{"id":17595,"date":"2018-03-09T09:05:44","date_gmt":"2018-03-09T09:05:44","guid":{"rendered":"https:\/\/www.deberes.net\/tesis\/sin-categoria\/estrategia-diagnostica-y-terapeutica-en-el-paciente-con-derrame-pericardico\/"},"modified":"2018-03-09T09:05:44","modified_gmt":"2018-03-09T09:05:44","slug":"estrategia-diagnostica-y-terapeutica-en-el-paciente-con-derrame-pericardico","status":"publish","type":"post","link":"https:\/\/www.deberes.net\/tesis\/ciencias-medicas\/estrategia-diagnostica-y-terapeutica-en-el-paciente-con-derrame-pericardico\/","title":{"rendered":"Estrategia diagn\u00f3stica y terap\u00e9utica en el paciente con derrame peric\u00e1rdico"},"content":{"rendered":"<h2>Tesis doctoral de <strong> Jordi Merc\u00e9 Klein <\/strong><\/h2>\n<p>Esta tesis se presenta como compendio de publicaciones en revistas cient\u00edficas. en ellas se analizan varios aspectos referentes al diagn\u00f3stico y manejo de pacientes con derrame peric\u00e1rdico. Inclu\u00edmos 322 pacientes con derrame moderado o severo, definido como la suma de espacios libres de ecos en sacos anterior y posterior de 10 a 20 mm \u00f3 de m\u00e1s de 20 mm, respectivamente.  diagn\u00f3stico etiol\u00f3gico  el derrame diagnosticado en el contexto de determinadas condiciones o enfermedades conocidas que son su causa probable, se denomina derrame secundario, y en la mayor\u00eda de los casos ambos estar\u00e1n relacionado (96% en nuestra serie). en casos de derrame primario, nuestra hip\u00f3tesis es que determinados datos cl\u00ednicos y ecocardiogr\u00e1ficos pueden ser \u00fatiles para establecer un diagn\u00f3stico de sospecha que oriente el estudio etiol\u00f3gico y las exploraciones a practicar. as\u00ed, la presencia de signos\/s\u00edntomas inflamatorios se asocia al diagn\u00f3stico de pericarditis aguda idiop\u00e1tica independientemente de la cuant\u00eda del derrame y de la presencia o no de taponamiento (lr =5.5, 95% ci:4.2-7.1). En ausencia de signos inflamatorios, la presencia de taponamiento se asocia a una mayor probabilidad de pericarditis neopl\u00e1sica (lr=2.8, 95% ci:1.5-5.4); y finalmente, en pacientes con derrame severo o masivo en ausencia de signos inflamatorios y de taponamiento card\u00edaco, el diagn\u00f3stico m\u00e1s probable es el de derrame cr\u00f3nico idiop\u00e1tico (lr=22,95% ci:3.2-150).  otra cuesti\u00f3n analizada fue la influencia de la edad en el espectro etiol\u00f3gico y evoluci\u00f3n del derrame peric\u00e1rdico. Clasificamos a los pacientes en dos grupos seg\u00fan su edad fuera inferior o superior a 65 a\u00f1os.  las formas idiop\u00e1ticas y neopl\u00e1sicas de derrame fueron igualmente frecuentes en ambos grupos de pacientes. Las pericarditis tuberculosas y purulenta fueron m\u00e1s frecuentes en el grupo de pacientes m\u00e1s jovenes (5.9% vs 0.9%, p&lt;0,05), mientras que el derrame asociado a cardiopat<\/p>\n<p>&nbsp;<\/p>\n<h3>Datos acad\u00e9micos de la tesis doctoral \u00ab<strong>Estrategia diagn\u00f3stica y terap\u00e9utica en el paciente con derrame peric\u00e1rdico<\/strong>\u00ab<\/h3>\n<ul>\n<li><strong>T\u00edtulo de la tesis:<\/strong>\u00a0 Estrategia diagn\u00f3stica y terap\u00e9utica en el paciente con derrame peric\u00e1rdico <\/li>\n<li><strong>Autor:<\/strong>\u00a0 Jordi Merc\u00e9 Klein <\/li>\n<li><strong>Universidad:<\/strong>\u00a0 Aut\u00f3noma de barcelona<\/li>\n<li><strong>Fecha de lectura de la tesis:<\/strong>\u00a0 19\/06\/2002<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h3>Direcci\u00f3n y tribunal<\/h3>\n<ul>\n<li><strong>Director de la tesis<\/strong>\n<ul>\n<li>Jaime Sagrista Sauleda<\/li>\n<\/ul>\n<\/li>\n<li><strong>Tribunal<\/strong>\n<ul>\n<li>Presidente del tribunal: rafael Esteban  mur <\/li>\n<li>pilar Tornos mas (vocal)<\/li>\n<li>alfredo Bardaji ruiz (vocal)<\/li>\n<li>  (vocal)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Tesis doctoral de Jordi Merc\u00e9 Klein Esta tesis se presenta como compendio de publicaciones en revistas cient\u00edficas. en ellas se [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center 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