Objective: Evaluating the prevalence of sarcopenia in women submitted to bariatric surgery -Rouxen-Y gastric bypass. Design: Observational, cross-sectional study. Subjects and methods: Women (18-65 years old) who underwent bariatric surgery (BG) ≥ 2 years and reached stable weight ≥ 6 months, were investigated. Control group (CG) comprised non-operated matched women with obesity. Body composition was determined through dual-energy X-ray absorptiometry. Low lean mass (LLM) was defined as appendicular lean mass index (ALM kg/height m²) < 5.5 kg/m². Physical strength was assessed through dynamometer and sit-to-stand test (SST), whereas performance was assessed through 4-m gait speed and Short Physical Performance Battery Tests (SPPB). Sarcopenia was diagnosed in the presence of LLM and low strength. Results: One-hundred and twenty women (60 in each group, 50 ± 9.7 years old) were investigated. All anthropometric and body composition parameters were lower in BG than in CG, whereas strength and performance were similar between groups. Women with reduced strength presented high total fat mass and low physical activity level (p < 0.005). LLM was observed in 35% of BG and in 18.3% of CG (p = 0.04), whereas sarcopenia was diagnosed in 28.3% of BG and in 16.6% of CG (p = 0.12). Sarcopenic women in BG had better performance both in SST (p = 0.001) and SPPB (p = 0.004). Total lean mass (OR:1.41, 95% CI [1.18; 1.69], p < 0.001) and obesity (OR: 38.2 [2.27; 644.12], p < 0.001) were associated with sarcopenia in the multivariate analysis. Conclusion: Despite great weight loss, sarcopenia prevalence did not increase in BG and its presence was influenced by total lean mass and obesity.
Introdução: O melanoma e a principal causa de morte entre as neoplasias malignas cutâneas primarias. Sua incidência mundial vem aumentando progressivamente, entretanto, existem escassas informações epidemiológicas nacionais. Objetivo: Analisar os perfis epidemiológico e histopatológico de melanomas cutâneos diagnosticados em hospital universitário nos últimos 16 anos. Método: Serie histórica de casos de melanoma cutâneo realizada por meio da revisão de prontuários e laudos histopatológicos de 2001 a 2016. Resultados: A frequência manteve-se com média de 2,99 melanomas por mil novos atendimentos ambulatoriais. A casuística foi de 224 melanomas cutâneos em 211 pacientes, brancos (98,6%), mulheres (55,9%), com idade média de 57,3 anos. O tempo médio entre o aparecimento da lesão (desde surgimento da lesão ou desde que a lesão começou a se modificar, relatado pelo paciente) e o diagnóstico foi 4,8 anos. O tamanho predominante foi de 0,5 a 2 cm, acometendo principalmente a região cefálica em indivíduos maiores de 60 anos e troncular naqueles menores de 60 anos. “Outros melanomas” (34,8%) e melanoma extensivo superficial (31,7%) foram os subtipos mais frequentes. A maioria dos casos apresentou índice de Breslow ≤1mm (70%). Os subtipos mais finos (≤1 mm) foram extensivo superficial e lentigo maligno. Melanomas nodulares possuíam Breslow intermediário (1 a 4 mm) ou espesso (≥4 mm) com altas taxas de disseminação e metástase linfonodal. Conclusão: A frequência manteve-se estável. Houve prevalência em população maior de 60 anos. Os subtipos mais frequentes foram “outros melanomas” e extensivo superficial com localização cefálica e troncular em sua maioria.
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