Effects of whole-body vibration on body composition, microbiota, cardiometabolic markers, physical fitness, and quality of life after bariatric surgery: protocol for a randomized controlled trial.

BACKGROUND: Morbid obesity is a complex chronic condition characterized by a body mass index of 40 kg/m2 or higher. The incidence of the condition is on the rise in developed countries, and bariatric surgery has been proposed as a potential solution to address this trend. Nonetheless, bariatric surgery may also result in adverse effects, including a reduction in bone mineral density (BMD) and muscle mass, as well as an increased risk of fractures. The present study aims to elucidate the effects of bariatric surgery and whole-body vibration (WBV) training on body composition, microbiota, physical fitness, quality of life, and cardiometabolic markers. METHODS: Twenty-eight participants (14 females), aged 18 to 50 years, will undergo sleeve gastrectomy surgery. They will be randomly allocated into a control group or a WBV training group. The WBV group will train three times per week with increasing intensities and duration ranging from 30 to 45 min over the 4-month training period. Measurements of body composition (dual-energy X-ray absorptiometry and peripheral quantitative computed tomography), physical fitness (muscular strength, agility, cardiorespiratory fitness, and balance), gait biomechanics, cardiometabolic markers, gut microbiota, quality of life, and physical activity levels will be collected at four different time points: (1) prior to the surgery, (2) 45 days post-surgery, (3) 6 months post-surgery, and (4) 18 months post-surgery. DISCUSSION: Both groups are expected to experience improvements in most of the aforementioned variables. Nonetheless, we expect the WBV group to show larger improvements proving that the training is effective and safe. TRIAL REGISTRATION: Clinicaltrials.gov NCT05695599. Registered on January 25, 2023.

Hepatocarcinoma sobre hígado ectópico peritoneal / Ectopic hepatocellular carcinoma arising from the peritoneum

El hepatocarcinoma (HCC) sobre hígado ectópico es una entidad rara. La mayoría de los casos son asintomáticos y se descubren de manera casual en una autopsia o laparoscopia. En ocasiones producen clínica como dolor abdominal o hemorragia intraabdominal. Se realiza revisión de la literatura y se presenta el caso de una mujer de 68 años diagnosticada de hepatocarcinoma sobre hígado ectópico peritoneal a raíz de un estudio por hipertransaminasemia leve asintomática

Ectopic hepatocellular carcinoma is a rare entity. Most cases are asymptomatic and are occasionally found during autopsy or laparoscopy. They may sometimes cause relevant clinical problems such as abdominal pain or intra-abdominal bleeding. In this clinical case report, we review the literature in order to decipher the case of a 68-year-old female with an ectopic hepatocellular carcinoma that arose from the peritoneum. The patient was diagnosed after being studied due to a mild asymptomatic hypertransaminasemia

Ectopic hepatocellular carcinoma arising from the peritoneum.

Ectopic hepatocellular carcinoma is a rare entity. Most cases are asymptomatic and are occasionally found during autopsy or laparoscopy. They may sometimes cause relevant clinical problems such as abdominal pain or intra-abdominal bleeding. In this clinical case report, we review the literature in order to decipher the case of a 68-year-old female with an ectopic hepatocellular carcinoma that arose from the peritoneum. The patient was diagnosed after being studied due to a mild asymptomatic hypertransaminasemia.

Abdomen agudo en paciente anciano / Acute abdomen in an elderly patient

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Factores ecográficos predictivos de invasión linfática en el cáncer de recto. Estudio “ex-corpore” / Predictive ultrasound factors of lymphatic invasion in rectal cancer: "extra-corporeal" study

Objetivo: la eficacia en la valoración preoperatoria mediante ecografía endorrectal de los ganglios linfáticos se sitúa en torno al 50-70%, no existiendo unos patrones eco-morfológicos de amplio uso clínico. En este estudio valoramos los parámetros morfológicos conocidos para buscar una herramienta de ayuda clínica que mejore la precisión diagnóstica en la valoración de los ganglios linfáticos del mesorrecto. Material y método: las piezas quirúrgicas de 24 pacientes sometidos a cirugía radical por cáncer de recto sin radioterapia previa fueron sumergidas en un baño de agua caliente inmediatamente después de la cirugía y estudiadas mediante ecografía endoluminal (sonda circular de 360° y transductor de 10 Mhz). Se tomaron imágenes de todos los ganglios visualizados que fueron marcados adecuadamente para su estudio anatomopatológico. Resultados: el estudio “in vitro” de las 24 piezas de resección llevó a la identificación de 318 nódulos (218 no neoplásicos y 100 neoplásicos). Todas las variables ecográficas estudiadas se mostraron significativas, pero solo la lobulación, la ecogenicidad y la reflexión hiliar lo fueron independientes. Usando el sumatorio de todos los parámetros morfológicos se diseñó un sistema de puntuación con una sensibilidad del 98% y una especificidad del 99,1%. Conclusiones: el análisis pormenorizado de las imágenes ganglionares ecográficas puede conseguir una eficacia diagnóstica muy elevada y ayudar en la selección del tratamiento más adecuado para cada paciente (AU)

Objective: the accuracy of preoperative endorectal ultrasound in the status evaluation of lymph nodes is around 50-70%, with a lack of eco-morphological patterns of clinical use. Since, accurate local staging is of great value in prognosis and decision-making we decided to analyze the referenced eco-morphological parameters in a try to find a proper predictive tool of clinical help that could improve the accuracy of rectal ultrasound. Material and method: the resected specimens of 24 patients that were operated on by radical surgery because rectal cancer, without preoperative radiotherapy were suspended in warm water and ultrasound scanned (360° circular probe with a transducer of 10 Mhz). All souspicious nodes were recorded and marked for the definitive histological report. Results: from the 24 specimens, 318 nodes were imaged (210 benign and 100 involved). All ultrasound parametes analysed were significant but only lobulation, echogenicity and hilar reflection were independent values. An score system was design with the addition of all parameters that showed a sensitivity of 98% and specificity of 99,1%. Conclusions: our study shows that a careful study of ultrasound lymph node images can get a high level of accuracy and better help in tailoring the treatment of any particular case (AU)