Journal of Personalized Medicine最新文献

Background: The aim of this systematic review was to evaluate the clinical efficacy, benefits, and limitations of piezosurgery in tooth extractions compared to conventional methods. Piezosurgery has emerged as a minimally invasive alternative, promoting better preservation of soft tissues and bone structures. Understanding its impact on postoperative outcomes such as pain, swelling, trismus, and bone healing is critical for its application in oral surgery; Materials and Methods: We restricted our search to English-language articles published between 1 January 2004 and 28 August 2024, in PubMed, Scopus, and Web of Science. The Boolean search keywords "piezosurgery AND tooth extraction" were used. Results: A total of 983 articles were identified, and after duplicates were removed, 766 studies were screened. Following the application of inclusion and exclusion criteria, seven articles were selected for qualitative analysis. Conclusions: The literature suggests that piezosurgery offers advantages, such as reduced postoperative pain, swelling, and trismus, despite longer surgical times compared to conventional methods. While piezosurgery shows promise for improved patient comfort and soft tissue preservation, further research is required to validate its long-term impact on bone healing and regeneration.

Currently, common treatment approaches for neoplastic diseases include surgery, radiation, and/or anticancer drugs (chemotherapy, hormone medications, and targeted therapies). In particular, anticancer medicines destroy cancerous cells by blocking certain pathways that aid in the disease's initiation and progression. These pharmaceutical drugs' capacity to inhibit malignant cells has made them indispensable in the treatment of neoplastic disorders. Nonetheless, considering their cyto- and neurotoxicity, as well as their inflammatory responses, these medications may also have unfavorable systemic and ocular side effects. In fact, it is well known that ocular posterior segment side effects, including retinal and vascular complications, have a negative influence on the patient's eyesight and quality of life. However, the underlying mechanisms contributing to the development of these side effects remain incompletely recognized, especially in the case of newly available anticancer drugs. The purpose of this literature review is to analyze the possible side effects of new anticancer drugs on the posterior segment of the eye, trying to better understand the involved pharmacological mechanisms and offer helpful guidance on their appropriate management.

Background/Objectives: Periostin's role in the pathogenesis of inflammatory diseases, particularly in the nose and paranasal sinuses, is an area of growing interest. This study aims to evaluate the expression of periostin in mucoceles, inverted papillomas, choanopolyps and retention cysts. Methods: Tissue samples collected during functional endoscopic sinus surgery (FESS) were analyzed for POSTN gene mRNA expression using qPCR. Periostin protein levels were measured via ELISA and Western Blot. Serum periostin levels were also assessed through ELISA in both patients (n = 54) and controls (n = 12). Results: A total of 66 participants were recruited, including 18 with inverted papillomas, 10 with mucoceles, 10 with choanopolyps, 16 with retention cysts and 12 controls. There were no significant alternations between tissue and serum samples of inverted papilloma compared to the control group. Choanopolyp tissues exhibited elevated POSTN protein expression, though POSTN mRNA and serum levels remained unchanged. In mucoceles, periostin levels were significantly elevated in both tissues and serum. Retention cyst tissues demonstrated an increase in POSTN mRNA and protein expression, whereas serum periostin levels remained consistent with those observed in the control group. Conclusions: The findings suggest that periostin may play a role in the pathophysiology of benign non-neoplastic lesions of the nose and paranasal sinuses such as mucoceles, retention cysts and choanopolyps, highlighting a need for more investigation in this subject.

The journal's Editorial Office and Editorial Board are jointly issuing a resolution and removal of the Journal Notice linked to this article [...].

Background/Objectives: Instability is a major reason for revision after total hip arthroplasty (THA), and acetabular cup placement in the "traditional" safe zone does not protect against dislocations. Spinopelvic mobility may play a role in impingement and dislocation after THA. Personalized acetabular cup placement that incorporates spinopelvic mobility is currently lacking in the literature. Methods: The spinopelvic motion of 116 patients was evaluated during preoperative planning. All patients underwent radiological assessments with an anteroposterior pelvis radiograph in the standing and supine positions and a lateral view of the lumbar spine and pelvis in the standing and sitting positions. The pelvic incidence, pelvic tilt, sacral slope, standing anterior pelvic plane tilt, sitting anterior pelvic plane tilt, and lumbar lordosis angle were measured, and the degree of pelvic motion from standing to sitting was calculated. The development of the patient-specific target for the acetabular cup was based on the mean mobility of the whole group and the specific posture of each patient. Results: The average pelvic incidence was 51.0 ± 13.1 degrees, the sacral slope was 35.0 ± 10.3 degrees, the pelvic tilt was 16.0 ± 13.3 degrees, the standing anterior pelvic plane tilt was 3.4 ± 12 degrees backward, and the degree of lumbar lordosis was 39.5 ± 11.3 degrees. The mean spinopelvic mobility was 27.3 ± 13.4 degrees. The measurements had good to excellent interobserver and intraobserver reliability. On the basis of these measurements, we developed a novel algorithm for a patient-specific target for acetabular cup placement. Conclusions: the evaluation of spinopelvic mobility has good to excellent interobserver and intraobserver reliability and can be used for personalized acetabular cup placement.

Introduction: The incidence of breast cancer, as well as diabetes mellitus (DM), has continuously increased in recent years. The concurrent study of these diseases is particularly important, as there is a strong correlation between them due to hormonal, biochemical, and environmental factors. Moreover, the underlying metabolic dysfunction in this case could affect the treatment of breast cancer, as well as overall survival. In addition, the relationship of these two diseases with depression is not well studied. Patients with DM and cancer patients both experience depressive symptoms that have an impact on their mental health, as well as their quality of life. Personalized medicine offers a potential solution to these challenges by tailoring treatments to individual patient profiles. The present study will attempt to fill a gap in the existing literature regarding the relationship of patients with concurrent breast cancer and DM experiencing depression. More specifically, it will attempt to answer the question of whether there is a strong correlation between breast cancer, DM, and mental health in patients from a large geographical division of the country. Methodology: This was a cross-sectional study. A total of 120 female patients participated in the research, 60 with type 2 diabetes mellitus (T2DM) (group B) and 60 with T2DM and breast cancer (group A). The DASS-21 questionnaire was used to determine their levels of anxiety and depression, and ADDQoL-19 was used to measure the patients' quality of life. Results: Regarding quality of life, women with T2DM and breast cancer showed a better quality of life (QoL) than women with T2DM. Women who were retired (p = 0.025) and consequently postmenopausal (p = 0.035) demonstrated the highest levels of QoL, while stage III cancer patients had lower ADDQoL-19 scores. Regarding mental health, in the women from group A, a positive correlation of treatment with the occurrence of anxiety and depression (p = 0.034) and a negative correlation of cancer stage with mental health was observed. The women in group B (those with T2DM only) showed better mental health outcomes related to their treatment (p = 0.009). However, both married and unmarried women in this study experienced mental health burdens, with no significant difference between the two groups in terms of mental health impact. These findings suggest that marital status did not significantly influence the mental health of the participants in this study. Conclusions: Women with T2DM and breast cancer generally presented a better clinical picture than women with T2DM alone. Therefore, the comorbidity of these two diseases did not seem to negatively affect the quality of life and mental health of these women.

Objective: A controversial aspect of pediatric septic shock management is corticosteroid therapy. Current guidelines do not recommend its use in forms responsive to fluids and inotropes but leave the decision to physicians in forms refractory to the first steps of therapy. Data Sources: Review of literature from January 2013 to December 2023 from online libraries Pubmed, Medline, Cochrane Library, and Scopus. Study Selection: The keywords "septic shock", "steroids" and "children" were used. Data Extraction: Of 399 articles, 63 were selected. Data Synthesis: Regarding mortality, although the 2019 Cochrane review supports reduced mortality, benefits on long-term mortality and in patients with CIRCI (critical illness-related corticosteroid insufficiency) are not clear. Yang's metanalysis and retrospective studies of Nichols and Atkinson show no difference or even an increase in mortality. Regarding severity, the Cochrane review claims that hydrocortisone seems to reduce the length of intensive care hospitalization but influences the duration of ventilatory and inotropic support, and the degree of multi-organ failure appears limited. Further controversies exist on adrenal function evaluation: according to literature, including the Surviving Sepsis Campaign guidelines, basal or stimulated hormonal dosages do not allow the identification of patients who could benefit from hydrocortisone therapy (poor reproducibility). Regarding side effects, muscle weakness, hypernatremia, and hyperglycemia are the most observed. Conclusions: The literature does not give certainties about the efficacy of corticosteroids in pediatric septic shock, as their influence on primary outcomes (mortality and severity) is controversial. A subgroup of patients suffering from secondary adrenal insufficiency could benefit from it, but it remains to be defined how to identify and what protocol to use to treat them.

Aim: The purpose of the study was to identify potential differences between patients with right colon cancer and left colon cancer in epidemiological, clinical presentation, pathological, and surgical results in addition to the impact of the sidedness on disease-free survival (DFS) and overall survival (OS). Method: Patients with a diagnosis of colon cancer stages I-IV between 2010 and 2020 were identified from a prospective database in a tertiary single center. Right and left-sided cancer were compared regarding epidemiological, clinical presentation, pathological, and surgical results. Survival analysis was conducted using the Kaplan-Meier method and adjusted hazard ratios for mortality (OS) and disease-free survival (DFS) were obtained using Cox proportional hazards regression. Results: The right colon group included 82 (31%) patients and the left colon group 182 (69%). After adjusted analysis, RCC presented less bleeding (RP: 0.31; CI: 0.18-0.56; p: 0.0001) and change in bowel habits (RP: 0.60; CI: 0.41-0.87; p: 0.0069). A laparotomy approach was more performed in LCC (RP: 0.64; CI: 0.47-0.86; p: 0.0029). Regarding pathological results, RCC had more poorly differentiated tumors (RP: 0.81; CI: 0.70-0.94; p: 0.05). In the adjusted analysis, there was no difference in survival for right-sided compared to left-sided colon cancer: the hazard ratios were 1.36 (CI 95%: 0.61-3.01; p: 0.4490) for OS and 2.04 (CI: 0.91-4.59; p: 0.0814) for DFS. Conclusions: In this population-based cohort, we found no impact of colon cancer sidedness on OS and DFS. RCC presented less differentiated tumors and LCC presented more bleeding and change in bowel habits.

Background/Objectives: One prior study revealed that a newly developed auto-titrating mandibular advancement device (AMAD) could potentially enhance polysomnographic outcomes in individuals with obstructive sleep apnea (OSA). However, evidence regarding its impact on autonomic nervous system dysregulation in OSA remains limited. In this study, we aimed to compare the effects of conventional mandibular advancement devices (MADs) and AMDA on autonomic function. Methods: We retrospectively reviewed data from patients who visited a sleep center with complaints of snoring and sleep apnea (30 and 15 patients in the conventional MAD and AMAD groups, respectively). We assessed heart rate variability (HRV) frequency-domain metrics such as total power (TP), very low frequency (VLF), low frequency (LF), and high frequency (HF) using ultra-short-term and short-term modalities, assessing sympathetic and parasympathetic activity changes across treatment groups. Results: Conventional MAD treatment was associated with reductions in LF and LF/HF ratios, whereas AMAD treatment was linked to decreases in TP, VLF, LF, and LF/HF ratios. Notably, in patients with moderate OSA, LF values were significantly lower in the AMAD group than in the conventional MAD group. Conclusions: These findings suggest that both devices could reduce sympathetic over-activity in patients with OSA, with AMAD demonstrating greater efficacy, particularly in those with moderate OSA.

Background/Objectives: Mismatch repair (MMR) status is an important prognostic and predictive indicator in cancer, distinguishing proficient (pMMR) tumors from deficient (dMMR) ones. This study aimed to determine the prevalence of dMMR in colorectal (CRC) and selected non-CRC solid tumors (gastric, esophageal, and endometrial cancers). Methods: This retrospective study was conducted at a private health institution in Mexico City, analyzing patients diagnosed with colorectal, gastric, esophageal, or endometrial cancer from January 2017 to December 2020. dMMR prevalence was assessed using available status information and tissue samples for immunohistochemistry (IHC). Data were analyzed via SPSS, presenting results in frequencies and percentages. Results: Most solid tumors exhibited MSH2, MSH6, and MLH1 expression above 90%, with slightly lower levels in endometrial cancer. Esophageal cancer showed 100% pMMR. dMMR prevalence was found to be 12.7% for CRC, 8.3% for gastric, and 18.5% for endometrial cancers. Prevalence rates were similar across genders (11.1% in women and 12.9% in men), with the highest prevalence in the 41-50 age group (20%) and the lowest in the 31-40 age group (7.7%). Conclusions: This study offers valuable insights into the frequency of dMMR mutations in a cohort of the Mexican population, providing a basis for further research on their prevalence in Mexico.