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García Del Valle-Alegría GR, Osuna-Padilla IA, Gómez-Rodríguez AL, Alarcón-Dionet A, Rodriguez-Díaz Z, Buendía-Roldán I. Validity of bioelectric impedance analysis for body composition assessment in interstitial lung disease patients. NUTR HOSP 2024; 41:810-814. [PMID: 38501791 DOI: 10.20960/nh.04882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/20/2024] Open
Abstract
Introduction Background: changes in body composition (BC) are common in interstitial lung disease, which leads to an increased risk of complications and infections, and are associated with poor quality of life and worse outcomes. BC assessment is important to identify malnutrition and sarcopenia. However, gold-standard techniques are not available in all clinical settings. Aims: this study aimed to evaluate the agreement and reliability of body composition estimated by bioelectric impedance analysis (BIA) and measured using dual-energy X-ray absorptiometry (DEXA) in women with interstitial lung disease. Methods: this is a cross-sectional study. BC (fat mass and appendicular skeletal muscle mass) were assessed using BIA multifrequency and DEXA in standardized conditions. Agreement and reliability between techniques were evaluated using Bland-Altman plots and the intraclass correlation coefficient (ICC). Results: a total of 50 women were evaluated. No differences were observed for FM (BIA, 25.8 ± 10.2 kg and DEXA, 26.3 ± 10.0 kg, p = 0.77) and ASMM (BIA, 14.1 ± 2.7 kg and DEXA, 13.9 ± 2.3 kg, p = 0.83). Based on ICC, good reliability was observed for FM (ICC, 0.98) and ASMM (ICC, 0.93). Conclusion: BC estimated by BIA showed good agreement and reliability with DEXA measurements. In the absence of this method, BIA can replace the DEXA technique for body composition assessment.
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Affiliation(s)
| | - Iván Armando Osuna-Padilla
- Clinical Nutrition Coordination. Department of Critical Areas. Instituto Nacional de Enfermedades Respiratorias (INER)
| | | | - Aime Alarcón-Dionet
- Translational Research Laboratory in Aging and Pulmonary Fibrosis. Instituto Nacional de Enfermedades Respiratorias
| | - Zobeida Rodriguez-Díaz
- Translational Research Laboratory in Aging and Pulmonary Fibrosis. Instituto Nacional de Enfermedades Respiratorias
| | - Ivette Buendía-Roldán
- Translational Research Laboratory in Aging and Pulmonary Fibrosis. Instituto Nacional de Enfermedades Respiratorias
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2
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Iwanami Y, Ebihara K, Nakao K, Kubo R, Miyagi M, Nakamura Y, Sakamoto S, Kishi K, Okuni I, Ebihara S. Impact of Controlling Nutritional Status Score on Mortality in Elderly Patients with Idiopathic Pulmonary Fibrosis. J Clin Med 2024; 13:2825. [PMID: 38792367 PMCID: PMC11122391 DOI: 10.3390/jcm13102825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 05/01/2024] [Accepted: 05/07/2024] [Indexed: 05/26/2024] Open
Abstract
Background: There are only a few reports on the nutritional status and mortality of patients with idiopathic pulmonary fibrosis (IPF). As such, this study aims to investigate the relationship between controlling nutritional status (CONUT) and the mortality of elderly patients with IPF. Methods: A total of 170 IPF patients aged ≥65 years old who visited the rehabilitation department of our hospital between July 2014 and July 2021 (mean age: 75.7 ± 6.3 years, sex (male/female): 138/32, %FVC: 78.3 ± 18.3%) were retrospectively analyzed. The Kaplan-Meier method and log-rank test were applied. Furthermore, using a Cox proportional hazards model with multivariate analysis, we analyzed the relationship between all-cause mortality and baseline characteristics including CONUT. Results: Based on the CONUT score, the normal group included 101 cases, the mild group included 58 cases, the moderate group included 11 cases, and the severe group had 0 cases. There were 49 cases of all-cause mortality events, suggesting that the mortality of the moderate group was significantly poorer than that of the normal and mild groups (p < 0.05). Furthermore, multivariate analysis identified GAP stage (HR: 5.972, 95%CI: 2.901~12.291, p < 0.0001), mMRC scale (HR: 0.615, 95%CI: 0.389~0.971, p = 0.009), and CONUT (HR: 2.012, 95%CI: 1.192~3.395, p = 0.037) as factors significantly influencing mortality. Conclusions: Severe malnutrition was not observed in elderly patients with IPF. Moderate malnutrition was associated with a significantly higher risk of all-cause mortality, suggesting that CONUT is an important indicator for predicting mortality.
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Affiliation(s)
- Yuji Iwanami
- Department of Rehabilitation Medicine, Toho University Omori Medical Center, 6-11-1 Omori-nishi, Ota-ku, Tokyo 143-8541, Japan; (Y.I.); (K.E.); (K.N.); (R.K.); (I.O.)
| | - Kento Ebihara
- Department of Rehabilitation Medicine, Toho University Omori Medical Center, 6-11-1 Omori-nishi, Ota-ku, Tokyo 143-8541, Japan; (Y.I.); (K.E.); (K.N.); (R.K.); (I.O.)
| | - Keiko Nakao
- Department of Rehabilitation Medicine, Toho University Omori Medical Center, 6-11-1 Omori-nishi, Ota-ku, Tokyo 143-8541, Japan; (Y.I.); (K.E.); (K.N.); (R.K.); (I.O.)
| | - Ryuki Kubo
- Department of Rehabilitation Medicine, Toho University Omori Medical Center, 6-11-1 Omori-nishi, Ota-ku, Tokyo 143-8541, Japan; (Y.I.); (K.E.); (K.N.); (R.K.); (I.O.)
| | - Midori Miyagi
- Department of Rehabilitation Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan;
| | - Yasuhiko Nakamura
- Department of Respiratory Medicine, Toho University School of Medicine, 6-11-1 Omori-nishi, Ota-ku, Tokyo 143-8541, Japan; (Y.N.); (S.S.); (K.K.)
| | - Susumu Sakamoto
- Department of Respiratory Medicine, Toho University School of Medicine, 6-11-1 Omori-nishi, Ota-ku, Tokyo 143-8541, Japan; (Y.N.); (S.S.); (K.K.)
| | - Kazuma Kishi
- Department of Respiratory Medicine, Toho University School of Medicine, 6-11-1 Omori-nishi, Ota-ku, Tokyo 143-8541, Japan; (Y.N.); (S.S.); (K.K.)
| | - Ikuko Okuni
- Department of Rehabilitation Medicine, Toho University Omori Medical Center, 6-11-1 Omori-nishi, Ota-ku, Tokyo 143-8541, Japan; (Y.I.); (K.E.); (K.N.); (R.K.); (I.O.)
| | - Satoru Ebihara
- Department of Rehabilitation Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan;
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3
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Savvaides TM, Demetres MR, Aronson KI. Current Landscape and Future Directions of Patient Education in Adults with Interstitial Lung Disease. ATS Sch 2024; 5:184-205. [PMID: 38633514 PMCID: PMC11022645 DOI: 10.34197/ats-scholar.2023-0069re] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 09/21/2023] [Indexed: 04/19/2024] Open
Abstract
Background Understandable, comprehensive, and accessible educational materials for patients with interstitial lung disease (ILD) are lacking. Patients consistently ask for improved access to evidence-based information about ILD. Nonetheless, few research studies focus directly on developing and evaluating interventions to improve patient knowledge. Objective We describe the current landscape of patient education in ILD, identify gaps in current approaches to information delivery, and provide frameworks to address these challenges through novel educational tools. Methods A literature review was conducted in collaboration with a medical librarian (M.R.D.) in April 2022 using Ovid MEDLINE (1946-), Embase (1947-), Cochrane Central (1993-), and CINAHL (1961-). Search terms included "interstitial lung disease," "pulmonary fibrosis," "patient education," and "information seeking behavior" (see the data supplement for full search terms). Reference lists from selected articles were used to identify additional studies. Results Currently, patient education is commonly combined with exercise regimens in pulmonary rehabilitation programs in which benefits of the educational component alone are unclear. Few studies investigate improving knowledge access and acquisition for patients with ILD and their caregivers regarding self-management, oxygen use, and palliative care plans. Online distribution of health information through social media runs the risk of being unregulated and outdated, although it is an avenue of increasing accessibility. Conclusion By expanding access to novel ILD-specific education programs and accounting for social determinants of health that impact healthcare access, patient education has the potential to become more attainable, improving patient-centered outcomes. Further research into optimal development, delivery, and efficacy testing of patient education modalities in ILD is warranted.
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Affiliation(s)
| | - Michelle R. Demetres
- Samuel J. Wood Library & C.V. Starr
Biomedical Information Center, Weill Cornell Medicine, New York, New York
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4
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Oliveira A, Fabbri G, Gille T, Bargagli E, Duchemann B, Evans R, Pinnock H, Holland AE, Renzoni E, Ekström M, Jones S, Wijsenbeek M, Dinh-Xuan AT, Vagheggini G. Holistic management of patients with progressive pulmonary fibrosis. Breathe (Sheff) 2023; 19:230101. [PMID: 37719243 PMCID: PMC10501708 DOI: 10.1183/20734735.0101-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 07/18/2023] [Indexed: 09/19/2023] Open
Abstract
Progressive pulmonary fibrosis (PF) is a complex interstitial lung disease that impacts substantially on patients' daily lives, requiring personalised and integrated care. We summarise the main needs of patients with PF and their caregivers, and suggest a supportive care approach. Individualised care, education, emotional and psychological support, specialised treatments, and better access to information and resources are necessary. Management should start at diagnosis, be tailored to the patient's needs, and consider end-of-life care. Pharmacological and non-pharmacological interventions should be individualised, including oxygen therapy and pulmonary rehabilitation, with digital healthcare utilised as appropriate. Further research is needed to address technical issues related to oxygen delivery and digital healthcare. Educational aims To identify the main needs of patients with PF and their caregivers.To describe the components of a comprehensive approach to a supportive care programme for patients with PF.To identify further areas of research to address technical issues related to the management of patients with PF.
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Affiliation(s)
- Ana Oliveira
- Lab 3R Respiratory Research and Rehabilitation Laboratory, School of Health Sciences, University of Aveiro (ESSUA), IBMED Aveiro PT, Aveiro, Portugal
- School of Rehabilitation Science, Faculty of Health Science, McMaster University, Hamilton, ON, Canada
| | - Gaia Fabbri
- Respiratory Diseases and Lung Transplantation Unit, Department of Medical and Surgical Sciences and Neuro-Sciences, University of Siena, Siena, Italy
| | - Thomas Gille
- Inserm U1272 “Hypoxia & the Lung”, UFR SMBH Léonard de Vinci, Université Sorbonne Paris Nord, Bobigny, France
- Service Physiologie et Explorations Fonctionnelles, Hôpitaux Universitaires de Paris Seine-Saint-Denis, Assistance Publique – Hôpitaux de Paris, Bobigny, France
| | - Elena Bargagli
- Respiratory Diseases and Lung Transplantation Unit, Department of Medical and Surgical Sciences and Neuro-Sciences, University of Siena, Siena, Italy
| | - Boris Duchemann
- Inserm U1272 “Hypoxia & the Lung”, UFR SMBH Léonard de Vinci, Université Sorbonne Paris Nord, Bobigny, France
- Service d'oncologie médicale et thoracique, Hôpitaux Universitaires de Paris Seine-Saint-Denis, Assistance Publique – Hôpitaux de Paris, Bobigny, France
| | - Rachel Evans
- Department of Respiratory Sciences, University of Leicester, Glenfield Hospital, Leicester, UK
| | - Hilary Pinnock
- Allergy and Respiratory Research Group, Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - Anne E. Holland
- Central Clinical School, Monash University and Department of Physiotherapy, Alfred Health, Melbourne, Australia
| | - Elisabetta Renzoni
- Interstitial Lung Disease Unit, Royal Brompton and Harefield Clinical Group, Guy's and St Thomas’ NHS Foundation Trust, London, UK
- Margaret Turner Warwick Centre for Fibrosing Lung Diseases, NHLI, Imperial College, London, UK
| | - Magnus Ekström
- Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Respiratory Medicine, Allergology and Palliative Medicine, Lund, Sweden
| | - Steve Jones
- European Pulmonary Fibrosis Federation, Brussels, Belgium
| | - Marlies Wijsenbeek
- Centre for Expertise for Interstitial Lung Disease and Sarcoidosis, Department of Respiratory Medicine, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
| | - Anh Tuan Dinh-Xuan
- Service de Physiologie-Explorations Fonctionnelles, Assistance Publique-Hôpitaux de Paris, Hôpital Cochin, Université Paris Cité, Paris, France
| | - Guido Vagheggini
- Department of Internal Medicine and Medical Specialties, Respiratory Failure Pathway, Azienda USL Toscana Nordovest, Pisa, Italy
- Fondazione Volterra Ricerche ONLUS, Volterra (PI), Italy
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5
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Khor YH, Cottin V, Holland AE, Inoue Y, McDonald VM, Oldham J, Renzoni EA, Russell AM, Strek ME, Ryerson CJ. Treatable traits: a comprehensive precision medicine approach in interstitial lung disease. Eur Respir J 2023; 62:2300404. [PMID: 37263752 PMCID: PMC10626565 DOI: 10.1183/13993003.00404-2023] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 05/16/2023] [Indexed: 06/03/2023]
Abstract
Interstitial lung disease (ILD) is a diverse group of inflammatory and fibrotic lung conditions causing significant morbidity and mortality. A multitude of factors beyond the lungs influence symptoms, health-related quality of life, disease progression and survival in patients with ILD. Despite an increasing emphasis on multidisciplinary management in ILD, the absence of a framework for assessment and delivery of comprehensive patient care poses challenges in clinical practice. The treatable traits approach is a precision medicine care model that operates on the premise of individualised multidimensional assessment for distinct traits that can be targeted by specific interventions. The potential utility of this approach has been described in airway diseases, but has not been adequately considered in ILD. Given the similar disease heterogeneity and complexity between ILD and airway diseases, we explore the concept and potential application of the treatable traits approach in ILD. A framework of aetiological, pulmonary, extrapulmonary and behavioural and lifestyle treatable traits relevant to clinical care and outcomes for patients with ILD is proposed. We further describe key research directions to evaluate the application of the treatable traits approach towards advancing patient care and health outcomes in ILD.
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Affiliation(s)
- Yet H Khor
- Respiratory Research@Alfred, Central Clinical School, Monash University, Melbourne, Australia
- Department of Respiratory and Sleep Medicine, Austin Health, Heidelberg, Australia
- Institute for Breathing and Sleep, Heidelberg, Australia
- Faculty of Medicine, University of Melbourne, Melbourne, Australia
| | - Vincent Cottin
- National Coordinating Reference Centre for Rare Pulmonary Diseases, OrphaLung, Louis Pradel Hospital, Hospices Civils de Lyon, ERN-LUNG, Lyon, France
- UMR 754, Claude Bernard University Lyon 1, INRAE, Lyon, France
| | - Anne E Holland
- Respiratory Research@Alfred, Central Clinical School, Monash University, Melbourne, Australia
- Institute for Breathing and Sleep, Heidelberg, Australia
- Department of Respiratory and Sleep Medicine, Alfred Health, Melbourne, Australia
- Department of Physiotherapy, Alfred Health, Melbourne, Australia
| | - Yoshikazu Inoue
- Clinical Research Center, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai City, Japan
| | - Vanessa M McDonald
- National Health and Medical Research Council Centre for Research Excellence in Treatable Traits, New Lambton Heights, Australia
- Asthma and Breathing Research Centre, Hunter Medical Research Institute, New Lambton Heights, Australia
- School of Nursing and Midwifery, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, Australia
| | - Justin Oldham
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
- Department of Epidemiology, University of Michigan, Ann Arbor, MI, USA
| | - Elisabetta A Renzoni
- Interstitial Lung Disease Unit, Royal Brompton and Harefield Clinical Group, Guy's and St Thomas' NHS Foundation Trust, London, UK
- Margaret Turner Warwick Centre for Fibrosing Lung Disease, National Heart and Lung Institute, Imperial College London, London, UK
| | - Anne Marie Russell
- Exeter Respiratory Innovation Centre, University of Exeter, Exeter, UK
- Royal Devon University Hospitals, NHS Foundation Trust, Devon, UK
- Faculty of Medicine, Imperial College Healthcare NHS Trust, London, UK
| | - Mary E Strek
- Pulmonary and Critical Care Medicine, University of Chicago, Chicago, IL, USA
| | - Christopher J Ryerson
- Department of Medicine, University of British Columbia, Vancouver, BC, Canada
- Centre for Heart Lung Innovation, St. Paul's Hospital, Vancouver, BC, Canada
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6
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Zielinski M, Chwalba A, Jastrzebski D, Ziora D. Adipokines in interstitial lung diseases. Respir Physiol Neurobiol 2023:104109. [PMID: 37393966 DOI: 10.1016/j.resp.2023.104109] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 06/20/2023] [Accepted: 06/29/2023] [Indexed: 07/04/2023]
Abstract
Interstitial lung diseases (ILD) are a heterogenic group of respiratory diseases with complex pathogenesis. A growing number of evidence suggests role of adipose tissue and it's hormones (adipokines) in pathogenesis of various disorders, including lung tissue diseases. The aim of this study was to assess the concentrations of selected adipokines and their receptors (apelin, adiponectin, chemerin, chemerin receptor - CMKLR1) in patients with IPF (idiopathic pulmonary fibrosis) and sarcoidosis in comparison to healthy controls. We found changes in adipokines concentrations in ILD. Adiponectin concentrations were higher in all respiratory diseases patients in comparison to healthy controls. Apelin concentration in ILD patients was higher then those in healthy subjects. The trend of chemerin and CMKLR1 concentrations were similar, with highest concentrations seen in sarcoidosis. The study shows a difference of adipokines concentrations between patients with ILD and healthy controls. Adipokines are a potential marker and therapeutic target in patients with IPF and sarcoidosis.
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Affiliation(s)
- M Zielinski
- Department of Lung Diseases and Tuberculosis, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Poland.
| | - A Chwalba
- Department of Lung Diseases and Tuberculosis, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Poland
| | - D Jastrzebski
- Department of Lung Diseases and Tuberculosis, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Poland
| | - D Ziora
- Department of Lung Diseases and Tuberculosis, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Poland
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7
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Weber A, Müller I, Büchi AE, Guler SA. Prevalence and assessment of frailty in interstitial lung disease - a systematic review and meta-analysis. Chron Respir Dis 2023; 20:14799731231196582. [PMID: 37746859 PMCID: PMC10521296 DOI: 10.1177/14799731231196582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 08/01/2023] [Indexed: 09/26/2023] Open
Abstract
BACKGROUND Frailty is a multisystem dysregulation that challenges homeostasis and increases vulnerability towards stressors. In patients with interstitial lung diseases (ILD) frailty is associated with poorer lung function, greater physical impairment, and higher symptom burden. Our understanding of the prevalence of frailty in ILD and consequently its impact on the ILD population is limited. OBJECTIVE AND METHODS We aimed to systematically review frailty assessment tools and to determine frailty prevalence across different ILD cohorts. Meta-analyses were used to calculate the pooled prevalence of frailty in the ILD population. RESULTS We identified 26 studies (15 full-texts, 11 conference abstracts) including a total of 4614 patients with ILD. The most commonly used frailty assessment tools were the Fried Frailty Phenotype (FFP), the Short Physical Performance Battery (SPPB), and the cumulative Frailty Index (FI). Data allowed for meta-analyses of FFP and SPPB prevalence. The pooled prevalence of frailty was 35% (95% CI 25%-45%) by FFP, and 19% (95% CI 12%-28%) by SPPB. CONCLUSIONS Frailty is common in ILD, with considerable variability of frailty prevalence depending on the frailty assessment tool used. These findings highlight the importance of frailty in ILD and the need for a standardized approach to frailty assessment in this population.
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Affiliation(s)
- Angela Weber
- Department of Pulmonary Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Ilena Müller
- Department of Pulmonary Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Annina E. Büchi
- Department of Pulmonary Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Sabina A. Guler
- Department of Pulmonary Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Department of BioMedical Research, University of Bern, Bern, Switzerland
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8
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Pastor R, Bouzas C, Albertos I, García C, García Á, Prieto T, Velázquez J, Sánchez-Jiménez E, Rodríguez R, Martín FJ, Campón AM, Tur JA. Health-Related Quality of Life in Spanish Schoolchildren and Its Association with the Fitness Status and Adherence to the Mediterranean Diet. Nutrients 2022; 14:2322. [PMID: 35684122 PMCID: PMC9182729 DOI: 10.3390/nu14112322] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 05/28/2022] [Accepted: 05/30/2022] [Indexed: 11/19/2022] Open
Abstract
Background: Health-related quality of life (HRQoL) allows knowing the subject’s feelings in distress and well-being, as well as perception of current and future health. Objective: To assess associations between health-related quality of life, fitness status, and adherence to the Mediterranean diet in Spanish children and adolescents. Methods: A cross-sectional study was carried out in a sample of 305 (47.2% women) children and adolescents aged between 8 and 16 years, in the primary and secondary schools of the province of Ávila (central Spain) (NCT05380674). Subjects were classified according to their quality of life: group 1 (highest quality of life) > group 2 (medium quality of life) > group 3 (lowest quality of life). Results: More participants in group 1 showed higher adherence to Mediterranean diet (70.8%) than other groups (group 2: 55.0%; group 3: 43.4%). It was less likely to find optimal levels of muscle strength as quality of life decreased (OR; 95% CI: group 2: 0.535; 0.303−0.955; and group 3: 0.424; 0.234−0.768). Similar trends were found for speed and agility, but only group 3 showed significant results (OR; 95% CI: group 3: 0.297; 0.162−0.545). Flexibility was also the worst in groups 2 and 3 (OR; 95% CI: G2: 0.403; 0.213−0.762; and group 3: 0.520; 0.282−0.958). Conclusion: High fitness status and adherence to the Mediterranean diet were associated with improved health-related quality of life in schoolchildren of central Spain.
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Affiliation(s)
- Rosario Pastor
- Research Group on Community Nutrition and Oxidative Stress, University of the Balearic Islands-IUNICS, 07122 Palma de Mallorca, Spain; (R.P.); (C.B.)
- Faculty of Health Sciences, Catholic University of Avila, 05005 Avila, Spain; (I.A.); (C.G.); (Á.G.); (T.P.); (J.V.); (E.S.-J.); (R.R.); (F.J.M.); (A.M.C.)
| | - Cristina Bouzas
- Research Group on Community Nutrition and Oxidative Stress, University of the Balearic Islands-IUNICS, 07122 Palma de Mallorca, Spain; (R.P.); (C.B.)
- Faculty of Health Sciences, Catholic University of Avila, 05005 Avila, Spain; (I.A.); (C.G.); (Á.G.); (T.P.); (J.V.); (E.S.-J.); (R.R.); (F.J.M.); (A.M.C.)
- CIBEROBN (Physiopathology of Obesity and Nutrition), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Foundation Health Research Institute of the Balearic Islands (IDISBA), 07120 Palma de Mallorca, Spain
| | - Irene Albertos
- Faculty of Health Sciences, Catholic University of Avila, 05005 Avila, Spain; (I.A.); (C.G.); (Á.G.); (T.P.); (J.V.); (E.S.-J.); (R.R.); (F.J.M.); (A.M.C.)
| | - Carolina García
- Faculty of Health Sciences, Catholic University of Avila, 05005 Avila, Spain; (I.A.); (C.G.); (Á.G.); (T.P.); (J.V.); (E.S.-J.); (R.R.); (F.J.M.); (A.M.C.)
| | - Ángela García
- Faculty of Health Sciences, Catholic University of Avila, 05005 Avila, Spain; (I.A.); (C.G.); (Á.G.); (T.P.); (J.V.); (E.S.-J.); (R.R.); (F.J.M.); (A.M.C.)
| | - Teresa Prieto
- Faculty of Health Sciences, Catholic University of Avila, 05005 Avila, Spain; (I.A.); (C.G.); (Á.G.); (T.P.); (J.V.); (E.S.-J.); (R.R.); (F.J.M.); (A.M.C.)
| | - Jorge Velázquez
- Faculty of Health Sciences, Catholic University of Avila, 05005 Avila, Spain; (I.A.); (C.G.); (Á.G.); (T.P.); (J.V.); (E.S.-J.); (R.R.); (F.J.M.); (A.M.C.)
| | - Elena Sánchez-Jiménez
- Faculty of Health Sciences, Catholic University of Avila, 05005 Avila, Spain; (I.A.); (C.G.); (Á.G.); (T.P.); (J.V.); (E.S.-J.); (R.R.); (F.J.M.); (A.M.C.)
| | - Rocío Rodríguez
- Faculty of Health Sciences, Catholic University of Avila, 05005 Avila, Spain; (I.A.); (C.G.); (Á.G.); (T.P.); (J.V.); (E.S.-J.); (R.R.); (F.J.M.); (A.M.C.)
| | - Francisco Javier Martín
- Faculty of Health Sciences, Catholic University of Avila, 05005 Avila, Spain; (I.A.); (C.G.); (Á.G.); (T.P.); (J.V.); (E.S.-J.); (R.R.); (F.J.M.); (A.M.C.)
| | - Angélica María Campón
- Faculty of Health Sciences, Catholic University of Avila, 05005 Avila, Spain; (I.A.); (C.G.); (Á.G.); (T.P.); (J.V.); (E.S.-J.); (R.R.); (F.J.M.); (A.M.C.)
| | - Josep A. Tur
- Research Group on Community Nutrition and Oxidative Stress, University of the Balearic Islands-IUNICS, 07122 Palma de Mallorca, Spain; (R.P.); (C.B.)
- CIBEROBN (Physiopathology of Obesity and Nutrition), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Foundation Health Research Institute of the Balearic Islands (IDISBA), 07120 Palma de Mallorca, Spain
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9
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Rinaldi S, Balsillie C, Truchon C, AL‐Mubarak A, Mura M, Madill J. Nutrition implications of intrinsic restrictive lung disease. Nutr Clin Pract 2022; 37:239-255. [DOI: 10.1002/ncp.10849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 01/26/2022] [Accepted: 01/28/2022] [Indexed: 11/07/2022] Open
Affiliation(s)
- Sylvia Rinaldi
- School of Food and Nutritional Science, Brescia University College Western University London Ontario Canada
| | - Christine Balsillie
- School of Food and Nutritional Science, Brescia University College Western University London Ontario Canada
| | - Cassandra Truchon
- School of Food and Nutritional Science, Brescia University College Western University London Ontario Canada
| | - Awatif AL‐Mubarak
- School of Food and Nutritional Science, Brescia University College Western University London Ontario Canada
| | - Marco Mura
- Division of Respirology, Schulich School of Medicine and Dentistry Western University London Ontario Canada
| | - Janet Madill
- School of Food and Nutritional Science, Brescia University College Western University London Ontario Canada
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10
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Morrow LE, Hilleman D, Malesker MA. Management of patients with fibrosing interstitial lung diseases. Am J Health Syst Pharm 2022; 79:129-139. [PMID: 34608488 PMCID: PMC8881211 DOI: 10.1093/ajhp/zxab375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
PURPOSE This article summarizes the appropriate use and pharmacology of treatments for fibrosing interstitial lung diseases, with a specific focus on the antifibrotic agents nintedanib and pirfenidone. SUMMARY The interstitial lung diseases are a heterogenous group of parenchymal lung disorders with a common feature-infiltration of the interstitial space with derangement of the normal capillary-alveolar anatomy. Diseases characterized by fibrosis of the interstitial space are referred to as the fibrosing interstitial lung diseases and often show progression over time: idiopathic pulmonary fibrosis is the most common fibrotic interstitial lung disease. Historically, therapies for fibrosing lung diseases have been limited in number, questionable in efficacy, and associated with potential harms. Food and Drug Administration (FDA) approval of the antifibrotic agents nintedanib and pirfenidone for idiopathic pulmonary fibrosis in 2014 heralded an era of reorganization of therapy for the fibrotic interstitial lung diseases. Subsequent investigations have led to FDA approval of nintedanib for systemic sclerosis-associated interstitial lung disease and interstitial lung diseases with a progressive phenotype. Although supportive care and pulmonary rehabilitation should be provided to all patients, the role(s) of immunomodulators and/or immune suppressing agents vary by the underlying disease state. Several agents previously used to treat fibrotic lung diseases (N-acetylcysteine, anticoagulation, and pulmonary vasodilators) lack efficacy or cause harm. CONCLUSION With the introduction of effective pharmacotherapy for fibrosing interstitial lung disease, pharmacists have an increasingly important role in the interdisciplinary team managing these patients.
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Affiliation(s)
- Lee E Morrow
- Creighton University School of Medicine, Omaha, NE
- Creighton University School of Pharmacy and Health Professions, Omaha, NE, USA
| | - Daniel Hilleman
- Creighton University School of Pharmacy and Health Professions, Omaha, NE
- Creighton University School of Medicine, Omaha, NE, USA
| | - Mark A Malesker
- Creighton University School of Pharmacy and Health Professions, Omaha, NE
- Creighton University School of Medicine, Omaha, NE, USA
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11
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Khanna D, Lescoat A, Roofeh D, Bernstein EJ, Kazerooni EA, Roth MD, Martinez F, Flaherty KR, Denton CP. Systemic Sclerosis-Associated Interstitial Lung Disease: How to Incorporate Two Food and Drug Administration-Approved Therapies in Clinical Practice. Arthritis Rheumatol 2022; 74:13-27. [PMID: 34313399 PMCID: PMC8730677 DOI: 10.1002/art.41933] [Citation(s) in RCA: 63] [Impact Index Per Article: 31.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 07/22/2021] [Indexed: 01/03/2023]
Abstract
Systemic sclerosis (SSc; scleroderma) has the highest individual mortality of all rheumatic diseases, and interstitial lung disease (ILD) is among the leading causes of SSc-related death. Two drugs are now approved by the US Food and Drug Administration (FDA) and indicated for slowing the rate of decline in pulmonary function in patients with SSc-associated ILD (SSc-ILD): nintedanib (a tyrosine kinase inhibitor) and tocilizumab (the first biologic agent targeting the interleukin-6 pathway in SSc). In addition, 2 generic drugs with cytotoxic and immunoregulatory activity, mycophenolate mofetil and cyclophosphamide, have shown comparable efficacy in a phase II trial but are not FDA-approved for SSc-ILD. In light of the heterogeneity of the disease, the optimal therapeutic strategy for the management of SSc-ILD is still to be determined. The objectives of this review are 2-fold: 1) review the body of research focused on the diagnosis and treatment of SSc-ILD; and 2) propose a practical approach for diagnosis, stratification, management, and therapeutic decision-making in this clinical context. This review presents a practical classification of SSc patients in terms of disease severity (subclinical versus clinical ILD) and associated risk of progression (low versus high risk). The pharmacologic and nonpharmacologic options for first- and second-line therapy, as well as potential combination approaches, are discussed in light of the recent approval of tocilizumab for SSc-ILD.
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Affiliation(s)
- Dinesh Khanna
- University of Michigan Scleroderma Program,Division of Rheumatology, Department of Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Alain Lescoat
- University of Michigan Scleroderma Program,Department of Internal Medicine and Clinical Immunology, CHU Rennes, Univ Rennes, France,,University of Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail), Rennes, France
| | - David Roofeh
- University of Michigan Scleroderma Program,Division of Rheumatology, Department of Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Elana J Bernstein
- Division of Rheumatology, Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | - Ella A Kazerooni
- Department of Radiology, University of Michigan, Ann Arbor, MI, USA
| | - Michael D Roth
- Division of Pulmonary Medicine, Department of Medicine, UCLA, Los Angeles USA
| | - Fernando Martinez
- Division of Pulmonary Medicine, Department of Medicine, NYU/ Cornell University, NY, USA
| | - Kevin R Flaherty
- Division of Pulmonary Medicine, Department of Medicine, University of Michigan, Ann Arbor, MI, USA
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12
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Benavides-Cordoba V, Barros-Poblete M, Vieira RP, Mazzucco G, Fregonezi G, Torres-Castro R. Provision of pulmonary rehabilitation in Latin America 18 months after the COVID-19 pandemic: A survey of the Latin American Thoracic Association. Chron Respir Dis 2022; 19:14799731221104102. [PMID: 35616253 PMCID: PMC9149608 DOI: 10.1177/14799731221104102] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Introduction The Coronavirus disease (COVID-19) pandemic has significantly altered the
provision of rehabilitation services, especially pulmonary rehabilitation
(PR). Our objective was to assess the provision of PR services in Latin
America 18 months after the COVID-19 pandemic was declared. Methods A cross-sectional study that included professionals dedicated to PR in
centres in Latin America was applied. Responses to an online questionnaire
were collected from May to September 2021. The following data were included
for the analysis: demographic data, evaluation strategies, program
structure, PR intervention in post-COVID-19 patients, and perception of
strategies therapies for the care of post-COVID-19 patients. The
questionnaire was distributed in Spanish and Portuguese languages. Results Responses were received from 196 PR centres. Exercise tolerance was
predominantly measured with the six-minute walk test. Less than 50% of the
institutions evaluate quality of life, physical qualities, symptoms, and
lung function. Most of the programmes have physiotherapists (90.8%), as well
as pulmonologists (60%), and psychologists (35%), among other
professionals. Conclusion PR services in Latin America have adapted in their way to the requirements of
the pandemic, and most continued to provide face-to-face services. It was
identified that the application of the programs is heterogeneous both in
evaluations and interventions.
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Affiliation(s)
- Vicente Benavides-Cordoba
- Facultad de Ciencias de la Salud, 27965Pontificia Universidad Javeriana Cali. Universidad del Valle, Cali, Colombia
| | - Marisol Barros-Poblete
- Programa de Doctorado en Ciencias Médicas, Escuela de Graduados Facultad de Medicina, 28040Universidad Austral de Chile, Valdivia, Chile
| | - Rodolfo P Vieira
- Post-graduate Program in Rehabilitation Sciences and Human Movement and in Pharmaceutical Sciences, Federal University of Sao Paulo (UNIFESP), Santos - SP, Brazil; Post-graduation Program in Bioenginnering, Universidade Brasil, São Paulo - SP, Brazil
| | - Guillermo Mazzucco
- Centro Universitario de Asistencia, Docencia e Investigación, 560989Instituto Cardiovascular de Rosario (ICR), Universidad del Gran Rosario, Rosario, Argentina
| | - Guilherme Fregonezi
- PneumoCardioVascular Lab/HUOL & Laboratório de Inovação Tecnológica em Reabilitação, Hospital Universitário Onofre Lopes, Empresa Brasileira de Serviços Hospitalares (EBSERH) & Departamento de Fisioterapia, 28123Universidade Federal do Rio Grande do Norte, Natal, Brasil.,International Physiotherapy Research Network (PhysioEvidence), Barcelona, Spain
| | - Rodrigo Torres-Castro
- International Physiotherapy Research Network (PhysioEvidence), Barcelona, Spain.,Department of Physical Therapy, Faculty of Medicine, 14655University of Chile, Santiago, Chile
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13
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Faverio P, Fumagalli A, Conti S, Madotto F, Bini F, Harari S, Mondoni M, Oggionni T, Barisione E, Ceruti P, Papetti MC, Bodini BD, Caminati A, Valentino A, Centanni S, Noè D, Della Zoppa M, Crotti S, Grosso M, Sukkar SG, Modina D, Andreoli M, Nicali R, Suigo G, De Giacomi F, Busnelli S, Cattaneo E, Mantovani LG, Cesana G, Pesci A, Luppi F. Nutritional assessment in idiopathic pulmonary fibrosis: a prospective multicentre study. ERJ Open Res 2021; 8:00443-2021. [PMID: 35265706 PMCID: PMC8899499 DOI: 10.1183/23120541.00443-2021] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 09/27/2021] [Indexed: 12/04/2022] Open
Abstract
Background Nutritional status impacts quality of life and prognosis of patients with respiratory diseases, including idiopathic pulmonary fibrosis (IPF). However, there is a lack of studies performing an extensive nutritional assessment of IPF patients. This study aimed to investigate the nutritional status and to identify nutritional phenotypes in a cohort of IPF patients at diagnosis. Methods Patients underwent a thorough pulmonary and nutritional evaluation including questionnaires on nutritional status, and physical activity, anthropometry, body impedance, dynamometry, 4-m gait speed and blood tests. Results 90 IPF patients (78.9% males, mean age 72.7 years) were enrolled. The majority of patients were classified as Gender-Age-Physiology Index stage 2 (47, 52.2%) with an inactive lifestyle according to International Physical Activity Questionnaire score (39, 43.3%), and had mean forced vital capacity and diffusing capacity for carbon monoxide 86.5% and 54.2%, respectively. In regards to nutritional phenotypes, the majority of patients were normally nourished (67.8%, 95% CI 58.6–77.7%), followed by non-sarcopenic obese (25.3%, 95% CI 16.1–35.2%), sarcopenic (4.6%, 95% CI 0.0–14.5%) and sarcopenic obese (2.3%, 95% CI 0.0–12.2%). Among the normally nourished, 49.2% showed early signs of nutritional and physical performance alterations, including body mass index ≥30 kg·m−2 in 4.3%, history of weight loss ≥5% in 11.9%, and reduction of gait speed and hand grip strength in 11.9% and 35.6%, respectively. Low vitamin D values were observed in 56.3% of cases. Conclusions IPF patients at diagnosis are mainly normally nourished and obese, but early signs of nutritional and physical performance impairment can already be identified at this stage. Patients with IPF at diagnosis are mainly normally nourished and obese but early signs of nutritional and physical performance impairment can already be identified. Sarcopenia is identified only in a minority of cases; cachexia has not been observed.https://bit.ly/3kZuRh2
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14
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Dynapenia is highly prevalent in older patients with advanced idiopathic pulmonary fibrosis. Sci Rep 2021; 11:17884. [PMID: 34504219 PMCID: PMC8429581 DOI: 10.1038/s41598-021-97424-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 07/12/2021] [Indexed: 02/06/2023] Open
Abstract
Body composition and muscle strength are emerging aspects in idiopathic pulmonary fibrosis (IPF) clinical assessment. We aimed to study the relationships of handgrip strength (HGS) with anthropometric variables, body composition, and disease staging, and to evaluate the prevalence of dynapenia in 102 clinically stable IPF patients (70 M; mean age: 69.4 years). Fat-free mass (FFM), skeletal muscle (SM) were estimated with bioimpedance analysis. HGS was measured with a digital handle dynamometer for both dominant and non-dominant body sides. Dynapenia was identified according to six recognized criteria sets. Mean body mass index (BMI) was 28.2 ± 4.7 kg/m2, with a prevalence of overweight (BMI > 25 and < 30 kg/m2) and obesity (BMI ≥ 30 kg/m2) of 35% and 37%, respectively. FFM and SM were greater in males, whereas percentage body fat was higher in women. HGS was higher and declined with age slightly more rapidly in men, showing a stronger correlation with FFM and SM. Dynapenia prevalence ranged from 20.6 to 56.9%, depending on the criteria used, and was more frequent in older patients and advanced disease. Dynapenia is highly prevalent in IPF. HGS is a promising proxy marker of muscle function to be used in clinical evaluation and follow-up programs.
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