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Biomedical subjects

J L Tapia

Publications and source records attributed to J L Tapia.

At least 19 recordsLinked to original sources
PubMed2006

Sialolithiasis in a residual Wharton's duct after excision of a submandibular salivary gland.

Treatment of salivary stones includes both surgical and non-surgical techniques. Surgical approaches range from excision of the sialolith, for those near the duct orifice, to removal of the affected salivary gland and its associated duct, for stones near the hilum of the gland. We present a case of two sialoliths triggering an acute infection in a residual Wharton's duct, 12 years after the removal of the associated submandibular gland. Excision of the sialoliths and treatment of the infected duct via sialodochoplasty was successfully performed in this patient. If the Wharton's duct is not removed with the associated submandibular gland, the potential for infection and continuous growth of dormant calcifications exists. We also address the aetiology, pathogenesis, and management of patients with sialolithiasis in the absence of a major salivary gland.

Adult↗
PubMed2002

Serendipitous diagnosis of protein S deficiency.

A 46-year-old male sought periodontal care for a swelling on his right mandibular gingiva. An excisional biopsy revealed a well-differentiated squamous cell carcinoma. Surgical treatment consisted of a right segmental mandibulectomy with ipsilateral right neck dissection and fibular free flap reconstruction. Two days after the surgical procedure, a weakened Doppler signal suggested vascular compromise of the graft. The patient was returned to the operating room where complete thrombosis of the internal jugular vein (recipient vessel) was observed. This event prompted a complete hematological evaluation that disclosed low serum levels of protein S. The patient was started on systemic heparin and local medicinal leeches. A week later, systemic warfarin sodium was added and successfully resolved the vascular compromise of the graft. Two years later, the patient is active and lives a full life with occasional adjustments of warfarin sodium. This case represents the first report on the treatment of gingival carcinoma that led to the serendipitous discovery of an unrelated and unusual systemic condition, protein S deficiency.

Anticoagulants↗
PubMed1998

The effect of early dexamethasone administration on bronchopulmonary dysplasia in preterm infants with respiratory distress syndrome.

OBJECTIVES: This study was carried to evaluate the effect of early administration of dexamethasone on the incidence of bronchopulmonary dysplasia (BPD) and/or death in surfactant-treated preterm infants with respiratory distress syndrome (RDS). STUDY DESIGN: In a multicenter, double-blind, placebo-controlled trial, 109 preterm infants with RDS and birth weights between 700 and 1600 gm, who were treated with mechanical ventilation and surfactant, were randomly assigned before 36 hours of life to receive dexamethasone (n = 55) or placebo (n = 54) for 12 days. RESULTS: There were no differences in the incidence of BPD and/or death between groups. However, fewer patients in the dexamethasone group were oxygen-dependent at 36 weeks after conception (8% vs 33%, p < 0.05). The dexamethasone group had a lower incidence of necrotizing enterocolitis (0% vs 9%, p < 0.05). The incidence of arterial hypertension, hyperglycemia, and sepsis was not affected by the treatment. Basal and poststimulation serum cortisol levels did not differ between groups. CONCLUSION: The administration of dexamethasone early in the course of RDS does not decrease the incidence of BPD and/or death in preterm infants. However, dexamethasone may reduce oxygen dependency at 36 weeks after conception.

Anti-Inflammatory Agents↗
PubMed1995

Does continuous positive airway pressure (CPAP) during weaning from intermittent mandatory ventilation in very low birth weight infants have risks or benefits? A controlled trial.

OBJECTIVE: The purpose of this study was to evaluate three ventilator weaning strategies and to evaluate whether the use of continuous positive airway pressure (CPAP) via a nasopharyngeal or endotracheal tube would increase the likelihood of extubation failure in very low birth weight (VLBW) infants. STUDY DESIGN: We studied prospectively 87 preterm infants (mean +/- SD; birth weight: 1078 +/- 188 g; gestational age: 28.8 +/- 2.2 weeks) who were in the process of being weaned from intermittent mandatory ventilation (IMV). Infants were assigned by systematic sampling to one of the following three treatment groups: (1) direct extubation from IMV (D.EXT) (n = 30); (2) preextubation endotracheal CPAP (ET-CPAP) for 12-24 hr (n = 28); or (3) postextubation nasopharyngeal CPAP (NP-CPAP) for 12-24 hr (n = 29). Failure was defined as the need for resumption of mechanical ventilation within 72 hr of extubation due to frequent or severe apnea and/or respiratory failure (pH < 7.25, PaCO2 > 60 mm Hg, and/or requirement for oxygen FiO2 > 60%). RESULTS: There were no significant differences in failure rates among the three procedures. Failures were 2/30 (7%) in D.EXT; 4/28 (14%) in ET-CPAP; and 7/29 (24%) in the NP-CPAP. There were also no differences in FiO2, PaO2, and respiratory rates before and after discontinuation of IMV among the three groups. PaCO2 values were slightly higher in the NP-CPAP group 12-24 hr after weaning from IMV. CONCLUSION: We were unable to demonstrate a clear difference in extubation outcome by use of CPAP administered via an endotracheal or nasopharyngeal tube when compared to direct extubation from low-rate IMV in VLBW infants.

Airway Resistance↗
PubMed1994

Experimental transmission of Babesia microti infection by the oral route.

Previously we have described the transmission of malaria by the oral route in a murine model. Due to the similarities between Plasmodium and Babesia, we tried to reproduce oral transmission in parasites of the latter genus by ingestion of infected blood and by cannibalism. In the first case, experimental mice were inoculated orally with 20, 50, or 100 microliters of Babesia microti-infected blood, and in the second, each fasted experimental mouse was offered the corpse of an infected mouse serving as the bait inoculum. B. microti infection was acquired by 3.7% of all experimental animals orally inoculated with infected blood and by 15.1% of all mice inoculated by cannibalism. The approximate period of prepatency ran from 2 to 4 weeks. No control mouse acquired the infection. This represents the first time that oral transmission of babesiosis has been described. This kind of transmission may be present in nature. Babesiosis may be acquired and maintained in nature in the absence of ticks.

Administration, Oral↗
PubMed1994

Estimation of the time required by the malaria parasites to cross the digestive tract to reach blood in mice inoculated by the oral route.

In a previous report we described the transmission of the malaria parasites by the oral route in a murine model. Later, we performed some experiments to demonstrate the transmission of malaria infection by cannibalism. Now we commence to look for the site, mechanism and stages of the parasite involved in crossing the alimentary canal to reach blood and start the infection. To know the invasive stage of the parasite and the way it penetrates, we wanted first to find the level of the digestive tract through which the parasites cross, to restrict the area to be studied. We proposed that the crossing place would be known, if the crossing time of the parasite could be established. Mice were orally inoculated with Plasmodium yoelii yoelii infected blood and their blood was transferred at different times into clean recipient mice intraperitoneally. Malaria infection detected in recipient mice proved that infective forms of the parasite were circulating in the donor mice at the time the blood samples were taken. In this way, we observed that: i) although most parasites required between 2 to 10 min for crossing the alimentary canal, in some case the process can last for 22 hrs; ii) the parasites circulate in blood for variable periods of time (only two minutes in the shortest, and from 10 min on in the longest) being infective to blood recipients. Most orally-inoculated mice whose blood infects other mice, became transient carriers of parasites unable to establish in them.

Administration, Oral↗
PubMed1993

Experimental transmission of murine malaria by the oral route.

A total of 116 young male CD1 mice were orally inoculated with mouse blood; half of the animals received 0.2 ml of uninfected blood and the others were given 0.2 ml of Plasmodium berghei yoelii-infected blood in six experiments performed at different times. Almost 30% of the experimental mice acquired malaria as demonstrated by the observation of parasites in their blood. In no case were parasites found in the blood of control mice. Rodent malaria parasites may be transmitted to CD1 mice by the ingestion of mouse blood parasitized by P. b. yoelii. As far as we know, this study represents the first demonstration of oral transmission of murine malaria. Oral transmission studies in this mouse-Plasmodium model may produce very important information on the biology of the malaria parasites.

Administration, Oral↗
PubMedDate not supplied

[Incidence of bronchopulmonary dysplasia].

The incidence of bronchopulmonary dysplasia (BPD) was retrospectively studied in all ventilated newborns at a neonatal intensive care unit of a university based hospital at Santiago, Chile along a 5 years period (1983-1987). BPD incidence among the whole sample of newborn infants requiring artificial ventilation was analysed according to birth weight (BW) and compared with that of newborns surviving after 28 days of life. The possible association of BPD with hyaline membrane disease (HMD), ductus arteriosus (DA) and pulmonary air leak (PAL) was studied. The total number of ventilated newborns was 200, incidence of BPD was 9.5% (19/200) and lethality for BPD was 5.2% (1/19). The incidence of BPD increased progressively with decreasing BW, reaching 37.5% in infants less than 1,000 g (p less than 0.001 chi 2). Among 28 day survivors incidence of BPD in the same BW group increased to 75% (p less than 0.05). These findings support the idea that the incidence of BPD increases with improved survival of low birth weight infants. A positive association of BPD with DA and PAL was seen with 10/19 versus 33/181 incidence for DA (p less than 0.01) and 6/19 versus 16/181 for PAL (p less than 0.01) among patients with and those without BPD respectively, but not with HMD.

Birth Weight↗
PubMedDate not supplied

[Intrauterine growth in Chilean middle class newborn infants].

Intrauterine growth of 11,543 newborn infants, liveborn between 1978 to 1987 that met prospective selection conditions (without intrauterine growth retardation risk) and their data are reported. MBW and weight percentiles 10, 25, 50, 75, 90 from 26 throughout 42 week of gestational age are reported. Selection of cases was important in obtaining adequate percentiles of birth-weight vs gestational age. The intrauterine growth pattern herein reported is recommended for evaluation of chilean newborns, because it is different to that of some foreign countries and the studied sample seems representative of chilean babies.

Birth Weight↗