[D-dimer testing in the emergency department: age adjustment, inappropriate use, and ability to predict the extension and severity of pulmonary embolism].

Objectives: To evaluate whether using D-dimer test results adjusted for age according to the formula proposed by Douma et al. improves diagnostic accuracy; to assess the appropriateness of ordering D-dimer tests on clinical suspicion of pulmonary embolism; and to explore the association of test results with the extension and severity of the embolism.

Material And Methods: Retrospective observational study of 1833 cases in which D-dimer testing was ordered for patients in our hospital's emergency department in the course of a year.

Mediastinal fibrosis and superior vena cava syndrome.

Superior vena cava syndrome is a clear sign for clinicians of infiltrative mediastinal involvement, usually caused by neoplasms in this location, and it is an indicator of poor prognosis. However, other diseases of benign origin can also cause these alterations. We present the case of a 34-year-old patient who debuted with symptoms of superior vena cava syndrome due to idiopathic mediastinal fibrosis, which presented a torpid evolution and few therapeutic alternatives.