Revista Espanola de Sanidad Penitenciaria最新文献

{"title":"Cost-effectiveness analysis of chronic hepatitis C treatment in the prison population in Spain.","authors":"A Marco,&nbsp;R Domínguez-Hernández,&nbsp;M A Casado","doi":"10.18176/resp.00012","DOIUrl":"https://doi.org/10.18176/resp.00012","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the cost-effectiveness of direct-acting antiviral (DAAs) treatment versus non-treatment in prisoners awaiting treatment for chronic hepatitis C (CHC) and to analyse the clinical and economic impact of the treatment on liver complications and mortality.</p><p><strong>Material and method: </strong>A lifetime Markov model was developed to simulate treatment and disease progression from an estimated cohort of 4,408 CHC prisoners treated with DAAs over 2 years (50% of patient each year) versus no treatment. In the treated cohort, a sustained viral response of 95% was associated. Patient characteristics, transition probabilities, utilities and costs (pharmacological and healthcare states) were obtained from published literature. The model estimated healthcare costs and benefits, incremental cost-utility ratio (ICUR) based on total costs and the quality-adjusted life year (QALY) and avoided clinical events. A National Healthcare System perspective was adopted with a 3% annual discount rate for both costs and health outcomes. Sensitivity analyses were performed to assess uncertainty.</p><p><strong>Results: </strong>In the DDA treated cohort, the model estimated a decrease of 92% of decompensated cirrhosis and 83% of hepatocellular carcinoma, 88% liver-related mortality cases were reduced, 132 liver transplants were avoided. The treatment achieved an additional 5.0/QALYs (21.2 vs. 16.2) with an incremental cost of €3,473 (€24,088 vs. €20,615) per patient with an ICUR of €690 per QALY gained.</p><p><strong>Discussion: </strong>Considering the willingness-to-pay threshold used in Spain (€22,000-30,000/QALY), DAAs treatment for prisoners with CHC is a highly cost-effective strategy, reduces infection transmission, increases survival and reduces complications due to liver disease, as well as the cost associated with its management.</p>","PeriodicalId":30044,"journal":{"name":"Revista Espanola de Sanidad Penitenciaria","volume":"22 2","pages":"66-74"},"PeriodicalIF":0.0,"publicationDate":"2020-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/48/b5/2013-6463-sanipe-22-02-66.PMC7537362.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38179821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Danger of major outbreaks of COVID-19 in the Peruvian prison population.","authors":"E Enoki-Miñano,&nbsp;M Ruiz-Barrueto","doi":"10.18176/resp.00016","DOIUrl":"https://doi.org/10.18176/resp.00016","url":null,"abstract":"","PeriodicalId":30044,"journal":{"name":"Revista Espanola de Sanidad Penitenciaria","volume":"22 2","pages":"91-92"},"PeriodicalIF":0.0,"publicationDate":"2020-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/2c/9a/2013-6463-sanipe-22-02-91.PMC7537358.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38179749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transmission and prevention of SARS-CoV-2 (COVID-19) in prisons.","authors":"S Iglesias Osores","doi":"10.18176/resp.00015","DOIUrl":"https://doi.org/10.18176/resp.00015","url":null,"abstract":"","PeriodicalId":30044,"journal":{"name":"Revista Espanola de Sanidad Penitenciaria","volume":"22 2","pages":"87-90"},"PeriodicalIF":0.0,"publicationDate":"2020-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6a/ab/2013-6463-sanipe-22-02-87.PMC7537360.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38179745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of the use of atypical antipsychotics in metabolic syndrome.","authors":"P Doménech-Matamoros","doi":"10.18176/resp.00014","DOIUrl":"10.18176/resp.00014","url":null,"abstract":"<p><strong>Objectives: </strong>To describe the possible relationship between the use of antipsychotic drugs and the presence of metabolic syndrome. Other objectives are to list the main side effects of antipsychotic treatment, and to determine if there is any pharmacological treatment that can contribute towards counteracting metabolic syndrome.</p><p><strong>Material and method: </strong>A narrative bibliographic review was carried out of the following databases: PubMed, Cochrane, CINAHL, IBECS, LILACS and HealthCare. Preference in the selection process was given to clinical trials and systematic review articles or review articles and some articles that were considered relevant because of their content. The time period was limited to between January 2014 and November 2019. The languages were English and Spanish. Repeated articles and those that were not related to the objectives were rejected. The search criteria were: \"antipsychotic AND metabolic syndrome\"; \"schizophrenia AND metabolic syndrome\"; \"bipolar disorder AND metabolic syndrome\"; \"metabolic syndrome AND suicide NOT disorder\"; \"metabolic syndrome AND prisons\"; \"metabolic syndrome AND prolactin\".</p><p><strong>Results: </strong>24 articles were selected out of the 510 that were consulted. The relationship between atypical antipsychotics and metabolic syndrome was evident. Other anticholinergic, antidopaminergic effects, extrapyramidal syndromes, neuroleptic malignant syndrome, hypotension, arrhythmias, sedation, hypovitaminosis D, increased prolactin, sexual dysfunction, sleep disturbances, etc. are also highlighted. Pharmacological associations with other drugs were also found.</p><p><strong>Discussion: </strong>There is a relationship between the use of atypical antipsychotics and weight gain, lipid disorders, glucose and high blood pressure. There are some associated drugs that decrease some symptoms (ranitidine, topiramate, metformin, melatonin, modafinil). Patients taking this type of medication should be monitored and encouraged to lead healthy lifestyles.</p>","PeriodicalId":30044,"journal":{"name":"Revista Espanola de Sanidad Penitenciaria","volume":"22 2","pages":"80-86"},"PeriodicalIF":0.0,"publicationDate":"2020-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b3/80/2013-6463-sanipe-22-02-80.PMC7537359.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38179747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabolic comorbidity, the new enemy. Metabolic syndrome and steatohepatitis.","authors":"J M Rivera Esteban,&nbsp;S Augustin Recio","doi":"10.18176/resp.00010","DOIUrl":"https://doi.org/10.18176/resp.00010","url":null,"abstract":"55 doi: 10.18176/resp.00010 In recent decades we have observed a progressive increase in the prevalence of non-communicable chronic diseases worldwide. This trend is more notable in developed countries and has been attributed to (amongst other factors) a gradual ageing of the population, unhealthy lifestyles and to healthcare advances that have increased life expectancy. The prison population is also afectted by these global socio-demographic changes. The prison population in Spain has been ageing progressively in recent years, mainly due to an increased imprisonment of older people and longer sentences. At present, the average age of inmates in Spain is 39 years and almost 30% of inmates are over 45 years of age1,2. One non-communicable chronic disease that has recently come under the spotlight is metabolic syndrome. The incidence of this condition has increased exponentially in recent years to become one of the main public health concerns of this century and is now a high priority health objective at international level. Metabolic syndrome is made up of a spectrum of diseases (obesity, higharterial hypertension, diabetes mellitus and dyslipidemia), and their importance rests on their role as risk factors for high morbimortality diseases, such as cardiovascular, respiratory and hepatic diseases, etc3,4. National studies in general population shows a prevalence of metabolic syndrome in Spain around 22-32%, but unfortunately there are very few studies evaluating the presence and impact of metabolic syndrome in prison population. The prevalence of arterial hypertensión in Spanish prisons is estimated to be 25%; while levels of dyslipidemia are estimated at 18% and diabetes mellitus at 10% in persons over 45 years of age, while 20% of such patients are obese (defined as a body mass index of over 30 kg/m2)5,6 Such numbers contradict the stereotypical perceptions held in experts circles outside prison, since they are not very different from those observed amongst the general population. One factor that could help to explain the increase of metabolic pathology amongst inmates is that the prison population is ageing, as we commented above. Another probable explanation is that particular factors of this population are contributing towards the increase in prevalence. On the one hand, we know that the prevalence of metabolic syndrome increases by up to 70% in patients with mental illnesses in the general population. These patients often take second-generation antipsychotic drugs, which are linked to weight gain and the risk of dyslipidemia or diabetes mellitus. This factor takes on even greater importance in prison, where the prevalence of severe mental illness is four times that of the general population, and almost half of the patients that go to psychiatric consultations in prison receive treatment with neuroleptic medication7. It has also been documented that the prison population is more likely to fall ill than the general public, when compared by age","PeriodicalId":30044,"journal":{"name":"Revista Espanola de Sanidad Penitenciaria","volume":"22 2","pages":"55-57"},"PeriodicalIF":0.0,"publicationDate":"2020-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/26/4c/2013-6463-sanipe-22-02-55.PMC7537357.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38179743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of overweight and obesity in a Mexican prison.","authors":"A J Argüello-González,&nbsp;M A García-Zazueta","doi":"10.18176/resp.00011","DOIUrl":"https://doi.org/10.18176/resp.00011","url":null,"abstract":"<p><strong>Objectives: </strong>Overweight and obesity constitute a public health problem; There are few prevalence studies of inmates. The objectives of this study are to determine the prevalence of overweight and obesity amongst inmates of the Islas Marias Prison Complex and to evaluate the waist-to-hip ratio (WHR) and the waist-to-height ratio (WHtR) as diagnostic measurements for abdominal obesity in this population.</p><p><strong>Material and method: </strong>Analytical, retrospective cross-sectional study at Rural Hospital No. 20 Islas Marias Nayarit, Mexico, with 426 cases from January 2016 to March 2017, who were male inmates from 18 to 73 years of age. The following ratios were calculated: BMI, WHR WHtR. A descriptive analysis was carried out for quantitative variables, frequencies and percentages by group, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), Youden index, positive and negative likelihood ratios of WHR and WHtR; ANOVA F test, Student's t-test, ROC curve, STROBE statement, SPSS v. 22.</p><p><strong>Results: </strong>51.41% cases presented as overweight, 25.35% were obese, the cut-off point was 0.935 for WHR (s = 0.833; e = 0.717) and 0.545 for WHtR ICA (s = 0.981; e = 0.818). WHtR showed a good performance according to the Youden index.</p><p><strong>Discussion: </strong>There was a high prevalence of overweight and obesity in prisoners at the Islas Marias Prison Complex, WHtR showed better performance than WHR for diagnosing abdominal obesity. It is suggested that measurement of WHI should be included in daily medical practice.</p>","PeriodicalId":30044,"journal":{"name":"Revista Espanola de Sanidad Penitenciaria","volume":"22 2","pages":"58-65"},"PeriodicalIF":0.0,"publicationDate":"2020-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1e/2e/2013-6463-sanipe-22-02-58.PMC7537363.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38179746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceived social support, resilience and consumption of psychoactive substances amongst inmates in prisons.","authors":"F Caravaca-Sánchez,&nbsp;M García-Jarillo","doi":"10.18176/resp.00013","DOIUrl":"https://doi.org/10.18176/resp.00013","url":null,"abstract":"<p><strong>Objectives: </strong>To determine the influence of perceived social support and resilience in the use of alcohol and other drugs amongst female inmates.</p><p><strong>Material and method: </strong>A cross-sectional study with 174 inmates was conducted in two prisons in the Region of Murcia. A self-administered questionnaire was used, which included socio-demographic, prison, alcohol and other drug consumption, perceived social support and resilience variables.</p><p><strong>Results: </strong>28.2% of the inmates consumed at least one of the substances analyzed (alcohol, cannabis, cocaine, heroin and/or tranquillizers without medical prescription) in prison. The female consumers showed significantly lower levels of perceived social support and resilience, compared to the counterparts who did not consume in prison.</p><p><strong>Discussion: </strong>Findings show how perceived social support and resilience are factors of protection against substance use in prison, and these can be incorporated in future prevention programs for the consumption of alcohol and other drugs during imprisonment.</p>","PeriodicalId":30044,"journal":{"name":"Revista Espanola de Sanidad Penitenciaria","volume":"22 2","pages":"75-79"},"PeriodicalIF":0.0,"publicationDate":"2020-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d5/fe/2013-6463-sanipe-22-02-75.PMC7537361.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38179822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mental illness and social exclusion: assessment of the risk of violence after release.","authors":"R Fernández-García-Andrade,&nbsp;B Serván-Rendón-Luna,&nbsp;V Vidal-Martínez,&nbsp;E Medina-Téllez de Meneses,&nbsp;B Reneses-Prieto","doi":"10.18176/resp.0004","DOIUrl":"https://doi.org/10.18176/resp.0004","url":null,"abstract":"<p><strong>Objectives: </strong>To examine the predictive validity of the HCR-20 (The Historical Clinical Risk Management-20) to predict future violent incidents in a representative sample of patients with severe mental disorders and with a history of previous admission to prison, who after release are in a situation of extreme social exclusion.</p><p><strong>Material and method: </strong>The study sample was selected from the 235 patients treated by the Mental Health Street Team of Madrid (ECASAM) from June 2014 to June 2017, including those with a previous history of a previous internment in a penitentiary (about which, the HCR-20 was completed).</p><p><strong>Results: </strong>Of the 44 patients included, 29.6% (n=13) ended up participating in a violent incident after the release. The ROC curves (Receiver Operating Characteristic) analysis indicated that the total score of HCR-20 (AUC 0.98, p=0.01) has a high predictive validity.</p><p><strong>Conclusions: </strong>The social and medical changes that take place after the release of patients with severe mental illness justify the need to reassess the risk of violence. In this evaluation, the HCR-20 guide is a useful tool for predicting the risk of involvement in future violent incidents, and the inclusion of factors such as social exclusion and its consequences, as well as problems with substance use is especially important.</p>","PeriodicalId":30044,"journal":{"name":"Revista Espanola de Sanidad Penitenciaria","volume":"22 1","pages":"23-31"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e4/ab/2013-6463-sanipe-22-01-23.PMC7307656.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37933346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Involuntary outpatient treatment: the ethical implications.","authors":"M Castellano Arroyo","doi":"10.18176/resp.0001","DOIUrl":"https://doi.org/10.18176/resp.0001","url":null,"abstract":"","PeriodicalId":30044,"journal":{"name":"Revista Espanola de Sanidad Penitenciaria","volume":"22 1","pages":"6-8"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/17/8a/2013-6463-sanipe-22-01-6.PMC7307657.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37933351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychiatrists' opinion about involuntary outpatient reatment.","authors":"A Moleón Ruiz,&nbsp;J C Fuertes Rocañín","doi":"10.18176/resp.0006","DOIUrl":"https://doi.org/10.18176/resp.0006","url":null,"abstract":"<p><strong>Introduction: </strong>Involuntary outpatient treatment (IOT) is a kind of compulsory outpatient treatment, whose aim is to improve the adherence to the treatment in people with severe mental illness and with no awareness of disease. In these cases, therapeutic abandonment involves a high risk of relapse, with appearance of disruptive and/or self-aggressive or hetero-aggressive behavior, repeated hospitalizations and frequent emergencies. The application of IOT is not an issue without contention. Therefore, the need of legislative regulation in Spain has been a controversial subject for several years, and there are both advocates and opponents.</p><p><strong>Objective: </strong>The objective of this study is to bring together the opinion of clinical psychiatrists and resident doctors in psychiatry on the involuntary outpatient treatment and its legislative regulation.</p><p><strong>Material and method: </strong>This study is descriptive in nature. The study population consists of 42 clinical professionals in mental health (32 psychiatrists and 10 resident doctors in psychiatry). At the beginning of this study (March 2018), some of these professionals were working in the Psychiatry Department's facilities of the University Hospital Complex of Huelva. A personal survey in paper form consisting of ten questions about IOT was carried out to each member of this study.</p><p><strong>Results: </strong>85.7% of clinicians know the current initiative that tries to carry out the legislative regulation of IOT, and 92.8% of them agree to such regulation. In this sense, 83.3% of them are against the fact that more coercive measures for the psychiatric patients such as the involuntary commitment or the civil incapacitation are regulated and IOT is not. On the one hand, 78.6% of the professionals in mental health believe that IOT is beneficial for the patients. Moreover, 95.2% of them think that is beneficial for their relatives, too. On the other hand, 78.6% of clinicians do not consider that the application of IOT to mentallyill patients is stigmatizing.</p><p><strong>Conclusion: </strong>The vast majority of clinicians think that the legislative regulation of involuntary outpatient treatment is necessary in Spain, and they think this treatment is beneficial not only for the patient but also for their family.</p>","PeriodicalId":30044,"journal":{"name":"Revista Espanola de Sanidad Penitenciaria","volume":"22 1","pages":"39-45"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/cb/b7/2013-6463-sanipe-22-01-39.PMC7307653.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37933348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}