Literature Reviews

May 2012

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Title: Perspectives of patients, family caregivers and physicians about the use of opioids for refractory dyspnea in advanced chronic obstructive pulmonary disease.
Authors: Rocker G, Young J, Donahue M, Farquhar M, Simpson C.
Source: CMAJ. 2012 Apr 23. [Epub ahead of print].

Summary: Rocker at al. conducted two qualitative studies to explore the experiences of patients and family caregivers with opioids for refractory COPD-related dyspnea and the perspectives and attitudes of physicians toward opioids in this context. Discrepancies between the positive experiences of patients and family caregivers with opioids and the reluctance of physicians to prescribe opioids for refractory dyspnea constitute an important gap in care.

Title: Discrepancies Between Patients' and Partners' Perceptions of Unsupportive Behavior in Chronic Obstructive Pulmonary Disease.
Authors: Snippe E, Maters GA, Wempe JB, Hagedoorn M, Sanderman R.
Abstract: J Fam Psychol. 2012 Apr 30. [Epub ahead of print].

Summary: Snippe et al. aimed to investigate whether discrepancies between patients' and partners' perceptions of two types of unsupportive partner behavior-overprotection and protective buffering-were associated with the level of distress reported by patients with chronic obstructive pulmonary disease (COPD) and to evaluate whether the direction of the differences between patients' and partners' perceptions was associated with distress (i.e., whether patient distress was associated with greater patient or greater partner reports of unsupportive partner behavior). This study showed that patients' distress was associated not only with patients' perceptions, but also with discrepancies between patients' and partners' perceptions of unsupportive partner behavior.

Title: Symptom Distress in Advanced Chronic Organ Failure: Disagreement among Patients and Family Caregivers.
Authors: Janssen DJ, Spruit MA, Wouters EF, Schols JM.
Source: J Palliat Med. 2012 Apr;15(4):447-56. Epub 2012 Apr 4.

Summary: The aim of the present cross-sectional study was to examine agreement in severity of symptom distress, presence of symptom-related interventions, and satisfaction with medical treatment among patients with advanced chronic obstructive pulmonary disease (COPD), chronic heart failure (CHF) and chronic renal failure (CRF) and their family caregivers. Studies using proxy reporting reflect the views of proxies and do not accurately represent the patients' experience. For clinical care, it's important to pay attention to the perception from the patient as well as the perception from the family caregiver of symptom distress, presence of symptom-related interventions, and satisfaction with treatment.

Muscle Function and Exercise Performance

Title: Ventilatory and cardiocirculatory exercise profiles in COPD: the role of pulmonary hypertension (PH).
Authors: Boerrigter BG, Bogaard HJ, Trip P, Groepenhoff H, Rietema H, Holverda S, Boonstra A, Postmus PE, Westerhof N, Vonk-Noordegraaf A.
Source: Chest. 2012 May 3. [Epub ahead of print]. Boerrigter et al. evaluated and compared the circulatory and ventilatory profiles during exercise in COPD-patients without PH, with moderate PH and with severe PH. COPD patients with severe PH showed an exhausted circulatory reserve at the end of exercise. A profile of circulatory reserve in combination with ventilatory impairments was found in COPD-patients with moderate PH or no PH. The results suggest that pulmonary vasodilation might only improve exercise tolerance in COPD patients with severe PH.

Title: Vitamin D and skeletal muscle strength and endurance in chronic obstructive pulmonary disease.
Authors: Jackson AS, Shrikrishna D, Kelly JL, Hart N, Moxham J, Polkey MI, Kemp P, Hopkinson NS.
Source: Eur Respir J. 2012 May 3. [Epub ahead of print].

Summary: In 104 COPD patients (mean(SD) FEV1 44(22)%predicted) and 100 age and sex-matched controls serum 25(OH)D, 1,25(OH)2D and parathyroid hormone levels were measured and related to quadriceps strength and endurance. In contrast to healthy controls, muscle strength is not associated with vitamin D levels in COPD which may represent vitamin D resistance.

Title: Cerebral cortex oxygen delivery and exercise limitation in patients with COPD.
Authors: Vogiatzis I, Louvaris Z, Habazettl H, Andrianopoulos V, Wagner H, Roussos C, Wagner PD, Zakynthinos S.
Source: Eur Respir J. 2012 May 3. [Epub ahead of print].

Summary: It remains unknown whether in patients with COPD the well documented improvement in exercise tolerance with oxygen supplementation may also be partly due to the increase in cerebral oxygenation. Vogiatzis et al. concluded that their results do not support the hypothesis that an improvement in cerebral cortex oxygen availability plays a contributing role in increasing exercise capacity with oxygen or heliox in patients with COPD.

Title: Association between disease-related factors and balance and falls among the elderly with COPD: a cross-sectional study.
Authors: Ozalevli S, Ilgin D, Narin S, Akkoclu A.
Source: Aging Clin Exp Res. 2011 Oct;23(5-6):372-7.

Summary: Ozalevli et al. aimed to investigate the relationship between disease-related factors and balance, and a history of falls in chronic obstructive pulmonary disease (COPD). According to these results, hypoxemia, dyspnea and fatigue are disease- related factors, which are related with balance impairment and falls in COPD patients.

Title: Six-minute walk distance and work relationship with incremental treadmill cardiopulmonary exercise test in COPD.
Authors: Poersch K, Berton DC, Canterle DB, Castilho J, Lopes AL, Martins J, Oliveira AR, Teixeira PJ.
Source: Clin Respir J. 2012 Apr 24. doi: 10.1111/j.1752-699X.2012.00295.x. [Epub ahead of print].

Summary: The objective of this study was to evaluate the correlation between the 6-MWD and its derivative body weight-walking distance product, an estimation of the work performed during the 6-MWT, with peak from a treadmill CPET. A better association was found between the work estimated from the 6-MWT and peak achieved during CPET, in this case with a treadmill, than the 6-MWD alone.

Authors: Lemire BB, Debigare R, Dubé A, Thériault ME, Cote CH, Maltais F.
Source: J Appl Physiol. 2012 Apr 19. [Epub ahead of print].

Summary: The aim was to investigate the level of activation of p38 MAPK, ERK 1/2 and JNK in the quadriceps of patients with COPD. These data support the hypothesis that the MAPKs might play a role in the development of muscle atrophy in COPD.

Problematic Activities of Daily Life and Physical Inactivity

Title: Daily step counts in a US cohort with COPD.
Authors: Moy ML, Danilack VA, Weston NA, Garshick E.
Source: Respir Med. 2012 Apr 19. [Epub ahead of print].

Summary: Baseline values for daily step counts in US adults with COPD and knowledge of its accurate measurement, natural change over time, and independent relationships with measures of COPD severity are limited. Accurately measured, daily step counts decline over time partly due to season and capture unique information about COPD status.

Title: A cross sectional observational study on the influence of chronic obstructive pulmonary disease on activities of daily living: the COPD-Life study.
Authors: Polatlı M, Bilgin C, Saylan B, Başlılar S, Toprak E, Ergen H, Bakan ND, Kart L, Kılıç Z, Ustünel A, Sengün A, Varol Y, Yılmaz A, Ataol C, Bulgur D, Bozdoğan S, Tunaboyu I, Ozkan ZG, Uysal E, Gülgösteren S, Akın N, Selim Y, Irmak M, Turgut E, Keskin O, Bektaş Uysal H, Sofuoğlu N, Yılmaz M.
Source: Tuberk Toraks. 2012 Mar;60(1):1-12.

Summary: This study was designed to identify the impact of chronic obstructive pulmonary disease (COPD) on activities of daily living, life styles and needs in patients. These findings indicate that the likelihood of COPD patient population to be composed of younger and active individuals who do not spend majority of their time at home/in bed as opposed to popular belief. Therefore, availability of a portable and easy to use device for medication seems to be important to enhance daily living.

Title: Daily activities are sufficient to induce dynamic pulmonary hyperinflation and dyspnea in chronic obstructive pulmonary disease patients.
Authors: Castro AA, Kümpel C, Rangueri RC, Oliveira MD, Dornelles RA, Brito ER, Seki TM, Porto EF.
Source: Clinics (Sao Paulo). 2012;67(4):319-25.

Summary: The aim of this study was to measure dynamic lung hyperinflation and its influence on dyspnea perception in moderate and severe chronic obstructive pulmonary disease patients after performing activities of daily living. Chronic obstructive pulmonary disease patients exhibited reductions in inspiratory capacity and increases in dyspnea perception during commonly performed activities of daily living, which may limit physical performance in these patients.


Title: Systemic inflammation and comorbidities in chronic obstructive pulmonary disease.
Authors: Agustí A, Faner R.
Source: Proc Am Thorac Soc. 2012 May;9(2):43-6.

Summary: The relationship between systemic inflammation and comorbidities in patients with chronic obstructive pulmonary disease (COPD) is unclear. This article discusses (1) the prevalence and clinical impact of comorbidities in COPD; (2) the current knowledge on definition, prevalence, consequences, and treatment of systemic inflammation in COPD; and (3) the relationship of systemic inflammation and lung cancer in COPD.

Title: Pain in people with chronic obstructive pulmonary disease (COPD).
Authors: Hajghanbari B, Holsti L, Road JD, Darlene Reid W.
Source: Respir Med. 2012 Apr 22. [Epub ahead of print].

Summary: The purposes of this study were to determine if pain is more common in COPD patients than in healthy people and if it was related to self-reported physical activity, health related quality of life (HRQoL) and comorbidities. COPD patients demonstrate more pain which interferes with activities more so than healthy people of similar age. Pain is also negatively associated with HRQoL in COPD.

Cognitive Function

Title: Changes in Neurocognitive Functioning Following Lung Transplantation.
Authors: Hoffman BM, Blumenthal JA, Carney RC, O'Hayer CV, Freedland K, Smith PJ, Babyak MA, Davis RD, Mathew JP, Martinu T, Palmer S.
Source: Am J Transplant. 2012 Apr 30. doi: 10.1111/j.1600-6143.2012.04072.x. [Epub ahead of print].

Summary: Hoffman et al. administered 10 tests of neurocognitive functioning before and 6 months following lung transplantation and sought to identify predictors of change. Lung transplantation, like cardiac revascularization procedures, appears to be associated with cognitive decline in a subset of older patients, which could impact daily functioning posttransplant.


Title: Nutrition screening in patients with COPD. Author: Evans A.
Source: Nurs Times. 2012 Mar 13-19;108(11):12-4.

Summary: Nutrition and weight management are increasingly recognised as important factors in managing patients with chronic obstructive pulmonary disease (COPD). This article discusses the impact of COPD symptoms on nutrition, and gives advice on the importance of regular nutritional screening using a validated tool.

Title: Nutritional support in chronic obstructive pulmonary disease: a systematic review and meta-analysis.
Authors: Collins PF, Stratton RJ, Elia M.
Source: Am J Clin Nutr. 2012 Apr 18. [Epub ahead of print].

Summary: The objective was to conduct a meta-analysis of randomized controlled trials (RCTs) to clarify the efficacy of nutritional support in improving intake, anthropometric measures, and grip strength in stable COPD. This systematic review and meta-analysis showed that nutritional support, mainly in the form of oral nutritional supplements, improves total intake, anthropometric measures, and grip strength in COPD.