Management of acute traumatic stress in nuclear and radiological emergencies.

In order to effectively respond to and minimize the psychological impact following disasters, such as radio-nuclear ones, it is essential to understand the mechanisms involved in such conditions and how to prevent and treat the psychological impacts, including those related to acute traumatic stress and its consequences across life span. Radio-nuclear emergencies may cause psychological traumatic stress, with its potentially significant consequences in mental health, with both short and long-term effects, which extend beyond the individuals directly affected. Ionizing radiation cannot be perceived by human senses and most people are unaware of the magnitude of its effects, which could result in feelings of helplessness and vulnerability. Those situations with a high degree of uncertainty, regarding potential future health effects, are more psychologically traumatic than others. The present century has witnessed a steady increase in the number of publications concerning the mental health impact of traumatic events, showing the need of increasing the study of traumatic stress and its impact on mental health. A prompt, planned and effective response to manage disaster-induced acute traumatic stress may prevent the evolutionary reactions of traumatic stress into disorders or even chronic stress diseases that can appear after a nuclear or radiological emergency.

Treatment of posttraumatic stress disorder with venlafaxine extended release: a 6-month randomized controlled trial.

CONTEXT: No large-scale posttraumatic stress disorder drug trials have been conducted to evaluate treatment effects beyond 12 weeks outside of those with selective serotonin reuptake inhibitors. OBJECTIVE: To evaluate the efficacy of venlafaxine extended release (ER), a serotonin norepinephrine reuptake inhibitor, in posttraumatic stress disorder. DESIGN: 6-month, double-blind, placebo-controlled trial. SETTING: International study at 56 sites. Patients Adult outpatients (N = 329) with a primary diagnosis of posttraumatic stress disorder as defined in the DSM-IV, symptoms for 6 months or longer, and a 17-item Clinician-Administered Posttraumatic Stress Disorder Scale score of 60 or higher. Intervention Patients randomly assigned to receive flexible doses of venlafaxine ER (37.5-300 mg/d) or placebo for 24 weeks. MAIN OUTCOME MEASURES: Primary measure was the change from baseline in the Clinician-Administered Posttraumatic Stress Disorder Scale score. Secondary measures included remission, defined as a Clinician-Administered Posttraumatic Stress Disorder Scale score of 20 or lower, and changes in symptom cluster scores, frequency of remission, and time to remission. Measures of stress vulnerability, resilience, depression, quality of life, functioning, and global illness severity were also taken. RESULTS: Mean changes from baseline in Clinician-Administered Posttraumatic Stress Disorder Scale total scores at end point were -51.7 for venlafaxine ER and -43.9 for placebo (P = .006). Improvement was significantly greater for the venlafaxine ER group than for the placebo group in cluster scores for reexperiencing (P = .008) and avoidance/numbing (P = .006), but not for hyperarousal. Remission rates were 50.9% for venlafaxine ER and 37.5% for placebo (P = .01). The venlafaxine ER group also showed significantly greater improvement at end point than the placebo group (P<.05) on all other reported outcome measures. The mean maximum daily dose of venlafaxine ER was 221.5 mg/d. Withdrawal rates were similar between groups with no significant difference in dropouts attributable to adverse events. CONCLUSION: In this study, venlafaxine ER was effective and well tolerated in short-term and continuation treatment of patients with posttraumatic stress disorder.

Valor de un examen médico de ingreso a una institución deportiva / Importance of admission medical test at the sport institution

Mediante el examen médico obligatorio al socio que ingresa a la institución se han podido detectar 232 casos de sobrepeso, 140 casos de trastornos de columna y posturales, 52 casos de trastornos cardiovasculares y circulatorios y 27 distintas afecciones, descriptas anteriormente, totalizando 450 casos (un total de 48 por ciento del total de 941 examinados). Todos ellos han sido asesorados sobre la importancia de un control médico, seguimiento y tratamiento médico-kinésico adecuado. Con el modo operativo utilizado se hace hincapié en la profilaxis y educación para la salud, para lograr un mayor bienestar psicofísico y calidad de vida. Por tal motivo, en las instituciones deportivas se recomienda conformar grupos de orientación sobre nutrición y obesidad, gimnasia correctiva, charlas educativas de difusión con el objetivo de alcanzar una garantía para su salud y mejor utilización de potencialidades y cumplimientos de las expectativas. Se desea enfatizar la importancia de la medicina preventiva destinada a un grupo etáreo compuesto por deportistas que realizan actividad física con fines recreativos y no competitivos

Valor de un examen médico de ingreso a una institución deportiva / Importance of admission medical test at the sport institution

Mediante el examen médico obligatorio al socio que ingresa a la institución se han podido detectar 232 casos de sobrepeso, 140 casos de trastornos de columna y posturales, 52 casos de trastornos cardiovasculares y circulatorios y 27 distintas afecciones, descriptas anteriormente, totalizando 450 casos (un total de 48 por ciento del total de 941 examinados). Todos ellos han sido asesorados sobre la importancia de un control médico, seguimiento y tratamiento médico-kinésico adecuado. Con el modo operativo utilizado se hace hincapié en la profilaxis y educación para la salud, para lograr un mayor bienestar psicofísico y calidad de vida. Por tal motivo, en las instituciones deportivas se recomienda conformar grupos de orientación sobre nutrición y obesidad, gimnasia correctiva, charlas educativas de difusión con el objetivo de alcanzar una garantía para su salud y mejor utilización de potencialidades y cumplimientos de las expectativas. Se desea enfatizar la importancia de la medicina preventiva destinada a un grupo etáreo compuesto por deportistas que realizan actividad física con fines recreativos y no competitivos (AU)