Objective: To evaluate the effectiveness of 12-week nutritional support using oral dietary supplements containing whey peptides and BCAA on inflammation and nutrition status in patients with chronic obstructive pulmonary disease (COPD) undergoing pulmonary rehabilitation.

Subjects and methods: Thirty-five stable COPD patients who were undergoing pulmonary rehabilitation were divided into the supplemented group and the non-supplemented control group in an open-label controlled trial. Of the 35 patients, 23 were included in per protocol set analysis. Primary outcomes were levels of the systemic inflammatory markers TNF-α, IL-6, IL-8, and CRP and the nutritional marker serum albumin. Secondary outcomes were transthyretin level, transferrin level, body composition, respiratory function, respiratory muscle strength, 6-minute walk-test distance, muscle strength, and quality of life (QOL).

Results: The supplemented group showed significantly greater changes from baseline in serum albumin level(primary outcome)and body composition, transthyretin level, transferrin level, muscle strength, and QOL (secondary outcomes), as well as significant improvement in scores on the COPD Assessment Test and St. George's Respiratory Questionnaire,[[not in the Japanese abstract]] than in the non-supplemented control group.

Conclusion: This study showed that the nutritional support provided improved serum albumin level, a nutritional marker, in COPD patients.

Objective: The aim of this study was to investigate the methods used for maintenance of percutaneous endoscopic gastrostomy (PEG) catheters by nurses and the catheter replacement intervals in hospitals and facilities covered by long-term care insurance in Japan.

Subjects and methods: A questionnaire was sent to nurses at 2,000 randomly selected hospitals and facilities covered by long-term care insurance.

Results: A total of 287 facilities that used PEG catheters responded. The most common mean catheter replacement interval was 1 month or longer for the balloon type and 4 months or longer for the bumper type. Filling unused catheters with water was a common method for preventing contamination and blockage, while flushing catheters with water was commonly regarded as effective for removing contaminants. Facilities that replaced balloon-type catheters at 1 month or longer were significantly more likely to employ a part-time certified nutritionist than facilities that exchanged them within 1 month (p=0.02).

Conclusion: Allocation of an appropriate number of nutritionists who work cooperatively with nurses can extend PEG catheter use. Also, filling the catheters with water when unused and flushing them with water when contaminated are commonly used measures in PEG catheter management.