Effects of malnutrition on mortality in oldest-old inpatients with COVID-19 in the GERIA-COVID cohort: Additional findings from the AgeBru cohort.

peer reviewe

Association between Malnutrition Assessed by the Global Leadership Initiative on Malnutrition Criteria and Mortality in Older People: A Scoping Review.

peer reviewedThe Global Leadership Initiative on Malnutrition (GLIM) criteria were introduced in 2018 for the diagnosis of malnutrition in adults. This review was aimed at gathering the evidence about the association between malnutrition according to the GLIM criteria and mortality in older people, an emerging and clinically meaningful topic in the implementation of the GLIM criteria in geriatric healthcare settings. This scoping review considered meta-analyses, systematic reviews, cohort studies, and cross-sectional studies published in PubMed, Scopus, and the Cochrane Database for Systematic Reviews from the development of the GLIM criteria in 2018 to January 2023. Seventeen articles (15 cohort and 2 cross-sectional studies) were included. The association between GLIM criteria and mortality had been assessed in hospitalized (11 over the 17 articles) and community-dwelling older populations, and those in nursing homes. The review found a strong association between malnutrition according to GLIM criteria and mortality in hospitalized (1.2-fold to 7-fold higher mortality) and community-dwelling older people (1.6-fold to 4-fold higher mortality). These findings highlight the prognostic value of the GLIM criteria and support strategies towards the implementation of malnutrition evaluation according to the GLIM, in order to optimize comprehensive geriatric assessment and provide older people with the highest quality of nutritional care. Studies in nursing home populations were very scarce and may be urgently required

Role of Th2 cytokines and polymorphonuclear cells in allograft rejection in mice

Acute allograft rejection remains a major problem in solid organ transplantation, because rejection may lead to acute or chronic loss of graft function. The failure of certain anti-rejection prophylactic treatments suggests that several unexpected pathways might be involved in the rejection process.The aim of our experiments was to investigate the effector mechanisms responsible for skin graft rejection in mice. To adress this question, we took advantage of the possibility to restrict the alloimmune response to isolated allogeneic MHC class II molecules or to isolated minor transplantation antigens, combined with the possibility to study separately the response of CD4+ or CD8+ T cells in mice deficient for Th1 or Th2 cytokines or cytotoxic molecules. We used the bm12 skin graft combination (C57BL/6 H2Kbm12 grafted on C57BL/6 H2Kb) as a model of single MHC class II disparity and the b2microglobulin skin graft model (C57BL/6 b2m+/+ grafted on C57BL/6 b2m-/-) as a model of minor transplantation antigen disparity. Our goal was to engage a limited number of effectors, trying in a second time to block each rejection pathway selectively. We showed that Fas/FasL-mediated CD4+ T cells cytotoxicity, eosinophil recruitment, activation and degranulation induced by Th2 derived cytokines, and CD4-derived IFN-g production are involved in the rejection of grafts bearing either a single MHC class II disparity or b2m-derived minor histocompatibilty antigens. In addition, rejection of MHC class II disparate skin grafts also includes the participation of neutrophils, in particular conditions where the occurrence of the Th2/eosinophil pathway was prevented. Altogether, our data show a multiplicity and a redundancy of the effector pathways participating in allograft rejection. Among the different effectors pathways identified, including effectors from both innate and adaptive immune systems, some act synergistically, whereas others act as alternative pathways, depending of the degree of donor-recipient mismatch.Doctorat en Sciences médicalesinfo:eu-repo/semantics/nonPublishe

Can mirtazapine counteract the weight loss associated with alzheimer disease? A retrospective open-label study

Weight loss is a frequent complication of Alzheimer disease (AD), associated with increased morbidity and mortality. Increased appetite and weight gain are known side effects of the antidepressant mirtazapine. This analysis was undertaken to assess the safety and potential utility of mirtazapine to counteract weight loss in patients with AD or mixed AD (AD with cerebrovascular lesions). We performed a retrospective analysis of the clinical records of all outpatients attending our memory clinic for AD or mixed AD, who had received mirtazapine (30 mg daily) with the specific purpose of inducing weight or appetite gain. Data were available for a total of 22 patients (mean age, 80.9 y, 86.4% female). The mean weight at baseline was 52.4 kg and the mean BMI was 20.5 kg/m. 77.3% of the patients had gained weight after 3 months (mean gain, 1.93 kg or 3.9% of initial body weight) and 82.3% after 6 months (2.11 kg or 4.6%). One patient had to discontinue mirtazapine because of daytime sleepiness. Mirtazapine seems to be a safe and useful approach to counteract weight loss in AD, if possible in combination with nonpharmacological interventions. Body weight should be monitored during treatment to avoid excessive weight gain. © 2014 by Lippincott Williams and Wilkins.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Do local meteorological conditions influence skin irritation caused by transdermal rivastigmine? A retroprospective, pilot study

Objective: This retrospective study aimed to evaluate the incidence of transdermal rivastigmine treatment withdrawal secondary to adverse skin reactions among the patients from our Memory Clinic. In addition, we tested whether climatic conditions might have an influence on skin irritations leading to eventual treatment disruption. Methods: We performed a retrospective review of patients from the Brugmann University Hospital Memory Clinic having started transdermal rivastigmine between June 2008 and December 2010. Local meteorological data were provided by the Royal Meteorological Institute of Belgium. Results: A total of 26.9% of the patients experienced adverse skin reactions at the rivastigmine application site, leading to treatment discontinuation in 19.2% of the cases. Rivastigmine cutaneous tolerability was not found to be related to demographic parameters, Mini Mental Status Examination score, or type of dementia. High temperature and low air humidity during the first month of treatment were found to be associated with a higher incidence of skin reactions and secondary treatment disruption. Conclusions: Transdermal rivastigmine induced a higher incidence of cutaneous adverse events than previously reported in a prospective clinical trial. Moreover, it seems that meteorological conditions favoring skin perspiration (high temperature and low air humidity) during the first month of treatment might have an influence on transdermal rivastigmine skin tolerability. Copyright © 2012 by Lippincott Williams & Wilkins.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Retrospective cohort study of the prevalence of chronic kidney disease among patients attending a Memory Clinic

info:eu-repo/semantics/publishe

Role des eosinophiles dans les rejets aigus et chroniques d'allogreffes

SCOPUS: no.jinfo:eu-repo/semantics/publishe

Le rôle des neutrophiles dans le rejet d'allogreffe.

Because rejection of allografts is primarily caused by T and B lymphocyte responses to allogeneic histocompatibility molecules, the role of innate immunity in organ transplant rejection is often overlooked. However, the very first damages to vascularized organ allografts are caused by ischemia-reperfusion, an inflammatory reaction involving activation of vascular endothelial cells and release of neutrophil chemoattractants. Herein, we review experimental observations suggesting that the early neutrophil influx in organ transplants favors T cell-mediated rejection.English AbstractJournal ArticleReviewinfo:eu-repo/semantics/publishe

Unmet needs, health policies, and actions during the Covid-19 pandemic: A report from 6 European countries

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The role of neutrophils during allograft rejection

info:eu-repo/semantics/publishe