CHE-S® as a tool to predict the Caregiver's ability to actively manage disability of stroke patients admitted to the ward of the complex rehabilitation structure of ASUGI

Introduction: This article affirms that measuring the Caregiver's emotional experience and engagement, especially as the condition of the person assisted changes, is useful for assessing the sustainability of the care plan. Methods: With this pilot study, aimed at detecting the level of Caregiver engagement, by using the Caregiving Engagement Scale (CHE-S®), for people suffering from chronic and/or fragile pathologies, it was decided to verify the relationship between engagement levels and other variables such as: socio-demographic characteristics of the Caregiver; duration and frequency person; clinical characteristics of the assisted person. Results and Conclusions: In the future, the results of this research will allow to define new working practices to support those who take on the responsibility and burden of caring for a sick, fragile, disabled family member

Outcome of laparoscopic gastric bypass in obese and diabetic patients: when surgery fails.

BACKGROUND: The beneficial effects of bariatric surgery on diabetes and obesity have been widely demonstrated in literature. The aim of our study was to evaluate the rate of failure of laparoscopic gastric bypass both in terms of weight loss and metabolic remission after one follow-up year. METHODS: A longitudinal, multicentric prospective study was carried out on 771 patients affected by pathological obesity. The following parameters were recorded for each patient before surgery: anthropometric, metabolic, social, smoking habits and previous failure of other bariatric procedures. After 1 follow-up year, final weight, final BMI, final percentage of lost excess body weight and percentage of lost BMI were evaluated. RESULTS: Statistical analysis showed a correlation between BMI > 50 Kg/m2 , presence of metabolic syndrome, presence of diabetes, gastric pouch volume greater than 60 ml and failure of weight loss outcome. Statistical analysis of metabolic failure has recognized a high preoperative HbA1c % value as a statistically significant negative predictive factor. CONCLUSIONS: Bariatric Surgery is the most effective treatment for weight loss and metabolic improvement. However, in our study, surgery did not achieve the expected outcome in patients with specific metabolic, anthropometric and surgical characteristics (BMI > 50 Kg/m2, presence of metabolic syndrome, presence of T2DM with high preoperative HbA1c % level and gastric pouch volume greater than 60 ml