2015年4月12日日曜日

Dysphagia: current reality and scope of the problem

Clavé先生のレビュー論文Dysphagia: current reality and scope of the problemが
NATURE REVIEWS GASTROENTEROLOGY & HEPATOLOGYに掲載されています。

Clavé P, Shaker R. Dysphagia: current reality and scope of the problem. Nat Rev Gastroenterol Hepatol. 2015 Apr 7. doi: 10.1038/nrgastro.2015.49.

http://www.nature.com/nrgastro/journal/vaop/ncurrent/full/nrgastro.2015.49.html

 Impact Factor10台の雑誌ですので、嚥下のレビュー論文の中で、とても重要なものと考えます。
この中でサルコペニアの嚥下障害について以下のように記載されていました。
64が前田先生の論文、65・66が私の論文の引用です。
Studies have also found that malnutri‑
tion and sarcopenia are associated with oropharyngeal
dysphagia in elderly people.51,64 Sarcopenic dysphagia is
a new concept that describes oropharyngeal dysphagia
caused by sarcopenia of generalized skeletal muscles and
swallowing muscles, and which requires a combination
of both rehabilitation and nutritional treatment.65,66

 これでサルコペニアの嚥下障害の、アカデミックな世界における位置づけは変わると感じています。
2012年に書籍「サルコペニアの摂食・嚥下障害」を出版した時は、コンセプト先行でした。
それから2年半経過して、エビデンスが少し増えてきて、新しいコンセプトとして明記されました。
サルコペニアの嚥下障害は日本が先行している領域ですので、引き続き研究を頑張らないとですね。

Abstract
Dysphagia is a symptom of swallowing dysfunction that occurs between the mouth and the stomach. Although oropharyngeal dysphagia is a highly prevalent condition (occurring in up to 50% of elderly people and 50% of patients with neurological conditions) and is associated with aspiration, severe nutritional and respiratory complications and even death, most patients are not diagnosed and do not receive any treatment. By contrast, oesophageal dysphagia is less prevalent and less severe, but with better recognized symptoms caused by diseases affecting the enteric nervous system and/or oesophageal muscular layers. Recognition of the clinical relevance and complications of oesophageal and oropharyngeal dysphagia is growing among health-care professionals in many fields. In addition, the emergence of new methods to screen and assess swallow function at both the oropharynx and oesophagus, and marked advances in understanding the pathophysiology of these conditions, is paving the way for a new era of intensive research and active therapeutic strategies for affected patients. Indeed, a unified field of deglutology is developing, with new professional profiles to cover the needs of all patients with dysphagia in a nonfragmented way.