Background: Adults living with Chronic Obstructive Pulmonary Disease (COPD) often have difficulties when trying to access health care services. Interactive communication technologies are a valuable tool to enable patients to access supportive interventions to cope with their disease. The aim of this revision and meta-analysis is to analyze the content and efficacy of web-based supportive interventions in quality of life in COPD. Methods: Medline (via PubMed), Web of Science, and Scopus were the databases used to select the studies for this systematic review. A screening, analysis, and assessment of the methodological quality was carried out by two independent researchers. A meta-analysis of the extracted data was performed. Results: A total of 9 of the 3089 studies reviewed met the inclusion criteria. Most repeated web content elements were educational and involved communication with healthcare professional content. Finally, seven of the nine studies were included in a quantitative analysis. Web-based supportive interventions significantly improved quality of life when added to usual care (SMD = −1.26, 95% CI = −1.65, −0.86; p < 0.001) but no significant differences were found when compared with an autonomous pedometer walking intervention (p = 0.64) or a face-to-face treatment (p = 0.82). Conclusion: This systematic review and meta-analysis suggests that web-based supportive interventions may complement or accompany treatments in COPD patients due to the advantages of online interventions. The results obtained should be treated with caution due to the limited number of studies in this area and methodological weaknesses.

The main objective of this study is to determine the relationship between physical activity (PA) level prior to hospitalization and the pulmonary symptomatology, functionality, exercise capacity, and strength of acute exacerbated chronic obstructive pulmonary disease (COPD) patients. In this observational study, all data were taken during the patient’s first day in hospital. Patients were divided into two groups (a PA group, and a physical inactivity (PI) group), according to the PA level evaluated by the Baecke questionnaire. Cough status was evaluated by the Leicester Cough Questionnaire (LCQ), and dyspnea was assessed using the modified Medical Research Council dyspnea scale (mMRC). Functionality was measured by the Functional Independence Measure (FIM) and the London Chest Activity of Daily Living scale (LCADL). Exercise capacity was evaluated by the two-minute step-in-place (2MSP) test, and strength assessed by dynamometry. A total of 151 patients were included in this observational study. Patients in the PI group obtained worse results compared to the PA group, and significant differences (p < 0.05) were found in all of the variables. Those COPD patients who regularly perform PA have less dyspnea and cough, as well as better functionality, exercise capacity and strength during an exacerbation, without relationship to the severity of the pathology.

Improvements in diagnosis and treatment of head and neck cancer (HNC) patients have resulted in improved long-term survival rates. However, a variety of symptoms and comorbidities, often secondary ...

Clinical placements are an important part of health students’ training. Whilst much value is placed on the clinical environment as a place to learn, there is a paucity of direct evidence about its effectiveness. The aim of this study was to compare the competence, importance, and interest in cardiorespiratory physiotherapy of students before and after one month of clinical practice. A pre- and post-placement questionnaire about students’ interest in different physiotherapy subspecialties was used. The students with a cardiorespiratory clinical placement showed a significant change in their perception about the importance of the cardiorespiratory specialty (0.348 ± 1.01; p < 0.001), while no significant change was observed in the students without cardiorespiratory placement (−0.014 ± 0.825; p = 0.883). The presence or absence of clinical placements seems to have a definitive impact on students’ choice of a specialty. This implies the need for developing a set of clinical placements in all the subareas of physiotherapy in order to give undergraduate students the opportunity to make a better decision.

Introduction: Malignant pleural effusion (MPE) is one of the most common forms of pleural effusion and is defined as the presence of neoplastic cells in the pleural fluid. The prevalence is high, affecting up to 150,000 people in the United States. MPE patients9 prognosis is variable and depends on several factors. Psychological distress is defined as a multifactorial emotional experience that can include feelings of vulnerability, sadness and fear. Previous studies have reported an association between psychological distress and physical outcomes in patients with cancer, however, there are limited data about its relationship with MPE prognosis. Objective: To determine whether psychological distress is associated with symptom burden in patients with MPE. Methods: A longitudinal observational prospective cohort study was carried out in the University Hospital Complex in Granada, Spain. Patients diagnosed with MPE were recruited and divided into two groups depending on the presence of psychological distress. All patients were evaluated at hospital admission and at discharge. Outcome measures included symptom burden: dyspnoea (Borg scale), pain (Visual Analogue Scale) and cough (Leicester Cough Questionnaire). Results: 68 MPE patients were included in the study. Significant differences were found between groups in symptoms at discharge, with worse results in the group with psychological distress: dyspnoea (p=0.027), pain (p=0.013) and cough (p=0.009). Conclusion: Symptom burden at discharge, in patients with MPE, could be associated to the presence of psychological distress. Patients with psychological distress present a worse recovery, with more dyspnea, pain and cough.

Introduction: The clinical relevance of physical activity during hospitalization following lung resection remains unknown. Objective: To evaluate the relationship between the number of in-patient steps after lung surgery and the symptoms, sleep quality and health status at discharge and one month after surgery. Methods: We carried out an observational prospective cohort study, including 73 patients who underwent lung resection in the Thoracic Surgery Service of the “Hospital Virgen de las Nieves” (Granada). The number of steps was measured using a triaxial accelerometer. The sleep quality (Pittsburg sleep quality index), the severity of symptoms and health status (Euroqol-5 dimensions) of the patients included in the study were examined at discharge and one month after surgery. Symptoms included dyspnea (Borg modified scale), fatigue (Fatigue Severity Scale) and pain (Brief Pain Inventory). Results: Of the 73 patients, there were 35 cases that were active and 38 that were classified as sedentary. The mean number of steps walked during three in-patient days was 523±2.267 and 6.689±3.256 (p<0.001), for sedentary and active group respectively. The sleep quality and health status presented worse results in the sedentary group at discharge and in the follow-up (p<0.05). The symptoms scores on sedentary group at discharge and in the follow-up were significantly worse for dyspnea, fatigue and pain (p< 0.05). The correlation analysis shows significant correlations (r<0.500) between in-patient steps per day and clinical impact at one month follow-up after surgery. Conclusions: In-patient step count may be relevant during hospitalization and within the first month following lung resection surgery.