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F Calvo Rigual

Publications and source records attributed to F Calvo Rigual.

13 recordsLinked to original sources
PubMed2006

[Endemic goiter and iodine deficiency: are they still a reality in Spain].

OBJECTIVE: To estimate the prevalence of goiter and iodine deficiency in a health district in the Autonomous Community of Valencia, given the absence of data in this region of Spain. MATERIAL AND METHODS: We conducted a descriptive, epidemiologic, cross-sectional study, stratified by age and sex, in four interior regions of the province of Valencia. We selected students aged from 6 to 14 years old in 20 centers. Thyroid examination was performed by means of palpation and inspection (goiter > or = 0B). Urinary iodine excretion was analyzed in a routine urine sample. Sociodemographic and anthropometric data, as well as nutritional iodine status, were recorded in a standardized survey. In children with goiter, thyroid-stimulating hormone (TSH), free T4, and antithyroid antibodies were determined. RESULTS: We studied 928 children (478 boys and 450 girls). The prevalence of goiter was 33.7 % (95 % CI: 30.7-36.9 %). There were no significant differences in the prevalence of goiter by age or sex, but an inverse correlation was detected between the prevalence of goiter and parental socioeconomic position. Mean urinary iodine excretion was 155 .g/l, with no significant correlation with the prevalence of goiter. In children with goiter, 13 had positive antithyroid antibodies, 18 had high TSH (subclinical hypothyroidism), and one had suppressed TSH (subclinical hyperthyroidism). CONCLUSIONS: There is endemic goiter in the region studied. Urinary iodine levels were in the normal range and could be interpreted as indicating a transition phase to an improvement in iodine deficiency. Autoimmune diseases would only explain 4 % of cases of goiter.

Adolescent↗
PubMed2003

[Survey of the judicious use of antibiotics in primary care].

OBJECTIVE: To identify pediatricians' antibiotic prescribing habits in acute otitis media and tonsillopharyngitis and to determine the interaction between parents and pediatricians concerning antibiotic use in the Autonomous Community of Valencia (Spain). METHOD: Four hundred members of the Valencian Society of Pediatrics were randomly selected. A semi-structured questionnaire with non-excluding answers was sent by mail and, when responses were not obtained, a second one was sent. The confidentiality of the information was guaranteed. RESULTS: Of 400 questionnaires sent, 143 (35.8 %) were completed; 88.1 % were completed by pediatricians and 51.1 % by primary care workers. A total of 48.3 % of pediatricians used antibiotics in all cases of acute otitis media and 94.5 % prescribed them when fever and otalgia persisted for more than 48 hours. Amoxicillin-clavulanate was the most frequently prescribed antibiotic (63.6 %). Less than 10 % of pediatricians prescribed antibiotics as empirical treatment in tonsillopharyngitis; amoxicillin was the most frequently prescribed antibiotic (54.6 %). Indications for antibiotic treatment were fever, odynophagia and adenomegaly (69.5 %) and tonsillar exudate (62.5 %). Inappropriate antibiotic use was mainly due to excess workload. Providing health education to parents could be the best way of reducing inappropriate use. CONCLUSIONS: Antibiotic use is frequent in the treatment of acute otitis media. Amoxicillin-clavulanate and amoxicillin were the most frequently prescribed antibiotics in tonsillopharyngitis. Providing health education to parents and reducing pediatricians' workload would decrease inappropriate antibiotic use.

Anti-Bacterial Agents↗
PubMed1999

[Inappropriate use of pediatric hospitalization].

OBJECTIVE: Our aim was to identify the inappropriate utilization of pediatric hospitalization, its reasons and associated factors. PATIENTS AND METHODS: Three hundred twenty-three medical records were randomly selected among the patients aged 6 months to 14 years and hospitalized in 1995 in a public hospital of the Community of Valencia. The validated Spanish version of the "Pediatric Appropriateness Evaluation Protocol" was retrospectively applied. The proportions of inappropriate admissions and stays and their reasons were estimated and their association with certain factors analyzed. RESULTS: Of the admissions 17.7% (95% CI: 13.5-21.8) and 15.5% of the stays (95% CI: 11.5-19.4) were considered inappropriate. The most frequent reason for inappropriate admission was that diagnostic and therapeutic needs might have been solved by ambulatory care. Inappropriate stays were in mot cases (70%) due to that doctors did not pay attention to keeping the patient in the hospital although acute care was no longer needed. Female patients, non-elective admissions, admissions by general pediatricians or traumatology and weekend stays had significantly higher proportions of inappropriate utilization. CONCLUSIONS: A considerable proportion of inappropriate admissions and stays was observed, although it is in the lower range of those observed in other studies in pediatric patients. The most frequent reasons were attributed to an excessively conservative medical practice.

Adolescent↗
PubMed1998

[The value of C-reactive protein in the diagnosis of acute appendicitis in children].

OBJECTIVE: The aim of this study was to evaluate the usefulness of C-reactive protein values in the diagnosis of acute appendicitis, either as a single test or in combination with total white cell count. PATIENTS AND METHODS: Two hundred and thirty-one children with suspected appendicitis were analyzed. C-reactive protein and total white cell counts were measured and compared with the duration of symptoms and histological diagnosis. Both tests were compared by receiver-operating characteristic curves and the probability for the use of both tests together was calculated. RESULTS: Ninety out of 231 patients had abdominal pain that did not demand surgery. One hundred and forty-one children had histologically confirmed appendicitis (subgroups: 101 acute, 25 gangrenous and 15 perforated appendices). Mean C-reactive protein levels at admission were 25.1, 55 and 66.7 mg/L, respectively in these histological subgroups and 14.9 mg/L in the non-appendicitis group (p < 0.001). The total white cell count was also statistically significant. Both tests were equally valuable in patients whose symptoms had a duration of more than 12 hours. The total white cell count was more valuable in patients with less than 12 hours of symptoms. The likelihood ratio for appendicitis was 2.72 for a C-reactive protein greater than 20 mg/l and a total white cell count above 15,000/mm3. The likelihood ratio of not having appendicitis was 0.37 when both tests were below these values. CONCLUSIONS: Measurement of C-reactive protein is useful in the diagnosis of acute appendicitis, mainly in cases with more than 12 hours of evolution. The combined tests improved the predictive values.

Acute Disease↗
PubMed1995

[Measles seroprevalence in the schoolchildren of Valencia. The Measles Study Group].

BACKGROUND: People born between 1978 and 1982 were the most affected by measles in the outbreaks occurring in the Valencian Community (Spain) in 1993. This age group has not been systematically immunized against measles and has not suffered the last large measles epidemics. HYPOTHESIS: global seroprevalence against measles in this age group is inadequate to prevent new outbreaks. METHODS: Prospective seroepidemiologic study in a sample of school-attending children, born between 1978 and 1982. Randomized sampling of all classrooms 5th to 8th grade high school of a Health Area; stratification depending on the population of the village (< 5,000, 5,001-20,000, > 20,000 inhabitants). Antecedents of measles immunization and the disease were collected. Measles IgG antibodies were measured by enzyme immunoassay, antibody titers 1:80 or higher were considered protective. RESULTS: Sample of 410 subjects, belonging to 17 classes. Measles antibody prevalence was 80.2% (95% CI: 76.6-83.8%), and was higher in less populated villages (p < 0.03). Immunization status was known in 253 subjects (61.7%). Protective titers were present in 86.1% of the vaccinated and in 68.1% of the non vaccinated (p < 0.001). CONCLUSIONS: There is a large percentage of subjects born between 1978 and 1982 unprotected against measles. Elimination of the disease will not be able unless an extraordinary vaccination campaign to include these subjects is taken.

Adolescent↗
PubMed1993

[Survey of arterial blood pressure in children and adolescents in the population of Guadasuar].

Five hundred seventy-seven children (301 boys and 276 girls) from Guadasuar, whose blood pressure (BP) was taken in 1984, were reexamined over a three year period. The second of three BP readings, the most physiological, was used for the study. Among the boys, there was an increase in the systolic BP up to 16 years of age. The diastolic BP increased up to 12 years of age. For the girls, there was an increment of the systolic and diastolic BP us to 13 years of age. Our results, especially the diastolic readings, are higher than those of Sánchez (Spain) and of the Task Force (USA). The BP value at puberty could be important for the detection of future hypertension cases.

Adolescent↗
PubMed1993

[Correlation of arterial tension in the child population of Guadasuar].

A longitudinal study of blood pressure (BP) in children from Guadasuar was undertaken in 1984 and 1987. The subjects included 577 children from 5 to 14 years of age. The regression analysis for systolic BP was r = 0.34 (p < 0.00000) (r = 0.38 in males and 0.30 in females). The diastolic BP was not significant. The tracking was studied for 84 cases detected in 1984 with BP values in the 95th percentile or above (for age and sex). In 1987, only 17 cases (20.2%) remained in this classification. This trend towards the normalization of BP as time progressed, and the low correlations found suggest that there is no predictability for high BP with only one measurement of BP.

Adolescent↗
PubMed1992

[Variations in hospitalization rates of non-neonatal hospital admissions to pediatric departments of three district hospitals].

Hospitalization rates of children from three health districts were analyzed. The rates ranged from 30 to 40 admissions per 1000 children. The length of hospital stay, the rates of transfers and deaths were similar. Admission rates were different for certain selected diagnoses: gastroenteritis, pneumonia, bronchiolitis, head trauma and ear, nose and throat procedures. The variations were not related to differences in physician or bed supply, nor to severity or the disease of a delay in getting medical care. The demographic and geographic characteristics and the different patterns of practice can be associated with the observed variations. The health status of these children must be determined before considering which rate is correct.

Age Factors↗
PubMed1981

[Tuberculous meningitis in children. Study of 34 cases (author's transl)].

Thirty four cases of tuberculous meningitis in children of 6 months to 8 years of age are reviewed. Maximum frequency (44% of the cases) correspond to 0.5 to 2 year age group. In 55.8% of the cases symptoms appeared less than 20 days before admission to hospital. On admission 24% of the cases were in stage I, 64.7% in stage II and 11.7% in stage III according to the criteria of the Medical Research Council. None of the patients had been vaccinated with BCG. a family history of active tuberculosis was shown in 29.4% of the cases. "Mycobacterium tuberculosis" was isolated from spinal fluid in only 20.5% of the cases. A positive Mantoux was found in 70.5% and 50% showed a pathological chest X-ray film. A triple-drug therapy was instituted immediately after diagnosis. First choice drugs were streptomycin, rifampicin and isoniazid. Average length of treatment was 21 months. Corticosteroids were given to 17 children. Most frequent complications were convulsions, hydrocephalus, ophthalmoplegia, hyponatremia and hepatotoxicity due to rifampicin. Mortality rate was 14% and 55% of the survivors developed sequelae. Relations between precocity of diagnosis, therapeutic protocol and evolution are discussed. Importance of early diagnosis is stressed.

Antitubercular Agents↗
PubMed1981

[Hepatotoxicity of rifampicin and isoniazid in the treatment of tuberculous meningitis (author's transl)].

Thirty four children with tuberculous meningitis were treated with rifampicin (mean, 17 mg/kg/day) and isoniazid (mean, 18 mg/kg/day). Fifteen (44%) showed rise in transaminase GOT and GPT values and four cases (11.7%) developed jaundice, hepatomegaly and low prothrombin levels. Rifampicin was removed in only nine of these 15 cases with signs of liver disfunction, but complete normalization of liver function and disappearance of symptoms occurred in all cases even when the treatment was not interrupted. Children are more sensitive to hepatic injury during rifampicin and isoniazid combination therapy than adults. Our results indicate very good prognosis for this hepatopathy and suggest that rifampicin need not be withdrawn in the benign situations. Removal of the rifampicin treatment may delay recovery of serious cases of tuberculous meningitis.

Chemical and Drug Induced Liver Injury↗
PubMedDate not supplied

[Inappropriate utilization of pediatric hospitalization. Validation of the pediatric appropriateness evaluation protocol Spanish version].

OBJECTIVE: To validate the Spanish version of the Pediatric Appropriateness Evaluation Protocol (PAEP). METHODS: The protocol was applied by two independent reviewers to a sample of 104 clinical records of pediatric patients (age 6 months to 14 years) admitted to a general hospital in the Valentian Community. Reliability was tested by comparing their results. Validity was tested by comparing the results of one reviewer with the judgment of three pediatricians. The following measures were calculated: overall agreement (IO), specific agreement (IE), Cohen's κ, inappropriate use ratio, and, to evaluate the predictive value, sensitivity, specificity and positive and negative predictive value. RESULTS: Interobserver reliability was high: the IO for admissions was 94.2% and 96.2% for days of care. The IE was 66.7% and 75% respectively, and κ showed values of excellent agreement: 0.77 (95% CI 0.59-0.94) for admissions and 0.83 (95% CI 0.68-0.99) for days of care. Validity was moderate: the IO for admissions was 92.35, and 90.4% for days of care. The IE was 60% and 58.3% respectively, and κ showed values of good agreement: 0.70 (95% CI 0.51-0.90) for admissions and 0.68 (95% CI 0.50-0.86) for days of care. Inappropriate use ratio was 1.13 for admissions and 0.73 for days of care. The sensitivity and specificity were high for admissions (80% and 94% respectively), while sensitivity was lower for days of care (64% and 98%). Regarding the prevalence of inappropriate use of this study, the positive predictive value ranged between 71% and 88%, and the negative predictive value ranged between 97% and 91%. CONCLUSIONS: PAEP has a high reliability, moderate validity and good predictive value face to clinical judgment, and it is a useful instrument for assessing the inappropriate utilization of pediatric hospitalization.

Adolescent↗