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- 저자 : De Hertogh, G. (검색결과 2 건)
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Aafke J. de Groot,Elizabeth M. Wattel,Romke van Balen,Cees M.P.M. Hertogh,Johannes C. van der Wouden 대한노인병학회 2023 Annals of geriatric medicine and research Vol.27 No.4
Background: We assessed the vulnerability of patients aged ≥70 years during hospital admission based on the Short Dutch Safety Management Screening (DSMS). Screening of four geriatric domains aims to prevent adverse outcomes and may support targeted discharge planning for post-acute care. We explored whether the DSMS criteria for acutely admitted patients were associated with rehabilitation-oriented care needs. Methods: This retrospective cohort study included community-dwelling patients aged ≥70 years acutely admitted to a tertiary hospital. We recorded patient demographics, morbidity, functional status, malnutrition, fall risk, and delirium and used descriptive analysis to calculate the risks by comparing the discharge destination groups. Results: Among 491 hospital discharges, 349 patients (71.1%) returned home, 60 (12.2%) were referred for geriatric rehabilitation, and 82 (16.7%) to other inpatient post-acute care. Non-home referrals increased with age from 21% (70–80 years) to 61% (>90 years). A surgical diagnosis (odds ratio [OR]=4.92; 95% confidence interval [CI], 2.03–11.95), functional decline represented by Katz-activities of daily living positive screening (OR=3.79; 95% CI, 1.76–8.14), and positive fall risk (OR=2.87; 95% CI, 1.31–6.30) were associated with non-home discharge. The Charlson Comorbidity Index did not differ significantly between the groups. Conclusion: Admission diagnosis and vulnerability screening outcomes were associated with discharge to rehabilitation-oriented care in patients >70 years of age. The usual care data from DSMS vulnerability screening can raise awareness of discharge complexity and provide opportunities to support timely and personalized transitional care.
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Maerten, P.,Kwon, B. S.,Shen, C.,De Hertogh, G.,Cadot, P.,Bullens, D. M. A.,Overbergh, L.,Mathieu, C.,Van Assche, G.,Geboes, K.,Rutgeerts, P.,Ceuppens, J. L. Blackwell Science Ltd 2006 Clinical and experimental immunology Vol.143 No.2
<P>Summary</P><P>4-1BB ligand (4-1BBL) expressed on antigen-presenting cells interacts with 4-1BB on activated T cells (especially CD8<SUP>+</SUP> cells) and co-stimulates the latter to secrete cytokines and to proliferate. The role of 4-1BB−4-1BBL interaction was studied here in a model of colitis based on naive CD4<SUP>+</SUP> T cell transfer to SCID mice, a disease model in which CD8 cells do not take part. We found that CD4<SUP>+</SUP> T cells from 4-1BB-deficient mice, after transfer in SCID mice, proliferated more rapidly compared to wild-type CD4<SUP>+</SUP> T cells. Mice reconstituted with naive CD4<SUP>+</SUP> T cells from 4-1BB-deficient mice developed colitis, however, with a mixed Th1/Th2 response, in contrast to the Th1-type response in mice reconstituted with wild-type naive CD4<SUP>+</SUP> T cells. Importantly, this altered cytokine response did not temper colitis severity. Although it has been reported previously that 4-1BB co-stimulation may contribute to regulatory T cell functioning, we found that CD4<SUP>+</SUP>CD25<SUP>+</SUP> regulatory T cells from 4-1BB-deficient mice were perfectly able to prevent naive CD4<SUP>+</SUP> T cell-induced colitis. In conclusion, our data provide evidence that 4-1BB−4-1BBL interaction modulates the effector CD4<SUP>+</SUP> T cell-driven immune response and cytokine production in experimental colitis without affecting regulatory T cell function.</P>
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