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| 1 | Diagnosis and management of pericardial effusion显示文摘Pericardial effusion is a common finding in everyday clinical practice.The first challenge to the clinician is to try to establish an etiologic diagnosis.Sometimes,the pericardial effusion can be easily related to a known underlying disease,such as acute myocardial infarction, cardiac surgery,end-stage renal disease or widespread metastatic neoplasm.When no obvious cause is apparent,some clinical findings can be useful to establish a diagnosis of probability.The presence of acute inflammatory signs(chest pain,fever,pericardial friction rub) is predictive for acute idiopathic pericarditis irrespective of the size of the effusion or the presence or absence of tamponade.Severe effusion with absence of inflammatory signs and absence of tamponade is predictive for chronic idiopathic pericardial effusion,and tamponade without inflammatory signs for neoplastic pericardial effusion.Epidemiologic considerations are very important,as in developed countries acute idiopathic pericarditis and idiopathic pericardial effusion are the most common etiologies,but in some underdeveloped geographic areas tuberculous pericarditis is the leading cause of pericardial effusion.The second point is the evaluation of the hemodynamic compromise caused by pericardial fluid.Cardiac tamponade is not an'all or none'phenomenon,but a syndrome with a continuum of severity ranging from an asymptomatic elevationof intrapericardial pressure detectable only through hemodynamic methods to a clinical tamponade recognized by the presence of dyspnea,tachycardia,jugular venous distension,pulsus paradoxus and in the more severe cases arterial hypotension and shock.In the middle,echocardiographic tamponade is recognized by the presence of cardiac chamber collapses and characteristic alterations in respiratory variations of mitral and tricuspid flow.Medical treatment of pericardial effusion is mainly dictated by the presence of inflammatory signs and by the underlying disease if present.Pericardial drainage is mandatory when clinical tamponade is present.In the absence of clinical tamponade,examination of the pericardial fluid is indicated when there is a clinical suspicion of purulent pericarditis and in patients with underlying neoplasia.Patients with chronic massive idiopathic pericardial effusion should also be submitted to pericardial drainage because of the risk of developing unexpected tamponade.The selection of the pericardial drainage procedure depends on the etiology of the effusion.Simple pericardiocentesis is usually sufficient in patients with acute idiopathic or viral pericarditis.Purulent pericarditis should be drained surgically,usually through subxiphoid pericardiotomy. Neoplastic pericardial effusion constitutes a more difficult challenge because reaccumulation of pericardial fluid is a concern.The therapeutic possibilities include extended indwelling pericardial catheter,percutaneous pericardiostomy and intrapericardial instillation of antineoplastic and sclerosing agents.Massive chronic idiopathic pericardial effusions do not respond to medical treatment and tend to recur after pericardiocentesis, so wide anterior pericardiectomy is finally necessary in many cases. | Jaume Sagristà-Sauleda Axel Sarrias Mercé Jordi Soler-Soler | 2011 | World Journal of Cardiology2011，3，5： | 10 |
| 2 | Evolution of pore solution chemistry, electro-osmosis and rehar corrosion rate induced by realkalisation显示文摘 | ANDRADE C CASTELLOTE M SARRIA J | 1999 | Materials and Structures1999，32，220： | 1 |
| 3 | Sociodemographic factors and trends on over-weight prevalence in children and adolescents in Aragon (Spain) from 1985 to 1995显示文摘 | Moreno LA Sarria A Fleta J | 1985 | J Clin Epidemiol1985，54，： | 1 |
| 4 | Acytoplasmic male sterility-associated mitochondrial peptide in common bean is posttranslationally regulated显示文摘 | SARRIA R Lyznik A Vallejos C E | 1998 | Plant Cell1998，10，： | 1 |
| 5 | Transgenic plants of cassava (Manihot esculenta) with resistance to Basta obtained by Agrobacterium mediated trans- formation显示文摘 | Sarria R Torres E Sarria A F R et aI | 2000 | Plant Cell Rep2000，19，： | 1 |
| 6 | Lung inflammatory pattern and antibiotic treatment in pneumonia显示文摘 | María-JoséLorenzo Inés Moret Benjamín Sarria | 2015 | Respir Res2015，16，5： | 1 |
| 7 | Agrobacterium- mediated transformation of Stylosanthes guianensis and production of transgenic plants显示文摘 | Sarria R Calderon A Thro A M | 1994 | Plant Sci1994，96，： | 1 |
| 8 | Photochemical versus coupled photochemical-biological flow system for the treatment of two biorecal-citrant herbicides:metobromuron and isoproturon显示文摘 | Parra S Sarria V Malato S | 2000 | Applied Catalysis B-Environmental2000，27，3： | 1 |
| 9 | Candida glabrata endophthalmitis treated successfully with caspofungin显示文摘 | Sarria JC Bradley JC Habash R | 2005 | Clin Infect Dis2005，40，9： | 1 |
| 10 | Relative Humidity in the Interior of Concrete Exposed to Natural and Artificial Weathering 显示文摘 | Andrade C Sarria J Alonso C | 1999 | Cement and Concrete Research1999，29，6： | 1 |
| 11 | Complement and innate immunity显示文摘 | Song WC Sarrias MR Lambris JD | 2000 | Immunopharmacology2000，49，： | 1 |
| 12 | Post-infectiousbronchiolitis obliterans: can CT scan findings at early age anticipate lung function? 显示文摘 | Mattiello R Sarria EE Mallol J | 2010 | Pediatr Pulmonol2010，45，4： | 1 |
| 13 | Photochemical Versus Coupled Photochemical-biological Flow System for the Treatment of Two Biorecalcitrant Herbicides:Metobromuron and Isoproturon显示文摘 | PARRA S SARRIA V MALATO S | 2000 | Applied Catalysis B:Environmental2000，27，： | 1 |
| 14 | Increased lung neutrophil apoptosis and inflammation resolution in nonresponding pneumonia 显示文摘 | Moret I Lorenzo M J Sarria B | 2011 | Eur Respir J2011，38，5： | 1 |
| 15 | Identification and functional characterization of the hepatic stellate cell CD38 cell surface molecule显示文摘 | March S Graupera M Rosa Sarrias M | 2007 | Am J Pathol2007，170，： | 1 |
| 16 | Community- Based Therapy for Multidrug-Resistant Tuberculosis in Lima, Peru显示文摘 | Mitnick C Bayona J Palacios E Shin S Furin J Alcantara F Sdnchez E Sarria M Becerra M Fawzi MC Kapiga S Neuberg D Maguire JH Kim JY Farmer P | 2003 | N EnglJ Med2003，348，2： | 1 |
| 17 | Determinants of resting energy expenditure in obese and nonobese children and adolescents 显示文摘 | Rodriguez G Moreno LA Sarria A | 2002 | J Physiol Biochem2002，58，1： | 1 |
| 18 | Optimizing solar photocatalytic mineralization of pesticides by adding inorganic oxidizing species: application to the recycling of pesticide containers 显示文摘 | Parras S Sarria V Malato S | 2000 | Appl Catal B: Environ2000，28，： | 1 |
| 19 | N-acetylcysteine inhibits TNF-alpha, sTNFR, and TGF-betal release by alveolar macrophages in idiopathic pulmonary fibrosis in vitro 显示文摘 | Cu A Ye Q Sarria R | 2009 | Sarcoidosis Vase Diffuse Lung Dis2009，26，2： | 1 |
| 20 | Relative humidity in the interior of concrete exposed to natural and artificial weathering显示文摘 | Andrade C Sarria J Alonso C | 1999 | Cement and Concrete Research1999，29，8： | 1 |
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