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(1) Background: There are conflicting results on whether weight loss after bariatric surgery (BS) might be associated with quality of life (QoL)/depressive symptomatology. We aim to determine whether BS outcomes are associated with QoL/depressive symptomatology in studied patients at the 8-year follow-up after BS, as well as their relationship with different serum proteins and miRNAs. (2) Methods: A total of 53 patients with class III obesity who underwent BS, and then classified into "good responders" and "non-responders" depending on the percentage of excess weight lost (%EWL) 8 years after BS (%EWL ≥ 50% and %EWL < 50%, respectively), were included. Basal serum miRNAs and different proteins were analysed, and patients completed tests to evaluate QoL/depressive symptomatology at 8 years after BS. (3) Results: The good responders group showed higher scores on SF-36 scales of physical functioning, role functioning-physical, role functioning-emotional, body pain and global general health compared with the non-responders. The expression of hsa-miR-101-3p, hsa-miR-15a-5p, hsa-miR-29c-3p, hsa-miR-144-3p and hsa-miR-19b-3p were lower in non-responders. Hsa-miR-19b-3p was the variable associated with the response to BS in a logistic regression model. (4) Conclusions: The mental health of patients after BS is limited by the success of the intervention. In addition, the expression of basal serum miRNAs related to depression/anxiety could predict the success of BS.

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BACKGROUND: The aim of this study was to study the process of intestinal adaptation in the three limbs of the small intestine after malabsorptive bariatric surgery: the biliopancreatic limb, the alimentary limb, and the common channel. These limbs are exposed to different stimuli, namely, gastrointestinal transit and nutrients in the alimentary limb, biliopancreatic secretions in the biliopancreatic limb, and a mix of both in the common channel. We also wished to investigate the effect of glutamine supplementation on the adaptation process. METHODS: Three types of surgery were performed using a porcine model: biliopancreatic bypass (BPBP), massive (75%) short bowel resection as the positive control, and a sham operation (transection) as the negative control. We measured the height and width of intestinal villi, histidine decarboxylase (HDC) activity, and amount of HDC messenger RNA (mRNA) (standard diet or a diet supplemented with glutamine). RESULTS: An increase in HDC activity and mRNA expression was observed in the BPBP group. This increase coincided with an increase in the height and width of the intestinal villi. The increase in villus height was observed immediately after surgery and peaked at 2 weeks. Levels remained higher than those observed in sham-operated pigs for a further 4 weeks. CONCLUSIONS: The intestinal adaptation process in animals that underwent BPBP was less intense than in those that underwent massive short bowel resection and more intense than in those that underwent transection only. Supplementation with glutamine did not improve any of the parameters studied, although it did appear to accelerate the adaptive process.

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OBJECTIVES: Although prostate cancer is probably the most frequent cancer in men, little is known about its etiology. Clear evidence exists about variations in the incidence of prostate cancer between populations living in different countries. These variations could be explained by differences in lifestyle and a possible association with a set of substances that are able to intervene in the origin of the disease. METHODS: The reason that lifestyle may be the cause of prostate cancer is related to endocrine disruptors. These are a group of chemical substances that can mimic or alter hormone signaling. These disruptors are able to exert their effect at very low doses and act insidiously over the years, even being able to pass their effect on from one generation to the next. Cholesterol is an essential precursor in the synthesis of androgens, estrogens and other substances that are active in prostate cancer. Cholesterol is a central metabolite in lipid metabolism, the inflammatory response and other elements involved in the formation and progression of cancer. High cholesterol concentrations can give rise to the accumulation of androgens in tumor cells. Additionally, endocrine disruptors have been identified as being responsible for processes related with fertility, genital malformations and various hormonedependent cancers. Disruptors already identified include diethylstilbestrol, dichlorodiphenyltrichloroethane (DDT), polychlorinated biphenyls and dioxins. RESULTS: Though no clear direct association has yet been found in humans between most endocrine disruptors and prostate cancer, evidence suggests that an inadequate diet and contact with certain toxic agents predisposes to the disease. These disruptors are known to be especially relevant at particular times, such as during pregnancy, neonatal stages and puberty. CONCLUSIONS: The problem with these toxic agents is that their peculiarities and way of acting over time make their study difficult. Nonetheless, research must be encouraged given their importance.

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OBJETIVOS: Aunque el cáncer de próstata es, probablemente, el cáncer más frecuente en el varón, se conoce poco acerca de su etiología. Existen claras variaciones en la incidencia de cáncer de próstata entre las poblaciones de distintos países. Estas variaciones podrían explicarse por las diferencias en el estilo de vida y por una posible asociación con un conjunto de sustancias capaces de intervenir en el origen de la enfermedad. MÉTODOS: La razón por la que el estilo de vida puede ser causa del cáncer de próstata está relacionada con los disruptores endocrinos. Éstos son un grupo de sustancias químicas que pueden imitar o alterar la señalización hormonal. Dichos disruptores son capaces de ejercer su efecto a dosis muy bajas y actúan insidiosamente a lo largo de los años, incluso pudiendo trasmitir su efecto de una generación a la siguiente. El colesterol es un precursor esencial en la síntesis de andrógenos, estrógenos y otras sustancias activas en el cáncer de próstata. El colesterol es un elemento central en el metabolismo de los lípidos, la respuesta inflamatoria y otros elementos implicados en la formación y progresión del cáncer. Concentraciones altas de colesterol pueden dar lugar a la acumulación de andrógenos en las células tumorales. Además, los disruptores endocrinos han sido identificados como responsables de procesos relacionados con la fertilidad, malformaciones genitales y varios cánceres hormonodependientes. Los disruptores ya identificados incluyen dietilestilbestrol, diclorodifeniltricloroetano (DDT), bifenilos policlorados y dioxinas. RESULTADOS: Aunque aún no se ha encontrado en humanos una asociación directa y clara entre la mayoría de los disruptores endocrinos y el cáncer de próstata, la evidencia sugiere que una dieta inadecuada y el contacto con ciertos agentes tóxicos predisponen a la enfermedad. Se sabe que estos disruptores son especialmente relevantes en determinados momentos de la vida, como durante el embarazo, las etapas neonatales y la pubertad. CONCLUSIONES: El problema con estos agentes tóxicos es que sus peculiaridades y el modo de actuar en el tiempo dificultan su estudio. Sin embargo, dada su importancia, debería fomentarse su investigación

OBJECTIVES: Although prostate cancer is probably the most frequent cancer in men, little is known about its etiology. Clear evidence exists about variations in the incidence of prostate cancer between populations living in different countries. These variations could be explained by differences in lifestyle and a possible association with a set of substances that are able to intervene in the origin of the disease. METHODS: The reason that lifestyle may be the cause of prostate cancer is related to endocrine disruptors. These are a group of chemical substances that can mimic or alter hormone signaling. These disruptors are able to exert their effect at very low doses and act insidiously over the years, even being able to pass their effect on from one generation to the next. Cholesterol is an essential precursor in the synthesis of androgens, estrogens and other substances that are active in prostate cancer. Cholesterol is a central metabolite in lipid metabolism, the inflammatory response and other elements involved in the formation and progression of cancer. High cholesterol concentrations can give rise to the accumulation of androgens in tumor cells. Additionally, endocrine disruptors have been identified as being responsible for processes related with fertility, genital malformations and various hormonedependent cancers. Disruptors already identified include diethylstilbestrol, dichlorodiphenyltrichloroethane (DDT), polychlorinated biphenyls and dioxins. RESULTS: Though no clear direct association has yet been found in humans between most endocrine disruptors and prostate cancer, evidence suggests that an inadequate diet and contact with certain toxic agents predisposes to the disease. These disruptors are known to be especially relevant at particular times, such as during pregnancy, neonatal stages and puberty. CONCLUSIONS: The problem with these toxic agents is that their peculiarities and way of acting over time make their study difficult. Nonetheless, research must be encouraged given their importance

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AIM: To analyze the attitude of Spanish medical students toward living liver donation (LLD) and to establish which factors have an influence on this attitude. STUDY TYPE: A sociological, interdisciplinary, multicenter and observational study. STUDY POPULATION: Medical students enrolled in Spain (n = 34000) in the university academic year 2010-2011. SAMPLE SIZE: A sample of 9598 students stratified by geographical area and academic year. Instrument used to measure attitude: A validated questionnaire (PCID-DVH RIOS) was self-administered and completed anonymously. Data collection procedure: Randomly selected medical schools. The questionnaire was applied to each academic year at compulsory sessions. STATISTICAL ANALYSIS: Student´s t test, χ(2) test and logistic regression analysis. RESULTS: The completion rate was 95.7% (n = 9275). 89% (n = 8258) were in favor of related LLD, and 32% (n = 2937) supported unrelated LLD. The following variables were associated with having a more favorable attitude: (1) age (P = 0.008); (2) sex (P < 0.001); (3) academic year (P < 0.001); (4) geographical area (P = 0.013); (5) believing in the possibility of needing a transplant oneself in the future (P < 0.001); (6) attitude toward deceased donation (P < 0.001); (7) attitude toward living kidney donation (P < 0.001); (8) acceptance of a donated liver segment from a family member if one were needed (P < 0.001); (9) having discussed the subject with one's family (P < 0.001) and friends (P < 0.001); (10) a partner's opinion about the subject (P < 0.001); (11) carrying out activities of an altruistic nature; and (12) fear of the possible mutilation of the body after donation (P < 0.001). CONCLUSION: Spanish medical students have a favorable attitude toward LLD.

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PURPOSES: To evaluate in an animal model the feasibility of a novel concept of hand-assisted surgery consisting of inserting two hands into the abdomen instead of one. The chosen procedure was retroperitoneal lymph node dissection (L-RPLND) that was performed in five pigs. SURGICAL TECHNIQUE: A Pfannestiel and a transverse epigastric incisions were made through which both hands were introduced. The scope was inserted through the umbilicus. The colon was moved medially and the dissection was performed as in open surgery using short conventional surgical instruments. COMMENTS: The surgery was fulfilled easily and safely in quite a similar way as in open surgery. Two-handed laparoscopy may be indicated in cases that still today require an open approach as apparently makes the operation easier and significantly shortens the surgery time. However, new opinions and trials are required.

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Purposes To evaluate in an animal model the feasibility of a novel concept of hand-assisted surgery consisting of inserting two hands into the abdomen instead of one. The chosen procedure was retroperitoneal lymph node dissection (L-RPLND) that was performed in five pigs. Surgical Technique A Pfannestiel and a transverse epigastric incisions were made through which both hands were introduced. The scope was inserted through the umbilicus. The colon was moved medially and the dissection was performed as in open surgery using short conventional surgical instruments. Comments The surgery was fulfilled easily and safely in quite a similar way as in open surgery. Two-handed laparoscopy may be indicated in cases that still today require an open approach as apparently makes the operation easier and significantly shortens the surgery time. However, new opinions and trials are required. .

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