and Discussion</i>) This overview highlights the following: KPIs are crucial for advancing radiology by supporting the evolution of imaging technologies (e.g., CT, MRI) and integrating emerging technologies like AI and AR/VR. They ensure high standards in diagnostic accuracy, image quality, and operational efficiency, enhancing diagnostic capabilities and streamlining workflows. KPIs are vital for radiological safety, measuring adherence to protocols that minimize radiation exposure and protect patients. The effective integration of KPIs into healthcare systems requires systematic development, validation, and standardization, supported by national and international initiatives. Addressing challenges like CAD-CAM technology and home-based radiology is essential. Developing specialized KPIs for new technologies will be key to continuous improvement in patient care and radiological practices. (<i>Conclusions</i>) In conclusion, KPIs are essential for advancing radiology, while future research should focus on improving data access and developing specialized KPIs to address emerging challenges. Future research should focus on expanding documentation sources, improving web search methods, and establishing direct connections with scientific associations.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11433247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348809","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}
Eskezeia Y Dessie, Lili Ding, Latha Satish, Tesfaye B Mersha
Background: Atopic dermatitis (AD) is a common inflammatory skin condition with complex origins. Current treatments often yield suboptimal results due to an incomplete understanding of its underlying mechanisms. This study aimed to identify pathway and gene signatures that distinguish between lesional AD, non-lesional AD, and healthy skin.
Method: We conducted differential gene expression and co-expression network analyses to identify differentially co-expressed genes (DCEGs) in lesional AD vs. healthy skin, lesional vs. non-lesional AD, and non-lesional AD vs. healthy skin. Modules associated with lesional and non-lesional AD were identified based on the correlation coefficients between module eigengenes and clinical phenotypes (|R| ≥ 0.5, p-value < 0.05). Subsequently, we employed Ingenuity Pathway Analysis (IPA) on the identified DCEGs, followed by machine learning (ML) analysis within the pathway expression framework. The ML analysis of pathway expressions, selected by IPA and derived from gene expression data, identified relevant pathway signatures, which were validated using an independent dataset and correlated with AD severity measures (EASI and SCORAD).
Results: We identified 975, 441, and 40 DCEGs in lesional vs. healthy skin, lesional vs. non-lesional, and non-lesional vs. healthy skin, respectively. IPA and ML analyses revealed 25 relevant pathway signatures, including wound healing, glucocorticoid receptor signaling, and S100 gene family signaling pathways. Validation confirmed the significance of 10 pathway signatures, which were correlated with the AD severity measures. DCEGs such as MMP12 and S100A8 demonstrated high diagnostic efficacy (AUC > 0.70) in both the discovery and validation datasets.
Conclusions: Differential gene expression, co-expression networks and ML analyses of pathway expression have unveiled relevant pathways and gene signatures that distinguish between lesional, non-lesional, and healthy skin, providing valuable insights into AD pathogenesis.
背景:特应性皮炎(AD)是一种常见的炎症性皮肤病,病因复杂。由于对特应性皮炎的潜在机制了解不全面,目前的治疗方法往往达不到最佳效果。本研究旨在确定区分病变性 AD、非病变性 AD 和健康皮肤的通路和基因特征:我们进行了差异基因表达和共表达网络分析,以确定病变性 AD 与健康皮肤、病变性 AD 与非病变性 AD 以及非病变性 AD 与健康皮肤中的差异共表达基因(DCEGs)。根据模块基因与临床表型之间的相关系数(|R| ≥ 0.5,p 值 < 0.05),确定了与病变和非病变 AD 相关的模块。随后,我们对确定的 DCEGs 采用了 Ingenuity Pathway Analysis (IPA),然后在通路表达框架内进行了机器学习 (ML) 分析。通过对IPA选择的、来自基因表达数据的通路表达进行ML分析,确定了相关的通路特征,并通过一个独立的数据集对其进行了验证,还将其与AD严重程度测量(EASI和SCORAD)相关联:结果:我们在病变皮肤与健康皮肤、病变皮肤与非病变皮肤、非病变皮肤与健康皮肤中分别发现了 975 个、441 个和 40 个 DCEG。IPA和ML分析揭示了25个相关通路特征,包括伤口愈合、糖皮质激素受体信号传导和S100基因家族信号传导通路。验证证实了 10 个通路特征的重要性,这些通路特征与注意力缺失症的严重程度相关。在发现数据集和验证数据集中,MMP12和S100A8等DCEG都显示出很高的诊断效力(AUC > 0.70):差异基因表达、共表达网络和通路表达的ML分析揭示了区分病变、非病变和健康皮肤的相关通路和基因特征,为了解AD发病机制提供了有价值的信息。
{"title":"Co-Expression Network and Machine Learning Analysis of Transcriptomics Data Identifies Distinct Gene Signatures and Pathways in Lesional and Non-Lesional Atopic Dermatitis.","authors":"Eskezeia Y Dessie, Lili Ding, Latha Satish, Tesfaye B Mersha","doi":"10.3390/jpm14090960","DOIUrl":"https://doi.org/10.3390/jpm14090960","url":null,"abstract":"<p><strong>Background: </strong>Atopic dermatitis (AD) is a common inflammatory skin condition with complex origins. Current treatments often yield suboptimal results due to an incomplete understanding of its underlying mechanisms. This study aimed to identify pathway and gene signatures that distinguish between lesional AD, non-lesional AD, and healthy skin.</p><p><strong>Method: </strong>We conducted differential gene expression and co-expression network analyses to identify differentially co-expressed genes (DCEGs) in lesional AD vs. healthy skin, lesional vs. non-lesional AD, and non-lesional AD vs. healthy skin. Modules associated with lesional and non-lesional AD were identified based on the correlation coefficients between module eigengenes and clinical phenotypes (|R| ≥ 0.5, <i>p</i>-value < 0.05). Subsequently, we employed Ingenuity Pathway Analysis (IPA) on the identified DCEGs, followed by machine learning (ML) analysis within the pathway expression framework. The ML analysis of pathway expressions, selected by IPA and derived from gene expression data, identified relevant pathway signatures, which were validated using an independent dataset and correlated with AD severity measures (EASI and SCORAD).</p><p><strong>Results: </strong>We identified 975, 441, and 40 DCEGs in lesional vs. healthy skin, lesional vs. non-lesional, and non-lesional vs. healthy skin, respectively. IPA and ML analyses revealed 25 relevant pathway signatures, including wound healing, glucocorticoid receptor signaling, and S100 gene family signaling pathways. Validation confirmed the significance of 10 pathway signatures, which were correlated with the AD severity measures. DCEGs such as MMP12 and S100A8 demonstrated high diagnostic efficacy (AUC > 0.70) in both the discovery and validation datasets.</p><p><strong>Conclusions: </strong>Differential gene expression, co-expression networks and ML analyses of pathway expression have unveiled relevant pathways and gene signatures that distinguish between lesional, non-lesional, and healthy skin, providing valuable insights into AD pathogenesis.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11433539/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348748","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}
Bhawna Agarwal, Maria Eleonora Bizzoca, Gennaro Musella, Danila De Vito, Lorenzo Lo Muzio, Andrea Ballini, Stefania Cantore, Flavio Pisani
Background: Periodontal disease and tooth loss have been long suggested as risk factors of mild cognitive impairment. The underlying mechanisms could be systemic chronic inflammatory mediators, direct pathologic challenge to the nervous system, malnutrition and/or loss of neurosensory stimulation input causing brain atrophy. This review aimed to examine the existing literature studies linking the effect of periodontal disease and tooth loss on the development of mild cognitive impairment.
Methods: A systematic review using PEO was conducted. Three electronic databases, namely Embase, Medline and DOSS (UCLan), were searched for relevant articles published up to April 2023. Google Scholar and a hand search were also conducted to ensure no relevant studies had been missed. The Newcastle-Ottawa scale was used to assess the quality of studies.
Results: The findings showed that chronic periodontitis and tooth loss, both individually and in combination, led to an increased risk of mild cognitive decline in adults over 50 years. Within the limitations of this review, periodontitis and tooth loss both contribute to an increased risk of mild cognitive impairment and dementia, but the evidence so far is not strong.
Conclusions: In future, more robustly designed studies investigating periodontal disease and tooth losslink with cognitive health decline are required with a longer follow-up duration.
{"title":"Tooth Loss in Periodontitis Patients-A Risk Factor for Mild Cognitive Impairment: A Systematic Review and Meta-Analysis.","authors":"Bhawna Agarwal, Maria Eleonora Bizzoca, Gennaro Musella, Danila De Vito, Lorenzo Lo Muzio, Andrea Ballini, Stefania Cantore, Flavio Pisani","doi":"10.3390/jpm14090953","DOIUrl":"https://doi.org/10.3390/jpm14090953","url":null,"abstract":"<p><strong>Background: </strong>Periodontal disease and tooth loss have been long suggested as risk factors of mild cognitive impairment. The underlying mechanisms could be systemic chronic inflammatory mediators, direct pathologic challenge to the nervous system, malnutrition and/or loss of neurosensory stimulation input causing brain atrophy. This review aimed to examine the existing literature studies linking the effect of periodontal disease and tooth loss on the development of mild cognitive impairment.</p><p><strong>Methods: </strong>A systematic review using PEO was conducted. Three electronic databases, namely Embase, Medline and DOSS (UCLan), were searched for relevant articles published up to April 2023. Google Scholar and a hand search were also conducted to ensure no relevant studies had been missed. The Newcastle-Ottawa scale was used to assess the quality of studies.</p><p><strong>Results: </strong>The findings showed that chronic periodontitis and tooth loss, both individually and in combination, led to an increased risk of mild cognitive decline in adults over 50 years. Within the limitations of this review, periodontitis and tooth loss both contribute to an increased risk of mild cognitive impairment and dementia, but the evidence so far is not strong.</p><p><strong>Conclusions: </strong>In future, more robustly designed studies investigating periodontal disease and tooth losslink with cognitive health decline are required with a longer follow-up duration.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11433130/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348856","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}
Jaime Barrio-Cortes, Beatriz Benito-Sánchez, Raquel Sánchez-Ruano, César Alfonso García-Hernández, María Teresa Beca-Martínez, María Martínez-Cuevas, Almudena Castaño-Reguillo, Cristina Muñoz-Lagos
Pediatric patients with chronic conditions frequently have unmet care needs, make extensive use of healthcare services, and often encounter fragmented, non-centered care. This study aimed to analyze the differences in the utilization of primary care (PC) and hospital care (HC) services by these patients according to sex, age, and complexity and to identify associated factors. A cross-sectional study was conducted in a basic health area of Madrid, including patients under 18 years. Among these patients, 15.7% had ≥1 chronic disease, 54.1% were male, the average age was 9.5 years, 3.5% had complexity, and 11.3% had multimorbidity. The mean number of contacts/year with the healthcare system was 9.1, including 8.3 contacts/year with PC (4.9 with pediatricians and 1.9 with nurses) and 0.8 contacts/year with HC (0.8 in external consultations and 0.01 hospitalizations). The factors associated with PC utilization were complexity; female sex; European origin; and diseases like asthma, epilepsy, stroke, recurrent urinary infection, attention deficit hyperactivity disorder, and anxiety, while older age was negatively associated. Thyroid disorders were significantly associated with HC utilization. These findings could help guide the design of optimized pediatric patient-centered care approaches to coordinate care across healthcare services and reduce high healthcare utilization, therefore improving the healthcare outcomes and quality of life for these patients.
儿科慢性病患者的护理需求经常得不到满足,他们会大量使用医疗保健服务,而且经常会遇到零散的、非以患者为中心的护理。本研究旨在根据性别、年龄和病情复杂程度,分析这些患者在使用初级保健(PC)和医院护理(HC)服务方面的差异,并找出相关因素。这项横断面研究在马德里的一个基础医疗区进行,包括 18 岁以下的患者。在这些患者中,15.7%≥患有一种慢性疾病,54.1%为男性,平均年龄为9.5岁,3.5%病情复杂,11.3%患有多种疾病。与医疗系统的平均接触次数为 9.1 次/年,其中与 PC 的接触次数为 8.3 次/年(与儿科医生的接触次数为 4.9 次/年,与护士的接触次数为 1.9 次/年),与 HC 的接触次数为 0.8 次/年(外部咨询 0.8 次/年,住院 0.01 次/年)。与使用 PC 相关的因素有:复杂性;女性;欧洲血统;以及哮喘、癫痫、中风、反复泌尿感染、注意缺陷多动障碍和焦虑等疾病,而年龄偏大则呈负相关。甲状腺疾病与使用 HC 显著相关。这些发现有助于指导设计优化的儿科以患者为中心的护理方法,以协调各医疗服务机构的护理工作,减少医疗服务的高使用率,从而改善这些患者的医疗效果和生活质量。
{"title":"Utilization of Healthcare Services in Patients with Chronic Diseases under 18 Years Old: Differences and Contributing Factors.","authors":"Jaime Barrio-Cortes, Beatriz Benito-Sánchez, Raquel Sánchez-Ruano, César Alfonso García-Hernández, María Teresa Beca-Martínez, María Martínez-Cuevas, Almudena Castaño-Reguillo, Cristina Muñoz-Lagos","doi":"10.3390/jpm14090956","DOIUrl":"https://doi.org/10.3390/jpm14090956","url":null,"abstract":"<p><p>Pediatric patients with chronic conditions frequently have unmet care needs, make extensive use of healthcare services, and often encounter fragmented, non-centered care. This study aimed to analyze the differences in the utilization of primary care (PC) and hospital care (HC) services by these patients according to sex, age, and complexity and to identify associated factors. A cross-sectional study was conducted in a basic health area of Madrid, including patients under 18 years. Among these patients, 15.7% had ≥1 chronic disease, 54.1% were male, the average age was 9.5 years, 3.5% had complexity, and 11.3% had multimorbidity. The mean number of contacts/year with the healthcare system was 9.1, including 8.3 contacts/year with PC (4.9 with pediatricians and 1.9 with nurses) and 0.8 contacts/year with HC (0.8 in external consultations and 0.01 hospitalizations). The factors associated with PC utilization were complexity; female sex; European origin; and diseases like asthma, epilepsy, stroke, recurrent urinary infection, attention deficit hyperactivity disorder, and anxiety, while older age was negatively associated. Thyroid disorders were significantly associated with HC utilization. These findings could help guide the design of optimized pediatric patient-centered care approaches to coordinate care across healthcare services and reduce high healthcare utilization, therefore improving the healthcare outcomes and quality of life for these patients.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11433122/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348774","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}
Background: The early detection of mental health crises is crucial for timely interventions and improved outcomes. This study explores the potential of artificial intelligence (AI) in analyzing social media data to identify early signs of mental health crises.
Methods: We developed a multimodal deep learning model integrating natural language processing and temporal analysis techniques. The model was trained on a diverse dataset of 996,452 social media posts in multiple languages (English, Spanish, Mandarin, and Arabic) collected from Twitter, Reddit, and Facebook over 12 months. Its performance was evaluated using standard metrics and validated against expert psychiatric assessments.
Results: The AI model demonstrated a high level of accuracy (89.3%) in detecting early signs of mental health crises, with an average lead time of 7.2 days before human expert identification. Performance was consistent across languages (F1 scores: 0.827-0.872) and platforms (F1 scores: 0.839-0.863). Key digital markers included linguistic patterns, behavioral changes, and temporal trends. The model showed varying levels of accuracy for different crisis types: depressive episodes (91.2%), manic episodes (88.7%), suicidal ideation (93.5%), and anxiety crises (87.3%).
Conclusions: AI-powered analysis of social media data shows promise for the early detection of mental health crises across diverse linguistic and cultural contexts. However, ethical challenges, including privacy concerns, potential stigmatization, and cultural biases, need careful consideration. Future research should focus on longitudinal outcome studies, ethical integration of the method with existing mental health services, and developing personalized, culturally sensitive models.
{"title":"Early Detection of Mental Health Crises through Artifical-Intelligence-Powered Social Media Analysis: A Prospective Observational Study.","authors":"Masab A Mansoor, Kashif H Ansari","doi":"10.3390/jpm14090958","DOIUrl":"https://doi.org/10.3390/jpm14090958","url":null,"abstract":"<p><strong>Background: </strong>The early detection of mental health crises is crucial for timely interventions and improved outcomes. This study explores the potential of artificial intelligence (AI) in analyzing social media data to identify early signs of mental health crises.</p><p><strong>Methods: </strong>We developed a multimodal deep learning model integrating natural language processing and temporal analysis techniques. The model was trained on a diverse dataset of 996,452 social media posts in multiple languages (English, Spanish, Mandarin, and Arabic) collected from Twitter, Reddit, and Facebook over 12 months. Its performance was evaluated using standard metrics and validated against expert psychiatric assessments.</p><p><strong>Results: </strong>The AI model demonstrated a high level of accuracy (89.3%) in detecting early signs of mental health crises, with an average lead time of 7.2 days before human expert identification. Performance was consistent across languages (F1 scores: 0.827-0.872) and platforms (F1 scores: 0.839-0.863). Key digital markers included linguistic patterns, behavioral changes, and temporal trends. The model showed varying levels of accuracy for different crisis types: depressive episodes (91.2%), manic episodes (88.7%), suicidal ideation (93.5%), and anxiety crises (87.3%).</p><p><strong>Conclusions: </strong>AI-powered analysis of social media data shows promise for the early detection of mental health crises across diverse linguistic and cultural contexts. However, ethical challenges, including privacy concerns, potential stigmatization, and cultural biases, need careful consideration. Future research should focus on longitudinal outcome studies, ethical integration of the method with existing mental health services, and developing personalized, culturally sensitive models.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11433454/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348727","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}
Ziv Savin, Lin Levin, Alon Lazarovich, Barak Rosenzweig, Reut Shashar, Azik Hoffman, Jonathan Gal, Miki Haifler, Ilona Pilosov, Yuval Freifeld, Sagi Arieh Shpitzer, Shay Golan, Roy Mano, Ofer Yossepowitch
Introduction: Current guidelines endorse the use of perioperative chemotherapy (POC) in muscle-invasive bladder cancer (MIBC) to enhance the long-term overall survival (OS) compared to radical cystectomy (RC) alone. This study aims to assess the impact of POC on the OS in frail and morbid (F-M) patients undergoing RC.
Methods: A retrospective multicenter study of 291 patients who underwent RC between 2015 and 2019 was performed. Patients with both a Charlson comorbidity index ≥ 4 and Modified Frailty Index ≥ 2 were classified as the F-M cohort. We compared the clinical and pathological characteristics and outcomes of the F-M patients who received POC to those who underwent RC alone. Univariable and multivariable analyses were performed to identify the predictors of the OS.
Results: The F-M cohort included 102 patients. POC was administered to 44% of these patients: neoadjuvant (NAC) to 31%, adjuvant (AC) to 19%, and both to 6 (6%). The OS was significantly lower in the F-M cohort compared to in the healthier patients (median OS 42 months, p = 0.02). The F-M patients who received POC were younger, less morbid and had better renal function. Although POC was marginally associated with improved OS in the univariable analysis (p = 0.06), this was not significant in the multivariable analysis (p = 0.50). NAC was associated with improved OS in the univariable analysis (p = 0.004) but not after adjustment for competing factors (p = 1.00). AC was not associated with the OS.
Conclusions: POC does not improve the OS in F-M patients undergoing RC. Personalized treatment strategies and further prospective studies are needed to optimize care in this unique vulnerable population.
{"title":"Evaluating the Survival Benefits of Perioperative Chemotherapy in Frail and Morbid Muscle-Invasive Bladder Cancer Patients.","authors":"Ziv Savin, Lin Levin, Alon Lazarovich, Barak Rosenzweig, Reut Shashar, Azik Hoffman, Jonathan Gal, Miki Haifler, Ilona Pilosov, Yuval Freifeld, Sagi Arieh Shpitzer, Shay Golan, Roy Mano, Ofer Yossepowitch","doi":"10.3390/jpm14090954","DOIUrl":"https://doi.org/10.3390/jpm14090954","url":null,"abstract":"<p><strong>Introduction: </strong>Current guidelines endorse the use of perioperative chemotherapy (POC) in muscle-invasive bladder cancer (MIBC) to enhance the long-term overall survival (OS) compared to radical cystectomy (RC) alone. This study aims to assess the impact of POC on the OS in frail and morbid (F-M) patients undergoing RC.</p><p><strong>Methods: </strong>A retrospective multicenter study of 291 patients who underwent RC between 2015 and 2019 was performed. Patients with both a Charlson comorbidity index ≥ 4 and Modified Frailty Index ≥ 2 were classified as the F-M cohort. We compared the clinical and pathological characteristics and outcomes of the F-M patients who received POC to those who underwent RC alone. Univariable and multivariable analyses were performed to identify the predictors of the OS.</p><p><strong>Results: </strong>The F-M cohort included 102 patients. POC was administered to 44% of these patients: neoadjuvant (NAC) to 31%, adjuvant (AC) to 19%, and both to 6 (6%). The OS was significantly lower in the F-M cohort compared to in the healthier patients (median OS 42 months, <i>p</i> = 0.02). The F-M patients who received POC were younger, less morbid and had better renal function. Although POC was marginally associated with improved OS in the univariable analysis (<i>p</i> = 0.06), this was not significant in the multivariable analysis (<i>p</i> = 0.50). NAC was associated with improved OS in the univariable analysis (<i>p</i> = 0.004) but not after adjustment for competing factors (<i>p</i> = 1.00). AC was not associated with the OS.</p><p><strong>Conclusions: </strong>POC does not improve the OS in F-M patients undergoing RC. Personalized treatment strategies and further prospective studies are needed to optimize care in this unique vulnerable population.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11433015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348757","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}
Introduction: The DRAF III procedure is indicated for the treatment of benign and selected malignant frontal sinus pathology. Several attempts have been made to find an intra or pre-operative measurement that was predictive of the feasibility of this operation and its success. Among those, the frontal sinus outflow tract anteroposterior diameter (FOAP) appears to be the one with the highest applicability in clinical practice, since it is easy to measure on pre-operative CT scan. The objective of the study is to evaluate whether the minimum and maximum frontal sinus outflow anteroposterior diameters (FOAP min and FOAP max) are associated with the risk of failure and consequently with the need for surgical revision. Secondly, we ought to evaluate whether the angle between the glabella and the nasion on the sagittal plane could influence surgical outcome. Material and Methods: This is a retrospective study on patients who underwent DRAF III for benign pathologies at a tertiary Italian referral center from January 2000 to July 2022. FOAP min and FOAP max were measured on the mid-sagittal sections of a pre-operative CT scan. The glabella-nasion angle (G-N angle) was calculated on the same sagittal section. These measurements were compared between patients who experienced a recurrence and those who did not. If a post-operative CT scan was available, the obtained anteroposterior diameter (OD) of the frontal sinus neo-ostium was also measured on the same section. A correlation analysis was performed between the three pre-operative radiologic parameters and OD. Results: Twenty-nine patients were included in the study. Six patients experienced restenosis requiring surgical revision. The median FOAP max resulted significantly higher in patients who did not experience recurrence (median: 14.8 mm, IQR: 3.84) than in patients who experienced a recurrence (median: 11.9 mm, IQR: 1.14) (p = 0.04). The FOAP max also showed a good positive correlation with OD (p = 0.0001; r = 0.7). The correlation between FOAP min and OD was not statistically significant, nor was a correlation found between FOAP min and recurrence risk. The G-N angle was not significantly different in patients who experienced recurrence and those who did not, nor did it show a correlation with OD. Discussion: The FOAP max might be a valid pre-operative radiologic parameter to guide a surgeon's approach to a DRAF III procedure, as it is easy to measure, shows a good correlation with OD, and seems to influence the risk of recurrence.
{"title":"Influence of Pre-Operative Estimation of Draf III Expected Diameter on Surgical Outcome.","authors":"Matteo Alicandri-Ciufelli, Carla Cantaffa, Margherita Basso, Vito Colacurcio, Daniele Marchioni, Daniela Lucidi","doi":"10.3390/jpm14090951","DOIUrl":"https://doi.org/10.3390/jpm14090951","url":null,"abstract":"<p><p><b>Introduction</b>: The DRAF III procedure is indicated for the treatment of benign and selected malignant frontal sinus pathology. Several attempts have been made to find an intra or pre-operative measurement that was predictive of the feasibility of this operation and its success. Among those, the frontal sinus outflow tract anteroposterior diameter (FOAP) appears to be the one with the highest applicability in clinical practice, since it is easy to measure on pre-operative CT scan. The objective of the study is to evaluate whether the minimum and maximum frontal sinus outflow anteroposterior diameters (FOAP min and FOAP max) are associated with the risk of failure and consequently with the need for surgical revision. Secondly, we ought to evaluate whether the angle between the glabella and the nasion on the sagittal plane could influence surgical outcome. <b>Material and Methods</b>: This is a retrospective study on patients who underwent DRAF III for benign pathologies at a tertiary Italian referral center from January 2000 to July 2022. FOAP min and FOAP max were measured on the mid-sagittal sections of a pre-operative CT scan. The glabella-nasion angle (G-N angle) was calculated on the same sagittal section. These measurements were compared between patients who experienced a recurrence and those who did not. If a post-operative CT scan was available, the obtained anteroposterior diameter (OD) of the frontal sinus neo-ostium was also measured on the same section. A correlation analysis was performed between the three pre-operative radiologic parameters and OD. <b>Results</b>: Twenty-nine patients were included in the study. Six patients experienced restenosis requiring surgical revision. The median FOAP max resulted significantly higher in patients who did not experience recurrence (median: 14.8 mm, IQR: 3.84) than in patients who experienced a recurrence (median: 11.9 mm, IQR: 1.14) (<i>p</i> = 0.04). The FOAP max also showed a good positive correlation with OD (<i>p</i> = 0.0001; r = 0.7). The correlation between FOAP min and OD was not statistically significant, nor was a correlation found between FOAP min and recurrence risk. The G-N angle was not significantly different in patients who experienced recurrence and those who did not, nor did it show a correlation with OD. <b>Discussion</b>: The FOAP max might be a valid pre-operative radiologic parameter to guide a surgeon's approach to a DRAF III procedure, as it is easy to measure, shows a good correlation with OD, and seems to influence the risk of recurrence.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11433615/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348766","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}