Progression of ECG in hydroxychloroquine overdose.

Hydroxychloroquine overdose is associated with myocardial toxicity and conduction disorders. We report a case of hydroxychloroquine overdose that demonstrated a rapid progressive intraventricular conduction delay and QT prolongation resulting in significant bradycardia and shock despite aggressive treatment. We describe the rare capture of abrupt abnormalities of this overdose in sequential electrocardiograms in the immediate hours post-ingestion.

Massive Tension Hemothorax After Pacemaker Implantation.

A case of an 85-year-old male on apixaban and clopidogrel undergoing pacemaker implantation is described. After procedure he developed unilateral tension hemothorax and required emergent drainage and exploratory thoracotomy. No vascular, cardiac, or pulmonary source was identified.

Pharmacodynamic Effects When Clopidogrel is Given Before Cangrelor Discontinuation.

Objective: To determine whether initiation of clopidogrel before discontinuation of cangrelor would impact on the recovery of platelet reactivity.

Background: The active metabolite of clopidogrel cannot bind to P2Y12 when cangrelor occupies the receptor. Pharmacodynamic studies have shown that this interaction is avoided when clopidogrel is given at the end of the cangrelor infusion.

Pharmacodynamic effects during the transition between cangrelor and ticagrelor.

Objectives: This study sought to determine pharmacodynamic effects during transition from intravenous cangrelor to oral ticagrelor and from oral ticagrelor to intravenous cangrelor.

Background: Cangrelor is an intravenous antagonist of P2Y12 and its use will require transition to and from oral agents.

Methods: Patients (n = 12) with stable coronary artery disease who were taking aspirin 81 mg daily were recruited.

Survey of sensitive information written in patient notes by psychiatry trainees.

Objective: Allowing psychiatric patients access to their electronic medical record (EMR) may cause difficulty related to the sensitivity of the note content. The authors investigated whether notes written by psychiatry trainees were ready for release to patients.

Methods: Authors conducted a review of 128 PGY-3 to PGY-5 outpatient notes not explicitly marked as "highly confidential.

Reproducibility of QuantiFERON-TB gold in-tube assay.

Studies are needed to characterize the reproducibility of QuantiFERON-TB Gold (QFT-G) for targeted U.S. screening populations.