Problemas de salud mental en población penitenciaria. Un enfoque de salud pública / Mental health problems in prison population. A public health approach

Se revisa la literatura internacional sobre la prevalencia de personas con problemas de salud mental en instituciones penitenciarias, con especial interés por quienes presentan trastornos mentales graves. Se valoran así la magnitud del problema, sus probables factores causales y las soluciones posibles, en general y en su aplicación a nuestro país, tratando de situarse en una perspectiva intersectorial de salud pública, más allá de la habitualmente limitada de la psiquiatría. (AU)

International literature on the prevalence of people with mental health problems in prisons population is reviewed, with special interest for those with severe mental disorders. The magnitude of the problem, its likely causal factors and possible solutions, in general and in its application to our country, are valued, trying to offer a cross-sectoral perspective of public health, beyond the usually limited from psychiatry. (AU)

[High prevalence of left ventricular hypertrophy in patients with hypertension of long course]. / Elevada prevalencia de hipertrofia ventricular izquierda en pacientes con hipertensión arterial de larga evolución.

BACKGROUND AND OBJECTIVE: Left ventricular hypertrophy (LVH) is the most frequent manifestation of cardiac damage in hypertension. The objective of this study was to evaluate the prevalence of LVH in hypertensive patients of long evolution at Primary Care (PC) and to describe their epidemiological profile. PATIENTS AND METHOD: 915 hypertensive patients treated for more than 5 years with antihypertensive drugs, who were attended in a consecutive way by de PC physicians, were evaluated in a multicentral and descriptive study. Clinical evaluation data together with electrocardiographic (EKG) and laboratory results were recorded. LVH was assessed by the Cornell and/or Sokolow-Lyon criteria. RESULTS: Study population was characterized by a mean age of 68.7 years, 63% women, 31.6% diabetics, and 37.5% presented controlled blood pressure levels. 30.5% of them presented LVH criteria on EKG, being more prevalent among women, and on the other hand, women with LVH were of a greater age. 30% of patients presented history of cardiovascular disease and heart failure was more frequent among those with LVH. 54% were polymedicated with blood pressure lowering drugs, however there were no differences between groups of patients with and without LVH regarding their treatment. The Cornell criterion and the Sokolow-Lyon criterion alone were presented in a 77% and 12% of patients, respectively, and 11% of them were positive for both criteria. Patients with positivity for only the Cornell criterion were characterized by a greater prevalence of women and obesity. CONCLUSIONS: The prevalence of LVH assessed by EKG criteria is high among hypertensive population of long evolution. A greater effort is needed to guarantee a periodic EKG performance in hypertensive patients together with a therapeutic strategy improvement.