Journal of Personalized Medicine

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 [...] Read more.

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 [...] Read more.

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

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

15 pages, 748 KB

Open AccessArticle

High Cerebral Oxygen Saturation Levels During One-Lung Ventilation Predict Better Cognitive and Clinical Outcomes After Thoracic Surgery: A Retrospective Observational Study

by Ignacio Garutti, Francisco de la Gala, Javier Hortal, Almudena Reyes, Elena de la Fuente, David Martinez-Gascueña, Carlos Alberto Calvo, Santiago Hernández, Estrela Caamaño, Carlos Simón, Elena Vara and Patricia Piñeiro

J. Pers. Med. 2025, 15(9), 445; https://doi.org/10.3390/jpm15090445 - 22 Sep 2025

Abstract

Background: Cerebral desaturation during one-lung ventilation (OLV) in thoracic surgery has been associated with postoperative cognitive dysfunction (POCD). While the adverse effects of low intraoperative regional cerebral oxygen saturation (rScO₂) are well documented, the potential clinical value of maintaining supranormal rScO [...] Read more.

Background: Cerebral desaturation during one-lung ventilation (OLV) in thoracic surgery has been associated with postoperative cognitive dysfunction (POCD). While the adverse effects of low intraoperative regional cerebral oxygen saturation (rScO₂) are well documented, the potential clinical value of maintaining supranormal rScO₂ levels has not been thoroughly studied. Methods: We conducted a retrospective observational study based on a previously collected cohort from a tertiary university hospital. Adult patients undergoing elective thoracic surgery between January 2019 and December 2022 were included, provided they received lidocaine either intravenously or via a paravertebral block as part of a standardized anesthetic protocol. Patients were divided into the following two groups based on their mean INVOS values 30 min into OLV: those with rScO₂ ≥75% (H-INVOS group) and <75% (L-INVOS group). Intraoperative physiological variables, inflammatory biomarkers, cognitive function via the Mini-Mental State Examination, and postoperative outcomes were analyzed. Results: The H-INVOS group exhibited significantly higher preoperative lung function, higher PaO₂ and PaCO₂ values during OLV, and higher hemoglobin concentrations across all timepoints. They also demonstrated better preservation of cognitive function, lower IL-18 expression at 24 h postoperatively, and shorter hospital stays. There were no statistically significant differences in intraoperative hemodynamics or ventilatory mechanics. Full article

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

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10 pages, 711 KB

Open AccessArticle

Diabetes Phenotypes in Patients Presenting a Myocardial Infarction: Progress Towards Precision Medicine?

by Christelle Lacqua, Arnaud Barbou, Marianne Zeller, Ludwig Serge Aho Glele, Héloïse Adam, Florence Bichat, Jean-Michel Petit, Yves Cottin and Mathieu Boulin

J. Pers. Med. 2025, 15(9), 444; https://doi.org/10.3390/jpm15090444 - 21 Sep 2025

Abstract

Background/Objectives: Despite advances in personalized medicine, diabetes classification and management have remained widely unchanged for decades. The aims of the present study were to determine profiles of patients with type 2 diabetes at the time of their myocardial infarction and to assess [...] Read more.

Background/Objectives: Despite advances in personalized medicine, diabetes classification and management have remained widely unchanged for decades. The aims of the present study were to determine profiles of patients with type 2 diabetes at the time of their myocardial infarction and to assess 1-year cardiovascular events. Methods: All type 2 diabetic patients admitted for myocardial infarction in our Coronary Intensive Care Unit between 1 April 2021 and 30 June 2023 were included in this retrospective study. To identify patient profiles, we performed a data-driven cluster analysis based on the k-means method according to six characteristics considered as the most relevant in the literature (age at diabetes diagnosis, body mass index, glycated hemoglobin, glutamate decarboxylase antibodies, insulin resistance and beta-cell function). Cox multivariate models were used to identify predictors of 1-year cardiovascular event- and major adverse cardiovascular event-free survivals. Results: This study included 250 patients with a median age of 71 years. Our cluster repartition was as follows: 46% patients presented a severe insulin-deficient diabetes, 3% a severe insulin-resistant diabetes, 16% a mild obesity-related diabetes, 33% a mild age-related diabetes, and 2% patients suffered from a severe autoimmune diabetes. In multivariate analyses, the only independent factor for both longer cardiovascular event- and major adverse cardiovascular event-free survival was a higher glomerular function rate (hazard ratio of 0.97 and 0.98 per 1 mL/mn/1.73 m²; p = 0.01 and p = 0.03, respectively). Conclusions: This study suggests that the severe insulin-deficient diabetes and mild age-related diabetes pathophysiological phenotypes, easily estimated using insulin resistance and beta-cell function as well as age at diabetes diagnosis, body mass index, and glycated hemoglobin, were more frequent among diabetic patients at the time of their myocardial infarction. In daily clinical practice, caution is needed for patients with a low glomerular function rate, as this was associated with shorter cardiovascular event- and major adverse cardiovascular event-free survival at 1-year. Full article

(This article belongs to the Section Diagnostics in Personalized Medicine)

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11 pages, 472 KB

Open AccessCommentary

Future of Valvular Heart Disease and Structural Heart Interventions: Why So Much Excitement?

by Eirini Beneki and Julia Grapsa

J. Pers. Med. 2025, 15(9), 443; https://doi.org/10.3390/jpm15090443 - 19 Sep 2025

Abstract

Valvular heart disease (VHD) is becoming increasingly prevalent in the aging population and continues to be a major contributor to cardiovascular morbidity and mortality. Advances in non-invasive imaging, able to confirm the presence and severity of valve disease, have been crucial in revealing [...] Read more.

Valvular heart disease (VHD) is becoming increasingly prevalent in the aging population and continues to be a major contributor to cardiovascular morbidity and mortality. Advances in non-invasive imaging, able to confirm the presence and severity of valve disease, have been crucial in revealing VHD mechanisms through the assessment of morphological and functional changes. In parallel, immense progress in both surgical techniques and catheter-based interventions has broadened therapeutic options, particularly for high-risk and elderly patients. Despite the availability of evidence-based guidelines, a shared decision-making process should play a key role in the final decision for therapy, outlining the goals and risks of possible intervention coupled with the patient’s own needs and expectations. Future research should aim to develop safer, more effective, and longer-lasting treatments tailored to the unique need of each patient with VHD. Full article

(This article belongs to the Special Issue The Development of Echocardiography in Heart Disease)

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16 pages, 400 KB

Open AccessArticle

The Role of Age at Onset on the Clinical Course and Biochemical Parameters of Anorexia Nervosa

by Lorenzo Ferrario, Andrea Costantino, Letizia Maria Affaticati, Massimo Clerici, Antonios Dakanalis, Enrico Capuzzi and Massimiliano Buoli

J. Pers. Med. 2025, 15(9), 442; https://doi.org/10.3390/jpm15090442 - 17 Sep 2025

Abstract

Background: Anorexia nervosa (AN) has the highest mortality rate among psychiatric disorders, making early diagnosis and tailored management crucial. This study aimed to evaluate the impact of age at onset (AAO)—childhood/adolescence versus adulthood—on the clinical course and associated biochemical parameters. Methods: Seventy-six female [...] Read more.

Background: Anorexia nervosa (AN) has the highest mortality rate among psychiatric disorders, making early diagnosis and tailored management crucial. This study aimed to evaluate the impact of age at onset (AAO)—childhood/adolescence versus adulthood—on the clinical course and associated biochemical parameters. Methods: Seventy-six female patients with AN were divided into two groups based on AAO (<18 years vs. ≥18 years). Group comparisons were performed using t-tests for continuous variables and χ² tests for categorical variables. Correlation analyses assessed associations between AAO and continuous variables. Significant findings were entered into regression models, including a binary logistic regression with AAO as the dependent variable and a linear regression with significant correlations as predictors. Results: The early-onset group showed significantly higher potassium levels and a lower sodium/potassium ratio (Na⁺/K⁺) compared with the late-onset group (potassium: t = 0.93, p < 0.01; Na⁺/K⁺: t = 3.39, p < 0.01). AAO was strongly inversely correlated with potassium levels (r = −0.75, p < 0.01) and positively correlated with cholesterol (r = 0.574, p < 0.01) and Na⁺/K⁺ (r = 0.78, p = 0.01). Binary logistic regression correctly classified 87% of cases, showing that lower Na⁺/K⁺ was associated with earlier onset (OR = 2.23, p = 0.03). Linear regression confirmed significant associations of AAO with cholesterol levels (B = 0.07, p = 0.02) and Na⁺/K⁺ (B = 1.68, p < 0.01). Conclusions: AAO in AN is strongly associated with specific biochemical parameters. Early-onset patients exhibit more severe electrolyte imbalances, while late-onset cases show higher cholesterol levels, suggesting increased cardiovascular risk. These findings emphasize the importance of personalized treatment approaches according to AAO, although further studies are warranted to confirm these results. Full article

(This article belongs to the Special Issue Advancements in Psychiatry: Exploring New Horizons in Mental Health)

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11 pages, 573 KB

Open AccessArticle

Cluster-Based Immunization Patterns in Diabetes Mellitus: Insights for Personalized Preventive Care

by Teresa Gisinger, Alexandra Kautzky-Willer and Michael Leutner

J. Pers. Med. 2025, 15(9), 441; https://doi.org/10.3390/jpm15090441 - 16 Sep 2025

Abstract

Background: We investigated immunization status and preventive care among diabetes mellitus (DM) patients by stratifying them into clinically distinct risk clusters based on comorbidities, reflecting a personalized medicine approach. Methods: Using the Austrian health interview survey 2019, we identified four groups: [...] Read more.

Background: We investigated immunization status and preventive care among diabetes mellitus (DM) patients by stratifying them into clinically distinct risk clusters based on comorbidities, reflecting a personalized medicine approach. Methods: Using the Austrian health interview survey 2019, we identified four groups: cluster 1 (DM, arterial hypertension (aHTN), dyslipidemia; n = 215), cluster 2 (DM, aHTN, dyslipidemia, obesity class II; n = 33), cluster 3 (DM, aHTN, dyslipidemia, depression; n = 65), and a control cohort (DM without hyperlipidemia, hypertension, depression, or obesity class II; n = 214). The cohorts were compared by chi² tests. By logistic regression the association of the cluster-related variables and the vaccination status/preventive care variables were analyzed. Results: Significant differences in intact diphtheria immunization between the cohorts exist (cluster 1: 45.6%, cluster 2: 27.3%, cluster 3: 52.3%, control: 51.9%, p-value 0.047). Differences in intact tetanus (42.4% vs. 64%, p = 0.027) and diphtheria (27.3% vs. 51.9%, p = 0.013) immunization between cluster 2 and control cohort were investigated. Cluster 2 was negatively associated with tetanus (OR 0.83, p = 0.009) and diphtheria (OR 0.85, p = 0.018) immunization. Cluster 1 reports higher rates of fecal occult blood test (50.7% vs. 39.3%, p = 0.022) and cluster 2 reports a higher rate of colonoscopy (24.2% vs. 8.9%, p = 0.015) in comparison to the control cohort. Conclusions: A personalized medicine approach reveals that DM patients with specific comorbidity patterns, particularly those with hypertension, dyslipidemia, and obesity class II, have lower immunization rates—highlighting the need for targeted preventive strategies. Full article

(This article belongs to the Special Issue Diabetes Mellitus: Current Research and Future Perspectives, 2nd Edition)

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22 pages, 1332 KB

Open AccessSystematic Review

The Precision Paradigm in Periodontology: A Multilevel Framework for Tailored Diagnosis, Treatment, and Prevention

by Gianna Dipalma, Angelo Michele Inchingolo, Francesco Inchingolo, Irene Palumbo, Lilla Riccaldo, Mariafrancesca Guglielmo, Roberta Morolla, Andrea Palermo, Grazia Marinelli and Alessio Danilo Inchingolo

J. Pers. Med. 2025, 15(9), 440; https://doi.org/10.3390/jpm15090440 - 16 Sep 2025

Abstract

Background: Precision medicine in periodontology seeks to individualize prevention, diagnosis, and treatment based on biological, genetic, behavioral, and environmental factors. This approach addresses the limitations of standardized protocols, which often fail to consider patient-specific variability in disease susceptibility and progression. Materials and [...] Read more.

Background: Precision medicine in periodontology seeks to individualize prevention, diagnosis, and treatment based on biological, genetic, behavioral, and environmental factors. This approach addresses the limitations of standardized protocols, which often fail to consider patient-specific variability in disease susceptibility and progression. Materials and Methods: A systematic review was conducted following PRISMA guidelines and registered in PROSPERO (ID: CRD42024593760). Searches were performed in PubMed, Scopus, and Web of Science (2014–2025) using terms related to precision and personalized medicine in periodontology. Studies were screened based on predefined inclusion criteria, and risk of bias was assessed using the ROBINS tool. Results: Sixteen studies met the inclusion criteria. Diagnostic tools integrating biomarkers (e.g., IL-1β, salivary and GCF proteomics) and digital platforms (e.g., flowcharts and decision support systems) showed improved accuracy and early disease detection. Personalized treatments, including host-modulating therapies and customized antibiotics, improved clinical outcomes. Tailored preventive strategies based on genetic, systemic, and behavioral risk profiling reduced tooth loss and optimized care frequency. Conclusions: Precision periodontology enhances patient-centered care by integrating omics technologies, real-time diagnostics, and behavioral insights. This paradigm improves diagnostic precision, therapeutic outcomes, and long-term prevention, supporting its broader implementation in clinical practice. Full article

(This article belongs to the Special Issue Advances in Personalized Cosmetic and Restorative Dentistry)

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35 pages, 1744 KB

Open AccessReview

Personalizing Cochlear Implant Care in Single-Sided Deafness: A Distinct Paradigm from Bilateral Hearing Loss

by Emmeline Y. Lin, Stephanie M. Younan, Karen C. Barrett and Nicole T. Jiam

J. Pers. Med. 2025, 15(9), 439; https://doi.org/10.3390/jpm15090439 - 15 Sep 2025

Abstract

Background: Cochlear implants (CIs) serve diverse populations with hearing loss, but patients with single-sided deafness (SSD) often show lower post-implantation usage and satisfaction than bilateral CI users. This disparity may stem from their normal contralateral ear providing sufficient auditory input for many daily [...] Read more.

Background: Cochlear implants (CIs) serve diverse populations with hearing loss, but patients with single-sided deafness (SSD) often show lower post-implantation usage and satisfaction than bilateral CI users. This disparity may stem from their normal contralateral ear providing sufficient auditory input for many daily situations, reducing the perceived need for consistent CI use. Consequently, uniform screening and evaluations, typically designed for bilateral hearing loss, often fail to address SSD’s unique needs. Methods: This narrative review synthesizes the current literature to explore patient and device factors shaping CI integration, outcomes, and experience in SSD. It highlights implications for developing personalized care strategies distinct from those used in bilateral hearing loss. Results: SSD patients face unique challenges: reliance on compensatory behaviors and significant auditory processing difficulties like acoustic–electric mismatch and place–pitch discrepancy. Anatomical factors and deafness of duration also impact outcomes. Traditional measures are often insufficient due to ceiling effects. Music perception offers a sensitive metric and rehabilitation tool, while big data and machine learning show promise for predicting outcomes and tailoring interventions. Conclusions: Optimizing CI care for SSD necessitates a personalized approach across candidacy, counseling, and rehabilitation. Tailored strategies, including individualized frequency mapping, adaptive auditory training, advanced outcome metrics like music perception, and leveraging big data for precise, data-driven predictions, are crucial for improving consistent CI usage and overall patient satisfaction. Full article

(This article belongs to the Special Issue Otolaryngology: Big Data Application in Personalized Medicine)

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14 pages, 417 KB

Open AccessArticle

Association of Insulin Resistance with Dysglycemia in Elder Koreans: Age- and Sex-Specific Cutoff Values

by Sang Min Yoon and Boyoung Park

J. Pers. Med. 2025, 15(9), 438; https://doi.org/10.3390/jpm15090438 - 15 Sep 2025

Abstract

Background/Objectives: Dysglycemia including pre-diabetes mellitus (Pre-DM) and type 2 diabetes mellitus (T2DM) is associated with insulin resistance. This study aimed to support personalized early diagnosis of dysglycemia by proposing optimal, sex- and age-specific cutoff values for Homeostatic Model Assessment of Insulin Resistance [...] Read more.

Background/Objectives: Dysglycemia including pre-diabetes mellitus (Pre-DM) and type 2 diabetes mellitus (T2DM) is associated with insulin resistance. This study aimed to support personalized early diagnosis of dysglycemia by proposing optimal, sex- and age-specific cutoff values for Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) and Homeostatic Model Assessment of Beta-Cell Function (HOMA-β) in Koreans aged ≥65 years. Methods: This study analyzed 3862 older Koreans from the 8th Korea National Health and Nutrition Examination Survey data (2019–2021), excluding those with prior diabetes or medication. The participants were classified into normal and dysglycemia groups, based on fasting plasma glucose (FPG) and glycated hemoglobin (HbA1c). Sex- and age-specific optimal cutoff values were determined using Youden’s Index (YI) and area under the curve (AUC). Results: For T2DM, the optimal HOMA-IR cutoff was 2.25 for men and 2.03 for women, with strong discriminative performance (AUCs: 0.828 and 0.823, respectively). Stratifying cutoff values further by sex and age improved the diagnostic accuracy (AUC > 0.83 in most subgroups), underscoring the value of tailored thresholds. For pre-DM, the HOMA-IR cutoff was 1.73 in men and 1.85 in women (AUCs: 0.682 and 0.665, respectively). Age- and sex-specific cutoffs modestly improved AUCs, particularly in men (up to 0.7), although the improvement was less consistent among women. HOMA-β showed no significant association with dysglycemia, and no meaningful cutoff values were identified. Conclusions: HOMA-IR is a promising marker for the early identification of dysglycemia in older adults when interpreted through a personalized lens. Applying sex- and age-specific cutoff values enhances diagnostic precision and supports a more individualized approach to metabolic risk assessment. Further longitudinal studies are warranted to validate these personalized thresholds and to optimize early detection strategies in diverse populations. Full article

(This article belongs to the Special Issue Diabetes Mellitus: Current Research and Future Perspectives, 2nd Edition)

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26 pages, 1717 KB

Open AccessReview

Anti-Amyloid Monoclonal Antibodies for Alzheimer’s Disease: Evidence, ARIA Risk, and Precision Patient Selection

by Amer E. Alkhalifa, Abdulrahman Al Mokhlf, Hande Ali, Nour F. Al-Ghraiybah and Vasiliki Syropoulou

J. Pers. Med. 2025, 15(9), 437; https://doi.org/10.3390/jpm15090437 - 15 Sep 2025

Abstract

Alzheimer’s disease (AD) is the most common cause of dementia, pathologically defined by extracellular amyloid-β (Aβ) plaques and intracellular tau neurofibrillary tangles. Recent U.S. Food and Drug Administration (FDA) approvals of anti-amyloid monoclonal antibodies (mAbs) aducanumab, lecanemab, and donanemab represent the first disease-modifying [...] Read more.

Alzheimer’s disease (AD) is the most common cause of dementia, pathologically defined by extracellular amyloid-β (Aβ) plaques and intracellular tau neurofibrillary tangles. Recent U.S. Food and Drug Administration (FDA) approvals of anti-amyloid monoclonal antibodies (mAbs) aducanumab, lecanemab, and donanemab represent the first disease-modifying therapies for early AD. These therapies have generated both optimism and controversy due to modest efficacy and safety concerns, particularly amyloid-related imaging abnormalities (ARIAs). This review synthesizes current evidence on the efficacy, safety, and biomarker-guided use of anti-Aβ mAbs in AD. Methods: We searched PubMed, Scopus, Web of Science, and Google Scholar to 31 July 2025 for studies on anti-amyloid mAbs in AD. Sources included peer-reviewed articles and regulatory reports. The extracted data covered study design, population, amyloid confirmation, dosing, outcomes, biomarkers, ARIA incidence, and management. Results: Anti-amyloid mAbs consistently demonstrated robust amyloid clearance and modest slowing of clinical decline in early symptomatic AD. Differences emerged across agents in efficacy signals, safety profiles, and regulatory outcomes. Lecanemab and donanemab showed more consistent cognitive benefits, while aducanumab yielded mixed findings, leading to its withdrawal. ARIAs were the most frequent adverse events, occurring more often in APOE ε4 carriers and typically during early treatment. Biomarker analyses also revealed favorable downstream effects, including reductions in phosphorylated tau and markers of astroglial injury, supporting engagement of disease biology. Conclusions: Anti-amyloid mAbs provide proof of concept for AD modification, with the greatest benefit in early disease stages and moderate tau burden. Optimal use requires biomarker confirmation of the amyloid, careful tau staging, and genetic risk assessment. While limitations remain, these therapies represent a pivotal step toward precision neurology and may serve as a foundation for multimodal strategies targeting tau, neuroinflammation, and vascular pathology. Full article

(This article belongs to the Section Disease Biomarkers)

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3 pages, 297 KB

Open AccessEditorial

Journal of Personalized Medicine—Aims and Scope Update

by Kenneth P. H. Pritzker

J. Pers. Med. 2025, 15(9), 436; https://doi.org/10.3390/jpm15090436 - 11 Sep 2025

Abstract

Journal of Personalized Medicine (JPM) [...] Full article

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16 pages, 2109 KB

Open AccessArticle

Safety of Primary Tracheoesophageal Puncture in Patients Submitted to Enlarged Total Laryngectomy with Pectoralis Major Reconstruction

by Emilia Degni, Sebastiana Lai, Carlo Camillo Ciccarelli, Gamze Yesilli Puzella, Claudia Crescio, Paolo Tropiano, Valeria Fois, Claudio Parrilla, Jacopo Galli and Francesco Bussu

J. Pers. Med. 2025, 15(9), 435; https://doi.org/10.3390/jpm15090435 - 10 Sep 2025

Abstract

Background/Objectives: Total laryngectomy (TL) remains a key treatment option for advanced laryngeal cancer. Primary tracheoesophageal puncture (TEP) with voice prosthesis (VP) enables early speech restoration and is increasingly adopted, even in patients with conditions traditionally considered contraindications, such as prior/adjuvant radiotherapy, extended resections, [...] Read more.

Background/Objectives: Total laryngectomy (TL) remains a key treatment option for advanced laryngeal cancer. Primary tracheoesophageal puncture (TEP) with voice prosthesis (VP) enables early speech restoration and is increasingly adopted, even in patients with conditions traditionally considered contraindications, such as prior/adjuvant radiotherapy, extended resections, and immediate reconstructive procedures. This study evaluates complication rates and long-term outcomes associated with primary TEP in these settings. Methods: A retrospective cohort of 101 patients undergoing TL for laryngeal or hypopharyngeal squamous cell carcinoma at the University Hospital of Sassari (August 2017–December 2024) was analyzed. Demographic, clinical, surgical, and oncological data were collected, with a particular focus on postoperative early complications and late sequelae and oncological outcomes. Results: Primary TEP was performed in 78 patients (77.2%). Overall, pharyngocutaneous fistula occurred in 6/101 patients (5.9%), postoperative bleeding in 5/101 (5.0%), and dysphagia in 11/101 (10.9%), with only 2/11 (2.0%) requiring intervention. Mean follow-up was 44.6 ± 3.2 months (median 41, range 4–93). No significant association was found between primary TEP and complication rates, including in patients undergoing enlarged TL with pectoralis major reconstruction. Conclusions: Primary TEP appears safe and effective, even in cases requiring extended resections and reconstructive procedures. It should be considered to enhance functional recovery and postoperative quality of life for all motivated patients undergoing total laryngectomy without patient-related contraindications. Our findings may constitute a step towards personalized medicine in laryngeal oncology as they support priortizing patient-specific factors, such as pneumological and neurological clinical conditions and level of cooperation, over purely surgical considerations. Full article

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

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15 pages, 695 KB

Open AccessArticle

Cancer Prevention Pathways in People Living with HIV: Assessment of Prevalence and Related Factors Among Individuals Attending HIV Division of Ferrara Hospital

by Daniela Segala, Mario Stancanelli and Rosario Cultrera

J. Pers. Med. 2025, 15(9), 434; https://doi.org/10.3390/jpm15090434 - 9 Sep 2025

Abstract

Background. Oncological diseases are among the leading causes of death in people living with HIV (PLWH). With the introduction of antiretroviral therapy and the consequent reduction in AIDS-defining cancers (ADC), there has been a growing incidence of non-AIDS-defining cancers (NADC). Methods. A retrospective [...] Read more.

Background. Oncological diseases are among the leading causes of death in people living with HIV (PLWH). With the introduction of antiretroviral therapy and the consequent reduction in AIDS-defining cancers (ADC), there has been a growing incidence of non-AIDS-defining cancers (NADC). Methods. A retrospective observational study (cross sectional prevalence analysis) was conducted to investigate the prevalence and spectrum of oncological diseases in patients attending the HIV/AIDS Division at the Ferrara Hospital. The sample included 534 patients evaluated between January 2023 and November 2024 (534/682 met eligibility). Demographic, clinical, and serological data were extracted from medical records. The CDC’s 2014 definition has been adopted for the ADC/NADC classification. Statistical analysis was performed using SPSS version 29 and G*Power 3.1 software. Results. The data analysis revealed 62.8% NADC vs. 37.2% ADC (44 NADCs vs. 26 ADCs). Male individuals and those aged 50 and older were more represented. Patients with ADC more often fell into C2–C3 groups, indicative of severe immunodeficiency, while NADCs were more prevalent in clinical groups A1–B3. Statistical analysis showed that viral load was more frequently under 50 copies/mL in the NADC group, while it tended to be higher in the ADC group. Conclusions. These results align with current scientific evidence regarding the global prevalence of ADCs and NADCs. The findings highlight the need to implement targeted oncological screening strategies for HIV-positive patients to promote early diagnosis and improve prognosis. Full article

(This article belongs to the Special Issue Advances in Infectious Disease Epidemiology)

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13 pages, 601 KB

Open AccessArticle

Prevalence of Undiagnosed Risk Factors in Patients with First-Ever Ischemic Stroke Treated at MUHC: A Retrospective Analysis

by Shorog Althubait, Heather Perkins, Robert Cote, Theodore Wein, Jeffrey Minuk, Eric Erhensperger, Liam Durcan, Aimen Moussaddy and Lucy Vieira

J. Pers. Med. 2025, 15(9), 433; https://doi.org/10.3390/jpm15090433 - 9 Sep 2025

Abstract

Background: Ischemic stroke is a leading cause of morbidity and mortality worldwide. Despite established prevention strategies, many patients present with previously undiagnosed vascular risk factors (URFs) at the time of their first-ever ischemic stroke, suggesting missed opportunities for early detection. In Canada, particularly [...] Read more.

Background: Ischemic stroke is a leading cause of morbidity and mortality worldwide. Despite established prevention strategies, many patients present with previously undiagnosed vascular risk factors (URFs) at the time of their first-ever ischemic stroke, suggesting missed opportunities for early detection. In Canada, particularly in Quebec, access to primary care is inconsistent, and a substantial proportion of the population lacks attachment to a family doctor (FD). Objective: This study aimed to determine the prevalence of URFs among patients with first-ever ischemic stroke and to evaluate the relationship between URFs, geographic region, and access to primary care in Quebec, Canada. We hypothesized that patients without an FD would have a higher prevalence of URFs. Methods: We conducted a retrospective chart review of 610 patients admitted with first-ever ischemic stroke to the McGill University Health Center (MUHC) between 2014 and 2017. Data collected included demographics; known and undiagnosed stroke risk factors such as hypertension (HTN), diabetes mellitus (DM), hyperlipidemia (HLD), and atrial fibrillation (AF); FD status; and geographic location based on postal code. Results: Among the 610 patients, 136 (22.3%) had at least one URF. The most common URF was HLD (14.3%), followed by HTN (6.2%), AF (1.6%), and DM (0.1%). Of 609 patients with available data, 146 (23.97%) lacked an FD. Patients without an FD were significantly more likely to have undiagnosed HTN (7.6% vs. 2.1%, p = 0.008). No significant differences were observed for the other URFs. Geographic variation was noted in both URF prevalence and FD access, but regional differences were not statistically significant. Conclusions: Our findings support the hypothesis that a lack of an FD is associated with a higher prevalence of undiagnosed HTN in ischemic stroke patients. Targeted screening and improved access to primary care, particularly in underserved regions, may help to reduce the burden of preventable stroke by facilitating the earlier identification and management of modifiable risk factors. Full article

(This article belongs to the Section Personalized Preventive Medicine)

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12 pages, 1004 KB

Open AccessArticle

Machine-Learning-Based Survival Prediction in Castration-Resistant Prostate Cancer: A Multi-Model Analysis Using a Comprehensive Clinical Dataset

by Jeong Hyun Lee, Jaeyun Jeong, Young Jin Ahn, Kwang Suk Lee, Jong Soo Lee, Seung Hwan Lee, Won Sik Ham, Byung Ha Chung and Kyo Chul Koo

J. Pers. Med. 2025, 15(9), 432; https://doi.org/10.3390/jpm15090432 - 8 Sep 2025

Abstract

Purpose: Accurate survival prediction is essential for optimizing the treatment planning in patients with castration-resistant prostate cancer (CRPC). However, the traditional statistical models often underperform due to limited variable inclusion and an inability to account for complex, multidimensional data interactions. Methods: We retrospectively [...] Read more.

Purpose: Accurate survival prediction is essential for optimizing the treatment planning in patients with castration-resistant prostate cancer (CRPC). However, the traditional statistical models often underperform due to limited variable inclusion and an inability to account for complex, multidimensional data interactions. Methods: We retrospectively collected 46 clinical, laboratory, and pathological variables from 801 patients with CRPC, covering the disease course from the initial disease diagnosis to CRPC progression. Multiple machine learning (ML) models, including random survival forests (RSFs), XGBoost, LightGBM, and logistic regression, were developed to predict cancer-specific mortality (CSM), overall mortality (OM), and 2- and 3-year survival status. The dataset was split into training and test cohorts (80:20), with 10-fold cross-validation. The performance was assessed using the C-index for regression models and the AUC, accuracy, precision, recall, and F1-score for classification models. Model interpretability was assessed using SHapley Additive exPlanations (SHAP). Results: Over a median follow-up of 24 months, 70.6% of patients experienced CSM. RSFs achieved the highest C-index in the test set for both CSM (0.772) and OM (0.771). For classification tasks, RSFs demonstrated a superior performance in predicting 2-year survival, while XGBoost yielded the highest F1-score for 3-year survival. The SHAP analysis identified time to first-line CRPC treatment and hemoglobin and alkaline phosphatase levels as key predictors of survival outcomes. Conclusion: The RSF and XGBoost ML models demonstrated a superior performance over that of traditional statistical methods in predicting survival in CRPC. These models offer accurate and interpretable prognostic tools that may inform personalized treatment strategies. External validation and the integration of emerging therapies are warranted for broader clinical applicability. Full article

(This article belongs to the Section Personalized Medical Care)

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27 pages, 2698 KB

Open AccessReview

Metabolic Signature of FLT3-Mutated AML: Clinical and Therapeutic Implications

by Cristina Banella, Gianfranco Catalano, Maura Calvani, Eleonora Candi, Nelida Ines Noguera and Serena Travaglini

J. Pers. Med. 2025, 15(9), 431; https://doi.org/10.3390/jpm15090431 - 8 Sep 2025

Abstract

Acute Myeloid Leukemia (AML) is a genetically and clinically heterogeneous malignancy marked by poor prognosis and limited therapeutic options, especially in older patients. While conventional treatments such as the “7 + 3” chemotherapy regimen and allogeneic stem cell transplantation remain standard care options, [...] Read more.

Acute Myeloid Leukemia (AML) is a genetically and clinically heterogeneous malignancy marked by poor prognosis and limited therapeutic options, especially in older patients. While conventional treatments such as the “7 + 3” chemotherapy regimen and allogeneic stem cell transplantation remain standard care options, the advent of next-generation sequencing (NGS) has transformed our understanding of AML’s molecular complexity. Among the emerging hallmarks of AML, metabolic reprogramming has gained increasing attention for its role in supporting leukemic cell proliferation, survival, and therapy resistance. Distinct AML subtypes—shaped by specific genetic alterations, including FLT3, NPM1, and IDH mutations—exhibit unique metabolic phenotypes that reflect their underlying molecular landscapes. Notably, FLT3-ITD mutations are associated with enhanced reactive oxygen species (ROS) production and altered energy metabolism, contributing to disease aggressiveness and poor clinical outcomes. This review highlights the interplay between metabolic plasticity and genetic heterogeneity in AML, with a particular focus on FLT3-driven metabolic rewiring. We discuss recent insights into how these metabolic dependencies may be exploited therapeutically, offering a rationale for the development of metabolism-targeted strategies in the treatment of FLT3-mutated AML. Full article

(This article belongs to the Special Issue Acute Myeloid Leukemia: Current Progress and Future Directions)

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15 pages, 367 KB

Open AccessStudy Protocol

The CORTEX Project: A Pre–Post Randomized Controlled Feasibility Trial Evaluating the Efficacy of a Computerized Cognitive Remediation Therapy Program for Adult Inpatients with Anorexia Nervosa

by Giada Pietrabissa, Davide Maria Cammisuli, Gloria Marchesi, Giada Rapelli, Federico Brusa, Gianluigi Luxardi, Giovanna Celia, Alessandro Chinello, Chiara Cappelletti, Simone Raineri, Luigi Enrico Zappa, Stefania Landi, Francesco Monaco, Ernesta Panarello, Stefania Palermo, Sara Mirone, Francesca Tessitore, Mauro Cozzolino, Leonardo Mendolicchio and Gianluca Castelnuovo

J. Pers. Med. 2025, 15(9), 430; https://doi.org/10.3390/jpm15090430 - 8 Sep 2025

Abstract

Background/Objectives: Anorexia nervosa (AN) is marked by cognitive deficits, particularly reduced mental flexibility and weak central coherence, which may sustain the core psychopathological symptoms. While cognitive remediation therapy (CRT) has shown efficacy in improving these cognitive processes in AN, evidence on computer-based CRT [...] Read more.

Background/Objectives: Anorexia nervosa (AN) is marked by cognitive deficits, particularly reduced mental flexibility and weak central coherence, which may sustain the core psychopathological symptoms. While cognitive remediation therapy (CRT) has shown efficacy in improving these cognitive processes in AN, evidence on computer-based CRT remains limited. This study aims to evaluate the feasibility and efficacy of integrating computer-assisted cognitive remediation therapy (CA-CRT) into standard nutritional rehabilitation (treatment as usual, TAU) to improve the targeted cognitive and psychological parameters among inpatients with AN in a more personalized and scalable way. Methods: A multicenter randomized controlled trial (RCT) will be conducted. At least 54 participants with a diagnosis of AN will be recruited at each site and randomized into either the experimental or control group after initial screening. The intervention will last five weeks and include 15 individual CA-CRT sessions alongside 10 individual CR sessions, delivered in addition to standard care. The primary and secondary outcomes will be assessed at the end of the intervention to evaluate the changes in cognitive flexibility, central coherence, and psychological functioning. Results: Participants receiving CA-CRT are expected to develop more flexible and integrated thinking styles and achieve greater improvements in clinical outcomes compared to those receiving standard care alone, supporting a more personalized therapeutic approach. Conclusions: These findings would underscore the feasibility and clinical value of incorporating CA-CRT into standard inpatient treatment for AN. By specifically targeting cognitive inflexibility and poor central coherence in a scalable, individualized format, CA-CRT may enhance treatment effectiveness and support the development of patient-centered interventions tailored to the cognitive profiles of individuals with AN. Full article

(This article belongs to the Special Issue Personalized Therapy for Psychophysical Health: An Integrative Approach)

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