The Journal of the Oklahoma State Medical Association
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J Okla State Med Assoc · Nov 2007
The association of pseudoephedrine sales restrictions on emergency department urine drug screen results in Oklahoma.
On June 15, 2004, Oklahoma became the first state to reclassify pseudoephedrine as a Schedule V drug. Arrests in Oklahoma for the manufacture of methamphetamines in clandestine laboratories precipitously declined. It was hypothesized that a decrease in methamphetamine use could be shown in the patient population in Oklahoma's largest emergency department. ⋯ There was a significant increase in the total tests performed and the percentage of positive test results for the amphetamine drug class (p = 0.0004, R2 = 0.3785) over time. These results suggest that methamphetamine usage has not decreased in the emergency department patient population. Possibly, methamphetamine usage in Oklahoma has not been impacted by the passage of HB 2176 due to an increase in drug trafficking of methamphetamine into the state.
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J Okla State Med Assoc · Jul 2006
Admitting a patient "to" observation or "for" observation--what is the difference?
Coding and billing of a patient placed in "observation" status can be confusing, especially in a busy Emergency Department. If physicians know the rules related to observation status, they can avoid denials or accusations of false claims. ⋯ If the order states "admit to observation," this normally would be interpreted as an order for outpatient observation. Physicians are encouraged to write admission orders that clearly state the level of services intended; for example, wording such as "place in outpatient observation" or "admit as inpatient," to clearly convey the physician's intent.
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J Okla State Med Assoc · Jun 2006
ReviewElevated cardiac troponins: their significance in acute coronary syndrome and noncardiac conditions.
Elevated cardiac troponin I or T levels are caused by cardiac injury. Such elevations in patients with acute coronary syndrome are crucial in terms of diagnosis, risk stratification and guiding therapy. ⋯ The literature on elevated cardiac troponins in patients with acute coronary syndrome, patients without acute coronary syndrome and patients with chronic renal failure is summarized. The significance of elevated cardiac troponins in each group as it relates to prognosis and guiding treatment options is discussed.
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J Okla State Med Assoc · Dec 2005
Mechanisms of head injury in bull riders with and without the Bull Tough helmet--a case series.
Bull riding is one of the most dangerous sporting activities of the modern era. Head injuries are common in bull riders, yet helmets and faceguards are rarely mandated in competitive bull riding events and few participants use such protective headgear. ⋯ Bull riders are at great risk of suffering severe head and facial injuries. Safe and effective helmets with protective face guards must be worn by bull riders if the incidence of these injuries is to be diminished. Organizations, promoters and schools that sponsor bull riding events, especially for minors, should mandate protective headgear in order to better protect these athletes.