Dysphagia is one of the most critical problems in patients with progressive neuromuscular diseases. However, clinically useful and practical scales to evaluate dysphagia are limited. Therefore, the aim of this study was to develop such a scale. An 8-stage Neuromuscular Disease Swallowing Status Scale (NdSSS) was developed and tested for its inter- and intrarater reliabilities, concurrent validity, and responsiveness. The NdSSS was used to evaluate 134 patients with Duchenne muscular dystrophy (DMD) and 84 patients with amyotrophic lateral sclerosis (ALS). Inter- and intrarater reliabilities were examined with weighted kappa statistics. Concurrent validity was assessed by correlating the NdSSS with the existing scales [Functional Oral Intake Scale (FOIS), Functional Intake LEVEL Scales (FILS), and ALS Functional Rating Scale-Revised Swallow (ALSFRS-R Sw)], using Spearman's correlation coefficients. Responsiveness was determined with the standardized response mean (SRM). For inter- and intrarater reliabilities, the weighted kappas were 0.95 and 1.00, respectively, for DMD; and 0.98 and 0.98, respectively, for ALS. The NdSSS showed strong correlations with the FOIS (rs = 0.87 for DMD, rs = 0.93 for ALS, p < 0.001), FILS (rs = 0.89 for DMD, rs = 0.92 for ALS, p < 0.001), and ALSFRS-R SW (rs = 0.93, p < 0.001). SRMs were 0.65 for DMD and 1.21 for ALS. The SRM was higher in DMD patients for the NdSSS than for the other scales, while it was similar in ALS patients and the other scales. Our originally developed NdSSS demonstrated sufficient reliability, validity, and responsiveness in patients with DMD and ALS. It is also useful in evaluating dysphagia in patients with progressive neuromuscular diseases.

We developed a novel method of quantifying respiratory movement called RMET that was feasible to use in daily clinical practice.

Emergency foods provided following disasters have considerably different textures from regularly consumed foods. This may lead to an increase in the rate of aspiration pneumonia in vulnerable populations after a disaster. However, no studies have focused on this issue. To better estimate the size of the population with swallowing disorders (i.e. dysphagia), a local district-based total population survey of community-dwelling elderly care recipients who were registered in the mandatory longterm care insurance system in Shinjuku city, Tokyo, Japan was performed. Data were collected by governmentcertified care managers. While 23.1% of the population experienced dysphagia in ordinary settings (i.e. non-oral nutrition intake or daily dependency on texture-modified foods), an additional 11.5% were identified as at-risk solely through a diet consisting of emergency foods. This study indicates the importance of preparedness measures that take this latter population into account. Objective: There are a lack of disaster preparedness measures that target populations with dysphagia. In particular, disaster response plans frequently overlook differences in textures between emergency foods and regularly consumed foods. The aim of this study was to estimate the number of communitydwelling elderly care recipients requiring specific food preparations, including the population at risk of aspiration when solely consuming common emergency foods. Design: A cross-sectional study. Patients: Community-dwelling elderly care recipients who were certified by the public long-term care insurance system in Japan and registered at one of 77 care managing offices in Shinjuku city. Methods: Special needs regarding food intake and risks associated with receiving emergency foods were assessed by government-certified care managers. Results: Data were acquired from 1,271 care recipients. Notably, 23.1% of the sampled population had special needs regarding food intake at all times (e.g. non-oral intake or need for texture-modified foods). An additional 11.5% were estimated to experience difficulty when ingesting common emergency foods, despite the ability to consume regular foods. Conclusion: A relatively large portion of communitydwelling elderly people will be at risk of aspiration due to the intake of commonly distributed emergency foods following a disaster. Appropriate preparation based on an assessment of special needs regarding food intake is therefore required when planning for future disasters.

A 68-year-old man was referred to our hospital for the evaluation and treatment of chest discomfort and syncope. He was diagnosed with variant angina by prolonged ischemic episode with ST-segment elevation in leads II, III, and aV F . His symptoms had a seasonal trend and occurred only from April to September. In other seasons, he had no symptoms even with no medication. He had a history of nasal polyps and allergic rhinitis. His symptoms increased in frequency and intensity, and the attacks were not fully controlled by multiple drug therapy. Sarpogrelate hydrochloride, however, resulted in complete resolution of his symptoms. Further examination revealed that he was allergic to mites, Dermatophagoides farina, which were prevalent mainly from April to September. The allergic mechanism was suggested to be involved in the seasonal variety in angina attacks.

No abstract