Journal of Personalized Medicine

14 pages, 602 KiB

Open AccessArticle

Development of Metabolic Syndrome Decreases Bone Mineral Density T-Score of Calcaneus in Foot in a Large Taiwanese Population Follow-Up Study

by Hsuan Chiu, Mei-Yueh Lee, Pei-Yu Wu, Jiun-Chi Huang and Szu-Chia Chen

J. Pers. Med. 2021, 11(5), 439; https://doi.org/10.3390/jpm11050439 - 20 May 2021

Cited by 4 | Viewed by 2319

Abstract

Studies have suggested that there may be common pathogenic pathways linking osteoporosis and metabolic syndrome (MetS) due to the multiple risk factors for atherosclerotic cardiovascular disease caused by MetS. However, results on the association between MetS and bone health are inconsistent and sometimes [...] Read more.

Studies have suggested that there may be common pathogenic pathways linking osteoporosis and metabolic syndrome (MetS) due to the multiple risk factors for atherosclerotic cardiovascular disease caused by MetS. However, results on the association between MetS and bone health are inconsistent and sometimes contradictory. In this study, we aimed to investigate the associations between the effects of MetS risk factors and bone mineral density (BMD) T-score in a longitudinal study of 27,033 participants from the Taiwan Biobank with a follow-up period of 4 years. BMD of the calcaneus was measured in the non-dominant foot using ultrasound in the Taiwanese population. The overall prevalence rates of MetS were 16.7% (baseline) and 21.2% (follow-up). The participants were stratified into four groups according to the status of MetS (no/yes at baseline and follow-up). We investigated associations between MetS and its five components (baseline, follow-up) with BMD ΔT-score and found that the (no, yes) MetS group, (no, yes) abdominal obesity group, (no, yes) hypertriglyceridemia group, and (no, yes) low high-density lipoprotein (HDL) cholesterol group had the lowest ΔT-score. Furthermore, in the (no, yes) MetS group, high Δwaist circumference (p = 0.009), high Δtriglycerides (p = 0.004), low ΔHDL cholesterol (p = 0.034), and low Δsystolic blood pressure (p = 0.020) were significantly associated with low ΔT-score, but Δfasting glucose was not. In conclusion, in this large population-based cohort study, our data provide evidence that the development of MetS is strongly associated with increased rates of BMD loss in the Taiwanese population. This suggests that the prevention of MetS should be taken into consideration in the prevention of osteoporosis in the Taiwanese population. Full article

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3 pages, 152 KiB

Open AccessEditorial

Understanding Neuromuscular Health and Disease: Advances in Genetics, Omics, and Molecular Function

by William J. Duddy and Stephanie Duguez

J. Pers. Med. 2021, 11(5), 438; https://doi.org/10.3390/jpm11050438 - 20 May 2021

Viewed by 2669

Abstract

The field of neuromuscular research has seen considerable recent advances in the molecular and cellular understanding of muscle biology, and the treatment of neuromuscular disease [...] Full article

(This article belongs to the Special Issue Understanding Neuromuscular Health and Disease: Advances in Genetics, Omics, and Molecular Function)

7 pages, 192 KiB

Open AccessReview

Human Body Rhythms in the Development of Non-Invasive Methods of Closed-Loop Adaptive Neurostimulation

by Alexander Fedotchev, Sergey Parin, Sofia Polevaya and Anna Zemlianaia

J. Pers. Med. 2021, 11(5), 437; https://doi.org/10.3390/jpm11050437 - 20 May 2021

Cited by 11 | Viewed by 2524

Abstract

The creation and improvement of non-invasive closed-loop brain stimulation technologies represent an exciting and rapidly expanding field of neuroscience. To identify the appropriate way to close the feedback loop in adaptive neurostimulation procedures, it was previously proposed to use on-line automatic sensory stimulation [...] Read more.

The creation and improvement of non-invasive closed-loop brain stimulation technologies represent an exciting and rapidly expanding field of neuroscience. To identify the appropriate way to close the feedback loop in adaptive neurostimulation procedures, it was previously proposed to use on-line automatic sensory stimulation with the parameters modulated by the patient’s own rhythmical processes, such as respiratory rate, heart rate, and electroencephalogram (EEG) rhythms. The current paper aims to analyze several recent studies demonstrating further development in this line of research. The advantages of using automatic closed-loop feedback from human endogenous rhythms in non-invasive adaptive neurostimulation procedures have been demonstrated for relaxation assistance, for the correction of stress-induced functional disturbances, for anxiety management, and for the cognitive rehabilitation of an individual. Several distinctive features of the approach are noted to delineate its further development. Full article

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19 pages, 27523 KiB

Open AccessArticle

Simultaneous Inhibition of Three Major Cytokines and Its Therapeutic Effects: A Peptide-Based Novel Therapy against Endotoxemia in Mice

by Hung-Jen Shih, Chao-Yuan Chang, Milton Chiang, Van Long Le, Hao-Jen Hsu and Chun-Jen Huang

J. Pers. Med. 2021, 11(5), 436; https://doi.org/10.3390/jpm11050436 - 20 May 2021

Cited by 6 | Viewed by 3645

Abstract

Three major cytokines, including tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and IL-6, mediate endotoxemia-induced liver injury. With the similar structures to the binding domains of the three cytokines to their cognate receptors, the novel peptide KCF18 can simultaneously inhibit TNF-α, IL-1β, and IL-6. [...] Read more.

Three major cytokines, including tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and IL-6, mediate endotoxemia-induced liver injury. With the similar structures to the binding domains of the three cytokines to their cognate receptors, the novel peptide KCF18 can simultaneously inhibit TNF-α, IL-1β, and IL-6. We elucidated whether KCF18 can alleviate injury of liver in endotoxemic mice. Adult male mice (BALB/cJ) were intraperitoneally (i.p.) administered lipopolysaccharide (LPS, 15 mg/kg; LPS group) or LPS with KCF18 (LKCF group). Mice in the LKCF group received KCF18 (i.p.) at 2 h (0.6 mg/kg), 4 h (0.3 mg/kg), 6 h (0.3 mg/kg), and 8 h (0.3mg/kg) after LPS administration. Mice were sacrificed after receiving LPS for 24 h. Our results indicated that the binding levels of the three cytokines to their cognate receptors in liver tissues in the LKCF group were significantly lower than those in the LPS group (all p < 0.05). The liver injury level, as measured by performing functional and histological analyses and by determining the tissue water content and vascular permeability (all p < 0.05), was significantly lower in the LKCF group than in the LPS group. Similarly, the levels of inflammation (macrophage activation, cytokine upregulation, and leukocyte infiltration), oxidation, necroptosis, pyroptosis, and apoptosis (all p < 0.05) in liver tissues in the LKCF group were significantly lower than those in the LPS group. In conclusion, the KCF18 peptide–based simultaneous inhibition of TNF-α, IL-1β, and IL-6 can alleviate liver injury in mice with endotoxemia. Full article

(This article belongs to the Special Issue Personalized Diagnosis and Treatment of Patients with Sepsis)

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15 pages, 5081 KiB

Open AccessArticle

Customization of Diet May Promote Exercise and Improve Mental Wellbeing in Mature Adults: The Role of Exercise as a Mediator

by Lina Begdache and Cara M. Patrissy

J. Pers. Med. 2021, 11(5), 435; https://doi.org/10.3390/jpm11050435 - 19 May 2021

Cited by 10 | Viewed by 14233

Abstract

Diet, dietary practices and exercise are modifiable risk factors for individuals living with mental distress. However, these relationships are intricate and multilayered in such a way that individual factors may influence mental health differently when combined within a pattern. Additionally, two important factors [...] Read more.

Diet, dietary practices and exercise are modifiable risk factors for individuals living with mental distress. However, these relationships are intricate and multilayered in such a way that individual factors may influence mental health differently when combined within a pattern. Additionally, two important factors that need to be considered are gender and level of brain maturity. Therefore, it is essential to assess these modifiable risk factors based on gender and age group. The purpose of the study was to explore the combined and individual relationships between food groups, dietary practices and exercise to appreciate their association with mental distress in mature men and women. Adults 30 years and older were invited to complete the food–mood questionnaire. The anonymous questionnaire link was circulated on several social media platforms. A multi-analyses approach was used. A combination of data mining techniques, namely, a mediation regression analysis, the K-means clustering and principal component analysis as well as Spearman’s rank–order correlation were used to explore these research questions. The results suggest that women’s mental health has a higher association with dietary factors than men. Mental distress and exercise frequency were associated with different dietary and lifestyle patterns, which support the concept of customizing diet and lifestyle factors to improve mental wellbeing. Full article

(This article belongs to the Special Issue Personalized Therapy, Personalized Nutrition, and Chronic Disease)

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8 pages, 233 KiB

Open AccessArticle

Arthroscopic Repair in Tibial Spine Avulsion Fractures Using Polyethylene Terephthalate Suture: Good to Excellent Results in Pediatric Patients

by Octav Marius Russu, Tudor Sorin Pop, Emilian Ciorcila, István Gergely, Sándor-György Zuh, Cristian Trâmbițaș, Paul Gabriel Borodi, Zsuzsanna Incze-Bartha, Andrei Marian Feier and Vlad Alexandru Georgeanu

J. Pers. Med. 2021, 11(5), 434; https://doi.org/10.3390/jpm11050434 - 19 May 2021

Cited by 5 | Viewed by 2637

Abstract

Background: The objective of the arthroscopic treatment in tibial spine avulsion fractures (TSAF) is to achieve firm reduction and strong internal fixation while still having the patient undergo a minimally invasive procedure. Material and methods: The study was performed on 12 young patients [...] Read more.

Background: The objective of the arthroscopic treatment in tibial spine avulsion fractures (TSAF) is to achieve firm reduction and strong internal fixation while still having the patient undergo a minimally invasive procedure. Material and methods: The study was performed on 12 young patients with avulsion fracture of the anterior tibial spine. All 12 patients had type 3 Modified Meyers and McKeever fractures. The injury mechanism was direct anterior to posterior trauma in full leg length hyperextension with sport trauma reported in all cases. The physical examination revealed decreased range of motion, extension deficit, and pain during walking. Radiology, MRI, and CT pathologic findings described complete fracture of the anterior tibial spine with no clear signs of callus formation at the time of examination. All patients underwent arthroscopic suture surgical treatment. The Tegner, the Lysholm, and the International Knee Documentation Committee (IKDC) scores were used to evaluate subjective outcomes at three and six months after the surgery. Radiographs were used to assess callus formation and healing status of the fracture. Results: The mean IKDC score was 33.4 ± 23.3 (p = 0.032) preoperatively and 84.2 ± 14.3 at final follow-up (p = 0.0032, CI = 95%). The mean Tegner score improved from 3.8 ± 1.1 pre-operatively to 6.7 ± 2.2 at six months follow-up (p = 0.0231, CI = 95%). The Lysholm score differed significantly at baseline compared to final follow-up (53.7 ± 17.3 vs. 87.7 ± 9.9; p = 0.0066, CI = 95%). In all cases (n = 12), the radiographs taken after six months revealed the healing of the fracture in the anatomic position without secondary displacement. No functional knee instability was detected at the end of the study. Conclusions: The study provides preliminary promising results regarding fracture healing, knee stability, and functional subjective scores. Patient selection was a major factor of success prediction for this technique. Full article

15 pages, 250 KiB

Open AccessFeature PaperArticle

Complexity of Nurse Practitioners’ Role in Facilitating a Dignified Death for Long-Term Care Home Residents during the COVID-19 Pandemic

by Shirin Vellani, Veronique Boscart, Astrid Escrig-Pinol, Alexia Cumal, Alexandra Krassikova, Souraya Sidani, Nancy Zheng, Lydia Yeung and Katherine S. McGilton

J. Pers. Med. 2021, 11(5), 433; https://doi.org/10.3390/jpm11050433 - 19 May 2021

Cited by 21 | Viewed by 5030

Abstract

Due to the interplay of multiple complex and interrelated factors, long-term care (LTC) home residents are increasingly vulnerable to sustaining poor outcomes in crisis situations such as the COVID-19 pandemic. While death is considered an unavoidable end for LTC home residents, the importance [...] Read more.

Due to the interplay of multiple complex and interrelated factors, long-term care (LTC) home residents are increasingly vulnerable to sustaining poor outcomes in crisis situations such as the COVID-19 pandemic. While death is considered an unavoidable end for LTC home residents, the importance of facilitating a good death is one of the primary goals of palliative and end-of-life care. Nurse practitioners (NPs) are well-situated to optimize the palliative and end-of-life care needs of LTC home residents. This study explores the role of NPs in facilitating a dignified death for LTC home residents while also facing increased pressures related to the COVID-19 pandemic. The current exploratory qualitative study employed a phenomenological approach. A purposive sample of 14 NPs working in LTC homes was recruited. Data were generated using semi-structured interviews and examined using thematic analysis. Three categories were derived: (a) advance care planning and goals of care discussions; (b) pain and symptom management at the end-of-life; and (c) care after death. The findings suggest that further implementation of the NP role in LTC homes in collaboration with LTC home team and external partners will promote a good death and optimize the experiences of residents and their care partners during the end-of-life journey. Full article

(This article belongs to the Special Issue Personalized Nursing and Health Care)

14 pages, 948 KiB

Open AccessArticle

Biomarkers Linked with Dynamic Changes of Renal Function in Asymptomatic and Mildly Symptomatic COVID-19 Patients

by Ya-Chieh Chang, Ping-Huang Tsai, Yu-Ching Chou, Kuo-Cheng Lu, Feng-Yee Chang and Chia-Chao Wu

J. Pers. Med. 2021, 11(5), 432; https://doi.org/10.3390/jpm11050432 - 19 May 2021

Cited by 12 | Viewed by 2373

Abstract

The catastrophic coronavirus disease 2019 (COVID-19) pandemic is currently a critical global issue. One well-known complication of COVID-19 in severe cases is acute kidney injury, but no research has given a description of its impact on the kidney in patients with mild symptoms. [...] Read more.

The catastrophic coronavirus disease 2019 (COVID-19) pandemic is currently a critical global issue. One well-known complication of COVID-19 in severe cases is acute kidney injury, but no research has given a description of its impact on the kidney in patients with mild symptoms. We explore the renal function changes in mild COVID-19 patients. This retrospective, single-center study included 27 participants with laboratory-detected severe acute respiratory syndrome coronavirus two (SARS-CoV-2) infection who were admitted to the Tri-Service General Hospital from 4 February to 26 May 2020 and analyzed their clinical features, radiological findings, and laboratory data. Data collected upon admission and discharge showed a median estimated glomerular filtration rate (eGFR) of 106.7 mL/min/1.732 m² and 112.2 mL/min/1.732 m², respectively, with a p-value of 0.044. A correlation between renal function and the severity of infection was also found and was statistically significant upon admission. Patients with a lower lymphocyte count or higher C-reactive protein, neutrophil count, and neutrophil-to-lymphocyte ratio presented with a decreased eGFR during their early infection phase. The biomarkers (CRP and NLR) may be linked with dynamic changes of renal function in COVID-19 patients who are asymptomatic or have mild symptoms. Full article

(This article belongs to the Special Issue COVID-19 Related Complications)

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15 pages, 3435 KiB

Open AccessArticle

SARS-CoV-2-Laden Respiratory Aerosol Deposition in the Lung Alveolar-Interstitial Region Is a Potential Risk Factor for Severe Disease: A Modeling Study

by Sabine Hofer, Norbert Hofstätter, Albert Duschl and Martin Himly

J. Pers. Med. 2021, 11(5), 431; https://doi.org/10.3390/jpm11050431 - 19 May 2021

Cited by 8 | Viewed by 15752

Abstract

COVID-19, predominantly a mild disease, is associated with more severe clinical manifestation upon pulmonary involvement. Virion-laden aerosols and droplets target different anatomical sites for deposition. Compared to droplets, aerosols more readily advance into the peripheral lung. We performed in silico modeling to confirm [...] Read more.

COVID-19, predominantly a mild disease, is associated with more severe clinical manifestation upon pulmonary involvement. Virion-laden aerosols and droplets target different anatomical sites for deposition. Compared to droplets, aerosols more readily advance into the peripheral lung. We performed in silico modeling to confirm the secondary pulmonary lobules as the primary site of disease initiation. By taking different anatomical aerosol origins into consideration and reflecting aerosols from exhalation maneuvers breathing and vocalization, the physicochemical properties of generated respiratory aerosol particles were defined upon conversion to droplet nuclei by evaporation at ambient air. To provide detailed, spatially-resolved information on particle deposition in the thoracic region of the lung, a top-down refinement approach was employed. Our study presents evidence for hot spots of aerosol deposition in lung generations beyond the terminal bronchiole, with a maximum in the secondary pulmonary lobules and a high preference to the lower lobes of both lungs. In vivo, initial chest CT anomalies, the ground glass opacities, resulting from partial alveolar filling and interstitial thickening in the secondary pulmonary lobules, are likewise localized in these lung generations, with the highest frequency in both lower lobes and in the early stage of disease. Hence, our results suggest a disease initiation right there upon inhalation of virion-laden respiratory aerosols, linking the aerosol transmission route to pathogenesis associated with higher disease burden and identifying aerosol transmission as a new independent risk factor for developing a pulmonary phase with a severe outcome. Full article

(This article belongs to the Special Issue COVID-19 Related Complications)

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12 pages, 2879 KiB

Open AccessArticle

Viability of Quercetin-Induced Dental Pulp Stem Cells in Forming Living Cellular Constructs for Soft Tissue Augmentation

by Hytham N. Fageeh, Shilpa Bhandi, Mohammed Mashyakhy, Ahmed Al Kahtani, Zahi Badran, Deepak Mehta, Hammam Ibrahim Fageeh, Thodur Madapusi Balaji, Hosam Ali Baeshen, Saranya Varadarajan, A. Thirumal Raj, Vikrant R. Patil, Nishant Vyas, Alessio Zanza, Luca Testarelli and Shankargouda Patil

J. Pers. Med. 2021, 11(5), 430; https://doi.org/10.3390/jpm11050430 - 18 May 2021

Cited by 4 | Viewed by 3141

Abstract

Autogenous gingival grafts used for root coverage or gingival augmentation procedures often result in donor site morbidity. Living cellular constructs as an exogenous alternative have been proven to be associated with lower morbidity. With the available background information, the present study aims to [...] Read more.

Autogenous gingival grafts used for root coverage or gingival augmentation procedures often result in donor site morbidity. Living cellular constructs as an exogenous alternative have been proven to be associated with lower morbidity. With the available background information, the present study aims to assess if quercetin-induced living cell constructs, derived from dental pulp stem cells, have the potential to be applied as a tool for soft tissue augmentation. The characterized dental pulp stem cells (positive for CD73, CD90, and negative for CD34, HLA-DR) were expanded in Dulbecco’s Modified Eagle’s medium (DMEM) supplemented with 10 mM quercetin. The handling properties of the quercetin-induced dental pulp stem cell constructs were assessed by visual, and tactile sensation. A microscopic characterization using hematoxylin and eosin staining, and qRT-PCR-based analysis for stemness-associated genes (OCT4, NANOG, SOX2, and cMyc) was also performed. Dental pulp stem cells without quercetin administration were used as the control. Dental pulp stem cell constructs induced by quercetin easily detached from the surface of the plate, whereas there was no formation in the control cells. It was also simple to transfer the induced cellular construct on the flattened surface. Microscopic characterization of the constructs showed cells embedded in a tissue matrix. Quercetin also increased the expression of stemness-related genes. The use of quercetin-induced DPSC living constructs for soft tissue augmentation could provide an alternative to autogenous soft tissue grafts to lower patient morbidity and improve esthetic outcomes. Full article

(This article belongs to the Section Clinical Medicine, Cell, and Organism Physiology)

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20 pages, 2715 KiB

Open AccessArticle

Effectiveness of Cognitive Rehabilitation in Parkinson’s Disease: A Systematic Review and Meta-Analysis

by Itsasne Sanchez-Luengos, Yolanda Balboa-Bandeira, Olaia Lucas-Jiménez, Natalia Ojeda, Javier Peña and Naroa Ibarretxe-Bilbao

J. Pers. Med. 2021, 11(5), 429; https://doi.org/10.3390/jpm11050429 - 18 May 2021

Cited by 14 | Viewed by 4959

Abstract

Cognitive deficits influence the quality of life of Parkinson’s disease (PD) patients. In order to reduce the impact of cognitive impairment in PD, cognitive rehabilitation programs have been developed. This study presents a systematic review and meta-analysis regarding the effectiveness of cognitive rehabilitation [...] Read more.

Cognitive deficits influence the quality of life of Parkinson’s disease (PD) patients. In order to reduce the impact of cognitive impairment in PD, cognitive rehabilitation programs have been developed. This study presents a systematic review and meta-analysis regarding the effectiveness of cognitive rehabilitation in non-demented PD patients. Twelve articles were selected according to PRISMA guidelines. The systematic review showed that attention, working memory, verbal memory, executive functions and processing speed were the most frequently improved domains. Meta-analysis results showed moderate effects on global cognitive status (g = 0.55) and working memory (g = 0.50); small significant effects on verbal memory (g = 0.41), overall cognitive functions (g = 0.39) and executive functions (g = 0.30); small non-significant effects on attention (g = 0.36), visual memory (g = 0.29), verbal fluency (g = 0.27) and processing speed (g = 0.24); and no effect on visuospatial and visuoconstructive abilities (g = 0.17). Depressive symptoms showed small effect (g = 0.24) and quality of life showed no effect (g = −0.07). A meta-regression was performed to examine moderating variables of overall cognitive function effects, although moderators did not explain the heterogeneity of the improvement after cognitive rehabilitation. The findings suggest that cognitive rehabilitation may be beneficial in improving cognition in non-demented PD patients, although further studies are needed to obtain more robust effects. Full article

(This article belongs to the Special Issue Personalized Medicine for Parkinson's Disease: New Concepts and Future of Individualized Management)

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12 pages, 4481 KiB

Open AccessArticle

Association of Preoperative Prognostic Nutritional Index and Postoperative Acute Kidney Injury in Patients Who Underwent Hepatectomy for Hepatocellular Carcinoma

by Ji Hoon Sim, In-Gu Jun, Young-Jin Moon, A Rom Jeon, Sung-Hoon Kim, Bomi Kim and Jun-Gol Song

J. Pers. Med. 2021, 11(5), 428; https://doi.org/10.3390/jpm11050428 - 18 May 2021

Cited by 14 | Viewed by 2160

Abstract

Various biological indicators are reportedly associated with postoperative acute kidney injury (AKI) in the surgical treatment of hepatocellular carcinoma (HCC). However, only a few studies have evaluated the association between the preoperative prognostic nutritional index (PNI) and postoperative AKI. This study evaluated the [...] Read more.

Various biological indicators are reportedly associated with postoperative acute kidney injury (AKI) in the surgical treatment of hepatocellular carcinoma (HCC). However, only a few studies have evaluated the association between the preoperative prognostic nutritional index (PNI) and postoperative AKI. This study evaluated the association of the preoperative PNI and postoperative AKI in HCC patients. We retrospectively analyzed 817 patients who underwent open hepatectomy between December 2007 and December 2015. Multivariate regression analysis was performed to evaluate the association between the PNI and postoperative AKI. Additionally, we evaluated the association between the PNI and outcomes such as postoperative renal replacement therapy (RRT) and mortality. Cox regression analysis was performed to assess the risk factors for one-year and five-year mortality. In the multivariate analysis, high preoperative PNI was significantly associated with a lower incidence of postoperative AKI (odds ratio (OR): 0.92, 95% confidence interval (CI): 0.85 to 0.99, p = 0.021). Additionally, diabetes mellitus and the use of synthetic colloids were significantly associated with postoperative AKI. PNI was associated with postoperative RRT (OR: 0.76, 95% CI: 0.60 to 0.98, p = 0.032) even after adjusting for other potential confounding variables. In the Cox regression analysis, high PNI was significantly associated with low one-year mortality (Hazard ratio (HR): 0.87, 95% CI: 0.81 to 0.94, p < 0.001), and five-year mortality (HR: 0.93, 95% CI: 0.90–0.97, p < 0.001). High preoperative PNI was significantly associated with a lower incidence of postoperative AKI and low mortality. These results suggest that the preoperative PNI might be a predictor of postoperative AKI and surgical prognosis in HCC patients undergoing open hepatectomy. Full article

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13 pages, 1189 KiB

Open AccessArticle

Concurrent Chemoradiation in Anal Cancer Patients Delivered with Bone Marrow-Sparing IMRT: Final Results of a Prospective Phase II Trial

by Francesca Arcadipane, Patrick Silvetti, Francesco Olivero, Alessio Gastino, Roberta Carlevato, Ilaria Chiovatero, Lavinia Spinelli, Massimiliano Mistrangelo, Paola Cassoni, Giuliana Ritorto, Elena Gallio, Adriana Lesca, Riccardo Faletti, Francesca Romana Giglioli, Christian Fiandra, Umberto Ricardi and Pierfrancesco Franco

J. Pers. Med. 2021, 11(5), 427; https://doi.org/10.3390/jpm11050427 - 18 May 2021

Cited by 8 | Viewed by 2135

Abstract

We investigated the role of the selective avoidance of haematopoietically active pelvic bone marrow (BM), with a targeted intensity-modulated radiotherapy (IMRT) approach, to reduce acute hematologic toxicity (HT) in anal cancer patients undergoing concurrent chemo-radiation. We designed a one-armed two-stage Simon’s design study [...] Read more.

We investigated the role of the selective avoidance of haematopoietically active pelvic bone marrow (BM), with a targeted intensity-modulated radiotherapy (IMRT) approach, to reduce acute hematologic toxicity (HT) in anal cancer patients undergoing concurrent chemo-radiation. We designed a one-armed two-stage Simon’s design study to test the hypothesis that BM-sparing IMRT would improve by 20% the rate of G0–G2 (vs. G3–G4) HT, from 42% of RTOG 0529 historical data to 62% (α = 0.05; β = 0.20). A minimum of 21/39 (54%) with G0–G2 toxicity represented the threshold for the fulfilment of the criteria to define this approach as ‘promising’. We employed ¹⁸FDG-PET to identify active BM within the pelvis. Acute HT was assessed via weekly blood counts and scored as per the Common Toxicity Criteria for Adverse Effects version 4.0. From December 2017 to October 2020, we enrolled 39 patients. Maximum observed acute HT comprised 20% rate of ≥G3 leukopenia and 11% rate of ≥G3 thrombocytopenia. Overall, 11 out of 39 treated patients (28%) experienced ≥G3 acute HT. Conversely, in 28 patients (72%) G0–G2 HT events were observed, above the threshold set. Hence, ¹⁸FDG-PET-guided BM-sparing IMRT was able to reduce acute HT in this clinical setting. Full article

(This article belongs to the Special Issue Imaging Biomarkers for Stratified Medicine and Personalised Healthcare)

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16 pages, 1346 KiB

Open AccessArticle

Psychoactive Medication, Violence, and Variant Alleles for Cytochrome P450 Genes

by Selma J. M. Eikelenboom-Schieveld and James C. Fogleman

J. Pers. Med. 2021, 11(5), 426; https://doi.org/10.3390/jpm11050426 - 18 May 2021

Viewed by 4357

Abstract

From the start of the use of psychoactive prescription medications in the 1950s, physicians reported paradoxical adverse reactions, ranging from newly developing depressions to an increase in existing mood disorders, and extremely violent and bizarre acts of suicide and homicide. It is hypothesized [...] Read more.

From the start of the use of psychoactive prescription medications in the 1950s, physicians reported paradoxical adverse reactions, ranging from newly developing depressions to an increase in existing mood disorders, and extremely violent and bizarre acts of suicide and homicide. It is hypothesized that interactions between the drugs and the enzymes that are primarily responsible for their metabolism (cytochrome P450s) could cause these reactions. In this research, we evaluate statistical associations between CYP450 variant alleles, psychoactive medication, and acts of violence. Fifty-five persons who showed violent behavior or an altered emotional state were investigated for prescribed medication. Fifty-eight volunteers with no history of violence served as the controls. Genetic testing was performed on CYP2B6, CYP2C8, CYP2C9, CYP2C19, CYP2D6 and CYP3A4. Statistical analysis was applied to gender, age, number of variant alleles, number and kind of medications, and potential drug–drug, drug–gene, and drug–drug–gene interactions. Four risk factors for developing an altered emotional state and/or acts of violence were identified. There is an association between prescription drugs (most notably antidepressants and other psychoactive medication), having variant alleles for CYP450 genes, and altered emotional states or acts of violence. Full article

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11 pages, 962 KiB

Open AccessArticle

Polygenic Panels Predicting the Susceptibility of Multiple Upper Aerodigestive Tract Cancer in Oral Cancer Patients

by Huei-Tzu Chien, Chi-Chin Yeh, Chi-Kuang Young, Tzu-Ping Chen, Chun-Ta Liao, Hung-Ming Wang, Kai-Lun Cho and Shiang-Fu Huang

J. Pers. Med. 2021, 11(5), 425; https://doi.org/10.3390/jpm11050425 - 18 May 2021

Cited by 1 | Viewed by 2094

Abstract

Head and neck cancer was closely related with habitual use of cigarette and alcohol. Those cancer patients are susceptible to develop multiple primary tumors (MPTs). In this study, we utilized the single nucleotide polymorphisms (SNPs) array (Affymetrix Axion Genome-Wide TWB 2.0 Array Plate) [...] Read more.

Head and neck cancer was closely related with habitual use of cigarette and alcohol. Those cancer patients are susceptible to develop multiple primary tumors (MPTs). In this study, we utilized the single nucleotide polymorphisms (SNPs) array (Affymetrix Axion Genome-Wide TWB 2.0 Array Plate) to investigate patients’ risks of developing multiple primary cancers. We recruited 712 male head and neck cancer patients between Mar 1996 and Feb 2017. Two hundred and eighty-six patients (40.2%) had MPTs and 426 (59.8%) had single cancer. Four hundred and twelve normal controls were also recruited. A list of seventeen factors was extracted and ten factors were demonstrated to increase the risks of multiple primary cancers (alcohol drinking, rs118169127, rs149089400, rs76367287, rs61401220, rs141057871, rs7129229, older age, rs3760265, rs9554264; all were p value < 0.05). Polygenic scoring model was built and the area under curve to predict the risk developing MPTs is 0.906. Alcohol drinking, among the seventeen factors, was the most important risk factor to develop MPT in upper aerodigestive tract (OR: 7.071, 95% C.I.: 2.134–23.434). For those with high score in polygenic model, routine screening of upper digestive tract including laryngoscope and esophagoscope is suggested to detect new primaries early. Full article

(This article belongs to the Special Issue Personalized Medicine in Oral Cancer)

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14 pages, 876 KiB

Open AccessArticle

Evaluation of Drug—Drug Interactions in EGFR-Mutated Non-Small-Cell Lung Cancer Patients during Treatment with Tyrosine-Kinase Inhibitors

by Mario Occhipinti, Marta Brambilla, Giulia Galli, Sara Manglaviti, Maristella Giammaruco, Arsela Prelaj, Roberto Ferrara, Alessandro De Toma, Claudia Proto, Teresa Beninato, Emma Zattarin, Giuseppe Lo Russo, Alain Jonathan Gelibter, Maurizio Simmaco, Robert Preissner, Marina Chiara Garassino, Filippo De Braud and Paolo Marchetti

J. Pers. Med. 2021, 11(5), 424; https://doi.org/10.3390/jpm11050424 - 18 May 2021

Cited by 10 | Viewed by 2876

Abstract

(1) Background. The onset of a drug–drug interaction (DDI) may affect treatment efficacy and toxicity of advanced non-small-cell lung cancer (aNSCLC) patients during epidermal growth factor receptor (EGFR) tyrosine-kinase inhibitor (TKI) use. Here we present the use of Drug-PIN^® (Personalized Interactions Network) [...] Read more.

(1) Background. The onset of a drug–drug interaction (DDI) may affect treatment efficacy and toxicity of advanced non-small-cell lung cancer (aNSCLC) patients during epidermal growth factor receptor (EGFR) tyrosine-kinase inhibitor (TKI) use. Here we present the use of Drug-PIN^® (Personalized Interactions Network) software to detect DDIs in aNSCLC patients undergoing EGFR-TKIs. (2) Methods. We enrolled patients with Stage IV aNSCLC already treated with or candidates to receive EGFR-TKIs, in any line; ECOG PS 0–2; taking at least one concomitant drug. Cancer treatments, concomitant drugs, and clinical and laboratory data were collected and inserted in Drug-PIN^®. (3) Results. Ninety-two patients, median age of 68.5 years (range 43–89), were included. In total, 20 clinically relevant DDIs needing medical intervention in a total of 14 patients were identified; the 14 major DDIs were related to a high-grade interaction between TKIs and SSRIs, antipsychotics, antiepileptics, H2-receptor antagonist and calcium antagonists. A negative association between statin intake and PFS was identified (p = 0.02; HR 0.281, 95% CI 0.096–0.825). (4) Conclusions. This is the first retrospective study assessing the prevalence of DDIs, the clinical need for medical intervention and the impact of concomitant drugs on EGFR-TKIs survival in aNSCLC. Full article

(This article belongs to the Section Pharmacogenetics)

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18 pages, 558 KiB

Open AccessReview

Patient-Derived Cancer Organoids for Precision Oncology Treatment

by Mark N. Pernik, Cylaina E. Bird, Jeffrey I. Traylor, Diana D. Shi, Timothy E. Richardson, Samuel K. McBrayer and Kalil G. Abdullah

J. Pers. Med. 2021, 11(5), 423; https://doi.org/10.3390/jpm11050423 - 17 May 2021

Cited by 20 | Viewed by 6421

Abstract

The emergence of three-dimensional human organoids has opened the door for the development of patient-derived cancer organoid (PDO) models, which closely recapitulate parental tumor tissue. The mainstays of preclinical cancer modeling include in vitro cell lines and patient-derived xenografts, but these models lack [...] Read more.

The emergence of three-dimensional human organoids has opened the door for the development of patient-derived cancer organoid (PDO) models, which closely recapitulate parental tumor tissue. The mainstays of preclinical cancer modeling include in vitro cell lines and patient-derived xenografts, but these models lack the cellular heterogeneity seen in human tumors. Moreover, xenograft establishment is resource and time intensive, rendering these models difficult to use to inform clinical trials and decisions. PDOs, however, can be created efficiently and retain tumor-specific properties such as cellular heterogeneity, cell–cell and cell–stroma interactions, the tumor microenvironment, and therapeutic responsiveness. PDO models and drug-screening protocols have been described for several solid tumors and, more recently, for gliomas. Since PDOs can be developed in clinically relevant time frames and share many characteristics of parent tumors, they may enhance the ability to provide precision oncologic care for patients. This review explores the current literature on cancer organoids, highlighting the history of PDO development, organoid models of glioma, and potential clinical applications of PDOs. Full article

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Graphical abstract

12 pages, 534 KiB

Open AccessArticle

Increased Incidence and Associated Risk Factors of Aspergillosis in Patients with Bronchiectasis

by Bumhee Yang, Taehee Kim, Jiin Ryu, Hye Yun Park, Bin Hwangbo, Sun-Young Kong, Yong-Soo Kwon, Seung Jun Lee, Seung Won Ra, Yeon-Mok Oh, Jang Won Sohn, Kang Hyeon Choe, Hayoung Choi and Hyun Lee

J. Pers. Med. 2021, 11(5), 422; https://doi.org/10.3390/jpm11050422 - 17 May 2021

Cited by 8 | Viewed by 2518

Abstract

There are insufficient data regarding the relationship between non-cystic fibrosis bronchiectasis and incident aspergillosis. We performed a population-based, matched cohort study using data from the Korean National Health Insurance database between 2003 and 2013. The incidence of aspergillosis was 50/100,000 person-years in the [...] Read more.

There are insufficient data regarding the relationship between non-cystic fibrosis bronchiectasis and incident aspergillosis. We performed a population-based, matched cohort study using data from the Korean National Health Insurance database between 2003 and 2013. The incidence of aspergillosis was 50/100,000 person-years in the bronchiectasis cohort and 11/100,000 person-years in the matched cohort (subdistribution hazard ratio, 4.53; 95% confidence interval (CI), 3.25–6.32). Among the bronchiectasis cohort, chronic obstructive pulmonary disease (adjusted HR, 1.95; 95% CI, 1.07–3.57), previous pulmonary tuberculosis (adjusted HR, 3.67; 95% CI, 2.03–6.64), and non-tuberculous mycobacterial pulmonary disease (adjusted HR, 11.25; 95% CI, 1.49–85.18) increased the risk of incident aspergillosis. The incidence of aspergillosis in patients with bronchiectasis was approximately 4.5-fold that in those without bronchiectasis. Comorbid pulmonary diseases—chronic obstructive pulmonary disease, previous pulmonary tuberculosis, and non-tuberculous mycobacterial pulmonary disease—significantly increased the risk of aspergillosis in patients with bronchiectasis. Our study indicates that close monitoring is warranted for aspergillosis in patients with bronchiectasis. Full article

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13 pages, 1604 KiB

Open AccessArticle

Personalized Medicine Based on Nasal Epithelial Cells: Comparative Studies with Rectal Biopsies and Intestinal Organoids

by Iris A. L. Silva, Violeta Railean, Aires Duarte and Margarida D. Amaral

J. Pers. Med. 2021, 11(5), 421; https://doi.org/10.3390/jpm11050421 - 16 May 2021

Cited by 19 | Viewed by 3181

Abstract

As highly effective CFTR modulator therapies (HEMT) emerge, there is an unmet need to find effective drugs for people with CF (PwCF) with ultra-rare mutations who are too few for classical clinical trials and for whom there are no drug discovery programs. Therefore, [...] Read more.

As highly effective CFTR modulator therapies (HEMT) emerge, there is an unmet need to find effective drugs for people with CF (PwCF) with ultra-rare mutations who are too few for classical clinical trials and for whom there are no drug discovery programs. Therefore, biomarkers reliably predicting the benefit from CFTR modulator therapies are essential to find effective drugs for PwCF through personalized approaches termed theranostics. Here, we assess CFTR basal function and the individual responses to CFTR modulators in primary human nasal epithelial (pHNE) cells from PwCF carrying rare mutations and compare these measurements with those in native rectal biopsies and intestinal organoids, respectively, in the same individual. The basal function in pHNEs shows good correlation with CFTR basal function in rectal biopsies. In parallel, CFTR rescue in pHNEs by CFTR modulators correlates to that in intestinal organoids. Altogether, results show that pHNEs are a bona fide theranostic model to assess CFTR rescue by CFTR modulator drugs, in particular for PwCF and rare mutations. Full article

(This article belongs to the Special Issue Cystic Fibrosis and Personalized Medicine)

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10 pages, 1022 KiB

Open AccessArticle

Lincp21-RNA as Predictive Response Marker for Preoperative Chemoradiotherapy in Rectal Cancer

by Jose Carlos Benitez, Marc Campayo, Tania Díaz, Carme Ferrer, Melissa Acosta-Plasencia, Mariano Monzo, Luis Cirera, Benjamin Besse and Alfons Navarro

J. Pers. Med. 2021, 11(5), 420; https://doi.org/10.3390/jpm11050420 - 16 May 2021

Cited by 6 | Viewed by 2431

Abstract

Preoperative chemoradiotherapy (CRT) is a standard treatment for locally advanced rectal cancer (RC) patients, but its use in non-responders can be associated with increased toxicities and resection delay. LincRNA-p21 is a long non-coding RNA involved in the p53 pathway and angiogenesis regulation. We [...] Read more.

Preoperative chemoradiotherapy (CRT) is a standard treatment for locally advanced rectal cancer (RC) patients, but its use in non-responders can be associated with increased toxicities and resection delay. LincRNA-p21 is a long non-coding RNA involved in the p53 pathway and angiogenesis regulation. We aimed to study whether lincRNA-p21 expression levels can act as a predictive biomarker for neoadjuvant CRT response. We analyzed RNAs from pretreatment biopsies from 70 RC patients treated with preoperative CRT. Pathological response was classified according to the tumor regression grade (TRG) Dworak classification. LincRNA-p21 expression was determined by RTqPCR. The results showed that lincRNA-p21 was upregulated in stage III tumors (p = 0.007) and in tumors with the worst response regarding TRG (p = 0.027) and downstaging (p = 0.016). ROC curve analysis showed that lincRNA-p21 expression had the capacity to distinguish a complete response from others (AUC:0.696; p = 0.014). LincRNA-p21 was shown as an independent marker of preoperative CRT response (p = 0.047) and for time to relapse (TTR) (p = 0.048). In conclusion, lincRNA-p21 is a marker of advanced disease, worse response to neoadjuvant CRT, and shorter TTR in locally advanced RC patients. The study of lincRNA-p21 may be of value in the individualization of pre-operative CRT in RC. Full article

(This article belongs to the Special Issue Cancer Biomarker Research and Personalized Medicine)

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17 pages, 1882 KiB

Open AccessArticle

Three-Year Follow-Up of Laser In Situ Keratomileusis Treatments for Myopia: Multi-Center Cohort Study in Korean Population

by Jae-Yong Kim, Hun Lee, Choun-Ki Joo, Joon-Young Hyon, Tae-Im Kim, Jin-Hyoung Kim, Jin-Kuk Kim, Eun-Young Cho, Ji-Eun Choi, Na-Rae Lee and Hung-Won Tchah

J. Pers. Med. 2021, 11(5), 419; https://doi.org/10.3390/jpm11050419 - 16 May 2021

Cited by 4 | Viewed by 2570

Abstract

This multi-center cohort study included 3401 myopic laser in situ keratomileusis (LASIK) procedures conducted in 1756 myopia patients between 2002 and 2005. Pre- and postoperative uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), and manifest refraction spherical equivalent (SE) were recorded. Factors [...] Read more.

This multi-center cohort study included 3401 myopic laser in situ keratomileusis (LASIK) procedures conducted in 1756 myopia patients between 2002 and 2005. Pre- and postoperative uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), and manifest refraction spherical equivalent (SE) were recorded. Factors predicting low postoperative efficacy (defined as a postoperative UCVA < 0.5) were identified using univariate and multivariate logistic regression analysis. Compared with 1 month postoperatively, logMAR UCVA at 3 months postoperatively was significantly decreased (p = 0.002) and that at 2 and 3 years was significantly increased (p < 0.001). LogMAR BCVA at 2 years postoperatively was significantly decreased compared with 1 month postoperatively (p = 0.008). Over the 3-year postoperative period, overall refractive predictability within ±1.00 D and ±0.50 D ranged from 69.0% to 86.2% and from 43.3% to 67.8%, respectively. This also decreased from 1 month to 6 months postoperatively (p < 0.005). Multivariate logistic regression analysis using generalized estimating equations, revealed that higher preoperative SE (odds ratio [OR], 2.58 and 7.23; p < 0.001) and lower preoperative BCVA (OR, 2.44; p = 0.003) were predictive of a low postoperative efficacy. In summary, myopic LASIK can be effective and safe with a high refractive predictability in a Korean population, but myopic regression occurs over time. Higher preoperative SE and lower preoperative BCVA are predictive of a low postoperative efficacy. Full article

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11 pages, 1150 KiB

Open AccessReview

Fertility, Pregnancy and Lactation Considerations for Women with CF in the CFTR Modulator Era

by Raksha Jain and Jennifer L. Taylor-Cousar

J. Pers. Med. 2021, 11(5), 418; https://doi.org/10.3390/jpm11050418 - 15 May 2021

Cited by 26 | Viewed by 5116

Abstract

Cystic fibrosis (CF) is an autosomal recessive genetic disorder impacting approximately 80,000 people of all races and ethnicities world-wide. CF is caused by mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene which encodes a protein of the same name. Protein dysfunction [...] Read more.

Cystic fibrosis (CF) is an autosomal recessive genetic disorder impacting approximately 80,000 people of all races and ethnicities world-wide. CF is caused by mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene which encodes a protein of the same name. Protein dysfunction results in abnormal chloride and bicarbonate transport in mucus membranes, including those in the respiratory, gastrointestinal and reproductive tracts. Abnormal anion transport causes viscous secretions at the site of involvement. The majority of people with CF succumb to respiratory failure following recurrent cycles of infection and inflammation in the airways. Historically, providers treated the signs and symptoms of CF, but since 2012, have been able to impact the basic defect for the subset of people with CF who have mutations that respond to the new class of drugs, CFTR protein modulators. With the improved health and longevity afforded by CFTR modulators, more women are interested in parenthood and are becoming pregnant. Furthermore, this class of drugs likely increases fertility in women with CF. However, the safety of CFTR modulators in pregnancy and lactation is only beginning to be established. We summarize available data on the impact of CFTR modulators on fertility, pregnancy and lactation in women with CF. Full article

(This article belongs to the Special Issue Cystic Fibrosis and Personalized Medicine)

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8 pages, 3676 KiB

Open AccessArticle

Alteration of White Matter in Patients with Central Post-Stroke Pain

by Jung Geun Park, Bo Young Hong, Hae-Yeon Park, Yeun Jie Yoo, Mi-Jeong Yoon, Joon-Sung Kim and Seong Hoon Lim

J. Pers. Med. 2021, 11(5), 417; https://doi.org/10.3390/jpm11050417 - 15 May 2021

Cited by 9 | Viewed by 2655

Abstract

A stroke may be followed by central post-stroke pain (CPSP), which is characterized by chronic neuropathic pain. The exact mechanism has not yet been fully uncovered. We investigated alterations in the white matters in patients with CPSP, compared with stroke patients without CPSP [...] Read more.

A stroke may be followed by central post-stroke pain (CPSP), which is characterized by chronic neuropathic pain. The exact mechanism has not yet been fully uncovered. We investigated alterations in the white matters in patients with CPSP, compared with stroke patients without CPSP and normal controls. Our retrospective cross-sectional, case-control study participants were assigned to three groups: CPSP (stroke patients with CPSP (n = 17)); stroke control (stroke patients without CPSP (n = 26)); and normal control (normal subjects (n = 34)). The investigation of white matter for CPSP was focused on the values of fiber numbers (FN) and fractional anisotrophy (FA) for spinothalamic tract (STT), anterior thalamic radiation (ATR), superior thalamic radiation (STR) and posterior thalamic radiation (PTR), and corticospinal tract (CST) was measured. The FA for the STT and STR of the CPSP group were lower than those for the stroke control and normal control groups. The FA of CST and ATR did not differ between the CPSP and stroke groups, but both differed from the normal control. The FA of PTR in the stroke control group differed from the normal control group, but not from the CPSP group. The FN of CST, STT, ATR, and STR for the CPSP and stroke control groups did not differ from each other, but both differed from those of normal controls. FN of PTR did not differ between the CPSP and normal control groups. The alterations in the spinothalamic tract and superior thalamic radiation after stroke would play a role in the pathogenesis of CPSP. Full article

(This article belongs to the Special Issue Functional Impairment Evaluation and Personalized Treatment in Stroke Patients)

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13 pages, 994 KiB

Open AccessArticle

Prevalence and Risk Factors of Respiratory Syncytial Virus in Children under 5 Years of Age in the WHO European Region: A Systematic Review and Meta-Analysis

by Nora Suleiman-Martos, Alberto Caballero-Vázquez, Jose Luis Gómez-Urquiza, Luis Albendín-García, Jose Luis Romero-Béjar and Guillermo A. Cañadas-De la Fuente

J. Pers. Med. 2021, 11(5), 416; https://doi.org/10.3390/jpm11050416 - 15 May 2021

Cited by 19 | Viewed by 4146

Abstract

A respiratory syncytial virus (RSV) is the major cause of respiratory tract infection in children under 5 years. However, RSV infection in the European Region of the World Health Organization has not been systematically reviewed. The aim was to determine the prevalence and [...] Read more.

A respiratory syncytial virus (RSV) is the major cause of respiratory tract infection in children under 5 years. However, RSV infection in the European Region of the World Health Organization has not been systematically reviewed. The aim was to determine the prevalence and factors associated with RSV in children under 5 years of age in European regions. A systematic review and meta-analysis was performed. CINAHL, Medline, LILACS, ProQuest, SciELO, and Scopus databases were consulted for studies published in the last 5 years, following Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines. The search equation was “respiratory syncytial virus AND (newborn OR infant OR child) AND (prevalence OR risk factors)”. Studies reporting the prevalence of RSV were eligible for inclusion in the meta-analysis. A total of 20 articles were included. The meta-analytic prevalence estimation of RSV, with a sample of n = 16,115 children, was 46% (95% CI 34–59%). The main risk factors were age, male gender, winter season, and environmental factors such as cold temperatures, higher relative humidity, high concentrations of benzene, exposure to tobacco, and living in urban areas. Robust age-specific estimates of RSV infection in healthy children should be promoted in order to determine the optimal age for immunization. In addition, it is necessary to analyse in greater depth the potentially predictive factors of RSV infection, to be included in prevention strategies. Full article

(This article belongs to the Section Epidemiology)

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13 pages, 1976 KiB

Open AccessArticle

Sex-Specific Association of Uric Acid and Kidney Function Decline in Taiwan

by Po-Ya Chang, Yu-Wei Chang, Yuh-Feng Lin and Hueng-Chuen Fan

J. Pers. Med. 2021, 11(5), 415; https://doi.org/10.3390/jpm11050415 - 15 May 2021

Cited by 9 | Viewed by 3381

Abstract

An elevated serum urate concentration is associated with kidney damage. Men’s uric acid levels are usually higher than women’s. However, postmenopausal women have a higher risk of gout than men, and comorbidities are also higher than in men. This study examined the sex [...] Read more.

An elevated serum urate concentration is associated with kidney damage. Men’s uric acid levels are usually higher than women’s. However, postmenopausal women have a higher risk of gout than men, and comorbidities are also higher than in men. This study examined the sex differences in the relationship between hyperuricemia and renal progression in early chronic kidney disease (CKD) and non-CKD, and further examined the incidence of CKD in non-CKD populations among patients over 50 years of age. We analyzed 1856 women and 1852 men participating in the epidemiology and risk factors surveillance of the CKD database. Women showed a significantly higher risk of renal progression and CKD than men within the hyperuricemia group. After adjusting covariates, women, but not men resulted in an hazard ratio (HR) for developing renal progression (HR = 1.12; 95% CI 1.01–1.24 in women and HR = 1.03; 95% CI 0.93–1.13 in men) and CKD (HR = 1.11; 95% CI 1.01–1.22 in women and HR = 0.95; 95% CI 0.85–1.05 in men) for each 1 mg/dL increase in serum urate levels. The association between serum urate levels and renal progression was stronger in women. Given the prevalence and impact of kidney disease, factors that impede optimal renal function management in women and men must be identified to provide tailored treatment recommendations. Full article

(This article belongs to the Special Issue Personalized Medicine in Epidemics)

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17 pages, 13467 KiB

Open AccessArticle

Impacts of Interaction of Mental Condition and Quality of Life between Donors and Recipients at Decision-Making of Preemptive and Post-Dialysis Living-Donor Kidney Transplantation

by Toshiki Hasegawa, Kouhei Nishikawa, Yuko Tamura, Tomoka Oka, Aiko Urawa, Saori Watanabe, Shugo Mizuno and Motohiro Okada

J. Pers. Med. 2021, 11(5), 414; https://doi.org/10.3390/jpm11050414 - 14 May 2021

Cited by 3 | Viewed by 2936 | Correction

Abstract

Pre-emptive kidney transplantation (PEKT) is considered one of the most effective types of kidney replacement therapies to improve the quality of life (QOL) and physical prognosis of patients with end-stage renal disease (ESRD). In Japan, living-donor kidney transplantation is a common therapeutic option [...] Read more.

Pre-emptive kidney transplantation (PEKT) is considered one of the most effective types of kidney replacement therapies to improve the quality of life (QOL) and physical prognosis of patients with end-stage renal disease (ESRD). In Japan, living-donor kidney transplantation is a common therapeutic option for patients undergoing dialyses (PDKT). Moreover, during shared decision-making in kidney replacement therapy, the medical staff of the multidisciplinary kidney team often provide educational consultation programmes according to the QOL and sociopsychological status of the ESRD patient. In Japan, the majority of kidney donations are provided by living family members. However, neither the psychosocial status of donors associated with the decision-making of kidney donations nor the interactions of the psychosocial status between donors and recipients have been clarified in the literature. In response to this gap, the present study determined the QOL, mood and anxiety status of donors and recipients at kidney transplantation decision-making between PEKT and PDKT. Deterioration of the recipient’s QOL associated with “role physical” shifted the decision-making to PEKT, whereas deterioration of QOL associated with “role emotional” and “social functioning” of the recipients shifted the decision-making to PDKT. Furthermore, increased tension/anxiety and depressive mood contributed to choosing PDKT, but increased confusion was dominantly observed in PEKT recipients. These direct impact factors for decision-making were secondarily regulated by the trait anxiety of the recipients. Unlike the recipients, the donors’ QOL associated with vitality contributed to choosing PDKT, whereas the physical and mental health of the donors shifted the decision-making to PEKT. Interestingly, we also detected the typical features of PEKT donors, who showed higher tolerability against the trait anxiety of reactive tension/anxiety than PDKT donors. These results suggest that choosing between either PEKT or PDKT is likely achieved through the proactive support of family members as candidate donors, rather than the recipients. Furthermore, PDKT is possibly facilitated by an enrichment of the life–work–family balance of the donors. Therefore, multidisciplinary kidney teams should be aware of the familial psychodynamics between patients with ESRD and their family members during the shared decision-making process by continuing the educational consultation programmes for the kidney-replacement-therapy decision-making process. Full article

(This article belongs to the Special Issue Frontiers in Chronic Kidney Disease)

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14 pages, 10300 KiB

Open AccessArticle

A Systemic Inflammation Response Score for Prognostic Prediction of Breast Cancer Patients Undergoing Surgery

by Kaiming Zhang, Liqin Ping, Xueqi Ou, Meiheban Bazhabayi and Xiangsheng Xiao

J. Pers. Med. 2021, 11(5), 413; https://doi.org/10.3390/jpm11050413 - 14 May 2021

Cited by 3 | Viewed by 1859

Abstract

Background: Systemic inflammatory response is related to the occurrence, progression, and prognosis of cancers. In this research, a novel systemic inflammation response score (SIRS) was calculated, and its prognostic value for postoperative stage I-III breast cancer (BC) patients was analyzed. Methods: 1583 BC [...] Read more.

Background: Systemic inflammatory response is related to the occurrence, progression, and prognosis of cancers. In this research, a novel systemic inflammation response score (SIRS) was calculated, and its prognostic value for postoperative stage I-III breast cancer (BC) patients was analyzed. Methods: 1583 BC patients were included in this research. Patients were randomly divided into a training cohort (n = 1187) and validation cohort (n = 396). SIRS was established in the training cohort based on independent prognostic hematological indicator, its relationship between prognosis and clinical features was analyzed. Then, a nomogram consisted of SIRS and clinical features was established, its performance was examined by calibration plots and receiver operating characteristic curve analysis. Results: The SIRS was an independent prognostic indicator for BC patients, and a high-SIRS was related to multifocality, advanced N stage, and worse prognosis. Incorporating SIRS into a nomogram could accurately predict the prognosis of BC patients, the results of receiver operating characteristic (ROC) curve analysis showed that the area under the curve (AUC) of nomogram was up to 0.806 in training cohort and 0.905 in the validation cohort. Conclusion: SIRS was associated with the prognosis of patients with breast cancer. Nomogram based on SIRS can accurately predict the prognosis of breast cancer patients. Full article

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10 pages, 250 KiB

Open AccessArticle

CLOCK Gene Variation Is Associated with the Incidence of Metabolic Syndrome Modulated by Monounsaturated Fatty Acids

by Dayeon Shin and Kyung-Won Lee

J. Pers. Med. 2021, 11(5), 412; https://doi.org/10.3390/jpm11050412 - 14 May 2021

Cited by 4 | Viewed by 2358

Abstract

The circadian locomotor output cycles kaput (CLOCK) gene plays a crucial role in regulating circadian rhythms through its transcription factor gene product. The objective of this study was to investigate the association between CLOCK rs1801260 and the incidence of metabolic syndrome [...] Read more.

The circadian locomotor output cycles kaput (CLOCK) gene plays a crucial role in regulating circadian rhythms through its transcription factor gene product. The objective of this study was to investigate the association between CLOCK rs1801260 and the incidence of metabolic syndrome modulated by dietary monounsaturated fatty acid (MUFA) intake in Korean adults. Using a dataset from the Ansan-Ansung Cohort Study of the Korean Genome and Epidemiology Study, 3608 Korean adults were included after an average of nine years of follow-up. Men who were minor allele carriers (G allele) of CLOCK rs1801260 had a 18% higher incidence of metabolic syndrome than non-carriers [hazard ratio (HR), 1.18; 95% confidence interval (CI), 1.00–1.40; p Value = 0.047]. By dichotomizing dietary MUFA intake, we observed that men who were minor allele carriers (G allele) of CLOCK rs1801260 had a 42% increased incidence of metabolic syndrome when dietary MUFA intake was ≤3.5% (HR: 1.42, 95% CI 1.23–1.81; p Value = 0.004). No significant association was found between CLOCK rs1801260 and the incidence of metabolic syndrome modulated by dietary MUFA intake in women. CLOCK polymorphisms affected metabolic syndrome, modulated by dietary MUFA intake in men. These results suggest the significance of CLOCK genes in the pathogenesis of metabolic syndrome and the modulating role of dietary MUFA intake and provide new insights into the underlying mechanisms connecting the circadian system, dietary factors, and metabolic syndrome. Full article

(This article belongs to the Special Issue Personalized Therapy, Personalized Nutrition, and Chronic Disease)

6 pages, 223 KiB

Open AccessStudy Protocol

Patient-Centered Care for People with Depression and Anxiety: An Integrative Review Protocol

by Lara Guedes de Pinho, Tânia Correia, Manuel José Lopes, César Fonseca, Maria do Céu Marques, Francisco Sampaio and Helena Reis do Arco

J. Pers. Med. 2021, 11(5), 411; https://doi.org/10.3390/jpm11050411 - 13 May 2021

Cited by 6 | Viewed by 3557

Abstract

Introduction: Depression and anxiety are mental diseases found worldwide, with the tendency to worsen in the current pandemic period. These illnesses contribute the most to the world’s rate of years lived with disability. We aim to identify and synthesize indicators for the [...] Read more.

Introduction: Depression and anxiety are mental diseases found worldwide, with the tendency to worsen in the current pandemic period. These illnesses contribute the most to the world’s rate of years lived with disability. We aim to identify and synthesize indicators for the care process of the person with depression and/or anxiety disorders, based on patient-centered care, going through the stages of diagnostic assessment, care planning, and intervention. Methods and analysis: An integrative literature review will be conducted, and the research carried out on the following databases: MEDLINE, PsycINFO, Scopus, and Psychology and Behavioral Sciences Collection, CINAHL, Web of Science, TrialRegistry, and MedicLatina. The research strategy contains the following terms MesH or similar: “patient-centered care,” “depression,” and “anxiety.” Two independent revisers will perform the inclusion and exclusion criteria analysis, the quality analysis of the data, and its extraction for synthesis. Disagreements will be resolved by a third revisor. All studies related to diagnostic assessment, care planning, or intervention strategies will be included as long as they focus on care focused on people with depression and anxiety, regardless of the context. Given the plurality of the eligible studies, we used the narrative synthesis method for the analysis of the diagnostic assessment, the care and intervention planning, and the facilitators and barriers. PROSPERO registration number: CRD42021235405. Full article

17 pages, 386 KiB

Open AccessReview

Future Perspectives of Proton Therapy in Minimizing the Toxicity of Breast Cancer Radiotherapy

by Marika Musielak, Wiktoria M. Suchorska, Magdalena Fundowicz, Piotr Milecki and Julian Malicki

J. Pers. Med. 2021, 11(5), 410; https://doi.org/10.3390/jpm11050410 - 13 May 2021

Cited by 12 | Viewed by 3783

Abstract

The toxicity of radiotherapy is a key issue when analyzing the eligibility criteria for patients with breast cancer. In order to obtain better results, proton therapy is proposed because of the more favorable distribution of the dose in the patient’s body compared with [...] Read more.

The toxicity of radiotherapy is a key issue when analyzing the eligibility criteria for patients with breast cancer. In order to obtain better results, proton therapy is proposed because of the more favorable distribution of the dose in the patient’s body compared with photon radiotherapy. Scientific groups have conducted extensive research into the improved efficacy and lower toxicity of proton therapy for breast cancer. Unfortunately, there is no complete insight into the potential reasons and prospects for avoiding undesirable results. Cardiotoxicity is considered challenging; however, researchers have not presented any realistic prospects for preventing them. We compared the clinical evidence collected over the last 20 years, providing the rationale for the consideration of proton therapy as an effective solution to reduce cardiotoxicity. We analyzed the parameters of the dose distribution (mean dose, Dmax, V5, and V20) in organs at risk, such as the heart, blood vessels, and lungs, using the following two irradiation techniques: whole breast irradiation and accelerated partial breast irradiation. Moreover, we presented the possible causes of side effects, taking into account biological and technical issues. Finally, we collected potential improvements in higher quality predictions of toxic cardiac effects, like biomarkers, and model-based approaches to give the full background of this complex issue. Full article

(This article belongs to the Special Issue The Role of Radiation in Cancer Treatment: New Insights towards Personalized Therapies)

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