Folate status in women of childbearing age in the Urban Metropolitan Region of Chile: results from the National Health Survey 2016-2017.

OBJECTIVE: To analyse serum folate levels in women of childbearing age in the Metropolitan Region (MR) of Chile. DESIGN: Cross-sectional design as part of the 2016-2017 National Health Survey (Encuesta Nacional de Salud, ENS 2016-2017), using a household-based multistage stratified random sample. Serum folate levels measured by electrochemiluminescence immunoassay in fasting venous blood samples were classified as deficient (<4·4 ng/ml), normal (4·4-20 ng/ml) or supraphysiological (>20 ng/ml). SETTING: The MR of Chile. PARTICIPANTS: Women of reproductive age (15-49 years, n 222) from the MR participated in the ENS 2016-2017. RESULTS: The mean, median and range of serum folate were 14·2 (se 0·4), 13·9 and 2·1-32·2 ng/ml, respectively. Folate deficiency was detected in 0·9 % of women, while 7·0 % had supraphysiological levels of the vitamin. No significant effects of age, educational level, marital status, parity, smoking status or nutritional status on serum folate levels were detected by univariate or multivariate analyses. Intake of folic acid supplements showed a significant association with serum folate levels, but only 1·2 % of women used supplements. CONCLUSIONS: Folate deficiency in women of reproductive age living in the MR of Chile is almost inexistent according to the ENS 2016-2017, suggesting that the current population-wide mandatory folic acid fortification of flour is an effective and equitable measure to prevent folate deficiency. These results support the option of maintaining current folic acid fortification in Chile, particularly based on the low adherence to supplementation regimes evidenced in other populations.

The anti MRSA biofilm activity of Thymus vulgaris essential oil in nanovesicles.

BACKGROUND: Thymus vulgaris essential oil (T) could be an alternative to classical antibiotics against bacterial biofilms, which show increased tolerance to antibiotics and host defence systems and contribute to the persistence of chronic bacterial infections. HYPOTHESIS: A nanovesicular formulation of T may chemically protect the structure and relative composition of its multiple components, potentially improving its antibacterial and antibiofilm activity. STUDY DESIGN: We prepared and structurally characterized T in two types of nanovesicles: nanoliposomes (L80-T) made of Soybean phosphatidylcholine (SPC) and Polysorbate 80 (P80) [SPC:P80:T 1:0.75:0.3 w:w], and nanoarchaeosomes (A80-T) made of SPC, P80 and total polar archaeolipids (TPA) extracted from archaebacteria Halorubrum tebenquichense [SPC:TPA:P80:T 0.5:0.50.75:0.7 w:w]. We determined the macrophage cytotoxicity and the antibacterial activity against Staphylococcus aureus ATCC 25,923 and four MRSA clinical strains. RESULTS: L80-T (Z potential -4.1 ±â€¯0.6 mV, ∼ 115 nm, ∼ 22 mg/ml T) and A80-T (Z potential -6.6 ±â€¯1.5 mV, ∼ 130 nm, ∼ 42 mg/ml T) were colloidally and chemically stable, maintaining size, PDI, Z potential and T concentration for at least 90 days. While MIC90 of L80-T was > 4 mg/ml T, MIC90 of A80-T was 2 mg/ml T for all S. aureus strains. The antibiofilm formation activity was maximal for A80-T, while L80-T did not inhibit biofilm formation compared to untreated control. A80-T significantly decreased the biomass of preformed biofilms of S. aureus ATCC 25,923 strain and of 3 of the 4 clinical MRSA isolates at 4 mg/ml T. It was found that the viability of J774A.1 macrophages was decreased significantly upon 24 h incubation with A80-T, L80-T and T emulsion at 0.4 mg/ml T. These results show that from 0.4 mg/ml T, a value lower than MIC90 and the one displaying antibiofilm activity, with independence of its formulation, T significantly decreased the macrophages viability. CONCLUSION: Overall, because of its lower MIC90 against planktonic bacteria, higher antibiofilm formation capacity and stability during storage, A80-T resulted better antibacterial agent than T emulsion and L80-T. These results open new avenues to explode the A80-T antimicrobial intracellular activity.

La suplementación materna con ácido docosahexaenoico (DHA) carece de beneficio clínicamente significativo / Evaluation of maternal and fetal benefits of prenatal supplementation with docosahexaenoic acid (DHA)

Objetivo: Evaluar los beneficios maternos y fetales de la suplementación prenatal con ácido docosahexae-noico (DHA). Método: Revisión sistemática de investigaciones clínicas controladas aleatorizadas. Resultados: La suplementación prenatal con DHA incrementó los niveles de DHA en sangre materna, en la leche materna o células neonatales. La suplementación con DHA no redujo los síntomas depresivos maternos ni mejoró el desempeño neurológico y visual de los niños. Aunque se apreció un menor riesgo de retraso cognitivo entre los hijos de mujeres suplementadas con DHA (RR 0,4; IC 95 por ciento 0,22-0,78) y un mejor desempeño en el procesamiento mental a los 4 años, el seguimiento a 7 años mostró ausencia de diferencias significativas en el nivel intelectual. El análisis secundario de dos estudios mostró que la suplementación con DHA redujo el riesgo de parto prematuro < 34 semanas (RR 0,49; IC95 por ciento 0,25-0,94; p=0,03), ingreso a UCI neonatal (RR 0,57; IC95 por ciento 0,34-0,97; p=0,04), peso < 2500 g (RR 0,65; IC95 por ciento 0,44-0,96; p=0,03) y restricción de crecimiento intrauterino en pacientes primigestas (RR 0,5; IC 95 por ciento 0,3-1,0; p=0,03). Sin embargo, la prevención de parto prematuro no fue reproducida en estudio diseñado específicamente para ello. Conclusiones: Los estudios reportan un mayor contenido de DHA materno y neonatal en respuesta a la su-plementación prenatal con este ácido graso. Sin embargo, la ausencia actual de efectos clínicos relevantes no permite apoyar ni descartar completamente esta intervención durante el embarazo.

Aims: To evaluate maternal and fetal benefits of prenatal supplementation with docosahexaenoic acid (DHA). Method: Systematic review of clinical randomized controlled trials. Results: Prenatal DHA supplementation increased DHA levels on maternal blood, breast milk or neonatal cells. Maternal supplementation with DHA neither reduced mother's depressive symptoms nor improved the neurological and visual performance of the children. Although it was observed a reduction in risk of cognitive delay between infants of women supplemented with DHA (RR 0.4; IC95 percent 0.22-0.78) and a better performance in the mental processing at the age of 4, the 7 years follow-up showed absence of significant differences in the intellectual level. The secondary analysis of two studies showed that the supplementation with DHA reduced the risk of premature birth <34 weeks (RR 0.49; IC95 percent 0.25-0.94; p=0.03), neonatal ICU hospitalizations (RR 0.57; IC95 percent 0.34-0.97; p=0.04), birth weight <2500 g (RR 0.65; IC95 percent 0.44-0.96; p=0.03) and intrauterine growth restriction in nulliparous patients (RR 0.5; IC95 percent 0.3-1.0; p=0.03). Nevertheless, prevention of premature birth was not reproduced in a specifically designed study. Conclusions: Studies report an increased mother and neonatal content of DHA in response to prenatal supplementation with this polyunsaturated long chain fatty acid. Nevertheless, at date the absence of relevant clinical effects do not permit to support or to reject maternal dietary supplementation with DHA during pregnancy.