Fatores que propiciam o ganho de peso em pacientes pós cirurgia bariátrica / Factors that favor weight gain in patients after bariatric surgery

Introdução: Atualmente a cirurgia bariátrica (CB) é considerada o tratamento padrão para obesidade severa mas, apesar de apresentar como principal resultado a perda de peso, a recuperação de peso dos pacientes é significativa. Objetivo: Avaliar os possíveis fatores de influência na recidiva do ganho de peso (parcial ou total) em pacientes submetidos à cirurgia bariátrica. Revisão bibliográfica: Foi realizada uma revisão narrativa da literatura. Considerações finais: As causas subjacentes que aumentam o risco de recidiva de reganho de peso (RP) incluem fatores anatômicos, cirúrgicos, hormonais, psiquiátricos, comportamentais e atividade física. Abordar esses preditores de recuperação de peso de forma sistemática é oportuno, uma vez que são fatores modificáveis. Apesar de ainda haver muitas teorias sobre a relação de alguns preditores de RP, os dados apresentados nessa revisão narrativa são suficientes para abordar os fatores de recidiva de peso e as comorbidades geradas pela doença

AL16ALA-SOD2 polymorphism predicts recurrence risk of breast cancer in patients treated with adjuvant tamoxifen

Introduction: Approximately 30% of patients with hormone receptor-positive breast cancer show resistance to tamoxifen, which may result in local or distant recurrence. Based on previous evidence, it can be inferred that tamoxifen sensitivity is influenced by an oxidative genetic imbalance. Objective: To evaluate the association between the genotypes of SOD2 single-nucleotide polymorphisms and the risk of recurrence in patients with luminal breast cancer treated with adjuvant tamoxifen. Methods: This is a retrospective cohort study. Biopsy samples from tumors were used for Val16Ala-SNP real-time PCR genotyping. Other potential markers of apoptosis and proliferation were analyzed by immunohistochemistry. Survival was defined as follow-up of a minimum of 72 months and compared using Cox regression multivariate analysis adjusted for grade, clinical staging, and Bcl-2 and Ki67 markers. Results: 36% patients relapsed, 35% presented with histological grade 3, and 29% had clinical stage III. The frequencies of SOD2 were 35% Ala/Ala, 35% Val/Val, and 30% Ala/Val. Val-allele women tended to be more at risk for recurrence than others (RR = 2.14 (95% CI 0.84–5.47). Patients with the Val allele had a 15% reduction in relapse-free survival, whereas with Ala/Ala, this reduction was only 8%. The expression of Caspase-3 was low in patients with relapse (p = 0.008). Conclusion: This study emphasizes the importance of oxidative response in cancer cells during tamoxifen treatment. The presence of the Val allele showed a strong trend, which could be considered as a hypothesis generator