María Gormaz

Hospital Universitari i Politècnic la Fe, Valenza, Valencia, Spain

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Publications (11)14.18 Total impact

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    ABSTRACT: The role of microbial colonization is indispensable for keeping a balanced immune response in life. However, the events that regulate the establishment of the microbiota, their timing, and the way in which they interact with the host are not yet fully understood. Factors such as gestational age, mode of delivery, environment, hygienic measures and diet influence the establishment of microbiota in the perinatal period. Environmental microbes constitute the most important group of exogenous stimuli in this critical time frame. However, the settlement of a stable gut microbiota in preterm infants is delayed compared to term infants. Preterm infants have an immature gastrointestinal tract and immune system which predisposes to infectious morbidity. Neonatal microbial dynamics and alterations in early gut microbiota may precede and/or predispose to diseases such as necrotizing enterocolitis, late-onset sepsis or others. During this critical period, nutrition is the principal contributor for immunological and metabolic development, and microbiological programming. Breast milk is a known source of molecules that act synergistically to protect the gut barrier and enhance the maturation of the gut-related immune response. Host-microbe interactions in preterm infants and the protective role of diet focused on breast milk impact are beginning to be unveiled.Pediatric Research (2015); doi:10.1038/pr.2015.54.
    No preview · Article · Mar 2015 · Pediatric Research
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    ABSTRACT: Lyophilization appears to be a viable method for storing human milk, assuring no microbiological contamination and preserving its health benefits and antibacterial properties. To evaluate and compare the effects of different storage methods (lyophilization and freezing at -20°C and -80°C) and maternal factors (gestational length or time postpartum) upon the microbiological contents and bactericidal activity of human milk. The possible relationship between bactericidal activity and the content of certain nutrients and functional components is also investigated. Microbiological content, bactericidal activity, sialic acid and ganglioside contents, as well as protein, fat and lactose concentrations were assessed in 125 human milk samples from 65 healthy donors in the Human Milk Bank of La Fe (Valencia, Spain). Lyophilization and storage at -80°C significantly reduced the content of mesophilic aerobic microorganisms and S. epidermidis when compared to storage at -20°C. Bactericidal activity was not significantly modified by lyophilization when compared to freezing at either -20°C or -80°C. Bactericidal activity was not correlated with fat, protein or lactose content, but was significantly correlated to ganglioside content. The bactericidal activity was significantly greater (p < 0.05) in mature milk and in milk from women with term delivery than in milk from early lactation (days1-7 postpartum) and milk from women with pre-term delivery, respectively. Lyophilization and storage at -80°C of human milk yields similar results and are superior to storage at -20C with regard to microbial and bactericidal capacities, being a feasible alternative for human milk banks.
    No preview · Article · Nov 2014 · Journal of Pediatric Gastroenterology and Nutrition
  • M. Vento · M. Gormaz

    No preview · Article · Jul 2014 · Revista española de pediatría
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    ABSTRACT: Fetal to neonatal transition poses a relevant threat to the newly born infant. In few minutes oxygen delivery to tissue will rise abruptly. In addition, very often aggressive therapies which include the use of oxygen are going to be necessary to assure survival of the neonate. Interestingly, the antioxidant defense system maturation pattern is not complete until the end of gestation and, therefore, preterm babies are endowed with an immature and less effective antioxidant armamentarium. Under these circumstances preterm infants are prone to oxidative stress derived serious conditions such as retinopathy of prematurity, bronchopulmonary dysplasia or intra-periventricular hemorrhage. Remarkably, human milk even in preterm mothers provides with a vast array of antioxidant substances that will undoubtedly help the infant to confront with a pro-oxidant milieu. These antioxidant properties render human milk essential for the survival of preterm infants and its use should be therefore strongly reinforced.
    Full-text · Article · Jan 2013 · Journal of Pediatric Biochemistry
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    ABSTRACT: 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.
    No preview · Article · Jul 2012 · Maternal and Child Nutrition
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    ABSTRACT: Aquaporins (AQPs) constitute a family of channel proteins implicated in transmembrane water transport. Thirteen different AQPs (AQP0-12) have been described but their precise biologic function still remains unclear. AQPs 1, 3, 4, 8, and 9 expression has been described in human chorion, amnion and placenta; however, AQP4 is the only that has been identified in the first trimester of human pregnancy. To assess multiplicity of AQPs expression from 10th to 14th week gestation. Chorionic villi samples (CVS) collected in pregnant women for prenatal diagnosis were analysed by real time-PCR to assess cDNA expression of AQPs 1, 2, 3, 4, 5, 6, 7, 8, 9, and 11, and compared with AQPs expression in placentas from normal term pregnancies. 26 CVS corresponding to 26 pregnant women (age: 32.7±4.5 years; gestational age: 12.4±0.9 weeks) and 10 placental samples corresponding to normal term pregnancies were analysed. In CVS karyotype was normal in 16 cases, trisomy in 6 cases, mosaicism in 1 and unknown in 1. We found high mRNA expression for AQPs 1, 3, 9 and 11, low for AQPs 4, 5, and 8, and non-detectable for AQPs 2, 6, and 7 in chorionic villi. This is the first study systematically assessing the expression of a multiplicity of AQPs in chorionic villi samples between 10th and 14th weeks of gestation. High expression of AQP11 has been identified for the first time in early stages of human pregnancy. Chromosomal abnormalities did not alter AQPs' expression.
    Full-text · Article · Feb 2012 · Early human development
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    ABSTRACT: Background/objectives: Aquaporins (AQPs) are a family of proteins (AQP0-12) ubiquitously expressed acting as cell membrane water channels. AQP 1/3/8/9 expression has been found in human placenta and fetal membranes; however, AQP4 is the only identified in first trimester fetal tissue samples. We aimed to determine AQP mRNA expression in first trimester of pregnancy and compare it to the expression in placenta at delivery.
    Full-text · Article · Nov 2011 · Pediatric Research
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    M. Miranda · M. Gormaz · F. J. Romero · D. Silvestre
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    ABSTRACT: Maternal milk is the optimal feeding way for the infant at least for the first six months of life. Its properties include nutrients intake and, particularly, to provide the infant with several beneficial compounds improving his growth and protecting him from the diseases typical of this time period. These properties justify the manipulating processes before its intake in order to promote and warrant the adherence to it, both at the hospital and at home, being more important in premature infants and/or with low birth weight given their increased vulnerability, is spite of the fact that during these processes some of its properties may be partially lost. There exist, therefore, an interest in knowing the impact of the procedures applied to human milk on its qualitative properties, such as the antioxidant capacity. Objective: This work assesses the stability of the antioxidant capacity of human milk during its storage at 4o C, longitudinally from its extraction until 48 h of refrigeration, as well as the pH changes. Method: the milk from 30 healthy women was analyzed. The milk's antioxidant capacity was assessed by the following parameters: total antioxidant capacity and level of malondialdehyde. The results obtained showed that pH decreases gradually from the storage beginning, whereas the antioxidant capacity remains constant for the first 24 hours, with a different result depending on the parameter used, and thereafter significant changes were observed. Conclusions: In case of needing extraction and storage of maternal milk before its consumption, the storage time should be minimized, preferably less than 24 hours in order to preserve the oxidative stress.
    Full-text · Article · Aug 2011 · Nutricion hospitalaria: organo oficial de la Sociedad Espanola de Nutricion Parenteral y Enteral
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    M Miranda · M Gormaz · F J Romero · D Silvestre
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    ABSTRACT: Maternal milk is the optimal feeding way for the infant at least for the first six months of life. Its properties include nutrients intake and, particularly, to provide the infant with several beneficial compounds improving his growth and protecting him from the diseases typical of this time period. These properties justify the manipulating processes before its intake in order to promote and warrant the adherence to it, both at the hospital and at home, being more important in premature infants and/or with low birth weight given their increased vulnerability, is spite of the fact that during these processes some of its properties may be partially lost. There exist, therefore, an interest in knowing the impact of the procedures applied to human milk on its qualitative properties, such as the antioxidant capacity. This work assesses the stability of the antioxidant capacity of human milk during its storage at 4º C, longitudinally from its extraction until 48 h of refrigeration, as well as the pH changes. the milk from 30 healthy women was analyzed. The milk's antioxidant capacity was assessed by the following parameters: total antioxidant capacity and level of malondialdehyde. The results obtained showed that pH decreases gradually from the storage beginning, whereas the antioxidant capacity remains constant for the first 24 hours, with a different result depending on the parameter used, and thereafter significant changes were observed. In case of needing extraction and storage of maternal milk before its consumption, the storage time should be minimized, preferably less than 24 hours in order to preserve the oxidative stress.
    Full-text · Article · Aug 2011 · Nutricion hospitalaria: organo oficial de la Sociedad Espanola de Nutricion Parenteral y Enteral
  • M. Gormaz · V. Roqués · J. Dalmau · M. Vento · E. Torres · I. Vitoria

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    V Roqués · C Fernández · M Gormaz · M A Cabezas
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    ABSTRACT: INTRODUCCION La infección bacteriana en el periodo neonatal precisa de un diagnostico precoz para establecer el oportuno tratamiento antibiótico. Se disponen de diferentes métodos: clínicos (factores de riesgo perinatal, sintomatología clínica), relación I: T (leucocitos inmaduros total de granulocitos), reactantes de fase aguda (proteína C reactiva, fibronectina, etc.) y citoquinas sin que ninguno de ellos pueda utilizarse de forma individualizada. La positividad de dos o más de ellos de forma conjunta son indicadores de sepsis especialmente en niños cuya madre ha recibido tratamiento antibiótico durante el parto. El hallazgo positivo en sangre bacteriológico se ve también limitado por ser tardío y afectarse por el tratamiento antibiótico materno. En los últimos años la procalcitonina se ha demostrado como un buen marcador precoz de infección bacteriana en el periodo neonatal, con alta sensibilidad y especificidad sobre todo en las primeras 24 horas de vida, es rápido, refleja de forma precoz el efecto apropiado antibiótico y no se ve afectado por el tratamiento antibiótico materno intraparto. Se eleva significativamente en niños con infección bacteriana y solo moderadamente o no se eleva en infecciones viricas e infecciones locales. En las primeras 24 horas sus valores difieren de los considerados normales en otras etapas de la vida, de forma que pueden obtenerse hasta niveles de 21 ng/ml, no obstante en situaciones de infección estos se encuentran sensiblemente elevados, con incremento que puede ser detectado a las 2 o 3 horas del comienzo de la infección. Puede preceder al aumento de la Proteína C Reactiva, típico marcador de infección bacteriana e inflamación, y sus valores parecen estar relacionados con la severidad de la sepsis y/o meningitis. En la sepsis nosocomial sus primeros signos clínicos son inespecificos y pueden asimilarse a otros procesos no infecciosos, los métodos de diagnostico son de baja sensibilidad, inclusive el hemocultivo positivo que es difícil diferenciar de la contaminación. Recientes estudios han demostrado que las concentraciones de procalcitonina pueden ut ilizarse como indicador de sepsis tardía neonatal en relación con el tipo de germen. La hipótesis por tanto es que la Procalcitonina puede utilizarse como marcador más precoz de infección bacteriana neonatal, tanto en sepsis de transmisión vertical (aque llas que se producen en las primeras 72 horas de vida), como en las de transmisión horizontal o nosocomiales (mas de 3 días de vida y menos de 28).
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