Estudio para determinar si existe diferencia significativa entre los parámetros metábólicos de esteatosis hepática no alcohólica en pacientes con diabetes tipo 2 de reciente diagnóstico controlados y no controlados. Se realizó un estudio retrospectivo de tipo caso control, realizado en el Hospital Guillermo Almenara Irigoyen, Lima – Perú, durante los meses de noviembre de 2014 a febrero de 2015. Constó de 231 pacientes: 147 pacientes con Diabetes Mellitus tipo 2 (DM2) de diagnóstico reciente con mal control glicémico y esteatosis hepática no alcohólica (EHNA), y 84 pacientes con DM2 de diagnóstico reciente con adecuado control y EHNA. Se considera importante en pacientes diabéticos de reciente diagnóstico establecer precozmente la presencia de EHNA y a partir de ello incidir en un control más estricto de los niveles de glicemia y de los demás parámetros metabólicos,...

Post-gastric bypass hypoglycemia is characterized by postprandial hypoglycemia with pancreatic islet-cell hypertrophy in patients who have undergone a bariatric surgery and may be prone to hypoglycemia due to NAFLD, obesity, and impaired insulin and glucagon secretion.We present the case of a 44-year-old obese woman with NAFLD who underwent a Roux-en-Y gastric bypass and years later presented with severe hypoglycemia. She was diagnosed with endogenous hyperinsulinemic hypoglycemia and beta-cell hyperplasia.Post-gastric bypass hypoglycemia is a scenario that will be faced more often; therefore, it is important to take it into account for a timely treatment.

Objective: To determine the effectiveness of vitamin E in nonalcoholic fatty liver disease (NAFLD) among type 2 diabetes patients without advanced fibrosis.Materials and methods: A quasi-experimental analytical study consisting of two groups: an experimental one, which received vitamin E 400 IU in addition to the standard treatment, and a control group, which received only the standard treatment. The study included 71 patients in each group. Both groups underwent liver fibrosis scoring, liver ultrasound and glutamate pyruvate transaminase measurement at study baseline and after six months. Moreover, the Wilcoxon test was used to compare the concentrations of fibrosis score and glutamate pyruvate transaminase values within the same group, and the Mann-Whitney U test was used to evaluate the differences between the experimental and control groups. The Wilcoxon test was also used to compare...

Nonalcoholic fatty liver disease (NAFLD) is caused by a build-up of triglyceride macrovesicles in the liver not related toother etiologies such as alcoholism, medications or genetic disorders. The spectrum of this condition includes nonalcoholic steatohepatitis (NASH) and simple fatty liver.In 2020, an international panel of experts proposed a new name for this entity and considered that the term “metabolicassociated fatty liver disease” (MAFLD) would be the most appropriate to refer to a comprehensive but simple set ofcriteria for the diagnosis of MAFLD, which is not related to the amount of alcohol consumption and can occur in patientsin any clinical setting.NAFLD is a manifestation of metabolic syndrome and shows high prevalence and risk of rapid progression in patientswith type 2 diabetes (T2DM). The current model considers that this process occurs as a consequence of “multiple...

Paragangliomas are uncommon tumors that originate in the autonomic nervous system and whose clinical manifestations result from excessive catecholamine production. Most of those arising from parasympathetic ganglia are located in the neck and at the base of the skull, along the branches of the glossopharyngeal and vagus nerves. On the other hand, sympathetic paragangliomas occur outside the adrenal, gland along the sympathetic chain. Approximately 75 % of them occur in the abdomen, most of which are functional and present with hypersecretion of catecholamines. These tumors exhibit varying degress of aggressiveness and are characterized by a wide spectrum of hereditary predisposition. In fact, more than one-third exhibit such susceptibility. Five hereditary syndromes have been described, each with different pathogenic variants. Moreover, it is known that there are various genotypic and ph...

Diabetic hand syndrome is a rare and underdiagnosed complication of diabetes mellitus. This term is used to describe a potentially dangerous infection of the hand, characterized by debilitating musculoskeletal disorders. Although the diagnosis is commonly made in tropical regions, cases have also been reported in non-tropical and in marginal urban areas. The pathophysiology of this syndrome remains unclear because, unlike diabetic foot, peripheral neuropathy and vascular disease do not seem to a play major role. Evidence suggests that it may be associated with the duration of diabetes, poor metabolic control and microvascular complications. In this article, we present the cases of two patients with diabetic hand syndrome. The first case involves a 52-year-old female patient from a rural area, diagnosed with type 2 diabetes mellitus six years ago, currently in poor metabolic control. She ...

La esteatosis hepática no alcohólica (EHNA) está ampliamente distribuida a nivel mundial y es más frecuente en sujetos con dislipidemia, síndrome metabólico, obesos y con DM2 (34-74%). Sin embargo, la prevalencia de cirrosis por EHNA en la población general no se conoce, lo que es aún materia de investigación en nuestro medio. Objetivo: Determinar si existe diferencia significativa entre los parámetros metábólicos de esteatosis hepática no alcohólica en pacientes con diabetes tipo 2 de reciente diagnóstico controlados y no controlados. Material y métodos: Estudio retrospectivo de tipo caso control, realizado en el Hospital Guillermo Almenara Irigoyen, Lima – Perú, durante los meses de noviembre de 2014 a febrero de 2015. Constó de231 pacientes: 147 pacientes con DM2 de diagnóstico reciente con mal control glicémico y EHNA y 84 pacientes con DM2 de diagnóstico recie...

Determina la efectividad de la vitamina E sobre los niveles de transaminasas y severidad ecográfica en el tratamiento de la esteatosis hepática no alcohólica en diabéticos tipo 2 de diagnóstico reciente. Realiza un estudio analítico cuasi experimental. Se formaron dos grupos, uno experimental que recibió vitamina E a dosis de 400 UI además del manejo convencional y otro grupo control con solo el manejo convencional. El estudio incluyó a 71 pacientes en cada grupo. Ambos grupos fueron sometidos a una ecografía y a la medición de TGP al inicio y tras 6 meses así como evaluación de actividad fibrótica mediante NAFLD score.Para comparar las concentraciones de TGP dentro de un mismo grupo se empleó la prueba Wilcoxon y para evaluar diferencias entre el grupo experimenta y control se realizo prueba de U de Mann-Whitney. Asimismo, para comparar severidad ecográfica se empleó la...

Determina factores de riesgo sociodemográficos, antropométricos, bioquímicometabólicos, clínicos y comorbilidades asociadas a fibrosis avanzada por esteatohepatitis no alcohólica en pacientes con diabetes mellitus tipo 2 (DM2) atendidos en el Hospital Nacional Dos de Mayo 2009-2018. La metodología usada fue de estudio de casos y controles. Se revisaron historias clínicas de 174 pacientes con esteatosis hepática no alcohólica (EHGNA) y DM2 que cumplieron criterios de inclusión y exclusión. Los casos fueron pacientes con DM2 y fibrosis avanzada por EHGNA. Los controles fueron pacientes sin fibrosis avanzada de EHGNA con DM2. La presencia de fibrosis hepática avanzada fue definida por paneles clínicos de APRI >1.5, FIB 4 > 3.25 y NALFD score >0.67 y/o resultado de biopsia hepática. En una ficha se recolectaron datos de diferentes variables. Para determinar la fuerza de asocia...