Objectives: Although osteoporosis affects approximately 15.9 million people in Japan, screening rates remain low.Dental panoramic radiographs (DPRs), routinely used in general dental practice, may facilitate opportunistic screening, yet referrals based on these images are not widely implemented. This study evaluated referral rates to orthopedic departments of patients with suspected osteoporosis identified using DPRs. Methods: Among 3237 female patients aged ≥ 50 who underwent DPRs between February 2022 and October 2024, 328 without a prior osteoporosis diagnosis were identified as suspected cases. Their primary dentists referred these patients to our hospital’s orthopedic department. Additionally, trained oral radiologists optionally provided information on osteoporosis. We assessed (1) the overall referral rate, (2) differences in referral rates based on whether an explanation by oral radiologist was provided, (3) referral rates stratified by age group, and (4) the prevalence of osteoporosis, osteopenia, and asymptomatic vertebral fractures among referred patients. Results: Of the 328 patients, 53 (16.2%) visited the orthopedic department. Referral rates were significantly higher among patients who received explanations from trained oral radiologists (50.9%) than among patients who did not (9.1%). Referral rates peaked among patients in their 60s (23.7%). Among referred patients, 60.4% were diagnosed with osteoporosis and 37.7% with osteopenia; five patients had asymptomatic vertebral fractures. Conclusions Despite easy access to orthopedic care, referral rates remained low, likely due to limited awareness.Explanations by trained oral radiologists significantly improved referral rates, highlighting the importance of dentist-led education and interdisciplinary collaboration in promoting osteoporosis screening in general dental practice.

Objectives: Postmenopausal women with osteoporosis are frequently underdiagnosed. In Japan, general dental practitioners have begun using the cortical shape of the mandible on dental panoramic radiographs (PRs) to identify and refer women at risk of osteoporosis to medical professionals. It remains unclear whether dental students, after relevant education, possess the ability to identify these at-risk individuals. This study evaluated the ability of dental students to screen for osteoporosis on PRs. Methods: A cohort of 113 fifth-year dental students participated in a lecture on osteoporosis screening using PRs.The students then categorized the mandibular inferior cortex on PRs from 30 postmenopausal women (11 with osteoporosis) as normal, mildly to moderately eroded, or severely eroded. Interobserver agreement between the students and an expert oral radiologist using two cortical groups (normal to moderately eroded and severely eroded) was assessed through kappa statistics. Screening ability for osteoporosis detection by identifying severely eroded cortices was calculated and compared with that of the Osteoporosis Self-assessment Tool for Asians (OSTA). Results: Twenty-one (18.6%) students demonstrated moderate to substantial agreement with the expert. The mean sensitivity, specificity, and positive and negative predictive values for these students in identifying osteoporosis were 60.2%, 88.0%, 76.3%, and 80.0%, respectively. For the OSTA, sensitivity, specificity, and positive and negative predictive values were 27.3%, 68.4%, 33.3%, and 61.9%, respectively. Conclusions Even with minimal education, approximately one-fourth of dental students may accurately identify postmenopausal women with osteoporosis on PRs, outperforming questionnaire-based screening tools.

Objectives: Postmenopausal women with osteoporosis are frequently underdiagnosed. In Japan, general dental practitioners have begun using the cortical shape of the mandible on dental panoramic radiographs (PRs) to identify and refer women at risk of osteoporosis to medical professionals. It remains unclear whether dental students, after relevant education, possess the ability to identify these at-risk individuals. This study evaluated the ability of dental students to screen for osteoporosis on PRs. Methods: A cohort of 113 fifth-year dental students participated in a lecture on osteoporosis screening using PRs.The students then categorized the mandibular inferior cortex on PRs from 30 postmenopausal women (11 with osteoporosis) as normal, mildly to moderately eroded, or severely eroded. Interobserver agreement between the students and an expert oral radiologist using two cortical groups (normal to moderately eroded and severely eroded) was assessed through kappa statistics. Screening ability for osteoporosis detection by identifying severely eroded cortices was calculated and compared with that of the Osteoporosis Self-assessment Tool for Asians (OSTA). Results: Twenty-one (18.6%) students demonstrated moderate to substantial agreement with the expert. The mean sensitivity, specificity, and positive and negative predictive values for these students in identifying osteoporosis were 60.2%, 88.0%, 76.3%, and 80.0%, respectively. For the OSTA, sensitivity, specificity, and positive and negative predictive values were 27.3%, 68.4%, 33.3%, and 61.9%, respectively. Conclusions Even with minimal education, approximately one-fourth of dental students may accurately identify postmenopausal women with osteoporosis on PRs, outperforming questionnaire-based screening tools.

Objectives: Postmenopausal women with osteoporosis are frequently underdiagnosed. In Japan, general dental practitioners have begun using the cortical shape of the mandible on dental panoramic radiographs (PRs) to identify and refer women at risk of osteoporosis to medical professionals. It remains unclear whether dental students, after relevant education, possess the ability to identify these at-risk individuals. This study evaluated the ability of dental students to screen for osteoporosis on PRs. Methods: A cohort of 113 fifth-year dental students participated in a lecture on osteoporosis screening using PRs.The students then categorized the mandibular inferior cortex on PRs from 30 postmenopausal women (11 with osteoporosis) as normal, mildly to moderately eroded, or severely eroded. Interobserver agreement between the students and an expert oral radiologist using two cortical groups (normal to moderately eroded and severely eroded) was assessed through kappa statistics. Screening ability for osteoporosis detection by identifying severely eroded cortices was calculated and compared with that of the Osteoporosis Self-assessment Tool for Asians (OSTA). Results: Twenty-one (18.6%) students demonstrated moderate to substantial agreement with the expert. The mean sensitivity, specificity, and positive and negative predictive values for these students in identifying osteoporosis were 60.2%, 88.0%, 76.3%, and 80.0%, respectively. For the OSTA, sensitivity, specificity, and positive and negative predictive values were 27.3%, 68.4%, 33.3%, and 61.9%, respectively. Conclusions Even with minimal education, approximately one-fourth of dental students may accurately identify postmenopausal women with osteoporosis on PRs, outperforming questionnaire-based screening tools.

Objectives: Postmenopausal women with osteoporosis are frequently underdiagnosed. In Japan, general dental practitioners have begun using the cortical shape of the mandible on dental panoramic radiographs (PRs) to identify and refer women at risk of osteoporosis to medical professionals. It remains unclear whether dental students, after relevant education, possess the ability to identify these at-risk individuals. This study evaluated the ability of dental students to screen for osteoporosis on PRs. Methods: A cohort of 113 fifth-year dental students participated in a lecture on osteoporosis screening using PRs.The students then categorized the mandibular inferior cortex on PRs from 30 postmenopausal women (11 with osteoporosis) as normal, mildly to moderately eroded, or severely eroded. Interobserver agreement between the students and an expert oral radiologist using two cortical groups (normal to moderately eroded and severely eroded) was assessed through kappa statistics. Screening ability for osteoporosis detection by identifying severely eroded cortices was calculated and compared with that of the Osteoporosis Self-assessment Tool for Asians (OSTA). Results: Twenty-one (18.6%) students demonstrated moderate to substantial agreement with the expert. The mean sensitivity, specificity, and positive and negative predictive values for these students in identifying osteoporosis were 60.2%, 88.0%, 76.3%, and 80.0%, respectively. For the OSTA, sensitivity, specificity, and positive and negative predictive values were 27.3%, 68.4%, 33.3%, and 61.9%, respectively. Conclusions Even with minimal education, approximately one-fourth of dental students may accurately identify postmenopausal women with osteoporosis on PRs, outperforming questionnaire-based screening tools.

Glucocorticoid-induced osteoporosis is one of the most common and serious adverse effects of glucocorticoid use. Pharmacological treatment is strongly recommended for patients at a high risk of fracture；however, it is generally avoided during pregnancy. Here, we present the rehabilitation of a pregnant patient with multiple vertebral fractures caused by glucocorticoid-induced osteoporosis. A 27-year-old woman with systemic lupus erythematosus had an unplanned pregnancy and began receiving oral glucocorticoid therapy (15 mg/day). Pharmacological treatment of osteoporosis was not recommended during pregnancy. At 31 weeks of gestation, the patient was admitted to our hospital with severe back pain. Plain X-rays showed multiple vertebral fractures. The patient was diagnosed with glucocorticoid-induced osteoporosis. She required prolonged bed rest until birth because of severe pain and high risk of additional fractures. The therapeutic strategy after delivery was shared with the Departments of Rehabilitation, Obstetrics, and Gynecology, Rheumatology, and Orthopedic Surgery. At 37 weeks of gestation, she gave birth by cesarean section, and teriparatide administration was started immediately. Six days after delivery, computed tomography showed multiple vertebral fractures from Th5 to L5, and L2-L4 bone mineral density was 0.798 g/cm2, which was 67％ of the young adult mean. She wore a corset and began a rehabilitation program. Frequent consultations were conducted with an orthopedic surgeon, and the patient carefully proceeded with getting out of bed. She gradually regained the ability to sit, stand, and walk. Sixty-three days after delivery, she could walk with a cane and was discharged from our hospital.

Glucocorticoid-induced osteoporosis is one of the most common and serious adverse effects of glucocorticoid use. Pharmacological treatment is strongly recommended for patients at a high risk of fracture；however, it is generally avoided during pregnancy. Here, we present the rehabilitation of a pregnant patient with multiple vertebral fractures caused by glucocorticoid-induced osteoporosis. A 27-year-old woman with systemic lupus erythematosus had an unplanned pregnancy and began receiving oral glucocorticoid therapy (15 mg/day). Pharmacological treatment of osteoporosis was not recommended during pregnancy. At 31 weeks of gestation, the patient was admitted to our hospital with severe back pain. Plain X-rays showed multiple vertebral fractures. The patient was diagnosed with glucocorticoid-induced osteoporosis. She required prolonged bed rest until birth because of severe pain and high risk of additional fractures. The therapeutic strategy after delivery was shared with the Departments of Rehabilitation, Obstetrics, and Gynecology, Rheumatology, and Orthopedic Surgery. At 37 weeks of gestation, she gave birth by cesarean section, and teriparatide administration was started immediately. Six days after delivery, computed tomography showed multiple vertebral fractures from Th5 to L5, and L2-L4 bone mineral density was 0.798 g/cm2, which was 67％ of the young adult mean. She wore a corset and began a rehabilitation program. Frequent consultations were conducted with an orthopedic surgeon, and the patient carefully proceeded with getting out of bed. She gradually regained the ability to sit, stand, and walk. Sixty-three days after delivery, she could walk with a cane and was discharged from our hospital.

Objectives: Postmenopausal women with osteoporosis are frequently underdiagnosed. In Japan, general dental practitioners have begun using the cortical shape of the mandible on dental panoramic radiographs (PRs) to identify and refer women at risk of osteoporosis to medical professionals. It remains unclear whether dental students, after relevant education, possess the ability to identify these at-risk individuals. This study evaluated the ability of dental students to screen for osteoporosis on PRs. Methods: A cohort of 113 fifth-year dental students participated in a lecture on osteoporosis screening using PRs.The students then categorized the mandibular inferior cortex on PRs from 30 postmenopausal women (11 with osteoporosis) as normal, mildly to moderately eroded, or severely eroded. Interobserver agreement between the students and an expert oral radiologist using two cortical groups (normal to moderately eroded and severely eroded) was assessed through kappa statistics. Screening ability for osteoporosis detection by identifying severely eroded cortices was calculated and compared with that of the Osteoporosis Self-assessment Tool for Asians (OSTA). Results: Twenty-one (18.6%) students demonstrated moderate to substantial agreement with the expert. The mean sensitivity, specificity, and positive and negative predictive values for these students in identifying osteoporosis were 60.2%, 88.0%, 76.3%, and 80.0%, respectively. For the OSTA, sensitivity, specificity, and positive and negative predictive values were 27.3%, 68.4%, 33.3%, and 61.9%, respectively. Conclusions Even with minimal education, approximately one-fourth of dental students may accurately identify postmenopausal women with osteoporosis on PRs, outperforming questionnaire-based screening tools.

Background: Cell blocks (CBs) from pleural fluid are frequently used in the practice of respiratory medicine, but there have been few reports on the use of CBs from forceps and brush washing fluid in bronchoscopy for pathological diagnosis. We retrospectively analyzed the usefulness of CBs from forceps and brush washing fluid. 　Patients and Methods: Patients who underwent bronchoscopy and had CBs made from forceps and brush washing fluid in bronchoscopy at our institution between June 2016 and May 2021 were included. Cases in which additional information was obtained from CBs were reviewed in detail. 　Results: In total, 138 patients had CBs made from forceps and brush washing fluid in bronchoscopy during the study period. EBUS-GS (endobronchial ultrasound-guide sheath) was used for 102 of these patients. The final diagnosis was lung cancer in 114 cases, infection disease in 10 cases, metastatic lung tumor in 8 cases, lymphoproliferative disease in 2 cases, sarcoidosis in 1 case, and organizing pneumonia in 1 case. There were 13 cases with additional information obtained from CBs, all of which were cases of malignant tumors. 　Conclusions: CBs from forceps and brush washing fluid in bronchoscopy were useful for pathological diagnosis in some cases.

Basic procedures that cardiovascular surgeons routinely perform are rarely discussed, despite the great variability among facilities. We conducted a questionnaire survey on Extracorporeal Membrane Oxygenation (ECMO) targeting under-forty cardiovascular surgeons and obtained responses from 53 surgeons. We report the questionnaire results.