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[PMID]:29489689
[Au] Autor:Jiang L; Tao T; Zheng J; Jia Z; Xu H; Ni Y
[Ad] Endereço:Department of Cardiothoracic Surgery, The First Affiliated Hospital of Zhejiang University, Hangzhou, China.
[Ti] Título:Case report of refractory pericardial effusion associated with lymphatic fistula due to surgical injury during sternotomy.
[So] Source:Medicine (Baltimore);97(9):e9892, 2018 Mar.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: A 35-year old Chinese female was admitted to hospital with refractory pericardial effusions 10 days post mitral valve replacement via median sternotomy. We performed an exploratory resternotomy and found lymphatic leakage on the surface of the diaphragm which was continuously emitting a light yellow fluid. PATIENT CONCERNS: The patient complained of no obvious discomfort except for the concern of massive pericardial effusion drainage. DIAGNOSES: Exploratory resternotomy and biochemical testing lead to a supradiaphragmatic lymphatic fistula being diagnosed as the cause of the refractory pericardial effusion. INTERVENTIONS: The fistula was closed with a continuous suture and no other fistulas were found after a thorough exploration. OUTCOMES: The patient was discharged home on postoperative day 5 and recovery was uneventful. LESSONS: In this case a timely exploratory resternotomy proved effective in seeking the cause of and treating pericardial effusion following cardiac surgery.
[Mh] Termos MeSH primário: Complicações Intraoperatórias/etiologia
Doenças Linfáticas/complicações
Derrame Pericárdico/etiologia
Fístula do Sistema Respiratório/complicações
Esternotomia/efeitos adversos
[Mh] Termos MeSH secundário: Adulto
Diafragma/patologia
Diafragma/cirurgia
Drenagem
Feminino
Seres Humanos
Complicações Intraoperatórias/patologia
Doenças Linfáticas/patologia
Derrame Pericárdico/cirurgia
Fístula do Sistema Respiratório/patologia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180307
[Lr] Data última revisão:
180307
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180301
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009892


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[PMID]:29381944
[Au] Autor:Bastida JM; Cano-Mozo MT; Lopez-Cadenas F; Vallejo VE; Merchán S; Santos-Montón C; González-Calle D; Carrillo J; Martín AA; Torres-Hernández JA; González M; Martín-Herrero F; Pabón P; González-Porras JR
[Ad] Endereço:Department of Hematology, Hospital Universitario de Salamanca-IBSAL, Salamanca.
[Ti] Título:Hemorrhagic pericardial effusion as the debut of acquired hemophilia in a chronic lymphocytic leukemia patient: A case report, and a review of acquired hemophilia A-related hematological malignancies.
[So] Source:Medicine (Baltimore);96(47):e8669, 2017 Nov.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Acquired hemophilia A (AHA) is a rare bleeding disease caused by autoantibodies against factor VIII. Spontaneous bleeding symptoms usually affect the skin and muscle, while pericardial effusion is an extremely rare manifestation. In the elderly, anticoagulant treatment is frequent and bleeding symptoms are usually associated with this. CLINICAL FINDINGS: We report a hemorrhagic pericardial effusion as the AHA debut in a patient with untreated chronic lymphocytic leukemia and anticoagulated with apixaban for atrial fibrillation and chronic arterial ischemia. The patient was treated with recombinant activated factor VII to control the active bleeding and corticosteroids and cyclophosphamide to eradicate the inhibitor. In addition, a briefly review of hematological malignancies associated to acquired hemophilia was performed. PARTICULARITIES:: a) anticoagulant treatment may confuse the suspicion of AHA and its diagnosis; b) hemorrhagic pericardial effusion is an extremely rare presentation; c) bypassing agents raise the risk of thromboembolism; d) hematological malignancies rarely cause AHA (<20% of cases). CONCLUSION: A multidisciplinary team is needed to diagnose and manage AHA effectively. The use of anticoagulants may lead to the misdiagnosis of clinical symptoms. Chronic lymphocytic leukemia is one of the main causes of hematological malignancies associated. The specific treatment of CLL is still recommended in the event of active disease.
[Mh] Termos MeSH primário: Fator VIII
Fator VIIa/administração & dosagem
Hemofilia A
Leucemia Linfocítica Crônica de Células B
Derrame Pericárdico
Pericardiectomia/métodos
[Mh] Termos MeSH secundário: Idoso
Anticorpos/sangue
Testes de Coagulação Sanguínea/métodos
Coagulantes/administração & dosagem
Ciclofosfamida/administração & dosagem
Ecocardiografia/métodos
Fator VIII/análise
Fator VIII/imunologia
Hemofilia A/sangue
Hemofilia A/complicações
Hemofilia A/etiologia
Seres Humanos
Imunossupressores/administração & dosagem
Leucemia Linfocítica Crônica de Células B/complicações
Leucemia Linfocítica Crônica de Células B/diagnóstico
Masculino
Derrame Pericárdico/diagnóstico
Derrame Pericárdico/etiologia
Derrame Pericárdico/fisiopatologia
Prednisona/administração & dosagem
Radiografia Torácica/métodos
Proteínas Recombinantes/administração & dosagem
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antibodies); 0 (Coagulants); 0 (Immunosuppressive Agents); 0 (Recombinant Proteins); 8N3DW7272P (Cyclophosphamide); 9001-27-8 (Factor VIII); AC71R787OV (recombinant FVIIa); EC 3.4.21.21 (Factor VIIa); VB0R961HZT (Prednisone)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180208
[Lr] Data última revisão:
180208
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180201
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008669


  3 / 7669 MEDLINE  
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[PMID]:29310373
[Au] Autor:Kim SH; Park AY; Cho HB; Yoo JH; Park SY; Chung JW; Kim MG
[Ad] Endereço:Department of Anesthesiology and Pain Medicine, Soonchunhyang University Hospital Seoul, Hannam-dong, Yongsan-gu, Seoul, Korea.
[Ti] Título:A rare case of nonresterilized reinforced ETT obstruction caused by a structural defect: A case report.
[So] Source:Medicine (Baltimore);96(48):e8886, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Various factors can cause ventilatory failure after endotracheal tube (ETT) intubation, which is associated with increased patient morbidity and mortality. PATIENT CONCERNS: A 76-year-old woman who was diagnosed with a hemopericardium and suspicion of a major-vessel injury due to dislocation of the clavicular fracture fixation screw. DIAGNOSIS: Non-resterilized reinforced ETT obstruction caused by a structural defect. INTERVENTION: Endotracheal tube was exchanged. OUTCOMES: The ventilator profile showed rapid improvement. LESSONS: Anesthesiologists should consider that a non-resterilized reinforced ETT may be defective. An ETT defect can cause high PIP and ETT obstruction without kinking or foreign materials.
[Mh] Termos MeSH primário: Intubação Intratraqueal/efeitos adversos
[Mh] Termos MeSH secundário: Idoso
Tronco Braquiocefálico/lesões
Clavícula/lesões
Clavícula/cirurgia
Falha de Equipamento
Feminino
Seres Humanos
Derrame Pericárdico/etiologia
Derrame Pericárdico/cirurgia
Retratamento
Esternotomia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180115
[Lr] Data última revisão:
180115
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180110
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008886


  4 / 7669 MEDLINE  
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[PMID]:29205990
[Au] Autor:Sinisalo J; Gunn J
[Ti] Título:Pericardial drainage and sampling.
[So] Source:Duodecim;133(4):417-23, 2017.
[Is] ISSN:0012-7183
[Cp] País de publicação:Finland
[La] Idioma:eng
[Ab] Resumo:Invasive treatment of pericardial effusion comes into question when the volume of liquid in the pericardium limits the pumping action, the cause of effusion is unclear, the response to conservative treatment has been poor, or administration of a drug into the pericardium is desired. A number of surgical means or puncture techniques are available for pericardial drainage. We present the indications and modes of treatment for invasive treatment of pericardial effusion. Thrombi, pus or air may also occasionally be present in the pericardium, limiting the heart's pumping action.
[Mh] Termos MeSH primário: Drenagem/métodos
Derrame Pericárdico/cirurgia
[Mh] Termos MeSH secundário: Seres Humanos
Punções
Manejo de Espécimes
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180108
[Lr] Data última revisão:
180108
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171206
[St] Status:MEDLINE


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[PMID]:29205988
[Au] Autor:Turpeinen A; Hedman M
[Ti] Título:Pericardial fluid: assessment and examination.
[So] Source:Duodecim;133(4):403-10, 2017.
[Is] ISSN:0012-7183
[Cp] País de publicação:Finland
[La] Idioma:eng
[Ab] Resumo:Pericardial fluid is a common finding on echocardiography. Less than 10 mm of fluid on ultrasound scan is not necessarily associated with any significant illness. Clinical examination, blood count, renal and liver enzymes and thyroid function tests as well as inflammatory marker tests are often adequate for a patient who is in good health. A significant amount of fluid requires further investigations, especially in a symptomatic patient. Cancers, infections and various systemic diseases are the most common causes of prominent effusion.
[Mh] Termos MeSH primário: Derrame Pericárdico/diagnóstico
Derrame Pericárdico/etiologia
Líquido Pericárdico/química
[Mh] Termos MeSH secundário: Ecocardiografia
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180108
[Lr] Data última revisão:
180108
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171206
[St] Status:MEDLINE


  6 / 7669 MEDLINE  
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[PMID]:29205986
[Au] Autor:Kytö V; Matti Niemelä M
[Ti] Título:Acute pericarditis.
[So] Source:Duodecim;133(4):391-6, 2017.
[Is] ISSN:0012-7183
[Cp] País de publicação:Finland
[La] Idioma:eng
[Ab] Resumo:Acute pericarditis is typically associated with a viral infection. Chest pain appearing in connection with or soon after the symptoms of infection is the characteristic symptom. Diagnosis is based on the recognition of two characteristic findings (pericardial chest pain, pericardial friction rub, new ECG changes or new pericardial effusion). Medication with an anti-inflammatory analgesic for 1 to 2 weeks is the first-line treatment. A longer course of colchicine is recommended for the prevention of recurrence of the disease. The use of glucocorticoids should be avoided due to the associated risk of recurrence. Exercise and physical activity are harmful during pericarditis.
[Mh] Termos MeSH primário: Anti-Inflamatórios não Esteroides/uso terapêutico
Colchicina/uso terapêutico
Pericardite/diagnóstico
Pericardite/tratamento farmacológico
Moduladores de Tubulina/uso terapêutico
[Mh] Termos MeSH secundário: Doença Aguda
Dor no Peito
Eletrocardiografia
Seres Humanos
Derrame Pericárdico/diagnóstico
Fatores de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Anti-Inflammatory Agents, Non-Steroidal); 0 (Tubulin Modulators); SML2Y3J35T (Colchicine)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180108
[Lr] Data última revisão:
180108
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171206
[St] Status:MEDLINE


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[PMID]:29054227
[Au] Autor:Andrä M; Baumer H; Mittergradnegger F; Laschitz M; Petek T; Wandschneider W
[Ad] Endereço:Department of Cardiothoracic and Vascular Surgery, Klagenfurt Clinic, Klagenfurt, Austria; Department of Surgery, Section for Surgical Research, Medical University Graz, Graz, Austria. Electronic address: michaela.andrae@kabeg.at.
[Ti] Título:Life-Threatening Cardiac Perforation After Posterior Spondylodesis.
[So] Source:Ann Thorac Surg;104(5):e355-e357, 2017 Nov.
[Is] ISSN:1552-6259
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:This reports presents a case of a 62-year-old woman with hemorrhagic hypovolemic shock, respiratory distress, and pericardial effusion secondary to right atrial perforation caused by a cement embolus after dorsal spondylodesis. Despite optimal intensive care support for a supposed pulmonary embolism, the patient's condition markedly deteriorated. On delayed embolus recognition by contrast-enhanced computed tomography and transesophageal echocardiography, she had to undergo cardiac surgery. Cardiac involvement is a rare but important complication, with few cases described after vertebroplasty and none after spondylodesis. In our case, diagnosis before perforation would have allowed an endovascular approach, thereby avoiding open heart surgery.
[Mh] Termos MeSH primário: Cimentos para Ossos/efeitos adversos
Procedimentos Cirúrgicos Cardíacos/métodos
Traumatismos Cardíacos/etiologia
Traumatismos Cardíacos/cirurgia
Vértebras Lombares/lesões
Fusão Vertebral/efeitos adversos
[Mh] Termos MeSH secundário: Acidentes por Quedas
Estado Terminal/terapia
Ecocardiografia Transesofagiana/métodos
Feminino
Seguimentos
Átrios do Coração/diagnóstico por imagem
Átrios do Coração/lesões
Traumatismos Cardíacos/diagnóstico por imagem
Seres Humanos
Vértebras Lombares/cirurgia
Meia-Idade
Derrame Pericárdico/diagnóstico por imagem
Derrame Pericárdico/etiologia
Derrame Pericárdico/cirurgia
Medição de Risco
Fraturas da Coluna Vertebral/diagnóstico por imagem
Fraturas da Coluna Vertebral/cirurgia
Fusão Vertebral/métodos
Tomografia Computadorizada por Raios X/métodos
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Bone Cements)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171102
[Lr] Data última revisão:
171102
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171022
[St] Status:MEDLINE


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[PMID]:28877028
[Au] Autor:Cerrato E; Varbella F
[Ad] Endereço:Infermi Rivoli and San Luigi Gonzaga University Hospital, Turin, Italy enrico.cerrato@gmail.com.
[Ti] Título:Left Ventricular Free-Wall Rupture.
[So] Source:N Engl J Med;377(10):e13, 2017 Sep 07.
[Is] ISSN:1533-4406
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Ruptura Cardíaca Pós-Infarto/diagnóstico por imagem
Ventrículos do Coração/diagnóstico por imagem
Ventriculografia com Radionuclídeos
[Mh] Termos MeSH secundário: Idoso
Eletrocardiografia
Evolução Fatal
Ruptura Cardíaca Pós-Infarto/complicações
Seres Humanos
Masculino
Derrame Pericárdico/etiologia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; VIDEO-AUDIO MEDIA
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170918
[Lr] Data última revisão:
170918
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170907
[St] Status:MEDLINE
[do] DOI:10.1056/NEJMicm1613367


  9 / 7669 MEDLINE  
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[PMID]:28816165
[Au] Autor:Ning MS; Tang L; Gomez DR; Xu T; Luo Y; Huo J; Mouhayar E; Liao Z
[Ad] Endereço:Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
[Ti] Título:Incidence and Predictors of Pericardial Effusion After Chemoradiation Therapy for Locally Advanced Non-Small Cell Lung Cancer.
[So] Source:Int J Radiat Oncol Biol Phys;99(1):70-79, 2017 Sep 01.
[Is] ISSN:1879-355X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: Findings from Radiation Therapy Oncology Group (RTOG) 0617 suggested that collateral radiation to the heart may contribute to early death in patients receiving chemoradiation therapy for non-small cell lung cancer (NSCLC); however, reports of cardiac toxicity after thoracic radiation therapy (RT) remain limited. Because pericardial disease is the most common cardiac complication of thoracic RT, we investigated the incidence of and risk factors for pericardial effusion (PCE) in patients enrolled in a phase 2 prospective randomized study of intensity modulated RT versus proton therapy for locally advanced NSCLC. METHODS AND MATERIALS: From July 2009 through April 2014, 201 patients were prospectively treated with proton beam therapy or intensity modulated RT to 60 to 74 Gy with concurrent chemotherapy. The primary endpoint (grade ≥2 PCE) was diagnosed on review of follow-up images. Clinical characteristics and cardiac dose-volume parameters associated with PCE were identified via Cox proportional hazards modeling and recursive partitioning analysis of null Martingale residuals. Reproducibility was evaluated in a separate retrospective cohort of 301 patients. RESULTS: The cumulative incidence rates of PCE among patients in the trial were 31.4% at 1 year and 45.4% at 2 years, with a median time to PCE of 8.9 months. Several cardiac dose-volume parameters (eg, V20 [volume receiving ≥20 Gy] to V65 [volume receiving ≥65 Gy]) predicted PCE, but heart volume receiving ≥35 Gy (HV35) was the most strongly associated, with a cutoff volume of 10%. On multivariate analysis, HV35 >10% independently predicted PCE (hazard ratio [HR], 2.14; P=.002), a finding that maintained reproducibility in the retrospective validation cohort. Other factors associated with PCE included receipt of adjuvant chemotherapy (HR, 2.82; P<.001) and prior cardiac disease (HR, 1.68; P=.020). CONCLUSIONS: PCE was common after RT for NSCLC, occurring in nearly half of patients even after moderate radiation doses to the heart. Adjuvant chemotherapy may increase the risk of PCE, and HV35 >10% may identify patients at risk of development of this cardiac toxicity.
[Mh] Termos MeSH primário: Carcinoma Pulmonar de Células não Pequenas/terapia
Coração/efeitos da radiação
Neoplasias Pulmonares/terapia
Derrame Pericárdico/epidemiologia
Derrame Pericárdico/etiologia
Terapia com Prótons/efeitos adversos
Radioterapia de Intensidade Modulada/efeitos adversos
[Mh] Termos MeSH secundário: Idoso
Antineoplásicos/efeitos adversos
Carcinoma Pulmonar de Células não Pequenas/patologia
Quimiorradioterapia/efeitos adversos
Quimiorradioterapia/métodos
Feminino
Coração/diagnóstico por imagem
Seres Humanos
Incidência
Neoplasias Pulmonares/patologia
Masculino
Análise Multivariada
Modelos de Riscos Proporcionais
Estudos Prospectivos
Dosagem Radioterapêutica
Radioterapia Guiada por Imagem/efeitos adversos
Radioterapia Guiada por Imagem/métodos
Estudos Retrospectivos
Fatores de Risco
[Pt] Tipo de publicação:CLINICAL TRIAL, PHASE II; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Antineoplastic Agents)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:171104
[Lr] Data última revisão:
171104
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170818
[St] Status:MEDLINE


  10 / 7669 MEDLINE  
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[PMID]:28739031
[Au] Autor:Horr SE; Mentias A; Houghtaling PL; Toth AJ; Blackstone EH; Johnston DR; Klein AL
[Ad] Endereço:Heart and Vascular Institute, Center for the Diagnosis and Treatment of Pericardial Disease, Department of Cardiovascular Medicine and Department of Thoracic and Cardiovascular Surgery Cleveland Clinic, Cleveland, Ohio. Electronic address: HorrS@CCF.org.
[Ti] Título:Comparison of Outcomes of Pericardiocentesis Versus Surgical Pericardial Window in Patients Requiring Drainage of Pericardial Effusions.
[So] Source:Am J Cardiol;120(5):883-890, 2017 Sep 01.
[Is] ISSN:1879-1913
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Comparative outcomes of patients undergoing pericardiocentesis or pericardial window are limited. Development of pericardial effusion after cardiac surgery is common but no data exist to guide best management. Procedural billing codes and Cleveland Clinic surgical registries were used to identify 1,281 patients who underwent either pericardiocentesis or surgical pericardial window between January 2000 and December 2012. The 656 patients undergoing an intervention for a pericardial effusion secondary to cardiac surgery were also compared. Propensity scoring was used to identify well-matched patients in each group. In the overall cohort, in-hospital mortality was similar between the group undergoing pericardiocentesis and surgical drainage (5.3% vs 4.4%, p = 0.49). Similar outcomes were found in the propensity-matched group (4.9% vs 6.1%, p = 0.55). Re-accumulation was more common after pericardiocentesis (24% vs 10%, p <0.0001) and remained in the matched cohorts (23% vs 9%, p <0.0001). The secondary outcome of hemodynamic instability after the procedure was more common in the pericardial window group in both the unmatched (5.2% vs 2.9%, p = 0.036) and matched cohorts (6.1% vs 2.0%, p = 0.022). In the subgroup of patients with a pericardial effusion secondary to cardiac surgery, there was a lower mortality after pericardiocentesis in the unmatched group (1.5% vs 4.6%, p = 0.024); however, after adjustment, this difference in mortality was no longer present (2.6% vs 4.5%, p = 0.36). In conclusion, both pericardiocentesis and surgical pericardial window are safe and effective treatment strategies for the patient with a pericardial effusion. In our study there were no significant differences in mortality in patients undergoing either procedure. Observed differences in outcomes with regard to recurrence rates, hemodynamic instability, and in those with postcardiac surgery effusions may help to guide the clinician in management of the patient requiring therapeutic or diagnostic drainage of a pericardial effusion.
[Mh] Termos MeSH primário: Procedimentos Cirúrgicos Cardíacos/métodos
Drenagem/métodos
Derrame Pericárdico/cirurgia
Pericardiocentese/métodos
Sistema de Registros
[Mh] Termos MeSH secundário: Ecocardiografia
Feminino
Mortalidade Hospitalar/tendências
Seres Humanos
Masculino
Meia-Idade
Ohio/epidemiologia
Derrame Pericárdico/diagnóstico
Derrame Pericárdico/mortalidade
Estudos Retrospectivos
Taxa de Sobrevida/tendências
Resultado do Tratamento
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170901
[Lr] Data última revisão:
170901
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170726
[St] Status:MEDLINE



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