Methadone for Fun Sake… Kidneys Are at Stake!!!

Acute renal failure from rhabdomyolysis is a well-established clinical entity; however, rhabdomyolysis exclusively caused by the ingestion of methadone requiring hemodialysis is very uncommon. With a similar mechanism to opiates, methadone can cause rhabdomyolysis and further consequences. Given the increasing use of methadone as a therapy for opiate dependence, clinicians prescribing this medication should be aware of this life-threatening complication.

SLE or hypothyroidism: who can triumph in cardiac tamponade?

A 36-year-old Hispanic woman with a history of systemic lupus erythaematosus (SLE) in remission presented with progressive dyspnoea, bilateral leg swelling and increasing fatigue with rapid weight gain over the past few months. Her physical examination showed mildly tender thyromegaly and pericardial rub. Investigations showed new onset marked hypothyroidism as well as an active lupus serology with echocardiogram confirming severe pericardial effusion and a tamponade phenomenon.

Granulomatous Mastitis in a Hispanic Woman.

A 33-year-old mother of 2 healthy children presented with bilateral recurrent breast infections despite successful treatment of each episode of an infection. With a negative rheumatologic medical history as well as a negative review of systems, she continued to have these infections frequently. Hence, a breast biopsy was performed after the treatment with a course of antimicrobials, which revealed changes suggestive of granulomatous mastitis.

Patients' preferences for selection of endpoints in cardiovascular clinical trials.

Background: To reduce the duration and overall costs of cardiovascular trials, use of the combined endpoints in trial design has become commonplace. Though this methodology may serve the needs of investigators and trial sponsors, the preferences of patients or potential trial subjects in the trial design process has not been studied.

Objective: To determine the preferences of patients in the design of cardiovascular trials.