Papers by IRMA ALEJANDRA CORONADO ZARCO
Frontiers in Pediatrics
Passive transplacental immunity is crucial for neonatal protection from infections. Data on the c... more Passive transplacental immunity is crucial for neonatal protection from infections. Data on the correlation between neonatal immunity to SARS-CoV-2 and protection from adverse outcomes is scarce. This work aimed to describe neonatal seropositivity in the context of maternal SARS-CoV-2 infection, seropositivity, and neonatal outcomes. This retrospective nested case-control study enrolled high-risk pregnant women with a SARS-CoV-2 RT-PCR positive test who gave birth at the Instituto Nacional de Perinatología in Mexico City and their term neonates. Anti-SARS-CoV-2 IgG antibodies in maternal and cord blood samples were detected using a chemiluminescent assay. In total, 63 mother-neonate dyads (mean gestational age 38.4 weeks) were included. Transplacental transfer of SARS-CoV-2 IgG occurred in 76% of neonates from seropositive mothers. A positive association between maternal IgG levels and Cycle threshold (Ct) values of RT-qPCR test for SARS-CoV-2 with neonatal IgG levels was observed. ...
Medizinische Informatik und Statistik, 1986
Grundlage jedes Expertensystems ist das implementierte Wissen. Am Beispiel der Nierentransplantat... more Grundlage jedes Expertensystems ist das implementierte Wissen. Am Beispiel der Nierentransplantation wird ein Uberblick zu den verschiedenen Wissenselementen gegeben. Die fur das therapeutische Handeln relevanten Merkmale, ihre variierende Bedeutung im zeitlichen Verlauf und das vom Arzt potentiell zu berucksichtigende Datenvolumen je Patient wird aufgezeigt.
Perinatología y Reproducción Humana, 2018
Cómo citar este artículo: Flores-Robles CM, et al. Tamizaje neonatal de hipotiroidismo congénito,... more Cómo citar este artículo: Flores-Robles CM, et al. Tamizaje neonatal de hipotiroidismo congénito, análisis de la evidencia actual y propuesta de tamizaje para la población mexicana.
This is an analysis about the form in which written communication can become a tool of influence ... more This is an analysis about the form in which written communication can become a tool of influence and legitimacy for ethics committees. It stems from a historical revision of documents generated by diverse types of ethics committees which have had an influence on transcendental decisions on the medical, legal, and social spheres and proposes some factors to be considered in every document generated by committees in their activities as well as the scientific, medical, social, and legal contexts. This review and the historical analysis generate a list of functions for the diverse publications of ethics committees.Este es un análisis sobre la forma en que la comunicación escrita puede llegar a ser una herramienta de influencia y legitimidad para los comités de ética. Se plantea a partir de una revisión histórica de documentos generados por diversos tipos de comités de ética, que han influido en toma de decisiones trascendentales en el ámbito médico, legal y social, y propone algunos fac...
newborns remains a challenge in clinical practice. Despite international feeding guidelines in wh... more newborns remains a challenge in clinical practice. Despite international feeding guidelines in which it is recognized that human milk is the best source of nutrition for preterm infants, 1 their implementation varies widely even for those born at 33 to <37 weeks’ gestation, 2 who constitute 8% to 9% of all births, represent the vast majority of preterm infants, 3 and remain at higher risk than their term counterparts. In addition, there is no international consensus regarding how the growth of preterm infants should be monitored or what constitutes the ideal pattern of growth, including the period after they have reached term. This situation is even more unclear for those born very preterm (ie, <32 weeks’ gestation), 4, 5 who are at the highest risk but only represent 10% of all preterm births.3
Perinatologia Y Reproduccion Humana, 2014
Editora huésped del tomo de bioetica de la revista. En el editorial se analiza el papel que ocupa... more Editora huésped del tomo de bioetica de la revista. En el editorial se analiza el papel que ocupan actualmente los comités de bioetica en la atención de los grupos vulnerables que conforman la salud perinatal.
Editorial reflexivo sobre los avances de la neonatología y la aportación de Virgina Apgar.
Perinatologia y Reproducción Humana, 2017
Introduction: Skin-to-skin contact (CPP) is the placement of the naked newborn on the mother’sbre... more Introduction: Skin-to-skin contact (CPP) is the placement of the naked newborn on the mother’sbreast, covered only with a cap, sheet or gown.Objective: To determine the effect of skin-to-skin contact in the breastfeeding of infants in theNational Institute of Perinatology.Material and methods: Prospective, descriptive, observational, and cross-sectional study wasperformed, including a search for the information in the database of the Immediate Care Unitfor the Newborn from 1 August 2015 to 31 July 2016. The data obtained were Gestational age,weight, Apgar, maternal pathology, skin-to-skin contact, duration, and feeding.Results: There were 3175 births, with 2228 term neonates. CPP was performed in 1486 neona-tes (78.95%), with a weight of 2,045 to 4,200 g. The majority of patients who were breastfed(78.7%) had had skin-to-skin contact. Likewise, it was observed that CPP significantly favouredbreastfeeding (RR=143.28; 95% CI: 75.5-271.7).Discussion: CPP favours breastfeeding (99.2%), m...
Perinatología y Reproducción Humana
Perinatología y Reproducción Humana, Dec 1, 2017
ntroducción: Los prematuros pueden presentar lesiones por reperfusión hiperóxica, por lo quese de... more ntroducción: Los prematuros pueden presentar lesiones por reperfusión hiperóxica, por lo quese deben evitar niveles nocivos de oxígeno.Objetivo: Determinar, durante la reanimación neonatal de recién nacidos de 27 a 30 semanasde edad gestacional, los requerimientos de oxígeno, el porcentaje de saturación y su relacióncon la morbilidad neonatal.Material y métodos: Estudio transversal observacional y analítico. Se incluyeron neonatos de27 a 30 semanas de gestación; se excluyeron neonatos con malformaciones congénitas mayoresy las defunciones antes de las 36 semanas de edad gestacional corregida. Se dividieron en grupo1, neonatos de 27 y 28 semanas, y grupo 2, neonatos de 29 y 30 semanas; se analizaron variablesmaternas y neonatales con requerimiento de FiO2y saturación de oxígeno a los 5 y 10 minutos,así como el desarrollo de morbilidad neonatal.Resultados: Ingresaron 39 neonatos en el grupo 1 y 31 en el grupo 2. La FiO2en promediopara el grupo 1 a los 5 minutos fue del 77.56%, y para el grupo 2, del 64.9% (p = 0.045). Elgrupo 1 necesitó mayor concentración de oxígeno para alcanzar saturaciones &gt; 80%. Hubo unaumento de riesgo para hemorragia intraventricular (OR 3.21; IC95%: 1.07-9.60) en el grupo 1.La morbilidad no tuvo relación con la saturación de oxígeno durante la reanimación neonatal
Perinatología y Reproducción Humana, Dec 1, 2017
Perinatología y Reproducción Humana, Mar 1, 2018
Introduction: After congenital hydrocephalus, spinal dysraphisms represent the second cause of ne... more Introduction: After congenital hydrocephalus, spinal dysraphisms represent the second cause of neurosurgical consultation within the National Institute of Perinatology ‘Isidro Espinosa de los Reyes’ in Mexico City (INPer). The objective of the present study is to establish the demographic and epidemiological characteristics of live newborns with neural tube defects, during the past year. Material and methods: We carried out a descriptive, observational, retrospective study, including all live births within the Institute and diagnosis at discharge of cranial and/or spinal neural tube defects. The analysis is presented with descriptive statistics, using frequency tables, medians and ranges. Results: Fifteen live births with neural tube closure defects were recorded, of which 3 had more than one defect other than the Chiari malformation, and 80% presented hydrocephalus. All the mothers reported adequate intake of folate. There was no history of relatives with dysraphisms or maternal consumption of anti epileptic drugs. One patient with a closed defect developed fistula and infectious ventriculitis as a surgical complication. Conclusion: The number of cases attended in the INPer, due to neural tube defects, tripled compared to the previous year. The post natal care provided showed fewer complications than those reported in the literature, specifically infectious complications, due to timely multidisciplinary care and possibly due to the surgical closure of all open neural tube defects within the first 24 h
Acta Pediátrica de México
INTRODUCCIÓN: La disponibilidad y comercialización de la inmunoglobulina G humana ha modificado e... more INTRODUCCIÓN: La disponibilidad y comercialización de la inmunoglobulina G humana ha modificado el curso y pronóstico de diversas enfermedades. Hoy en día representa el tratamiento de primera línea para al menos 10 enfermedades y de segunda línea, empírico o de indicación compasiva en otras alteraciones. La mayor parte de estas enfermedades son excepcionales (afectan a menos de 1 de cada 2000 individuos), por lo que la generación de evidencia robusta derivada de ensayos clínicos aleatorizados y controlados no es común. OBJETIVO: desarrollar Elaborar o Emitir un Consenso Mexicano para la prescripción de Inmunoglobulina G Humana como tratamiento de reemplazo e inmunomodulación con un enfoque de medicina basada en evidencias. MATERIALES Y MÉTODOS: Se integró un grupo multidisciplinario de especialistas en diversas áreas de la medicina en México, con la finalidad de emitir un análisis crítico y sistematizado de la evidencia clínica disponible para la prescripción de la inmunoglobulina G...
International journal for quality in health care : journal of the International Society for Quality in Health Care, Jan 4, 2018
To develop quality of care (QoC) indicators, evaluate the quality of the processes of care (QPC) ... more To develop quality of care (QoC) indicators, evaluate the quality of the processes of care (QPC) and clinical outcomes, and analyze the association between the QPC and severe clinical outcomes of preterm newborns admitted to neonatal intensive care units (NICUs). Mixed methods approach: (1) development of QoC indicators via modified RAND/UCLA method; (2) cross-sectional study of QoC evaluation and (3) multiple logistic regression analysis to ascertain the association between the QPC and severe clinical outcomes. Two NICUs belonged to the Mexican Institute of Social Security in Mexico City. About 489 preterm neonates (<37 weeks of gestation) without severe congenital anomalies. The QoC indicators; ≥60% of recommended QPC and severe clinical outcomes. The QoC included 10 QPC indicators across four domains: respiratory, nutrition and metabolism, infectious diseases, and screening, and five outcome indicators. The lower QPC indicators were for the nutrition and metabolism domain (17....
Cardiology in the young, 2018
IntroductionIntracardiac rhabdomyomas can cause severe ventricular dysfunction and outflow tract ... more IntroductionIntracardiac rhabdomyomas can cause severe ventricular dysfunction and outflow tract obstruction.Case reportA term newborn infant with antenatal diagnosis of giant left ventricle rhabdomyoma presented with cardiac failure and duct-dependent systemic circulation after birth. She was treated successfully with everolimus, showing decrease in tumour size and improvement in left ventricular ejection fraction.DiscussionTumour regression rate was 0.32 cm2/day and improved to 0.80 cm2/day with the use of everolimus. Herein we report a newborn with inoperable giant left ventricular cardiac rhabdomyoma and significant regression of the tumour. To our knowledge, this is the largest left ventricular rhabdomyoma reported. A review of the literature was undertaken for comparison. Everolimus has proven to be efficacious in size reduction of cardiac rhabdomyomas in cases when surgical resection is not possible.
The American journal of clinical nutrition, Jan 20, 2016
There is no consensus with regard to which charts are most suitable for monitoring the postnatal ... more There is no consensus with regard to which charts are most suitable for monitoring the postnatal growth of preterm infants. We aimed to assess the strategies used to develop existing postnatal growth charts for preterm infants and their methodologic quality. A systematic review of observational longitudinal studies, whose primary objective was to create postnatal growth charts for preterm infants, was conducted. Thirty-eight items distributed in 3 methodologic domains ("study design," "statistical methods," and "reporting methods") were assessed in each study. Each item was scored as a "low" or "high" risk of bias. Two reviewers independently selected the studies, assessed the risk of bias, and extracted data. A total quality score [(number of "low risk" of bias marks/total number of items assessed) × 100%] was calculated for each study. Median (range, IQR) quality scores for each methodologic domain and for all included st...
Acta bioethica, 2013
Este es un análisis sobre la forma en que la comunicación escrita puede llegar a ser una herramie... more Este es un análisis sobre la forma en que la comunicación escrita puede llegar a ser una herramienta de influencia y legitimidad para los comités de ética. Se plantea a partir de una revisión histórica de documentos generados por diversos tipos de comités de ética, que han influido en toma de decisiones trascendentales en el ámbito médico, legal y social, y propone algunos factores a considerar en la estructuración de todo documento generado por los comités a partir de sus actividades, así como el contexto médico, científico, social y legal. Esta revisión y análisis histórico genera una lista de funciones que podrían tener las diversas publicaciones de los comités de bioética. Palabras clave: comités de ética, publicaciones éticas Considerations on the publication of decisions by ethics committees Abstract: This is an analysis about the form in which written communication can become a tool of influence and legitimacy for ethics committees. It stems from a historical revision of documents generated by diverse types of ethics committees which have had an influence on transcendental decisions on the medical, legal, and social spheres and proposes some factors to be considered in every document generated by committees in their activities as well as the scientific, medical, social, and legal contexts. This review and the historical analysis generate a list of functions for the diverse publications of ethics committees
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Papers by IRMA ALEJANDRA CORONADO ZARCO