Percorrer por autor "Miranda, Ana da Costa"
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- Perfil Terapêutico da Hipertensão na rede Médicos Sentinela : 12 Anos DepoisPublication . Souto, Diana; Simões, José Augusto; Torre, Carla; Mendes, Zilda; Falcão, Isabel Marinho; Ferreira, Fernando; Miranda, Ana da Costa; Dias, Carlos MatiasObjectives: To determine the treatment profile of hypertension in theQPortuguese sentinel practice network and compare the results 12 years after an initial study. Study design: Cross-sectional study Setting: Portuguese sentinel practice network Participants: Hypertensive patients over 18 years of age on the lists of general practitioners in the sentinel practice network who attended a consultation with their physician between June 7, 2010 and December 31, 2010. Results: In 2010, 616 hypertensive patients were included in the study. Between the two periods (1998 and 2010) there was a slight increase in the average age of the participants (62.0 years in 1998 and 64.3 years in 2010), with a higher proportion of female patients in both periods. The meanQaverage duration of hypertension since the time of diagnosis increased significantly (<0.0001). Approximately half of the hypertensive patients presented target organ damage, in both periods with heart disease as the most common lesion. Dyslipidemia, hyperuricemia and diabetes were the most common co-morbid conditions. From 1998 to 2010, the proportion of patients on monotherapy decreased from 47.6% to 30.3%. Angiotensin-converting enzyme inhibitors were the most frequently prescribed drugs for monotherapy in both periods. In 1998, the antihypertensive treatment most frequently prescribed was angiotensin-converting enzyme inhibitors as monotherapy (24.3%). In 2010 the combination of angiotensin receptor blockers with thiazide diuretics was the most common treatment (15.4%). Conclusions: Drugs acting on the renin-angiotensin system were the antihypertensive drugs most frequently prescribed in both periods as monotherapy and in combination with other drugs. The number of antihypertensive drugs prescribed differed between the two periods in relation to the existence and type of co-morbidities.
- Real-world effectiveness of aromatase inhibitors and fulvestrant in HR+/HER2- advanced breast cancer : a snapshot of the last two years before conventional use of CDK 4/6 inhibitors in a Portuguese institutionPublication . Teodoro, Maria Inês; Mayer, Alexandra; Miranda, Ana da Costa; Nunes, Hugo; Costa, Filipa Alves da; Lourenço, AntónioBackground: Monotherapy with aromatase inhibitors and fulvestrant were the standard-of-care for hormone receptor-positive (HR+)/human epidermal growth factor receptor-type2 negative (HER2-) advanced breast cancer, before integration of cyclin-dependent kinase 4/6 inhibitors. Effectiveness data is essential for regulatory action, but little is known about real-world use of aromatase inhibitors and fulvestrant. Methods: A retrospective cohort study was conducted resorting to data from a cancer registry to identify adult women with HR+/HER2- advanced breast cancer exposed to aromatase inhibitors or fulvestrant (31 May 2017–31 March 2019) at the main oncology hospital in Portugal. Cases were updated with follow-up until death or cut-off (31 March 2021) and pseudoanonymized data extracted. Primary outcome was overall survival (OS) and secondary time to treatment failure (TTF), estimated using survival analysis and compared with published trials. Results: 192 patients were distributed by subgroups according to the medicine. Letrozole: OS 30.8 (95% confidence interval (CI) 20.6–41.4); TTF 11.2 (95%CI 8.7–13.7). Exemestane: OS 22.1 (95%CI 9.7–34.6); TTF 6.0 (95%CI 4.1–7.8). Fulvestrant: OS 21.6 (95%CI 16.5–26.7); TTF 5.6 (95%CI 4.5–6.6). Conclusions: Estimated effectiveness (OS) of letrozole and fulvestrant was, respectively, 3.2–3.5 months lower than reported. The clinical meaning seems uncertain and may be explained by a higher proportion of worse prognostic characteristics in patients treated in the real-world.
- Sexual dysfunction in breast cancer survivors: cross-cultural adaptation of the Sexual Activity Questionnaire for use in PortugalPublication . Costa, Filipa Alves da; Ribeiro, Manuel Castro; Braga, Sofia; Carvalho, Elisabete; Francisco, Fátima; Miranda, Ana da Costa; Moreira, António; Fallowfield, Lesley"Introduction: The increasing survivor population of breast cancer has shifted research and practice interests into the impacts of the disease and treatment in quality of life aspects. The lack of tools available in Portuguese to objectively evaluate sexual function led to the development of this study, which aimed to cross-culturally adapt and validate the Sexual Activity Questionnaire for use in Portugal. Material and Methods: The questionnaire was translated and back-translated, refined following face-to-face interviews with seven breast cancer survivors, and then self-administered by a larger sample at baseline and a fortnight later to test validity and reliability. Results: Following cognitive debriefing (n = 7), minor changes were made and the Sexual Activity Questionnaire was then tested with 134 breast cancer survivors. A 3-factor structure explained 75.5% of the variance, comprising the Pleasure, Habit and Discomfort scales, all yielding good internal consistency (Cronbach’s α > 0.70). Concurrent validity with the FACt-An and the BCPT checklist was good (Spearman’s r > 0.65; p-value < 0.001) and reliability acceptable (Cohen’s k > 0.444). The Sexual Activity Questionnaire allowed the identification of 23.9% of sexually inactive women, for whom the main reasons were lack of interest or motivation and not having a partner. Discussion: Patient-reported outcomes led to a more comprehensive and improved approach to cancer, tackling areas previously abandoned. Future research should focus on the validation of this scale in samples with different characteristics and even in the overall population to enable generalizability of the findings. Conclusion: The adapted Sexual Activity Questionnaire is a valid tool for assessing sexual function in breast cancer survivors in Portugal."
- Using cancer registries to supplement clinical trial data and inform regulatory decisionPublication . Costa, Filipa Alves da; Miranda, Ana da Costa