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Aronson KI, Rajan M, Varadarajan J, Paul TK, Swigris JJ, Krishnan JK, Kaner RJ, Martinez FJ, Safford MM, Pinheiro LC. Development and initial validation of a disease-specific instrument to measure health-related quality of life in hypersensitivity pneumonitis. ERJ Open Res 2024; 10:00155-2024. [PMID: 39104956 PMCID: PMC11299010 DOI: 10.1183/23120541.00155-2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Accepted: 04/10/2024] [Indexed: 08/07/2024] Open
Abstract
Rationale and objective Disease-specific health-related quality of life (HRQOL) instruments enable us to capture domains that are most relevant to specific patient populations and are useful when a more individualised approach to patient assessment is desired. In this study, we assessed the validity and reliability of the first instrument specifically developed to measure HRQOL in hypersensitivity pneumonitis (HP). Methods A 39-item HP-HRQOL instrument and several anchors were collected from a cohort of patients with HP. Exploratory factor analysis and item reduction were utilised to construct a shortened version of the instrument. Several validity and reliability analyses were conducted on this version of the HP-HRQOL. Measurements and main results 59 patients with HP completed the study. The revised HP-HRQOL instrument comprises 15 items composing two factors (domains): 1) impacts on daily life; and 2) mental wellbeing. Internal consistency reliability was strong for Factor 1 (Cronbach's α=0.94, 95% CI 0.92-0.96) and Factor 2 (Cronbach's α=0.89, 95% CI 0.85-0.94). Test-retest reliability was strong (ICC 0.94, 95% CI 0.89-0.97). The HP-HRQOL strongly correlated with other validated patient-reported outcome measures and moderately correlated with % predicted forced vital capacity. The HP-HRQOL distinguished between those with different severities of HP as determined by lung function and supplemental oxygen use. Conclusions The HP-HRQOL, the first patient-reported outcome instrument specific to adults with HP, possesses strong validity and reliability characteristics for measuring disease-specific HRQOL and distinguishes among patients with different severities of disease.
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Affiliation(s)
- Kerri I. Aronson
- Division of Pulmonary and Critical Care, Weill Cornell Medicine, New York, NY, USA
| | - Mangala Rajan
- Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Janani Varadarajan
- Division of Pulmonary and Critical Care, Weill Cornell Medicine, New York, NY, USA
| | - Tessy K. Paul
- Division of Pulmonary and Critical Care Medicine, University of Virginia, Charlottesville, VA, USA
| | - Jeffrey J. Swigris
- Center for Interstitial Lung Disease, National Jewish Health, Denver, CO, USA
| | - Jamuna K. Krishnan
- Division of Pulmonary and Critical Care, Weill Cornell Medicine, New York, NY, USA
| | - Robert J. Kaner
- Division of Pulmonary and Critical Care, Weill Cornell Medicine, New York, NY, USA
- Department of Genetic Medicine, Weill Cornell Medicine New York, NY, USA
| | - Fernando J. Martinez
- Division of Pulmonary and Critical Care, Weill Cornell Medicine, New York, NY, USA
| | - Monika M. Safford
- Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Laura C. Pinheiro
- Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, New York, NY, USA
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2
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Heredia-Rizo AM, Martinez-Calderon J, Piña-Pozo F, González-García P, García-Muñoz C. Effectiveness of mind-body exercises in chronic respiratory diseases: an overview of systematic reviews with meta-analyses. Disabil Rehabil 2024; 46:2496-2511. [PMID: 37480272 DOI: 10.1080/09638288.2023.2233899] [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: 12/28/2022] [Accepted: 07/04/2023] [Indexed: 07/23/2023]
Abstract
PURPOSE To gather evidence on the effectiveness and safety of qigong, tai chi, and yoga to modulate symptoms associated with chronic respiratory diseases. METHODS A search of systematic reviews was conducted in CINHAL, Embase, PubMed, PsycINFO, SPORTDiscus, and the Cochrane Library from inception to November 2022. Systematic reviews with meta-analyses investigating physical and psychological measures were eligible. The methodological quality of systematic reviews (AMSTAR-2), the spin of information in abstracts, and the overlap of primary studies were explored. RESULTS Twenty-seven systematic reviews involving 37 000 participants, 146 studies, and 150 meta-analyses were included. Reviews investigated asthma (n = 4) and chronic obstructive pulmonary disease (COPD) (n = 23). Most reviews discussed their findings without considering the risk of bias of primary studies. The overlap ranged between slight (5%) and very high (35%). Yoga was better than control interventions to improve symptoms related with asthma. In adults with COPD, qigong improved dyspnoea, exercise endurance, lung function, and quality of life, while tai chi and yoga increased exercise endurance. CONCLUSIONS The impact of yoga on symptoms associated with asthma varied depending on the lung function parameter and the control group. Qigong, tai chi, and yoga could be effective to improve COPD-related symptoms, especially exercise endurance.
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Affiliation(s)
- Alberto Marcos Heredia-Rizo
- Departamento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, c/Avicena s/n, Sevilla, Spain
- Instituto de Biomedicina de Sevilla, IBiS, Departamento de Fisioterapia, Universidad de Sevilla, Seville, Spain
- CTS 1110: Uncertainty, Mindfulness, Self, and Spirituality (UMMS) Research Group, Andalusia, Spain
| | - Javier Martinez-Calderon
- Departamento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, c/Avicena s/n, Sevilla, Spain
- CTS 1110: Uncertainty, Mindfulness, Self, and Spirituality (UMMS) Research Group, Andalusia, Spain
| | - Fernando Piña-Pozo
- CTS 1110: Uncertainty, Mindfulness, Self, and Spirituality (UMMS) Research Group, Andalusia, Spain
- Departamento de Fisioterapia, Escuela Universitaria Francisco Maldonado, Universidad de Sevilla, Osuna, Spain
| | - Paula González-García
- Departamento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, c/Avicena s/n, Sevilla, Spain
- Instituto de Biomedicina de Sevilla, IBiS, Departamento de Fisioterapia, Universidad de Sevilla, Seville, Spain
| | - Cristina García-Muñoz
- CTS 1110: Uncertainty, Mindfulness, Self, and Spirituality (UMMS) Research Group, Andalusia, Spain
- Departamento de Enfermería y Fisioterapia, Facultad de Enfermería y Fisioterapia, Universidad de Cádiz, Cádiz, Spain
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3
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Abdo M, Kunisaki KM, Morris A, Stosor V, Chang D, D'Souza G, Crothers K, Abdel-Maksoud M, DiGuiseppi C, Brown TT, Erlandson KM, MaWhinney S. Pulmonary Function and Quality of Life in Aging Men With and Without HIV from the Multicenter AIDS Cohort Study. AIDS Res Hum Retroviruses 2023; 39:621-632. [PMID: 37276144 PMCID: PMC10712368 DOI: 10.1089/aid.2023.0001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023] Open
Abstract
People living with HIV have greater pulmonary function impairments and decreased health-related quality of life (HRQoL) compared to uninfected peers. We examined whether pulmonary impairment was associated with HRQoL or respiratory health status. Using Multicenter AIDS Cohort Study data (2017-2019), associations between outcomes [HRQoL (36-Item Short Form Survey) and respiratory health status (St. George's Respiratory Questionnaire)] with pulmonary impairment [diffusing capacity for carbon monoxide (DLCO) and forced expiratory volume in 1 s (FEV1), defined as <80% predicted for both] were examined. Adjusted analyses utilized linear and zero-inflated beta regression, the latter summarized by odds ratio (OR) and quotient ratios (QRs). We also considered whether the subset of adjustment variables age, HIV serostatus, or smoking modified the relationships examined. Of 1048 men, 55% had HIV, with median age 57 [interquartile range (IQR) = 48, 64] years and 1.2 (IQR = 0, 18.1) smoking pack-years. Impaired DLCO, but not impaired FEV1, was significantly associated with lower physical HRQoL [-2.71 (-4.09, -1.33); -1.46 (-3.45, 0.54), respectively]. Pulmonary impairment was associated with higher odds of any St. George's Respiratory Questionnaire (SGRQ) (total score) limitation [DLCO OR = 1.53 (1.15, 2.04); FEV1 OR = 2.48 (1.16, 5.30)] and was elevated in individuals with more severe SGRQ limitations [DLCO QR = 1.13 (0.94, 1.36); FEV1 QR = 1.27 (0.98, 1.64)]. HIV did not modify any associations examined. Age modified the DLCO and any respiratory limitation (SGRQ symptom score) association for every 10 mL CO/min/mmHg decrease in DLCO [age 30 OR = 1.03 (0.51, 2.08); age 50 OR = 1.85 (1.27, 3.85); and age 70 OR = 3.45 (2.00, 5.88)]. Similarly, age modified the DLCO and any respiratory limitation (SGRQ total score) association. FEV1 associations with SGRQ and HRQoL scores were similar across all ages. Impaired pulmonary function was associated with lower HRQoL and greater respiratory impairments. Future studies can determine if interventions aimed at preserving pulmonary function are effective in improving HRQoL and respiratory health among aging men with and without HIV.
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Affiliation(s)
- Mona Abdo
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Ken M. Kunisaki
- Pulmonary Section, Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota, USA
- Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA
| | - Alison Morris
- Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Valentina Stosor
- Division of Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Dong Chang
- Division of Respiratory and Critical Care Physiology and Medicine, Los Angeles Biomed Research Institute at Harbor-University of California Los Angeles Medical Center, Torrance, California, USA
| | - Gypsyamber D'Souza
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Kristina Crothers
- Division of Pulmonary, Critical Care and Sleep Medicine, Veterans Affairs Puget Sound Healthcare System, University of Washington, Seattle, Washington, USA
| | - Madiha Abdel-Maksoud
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Carolyn DiGuiseppi
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Todd T. Brown
- Division of Endocrinology, Diabetes, and Metabolism, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Kristine M. Erlandson
- Division of Infectious Disease, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Samantha MaWhinney
- Department of Biostatistics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
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4
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Aversa Z, Atkinson EJ, Carmona EM, White TA, Heeren AA, Jachim SK, Zhang X, Cummings SR, Chiarella SE, Limper AH, LeBrasseur NK. Biomarkers of cellular senescence in idiopathic pulmonary fibrosis. Respir Res 2023; 24:101. [PMID: 37029417 PMCID: PMC10080755 DOI: 10.1186/s12931-023-02403-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 03/19/2023] [Indexed: 04/09/2023] Open
Abstract
BACKGROUND Cellular senescence is a cell fate in response to diverse forms of age-related damage and stress that has been implicated in the pathogenesis of idiopathic pulmonary fibrosis (IPF). The associations between circulating levels of candidate senescence biomarkers and disease outcomes have not been specifically studied in IPF. In this study we assessed the circulating levels of candidate senescence biomarkers in individuals affected by IPF and controls and evaluated their ability to predict disease outcomes. METHODS We measured the plasma concentrations of 32 proteins associated with senescence in Lung Tissue Research Consortium participants and studied their relationship with the diagnosis of IPF, parameters of pulmonary and physical function, health-related quality of life, mortality, and lung tissue expression of P16, a prototypical marker of cellular senescence. A machine learning approach was used to evaluate the ability of combinatorial biomarker signatures to predict disease outcomes. RESULTS The circulating levels of several senescence biomarkers were significantly elevated in persons affected by IPF compared to controls. A subset of biomarkers accurately classified participants as having or not having the disease and was significantly correlated with measures of pulmonary function, health-related quality of life and, to an extent, physical function. An exploratory analysis revealed senescence biomarkers were also associated with mortality in IPF participants. Finally, the plasma concentrations of several biomarkers were associated with their expression levels in lung tissue as well as the expression of P16. CONCLUSIONS Our results suggest that circulating levels of candidate senescence biomarkers are informative of disease status, pulmonary and physical function, and health-related quality of life. Additional studies are needed to validate the combinatorial biomarkers signatures that emerged using a machine learning approach.
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Affiliation(s)
- Zaira Aversa
- Robert and Arlene Kogod Center on Aging, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN, USA
| | | | - Eva M Carmona
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Thomas A White
- Robert and Arlene Kogod Center on Aging, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Amanda A Heeren
- Robert and Arlene Kogod Center on Aging, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Sarah K Jachim
- Mayo Clinic Graduate School of Biomedical Sciences, Rochester, MN, USA
| | - Xu Zhang
- Robert and Arlene Kogod Center on Aging, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Steven R Cummings
- Departments of Medicine, Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
- Research Institute, California Pacific Medical Center, San Francisco, CA, USA
| | | | - Andrew H Limper
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Nathan K LeBrasseur
- Robert and Arlene Kogod Center on Aging, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN, USA.
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5
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Kirsten D, de Vries U, Costabel U, Koschel D, Bonella F, Günther A, Behr J, Claussen M, Schwarz S, Prasse A, Kreuter M. [Linguistic Validation of the "German Lung Fibrosis Health Related Quality of Life Questionnaire"]. Pneumologie 2021; 75:753-760. [PMID: 34428830 DOI: 10.1055/a-1334-2745] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
UNLABELLED Health status and quality of life are impaired in patients with idiopathic pulmonary fibrosis (IPF) and idiopathic non-specific interstitial fibrosis (iNSIP). In Germany exists only the K-BILD questionnaire for patients with ILD 1 in a professional translation by Kreuter et al. 2 This questionnaire focuses on the main problems in patients with progressive lung fibrosis in a limited manner. Therefore a new quality of life questionnaire for patients with idiopathic pulmonary fibrosis was developed and linguistically validated. METHODS The linguistic validation of our questionnaire was carried out in a multistage process in collaboration with the developer of the questionnaire and bilingual, professional translators. Review by the developers and back translations as well as clinical assessment by IPF- and iNSIP-patients ensured that the translated questionnaire reflected the intention of the original English version of our questionnaire.Cross-validation was carried out with the St. Georges Respiratory Questionnaire (SGRQ). RESULTS The new questionnaire concerning the health status was composed in English and German language. The questions cover five scales (sensitivity, selectivity and symptoms like breathlessness and cough and a visual analog scale on general health status) with 23 items. CONCLUSIONS The results show that the FFB maps the special needs of the patients with IPF and iNSIP well and can support clinical and scientific questions and can be helpful in monitoring the clinical course.
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Affiliation(s)
| | - U de Vries
- Zentrum für Klinische Psychologie und Rehabilitation der Universität Bremen
| | - U Costabel
- Klinik für Pneumologie, Ruhrlandklinik, Universitätsmedizin Essen
| | | | - F Bonella
- Klinik für Pneumologie, Ruhrlandklinik, Universitätsmedizin Essen
| | - A Günther
- Medizinische Klinik Universität Gießen
| | - J Behr
- Medzinische Klinik und Poliklinik V, LMU Klinikum, Mitglied des Deutschen Zentrums für Lungenforschung (DZL)
| | | | - S Schwarz
- Asklepios Klinikum Harburg, Lungenabteilung
| | - A Prasse
- Klinik für Pneumologie, Medizinische Hochschule Hannover
| | - M Kreuter
- Zentrum für interstitielle und seltene Lungenerkrankungen, Thoraxklinik, Universitätsklinikum Heidelberg und Deutsches Zentrum für Lungenforschung, Heidelberg
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6
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Kirsten D, de Vries U, Costabel U, Koschel D, Bonella F, Günther A, Behr J, Claussen M, Schwarz S, Prasse A, Kreuter M. A New Tool to Assess Quality of Life in Patients with Idiopathic Pulmonary Fibrosis or Non-specific Interstitial Pneumonia. Pneumologie 2021; 76:25-34. [PMID: 34521147 PMCID: PMC8789482 DOI: 10.1055/a-1579-7618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background
Quality of life (QoL) is significantly impaired in patients with pulmonary fibrosis, however reliable tools to assess QoL issues specific for this group of patients are still missing. We thus aimed to develop a new questionnaire called “Quality of life in patients with idiopathic pulmonary fibrosis” (QPF) to measure QoL in patients with fibrotic idiopathic interstitial pneumonias (IIP).
Methods
An item pool was created on the basis of a German expert group with support of patients suffering from pulmonary fibrosis. In a 1st step, this version of the questionnaire was completed by 52 patients with idiopathic pulmonary fibrosis (IPF) or non-specific interstitial pneumonia (NSIP). Following this, an item- and an exploratory factor analysis was carried out and a 2nd version created. In a multicenter validation study in a one-group pre-post design, the questionnaire was filled in by 200 patients with IIP (IPF = 190, iNSIP = 10) at 2 time points with an interval of 6 months. Cross-validation was carried out with the St. Georges Respiratory Questionnaire (SGRQ).
Results
The mean age of the patients was 71.0 years (50–90 years), 82.5 % were male. Item analysis revealed that most of Cronbach alpha and selectivity values of QPF-scales could be considered as sufficient (e. g. QPF-scale “condition” [alpha = 0.827], “impairment” [alpha = 0.882]). At scale level, there were significant differences in terms of a deterioration or improvement in the QPF-condition and QPF-breathlessness scales and also in the SGRQ-activity scale. Analysis of construct validation of QPF and SGRQ showed moderate correlations between both questionnaires. A deterioration in health status from the patient’s and doctorʼs perspective was seen in the scales “impairment”, “shortness of breath” and “health status” of the QPF. The QPF was able to detect a change in the patientʼs mood (“condition” scale) in the course of treatment.
Conclusion
This newly developed questionnaire maps the special needs of the patients well. The QPF is suitable for screening of quality of life as well as for supplementing the medical history and for monitoring the course of disease in fibrotic IIPs.
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Affiliation(s)
| | - Ulrike de Vries
- Zentrum für Klinische Psychologie und Rehabilitation der Universität Bremen
| | - Ulrich Costabel
- Klinik für Pneumologie, Ruhrlandklinik, Universitätsmedizin Essen
| | | | | | | | - Jürgen Behr
- Department of Internal Medicine V, LMU Klinikum, University of Munich and German Center for Lung Research
| | | | | | - Antje Prasse
- Medizinische Hochschule Hannover, Klinik für Pneumologie; Pneumologie und Beatmungsmedizin
| | - Michael Kreuter
- Center for interstitial and rare lung diseases, Pneumology, Thoraxklinik, University of Heidelberg and German Center for Lung ResearchHeidelberg, Germany
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7
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Yang L, Zhong D, Zhang Y, Li Y, Liu T, Zheng Y, Wang W, Li J, Guan L, Jin R. Tai Chi for Chronic Obstructive Pulmonary Disease (COPD): An Overview of Systematic Reviews. Int J Gen Med 2021; 14:3017-3033. [PMID: 34234531 PMCID: PMC8254601 DOI: 10.2147/ijgm.s308955] [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: 03/01/2021] [Accepted: 05/18/2021] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE Since current systematic reviews (SRs) show that results of effectiveness on Tai Chi for chronic obstructive pulmonary disease (COPD) are inconsistent, the purpose of this study is to find the reasons of the disparity by comprehensively appraising the related SRs. METHODS Six databases were systematically searched from the inception date to April 17, 2021. The methodological quality, the risk of bias, the reporting quality, and the quality of evidence were independently assessed by two reviewers with the AMSTAR 2, ROBIS, PRISMA, and GRADE. RESULTS A total of 12 studies met the inclusion criteria: 10 SRs were rated critically low quality and two SRs were low quality by AMSTAR 2. By the ROBIS, four out of 12 SRs were rated as "low risk". According to PRISMA, nine out of 12 SRs were adequately reported over 80%. With the GRADE tool, three out of 12 SRs rated the FEV1 as "Moderate", one out of 12 SRs (1/12, 9%) rated the FEV1/FVC (%) as "Moderate", three out of 12 SRs assessed the 6MWD as "Moderate", three out of 12 SRs evaluated the SGRQ as "Moderate", and the remaining evidence was fully rated as "Low" or "Very Low". CONCLUSION We found that the methodological quality, risk of bias, reporting quality, and quality of evidence of the included SRs on Tai Chi for COPD were suboptimal. These limitations may have a negative impact on SRs, consequently leading to inconsistent results. Further well-conducted SRs with less risk of bias, more rigorous methodology, normative reporting and high-quality of evidence are needed to provide robust evidence on Tai Chi for COPD. REGISTRATION NUMBER This study has been registered in the PROSPERO International Prospective Register of Systematic Reviews (registration number: CRD42019126600).
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Affiliation(s)
- Luping Yang
- Department of Rehabilitation Technology, Sichuan Nursing Vocational College, Chengdu, 610037, People’s Republic of China
| | - Dongling Zhong
- Department of Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, 610037, People’s Republic of China
| | - Yue Zhang
- Department of Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, 610037, People’s Republic of China
| | - Yuxi Li
- Department of Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, 610037, People’s Republic of China
| | - Tianyu Liu
- Department of Sport, Chengdu University of Traditional Chinese Medicine, Chengdu, 610037, People’s Republic of China
| | - Yaling Zheng
- Department of Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, 610037, People’s Republic of China
| | - Wei Wang
- Department of Rehabilitation, Kunming Municipal Hospital of Traditional Chinese Medicine, Kunming, 650000, People’s Republic of China
| | - Juan Li
- Department of Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, 610037, People’s Republic of China
| | - Li Guan
- Department of Rehabilitation, People’s Hospital of Fushun County, Zigong, 643000, People’s Republic of China
| | - Rongjiang Jin
- Department of Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, 610037, People’s Republic of China
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8
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Liu QW, Qin T, Hu B, Zhao YL, Zhu XL. Relationship between illness perception, fear of progression and quality of life in interstitial lung disease patients: A cross-sectional study. J Clin Nurs 2021; 30:3493-3505. [PMID: 33998090 DOI: 10.1111/jocn.15852] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 03/31/2021] [Accepted: 04/22/2021] [Indexed: 01/02/2023]
Abstract
AIMS AND OBJECTIVES This study aimed to investigate whether fear of progression mediates the association between illness perception and quality of life among interstitial lung disease patients. BACKGROUND So far, the physiological treatment of interstitial lung disease is limited. In addition to immunosuppressants such as glucocorticoids, two anti-fibrosis drugs (pirfenidone and nintedanib) have shown moderately beneficial effects on slowing the progression of interstitial lung disease fibrosis. However, none of these drugs has shown reliable or strong beneficial effects on improving quality of life. Psychological care and mental health support strategies focusing on improving patients' quality of life are particularly important. DESIGN A cross-sectional study. METHODS A convenience sample of patients suffering from interstitial lung disease were enrolled from August to December 2019. Data including sociodemographic and clinical characteristics, illness perception, fear of progression and quality of life were collected. The descriptive analysis and Pearson correlations were analysed by SPSS 26.0 (IBM Corp.). PROCESS v3.4 (by Andrew F. Hayes) macro was applied to analyse the mediating effects. We used the STROBE checklist to report the results. RESULTS Both illness perception and fear of progression were correlated with quality of life. Fear of progression mediated the association between illness perception and quality of life. The indirect effect was 0.121, and the proportion of intermediary effect in the main effect was 26.36%. CONCLUSION Interstitial lung disease patients experience relatively poor quality of life and fear of progression exerts a mediating role between illness perception and quality of life. RELEVANCE TO CLINICAL PRACTICE This study alerts medical staff to pay attention to negative illness perception and excessive fear, which is helpful to formulate effective interventions to manage interstitial lung disease patients' quality of life.
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Affiliation(s)
- Qing-Wei Liu
- Department of Medicine, School of Nursing, Qingdao University, Qingdao, China
| | - Tong Qin
- Department of Medicine, School of Nursing, Qingdao University, Qingdao, China
| | - Bo Hu
- Department of Thoracic Surgery, Municipal Hospital, Qingdao, China
| | - Ya-Ling Zhao
- Department of Medicine, School of Nursing, Qingdao University, Qingdao, China
| | - Xiu-Li Zhu
- Department of Medicine, School of Nursing, Qingdao University, Qingdao, China
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9
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Tubío-Pérez RA, Torres-Durán M, Pérez-Ríos M, Fernández-Villar A, Ruano-Raviña A. Lung emphysema and lung cancer: what do we know about it? ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:1471. [PMID: 33313216 PMCID: PMC7723574 DOI: 10.21037/atm-20-1180] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Emphysema and lung cancer (LC) are two diseases which share common risk factors, e.g., smoking. In recent years, many studies have sought to analyse this association. By way of illustration, we conducted a review of the scientific literature of the studies published to date, whose main designated aim was to demonstrate the relationship between emphysema and LC, and this association's influence on the histology, prognosis and molecular mechanisms responsible. We included over 40 studies (ranging from case-control and cohort studies to systematic reviews and meta-analyses), which highlight the association between emphysema and LC, independently of smoking habit. These studies also report a possible influence on histology, with adenocarcinoma being the most frequent lineage, and an association with poor prognosis, which affects both survival and post-operative complications. Oxidative stress, which generates chronic inflammatory status as well as the presence of certain polymorphisms in various genes (CYP1A1, TERT, CLPTM1L, ERK), gives rise-in the case of patients with emphysema-to alteration of cellular repair mechanisms, which in turn favours the proliferation of neoplastic epithelial cells responsible for the origin of LC.
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Affiliation(s)
- Ramón A Tubío-Pérez
- Pulmonary Department, Hospital Álvaro Cunqueiro, EOXI, Vigo, Spain.,NeumoVigoI+i Research Group, Vigo Biomedical Research Institute (IBIV), Galicia, Spain
| | - María Torres-Durán
- Pulmonary Department, Hospital Álvaro Cunqueiro, EOXI, Vigo, Spain.,NeumoVigoI+i Research Group, Vigo Biomedical Research Institute (IBIV), Galicia, Spain
| | - Mónica Pérez-Ríos
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain.,CIBER de Epidemiología y Salud Pública, CIBERESP, Madrid, Spain
| | - Alberto Fernández-Villar
- Pulmonary Department, Hospital Álvaro Cunqueiro, EOXI, Vigo, Spain.,NeumoVigoI+i Research Group, Vigo Biomedical Research Institute (IBIV), Galicia, Spain
| | - Alberto Ruano-Raviña
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain.,CIBER de Epidemiología y Salud Pública, CIBERESP, Madrid, Spain
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10
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Maqhuzu PN, Szentes BL, Kreuter M, Bahmer T, Kahn N, Claussen M, Holle R, Schwarzkopf L. Determinants of health-related quality of life decline in interstitial lung disease. Health Qual Life Outcomes 2020; 18:334. [PMID: 33032602 PMCID: PMC7542726 DOI: 10.1186/s12955-020-01570-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 09/21/2020] [Indexed: 12/13/2022] Open
Abstract
Background Health-related quality of life (HRQL) in interstitial lung disease (ILD) patients is impaired. We aimed to identify baseline predictors for HRQL decline within a 12-month observation period.
Methods We analyzed 194 ILD patients from two German ILD-centers in the observational HILDA study. We employed the disease-specific King’s Brief Interstitial Lung Disease questionnaire (K-BILD) with the subdomains ‘psychological impact’, ‘chest symptoms’ and ‘breathlessness and activities’, and the generic EQ-5D Visual Analog Scale (VAS). We evaluated how many patients experienced a clinically meaningful decline in HRQL. Subsequently, we investigated medical and sociodemographic factors as potential predictors of HRQL deterioration. Results Within the study population (34.0% male, Ø age 61.7) mean HRQL scores hardly changed between baseline and follow up (K-BILD: 52.8 vs. 52.5 | VAS: 60.0 vs. 57.3). On the intra-individual level, 30.4% (n = 59) experienced a clinically relevant deterioration in K-BILD total score and 35.4% (n = 68) in VAS. Lower baseline forced vital capacity (FVC) % predicted determined HRQL decline in K-BILD total score (ß-coefficient: − 0.02, p = 0.007), VAS (ß-coefficient: − 0.03, p < 0.0001), and in the subdomain ‘psychological impact’ (ß-coefficient: − 0.02, p = 0.014). Lower baseline diffusing capacity of carbon monoxide (DLCO) % predicted determined deterioration in ‘breathlessness and activities’ (ß-coefficient: − 0.04, p = 0.003) and ‘chest symptoms’ (ß-coefficient: − 0.04, p = 0.002). Additionally, increasing age predicted decline in ‘psychological impact’ (ß-coefficient: 0.06, p < 0.007). Conclusion Around a third of ILD patients experienced a clinically relevant HRQL deterioration in a 12-month period, which was associated with baseline lung function values in all K-BILD domains. As lung function values are time-dependent variables with possible improvements, in contrast to age and ILD subtype, it, thus, seems important to improve lung function and prevent its decline in order to maintain HRQL on the possibly highest level.
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Affiliation(s)
- Phillen Nozibuyiso Maqhuzu
- Helmholtz Zentrum München - German Research Center for Environmental Health (GmbH), Institute of Health Economics and Health Care Management, Comprehensive Pneumology Center Munich (CPC-M), German Center for Lung Research (DZL), Ingolstaedter Landstr. 1, 85764, Neuherberg, Germany.
| | - Boglarka L Szentes
- Helmholtz Zentrum München - German Research Center for Environmental Health (GmbH), Institute of Health Economics and Health Care Management, Comprehensive Pneumology Center Munich (CPC-M), German Center for Lung Research (DZL), Ingolstaedter Landstr. 1, 85764, Neuherberg, Germany
| | - Michael Kreuter
- Center for Interstitial and Rare Lung Diseases, Thoraxklinik, University of Heidelberg, German Center for Lung Research (DZL), Röntgenstr. 1, 69126, Heidelberg, Germany
| | - Thomas Bahmer
- LungenClinic Grosshansdorf GmbH Pneumology, German Center for Lung Research (DZL), Wöhrendamm 80, 22927, Großhansdorf, Germany.,University Hospital Schleswig-Holstein Campus Kiel, Internal Medicine I, German Center for Lung Research (DZL), Arnold-Heller-Str. 3 /Haus 41a, 24105, Kiel, Germany
| | - Nicolas Kahn
- Department of Pneumology and Critical Care Medicine, Thoraxklinik, University of Heidelberg, German Center for Lung Research (DZL), Röntgenstr. 1, 69126, Heidelberg, Germany
| | - Martin Claussen
- LungenClinic Grosshansdorf GmbH Pneumology, German Center for Lung Research (DZL), Wöhrendamm 80, 22927, Großhansdorf, Germany
| | - Rolf Holle
- Helmholtz Zentrum München - German Research Center for Environmental Health (GmbH), Institute of Health Economics and Health Care Management, Comprehensive Pneumology Center Munich (CPC-M), German Center for Lung Research (DZL), Ingolstaedter Landstr. 1, 85764, Neuherberg, Germany.,Institute for Medical Information Processing, Biometry, and Epidemiology, Marchioninistr. 15, 81377, Munich, Germany
| | - Larissa Schwarzkopf
- Helmholtz Zentrum München - German Research Center for Environmental Health (GmbH), Institute of Health Economics and Health Care Management, Comprehensive Pneumology Center Munich (CPC-M), German Center for Lung Research (DZL), Ingolstaedter Landstr. 1, 85764, Neuherberg, Germany.,Institut Fuer Therapieforschung (IFT), Leopoldstr. 175, 80804, Munich, Germany
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11
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Association of Lung Function With HIV-Related Quality of Life and Health Care Utilization in a High-Risk Cohort. J Acquir Immune Defic Syndr 2020; 85:219-226. [PMID: 32931685 PMCID: PMC7494951 DOI: 10.1097/qai.0000000000002431] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Chronic respiratory disease represents an important comorbidity for persons living with HIV (PLWH). HIV itself is associated with greater impairment in lung function. We aimed to determine the association between declining lung function and both quality of life (QOL) and health care utilization for PLWH. METHODS Using longitudinal data from the Study of HIV Infection in the Etiology of Lung Disease 2009-2017, we studied the association between changes in lung function and both QOL and acute care events (emergency department visit or hospitalization). The Medical Outcomes Studies-HIV Questionnaire provided QOL domains. Multivariable regression models were performed with generalized estimating equations accounting for 1499 participants, 485 with HIV, contributing 10,825 spirometry visits. RESULTS Among PLWH, decreased FEV1 was associated with worse physical health for those with higher viral load [β: -1.66, 95% confidence interval (CI): -3.11 to -0.39] compared to those with viral suppression (β: -0.58, 95% CI: -1.06 to -0.162), even in those without airflow obstruction. Lower FEV1 was also associated with increased odds of both emergency department (odds ratio: 1.21, 95% CI: 1.09 to 1.34) and inpatient (odds ratio: 1.26, 95% CI: 1.12 to 1.42) hospitalizations for PLWH. Lung function was not associated with increased odds of acute care events for HIV-uninfected participants. CONCLUSIONS FEV1 declines represent an independent predictor of QOL and acute care events among PLWH. Although the generalizability of these results may be limited, because of the high-risk population included, findings suggest that care for PLWH should involve monitoring FEV1 over time, especially in those with poor virologic control, with emphasis on the development and implementation of interventions to mitigate lung function decline.
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12
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Evaluation of health-related quality of life and the related factors in a group of Chinese patients with interstitial lung diseases. PLoS One 2020; 15:e0236346. [PMID: 32726327 PMCID: PMC7417083 DOI: 10.1371/journal.pone.0236346] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Accepted: 07/03/2020] [Indexed: 12/18/2022] Open
Abstract
Introduction Interstitial lung diseases (ILDs) include a wide variety of chronic
progressive pulmonary diseases characterized by lung inflammation, fibrosis
and hypoxemia and can progress to respiratory failure and even death. ILDs
are associated with varying degrees of quality of life impairments in
affected people. Studies on the quality of life in patients with ILDs are
still limited, and there are few studies with long-term follow-up periods in
these patients. Methods Data from patients who were clinically diagnosed with ILDs in the Respiratory
Department, Beijing Chaoyang Hospital, Capital Medical University from
January 2017 to February 2018 were collected. Clinical status and HRQoL were
assessed at baseline and subsequently at 6- and 12-month intervals with the
LCQ, mMRC, HADS, SF-36, and SGRQ. Multivariate linear regression was used to
evaluate the determinants of the decline in HRQoL. Results A total of 139 patients with idiopathic interstitial pneumonia (IIP) and 30
with connective tissue disease-associated ILD (CTD-ILD) were enrolled, 140
of whom completed the follow-up. The mean age was 63.7 years, and 92
patients were men. At baseline, the decline in HRQoL assessed by the SF-36
and SGRQ was significantly associated with the mMRC, LCQ and HADS depression
score. In the follow-up, changes in FVC%, DLco%, mMRC and LCQ were
significantly associated with changes in HRQoL. Conclusions HRQoL in both IIP and CTD-ILD patients deteriorates to varying degrees, and
the trend suggests that poor HRQoL in these patients is associated with many
determinants, primarily dyspnea, cough and depression. Improving HRQoL is
the main aim when treating patients living with ILDs.
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13
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Mugii N, Someya F. Ability of the COPD Assessment Test to evaluate the lung‐specific quality of life in systemic sclerosis‐associated interstitial lung disease. THE CLINICAL RESPIRATORY JOURNAL 2020; 14:527-532. [PMID: 32045097 PMCID: PMC7318680 DOI: 10.1111/crj.13162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 02/05/2020] [Accepted: 02/06/2020] [Indexed: 11/27/2022]
Abstract
Introduction The COPD Assessment Test (CAT) is utilised to evaluate the treatment outcome regarding the health status in idiopathic interstitial pneumonia (IIP). However, the ability of the CAT to evaluate the lung‐specific quality of life in systemic sclerosis‐associated interstitial lung disease (SSc‐ILD) is not established. Therefore, we investigated whether CAT scores can be used to evaluate SSc‐ILD as they are for IIP. Methods A total of 150 patients with IIP or SSc‐ILD who were evaluated by the CAT were retrospectively assigned to this study. Clinical data at the visit for the CAT were analysed. Results The forced vital capacity and distance walked during the 6‐minute walk test (6MWD) were significantly correlated with the CAT score for SSc‐ILD and IIP, and the CAT scores were similarly distributed in SSc‐ILD and IIP. The CAT score of SSc‐ILD patients was negatively affected by pulmonary arterial hypertension, but not by corticosteroids, which affected it in IIP patients. CAT scores of patients with either disease receiving home oxygen therapy were poor. In multiple regression analysis, pulmonary arterial hypertension and 6MWD were independent predictors for the CAT score in patients with SSc‐ILD, while corticosteroid administration was selected as an independent factor in patients with IIP. Conclusions Our study suggests that the CAT can be applied to evaluate the lung‐specific quality of life in SSc‐ILD similar to IIP regarding the pulmonary function, but it should be noted that pulmonary arterial hypertension in SSc‐ILD influences the CAT score.
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Affiliation(s)
- Naoki Mugii
- Graduate School of Health Sciences, College of Medical, Pharmaceutical and Health Sciences Kanazawa University Kanazawa Japan
- Kanazawa University Hospital Kanazawa University Kanazawa Japan
| | - Fujiko Someya
- School of Health Sciences Kanazawa University Kanazawa Japan
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14
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Distler O, Assassi S, Cottin V, Cutolo M, Danoff SK, Denton CP, Distler JHW, Hoffmann-Vold AM, Johnson SR, Müller Ladner U, Smith V, Volkmann ER, Maher TM. Predictors of progression in systemic sclerosis patients with interstitial lung disease. Eur Respir J 2020; 55:13993003.02026-2019. [PMID: 32079645 PMCID: PMC7236865 DOI: 10.1183/13993003.02026-2019] [Citation(s) in RCA: 119] [Impact Index Per Article: 29.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 02/09/2020] [Indexed: 12/17/2022]
Abstract
Systemic sclerosis (SSc) is a systemic autoimmune disease affecting multiple organ systems, including the lungs. Interstitial lung disease (ILD) is the leading cause of death in SSc. There are no valid biomarkers to predict the occurrence of SSc-ILD, although auto-antibodies against anti-topoisomerase I and several inflammatory markers are candidate biomarkers that need further evaluation. Chest auscultation, presence of shortness of breath and pulmonary function testing are important diagnostic tools, but lack sensitivity to detect early ILD. Baseline screening with high-resolution computed tomography (HRCT) is therefore necessary to confirm an SSc-ILD diagnosis. Once diagnosed with SSc-ILD, patients' clinical courses are variable and difficult to predict, although certain patient characteristics and biomarkers are associated with disease progression. It is important to monitor patients with SSc-ILD for signs of disease progression, although there is no consensus about which diagnostic tools to use or how often monitoring should occur. In this article, we review methods used to define and predict disease progression in SSc-ILD. There is no valid definition of SSc-ILD disease progression, but we suggest that either a decline in forced vital capacity (FVC) from baseline of ≥10%, or a decline in FVC of 5–9% in association with a decline in diffusing capacity of the lung for carbon monoxide of ≥15% represents progression. An increase in the radiographic extent of ILD on HRCT imaging would also signify progression. A time period of 1–2 years is generally used for this definition, but a decline over a longer time period may also reflect clinically relevant disease progression. Lung function tests and chest imaging help predict who has SSc-associated ILD and whether it will progress. In the absence of standardised methods for doctors, we recommend a strategy that combines both lung function tests and chest imaging.http://bit.ly/2uK9ZD2
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Affiliation(s)
- Oliver Distler
- Dept of Rheumatology, University Hospital Zurich, Zurich, Switzerland
| | - Shervin Assassi
- Dept of Rheumatology and Clinical Immunogenetics, McGovern Medical School, University of Texas, Houston, TX, USA
| | - Vincent Cottin
- National Reference Center for Rare Pulmonary Diseases, Louis Pradel Hospital, Hospices Civils de Lyon, Claude Bernard University Lyon 1, UMR754, Lyon, France
| | - Maurizio Cutolo
- Research Laboratory, Clinical Division of Rheumatology, Dept of Internal Medicine DIMI, University of Genoa, IRCSS Polyclinic Hospital San Martino, Genoa, Italy
| | - Sonye K Danoff
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins Medicine, Baltimore, MD, USA
| | - Christopher P Denton
- UCL Centre for Rheumatology and Connective Tissue Diseases, Royal Free Hospital, London, UK
| | - Jörg H W Distler
- Dept of Internal Medicine 3, University of Erlangen-Nuremberg, Erlangen, Germany
| | | | - Sindhu R Johnson
- Toronto Scleroderma Program, Dept of Medicine, Toronto Western and Mount Sinai Hospitals, University of Toronto, Toronto, ON, Canada
| | - Ulf Müller Ladner
- Dept of Rheumatology and Clinical Immunology, Justus-Liebig University Giessen, Campus Kerckhoff, Bad Nauheim, Germany
| | - Vanessa Smith
- Dept of Rheumatology, Ghent University Hospital, Ghent, Belgium.,Dept of Internal Medicine, Ghent University, Unit for Molecular Immunology and Inflammation, VIB Inflammation Research Center (IRC), Ghent, Belgium
| | - Elizabeth R Volkmann
- Dept of Medicine, Division of Rheumatology, University of California, David Geffen School of Medicine, Los Angeles, CA, USA
| | - Toby M Maher
- National Heart and Lung Institute, Imperial College London, London, UK.,NIHR Respiratory Clinical Research Facility, Royal Brompton Hospital, London, UK
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15
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Cho JG, Teoh A, Roberts M, Wheatley J. The prevalence of poor sleep quality and its associated factors in patients with interstitial lung disease: a cross-sectional analysis. ERJ Open Res 2019; 5:00062-2019. [PMID: 31304178 PMCID: PMC6612606 DOI: 10.1183/23120541.00062-2019] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 05/14/2019] [Indexed: 01/25/2023] Open
Abstract
Background Many patients with interstitial lung disease (ILD) experience poor sleep quality, which may contribute to decreased quality of life. Sleep disordered breathing is commonly associated with ILD but there is less information on other factors that may contribute to poor sleep quality. Methods We conducted a cross-sectional analysis of 101 patients with a diagnosis of ILD at a pulmonary rehabilitation assessment clinic. We assessed the prevalence of poor sleep quality using the Pittsburgh Sleep Quality Index (PSQI) and performed multivariable logistic regression analysis to determine factors independently associated with poor sleep quality. Results Median forced expiratory volume in 1 s was 64% predicted (interquartile range (IQR) 50–77%) and vital capacity was 62% predicted (IQR 48–78%). 67 (66%) out of 101 patients reported poor sleep quality. The median PSQI was 8 units (IQR 4–11 units). There were no significant differences in physical or physiological parameters including age, sex distribution, body mass index or spirometry values between subjects with good sleep quality and those with poor sleep quality (all p>0.1). Multivariable logistic regression showed that depression (p=0.003) and Epworth Sleepiness Scale (p=0.03) were independently associated with poor sleep quality. Conclusion Poor sleep quality is common in patients with ILD and is independently associated with increasing symptoms of depression and sleepiness. Routine assessment of sleep quality should be undertaken and interventions targeting depression and coexisting sleep disorders may be required in symptomatic patients to determine if sleep quality and ultimately, health-related quality of life improves as a result. Poor sleep quality is common in patients with interstitial lung disease and is independently associated with increasing symptoms of depression and sleepinesshttp://bit.ly/2WeQbzw
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Affiliation(s)
- Jin-Gun Cho
- Westmead Hospital, Dept of Respiratory and Sleep Medicine, Westmead, Australia.,University of Sydney, Ludwig Engel Centre for Respiratory Research, Westmead Institute for Medical Research, Sydney, Australia
| | - Alan Teoh
- Westmead Hospital, Dept of Respiratory and Sleep Medicine, Westmead, Australia
| | - Mary Roberts
- University of Sydney, Ludwig Engel Centre for Respiratory Research, Westmead Institute for Medical Research, Sydney, Australia.,Westmead Hospital, Respiratory Ambulatory Care Service, Dept of Respiratory and Sleep Medicine, Westmead, Australia
| | - John Wheatley
- Westmead Hospital, Dept of Respiratory and Sleep Medicine, Westmead, Australia.,University of Sydney, Ludwig Engel Centre for Respiratory Research, Westmead Institute for Medical Research, Sydney, Australia
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16
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Wen Y, Wang D, Zhou M, Zhou Y, Guo Y, Chen W. Potential Effects of Lung Function Reduction on Health-Related Quality of Life. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16020260. [PMID: 30658477 PMCID: PMC6352019 DOI: 10.3390/ijerph16020260] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 01/02/2019] [Accepted: 01/04/2019] [Indexed: 01/06/2023]
Abstract
Health-related quality of life (HRQOL) was reported to reflect overall quality of life and individual perceptions related to health. Decreased lung function is associated with reduced ventilation and oxygen intake and reported to affect body functions. However, the effect of lung function reduction on HRQOL is still unclear. A total of 8398 retired workers from Dongfeng-Tongji Cohort Study were included in this cross section study. Lung function was measured using an electronic spirometer. HRQOL was evaluated through a questionnaire designed according to the WHOQOL-BREF. The mean of the HRQOL scores of its four domains (physical health, psychological state, social relationships and environment) is the total HRQOL score. A general linear model was used to analyse the association between lung function and HRQOL. In the continuous analysis by the general linear model, FVC was associated with the total HRQOL, physical health domain and social relationships domain scores. In the categorical analysis, there was a linear trend between FVC and the total HRQOL and physical health scores. We also found a similar relationship between FEV1 and HRQOL scores. Further analysis suggested that elevated lung function could improve the scores of pain and discomfort facet and independence facet of physical health domain. The lung function was significantly positively associated with HRQOL in middle-aged and older Chinese.
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Affiliation(s)
- Yuhan Wen
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
| | - Dongming Wang
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
| | - Min Zhou
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
| | - Yun Zhou
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
| | - Yanjun Guo
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
| | - Weihong Chen
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
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17
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Szentes BL, Kreuter M, Bahmer T, Birring SS, Claussen M, Waelscher J, Leidl R, Schwarzkopf L. Quality of life assessment in interstitial lung diseases:a comparison of the disease-specific K-BILD with the generic EQ-5D-5L. Respir Res 2018; 19:101. [PMID: 29801506 PMCID: PMC5970441 DOI: 10.1186/s12931-018-0808-x] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 05/08/2018] [Indexed: 12/18/2022] Open
Abstract
Background Patients with interstitial lung diseases (ILD) have impaired health-related quality of life (HRQL). Little is known about the applicability of the disease-specific King’s Brief Interstitial Lung Disease questionnaire (K-BILD) and the generic EQ-5D-5L in a German setting. Methods We assessed disease-specific (K-BILD) and generic HRQL (EQ-5D experience based value set (EBVS) and Visual Analog Scale (VAS)) in 229 patients with different ILD subtypes in a longitudinal observational study (HILDA). Additionally, we assessed the correlation of the HRQL measures with lung function and comorbidities. In a linear regression model, we investigated predictors (including age, sex, ILD subtype, FVC percentage of predicted value (FVC%pred), DLCO percentage of predicted value, and comorbidities). Results Among the 229 patients mean age was 63.2 (Standard deviation (SD): 12.9), 67.3% male, 24.0% had idiopathic pulmonary fibrosis, and 22.3% sarcoidosis. Means scores were as follows for EQ-5D EBVS 0.66(SD 0.17), VAS 61.4 (SD 19.1) and K-BILD Total 53.6 (SD 13.8). K-BILD had good construct validity (high correlation with EQ-5D EBVS (0.71)) and good internal consistency (Cronbach’s alpha 0.89). Moreover, all HRQL measures were highly accepted by patients including low missing items and there were no ceiling or floor effects. A higher FVC % pred was associated with higher HRQL in all measures meanwhile comorbidities had a negative influence on HRQL. Conclusions K-BILD and EQ-5D had similar HRQL trends and were associated similarly to the same disease-related factors in Germany. Our data supports the use of K-BILD in clinical practice in Germany, since it captures disease specific effects of ILD. Additionally, the use of the EQ-5D-5L could provide comparison to different disease areas and give an overview about the position of ILD patients in comparison to general population. Electronic supplementary material The online version of this article (10.1186/s12931-018-0808-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Boglárka Lilla Szentes
- Helmholtz Zentrum München - German Research Center for Environmental Health (GmbH), Institute of Health Economics and Health Care Management, Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research (DZL), Ingolstaedter Landstrasse 1, 85764, Neuherberg, Germany.
| | - Michael Kreuter
- Center for Interstitial and Rare Lung Diseases Pneumology and Respiratory Critical Care Medicine, Thoraxklinik University of Heidelberg, Translational Lung Research Center Heidelberg (TLRC), Member of the German Center for Lung Research (DZL), Roentgenstrasse, 169126, Heidelberg, Germany
| | - Thomas Bahmer
- LungenClinic Grosshansdorf GmbH Pneumology, Member of the Airway Research Center North (ARCN), German Center for Lung Research (DZL), Wöhrendamm, 80 22927, Großhansdorf, Germany
| | - Surinder S Birring
- Centre of Human & Aerospace Physiological Sciences, School of Basic & Medical Biosciences Faculty of Life Sciences & Medicine, King's College London, London, WC2R 2LS, UK.,Department of Respiratory Medicine, King's College Hospital, Denmark Hill, Brixton, London, SE5 9RS, UK
| | - Martin Claussen
- LungenClinic Grosshansdorf GmbH Pneumology, Member of the Airway Research Center North (ARCN), German Center for Lung Research (DZL), Wöhrendamm, 80 22927, Großhansdorf, Germany
| | - Julia Waelscher
- Center for Interstitial and Rare Lung Diseases Pneumology and Respiratory Critical Care Medicine, Thoraxklinik University of Heidelberg, Translational Lung Research Center Heidelberg (TLRC), Member of the German Center for Lung Research (DZL), Roentgenstrasse, 169126, Heidelberg, Germany
| | - Reiner Leidl
- Helmholtz Zentrum München - German Research Center for Environmental Health (GmbH), Institute of Health Economics and Health Care Management, Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research (DZL), Ingolstaedter Landstrasse 1, 85764, Neuherberg, Germany.,Munich Center of Health Sciences, Ludwig-Maximilians-Universität München, Ludwigstr. 28, 80539, Munich, RG, Germany
| | - Larissa Schwarzkopf
- Helmholtz Zentrum München - German Research Center for Environmental Health (GmbH), Institute of Health Economics and Health Care Management, Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research (DZL), Ingolstaedter Landstrasse 1, 85764, Neuherberg, Germany
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18
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Oxygen Therapy for Interstitial Lung Disease: Physicians’ Perceptions and Experiences. Ann Am Thorac Soc 2017; 14:1772-1778. [DOI: 10.1513/annalsats.201705-372oc] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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19
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Someya F, Nakagawa T, Mugii N. The COPD Assessment Test as a Prognostic Marker in Interstitial Lung Disease. CLINICAL MEDICINE INSIGHTS-CIRCULATORY RESPIRATORY AND PULMONARY MEDICINE 2016; 10:27-31. [PMID: 27812295 PMCID: PMC5089852 DOI: 10.4137/ccrpm.s40792] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Revised: 09/29/2016] [Accepted: 10/08/2016] [Indexed: 11/12/2022]
Abstract
The chronic obstructive pulmonary disease (COPD) Assessment Test (CAT), which was developed to measure the health status of patients with COPD, was applied to patients with interstitial lung disease, aiming to examine the CAT as a predictor of outcome. Over a follow-up period of more than one year, 101 consecutive patients with interstitial lung disease were evaluated by the CAT. The CAT scores of 40 in total were categorized into four subsets according to the severity. Patients with higher (more severe) scores exhibited lower forced vital capacity and lung diffusion capacity for carbon monoxide. The survival rate was significantly lower in patients with higher scores (log-rank test, P = 0.0002), and the hazard ratios for death of the higher scores and lower lung diffusion capacity for carbon monoxide were independently significant. These findings suggest that CAT can indicate the risk of mortality in patients with interstitial lung disease.
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Affiliation(s)
- Fujiko Someya
- School of Health Sciences, Kanazawa University, Kodatsuno, Kanazawa, Japan
| | - Takao Nakagawa
- School of Health Sciences, Kanazawa University, Kodatsuno, Kanazawa, Japan
| | - Naoki Mugii
- Division of Rehabilitation, Kanazawa University Hospital, Kanazawa University, Takaramachi, Kanazawa, Japan
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Elliott JE, Greising SM, Mantilla CB, Sieck GC. Functional impact of sarcopenia in respiratory muscles. Respir Physiol Neurobiol 2016; 226:137-46. [PMID: 26467183 PMCID: PMC4838572 DOI: 10.1016/j.resp.2015.10.001] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Accepted: 10/06/2015] [Indexed: 01/06/2023]
Abstract
The risk for respiratory complications and infections is substantially increased in old age, which may be due, in part, to sarcopenia (aging-related weakness and atrophy) of the diaphragm muscle (DIAm), reducing its force generating capacity and impairing the ability to perform expulsive non-ventilatory motor behaviors critical for airway clearance. The aging-related reduction in DIAm force generating capacity is due to selective atrophy of higher force generating type IIx and/or IIb muscle fibers, whereas lower force generating type I and IIa muscle fiber sizes are preserved. Fiber type specific DIAm atrophy is also seen following unilateral phrenic nerve denervation and in other neurodegenerative disorders. Accordingly, the effect of aging on DIAm function resembles that of neurodegeneration and suggests possible common mechanisms, such as the involvement of several neurotrophic factors in mediating DIAm sarcopenia. This review will focus on changes in two neurotrophic signaling pathways that represent potential mechanisms underlying the aging-related fiber type specific DIAm atrophy.
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Affiliation(s)
- Jonathan E Elliott
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, USA
| | - Sarah M Greising
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, USA
| | - Carlos B Mantilla
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, USA; Department of Anesthesiology, Mayo Clinic, Rochester, MN, USA
| | - Gary C Sieck
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, USA; Department of Anesthesiology, Mayo Clinic, Rochester, MN, USA.
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21
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Health Conditions as Mediators of the Association Between World Trade Center Exposure and Health-Related Quality of Life in Firefighters and EMS Workers. J Occup Environ Med 2016; 58:200-6. [DOI: 10.1097/jom.0000000000000597] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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22
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Older adults with chronic lung disease report less limitation compared with younger adults with similar lung function impairment. Ann Am Thorac Soc 2015; 12:21-6. [PMID: 25473938 DOI: 10.1513/annalsats.201407-312oc] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
RATIONALE Disability guidelines are often based on pulmonary function testing, but factors other than lung function influence how an individual experiences physiologic impairment. Age may impact the perception of impairment in adults with chronic lung disease. OBJECTIVES To determine if self-report of physical functional impairment differs between older adults with chronic lung disease compared with younger adults with similar degrees of lung function impairment. METHODS The Lung Tissue Research Consortium provided data on 981 participants with chronic obstructive pulmonary disease and interstitial lung disease who were well characterized with clinical, radiological, and pathological diagnoses. We used multiple logistic regression to determine if responses to health status questions (from the Short Form-12 and St. George's Respiratory Questionnaire) related to perception of impairment differed in older adults (age ≥ 65 yr, n = 427) compared with younger adults (age < 65 yr, n = 393). MEASUREMENTS AND MAIN RESULTS Pulmonary function was higher in older adults (median FEV1 %, 70) compared with younger adults (median FEV1 %, 62) (P < 0.001), whereas the median 6-minute-walk distance was similar between groups (372 m vs. 388 m, P = 0.21). After adjusting for potential confounders, older adults were less likely to report that their health limited them significantly in performing moderate activities (odds ratio [OR], 0.36; 95% confidence interval [CI], 0.22-0.58) or climbing several flights of stairs (OR, 0.51; 95% CI, 0.34-0.77). The odds of reporting that their physical health limited the kinds of activities they performed were reduced by 63% in older adults (OR, 0.37; 95% CI, 0.24-0.58), and, similarly, the odds of reporting that their health caused them to accomplish less than they would like were also lower in older adults (OR, 0.39; 95% CI, 0.25-0.60). The OR for reporting that their breathing problem stops them from doing most things or everything was 0.35 (95% CI, 0.22-0.55) in older adults versus younger adults. CONCLUSIONS Older adults with chronic lung disease were less likely to report significant impairment in their activities compared with younger adults, suggesting they may perceive less limitation.
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Rafiq R, Aleva FE, Schrumpf JA, Heijdra YF, Taube C, Daniels JM, Lips P, Bet PM, Hiemstra PS, van der Ven AJ, den Heijer M, de Jongh RT. Prevention of exacerbations in patients with COPD and vitamin D deficiency through vitamin D supplementation (PRECOVID): a study protocol. BMC Pulm Med 2015; 15:106. [PMID: 26399451 PMCID: PMC4580355 DOI: 10.1186/s12890-015-0101-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Accepted: 09/11/2015] [Indexed: 12/20/2022] Open
Abstract
Background Vitamin D is well known for its function in calcium homeostasis and bone mineralisation, but is increasingly studied for its potential immunomodulatory properties. Vitamin D deficiency is a common problem in patients with COPD. Previous studies have not demonstrated a beneficial effect of vitamin D on exacerbation rate in COPD patients. However, subgroup analyses suggested protective effects in vitamin D deficient patients. Our objective is to assess the effect of vitamin D supplementation on exacerbation rate specifically in vitamin D deficient COPD patients. Methods/Design We will perform a randomised, multi-center, double-blind, placebo-controlled intervention study. The study population consists of 240 COPD patients aged 40 years and older with vitamin D deficiency (25-hydroxyvitamin D concentration < 50 nmol/L). Participants will be recruited after an exacerbation and will be randomly allocated in a 1:1 ratio to receive vitamin D3 16800 IU or placebo orally once a week during 1 year. Participants will receive a diary card to register the incidence of exacerbations and changes in medication during the study period. Visits will be performed at baseline, at 6 months and at 12 months after randomisation. Participants will undergo spirometry, measurement of total lung capacity and assessment of maximal respiratory mouth pressure. Several physical performance and hand grip strength tests will be performed, questionnaires on quality of life and physical activity will be filled in, a nasal secretion sample and swab will be obtained and blood samples will be taken. The primary outcome will be exacerbation rate. Discussion This study will be the first RCT aimed at the effects of vitamin D supplementation on exacerbation rate in vitamin D deficient COPD patients. Also, in contrast to earlier studies that used infrequent dosing regimens, our trial will study effects of a weekly dose of vitamin D supplementation. Secondly, the immunomodulatory effects of vitamin D on host immune response of COPD patients and underlying mechanisms will be studied. Finally, the effects on physical functioning will be examined. Trial registration This trial is registered in ClinicalTrials.gov, ID number NCT02122627. Date of Registration April 2014.
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Affiliation(s)
- Rachida Rafiq
- Department of Internal Medicine and Endocrinology, VU University Medical Center, Amsterdam, The Netherlands.
| | - Floor E Aleva
- Department of Pulmonology, Radboud University Medical Center, Nijmegen, The Netherlands. .,Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.
| | - Jasmijn A Schrumpf
- Department of Pulmonology, Leiden University Medical Center, Leiden, The Netherlands.
| | - Yvonne F Heijdra
- Department of Pulmonology, Radboud University Medical Center, Nijmegen, The Netherlands.
| | - Christian Taube
- Department of Pulmonology, Leiden University Medical Center, Leiden, The Netherlands.
| | - Johannes Ma Daniels
- Department of Pulmonology, VU University Medical Center, Amsterdam, The Netherlands.
| | - Paul Lips
- Department of Internal Medicine and Endocrinology, VU University Medical Center, Amsterdam, The Netherlands.
| | - Pierre M Bet
- Department of Clinical Pharmacology and Pharmacy, VU University Medical Center, Amsterdam, The Netherlands.
| | - Pieter S Hiemstra
- Department of Pulmonology, Leiden University Medical Center, Leiden, The Netherlands.
| | - André Jam van der Ven
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.
| | - Martin den Heijer
- Department of Internal Medicine and Endocrinology, VU University Medical Center, Amsterdam, The Netherlands.
| | - Renate T de Jongh
- Department of Internal Medicine and Endocrinology, VU University Medical Center, Amsterdam, The Netherlands.
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The psychometric properties of the St George's Respiratory Questionnaire (SGRQ) in patients with idiopathic pulmonary fibrosis: a literature review. Health Qual Life Outcomes 2014; 12:124. [PMID: 25138056 PMCID: PMC4148554 DOI: 10.1186/s12955-014-0124-1] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Accepted: 08/05/2014] [Indexed: 11/10/2022] Open
Abstract
Assessment of health-related quality of life (HRQL) is particularly important in patients with progressive and incurable diseases such as idiopathic pulmonary fibrosis (IPF). The St George's Respiratory Questionnaire (SGRQ) has frequently been used to measure HRQL in patients with IPF, but it was developed for patients with obstructive lung diseases. The aim of this review was to examine published data on the psychometric performance of the SGRQ in patients with IPF. A comprehensive search was conducted to identify studies reporting data on the internal consistency, construct validity, test-retest reliability, and interpretability of the SGRQ in patients with IPF, published up to August 2013. In total, data from 30 papers were reviewed. Internal consistency was moderate for the SGRQ symptoms score and excellent for the SGRQ activity, impact and total scores. Validity of the SGRQ symptoms, activity, impact and total scores was supported by moderate to strong correlations with other patient-reported outcome measures and with a measure of exercise capacity. Most correlations were moderately strong between SGRQ activity or total scores and forced or static vital capacity, the most commonly used marker of IPF severity. There was evidence that changes in SGRQ domain and total scores could detect within-subject improvement in health status, and differentiate groups of patients whose health status had improved, declined or remained unchanged. Although the SGRQ was not developed specifically for use with patients with IPF, on balance, its psychometric properties are adequate and suggest that it may be a useful measure of HRQL in this patient population. However, several questions remain unaddressed, and further research is needed to confirm the SGRQ's utility in IPF.
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Hohberger LA, Schroeder DR, Bartholmai BJ, Yang P, Wendt CH, Bitterman PB, Larsson O, Limper AH. Correlation of regional emphysema and lung cancer: a lung tissue research consortium-based study. J Thorac Oncol 2014; 9:639-45. [PMID: 24662456 PMCID: PMC3984592 DOI: 10.1097/jto.0000000000000144] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Chronic obstructive pulmonary disease and lung cancer are linked because both airflow obstruction and emphysema, on computer tomography, are independent risk factors for lung cancer. However, the local risk of malignancy relative to development of regional emphysema has not yet been defined. Specifically, it is not known if primary lung cancers are associated with regions of worse emphysema within individual patients. METHODS We performed a database analysis evaluating the association between the degree of regional emphysema as scored on computer tomography and development of primary lung cancer. We also studied the association between regional emphysema and benign lung nodules. We assembled two distinct cohorts using the National Heart, Lung, and Blood Institute's Lung Tissue Research Consortium database, hypothesizing that lung malignancy will preferentially locate in the regions of the most severe emphysema. RESULTS In the Lung Tissue Research Consortium database, 624 cases met criteria for the malignant nodule cohort and 64 were included in the benign nodule cohort. When comparing location of a malignant nodule to other lung regions within the same person, the odds of having a more severe emphysema score in the location of lung cancer was 1.342 (95% confidence interval 1.112-1.620; p = 0.0022). When comparing location of a benign nodule to other lung regions within the same person, the odds of having a more severe emphysema score in the location of the benign nodule was 1.118 (95% confidence interval 0.725-1.725; p = 0.6137). CONCLUSIONS Primary lung cancers are associated with areas of worse regional emphysema.
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Affiliation(s)
- Laurie A. Hohberger
- Mayo Clinic, Division of Pulmonary and Critical Care Medicine, Rochester, MN
| | | | | | - Ping Yang
- Mayo Clinic, Department of Epidemiology, Rochester, MN
| | - Christine H. Wendt
- University of Minnesota Medical School, Division of Pulmonary and Critical Care Medicine and VAMC, Minneapolis, MN
| | - Peter B. Bitterman
- University of Minnesota Medical School, Division of Pulmonary and Critical Care Medicine, Minneapolis, MN
| | - Ola Larsson
- Karolinska Institute, Department of Oncology-Pathology, Stockholm, Sweden
| | - Andrew H Limper
- Mayo Clinic, Division of Pulmonary and Critical Care Medicine, Rochester, MN
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Leung JM, Liu JC, Mtambo A, Ngan D, Nashta N, Guillemi S, Harris M, Lima VD, Mattman A, Shaipanich T, Raju R, Hague C, Leipsic JA, Sin DD, Montaner JS, Man SP. The determinants of poor respiratory health status in adults living with human immunodeficiency virus infection. AIDS Patient Care STDS 2014; 28:240-7. [PMID: 24742270 DOI: 10.1089/apc.2013.0373] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
The increased longevity afforded by combination antiretroviral therapy in developed countries has led to an increased concern regarding senescence-related diseases in patients with human immunodeficiency virus (HIV) infection. Previous epidemiologic analyses have demonstrated an increased risk of chronic obstructive pulmonary disease, as well as a significant burden of respiratory symptoms in HIV-infected patients. We performed the St. George's Respiratory Questionnaire (SGRQ) in 199 HIV-positive men, and determined the predominant factors contributing to poor respiratory-related health status. In univariate analyses, worse SGRQ scores were associated with respiratory-related variables such as greater smoking pack-year history (p=0.028), lower forced expiratory volume in 1 second (FEV1) (p<0.001), and worse emphysema severity as quantified by computed tomographic imaging (p=0.017). In addition, HIV-specific variables, such as a history of plasma viral load >100,000 copies/mL (p=0.043), lower nadir CD4 cell count (p=0.040), and current CD4 cell count ≤350 cells/μL (p=0.005), as well as elevated levels of inflammatory markers, specifically plasma interleukin (IL)-6 (p=0.002) and alpha-1 antitrypsin (p=0.005) were also associated with worse SGRQ scores. In a multiple regression model, FEV1, current CD4 count ≤350 cells/μL, and IL-6 levels remained significant contributors to reduced respiratory-related health status. HIV disease activity as measured by HIV-related immunosuppression in conjunction with the triggering of key inflammatory pathways may be important determinants of worse respiratory health status among HIV-infected individuals. Limitations of this analysis include the absence of available echocardiograms, diffusion capacity and lung volume testing, and an all-male cohort due to the demographics of the clinic population.
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Affiliation(s)
| | - Joseph C. Liu
- UBC James Hogg Research Centre, Vancouver, BC, Canada
| | - Andy Mtambo
- AIDS Research Program, St. Paul's Hospital, Vancouver, BC, Canada
| | - David Ngan
- UBC James Hogg Research Centre, Vancouver, BC, Canada
| | - Negar Nashta
- AIDS Research Program, St. Paul's Hospital, Vancouver, BC, Canada
| | - Silvia Guillemi
- AIDS Research Program, St. Paul's Hospital, Vancouver, BC, Canada
- Department of Family Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Division of HIV/AIDS, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Marianne Harris
- AIDS Research Program, St. Paul's Hospital, Vancouver, BC, Canada
- Department of Family Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Division of HIV/AIDS, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Viviane D. Lima
- BC Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, BC, Canada
| | - Andre Mattman
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Tawimas Shaipanich
- UBC Department of Medicine and Division of Respiratory Medicine, St. Paul's Hospital, Vancouver, BC, Canada
| | - Rekha Raju
- Department of Radiology and Diagnostic Imaging, St. Paul's Hospital, Vancouver, BC, Canada
| | - Cameron Hague
- Department of Radiology and Diagnostic Imaging, St. Paul's Hospital, Vancouver, BC, Canada
| | - Jonathon A. Leipsic
- Department of Radiology and Diagnostic Imaging, St. Paul's Hospital, Vancouver, BC, Canada
| | - Don D. Sin
- UBC James Hogg Research Centre, Vancouver, BC, Canada
- UBC Department of Medicine and Division of Respiratory Medicine, St. Paul's Hospital, Vancouver, BC, Canada
| | - Julio S. Montaner
- BC Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, BC, Canada
| | - S.F. Paul Man
- UBC James Hogg Research Centre, Vancouver, BC, Canada
- UBC Department of Medicine and Division of Respiratory Medicine, St. Paul's Hospital, Vancouver, BC, Canada
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27
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Someya F, Nakagawa T. Application of the COPD Assessment Test (CAT) to Patients with Interstitial Lung Disease. Health (London) 2014. [DOI: 10.4236/health.2014.619295] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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