Publications by authors named "Helene Levassort"

Article Synopsis
  • People with chronic kidney disease (CKD) face a higher risk of cognitive impairment (CI), and this study investigates the link between anticholinergic medications and cognitive performance in CKD patients.
  • The research involved a prospective cohort study of 3007 nephrology outpatients, where data on medication prescriptions and cognitive function were collected over five years.
  • Findings revealed that over half of the participants were prescribed anticholinergic drugs, with those having a high anticholinergic burden more likely to experience cognitive impairment, particularly if they had a history of neurological disorders or were on multiple medications.
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Purpose Of Review: The risk of cognitive impairment is higher in people with CKD than in the general population. The complex relationship between CKD and cognitive dysfunction has not been extensively characterized. Here, we review epidemiological associations, specific patterns of CKD-related cognitive impairment, the underlying mechanisms, and recently published data on relevant biomarkers.

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Article Synopsis
  • * In a cohort of 2505 CKD patients, researchers found that while urea levels did not significantly predict new antidepressant prescriptions, higher urea was linked to worsening depressive symptoms over a 5-year follow-up.
  • * The findings suggest a connection between serum urea levels and depression symptoms, highlighting the need for further research to clarify the mechanisms involved.
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Article Synopsis
  • * In France, the incidence of treated CKD remains stable overall, but it is increasing significantly in individuals over 85.
  • * Advanced CKD leads to serious complications like imbalances in water and minerals, anemia, and higher cardiovascular risks; addressing risk factors and enhancing nephroprotection practices can help mitigate these issues.
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Neurocognitive disorders (NCD) are common in patients with chronic kidney disease (CKD). It is essential to identify and characterize these disorders at an early stage, so as to be able to offer appropriate treatment. In a chronic disease such as CKD, the patient's involvement in decision-making is a major challenge, given the prospects for suppletive treatment: hemodialysis, peritoneal dialysis, kidney transplantation or non-dialytic drug therapy.

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Kidney disease, whether acute or chronic, is a particularly common condition in the elderly, due to its main risk factors, the prevalence of which increases with age, and the fact that recovery from acute tubular damage is slower. Wherever possible, treatment of renal failure should be anticipated and discussed with the patient as part of a shared medical decision. Numerous treatment options are available to ensure maximum integration into the patient's life and care plan: renal transplantation for the most robust patients, hemodialysis in a care facility or at home, peritoneal dialysis at home, or medical treatment without dialysis.

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Article Synopsis
  • - Acute renal failure (ARF) is a common issue in hospitals, impacting 20% of patients, and is especially prevalent in the elderly due to age-related kidney function changes.
  • - Aging kidneys struggle with maintaining fluid and sodium balance, making seniors more susceptible to chronic kidney disease and other illnesses like diabetes and hypertension.
  • - Elderly patients are at higher risk for specific types of acute kidney injury (AKI), including iatrogenic AKI from multiple medications, functional AKI from fluid balance disruptions, and obstructive AKI due to urological problems.
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One of the kidney's major functions is to adjust the water and sodium balance in order to maintain a state of equilibrium. In the course of aging, even in the absence of renal pathology, changes are observed not only in renal macrostructure (reduction in kidney size, increase in the number of cysts), but also in microstructure (arteriosclerosis, glomerulosclerosis, fibrosis and tubular atrophy). All these changes can disrupt the homeostasis of water and sodium balances.

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The kidney performs several major functions: it eliminates toxins produced by cellular or xenobiotic metabolism, regulates the homeostasis of the internal environment and plays a hormonal role, producing erythropoietin, calcitriol and renin. Maintaining the body's homeostasis (hydric, ionic [sodium, potassium, calcium, phosphorus, etc.] or acid-base balance) requires the successive action of plasma filtration, followed by reabsorption/secretion mechanisms, which take place in the various portions of the kidney's functional unit known as the nephron.

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Background: Chronic kidney disease (CKD) is associated with an elevated risk of neurocognitive disorders (NCDs). It remains unclear whether CKD-related NCDs have a specific cognitive pattern or are earlier-onset phenotypes of the main NCDs (vascular NCDs and Alzheimer's disease).

Methods: We used the Mini Mental State Examination score (MMSE) to assess cognitive patterns in 3003 CKD patients (stage 3-4) followed up over 5 years in the Chronic Kidney Disease-Renal Epidemiology and Information Network (CKD-REIN) cohort.

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Cognitive functions enable us to receive, select, store, transform, process and retrieve the information we receive from the outside world. These functions are controlled by different brain structures that interact with each other, enabling us to interact with and understand the world around us. In the course of aging or the onset of neurocognitive diseases, these functions may be impaired to a greater or lesser extent, giving rise to a considerable variety of neurocognitive impairment profiles.

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Swallowing disorders, which are frequent in geriatrics, are linked to multiple pathologies: cancer, stroke, neurocognitive disorders, acute confusion, vigilance disorders, etc. They can have serious consequences and therefore require special care. From the identification of the disorders by the doctor, the nurse, the caregiver, to the speech therapy assessment, through the adaptation of the diet by the dietician, the management of swallowing disorders concerns all the medical and paramedical staff.

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Background: Chronic kidney disease (CKD) is associated with cognitive impairment in general population. We assessed the association between kidney and cognitive functions in patients with CKD and the influence of cardiovascular (CV) risk factors, and depression on this association.

Methods: The CKD-Renal Epidemiology and Information Network cohort included 3033 patients with CKD stages 3-4, followed for 5 years.

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Aphasia, resulting from a brain lesion, leads to a partial or total loss of language in the elderly. By affecting communication abilities, it has repercussions on the life of the subject and his family. There are two types of aphasia.

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Résumé La confusion est fréquente et grave chez le sujet âgé hospitalisé, alors qu'elle est souvent évitable. Plusieurs études sur les connaissances des infirmier(e)s et des médecins sur la confusion révèlent un manque de formation. En France, l'interne est souvent le prescripteur de première ligne en hospitalisation.

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The prescription of lubricating laxatives (paraffin oil) is widespread in geriatrics because of the frequency of constipation. These molecules can cause serious adverse effects such as lipoid pneumonia, especially in subjects with swallowing disorders.

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With the ageing of the population and the increase in the incidence of cancer in the population over 75 years of age, a partnership between geriatricians and oncologists is becoming necessary to optimise the management of these patients. There is great variability in the profiles of elderly patients and age cannot be the only criterion of the decision making. Thus, it is necessary to identify patients who will benefit from an in-depth geriatric assessment (IGA) and the G8 screening tool used in oncology consultations allows to do so.

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