Impacto da suplementação de ácidos graxos ômega-3 nos transtornos do espectro autista: revisão sistemática baseada em ensaios clínicos randomizados e controlados / Impact of omega-3 fatty acids supplementation on autism spectrum disorders: systematic review based on randomized controlled clinical trials

Os transtornos do espectro autista (TEAs) são disfunções do desenvolvimento neurológico associadas à alteração de diversos sintomas comportamentais, nos quais se destacam a redução de interações sociais e a execução de atividades repetitivas. Atualmente, o tratamento farmacológico é limitado e parece contribuir para o desenvolvimento de morbidades cardiovasculares. Associado a esse perfil, o restrito e seletivo padrão alimentar, promove o desenvolvimento de diversas deficiências nutricionais, entre as quais, os ácidos graxos essenciais como o ômega-3 (ω-3). Nesta revisão sistemática, baseada em estudos randomizados e controlados, foram selecionados estudos realizados nos últimos 10 anos. Os resultados mostram que a heterogeneidade das populações estudadas com grande variação na dose e tipo de ω-3 administrados em tempos distintos de seguimento dificultam a avaliação precisa da eficácia da intervenção baseada no uso de ω-3. Desta forma, o uso de ω-3 como terapia adjuvante no tratamento de TEA não deve ser recomendado rotineiramente na prática clínica, apesar de sua essencialidade para o adequado desenvolvimento neurológico

Autism spectrum disorders (ASDs) are neurodevelopmental dysfunctions associated with a number of altered behavioral symptoms, including reduced social interactions and the performance of repetitive activities. Pharmacological treatment is currently limited, and appears to contribute to the development of cardiovascular morbidity. Associated with this profile, a restricted and selective dietary pattern promotes the development of several nutritional deficiencies, including essential fatty acids, such as omega-3 (ω-3). In this systematic review, based on randomized controlled trials, studies performed in the last 10 years were selected. The results show that the heterogeneity of the populations studied, with wide variation in the dose and type of ω-3 administered at different times during follow-up, hinder more precise assessment of the effectiveness of the intervention based on the use of ω-3. Thus, the use of ω-3 as adjuvant therapy in the treatment of ASDs should not be routinely recommended in clinical practice, even though it is essential for proper neurological development

Quality indicators for enteral and parenteral nutrition therapy: application in critically ill patients "at nutritional risk".

INTRODUCTION: Quality Indicators for Nutritional Therapy (QINT) allow a practical assessment of nutritional therapy (NT) quality. OBJECTIVE: To apply and monitor QINT for critically ill patients at nutritional risk. METHODS: Cross sectional study including critically ill patients > 18 years old, at nutritional risk, on exclusive enteral (ENT) or parenteral nutritional therapy (PNT) for > 72 hours. After three consecutive years, 9 QINT were applied and monitored. Statistical analysis was performed with SPSS version 17.0. RESULTS: A total of 145 patients were included, 93 patients were receiving ENT, among then 65% were male and the mean age was 55.7 years (± 17.4); 52 patients were receiving PNT, 67% were male and the mean age was 58.1 years (± 17.4). All patients (ENT and PNT) were nutritionally screened at admission and their energy and protein needs were individually estimated. Only ENT was early initiated, more than 70% of the prescribed ENT volume was infused and there was a reduced withdrawal of enteral feeding tube. The frequency of diarrhea episodes and digestive fasting were not adequate in ENT patients. The proper supply of energy was contemplated only for PNT patients and there was an expressive rate of oral intake recovery in ENT patients. CONCLUSION: After three years of research, the percentage of QINT adequacy varied between 55%-77% for ENT and 60%-80% for PNT. The results were only made possible by the efforts of a multidisciplinary team and the continuous re-evaluation of the procedures in order to maintain the nutritional assistance for patients at nutritional risk.