RESUMO Racional: Há diferentes opções de tratamento para a doença de Crohn, porém, em alguns casos, há a necessidade de outras abordagens terapêuticas, como o uso de células-tronco mesenquimais derivadas do tecido adiposo. Objetivo: Revisar sistematicamente a literatura para determinar as diferentes formas de administração das células-tronco mesenquimais derivadas do tecido adiposo em seres humanos com doença de Crohn refratária luminal e fistulizante perianal. Método: Buscaram-se artigos publicados entre 2008 e 2018 nas bases de dados PubMed e ScienceDirect, pelos descritores: Crohn’s disease, fistulizing Crohns disease, luminal Crohns disease e transplantation of mesenchymal stem cells ou mesenchymal stem cell ou stromal cells. Treze artigos foram selecionados. Resultados: Somente um trabalho se referiu à doença luminal. A quantidade de células administradas foi variável, obtendo-se principalmente do tecido adiposo subcutâneo por lipoaspiração. Destacou-se o transplante autólogo com a infusão exclusiva de células-tronco mesenquimais. Os procedimentos realizados no pré-transplante foram principalmente o de curetagem, colocação de setons e suturas com fio absorvível, e de exames e tratamento medicamentoso para a doença luminal. No transplante, ocorreu a injeção das células por todo o trajeto fistuloso, principalmente nas paredes do trato. Conclusão: Embora o uso de células-tronco mesenquimais seja promissor, o transplante na região luminal deve ser mais investigado. A injeção exclusiva de células-tronco mesenquimais é mais explorada quando comparada ao tratamento conjunto com outros produtos. A forma de preparo do trato fistuloso e o local de transplante envolvem cuidados médicos padronizados na maioria dos estudos.

ABSTRACT Background: Crohn’s disease is a pathological condition that has different options of treatment, but there are patients who need other therapeutic approach, such as the use of adipose-derived mesenchymal stem cells. Aim: Systematic literature review to determine the different ways of adipose-derived mesenchymal stem cells administration in humans with luminal refractory and perianal fistulizing Crohn’s disease. Methods: It was conducted a search for articles (from 2008 to 2018) on PubMed and ScienceDirect databases using the keywords Crohn’s disease, fistulizing Crohn’s disease, luminal Crohn’s disease and transplantation of mesenchymal stem cells or mesenchymal stem cells or stromal cells. Thirteen publications were selected for analysis. Results: Only one study referred to the luminal Crohn´s disease. The number of cells administered was variable, occurring mainly through subcutaneous adipose tissue by liposuction. It could be highlighted the autologous transplant with exclusive infusion of mesenchymal stem cells. The procedures involved in pre-transplant were mainly curettage, setons placement and stitching with absorbable suture, and conducting tests and drug treatment for luminal Crohn´s disease. During transplant, the injection of mesenchymal stem cells across the fistula path during the transplant was mainly on the intestinal tract wall. Conclusion: Although the use of mesenchymal stem cells is promising, the transplant on the luminal region should be more investigated. The injection of mesenchymal stem cells, exclusively, is more explored when compared to treatment with other products. The preparation of the fistulizing tract and the location of cell transplantation involve standardized health care in most studies.

ABSTRACT The study evaluated the effects of brown flaxseed supplementation in natura on the prevention of DNA damage induced by 1,2-dimethylhydrazine (DMH) in vivo. The experimental groups were Negative and Positive Controls and the protocols of Pre-treatment, Simultaneous, Post-treatment, Pre+continuous in relation to the supplementation of brown flaxseed and administration with carcinogenic compound. The results showed that brown flaxseed supplementation does not cause genomic and genetic damage. In addition, brown flaxseed showed a chemopreventive food that reduced the damages assessed by the comet assay up to 94.07x and the damages assessed by the micronucleus assay up to 91.88x. Brown flaxseed supplementation also increased the frequency of monocytes and lymphocytes indicating immunological improvements. Thus, brown flaxseed supplementation is considered safe and reduces the frequency of DNA damage that can lead to tumors. Therefore, if these events are confirmed in humans, flaxseed will have reinforced its indication as a functional chemopreventive food in the prevention of cancer.

Resumo Foram avaliadas, sistematicamente, pesquisas que desenvolveram ações interdisciplinares em escolas, visando modificar os níveis de pressão arterial ou o consumo de sal e/ou sódio por crianças. Foram incluídos estudos disponíveis nas bases de dados PubMed, ScienceDirect e Lilacs, associando-se as palavras-chave: intervention study, nutrition intervention, school children, school health, blood pressure, sodium e salt. A busca incluiu artigos em português, inglês e espanhol dos últimos 15 anos que tiveram como participantes crianças pré-escolares ou escolares. Com relação à mudança nos níveis de pressão arterial, foram identificados sete trabalhos com resultados positivos e significativos e seis que não apresentaram alteração. Quanto à modificação na ingestão de alimentos com alto teor de sal e/ou sódio, quatro trabalhos apresentaram resultados positivos e significativos e um sem sucesso. Concluiu-se que as intervenções que utilizam educação nutricional combinadas com atividade física predominam na literatura. Sendo que estas ações demonstraramse mais efetivas quando realizadas por um período longo de tempo.

Abstract Researches that developed interdisciplinary actions in schools seeking to modify the arteial pressure levels or salt and/or sodium consumption by children were analyzed. Studies available on the PubMed, ScienceDirect and Lilacs databases, associating the keywords: intervention study, nutrition intervention, schoolchildren, school health, blood pressure, sodium and salt were included. The research included articles from the last 15 years, in Portuguese, English and Spanish, which had preschool or school children as participants. With respect to the change of the blood pressure levels, 7 studies with positive and significant results and 6 without variation were identified. In terms of modification of the ingestion of food with high salt and/or sodium content, 4 studies revealed positive and significant results, and only one was unsuccessful. The conclusions drawn are that the interventions that use nutritional education combined with physical activities prevail in the literature. However, these actions proved to be more effective when implemented over a long period of time.

Resumo Foram avaliadas, sistematicamente, pesquisas que desenvolveram ações interdisciplinares em escolas, visando modificar os níveis de pressão arterial ou o consumo de sal e/ou sódio por crianças. Foram incluídos estudos disponíveis nas bases de dados PubMed, ScienceDirect e Lilacs, associando-se as palavras-chave: intervention study, nutrition intervention, school children, school health, blood pressure, sodium e salt. A busca incluiu artigos em português, inglês e espanhol dos últimos 15 anos que tiveram como participantes crianças pré-escolares ou escolares. Com relação à mudança nos níveis de pressão arterial, foram identificados sete trabalhos com resultados positivos e significativos e seis que não apresentaram alteração. Quanto à modificação na ingestão de alimentos com alto teor de sal e/ou sódio, quatro trabalhos apresentaram resultados positivos e significativos e um sem sucesso. Concluiu-se que as intervenções que utilizam educação nutricional combinadas com atividade física predominam na literatura. Sendo que estas ações demonstraramse mais efetivas quando realizadas por um período longo de tempo.

Abstract Researches that developed interdisciplinary actions in schools seeking to modify the arteial pressure levels or salt and/or sodium consumption by children were analyzed. Studies available on the PubMed, ScienceDirect and Lilacs databases, associating the keywords: intervention study, nutrition intervention, schoolchildren, school health, blood pressure, sodium and salt were included. The research included articles from the last 15 years, in Portuguese, English and Spanish, which had preschool or school children as participants. With respect to the change of the blood pressure levels, 7 studies with positive and significant results and 6 without variation were identified. In terms of modification of the ingestion of food with high salt and/or sodium content, 4 studies revealed positive and significant results, and only one was unsuccessful. The conclusions drawn are that the interventions that use nutritional education combined with physical activities prevail in the literature. However, these actions proved to be more effective when implemented over a long period of time.