Effects of pulmonary rehabilitation on exercise capacity and disease impact in patients with chronic obstructive pulmonary disease and obesity.

OBJECTIVES: To explore the influence of obesity on outcomes of exercise capacity and disease impact in patients with chronic obstructive pulmonary disease (COPD) in response to pulmonary rehabilitation (PR) and to compare outcomes to those of normal weight and overweight counterparts. DESIGN: Secondary data analysis of clinical database. SETTING: St. James's Hospital, Dublin, Ireland. PARTICIPANTS: 155 participants with a primary diagnosis of COPD who completed a PR programme between 2012 and 2014. MAIN OUTCOME MEASURES: Exercise capacity evaluated using the Six Minute Walk Test (6MWT) and the COPD Assessment Test (CAT) evaluated disease impact. RESULTS: Walking distance in the 6MWT improved significantly [mean difference of 55m (95% CI: 42 to 68; p<0.001)] and similarly [F(2, 92)=1.434, p=0.24] across all BMI categories, although the level of improvement reached clinical significance in the normal/underweight and overweight categories only. Disease impact on the CAT score improved across all body mass index (BMI) classifications by 2.3 points (95% CI: 0.9 to 3.6; p<0.050) which reached clinical significance and did not vary across BMI categories [F(2, 80)=0.534, p=0.58]. CONCLUSION: Exercise capacity and self-report disease impact of individuals with COPD improved similarly in response to PR irrespective of BMI.

Gender variations in the social impact of oral health.

BACKGROUND: There is a growing interest in gender related health issues, however, there is little data concerning the relationships between oral health and gender other than on tooth loss. In particular, there is little information on differences in the social impact of oral health between men and women. AIM: The aim of this study was to identify gender variations in the social and psychological impacts of oral health. DESIGN: A random probability sample of 1,865 adults (1,049 women and 816 men) took part in the study to determine how oral health "reduces" and "adds to" quality of life in a nation-wide survey. RESULTS: Women perceived oral health as having a greater impact than men on their quality of life in general, having a greater negative impact (p < 0.01) and a greater positive impact (p < 0.05). Specifically women perceived oral health as causing them more pain (p < 0.05), embarrassment (p < 0.05) and being detrimental to their finances (p < 0.05) compared to men. Women also more frequently perceived oral health as enhancing their life quality (p < 0.05), their moods (p < 0.05), their appearance (p < 0.01) and their general well being (p < 0.01) than men. CONCLUSION: There are gender variations in the social and psychological impacts of oral health. These findings may help in understanding gender differences in oral health needs and behaviour and have implications in assessing oral health needs.