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Biomedical subjects

L Tapia Ceballos

Publications and source records attributed to L Tapia Ceballos.

8 recordsLinked to original sources
PubMed2001

[Persistent hyperglycemia and hyperinsulinemia in a newborn infant].

Management of neonatal hyperglycemia is complex, especially in immature newborns. Etiology is diverse, the most frequent cause being iatrogeny. Neonatal diabetes mellitus is a rare cause of hyperglycemia during the first days of life. Insulin treatment is sometimes required to control the condition. When insulin requirements exceed 2I U/kg/day insulin resistance syndrome should be suspected. We present the case of a newborn infant with Donohue syndrome, or leprechaunism, which is a rare, genetically determined dysmorphic syndrome leading to significant insulin resistance.

Abnormalities, Multiple↗
PubMed2000

[Use of intrapleural urokinase in children].

OBJECTIVE: To present the use of intrapleural urokinase as an alternative to surgical management of complicated pleural effusions in children. To add new cases to the literature and set bases for the development of a standardized protocol. METHOD: Presentation of three cases in children under three years of age treated with intrapleural urokinase. RESULTS: Resolution of the effusions with lack of adverse effects. CONCLUSION: Treatment of pleural effusions when loculations develop. This invasive approach might be avoided in some cases by instillation of a fibrinolytic agent such as urokinase into the pleural space, this being an efficient and safe procedure.

Child, Preschool↗
PubMed1999

[High rate of early hospitalization in healthy newborns].

OBJECTIVE: The length of hospital stay of healthy term newborns and their mothers varies in different developed countries. The American Academy of Pediatrics defines early postpartum discharge (EPD) as a discharge occurring within 48 hours of postpartum. EPD has been advocated by patients as part of the humanization of care after delivery and by health services as a more efficient management of resources. Controversies in relation to EPD focus on its impact on initiation and maintenance of breastfeeding, the possible increase of readmissions of newborns with jaundice and the influence on newborn screening for endocrine and metabolic disorders. PATIENTS AND METHODS: Five years ago we started an EPD program for healthy term newborns. We present a descriptive observational study including a series of 2798 consecutive live newborns over a period of 19 months (April 1996 to October 1997). Data about breastfeeding at the time of discharge, coverage of hypothyroidism and phenylketonuria screening and readmissions for newborn jaundice were collected during this period. RESULTS: During the defined period of time, 2798 live newborns were registered. Of these, 2109 (75.38%) were included in the EPD group, the majority of them (75.86%) between 24 and 40 hours postpartum. Breastfeeding was implemented in 95.82% of the newborns, 3.56% of the mothers decided to use artificial formulas and 0.52% were prescribed artificial formulas due to health problems in the mother. In relation to newborn screening of endocrine and metabolic diseases, we found similar coverage of hypothyroid screening compared to the other 7 maternities in our province (public and private) and of phenylketonuria screening compared to the other 5 primary care districts. Regarding newborn jaundice, we detected 47 readmissions, which is 2.23% of the total EPD. These newborns were treated with phototherapy and none required exchange transfusion. The mean value of total serum bilirubin at the time of readmission was 18.7 mg/dl, with a range between 15.1 and 22.6 mg/dl. CONCLUSIONS: In our experience, 75.38% of live newborns were included in a EPD program that has been shown to be safe in relation to controversial subjects, although the limitations of an observational study must be taken into consideration. The safety of this program is inferred by the high proportion of breastfeeding on EPD (95.82%), coverage of endocrine and metabolic screening comparable to other surrounding hospitals and adequate control of hyperbilirubinemia in the newborn period.

Female↗
PubMed1998

[Effectiveness of brain imaging in children with headache].

OBJECTIVE: Headache is a common complaint in children and brain imaging has become widely used to evaluate this clinical condition. We studied the value of neuroimaging in children with chronic headaches. PATIENTS AND METHODS: A retrospective chart review was conducted of all children referred to the pediatric outpatient clinic for evaluation of headache over a 3-year period. The charts were reviewed for headache characteristics, clinical indications for performing neuroimaging, and imaging results. Special attention was paid to evidence of space-occupying lesions. RESULTS: A total of 160 records were studied, with subjects ranging in age from 4 to 14 years. Most patients were diagnosed as having migraine headaches (60%) or chronic tension headaches (29.5%). Other diagnoses were post-traumatic (6%) and unclassified (4%). Sixty-six patients (41%) had computed tomography imaging performed. In most cases, brain imaging studies were performed because of clinical data (41%) like atypical pattern, sleep-related headache or increase of headache, because of the parents' concerns about brain lesions (38%) and because of an age less than 5 years (14%). Structural changes were found on brain imaging in 4 patients, but none indicated the presence of a treatable space-occupying lesion and all were deemed unrelated to the headache. Our findings of no relevant abnormalities in a series of 66 neuroimaging studies indicate that the maximal rate at which such abnormalities might appear in this population is 4.4%. CONCLUSIONS: These results indicate that neuroimaging studies have very limited value in the clinical evaluation of pediatric patients with chronic headache and should be reserved for those patients with clinical evidence suggestive of underlying structural lesion.

Adolescent↗
PubMed1997

[Prognostic value and accuracy of crisis indicators in severe asthma].

OBJECTIVE: The objective of this study was to evaluate the predictive index of several scores such as the Scarfone score. Wood-Downes modified by Ferrés and transcutaneous oxygen saturation. (Stc,O2) for the detection of severe asthma exacerbations. PATIENTS AND METHODS: A transverse study design was used. Sixty patients under 15 years of age admitted consecutively with acute asthma were included in the study. We evaluated the relation (Pearson "r" correlation), precision (sensibility and specificity) and odds ratio (logistic regression) of the scores and Stc,O2 with the number of salbutamol doses required by the patients during their hospitalization. RESULTS: The number of doses of bronchodilator needed to revert acute asthma relates to the hospital stay (r = 0.74, p < 0.0002), to all the scores taken into account (r > 0.65, 0 < 0.001) an to the Stc,O2 (r = -0.66, p < 0.001). The evaluated scores are prognostic factors for severe acute asthma, while heart rate and respiratory rate did not predict severe acute asthma. CONCLUSIONS: We have to identify, treat and classify as having severe acute asthma those patients who after receiving three doses of inhaled bronchodilator show a Scarfone score over 10 or a Ferrés score over 8, these being situations related to an increased need of bronchodilator therapy and a longer hospital stay.

Acute Disease↗