Association of the Maternal Folic Acid Supplementation with the Autism Spectrum Disorder: A Systematic Review.

OBJECTIVE: To analyze the scientific production regarding maternal folic acid (FA) supplementation and its relationship with autistic spectrum disorder (ASD). DATA SOURCES: We performed unrestricted electronic searches in the BIREME virtual bank, Virtual Health Library (VHL) and Medical Literature Analysis and Retrieval System Online (MEDLINE/PubMed) databases. SELECTION OF STUDIES: For sample selection, articles that met the proposed objectives were included, published in English, Spanish and Portuguese, the use of Health Sciences Descriptors (DeCS): autistic OR autism AND autism spectrum disorder AND folic acid, AND, with the use of the Medical Subject Headings (MeSH): autistic OR autism AND autistic spectrum disorder AND folic acid. DATA COLLECTION: Data extraction was performed by the reviewers with a preestablished data collection formulary. DATA SYNTHESIS: The Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) was used based on a checklist with 27 items and a 4-step flowchart. RESULTS: A total of 384 articles was found by the search strategies, of which 17 were eligible following the pre-established criteria. The main findings of the present review point to maternal FA supplementation in the pre-conception period and beginning of pregnancy as a protective effect in relation to ASD, which should be indicated in this period as prevention to the problem. CONCLUSION: According to the research analyzed, more studies are necessary to know its effects on pregnancy, since the consumption of excessive FA may not be innocuous.

OBJETIVO: Analisar a produção científica a respeito da suplementação de ácido fólico (AF) materno e sua relação com o transtorno do espectro autista (TEA). FONTES DE DADOS: Realizamos buscas eletrônicas irrestritas nas bases de dados do banco virtual BIREME, Biblioteca Virtual em Saúde (VHL) e Medical Literature Analysis and Retrieval System Online (MEDLINE / PubMed). SELEçãO DOS ESTUDOS: Incluímos os artigos publicados em inglês, espanhol e português, com o uso dos DeCS: autistic OR autism AND autism spectrum disorder AND folic acid, e com o uso dos Medical Subject Headings (MeSH, na sigla em inglês): autistic OR autism AND Autistic Spectrum Disorder AND folic acid ". COLETA DE DADOS: A extração de dados foi realizada pelos revisores com um formulário de coleta de dados pré-estabelecido. SíNTESE DOS DADOS: Foram usados os itens de relatório preferidos para protocolos de revisão sistemática e meta-análise (PRISMA-P) com base em uma lista de verificação com 27 itens e um fluxograma de 4 etapas. RESULTADOS: Foram encontrados 384 artigos pelas estratégias de busca, dos quais 17 eram elegíveis segundo os critérios pré-estabelecidos. Os principais achados da presente revisão apontam para a suplementação de AF materno no período de preconcepção e início da gravidez como efeito protetor em relação ao TEA, que deve ser indicada neste período como prevenção do problema. CONCLUSãO: De acordo com as pesquisas analisadas, mais estudos são necessários para conhecer seus efeitos sobre a gravidez, uma vez que o consumo excessivo de AF pode não ser inócuo.

Association of the Maternal Folic Acid Supplementation with the Autism Spectrum Disorder: A Systematic Review / Associação da suplementação de ácido fólico materno com o transtorno do espectro do autismo: uma revisão sistemática

Abstract Objective To analyze the scientific production regarding maternal folic acid (FA) supplementation and its relationship with autistic spectrum disorder (ASD). Data Sources We performed unrestricted electronic searches in the BIREME virtual bank, Virtual Health Library (VHL) and Medical Literature Analysis and Retrieval System Online (MEDLINE/PubMed) databases. Selection of Studies For sample selection, articles that met the proposed objectives were included, published in English, Spanish and Portuguese, the use of Health Sciences Descriptors (DeCS): autistic OR autism AND autism spectrum disorder AND folic acid, AND, with the use of the Medical Subject Headings (MeSH): autistic OR autism AND autistic spectrum disorder AND folic acid. Data Collection Data extraction was performed by the reviewers with a preestablished data collection formulary. Data Synthesis The Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) was used based on a checklist with 27 items and a 4-step flowchart. Results A total of 384 articles was found by the search strategies, of which 17 were eligible following the pre-established criteria. The main findings of the present review point to maternal FA supplementation in the pre-conception period and beginning of pregnancy as a protective effect in relation to ASD, which should be indicated in this period as prevention to the problem. Conclusion According to the research analyzed, more studies are necessary to know its effects on pregnancy, since the consumption of excessive FA may not be innocuous.

Resumo Objetivo Analisar a produção científica a respeito da suplementação de ácido fólico (AF) materno e sua relação com o transtorno do espectro autista (TEA). Fontes de Dados Realizamos buscas eletrônicas irrestritas nas bases de dados do banco virtual BIREME, Biblioteca Virtual em Saúde (VHL) e Medical Literature Analysis and Retrieval System Online (MEDLINE / PubMed). Seleção dos Estudos Incluímos os artigos publicados em inglês, espanhol e português, com o uso dos DeCS: autistic OR autism AND autism spectrum disorder AND folic acid, e com o uso dos Medical Subject Headings (MeSH, na sigla em inglês): autistic OR autism AND Autistic Spectrum Disorder AND folic acid ". Coleta de Dados A extração de dados foi realizada pelos revisores com um formulário de coleta de dados pré-estabelecido. Síntese dos Dados Foram usados os itens de relatório preferidos para protocolos de revisão sistemática e meta-análise (PRISMA-P) com base em uma lista de verificação com 27 itens e um fluxograma de 4 etapas. Resultados Foram encontrados 384 artigos pelas estratégias de busca, dos quais 17 eram elegíveis segundo os critérios pré-estabelecidos. Os principais achados da presente revisão apontam para a suplementação de AF materno no período de preconcepção e início da gravidez como efeito protetor em relação ao TEA, que deve ser indicada neste período como prevenção do problema. Conclusão De acordo com as pesquisas analisadas, mais estudos são necessários para conhecer seus efeitos sobre a gravidez, uma vez que o consumo excessivo de AF pode não ser inócuo.

Serological and molecular epidemiology of the Dengue, Zika and Chikungunya viruses in a risk area in Brazil.

BACKGROUND: The co-circulation of types of arbovirus in areas where they are endemic increased the risk of outbreaks and limited the diagnostic methods available. Here, we analyze the epidemiological profile of DENV, CHIKV and ZIKV at the serological and molecular level in patients with suspected infection with these arboviruses in the city of Juazeiro do Norte, Ceará, Brazil. METHODS: In 2016, the Central Public Health Laboratory (LACEN) of Juazeiro do Norte received 182 plasma samples from patients who visited health facilities with symptoms compatible with arbovirus infection. The LACEN performed serological tests for detection of IgM/IgG to DENV and CHIKV. They then sent these samples to the Retrovirology Laboratory of the Federal University of São Paulo and Faculty of Medical of the ABC where molecular analyses to confirm the infection by DENV, ZIKV and CHIKV were performed. The prevalence of IgM/IgG antibodies and of infections confirmed by RT-qPCR were presented with 95% confidence interval. RESULTS: In serologic analysis, 125 samples were positive for antibodies against CHIKV and all were positive for antibodies against DENV. A higher prevalence of IgG against CHIKV (63.20% with 95% CI: 45.76-70.56) than against DENV (95.05% with 95% CI: 78.09-98.12) was observed. When the samples were submitted to analysis by RT-qPCR, we observed the following prevalence: mono-infection by ZIKV of 19.23% (95% CI: 14.29-34.82) patients, mono-infection by CHIKV of 3.84% (95% CI: 2.01-5.44) and co-infection with ZIKV and CHIKV of 1.09% (95% CI: 0.89-4.56). CONCLUSION: The serologic and molecular tests performed in this study were effective in analyzing the epidemiological profile of DENV, CHIKV and ZIKV in patients with suspected infection by these arboviruses in the city of Juazeiro do Norte, Ceará/Brazil.

In vitro antimicrobial activity of the essential oil from Vanillosmopsis arborea Barker (Asteraceae) and its major constituent, α-bisabolol.

Vanillosmopsis arborea Barker (Asteraceae), commonly known as "candeeiro" is an endemic tree to the Caatinga biome, in northeast Brazil. The major component of its essential oil is α-bisabolol, a monocyclic sesquiterpene alcohol with several biological activities reported. In this study, the antimicrobial activity of the essential oil of V. arborea was investigated in comparison with its major component α-bisabol. The antimicrobial activity was performed against Escherichia coli ATCC 25922, Staphylococcus aureus ATCC 12692, Candida albicans (CA) INCQS 40006, Candida krusei (CK) INCQS 40095, Candida tropicalis (CT) INCQS 40042, and multiresistant bacterial strains Staphylococcus aureus 03 and Escherichia coli 08 by the microdilution method and direct contact modulation. The results showed that all strains were sensitive to the samples, except E. coli against the essential oil. Both the essential oil and the α-bisabolol had a synergistic effect against all strains, except for ampicillin against S. aureus 03, which did not show any modifications when combined with the oil. These data show the potential of V. arborea essential oil as an antibiotic modulator as well as a source of bioactive compounds with potential for the development of antimicrobial drugs as well as adjuvant to therapy against these pathogens.

Late Presentation HIV/AIDS Is Still a Challenge in Brazil and Worldwide.

Despite all the efforts to contain the HIV/AIDS epidemics, there still are individuals of unknown diagnosis. These present high risk of mortality and after diagnosis respond very poorly to treatment. Late testing also represents a reduced opportunity in controlling the transmission of HIV and causes an indirect increase in the transmission rates of other diseases, such as tuberculosis. In European countries, as well as in the United States, a great number of people, represented especially by illegal immigrants, black individuals, and women, markedly present at a later state of infection. In 1996, Brazil was the very first developing country to offer free and universal access to antiretroviral therapy, as well as easy access to HIV testing and care. Nonetheless, there is still a significant number of young and adult subjects who look for HIV/AIDS services and hospitals at later stage of infection by HIV (late presenters). Here we discuss important aspects related to the late diagnosis of HIV in Brazil and worldwide.