Scielo RSS <![CDATA[Revista Española de Sanidad Penitenciaria]]> http://scielo.isciii.es/rss.php?pid=1575-062020200002&lang=pt vol. 22 num. 2 lang. pt <![CDATA[SciELO Logo]]> http://scielo.isciii.es/img/en/fbpelogp.gif http://scielo.isciii.es <![CDATA[The new healthcare model in prison nursing]]> http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1575-06202020000200001&lng=pt&nrm=iso&tlng=pt <![CDATA[Metabolic comorbidity, the new enemy. Metabolic syndrome and steatohepatitis]]> http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1575-06202020000200002&lng=pt&nrm=iso&tlng=pt <![CDATA[Prevalence of overweight and obesity in a Mexican prison]]> http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1575-06202020000200003&lng=pt&nrm=iso&tlng=pt ABSTRACT Objectives 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. Material and method 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. Results 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. Discussion 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.<hr/>RESUMEN Objetivos El sobrepeso y la obesidad constituyen un problema de salud publica; existen pocos estudios de prevalencia en personas reclusas. El objetivo de este estudio es determinar la prevalencia de sobrepeso y obesidad en personas reclusas del Complejo Penitenciario Islas Marías (México) y evaluar el índice cintura cadera (ICC) y el índice cintura altura (ICA) como medidas de diagnostico para la obesidad abdominal en dicha población. Material y método Estudio transversal analítico, retrospectivo en el Hospital Rural No. 20 de las Islas Marías Nayarit, México, con 426 expedientes, desde enero de 2016 hasta marzo de 2017, de sexo masculino, con edades de 18 a 73 anos. Se calculo: el índice de masa corporal (IMC), el ICC y el ICA. Se realizo un análisis descriptivo para variables cuantitativas, frecuencias y porcentajes por grupo, sensibilidad, especificidad, valor predictivo positivo (VPP), valor predictivo negativo (VPN), índice de Youden, razón de verosimilitud positiva y negativa del ICC y del ICA; la prueba F de ANOVA, el test t de estudiante (t de Student), la curva de la característica operativa del receptor (ROC), la declaración STROBE (Strengthening the Reporting of Observational studies in Epidemiology) y el programa estadistico SPSS v. 22. Resultados El 51,41% presento sobrepeso y el 25,35% obesidad, el punto de corte fue 0,935 para el ICC (sensibilidad [s] = 0,833; especificidad [e] = 0,717) y 0,545 para el ICA (s = 0,981; e = 0,818). El ICA presento un buen rendimiento según el índice de Youden. Discusión Existió una alta prevalencia de sobrepeso y obesidad en los reclusos del Complejo Penitenciario Islas Marías, el ICA mostro mejor rendimiento que el ICC para el diagnostico de obesidad abdominal. Se sugiere integrar la medición del ICA en la practica medica diaria. <![CDATA[Cost-effectiveness analysis of chronic hepatitis C treatment in the prison population in Spain]]> http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1575-06202020000200004&lng=pt&nrm=iso&tlng=pt ABSTRACT Objectives 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. Material and method 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. Results 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. Discussion 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.<hr/>RESUMEN Objetivos Evaluar, en presos con hepatitis C crónica (HCc) pendientes de tratamiento, el coste-efectividad de tratarlos con antivirales de acción directa (AAD) frente a no tratarlos, y analizar el impacto clínico y económico del tratamiento sobre las complicaciones hepáticas y la mortalidad. Material y método Se desarrolló un modelo de Markov para simular el tratamiento y proyectar la progresión de la enfermedad de una cohorte estimada de 4.408 reclusos con HCc tratados con AAD en dos años (el 50% cada año) frente a ningún tratamiento. En los tratados, se asoció una respuesta viral sostenida del 95%. Las características de los pacientes, las probabilidades de transición, las utilidades y los costes (farmacológicos y estados de salud) se obtuvieron de publicaciones científicas. El modelo estimó costes y resultados en salud, la relación coste-utilidad incremental (RCUI), a partir de los costes totales y años de vida ajustados por calidad (AVAC) y los eventos clínicos evitados. La perspectiva fue la del Sistema Nacional de Salud (SNS) y se aplicó una tasa de descuento anual (el 3%) para costes y resultados en salud. La robustez de los resultados se evaluó mediante un análisis de sensibilidad. Resultados En la población tratada, el modelo estimó una reducción del 92% de los casos de cirrosis descompensada y del 83% de carcinoma hepatocelular, se evitaron 132 trasplantes hepáticos y disminuyó el 88% la mortalidad hepática. El tratamiento consiguió 5,0/AVAC adicionales (21,2 frente al 16,2), con un coste incremental de 3.473 euros (24.088 € frente a 20.615 €) por paciente y una RCUI de 690 €/AVAC ganado. Discusión: Considerando el umbral de disponibilidad a pagar utilizado en España (22.000-30.000 €/AVAC), el tratamiento con AAD en los presos con HCc es una estrategia altamente coste-efectiva, reduce la transmisión, aumenta la supervivencia y reduce las complicaciones hepáticas, así como los costes asociado a su manejo. <![CDATA[Perceived social support, resilience and consumption of psychoactive substances amongst inmates in prisons]]> http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1575-06202020000200005&lng=pt&nrm=iso&tlng=pt ABSTRACT Objectives To determine the influence of perceived social support and resilience in the use of alcohol and other drugs amongst female inmates. Material and method 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. Results 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. Discussion 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.<hr/>RESUMEN Objetivos Determinar la influencia del apoyo social percibido y la resiliencia en el consumo de alcohol y otras drogas en mujeres privadas de libertad. Material y método Estudio transversal con 174 internas en dos establecimientos penitenciarios de la Región de Murcia. Se utilizó un cuestionario autosuministrado incluyendo variables sociodemográficas, penitenciarias, consumo de alcohol y otras drogas, apoyo social percibido y resiliencia. Resultados El 28,2% de las internas consumió al menos una de las sustancias analizadas (alcohol, cannabis, cocaína, heroína y/o tranquilizantes sin receta médica) en prisión. Las internas consumidoras mostraban significativamente menor nivel de apoyo social percibido y de resiliencia, respecto a aquellas que no consumían en prisión. Discusión Los resultados reflejan cómo el apoyo social percibido y la resiliencia son factores de protección ante el consumo en prisión, pudiendo ser incorporados estos en futuros programas de prevención de consumo de alcohol y otras drogas durante la pena privativa de libertad. <![CDATA[Influence of the use of atypical antipsychotics in metabolic syndrome]]> http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1575-06202020000200006&lng=pt&nrm=iso&tlng=pt ABSTRACT Objectives 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. Material and method 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”. Results 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. Discussion 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.<hr/>RESUMEN Objetivos Determinar la influencia del apoyo social percibido y la resiliencia en el consumo de alcohol y otras drogas en mujeres privadas de libertad. Material y método Estudio transversal con 174 internas en dos establecimientos penitenciarios de la Región de Murcia. Se utilizó un cuestionario autosuministrado incluyendo variables sociodemográficas, penitenciarias, consumo de alcohol y otras drogas, apoyo social percibido y resiliencia. Resultados El 28,2% de las internas consumió al menos una de las sustancias analizadas (alcohol, cannabis, cocaína, heroína y/o tranquilizantes sin receta médica) en prisión. Las internas consumidoras mostraban significativamente menor nivel de apoyo social percibido y de resiliencia, respecto a aquellas que no consumían en prisión. Discusión Los resultados reflejan cómo el apoyo social percibido y la resiliencia son factores de protección ante el consumo en prisión, pudiendo ser incorporados estos en futuros programas de prevención de consumo de alcohol y otras drogas durante la pena privativa de libertad. <![CDATA[Transmission and prevention of SARS-CoV-2 (COVID-19) in prisons]]> http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1575-06202020000200007&lng=pt&nrm=iso&tlng=pt ABSTRACT Objectives 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. Material and method 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”. Results 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. Discussion 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.<hr/>RESUMEN Objetivos Determinar la influencia del apoyo social percibido y la resiliencia en el consumo de alcohol y otras drogas en mujeres privadas de libertad. Material y método Estudio transversal con 174 internas en dos establecimientos penitenciarios de la Región de Murcia. Se utilizó un cuestionario autosuministrado incluyendo variables sociodemográficas, penitenciarias, consumo de alcohol y otras drogas, apoyo social percibido y resiliencia. Resultados El 28,2% de las internas consumió al menos una de las sustancias analizadas (alcohol, cannabis, cocaína, heroína y/o tranquilizantes sin receta médica) en prisión. Las internas consumidoras mostraban significativamente menor nivel de apoyo social percibido y de resiliencia, respecto a aquellas que no consumían en prisión. Discusión Los resultados reflejan cómo el apoyo social percibido y la resiliencia son factores de protección ante el consumo en prisión, pudiendo ser incorporados estos en futuros programas de prevención de consumo de alcohol y otras drogas durante la pena privativa de libertad. <![CDATA[Danger of major outbreaks of COVID-19 in the Peruvian prison population]]> http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1575-06202020000200008&lng=pt&nrm=iso&tlng=pt ABSTRACT Objectives 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. Material and method 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”. Results 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. Discussion 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.<hr/>RESUMEN Objetivos Determinar la influencia del apoyo social percibido y la resiliencia en el consumo de alcohol y otras drogas en mujeres privadas de libertad. Material y método Estudio transversal con 174 internas en dos establecimientos penitenciarios de la Región de Murcia. Se utilizó un cuestionario autosuministrado incluyendo variables sociodemográficas, penitenciarias, consumo de alcohol y otras drogas, apoyo social percibido y resiliencia. Resultados El 28,2% de las internas consumió al menos una de las sustancias analizadas (alcohol, cannabis, cocaína, heroína y/o tranquilizantes sin receta médica) en prisión. Las internas consumidoras mostraban significativamente menor nivel de apoyo social percibido y de resiliencia, respecto a aquellas que no consumían en prisión. Discusión Los resultados reflejan cómo el apoyo social percibido y la resiliencia son factores de protección ante el consumo en prisión, pudiendo ser incorporados estos en futuros programas de prevención de consumo de alcohol y otras drogas durante la pena privativa de libertad.