Utility of Cardiac Troponin to Predict Drug Overdose Mortality.

Drug overdose is now the leading cause of injury-related mortality in the USA, but the prognostic utility of cardiac biomarkers is unknown. We investigated whether serum cardiac troponin I (cTnI) was associated with overdose mortality. This prospective observational cohort studied adults with suspected acute drug overdose at two university hospital emergency departments (ED) over 3 years.

Clinical risk factors for in-hospital adverse cardiovascular events after acute drug overdose.

Objectives: It was recently demonstrated that adverse cardiovascular events (ACVE) complicate a high proportion of hospitalizations for patients with acute drug overdoses. The aim of this study was to derive independent clinical risk factors for ACVE in patients with acute drug overdoses.

Methods: This prospective cohort study was conducted over 3 years at two urban university hospitals.

Racial susceptibility for QT prolongation in acute drug overdoses.

Background And Purpose: QT prolongation independently predicts adverse cardiovascular events in suspected poisoning. We aimed to evaluate the association between race and drug-induced QT prolongation for patients with acute overdose.

Methods: This was a cross-sectional observational study at two urban teaching hospitals.

Incidence of adverse cardiovascular events in adults following drug overdose.

Objectives: Drug overdose is a leading cause of cardiac arrest and is currently the second leading cause of overall injury-related fatality in the United States. Despite these statistics, the incidence of adverse cardiovascular events (ACVEs) in emergency department (ED) patients following acute drug overdose is unknown. With this study, we address the 2010 American Heart Association Emergency Cardiovascular Care update calling for research to characterize the incidence of in-hospital ACVE following drug overdose.

QT interval screening in methadone maintenance treatment: report of a SAMHSA expert panel.

In an effort to enhance patient safety in opioid treatment programs, the Substance Abuse and Mental Health Saervices Administration convened a multi-disciplinary Expert Panel on the Cardiac Effects of Methadone. Panel members (Appendix A) reviewed the literature, regulatory actions, professional guidances, and opioid treatment program experiences regarding adverse cardiac events associated with methadone. The Panel concluded that, to the extent possible, every opioid treatment program should have a universal Cardiac Risk Management Plan (incorporating clinical assessment, electrocardiogram assessment, risk stratification, and prevention of drug interactions) for all patients and should strongly consider patient-specific risk minimization strategies (such as careful patient monitoring, obtaining electrocardiograms as indicated by a particular patient's risk profile, and adjusting the methadone dose as needed) for patients with identified risk factors for adverse cardiac events.

QTc interval screening in methadone treatment.

Description: An independent panel developed cardiac safety recommendations for physicians prescribing methadone.

Methods: Expert panel members reviewed and discussed the following sources regarding methadone: pertinent English-language literature identified from MEDLINE and EMBASE searches (1966 to June 2008), national substance abuse guidelines from the United States and other countries, information from regulatory authorities, and physician awareness of adverse cardiac effects. RECOMMENDATION 1 (DISCLOSURE): Clinicians should inform patients of arrhythmia risk when they prescribe methadone.

The use of standardised patients to assess clinical competence: does practice make perfect?

Context: The use of standardised patients (SPs) is now an integral component of the United States Medical Licensing Examination (USMLE). This new requirement has caused more schools to include SP examinations (SPEs) in their curricula. This study reviews the effect of prior experience with SPs in a medical school curriculum on SPE pass rates.

The Mount Sinai School of Medicine Consortium for Graduate Medical Education: a collaboration to enhance quality.

Over the years, the Graduate Medical Education (GME) programs have become increasingly complex; unfortunately, this trend has been accompanied by a decrease in federal funding. In 1996, in an attempt to enhance the GME effort, Mount Sinai School of Medicine formed its Consortium for Graduate Medical Education. At present the Consortium consists of 13 institutions and more than 2,000 house staff.

Innovative Clinical Addiction Research Training Track in Preventive Medicine.

Medical education related to identification, diagnosis and management of alcohol and other drug problems receives inadequate attention in the undergraduate curriculum and during residency training. This article describes the design, implementation, and evaluation of a new track in Clinical Addiction Research Training (CART) in a General Preventive Medicine (GPM) residency program. CART is comprised of a new course in Addiction Medicine, new practicum sites in addiction medicine research and treatment, and a CART-designated resident.

An Assessment of House Staff's Knowledge of Alcohol and Substance Abuse Utilizing Standardized Patients.

Utilizing standardized patients (SPs), house staff knowledge of alcohol and substance abuse was assessed in residents just prior to their starting their first graduate year of training. A total of 345 residents from 13 different residencies in eight institutions participated in this program. Each resident was assigned four SP cases.