Browsing by Author "Moita, J"
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- A importância da dispneia no diagnóstico da doença pulmonar obstrutiva crónica: uma análise descritiva de uma coorte estável em Portugal (ensaio clínico SAFE)Publication . Bárbara, C; Moita, J; Cardoso, J; Costa, R; Redondeiro, R; Gaspar, MIntrodução: Este estudo teve como objectivo determinar os principais sintomas percepcionados pelos doentes com doença pulmonar obstrutiva crónica (DPOC) numa coorte de doentes que participaram num grande ensaio clínico, que avaliou o tiotrópio e que decorreu em Portugal. População e métodos: A caracterização dos sintomas, no momento de avaliação basal dos doentes foi efectuada através do recurso a um questionário padronizado. Os doentes foram inquiridos quanto aos principais sintomas que tinham levado ao diagnóstico e também quanto ao sintoma actual mais problemático. Resultados: Os resultados foram obtidos de 298 doentes, maioritariamente masculinos (95%), que apresentavam, uma média (desvio padrão) de volume expiratório forçado no primeiro segundo basal de 1,1 (0,4) L (40,6 [13.3] % do valor preditivo), uma duração média da doença de 14,4 (10,1) anos e uma carga tabágica de 55,1 (25,3) unidades maço ano. A dispneia foi o sintoma mais frequentemente reportado, como tendo sido o sintoma que levou ao diagnóstico da doença (55,0% de doentes), seguindo-se-lhe a tosse (33,2%). A dispneia foi também o sintoma actual mais problemático (82,6%), seguindo-se-lhe também a tosse (8,4%). A presença de dispneia ou tosse foi independente da gravidade da DPOC. As comorbilidades mais frequentemente reportadas foram as doenças cardiovasculares (49% dos doentes), gastrointestinais (20%) e metabólicas (16%), principalmente a diabetes mellitus.
- The importance of dyspnoea in the diagnosis of chronic obstructive pulmonary disease: a descriptive analysis of a stable cohort in Portugal (SAFE Trial)Publication . Bárbara, C; Moita, J; Cardoso, J; Costa, R; Redondeiro, R; Gaspar, MINTRODUCTION: The aim of this study was to determine patient-perceived characteristics of chronic obstructive pulmonary disease (COPD) in patients participating in a large trial evaluating tiotropium bromide. PATIENTS AND METHODS: Baseline symptoms were assessed by means of a standardized questionnaire. Patients reported symptoms that led to diagnosis as well as their current most troublesome symptom. RESULTS: Data were obtained from 298 patients, mostly male (95%), with mean (standard deviation) baseline forced expiratory volume in 1 second of 1.1 (0.4) L (40.6 [13.3] % of predicted), mean disease duration of 14.4 (10.1) years and smoking history of 55.1 (25.3) pack-years. Dyspnoea was the most frequently reported symptom leading to COPD diagnosis (55.0% of patients), followed by cough (33.2%). Dyspnoea was also the current most troublesome symptom (82.6%), followed by cough (8.4%). The presence of dyspnoea or cough was independent of COPD severity. The most commonly reported co-morbidities were cardiovascular disorders (49% of patients), gastrointestinal disorders (20%) and metabolic disorders (16%), mainly diabetes mellitus. CONCLUSIONS: This analysis confirms the importance of dyspnoea as the most common symptom leading to initial COPD diagnosis and the symptom most troublesome to patients. Co-morbidities are common among COPD patients, and hence spirometric testing is appropriate in a patient who presents with dyspnoea associated with such a condition.
- Tiotropium improves FEV1 in patients with COPD irrespective of smoking statusPublication . Moita, J; Bárbara, C; Cardoso, J; Costa, R; Sousa, M; Ruiz, J; Santos, MLThis study evaluated whether the effect of tiotropium on the change in trough forced expiratory volume in 1s (FEV1), vs. placebo, is affected by smoking status. In a 3-month, double-blind study in 31 centres in Portugal, 311 (289 completed) patients were randomised to tiotropium 18 microg once daily or placebo. Baseline mean (standard deviation (SD)) FEV1 was 1.11 (0.39) l in the tiotropium group and 1.13 (0.39) l in the placebo group. Patients had an average smoking history of 55 (25.7) pack-years; 80 (26%) were smokers and 224 (74%) were ex-smokers. The primary end-point was change in morning pre-dose (i.e. trough) FEV1 after 12 weeks. Trough FEV1 at 12 weeks was significantly improved with tiotropium vs. placebo: the difference in means was 102 ml, P=0.0011, 95% confidence interval (CI) (41, 164). The difference in means in smokers was 138 ml, P=0.0105, CI (32, 244); in ex-smokers it was 66 ml, P=0.0375, CI (3, 129). The difference between smokers and ex-smokers was not statistically significant (P=0.6982) and may be due to greater variability and differences in disease severity. The significant improvement in lung function in patients treated with tiotropium vs. placebo in both smokers and ex-smokers suggests that tiotropium is an effective and well-tolerated therapy in chronic obstructive pulmonary disease (COPD), regardless of smoking status.