The Journal of the Oklahoma State Medical Association
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J Okla State Med Assoc · Jul 2012
Case ReportsBrugada pattern mimicking acute coronary syndrome in a febrile state.
The Brugada type pattern is characterized by a coved or saddleback shaped ST-segment elevation in the right precordial leads (V1-V3) on a surface 12 lead electrocardiogram (ECG). This pattern can be seen spontaneously, induced by sodium channel blocking drugs or rarely by hyperthermia. ⋯ Such ECG's could easily be mistaken for acute ST segment elevation myocardial infarction and thus pose a unique clinical challenge to emergency room physicians. We report such a case of fever induced Brugada pattern and discuss the underlying mechanisms.
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J Okla State Med Assoc · Mar 2012
Assessment of anesthesia provides' opinions regarding pediatric induction practices in the state of Oklahoma.
The induction of anesthesia in children is commonly carried out by the administration of inhaled anesthetics via face mask as opposed to an intravenous induction. Thus far, no study has assessed the opinions of anesthesia providers regarding commonly used induction techniques. We surveyed current attitudes among anesthesiologist to understand anesthesia induction techniques in pediatric patients in the community. ⋯ To evaluate pediatric anesthesia induction techniques, the attitudes of anesthesia providers were assessed. Although 84% of responders felt comfortable with pediatric patients and 77% felt proficient, our data suggests that further education and research can be done to help facilitate a higher percentage who feel comfortable with pediatric induction techniques.
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J Okla State Med Assoc · Nov 2011
Case ReportsOcular injuries from shake and bake methamphetamine labs.
To review ocular injuries resulting from "shake and bake" methamphetamine labs. ⋯ Methamphetamine production by means of the"shake and bake" method can result in combined thermal and alkali ocular injury. Patients who sustain this type of injury may not accurately report the mechanism of exposure. Increased awareness of this type of ocular injury may increase the rapidity of diagnosis, avoid early misdiagnosis, and ultimately improve outcomes.
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The Accountable Care Organizations (ACOs) shared savings program has serious concerns about anti-trust and anti-fraud laws. Additionally, ACOs present several other legal concerns relating to the duties and responsibilities of the physician-hospital partnership. ⋯ The structure and procedures required of ACOs may be detrimental and may significantly impact the liability of its contracting physicians. Therefore, it behooves physicians to obtain legal advice regarding one's estate planning and legal asset protection or wealth management techniques, and to thoroughly review the agreement with one's attorney before signing a contract with an ACO.