EMBARGOED FOR RELEASE UNTIL 5 P.M., EST, MONDAY, NOVEMBER 30, 1998

December 1, 1998, Tip Sheet

Annals of Internal Medicine is published by the American College of Physicians-American Society of Internal Medicine (ACP-ASIM), an organization of more than 110,000 physicians trained in internal medicine. The following highlights are not intended to substitute for articles as sources of information. For a copy of an article, call 1-800-523-1546, ext. 2656 or 215-351-2656. The full text of selected articles can be accessed on December 1, 1998, on the Internet at www.acponline.org/journals/annals. * * *

Emergency Department System Accurate in Discriminating Among Some Heart Problems

A new system, using medical history information plus electrocardiograph (ECG) findings, estimated the probability that a patient admitted to a hospital emergency department with chest pain was suffering from acute cardiac ischemia and printed this information on the ECG report (Article, p. 845). Researchers estimate that wide use of the system in the U.S. could safely prevent more than 200,000 unnecessary hospitalizations and more than 100,000 unnecessary admissions to hospital coronary care units and would not change appropriate admissions of acute heart attacks or unstable angina. * * *

Medical Ethics Not Immutable: Efforts are Needed to Raise Awareness and Guide Action

Ethical principles in Western medicine were distorted and subverted by the movements for racial hygiene, eugenics and the Holocaust, says a prominent internist (Medicine and Public Issues, p. 891). Today in the U.S., reports of ethically flawed research and striking inequalities in access to and the quality of health care signify the need for active work to preserve and improve the medical ethos. * * *

Diet Drugs May Pose Less Risk for Heart Valve Disease than Previously Thought

A group of 46 people who had echocardiography before using the diet drugs fenfluramine or dexfenfluramine were studied with follow-up echocardiography (Brief Communications, p. 870). This study found a lower risk for new heart valve lesions associated with the diet drugs than previous estimates. An editorial speculates on why the risk was lower in these patients and why the link between the drugs and valve disease was not discovered earlier (Editorial, p. 903). * * *

With New Ability to Treat HIV, Physicians Must Not Abandon Older Skills (Perspective, p. 899.)

Annals Supplement Explores Screening for Iron Overload (See neighboring news release called IRON.ACP in Newswise MedNews Library.)

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