Mini Nutritional Assessment Short-Form as screening tool for osteoporosis in patients with chronic obstructive pulmonary disease.

BACKGROUND AND OBJECTIVES: Osteoporosis is a common complication of chronic obstructive pulmonary dis-ease (COPD). It is impractical to measure bone mineral density (BMD) in all patients with COPD. This study aimed to investigate the relationship between Mini Nutritional Assessment Short-Form (MNA-SF), a simple nutritional status questionnaire, and osteoporosis, and to determine whether it can be used as a reliable screening tool for osteoporosis in patients with COPD. METHODS AND STUDY DESIGN: Thirty-seven patients with stable COPD were enrolled in this prospective cohort study. Patients with MNA-SF scores >11 were defined as well-nourished, and those with scores of ≤11 being at risk for malnutrition. Body composition, BMD, and undercarboxylated osteocalcin (ucOC), a bone metabolism marker, were measured using bioelectrical impedance, dual energy X-ray, and electrochemiluminescence immunoassay, respectively. RESULTS: Seventeen (45.9%) were classified as at risk for malnutrition, and 13 (35.1%) had osteoporosis. Patients at risk for malnutrition had significantly more osteoporosis and higher ucOC values than well-nourished patients (p=0.007, p=0.030, respectively). Patients with osteoporosis also had significantly lower body mass index (BMI) and fat-free mass index than those without osteoporosis (p= 0.007 and p=0.005, respectively), although FEV1 % pred was not significantly different. MNA-SF (cutoff value; 11) had better sensitivity to identify the presence of osteoporosis than BMI (cutoff value; 18.5 kg/m2) (sensitivity, 0.769; specificity, 0.708; sensitivity, 0.462; specificity, 0.875, respectively). CONCLUSIONS: MNA-SF was associated with osteoporosis and bone metabolism markers in patients with COPD. MNA-SF may be a useful screening tool for osteoporo-sis in patients with COPD.

Serum Free Radical Scavenging Capacity Profiles of Patients with Chronic Obstructive Pulmonary Disease.

Background: Oxidative stress is an important mechanism for the development and progression of chronic obstructive pulmonary disease (COPD). It may also contribute to systemic manifestation in patients with COPD. Reactive oxygen species (ROS) including free radicals play a crucial role in oxidative stress in COPD. The aims of this study were to determine serum scavenging capacity profile against multiple free radicals and to evaluate its correlation with pathophysiology, exacerbations, and prognosis in patients with COPD. Methods: Serum scavenging capacity profile against multiple free radicals comprising hydroxyl radical (•OH), superoxide radical (O2 -•), alkoxy radical (RO•), methyl radical (•CH3), alkylperoxyl radical (ROO•), and singlet oxygen (1O2) was assessed using the multiple free-radical scavenging method in 37 patients with COPD (mean age, 71 years; mean forced expiratory volume in 1 s, 55.2% predicted). The severity of emphysema was evaluated by Goddard classification on chest computed tomography. Exacerbations were recorded prospectively for 1 year and the overall mortality was assessed 5 years after the initial assessment. Results: •OH scavenging capacity was significantly decreased (p < 0.05) and O2 -• and •CH3 scavenging capacity tended to decrease in patients with COPD compared to that in healthy controls. On the other hand, ROO• scavenging capacity tended to increase. In addition, RO• scavenging capacity was associated with severity of emphysema (p < 0.05) and exacerbation frequency (p < 0.02). There was a difference in the profile of the scavenging capacity between survived and deceased patients with COPD for 5 years after initial assessment. Conclusion: Characteristic profile of free radical scavenging capacity can provide insight into the pathophysiology and prognosis of patients with COPD.

Endobronchial Watanabe Spigots for Treatment of Pyopneumothorax due to Nontuberculous Mycobacteriosis in a Patient with Rheumatoid Arthritis: A Case Report Based on Past Experience.

Nontuberculous mycobacterial lung disease sometimes causes pneumothorax and empyema, which are often intractable because of patients' background factors. Biological products used in the treatment of rheumatoid arthritis have caused the problem of an increase in infection rates as a side effect, one of which is nontuberculous mycobacteriosis (NTM). On the basis of past experience, we report the case of a patient who had a history of undergoing treatment with biological products against rheumatoid arthritis. The patient was treated for NTM-induced pyopneumothorax by endoscopic bronchial occlusion therapy using endobronchial Watanabe spigots.

Prevalence of chronic obstructive pulmonary disease in independent community-dwelling older adults: The Fujiwara-kyo study.

AIM: As the Japanese population ages, the number of older patients with chronic obstructive pulmonary disease (COPD) is expected to increase, but the prevalence of COPD in patients aged ≥80 years remains unclear. The purpose of the present study was to determine the prevalence of COPD in independent community-dwelling older adults aged ≥80 years. METHODS: We investigated the prevalence of COPD in 2862 independent community-dwelling older adults (1504 men, 1358 women, mean age 77.7 ± 7.0 years) who underwent spirometry in the Fujiwara-kyo study, a study of successful aging in older adults. Those participants with airflow limitation (forced expiratory volume in 1 s/forced vital capacity <0.7) who indicated on a self-administered questionnaire that they had a history of smoking and did not have bronchial asthma were considered to have COPD. RESULTS: The prevalence of COPD was 16.9% among all participants and 37.4% among smokers. The prevalence among individuals aged ≥80 years (19.7%) was significantly higher than that among those aged <80 years (16.0%; P < 0.05). When forced expiratory volume in 1 s/forced vital capacity lower limit of normal was used as the criterion for airflow limitation, the prevalence fell to 11.0%. Patients with mild-to-moderate airflow limitation (stage I/stage II) accounted for the great majority (91.2%) of COPD patients aged ≥80 years. CONCLUSIONS: A high prevalence of mild-to-moderate COPD was observed even in the independent community-dwelling older adults aged ≥80 years. However, the benefits of the spirometric screening and treatment for these patients needs to be determined. Geriatr Gerontol Int 2017; 17: 2421-2426.