[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.

Effect of consumption of tomato juice enriched with n-3 polyunsaturated fatty acids on the lipid profile, antioxidant biomarker status, and cardiovascular disease risk in healthy women.

PURPOSE: We compared the effects of consumption of n-3 polyunsaturated fatty acids (PUFA)-enriched tomato juice versus plain tomato juice on the serum lipid profile and levels of biomarkers related to antioxidant status and cardiovascular disease (CVD) risk in women. METHODS: Eighteen healthy women participated in a 2-week intervention trial involving the daily intake of 500 mL of n-3 PUFA-enriched juice (n = 11) or plain tomato juice (n = 7). Each serving of enriched juice provided 250 mg of eicosapentaenoic acid (EPA) plus docosahexanoic acid (DHA). Both juices provided natural antioxidant compounds such as phenolics (181 mg) and lycopene (26.5 mg). RESULTS: Intervention with the enriched juice had no effect on the lipid profile, and serum levels of triglycerides and cholesterol (total, LDL, and HDL) remained unchanged. The serum antioxidant status improved following juice intake, as revealed by an increase in total antioxidant capacity and a slight decrease in lipid peroxidation. The serum levels of homocysteine, a cardiovascular risk factor, decreased following n-3 PUFA-enriched juice consumption. A decrease in vascular adhesion molecule 1 (VCAM-1) levels was also noted after intake of either plain or enriched tomato juice, whereas intercellular adhesion molecule 1 (ICAM-1) levels only decreased following intake of the enriched juice. CONCLUSIONS: Overall, stronger positive amelioration of CVD risk factors was observed following the intake of n-3 PUFA-enriched juice than after plain tomato juice consumption, which suggested a possible synergistic action between n-3 PUFAs and tomato antioxidants.

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)

Bortezomib como alternativa en el tratamiento de pacientes con gammapatías malignas / Bortezomib as an alternative in the treatment of patients with malignant gammopathy

Objetivo: Describir el uso de bortezomib en un hospital comarcal como alternativa en el tratamiento de gammapatías malignas. Métodos: Análisis retrospectivo de los pacientes tratados con bortezomib en nuestro hospital desde noviembre de 2005 hasta octubre de 2007. A partir de la revisión de las historias clínicas de los pacientes se recogieron los datos correspondientes al diagnóstico, tratamientos previos a bortezomib, fecha de la última progresión de la enfermedad, número de ciclos de bortezomib, respuesta a éste, super vivencia global y libre de progresión, complicaciones y efectos secundarios. Resultados: El 47% de los pacientes estudiados eran varones (5/12), con una mediana de edad de 67 años (rango, 40-81 años). El diagnóstico principal fue mieloma múltiple, solo o asociado a plasmocitoma. El inicio con bortezomib coincidió con la última progresión de la enfermedad en el 83% de los pacientes (10/12). El 50% completó 7-8 ciclos con bortezomib. Se obtuvo respuesta en el 58% de los pacientes (7/12), alcanzándose criterios de respuesta parcial en el 33% (4/12) y respuesta completa en el 25% (3/12). Las reacciones adversas más frecuentes fueron neuropatía y toxicidad gastrointestinal, y supuso la suspensión del tratamiento en el 50% de los casos. Conclusiones: Según los resultados obtenidos, bortezomib es una buena alternativa en el tratamiento de las gammapatías malignas, sobre todo en el caso de plasmocitomas (AU)

Objective: To describe the use of bortezomib in a district hospital as an alternative in the treatment of malignant gammopathy. Methods: A retrospective analysis was carried out on patients treated with bortezomib in our hospital between November 2005 and October 2007. The patients’ medical histories were used to obtain data regarding diagnosis, treatments prior to bortezomib, date of the last disease progression, number of bortezomib courses, response to bortezomib, overall and event free survival. Results: 47% of the patients studied were male (5/12). The medianage was 67, (age range between 40 and 81). The main diagnosis was multiple myeloma on its own or associated with plasmocytoma. Bortezomib initiation coincided with the last disease progression in 83%of patients (10/12). 50% of the patients completed 7-8 courses of bortezomib. Response was seen in 58% of the patients (7/12), partial response in 33% of them (4/12) and complete response in 25%(3/12). The most common adverse reactions were neuropathy and gastrointestinal toxicity which required treatment to be discontinued in 50% of cases. Conclusions: According to the results obtained, bortezomib is a good alternative in the treatment of malignant gammopathy, above all in the case of plasmocytomas (AU)

[Bortezomib as an alternative in the treatment of patients with malignant gammopathy]. / Bortezomib como alternativa en el tratamiento de pacientes con gammapatías malignas.

OBJECTIVE: To describe the use of bortezomib in a district hospital as an alternative in the treatment of malignant gammopathy. METHODS: A retrospective analysis was carried out on patients treated with bortezomib in our hospital between November 2005 and October 2007. The patients' medical histories were used to obtain data regarding diagnosis, treatments prior to bortezomib, date of the last disease progression, number of bortezomib courses, response to bortezomib, overall and event free survival. RESULTS: 47% of the patients studied were male (5/12). The median age was 67, (age range between 40 and 81). The main diagnosis was multiple myeloma on its own or associated with plasmocytoma. Bortezomib initiation coincided with the last disease progression in 83% of patients (10/12). 50% of the patients completed 7-8 courses of bortezomib. Response was seen in 58% of the patients (7/12), partial response in 33% of them (4/12) and complete response in 25% (3/12). The most common adverse reactions were neuropathy and gastrointestinal toxicity which required treatment to be discontinued in 50% of cases. CONCLUSIONS: According to the results obtained, bortezomib is a good alternative in the treatment of malignant gammopathy, above all in the case of plasmocytomas.

[Nutritional assessment at the time of hospital-admission: study initiation among different methodologies]. / Valoración nutricional al ingreso hospitalario: iniciación al estudio entre distintas metodologías.

BACKGROUND AND OBJECTIVES: The elevated prevalence figures of hyponutrition in hospitalized patients--near 40%--is an issue of concern. This allows deducing that early identification of malnourished, or at risk for hyponutrition, patients by means of effective nutritional assessment methods may represent an essential tool for nutritional planning. The aim of this study was applying to a same group of patients different nutritional assessment methods (objective and subjective) at the time of hospital admission in order to assess the degree of effectiveness for its clinical application. SETTING, PATIENTS AND INTERVENTIONS: A prospective randomized study is designed, in which 50 admitted patients of our hospital are included between October 1st and December 31st of 2004, 9 of them being rejected for laboratory errors. During the first 3 days of hospital staying, anthropometrics (weight, height, arm circumference, and tricipital fold measure), biochemistry (full blood count, albumin, pre-albumin, retinol-bound protein, transferrin, and cholesterol), two nutritional assessment questionnaires (Global Subjective Assessment (GSA) and Mini Nutritional Assessment (MNA). RESULTS: Thechi-squared2 test has been applied to compare the results obtained from the different objective methods, separately and globally, with the MNA and GSA questionnaires, establishing the following anthropometrical comparisons: anthropometrics/MNA, Biochemistry/MNA, Chang/MNA, anthropometrics/GSA, Biochemistry/GSA, Chang/GSA, and MNA/GSA. Statistical significance has been set at p < 0.05. Statistical analysis has been done with the SPSS v.11 software. We have not observed a statistical significance between any of the three objective parameters studied: biochemistry, anthropometrics and immunology separately considered in the two nutritional assessment questionnaires. However, the significance is positive when we relate the results obtained by the Chang method, which comprises the three types of objective parameters, with those from the MNA and GSA. A statistical significance was also reached when relating both subjective methods between each other: MNA and GSA. CONCLUSIONS: Both the GSA and MNA represent a good indicator to determine high-risk patients for developing complications attributable to hyponutrition. We can attribute them a predictive power similar to that of objective data considered as a whole.

Valoración nutricional al ingreso hospitalario: iniciación al estudio entre distintas metodologías / Nutritional assessment at the time of hospital-admission: study initiation among different methodologies

Antecedentes y Objetivos: Las altas cifras iniciales de prevalencia de desnutrición en los enfermos hospitalizados-cercanos al 40%- es un dato preocupante. Esto permite deducir que la identificación precoz de enfermos desnutridos o en riesgo de estarlo, mediante métodos de valoración nutricional eficaces puede constituir una herramienta fundamental de cara a la planificación nutricional. El objetivo del presente trabajo ha sido aplicar a un mismo grupo de pacientes distintos métodos de valoración nutricional (objetivos y subjetivos) a su ingreso hospitalario, a fin de valorar el grado de efectividad para su aplicación en la clínica. Ámbito, Pacientes e Intervenciones: Se diseña un estudio prospectivo y aleatorio, en el cual se incluyen 50 pacientes ingresados en nuestro hospital entre el 1 de octubre y el 31 de diciembre del 2004, siendo desestimados 9 casos por fallos en las analíticas. En los tres primeros días de estancia hospitalaria se les realiza antropometría(peso, talla, circunferencia del brazo y medida del pliegue tricipital), bioquímica (hemograma, albúmina, prealbúmina,proteína ligada al retinol, transferrina y colesterol) dos encuestas de valoración nutricional (Valoración Subjetiva Global (VSG) y Mini Nutricional Assessment (MNA). Resultados: Se ha aplicado el test de χ2 para comparar los resultados obtenidos de los diferentes métodos objetivos, por separado y en conjunto, con métodos MNA y VSG, estableciéndose las siguientes comparaciones:Antropometría/MNA, Bioquímica/MNA, Inmunología/ MNA, Chang/MNA, Antropometría/VSG, Bioquímica/VSG, Inmunología/VSG, Chang/VSG y MNA/VSG.La significación estadística se ha considerado para un valor de p < 0,05. El análisis estadístico se ha realizado con ayuda del programa SPSS v.11. No se ha observado significación estadística en la relación entre cualquiera de los tres tipos de parámetros objetivos estudiados: (bioquímica, antropometría e inmunología) considerados aisladamente y las dos encuestas de valoración nutricional. En cambio, la significación es positiva al relacionar los resultados obtenidos por el método de Chang que engloba los tres tipos de parámetros objetivos, con los resultados de la MNA y de la VSG. También se alcanzó significación estadística al relacionar entre sí los dos métodos subjetivos empleados: la MNA y la VSG. Conclusiones: Tanto la VSG como la MNA constituyen un buen indicador para determinar los pacientes en alto riesgo de desarrollar complicaciones atribuibles a la desnutrición. Podemos atribuirles un poder predictivo igual al de los datos de objetivos considerados en conjunto (AU)

Background and objectives: The elevated prevalence figures of hyponutrition in hospitalized patients -near 40%- is an issue of concern. This allows deducing that early identification of malnourished, or at risk for hyponutrition, patients by means of effective nutritional assessment methods may represent an essential tool for nutritional planning.The aim of this study was applying to a same group of patients different nutritional assessment methods (objective and subjective) at the time of hospital admission in order to assess the degree of effectiveness for its clinical application. Setting, Patients and Interventions: A prospective randomized study is designed, in which 50 admitted patients of our hospital are included between October 1st and December 31st of 2004, 9 of them being rejected for laboratory errors. During the first 3 days of hospital staying, anthropometrics (weight, height, arm circumference,and tricipital fold measure), biochemistry (full blood count, albumin, pre-albumin, retinol-bound protein, transferrin, and cholesterol), two nutritional assessment questionnaires (Global Subjective Assessment (GSA) and Mini Nutritional Assessment (MNA). Results: The χ2 test has been applied to compare the results obtained from the different objective methods, separately and globally, with the MNA and GSA questionnaires, establishing the following anthropometrical comparisons: anthropometrics/MNA, Biochemistry/ MNA, Chang/MNA, anthropometrics/GSA, Biochemistry/GSA, Chang/GSA, and MNA/GSA. Statistical significance has been set at p < 0.05. Statistical analysis has been done with the SPSS v.11 software.We have not observed a statistical significance between any of the three objective parameters studied: biochemistry, anthropometrics and immunology separately considered in the two nutritional assessment questionnaires. However, the significance is positive when we relate the results obtained by the Chang method, which comprises the three types of objective parameters, with those from the MNA and GSA. A statistical significance was also reached when relating both subjective methods between each other: MNA and GSA. Conclusions: Both the GSA and MNA represent a good indicator to determine high-risk patients for developing complications attributable to hyponutrition. We can attribute them a predictive power similar to that of objective data considered as a whole (AU)

Valoración nutricional en el enfermo oncológico: estudio sobre metodología objetiva-subjetiva / Nutritional valuation on oncologic patient: objective-subjective methodology research

Fundamentos: En la práctica clínica, el objetivo de la valoración nutricional es identificar los pacientes con malnutrición o con riesgo que pueden beneficiarse de un adecuado abordaje nutricional posterior. Para ello, es necesario disponer de un método de valoración del estado nutricional sencillo de realizar, reproducible, que pueda ser llevado a cabo por cualquier terapeuta, de bajo coste y capaz de identificar a pacientes con déficit nutricional o riesgo de malnutrición. El objetivo de nuestro estudio ha sido aplicara un mismo grupo de pacientes distintos métodos de valoración nutricional (objetivos y subjetivos) para determinar la variación entre los resultados obtenidos por cada uno de ellos y encontrar un método sencillo y fiable que se pueda utilizar como método de rutina aplicado apacientes oncológicos cuando ingresan en el hospital. Métodos: Se ha diseñado un estudio prospectivo y aleatorio, seleccionando al azar 25pacientes oncológicos a los que se les aplicaron en los tres primeros días de estancia hospitalaria las medidas de estudio: antropometría(peso, talla, circunferencia del brazo y medida del pliegue tricipital), analítica (hemograma, albúmina, prealbúmina, proteína ligada al retinol, transferrina y colesterol) y dos encuestas de valoración nutricional (VSG-GP y MNA).Resultados: No hemos encontrado significación estadística entre cualquiera de los tres tipos de parámetros objetivos estudiados aisladamente(bioquímica, antropometría e inmunología)con ninguna de las dos encuestas de valoración nutricional (Tabla IV). En cambio, sí se han podido relacionar los resultados obtenidos por el método de Chang que engloba dichos parámetros objetivos, con los resultados de la MNA y los de la VSG (Tabla IV). Conclusiones: Tanto la VSG-GP como la MNA son dos métodos subjetivos de valoración nutricional fáciles de realizar y con una buena correlación respecto a los métodos objetivos (AU)

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