RESUMO

The scope of this article is to screen the symptoms of Post-Traumatic Stress Disorder (PTSD) among the professionals who provided humanitarian aid for the Haitian population after the 2010 earthquake. It involvess a cross-sectional study. The Impact of Event Scale - Revised (IES-R) was used for screening symptoms of PTSD. The participants included 32 Brazilians (mean age = 37.58 +/-7.01), 22 Americans (mean age =33.67 +/-8.03) and 12 Ecuadorians (mean age = 44.80 +/- 15.88). The professionals did not have PTSD symptoms. The relationship between prior experience variables in disaster situations and the total score of the IES-R (F (2) = 4.34, p = 0.017), as well as prior experience in disaster situations and the intrusion subscale (F (2) = 3.94, p = 0.024) were significant in linear regression models. The number of prior experiences was revealed as a significant predictor for the total score of IES (p < 0.05). The results showed that current experiences can be exacerbated by memories of prior experiences, increasing the likelihood of developing PTSD. Therefore the mental health care of the professionals should foster the early identification of prior experience risk factors, thereby not permitting voluntary initiative to transcend selective criteria and specific care.

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RESUMO

O artigo tem por objetivo rastrear sintomatologia de transtorno de estresse pós-traumático (TEPT) em profissionais que prestaram ajuda humanitária à população haitiana, após o terremoto de 2010. Estudo transversal. A sintomatologia de TEPT foi avaliada pela Escala Impacto do Evento - Revisada (IES-R). Os participantes foram 32 brasileiros (idade m = 37.58 +/- 7.01), 22 estadosunidenses (idade m = 33.67 +/- 8.03) e 12 equatorianos (idade m = 44.80 +/- 15.88) e não apresentaram sintomatologia de TEPT. A relação entre as variáveis experiência prévia em situação de desastre e escore total da IES-R [F(2) = 4.34, p = 0.017] bem como experiência prévia em situação de desastre e subescala intrusão [F(2) = 3.94, p = 0.024] foram significantes nos modelos de regressão linear. Experiência prévia se mostrou preditor significante para escore total da IES-R (p < 0,05). Os resultados demonstraram que vivências atuais podem ser potencializadas pelas memórias de experiências anteriores, aumentando a probabilidade de desenvolvimento de TEPT. Portanto, o cuidado com a saúde mental dos profissionais deve favorecer a precoce identificação do fator de risco experiência prévia, não permitindo que a iniciativa voluntária se sobreponha aos critérios seletivos e aos cuidados específicos.

The scope of this article is to screen the symptoms of Post-Traumatic Stress Disorder (PTSD) among the professionals who provided humanitarian aid for the Haitian population after the 2010 earthquake. It involvess a cross-sectional study. The Impact of Event Scale - Revised (IES-R) was used for screening symptoms of PTSD. The participants included 32 Brazilians (mean age = 37.58 +/-7.01), 22 Americans (mean age =33.67 +/-8.03) and 12 Ecuadorians (mean age = 44.80 +/- 15.88). The professionals did not have PTSD symptoms. The relationship between prior experience variables in disaster situations and the total score of the IES-R (F (2) = 4.34, p = 0.017), as well as prior experience in disaster situations and the intrusion subscale (F (2) = 3.94, p = 0.024) were significant in linear regression models. The number of prior experiences was revealed as a significant predictor for the total score of IES (p < 0.05). The results showed that current experiences can be exacerbated by memories of prior experiences, increasing the likelihood of developing PTSD. Therefore the mental health care of the professionals should foster the early identification of prior experience risk factors, thereby not permitting voluntary initiative to transcend selective criteria and specific care.

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OBJECTIVE: To investigate the presence of depression and anxiety symptoms in survivors of the Haiti earthquake who were assisted by a healthcare team from the Hospital Israelita Albert Einstein, and to evaluate the impact that losing a family member during this catastrophe could have on the development of these symptoms. METHODS: Forty survivors of the Haiti earthquake who were assisted by the healthcare team between February and March of 2010 were included in this study. All subjects underwent a semi-structured interview. The group was divided into Group A (individuals who had some death in the family due to the disaster) and Group B (those who did not lose any family member). RESULTS: A total of 55% of the subjects had depression symptoms whereas 40% had anxiety symptoms. The individuals who lost a family member were five times more likely to develop anxiety and depression symptoms than those who did not. CONCLUSION: Catastrophe victims who lost at least one family member due to the disaster were more likely to develop anxiety and depression symptoms. To these individuals, as well as others showing psychological distress, should be offered early mental health care to help them cope with the great emotional distress inherent in these situations.

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OBJETIVO: Investigar a presença de sintomas de depressão e ansiedade em sobreviventes do terremoto do Haiti, que foram atendidos pela equipe de saúde do Hospital Israelita Albert Einstein, e avaliar o impacto que a perda de um familiar durante a catástrofe pode causar no desenvolvimento desses sintomas. MÉTODOS: Quarenta sobreviventes do terremoto do Haiti, atendidos pela equipe de saúde, entre fevereiro e março de 2010, foram incluídos neste estudo. Todos os indivíduos foram submetidos a uma entrevista semiestruturada. O grupo foi dividido em dois: Grupo A (que perderam um familiar na catástrofe) e Grupo B (aqueles que não tiveram perdas). RESULTADOS: Um total de 55% dos indivíduos apresentavam sintomas de depressão e 40% de ansiedade. Os indivíduos que perderam familiares tinham cinco vezes mais probabilidade de desenvolver ansiedade e depressão do que aqueles não tiveram perdas. CONCLUSÃO: As vítimas de catástrofes que perderam pelo menos um familiar no desastre têm maior probabilidade de desenvolver sintomas de depressão e ansiedade. A esses indivíduos, assim como outros que demonstravam estresse psicológico, devem ser oferecidos, precocemente, cuidados de saúde mental, para ajudá-los a suportar o grande estresse emocional inerente a essas situações.

OBJECTIVE: To investigate the presence of depression and anxiety symptoms in survivors of the Haiti earthquake who were assisted by a healthcare team from the Hospital Israelita Albert Einstein, and to evaluate the impact that losing a family member during this catastrophe could have on the development of these symptoms. METHODS: Forty survivors of the Haiti earthquake who were assisted by the healthcare team between February and March of 2010 were included in this study. All subjects underwent a semi-structured interview. The group was divided into Group A (individuals who had some death in the family due to the disaster) and Group B (those who did not lose any family member). RESULTS: A total of 55% of the subjects had depression symptoms whereas 40% had anxiety symptoms. The individuals who lost a family member were five times more likely to develop anxiety and depression symptoms than those who did not. CONCLUSION: Catastrophe victims who lost at least one family member due to the disaster were more likely to develop anxiety and depression symptoms. To these individuals, as well as others showing psychological distress, should be offered early mental health care to help them cope with the great emotional distress inherent in these situations.

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Pancreas transplantation (PT) is a relatively uncommon therapy for non-uremic type 1 diabetes, as the severity of diabetes must warrant the risk of immunosuppression. In pediatric diabetic patients, who are less likely to display uremia because of the duration of diabetes, there is very little experience with pancreas transplantation alone (PTA). This report describes a 13-yr-old male PTA recipient. This patient was initially diagnosed with type 1 diabetes mellitus at the age of four yr. Following a multidisciplinary evaluation, PTA was found to be indicated based on a history of severe labile diabetes and hypoglycemic unawareness resulting in frequent episodes of hypoglycemia and hospital admissions. Because of the failure of medical management of the patient's diabetes, a whole organ bladder and systemic drained PTA was performed. Immunosuppression included thymoglobulin, tacrolimus, mycophenolate mofetil, and steroids. Early outcome was uneventful and patient was discharged 12 d after surgery normoglycemic and insulin-free. An episode of acute rejection (Maryland grade II) 20-d post-transplant was successfully treated with corticosteroids. A second and more severe episode of rejection (Maryland grade IV) occurred 13 months post-transplant, requiring treatment with thymoglobulin and conversion from steroid to sirolimus. On tacrolimus, sirolimus, and mycophenolic acid, he remains euglycemic and insulin-free 38 months after PTA. His quality-of-life is judged to be superior to his insulin dependent state prior to transplantation. According to the medical literature, this is the youngest patient ever to undergo PTA.

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