Screening and diagnostic tools for autism spectrum disorder: Systematic review and meta-analysis.

INTRODUCTION: Autism Spectrum Disorder (ASD) is a heterogeneous neurodevelopmental disorder, with main manifestations related to communication, social interaction, and behavioral patterns. The slight dynamics of change in the child over time require that the onset of clinical manifestations presented by the child be more valued, with the aim of stabilizing the condition. Faced with a variety of methods for diagnosing ASD, the question arises as to which method should be used. This systematic review aims to recommend the best tools to perform screening and diagnosis. METHODOLOGY: This systematic review followed the PRISMA guidelines. The databases MEDLINE, Embase, CENTRAL (Cochrane), and Lilacs were accessed, and gray and manual searches were performed. The search strategy was created with terms referring to autism and the diagnosis/broad filter. The studies were qualitatively evaluated and quantitatively. Statistical analysis was performed using Meta-diSc-2.0 software, the confidence interval was 95 %. RESULTS: The M-CHAT-R/F tool demonstrated a sensitivity of 78 % (95 % CI 0.57‒0.91) and specificity of 0.98 (95 % CI 0.88-1.00). The diagnostic tools demonstrated sensitivity and specificity respectively of: ADOS, sensitivity of 87 % (95 % CI 0.79‒0.92) and specificity 75 % (95 % CI 0.73‒0.78); ADI-R demonstrated test sensitivity of 77 % (95 % CI 0.56‒0.90) and specificity 68 % (95 % CI 0.52‒0.81), CARS test sensitivity was 89 % (95 % CI 0.78‒0.95) and specificity 79 % (95 % CI 0.65‒0.88). CONCLUSION: It is mandatory to apply a screening test, the most recommended being the M-CHAT-R/F. For diagnosis CARS and ADOS are the most recommended tools.

Screening and diagnostic tools for autism spectrum disorder: Systematic review and meta-analysis

Abstract Introduction Autism Spectrum Disorder (ASD) is a heterogeneous neurodevelopmental disorder, with main manifestations related to communication, social interaction, and behavioral patterns. The slight dynamics of change in the child over time require that the onset of clinical manifestations presented by the child be more valued, with the aim of stabilizing the condition. Faced with a variety of methods for diagnosing ASD, the question arises as to which method should be used. This systematic review aims to recommend the best tools to perform screening and diagnosis. Methodology This systematic review followed the PRISMA guidelines. The databases MEDLINE, Embase, CENTRAL (Cochrane), and Lilacs were accessed, and gray and manual searches were performed. The search strategy was created with terms referring to autism and the diagnosis/broad filter. The studies were qualitatively evaluated and quantitatively. Statistical analysis was performed using Meta-diSc-2.0 software, the confidence interval was 95 %. Results The M-CHAT-R/F tool demonstrated a sensitivity of 78 % (95 % CI 0.57‒0.91) and specificity of 0.98 (95 % CI 0.88-1.00). The diagnostic tools demonstrated sensitivity and specificity respectively of: ADOS, sensitivity of 87 % (95 % CI 0.79‒0.92) and specificity 75 % (95 % CI 0.73‒0.78); ADI-R demonstrated test sensitivity of 77 % (95 % CI 0.56‒0.90) and specificity 68 % (95 % CI 0.52‒0.81), CARS test sensitivity was 89 % (95 % CI 0.78‒0.95) and specificity 79 % (95 % CI 0.65‒0.88). Conclusion It is mandatory to apply a screening test, the most recommended being the M-CHAT-R/F. For diagnosis CARS and ADOS are the most recommended tools.

Avaliação morfológica do cólon proximal de ratos diabéticos suplementados com extrato de Agaricus blazei murrill / Morphological evaluation of the proximal colon of diabetic rats supplemented with agaricus blazei murrill extract / Evaluación morfológica del colon proximal de ratas diabéticas suplementadas con extracto de agaricus blazei murrill

O diabetes mellitus tipo I é resultado da absoluta deficiência de insulina, estando associado à anormalidades no metabolismo. Transtornos no trato gastrointestinal, tais como vômitos, disfagia e diarreia são frequentes no diabetes, sendo relacionados a alterações na morfologia intestinal e no sistema nervoso entérico. Compostos ricos em antioxidantes vem sendo utilizados como prevenção ou tratamento do diabetes. Agaricus blazei Murrill possui grande interesse farmacológico pelas propriedades anti-inflamató- rias, hipoglicêmicas e antioxidantes. Neste trabalho, avaliamos a integridade estrutural da parede e inervação intrínseca do cólon proximal em modelo experimental de diabetes induzido por estreptozotocina, tratados ou não com A. blazei. Ratos Wistar foram dividi- dos em grupos: normoglicêmicos (N), diabéticos (D) e com suplementação (NB e DB) por gavagem do extrato hidroalcoólico de Agaricus blazei (200mg/Kg), por 120 dias. Amostras do cólon proximal foram destinadas à técnicas histológicas para análise mor- fométrica da túnica mucosa, profundidade das criptas, muscular da mucosa, muscular ex- terna e parede total, número de células caliciformes e avaliação morfoquantitativa da pop- ulação mioentérica. O diabetes promoveu redução da muscular externa e muscular da mucosa com aumento na profundidade das criptas e área nuclear neuronal. O extrato promoveu hipertrofia da mucosa e muscular da mucosa. Houve manutenção na espessura da parede total, número de células caliciformes e na população neuronal mioentérica no diabetes e na suplementação. Conclui-se que o diabetes induzido por estreptozotocina e a suplementação com o extrato de Agaricus blazei causam ajustes morfológicos nas túnicas intestinais, sem interferir na parede e inervação mioentérica do cólon proximal, preservando a morfofisiologia absortiva e motora deste segmento

Type I diabetes mellitus is a result of absolute insulin deficiency and is associated with abnormalities in metabolism. Disorders in the gastrointestinal tract, such as vomiting, dysphagia and diarrhea are common in diabetes, being related to changes in intestinal morphology and enteric nervous system. Antioxidant rich compounds have been used as prevention or treatment of diabetes. Agaricus blazei Murrill is highly pharmacologically interested in anti-inflammatory, hypoglycemic and antioxidant properties. In this work, we evaluated the structural integrity of the wall and intrinsic innervation of the proximal colon in an experimental model of streptozotocin-induced diabetes, treated or not with A. blazei Wistar rats were divided into groups: normoglycemic (N), diabetic (D) and supplementation (NB and DB) by gavage of the hydroalcoholic extract of Agaricus blazei (200mg / kg) for 120 days. Samples of the proximal colon were used for histological techniques for morphometric analysis of the mucosa, depth of the crypts, muscularis mucosa, external muscular and total wall, number of goblet cells and morpho-quantitative evaluation of the myenteric population. Diabetes promoted reduction of muscularis mucosa and external muscular with increased depth of the crypts and nuclear neuronal area. The extract promoted mucosa and muscular of the mucosa hypertrophy. There were maintenance of total wall thickness, number of goblet cells and in the myenteric neuronal population in diabetes and supplementation. It is concluded that streptozotocin-induced diabetes and supplementation with Agaricus blazei extract cause morphological adjustments in the intestinal tunica, without interfering with the wall and myenteric innervation of the proximal colon, preserving the absorptive and motor morphophysiology of this segment.

La diabetes mellitus tipo I es el resultado de la deficiencia absoluta de insulina y se asocia con anomalías en el metabolismo. Los trastornos del tracto gastrointestinal, como vómitos, disfagia y diarrea son frecuentes en la diabetes, estando relacionados con cambios en la morfología intestinal y en el sistema nervioso entérico. Los compuestos ricos en antioxidantes se han utilizado como prevención o tratamiento de la diabetes. Agaricus blazei Murrill está muy interesado farmacológicamente en propiedades antiinflamatorias, hipoglucémicas y antioxidantes. En este trabajo, se evaluó la integridad estructural de la pared e inervación intrínseca del colon proximal en un modelo experimental de diabetes inducida por estreptozotocina, tratada o no con ratas A. blazei Wistar, divididas en grupos: normoglucémico (N), diabético (D) y suplementación (NB y DB) por sonda del extracto hidroalcohólico de Agaricus blazei (200mg/kg) por 120 días. Se utilizaron muestras del colon proximal para técnicas histológicas de análisis morfométrico de la mucosa, profundidad de las criptas, mucosa muscular, pared externa muscular y total, número de células caliciformes y evaluación morfo-cuantitativa de la población mientérica. La diabetes promovió la reducción de la muscular de la mucosa y de la muscular externa con el aumento de la profundidad de las criptas y del área neuronal nuclear. El extracto promovió la hipertrofia mucosa y muscular de la mucosa. Hubo mantenimiento del espesor total de la pared, número de células caliciformes y en la población neuronal mientérica en diabetes y suplementación. Se concluye que la diabetes inducida por estreptozotocina y la suplementación con extracto de Agaricus blazei causan ajustes morfológicos en la túnica intestinal, sin interferir con la pared e inervación mientérica del colon proximal, conservando la morfofisiología absortiva y motora de este segmento.