Purpose
To evaluate the diagnostic performance of chest CT to differentiate coronavirus disease 2019 (COVID-19) pneumonia in non-high-epidemic area in Japan.
Materials and methods
This retrospective ...study included 21 patients clinically suspected COVID-19 pneumonia and underwent chest CT more than 3 days after the symptom onset: six patients confirmed COVID-19 pneumonia by real-time reverse-transcription polymerase chain reaction (RT-PCR) and 15 patients proved uninfected. Using a Likert scale and its receiver operating characteristic curve analysis, two radiologists (R1/R2) evaluated the diagnostic performance of the five CT criteria: (1) ground glass opacity (GGO)-predominant lesions, (2) GGO- and peripheral-predominant lesions, (3) bilateral GGO-predominant lesions; (4) bilateral GGO- and peripheral-predominant lesions, and (5) bilateral GGO- and peripheral-predominant lesions without nodules, airway abnormalities, pleural effusion, and mediastinal lymphadenopathy.
Results
All patients confirmed COVID-19 pneumonia had bilateral GGO- and peripheral-predominant lesions without airway abnormalities, mediastinal lymphadenopathy, and pleural effusion. The five CT criteria showed moderate to excellent diagnostic performance with area under the curves (AUCs) ranging 0.77–0.88 for R1 and 0.78–0.92 for R2. The criterion (e) showed the highest AUC.
Conclusion
Chest CT would play a supplemental role to differentiate COVID-19 pneumonia from other respiratory diseases presenting with similar symptoms in a clinical setting.
Renal denervation is a promising new non-pharmacological treatment for resistant hypertension. However, there is a lack of data from Asian patients. The REQUIRE trial investigated the blood ...pressure-lowering efficacy of renal denervation in treated patients with resistant hypertension from Japan and South Korea. Adults with resistant hypertension (seated office blood pressure ≥150/90 mmHg and 24-hour ambulatory systolic blood pressure ≥140 mmHg) with suitable renal artery anatomy were randomized to ultrasound renal denervation or a sham procedure. The primary endpoint was change from baseline in 24-hour ambulatory systolic blood pressure at 3 months. A total of 143 patients were included (72 renal denervation, 71 sham control). Reduction from baseline in 24-hour ambulatory systolic blood pressure at 3 months was not significantly different between the renal denervation (-6.6 mmHg) and sham control (-6.5 mmHg) groups (difference: -0.1, 95% confidence interval -5.5, 5.3; p = 0.971). Reductions from baseline in home and office systolic blood pressure (differences: -1.8 mmHg p = 0.488 and -2.0 mmHg p = 0.511, respectively), and medication load, did not differ significantly between the two groups. The procedure-/device-related major adverse events was not seen. This study did not show a significant difference in ambulatory blood pressure reductions between renal denervation and a sham procedure in treated patients with resistant hypertension. Although blood pressure reduction after renal denervation was similar to other sham-controlled studies, the sham group in this study showed much greater reduction. This unexpected blood pressure reduction in the sham control group highlights study design issues that will be addressed in a new trial. CLINICAL TRIAL REGISTRATION: NCT02918305 ( http://www.clinicaltrials.gov ).
OBJECTIVEThis study aimed to elucidate the difference in virulence of Candida albicans derived from oral candidiasis and non-oral candidiasis patients, and its genotype differences in Hokkaido to ...obtain a clue of a platform to develop new approaches for diagnosis and treatment.DESIGNC. albicans strains were collected from patients who visited the Hokkaido University Hospital Dental Center. Each strain was examined to i) identify the Candida albicans genotype by PCR, ii) measure the strain's extracellular secretory enzyme activity, iii) determine the strain's ability to induce the production of interleukin-8, and iv) determine the strain's ability to induce cell death.RESULTSCertain virulence-related protease activities and cytotoxicity were higher in strains derived from patients with oral candidiasis compared with strains derived from patients without oral candidiasis. This is the first report on genotypes and the virulence-related activities, such as some protease secretion, IL-8 induction and cytotoxicity of C. albicans in Hokkaido.CONCLUSIONSThe virulence-related activities of the fungal strain may influence the pathogenesis of oral candidiasis, such as production of secreted aspartyl protease and cytotoxicity. In addition, C. albicans genotype C may be important for pathogenicity in Hokkaido, because the ratio of genotype C was increased in strains derived from oral candidiasis patients.
Medication‐related osteonecrosis of the jaw (MRONJ) has been commonly known as a adverse side effect of antiresorptive or antiangiogenic agents for the treatment of osteoporosis patients. Although ...there is considerable evidence on the occurrence of MRONJ in the literature, the number of studies focusing on Stage 3 MRONJ attributable to oral administration of bisphosphonates (BPs) in patients with osteoporosis is limited. The patient had exposed necrotic bone in the mandible and pus discharge through an extraoral fistula attributed to an oral BPs for the treatment of steroidal osteoporosis. She was diagnosed with Stage 3 MRONJ. She had no other identifiable cause of mandible necrosis. Given the severity and risk of pathological fractures of the mandibular bone, an extensive surgical therapy was performed after failure of compressive conservative therapy. Our surgical treatment satisfied the patient with regard to esthetics, leading to a dramatic improvement in her quality of life for 5 years after surgery. We report a case of Stage 3 MRONJ associated with BP administration for steroid‐induced osteoporosis and discuss esthetically successful reconstruction of the mandible using mandibular reconstruction plates following segmental mandibulectomy. To prevent such severe complications, it is important to develop appropriate medical and surgical treatment strategy for immunosuppressed patients with osteoporosis.
Background Ethyl loflazepate (EL) is a benzodiazepine derivative that has been reported to activate the gustatory cortex. Our department routinely uses EL as a first-line treatment for idiopathic and ...psychogenic taste disorders, although little has been reported in the literature with respect to patient outcomes, so we conducted a retrospective study examining its safety and efficacy. Methods Between 2008 and 2020, 49 patients (14 males and 35 females; mean age, 62.1 years) were diagnosed with taste disorders and received EL as their only treatment for > 14 days. Severity of taste disorder was evaluated using the paper disc method by Sakai et al., and treatment efficacy was evaluated using the Visual Analog Scale, wherein patients gave subjective ratings for their symptoms (reductions by > 50% after administration of EL for 4 weeks were defined as improvements). Results Results showed that the improvement rates for patients with idiopathic and psychogenic taste disorders were 55 and 70%, respectively. Additionally, the majority (78%) improved within 2 weeks, and side effects were mild (seven cases with drowsiness and one case with dizziness). Conclusions We conclude that EL is an appropriate first-line medication for patients with idiopathic and psychogenic taste disorders. Keywords: Ethyl loflazepate, Idiopathic taste disorder, Psychogenic taste disorder
This study aimed to determine the factors associated with the co-infection of Candida albicans and Candida glabrata. This retrospective study conducted between January 2015 and 2020 comprised 131 ...patients who were diagnosed with oral candidiasis. The factors associated with this condition were analyzed by univariate and multivariate logistic regression. Age and denture use were identified as significant risk factors in the univariate analysis. The multivariate logistic regression analysis revealed that denture use (odds ratio OR, 8.44 95% confidence interval CI, 1.99–28.3) and immunosuppressive therapy (OR, 9.20; 95% CI, 1.19–62.0) had significant effects on co-infection with the two Candida species. These findings suggest that immunosuppressive therapy using and dentures is significantly associated with oral candidiasis caused by co-infection of C. albicans and C. glabrata.
Our understanding of the relationship between oral
and systemic conditions has significantly increased recently, which this study aims to extend further by investigating the risks of oral ...candidiasis. A total of 314 patients were involved in this study and underwent an oral swab test at the Department of Oral Medicine, Hokkaido University Hospital, between January and December 2021. Data were collected on age, sex, white and red blood cell counts, Hb, total protein, vitamin B12, as well as serum albumin, iron, copper, and zinc levels. The clinical fungus samples were swabbed to identify those with
species using a MALDI Biotyper, then applied analysis of covariance and multivariant logistic regression analysis. It was possible to assess the oral swab test results without considering the difference between sex (
= 0.946). The oral swab test results were associated with aging (odds ratio: 1.03) and serum albumin levels (odds ratio: 0.32). In summary, the results of our study suggest a relationship between aging and oral candidiasis and offer in-depth insights into how to prevent or treat oral candidiasis onset.
Burning mouth syndrome (BMS) is a chronic condition characterized by pain in the oral cavity. Kampo medicine is a traditional Japanese medical system that has its roots partly in ancient Chinese ...medicine. The purpose of this study is to evaluate the efficacy of rikkosan-a traditional Japanese herbal medicine (Kampo)-in the treatment of primary BMS.
A single-center retrospective study was conducted in 32 patients who were diagnosed with primary BMS and treated with rikkosan alone through gargling (2.5 g rikkosan dissolved in 50 mL hot water) three times daily. Patients were asked to evaluate their pain using a numerical rating scale (NRS) at first visit and after 1 month. One patient had stomatitis as a side effect after gargling with rikkosan, however, no side effects were observed in other patients. Overall NRS scores decreased significantly between the first visit (7.6 ± 2.7) and the 1-month visit (5.6 ± 2.8).
Rikkosan may be an effective treatment for primary BMS.
This study aimed to determine the appropriate treatment methods and evaluate associated factors by comparing nonoperative treatment alone with a combination of both nonoperative and surgical ...treatment in 34 patients with mandibular osteoradionecrosis (mORN). The associated cure factors were analyzed by Cox regression. Propensity scores were calculated from factors that were not significant in the univariate analysis and used as covariates in the multivariate analysis. The cure rate among patients who received nonoperative and surgical treatment was higher than that observed with nonoperative treatment alone. Only the treatment method was associated with cure in both univariate and multivariate analyses.
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