Oral nutritional supplements are widely recommended to head-and-neck cancer patients undergoing anti-cancer treatment; however, their effects on the outcomes of most importance to patients are unclear. This study aimed to systematically review the evidence of effect of oral nutritional supplements on mortality, treatment tolerance, quality of life, functional status, body weight and adverse effects. We searched PubMed, Embase, CENTRAL, LILACS, Web of Science, CINAHL, two trial registry platforms, three sources of grey literature and reference lists of included studies. We assessed the risk of bias using the revised Cochrane risk-of-bias tool (RoB 2), and certainty of evidence using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach. We used random-effects models with Hartung–Knapp correction for the meta-analyses. We included fifteen trials, of which five were ongoing or unpublished, providing evidence in four comparisons. We found very low to low certainty evidence for the effect of oral nutritional supplements on mortality, treatment tolerance, quality of life, functional status and adverse effects. When compared with nutritional counselling alone, nutritional counselling plus oral nutritional supplements probably increased body weight slightly. We also found adverse events relating to supplements use such as nausea, vomiting and feeling of fullness. Possible increases in mortality, treatment tolerance and quality of life besides a possible decrease in functional status are worthy of further investigation. Future research could attempt to address the clinical importance of a probable increase in body weight. Possible adverse effects of the use of oral nutritional supplements should not be overlooked.

Context: Biochemical markers correlate positively with the development and severity of obesity, depression, and anxiety, and can be modulated by changes in intestinal microbiota composition.Objective: A systematic review and meta-analysis was conducted to determine the effects of prebiotics or synbiotics on blood biomarkers of obesity, depression, and anxiety (including: ACTH [adrenocorticotropic hormone], cortisol, leptin, ghrelin, TSH [thyroid-stimulating hormone], PTH [parathyroid hormone], vitamin D, BDNF [brain-derived neurotrophic factor], and PCR [polymerase chain reaction]) in individuals with overweight or obesity.Data Sources: MEDLINE, Web of Science, Scopus, and CENTRAL databases were searched, along with the reference lists of included articles. Authors were contacted for unpublished data.Study Selection: RCT in individuals with overweight or obesity, supplemented with prebiotics or synbiotics, assessing any of the outcomes of interest.Data Extraction: Data were extracted independently by three researchers.Results: Thirteen studies were identified up to March 7, 2018. Regarding outcomes, 1 study assessed leptin, 4 studies assessed ghrelin, and 10 studies assessed CRP (C-reactive protein). Meta-analysis showed reduction in serum concentrations of ghrelin (−37.17 pg/mL; 95%CI = −69.62, −4.73; P = 0.025) and CRP (SMD [standardized mean difference] = −0.31; 95%CI = −0.58, −0.04; P = 0.027) after supplementation of inulin-type fructans.Conclusions: Prebiotics may help regulate blood concentrations of ghrelin and CRP in overweight or obese individuals.

Resumo: Objetivo: conhecer a experiência dos familiares no convívio de crianças com TEA. Metodologia: pesquisa qualitativa, realizada através de Grupo Focal com familiares de oito crianças com diagnóstico de TEA. A coleta de dados ocorreu no mês de setembro de 2016, através de questões norteadoras discutidas no grupo. Os relatos foram gravados em áudios e transcrito pelos autores. A análise foi realizada a partir da Análise de Conteúdo. Resultados: A partir da análise dos dados surgiram três categorias: ‘a descoberta do autismo’; ‘experiências dos familiares após o diagnóstico de autismo’ e ‘atendimento em saúde da criança com autismo’. Conclusão: o autismo é um transtorno que causa muitas adaptações e mudanças na vida dos familiares envolvidos, surgindo a necessidade do apoio dos profissionais de saúde no suporte dos cuidados prestado a estas crianças.Descritores: Autismo; Relações Familiares; Acontecimentos que Mudam a Vida; Enfermagem.THE EXPERIENCE OF FAMILIARS IN THE COEXISTENCE OF CHILDREN WITH AUTISTIC SPECTRUM DISORDER (ASD) Objective: to know the experience of family members living with children with ASD. Methodology: qualitative research, carried out through a Focal Group with relatives of eight children diagnosed with ASD. Data collection occurred in September 2016, through guiding questions discussed in the group. The reports were recorded in audios and transcribed by the authors. The analysis was made from the Content Analysis. Results: From the analysis of the data emerged three categories: ‘the discovery of autism’; ‘Family experiences after the diagnosis of autism’ and ‘health care of the child with autism’. Conclusion: autism is a disorder that causes many adaptations and changes in the lives of the family members involved, resulting in the need of the support of the health professionals in the support of the care provided to these children.Descriptors: Autism; Family Relations; Life Changing Events; Nursing.LA EXPERIENCIA DE LOS FAMILIARES EN LA CONVIVENCIA DE NIÑOS CON TRANSTORNO DEL ESPECTRO AUTISTA (TEA)Resumen: Objetivo: conocer la experiencia de los familiares en la convivencia de niños con TEA. Metodología: investigación cualitativa, realizada a través de Grupo Focal con familiares de ocho niños con diagnóstico de TEA. La recolección de datos ocurrió en el mes de septiembre de 2016, a través de cuestiones orientadoras discutidas en el grupo. Los relatos fueron grabados en audios y transcrito por los autores. El análisis fue realizado a partir de la Análisis de Contenido. Resultados: A partir del análisis de los datos surgieron tres categorías: ‘el descubrimiento del autismo’; “Experiencias de los familiares después del diagnóstico de autismo” y “atención en salud del niño con autismo”. Conclusión: el autismo es un trastorno que causa muchas adaptaciones y cambios en la vida de los familiares involucrados, surgiendo a la necesidad del apoyo de los profesionales de salud en el soporte de los cuidados prestados a estos niños.Descriptores: Autismo; Relaciones Familiares; Acontecimientos que cambian la vida; Enfermería.

The development of leukemia and lymphomas is related to the increase in inflammatory process modulators. These, in turn, have divergent actions on the neoplastic process. Populations of T cells have different roles in the neoplastic environment; while interferon-gamma positive T cells have antitumor activity, the FoxP3+interleukin-10 positive population present a pro-tumor activity. Simultaneously, the inflammatory process promotes the mobilization of fatty acids from the cell membrane to produce lipid mediators, which also participate of the inflammatory response. Eicosapentaenoic (EPA) and docosahexaenoic (DHA) omega-3 fatty acids, when incorporated in the plasmatic membrane, decrease the arachidonic acid (AA) metabolism and the production of eicosanoids derived from it. Thus, an alternative family of lipid mediators are produced that are often less inflammatory than those produced from arachidonic acid. Fatty acids can also influence the production of peptide mediators such as cytokines, and the expression of transcription factors, which can determine the production patterns of eicosanoids and cytokines as well as cell differentiation. Due to these properties, the objective of this literature review was to investigate studies published over the last 15 years on the effects of using omega-3 fatty acids on inflammatory markers in leukemia and lymphomas.

Hematological malignancies present abnormal blood cells that may have altered functions. This study aimed to evaluate nutritional status, acute phase proteins, parameters of cell's functionality, and oxidative stress of patients with hematological malignancies, providing a representation of these variables at diagnosis, comparisons between leukemias and lymphomas and establishing correlations. Nutritional status, C-reactive protein (CRP), albumin, phagocytic capacity and superoxide anion production of mononuclear cells, lipid peroxidation and catalase activity in plasma were evaluated in 16 untreated subjects. Main diagnosis was acute leukemia (n = 9) and median body mass index (BMI) indicated overweight (25.6 kg/m(2)). Median albumin was below (3.2 g/dL) and CRP above (37.45 mg/L) the reference values. Albumin was inversely correlated with BMI (r = -0.53). Most patients were overweight before the beginning of treatment and had a high CRP/albumin ratio, which may indicate a nutrition inflammatory risk. BMI values correlated positively with lipid peroxidation and catalase activity. A strong correlation between catalase activity and lipid peroxidation was found (r = 0.75). Besides the elevated BMI, these patients also have elevated CRP values and unexpected relations between nutritional status and albumin, reinforcing the need for nutritional counseling during the course of chemotherapy, especially considering the correlations between oxidative stress parameters and nutritional status evidenced here.