著者
Takashi Ohrui
出版者
Tohoku University Medical Press
雑誌
The Tohoku Journal of Experimental Medicine (ISSN:00408727)
巻号頁・発行日
vol.207, no.1, pp.3-12, 2005 (Released:2005-08-04)
参考文献数
87
被引用文献数
42 44

Pneumonia is the fourth leading cause of death despite the availability of potent new antimicrobials in Japan. Aspiration of oropharyngeal bacterial pathogens to the lower respiratory tract is one of the most important risk factors for pneumonia. Impairments in swallowing and cough reflexes among disabled older persons, e.g., related to cerebrovascular disease, increase the risk of pneumonia. Thus, strategies to reduce the volumes and pathogenicity of aspirated material should be pursued. Since both swallowing and cough reflexes are mediated by endogenous substance P contained in the vagal and glossopharyngeal nerves, pharmacologic therapy using angiotensin-converting enzyme inhibitors, which decrease substance P catabolism, can improve both reflexes and result in the lowering of the risk of pneumonia. Similarly, since the production of substance P is regulated by dopaminergic neurons in the cerebral basal ganglia, treatment with dopamine analogs or potentiating drugs such as amantadine can reduce the incidence of pneumonia. Furthermore, since mortality from infections correlates with cutaneous anergy, interventions that reverse these age-associated changes in the immune system are also effective. The main theme of this review is to discuss how pneumonia develops in disabled older people and to suggest preventive strategies that may reduce the incidence of pneumonia among these subjects.

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抗精神病薬は、嚥下反射や咳反射の障害、鎮静作用、唾液分泌量の増加、咽頭・喉頭の筋緊張の変化など、複数のメカニズムによって誤嚥性肺炎のリスクを高める。 嚥下反射と咳反射は、咽頭と喉頭を支配する迷走神経と舌咽神経が関与している(https://t.co/KEfOWzGV7Q ) https://t.co/Svkdd2x4Ub
【重要】 φ(..)メモメモ 後で必ず読む! https://t.co/yVXuoS4Ovu
少しまとまった総説として、Tohoku Journal of Experimental Medicineに載っている総説も伝えておきました。https://t.co/XpSE0ZwlyH
"抗精神病薬は、嚥下反射や咳反射の障害、鎮静作用、唾液分泌量の増加、咽頭・喉頭の筋緊張の変化など、複数のメカニズムによって誤嚥性肺炎のリスクを高める。 嚥下反射と咳反射は、咽頭と喉頭を支配する迷走神経と舌咽神経が関与している(https://t.co/a5M8oCvk57 )" https://t.co/5bcguwPczj
@angelovalidiya @bartbuk Thank you for your guidance. In a 2003 study, BCG vaccination in the elderly was effective in preventing pneumonia. https://t.co/KrKTYtthO3 This paper doesn't seem to be well known because it's in Japanese. https://t.co/N1ekd4Zy04
@_LeMoog_ @gerdosi I am a reader of this BCG hypothesis website. https://t.co/Ad2ne8iFmZ I have seen the following paper here. "Establishment of BCG Vaccine Therapy for the Prevention of Elderly Pneumonia" https://t.co/KrKTYtthO3 It's Japanese. "https://t.co/N1ekd4Zy04"
Preventive Strategies for Aspiration Pneumonia in Elderly Disabled Persons. Tohoku Journal of Experimental Medicine, 2005 https://t.co/fnFL5T3L3b
Preventive Strategies for Aspiration Pneumonia in Elderly Disabled Persons https://t.co/2MLcXxHoaA
Regarding the application of #BCG to #COVID19 prevention, pioneering work was done in 2003-2004 to prevent pneumonia in bedridden patients by #TohokuUniversity. https://t.co/DqwPptnM1c and https://t.co/iAHWUNYwF6
サブスタンスPの生産は大脳基底核のドーパミン作動性ニューロンによって制御されており、ドーパミンアナログやアマンタジンによる治療により肺炎の発症率を低下させる。 さらに、感染症による死亡率は皮膚アレルギーと相関、加齢に伴う免疫系の変化を逆転させる介入も有効。 https://t.co/SZdX9MYBRC
BCGの肺炎に対する効果について、#東北大学 老年内科の大類孝先生という方が、2003年に日本呼吸器学会で発表していた。その内容の総説が東北ジャーナルに掲載されていた>>>J-STAGE Articles - Preventive Strategies for Aspiration Pneumonia in Elderly Disabled Persons https://t.co/eReYKwf1uj

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