Browsing by Author "Fonseca, Jorge"
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- Addressing ageism : be active in aging: study protocolPublication . Fernandes, Júlio Belo; Ramos, Catarina; Domingos, Josefa; Castro, Cidália; Simões, Aida; Bernardes, Catarina; Fonseca, Jorge; Proença, Luís; Grunho, Miguel; Moleirinho-Alves, Paula; Simões, Sérgio; Sousa-Catita, Diogo; Vareta, Diana Alves; Godinho, CatarinaAgeism refers to stereotyping (how we think), prejudice (how we feel), and discrimination (how we act) against people based on their age. It is a serious public health issue that can negatively impact older people’s health and quality of life. The present protocol has several goals: (1) adapt the Ambivalent Ageism Scale for the general Portuguese population and healthcare professionals; (2) assess the factorial invariance of the questionnaire between general population vs. healthcare professionals; (3) evaluate the level of ageism and its predictors in the general population and evaluate the level of ageism and its predictors in healthcare professionals; (4) compare the levels of ageism between groups and the invariance between groups regarding the explanatory model of predictors of ageism. This quantitative, cross-sectional, descriptive, observational study will be developed in partnership with several Healthcare Professional Boards/Associations, National Geriatrics and Gerontology Associations, and the Universities of the Third Age Network Association. The web-based survey will be conducted on a convenience sample recruited via various social media and institutional channels. The survey consists of three questionnaires: (1) Demographic data; (2) Ambivalent Ageism Scale; (3) Palmore-Neri and Cachioni questionnaire. The methodology of this study will include translation, pilot testing, semantic adjustment, exploratory and confirmatory factor analysis, and multigroup analysis of the Ambivalent Ageism Scale. Data will be treated using International Business Machines Corporation (IBM®) Statistical Package for the Social Sciences (SPSS) software and Analysis of Moment Structures (AMOS). Descriptive analysis will be conducted to assess the level of ageism in the study sample. The ageism levels between the two groups will be compared using the t-student test, and two Structural Equation Modeling will be developed to evaluate the predictors of ageism. Assessing ageism is necessary to allow healthcare professionals and policymakers to design and implement strategies to solve or reduce this issue. Findings from this study will generate knowledge relevant to healthcare and medical courses along with anti-ageism education for the Portuguese population.
- Bleeding and starving: fasting and delayed refeeding after upper gastrointestinal bleedingPublication . Fonseca, Jorge; Meira, Tânia; Nunes, Ana; Santos, Carla Adriana"Context - Early refeeding after nonvariceal upper gastrointestinal bleeding is safe and reduces hospital stay/costs. Objective - The aim of this study was obtaining objective data on refeeding after nonvariceal upper gastrointestinal bleeding. Methods - From 1 year span records of nonvariceal upper gastrointestinal bleeding patients that underwent urgent endoscopy: clinical features; rockall score; endoscopic data, including severity of lesions and therapy; feeding related records of seven days: liquid diet prescription, first liquid intake, soft/solid diet prescription, first soft/solid intake. Results - From 133 patients (84 men) Rockall classification was possible in 126: 76 score ≥5, 50 score <5. One persistent bleeding, eight rebled, two underwent surgery, 13 died. Ulcer was the major bleeding cause, 63 patients underwent endoscopic therapy. There was 142/532 possible refeeding records, no record 37% patients. Only 16% were fed during the first day and half were only fed on third day or later. Rockall <5 patients started oral diet sooner than Rockall ≥5. Patients that underwent endoscopic therapy were refed earlier than those without endotherapy. Conclusions - Most feeding records are missing. Data reveals delayed refeeding, especially in patients with low-risk lesions who should have been fed immediately. Nonvariceal upper gastrointestinal bleeding patients must be refed earlier, according to guidelines."
- Comparing assessment tools as candidates for personalized nutritional evaluation of senior citizens in a nursing homePublication . Sousa-Catita, Diogo; Bernardo, Maria Alexandra; Santos, Carla Adriana; Silva, Maria Leonor; Mascarenhas, Paulo; Godinho, Catarina; Fonseca, JorgeNutrition is an important health issue for seniors. In nursing homes, simple, inexpensive, fast, and validated tools to assess nutritional risk/status are indispensable. A multisurvey cross-sectional study with a convenient sample was created, comparing five nutritional screening/assessment tools and the time required for each, in order to identify the most useful instrument for a nursing home setting. Nutrition risk/status was evaluated using the following tools: Subjective Global Assessment (SGA), Mini Nutritional Assessment Short Form (MNA-SF), Malnutrition Universal Screening Tool (MUST), Nutritional Risk Screening 2002 (NRS 2002), and calf girth (CG). The time spent completing each tool was recorded. Eighty-three subjects were included. MNA-SF and CG were the screening tools that ranked highest with regards to malnutrition identification. CG failed to identify nutritional risk/malnutrition in seniors with lower limb edema. CG was the fastest tool while SGA was the slowest. This was the first study comparing non-invasive nutritional tools with time expended as a consideration in the implementation. CG is responsive, fast, and reliable in elders without edema. MNA-SF was more efficient at detecting malnutrition cases in the elderly population. Both MNA-SF and CG are considered the most suitable for the nursing home setting.
- Gastric outlet obstruction: an unusual adverse event of percutaneous endoscopic gastrostomyPublication . Barosa, Rita; Santos, Carla; Fonseca, JorgeLetter to the Editor
- Gut status in Parkinson’s disease: the GutSPark protocolPublication . Grunho, Miguel; Godinho, Catarina; Matos, António Alves de; Barroso, Helena; Carregosa, Ricardo; Marx, Frederico; Tomé, Morgane; Domingos, Josefa; Sousa-catita, Diogo; Botelho, João; Machado, Vanessa; Mendes, José João; Outeiro, Tiago; Fonseca, JorgeThe neuropathological hallmark of Parkinson’s disease (PD) is the accumulation of alpha–synuclein (AS) aggregates. The identification of AS aggregates in gut biopsy specimens from people with PD may provide an opportunity to identify PD at a very early stage, prior to symptom onset. Changes in gut microbiota and inflammatory conditions (such as periodontitis) may be linked with PD onset/evolution. This project aims to explore the concept of microbiota–gut–brain axis in PD, studying gut biopsy specimens for AS aggregates, oral and intestinal microbiota, associated digestive disorders and oral health, of both patients with PD and controls.
- Inflammatory bowel disease, alpha-synuclein aggregates and Parkinson’s disease: the InflamaSPark protocolPublication . Grunho, Miguel; Godinho, Catarina; Patita, Marta; Mocanu, Irina; Vieira, Ana Isabel; De Matos, António; Carregosa, Ricardo; Marx, Frederico; Tomé, Morgane; Sousa-Catita, Diogo; Proença, Luís; Outeiro, Tiago; Fonseca, JorgeThe hallmark of Parkinson’s disease (PD) is the accumulation of alpha-synuclein (AS) aggregates. Prior to the central nervous system involvement, PD establishes itself in the gut as a result of the complex interplay between microbiota, the host’s immune/neural systems and increased intestinal permeability. Inflammatory Bowel Disease (IBD) patients present a higher number of AS aggregates in the intestinal wall and an increased risk of developing PD. By studying AS aggregates in gut biopsy specimens of IBD patients and controls, this project aims to further clarify the pathophysiology of PD and to explore the potential of gut a biopsy for AS aggregates as a biomarker for prodromal PD.
- Long-term intestinal failure and home parenteral nutrition: a single center experiencePublication . Padinha, Mafalda; Oliveira, Cátia; Carlos, Sandra; Santos, Ana Paula; Brito, Marta; Santos, Carla Adriana; Fonseca, JorgeIntestinal failure is the reduction in gut function below the minimum necessary for the absorption of macronutrients and/or water electrolytes. The based treatment for type II and III intestinal failure patients is home parenteral nutrition (HPN) and hydration (HPH). This is a case-series study of HPN/HPH patients of the Hospital Garcia de Orta, Portugal, where thirteen patients present different underlying disorders and various IVS needs of nutrition and/or hydration. Most presented type III failure and most of them survived a long period under HPN and/or HNH.
- Malnutrition and clinical outcome of 234 head and neck cancer patients who underwent percutaneous endoscopic gastrostomyPublication . Fonseca, Jorge; Santos, Carla Adriana; Brito, JoséHead and neck cancer (HNC) patients who underwent percutaneous endoscopic gastrostomy (PEG) present malnutrition risk and speech impairments. Their assessment relies on objective anthropometric/laboratory data. Focusing on HNC PEG patients, our aims were to evaluate: 1) outcome; 2) nutritional status when the patients underwent PEG; and 3) association of nutritional status/outcome, creating a survival predictive model. We evaluated the outcome based on NRS 2002, dietary assessment, body mass index (BMI), mid-upper arm circumference (MUAC), triceps skinfold thickness (TSF), mid-arm muscle circumference (MAMC), albumin, transferrin, and cholesterol on the day of gastrostomy. Using BMI, TSF, MAMC, and laboratory data, a survival predictive model was created. Of the 234 patients (cancer stages III–IV), 149 died, 33 were still PEGfed, and 36 resumed oral intake (NRS-2002 3, caloric needs <50% in all). BMI was 12.7–43. 189, 197, and 168 patients displayed, respectively, low MUAC, TSF, and MAMC. 91, 155, and 119 patients displayed low albumin, transferrin, and cholesterol. Albumin, cholesterol, and transferrin were strongly associated with the outcome. A predictive model was created, discriminating between short-term survivors (<4 months) and long-term survivors. HNC patients were malnourished. Using anthropometric/laboratory parameters, a predictive model provides discrimination between patients surviving PEG for <4 months and long-term survivors. Teams taking care of PEG patients may provide special support to potential short-term survivors.
- Manifestações orais da colite ulcerosaPublication . Laranjeira, Nuno; Valido, Sara; Fonseca, Jorge; Coutinho, Ricardo; Leitão, JorgeA Doença Inflamatória Intestinal (DII) apresenta uma etiologia ainda desconhecida e abrange uma gama de entidades clínicas cuja especificidade principal passa pela inflamação crónica do tubo digestivo em diferentes localizações, sendo a Colite ulcerosa (CU) uma das doenças mais representativas. Os sintomas e a gravidade da CU são determinados através da extensão, da localização e do grau de atividade inflamatória. As manifestações extra-intestinais podem preceder, ser concomitantes ou surgir após as primeiras manifestações intestinais da CU e são importantes para o diagnóstico e o tratamento desta DII. Este artigo tem como objetivo rever a literatura que versa sobre as manifestações orais, nomeadamente a doença periodontal, a cárie e as lesões das mucosas.
- Manifestações orais da Doença de CrohnPublication . Laranjeira, Nuno; Valido, Sara; Coutinho, Ricardo; Fonseca, Jorge; Leitão, JorgeA Doença de Crohn (DC) é uma doença multifatorial, de etiologia ainda desconhecida, que afeta o tubo digestivo. Dada a sua associação a múltiplas manifestações extraintestinais, pode considerar-se uma doença sistémica, passível de atingir os vários órgãos e sistemas do organismo, incluindo a cavidade oral. São inúmeras as manifestações orais referidas na literatura que apresentam uma correlação direta ou indireta com a Doença de Crohn e englobam lesões ao nível periodontal, do tecido dentário e das mucosas. As manifestações orais da doença inflamatória intestinal (DII), onde se engloba a Doença de Crohn, constituem um problema clínico que exige multidisciplinaridade a fim de promover a melhoria de qualidade de vida nestes doentes. Neste artigo de revisão procurou-se averiguar na literatura quais são as manifestações orais que revelam uma maior associação com a doença e se demarcam como características chave para o diagnóstico precoce da DC.
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