Hacinamiento y sobreocupación penitenciaria. De qué hablamos y cuál es la situación en las prisiones españolas / No disponible

No disponible

El estrabismo del duque Sarmiento, virrey de la Nueva España / Strabismus of duke Sarmiento and Valladares, viceroy of New Spain

No disponible

Tratamiento de enfermedades oftalmológicas en el siglo XVI. Un análisis de las plantas medicinales novohispanas publicadas por Francisco Hernández / Treatment of ophthalmological diseases in the 16th century. An analysis of the medicinal plants from new Spain published by Francisco Hernández

No disponible

Episodes of voluntary total fasting (hunger strike) in Spanish prisons: A descriptive analysis.

OBJECTIVE: To provide a description of the frequency and main features of the episodes of voluntary total fasting (VTF) taking place in Spanish prisons. MATERIAL AND METHODS: Information on the episodes of VTF reported between 04/01/2013 and 03/31/2014 was gathered. Once the appropriate informed consent was given, other data on social, demographic, penitentiary and clinical aspects were collected. A descriptive study of such variables together with a bivariate analysis was then carried out by means of standard statistical techniques and binary logistic regression models. IBM SPSS Statistics v.20 software was used for this purpose. This study was approved by an accredited Clinical Research Ethics Committee. RESULTS: 354 episodes of VTF took place among an average population of 29,762 prisoners. Therefore, the incidence rate was 11.9 VTF episodes per ‰ inmates-year. Informed consent (IC) was given in 180 cases (50.8%). 114 were of Spanish nationality and the average age was 38.7 years old (95% CI 37.2-40.1). The median duration of the episodes was 3 days (IQR 1-10), ranged between 1 and 71 days. The main reason was a disagreement on the decisions of treatment groups (57 cases, 31.7%). The average weight loss was 1.3 kg (70.8 vs. 69.5; p < 0.0001) and 0.7 of the BMI (24.5 vs. 23.8; p < 0.0001). 60 prisoners (33.3%) lost no weight at all and only 8 (4.4%) lost over 12% of the basal weight (8.5 kg). Ketone smell was identified in 61 cases (33.9%) and ketonuria in 63 (35%). CONCLUSIONS: Only one third of those who go on hunger strike in prison actually fast. Revindicative episodes of voluntary total fasting are somewhat common in Spanish prisons, but rarely are they carried out rigorously and entail a risk for those who fast.

Professional deontology and medical practice in prisons.

OBJECTIVE: To study the knowledge on professional deontology amongst doctors in prisons. MATERIALS AND METHOD: Descriptive, transversal and multi-centre study. Labour, collegiate, social, demographic and deontological variables were collected. A descriptive analysis of the variables was performed. A bivariate analysis was made by binary logistic regression models, attending to the odds ratio, and assuming a 95% confidence interval. Data was processed by SPSS v.20 software. RESULTS: 118 doctors replied. 68 men (57.6%), with an average age of 51 years (50-53). 100 know about the Deontology Committee (84.7%), but just 77 (65.3%) know its functions properly. 42 (35.6%) know about the existence of the Deontological Code, and 37 (31.3%) have read and apply it. Those who made a correct definition of deontology do find more deontological issues in their daily work [23(46.9%) vs. 18(26.1%); OR: 2.506; IC95%: 1.153-5.451; p=0.020] and would denounce a colleague more often to the Medical Association [40(81.6%) vs. 42 (60.9%); OR: 2.857; IC95%: 1.197-6.819; p=0.018]. Older ones know more about the deontology commissions' functions [54(73%) vs. 23(52.3%); OR: 2.465; IC95%: 1.127-5.394; p=0.024] and have already denounced situations to the Medical Association [27(36.5% vs. 5(11.4%); OR: 4.481; IC95%: 1.577-12.733; p=0.005], but think that a different Care Ethics Committee is unnecessary [57(77%) vs. 42(95.5%); OR: 0.160; IC95%: 0.035- 0.729; p=0.018]. CONCLUSIONS: Prison doctors know little about what professional deontology really is. This knowledge increases with age in the profession and is associated with an increased perception of deontological issues in daily practice.

Deontología profesional y ejercicio médico en prisiones / Professional deontology and medical practices in prisons

Objetivo: Estudiar el conocimiento sobre la deontología profesional entre los médicos de prisiones. Material y Método: Estudio descriptivo, transversal y multicéntrico. Se recogieron variables laborales, colegiales, sociodemográficas y de cuestiones deontológicas. Se realizó un análisis descriptivo de las variables. Se hizo un análisis bivariante mediante modelos de regresión logística binaria con las odds ratio e intervalos de confianza al 95%. Los datos se procesaron con el programa SPSS v.20. Resultados: Contestaron 118 médicos. 68 hombres (57,6%), con mediana de edad de 51 años (50-53). Conocen qué es la Comisión Deontológica 100 (84,7%), pero sólo 77 (65,3%) conocen bien sus funciones. 42 (35,6%) conocen la existencia del Código de Deontología y 37 (31,3%) lo han leído y lo acatan. Los que definieron correctamente la Deontología profesional encuentran más problemas deontológicos en su ejercicio diario [23(46,9%) vs 18(26,1%); OR: 2,506; IC95%: 1,153-5,451; p=0,020] y denunciarían más a un colega ante su Colegio [40(81,6%) vs 42 (60,9%); OR: 2,857; IC95%: 1,197-6,819; p=0,018]. Los más antiguos conocen mejor las funciones de las Comisiones deontológicas [54(73%) vs 23(52,3%); OR: 2,465; IC95%: 1,127-5,394; p=0,024] y han denunciado situaciones ante su Colegio [27(36,5%) vs 5(11,4%); OR: 4,481; IC95%: 1,577-12,733; p=0,005], pero creen menos en la necesidad de un Comité ético asistencial propio de prisiones [57(77%) vs 42(95,5%); OR: 0,160; IC95%: 0,035-0,729; p=0,018].Conclusiones: Los médicos de prisiones conocen poco qué es la deontología profesional. Este conocimiento aumenta con la antigüedad en el ejercicio y se asocia a mayor percepción de problemas deontológicos en el ejercicio diario (AU)

Objective: To study knowledge of professional deontology amongst doctors in prisons. Materials and Method: Descriptive, transversal and multi-centre study. Labour, collegiate, social, demographic and deontological variables were collected. A descriptive analysis of the variables was performed. A bivariant analysis was made by binar y logistic regression models, attending to the odds ratio, and assuming a 95% confidence interval. Data is processed by SPSS v.20 software. Results: 118 doctors replied. 68 men (57.6%), average age 51 years (50-53). 100 know about the Deontology Commission (84.7%), but just 77 (65.3%) know its functions properly. 42 (35.6%) know about the existence of the Deontological Code, and 37 (31,3%) have read and apply it. Those who made a correct definition of deontology do find more deontological issues in theirdaily work [23(46.9%) vs 18(26.1%); OR: 2.506; IC95%: 1.153-5.451; p=0.020] and would denounce a colleague more often to the Medical Association [40(81.6%) vs 42 (60.9%); OR: 2.857; IC95%: 1.197-6.819; p=0.018]. Older ones know more about the deontology commissions’ functions [54(73%) vs 23(52.3%); OR: 2.465; IC95%: 1.127-5.394; p=0.024] and have already denounced situations to the Medical Association [27(36.5% vs 5(11.4%); OR: 4.481; IC95%: 1.577-12.733; p=0.005], but think that a different Care Ethics Committee is unnecessary [57(77%) vs 42(95.5%); OR: 0.160; IC95%: 0.035-0.729; p=0.018].Conclusions: Prison doctors know little about what professional deontology really is. This knowledge increases with age in the profession and is associated with increased perception of deontological issues in daily practice (AU)

[Hunger striking in prisons: ethics and the ethical and legal aspects]. / La huelga de hambre en el ámbito penitenciario: aspectos éticos, deontológicos y legales.

Hunger strike is a common form of protest in prisons and is a potential cause of many types of problems, both for the prison administration and the doctors who care for prisoners who participate in one. Issues of conflict of rights and obligations involved, and how to treat people who are subject to the Administration, which in this case takes the position of guarantor, have created major controversies over doctrine. Conscientious objection and the conflict of dual loyalty of doctors working in prisons are also issues closely linked to a prison hunger strike. In this paper we review the solution given to the problem of treatment of a prison hunger strike from three perspectives: ethics, ethical and legal.

La huelga de hambre en el ámbito penitenciario: aspectos éticos, deontológicos y legales / Hunger strinking in prisons: ethics and ethical and legal aspects

La huelga de hambre es una forma de reivindicación frecuente en prisiones y puede llegar a ocasionar multitud de problemas de todo tipo, tanto a la Administración penitenciaria como a los médicos encargados de la asistencia a los presos que la hacen. Asuntos como el conflicto de derechos y obligaciones en juego, así como la forma de tratarla en personas que están sujetas a la Administración, que en este caso adopta una posición de garante, han generado no poca polémica doctrinal. La objeción de conciencia y el conflicto de doble fidelidad de los médicos que trabajan en las prisiones son también asuntos muy ligados a una huelga de hambre penitenciaria. En este trabajo se revisará la solución que se da al problema del tratamiento de la huelga de hambre penitenciaria desde tres perspectivas: ética, deontológica y legal(AU)

Hunger strike is a common form of protest in prisons and is a potential cause of many types of problems, both for the prison administration and the doctors who care for prisoners who participate in one. Issues of conflict of rights and obligations involved, and how to treat people who are subject to the Administration, which in this case takes the position of guarantor, have created major controversies over doctrine. Conscientious objection and the conflict of dual loyalty of doctors working in prisons are also issues closely linked to a prison hunger strike. In this paper we review the solution given to the problem of treatment of a prison hunger strike from three perspectives: ethics, ethical and legal(AU)

[Overcrowding in prisons and its impact on health]. / Sobreocupación en los Centros Penitenciarios y su impacto en la salud.

Overcrowding in prisons is a common problem that affects many countries. It is difficult to define this term because there is no single internationally accepted standard. However, this is a situation that must be counteracted, because people's behaviour can be affected to the extent that it leads to self-harm or violent behaviour to others. But prison overcrowding also has other effects on the health and well being of the people living in these conditions and may also adversely affect public health and the prison system. It can increase the prevalence of diseases, particularly infectious and psychiatric disorders. It may also hinder the work of social rehabilitation and lead to inhuman, cruel or degrading treatment. This paper reviews the scant literature about overcrowding in prisons. Increasing awareness about the issue in the international community and prison administrations and above all, assigning specific economic resources, are key elements in preventing this deficit in social welfare and health care.

[Changes in the use of hospital resources from prison: a 16 year study]. / Cambios en el uso de recursos hospitalarios desde la prisión: un estudio de 16 años.

OBJECTIVE: To describe hospital morbidity caused by the inmates of our prison over the past 16 years. MATERIAL AND METHODS: retrospective study of hospital admissions between 01-01-1994 and 31-12-2009, divided into four periods. Socio-demographic variables were collected: duration of stay and discharge diagnosis. Quantitative variables were described as means and medians and qualitative variables as absolute and relative frequencies. A mean comparison was performed on quantitative variables and qualitative proportions. For equal variances, an ANOVA test was performed with linear trend study of encoding the variable "period" with orthogonal contrasts. Without equality of variances, comparisons were made using the Kruskal-Wallis test, and tendencies by means of the nonparametric Jonckheere-Terpstra test. For qualitative variables we used the Pearson Chi-Square, evaluating the trend with the chi-square for linear trend. RESULTS: 625 patients generated 996 admissions with no temporal variation. The median age is 33 years, with an upward trend (29 years to 38, p <0.0001). 47.9% were HIV + [(63.3% to 35.9%), p <0.0001]. The average stay was 9.6 days (95% CI 8.8 to 10.4) [11.9 (10.0 to 13.9) 9.6 (8.8 to 10.4), p = 0.002]. The frequency of internal and year 1000 remained unchanged (111.6 to 87.9, p = 0.366). The days of hospitalization decreased (3066 to 2442, p = 0.049)) and the average admitted per day (2.1 to 1.7, p = 0.049). CONCLUSIONS: The use of hospital resources from prison is constant. The way they use it has changed along with the pathology that causes it. HIV is no longer the primary pathology.

[Description of the psychiatric unit in prisons in the autonomous community of Valencia]. / Descripción de la consulta psiquiátrica en centros penitenciarios de la Comunidad Valenciana.

INTRODUCTION: Little work has been done on the contents of psychiatric consultancies in prisons. AIMS: To explore the sociodemographic, clinical and treatment profile of the patients who were assessed in the psychiatric consultancy of three prisons. METHODS: This is a prospective, longitudinal, descriptive and multicenter-based epidemiological study of patients who were assessed in the psychiatric consultacy of three prisons in the Autonomous Community of Valencia from 2009 to 2011. Sociodemographic, clinical and prison data was obtained from each patient. Their frequency was compared with Pearson's Ji² and averages with the ANOVA test or with The Kruskall-Wallis method. The probability of keeping the patients in schedule was calculated with Kaplan-Meier's curves and differences with the Mantel-Haenzsel method (Logrank) were established. A logistic regression model was designed to determine the data linked to frequent users. RESULTS: 786 patients were assessed in 2,006 visits (2.5 visits/patient). 90% were male, 88.2% Spanish and their average age was 36 years. 29.9% suffered from an infectious chronic pathology. 69.5% used some kinds of substance. 59.2% suffered from personality disorder and 11.6% from the spectrum of schizophrenia. The most frequent medical profiles were: 49.1% with anxiety disorder, 20.8% depressive disorder and 11.7% psychotic disorder. These psychotic disorders meant a greater probability of 1.5 times for maintaining in schedule. The most commonly prescribed medications were quetiapine, mirtazapine, pregabalin and diazepam. CONCLUSION: There is a high prevalence of mental disorders in prisons. It is necessary to improve the available resources to deal with these pathologies in the most effective way.

[Multi-centre study of the prevalence of infection from HIV and associated factors in Spanish prisons]. / Estudio multicéntrico de Prevalencia de Infección por el VIH y factores asociados en las prisiones de España.

OBJECTIVE: To determine the prevalence and associated factors of HIV infection amongst inmates in Spain. MATERIAL AND METHODS: Observational and transversal study (June 2008). For 62,000 inmates an "n" of 364 was determined (5% variability, error correction α 5% and 10% missing). 18 prisons were randomly selected and 21 inmates/prison. Frequency measurement: prevalence. Magnitude of the association: odds ratio of prevalence (ORP) with 95%. Statistical significance p<0.05. RESULTS: 371 prisoners were studied (91.6% male, 66.9% ≤ 40 years, 60.6% Spanish, 23.5% IDU and 71.2% incarcerated <5 years). HIV prevalence was 10.8% (CI: 7.5 to 14). 85% were co-infected with HCV, 12.5% with HBV and HCV and 63.2% with M. tuberculosis. This represents a proportion to the prison population of 9.2%, 1.3% and 6.7% respectively. HIV infection was associated with: a) > 40 years (p <0.01), b) imprisoned> 5 years (p <0.001), c) non-Arab (p <0.01), d) Spanish nationality (p <0.001), e) IDUs (p <0.001), f) co-infected with HCV (p <0.001), and g) co-infected with HBV (p <0.001]. Multivariate analysis confirmed the association: a) ≥ 40 years [OR = 2.66 (CI : 1.16-6.07), b) IDU [OR = 28.08 (IC-9.61-81.99), c) infected with HCV [OR = 6.96 (CI :1.90-25.39)], and d) infected with HBV [OR = 13.52 (CI = 1.76-103.82). CONCLUSION: The prevalence of HIV infection among prisoners in Spain is 10.8%. Those that are infected are usually IDUs and over 40 years. 85% are co-infected with HCV and 12.5% with HBV and HCV.

Cambios en el uso de recursos hospitalarios desde la prisión: un estudio de 16 años / Changes in the use of hospital resources from prison: a 16 year study

Objetivo: Describir la morbilidad hospitalaria provocada por los reclusos de nuestra prisión en los últimos 16 años. Material y método: Estudio descriptivo, retrospectivo de las hospitalizaciones entre 01-01-1994 y 31-12-2009, dividido en cuatro períodos iguales. Se recogieron variables sociodemográficas, de duración de la hospitalización y diagnóstico al alta. Se describieron las variables cuantitativas en forma de medias y medianas y las cualitativas como frecuencias absolutas y relativas. Se realizó comparación de medias en variables cuantitativas y de proporciones en las cualitativas. Para varianzas iguales se realizó un test de ANOVA, con estudio de tendencia lineal codificando la variable "período" con contrastes ortogonales. Sin igualdad de varianzas se comparó mediante test de Kruskal-Wallis, y la tendencia mediante la prueba no paramétrica de Jonckheere-Terpstra. Para las variables cualitativas se utilizó la Ji-Cuadrado de Pearson, valorando la tendencia con la Ji-Cuadrado de tendencia lineal. Resultados: 625 pacientes generaron 996 hospitalizaciones sin variación temporal. Edad mediana de 33 años, con tendencia ascendente (29 años hasta 38; p<0,0001). El 47,9% eran VIH+ [(63,3% hasta 35,9%); p<0,0001]. La estancia media fue de 9,6 días (IC95%: 8,8-10,4) [11,9(10,0-13,9) hasta 9,6(8,8-10,4); p=0,002]. La frecuentación por 1000 internos y año no varió (111,6 hasta 87,9; p=0,366). Los días de hospitalización bajaron (3.066 hasta 2.442; p=0,049); así como el promedio de ingresados por día (2,1 hasta 1,7; p=0,049). Conclusiones: El uso de recursos hospitalarios desde la prisión es constante. Ha cambiado la forma de uso y la patología que la origina. El VIH ya no es la principal patología(AU)

Objective: To describe hospital morbidity caused by the inmates of our prison over the past 16 years. Material and methods: retrospective study of hospital admissions between 01-01-1994 and 31-12-2009, divided into four periods. Socio-demographic variables were collected: duration of stay and discharge diagnosis. Quantitative variables were described as means and medians and qualitative variables as absolute and relative frequencies. A mean comparison was performed on quantitative variables and qualitative proportions. For equal variances, an ANOVA test was performed with linear trend study of encoding the variable "period" with orthogonal contrasts. Without equality of variances, comparisons were made using the Kruskal-Wallis test, and tendencies by means of the nonparametric Jonckheere-Terpstra test. For qualitative variables we used the Pearson Chi-Square, evaluating the trend with the chi-square for linear trend. Results: 625 patients generated 996 admissions with no temporal variation. The median age is 33 years, with an upward trend (29 years to 38, p <0.0001). 47.9% were HIV + [(63.3% to 35.9%), p <0.0001]. The average stay was 9.6 days (95% CI 8.8 to 10.4) [11.9 (10.0 to 13.9) 9.6 (8.8 to 10.4), p = 0.002]. The frequency of internal and year 1000 remained unchanged (111.6 to 87.9, p = 0.366). The days of hospitalization decreased (3066 to 2442, p = 0.049)) and the average admitted per day (2.1 to 1.7, p = 0.049). Conclusions: The use of hospital resources from prison is constant. The way they use it has changed along with the pathology that causes it. HIV is no longer the primary pathology(AU)

Descripción de la consulta psiquiátrica en centros penitenciarios de la Comunidad Valenciana / Description of the psychiatric unit in prisons in the Autonomous Community of Valencia

Introducción: Existen pocos trabajos sobre el contenido de las consultas psiquiátricas en las prisiones. Objetivos: Explorar el perfil sociodemográfico, clínico y de tratamiento de los pacientes valorados en la consulta psiquiátrica de tres centros penitenciarios. Métodos: Estudio epidemiológico multicéntrico, descriptivo, longitudinal, y prospectivo de los pacientes valorados en la consulta psiquiátrica de tres prisiones de la Comunidad Valenciana durante 2009, 2010 y 2011. Se obtuvieron variables clínicas, sociodemográficas y penitenciarias de cada paciente. Las frecuencias se compararon mediante la Ji2 de Pearson y las medias por el test de ANOVA o el método de Kruskall-Wallis. Se calculó la probabilidad de mantenerse en agenda psiquiátrica mediante curvas de Kaplan-Meier, estableciéndose las diferencias con el método de Mantel- Haenzsel (Logrank). Se diseñó un modelo de regresión logística para determinar las variables asociadas a hiperfrecuentación. Resultados: Se valoraron 786 pacientes en 2.006 consultas (2,5 visitas/paciente). El 90% eran varones y el 88,2% españoles, con una edad media de 36,0 años. El 29,9% tenían patología infecciosa crónica asociada. El 69,5% consume algún tipo de sustancia. El 59,2% sufría un trastorno de personalidad y el 11,6% del espectro de la esquizofrenia. Los cuadros clínicos más frecuentes fueron; 49,1% cuadros ansiosos, 20,8% depresivos y 11,7% síntomas psicóticos. Los trastornos psicóticos supusieron 1,5 veces más probabilidad (IC 95%; 1,1-1,9) de mantenerse más tiempo en agenda. Los fármacos más prescritos fueron quetiapina, mirtazapina, pregabalina y diacepam. Conclusiones: Los trastornos mentales en prisión son muy prevalentes. Es necesario potenciar los recursos disponibles para una adecuada atención de estas patologías(AU)

Introduction: Little work has been done on the contents of psychiatric consultancies in prisons. Aims: To explore the sociodemographic, clinical and treatment profile of the patients who were assessed in the psychiatric consultancy of three prisons. Methods: This is a prospective, longitudinal, descriptive and multicenter-based epidemiological study of patients who were assessed in the psychiatric consultacy of three prisons in the Autonomous Community of Valencia from 2009 to 2011. Sociodemographic, clinical and prison data was obtained from each patient. Their frequency was compared with Pearson’s Ji2 and averages with the ANOVA test or with The Kruskall-Wallis method. The probability of keeping the patients in schedule was calculated with Kaplan-Meier’s curves and differences with the Mantel-Haenzsel method (Logrank) were established. A logistic regression model was designed to determine the data linked to frequent users. Results: 786 patients were assessed in 2,006 visits (2.5 visits/patient). 90% were male, 88.2% Spanish and their average age was 36 years. 29.9% suffered from an infectious chronic pathology. 69.5% used some kinds of substance. 59.2% suffered from personality disorder and 11.6% from the spectrum of schizophrenia. The most frequent medical profiles were: 49.1% with anxiety disorder, 20.8% depressive disorder and 11.7% psychotic disorder. These psychotic disorders meant a greater probability of 1.5 times for maintaining in schedule. The most commonly prescribed medications were quetiapine, mirtazapine, pregabalin and diazepam. Conclusion: There is a high prevalence of mental disorders in prisons. It is necessary to improve the available resources to deal with these pathologies in the most effective way(AU)

Sobreocupación en los Centros Penitenciarios y su impacto en la salud / Overcrowding in prisons and its impact on health

La sobreocupación o el hacinamiento de los centros penitenciarios es un problema frecuente que afecta a muchos países. Es difícil definir estos términos ya que no hay un estándar único internacionalmente aceptado. Sin embargo, son situaciones que deben ser combatidas ya que pueden producir alteraciones en el comportamiento de las personas con aumento de las conductas violentas auto y heteroagresivas. Además, tienen otros impactos en la salud y el bienestar de quiénes lo padecen y repercuten también negativamente en la salud pública y en el sistema penitenciario en cuanto pueden aumentar la prevalencia de enfermedades, sobre todo infectocontagiosas y psiquiátricas, pueden dificultar las labores de rehabilitación social y pueden llegar a constituir un trato inhumano, cruel o degradante. En este trabajo se revisa la escasa bibliografía existente sobre la sobreocupación o hacinamiento en el ámbito penitenciario. Aumentar la sensibilización de la Comunidad Internacional y de las Administraciones Penitenciarias y, sobre todo, asignar recursos económicos específicos son elementos básicos para evitar este déficit sociosanitario(AU)

Overcrowding in prisons is a common problem that affects many countries. It is difficult to define this term because there is no single internationally accepted standard. However, this is a situation that must be counteracted, because people’s behaviour can be affected to the extent that it leads to self-harm or violent behaviour to others. But prison overcrowding also has other effects on the health and well being of the people living in these conditions and may also adversely affect public health and the prison system. It can increase the prevalence of diseases, particularly infectious and psychiatric disorders. It may also hinder the work of social rehabilitation and lead to inhuman, cruel or degrading treatment. This paper reviews the scant literature about overcrowding in prisons. Increasing awareness about the issue in the international community and prison administrations and above all, assigning specific economic resources, are key elements in preventing this deficit in social welfare and health care(AU)