Do high-protein diets have the potential to reduce gut barrier function in a sex-dependent manner?

PURPOSE: Impaired gut barrier function is associated with systemic inflammation and many chronic diseases. Undigested dietary proteins are fermented in the colon by the gut microbiota which produces nitrogenous metabolites shown to reduce barrier function in vitro. With growing evidence of sex-based differences in gut microbiotas, we determined whether there were sex by dietary protein interactions which could differentially impact barrier function via microbiota modification. METHODS: Fermentation systems were inoculated with faeces from healthy males (n = 5) and females (n = 5) and supplemented with 0.9 g of non-hydrolysed proteins sourced from whey, fish, milk, soya, egg, pea, or mycoprotein. Microbial populations were quantified using fluorescence in situ hybridisation with flow cytometry. Metabolite concentrations were analysed using gas chromatography, solid phase microextraction coupled with gas chromatography-mass spectrometry and ELISA. RESULTS: Increased protein availability resulted in increased proteolytic Bacteroides spp (p < 0.01) and Clostridium coccoides (p < 0.01), along with increased phenol (p < 0.01), p-cresol (p < 0.01), indole (p = 0.018) and ammonia (p < 0.01), varying by protein type. Counts of Clostridium cluster IX (p = 0.03) and concentration of p-cresol (p = 0.025) increased in males, while females produced more ammonia (p = 0.02), irrespective of protein type. Further, we observed significant sex-protein interactions affecting bacterial populations and metabolites (p < 0.005). CONCLUSIONS: Our findings suggest that protein fermentation by the gut microbiota in vitro is influenced by both protein source and the donor's sex. Should these results be confirmed through human studies, they could have major implications for developing dietary recommendations tailored by sex to prevent chronic illnesses.

A Review of the Effect of Iron Supplementation on the Gut Microbiota of Children in Developing Countries and the Impact of Prebiotics.

Iron is essential for many physiological functions of the body, and it is required for normal growth and development. Iron deficiency (ID) is the most common form of micronutrient malnutrition and is particularly prevalent in infants and young children in developing countries. Iron supplementation is considered the most effective strategy to combat the risk of ID and ID anaemia (IDA) in infants, although iron supplements cause a range of deleterious gut-related problems in malnourished children. The purpose of this review is to assess the available evidence on the effect of iron supplementation on the gut microbiota during childhood ID and to further assess whether prebiotics offer any benefits for iron supplementation. Prebiotics are well known to improve gut-microbial health in children and recent reports indicate that prebiotics can mitigate the adverse gut-related effects of iron supplementation in ID and IDA children. Thus, provision of prebiotics alongside iron supplements has the potential for an enhanced strategy for combating ID and IDA among children in the developing world. However, further understanding is required before the benefit of such combined treatments of ID in nutritionally-deprived children across populations can be fully confirmed. Such enhanced understanding is of high relevance in resource-poor countries where ID, poor sanitation and hygiene, alongside inadequate access to good drinking water and poor health systems are serious public health concerns.

Comparison of prebiotic candidates in ulcerative colitis using an in vitro fermentation model.

AIMS: This study explored the effect of three different prebiotics, the human milk oligosaccharide 2'-fucosyllactose (2'-FL), an oligofructose-enriched inulin (fructo-oligosaccharide, or FOS), and a galacto-oligosaccaride (GOS) mixture, on the faecal microbiota from patients with ulcerative colitis (UC) using in vitro batch culture fermentation models. Changes in bacterial groups and short-chain fatty acid (SCFA) production were compared. METHODS AND RESULTS: In vitro pH controlled batch culture fermentation was carried out over 48 h on samples from three healthy controls and three patients with active UC. Four vessels were run, one negative control and one for each of the prebiotic substrates. Bacterial enumeration was carried out using fluorescence in situ hybridization with flow cytometry. SCFA quantification was performed using gas chromatography mass spectrometry. All substrates had a positive effect on the gut microbiota and led to significant increases in total SCFA and propionate concentrations at 48 h. 2'-FL was the only substrate to significantly increase acetate and led to the greatest increase in total SCFA concentration at 48 h. 2'-FL best suppressed Desulfovibrio spp., a pathogen associated with UC. CONCLUSIONS: 2'FL, FOS, and GOS all significantly improved the gut microbiota in this in vitro study and also led to increased SCFA.

Mycoplasma bradburyae sp. nov. isolated from the trachea of sea birds.

In the search for mollicutes in wild birds, six Mycoplasma strains were isolated from tracheal swabs taken from four different species of seabirds. Four strains originated from three Yellow-legged gulls (Larus michahellis) and a Cory's shearwater (Calonectris borealis) from Spain, one from a South African Kelp gull (Larus dominicanus), and one from an Italian Black-headed gull (Chroicocephalus ridibundus). These Mycoplasma strains presented 99 % 16S rRNA gene sequence similarity values with Mycoplasma (M.) gallisepticum. Phylogenetic analyses of marker genes (16S rRNA gene and rpoB) confirmed the close relationship of the strains to M. gallisepticum and M. tullyi. The seabirds' strains grew well in modified Hayflick medium, and colonies showed typical fried egg morphology. They produced acid from glucose and mannose but did not hydrolyze arginine or urea. Transmission electron microscopy revealed a cell morphology characteristic of mycoplasmas, presenting spherical to flask-shaped cells with an attachment organelle. Gliding motility was also observed. Furthermore, serological tests, MALDI-ToF mass spectrometry and genomic studies demonstrated that the strains were different to any known Mycoplasma species, for which the name Mycoplasma bradburyae sp. nov. is proposed; the type strain is T158T (DSM 110708 = NCTC 14398).

The Effect of Probiotic Bacteria on Composition and Metabolite Production of Faecal Microbiota Using In Vitro Batch Cultures.

Probiotic supplements are increasingly being used to target the gut microbiome with a view to improving cognitive and psychological function via the gut-brain axis. One possible mechanism behind the effect of probiotics is through alterations to microbially-derived metabolites including short-chain fatty acids (SCFA) and neurotransmitters. However, research to date has largely been conducted in animal models or under conditions irrelevant to the human gastrointestinal tract (GIT). The aim of the current work was therefore to use anaerobic, pH controlled in vitro batch cultures to (a) assess the production of neuroactive metabolites in human faecal microbiota under conditions relevant to the human GIT, and (b) to explore how several pre-selected probiotic strains may affect bacterial composition and metabolite production. Enumeration of bacteria was assessed using fluorescence in situ hybridisation with flow cytometry, and concentrations of SCFAs and neurotransmitters were measured using gas chromatography and liquid chromatography mass spectroscopy, respectively. GABA, serotonin, tryptophan, and dopamine were successfully detected, suggesting some level of microbial derivation. The addition of Lactococcus lactis W58 and Lactobacillus rhamnosus W198 resulted in a significant increase in lactate after 8 h of fermentation, while no significant effect of probiotics on bacterial composition or neurotransmitter production was found.

Prevalencia de gérmenes con multi resistencia antibiótica en bacteriemia asociada a neutropenia febril en pacientes oncológicos hospitalizados. Un estudio de centro único / Prevalence of germs with multi antibiotic resistance in bacteremia associated with febrile neutropenia in hospitalized cancer patients. A single-center study

Introducción: El cáncer en el año 2020 provoco 1,4 millones de muertes, el 47% en personas menores de 65 años de edad,la neutropenia febril en el paciente oncológico aumenta los casos de infecciones graves, incrementando la morbimortalidad cuando no se ha empezado un tratamiento de oportuno. El objetivo del presente estudio fue describir una población con esta patología en un centro de referencia regional. Metodología: Este estudio transversal, se realizó en el Instituto Oncológico Nacional "Dr. Juan Tanca Marengo", Sociedad de Lucha contra el Cáncer, Solca Guayaquil, período enero 2020-junio 2021, con una muestra no probabilística, de pacientes con neoplasias, neutropenias y cultivos positivos. Se registraron variables demográficas, clínicas, de laboratorio. Se utiliza estadística descriptiva invariada. Resultados: Se analizan 126casos, de edad promedio 55 años, el 50.8% fue de sexo femenino; el 88.1 % ingresó con neutropenia febril; la estancia hospitalaria promedio fue de 7 días. La Escherichia coli fue el microorganismo más frecuente con el 17.5 %, seguido por Klebsiella neumonía en el 9.5 %, Enterobacteria aerógenas y Pseudomonas eruginosa en el 4.8 %. El 70.2 % de las bacterias aisladas presentó resistencia bacteriana, el 47 % fueron bacterias betalactamasa de espectro ampliado (BLEA), el 40 % fue betalactamasa de espectro extendido (BLEE), y el 5 % productor de carbapenémicas (KPC), el 57.5 % con resistencia bacteriana tuvo una estancia hospitalaria mayor a 7 días Conclusión: El principal microorganismo fue Escherichia coli y la resistencia mayormente la tuvieron las bacterias betalactamasa de espectro ampliado positiva; permitiendo conocer la epidemiología local del perfil microbiológico y su relación con los pacientes oncológicos con neutropenia febril

In troduction:Cancer in 2020 caused 1.4 million deaths, 47% in people under 65 years of age, febrile neu-tropenia in cancer patientsincreases cases of serious infections, increasing morbidity and mortality when Timely treatment has not been started. The objective of the present study was to describe a pop-ulation with this pathology in a regional reference center.Met hodology: This cross-sectional study was conducted at the National Oncology Institute "Dr. Juan Tanca Marengo," Society for the Fight Against Cancer, Solca-Guayaquil, period January 2020-June 2021, with a non-probabilistic sample of patients with neoplasms, neutropenia, and positive cultures. Demo-graphic, clinical, and laboratory variables were recorded. Univariate descriptive statistics are used.R esults: 126 cases were analyzed, with an average age of 55 years; 50.8% were female; 88.1% were admitted with febrile neutropenia; the average hospital stay was seven days. Escherichia coli was the most frequent microorganism with 17.5%, followed by Klebsiella pneumoniae in 9.5%, Enterobacter aerogenes, and Pseudomonas aureginosa in 4.8%. 70.2% of the isolated bacteria presented bacterial resistance, 47% were extendedspectrum beta-lactamase bacteria (ESBL), 40% were extended-spectrum betalactamase (ESBL), and 5% produced carbapenemases (KPC), 57.5% with bacterial resistance had a hospital stay greater than seven days.C o nclusion: The main microorganism was Escherichia coli, and resistance was primarily found in ex-tended-spectrum beta-lactamase-positive bacteria, allowing us to know the local epidemiology of the microbiological profile and its relationship with cancer patients with febrile neutropenia

Cranberry Arabino-Xyloglucan and Pectic Oligosaccharides Induce Lactobacillus Growth and Short-Chain Fatty Acid Production.

Numerous health benefits have been reported from the consumption of cranberry-derived products, and recent studies have identified bioactive polysaccharides and oligosaccharides from cranberry pomace. This study aimed to further characterize xyloglucan and pectic oligosaccharide structures from pectinase-treated cranberry pomace and measure the growth and short-chain fatty acid production of 86 Lactobacillus strains using a cranberry oligosaccharide fraction as the carbon source. In addition to arabino-xyloglucan structures, cranberry oligosaccharides included pectic rhamnogalacturonan I which was methyl-esterified, acetylated and contained arabino-galacto-oligosaccharide side chains and a 4,5-unsaturated function at the non-reducing end. When grown on cranberry oligosaccharides, ten Lactobacillus strains reached a final culture density (ΔOD) ≥ 0.50 after 24 h incubation at 32 °C, which was comparable to L. plantarum ATCC BAA 793. All strains produced lactic, acetic, and propionic acids, and all but three strains produced butyric acid. This study demonstrated that the ability to metabolize cranberry oligosaccharides is Lactobacillus strain specific, with some strains having the potential to be probiotics, and for the first time showed these ten strains were capable of growth on this carbon source. The novel cranberry pectic and arabino-xyloglucan oligosaccharide structures reported here combined with the Lactobacillus strains that can metabolize cranberry oligosaccharides and produce short-chain fatty acids, have excellent potential as health-promoting synbiotics.

Curvicollide D Isolated from the Fungus Amesia sp. Kills African Trypanosomes by Inhibiting Transcription.

Sleeping sickness or African trypanosomiasis is a serious health concern with an added socio-economic impact in sub-Saharan Africa due to direct infection in both humans and their domestic livestock. There is no vaccine available against African trypanosomes and its treatment relies only on chemotherapy. Although the current drugs are effective, most of them are far from the modern concept of a drug in terms of toxicity, specificity and therapeutic regime. In a search for new molecules with trypanocidal activity, a high throughput screening of 2000 microbial extracts was performed. Fractionation of one of these extracts, belonging to a culture of the fungus Amesia sp., yielded a new member of the curvicollide family that has been designated as curvicollide D. The new compound showed an inhibitory concentration 50 (IC50) 16-fold lower in Trypanosoma brucei than in human cells. Moreover, it induced cell cycle arrest and disruption of the nucleolar structure. Finally, we showed that curvicollide D binds to DNA and inhibits transcription in African trypanosomes, resulting in cell death. These results constitute the first report on the activity and mode of action of a member of the curvicollide family in T. brucei.

An In Vitro Approach to Studying the Microbial Community and Impact of Pre and Probiotics under Anorexia Nervosa Related Dietary Restrictions.

Individuals with anorexia nervosa (AN) often suffer psychological and gastrointestinal problems consistent with a dysregulated gut microbial community. Psychobiotics have been postulated to modify microbiota and improve mental well-being and gut symptoms, but there is currently a lack of evidence for such approaches in AN. The aim of this study was to use an in vitro colonic model to evaluate the impact of dietary restrictions associated with AN on the intestinal ecosystem and to assess the impact of pre and probiotic intervention. Bacteriology was quantified using flow cytometry combined with fluorescence in situ hybridisation and metabolic end products (including neurotransmitters) by gas chromatography and liquid chromatography mass spectrometry Consistent with previous research, the nutritional changes significantly reduced total microbiota and metabolites compared with healthy conditions. Pre and probiotic supplementation on restricted conditions enhanced the microbial community and modulated metabolic activity to resemble that of a healthy diet. The model system indicates that nutritional changes associated with AN can impact the microbial community, and that these changes can, at least in part, be restored through the use of pre and probiotic interventions.

Assessment of Lung Disease in Finishing Pigs at Slaughter: Pulmonary Lesions and Implications on Productivity Parameters.

Swine respiratory disease is associated with productive losses. We evaluated the prevalence of lung lesions with an emphasis on Mycoplasma hyopneumoniae (Mh), porcine circovirus type 2 (PCV2) and porcine reproductive and respiratory syndrome virus (PRRSV), as well as the impact on productive parameters in 108 finishing pigs at slaughter. Pathologic, immunohistochemical (IHC) and serologic analyses were performed. Pneumonic processes were observed in 73.1% of the animals. They mainly consisted of cranioventral bronchopneumonia (CBP) (46.3%) and pleuritis (17.6%). Microscopically, bronchointerstitial pneumonia (67.4%) was common and was occasionally combined (27.9%) with interstitial pneumonia (IP). Mh and PCV2-antigens were detected in bronchointerstitial pneumonia (70.7%) and IP cases (33.3%). There were low titers against Mh (18%) and high titers against PRRSV (100%) and PCV2 (65%). Animals with CBP remained at the farm longer; those with >10% of lung parenchyma involvement were sent later (208.8 days old) and had a lower average carcass weight (74.1 kg) and a lower daily weight gain (500.8 gr/day) compared with animals without lesions (567.2 gr/day, 77.7 kg, 200.8 days old). We suggest that animals that do not reach the weight at slaughter should be sent to slaughter regardless to avoid further negative impacts of respiratory disease in productive parameters.

Resistance to 16-Membered Macrolides, Tiamulin and Lincomycin in a Swine Isolate of Acholeplasma laidlawii.

Acholeplasma (A.) laidlawii is an opportunistic pathogen with the ability to disseminate resistance determinants to antibiotics; however, its resistance to macrolides has been less studied. The aim of the present study was to characterize the mechanisms responsible for the resistance to macrolides, tiamulin and lincomycin found in a strain of A. laidlawii isolated from a pig with pneumonia. MICs of erythromycin, 15- and 16-membered macrolides, tiamulin and lincomycin were determined by microdilution method with and without reserpine, an inhibitor of ABC efflux pumps and regions of the genome were sequenced. Reserpine only decreased lincomycin MIC but it did not change the MICs of macrolides and tiamulin. The analysis of the DNA sequence of 23S rRNA showed nucleotide substitutions at eight different positions, although none of them were at positions previously related to macrolide resistance. Five mutations were found in the L22 protein, one of them at the stop codon. In addition, two mutations were found in the amino acid sequence of L4. The combination of multiple mutations in the ribosomal proteins L22 and L4 together with substitutions in 23S rRNA DNA sequence was associated with the resistance to macrolides, the pleuromutilin and lincomycin in the studied A. laidlawii strain.

Malnutrition and Gut Microbiota in Children.

Malnutrition continues to threaten the lives of millions across the world, with children being hardest hit. Although inadequate access to food and infectious disease are the primary causes of childhood malnutrition, the gut microbiota may also contribute. This review considers the evidence on the role of diet in modifying the gut microbiota, and how the microbiota impacts childhood malnutrition. It is widely understood that the gut microbiota of children is influenced by diet, which, in turn, can impact child nutritional status. Additionally, diarrhoea, a major contributor to malnutrition, is induced by pathogenic elements of the gut microbiota. Diarrhoea leads to malabsorption of essential nutrients and reduced energy availability resulting in weight loss, which can lead to malnutrition. Alterations in gut microbiota of severe acute malnourished (SAM) children include increased Proteobacteria and decreased Bacteroides levels. Additionally, the gut microbiota of SAM children exhibits lower relative diversity compared with healthy children. Thus, the data indicate a link between gut microbiota and malnutrition in children, suggesting that treatment of childhood malnutrition should include measures that support a healthy gut microbiota. This could be of particular relevance in sub-Saharan Africa and Asia where prevalence of malnutrition remains a major threat to the lives of millions.

The Impact of Low-Level Iron Supplements on the Faecal Microbiota of Irritable Bowel Syndrome and Healthy Donors Using In Vitro Batch Cultures.

Ferrous iron supplementation has been reported to adversely alter the gut microbiota in infants. To date, the impact of iron on the adult microbiota is limited, particularly at low supplementary concentrations. The aim of this research was to explore the impact of low-level iron supplementation on the gut microbiota of healthy and Irritable Bowel Syndrome (IBS) volunteers. Anaerobic, pH-controlled in vitro batch cultures were inoculated with faeces from healthy or IBS donors along with iron (ferrous sulphate, nanoparticulate iron and pea ferritin (50 µmol-1 iron)). The microbiota were explored by fluorescence in situ hybridisation coupled with flow cytometry. Furthermore, metabolite production was assessed by gas chromatography. IBS volunteers had different starting microbial profiles to healthy controls. The sources of iron did not negatively impact the microbial population, with results of pea ferritin supplementation being similar to nanoparticulate iron, whilst ferrous sulphate led to enhanced Bacteroides spp. The metabolite data suggested no shift to potentially negative proteolysis. The results indicate that low doses of iron from the three sources were not detrimental to the gut microbiota. This is the first time that pea ferritin fermentation has been tested and indicates that low dose supplementation of iron is unlikely to be detrimental to the gut microbiota.

Antimicrobial susceptibility profiles of porcine mycoplasmas isolated from samples collected in southern Europe.

BACKGROUND: Mycoplasma (M.) hyopneumoniae, M. hyorhinis and M. hyosynoviae are significant pathogens for the porcine industry worldwide. The aim of the present study was to determine the antimicrobial susceptibility of six key antimicrobials (tylosin, tilmicosin, tylvalosin, lincomycin, tiamulin and valnemulin) routinely used for treating infections caused by these pathogens. Twenty-seven M. hyopneumoniae, 48 M. hyorhinis and 40 M. hyosynoviae field strains isolated from clinical samples from different Southern European countries between 2013 and 2018 using broth microdilution method were evaluated. RESULTS: Tylvalosin exhibited the highest in vitro activity among the macrolides assayed, with MIC90 values 4 to 5 two-fold dilutions lower than those of tylosin and tilmicosin. The pleuromutilin valnemulin showed one of the highest in vitro activities against the three mycoplasma species. On the contrary, lincomycin exhibited the highest MIC values of the antimicrobials tested. CONCLUSIONS: The data obtained in the present study supports the use of pleuromutilins and macrolides for the control of infections caused by porcine mycoplasmas. The use of lincomycin for the treatment of porcine mycoplasma infections should be carefully evaluated due to the presence of circulating field isolates with decreased susceptibility to this antimicrobial.

A study protocol for a randomised crossover study evaluating the effect of diets differing in carbohydrate quality on ileal content and appetite regulation in healthy humans.

Introduction: A major component of the digesta reaching the colon from the distal ileum is carbohydrate. This carbohydrate is subject to microbial fermentation and can radically change bacterial populations in the colon and the metabolites they produce, particularly short-chain fatty acids (SCFA). However, very little is currently known about the forms and levels of carbohydrate in the ileum and the composition of the ileal microbiota in humans. Most of our current understanding of carbohydrate that is not absorbed by the small intestine comes from ileostomy models, which may not reflect the physiology of an intact gastrointestinal tract. Methods: We will investigate how ileal content changes depending on diet using a randomised crossover study in healthy humans. Participants will be inpatients at the research facility for three separate 4-day visits. During each visit, participants will consume one of three diets, which differ in carbohydrate quality: 1) low-fibre refined diet; 2) high-fibre diet with intact cellular structures; 3) high-fibre diet where the cellular structures have been disrupted (e.g. milling, blending). On day 1, a nasoenteric tube will be placed into the distal ileum and its position confirmed under fluoroscopy. Ileal samples will be collected via the nasoenteric tube and metabolically profiled, which will determine the amount and type of carbohydrate present, and the composition of the ileal microbiota will be measured. Blood samples will be collected to assess circulating hormones and metabolites. Stool samples will be collected to assess faecal microbiota composition. Subjective appetite measures will be collected using visual analogue scales. Breath hydrogen will be measured in real-time as a marker of intestinal fermentation. Finally, an in vitro continuous fermentation model will be inoculated with ileal fluid in order to understand the shift in microbial composition and SCFA produced in the colon following the different diets. Registration: ISRCTN11327221.

First description of two moderately halophilic and psychrotolerant Mycoplasma species isolated from cephalopods and proposal of Mycoplasma marinum sp. nov. and Mycoplasma todarodis sp. nov.

Two moderately halophilic and psychrotolerant new Mycoplasma species were isolated from common cephalopods. Three strains were isolated in pure culture from two individual European flying squid (Todarodes sagittatus), and two individual octopuses (Octopus vulgaris). The strains showed optimal growth at 25 °C and a salinity of 3% (w/v) NaCl. Molecular analyses revealed that the isolates belonged to two new, but phylogenetically related species, divergent from all previously described Mollicutes, representing the first marine isolates of the class, and also the first Mycoplasma strains for which NaCl requirement has been demonstrated. A genome search against all available marine metagenomes and 16S rRNA gene databases indicated that these two species represent a novel non-free-living marine lineage of Mollicutes, specifically associated with marine animals. Morphology and physiology were compatible with other members of this group, and genomic and phenotypic analyses demonstrated that these organisms represent two novel species of the genus Mycoplasma, for which the names Mycoplasma marinum sp. nov. and Mycoplasma todarodis sp. nov. are proposed; the type strains are PET (DSM 105487T, CIP 111404T) and 5HT (DSM 105,488T, CIP 111405T), respectively.

Sexual Dimorphism in Immune Development and in Response to Nutritional Intervention in Neonatal Piglets.

Although sex disparity in immunological function and susceptibility to various inflammatory and infectious disease is recognized in adults, far less is known about the situation in young infants during immune development. We have used an outbred piglet model to explore potential early sex disparity underlying both mucosal immune development and systemic responses to novel antigen. Despite similarities in intestinal barrier function and therefore, presumably, antigen exposure, females had less CD172+ (Sirp-α) antigen presenting cells and expression of MHCIIDR at 28 days old compared to males, along with greater regulatory T-cell numbers. This suggests that, during infancy, females may have greater potential for local immune regulation than their male counterparts. However, females also presented with significantly greater systemic antibody responses to injected ovalbumin and dietary soya. Females also synthesized significantly more IgA in mesenteric lymph nodes, whereas males synthesized more in caecal mucosa, suggesting that plasma cells were retained within the MLN in females, but increased numbers of plasma cells circulated through to the mucosal tissue in males. Significant effects of inulin and Bifidobacterium lactis NCC2818 on the developing immune system were also sex-dependent. Our results may start to explain inconsistencies in outcomes of trials of functional foods in infants, as distinction between males and females is seldom made. Since later functionality of the immune system is highly dependent on appropriate development during infancy, stratifying nutritional interventions by sex may present a novel means of optimizing treatments and preventative strategies to reduce the risk of the development of immunological disorders in later life.

Influencia del estrés materno durante el embarazo en el desarrollo cognitivo del niño: una revisión / Influence of maternal stress during pregnancy on cognitive development of children: a review

Objetivo: Identificar la relación existente entre la exposición a niveles elevados de estrés durante el embarazo y la alteración del desarrollo cognitivo de los futuros hijos. Metodología: Se realizó una revisión de las bases de datos Scopus, PubMed y Web of Science, introduciendo los términos «pregnancy», «cortisol», «stress», «infant», «child» y «cognitive development». Se valoró la calidad metodológica de los artículos a través de la lista de revisión metodológica del Scottish Intercollegiate Guidelines Network. Resultados: Se obtuvo un total de 766 artículos, de los que 53 cumplían el objetivo de estudio, quedando reducidos finalmente a 25. En los cuatro grupos de edad analizados (que abarcaron desde los 7 meses hasta los 17 años) se hallaron estudios que presentaban una correlación positiva entre el estrés y/o la ansiedad con los resultados más bajos en el test de valoración del desarrollo cognitivo (aunque el periodo de edad en que esta correlación era más evidente fue el de los 13 meses a los 9 años), cualquier tipo de estrés (estuviera o no relacionado específicamente con el embarazo) y que en cualquier momento de la gestación podrían aparecer en los futuros hijos efectos perjudiciales en el lenguaje, la memoria de trabajo, el desarrollo psicomotor, el razonamiento perceptivo y la velocidad de procesamiento, entre otras posibles consecuencias. Conclusiones: Un exceso de estrés materno durante el embarazo puede tener consecuencias cognitivas negativas para el futuro hijo. Recomendamos que la matrona tome parte activa en el diagnóstico de estrés durante el embarazo, así como en la adopción de medidas para las mujeres con elevados niveles de estrés, con el fin de prevenir la afectación fetal (AU)

Objective: To determine the relationship between exposure to high levels of stress during pregnancy and impaired cognitive development of future children. Methodology: A review was made; in the databases Scopus, PubMed and Web of Science we introduced the terms 'pregnancy', 'cortisol', 'stress', 'infant', 'child', and 'cognitive development'. Methodological quality was assessed through the methodological checklist of the Scottish Intercollegiate Guidelines Network. Results: A total of 766 items, of which 53 were adequate to meet our goal, was obtained; this way, the final selection was reduced to 25 papers. Within the four age groups assessed (ranging from 7 months to 17 years), we find studies that found correlation between stress and/or anxiety with lower scores on tests of cognitive development, although the period in which this correlation is more evident is from 13 months to 9 years; any kind of stress (whether or not specifically related to pregnancy), at any time during pregnancy can have undesirable cognitive effects at language, working memory, psychomotor development, perceptual reasoning and processing speed, among other possible consequences. Conclusions: An excess of maternal stress during pregnancy can lead to undesirable consequences at cognitive level for the future child. We recommend that midwives become an active part in the diagnosis of stress in pregnancy, as well as taking action in women with high stress levels in order to prevent fetal impairment (AU)

Metaanálisis sobre los efectos de la acupresión durante el parto / Meta-analysis of the effects of acupressure during labor

Objetivo: Determinar la eficacia de la acupresión para el alivio del dolor de parto, en mujeres de parto con embarazo a término y de bajo riesgo, así como otros posibles efectos sobre el curso del parto. Método: Se realizó una búsqueda bibliográfica y una selección de ensayos sobre el tema basada en su calidad metodológica, y posteriormente se llevó a cabo el metaanálisis. Resultados: La acupresión resulta eficaz para aliviar el dolor del parto al compararla con un grupo placebo (GP) (-1,13; intervalo de confianza [IC] del 95%: de -1,66 a -0,60) y con un grupo control (GC) (-0,85; IC del 95%: de -1,13 a -0,57). Sus efectos se prolongan hasta 2 horas después de la aplicación de la técnica (GP: -1,30; IC del 95%: de -1,92 a -0,67; GC: -1,36; IC del 95%: de -2,02 a -0,70). También es eficaz para reducir la duración del parto (GP: -110,59; IC del 95%: de -182,21 a -38,96; GC: -189,73; IC del 95%: de -221,90 a -157,56), tanto del periodo de dilatación (GP: -39,04; IC del 95%: de -55,01 a -23,06; GC: -127,20; IC del 95%: de -219,05 a -35,35) como del expulsivo (GP: -9,31; IC del 95%: de -15,87 a -2,75; GC: no valorado). Asimismo, la acupresión se asocia a un menor riesgo de cesárea (GP: 0,34; IC del 95%: 0,15-0,76; GC: 0,35; IC del 95%: 0,16- 0,79). Y todo ello sin que la valoración neonatal mediante el test de Apgar se vea afectada negativamente. Conclusión: Se considera eficaz la aplicación de acupresión para el alivio del dolor durante el parto (AU)

Objective: To determine the efficacy of acupressure for the relief of labor pain in low risk, at term deliveries, as well as other effects on the course of labor. Method: An exhaustive bibliographic research was carried out, followed by a careful selection of studies based on their methodological quality, and subsequent meta-analysis. Results: Acupressure is effective for relieving labor pain when compared to a placebo group (PG) (-1.13; -1.66, -0.60; 95% CI) and a control group (CG) (-0.85; -1.13, -0.57; 95% CI) and that its effects last up to two hours after application of the technique (PG: -1.30; -1.92, -0.67; 95% CI; CG: -1.36; -2.02, -0.70; 95% CI). It is also effective in reducing the duration of labor (PG: -110.59; -182.21, -38.96; 95% CI; CG: -189.73; -221.90, -157.56; 95% CI), both first (PG: -39.04; -55.01, -23.06; 95% CI; CG: -127.20; -219.05, -35.35; 95% CI) and second stages (PG: -9.31; -15.87, -2,75; 95% CI; CG: not assessed). Furthermore, it is associated with fewer caesarean sections (PG: 0.34; 0.15, 0.76; 95% CI; CG: 0.35; 0.16, 0.79; 95% CI); and it has no neonatal affectation (assessed through the Apgar score). Conclusion: The application of this technique during childbirth is recommended, as well as its divulgation during pregnancy (AU)