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Titolo:
Interventions to prevent pneumonia among older adults
Autore:
Yamaya, M; Yanai, M; Ohrui, T; Arai, H; Sasaki, H;
Indirizzi:
Tohoku Univ, Sch Med, Dept Geriatr & Resp Med, Aoba Ku, Sendai, Miyagi 9808574, Japan Tohoku Univ Sendai Miyagi Japan 9808574 Ku, Sendai, Miyagi 9808574, Japan
Titolo Testata:
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY
fascicolo: 1, volume: 49, anno: 2001,
pagine: 85 - 90
SICI:
0002-8614(200101)49:1<85:ITPPAO>2.0.ZU;2-Y
Fonte:
ISI
Lingua:
ENG
Soggetto:
ANGIOTENSIN-CONVERTING ENZYME; SILENT CEREBRAL INFARCTION; SUBSTANCE-P; ASPIRATION PNEUMONIA; SWALLOWING REFLEX; COUGH REFLEX; GUINEA-PIGS; INFLUENZA VACCINATION; RESPIRATORY-TRACT; ELDERLY PATIENTS;
Keywords:
silent aspiration; substance P; dopamine; cerebrovascular disease; oral care;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Social & Behavioral Sciences
Clinical Medicine
Citazioni:
90
Recensione:
Indirizzi per estratti:
Indirizzo: Sasaki, H Tohoku Univ, Sch Med, Dept Geriatr & Resp Med, Aoba Ku, 1-1 Seiryo Mchi, Sendai, Miyagi 9808574, Japan Tohoku Univ 1-1 Seiryo Mchi Sendai Miyagi Japan 9808574 4, Japan
Citazione:
M. Yamaya et al., "Interventions to prevent pneumonia among older adults", J AM GER SO, 49(1), 2001, pp. 85-90

Abstract

Pneumonia is a common cause of death in older people. Antimicrobial drugs do not prevent pneumonia and, be cause of increasingly resistant organisms,their value in curing infection will become more limited. Establishing newstrategies to prevent pneumonia through consideration of the mechanisms ofthis devastating illness is essential. The purpose of this review is to discuss how pneumonia develops in older people and to suggest preventive strategies that may reduce the incidence of pneumonia among older adults. 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 older adults, e.g., related to cerebrovascular disease, increase the risk for the development of pneumonia. Thus, strategies to reduce the volumes and pathogenicity of aspirated material shouldbe pursued. For example, since both swallowing and cough reflexes are mediated by endogenous substance P, pharmacologic therapy using angiotensin-converting enzyme inhibitors, which decrease substance P catabolism, may 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 (and, of course, prevention of cerebral vascular disease, which can result in basal ganglia strokes) should affect the incidence of pneumonia. The purpose of this review is to consider promising pharmacologic treatments as methods of preventing pneumonia in older adults and to review other proven strategies, e.g., infection control and cerebrovascular disease prevention that will lessen the incidence of pneumonia.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 11/07/20 alle ore 13:35:07