Impaired Skeletal Muscle in Patients with Stable Chronic Obstructive Pulmonary Disease (COPD) Compared with Non-COPD Patients.

Purpose: This study was designed to investigate the differences in skeletal-muscle atrophy between patients with stable chronic obstructive pulmonary disease (COPD) and healthy controls; associated factors were also considered. The study comprised selected residents of communities near the First Affiliated Hospital of Soochow University in Suzhou City, East China. Patients and Methods: Included in this study were 123 COPD patients and 60 controls. All patients completed spirometry as well as examinations to determine their functional exercise capacity, body composition, and handgrip strength (HGS). Results: COPD patients had less fat-free mass (FFM), a lower FFM index (FFMI), and a lower 6-min walking distance (6MWD) compared with controls (P = 0.007, P = 0.020, and P < 0.001, respectively) (FFMI: 17.59 ± 1.83 vs 18.34 ± 1.64). The HGS of these patients was also lower compared with that of controls (32.88 ± 7.84 vs 35.48 ± 7.42), and HGS tended toward statistical significance (P = 0.064, respectively). In multivariate analysis, age (ß = -0.107, P < 0.001), gender (ß = 0.212, P < 0.001), body mass index (BMI) (ß = 0.462, P < 0.001), FEV1% (ß = 0.108, P = 0.009), and calf circumference (CC) (ß = 0.457, P < 0.001) were significantly associated with FFMI. Conclusion: Impaired skeletal muscle mass was more common in COPD patients than in controls. Multiple regression analysis showed that CC may be used to detect the degree of impairment, particularly by health-care providers working outside of the hospital.

Auricular acupressure for cancer-related fatigue during lung cancer chemotherapy: a randomised trial.

PURPOSE: To evaluate the effect of auricular acupressure (AA) on cancer-related fatigue (CRF), sleep disturbance and anxiety in lung cancer patients undergoing chemotherapy. MATERIALS AND METHODS: Patients were recruited from the respiratory department of a general hospital and were randomised into three groups. A 9-week course of AA using Semen Vaccariae (SV) (Group A)/AA using magnetic beads (Group B)/routine care (Group C) was implemented. CRF scores were used as the primary outcome while the sleep and anxiety scores were the secondary outcomes. Analysis of variance and least significant difference t-test were used to determine the intergroup differences and paired-sample t-test was used for the intragroup comparison. RESULTS: 100 lung cancer patients undergoing chemotherapy were included. Compared with Group C, AA could significantly alleviate CRF (F:24.63, p<0.01), especially for physical and affective fatigue and Group A was more effective for managing physical fatigue than Group B in per-protocol (PP) (-1.75 (-2.69 to -0.82), p<0.01)/Intention to Treat analysis (ITT) (-1.41 (-2.39 to -0.41), p=0.01) analysis. However, AA had no effect on cognitive fatigue. Compared with Group C, only Group A produced significant improvements in sleep quality in PP analysis (-1.17 (-2.23 to -0.10), p=0.03) while it yielded negative results in ITT analysis (-0.82 (-1.74 to 0.10), p=0.08). Compared with Group C, AA could significantly reduce anxiety in PP analysis (F:9.35, p<0.01) while there was no statistical difference between Group B and Group C (-0.95 (-2.81 to 0.90), p=0.31), Group A and Group B (-1.26 (-3.12 to 0.59), p=0.18) in ITT analysis. CONCLUSION: AA can alleviate CRF of lung cancer patients undergoing chemotherapy, especially for physical and affective fatigue. AA using SV is more effective for physical fatigue while AA using magnetic beads works better for anxiety. However, AA cannot improve the sleep quality. TRIAL REGISTRATION NUMBER: ISRCTNregistry (ISRCTN16408424).

Pulmonary tuberculosis with false-positive 18F-fluorodeoxyglucose positron emission tomography mimicking recurrent lung cancer: A case report.

Recurrent lung cancer is a common clinical condition. 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) is currently the predominant non-invasive imaging technique used for the detection of tumor recurrence. In the present study, the case of a 67-year-old male suspected to have postoperative recurrence of primary lung cancer was examined. Chest computed tomography (CT) scans identified a subpleural nodule grown within a short time period, along with the occurrence of multiple patchy shadows on the right lung. PET-CT scans revealed an increased FDG uptake in the surgical site, which exhibited features of a malignant disease. However, a video-assisted thoracoscopic biopsy provided the diagnosis of tuberculosis and guided further appropriate treatment. In conclusion, further evaluation is required in all patients with suspected metastatic and recurrent carcinoma.

Sudden and rapid progression of lung affectation but stability in kidney function: a case report of anti-neutrophil cytoplasmic antibody-associated vasculitis.

We report the case of a patient with anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) who exhibited sudden progression of lung infiltration while maintaining stable kidney function. The 69-year-old man was diagnosed with AAV and renal insufficiency 4 years ago. Pulmonic affectation was detected in the right lower lobe of lung by a computed tomography (CT) scan. After beginning cyclophosphamide pulse therapy and sequential therapy with low-dose prednisone, he underwent a 4-year follow-up to detect changes in hemoglobin levels and serum creatinine levels, and had chest CT examinations. The CT scan and creatinine assay showed stable pulmonic fibrosis and kidney function. Although there was no increase of creatinine and detectable perinuclear ANCA, the patient suffered a pulmonary hemorrhage and levels of hemoglobin became progressive lower; the lung infiltration was found to be enlarged compared to the last examination the previous year. After immunosuppressive therapy for one week, the lung fibrosis was progressive, increased pulmonary hemorrhage occurred, and the patient died due to respiratory failure but not end-stage renal failure.