National Institute of Perinatology

Mexico City, Mexico

National Institute of Perinatology

Mexico City, Mexico
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Vandenplas Y.,Vrije Universiteit Brussel | Gutierrez-Castrellon P.,National Institute of Perinatology | Velasco-Benitez C.,University of Valle | Palacios J.,University of San Carlos of Guatemala | And 5 more authors.
Nutrition | Year: 2013

Objective: In early infancy, various gastrointestinal symptoms (e.g., constipation, regurgitation, crying/fussiness, infantile colic, and excessive gas) are common problems and may result in numerous visits to pediatricians. Worldwide, this often results in switching infant formulas because parents (and sometimes doctors) believe these symptoms reflect a formula intolerance. However, in many cases, these infants are growing and developing normally. This study was performed to offer family pediatricians consensus-based algorithms on the management of the most common gastrointestinal symptoms in infants. Methods: A group of pediatric gastroenterologists and pediatric allergists from Europe, USA, Latin America, and Asia developed guidelines and practical algorithms to assist general pediatricians in addressing this challenge. Results: Five such practice recommendations were developed after a thorough literature review. These algorithms should not be considered as an "evidence-based guideline"; on the contrary, the authors are convinced that challenging these proposals will result in updated and improved versions. Conclusion: To date, these algorithms, based on the published literature, are the result of a broad consensus of pediatric gastroenterologists from different continents. © 2013 Elsevier Inc.

Burris H.H.,Beth Israel Deaconess Medical Center | Braun J.M.,Brown University | Byun H.-M.,Harvard University | Tarantini L.,University of Milan | And 6 more authors.
Epigenomics | Year: 2013

Aim: We examined the association between birth weight and methylation in the imprinted IGF/H19 loci, the nonimprinted gene NR3C1 and repetitive element DNA (LINE-1 and Alu). Materials & methods: We collected umbilical cord venous blood from 219 infants born in Mexico City (Mexico) as part of a prospective birth cohort study and analyzed DNA methylation using pyrosequencing. Results: Birth weight was not associated with DNA methylation of the regions studied. One of the CpG dinucleotides in the IGF2 imprinting control region (ICR)1 includes a potential C-T SNP. Among individuals with an absence of methylation at this site, probably due to a paternally inherited T allele, birth weight was associated with mean methylation status of both IGF2 ICR1 and ICR2. However, this association would not have survived adjustment for multiple testing. Conclusion: While we did not detect an association between DNA methylation and birth weight, our study suggests a potential gene-epigene interaction between a T allele in the IGF2 ICR1 and methylation of ICRs of IGF2, and fetal growth. © 2013 Future Medicine Ltd.

Zhang A.,University of Michigan | Hu H.,University of Michigan | Hu H.,Harvard University | Sanchez B.N.,University of Michigan | And 9 more authors.
Environmental Health Perspectives | Year: 2012

Background: Lead exposure in adults is associated with hypertension. Altered prenatal nutrition is associated with subsequent risks of adult hypertension, but little is known about whether prenatal exposure to toxicants, such as lead, may also confer such risks. Objectives: We investigated the relationship of prenatal lead exposure and blood pressure (BP) in 7- to 15-year-old boys and girls. Methods: We evaluated 457 mother-child pairs, originally recruited for an environmental birth cohort study between 1994 and 2003 in Mexico City, at a follow-up visit in 2008-2010. Prenatal lead exposure was assessed by measurement of maternal tibia and patella lead using in vivo K-shell X-ray fluorescence and cord blood lead using atomic absorption spectrometry. BP was measured by mercury sphygmomanometer with appropriate-size cuffs. Results: Adjusting for relevant covariates, maternal tibia lead was significantly associated with increases in systolic BP (SBP) and diastolic BP (DBP) in girls but not in boys (p-interaction with sex = 0.025 and 0.007 for SBP and DBP, respectively). Among girls, an interquartile range increase in tibia lead (13 μg/g) was associated with 2.11-mmHg [95% confidence interval (CI): 0.69, 3.52] and 1.60-mmHg (95% CI: 0.28, 2.91) increases in SBP and DBP, respectively. Neither patella nor cord lead was associated with child BP. Conclusions: Maternal tibia lead, which reflects cumulative environmental lead exposure and a source of exposure to the fetus, is a predisposing factor to higher BP in girls but not boys. Sex-specific adaptive responses to lead toxicity during early-life development may explain these differences.

Hernandez-Andrade E.,National Institute of Perinatology | Benavides-Serralde J.A.,National Institute of Perinatology | Cruz-Martinez R.,University of Barcelona | Welsh A.,University of New South Wales | Mancilla-Ramirez J.,National Institute of Perinatology
Fetal Diagnosis and Therapy | Year: 2012

Structural evaluation of the fetal heart is well established. Functional evaluation using pulsed-wave Doppler may also be performed. E/A ratios express the relationship between the maximal velocities of the E and A waveforms of ventricular filling. In normal fetuses, E/A ratios are usually <1 but show a constant increment during gestation, mainly related to the increment of the E wave. In intrauterine growth restriction (IUGR) fetuses, E/A ratios are lower compared to values in normally grown fetuses at the same gestational age. Cardiac outflows provide information on the time-velocity integral that, combined with the vessel area, allows calculation of the left and right cardiac outputs. In normal fetuses there is a predominance of the right ventricle (55-60%) in contributing to the combined cardiac output. In IUGR fetuses this predominance shifts to the left ventricle in order to increase the flow to the upper part of the fetal body and brain. The myocardial performance index (MPI) also provides information on systolic and diastolic cardiac function. The MPI is an early and consistent marker of cardiac dysfunction which becomes altered in early stages of chronic hypoxia or in cases with cardiac overload such as in twin-to-twin transfusion syndrome. Copyright © 2012 S. Karger AG, Basel.

Mousa A.A.,Virginia Commonwealth University | Cappello R.E.,Virginia Commonwealth University | Estrada-Gutierrez G.,Virginia Commonwealth University | Estrada-Gutierrez G.,National Institute of Perinatology | And 4 more authors.
American Journal of Pathology | Year: 2012

Maternal vascular dysfunction is a hallmark of preeclampsia. A recently described vascular phenotype of preeclampsia involves increased expression of matrix metalloproteinase-1 (MMP-1) in endothelial cells, vascular smooth muscle, and infiltrating neutrophils. In contrast, the expression of tissue inhibitor of metalloproteinases-1 (TIMP-1) and collagen type Iα 1 is either reduced or not changed in the vessels, suggesting an imbalance in vessel collagen degradation and synthesis in preeclampsia. In the present study, we explored the possible contribution of DNA methylation to the altered expression of genes involved in collagen metabolism. We assayed the differences in DNA methylation in omental arteries from normal pregnant and preeclamptic women, and determined whether reduced DNA methylation increases the expression of MMP-1 in cultured vascular smooth muscle cells and a neutrophil-like cell line, HL-60. Several MMP genes, including MMP1 and MMP8, were significantly less methylated in preeclamptic omental arteries, whereas TIMP and COL genes either were significantly more methylated or had no significant change in their DNA methylation status compared with normal pregnancy. Experimentally induced DNA hypomethylation increased MMP-1 expression in cultured vascular smooth muscle cells and MMP-1 cells. Our findings suggest that epigenetic regulation contributes to the imbalance in genes involved in collagen metabolism in blood vessels of preeclamptic women. © 2012 American Society for Investigative Pathology.

Reyes-Munoz E.,National Institute of Perinatology | Castellanos-Barroso G.,National Institute of Perinatology | Ramirez-Eugenio B.Y.,National Institute of Perinatology | Ortega-Gonzalez C.,National Institute of Perinatology | And 3 more authors.
Fertility and Sterility | Year: 2012

Objective: To study the incidence of gestational diabetes mellitus (GDM) in Mexican women with a history of infertility and polycystic ovary syndrome (PCOS) compared with women without PCOS matched by age, pregestational body mass index (BMI), and parity. Design: Historic cohort study. Setting: Level three medical institution. Patient(s): Group 1 (n = 52), women with a history of infertility and PCOS, and group 2 (n = 52), women without PCOS. Inclusion criteria were singleton pregnancy with ≤13 weeks of gestation. Exclusion criteria were pregestational diabetes mellitus and/or concomitant diseases. Intervention(s): Diagnosis of GDM was based on a 3-hour, 100-g oral glucose tolerance test (GTT) performed during the second trimester. Main Outcome Measure(s): Incidence and relative risk (RR) for GDM. Result(s): The incidence of GDM was 26.9% and 9.6% for groups 1 and 2, respectively (RR = 2.8; 95% confidence interval 1.08-7.2). No other between-group differences were observed in the incidence of miscarriage, preterm birth, premature rupture of membranes, preeclampsia, stillbirth, fetal malformations, or small or large for gestational age newborns. Conclusion(s): Pregnant Mexican women with a history of infertility and PCOS are at increased risk for developing GDM. This risk should be considered beginning early in the second trimester for a timely intervention and to improve the maternal-fetal prognosis. © 2012 American Society for Reproductive Medicine.

Sauer R.,National Institute of Perinatology | Roussev R.,Millenova Immunology Laboratories | Jeyendran R.S.,Andrology Laboratory Services Inc. | Coulam C.B.,Rinehart Center for Reproductive Medicine
Fertility and Sterility | Year: 2010

The prevalences of antiphospholipid antibodies (APAs) among 1,325 women with a history of unexplained infertility and 676 women experiencing recurrent implantation failure were compared with 789 women experiencing recurrent pregnancy loss and 205 fertile control women. Eight percent and 9% of women with a history of unexplained infertility and recurrent implantation failure had more than one positive APA compared with 1.5% of fertile negative control women and 11% of positive control women experiencing recurrent pregnancy loss. © 2010 by American Society for Reproductive Medicine.

Reyna Figueroa J.,National Institute of Perinatology | Ortiz J.,National Institute of Perinatology | Morales I.,National Institute of Perinatology
Gynecologic and Obstetric Investigation | Year: 2010

A new molecular biology technique was used in 2 subjects with systemic inflammatory response syndrome and negative blood cultures, in which broad-spectrum antibiotics were administered, without a visible improvement. Case 1: A 33-year-old female patient with a diagnosis of septic shock originating in the abdomen was admitted in a bad general state, presenting with systemic inflammatory response. The patient's general condition did not improve. As an alternative, we used molecular biology. Candida krusei was reported and the patient responded well to the treatment. Case 2: A woman in the 36th week of pregnancy, with diabetes mellitus and secondary renal insufficiency, presented with fever and hematological alterations. The patient's progress was slow and accompanied by persistent fever, bandemia and leukopenia, as well as signs of multiple organ dysfunction. The SeptiFast test identified Enterobacter cloacae/aerogenes as the cause of the disorder. However, the patient died 24 h after the antibiotics were changed. Copyright © 2010 S. Karger AG, Basel.

News Article | December 7, 2016

Fabián Díaz achieved a milestone last year when he derived the first human embryonic stem-cell line from cells of Mexican origin. Biologists across Mexico now use the stem cells, which Díaz — a researcher at the National Institute of Perinatology in Mexico City — created using embryos discarded by a fertility clinic. But in recent months, Díaz has put his stem-cell research on hold. He is waiting to see whether Mexico’s legislature will approve an amendment to the national health law that would ban experiments with human embryos. The proposal is winding its way through the legislature’s lower house, the Chamber of Deputies. To become law, it would have to be approved by the legislature and by Mexico’s president, Enrique Peña Nieto. “They want to eliminate an entire area of research in Mexico,” says René Drucker-Colín, a neurobiologist at the National Autonomous University of Mexico (UNAM) in Mexico City who hopes to use embryonic tissue as a treatment for people with Parkinson’s disease. The amendment is intended to regulate assisted reproduction, including the payment of surrogate mothers, donations to egg and sperm banks and the fertilization of more than three eggs at a time. But it would also ban the creation of human embryos for any purpose except reproduction and any research with existing human embryos. Such restrictions are intended to address Mexico’s thriving reproductive tourism industry, which has few protections for surrogate mothers. But the proposed amendment would have prohibited a scientific world first that took place in Mexico: the conception of a baby with DNA from three people. The child was born in April. His parents, who are from Jordan, used the treatment to prevent their baby from inheriting a disease that would otherwise be passed down through his mother’s mitochondrial DNA. The proposed changes to Mexico’s health law have the backing of the National Action Party (PAN) and Peña Nieto’s Institutional Revolutionary Party (PRI), but researchers worry that they are too broad. “We’re not against the regulation,” says Diana Escalante, a neurodevelopmental biologist at UNAM. “But the way in which they are doing it is just forbidding everything.” The amendment would prevent the creation of new embryonic stem-cell lines, she says, as well as a standard way to test whether the cells can develop into any cell type in the body. The penalties for violating the restrictions would include heavy fines and imprisonment. Human-rights groups have joined scientists in opposing the proposed amendment, which would restrict artificial reproduction to heterosexual couples. Only Mexican-national couples would be able to use surrogate mothers, who would be limited to their relatives. Opponents of the plan say that it discriminates against same-sex couples and people without family members of reproductive age. But Rosa Velez, a spokesperson for Sylvana Beltrones, the legislator who authored the amendment, says that the restrictions would protect human dignity and the legal rights of children who are created using fertility techniques and their parents. She adds that scientists would be able to study stem cells obtained from adults. Researchers have protested against the plan. On 24 October, more than 60 Mexican scientists sent a letter to the newspaper El Universal critizing the proposed amendment. Drucker-Colín says that he has also asked Mexico’s National Academy of Sciences to intercede with the politicians. The amendment would make it harder for scientists to study the earliest stages of human development, says Iván Velasco, a neurodevelopmental biologist at UNAM and president of the Mexican Society for Stem Cell Research. “It’s possible people will train abroad, but if they want to come back they won’t be able to do it here,” he says. Yet Velasco thinks that his own work, which uses existing human embryonic stem-cell lines, would be permitted. Others are worried about how a ban on the use of embryonic stem cells would affect clinical research. “We are close to beginning working with [embryonic stem] cells, and these laws are going to trash everything,” says Raymundo Cañales de la Fuente, a research gynaecologist at the Hospital Angeles Pedregal in Mexico City whose group looks for ways to improve the efficacy of assisted reproductive techniques. The amendment would limit the use of routine techniques used in fertility clinics, including a method used to screen embryos for genetic mutations before they are implanted into the mother. Such screening can prevent the transmission of severe genetic diseases, and help some infertile couples to understand why they are having trouble conceiving. If the technique is banned, researchers would need to rely on older, less precise methods to determine whether embryos are likely to survive implantation, says Patricia Grether, a geneticist at the National Institute of Perinatology. Clinicians could also send patients to the United States for treatment, but that is too expensive for many Mexicans. Velez says that the intent of the proposed amendment is to improve assisted reproduction, not to ban it. But Cañales de la Fuente says that the proposal would prevent many reputable clinics from offering such services. Clinicians would be limited to fertilizing three eggs at a time, reducing their success rates. They would also have to verify that a couple is not storing fertilized eggs at another clinic. With more than 100 such clinics in Mexico City alone, there is no practical way to do this. “We need to make a new law,” Cañales de la Fuente says. “Completely different from this one, with a scientific basis and a medical basis to be practical — and from the ministry of health, not from the congressmen.”

Hernandez-Andrade E.,National Institute of Perinatology | Benavides Serralde J.A.,National Institute of Perinatology
Prenatal Diagnosis | Year: 2012

Assessment of the fetal cerebral circulation provides important information on the hemodynamic changes associated with chronic hypoxia and intrauterine growth restriction. Despite the incorporation of new US parameters, the landmark for the fetal brain hemodynamic evaluation is still the middle cerebral artery. However, new vascular territories, such as the anterior and posterior cerebral arteries, might provide additional information on the onset of the brain sparing effect. The fractional moving blood volume estimation and three-dimensional power Doppler ultrasound indices are new techniques that seem to be promising in indentifying cases at earlier stages of vascular deterioration; still, they are not available for clinical application and more information is needed on the reproducibility and advantages of three-dimensional power Doppler ultrasound blood flow indices. In the past, the brain sparing effect was considered as a protective mechanism; however, recent information challenges this concept. There is growing evidence of an association between brain sparing effect and increased risk of abnormal neurodevelopment after birth. Even in mild late-onset intrauterine growth restriction affected fetuses with normal umbilical artery blood flow, increased cerebral blood perfusion can be associated with a substantial risk of abnormal neuroadaptation and neurodevelopment during childhood. © 2012 John Wiley & Sons, Ltd.

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