Utility of plasma CA125 as a proxy of intra-abdominal pressure in patients with acute heart failure.

AIMS: Increased intra-abdominal pressure (IAP) is now considered a potential contributor to organ damage and disease progression in acute heart failure (AHF). In this work, we aimed to determine if antigen carbohydrate 125 (CA125) is associated with IAP and to identify a cutpoint of CA125 useful for ruling out intra-abdominal hypertension (defined as IAP ≥ 12 mmHg). METHODS AND RESULTS: We prospectively evaluated a cohort of 53 patients admitted with AHF in which IAP was measured within the first 24-h of admission. The mean age was 80 ± 8 years, 31 (58.5%) were female, and 31 (58.5%) had left ventricular ejection fraction ≥50%. The median plasma levels of NT-proBNP and CA125 were 3830 pg/mL (2417-8929) and 45.8 U/mL (29.8-114.0), respectively. The median of IAP was 15 mmHg (11-17), and 39 (73%) patients had an IAP ≥ 12 mmHg. The diagnostic performance of CA125 for identifying an IAP ≥ 12 mmHg was tested using the receiving operating characteristic (ROC) curve. The cut-off for CA125 of 17.1 U/mL showed a sensitivity of 92%, a specificity of 50%, and an area under the ROC curve of 0.71. After multivariate adjustment, CA125 remained non-linearly and positively associated with higher IAP (P-value = 0.003), explaining almost 28% of the model's variability (R2: 27.6%). CONCLUSIONS: Patients with AHF and intra-abdominal hypertension had higher CA125 plasma levels. A baseline concentration of CA125 below 17.1 U/mL will increase the odds of identifying a subset of patients with normal IAP.

Lesión de vía urinaria superior tras traumatismo cerrado, a propósito de un caso / Upper urinary tract injury by blunt trauma, about a case

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Abscesos testiculares y hernia vesical / Testicular abscesses and bladder hernia

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Quiste de uraco / Urachal cyst

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Cistitis enfisematosa como causa infrecuente de infección urinaria / Emphysematous cystitis as a rare form of urinary tract infection

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Dolor en retropié: neuropatía de Baxter, a propósito de un caso / Hindfoot pain: Baxter neuropathy

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[Adnexal torsion caused by Fallopian tube cancer]. / Torsión anexial causada por cáncer de trompa de Falopio.

Fallopian tube cancer is the less frequent gynecological cancer. It occurs typically between 40 and 65 years old. Diagnosis is usually achieved earlier than in ovarian cancer cases, due to early symptoms (typically abdominal pain, hydro-hematorrhea and adnexal mass). Preoperative correct diagnosis is infrequent, being most cases diagnosed during the surgery or in the pathological study. Histologically and clinically is similar to ovarian cancer, being the serous low differentiated the most frequent type. An early suspicion and a correct intervention are essential to obtain correct diagnosis and treatment. Treatment protocols are similar to those of ovarian cancer recommended by the FIGO.

Anomalías de fusión y rotación del tracto urinario superior / Congenital kidney and upper urinary tract fusión and rotation anomalies

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