[Intensive care anaesthesia practice in the prison environment. Can a prisoner benefit from ambulatory anaesthesia]. / Pratique de l'anesthésie réanimation en milieu pénitentiaire. Un détenu peut-il bénéficier d'une anesthésie ambulatoire ?

Ambulatory anaesthesia is an anesthesia allowing the return of the patient home the same day. Even if the ambulatory hospitalization can, in theory, be applied to a prisoner as to every patient, caution is essential in such approach. Every anaesthetist reanimator doctor practicing in public hospitals may give care to patient prisoners while he is far from dominating all features of the prison world and while he must put down his therapeutic indications. The ambulatory anaesthesia in prison environment does not guarantee full security for the patient. Procedures could be set up between hospital complexes, caretakers practicing within penal middle (Unit of Consultation and Ambulatory Care [UCAC]) the prison service and hospital, the prefecture, to identify possible ambulatory interventions for a patient prisoner and to set up all guarantees of patient follow-up care in his return in prison environment. The development of interregional secure hospital units (ISHU) within teaching hospitals, allows an easier realization of interventions to the prisoners, but exists only in seven teaching hospitals in France.

[Healthcare of imprisoned juveniles: new regulations]. / Prise en charge sanitaire des mineurs détenus.

Several new French regulations have come into effect to regulate the healthcare of juvenile offenders in prison with the creation of French Young Offender Institutions. They complete the French prison healthcare methodological guide. This article presents the new developments in the healthcare of juveniles in prison. It specifies the limitations placed on the healthcare team's interventions on imprisoned juveniles. Promoting an individualized prisoner program, as is done in the school context, outlining parental involvement in this program, and withdrawing from the healthcare methodological guide the tasks that are not within the realm of the physician caring for the minor would be measures to ensure good ethical medical practices in prison. These could be applied to French secure training centers and secure children's homes.

[Obstructive lung diseases in a French prison: results of systematic screening]. / Dépistage de l'asthme et de la bronchopneumopathie obstructive à la maison d'arrêt d'Amiens: étude préliminaire transversale.

BACKGROUND: French prisoners have health problems that have been inadequately treated before imprisonment. This population has insufficient access to the healthcare system. Addictive behaviours, particularly smoking, are widespread. The aim of the study is to evaluate the prevalence of airflow limitation by using a primary care screening method adapted for the correctional facility and its inmates. METHOD: The screening of airflow limitation using a mobile spirometer is carried out in inmates consulting the primary care unit (UCSA) of Amiens prison. Patients consulting the UCSA between 16 August and 17 October 2006 and providing their consent are included in the study. The criteria for exclusion are: a counter-indication for spirometry, poor compliance with the effort of forced expiry after eight efforts, as well as refusal to take part in the study. The descriptive statistical analysis includes all of the quantitative and qualitative variables. RESULTS: Among the 210 patients included in the sample, only five patients refused to take part in the study. Their mean age was 37 (range: 16-65) and 90% were men. Ninety percent of this population were active smokers. Sixty percent of these smokers would like to quit. The spirometry detected 11% undiagnosed airflow limitation: 11 prisoners suffered from chronic obstructive lung disease and 13 prisoners suffered from asthma. DISCUSSION: Given the relative youth and high risk nature of these diagnosed patients, the potential for the long or short term aggravation, and a growing recognition of the seriousness of exposure to tobacco, the authors suggest that the systematic screening of inmates for airflow limitation may be used to assist in detecting serious health issues. Along with new French antismoking legislation, this screening may enable primary care workers to better reduce smoking habits in prisons.