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Objectives: To know the prevalence of osteopenia and osteoporosis in alcoholic cirrhotic males from 45 to 65 years old. To prove if the nutritional state is involved in the loss of bone mass in the hepatic disease., Study Population: 52 alcoholic cirrhotic males from 45 to 65 years old, with normal kidney function, non-sedentary and with no treatment that could alterate the study. Design and variables: transversal descriptive study finished in 2 years. The nutritional state was evaluated by means of classic anthropometric parameters (weight, height, perimeter of the arm and skin folds) and total body densitometry (DPX plus LUNAR-DEXA with dual energy X-ray absorptiometry., Statistical Analysis: Mc Intosh computer (Filemaker PRO program). T Student was used to compare groups and p was significant if alpha alpha < or = 0.05. Clinical severity of cirrhosis: Child-Turcotte classification., Results: Osteopenia was diagnosed if bone mineral density (BMD) was higher than 1 standard deviation (SD) but lower than 3 SD below T score (mean values for adult women) and osteoporosis (OP) if BMD was higher than 3 SD or vertebral compression fractures appeared in simple radiographies. The prevalence of bone disease was 58%. The percentages of fat obtained by means of anthropometric and densitometric measures were higher in non-osteopenic patients., Discussion: The prevalence of bone disease was higher than another studies. The total body densitometry is a more exact method to measure the percentage of body fat. The percentages of fat obtained with both methods were not related to the loss of bone mass. The nutritional state as an isolated factor does not lead to bone disease in these patients.

Insulinomas are rare tumors whose difficult diagnosis is usually delayed with respect to appearance of the first symptoms. The Whipple triad (symptoms of hypoglycemia, low blood glucose and rapid alleviation of symptoms after glucose administration) associated with an increase in plasma immunoreactive insulin (IRI) and low blood glucose levels constitute the diagnostic basis of insulinoma as the cause of organic hypoglycemia. Curative treatment entails surgery and its success will depend on the location of the tumor. Selective arteriography and, more recently, percutaneous transhepatic insulin determination (IRI) in the splenoportal axis have a diagnostic rate of 90%. Nevertheless, none of these topographic diagnostic methods replaces meticulous intraoperative exploration of the pancreas, which in our case was definitive for cure.