1.A Systematic Review and Meta-Analysis of Systemic Corticosteroids for the Palliation of Dyspnea in Patients with Cancer
Kozue SUZUKI ; Hideki KATAYAMA ; Hiroyuki KOHARA ; Yoshinobu MATSUDA ; Sho GOYA ; Jun KAKO ; Yoko KASAHARA ; Masanori MORI ; Takeo NAKAYAMA ; Hiroaki WATANABE ; Takashi YAMAGUCHI
Palliative Care Research 2025;20(2):95-102
Objective: Almost half of all patients with cancer experience dyspnea, which can have various causes. Although systemic corticosteroids are administered to relieve symptoms, their efficacy has not been established. This systematic review aims to determine the efficacy of systemic corticosteroids for dyspnea in patients with cancer. Methods: CENTRAL, MEDLINE, EMBASE, and Ichushi-Web databases were searched for articles published from their inception to September 23, 2019, on studies of systemic corticosteroid administration for dyspnea in patients with cancer. The primary outcome measure was dyspnea intensity, as assessed by patient-reported outcomes. Secondary outcome measures were quality of life, delirium, and severe adverse events. Results: Two RCTs were included in the meta-analysis. With regard to alleviating dyspnea, the systematic corticosteroid group was associated with significantly greater dyspnea relief than the placebo group (mean difference: −0.71 [95% CI: −1.4 to −0.03]). However, a meta-analysis of quality of life and delirium could not be performed due to insufficient data. Analysis of severe adverse events showed no significant difference in their incidence between the corticosteroid and control groups (relative rate: 0.96 [95% CI: 0.19-4.93]). Conclusions: Systemic corticosteroids may be effective in treating dyspnea in patients with cancer, particularly those with lung involvement. Limiting the conditions for which corticosteroids are approved is expected to promote their appropriate use and minimize their adverse effects. However, further investigation is needed to determine the appropriate dosage, and the conditions in which corticosteroids are effective.
2.Orthopedic referral rates following osteoporosis screening using dental panoramic radiography in female patients: A three-year prospective study
Noriyuki SUGINO ; Hiroko KUROIWA ; Hizuru OSANAI ; Shinichiro YAMADA ; Kozue MORI ; Hirokazu KOBAYASHI ; Daisuke HIGUCHI ; Nobuyuki UDAGAWA ; Akira TAGUCHI
Osteoporosis and Sarcopenia 2025;11(4):121-126
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.


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