Percorrer por autor "Mocanu, Irina"
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- Clinical nutrition in Portuguese gastroenterology departments : a multicentric studyPublication . Vara-Luiz, Francisco; Glória, Luísa; Mocanu, Irina; Curado, António; Medeiros, Isabel; Duarte, Maria Antónia; Banhudo, António; Ferreira, Susana; Vaz, Ana Margarida; Bastos, Isabel; Fonseca, JorgeBackground: Hospital nutrition is a major public health problem, as up to 50% of hospitalized patients suffer from undernutrition. Adequate nutritional support (NS) decreases morbidity/mortality, shortens the length of stay, and reduces costs. We aimed to evaluate the engagement of Portuguese gastroenterology departments in NS, especially in artificial nutrition (AN). Methods: Cross-sectional multicentric study, using an online survey sent to 31 Portuguese gastroenterology departments. Results: Nine centers were involved, and all departments were engaged in NS activities. The most performed nutrition technique was endoscopic gastrostomy and not all departments had the expertise to perform all nutrition procedures, namely, endoscopic jejunostomy. Two departments had an AN outpatient clinic. Five centers were involved in hospital nutrition committees. Only four performed systematic nutritional evaluation of every patient on admission. Two departments developed research in the nutrition field. An increase staff and nutrition training were pointed out as suggestions to improve NS. Conclusions: This study outlines a broad picture of NS/AN in Portuguese gastroenterology departments. Medical nutritional training and increasing nutrition teams’ staff may contribute to developing NS/AN. Multidisciplinary management of nutrition-related disorders is of utmost importance, and gastroenterologists are expected to be at the core of hospital nutrition.
- Digestive oncology in the COVID-19 pandemic eraPublication . Laranjo, Ana; Sabino, Júlia; Oliveira, Carla; Mocanu, Irina; Fonseca, Jorge; Brito, MarianaIntroduction: Since the rise of the COVID-19 pandemic there has been widespread concern regarding the possible delay in the diagnosis/treatment of cancer patients. We aimed to assess the impact of the COVID-19 pandemic on the diagnosis, treatment, and outcome of patients with digestive cancer. Methods: This was a retrospective study including patients with an inaugural digestive cancer diagnosis discussed for the first time at our center during the weekly digestive oncology reunion (DOR) meeting. The study group was enlisted from March to August 2020, and a control group was sourced from the equivalent period of 2018. Patients with a previous digestive cancer diagnosis/discussion in the DOR were excluded. The following data were collected: demographics, referral origin, tumor staging, first DOR discussion timing, treatment, and outcome. Results: A total of 235 patients were included: 107 in the study group (65.4% male, mean age 71.59 years); 128 in the control group (54.7% male, mean age 68.16 years). The mean number of clinical discussions per week was higher in 2018 (13.65 vs. 10.67, p = 0.040), without a difference in the mean number of patients discussed for the first time (inaugural diagnosis) between groups (p = 0.670). In the 2020 study group, more patients were referred to DOR from the emergency room (ER), fewer from the outpatient clinic/hospital wards (p < 0.001), and more were referred after urgent surgery (p = 0.022). There was no difference in the mean waiting time from diagnosis to first DOR discussion (p = 0.087). Tumor staging in colorectal, gastric, and esophageal cancer was not significantly different between the groups (p = 0897, p = 0.168, and p = 0.717). More patients in the study group presented with stage IV pancreatic cancer (p = 0.043). There was no difference in the time span from DOR until the beginning of neoadjuvant chemotherapy (p = 0.680) or elective surgery (p = 0.198), or from surgery until adjuvant chemotherapy (p = 0.396). Also, there was no difference in 30-day mortality from the first DOR date between the groups (p = 0.742). Conclusion: During the COVID-19 era there was a reduced number of clinical discussions in the DOR, but the number of debated patients with an inaugural digestive cancer diagnosis was similar. In the study group more patients were referred to DOR from the ER, and were referred after urgent surgery, suggesting a delayed demand for clinical attention. Study group patients were not significantly affected by the pandemic regarding timely DOR discussion, beginning of treatment, or 30-day mortality, reflecting the maintenance of the quality of care for digestive cancer patients.
- 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.
- Multiple bezoars causing small bowel obstruction : a unique case of resolution with upper and low GI endoscopyPublication . Brito, Mariana; Mocanu, Irina; Nunes, Ana; Fonseca, JorgeReports of obstructing foreign bodies in the small bowel are rare and the majority describe surgical resolution. We report a case of successful endoscopic treatment of a small bowel obstruction (SBO) caused by multiple bezoars. A 92-year-old female presented to the Emergency Department with a history of persistent vomiting. Computed tomography (CT) showed gastric distension and an intraluminal ovaloid foreign body with a heterogenous density in the second portion of the duodenum, suggestive of bezoar.