Efectos de la obesidad infantil sobre procesos cognitivos en población mexicana: posible participación del estrés oxidativo

BACKGROUND. Child malnutrition represents a major public health problem with physiological, psychological, and social short- and long-term implications. OBJECTIVE. To analyze the effects of nutritional status on cognitive function and its relationship with oxidative stress (OS) in mexican population aged 3 to 6 years. METHODS. Children were categorized into four groups: underweight, normal weight, overweight, and obesity. Glucose (Glu), cholesterol (Chol), high density lipoproteins (HDL), triglycerides (TG), insulin (INS), triglycerides/glucose (TyG) index, and the homeostatic model of insulin resistance (HOMA-IR) were analyzed. Additionally, OS (malondialdehyde [MDA] and nitrotyrosine [3-NT]) and antioxidant defense markers (superoxide dismutase [SOD], catalase [CAT] and the reduced/oxidized glutathione ratio [GSH/GSSG]) were quantified. To assess cognitive function, the Wechsler Preschool and Primary Scale of Intelligence (WPPSI-III) and the Infant Neuropsychological Maturity Questionnaire (CUMANIN) were applied. RESULTS. Children with obesity showed higher levels of MDA and 3-NT and increased SOD activity compared with normal weight children. Glu, Chol, TG levels, TyG indexes, HOMA-IR, MDA, 3-NT, and SOD were positively correlated with body mass index (BMI) and with percentiles from the Centers for Disease Control and Prevention (CDC-PC). However, CAT concentration and the GSH/GSSG ratio were negatively correlated with BMI and CDC- PC. For underweight children we found a positive correlation of TG levels and TyG indexes with BMI, whereas both markers were positively correlated with BMI and CDC-PC in overweight children. MDA were negatively correlated with BMI in underweight children, while a positive association was observed for overweight children. Finally, SOD, CAT and GSH/GSSG were negatively correlated with both BMI and CDC-PC in overweight children. According to the WPPSI-III, preschoolers presenting malnutrition at both extremes, underweight and obesity, showed lower scores than normal weight children for the Performance Intellectual Quotient (PIQ), Processing Speed (PS) and Full Scale Intellectual Quotient (FSIQ). For CUMANIN, Verbal Development (VD) and Global Development (GD) were poorly affected by underweight and obesity. Furthermore, children with obesity obtained the lowest outcomes in the Verbal Intellectual Quotient (VIQ), Non-Verbal Development (NVD), as well as in the Visoperception subscales; this last one, was also decreased in the overweight group. For correlations between metabolic markers, OS and cognitive processes, the VIQ did not show significant associations, while the PIQ, PS and FSIQ showed correlation with the rest of the markers with the exception of Glu and Col. All the correlations were negative with the exception of PIQ-CAT, PS-SOD and FSIQ -CAT, of positive type. The VD, NVD and GD quotients were all significantly associated with the biochemical markers, except for Glu and CAT. Those associations were negative, excluding NVD-3-NT, NVD-CAT, and GD-TyG, which were positive. CONCLUSIONS. Malnutrition, especially obesity, is associated with metabolic and OS disturbances, as well as with cognitive deficit in preschool children. It is urgent to design strategies to prevent malnutrition in this age group since this stage of development is crucial to potentially avoid future comorbidities.ANTEDECENTES. La malnutrición infantil representa un importante problema de salud pública con implicaciones fisiológicas, psicológicas y sociales a corto y largo plazo. OBJETIVO. Analizar los efectos del estado nutricional sobre la función cognitiva y su relación con el estrés oxidante (EO) sistémico en una población mexicana de 3 a 6 años. MÉTODO. Los niños se clasificaron en cuatro grupos: bajo peso, normopeso, sobrepeso, y obesidad. Se analizaron glucosa (Glu), colesterol (Col), lipoproteínas de alta densidad (HDL), triglicéridos (TG), insulina (INS), índice triglicéridos/glucosa (TyG) y el modelo homeostático para evaluar la resistencia a la insulina (HOMA-IR). Además, se cuantificaron marcadores de EO (malondialdehído [MDA] y 3-nitrotirosina [3-NT]) y de defensa antioxidante (superóxido dismutasa [SOD], catalasa [CAT] y la relación de glutatión reducido/oxidado [GSH/GSSG]). Para valorar la función cognitiva se aplicaron la Escala Wechsler de Inteligencia para los Niveles Preescolar y Primaria (WPPSI-III) y el Cuestionario de Madurez Neuropsicológica Infantil (CUMANIN). RESULTADOS. Los niños con obesidad mostraron niveles significativamente más altos de MDA y 3-NT y una mayor actividad de SOD en comparación con los niños con peso normal. Los niveles de Glu, Col, TG, índices TyG, HOMA-IR, MDA, 3-NT y SOD se correlacionaron positivamente con el índice de masa corporal (IMC) y los percentiles del Centro para el Control y Prevención de Enfermedades (PC CDC). Sin embargo, la concentración de CAT y la relación GSH/GSSG se correlacionaron negativamente con el IMC y PC CDC. En niños con bajo peso, encontramos una correlación positiva de los niveles de TG y los índices de TyG con el IMC, mientras que ambos marcadores se correlacionaron positivamente con el IMC y CDC PC en niños con sobrepeso. El MDA se correlacionó negativamente con el IMC en niños con bajo peso, mientras que se observó una asociación positiva en niños con sobrepeso. Finalmente, SOD, CAT y GSH/GSSG se correlacionaron negativamente con el IMC y PC CDC en niños con sobrepeso. Los niños preescolares con malnutrición en ambos extremos, bajo peso y obesidad, mostraron peor ejecución, que sus pares con normopeso, en los puntajes de Coeficiente Intelectual Ejecutivo (CIE), Velocidad de Procesamiento (VP) y Coeficiente de Inteligencia Total (CIT) según el WPPSI-III. En el CUMANIN, el Desarrollo Verbal (DV) y el Desarrollo Global (DG) se mostró pobremente afectado por el bajo peso y la obesidad. Adicionalmente, los menores con obesidad obtuvieron el menor desempeño en el Coeficiente Intelectual Verbal (CIV), Desarrollo No Verbal (DNV), así como en la subescala de Visopercepción, esta última al igual que el grupo con sobrepeso. En la correlación de los marcadores metabólicos y de EO con los procesos cognitivos evaluados, el CIV no arrojó asociaciones significativas, mientras que el CIE, VP y CIT mostraron correlación con el resto de marcadores con excepción de Glu y Col. Todas las correlaciones fueron negativas con excepción de CIE-CAT, VP-SOD y CIT-CAT, de tipo positivo. Los coeficientes DV, DNV y DG se asociaron todos significativamente con los marcadores bioquímicos, excepto con Glu y CAT. Dichas asociaciones fueron negativas, excluyendo DNV-3-NT, DNV-CAT y DG-TyG, que resultaron positivas. CONCLUSIONES. La malnutrición, especialmente la obesidad, se asocia con alteraciones metabólicas, de EO, así como con déficit cognitivo en niños en edad preescolar. Es urgente diseñar estrategias para prevenir la malnutrición en este grupo de edad, ya que esta etapa de desarrollo es crucial para evitar potencialmente futuras comorbilidades

Frequency of <i>Candida</i> spp. in the Oral Cavity of Asymptomatic Preschool Mexican Children and Its Association with Nutritional Status

Malnutrition is a public health problem in developing countries, affecting the child population, which favors the appearance of infections such as oral candidiasis. In Mexico, information on the presence of oral colonization by Candida spp. in asymptomatic children is scarce. The present study aimed to determine the presence of Candida spp. in the oral cavity of asymptomatic preschool Mexican children and its association with their nutritional status. A sample of oral mucosa was obtained using a sterile swab and then inoculated in Sabouraud dextrose agar with antibiotics, and the yeast growth was phenotypically identified. The anthropometric profile of children was performed based on the guidelines of the International Society for the Advancement of Kinanthropometry. In addition, eating habits were investigated. The possible associations between the variables were determined through the chi-square test (IC95%, p Candida was isolated, and the identified species were C. albicans (87.8%), C. glabrata (11.5%), C. krusei (5.8%) and C. parapsilosis (1.9%). The frequency of colonization was greater in males of six years (69.23%). There was no significant association between the colonization by Candida spp. and the nutritional status; however, a relation was observed with a high intake of simple carbohydrates

Remarkable Phenotypic Virulence Factors of <i>Microsporum canis</i> and Their Associated Genes: A Systematic Review

Microsporum canis is a widely distributed dermatophyte, which is among the main etiological agents of dermatophytosis in humans and domestic animals. This fungus invades, colonizes and nourishes itself on the keratinized tissues of the host through various virulence factors. This review will bring together the known information about the mechanisms, enzymes and their associated genes relevant to the pathogenesis processes of the fungus and will provide an overview of those virulence factors that should be better studied to establish effective methods of prevention and control of the disease. Public databases using the MeSH terms “Microsporum canis”, “virulence factors” and each individual virulence factor were reviewed to enlist a series of articles, from where only original works in English and Spanish that included relevant information on the subject were selected. Out of the 147 articles obtained in the review, 46 were selected that reported virulence factors for M. canis in a period between 1988 and 2023. The rest of the articles were discarded because they did not contain information on the topic (67), some were written in different languages (3), and others were repeated in two or more databases (24) or were not original articles (7). The main virulence factors in M. canis are keratinases, fungilisins and subtilisins. However, less commonly reported are biofilms or dipeptidylpeptidases, among others, which have been little researched because they vary in expression or activity between strains and are not considered essential for the infection and survival of the fungus. Although it is known that they are truly involved in resistance, infection and metabolism, we recognize that their study could strengthen the knowledge of the pathogenesis of M. canis with the aim of achieving effective treatments, as well as the prevention and control of infection

Fungal Melanonychia: A Systematic Review

Fungal melanonychia is an uncommon condition, most typically caused by opportunistic melanin-producing pigmented filamentous fungi in the nail plate. In the present study, the clinical characteristics of patients diagnosed with fungal melanonychia were analyzed through a systematic review of cases reported in the literature. The MESH terms used for the search were “melanonychia” AND “fungal” OR “fungi” through four databases: PubMed, SciELO, Google scholar and SCOPUS. After discarding inadequate articles using the exclusion criteria, 33 articles with 133 cases were analyzed, of which 44% were women, 56% were men and the age range was between 9 and 87 years. The majority of cases were reported in Turkey followed by Korea and Italy. Frequent causal agents detected were Trichophyton rubrum as non-dematiaceous in 55% and Neoscytalidium dimidiatum as dematiaceous in 8%. Predisposing factors included nail trauma, migration history, employment and/or outdoor activities. Involvement in a single nail was presented in 45% of the cases, while more than one affected nail was identified in 21%, with a range of 2 to 10 nails. Regarding the clinical classification, 41% evidenced more than one type of melanonychia, 21% corresponded to the longitudinal pattern and 13% was of total diffuse type. Likewise, the usual dermoscopic pattern was multicolor pigmentation. It is concluded that fungal melanonychia is an uncommon variant of onychomycosis and the differential diagnosis is broad, which highlights the complexity of this disease

Does the Fetus Limit Antibiotic Treatment in Pregnant Patients with COVID-19?

During pregnancy, there is a state of immune tolerance that predisposes them to viral infection, causing maternal-fetal vulnerability to the adverse effects of COVID-19. Bacterial coinfections significantly increase the mortality rate for COVID-19. However, it is known that all drugs, including antibiotics, will enter the fetal circulation in a variable degree despite the role of the placenta as a protective barrier and can cause teratogenesis or other malformations depending on the timing of exposure to the drug. Also, it is important to consider the impact of the indiscriminate use of antibiotics during pregnancy can alter both the maternal and fetal-neonatal microbiota, generating future repercussions in both. In the present study, the literature for treating bacterial coinfections in pregnant women with COVID-19 is reviewed. In turn, we present the findings in 50 pregnant women hospitalized diagnosed with SARS-CoV-2 without previous treatment with antibiotics; moreover, a bacteriological culture of sample types was performed. Seven pregnant women had coinfection with Staphylococcus haemolyticus, Staphylococcus epidermidis, Streptococcus agalactiae, Escherichia coli ESBL +, biotype 1 and 2, Acinetobacter jahnsonii, Enterococcus faecium, and Clostridium difficile. When performing the antibiogram, resistance to multiple drugs was found, such as macrolides, aminoglycosides, sulfa, dihydrofolate reductase inhibitors, beta-lactams, etc. The purpose of this study was to generate more scientific evidence on the better use of antibiotics in these patients. Because of this, it is important to perform an antibiogram to prevent abuse of empirical antibiotic treatment with antibiotics in pregnant women diagnosed with SARS-CoV-2