CASE: We present the case of a patient with nonalcoholic steatohepatitis or nonalcoholic fatty liver disease and resultant portal hypertension who developed an unusual porto-systemic shunt, which at first was thought to represent a highly vascular gynecologic mass. The splanchnic blood was shunted through a recanalized vein interconnecting the splenic vein with

the parametrial venous plexus.

CONCLUSION: Unrecognized portal hypertension and resultant porto-systemic shunts may mask themselves as vascular masses and result in catastrophic surgical outcomes if not fully characterized preoperatively. (Obstet Gynecol 2012;119:455-9) DOI: 10.1097/AOG.0b013e3182331611″
“Patients on peritoneal dialysis (PD) are at high cardiovascular (C-V) risk, and Selleck Emricasan dyslipidemia, one of the major traditional C-V risk factors, is a common complication in chronic kidney disease. PD treatment may worsen lipid profile, because it confers a more atherogenic state than hemodialysis. There is evidence that in the general population, lipid-lowering therapy reduces C-V mortality, both in terms of primary and secondary prevention. The association between dyslipidemia and C-V mortality in dialysis

patients is not well defined, and hypocholesterolemia, Selleck QNZ related to malnutrition/inflammation, is a confounding factor. However, despite the unfavorable lipid profile in PD patients and their high C-V mortality rate, until now we have had no conclusive data that the treatment of dyslipidemia in PD patients might contribute to reducing C-V mortality. click here At the moment, following the ATPIII and K-DOQI recommendations in considering dialysis patients as high

C-V risk patients seems a reasonable approach, awaiting new large trials in PD patients. The present therapeutic tools to treat dyslipidemia in PD patients, such as diet, fibrates, omega-3, statins, carnitine, phosphate binders and use of glucose-free dialysis bags, are considered, with attention to high-risk diabetic patients, with the possible use of intraperitoneal insulin. The data indicate a correctable nihilism in treating dyslipidemia in the general population, probably even exacerbated in PD patients. However, it will only be with the correction of all of the C-V risk factors, traditional and uremia-related ones, that in future we shall hope to observe the reduction of C-V death in PD patients.”
“Aim: The ultrastructural changes in the intestine were studied during experimental acute edematous and necrotizing porcine pancreatitis. The immunohistochemical expression of E-cadherin and beta-catenin in the jejunum and colon was assessed to characterize changes in the adherens junctions.

Methods: Twenty-four pigs were randomized to controls (n = 8) or to develop mild edematous (n = 8, saline infusion to pancreatic duct) or severe necrotizing pancreatitis (n = 8, taurocholic acid infusion).