Impact of hypochloremia as a prognostic factor in patients with heart failure, a retrospective cohort study.

BACKGROUND: some studies suggest that hypochloremia is a risk factor in the prognosis of heart failure (HF) in patients with recent decompensation. MATERIALS AND METHODS: retrospective cohort study of patients discharged due to HF decompensation who began follow-up in a specialized clinic. Two groups are defined: patients with hypochloremia (chloride < 98 mmol/L) and normochloremic patients (chloride > 98 mmol/L) in the initial assessment within the first month after discharge. The rate of intravenous diuretic rescue, emergency department visits, readmission for HF and cardiovascular (CV) death are compared using a Cox proportional hazards model. RESULTS: 165 patients were included (59% women, mean age 85 years), with 60 (36%) having hypochloremia. Both groups were comparable in terms of baseline characteristics, except for female sex, presence of peripheral artery disease, moderate-to-severe liver disease (more prevalent in the hypochloremia group), PROFUND index, and baseline furosemide dose (higher in patients with hypochloremia). The incidence of the primary event was higher in subjects with hypochloremia than in normochloremic subjects (HR: 1.59, 95% CI 0.97-2.62), mainly due to the need for intravenous diuretic rescue (HR: 1.86, 95% CI 1.07-3.24). CONCLUSIONS: hypochloremia following admission for HF decompensation is associated with a greater need for intravenous diuretic rescue therapy and probably worse overall prognosis across the spectrum of the disease, regardless of left ventricular ejection fraction (LVEF).

Trombosis venosa de retina. Auditoría de un programa de atención especializada / Retinal vein occlusion. Audit of a specialized care program

Background and objectives Retinal vein occlusion (RVO) is the second most frequent cause of retinal vascular disease and is related to classic cardiovascular risk factors. A specific program was designed to detect and treat risk factors in patients with RVO. The aim of this study is to audit the results of this program. Patients and methods The program consisted of a multidisciplinary clinical evaluation by the Ophthalmology and Internal Medicine Departments. All patients with RVO were screened, at minimum, for hypertension, diabetes, dyslipidemia, smoking, overweight, and antiphospholipid syndrome. New risk factors or poor control of known risk factors were expected to be found in at least one-third of the patients. Among them, therapeutic measures were expected to be taken in at least two-thirds. A dissociated automated search of the data of all patients who entered the program between April 2021 and April 2022 was performed. Results Fifty-six patients were included for analysis. Of these, 39 (69.6%) had at least one new or poorly controlled risk factor and 43 (76.8%) had their treatment modified in some way. Antiphospholipid syndrome was detected in five (8.9%). Only one patient had low-risk hereditary thrombophilia. After an exhaustive examination, no risk factors were found in 11 patients. Conclusion This specific program has been effective in detecting new or poorly controlled risk factors and improving their treatment (AU)

Antecedentes y objetivo La trombosis venosa de retina (TVR) es la segunda causa más frecuente de enfermedad vascular de la retina y se relaciona con factores de riesgo cardiovascular clásicos. Se diseñó un programa específico para detección y tratamiento de factores de riesgo en pacientes con TVR. El objetivo de este estudio es auditar los resultados de dicho programa. Pacientes y métodos El programa consistió en una evaluación clínica multidisciplinar por parte de Oftalmología y Medicina Interna. A todos los pacientes con TVR se les realizó cribado, al menos, de hipertensión arterial, diabetes, dislipidemia, tabaquismo, sobrepeso y síndrome antifosfolípido. Se esperó encontrar nuevos factores de riesgo o pobre control de los ya conocidos en, al menos, un tercio de los pacientes. Entre ellos, se esperó tomar alguna medida terapéutica en, al menos, dos tercios. Se llevó a cabo una búsqueda automatizada disociada de los datos de todos los pacientes que entraron en el programa entre abril de 2021 y abril de 2022. Resultados Cincuenta y seis pacientes se incluyeron para el análisis. De ellos, 39 (69,6%) tenían al menos un factor de riesgo nuevo o mal controlado, y 43 (76,8%) vieron modificado en algún modo su tratamiento. Se detectó síndrome antifosfolípido en 5 (8,9%). Solo un paciente tenía una trombofilia hereditaria de bajo riesgo. Tras un examen exhaustivo no se encontró factor de riesgo alguno en 11 pacientes. Conclusión Este programa específico ha sido efectivo para detectar factores de riesgo nuevos o mal controlados y mejorar su tratamiento (AU)

Retinal vein occlusion. Audit of a specialized care program.

BACKGROUND AND OBJECTIVES: Retinal vein occlusion (RVO) is the second most frequent cause of retinal vascular disease and is related to classic cardiovascular risk factors. A specific program was designed to detect and treat risk factors in patients with RVO. The aim of this study is to audit the results of this program. PATIENTS AND METHODS: The program consisted of a multidisciplinary clinical evaluation by the Ophthalmology and Internal Medicine Departments. All patients with RVO were screened, at minimum, for hypertension, diabetes, dyslipidemia, smoking, overweight, and antiphospholipid syndrome. New risk factors or poor control of known risk factors were expected to be found in at least one-third of the patients. Among them, therapeutic measures were expected to be taken in at least two-thirds. A dissociated automated search of the data of all patients who entered the program between April 2021 and April 2022 was performed. RESULTS: Fifty-six patients were included for analysis. Of these, 39 (69.6%) had at least one new or poorly controlled risk factor and 43 (76.8%) had their treatment modified in some way. Antiphospholipid syndrome was detected in five (8.9%). Only one patient had low-risk hereditary thrombophilia. After an exhaustive examination, no risk factors were found in 11 patients. CONCLUSION: This specific program has been effective in detecting new or poorly controlled risk factors and improving their treatment.