This study assessed the degree of smoking cessation advice given by health professionals, before and after their participation in a smoking cessation study using bupropion-sustained release (bupropion SR, Zyban). A total of 690 physicians and nurses who had smoked an average of 10 cigarettes/day over the previous year and were motivated to quit smoking, were randomised in a double-blind manner to receive bupropion SR (days 1-3, 150 mg/day; days 4-49, 150 mg twice daily) or placebo for 7 weeks, with follow-up to week 52. All subjects received regular follow-up and brief motivational support throughout the study. Questions regarding their smoking cessation advice formed part of the study, with the aim of determining whether study participants became more proactive with their smoking cessation advice. A positive shift from baseline to end of study was observed with respect to the advice and support they gave to their smoking patients. These changes were not related to study treatment or current smoking status. An increase in advising patients to quit smoking and in offering cessation counselling was observed. Participation in a smoking-cessation study by physicians and nurses who smoke has a positive effect, regardless of study medication, in smoking cessation advice and counselling given to their patients.

SUMMARYThe aim of this study was to determine theophylline clearance (CO values in adult patients using serum concentrations gathered from routine clinical care. This information was used to estimate an u priori dosing regimen that would permit steady-state concentrations of 5-15 mgllitre, now recommended for the treatment of chronic asthma, and to evaluate the need to establish monitoring strategies when theophylline is given at these lower doses and when it can be expected that almost no adverse effects are likely.Retrospective data from 204 asthmatic and COPD patients, with a total of 517 serum concentrations, were studied. Population pharmacokinetic analysis was performed with the MULTUELS) computer program according to a one-compartment model. The influence of the following factors on theophylline C Z were investigated: body weight (TBW, IBW and LBM) and age as continuous variables, and gender, smoking habit and the presence of congestive heart failure (CHF) as indicator variables. To validate the results of the population pharmacokinetic analysis, a second independent group of 63 patients was studied prospectively.Hypothesis testing to evaluate potentially significant factors produced a final model in which Cl was based on IBW (kg) and age (years), and was reduced by 25% in patients with moderate CHF and increased by 28% in patients who smoked (CI (Iitres/h)=(0-037 IBW-0-006 age) X 1-284 smoke x 0.751 CHF). The variability in CZ, expressed as the coefficient of variation, was 36%.In adult non-smoker and non-CHF patients, application of a maintenance dosing regimen Correspondence: A.

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Background: The Living with COPD (LCOPD), COPD and Asthma Fatigue Scale (CAFS), and COPD and Asthma Sleep Impact Scale (CASIS) are instruments developed to assess the overall impact of chronic obstructive pulmonary disease (COPD) on daily life, fatigue, and sleep impairment, respectively. Objectives: To assess the usefulness of these instruments and to identify factors associated with the concepts they measure. Method: The questionnaires were administered to patients with moderate to severe COPD. Descriptive analyses of sociodemographic and clinical data were performed, and bivariate and multivariate analyses were used to identify factors associated with the overall impact of COPD on patients' lives, fatigue, and sleep impairment. Results: A total of 408 patients was included (mostly males, 91.2%), with an average age of 68 years (SD = 9.3). Statistically significant differences were observed in the scores of the three questionnaires with regard to level of education, presence of chronic cough or expectoration, level of dyspnea, number of exacerbations, physical activity level, presence of depression and anxiety, and number of treatments indicated for COPD. The LCOPD and CAFS questionnaires also discriminated between different levels of airflow obstruction and, in the case of CAFS, age and gender. Linear regression showed that level of dyspnea, physical activity, and presence of anxiety were significantly related to the LCOPD, CAFS and CASIS scores. The presence of depression was significant in the LCOPD and CAFS questionnaires and chronic cough was significant in the CAFS questionnaire. Conclusions: The LCOPD, CAFS, and CASIS instruments are valid and useful in understanding the overall impact of COPD on daily life, fatigue, and sleep impairment in patients with moderate to severe COPD.