The American journal of the medical sciences
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Letter Case Reports
Multiple Myeloma With a "Normal" Erythrocyte Sedimentation Rate.
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Review Case Reports
A Unique Case of Co-Occurrence of Bilateral Pulmonary Artery Embolism and Right Atrium Thrombus.
Pulmonary embolism (PE) is considered a major cause of morbidity and mortality in both inpatient and outpatient settings. PE can be presented in different clinical pictures. ⋯ Although management changes between different PE sub-types, optimal medical therapy is not well established for coexisting PE with right atrial thrombus. Herein, we present a unique case of a 58-year-old male with bilateral PE and atrial thrombus, with no known underlying risk factors.
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Testing for collateral circulation of the hand before any radial artery procedure has been a subject of many controversies. Neither the Allen's test (AT) nor the plethysmography based Barbeau test, adequately and reliably test for collateral circulation. With growing interest in radial approaches for vascular procedures, its common use for arterial monitoring and blood gas sampling, there has been a growing interest in the relevance of assessing collateral hand circulation. ⋯ There is no standardization for being considered an abnormal test across literature and the significance of an abnormal test translating into a clinical outcome has not been investigated in prior studies. This may be attributed to the robust vascular supply of the hand, connections at the digital circulation level and vessel recruitment in an event of occlusion. We reviewed this topic extensively and make an argument that non-invasive collateral testing should be abandoned as a triage tool for radial artery procedures such as arterial punctures, arterial monitoring, and transradial vascular procedures.