The eMergency Medical Treatment and Active Labor Act of 1985: federal law, an Oklahoma experience relevant to the psychiatric patient.

The Emergency Medical Treatment and Active Labor Act of 1985 (EMTALA) was enacted to encourage emergency departments and physicians through fines and practice limitations to provide the same quality of care to all patients seeking medical assistance. Despite these penalties, violations continue to occur in all states including Oklahoma. One of the proposed reasons cited for this behavior is a physician's limited knowledge of the standard of care encompassed by the Act.

Using a filter to improve the chatroom experience in interactive medical education.

A computer chatroom exercise between faculty and students was used in a Human Behavior course for first-year medical students to provide an interactive exam review learning exercise. Two conditions were compared--one that filtered out all irrelevant student comments, and one without the filter that permitted all student comments. Four one-hour chatroom sessions, each with eight groups of five students, were conducted with all comments recorded.

Efficacy and safety of topiramate monotherapy in civilian posttraumatic stress disorder: a randomized, double-blind, placebo-controlled study.

Objective: This double-blind, placebo-controlled trial assessed efficacy and safety of topiramate monotherapy in civilian posttraumatic stress disorder (PTSD).

Method: Outpatients (18-64 years) with DSM-IV non-combat-related PTSD and Clinician-Administered PTSD Scale (CAPS) scores >or= 50 were eligible. Topiramate was started at 25 mg/day and titrated by 25-50 mg/week to 400 mg/day or maximum tolerated dose.

Physiologic reactivity despite emotional resilience several years after direct exposure to terrorism.

Objective: Six and a half to 7 years after the 1995 terrorist bombing in Oklahoma City, the authors assessed autonomic reactivity to trauma reminders and psychiatric symptoms in adults who had some degree of direct exposure to the blast.

Method: Sixty survivors who were listed in a state health department registry of persons exposed to the bombing and 60 age- and gender-matched members of the Oklahoma City metropolitan area community were assessed for symptoms of PTSD and depression and for axis I diagnoses. Heart rate and systolic, diastolic, and mean arterial blood pressures were measured before, during, and after bombing-related interviews.