Effect of anti-inflammatory supplementation with whey peptide and exercise therapy in patients with COPD

SummaryBackgroundOne of the major pathophysiologies in advanced chronic obstructive pulmonary disease (COPD) has been attributed to systemic inflammation. Meta-analysis of the 2005 Cochrane Database concluded the effect of nutritional supplementation alone on stable COPD was insufficient to promote body weight gain or exercise capacity. The aim of this study was to investigate the effectiveness of nutritional supplementation therapy using a nutritional supplement containing whey peptide with low-intensity exercise therapy in stable elderly patients with COPD.MethodIn stable elderly COPD patients with %IBW and %FEV1 of less than 110 and 80%, respectively, anti-inflammatory nutritional supplementation therapy was added to low-intensity exercise therapy. Thirty-six COPD patients were divided into those with and those without the ingestion of an anti-inflammatory nutritional supplement containing whey peptide, which exhibited an anti-inflammatory effect. These two groups were designated as the nutritional support and the control groups, respectively. The body composition, skeletal muscle strength, exercise tolerance, health-related QOL (HRQOL), and inflammatory cytokines were evaluated before and three months after nutritional support combined with exercise therapy in both the nutritional support group and the control group.ResultsIn the nutritional support group, the body weight, %IBW, FM, energy intake, %AC, Alb, PImax, PEmax, 6MWD, WBI, emotional function, and CRQ total were significantly increased, and the levels of hsCRP, IL-6, IL-8, and TNF-α were reduced significantly, while no significant change was noted in any item of physiological evaluation or any biomarker in the control group.ConclusionConcomitant use of a anti-inflammatory nutritional supplement containing whey peptide, which exhibits an anti-inflammatory effect, with exercise therapy in stable elderly COPD patients with %IBW<110% and %FEV1<80% may not only increase body weight but may also inhibit systemic inflammation and thus improve exercise tolerance and HRQOL

Questionnaire survey on the continuity of home oxygen therapy after a disaster with power outages

AbstractBackgroundAfter the Great East Japan Earthquake, oxygen-dependent patients in areas experiencing power outages could not continue home oxygen therapy (HOT) without oxygen cylinders. The purpose of this study was to examine use of oxygen cylinders in areas experiencing power outages and the effects of HOT interruption on patients' health.MethodsQuestionnaires were mailed to 1106 oxygen-dependent patients and HOT-prescribing physicians in Akita, near the disaster-stricken area. We investigated patients' actions when unable to use an oxygen concentrator and classified the patients based on oxygen cylinder use. Patients who experienced an interruption of or reduction in oxygen flow rate by their own judgment were assigned to the “interruption” and “reduction” groups, respectively; those who maintained their usual flow rate were assigned to the “continuation” group. Differences were tested using analysis of variance and the χ2 tests.ResultsIn total, 599 patients responded to the questionnaire. Oxygen cylinders were supplied to 574 patients (95.8%) before their oxygen cylinders were depleted. Comparison of the continuation (n=356), reduction (n=64), and interruption (n=154) groups showed significant differences in family structure (p=0.004), underlying disease (p=0.014), oxygen flow rate (p<0.001), situation regarding use (p<0.001), knowledge of HOT (p<0.001), and anxiety about oxygen supply (p<0.001). There were no differences in changes in physical condition.ConclusionsMost patients could receive oxygen cylinders after the disaster. Some patients discontinued their usual oxygen therapy, but their overall health status was not affected

PREVALENCE OF AIRFLOW LIMITATION IN PRIMARY CARE CLINICS IN AKITA PREFECTURE

Background : The prevalence of chronic obstructive pulmonary disease (COPD) continues to increase worldwide. However, it is often undiagnosed in primary care clinics due to the insufficient use of spirometry.Objectives : Screening spirometry of patients who attended primary care clinics was performed to estimate the prevalence of airflow limitation in general clinics in Akita prefecture.Methods : A total of 1,135 patients 40 years of age and older, who attended general clinics in Akita prefecture, were enrolled in this study. We defined airflow limitation as forced expiratory volume in one second (FEV1) over forced vital capacity (FVC) (FEV1/FVC) ＜ 70% in patients without active pulmonary disease. Patients with possible asthma were excluded according to history of bronchial asthma, symptoms specific to asthma, and answers to a patient characteristic questionnaire.Results : Of the patients in primary care clinics who were 40 years of age or older, prevalence of airflow limitation was 9.2%, of which 88% were undiagnosed as COPD in Akita prefecture. Thus, the widespread use of spirometry in general clinics and improved hospital and clinic cooperation are warranted to reduce the number of undiagnosed COPD cases. Furthermore, we demonstrated that patients with gastric ulcers had a high prevalence of airflow limitation