[Portal hypertension due to cavernomatosis of the portal vein].
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Biomedical subjects
Publications and source records attributed to J L Aranda Arcas.
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BASIS: Hyperlipidemia associated to nephrotic syndrome has been involved in the deterioration of the renal function in these patients. The reduction in the synthesis of cholesterol with pravastatin, an hydrophilic inhibitor of such synthesis, may improve both the dyslipemia, the renal function and the proteinuria. METHODS: We conducted a controlled open randomized study in 16 patients with proteinuria greater than 2 g/day, creatinine clearance greater than 0.5 ml/s (30 ml/min) and hypercholesterolemia with LDL cholesterol greater than 4.9 mmol/l (190 mg/dl) distributed in two groups. One of these groups received hypolipemiant dietetic treatment and 20-40 mg of pravastatin and the other group, only the dietetic treatment. RESULTS: The patients receiving pravastatin showed a 27% decrease in total plasmatic cholesterol, compared to a 6.7% in the control group (p < 0.01). This decrease was more evident in the LDL cholesterol fraction (44 vs 9%; p < 0.01). No significant modifications were observed in the HDL cholesterol fraction, triglycerides, renal function or proteinuria. Neither clinical nor enzymatiz adverse effects from hepatic or muscular origin were observed.
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A case is studied of a non-functioning right adrenal carcinoma which is initiated clinically by a compressive syndrome of the inferior vena cava, without other clinical manifestations to suggest the origin of the tumor. The clinical findings are discussed as well as the roentgenographic images, the computerized axial tomography and surgery, which was followed by the death of the patient, with considerations concerning the possible mechanisms that might explain the death. A bibliographic review is conducted on the most outstanding aspect of non-functioning adrenal tumors and the rarity with which they present themselves in this form, of which we have found only one previous report.