Plenitud existencial y síndrome de burnout en operarios a cargo del cuidado de jóvenes en hogares de alta complejidad de la DINAF

En el presente trabajo de investigación, se pretende realizar un acercamiento a la vivencia de plenitud existencial y del Síndrome de Burnout, en caso de estar presente éste último, en una muestra de catorce operadores del sistema de hogares de alta complejidad, dependientes de la DINAF, en la provincia de Mendoza, Argentina. El tema es relevante tanto desde lo laboral, ya que se considera dicho síndrome como consecuente al desempeño de la tarea en el ámbito de trabajo, como desde lo socio-afectivo, dado que dichos operadores, tienen la enorme responsabilidad de prestar servicios a una población de niños y jóvenes vulnerados en derechos primordiales. Se utilizó una metodología cuantitativa, con un diseño no experimental, transversal, de carácter descriptivo. Se aplicó la escala Maslach Burnout Inventory para la detección del Síndrome de Burnout a través de las dimensiones Cansancio Emocional, Despersonalización y Realización Personal. Complementándola con la escala existencial, que evalúa las capacidades existenciales de autodistanciamiento, autotrascendencia, libertad y responsabilidad. El objetivo es conocer las disposiciones de las variables de ambos constructos (MBI y Escala Existencial) en un contexto particular, donde las situaciones estresantes son habituales y recurrentes y se requiere gran entereza emocional para afrontarlas con aplomo. Para arribar a las deducciones pertinentes, se realizó un procesamiento de los datos, mediante pruebas estadísticas descriptivas, y se analizaron e interpretaron, de modo que se permitió definir los parámetros concluyentes de esta investigación.The aim of the present research work is to provide an understanding of the feeling of Existential Fullness and Burnout Syndrome in a sample of 14 operators of the high complexity household system, dependent on DINAF in the province of Mendoza, Argentina. The issue is relevant both from the point of view of workplace, since the syndrome is considered as being consistent with the performance of the task in the field of work, and from the socio-affective aspect, provided that these operators handle the enormous responsibility of providing services to a population of vulnerable children and young people as regards their fundamental rights. A quantitative methodology was used, with a non-experimental, cross-sectional, descriptive character. The Maslach Burnout Inventory scale was applied for the detection of Burnout syndrome through the dimensions of Emotional Fatigue, Depersonalization and Personal Realization. Complementing it with the Existential Scale, which evaluates the existential capacities of self-estrangement, self-transcendence, freedom and responsibility. The objective was to know the dispositions of the variables of both constructs (MBI and Existential Scale) in a particular context where stressful situations are habitual and recurrent and which requires great emotional strength to face them with sel-assurance. To arrive at the relevant deductions, the data were processed through descriptive statistical tests and analyzed and interpreted in a way that allowed the definition of the conclusive parameters of this investigation.Fil: Terranova, Milena Paol

The Isoform GC1f of the Vitamin D Binding Protein Is Associated with Bronchiectasis Severity

Vitamin D modulates immune responses and its deficiency has been observed in more than 60% of bronchiectasis patients. Vitamin D binding protein (DBP) is coded by the GC gene, is involved in the transport of vitamin D, and includes a number of isoforms based on single nucleotide polymorphisms (SNPs) in the coding region at rs7041 and rs4855. We evaluated the possible clinical impact of DBP polymorphisms and isoforms in an observational, cross-sectional study conducted in 116 bronchiectasis patients, who were genetically characterized for rs4588 and rs7041 SNPs. Results showed that the GC1f isoform (rs7041/rs4588 A/G) correlated with a more severe disease (18.9% vs. 6.3%, p = 0.038), a higher incidence of chronic infections (63.6% vs. 42%, p = 0.041), and a lower BACI score (0.0 (0.0, 2.5) vs. 3.0 (0.0, 3.0), p = 0.035). Moreover, blood concentration of vitamin D was higher in patients carrying GC1s (median (IQR): 20.5 (14.3, 29.7 vs. 15.8 (7.6, 22.4), p = 0.037)). Patients carrying GC1f isoform have a more severe disease, more chronic infections and lower asthmatic comorbidity in comparison to those without the GC1f isoform. Presence of the GC1s isoform (rs7041/rs4588 C/G) seems to be associated to a milder clinical phenotype with increased vitamin D levels and lower comorbidities score

Type 2 diabetes mellitus pharmacological remission with dapagliflozin plus oral semaglutide

Dapagliflozin, a sodium-glucose co-transporter-2 inhibitor and semaglutide, a glucagon-like peptide 1 receptor agonist, have both demonstrated efficacy in glycemic control, reducing blood pressure, body weight, risk of renal and heart failure in type 2 diabetes mellitus. In this observational, real-world, study we aimed to investigate the efficacy of the combination therapy with those two agents over glycemic control. We thus obtained the data of 1335 patients with type 2 diabetes followed by 11 Diabetes centers in Lombardia, Italy. A group of 443 patients was treated with dapagliflozin alone, the other group of 892 patients was treated with the combination therapy of dapagliflozin plus oral semaglutide. We analyzed changes in glycated hemoglobin from baseline to 6 months of follow-up, as well as changes in fasting glycemia, body weight, body mass index, systolic and diastolic pressure, heart rate, creatinine, estimated glomerular filtration rate and albuminuria. Both groups of patients showed an improvement of glycometabolic control after 6 months of treatment; indeed, the treatment with dapagliflozin plus oral semaglutide showed a reduction of glycated hemoglobin of 1.2% as compared to the 0.5% reduction observed in the dapagliflozin alone group. Significant changes were observed in body mass index, fasting plasmatic glucose, blood pressure, total cholesterol, LDL and albumin to creatinine ratio, with a high rate (55%) of near-normalization of glycated hemoglobin. Our real world data confirmed the potential of the oral combination therapy dapagliflozin with semaglutide in inducing pharmacological remission of type 2 diabetes mellitus

Antihypertensive treatment changes and related clinical outcomes in older hospitalized patients

Background: Hypertension management in older patients represents a challenge, particularly when hospitalized. Objective: The objective of this study is to investigate the determinants and related outcomes of antihypertensive drug prescription in a cohort of older hospitalized patients. Methods: A total of 5671 patients from REPOSI (a prospective multicentre observational register of older Italian in-patients from internal medicine or geriatric wards) were considered; 4377 (77.2%) were hypertensive. Minimum treatment (MT) for hypertension was defined according to the 2018 ESC guidelines [an angiotensin-converting-enzyme-inhibitor (ACE-I) or an angiotensin-receptor-blocker (ARB) with a calcium-channel-blocker (CCB) and/or a thiazide diuretic; if >80 years old, an ACE-I or ARB or CCB or thiazide diuretic]. Determinants of MT discontinuation at discharge were assessed. Study outcomes were any cause rehospitalization/all cause death, all-cause death, cardiovascular (CV) hospitalization/death, CV death, non-CV death, evaluated according to the presence of MT at discharge. Results: Hypertensive patients were older than normotensives, with a more impaired functional status, higher burden of comorbidity and polypharmacy. A total of 2233 patients were on MT at admission, 1766 were on MT at discharge. Discontinuation of MT was associated with the presence of comorbidities (lower odds for diabetes, higher odds for chronic kidney disease and dementia). An adjusted multivariable logistic regression analysis showed that MT for hypertension at discharge was associated with lower risk of all-cause death, all-cause death/hospitalization, CV death, CV death/hospitalization and non-CV death. Conclusions: Guidelines-suggested MT for hypertension at discharge is associated with a lower risk of adverse clinical outcomes. Nevertheless, changes in antihypertensive treatment still occur in a significant proportion of older hospitalized patients