RESUMO
ABSTRACT This study analyzed the profile of scientific production related to the nutritional aspects of the etiology and/or progress of Multiple Sclerosis (MS). We conducted an integrative review that analyzed 64 works published in English, Spanish or Portuguese between 2012 and 2017 on the relationship between nutrition and MS. There was a predominance of studies in humans (54.0%, n= 34) and randomized clinical trials (38.3%, n= 13). The association between vitamin D and etiology progression and/or development of disabilities resulting from MS was the most studied aspect (30.2%, n= 19), followed by studies that evaluated the importance of fat concentration and/or types for MS risk (22.2%, n= 14), and research that analyzed the role of antioxidant vitamins (19.0%; n= 12) in the disease development and/ or evolution. The study showed that most research involves small samples and that a healthy diet contributes to the prevention and mitigation of disease evolution. However, this affirmation cannot be made with regards to dietary supplements. Further research is necessary, from cross-sectional studies to randomized clinical trials considering the wide knowledge gap on this subject.
RESUMEN El presente estudio buscó plantear el perfil de las producciones científicas que relacionan aspectos nutricionales con la etiología y/o progresión de la Esclerosis Múltiple (EM). Fue una revisión integrativa que analizó 63 trabajos publicados en el idioma inglés, español y portugués, entre 2012 a 2017, sobre la relación entre los aspectos nutricionales y la EM. Predominaron estudios con seres humanos (54,0%, n= 34), del tipo ensayo clínico randomizado (38,3%, n= 13). La asociación de la vitamina D con la etiología, progresión y/o desarrollo de incapacidades consecuentes de la EM fue la más estudiada (30,2%, n= 19), seguida de los estudios que evaluaron la importancia de la concentración y/o de los tipos de gordura para el riesgo o progresión de la EM (22,2%, n= 14), y de estudios que analizaron el papel de las vitaminas antioxidantes (19,0%; n= 12) en el desencadenamiento y/o evolución de la enfermedad. La mayoría de los estudios incluyó muestras pequeñas y una dieta saludable que aporta con la prevención y atenuación de la evolución de la enfermedad. No se pueó hacer esta afirmación para los suplementos dietéticos. Son necesarios más estudios, dada la enorme laguna de conocimiento que envuelve el tema.
Assuntos
Humanos , Nutrientes , Progressão da Doença , Esclerose Múltipla/etiologia , Literatura de Revisão como AssuntoRESUMO
A retrospective chart review was performed on patients diagnosed as having myasthenia gravis in Ceará State, Brazil and who were followed from October 1981 to June 2009. Clinical and epidemiologic aspects were evaluated. In this work, 122 patients were studied, of whom 85 (69.7 percent) were females and 37 (30.3 percent) were males. The disease duration ranged from five months to 50 years (8.9±8.1 years). Age at the first symptoms varied from 0 to 74 years (31.9±14.4 years). The first main symptoms and signs were ptosis, diplopia and limb weakness. Generalized myasthenia was the most common clinical presentation, but 5.1 percent (n=6) persisted as ocular myasthenia. Thymectomy was performed in 42.6 percent (n=52) of myasthenic patients. A thymoma was present in 10 patients. Serum acetylcholine receptor (AChR) antibodies were present in 80 percent (n=20) of specimens tested. The data presented are similar to those of studies performed in other countries.
Foram analisados, retrospectivamente, os prontuários de pacientes miastênicos, diagnosticados e seguidos entre outubro de 1981 e junho de 2009 no Estado do Ceará, Brasil. Foram coletados dados clínicos e epidemiológicos. Na casuística foram estudados 122 pacientes: 85 (69,7 por cento) do sexo feminino e 37 (30,3 por cento) do sexo masculino. O tempo de doença variou de 5 meses a 50 anos (8,9±8,1 anos). A idade de inicio da doença variou de 0 a 74 anos (31,9±14,4 anos). Na amostra estudada, os primeiros sintomas foram principalmente ptose, diplopia e fraqueza dos membros. A maioria dos pacientes apresentou a forma generalizada, enquanto 5,1 por cento (n= 6) persistiram com miastenia ocular. Timectomia foi realizada em 42,6 por cento (n=52) dos pacientes. Timoma estava presente em 10 pacientes. Anticorpo anti-receptor de acetilcolina foi positivo em 80 por cento (n=20) das amostras testadas. Os aspectos clínicos e epidemiológicos da amostra estudada têm semelhança com aqueles estudados em outros países.