[Comprehensive care program for the mentally ill in Spanish prisons (PAIEM): assessment after four years operation]. / Programa de Atención Integral al Enfermo Mental en las prisiones españolas (PAIEM): valoración tras cuatro años de funcionamiento.

OBJECTIVE: To assess the comprehensive care program for the mentally ill in prison (PAIEM), which has been implemented for 3 years in Spanish prisons with the aim of improving processes and results. METHODS: Descriptive study of the data gathered from an anonymous questionnaire completed by members of the PAIEM team in prisons. Frequency distributions were obtained of all the variables relating to facts, attitudes, opinions, experiences, situations and processes of the PAIEM. RESULTS: 91.2% of the PAIEM teams responded. Psychologists, educators, doctors and social workers were the professionals that collaborated most actively in the PAIEM (73%-84%) and were the ones to act most frequently as tutors. The mentally ill are usually located in ordinary modules (80%). The most commonly used activities for their psycho-social rehabilitation are self care (73%), education for health, preparation for daily life and social skills (more than 60%). Interventions with families are basically by telephone (79%). Bivariate analysis showed that the PAIEMs that operate most effectively are those that coordinate well with other technical teams, that prepare referral more than six months prior to release and ones where the NGOs process the referrals. Over 71% of the professionals observed improvements of disabilities and needs in over half the patients more than half of the professionals involved are satisfied (3.4/5) with their participation, although they acknowledge that there is a greater work load. CONCLUSIONS: The activities of the PAIEM are adequate, especially in the phases of early detection, stabilisation and rehabilitation and less so in the social incorporation phase, which improves when the third sector intervenes in referrals of patients to the social health care network outside prison.

Programa de Atención Integral al Enfermo Mental en las prisiones españolas (paiem ). Valoración tras cuatro años de funcionamiento / Comprehensive Care Program for the Mentally ill in spanish prisons (paiem ). Assessment after four years operation

Objetivo: Evaluar el programa de atención integral a los enfermos mentales (PAIEM) implantado desde hace 3 años en las prisiones españolas, con el fin de mejorar su funcionamiento y resultados. Metodología: Estudio descriptivo de los datos recogidos en un cuestionario anónimo cumplimentado por los miembros del equipo PAIEM de los centros penitenciarios. Se obtuvieron distribuciones de frecuencia de todas las variables acerca de hechos, actitudes, opiniones, experiencias, situaciones y procesos del PAIEM. Resultados: Han respondido el 91,2% de los equipos del PAIEM. Psicólogos, educadores, médicos y trabajadores sociales son los profesionales que colaboran más activamente en el PAIEM (73%-84%) y los que con más frecuencia ejercen como tutores. Los enfermos mentales se ubican habitualmente en módulos ordinarios (80%). Las actividades más utilizadas para su rehabilitación psicosocial son autocuidados (73%) y educación para la salud, preparación para la vida diaria y habilidades sociales con más del 60%. Las intervenciones con las familias son básicamente por contacto telefónico (79%). En el análisis bivariante se demuestra que los PAIEM que mejor funcionan son los que tienen una buena coordinación con el resto de los equipos técnicos, los que preparan la derivación con más de seis meses previos a la libertad y en los que las ONG’s tramitan las derivaciones. Más del 71% de los profesionales observan mejoras en carencias y discapacidades en más de la mitad de los enfermos y están mayoritariamente satisfechos (3,4/5) de su participación, aunque reconocen mayor carga de trabajo. Conclusiones: Las actividades del PAIEM son adecuadas, en especial en las fases de detección precoz, estabilización y rehabilitación y menos en la fase de reincorporación social que mejora cuando interviene el tercer sector en las derivaciones del enfermo a la red sociosanitaria extrapenitenciaria (AU)

Objective: To assess the comprehensive care program for the mentally ill in prison (PAIEM), which has been implemented for 3 years in Spanish prisons with the aim of improving processes and results. Methods: Descriptive study of the data gathered from an anonymous questionnaire completed by members of the PAIEM team in prisons. Frequency distributions were obtained of all the variables relating to facts, attitudes, opinions, experiences, situations and processes of the PAIEM. Results: 91.2% of the PAIEM teams responded. Psychologists, educators, doctors and social workers were the professionals that collaborated most actively in the PAIEM (73%-84%) and were the ones to act most frequently as tutors. The mentally ill are usually located in ordinary modules (80%). The most commonly used activities for their psycho-social rehabilitation are self care (73%), education for health, preparation for daily life and social skills (more than 60%). Interventions with families are basically by telephone (79%). Bivariate analysis showed that the PAIEMs that operate most effectively are those that coordinate well with other technical teams, that prepare referral more than six months prior to release and ones where the NGOs process the referrals. Over 71% of the professionals observed improvements of disabilities and needs in over half the patients more than half of the professionals involved are satisfied (3.4/5) with their participation, although they acknowledge that there is a greater work load. Conclusions: The activities of the PAIEM are adequate, especially in the phases of early detection, stabilisation and rehabilitation and less so in the social incorporation phase, which improves when the third sector intervenes in referrals of patients to the social health care network outside prison (AU)

X-ray simulation with the Monte Carlo code PENELOPE. Application to Quality Control.

A realistic knowledge of the energy spectrum is very important in Quality Control (QC) of X-ray tubes in order to reduce dose to patients. However, due to the implicit difficulties to measure the X-ray spectrum accurately, it is not normally obtained in routine QC. Instead, some parameters are measured and/or calculated. PENELOPE and MCNP5 codes, based on the Monte Carlo method, can be used as complementary tools to verify parameters measured in QC. These codes allow estimating Bremsstrahlung and characteristic lines from the anode taking into account specific characteristics of equipment. They have been applied to simulate an X-ray spectrum. Results are compared with theoretical IPEM 78 spectrum. A sensitivity analysis has been developed to estimate the influence on simulated spectra of important parameters used in simulation codes. With this analysis it has been obtained that the FORCE factor is the most important parameter in PENELOPE simulations. FORCE factor, which is a variance reduction method, improves the simulation but produces hard increases of computer time. The value of FORCE should be optimized so that a good agreement of simulated and theoretical spectra is reached, but with a reduction of computer time. Quality parameters such as Half Value Layer (HVL) can be obtained with the PENELOPE model developed, but FORCE takes such a high value that computer time is hardly increased. On the other hand, depth dose assessment can be achieved with acceptable results for small values of FORCE.

Use of serial analysis of gene expression to generate kidney expression libraries.

Chronic renal disease initiation and progression remain incompletely understood. Genome-wide expression monitoring should clarify mechanisms that cause progressive renal disease by determining how clusters of genes coordinately change their activity. Serial analysis of gene expression (SAGE) is a technique of expression profiling, which permits simultaneous, comparative, and quantitative analysis of gene-specific, 9- to 13-bp sequence tags. Using SAGE, we have constructed a tag expression library from ROP-+/+ mouse kidney. Tag sequences were sorted by abundance, and identity was determined by sequence homology searching. Analyses of 3,868 tags yielded 1,453 unique kidney transcripts. Forty-two percent of these transcripts matched mRNA sequence entries with known function, 35% of the transcripts corresponded to expressed sequence tag (EST) entries or cloned genes, whose function has not been established, and 23% represented unidentified genes. Previously characterized transcripts were clustered into functional groups, and those encoding metabolic enzymes, plasma membrane proteins (transporters/receptors), and ribosomal proteins were most abundant (39, 14, and 12% of known transcripts, respectively). The most common, kidney-specific transcripts were kidney androgen-regulated protein (4% of all transcripts), sodium-phosphate cotransporter (0.3%), renal cytochrome P-450 (0.3%), parathyroid hormone receptor (0.1%), and kidney-specific cadherin (0.1%). Comprehensively characterizing and contrasting gene expression patterns in normal and diseased kidneys will provide an alternative strategy to identify candidate pathways, which regulate nephropathy susceptibility and progression, and novel targets for therapeutic intervention.

[Circadian variations in the production of superoxide and liberation of lysosomal enzymes of neutrophils in peripheral blood]. / Variaciones circadianas en la producción de superóxido y liberación de enzimas lisosómicas por los neutrófilos de sangre periférica.

Superoxide formation and lysosomal enzyme liberation circulating neutrophils has been assessed in healthy subjects. Blood samples were obtained at 8:00, 14:00, and 20:00 o'clock. The formation of superoxide followed a circadian rythm. Lowest concentration was found a 14:00 hours (4.59 +/- 2.09 nM reduced cytochrome/10(6) neutrophils). No 24 hour variation of betaglucuronidase and lysozyme liberation was proven. The number of neutrophil receptors for formyl-methyonil-leucyl-phenyl-alamine (FMLP) at the same hours did not show any circadian variation. The circadian changes of the functional capacity of the neutrophils might be one of the mechanisms that could justify the 24 hour variation of symptomatology characteristic of some diseases.

[Effect of corticosteroids, quinacrine and L-652, 731 on experimental aggregation of polymorphonuclear leukocytes induced by complement and platelet activating factor (PAF)]. / Efecto de los corticosteroides, de la quinacrina y del L-652,731 sobre la agregación experimental de los polimorfonucleares inducida por el complemento y FAP.

The effects of 6-methylprednisolone sodium succinate, quinacrine and the synthetic anti-PAF compound L-652,731 were studied on the PAF and complement induced aggregation of rabbit polymorphonuclear leukocytes in vivo. High doses (100-250 mg/kg) of corticosteroid were able to abrogate PAF and complement induced aggregation. Quinacrine (1.25 mg/kg), and L-652,731, partially precluded complement-depending aggregation. The L-652,731 dose employed was just enough to prevent PAF induced aggregation. These results suggest that in those pathological conditions in which polymorphonuclear aggregation occurs, factors other than those derived from plasmatic complement system activation, and laboring jointly with it, may be involved.

[Effects of pepstatin A on neutrophils; cross-deactivation with FMLP]. / Efectos de la pepstatina A sobre los neutrófilos; desactivación cruzada con el FMLP.

The ability of pepstatin A, a protease inhibitor produced by Streptomyces testaceus, to elicit a number of responses by the human PMN has been studied. In lysozyme and beta-glucuronidase release, pepstatin A 10(-5)M is equivalent to the synthetic oligopeptide N-formyl-methionyl-leucyl-phenylalanine (FMLP) 10(-7)M. In superoxide release, pepstatin A 10(-5)M produces 80% of that originated by FMLP 10(-7). After two minutes of incubation the superoxide release is important, there being no further increase after 10 minutes. Preincubation of the cells with cytochalasin B before stimulation with pepstatin A elicits a noticeable increase in O2- release. In chemotaxis, pepstatin A 10(-6) originates the same cell motility as FMLP 10(-9). Pepstatin A produces a cross deactivation with FMLP which adds further evidence to the hypothesis that both stimuli compete for the same receptor in the PMN.