Riesgo de desarrollar insulinoresistencia en pacientes que reciben terapia antirretroviral de máxima actividad (TARMA) en la clínica de VIH/SIDA del Hospital Dr. Enrique Garcés de Quito - Ecuador

Estudiar la relación entre el uso de terapia antirretroviral de máxima actividad (TARMA) y la presencia de insulinorresistencia en una muestra de pacientes infectados con VIH de la Clínica de VIH/SIDA del Hospital Dr. Enrique Garcés. MÉTODOS: Se condujo un estudio de tipo cohorte histórica, entre pacientes con TARMA y pacientes sin TARMA, sin diferencias significativas en edad, sexo y etnia. La evaluación incluyó un cuestionario que valoró tiempo de enfermedad, estadiaje de la misma, tipo y tiempo de TARMA, y otro cuestionario auto administrado para evaluar la presencia de síntomas depresivos

Atypical Abdominal Pain in a Patient With Liver Cirrhosis

The causes of abdominal pain in patients with liver cirrhosis and ascites are well-known but occasionally, atypical causes arise. We report the case of a patient with a ruptured, confined abdominal aortic aneurysm

Socioeconomic characteristics of patients evaluated for liver transplantation in a tertiary center

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Papillary in situ and intramucosal adenocarcinoma of the lower third of common bile duct. A report and review of the literature

We report the case of a 37-year-old woman with no relevant medical history. She was admitted to the hospital for epigastric pain related with food intake for 4 days; the pain did not improve with symptomatic management. A laparoscopic cholecystectomy due to acute lithiasic cholecystitis was performed. However, after 4 days, postoperative painless jaundice was evident; thus, endoscopic retrograde cholangiopancreatography was performed, which revealed an amputation of intrapancreatic common bile duct, as well as secondary intra- and extrahepatic bile duct dilatation. Brushing of the distal portion of the common bile duct revealed a well-differentiated adenocarcinoma. Therefore, a Whipple procedure with pylorus preservation was performed. Pathologic diagnosis of a papillary in situ adenocarcinoma with two microscopic foci of microinvasion was established. The pathologic Tumor-Node-Metastasis (TNM) stage was pT1, pN0, pM0, R0. The patient is asymptomatic and disease-free 24 months after surgery. In general, adenocarcinomas of the extrahepatic bile ducts are uncommon and have a poor prognosis. However, symptomatic patients with early disease stages are even rarer and can be cured surgically