Literature Reviews

June 2011

Body composition

Title: Depressive symptoms, inflammatory markers and body composition in elderly with and without chronic obstructive pulmonary disease (COPD).
Marinho PE, Castro CM, Raposo MC, Guerra RO, Andrade AD.
Source: Arch Gerontol Geriatr. 2011 May 31. [Epub ahead of print].

Summary: The aim was to assess the relationships between cortisol, interleukin-2 (Il-2) and tumor necrosis factor-α (TNF-α) levels in elderly with and without COPD presenting with or without depressive symptoms. Marinho et al. concluded that depressive symptoms as well as fat and lean body composition, due to preserved BMI in those with nutritional depletion, must be investigated.

Title: Therapeutic applications of ghrelin to cachexia utilizing its appetite-stimulating effect.
Akamizu T, Kangawa K.
Source: Peptides. 2011 May 23. [Epub ahead of print].

Summary: This review summarizes the therapeutic applications for ghrelin in the future.

Title: Quantitative CT: Associations between Emphysema, Airway Wall Thickness and Body Composition in COPD.
Rutten EP, Grydeland TB, Pillai SG, Wagers S, Dirksen A, Coxson HO, Gulsvik A, Wouters EF, Bakke PS.
Source: Pulm Med. 2011;2011:419328. Epub 2011 Jan 16.

Summary: The objective of the present study was to determine the association between CT phenotypes-emphysema by low attenuation area and bronchitis by airway wall thickness-and body composition parameters in a large cohort of subjects with and without COPD. The study of Rutten et al. strengthens the hypothesis that the subgroup of COPD cases with muscle wasting have emphysema. Airway wall thickness is positively associated with fat mass index in both subjects with and without COPD.

Title: Anthropometric midarm measurements can detect systemic fat-free mass depletion in patients with chronic obstructive pulmonary disease.
Authors: Sanchez FF, Faganello MM, Tanni SE, Lucheta PA, Pelegrino NG, Hasegawa SH, Ribeiro SM, Godoy I.
Source: Braz J Med Biol Res. 2011 May;44(5):453-9. Epub 2011 Mar 4.

Summary: This study aimed to determine whether anthropometric measurements of the midarm (MA) could identify subjects with whole body fat-free mass (FFM) depletion. Anthropometric MA measurements may provide useful information for identifying subjects with whole body FFM depletion. This is a low-cost technique and can be used in a wider patient population to identify those likely to benefit from a complete body composition evaluation.

Chronic care

Title: Quality of care of nurse-led and allied health personnel-led primary care clinics.
Authors: Chin WY, Lam CL, Lo SV.
Source: Hong Kong Med J. 2011 Jun;17(3):217-30.

Summary: Chin et al. reviewed the literature regarding quality of care of nurse-led and allied health personnel-led primary care clinics with specific attention to the quality indicators for fall prevention, continence care, pulmonary rehabilitation, mental health, pharmaceutical care, and wound care services.

Title: Gender and Health Status Response to Long-Term Oxygen Therapy in COPD Patients. [Article in English, Spanish].
Authors: Coleta KD, Lima DF, Tanni SE, Silveira LV, Godoy I, Godoy I.
Source: Arch Bronconeumol. 2011 May 30. [Epub ahead of print].

Summary: The aims of this study were: (1) to compare dyspnea perception and health status between male and female with very severe COPD at baseline and (2) to provide a prospective assessment of health status response to LTOT, according to gender. Coleta et al. conclude that the health status course in very severe COPD patients differs according to gender, as females show greater response longitudinally to LTOT.

Title: A new perspective on optimal care for patients with COPD.
Authors: Postma D, Anzueto A, Calverley P, Jenkins C, Make BJ, Sciurba FC, Similowski T, van der Molen T, Eriksson G.
Source: Prim Care Respir J. 2011 May 11. pii: pcrj-2011-02-0020-R1. doi: 10.4104/pcrj.2011.00041. [Epub ahead of print].

Summary: Postma et al. propose a new paradigm to achieve 'optimal COPD care' based on the concept that here-and-now goals should be integrated with goals to improve long-term outcomes and reduce future risks.

Skeletal muscles

Authors: Barreiro E, Ferrer D, Sanchez F, Minguella J, Marin-Corral J, Martinez-Llorens J, Lloreta J, Gea J.
Source: J Appl Physiol. 2011 Jun 2. [Epub ahead of print].

Summary: Barreiro et al. explored whether levels of inflammatory cells and apoptosis were increased in both respiratory and limb muscles of COPD patients without nutritional abnormalities. In severe COPD patients with preserved body composition, while increased apoptotic nuclei seems to be a contributor to their muscle dysfunction, cellular inflammation does not. The increased numbers of TUNEL-positive nuclei in their muscles suggest that they may also be exposed to a continuous repair/remodeling process.

Exercise testing and functional performance

Title: Impaired adrenergic- and corticotropic-axis outflow during exercise in chronic obstructive pulmonary disease.
Authors: Iranmanesh A, Rochester DF, Liu J, Veldhuis JD.
Source: Metabolism. 2011 May 30. [Epub ahead of print].

Summary: The study hypothesis was that chronic obstructive pulmonary disease (COPD) is marked by heightened sympathoadrenal outflow at comparable relative workloads. These current findings demonstrate impaired rather than augmented exercise-associated sympathocorticotropic-axis outflow in patients with COPD even when outcomes are normalized to maximal oxygen consumption, suggesting that factors other than fitness are at work.

Title: Use of the Functional Independence Measure (FIM) in People for Whom Weaning From Mechanical Ventilation Is Difficult.
Authors: Montagnani G, Vagheggini G, Panait Vlad E, Berrighi D, Pantani L, Ambrosino N.
Source: Phys Ther. 2011 May 19. [Epub ahead of print].

Summary: The purpose of this study was to examine the clinical utility of the FIM after a weaning program in people for whom weaning from mechanical ventilation is difficult. The FIM can be used as a functional status outcome measure in people for whom weaning from mechanical ventilation is difficult.

Title: Anemia of Chronic Disease in Chronic Obstructive Pulmonary Disease: A Case-Control Study of Cardiopulmonary Exercise Responses.
Authors: Boutou AK, Stanopoulos I, Pitsiou GG, Kontakiotis T, Kyriazis G, Sichletidis L, Argyropoulou P.
Source: Respiration. 2011 May 11. [Epub ahead of print].

Summary: This study investigated the prevalence of anemia of chronic disease (ACD) in COPD patients and its impact on dyspnea and exercise capacity, utilizing cardiopulmonary exercise testing (CPET). Boutou et al. concluded that ACD occurs in approximately 10% of stable COPD patients and has a negative impact on dyspnea and circulatory efficiency during exercise.

Palliative care and end-of-life communication

Title: Patient-Clinician Communication about End-of-Life Care Topics: Is Anyone Talking to Patients with Chronic Obstructive Pulmonary Disease?
Authors: Reinke LF, Slatore CG, Uman J, Udris EM, Moss BR, Engelberg RA, Au DH.
Source: J Palliat Med. 2011 Jun 1. [Epub ahead of print].

Summary: Reinke et al. describe patient-clinician communication practices about end-of-life care in patients with chronic obstructive pulmonary disease (COPD) using self-report questionnaires to: (1) characterize the content of patient-clinician communication about end-of-life care from the patient perspective, including topics that were not addressed and ratings of the quality of the communication for topics discussed and (2) determine whether clinician characteristics was associated with the absence of specific communication items addressed. All end-of-life communication topics were under addressed by clinicians, regardless of training, with four topics particularly unlikely to be discussed.

Title: Management of patients with end-stage chronic obstructive pulmonary disease.
Author: Berman AR.
Source: Prim Care. 2011 Jun;38(2):277-97.

Summary: This article reviews quality of life issues, proposed prognostic indicators, and pharmacologic and nonpharmacologic treatments in advanced COPD.

Title: Family Caregiving in Advanced Chronic Organ Failure.
Authors: Janssen DJ, Spruit MA, Wouters EF, Schols JM.
Source: J Am Med Dir Assoc. 2011 May 27. [Epub ahead of print].

Summary: This study aimed to assess caregiver burden as well as positive aspects of family caregiving in advanced chronic obstructive pulmonary disease (COPD), chronic heart failure (CHF), and chronic renal failure (CRF). Janssen et al. concluded that family caregiving for patients with COPD, CHF, or CRF should not only be seen as a burden, but also as a positive experience.

Pulmonary rehabilitation

Title: Vitamin D Status in Patients With Chronic Obstructive Pulmonary Disease who Participate in Pulmonary Rehabilitation.
Authors: Ringbaek T, Martinez G, Durakovic A, Thøgersen J, Midjord AK, Jensen JE, Lange P.
Source: J Cardiopulm Rehabil Prev. 2011 May 26. [Epub ahead of print].

Summary: Vitamin D deficiency is common in patients with chronic obstructive pulmonary disease; however, no study has evaluated the influence of vitamin D status on effects of pulmonary rehabilitation. Ringbaek et al. concluded that vitamin D deficiency was significantly associated with higher dropout rates from PR, and there was a tendency toward a poorer improvement in endurance shuttle walk time.

Title: Feasibility of transcutaneous electrical muscle stimulation in acute exacerbation of COPD.
Authors: Meglic U, Sorli J, Kosnik M, Lainscak M.
Source: Wien Klin Wochenschr. 2011 May 25. [Epub ahead of print].

Summary: This study investigated feasibility and safety of this method during acute exacerbation of chronic obstructive pulmonary disease. These results set the stage for future research to determine specific benefit of transcutaneous electrical muscle stimulation, either alone or in combination with nutritional support and pharmacological therapy.

Title: Development of a program for tele-rehabilitation of COPD patients across sectors: co-innovation in a network.
Authors: Dinesen B, Seeman J, Gustafsson J.
Source: Int J Integr Care. 2011 Jan;11:e012. Epub 2011 Mar 29.

Summary: This paper discusses the obstacles that arise in the co-innovation process of developing an integrated technique for tele-rehabilitation of COPD patients.

Title: Optimal duration of pulmonary rehabilitation for individuals with chronic obstructive pulmonary disease - a systematic review.
Authors: Beauchamp MK, Janaudis-Ferreira T, Goldstein RS, Brooks D.
Source: Chron Respir Dis. 2011;8(2):129-40.

Summary: The purpose of this review was to determine the impact of duration of pulmonary rehabilitation on measures of health-related quality of life and exercise tolerance in individuals with chronic obstructive pulmonary disease (COPD). The limited literature prevents a more definitive conclusion on optimal duration of rehabilitation.

Title: What prevents people with chronic obstructive pulmonary disease from attending pulmonary rehabilitation? A systematic review.
Authors: Keating A, Lee A, Holland AE.
Source: Chron Respir Dis. 2011;8(2):89-99.

Summary: The aim of this study was to determine the factors associated with uptake and completion of pulmonary rehabilitation for people with COPD. Keating et al. concluded that poor access to transport and lack of perceived benefit affect uptake of pulmonary rehabilitation. Current smokers and patients who are depressed are at increased risk of non-completion. Enhancing attendance in pulmonary rehabilitation will require more attention to transportation, support for those at risk of non-completion and greater involvement of patients in informed decisions about their care.

Title: Is preoperative physiotherapy/pulmonary rehabilitation beneficial in lung resection patients?
Authors: Nagarajan K, Bennett A, Agostini P, Naidu B.
Source: Interact Cardiovasc Thorac Surg. 2011 May 17. [Epub ahead of print].

Summary: The question addressed was whether preoperative physiotherapy pulmonary rehabilitation is beneficial for patients undergoing lung resection. Nagarajan et al. concluded that preoperative physiotherapy improves exercise capacity and preserves pulmonary function following surgery. Whether these benefits translate into a reduction in postoperative pulmonary complication is uncertain.

Title: Comprehensive out-patient pulmonary rehabilitation: Treatment outcomes in early and late stages of chronic obstructive pulmonary disease.
Authors: Ergün P, Kaymaz D, Günay E, Erdoğan Y, Turay UY, Demir N, Canak E, Sengül F, Egesel N, Köse SK.
Source: Ann Thorac Med. 2011 Apr;6(2):70-6.

Summary: The aim was to evaluate the outcomes of a comprehensive pulmonary rehabilitation (PR) in chronic obstructive pulmonary disease (COPD) and to establish whether in early disease stage PR is as effective as in late stages of disease. These results showed that patients with COPD had benefited from a comprehensive PR program in an out-patient setting regardless of disease severity. Even patients with earlier stage of disease should be referred and encouraged to participate in a PR program.

Symptoms of depression

Title: Prevalence of depressive symptoms in patients with chronic obstructive pulmonary disease: a systematic review, meta-analysis and meta-regression.
Authors: Zhang MW, Ho RC, Cheung MW, Fu E, Mak A.
Source: Gen Hosp Psychiatry. 2011 May-Jun;33(3):217-23. Epub 2011 Apr 27.

Summary: This meta-analytical review identified higher prevalence of depressive symptoms among COPD patients, and meta-regression showed that demographic and clinical factors were not the determinants of heterogeneity in prevalence of depressive symptoms.

Title: Multimorbidity and depression treatment.
Authors: Vyas A, Sambamoorthi U.
Source: Gen Hosp Psychiatry. 2011 May-Jun;33(3):238-45. Epub 2011 Mar 31.

Summary: Vyas et al. aimed to compare treatment for depression among individuals with multiple chronic physical conditions to those with single chronic physical condition, after controlling for demographic, socioeconomic, access to care and the number of outpatient visits. These findings suggest that competing demands due to multiple chronic conditions may not affect depression treatment.