In 1990, the first Teratogen Information Service in Brazil (SIAT) was implemented
in the Medical Genetics Service at Hospital de Clinicas de Porto Alegre. SIAT is
a free-to-use information service both to health professionals and the general
population, especially to women who are pregnant or planning pregnancy. The main
objective of this paper is to present the activities of SIAT in its initial
years (1990-2006), compared to those in the last decade (2007-2017). In addition
we review the scientific contribution of SIAT in the field of human
teratogenesis. Since 1990, SIAT received 10,533 calls. Use of medications were
the main reason for concern, accounting for 74% of all questions, followed by
other chemical exposures (occupational, cosmetics, environmental), and maternal
infectious diseases. Among its main contributions to scientific knowledge was
the collaboration for the identification of two new human teratogens:
misoprostol in the 1990s and Zika virus in 2015/16. In conclusion, SIAT is still
evolving, as is the Medical Genetics Service that hosts it. Through its 27 years
of existence more than 300 undergraduate and graduate students have rotated at
SIAT. Presently, SIAT is expanding the research to experimental teratogenesis
and to investigation of molecular mechanisms of teratogens.
Word count: 1551
Key Points QuestionCan single-channel electrocardiogram (ECG) -derived heart rate variability (HRV) recorded in toddlers yield a biomarker of fetal in utero exposure to Zika virus?
FindingsGrid Count measure of HRV serves as the best ECG-derived biomarker of fetal exposure to Zika virus infection with high classification performance.
MeaningIt is feasible to measure HRV in infants and toddlers using a small non-invasive portable ECG device. Such screening approach may uncover memory of in utero exposure to ZIKV.
AbstractAlthough Zika virus (ZIKV) seems to be prominently neurotropic, there are some reports of involvement of other organs, particularly the heart. Of special concern are those children exposed prenatally to ZIKV and born with no microcephaly or other congenital anomaly. Electrocardiogram (ECG) -derived heart rate variability (HRV) metrics represent an attractive, low cost, widely deployable tool for early identification of such children. We hypothesized that HRV in such children would yield a biomarker of fetal ZIKV exposure. We investigated the HRV properties of 21 infants aged 4 to 25 months from Brazil. The infants were divided in two groups, the ZIKV-exposed (n=13) and controls (n=8). Single channel ECG was recorded in each child at ~15 months of age and HRV was analyzed in 5 min segments to provide a comprehensive characterization of the degree of variability and complexity of the heart rate. Using a cubic Support Vector Machine (SVM) classifier we identified babies as Zika cases or controls with negative predictive value of 92% and positive predictive value of 86%. Our results show that HRV metrics can help differentiate between ZIKV-affected, yet asymptomatic, and non-ZIKV exposed babies. We identified the Grid Count as the best HRV measure in this study allowing such differentiation, regardless the presence of microcephaly. We show that it is feasible to measure HRV in infants and toddlers using a small non-invasive portable ECG device and that such approach may uncover memory of in utero exposure to ZIKV. This approach may be useful for future studies and low-cost screening tools involving this challenging to examine population.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.