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1. It’s more than low BMI: prevalence of cachexia and associated mortality in COPD

Author

McDonald, Merry-Lynn N, Wouters, Emiel FM, Rutten, Erica, Casaburi, Richard, Rennard, Stephen I, Lomas, David A, Bamman, Marcas, Celli, Bartolome, Agusti, Alvar, Tal-Singer, Ruth, Hersh, Craig P, Dransfield, Mark, and Silverman, Edwin K

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Lung, Nutrition, Chronic Obstructive Pulmonary Disease, Prevention, Respiratory, Good Health and Well Being, Aged, Body Mass Index, Cachexia, Consensus, Female, Humans, Male, Middle Aged, Mortality, Prevalence, Pulmonary Disease, Chronic Obstructive, Weight Loss, COPD, BODE, Weight loss, BMI, Cardiorespiratory Medicine and Haematology, Respiratory System, Cardiovascular medicine and haematology, Clinical sciences
Abstract

BackgroundCachexia is associated with increased mortality risk among chronic obstructive pulmonary disease (COPD) patients. However, low body mass index (BMI) as opposed to cachexia is often used, particularly when calculating the BODE (BMI, Obstruction, Dyspnea and Exercise) index. For this reason, we examined mortality using a consensus definition and a weight-loss definition of cachexia among COPD cases and compared two new COPD severity indices with BODE.MethodsIn the current report, the consensus definition for cachexia incorporated weight-loss > 5% in 12-months or low BMI in addition to 3/5 of decreased muscle strength, fatigue, anorexia, low FFMI and inflammation. The weight-loss definition incorporated weight-loss > 5% or weight-loss > 2% (if low BMI) in 12-months. The low BMI component in BODE was replaced with the consensus definition to create the CODE (Consensus cachexia, Obstruction, Dyspnea and Exercise) index and the weight-loss definition to create the WODE (Weight loss, Obstruction, Dyspnea and Exercise) index. Mortality was assessed using Kaplan-Meier survival and Cox Regression. Performance of models was compared using C-statistics.ResultsAmong 1483 COPD cases, the prevalences of cachexia by the consensus and weight-loss definitions were 4.7 and 10.4%, respectively. Cachectic patients had a greater than three-fold increased mortality by either the consensus or the weight-loss definition of cachexia independent of BMI and lung function. The CODE index predicted mortality slightly more accurately than the BODE and WODE indices.ConclusionsCachexia is associated with increased mortality among COPD patients. Monitoring cachexia using weight-loss criteria is relatively simple and predictive of mortality among COPD cases who may be missed if only low BMI is used.

Published
2019

2. Chest computed tomography-derived low fat-free mass index and mortality in COPD

Author

McDonald, Merry-Lynn N, Diaz, Alejandro A, Rutten, Erica, Lutz, Sharon M, Harmouche, Rola, San Jose Estepar, Raul, Kinney, Greg, Hokanson, John E, Gower, Barbara A, Wouters, Emiel FM, Rennard, Stephen I, Hersh, Craig P, Casaburi, Richard, Dransfield, Mark T, Silverman, Edwin K, and Washko, George R

Subjects
Biomedical and Clinical Sciences, Cardiovascular Medicine and Haematology, Lung, Nutrition, Clinical Research, Chronic Obstructive Pulmonary Disease, Respiratory, Good Health and Well Being, Adipose Tissue, Aged, Body Composition, Body Mass Index, Cohort Studies, Electric Impedance, Female, Humans, Internationality, Male, Middle Aged, Pulmonary Disease, Chronic Obstructive, Risk Factors, Survival Analysis, Tomography, X-Ray Computed, Medical and Health Sciences, Respiratory System, Cardiovascular medicine and haematology
Abstract

Low fat-free mass index (FFMI) is an independent risk factor for mortality in chronic obstructive pulmonary disease (COPD) not typically measured during routine care. In the present study, we aimed to derive fat-free mass from the pectoralis muscle area (FFMPMA) and assess whether low FFMIPMA is associated with all-cause mortality in COPD cases. We used data from two independent COPD cohorts, ECLIPSE and COPDGene.Two equal sized groups of COPD cases (n=759) from the ECLIPSE study were used to derive and validate an equation to calculate the FFMPMA measured using bioelectrical impedance from PMA. We then applied the equation in COPD cases (n=3121) from the COPDGene cohort, and assessed survival. Low FFMIPMA was defined, using the Schols classification (FFMI

Published
2017

3. Body mass index change in gastrointestinal cancer and chronic obstructive pulmonary disease is associated with Dedicator of Cytokinesis 1

Author

McDonald, Merry‐Lynn Noelle, Won, Sungho, Mattheisen, Manuel, Castaldi, Peter J, Cho, Michael H, Rutten, Erica, Hardin, Megan, Yip, Wai‐Ki, Rennard, Stephen I, Lomas, David A, Wouters, Emiel FM, Agusti, Alvar, Casaburi, Richard, Lange, Christoph P, O'Connor, George, Hersh, Craig P, and Silverman, Edwin K

Subjects
Epidemiology, Health Sciences, Genetics, Human Genome, Chronic Obstructive Pulmonary Disease, Digestive Diseases, Lung, Prevention, Nutrition, 2.1 Biological and endogenous factors, Aetiology, Cancer, Respiratory, Adult, Aged, Body Mass Index, Cachexia, Female, Gastrointestinal Neoplasms, Genetic Association Studies, Genetic Predisposition to Disease, Genome-Wide Association Study, Humans, Longitudinal Studies, Male, Middle Aged, Polymorphism, Single Nucleotide, Pulmonary Disease, Chronic Obstructive, rac GTP-Binding Proteins, GWAS, COPD, Longitudinal, BMI, Physiology, Clinical Sciences, Human Movement and Sports Sciences, Clinical sciences, Allied health and rehabilitation science, Sports science and exercise
Abstract

BackgroundThere have been a number of candidate gene association studies of cancer cachexia-related traits, but no genome-wide association study (GWAS) has been published to date. Cachexia presents in patients with a number of complex traits, including both cancer and COPD. The objective of the current investigation was to search for a shared genetic aetiology for change in body mass index (ΔBMI) among cancer and COPD by using GWAS data in the Framingham Heart Study.MethodsA linear mixed effects model accounting for age, sex, and change in smoking status was used to calculate ΔBMI in participants over 40 years of age with three consecutive BMI time points (n = 4162). Four GWAS of ΔBMI using generalized estimating equations were performed among 1085 participants with a cancer diagnosis, 204 with gastrointestinal (GI) cancer, 112 with lung cancer, and 237 with COPD to test for association with 418 365 single-nucleotide polymorphisms (SNPs).ResultsTwo SNPs reached a level of genome-wide significance (P

Published
2017

4. Vitamin D: beyond bone.

Author

Christakos, Sylvia, Hewison, Martin, Gardner, David G, Wagner, Carol L, Sergeev, Igor N, Rutten, Erica, Pittas, Anastassios G, Boland, Ricardo, Ferrucci, Luigi, and Bikle, Daniel D

Subjects
Immune System, Animals, Humans, Mice, Pulmonary Disease, Chronic Obstructive, Cardiovascular Diseases, Diabetes Mellitus, Type 2, Vitamin D Deficiency, Obesity, Autoimmune Diseases, Disease Models, Animal, Vitamin D, Receptors, Calcitriol, Cognition Disorders, Erythropoiesis, Calcium Signaling, Organ Specificity, Nutritional Requirements, Lactation, Pregnancy, Adult, Infant, Female, Male, Randomized Controlled Trials as Topic, vitamin D, cancer, immunity, pregnancy, obesity, diabetes, pulmonary disease, muscle, aging, cognitive function, Pulmonary Disease, Chronic Obstructive, Diabetes Mellitus, Type 2, Disease Models, Animal, Receptors, Calcitriol, General Science & Technology
Abstract

In recent years, vitamin D has been received increased attention due to the resurgence of vitamin D deficiency and rickets in developed countries and the identification of extraskeletal effects of vitamin D, suggesting unexpected benefits of vitamin D in health and disease, beyond bone health. The possibility of extraskeletal effects of vitamin D was first noted with the discovery of the vitamin D receptor (VDR) in tissues and cells that are not involved in maintaining mineral homeostasis and bone health, including skin, placenta, pancreas, breast, prostate and colon cancer cells, and activated T cells. However, the biological significance of the expression of the VDR in different tissues is not fully understood, and the role of vitamin D in extraskeletal health has been a matter of debate. This report summarizes recent research on the roles for vitamin D in cancer, immunity and autoimmune diseases, cardiovascular and respiratory health, pregnancy, obesity, erythropoiesis, diabetes, muscle function, and aging.

Published
2013

15. Self-management support in flemish primary care practice: the development of a preliminary conceptual model using a qualitative approach

Author

Timmermans, Lotte, Boeykens, Dagje, Sirimsi, Muhammed Mustafa, Decat, Peter, Foulon, Veerle, Van Hecke, Ann, Vermandere, Mieke, Schoenmakers, Birgitte, Remmen, Roy, Verté, Emily, Van Bogaert, Peter, De Loof, Hans, Van den Broeck, Kris, Anthierens, Sibyl, Huybrechts, Ine, Raeymaeckers, Peter, Buffel, Veerle, Devroey, Dirk, Aertgeerts, Bert, Timmmermans, Lotte, Declercq, Anja, Van de Velde, Dominique, Boeckstaens, Pauline, De Sutter, An, De Vriendt, Patricia, Lahousse, Lies, Pype, Peter, Roose, Rudie, Martin, Sandra, Rutten, Erica, Pless, Sam, Tuinstra, Anouk, Gauwe, Vanessa, Reynaert, Didier, Van Landschoot, Leen, Lopez Hartmann, Maja, Claeys, Tony, Vandenhoudt, Hilde, De Vliegher, Kristel, Op de Beeck, Susanne, Mental Health and Wellbeing research group, Frailty in Ageing, Gerontology, and Primary Care Academy

Subjects
INVOLVEMENT, Science & Technology, PERCEPTIONS, Primary Health Care, Patients, Health personnel, PATIENT, Medicine, General & Internal, Caregivers, PEOPLE, General & Internal Medicine, Qualitative research, Adaptation, Psychological, HEALTH-CARE, Medicine and Health Sciences, Self-management, Humans, CHRONIC DISEASE, Human medicine, Geriatrics and Gerontology, Family Practice, Life Sciences & Biomedicine, qualitative research, INTERVENTIONS
Abstract

Background Coping with a chronic disease can be really challenging. Self-management represents a promising strategy to improve daily life experiences. The role of primary healthcare professionals cannot be underestimated in supporting self-management. Due to a shortage of theory, implementation of self-management support is hindered in primary care practice. The aim of this study is to create a conceptual model for self-management support by analysing patients’ care experiences towards self-management support. Methods An explorative-descriptive qualitative study was conducted in Flanders, Belgium. Semi-structured interviews were performed with 16 patients and their informal caregiver (dyads) using a purposive sampling strategy and processed by an inductive content analysis, according to Graneheim and Lundman. Results Interviews revealed in-depth insights into patients’ care experiences. A conceptual model was developed for primary care practice, including five fundamental tasks for healthcare professionals - Supporting, Involving, Listening, Coordinating and Questioning (SILCQ) – contributing to the support of self-management of chronic patients. Conclusions This qualitative paper emphasises the use of the SILCQ-model to develop optimal roadmaps and hands-on toolkits for healthcare professionals to support self-management. The model needs to be further explored by all stakeholders to support the development of self-management interventions in primary care practice.

Published
2022
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27. Research update for articles published in EJCI in 2012

Author

Dullaart, Robin P.F., Al-Daghri, Nasser M., Ashina, Messoud, Bouzas-Mosquera, Alberto, Brunetti, Natale Daniele, Buechler, Christa, Chen, Harn-Shen, Corrales, Juan J., DʼArchivio, Massimo, Cas, Alessandra Dei, Pino, Guadalupe Garcia, Gómez-Abril, Segundo A., Györi, Dávid, Haslacher, Helmuth, Herder, Christian, Kerstens, Michiel N., Koutsilieris, Michael, Lombardi, Carlo, Lupattelli, Graziana, Mócsai, Attila, Msaouel, Pavlos, Orfao, Alberto, Ormazabal, Paulina, Pacher, Richard, Perkmann, Thomas, Peteiro, Jesús, Plischke, Max, Reynaert, Niki L., Ricci, Maria Anastasia, Robles, Nicolás Roberto, Rocha, Milagros, Rutten, Erica P.A., Sabico, Shaun, Santamaria, Francesca, Santoro, Francesco, Schmid, Andreas, Schmidt, Morten, Schytz, Henrik Winther, Shyu, Kou-Gi, Tada, Hayato, Thorand, Barbara, Valerio, Giuliana, Vesely, David L., Wu, Tzu-En, Yamagishi, Masakazu, and Yeh, Yao-Tsung

Published
2014
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29. Goal-oriented care for patients with chronic conditions or multimorbidity in primary care: A scoping review and concept analysis

Author

Boeykens, Dagje, Boeckxstaens, Pauline, De Sutter, An, Lahousse, Lies, Pype, Peter, DE VRIENDT, Patricia, Van de Velde, Dominique, Prazeres, Filipe, Remmen, Roy, Verté, Emily, Sirimisi, Muhammed Mustafa, Van Bogaert, Peter, De Loof, Hans, Van den Broeck, Kris, Anthierens, Sibyl, Huybrechts, Ine, Raeymaeckers, Peter, Buffel, Veerle, Devroey, Dirk, Aertgeerts, Bert, Schoenmakers, Birgitte, Timmermans, Lotte, Foulon, Veerle, Declerq, Anja, Verhaeghe, Nick, Van Hecke, Ann, Decat, Peter, Roose, Rudi, Martin, Sandra, Rutten, Erica, Pless, Sam, Gauwe, Vanessa, Reynaert, Didier, Van Landschoot, Leen, Lopez Hartmann, Maja, Claeys, Tony, Vandenhoudt, Hilde, De Vliegher, Kristel, Op de Beeck, Susanne, Mental Health and Wellbeing research group, Gerontology, Frailty in Ageing, and Primary Care Academy

Subjects
Patients, Systematic Reviews, Science, Health Care Providers, Decision Making, Social Sciences, COMMUNICATION, Research and Analysis Methods, PERSON-CENTERED CARE, Cognition, Physicians, GENERAL-PRACTICE, Medicine and Health Sciences, QUALITY, Psychology, Drug Interactions, Medical Personnel, OLDER-ADULTS, Primary Care, Pharmacology, Measurement, Multidisciplinary, CONSULTATIONS, MULTIPLE CHRONIC CONDITIONS, Cognitive Psychology, Multimorbidity, Biology and Life Sciences, Research Assessment, chronic, Health Care, Psychiatry and Mental health, Professions, HEALTH-CARE, People and Places, Medicine, CHRONIC DISEASE, Cognitive Science, Engineering and Technology, Population Groupings, Human medicine, Geriatrics and Gerontology, SHARED DECISION-MAKING, Research Article, Neuroscience
Abstract

Background The healthcare system is faced by an ageing population, increase in chronic conditions and multimorbidity. Multimorbid patients are faced with multiple parallel care processes leading to a risk of fragmented care. These problems relate to the disease-oriented paradigm. In this paradigm the treatment goals can be in contrast with what patients value. The concept of goal-oriented care is proposed as an alternative way of providing care as meeting patients’ goals could have potential benefits. Though, there is a need to translate this concept into tangible knowledge so providers can better understand and use the concept in clinical practice. The aim of this study is to address this need by means of a concept analysis. Method This concept analysis using the method of Walker and Avant is based on a literature search in PubMed, Embase, Cochrane Library, PsychInfo, CINAHL, OTSeeker and Web of Science. The method provides eight iterative steps: select a concept, determine purpose, determine defining attributes, identify model case, identify additional case, identify antecedents and consequences and define empirical referents. Results The analysis of 37 articles revealed that goal-oriented care is a dynamic and iterative process of three stages: goal-elicitation, goal-setting, and goal-evaluation. The process is underpinned by the patient’s context and values. Provider and patient preparedness are required to provide goal-oriented care. Goal-oriented care has the potential to improve patients’ experiences and providers’ well-being, to reduce costs, and improve the overall population health. The challenge is to identify empirical referents to evaluate the process of goal-oriented care. Conclusion A common understanding of goal-oriented care is presented. Further research should focus on how and what goals are set by the patient, how this knowledge could be translated into a tangible workflow and should support the development of a strategy to evaluate the goal-oriented process of care.

Published
2020

31. Osteoporosis in COPD

Author

Romme, Elisabeth A.P.M., primary, Smeenk, Frank W.J.M., additional, Wouters, Emiel F.M., additional, and Rutten, Erica P.A., additional

Published
2013
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34. Decreased whole-body and splanchnic glutamate metabolism in healthy elderly men and patients with chronic obstructive pulmonary disease in the postabsorptive state and in response to feeding

Author

Rutten, Erica P.A., Engelen, Marielle P.K.J., Castro, Carmen L.N., Wouters, Emiel F.M., Schols, Annemie M.W.J., and Deutz, Nicolaas E.P.

Subjects
Food/cooking/nutrition
Abstract

Decreased plasma and muscle glutamate concentrations have been observed in patients with chronic obstructive pulmonary disease (COPD), suggesting disturbances in glutamate metabolism. The present study was conducted to further examine glutamate metabolism in 8 male COPD patients (68 [+ or -] 4 y) by measurement of whole-body (WB) glutamate production and splanchnic glutamate extraction in the postabsorptive state as well as in response to feeding. Because COPD is particularly prevalent in the elderly and aging per se may also affect glutamate metabolism, 2 male control groups were included: 8 healthy elderly (63 [+ or -] 3 y) and 8 young (22 [+ or -] 1 y) subjects. On 2 test days, the stable isotope L-[sup.15]N-glutamate was infused i.v. or enterally according to a primed constant and continuous infusion protocol. After 90 min of infusion, subjects ingested a carbohydrateprotein drink (28% milk protein, 72% maltodextrin) every 20 min for 2 h. Arterialized-venous blood samples were taken at the end of the postabsorptive and feeding periods. Postabsorptive WB glutamate production and splanchnic glutamate extraction were significantly lower in the elderly and COPD patients than in the young (P < 0.01). Feeding further decreased WB endogenous glutamate production in the elderly and COPD patients, with COPD patients tending (P = 0.07) to have a greater decrease. Splanchnic glutamate extraction increased during feeding in the elderly (P < 0.05) but did not change in COPD patients. In conclusion, aging reduces postabsorptive WB endogenous glutamate production and splanchnic glutamate extraction. COPD does not affect postabsorptive WB glutamate metabolism but may influence splanchnic glutamate metabolism during feeding. KEY WORDS: * glutamate * aging * chronic obstructive pulmonarydisease * postabsorptive and fed states

Published
2005

44. Additional file 2: of Itâ s more than low BMI: prevalence of cachexia and associated mortality in COPD

Author

Merry-Lynn McDonald, Wouters, Emiel, Rutten, Erica, Casaburi, Richard, Rennard, Stephen, Lomas, David, Bamman, Marcas, Bartolome Celli, Agusti, Alvar, Tal-Singer, Ruth, Hersh, Craig, Dransfield, Mark, and Silverman, Edwin

Abstract

Figure S2. Relationship between percent emphysema at baseline and Year 1 with cachexia and weight-loss. (PDF 5 kb)

Published
2019
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45. Additional file 4: of Itâ s more than low BMI: prevalence of cachexia and associated mortality in COPD

Author

Merry-Lynn McDonald, Wouters, Emiel, Rutten, Erica, Casaburi, Richard, Rennard, Stephen, Lomas, David, Bamman, Marcas, Bartolome Celli, Agusti, Alvar, Tal-Singer, Ruth, Hersh, Craig, Dransfield, Mark, and Silverman, Edwin

Abstract

Table S1. Characteristics of ECLIPSE Study COPD cases stratified by BMI category. Continuous variables (age, FEV1pp) are represented by median (IQR). * indicates Pâ

Published
2019
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48. Additional file 5: of Itâ s more than low BMI: prevalence of cachexia and associated mortality in COPD

Author

Merry-Lynn McDonald, Wouters, Emiel, Rutten, Erica, Casaburi, Richard, Rennard, Stephen, Lomas, David, Bamman, Marcas, Bartolome Celli, Agusti, Alvar, Tal-Singer, Ruth, Hersh, Craig, Dransfield, Mark, and Silverman, Edwin

Subjects
respiratory tract diseases
Abstract

Table S2. Relationships between risk of death from any cause with consensus and weight loss (WL) definitions of cachexia including COPD cases who regained weight in COPD cases from ECLIPSE. Significant p-values are bolded. (DOCX 16 kb)

Published
2019
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49. Disease-Specific Comorbidity Clusters in COPD and Accelerated Aging

Author

Triest, Filip J. J., primary, Franssen, Frits M. E., additional, Reynaert, Niki, additional, Gaffron, Swetlana, additional, Spruit, Martijn A., additional, Janssen, Daisy J. A., additional, Rutten, Erica P. A., additional, Wouters, Emiel F. M., additional, and Vanfleteren, Lowie E. G. W., additional

Published
2019
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50. Body mass index change in gastrointestinal cancer and chronic obstructive pulmonary disease is associated with Dedicator of Cytokinesis 1

Author

McDonald, Merry-Lynn Noelle, Won, Sungho, Mattheisen, Manuel, Castaldi, Peter J, Cho, Michael H, Rutten, Erica, Hardin, Megan, Yip, Wai-Ki, Rennard, Stephen I, Lomas, David A, Wouters, Emiel FM, Agusti, Alvar, Casaburi, Richard, Lange, Christoph P, O'Connor, George, Hersh, Craig P, and Silverman, Edwin K

Subjects
Adult, Male, Chronic Obstructive, Cachexia, Physiology, Clinical Sciences, Body Mass Index, Pulmonary Disease, BMI, Humans, COPD, GWAS, Genetic Predisposition to Disease, Longitudinal Studies, Polymorphism, Genetic Association Studies, Gastrointestinal Neoplasms, Aged, Cancer, Single Nucleotide, Human Movement and Sports Sciences, Middle Aged, rac GTP-Binding Proteins, Longitudinal, Female, Genome-Wide Association Study
Abstract

BackgroundThere have been a number of candidate gene association studies of cancer cachexia-related traits, but no genome-wide association study (GWAS) has been published to date. Cachexia presents in patients with a number of complex traits, including both cancer and COPD. The objective of the current investigation was to search for a shared genetic aetiology for change in body mass index (ΔBMI) among cancer and COPD by using GWAS data in the Framingham Heart Study.MethodsA linear mixed effects model accounting for age, sex, and change in smoking status was used to calculate ΔBMI in participants over 40 years of age with three consecutive BMI time points (n = 4162). Four GWAS of ΔBMI using generalized estimating equations were performed among 1085 participants with a cancer diagnosis, 204 with gastrointestinal (GI) cancer, 112 with lung cancer, and 237 with COPD to test for association with 418 365 single-nucleotide polymorphisms (SNPs).ResultsTwo SNPs reached a level of genome-wide significance (P

Published
2017

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