Percorrer por autor "Grunho, Miguel"
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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.
- Consenso Português para o diagnóstico e gestão clínica da demência com corpos de Lewy (PORTUCALE)Publication . Monteiro, Ana; Velon, Ana Graça; Rodrigues, Ana Margarida; Oliveira, Ana; Valadas, Anabela; Nóbrega, Camila; Cruto, Catarina; Neutel, Dulce; Couto, Frederico Simões do; Morgado, Joana; Cerejeira, Joaquim; Ruano, Luís; Grunho, Miguel; Gago, Miguel; Tábuas-Pereira, Miguel; Taipa, Ricardo; Simões, Rita Moiron; Araújo, Rui; Barreto, Rui; Rocha, Sofia; Massano, JoãoLewy body dementia is a common cause of dementia leading to the progressive deterioration of cognitive function and motor skills, behavioral changes, and loss of autonomy, impairing the quality of life of patients and their families. Even though it is the second leading cause of neurodegenerative dementia, diagnosis is still challenging, due to its heterogenous clinical presentation, especially in the early stages of the disease. Accordingly, Lewy body dementia is often misdiagnosed and clinically mismanaged. The lack of diagnostic accuracy has important implications for patients, given their increased susceptibility to the adverse effects of certain drugs, such as antipsychotics, which may worsen some symptoms associated with Lewy body dementia. Therefore, a specialist consensus based on the analysis of the most updated and relevant literature, and on clinical experience, is useful to all professionals involved in the care of these patients. This work aims to inform and provide recommendations about the best diagnostic and therapeutic approaches in Lewy body dementia in Portugal. Moreover, we suggest some strategies in order to raise the awareness of physicians, policy makers, and the society at large regarding this disease.
- Endoscopic gastrostomy for nutritional support in post-stroke dysphagiaPublication . Patita, Marta; Nunes, Gonçalo; Grunho, Miguel; Santos, Carla Adriana; Fonseca, JorgeIntroduction: persistent dysphagia affects 15 % of stroke patients and contributes to malnutrition, aspiration, and death. This study aimed to characterize patients with post-stroke dysphagia who underwent percutaneous endoscopic gastrostomy (PEG), and to assess the impact of PEG feeding on nutritional status and outcome. Methods: an observational and retrospective study using records from patients with post-stroke dysphagia who underwent PEG. Body mass index (BMI), serum albumin, transferrin, and cholesterol were recorded at the time of PEG insertion (T0) and 3 months later (T3). The evolution of these parameters was analyzed and compared to survival. Results: we obtained data from 158 patients (53.2 % males) with a median age of 75 years. Most strokes were ischemic (n = 135, 85.4 %). Median time between stroke and PEG was 2 months. Median survival after gastrostomy was 16 months. At admission, 41.6 % of patients had low BMI, 62.3 % low albumin, 68.6 % low transferrin, and 59.6 % low cholesterol levels. The prevalence of low albumin and low transferrin was higher in the patients who underwent PEG more than 2 months after stroke. A significant increase in albumin and transferrin, and a normalization of cholesterol levels was observed after 3 months of PEG feeding. Mortality was 12.9 %, 27.7 %, and 40 % at 1, 3, and 12 months, respectively. Survival was lower in patients with low albumin, transferrin or total cholesterol at admission. Conclusions: the prevalence of malnutrition is high among patients with post-stroke dysphagia. PEG feeding improves albumin, transferrin, and cholesterol levels. Early post-PEG mortality is high and must be considered on an individual basis.
- 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.
- Lisbon Intensive Falls Trampoline Training (LIFTT) Program for people with Parkinson’s for balance, gait, and falls : study protocol for a randomized controlled trialPublication . Domingos, Josefa; Dean, John; Fernandes, Júlio Belo; Ramos, Catarina; Grunho, Miguel; Proença, Luís; Vaz, João R.; Godinho, CatarinaFalling and gait difficulties in people with Parkinson’s disease (PD) are associated with impaired reactive postural adjustments and impairments in attentional resources. Combined intensive balance motor and cognitive exercise can be beneficial. However, uncertainties persist regarding the true effects and safety when applying such training. Using trampoline beds may be a favorable safe environment for a highly intensive, cognitive, and balancing training approach. The primary goal of this randomized controlled trial is to assess the effects of an intensive cognitive-motor training program in a safe trampoline environment in addition to usual care on balance impairment, gait, physical capacity, fear of falling, falls frequency and severity, cognition, and clinical impairments in people with mild or moderate PD.
- Microbiota orchestra in Parkinson’s disease : the nasal and oral maestrosPublication . Rei, Nádia; Grunho, Miguel; Mendes, José João; Fonseca, JorgeParkinson’s disease (PD) is characterized by the progressive degeneration of dopaminergic neurons, leading to a range of motor and non-motor symptoms. Background/Objectives: Over the past decade, studies have identified a potential link between the microbiome and PD pathophysiology. The literature suggests that specific bacterial communities from the gut, oral, and nasal microbiota may be involved in neuroinflammatory processes, which are hallmarks of PD. This review aims to comprehensively analyze the current research on the composition, diversity, and dysbiosis characteristics of the nasal and oral microbiota in PD. Methods: Through a comprehensive search across scientific databases, we identify twenty original studies investigating the nasal and oral microbiota in PD. Results: Most of these studies demonstrate the substantial roles of bacterial communities in neuroinflammatory pathways associated with PD progression. They also underscore the influences of microbiota-derived factors on key aspects of PD pathology, including alpha-synuclein aggregation and immune dysregulation. Conclusions: Finally, we discuss the potential diagnostic and therapeutic implications of modulating the nasal and oral microbiota in PD management. This analysis seeks to identify potential avenues for future research in order to clarify the complex relationships between these microorganisms and PD.
- Nutrition and outcome of 100 endoscopic gastrostomy-fed citizens with severe dementiaPublication . Sousa-Catita, Diogo; Mascarenhas, Paulo; Oliveira, Cátia; Grunho, Miguel; Santos, Carla Adriana; Fonseca, JorgeDementia is a rising public health concern. Feeding and nutritional problems increase as the disease progresses, affecting the clinical course and caregiver burden. While some guidelines advise against percutaneous endoscopic gastrostomy (PEG) and tube feeding in advanced dementia, conflicting evidence exists. This study aims to evaluate the nutritional status and influence of PEG feeding on the outcome and evolution of nutritional/prognosis markers of patients with severe dementia (PWSD) who underwent gastrostomy for nutritional support. We conducted a 16-year retrospective study on 100 PEG-fed PWSD with strong familial support. We evaluated the survival PEG-feeding period, safety, and objective nutritional/prognosis data on the gastrostomy day and after 3 months: Body Mass Index (BMI), Mid Upper Arm Circumference, Tricipital Skinfold, Mid-Arm Muscle Circumference, albumin, transferrin, total cholesterol, and hemoglobin. Most patients presented low values in these nutritional/prognosis parameters. No major life-threatening PEG complications were reported. The mean survival time after gastrostomy was 27.9 months (median of 17 months). Female sex, BMI recovery at 3 months, and higher baseline hemoglobin levels were associated with a reduced risk of death and increased survival time. The study concluded that, in carefully selected PWSD with strong familial support, PEG feeding can improve nutritional status and have a positive impact on survival.
- Nutritional and motor functional status in Parkinson’s disease: the NutriSPark protocolPublication . Grunho, Miguel; Godinho, Catarina; Sousa-Catita, Diogo; Vicente, Filipa; Proença, Luís; Carregosa, Ricardo; Marx, Frederico; Tomé, Morgane; Domingos, Josefa; Fonseca, JorgeA growing body of evidence suggests that nutritional status may play an important role in the development and course of Parkinson’s disease (PD). Nutritional status is known to influence PD motor and non-motor features and is in turn influenced by disease duration and severity. A proper nutritional status assessment and intervention should be incorporated in the management and follow-up of PD patients. This study aims to characterize the impact of nutritional status in multiple domains of PD and to explore the feasibility and the effectiveness of a customized and intensive nutritional intervention compared to standard care.