[The effects of physical training on the body composition of patients with COPD]. / Die Auswirkungen von Sport auf die Körperzusammensetzung von COPD-Patienten.

AIM: The following controlled trial was conducted to determine the positive effects of exercise on the body composition of patients suffering from COPD. METHODS: A group consisting of 23 COPD patients who regularly participated in a guided exercise programme was compared with a control group consisting of 19 COPD patients who did not exercise. The relative changes of body mass index (BMI), body cell mass in % [BCM-(%)], extra cellular mass/body cell mass index (ECM/BCM index) and phase angle (angle between sinus current and sinus voltage) after 6 months and after one year were analysed for statistical differences. The values of BMI, BCM-(%), ECM/BCM index and phase angle at the beginning of the study were compared with the results during the course of the 18 months training merely within the exercising group. The body composition of the patients was determined with the help of the bioelectric impedance analysis (BIA) using the system "Nutriguard M" produced by "Data Input". RESULTS: Significantly raised phase angle values as well as significantly increased BCM-(%) values and a decreased ECM/BCM index were found in the group of patients who exercised compared with the COPD patients who did not exercise. While there were no differences concerning the BMI value, significant increases in BCM-(%) and phase angle and a significant decrease of the ECM/BCM index could be detected within the group that had been exercising. The best values were recorded after 6 months of exercising. The differences of the group responses resulted from a worsening of the body composition in the control group rather than from improvements in the exercise group. CONCLUSION: Physical exercise can improve or at least stabilise the body composition of COPD patients and should be recommended.

[Damage to the respiratory tract due to aspirated alendronate]. / Schädigung des Respirationstrakts durch aspiriertes Alendronat.

We describe the rare case of a high-grade chemical irritating-toxic damage to the larynx, the trachea and the bronchial system due to the aspiration of the bisphosphonate alendronate. The aspiration of alendronate was caused by oropharyngeal dysphagia. The 68-year-old female patient was sent to hospital with increasing hoarseness and a tormenting continuous cough of high intensity. X-Ray pictures of the thorax showed dystelectasis of the right middle lobe. Severe damage to the bronchial system caused by the aspirated alendronate was demonstrated by flexible bronchoscopy. Anti-obstructive, antiphlogistic and antibiotic treatment led to a gradual improvement of the symptoms. The administration of alendronate should be avoided in cases of dysphagia. Besides the danger of oesophageal injury, there is also the risk of aspiration that can be associated with severe damage to the bronchial system as this case study demonstrates.