Retrospective study on the efficacy of monocyte distribution width (MDW) as a screening test for COVID-19.

BACKGROUND: Pathogenic genetic testing for coronavirus disease 2019 (COVID-19) can detect viruses with high sensitivity; however, there are several challenges. In the prevention, testing, and treatment of COVID-19, more effective, safer, and convenient methods are desired. We evaluated the possibility of monocyte distribution width (MDW) as an infection biomarker in COVID-19 testing. METHODS: The efficacy of MDW as a screening test for COVID-19 was retrospectively assessed in 80 patients in the COVID-19 group and 232 patients in the non-COVID-19 group (141 patients with acute respiratory infection, 19 patients with nonrespiratory infection, one patient with a viral infection, 11 patients who had received treatment for COVID-19, one patient in contact with COVID-19 patients, and 59 patients with noninfectious disease). RESULTS: The median MDW in 80 patients in the COVID-19 group was 23.3 (17.2-33.6), and the median MDW in 232 patients in the non-COVID-19 group was 19.0 (13.6-30.2) (P < 0.001). When the COVID-19 group was identified using the MDW cut-off value of 21.3 from the non-COVID-19 group, the area under the curve (AUC) was 0.844, and the sensitivity and specificity were 81.3% and 78.2%, respectively. Comparison of MDW by severity between the COVID-19 group and patients with acute respiratory infection in the non-COVID-19 group showed that MDW was significantly higher in the COVID-19 group for all mild, moderate I, and moderate II disease. CONCLUSIONS: MDW (cut-off value: 21.3) may be used as a screening test for COVID-19 in fever outpatients. Trial registration This study was conducted after being approved by the ethics committee of National Hospital Organization Omuta National Hospital (Approval No. 3-19). This study can be accessed via https://omuta.hosp.go.jp/files/000179721.pdf .

An Inter- and Intraprofessional Education Program in Which Dental Hygiene Students Instruct Medical and Dental Students.

The aim of this study was to develop, implement, and evaluate an inter- and intraprofessional education program with a peer support joint practice in which dental hygiene students teach medical and dental students about oral health care for older people requiring long-term care. In 2015 at Tokyo Medical and Dental University, 22 dental hygiene students in their third year at the School of Oral Health Care Sciences (OH3), 110 students in their third year at the School of Medicine (M3), and 52 students in their third year at the School of Dentistry (D3) participated in this program. The OH3 students practiced with a whole-body-type simulator to learn oral health care for older people and then taught the methods to the M3 and D3 students according to their self-designed teaching plan. All M3 and D3 students experienced being both practitioner and patient. The number of respondents and response rates on the questionnaires after the training were 22 (100%), 102 (92.7%), and 52 (100%) for the OH3, M3, and D3 students, respectively. Self-assessment by the OH3 students indicated that they could supervise other students sufficiently (77-86%), and 91% of them found the preclinical practice with the simulator efficient for the peer support joint practice. Almost all the M3 and D3 students reported that they gained understanding of the methods (99%), significance (100%), and important points of oral health care for older people (97%) in addition to the jobs and roles of dental hygienists (93%) because of this program. The M3 students understood the methods and significance of oral health care more deeply than did the D3 students (p<0.05). This study found that an interprofessional program with a peer support joint practice to cultivate practical clinical ability aided in increasing understanding and cooperation between medicine and dentistry.

Radiofrequency ablation combined with bone cement injection for the treatment of bone malignancies.

PURPOSE: To evaluate the feasibility, safety, and effectiveness of combined treatment with radiofrequency (RF) ablation followed by bone cement injection in patients with malignant bone neoplasms. MATERIALS AND METHODS: Seventeen patients with 23 bone tumors were treated. The tumors, measuring 1.2-15 cm (mean, 4.9 +/- 3.5 cm), were located in the spine (n = 17), iliac bone (n = 3), sacrum (n = 2), and ischial bone (n = 1). All procedures were performed with computed tomographic (CT) fluoroscopic guidance. An electrode with an internally cooled tip was placed in the bone tumor through a biopsy needle and RF energy was applied, followed by cement injection. Pain relief was evaluated with use of the visual analogue scale score (VAS score). Local therapeutic effects were evaluated by contrast-enhanced MR imaging. Lack of tumor enhancement was considered to indicate necrosis. RESULTS: The procedures were technically successful in all patients except for one patient with an osteoblastic ischial lesion (22 of 23 patients; 96%). Pain was relieved within 1 week in all 13 patients who reported pain (13 of 13 patients; 100%), with a significant decrease in the VAS score from 8.4 to 1.1 (P <.001). Tumor necrosis was observed in 71% +/- 24% of the tumor volume (range, 14%-100%). Neural damage occurred in four patients in whom the tumor had invaded the posterior cortex of the vertebral body and pedicle. CONCLUSION: The combined therapy described here is both feasible and useful for the treatment of malignant bone neoplasms. The safety of the procedure depends on the tumor location. When the tumor is adjacent to the spinal cord, there is a risk of nerve injury.

Diagnosis of inflammatory pseudotumor of the liver.

Inflammatory pseudotumor (IPT) is a rare benign tumor of unknown origin, it has the appearance of a malignant tumor but has a benign histology and clinical course. Therefore, we studied five patients with IPT of the liver to determine what examination can aid in its diagnosis. Five cases of inflammatory pseudotumor of the liver were analyzed. All patients were examined by echography, computed tomography (CT), magnetic resonance imaging (MRI), endoscopic retrograde cholangiography (ERC) and angiography to diagnose the liver tumor. In all patients echography and CT scan showed a similar appearance while MRI showed a variable pattern. In two patients ERC showed a stenotic image of intra-hepatic bile ducts. In the angiographic study, the arterial phase in three patients showed a hypervascular tumor and in one patient, a hypovascular tumor. Vascular abnormality was presented in one patient. Similarly, portography in four patients showed some abnormality. We performed ultrasonography-guided percutaneous needle biopsy in two patients in order to diagnose IPT. Histological examinations of two patients were consistent with IPT. The other three patients underwent surgical treatment for a cholangiocellular carcinoma or abscess. It is difficult to diagnose IPT of the liver exclusively with an image examination. Ultrasonography-guided percutaneous liver biopsy should be performed in order to diagnose IPT by histology.