Effect of fruit and vegetable intake on oxidative stress and inflammation in COPD: a randomised controlled trial.

Epidemiological evidence supports a positive relationship between fruit and vegetable (FV) intake, lung function and chronic obstructive pulmonary disease (COPD). Increasing FV intake may attenuate the oxidative stress and inflammation associated with COPD. An exploratory randomised controlled trial to examine the effect of increased consumption of FV on oxidative stress and inflammation in moderate-to-severe COPD was conducted. 81 symptomatically stable patients with a habitually low FV intake (two or fewer portions of FV per day) were randomised to the intervention group (five or more portions of FV per day) or the control group (two or fewer portions of FV per day). Each participant received self-selected weekly home deliveries of FV for 12 weeks. 75 participants completed the intervention. There was a significant between-group change in self-reported FV intake and biomarkers of FV intake (zeaxanthin (p = 0.034) and ß-cryptoxanthin (p = 0.015)), indicating good compliance; post-intervention intakes in intervention and control groups were 6.1 and 1.9 portions of FV per day, respectively. There were no significant changes in biomarkers of airway inflammation (interleukin-8 and myeloperoxidase) and systemic inflammation (C-reactive protein) or airway and systemic oxidative stress (8-isoprostane). This exploratory study demonstrated that patients with moderate-to-severe COPD were able to comply with an intervention to increase FV intake; however, this had no significant effect on airway or systemic oxidative stress and inflammation.

Copying letters to patients with cystic fibrosis (CF): letter content and patient perceptions of benefit.

BACKGROUND: Copying letters involves generating an extra copy of all correspondence between healthcare professionals about the patient, to the patient. AIMS: To determine if the letter content was meaningful to the patient and to establish patient perceptions of copying letters from outpatient clinic visits. METHODS: To assess letter content, a copy of all outpatient clinic letters were collected during a one month period and each copy was assessed for the use of plain English using the Drivel Defence software. To establish patient perceptions, patients completed a questionnaire relating to the potential advantages and disadvantages of copying letters. RESULTS: Eighty letters were assessed for content. 77/80 (96.3%) of the letters had > or = 50% of sentences with <20 words. The mean (SD) sentence length was 15 (3) words. Abbreviations were minimal in most letters (71/80, 89%). Most letters explained the patient's clinical status in a meaningful way (76/80, 95%). Fifty patients completed a questionnaire. The large majority (46/50, 92%) "strongly agreed" or "agreed" that they felt more involved by receiving a copy. Most patients (48/50, 96%) would rather receive a copy with 40/50 (80%) reporting advantages. CONCLUSION: Copying letters is well received amongst patients with CF, with numerous advantages and few disadvantages reported.