Bion and Foulkes, a mythological encounter, only, but it is already enogh

Abstract We can affirm that Bion's summit and his impact on dialectics between alfa and beta elements constitute the most authentic and complete theory of Foulkes' summit: the group-analytical theory that a number of people have blamed him for not being able to or not knowing how to elaborate. Which certainly doesn't mean that psychoanalysis and group-analysis should coincide; rather, it means that the "group dynamics" described by Bion are part of the latter, to belong to its basic matrix, and that Bionian analysis, in the depth of the psychoanalytic process, can be seen as the necessary component for the "symbioticî encounter "between Bion's and Foulkes' thoughts. In any case, we are talking about an encounter built on "myth"

Estudio de desigualdad entre antecedentes migratorios: Un análisis de las expectativas educativas y el rendimiento académico en un contexto argentino

Esta investigación busca detectar desigualdades en las expectativas educativas y el rendimiento académico de personas con antecedentes migratorios en Argentina. Los resultados, obtenidos mediante regresiones lineales y análisis estadísticos, revelan que los estudiantes argentinos no dependen únicamente de su rendimiento académico para formar altas expectativas educativas. Los estudiantes migrantes presentan mayores expectativas y un mejor desempeño que los estudiantes locales. Los estudiantes argentinos nativos perciben un mayor apoyo emocional por parte de sus padres. Mientras tanto, las estudiantes mujeres tienen las expectativas educativas más altas, aunque los estudiantes varones logran un mejor rendimiento académico. Asimismo, nuestros hallazgos señalan que a mayor nivel económico, social y cultural, los estudiantes obtienen un mejor rendimiento académico y tienen expectativas más elevadas. Se observa igualdad en el apoyo brindado por los docentes a todos los estudiantes, quienes perciben de manera similar el respaldo positivo por parte de sus educadores. Por último, se destaca el compromiso constructivo y equitativo de los docentes con los estudiantes, sin importar su origen migratorio

Multicentric Atrial Strain COmparison between Two Different Modalities: MASCOT HIT Study

Two methods are currently available for left atrial (LA) strain measurement by speckle tracking echocardiography, with two different reference timings for starting the analysis: QRS (QRS-LASr) and P wave (P-LASr). The aim of MASCOT HIT study was to define which of the two was more reproducible, more feasible, and less time consuming. In 26 expert centers, LA strain was analyzed by two different echocardiographers (young vs senior) in a blinded fashion. The study population included: healthy subjects, patients with arterial hypertension or aortic stenosis (LA pressure overload, group 2) and patients with mitral regurgitation or heart failure (LA volume–pressure overload, group 3). Difference between the inter-correlation coefficient (ICC) by the two echocardiographers using the two techniques, feasibility and analysis time of both methods were analyzed. A total of 938 subjects were included: 309 controls, 333 patients in group 2, and 296 patients in group 3. The ICC was comparable between QRS-LASr (0.93) and P-LASr (0.90). The young echocardiographers calculated QRS-LASr in 90% of cases, the expert ones in 95%. The feasibility of P-LASr was 85% by young echocardiographers and 88% by senior ones. QRS-LASr young median time was 110 s (interquartile range, IR, 78-149) vs senior 110 s (IR 78-155); for P-LASr, 120 s (IR 80-165) and 120 s (IR 90-161), respectively. LA strain was feasible in the majority of patients with similar reproducibility for both methods. QRS complex guaranteed a slightly higher feasibility and a lower time wasting compared to the use of P wave as the reference

Clinical features and outcomes of elderly hospitalised patients with chronic obstructive pulmonary disease, heart failure or both

Background and objective: Chronic obstructive pulmonary disease (COPD) and heart failure (HF) mutually increase the risk of being present in the same patient, especially if older. Whether or not this coexistence may be associated with a worse prognosis is debated. Therefore, employing data derived from the REPOSI register, we evaluated the clinical features and outcomes in a population of elderly patients admitted to internal medicine wards and having COPD, HF or COPD + HF. Methods: We measured socio-demographic and anthropometric characteristics, severity and prevalence of comorbidities, clinical and laboratory features during hospitalization, mood disorders, functional independence, drug prescriptions and discharge destination. The primary study outcome was the risk of death. Results: We considered 2,343 elderly hospitalized patients (median age 81 years), of whom 1,154 (49%) had COPD, 813 (35%) HF, and 376 (16%) COPD + HF. Patients with COPD + HF had different characteristics than those with COPD or HF, such as a higher prevalence of previous hospitalizations, comorbidities (especially chronic kidney disease), higher respiratory rate at admission and number of prescribed drugs. Patients with COPD + HF (hazard ratio HR 1.74, 95% confidence intervals CI 1.16-2.61) and patients with dementia (HR 1.75, 95% CI 1.06-2.90) had a higher risk of death at one year. The Kaplan-Meier curves showed a higher mortality risk in the group of patients with COPD + HF for all causes (p = 0.010), respiratory causes (p = 0.006), cardiovascular causes (p = 0.046) and respiratory plus cardiovascular causes (p = 0.009). Conclusion: In this real-life cohort of hospitalized elderly patients, the coexistence of COPD and HF significantly worsened prognosis at one year. This finding may help to better define the care needs of this population

Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic

This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic

The role of immune suppression in COVID-19 hospitalization: clinical and epidemiological trends over three years of SARS-CoV-2 epidemic

Specific immune suppression types have been associated with a greater risk of severe COVID-19 disease and death. We analyzed data from patients >17 years that were hospitalized for COVID-19 at the “Fondazione IRCCS Ca′ Granda Ospedale Maggiore Policlinico” in Milan (Lombardy, Northern Italy). The study included 1727 SARS-CoV-2-positive patients (1,131 males, median age of 65 years) hospitalized between February 2020 and November 2022. Of these, 321 (18.6%, CI: 16.8–20.4%) had at least one condition defining immune suppression. Immune suppressed subjects were more likely to have other co-morbidities (80.4% vs. 69.8%, p < 0.001) and be vaccinated (37% vs. 12.7%, p < 0.001). We evaluated the contribution of immune suppression to hospitalization during the various stages of the epidemic and investigated whether immune suppression contributed to severe outcomes and death, also considering the vaccination status of the patients. The proportion of immune suppressed patients among all hospitalizations (initially stable at <20%) started to increase around December 2021, and remained high (30–50%). This change coincided with an increase in the proportions of older patients and patients with co-morbidities and with a decrease in the proportion of patients with severe outcomes. Vaccinated patients showed a lower proportion of severe outcomes; among non-vaccinated patients, severe outcomes were more common in immune suppressed individuals. Immune suppression was a significant predictor of severe outcomes, after adjusting for age, sex, co-morbidities, period of hospitalization, and vaccination status (OR: 1.64; 95% CI: 1.23–2.19), while vaccination was a protective factor (OR: 0.31; 95% IC: 0.20–0.47). However, after November 2021, differences in disease outcomes between vaccinated and non-vaccinated groups (for both immune suppressed and immune competent subjects) disappeared. Since December 2021, the spread of the less virulent Omicron variant and an overall higher level of induced and/or natural immunity likely contributed to the observed shift in hospitalized patient characteristics. Nonetheless, vaccination against SARS-CoV-2, likely in combination with naturally acquired immunity, effectively reduced severe outcomes in both immune competent (73.9% vs. 48.2%, p < 0.001) and immune suppressed (66.4% vs. 35.2%, p < 0.001) patients, confirming previous observations about the value of the vaccine in preventing serious disease

Le virement de la dynamique autoplastique à la dynamique alloplastique

L'auteur discute de l’influence possible de la psychothérapie sur la vie morale de l'individu qui s’y soumet. Il affirme que le progrès obtenu par la psychothérapie ne coïncide pas nécessairement avec le progrès moral, même s'il s'identifie souvent avec lui, sur le plan pratique. Une modification du critère fondamental de la psychothérapie, substituant au «test de la réalité » celui de l'actualité déjà préconisé par Freud, pourrait entraîner une convergence plus fréquente entre progrès psychothérapique et progrès moral.Ancona Leonardo. Le virement de la dynamique autoplastique à la dynamique alloplastique. In: Bulletin de psychologie, tome 23 n°281, 1970. pp. 208-214