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G Rodríguez Caravaca

Publications and source records attributed to G Rodríguez Caravaca.

7 recordsLinked to original sources
PubMed2005

[Epidural obstetric analgesia, maternal fever and neonatal wellness parameters].

OBJECTIVE: To study the relation between epidural analgesia and the development of maternal fever during labor and childbirth, and to determine the possible relation between that association and neonatal welfare and in the performance of tests to rule out sepsis in newborns. PATIENTS AND METHODS: Prospective study of all women who gave birth at Fundación Hospital Alcorcón over a period of 3 years. All the women were offered epidural analgesia based on infusion of 0.0625% bupivacaine and 2 microg x mL(-1). Data collected were age, nulliparity, epidural analgesia infusion, induction of labor, uterine stimulation with oxytocin, type of birth, fetal weight, duration of dilation and expulsion, Apgar score (at 1 and 5 minutes), umbilical artery pH, and maternal temperature. RESULTS: Data for 4364 women were analyzed. Fever developed during labor in 5.7%; 93.7% of the fevers occurred in women receiving epidural analgesia (P<0.05). Logistic regression analysis revealed that independent risk factors for the development of fever were epidural analgesia (odds ratio [OR], 1.78; 95% confidence interval [CI], 1.05-3.04), nulliparity (OR, 2,929; 95% CI, 2.005-4.279), fetal weight (OR, 1.484; 95% CI, 1.102-2.001), and duration of labor (OR, 1.003; 95% CI, 1.003-1.004). No significant differences in Apgar score at 5 minutes or umbilical artery pH were found between the women with and without fever. Tests to rule out sepsis were ordered for 85.1% of the infants of mothers with fever after epidural analgesia. CONCLUSIONS: Epidural analgesia was associated with greater risk of developing fever in mothers giving birth, but that association had no repercussion on the neonatal wellness parameters studied.

Adult↗
PubMed2004

[Potential impact of measures to minimise costs of pharmaceutical provision in the province of Toledo].

OBJECTIVE: To analyze the potential saving in the pharmaceutical cost that would suppose the use of equivalent pharmaceutical specialties and smaller price, in the main groups of pharmaceutical cost in 1998. DESIGN: Pharmacoepidemiologic study of drug utilization and a pharmaeconomic analysis of minimisation costs. LOCATION: Primary care of the province of Toledo. PARTICIPANTS: Prescriptions with official medical prescription of the pharmaceutical groups of greater cost during 1998 (peptic antiulcer, hipolipemiants, antagonists of calcium, hipotensors, peripheral vasodilators, macrolids, nonsteroidal antiinflamatories and antirheumatics, antidepressants and bronchodilatadors). MAIN MEASUREMENTS: Calculation of consumption by means of defined daily doses, cost of treatment to the day and potential saving. RESULTS: The potential saving in 1998 in the province of Toledo was 1405 million pesetas, which supposes 25% of the total amount of the pharmaceutical cost. Omeprazol, ranitidin and enalapril with 44.65, 46.02 and 32.84% of variation between prescribed and the cheapest alternative, were the specialties with a greater potential of saving. CONCLUSIONS: The alternative to prescribe equivalent pharmaceutical specialties and of smaller price has a great potential of saving.

Costs and Cost Analysis↗
PubMed2004

[Obstetric epidural analgesia: relationship between obstetric variables and the course of labor].

OBJECTIVES: To analyze the relationship between epidural analgesia and diverse obstetric and fetal variables as well as the impact of epidural analgesia on the rates of instrumental and cesarean delivery. PATIENTS AND METHODS: Observational study of women who gave birth at Fundación Hospital Alcorcón over a period of 3 years. All the women were offered obstetric epidural analgesia based on 0.0625% bupivacaine plus 2 microg/mL of fentanyl. The following data were recorded: age, nulliparity (yes/no) administration of epidural analgesia (yes/no), induction of labor (yes/no), stimulation of uterine activity with oxytocin (yes/no), type of delivery, fetal weight, duration of dilation, duration of expulsion, cause of cesarean. RESULTS: The records of 4364 women were gathered. The percentages of inductions, nulliparas, oxytocin stimulation, and fetal weight greater than 4 kg and less than 2.5 kg were higher among women taking epidural analgesia. The age of women who received epidurals was significantly lower. The durations of dilation and expulsion were longer among women receiving epidural analgesia, and epidural analgesia was associated with greater risk of instrumental and cesarean deliveries. The significant increase in administration of epidural blocks over the 3-year period of the study was not accompanied by an increased rate of instrumentally assisted deliveries or cesareans. CONCLUSIONS: It is difficult to evaluate the real influence of epidural analgesia on certain aspects of labor and its evolution. The strength of the association between epidural analgesia and greater risk of increased rates of instrumental and cesarean deliveries may be influenced by factors not considered in the present study.

Adult↗
PubMed2001

[Validity of the clinical diagnosis of the basal cell carcinoma in primary health care].

OBJECTIVE: To measure the validity of the clinical diagnosis of the basal cell carcinoma (BCC) in primary care. DESIGN: Cross-sectional study. SETTING: Primary health care Area 8 in Madrid. PATIENTS AND ITNERVENTIONS: A study was carried out on a group of patients that had been histopathologically diagnosed of BCC and on another that had received any of the most frequent differential diagnoses. A sample estimate was made with the most unfavourable situation of a sensitivity and a specificity of 50%, a precision of 5%, a confidence of 95% and losses of 20%. It was estimated that 962 cases were necessary. MEASUREMENTS: The histopathological diagnosis (gold standard) were compared to the clinical diagnosis. Sensitivity, specificity, predictive values, likelihood ratios and global value were estimated. RESULTS: 963 patients were included of which 7.6% were lost 890 cases were studied, 491 with BCC and 399 with differential diagnoses. The most frequent location of BCC was the face (65.8%). Sensitivity was 27.5% (95% CI, 23.531.5%), specificity 90.5% (95% CI, 87.5-93.5%), the global value of 55.7% (95% CI, 52.7-58.7%), positive predictive value, 78.0% (95% CI, 72.084.0%) and negative predictive value 50,3% (95% CI, 46.354.3%). CONCLUSIONS: Validity was moderate with low sensitivity and very low positive predictive value, the latter estimated for its expected prevalence. The clinical diagnosis of BCC in primary health care must be complemented with other diagnostic tests.

Aged↗
PubMedDate not supplied

[Diagnostic agreement between primary and hospital care in the assessment of basal cell carcinoma].

OBJECTIVE: To evaluate the diagnostic agreement between primary and hospital care. METHODS: Cross-sectional study. 491 patients who sought primary care for symptoms of suspected basal cell carcinoma and were referred to a dermatologist. The Kappa index was used to evaluate diagnostic concordance between primary and hospital care. RESULTS: The more frequent site of diagnosis was face (73.9%). The most frequent differential diagnosis in primary care was nevi (5.9%) while that in specialist care was actinic keratoses (2.2%). The diagnostic agreement was very low (kappa = 0.071; 95% IC = 0.0-0.15). CONCLUSIONS: The degree of agreement between primary and specialist care was low.

Aged↗