Providing competency-based family medicine residency training in substance abuse in the new millennium: a model curriculum.

Background: This article, developed for the Betty Ford Institute Consensus Conference on Graduate Medical Education (December, 2008), presents a model curriculum for Family Medicine residency training in substance abuse.

Methods: The authors reviewed reports of past Family Medicine curriculum development efforts, previously-identified barriers to education in high risk substance use, approaches to overcoming these barriers, and current training guidelines of the Accreditation Council for Graduate Medical Education (ACGME) and their Family Medicine Residency Review Committee. A proposed eight-module curriculum was developed, based on substance abuse competencies defined by Project MAINSTREAM and linked to core competencies defined by the ACGME.

Resuscitation in the hospital: circadian variation of cardiopulmonary arrest.

Purpose: Over 25 reports have found outpatient frequency of sudden cardiac death peaks between 6 am and noon; few studies, with inconsistent results, have examined circadian variation of death in hospitalized patients. This study assesses circadian variation in cardiopulmonary arrest of in-hospital patients across patient, hospital, and event variables and its effect on survival to discharge.

Methods: A retrospective, single institution registry included all admissions to the Medical Center of Central Georgia in which resuscitation was attempted between January 1987 and December 2000.

The effect of regulation of high blood pressure on plasma endothelin-1 levels in blacks with hypertension.

Plasma concentrations of immunoreactive endothelin-1 (irET-1) are significantly elevated in blacks with hypertension. In the present study, we investigated the effect of the regulation of high blood pressure on plasma irET-1 levels in black hypertensive individuals. After the initial blood samples were collected from 20 black patients with uncontrolled high blood pressure (Day 1), an intensive antihypertensive treatment was initiated, and the blood pressure and plasma irET-1 levels were monitored on days 2, 8, and 22.

Racial differences in plasma endothelin-1 concentrations in individuals with essential hypertension.

Hypertension is more prevalent in blacks than whites, and the reasons for this difference remain unclear. To test whether endothelin may play a role in these racial variations, we analyzed plasma samples from black and white women and men with high blood pressure by an enzyme-linked immunoassay specific for endothelin-1 (ET-1), a potent vasoconstrictor, and compared them with those obtained from similar subjects with normal blood pressure. Both female and male hypertensive blacks had elevated levels of immunoreactive ET-1 (11.

Trocar-site metastasis following laparoscopic cholecystectomy for unsuspected carcinoma of the gallbladder. Case report and review of the literature.

Fifteen cases of trocar-size metastasis from unsuspected gallbladder carcinoma following laparoscopic cholecystectomy have been reported in the literature. We present the case of a 66-year-old woman who developed this complication 21/2 months postoperatively. We feel that carcinoma of the gallbladder is a contraindication to laparoscopic cholecystectomy.