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20 November 2001 Annals of Internal Medicine 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 115,000 internal medicine physicians and medical students. The following highlights are not intended to substitute for articles as sources of information. For an embargoed fax of an article, call 1-800-523-1546, ext. 2656 or 215-351-2656.

Blood Thinner After Hip Replacement Appears to Reduce Chance of Clots

A new analysis of data on 1,953 patients in six previously published trials showed that hip replacement patients are prone to develop blood clots in the veins of the leg for up to six weeks after surgery (Article, p. 858). Patients who received a special blood thinner for four to six weeks after surgery were less likely to develop clots than patients who received a placebo (a dummy shot). The blood thinner, low-molecular-weight heparin, is given as a shot and, unlike other blood thinners, does not require frequent monitoring with blood tests.

Many Physicians Would Participate in Executions Even Though Professional Organizations Say Not To

Participating in executions violates the Hippocratic Oath and is prohibited by most medical societies, such as the American Medical Association (AMA) and the American College of Physicians-American Society of Internal Medicine. Despite these medical society policies, many physicians say they would be willing to participate in execution by lethal injection, a new study found (Brief Communication, p. 884). Of 413 physicians who responded to a questionnaire, 41 percent said they would perform at least one action proscribed by the AMA's ethics guidelines and 25 percent would perform five or more actions. Only three percent of the physicians were aware of professional guidelines on the issue. An accompanying editorial says the study shows that "some physicians are morally confused" (Editorial, p. 922). The writer calls on professional medical societies to re-emphasize their opposition to physician involvement in capital punishment.

Index Identifies Which Patients Most Likely to Get Pneumonia After Surgery

A new risk index, based on patients' characteristics and the type of surgery, identifies which patients are likely to develop pneumonia after surgery (Article, p. 847). Since 18 percent of postoperative patients get pneumonia, with a death rate of 30 to 40 percent depending on the type of surgery, physicians should assess patients' risks for postoperative pneumonia before surgery.

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