Maternal Overweight and Obesity and Their Effect on the Growth of the Newborn During the First Six Months of Life.

INTRODUCTION:  Maternal overweight and obesity during pregnancy have been shown to have multiple negative effects on the mother's health, which can even affect the infant's growth by increasing weight gain and altering various indicators, such as weight for age, length for age and weight for length. While breast milk on the other hand reduces these risks, and it's the best and most complete food for the newborn. It's a dynamic fluid capable of being modified to meet the needs of each stage of the newborn, but despite this capacity and the fact that maternal body mass index can have an impact on its components, through complex biological mechanisms, it manages to reduce the negative effects accumulated during pregnancy and even promotes a healthy state in the baby. In a country like Mexico, where overweight and obesity affect a large part of the population, it is important to study their causes and which could be the effect of this increased maternal overweight during pregnancy and lactation on newborns. OBJECTIVE: Identify the alterations associated with increased maternal body mass index during pregnancy and breastfeeding on mothers' health and their possible effect on the growth of the newborn during the first six months of life. MATERIAL AND METHODS: This was a prospective cohort study. Forty-two healthy binomials (mother and child), without problems during delivery and without serious illnesses during the breastfeeding period, were included. Maternal body mass index at the beginning of pregnancy allowed us to create two comparison groups between mothers: one with adequate weight, another with overweight or obesity. Follow-up was carried out once a month during the first six months of life, evaluating the somatometric development of mothers and children. All mothers completed the six-month period of exclusive breastfeeding. RESULTS:  There were differences between both groups of women. The one that included overweight and obese women compared to the group of women with adequate weight had a higher number of pregnancies, abortions, plasma glucose levels in the third trimester of pregnancy, and a lower number of prenatal control visits and plasma platelet levels (all with p<0.05). Regarding the baby's growth, there was a difference between the weight for length classification at 60-, 120-, 150- and 180-day follow-ups. The group to which the mother was assigned with respect to her body mass index at the beginning of pregnancy (adequate weight group and overweight/obese group) was the only factor associated with the risk of the baby being overweight according to weight for length indicator at the 180-day follow-up, with an OR = 5.2 (95%CI 1.02-26.59). CONCLUSIONS: Maternal overweight and obesity during pregnancy have a negative effect on the mother's health and baby's weight gain in its weight-for-length classification during the first six months of life. Although breastfeeding has been shown to have a positive effect on the growth of the baby, exposure to a higher maternal body mass index during pregnancy triggers important metabolic alterations that promote the development of diseases. It is important to establish weight control guidelines in women who wish to become pregnant to reduce the negative effects on the mother and offspring.

Nonelective cesarean section is associated with the prevalence of asthma among Mexican children who attended childcare centers.

Background: The cesarean section (CS) mode of delivery can influence the prevalence of bronchial asthma (BA), allergic rhinitis (AR), or atopic dermatitis (AD) by promoting modifications in the infantile microbiome. Objective: To analyze the prevalence of asthma in children who were born through CS and attended childcare centers. Methods: The data were obtained through an online survey that was answered anonymously by one of the parents; the survey inquired about the route of delivery of the child and the prevalence of BA, AR, and AD. Results: A total of 525 children were included. The frequency of births by vaginal, elective CS, or nonelective CS was 34.1%, 37.9%, and 28.0%, respectively, and the prevalence of BA, AR, and AD was 4.8%, 19.8%, and 12.4%, respectively. Multivariate analyses identified nonelective CS as a factor associated with the prevalence of BA (odds ratio: 3.51, P = 0.026). Conclusion: Our study shows that being born through nonelective CS can increase the probability of BA in children who attended daycare centers.

Red Meat Hypersensitivity and Probable Alpha-Gal Syndrome: Prevalence Among Adolescents.

INTRODUCTION: It is unknown whether late adolescents represent a particular risk group for the development of red meat hypersensitivity (RMH) and alpha-gal syndrome (AGS). This age group's physiological changes and eating habits could play a determining role. This study aimed to estimate the self-reported prevalence of RMH and probable AGS among late adolescents. METHODS: A cross-sectional study analyzed a sample of 1992 Mexican adolescents between 15 and 18 years of age. The data were obtained with a previously validated questionnaire that asked about the clinical manifestations related to red meat intake. Confidence intervals at 95% (95% CI) were estimated for proportions. RESULTS: In total, there were 19 adolescents with RMH, a prevalence of 1.0% (95% CI: 0.6-1.5%). The main red meats related to symptoms were pork (89.5%), beef (21.1%), lamb (10.5%), and mutton (5.1%). The most frequent manifestations of RMH were gastrointestinal (73.7%), respiratory (63.2%), and cutaneous (63.2%). Once the symptoms were grouped, there were two cases of urticaria (2/19, 10.5%) and six cases with probable anaphylaxis (6/19, 31.6%). Finally, three adolescents were considered probable cases of AGS, which represents a prevalence of 0.15% (95% CI: 0.1-0.4%). CONCLUSION: Although the prevalence of RMH in late adolescents is low, early detection is justified because approximately one-third present with severe symptoms.

Prevalence of allergic sensitization to Platanus occidentalis among adults with allergic rhinitis: A multicenter study.

Background: In the Americas there are few studies that have evaluated the frequency of allergic sensitization to Platanus occidentalis or sycamore pollen in adult patients with allergic rhinitis (AR). Objective: To determine the prevalence of allergic sensitization to P. occidentalis and to identify factors associated with its presentation. Methods: A cross-sectional study was carried out in 3 centers distributed in the northwest, west, and southeast of Mexico. Allergic sensitization to P. occidentalis was determined with a skin prick test. Prevalence and 95% confidence intervals (CI) were estimated. Results: A total of 404 patients were included, women were 233 (57.7%); the age mean was 33.8 ± 12.9 years. The overall prevalence of sensitization to P. occidentalis was 20.8% (95% CI, 17.1%-25.0%); in the northwestern: 15.9% (95% CI, 9.6%-25.1%); in the western: 21.8% (95% CI, 15.4%-29.9%); and in the southeastern: 22.4% (95% CI, 17.1%-38.8%). Multivariate analysis showed to the following allergens as factors associated with sycamore allergic sensitization: tree pollens (OR, 3.19; P = 0.001), weeds (OR, 2.49; P = 0.004), fungi (OR, 1.96; P = 0.014), and dog or cat epitheliums (OR, 1.88; P = 0.018). Conclusion: Allergic sensitization to P. occidentalis pollen in AR patients is not an infrequent event; consequently, we recommend doing the challenge test in all patients with this allergen, especially in those regions where the tree is present.

Factors Associated With Poor Sleep Quality Among Primary Healthcare Workers During the SARS-CoV-2 Pandemic.

INTRODUCTION: Sleep is one of the most important activities for health and the processes related to the central nervous system. Healthcare workers commonly present alterations in the sleep-wake cycle due to complex work schedules because 24-hour attention to the population is required in public health institutions. The increase in care needs caused by the COVID-19 pandemic caused changes in work schedules; as in Mexico, the number of patients requiring consultation in all public health units increased. Chronic partial sleep deprivation (< 7 hours of sleep in the 24-hour cycle) is the most frequent sleep alteration in Mexican health workers. However, it has not been explored whether work modifications due to the pandemic had an impact on the sleep quality of workers. OBJECTIVE: We aimed to describe the prevalence of poor sleep quality and the associated factors in workers (clinical and non-clinical) of a primary care medical unit. MATERIAL AND METHODS: We conducted an analytical and cross-sectional study during November and December 2022. We used the following tools for studying clinical and non-clinical staff working at a family medicine primary care unit: Pittsburgh Sleep Quality Index, Hamilton Anxiety Scale, Beck Depression Inventory, Maslach Burnout Inventory, and Graffar-Méndez-Castellanos socioeconomic level scale, as well as a data collection sheet and a survey of workers' knowledge, attitudes, fears, and needs regarding COVID-19. RESULTS: A total of 233 workers were surveyed. The prevalence of poor sleep quality was 56.7%. A higher score on the Beck Depression Inventory (OR: 1.21, CI 95%: 1.13-1.29), being a doctor (OR: 3.48, CI 95%: 1.5-8.01), and frequent alcohol consumption (OR: 2.4, CI 95%: 1.13-5.2) were identified as risk factors for poor sleep quality. A lower score in the depersonalization dimension of the Maslach Burnout Inventory (OR: 0.5, CI 95%: 0.26-0.99) was identified as a protective factor for poor sleep quality. CONCLUSIONS: During the pandemic, the stress of health workers increased due to work alterations that were necessary to treat the greatest number of patients, so their quality of sleep decreased. Unfortunately, the mental health of healthcare workers is often under-assessed in many institutions. Thus, it is relevant to identify risk factors for alterations (especially those of sleep), since by identifying the target population, comprehensive interventions can be carried out, which can reduce the prevalence of burnout, anxiety, and depression, but if not addressed, the alterations can lead to inadequate care for users of health units.

Mental Disorders Among Healthcare Workers During the Coronavirus Pandemic.

INTRODUCTION: Coronavirus disease 2019 (COVID-19) is a disease that has become a regular part of care by health services. In the beginning, health services faced immense pressure due to new disease exposure, irregular schedules, and high work stress for healthcare workers. Unfortunately, their mental health was not adequately safeguarded, and there are few healthcare units that screen staff for depression and anxiety. OBJECTIVE: The objective of this study is to describe the prevalence and factors associated with anxiety and depression diagnoses among healthcare workers during the coronavirus pandemic. MATERIALS AND METHODS: A cross-sectional study was conducted in which depression (Beck questionnaire) and anxiety (Hamilton questionnaire) were investigated in health staff, after providing informed consent. This study was carried out during November and December 2022. All workers in all areas of a first-level unit were invited to participate in this research, so no sample calculation or sampling technique was required. Statistical analysis was performed using X2 and Student's t-test. RESULTS: Among the 232 workers surveyed, the prevalence of mild anxiety, severe anxiety, and certain levels of depression was 42.1%, 33.5%, and 18.9%, respectively. The study revealed that smoking is associated with a higher risk of anxiety diagnosis (OR=4; CI95%=1.3-12.7). A higher score on the Hamilton Anxiety Scale (OR=1.07; CI95%=1.04-1.11) as well as not being permanent staff (OR=3.34; CI95%=1.2-9.3) was found associated with depression diagnosis. CONCLUSION: The SARS-CoV-2 pandemic increased the stress and pressure on healthcare workers. Thus, early detection, timely treatment, and effective prevention measures are necessary for safeguarding health status and the provision of healthcare services.

[Prevalence of asthma in patients hospitalized for pneumonia associated to SARS-CoV-2 infection]. / Prevalencia de asma en pacientes hospitalizados por neumonía asociada a infección por SARS-CoV-2.

BACKGROUND: The association between asthma and COVID-19 remains controversial. Objective. To establish the prevalence of asthma in a sample of patients with COVID-19-associated pneumonia; furthermore, to describe the clinical characteristics of patients with asthma compared to patients without asthma. METHODS: Clinical data corresponding to 120 patients hospitalized for pneumonia associated with SARS-CoV-2 infection were analyzed. Patients with and without asthma were compared based on COVID-19 severity. RESULTS: The prevalence of asthma in patients with COVID-19 pneumonia was 3.5% (95% CI: 2.0% to 5.1%). When comparing the severity of COVID-19 among asthma patients with non-asthma patients, it did not differ based on symptoms, comorbidity, duration of symptoms, need for assisted mechanical ventilation, biomarkers of inflammation, and the occurrence of death. Patients with asthma and COVID-19 showed a high T2 phenotype, poor respiratory function, and no regular treatment for asthma control. CONCLUSIONS: No significant differences in the frequency of assisted mechanical ventilation or death were observed between patients hospitalized for COVID-19-associated pneumonia with and without a history of asthma.

ANTECEDENTES: La asociación el asma con la COVID-19 continúa siendo controversial. Objetivo: establecer la prevalencia de asma en una muestra de pacientes con neumonía asociada COVID-19; además, describir las características clínicas de los pacientes con asma en comparación con los pacientes sin asma. MÉTODOS: La asociación el asma con la COVID-19 continúa siendo controversial. Objetivo: establecer la prevalencia de asma en una muestra de pacientes con neumonía asociada COVID-19; además, describir las características clínicas de los pacientes con asma en comparación con los pacientes sin asma. RESULTADOS: La prevalencia de asma en los pacientes con neumonía por COVID-19 fue del 3.5% (IC 95%: 1.5% a 9.6%). Al comparar la gravedad de la COVID-19 entre los pacientes con asma con los pacientes sin asma, ésta no difirió en función de los síntomas, la comorbilidad, la duración de los síntomas, la necesidad de ventilación mecánica asistida, los biomarcadores de inflamación y la ocurrencia de muerte. Los pacientes con asma y COVID-19 mostraron un fenotipo T2 alto, con pobre función respiratoria y sin uso de tratamiento regular para el control del asma. CONCLUSIONES: No se observaron diferencias significativas en la frecuencia de la ventilación mecánica asistida o de la muerte entre los pacientes hospitalizados por neumonía asociada con COVID-19 con y sin historia de asma.

Serum Vitamin D Is Inversely Associated with Blood Eosinophil Count Among Adults with Allergic Asthma.

OBJECTIVE: To evaluate the role that serum vitamin D concentration plays in the number of eosinophils in peripheral blood in adults with allergic asthma. MATERIAL AND METHODS: A total of 142 patients were categorized based on different cutoff points for eosinophils: ≥200, ≥300, ≥400, and ≥500 cells/mL. The vitamin D concentration was stratified into <20 and ≥20 ng/mL. The association between vitamin D (independent variable) and eosinophils (dependent variable) was explored using multivariate analysis. RESULTS: The average number of eosinophils in the included patients was 418 cells/mL, and 33.8% of the included patients had vita- min D concentrations ≥20 ng/mL. Asthmatic patients with vitamin D< 20 ng/mL had a higher mean concentration of eosinophils than did asthmatic patients with vitamin D ≥20 ng/mL (464 ± 377.7 eosinophils/mL vs. 327.8 ± 247.2 eosinophils/mL, P = .025). We also observed that vitamin D was inversely correlated with eosinophil count (rho = 0.244, P = .003). In the multivariate analysis, vitamin D <20 ng/mL showed a significant inverse association with each cutoff value for eosinophilia (odds ratio >1). CONCLUSION: Vitamin D concentrations <20 ng/mL are associated with a significant increase in the number of eosinophils in blood. Studies that analyze the use of vitamin D supplements as complementary therapy for the treatment of asthma are needed.

Prevalence of Latent Tuberculosis Infection (LTBI) in Mexican Patients With Rheumatoid Arthritis (RA).

INTRODUCTION: Patients with rheumatoid arthritis (RA) are at increased risk of developing tuberculosis, and even more so if they receive biological agents. In Mexico, the prevalence of latent tuberculosis infection (LTBI) in RA diagnosed by interferon-gamma release assay (IGRA) is largely unknown. The objective was to determine LTBI prevalence and the associated risk factors in rheumatoid arthritis patients. METHODS: A cross-sectional study was performed comprising 82 patients with RA who attended the rheumatology service at a second-level hospital. Demographic characteristics, comorbidity, Bacillus Calmette-Guerin (BCG) vaccination and smoking history, type of treatment, disease activity and functional capacity were investigated. The Disease Activity Score 28 and the Health Assessment Questionnaire-Disability Index were applied for the estimate of RA activity and functional capacity. Further information was compiled from the electronic medical records and personal interviews. LTBI was determined by QuantiFERON TB Gold Plus (QIAGEN, Germantown, USA). RESULTS: Prevalence of LTBI was 14% (95% confidence interval (CI): 8.6% to 23.9%). Factors associated with LTBI were history of smoking (odds ratio (OR) = 6.63 95% CI 1.01 to 43.3) and disability score (OR = 7.19 95%CI 1.41 to 36.6). CONCLUSIONS: The prevalence of LTBI in Mexican patients with RA was 14%. Our results suggest prevention of smoking and functional incapacity could reduce the risk of LTBI. Further research could endorse our results.