RESUMEN
The choroid, rich in vasculature, is a common site for ocular metastases, predominantly from breast and lung cancer. Unlike breast cancer, which may cause bilateral involvement, lung cancer typically leads to unilateral lesions. Adenocarcinoma is the primary lung cancer subtype associated with choroidal metastasis, while small cell lung cancer (SCLC) infrequently involves the choroid. In our case, a 69-year-old man with hypertension, hyperlipidemia, and chronic obstructive pulmonary disease presented with right eye visual disturbances and was diagnosed with choroidal metastasis. Subsequent imaging revealed lung cancer with widespread metastasis. Despite treatment postponement due to deteriorating health, the patient's condition worsened, leading to palliative care discharge. Despite its rarity, choroidal involvement in SCLC warrants further investigation to enhance diagnostic and therapeutic strategies. This case highlights the importance of meticulous evaluation and interdisciplinary care to optimize outcomes in patients with SCLC and choroidal metastasis.
RESUMEN
The prevalence of atrial fibrillation among older adults is increasing. Research has indicated that atrial fibrillation is linked to cognitive impairment disorders such as Alzheimer and vascular dementia, as well as Parkinson disease. Various mechanisms are believed to be shared between atrial fibrillation and cognitive impairment disorders. The specific pathologies and mechanisms of different cognitive disorders are still being studied. Potential mechanisms include cerebral hypoperfusion, ischemic or hemorrhagic infarction, and cerebrovascular reactivity to carbon dioxide. Additionally, circulatory biomarkers and certain infectious organisms appear to be involved. This review offers an examination of the overlapping epidemiology between atrial fibrillation and cognitive disorders, explores different cognitive disorders and their connections with this arrhythmia, and discusses trials and guidelines for preventing and treating atrial fibrillation in patients with cognitive disorders. It synthesizes existing knowledge on the management of atrial fibrillation and identifies areas that require further investigation to bridge the gap in understanding the complex relationship between dementia and atrial fibrillation.
RESUMEN
There are multiple mechanisms by which The Coronavirus-19 (COVID-19) infection can cause electrolyte abnormalities, which may not be the case for bacterial causes of pneumonia. This study aimed to assess the differences in electrolyte levels between patients suffering from COVID-19 and bacterial pneumonia. This is an original, retrospective study. Two cohorts of hospitalized patients were included, 1 suffering from COVID-19 and the other from bacterial pneumonia. Their day 1 and day 3 levels of sodium, potassium, magnesium, and phosphorus, as well as their outcomes, were extracted from the charts. Statistical analysis was subsequently performed. Mean admission levels of sodium, potassium, phosphorus, and magnesium were 135.64â ±â 6.13, 4.38â ±â 0.69, 3.53â ±â 0.69, and 2.03â ±â 0.51, respectively. The mean day 3 levels of these electrolytes were 138.3â ±â 5.06, 4.18â ±â 0.59, 3.578â ±â 0.59, and 2.11â ±â 0.64, respectively. Patients suffering from bacterial pneumonia were significantly older (Nâ =â 219, meanâ =â 64.88â ±â 15.99) than patients with COVID-19 pneumonia (Nâ =â 240, meanâ =â 57.63â ±â 17.87). Bacterial pneumonia group had significantly higher serum potassium (Nâ =â 211, meanâ =â 4.51â ±â 0.76), and magnesium (Nâ =â 115, meanâ =â 2.12â ±â 0.60) levels compared to COVID-19 group (Nâ =â 227, meanâ =â 4.254â ±â 0.60 for potassium and Nâ =â 118, meanâ =â 1.933â ±â 0.38 for magnesium). Only magnesium was significantly higher among day 3 electrolytes in the bacterial pneumonia group. No significant association between electrolyte levels and outcomes was seen. We found that COVID-19 patients had lower potassium and magnesium levels on admission, possibly due to the effect of COVID-19 on the renin-angiotensin-aldosterone system as well as patient characteristics and management. We did not find enough evidence to recommend using electrolyte levels as a determinator of prognosis, but more research is needed.