Health Research Institute La Fe

Valencia, Spain

Health Research Institute La Fe

Valencia, Spain

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Lehtonen L.,University of Turku | Gimeno A.,Polytechnic University of Valencia | Parra-Llorca A.,Health Research Institute La Fe | Vento M.,Polytechnic University of Valencia | Vento M.,Health Research Institute La Fe
Seminars in Fetal and Neonatal Medicine | Year: 2017

Early neonatal death (ENND), defined as the death of a newborn between zero and seven days after birth, represents 73% of all postnatal deaths worldwide. Despite a 50% reduction in childhood mortality, reduction of ENND has significantly lagged behind other Millennium Developmental Goal achievements and is a growing contributor to overall mortality in children aged <5 years. The etiology of ENND is closely related to the level of a country's industrialization. Hence, prematurity and congenital anomalies are the leading causes in high-income countries. Furthermore, sudden unexpected early neonatal deaths (SUEND) and collapse have only recently been identified as relevant and often preventable causes of death. Concomitantly, perinatal-related events such as asphyxia and infections are extremely relevant in Africa, South East Asia, and Latin America and, together with prematurity, are the principal contributors to ENND. In high-income countries, according to current research evidence, survival may be improved by applying antenatal and perinatal therapies and immediate newborn resuscitation, as well as by centralizing at-risk deliveries to centers with appropriate expertise available around the clock. In addition, resources should be allocated to the close surveillance of newborn infants, especially during the first hours of life. Many of the conditions leading to ENND in low-income countries are preventable with relatively easy and cost-effective interventions such as contraception, vaccination of pregnant women, hygienic delivery at a hospital, training health care workers in resuscitation practices, simplified algorithms that allow for early detection of perinatal infections, and early initiation of breastfeeding and skin-to-skin care. The future is promising. As initiatives undertaken in previous decades have led to substantial reduction in childhood mortality, it is expected that new initiatives targeting the perinatal/neonatal periods are bound to reduce ENND and provide these babies with a better future. © 2017 Elsevier Ltd.


Cernada M.,Health Research Institute La Fe | Cernada M.,Polytechnic University of Valencia | Brugada M.,Health Research Institute La Fe | Brugada M.,Polytechnic University of Valencia | And 3 more authors.
Neonatology | Year: 2014

Ventilator-associated pneumonia (VAP) is a serious complication related to mechanical ventilation in the neonatal period. However, lack of a specific definition and difficulties obtaining noncontaminated samples of the lower respiratory airway render microbiological diagnosis and etiological treatment extremely difficult. Thus far, only few studies have approached VAP using accepted Centers for Disease Control and Prevention criteria and reliable sampling techniques. In recent years, however, the blind-protected bronchoalveolar lavage technique with protected specimen brush and the development of validated biomarkers have attempted to overcome the diagnostic difficulties and assess the response to therapy. This updated review on neonatal VAP aims to stimulate neonatologists' interest in this subtle but serious complication of mechanical ventilation. © 2013 S. Karger AG, Basel.


Perez-Guaita D.,University of Valencia | Wilk A.,University of Ulm | Kuligowski J.,University of Valencia | Quintas G.,Health Research Institute la Fe | And 2 more authors.
Analytical and Bioanalytical Chemistry | Year: 2013

The use of chemometrics in order to improve the molecular selectivity of infrared (IR) spectra has been evaluated using classic least squares (CLS), partial least squares (PLS), science-based calibration (SBC), and multivariate curve resolution-alternate least squares (MCR-ALS) techniques for improving the discriminatory and quantitative performance of infrared hollow waveguide gas sensors. Spectra of mixtures of isobutylene, methane, carbon dioxide, butane, and cyclopropane were recorded, analyzed, and validated for optimizing the prediction of associated concentrations. PLS, CLS, and SBC provided equivalent results in the absence of interferences. After addition of the spectral characteristics of water by humidifying the sample mixtures, CLS and SBC results were similar to those obtained by PLS only if the water spectrum was included in the calibration model. In the presence of an unknown interferant, CLS revealed errors up to six times higher than those obtained by PLS. However, SBC provided similar results compared to PLS by adding a measured noise matrix to the model. Using MCR-ALS provided an excellent estimation of the spectra of the unknown interference. Furthermore, this method also provided a qualitative and quantitative estimation of the components of an unknown set of samples. In summary, using the most suitable chemometrics approach could improve the selectivity and quality of the calibration model derived for a sensor system, and may avoid the need to analyze expensive calibration data sets. The results obtained in the present study demonstrated that (1) if all sample components of the system are known, CLS provides a sufficiently accurate solution; (2) the selection between PLS and SBC methods depends on whether it is easier to measure a calibration data set or a noise matrix; and (3) MCR-ALS appears to be the most suitable method for detecting interferences within a sample. However, the latter approach requires the most extensive calculations and may thus result in limited temporal resolution, if the concentration of a component should be continuously monitored. © 2013 Springer-Verlag Berlin Heidelberg.


Vento M.,Polytechnic University of Valencia | Vento M.,Health Research Institute La Fe | Teramo K.,University of Helsinki
Seminars in Fetal and Neonatal Medicine | Year: 2013

The in-utero environment is relatively hypoxic, but fetal physiologic adaptation assures adequate tissue oxygen supply. Fetal reactions to acute or chronic hypoxia are different and are modified by the preceding fetal condition. Acute fetal hypoxia episodes are often not preventable. By contrast, good obstetric care during labor may prevent poor fetal outcome in many cases of acute fetal hypoxia. The pathophysiology of chronic fetal hypoxia caused by placental insufficiency differs from chronic fetal hypoxia seen during the last weeks of diabetic pregnancies. The efficacy of antenatal fetal surveillance methods in preventing perinatal complications is different in these two conditions. Electronic fetal heart rate testing and Doppler flow assessment methods have been successful in detecting chronic fetal hypoxia caused by placental insufficiency. However, these methods have been unable to prevent chronic fetal hypoxia complications in diabetic pregnancies. Therefore, research to find new strategies and early and reliable biomarkers is necessary to assess fetal well-being and to decide when to deliver the fetus. © 2013 Elsevier Ltd.


PubMed | Polytechnic University of Valencia, Health Research Institute La Fe and University of Helsinki
Type: | Journal: Data in brief | Year: 2016

This data article contains information on glutathione sulfonamide (GSA) structural confirmation and purity after synthesis, as well as mass spectrometry acquisition parameters for the determination of GSA and other biomarkers for the early assessment of intraamniotic fluid infection in amniotic fluid samples (Chfer-Perics et al., 2015) [1]. GSA standards were synthesized and structural confirmation was carried out employing time-of-flight mass spectrometry (TOF-MS); purity was assessed by high performance liquid chromatography (HPLC) with UV detection. For optimization of the acquisition parameters of GSA and other biomarkers, individual analytical standard solution at a concentration of 1molL(-) (1) was injected into an Acquity - Xevo TQ liquid-chromatography coupled to tandem mass spectrometry (LC-MS/MS) system from Waters (Milford, MA, USA) operating in the positive electrospray (ESI(+)) mode. Mass spectrometric detection of 3-nitro-tyrosine (3NO2-Tyr), 3-chloro-tyrosine (3Cl-Tyr), 8-hydroxy-2-deoxyguanosine (8OHdG), GSA and oxidized glutathione (GSSG) was carried out by multiple reaction monitoring (MRM). Linear response curves were calculated for each analyte normalizing the signal with peak areas of internal standards.


Silvestre D.,CEU Cardenal Herrera University | Fraga M.,CEU Cardenal Herrera University | Gormaz M.,Polytechnic University of Valencia | Gormaz M.,Health Research Institute La Fe | And 3 more authors.
Maternal and Child Nutrition | Year: 2014

The variability of human milk (HM) composition renders analysis of its components essential for optimal nutrition of preterm fed either with donor's or own mother's milk. To fulfil this requirement, various analytical instruments have been subjected to scientific and clinical evaluation. The objective of this study was to evaluate the suitability of a rapid method for the analysis of macronutrients in HM as compared with the analytical methods applied by cow's milk industry. Mature milk from 39 donors was analysed using an infrared human milk analyser (HMA) and compared with biochemical reference laboratory methods. The statistical analysis was based on the use of paired data tests. The use of an infrared HMA for the analysis of lipids, proteins and lactose in HM proved satisfactory as regards the rapidity, simplicity and the required sample volume. The instrument afforded good linearity and precision in application to all three nutrients. However, accuracy was not acceptable when compared with the reference methods, with overestimation of the lipid content and underestimation of the amount of proteins and lactose contents. The use of mid-infrared HMA might become the standard for rapid analysis of HM once standardisation and rigorous and systematic calibration is provided. © 2012 John Wiley & Sons Ltd.


PubMed | Polytechnic University of Valencia and Health Research Institute La Fe
Type: | Journal: Journal of the neurological sciences | Year: 2017

The high and increasing incidence of Alzheimer Disease (AD) worldwide is a major global concern. Classical diagnosis is carried out in the dementia phase, often in the moderate stages when treatment efficacy is limited. Nowadays, early diagnosis, even in pre-dementia stages, is possible in selected cases within an appropriate clinical setting, employing cerebral spinal fluid (CSF) sample analysis and neuroimaging procedures. In spite of the accurate diagnosis achieved by novel CSF biomarkers or positron emission tomography beta-amyloid tracers, these tests are invasive and expensive. Therefore, important work is being carried out to discover reliable biomarkers in peripheral biofluids (blood, plasma, urine) to be incorporated in clinical routine for early AD diagnosis. Although the nature of AD pathogenesis is complex, it is known that oxidative stress plays a key role, for which biomarkers are easily determined in peripheral biofluids. This review summarizes recent research on oxidative stress biomarkers in mild cognitive impairment due to AD. Among them, a promising research line is the study of the relationship between lipid peroxidation biomarkers and early AD clinical features. Results show a pronounced imbalance between scientific production and clinical reality due to the lack of clinical validation. We conclude that an important field in oxidative stress biomarkers could be developed with the aim to help clinicians in early disease diagnosis, effective treatment initiation and reliable disease monitoring.


PubMed | Polytechnic University of Valencia and Health Research Institute La Fe
Type: | Journal: Frontiers in pediatrics | Year: 2016

Fetal life elapses in a relatively low oxygen environment. Immediately after birth with the initiation of breathing, the lung expands and oxygen availability to tissue rises by twofold, generating a physiologic oxidative stress. However, both lung anatomy and function and the antioxidant defense system do not mature until late in gestation, and therefore, very preterm infants often need respiratory support and oxygen supplementation in the delivery room to achieve postnatal stabilization. Notably, interventions in the first minutes of life can have long-lasting consequences. Recent trials have aimed to assess what initial inspiratory fraction of oxygen and what oxygen targets during this transitional period are best for extremely preterm infants based on the available nomogram. However, oxygen saturation nomogram informs only of term and late preterm infants but not on extremely preterm infants. Therefore, the solution to this conundrum may still have to wait before a satisfactory answer is available.


PubMed | Polytechnic University of Valencia and Health Research Institute La Fe
Type: | Journal: Revista iberoamericana de micologia | Year: 2017

Candida auris is an emerging multidrug-resistant yeast that can cause invasive infections and is associated with high mortality. It is typically resistant to fluconazole and voriconazole and, some cases, also to echinocandins and amphotericin B. This species, phylogenetically related to Candida haemulonii, is frequently misidentified by commercial identification techniques in clinical laboratories; therefore, the real prevalence of C. auris infections may be underestimated.To describe the clinical and microbiological features of the first four cases of C. auris fungemia episodes observed in the European continent.The four patients were hospitalized in the adult surgical intensive care unit. A total of 8 isolates (two per patient) from blood and catheter tip were analyzed.All isolates were misidentified as Saccharomyces cerevisiae by AuxaColor 2, and as Candida sake by API ID20C. VITEK MS technology misidentified one isolate as Candida lusitaniae, another as C. haemulonii and could not identify the other six. C. auris identification was confirmed by ITS rDNA sequencing. All isolates were fluconazole (MIC >256mg/l) and voriconazole (MIC 2mg/l) resistant and susceptible to posaconazole, itraconazole, echinocandins and amphotericin B.C. auris should be regarded as an emerging pathogen, which requires molecular methods for definitive identification. Our isolates were highly resistant to fluconazole and resistant to voriconazole, but susceptible to the other antifungals tested, which emphasizes the importance of accurately identifying this species to avoid therapeutic failures.


PubMed | Polytechnic University of Valencia and Health Research Institute La Fe
Type: | Journal: Journal of chromatography. B, Analytical technologies in the biomedical and life sciences | Year: 2016

This paper describes a reliable analytical method based on Ultra High-Performance Liquid Chromatography coupled to tandem mass spectrometry to determine cortisol in saliva samples from healthy mothers (n=87) and newborns (n=65) at different time points: (i) 38 weeks of gestation, (ii) in the immediate postnatal period (48h) after a term delivery and, (iii) 3 months after delivery. The procedure is characterized by a simple sample treatment employing a sample volume of 25L. In addition to this, salivary -amylase was determined using a commercial kit. We have proposed potential reference ranges in saliva for cortisol (0.7-35nmolL(-1)) and -amylase (2-500UmL(-1)) in mothers, and for cortisol (0.1-56nmolL(-1)) and -amylase (0.1-500UmL(-1)) in newborn infants. In addition, statistical differences between the two sensitive population groups (mothers and newborns) at the perinatal and postnatal periods were studied. A lower concentration for maternal cortisol was found at 38 weeks of gestation than at 48h (p=0.048) or 3 months after delivery (p=0.021). Similar results were found for the -amylase determinations. Hence, higher concentrations than could be expected from a chronic stress marker were found at 3 months after delivery than at 38 weeks of gestation (p<0.001) or 48h after delivery (p<0.001). We conclude that this analytical method could be applied to further clinical research on perinatal and postnatal stress, such as threatened preterm labor and/or parenting stress, respectively.

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