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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 | The changing epidemiology of hepatitis C virus infection in Europe显示文摘 | Juan I. Esteban Silvia Sauleda Josep Quer | 2007 | Journal of Hepatology2007，，1： | 2 |
| 3 | T cell responses and viral variability in blood donation candidates with occult hepatitis B infection显示文摘 | Marta Bes Victor Vargas Maria Piron Natalia Casamitjana Juan Ignacio Esteban Nuria Vilanova Asuncion Pinacho Josep Quer Lluis Puig Jaime Guardia Silvia Sauleda | 2011 | Journal of Hepatology2011，，4： | 2 |
| 4 | NF-kappa B activation and iNOS upregulation in skeletal muscle of patients with COPD and low body weight显示文摘 | Agusti A Morla M Sauleda J | 2004 | Thorax2004，59，6： | 1 |
| 5 | Systemic effects of chronic obstructive pulmonary disease显示文摘 | Agusti AG Noguera A Sauleda J | 2003 | Eur Respir J2003，21，2： | 1 |
| 6 | Skeletal musclechanges in patients with obstructivesleep apnoea syndrome 显示文摘 | Sauleda J Garcia-Palmer FJ Tarraga S | 2003 | RespirMed2003，97，7： | 1 |
| 7 | HCV screening in blood donations using RT-PCR in mini-pool:the experience in Spain after routine use for 2 years显示文摘 | Eiras A Sauleda S Planelles D | 2003 | Transfusion2003，43，6： | 1 |
| 8 | The activity of cytochrome oxidase is increased in circulating lymphocytes of patients with chronic obstructive pulmonary disease,asthma,and chronic arthritis显示文摘 | Sauleda J Garcia-Palmer FJ Gonzalez G | 2000 | Am J Respir Crit Gare Med2000，161，： | 1 |
| 9 | Systemic effects of chronic obstructive pulmonary disease显示文摘 | Agusti AG Noguera A Sauleda J | 2003 | Eur Respir J2003，21，： | 1 |
| 10 | Aniline Mineralization by AOP's: Anodic Oxidation, Photocatalysis, Electron-Fenton and Photoelectro-Fenton Processes显示文摘 | Brillas E Mur E Sauleda R | 1998 | Appl Catal B: Environ1998，16，： | 1 |
| 11 | NF-kappaB activation and ilNO5 upregulation in skeletal muscle of patients with COPD and low body weight显示文摘 | Agusti A Morla M Sauleda J | 2004 | Thorax2004，59，6： | 1 |
| 12 | Anti-tissue antibodies are related to lung function in chronic obstructive pulmonary disease显示文摘 | Nunez B Sauleda J Ant6 J M | 2011 | Am J Respir Crit Care Med2011，183，8： | 1 |
| 13 | The changing epidemiology of hepatitis C virus infection in Europe 显示文摘 | Esteban J I Sauleda S Quer J | 2008 | J Hepatol2008，48，14： | 1 |
| 14 | Oxidative stress and airway inflammation in severe exacerbations of COPD显示文摘 | Drost EM Skwarski KM Sauleda J | 2005 | Thorax2005，60，5： | 1 |
| 15 | Oxida tive stress and airway inflammation in severe exacer bationsofCOPD 显示文摘 | Drost EM Skwarski KM Sauleda J | 2005 | Thorax2005，60，4： | 1 |
| 16 | The changing epidemiology of hepatitis C virus infection in Europe显示文摘 | Esteban JI Sauleda S Quer J | | 0，，1： | 1 |
| 17 | HCV screening in blood donations using RT-PCR in mini-pool: the experience in Spain after routine use for 2 years显示文摘 | Eiras A Sauleda S Planelles D | 2003 | Transfusion2003，43，6： | 1 |
| 18 | Oxidative stress and airway inflammation in severe exacerbations of COPD显示文摘 | DROST E M SKWARSKI K M SAULEDA J | 2005 | Thorax2005，60，： | 1 |
| 19 | Effects of obesity upon genioglossus structure and function in obstructive sleep apnea显示文摘 | CARRERA M BARBE F SAULEDA J | 2004 | Eur Respir J2004，23，： | 1 |
| 20 | HCV screening in blood donations using RT-PCR in mini-pool:the experience in Spain after routine usefor 2 years显示文摘 | Eiras A Sauleda S Planelles D | 2003 | Transfusion2003，43，6： | 1 |
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