LONGZIEKTEN Pubmed artikelen Concerns About Exercise Are Related to Walk Test Results in Pulmonary Rehabilitation for Patients with COPD. Fischer MJ, Scharloo M, Abbink J, van ‘t Hul A, van Ranst D, Rudolphus A, Weinman J, Rabe KF, Kaptein AA. Int J Behav Med. 2012, 19:39–47. PMID: 21080250. BACKGROUND: Although international guidelines on pulmonary rehabilitation acknowledge that psychological factors contribute to exercise intolerance in patients with chronic obstructive pulmonary disease (COPD), the few empirical studies investigating this association have found inconsistent results. PURPOSE: The purpose of this study is to investigate whether negative affect and beliefs about exercise of patients with COPD would be related to baseline 6-min walk (6-MW) test results in a pulmonary rehabilitation setting, after correction for physical variables (sex, age, height, weight, and lung function). A second aim was to examine whether patients’ beliefs are associated with treatment outcomes, as measured by an improvement in 6-MW distance. METHOD: A 12-week pulmonary rehabilitation program was completed by 166 patients. Beliefs (perceived necessity and concerns) about exercise and negative affect were assessed by a questionnaire. Clinical data were obtained from medical records. RESULTS: Baseline 6-MW distance was positively related to younger age, male gender, better pulmonary function, and having fewer concerns about exercise. After rehabilitation, patients had increased their walk distance by 12% (32 m), on average. Baseline physiological and psychological variables were unrelated to patients’ response to treatment (increase in walk distance). However, subgroup analysis showed that for patients with mild to moderate airflow obstruction, concerns about exercise were negatively related to response to treatment. CONCLUSION: We conclude that patients’ beliefs about the negative consequences of exercise are associated with baseline 6-MW test performance and response to treatment for patients with mild to moderate COPD. We recommend that patients’ concerns about exercise are discussed and, if necessary, corrected during the intake phase. Morbidly obese human subjects have increased peripheral blood CD4+ T cells with skewing toward a Treg- and Th2-dominated phenotype. van der Weerd K, Dik WA, Schrijver B, Schweitzer DH, Langerak AW, Drexhage HA, Kiewiet RM, van Aken MO, van huisstede A, van Dongen JJ, van der Lelij AJ, Staal FJ, van Hagen PM. Diabetes. 2012 Feb;61(2):401-8. Epub 2012 Jan 6. PMID: 22228716. PMCID: PMC3266399.Free PMC Article. 56 Obesity is associated with local T-cell abnormalities in adipose tissue. Systemic obesityrelated abnormalities in the peripheral blood T-cell compartment are not well defined. In this study, we investigated the peripheral blood T-cell compartment of morbidly obese and lean subjects. We determined all major T-cell subpopulations via six-color flow cytometry, including CD8+ and CD4+ T cells, CD4+ T-helper (Th) subpopulations, and natural CD4+CD25+FoxP3+ T-regulatory (Treg) cells. Moreover, molecular analyses to assess thymic output, T-cell proliferation (T-cell receptor excision circle analysis), and T-cell receptor-β (TCRB) repertoire (GeneScan analysis) were performed. In addition, we determined plasma levels of proinflammatory cytokines and cytokines associated with WETENSCHAPPELIJK jaarverslag 2012 Pagina 55
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