Journal of Personalized Medicine

16 pages, 1910 KB

Open AccessSystematic Review

Hepatocellular Carcinoma Transplant Criteria Show Poor Negative Predictive Value: A Systematic Review and Meta-Analysis

by Laura P. Frazão, Margarida C. Quaresma, José B. Pereira-Leal, Christophe Duvoux and Joana Cardoso

J. Pers. Med. 2025, 15(10), 449; https://doi.org/10.3390/jpm15100449 - 24 Sep 2025

Abstract

Background/Objectives: Multiple criteria are used worldwide to select hepatocellular carcinoma (HCC) patients with a low risk of recurrence for liver transplantation (LT). However, it remains unclear which criteria are best for the LT-involved stakeholders, particularly in accurately identifying patients at high risk of recurrence. This work aimed to identify the most accurate criteria for selecting HCC patients for LT. Methods: In June 2023, a systematic literature search was conducted in PubMed and CENTRAL to identify studies including LT selection criteria of HCC patients. Data was extracted from recurrence-free survival curves using a validated algorithm and subsequently used to calculate measures of diagnostic performance routinely used in clinical trials. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines were applied. Results: Of 815 records screened, only 17 met our study inclusion parameters, embodying 14 LT selection criteria. All LT criteria achieved an adjusted positive predictive value (aPPV) over 80%, indicating the correct selection of at least 80% of low-risk HCC patients. However, the adjusted negative predictive value (aNPV) was below 50% in most cases, indicating that these criteria cannot correctly identify patients with a true high risk of recurrence. This raises major ethical concerns regarding the models’ ability to exclude patients from LT. Since a perfect model is nonexistent, we created a ranking to account for the distinct concerns of all stakeholders in LT eligibility in the context of HCC. Conclusions: These results highlight the urgent need for refined or newly developed criteria with improved specificity and NPV to select more patients amenable to LT who are currently excluded. Full article

(This article belongs to the Section Personalized Therapy in Clinical Medicine)

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13 pages, 597 KB

Open AccessArticle

Closed-Incision Negative-Pressure Wound Therapy in Bypass Surgery: Evidence and Implications for Personalized Care

by Ali Taghizadeh-Waghefi, Veronica De Angelis, Taofeq Bastouni, Stanislaw Vander Zwaag, Manuel Wilbring, Konstantin Alexiou, Klaus Matschke, Utz Kappert and Asen Petrov

J. Pers. Med. 2025, 15(10), 448; https://doi.org/10.3390/jpm15100448 - 24 Sep 2025

Abstract

Objectives: Sternal wound infections (SWIs) after cardiac surgery remain a major complication and represent a significant clinical challenge. This article aims to evaluate the effectiveness of closed-incision negative-pressure wound therapy (ciNPWT) in preventing postoperative wound complications in high-risk patients undergoing coronary bypass surgery via full median sternotomy. Methods: Data on all consecutive patients undergoing coronary artery bypass surgery at our facility between March 2021 and March 2023 were retrospectively collected. The ciNPWT group consisted of 71 patients. A control group receiving conventional wound dressings was selected by propensity matching. The primary outcome was postoperative sternal wound complication of any severity, as well as superficial and deep SWIs. The secondary outcomes were hospital stay length, in-hospital mortality, and need for perioperative wound revision. Results: The incidence of postoperative SWIs was significantly higher in the ciNPWT group than in the control group (18 [25.4%] vs. 7 [9.9%], p = 0.03). Of these 25 cases, 20 had received postoperative ciNPWT and 5 conventional wound dressings, which was statistically different (15 [21.1%] vs. 5 [7.0%], p = 0.03). ciNPWT was also significantly associated with positive bacterial cultures (13 [18.3%] vs. 4 [5.6%], p = 0.04) and perioperative wound revision (11 [15.5%] vs. 6 [8.5%], p = 0.05). Conclusions: In consecutive high-risk patients undergoing coronary bypass surgery, the use of prophylactic ciNPWT did not improve wound healing compared to conventional wound dressings, raising concerns about its effectiveness in high-risk patients. Our results do not support the routine use of ciNPWT in this setting. Its potential value may instead lie in carefully defined patient subgroups, underscoring the relevance of our findings for patient-tailored care strategies in cardiac surgery. Full article

(This article belongs to the Special Issue Advances in Cardiothoracic Surgery)

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15 pages, 1036 KB

Open AccessSystematic Review

Computational Fluid Dynamics Approach for Direct Nose-to-Brain Drug Delivery: A Systematic Review and Meta-Analysis

by Priya Vishnumurthy, Thomas Radulesco, Gilles Bouchet, Alain Regard and Justin Michel

J. Pers. Med. 2025, 15(10), 447; https://doi.org/10.3390/jpm15100447 - 24 Sep 2025

Abstract

Background/Objectives: Optimizing drug deposition to the olfactory region is key in Nose-to-brain drug delivery strategies. However, findings from computational fluid dynamics (CFD) studies remain inconsistent concerning the parameters influencing olfactory deposition, limiting clinical translation and device optimization. This systematic review aims to identify robust CFD parameters for optimizing drug delivery to the olfactory region. Methods: A systematic review and meta-analysis were conducted following PRISMA guidelines, selecting studies reporting CFD simulations of nasal drug delivery with evaluation of olfactory deposition efficiency. The primary outcome was the correlation between each CFD parameter and olfactory deposition rate. Parameters included particle size, impaction parameter, flow rate, spray cone angle, insertion angle, injection velocity, head position, release position, and breathing pattern. Data were extracted and standardized, and statistical methods were used to assess correlations, heterogeneity, and potential biases in study results. Results: Smaller particle size (pooled r = −0.42) and lower impaction parameter (r = −0.39) were significantly associated with higher olfactory deposition. No consistent correlation was observed with breathing flow rate. Heterogeneity across studies was high (I² > 90%). Funnel plots asymmetry suggested potential publication bias in particle-related outcomes. Conclusions: Particle characteristics, especially size and inertia, are the most critical determinants of olfactory deposition in CFD simulations. These findings support design optimization of nasal delivery devices targeting the olfactory region and underscore the need for standardized reporting and validation across CFD studies. Full article

(This article belongs to the Special Issue Otolaryngology in Clinical Practice: The Necessity of Personalized Medicine)

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1 pages, 156 KB

Open AccessCorrection

Correction: Patano et al. Mandibular Crowding: Diagnosis and Management—A Scoping Review. J. Pers. Med. 2023, 13, 774

by Assunta Patano, Giuseppina Malcangi, Alessio Danilo Inchingolo, Grazia Garofoli, Nicole De Leonardis, Daniela Azzollini, Giulia Latini, Antonio Mancini, Vincenzo Carpentiere, Claudia Laudadio, Francesco Inchingolo, Silvia D’Agostino, Daniela Di Venere, Gianluca Martino Tartaglia, Marco Dolci, Gianna Dipalma and Angelo Michele Inchingolo

J. Pers. Med. 2025, 15(10), 446; https://doi.org/10.3390/jpm15100446 - 23 Sep 2025

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Abstract

Following discussions between the Editorial Board and the authors, the original published references numbered 47 and 48 have been removed from this paper [1], and reference number 47 has been replaced by the following reference:47 [...] Full article

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J. Pers. Med., Volume 15, Issue 10 (October 2025) – 4 articles

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