Compared with a twice-weekly resistance training program, the combination of once-weekly resistance and once-weekly endurance training not only produced similar gains in maximal strength, 6MWT performance, and quality of life but also produced improvements in muscle power and endurance performance. These findings may have implications for the prescription of resistance and endurance exercise for patients with chronic obstructive pulmonary disease.

BackgroundsAUDIPOC is a nationwide clinical audit that describes the characteristics, interventions and outcomes of patients admitted to Spanish hospitals because of an exacerbation of chronic obstructive pulmonary disease (ECOPD), assessing the compliance of these parameters with current international guidelines. The present study describes hospital resources, hospital factors related to case recruitment variability, patients’ characteristics, and adherence to guidelines.Methodology/Principal FindingsAn organisational database was completed by all participant hospitals recording resources and organisation. Over an 8-week period 11,564 consecutive ECOPD admissions to 129 Spanish hospitals covering 70% of the Spanish population were prospectively identified. At hospital discharge, 5,178 patients (45% of eligible) were finally included, and thus constituted the audited population. Audited patients were reassessed 90 days after admission for survival and readmission rates. A wide variability was observed in relation to most variables, hospital adherence to guidelines, and readmissions and death. Median inpatient mortality was 5% (across-hospital range 0–35%). Among discharged patients, 37% required readmission (0–62%) and 6.5% died (0–35%). The overall mortality rate was 11.6% (0–50%). Hospital size and complexity and aspects related to hospital COPD awareness were significantly associated with case recruitment. Clinical management most often complied with diagnosis and treatment recommendations but rarely (<50%) addressed guidance on healthy life-styles.Conclusions/SignificanceThe AUDIPOC study highlights the large across-hospital variability in resources and organization of hospitals, patient characteristics, process of care, and outcomes. The study also identifies resources and organizational characteristics associated with the admission of COPD cases, as well as aspects of daily clinical care amenable to improvement.

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A transbronchial lung cryobiopsy using a flexible cryoprobe has a good diagnostic yield and might be an alternative to consider in cases of diffuse ILD in which a histologic sample is required for diagnosis. This technique could avoid a large number of surgical biopsies.

The purpose of this study was to determine the potential relationship between muscle power of the lower extremities and the physical activity in older men with chronic obstructive pulmonary disease (COPD). Forty-four men (70.3 ± 6.7 years old) with moderate-to-severe COPD completed the 6-min walk test (6MWT), BODE (body mass index, obstruction, dyspnea, and exercise), a one-repetition maximum strength of the quadriceps femoris (1RM), and muscle power at 50% and 70% 1RM. Physical activity was measured using an accelerometer. The 6MWT was associated with muscle power at 50% 1RM (r = .40; P = .013) but not muscle power at 70% 1RM (r = .24; P = .15) or 1RM (r = .13; P = .44). Light-intensity activity was positively correlated with muscle power at 50% 1RM (r = .52; P = .001). Lower limb muscle power is associated with the 6MWT and light-intensity activities in older men with COPD.

Rhinomanometry is useful to predict the impact of structural nasal modifications on the positive pressure to support decision-making in relation to surgery.

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