<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0872-671X</journal-id>
<journal-title><![CDATA[Medicina Interna]]></journal-title>
<abbrev-journal-title><![CDATA[Medicina Interna]]></abbrev-journal-title>
<issn>0872-671X</issn>
<publisher>
<publisher-name><![CDATA[Sociedade Portuguesa de Medicina Interna]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0872-671X2021000100021</article-id>
<article-id pub-id-type="doi">10.24950/o/245/20/1/2021</article-id>
<title-group>
<article-title xml:lang="pt"><![CDATA[D-Dímeros no Diagnóstico de Tromboembolismo Venoso Num Serviço de Urgência]]></article-title>
<article-title xml:lang="en"><![CDATA[D-Dimer in Venous Thromboembolism Diagnosis in The Emergency Department]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Greenfield]]></surname>
<given-names><![CDATA[Helena]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Sousa]]></surname>
<given-names><![CDATA[Sílvia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Guedes]]></surname>
<given-names><![CDATA[Carolina]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Pedro Hispano Unidade Local de Saúde de Matosinhos Serviço de Medicina]]></institution>
<addr-line><![CDATA[Matosinhos ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hospital Pedro Hispano Unidade Local de Saúde de Matosinhos Serviço de Imunohemoterapia]]></institution>
<addr-line><![CDATA[Matosinhos ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Hospital Pedro Hispano Unidade Local de Saúde de Matosinhos Unidade de Cuidados Intermédios Polivalente]]></institution>
<addr-line><![CDATA[Matosinhos ]]></addr-line>
<country>Portugal</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>03</month>
<year>2021</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>03</month>
<year>2021</year>
</pub-date>
<volume>28</volume>
<numero>1</numero>
<fpage>21</fpage>
<lpage>27</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_arttext&amp;pid=S0872-671X2021000100021&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_abstract&amp;pid=S0872-671X2021000100021&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_pdf&amp;pid=S0872-671X2021000100021&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo:   Introdução:  O tromboembolismo venoso (TEV) engloba a trombose venosa profunda (TVP) e a embolia pulmonar (EP). O doseamento de D-dímeros tem uma sensibilidade superior a 95% e um elevado valor preditivo negativo para TEV. Propusemo-nos a analisar episódios de urgência em que foram doseados D-dímeros. As variáveis pesquisadas foram: sintomas ou sinais presentes, a adequabilidade do pedido de D-dímeros de acordo com a probabilidade pré-teste, a realização de tomografia computorizada com angiografia (angio-TC) e a confirmação/exclusão de TEV.   Métodos:  Análise retrospetiva dos episódios de urgência de 1 de julho a 31 de dezembro de 2017, referentes a doentes com mais de 18 anos, com doseamento de D-dímeros.   Resultados:  Foram incluídos 589 episódios. O género feminino representou 61,3% (n = 361) da amostra e a idade média foi de 62 ± 19 anos. Observamos doseamento de D-dímeros em doentes sem clínica sugestiva de TEV, em 110 episódios (19%). Em quatro doentes com alta-probabilidade pré-teste foi efetuado doseamento de D-dímeros; os D-dímeros estavam elevados em 55,5% de todos os episódios (327/589), mas apenas 28,1% (n = 92) destes fizeram angio-TC. O número total de casos de TEV confirmados foi de 27 (4,6%).   Discussão e Conclusão: Os resultados obtidos estão de acordo com a literatura. Reportam-se 3 erros na abordagem diagnóstica: doseamento de D-dímeros em doentes sem clínica sugestiva de TEV; doentes com alta-probabilidade submetidos a doseamento de D-dímeros; doentes com elevação de D-dímeros sem realização de angio-TC. Realçamos o interesse desta análise do ponto de vista económico e de não-maleficência no que respeita ao uso excessivo de exames no diagnóstico de TEV.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract: Introduction:Venous thromboembolism (VTE) refers to deep vein thrombosis (DVT) and pulmonary embolism (PE). D-dimer dosing has sensitivity of over 95% and high negative predictive value for the diagnosis of VTE. Our goal was to analyse every Emergency Department episode in which D-dimer dosing was performed. The variables analysed were: presence or absence of clinical symptoms suggestive of VTE, the suitability of D-dimer request according to pre-test probability scores, performance of computed tomography angiography (angio-CT) if D-dimer elevation and number of confirmed VTE.  Methods:  We performed a retrospectively analysis of all cases of patients over 18 years of age in whom D-Dimer dosing was performed in our Emergency Department from the 1st of July to the 31st of December of 2017.  Results:  589 episodes were included in our analysis. Female gender represented 61% (n = 361) and median age was 62 ± 19 years-old. We documented 110 episodes with D-dimer dosing without any suggestive symptoms of VTE. In four patients with high pre-test probability D-dimer was inadequately performed. D-dimer elevation was observed in 55,5% (327/589) of all episodes, but only 28,1% were submitted to angio-CT. Total VTE confirmed was 27 (4,6%).  Discussion and Conclusion:  Our results are according to the literature. We report 3 main diagnostic errors: D-dimer dosing in patients without symptoms of VTE; D-dimer dosing in high probability patients; and patients with elevated D-dimer who do not do angio-CT. This study enlightens the prejudice of excessive and inadequate exams in the diagnosis of VTE.]]></p></abstract>
<kwd-group>
<kwd lng="pt"><![CDATA[Produtos de Degradação da Fibrina e do Fibrinogénio]]></kwd>
<kwd lng="pt"><![CDATA[Serviço de Urgência]]></kwd>
<kwd lng="pt"><![CDATA[Tromboembolismo Venoso.]]></kwd>
<kwd lng="en"><![CDATA[Emergency Service, Hospital]]></kwd>
<kwd lng="en"><![CDATA[Fibrin and Fibrinogen Degradation Products]]></kwd>
<kwd lng="en"><![CDATA[Venous Thromboembolism]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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<given-names><![CDATA[EY]]></given-names>
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<article-title xml:lang=""><![CDATA[Joint Working Group on Post Analitycal Phase (WG-Post) of the European Organisation for External Quality Assurance Providers in Laboratory Medicine (EQALM). Is D-dimer used according to clinical algorithms in the diagnostic work-up of patients with suspicion of venous thromboembolism? A study in six European countries]]></article-title>
<source><![CDATA[Thromb Res.]]></source>
<year>2016</year>
<volume>142</volume>
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