Percorrer por autor "Vieira, Ana"
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- Age-related decline in intestinal villus length : a cross-sectional study on the human gutPublication . Vara-Luiz, Francisco; Palma, Carolina; Mendes, Ivo; Piçarra, Francisco; Teles, Ana Elisa; Nogueira, Filipe; Costa-Santos, Inês; Nunes, Gonçalo; Patita, Marta; Mocanu, Irina; Pires, Sara; Meira, Tânia; Vieira, Ana; Pinto-Marques, Pedro; Mascarenhas, Paulo; Leskiv, Iryna; Gomes-Pinto, Daniel; Fonseca, JorgeBackground/Objectives: There is widespread agreement that age is a significant predictor of impaired response to nutritional support. This is generally attributed to anabolic resistance, with impaired absorption considered irrelevant/non-existent. However, animal models demonstrate age-related structural changes in the intestinal mucosa that may reduce absorptive capacity. We aimed to evaluate potential histological changes in the duodenal mucosa associated with aging. Methods: We conducted a single-center observational cross-sectional study. Ambulatory younger (18–45 years) and older (≥70 years) adults referred for upper endoscopy were included and underwent duodenal biopsies. Those biopsies were analyzed and compared for histological/histomorphometric changes, including villus length. Clinical and laboratory data were also recorded. Results: One hundred patients were included (46 men/54 women), 50 aged 18–45 years and 50 aged ≥70 years. There were no duodenal endoscopic changes. The median villus length was 0.35 mm (IQR 0.32–0.41 mm) in older people, lower than in younger adults (0.57 mm; IQR 0.47–0.68 mm) (p < 0.001). In a multivariable regression model including age, sex, and Charlson comorbidity index, age remained inversely associated with villus length (p < 0.001). Older participants also exhibited lower hemoglobin, iron, folate, vitamin B12, albumin and vitamin D levels, despite normal inflammatory markers. Conclusions: Aging is associated with histological changes in the intestinal mucosa, including villus shortening. These findings support the concept of mucosal aging as a distinct biological process. Villus shortening may reflect reduced absorptive surface area and could contribute to age-related nutritional vulnerability, although its functional implications remain to be determined.
- Are cariogenic bacteria the major risk factor to dental caries in patients with ulcerative colitis?Publication . Rodrigues, Eduardo; Laranjeira, Nuno; Nunes, Gonçalo; Roque-Ramos, Lídia; Vieira, Ana; Fonseca, JorgeBackground – High prevalence of dental caries in ulcerative colitis (UC) has been attributed to diet and changes in salivary environment. Objective – We aimed to characterize the prevalence of dental caries, salivary flow rates, salivary buffering capacity and cariogenic bacteria counts of Mutans streptococci and Lactobacillus spp and to evaluate their relationship with drug therapy, disease activity and duration. Methods – A cross-sectional study was performed with UC patients followed in a tertiary center. Participants were submitted to a questionnaire (including demographic data, oral hygiene, eating habits) and a clinical observation with assessment of plaque index and Decayed, Missing and Filled Teeth index. Unstimulated/stimulated saliva was collected. Medical records, disease activity (Partial Mayo Score) and disease duration were collected. Laboratory data included salivary flow rates, salivary buffering capacity (CRT® buffer) and cariogenic bacteria count (Mutans streptococci and Lactobacillus spp) in saliva using the CRT® bacteria test (results: high or low counts). Results – Thirty UC patients were recruited. Oral hygiene routines were daily teeth brushing once or more (96.7%) and fluoride toothpaste (73.3%). Decayed, Missing and Filled Teeth index (mean 16.17±6.428) was not affected by the frequency of soft drinks, cakes, sweets and sugars between meals (P>0.2). Long-term disease showed a trend towards higher prevalence of caries (P=0.06). Most presented normal salivary flow rates, unstimulated (73.3%) and stimulated (60.0%), and high salivary buffering capacity (66.7%). Any association was found with age, gender, disease activity, disease duration and drug therapy. High Mutans streptococci and low Lactobacillus spp count were observed in 73.3% and 60% of patients, respectively. Patients with active disease (100%) and longer duration (88.9%) displayed higher Mutans streptococci count. Conclusion – The prevalence of dental caries observed in UC patients was significant and did not seem to be influenced by their eating habits. The high prevalence of Mutans streptococci count may be a major risk factor for dental caries and may be looked as part of the UC dysbiosis. Dental care of UC patients should be planned according with this microbiota variation
- Clinical, endoscopic and histologic differences in gastric mucosa between younger and older adults : an observational study on the aging stomachPublication . Vara-Luiz, Francisco; Mendes, Ivo; Palma, Carolina; Mascarenhas, Paulo; Teles, Ana Elisa; Santos, Inês Costa; Nunes, Gonçalo; Patita, Marta; Mocanu, Irina; Pires, Sara; Meira, Tânia; Vieira, Ana; Pinto-Marques, Pedro; Gomes-Pinto, Daniel; Fonseca, JorgeBackground/Objectives: Age-related changes in the gastric mucosa remain incompletely understood. We aimed to assess and compare clinical, endoscopic and histologic changes in the gastric mucosa associated with aging, and to explore whether gastric aging is associated with a distinct histological pattern. Methods: Single-center observational study. Younger (18–45 years) and older (≥70 years) adults undergoing elective upper endoscopy were included and underwent gastric biopsies. The clinical, endoscopic and histologic features were analyzed and compared. Results: A total of 100 patients were included (45 men/55 women), 50 with 18–45 years and 50 with ≥70 years. Dyspepsia, gastro-esophageal reflux disease and peptic ulcer disease were the most common indications for upper endoscopy. Gastric lesions (erythema, erosions, ulceration and polyps) were more common in older patients (80% vs. 50%, p = 0.003), as well as histologic changes such as chronic gastritis (56% vs. 38%, p = 0.004), chronic atrophic gastritis (CAG; 28% vs. 4%, p < 0.001) and intestinal metaplasia (28% vs. 4%, p < 0.001). These findings persisted after adjusting for Helicobacter pylori (H. pylori) status and proton pump inhibitor intake on the multivariate analysis. Prevalence of H. pylori was similar between both groups (28% vs. 32%, p = 0.189). Conclusions: Aging is associated with clinical, endoscopic and histologic changes in the gastric mucosa including CAG and metaplasia, independent of the presence of H. pylori. These findings may result from several aging-related pathophysiological processes and decades of cumulative gastric injury and support the hypothesis of an aging stomach phenotype, underscoring the need for an age-adjusted interpretation of gastric biopsies.
- Cross-cultural Adaptation and Validation of the Quebec Back Pain Disability Scale to European Portuguese LanguagePublication . Cruz, Eduardo Brazete; Fernandes, Rita; Carnide, Filomena; Vieira, Ana; Moniz, Sara; Nunes, FilipaLow back pain (LBP) is an extremely commonly health condition. It is a musculoskeletal complaint affecting most people at some point in their lives and the consequent health care, community, and personal costs are considerable.The clinical course of acute LBP has been described as initially favorable; however, beyond 6 weeks,only very small reductions in mean pain and disability seem to occur. According to a recent meta-analysis 6 individuals with persistent LBP are expected to have moderate levels of pain and disability. In these individuals, pain can fl uctuate over time with recurrences or exacerbations and has a major impact on their functionality. In the majority of the situations (85%), chronic LBP (CLBP) could not be assigned to a recognizable, known,specifi c pathology 15 , 16 and it is most accurately labeled as nonspecific CLBP (NSCLBP). Individuals with NSCLBP are commonly referred to physiotherapy services, 17 where reducing pain and disability are the main treatment goals and outcomes.The Quebec Back Pain Disability Scale (QBPDS) is one of the most recommended questionnaires to assess functional disability associated with LBP. It was developed as a measure of “functional disability,” which was defined by the authors as “perceived difficulty associated with simple physical activities.” It is a self-administered, 20-item questionnaire where patients are asked to rate their degree of difficulty in performing a specifi c activity from 0 (“not diffi cult at all”) to 5 (“unable to do”) in each item. The QBPDS score ranges from 0 to 100, with high values indicating higher levels of disability. The QBPDS has been extensively tested and is generally acknowledged to have good validity, reliability, and responsiveness. It has been translated and culturally adapted into different languages, including Portuguese from Brazil. However, the cultural and linguistic differences between the European Portuguese and the Brazilian Portuguese languages inhibit the use of the Brazilian version among Portuguese people. Therefore, the aim of this study was to conduct the crosscultural adaptation of the Portuguese version of the QBPDS and investigate its reliability and validity in patients with CLBP. This article is part of a larger research project aiming to validate tools with clinical relevance.
- Generative Artificial Intelligence in Higher Education: Challenges, Opportunities and Pedagogical ImplicationsPublication . Vieira, Ana; Mesquita, AnabelaGenerative Artificial Intelligence (GAI) is transforming Higher Education (HE), impacting academic writing, teaching methodologies and institutional practices. This study presents a literature review on the use of GAI in HE between 2024 and 2025, analyzing its strengths, weaknesses, opportunities and challenges. GAI improves productivity, student engagement, and personalization, but raises concerns about academic integrity, envy, and over-reliance on this technology. The results highlight the need for clear institutional policies, ethical guidelines and continuous training for teachers, ensuring a responsible integration of GAI. Future research should address pedagogical strategies, ethical issues, and long-term impacts of GAI on learning.
- Patient-reported outcome measures in clinical practice for tooth wear : a literature reviewPublication . Argolinha, Inês; Lobo, Sofia; Vieira, Ana; Botelho, João; Rua, João; Mendes, José João; Machado, VanessaTooth wear is a growing oral health concern with implications for function, esthetics, and psychological well-being, ultimately affecting oral health-related quality of life (OHRQoL). While clinical indices assess tooth wear severity, they fail to capture patient-reported outcomes (PROs) and patient-reported outcome measures (PROMs). This narrative review aims to identify and synthesize the use of PROs and PROMs used in adults with tooth wear and to map their assessed domains against the Wilson and Cleary model of health outcomes, highlighting gaps and guiding the development of condition-specific instruments. A comprehensive search of the literature was conducted across PubMed, MEDLINE, and Embase. Studies involving PROMs in adults with tooth wear were included. Extracted data encompassed psychometric properties and domains assessed. PROMs such as the OHIP, OES, OIDP, and QMFQ have been frequently used, focusing on functional limitation, esthetic perception, and psychological distress. However, no single instrument comprehensively addresses all relevant domains of the Wilson and Cleary model. Moreover, variation in tools and constructs limits comparability across studies and clinical settings. Existing PROMs capture only partial aspects of the patient experience related to tooth wear. When mapping these instruments to a validated theoretical model, significant gaps become evident, especially in terms of general health perceptions and overall quality of life metrics. To improve the evaluation and management of tooth wear in clinical settings, it is essential to create a condition-specific PROM based on a solid conceptual framework.