Traumatic stress, active engagement and resilience in first responders and civilians in the outbreak of war.

Background: The outbreak of war in Israel on 7 October and the unique events of that day have presented unprecedented challenges to first responders (FRs), who are professionally trained to engage in providing assistance in such circumstances. Moreover, while research demonstrates the long-term psychological consequences of FRs, little is known regarding how FR's engagement in providing assistance relates to stress and resilience levels as events continue to unfold.Objective: The current study examined the relationship between traumatic stress symptoms (TSS) and resilience levels among FRs and controls during the first weeks of the Iron Swords war, while focusing on the moderating role of active engagement in providing assistance.Method: Data were collected during the first month of the Iron Swords war from 374 participants living in Southern Israel, of whom 77 (20.6%) were FRs. All participants filled out scales assessing TSS and resilience and provided relevant background information.Results: High TSS levels were associated with reduced resilience in FRs and non-FRs. Moreover, both the study group and active engagement were significant moderators for the TSS-resilience link, which was insignificant among FRs who provided assistance and for civilians who did not provide assistance. However, the TSS-resilience association remained significant for FRs who did not engage in providing assistance and for civilians who did.Conclusions: Our findings highlight the importance of examining the extent to which FRs act in line with their duties during times of adverse stress. Clinical interventions aimed towards FRs who did not engage in providing assistance are needed and should focus on the extent to which their moral values, beliefs and expectations are met, as these appear critical parameters in preserving resilience.

First responders report increased traumatic stress and reduced resilience.Active engagement moderated first responders' traumatic stress­resilience link.Findings are discussed in the context of potentially morally injurious events.

A non-randomized pilot trial of the use of prazosin in the prevention of transition from acute stress disorder to post-traumatic stress disorder.

BACKGROUND: Following a traumatic event, 40-80% of the patients with acute stress disorder (ASD) will develop post-traumatic stress disorder (PTSD), 67% at 6 months. Alpha1-blockers are effective in treating some symptoms of PTSD but their usefulness in acute stress situations remains unclear. We hypothesized that reducing noradrenergic hyperactivity with an alpha1-blocker during the acute phase after a traumatic event could prevent the transition to PTSD in patients with ASD. OBJECTIVE: To investigate the efficacy and safety of a 1-month course of alpha1-blocker (prazosin) to prevent the transition to PTSD in patients with ASD at 6 months. METHOD: In a monocentric open-label prospective pilot study, 15 patients with ASD were included within 3-7 days of exposure to a traumatic event. After enrolment, they received prazosin LP at home at bedtime at 2.5 mg/day for 7 days and then 5 mg/day for 21 days. Incidence of PTSD was assessed at 6 months using the Clinician Administrated PTSD Scale (CAPS). RESULTS: At 6 months, 22% of patients who completed the study (2/9) met the diagnostic criteria for PTSD. This rate was significantly lower than that observed in previous studies (67%; p = .047). The treatment was well tolerated and there were no serious adverse events. CONCLUSIONS: These preliminary findings indicating the safety of prazosin and suggesting its potential to prevent the development of PTSD in ASD require to be replicated in large-scale randomized placebo-controlled studies.Trial registration: The study was pre-registered on a public database (www.clinicalTrials.gov identifier: NCT03045016).

Alpha1-blockers are safe and well tolerated in patients with acute stress disorder.The use of alpha1-blockers 3­7 days after traumatic exposure is worthy of study.Alpha1-blockers could prevent the transition to PTSD in ASD patients at 6 months.

Estrés agudo y crónico en la reparación ósea: un enfoque actualizado desde las neurociencias / Acute and chronic stress in bone repair: an updated approach from the neurosciences

Los mecanismos moleculares fisiológicos asociados a la respuesta ante el estrés agudo y crónico permiten entender los cambios que éstos pueden producir en los diversos tejidos del cuerpo. Diversas investigaciones resaltan el papel del estrés crónico en el desarrollo de disfunciones que afectan el equilibrio corporal; sin embargo, hay que considerar que los mecanismos relacionados con el estrés agudo, también pueden influir en el desarrollo de patologías y de la progresión de las manifestaciones deletéreas del estrés crónico. Por otro lado, uno de los tejidos más estudiados en los últimos años ha sido el tejido óseo, ya que éste se encuentra influenciado por factores nerviosos, endocrinos e inmunológicos. Esta revisión busca analizar las bases neurocientíficas de los mecanismos moleculares del estrés y su relación en el proceso de reparación ósea. Para esto, se realizó una búsqueda de la literatura en las bases de datos de Pubmed, Scopus y ScienceDirect, concluyendo que el estrés modifica la liberación de neurotransmisores, la acción del sistema nervioso autónomo, la liberación de hormonas corticotrópicas y la actividad de diversas citocinas; lo que conlleva al desequilibrio de los procesos de regulación y reparación del tejido óseo sometido a carga o lesión.

The physiological molecular mechanisms associated with the response to acute and chronic stress allow us to understand the changes that these can produce in the various tissues of the body. Various investigations highlight the role of chronic stress in the development of dysfunctions that affect body balance; However, it must be considered that the mechanisms related to acute stress can also influence the development of pathologies and the progression of the deleterious manifestations of chronic stress. On the other hand, one of the most studied tissues in recent years has been bone tissue, since it is influenced by nervous, endocrine and immunological factors. This paper seeks to analyze the neuroscientific bases of the molecular mechanisms of stress and their relationship in the bone repair process. Therefore, a literature search was carried out in the Pubmed, Scopus and ScienceDirect databases. Concluding that stress modifies the release of neurotransmitters, the action of the autonomic nervous system, the release of corticotropic hormones and the activity of various cytokines; which leads to the imbalance of the regulation and repair processes of the bone tissue subjected to load or injury.

Reacción al estrés agudo y el síndrome burn out en el personal del centro de salud de Santa Ana. Panamá

Introducción: la reacción al estrés agudo y síndrome burn out (SB) se diferencian: el primero es consecuencia de un estrés físico o psicológico excepcional y el segundo es consecuencia al estrés laboral; pero ambos comparten síntomas de tipo depresivo, ansiedad y somáticos. Objetivo: Evaluar las características clínicas y epidemiológicas con relación al trastorno por reacción al estrés agudo y síndrome burnout. Metodología: Estudio clínico Descriptivo y Transversal. Se analizaron 55 personas del centro de salud, se utilizaron 5 cuestionarios: Maslach Burnout Inventory (MBI), de estrés percibido (PSQ), sobre la salud del paciente-9 (PHQ-9), para trastorno de ansiedad generalizada (GAD-7) y sobre la salud del paciente-15 (PHQ-15). Los datos fueron analizados con el programa EPI INFO 7 utilizando descripciones de frecuencia, porcentaje, cruce de variables y pruebas de significancia estadísticas. Resultados: Se obtuvo una prevalencia del 5.4% SB, síntomas SB 25.4% y según las subescalas del SB se obtuvo CE (cansancio emocional) 14.5%, DE (despersonalización)18.1% y RP (realización personal) 18.1%. Hubo una relación positiva de CE, PSQ (0 ­ 0.49) y síntomas de ansiedad según GAD-7 (3%) (P=0.003), por el cual, posible hay un 5.4% con reacción al estrés agudo. Conclusiones: La prevalencia del personal del CS para SB fue de 5.4%, síntomas SB 25.4% y según las subescalas del SB se obtuvo CE 14.5%, DE 18.1% y RP 18.1%. Así mismo se encontró una relación significativa CE, PSQ (0 ­ 0.49) y síntomas de ansiedad según GAD-7 (3%) (P=0.003), por el cual, hay un posible 5.4% con reacción al estrés agudo. (provisto por Infomedic International)

Introduction: Acute stress reaction and burnout syndrome (BS) are different: the former is a consequence of exceptional physical or psychological stress and the latter is a consequence of occupational stress; but both share depressive, anxiety and somatic symptoms. Objective: To evaluate the clinical and epidemiological characteristics of acute stress reaction disorder and burnout syndrome. Methodology: Descriptive and cross-sectional clinical study. A total of 55 people from the health center were analyzed, 5 questionnaires were used: Maslach Burnout Inventory (MBI), perceived stress (PSQ), patient health questionnaire-9 (PHQ-9), generalized anxiety disorder (GAD-7) and patient health questionnaire-15 (PHQ-15). The data were analyzed with the EPI INFO 7 program using descriptions of frequency, percentage, crossing of variables and statistical significance tests. Results: There was a prevalence of 5.4% SB, SB symptoms 25.4% and according to the subscales of SB there was CE (emotional exhaustion) 14.5%, DE (depersonalization) 18.1% and RP (personal fulfillment) 18.1%. There was a positive relationship of CE, PSQ (0 - 0.49) and anxiety symptoms according to GAD-7 (3%) (P=0.003), whereby, possible there is 5.4% with acute stress reaction. Conclusions: The prevalence of CS personnel for SB was 5.4%, SB symptoms 25.4% and according to SB subscales CE 14.5%, DE 18.1% and RP 18.1% were obtained. Likewise, a significant relationship was found between CE, PSQ (0 - 0.49) and anxiety symptoms according to GAD-7 (3%) (P=0.003), whereby, there is a possible 5.4% with acute stress reaction. (provided by Infomedic International)

Mental health assessment of Spanish frontline healthcare workers during the SARS-CoV-2 pandemic.

BACKGROUND AND OBJECTIVE: The Covid-19 pandemic continues challenging health systems globally, exposing healthcare workers to constant physical and psychological stressors. To date, several studies have already shown the catastrophic impact on the mental health of medical personnel during the early period of the pandemic. Nevertheless, literature evidences the dearth of works that evaluate the effect over time, understanding the pandemic as a sustained extreme stressor. The present study examines the effect of the pandemic on the mental health of Covid-19 frontline healthcare workers at six months follow-up. MATERIAL AND METHODS: A total of 141 frontline healthcare workers from two tertiary hospitals were recruited between July and November 2020. Healthcare workers were evaluated psychologically at baseline and six months follow-up (January to May 2021) using psychometric tests for the assessment of acute stress (VASS, PSS-10, PCL-5), anxiety (STAI) and depression (PHQ-2) RESULTS: Overall, there was a general worsening of the mental health between the two psychological assessments, especially regarding depression and predisposition to perceiving the situations as a threat. Nurses and nurse aides showed poorer mental health while physicians improved over time. Reduced working hours and higher physical exercise resulted in better mental health among healthcare workers. Women and nursing staff were the most affected by psychological distress at baseline and six months follow-up. CONCLUSION: Reduced working hours, adequate resting periods, physical exercise, and efficient intervention strategies are of utmost importance in preventing, controlling, and reducing psychological distress among healthcare workers when coping with critical scenarios such as the current pandemic.

[Healthcare workers in intensive care units as second victims of SARS-CoV-2: results of a survey]. / Los trabajadores de áreas de cuidados críticos como segundas víctimas del SARS-CoV-2: resultados de una encuesta.

INTRODUCTION: SARS-CoV-2 epidemic has caused an exceptional situation in our country's healthcare system. Healthcare workers could become the second victims as consequence of this pandemic circumstances, such as: the huge work overload that healthcare workers have been exposed to, the excessive emotional overload, the stressful situations and the fear of being infected themselves and to infect their families. The aim of this study is to know the emotional overload of workers in intensive care units during SARS-CoV-2 epidemic in a tertiary hospital in the Community of Madrid. MATERIAL AND METHODS: Descriptive cross-sectional study, carried out through the voluntary completion by workers in intensive care units of a questionnaire adapted from the Acute Stress Scale «EASE COVID-19¼, with 10 closed-ended Likert scale questions, adding four questions: sex, professional category, if they usually work in intensive care units and the sacrifice in their routines. Data were collected in July 2020, to assess the impact of the first wave. A descriptive analysis was carried out as well as an analysis of the possible links between the collected variables and the emotional response. RESULTS: Fifty-four percent of surveyed respondents showed good emotional adjustment. The major concern of the participants was the possibility of infecting their families. The highest scores by categories were observed in nurses, assistant nursing care technicians and orderlies, while 100% of doctors showed good emotional adjustment, with no differences between genders. Sixty percent of participants modified their family routine, being medical residents who got the highest percentage. CONCLUSIONS: Sanitary crisis has turned healthcare workers into second victims of SARS-CoV-2. Their detection is essential to offer them help and resources to ensure their emotional well-being, removing barriers and helping them to be strengthened.

Efectos del estrés agudo en la ingesta de alimentos en estudiantes universitarios emocionalmente sanos / Effects of acute stress on food intake in emotionally healthy university students

Introducción y objetivo: Este estudio tuvo como objetivo examinar la relación entre el estrés agudo y la ingesta de alimentos utilizando una muestra de personas sin trastornos emocionales. Con el fin de manipular el estrés y evaluar la relación antes mencionada, se diseñó un escenario experimental, a través de una versión modificada del protocolo de inducción del estrés social, Trial Stress Social Test (TSST). Material y métodos: La muestra final incluyó a 82 participantes entre las edades de 18 y 30 años, que fueron asignados aleatoriamente en dos grupos. Los participantes asistieron a dos sesiones. Al principio, respondieron cuestionarios que recopilaban información sobre estrés - para garantizar la equivalencia de los grupos antes de cualquier exposición al experimento-. En la segunda sesión, para cada actividad asociada con el protocolo TSST, se evaluó el estrés percibido. Además, se evaluó la ingesta de alimentos. Para el análisis, se controlaron estadísticamente seis covariables: edad, sexo, IMC, alimentación emocional, restricción de alimentos y food craving. Además, la ingesta de alimentos se evaluó con la categoría: cantidad de alimentos poco saludables. Resultados: A través del análisis de regresión logística, se descubrió que, en condiciones de estrés agudo, una persona sana podría tener una mayor ingesta de alimentos poco saludables.Conclusiones: Las implicaciones teóricas y prácticas de los resultados contribuyen al desarrollo de investigaciones futuras en el campo de estudio.(AU)

Introduction and objective: This study aimed to examine the relationship between acute stress and food intake using a sample of people without emotional disturbances. In order to manipulate the stress and evaluate the aforementioned relationship, an experimental scenario was designed, through a version modified of the Social Stress induction protocol, Trial Stress Social Test (TSST). Material and methods: The final sample included 82 participants between the ages of 18 and 30 years, who were randomly assigned into two groups. Participants attended two sessions. In the beginning, they answered questionnaires that gathered information about: stress to guarantee the equivalence of the groups before any exposure to the experiment. In the second session, for each activity associated with the TSST protocol, the perceived stress was evaluated. Also, the food intake was evaluated. For the analysis, six covariates were statistically controlled: age, sex, BMI, emotional eating, food restriction and food craving. In addition, food intake was evaluated with the category: quantity of unhealthy food. Results: Through logistic regression analysis, it was found that, under acute stress conditions, a healthy person might have a higher intake of unhealthy food. Conclusions: Theoretical and practical implications of the results contribute in developing future research in the field of study.(AU)

Cardiovascular response to stress in patients with drug-resistant epilepsy: preliminary data / Respuesta cardiovascular al estrés en pacientes con epilepsia farmacorresistente: datos preliminares

Stress is a risk factor for cardiovascular diseases in the general population. Epilepsy has been considered a suitable model of chronic stress with a higher incidence of cardiovascular mortality than the general population. This study provides preliminary data about cardiovascular response to a cognitive stressor and a neuropsychological assessment in patients with epilepsy. It also explores the relationship between cardiovascular response and cognitive performance, depending on the side of seizure focus. Thirty-five patients with drug-resistant epilepsy, 17 with epileptogenic area (EA) in the left hemisphere (LH) and 18 with EA in the right hemisphere (RH), underwent a cognitive stressor and a neuropsychological assessment. The cardiovascular response was recorded throughout both conditions. Results showed that a long-lasting neuropsychological assessment was capable of producing a hemisphere-modulated cardiovascular response with heart rate (HR) decreases (and R-R interval increases) more pronounced in the LH patients than in the RH patients at the post-assessment period (p = .05 and p = .01, respectively). The hemisphere of EA moderated the relationship between cardiovascular response and cognitive performance (for all, p < .03). Our findings may have clinical implications from a preventive perspective since the EA hemisphere may be a relevant factor for coping with stress in people with drug-resistant epilepsy.(AU)

El estrés es un factor de riesgo para las enfermedades cardiovasculares en la población general. La epilepsia se ha considerado un modelo adecuado de estrés crónico, con mayor incidencia de mortalidad cardiovascular que la población general. Este estudio proporciona datos preliminares sobre la respuesta cardiovascular ante un estresor cognitivo y una evaluación neuropsicológica en pacientes con epilepsia, explorando las relaciones entre la respuesta cardiovascular y el rendimiento cognitivo dependiendo del hemisferio responsable de la epilepsia. Treinta y cinco pacientes con epilepsia farmacorresistente, 17 con el área epileptógena (AE) en el hemisferio izquierdo (HI) y 18 con AE en el hemisferio derecho (HD), se sometieron a un estres cognitivo y una evaluación neuropsicológica. La respuesta cardiovascular se registró durante toda la sesión en ambas condiciones. Los resultados mostraron que una evaluación neuropsicológica de larga duración fue capaz de producir una respuesta cardiovascular modulada por el hemisferio, con disminuciones de la frecuencia cardíaca (y aumentos del intervalo RR) más pronunciadas en el período post-evaluación en pacientes con epilepsia del HI que en pacientes con epilepsia del HD (p = .05, p = .01, respectivamente). El hemisferio del AE moderó la relación entre la respuesta cardiovascular y el rendimiento cognitivo (para todos, p < .03). Nuestros hallazgos podrían tener implicaciones clínicas desde una perspectiva preventiva, ya que sugieren que el hemisferio del AE podría ser un factor relevante en el afrontamiento del estrés en personas con epilepsia farmacorresistente.(AU)

Trastornos de estrés agudo: consideraciones a partir de un caso clínico en el ámbito militar / Acute Stress Disorders: Considerations from a clinical case in the military field

Introducción: Se presenta el caso de un militar de 32 años, varón, diagnosticado de trastorno de estrés agudo durante su despliegue en zona de operaciones en Afganistán. La sintomatología que manifestaba el paciente le incapacitaba para el servicio.Objetivo: El objetivo terapéutico es el control de la sintomatología de estrés del paciente y la normalización de su estado psicológico, para conseguir su completa reincorporación al servicio activo.Material y métodos: Diseño de caso único, pre-postratamiento. Para el diagnóstico y medida postratamiento se utilizó el Cuestionario de Adaptación 6RA, el Inventario de Ansiedad Estado-Rasgo y la escala de Síntomas de Estrés Agudo. Se aplicó un programa terapéutico breve compuesto de 7 sesiones y basado en psicoeducación, reestructuración cognitiva, entrenamiento en técnicas de relajación y exposición en vivo.Resultados: La evaluación postratamiento muestra una notable reducción de la sintomatología de estrés agudo. La normalización del estado psicológico del paciente permitió la reincorporación a su puesto, completando el resto de la misión sin novedad.Conclusiones: El presente trabajo pone de manifiesto la efectividad de las psicoterapias breves para el tratamiento de trastornos de estrés en operaciones militares en el exterior, al permitir al militar mantener su operatividad y reincorporarse al servicio lo más rápidamente posible. Las medidas preventivas previas al despliegue son fundamentales para la adaptación del militar.(AU)

Introduction: The case of a 32-year-old military man diagnosed with acute stress disorder during his deployment to the area of ​​operations in Afghanistan is presented. The symptoms manifested by the patient incapacitated him for the service.Objective: The therapeutic objective is to control the patient's stress symptoms and to normalize their psychological condition, to achieve their full return to active duty.Material and Methods: Single case design, pre-post treatment. The instruments used for the diagnosis and post-treatment measure were the Adaptation Questionnaire 6RA, the State-Trait Anxiety Inventory and the Acute Stress Symptoms Scale. A short therapeutic program of 7 sessions was applied, based on psychoeducation, cognitive restructuring, training in relaxation techniques and live exposure.Results: The post-treatment evaluation shows a significant reduction in the symptoms of acute stress. The normalization of the patient's psychological condition allowed him to return to work, completing the rest of the mission without incident.Conclusions: This paper shows the effectiveness of brief psychotherapies for the treatment of stress disorders in military operations abroad. These psychotherapies allow the military to maintain its operability and rejoin the military service as soon as possible. Pre-deployment preventive measures are essential for the military's adaptation.(AU)

Frequency of acute stress disorder in health care workers of a tertiary level pediatric hospital during the National Safe Distance Strategy for COVID-19 prevention.

Background: Acute stress disorder (ASD) is one of the most frequent mental illnesses occurring during sanitary emergencies. This study aimed to estimate the frequency of ASD in health care workers of a tertiary level pediatric hospital during the coronavirus disease (COVID-19) pandemic. Methods: We conducted a cross-sectional study in which health care workers completed a virtual questionnaire, including sociodemographic information and the ASD scale. Results: We analyzed 206 questionnaires. The population was divided into three groups: attending physicians, medical residents, and nursing personnel. The frequency of health care workers who showed at least nine symptoms of ASD was 88.8%. No significant differences were found between the studied groups. Conclusions: ASD is a frequent condition in health care workers in the context of the COVID-19 pandemic. We need to investigate further and assess risk and protective factors for developing this and other psychopathologies in this population.

Introducción: El trastorno por estrés agudo es una de las enfermedades mentales más frecuentemente manifestadas en emergencias sanitarias. El objetivo de este estudio fue conocer la frecuencia con la que se presentó el trastorno por estrés agudo en el personal de salud de un hospital pediátrico de tercer nivel durante la epidemia de COVID-19. Método: Se realizó un estudio transversal en el que trabajadores de la salud contestaron un cuestionario virtual que incluyó datos sociodemográficos y la Escala de Trastorno por Estrés Agudo. Resultados: Se analizaron 206 encuestas. La población se dividió en tres grupos: médicos adscritos, residentes y personal de enfermería. El 88.8% de los trabajadores de la salud reportaron más de nueve síntomas de trastorno por estrés agudo. No se encontraron diferencias significativas entre los grupos de estudio. Conclusiones: Los síntomas del trastorno por estrés agudo son frecuentes en los trabajadores de la salud en el contexto de la COVID-19. Es necesario investigar acerca de los factores de riesgo y protectores asociados al desarrollo de esta y otras psicopatologías en dicha población.

Frequency of acute stress disorder in health care workers of a tertiary level pediatric hospital during the National Safe Distance Strategy for COVID-19 prevention / Frecuencia de trastorno por estrés agudo en el personal de salud de un hospital pediátrico de tercer nivel durante la Jornada Nacional de Sana Distancia para la prevención de la COVID-19

Abstract Background: Acute stress disorder (ASD) is one of the most frequent mental illnesses occurring during sanitary emergencies. This study aimed to estimate the frequency of ASD in health care workers of a tertiary level pediatric hospital during the coronavirus disease (COVID-19) pandemic. Methods: We conducted a cross-sectional study in which health care workers completed a virtual questionnaire, including sociodemographic information and the ASD scale. Results: We analyzed 206 questionnaires. The population was divided into three groups: attending physicians, medical residents, and nursing personnel. The frequency of health care workers who showed at least nine symptoms of ASD was 88.8%. No significant differences were found between the studied groups. Conclusions: ASD is a frequent condition in health care workers in the context of the COVID-19 pandemic. We need to investigate further and assess risk and protective factors for developing this and other psychopathologies in this population.

Resumen Introducción: El trastorno por estrés agudo es una de las enfermedades mentales más frecuentemente manifestadas en emergencias sanitarias. El objetivo de este estudio fue conocer la frecuencia con la que se presentó el trastorno por estrés agudo en el personal de salud de un hospital pediátrico de tercer nivel durante la epidemia de COVID-19. Método: Se realizó un estudio transversal en el que trabajadores de la salud contestaron un cuestionario virtual que incluyó datos sociodemográficos y la Escala de Trastorno por Estrés Agudo. Resultados: Se analizaron 206 encuestas. La población se dividió en tres grupos: médicos adscritos, residentes y personal de enfermería. El 88.8% de los trabajadores de la salud reportaron más de nueve síntomas de trastorno por estrés agudo. No se encontraron diferencias significativas entre los grupos de estudio. Conclusiones: Los síntomas del trastorno por estrés agudo son frecuentes en los trabajadores de la salud en el contexto de la COVID-19. Es necesario investigar acerca de los factores de riesgo y protectores asociados al desarrollo de esta y otras psicopatologías en dicha población.

Impacto de la muerte infantil en residentes de pediatria / Impact of child death on pediatric trainees

Objetivo. - Establecer la prevalencia de Reacción de estrés agudo y Trastorno de estrés Postraumático (ASR/ TEPT) en residentes de Pediatría expuestos a muerte Infantil.Diseño. - Corte transversal.Lugar. ­ La Paz: Hospital del Niño Ovidio Aliaga Uría, Hospital Materno Infantil CNS, Hospital del Norte de El Alto, Hospital de la Banca Privada, y Hospital Boliviano Holandés. Santa Cruz: Hospital Mario Ortiz y Hospital Japonés. Cochabamba: Hospital Albina Patiño y Hospital Viedma.Participantes. ­ Residentes de Pediatría de Primer, Segundo y Tercer año de hospitales de la Paz, Santa Cruz y CochabambaMedición. - Mediante una encuesta diseñada en base a la CIE-10 (Clasificación Internacional de Enfermedades 10ª Revisión) y DSM-V (Manual diagnóstico y estadístico de trastornos mentales, 5ª edición).Resultados. ­De 181 residentes encuestados, sexo femenino 67% y masculino 33%, 85/181 (46.9%.) residentes habían estado expuestos con la muerte de un niño, ninguno había recibido capacitación sobre la muerte infantil. Prevalencia global de ASR fue n=58/181 (32%) y de TEPT n=27/181 (14,9%). La prevalencia fue mayor en residentes de segundo año ASR (39,66 %), TEPT (12.90%) y en mujeres ASR (43.68%) y TEPT (20.69%). Las alteraciones observadas fueron: Problemas de la Concentración 20,44%, Trastornos del Sueño 19,89%, Irritabilidad y Accesos de Ira 14,92 % y la Hipervigilia 9,39%.Conclusión. - La presencia de ASR y TEPT es alta en la Residencia de Pediatría de Hospitales del eje troncal de Bolivia. Por lo que existe mayor riesgo de desarrollar ASR y TEPT después de la muerte de un niño. Alteraciones de Vigilia y Comportamiento debe identificarse y reconocerse para permitir una pronta señalización para un mayor apoyo, incluida la evaluación psicológica o la intervención si es necesario.

Predictores de sintomatología postraumática aguda y crecimiento post-estrés tras un accidente laboral reciente / Predictors of Acute Posttraumatic Symptoms and Post- Stress Growth After a Recent Work Accident

Resumen El propósito de este estudio fue evaluar un modelo predictivo de sintomatología postraumática aguda (SPT) y de crecimiento post-estrés (CPE) en trabajadores que sufrieron un accidente laboral reciente. Se encuestaron 246 trabajadores (23.2% mujeres) entre los 18 y los 73 años. Se encontró que los principales predictores de la SPT son: severidad subjetiva del evento, afrontamiento religioso negativo, reinterpretación positiva y rumiación de tipos intrusiva, negativa y deliberada. A su vez, los principales predictores de CPE fueron: rumiación deliberada y afrontamiento religioso positivo. Se realizó un análisis de sendero para evaluar un modelo en el cual la rumiación intrusiva y la deliberada cumplen una función mediadora, obteniendo adecuados índices de ajuste. Se plantea la necesidad de contar con un método de evaluación temprana de las respuestas psicológicas tras un accidente.

Abstract The aim of this study is to evaluate a predictive model of acute posttraumatic symptomatology (PTS) and post-stress growth (PSG) in workers who suffered a recent work accident. To this end, 246 workers (23.2% women) were surveyed, aged between 18 and 73 years. The main predictors of PTS were subjective severity of event, negative religious coping, positive reinterpretation, and intrusive, brooding and deliberate rumination. At the same time, the main predictors of PSG were deliberate rumination and positive religious coping. A path analysis was performed to evaluate a model in which intrusive and deliberate rumination fulfill a mediating function, obtaining adequate goodness-of-fix indices. The need to have a method of early evaluation of psychological responses after an accident is proposed.

El estrés agudoiinterfiere con la evocación y pomueve la extinción de la memorria espacial en el laberinto de barnes / High stress interfers with evocation and promotes extintion of spatial memory in the Barnes maze

Para evaluar los efectos del estrés agudo sobre la recuperación y la extinción de la memoria espacial, se utilizaron ratas entrenadas en el laberinto circular de Barnes. El entrenamiento consistió de 8 ensayos de adquisición (intervalo entre ensayos, IEE, de 5 min) en donde los animales debían aprender a encontrar una caja meta ubicada en uno de los 18 agujeros del laberinto. Todos los animales adquirieron el aprendizaje espacial, ya que invirtieron menos tiempo en encontrar la caja meta y cometieron menos errores a medida que se sucedían los ensayos de entrenamiento. Veinticuatro horas después del entrenamiento se evaluó la retención y extinción del aprendizaje espacial mediante una prueba con caja meta (PCC) seguida de siete pruebas sin caja (PSC), con un IEE de 5 min. Una hora y media antes de la sesión de evaluación de la memoria un grupo de animales fue sometido a estrés por restricción de movimientos durante una hora, permitiéndoles un período de recuperación de 30 min y otro grupo permaneció en su caja hogar sin manipulación (control). Los resultados indican que el estrés deteriora el proceso de evocación de la memoria espacial, ya que los animales estresados cometieron un mayor número de errores y demoraron más tiempo en encontrar la caja meta durante la PCC , respecto de los controles. Además, el estrés facilita el proceso de extinción, ya que, durante las PSCs los animales estresados no mostraron una persistencia en la exploración del agujero que, en el entrenamiento, conducía a la caja meta.

To evaluate the effects of acute stress on evocation and extinction of a spatial memory task, we used rats trained in the Barnes circular maze. The training protocol consisted of eight acquisition trials (intertrial interval, ITI; 5 min) where animals must learn to find an escape box placed under one of these eighteen holes of the maze. All animals learned the spatial memory task as indicated by diminished escape latency and weighted errors along the eight acquisition trials. Twenty four hours after training spatial memory evocation and extinction were tested (one trial with escape box, and seven consecutive trials without escape box, ITI: 5 min). One hour and a half before memory evaluation session half of the animals underwent movement restriction during one hour (one hour stress, 1H) and were allowed 30 min to recover, while the other half stayed in their home cage without manipulation (control, C). Stressed animals displayed a significant increase both in escape latency and in weighted errors during the trial with scape box. These results indicate that movement restriction-induced stress deteriorates the spatial memory evocation. Moreover, movement restriction-induced stress during one hour facilitates extinction, showed by the non-persistence in the exploration of the escape hole during the trials without escape box.

Prevalencia del trastorno por estrés agudo y trastorno por estrés postraumático en soldados colombianos heridos en combate / Prevalence of acute stress disorder and post-traumatic stress disorder in Colombian soldiers wounded in combat / Prevalencia da reação ao stress agudo e do transtorno por stress postraumático nos soldados feridos no combate hospitalizado no Hospital Militar Central de Bogotá

El objetivo de este trabajo fue determinar la prevalencia de la reacción a estrés agudo y del trastorno por estrés postraumático en los soldados heridos en combate que ingresan al Hospital Militar. Para ello se realizó un estudio descriptivo de corte transversal en el que se aplicó el Clinical Administered Postraumática Stress Disorder Scale (CAPS) a una muestra de pacientes hospitalizados por heridas en combate en el Hospital Militar Central de Bogotá. Se midió la prevalencia y la frecuencia, haciendo un análisis bivariado de los datos obtenidos. Se obtuvo una prevalencia del 16,66% para trastorno por estrés postraumático y ningún caso de trastorno por estrés agudo, lo que proporciona una clara evidencia de que las lesiones provocadas durante un combate percibido como traumático, son un factor de riesgo mayor para el desarrollo de trastorno por estrés postraumático...

The objective of this work was to determine the prevalence of acute stress disorder and post-traumatic stress disorder in soldiers wounded in combat admitted to the Military Hospital. For this purpose we proceeded to realize a cross cut, descriptive study in which we applied the CAPS (clinical administered post traumatic stress disorder scale), to a sample of patients admitted due to combat wounds to the Hospital Militar Central de Bogota. We measured prevalence and frequency and did a bivariate analysis of the collected data. We obtained a prevalence of 16,66 % for posttraumatic stress disorder and there were no cases of acute stress disorder, providing clear evidence that the injuries provoked during combat perceived as traumatic, are a factor of significant risk for the development of post-traumatic stress disorder...

O objetivo deste trabalho foi determinar a prevalência da reação ao stress agudo e do transtorno do stress do pós-traumático nos soldados feridos no combate que ingressam no hospital militar. Foi realizado um estudo descritivo de corte transversal onde se aplicou o Clinical Administered Post Traumática Stress Disorder Scale (CAPS) a uma amostra de pacientes hospitalizados por feridas no combate no hospital militar central de Bogotá. Medimos a prevalência e a freqüência, fazendo um análise bivariado dos dados coletados. Uma prevalência de 16.66% para os transtornos por stress pós-traumático foi obtida e nenhum caso do transtorno por reação ao stress agudo, o que fornece uma evidência clara de que os ferimentos causados durante um combate percebido como traumático são o fator do risco maior para o desenvolvimento de transtornos por stress pós-traumático...