TY - JOUR T1 - JournalScan JF - Emergency Medicine Journal JO - Emerg Med J SP - 205 LP - 206 VL - 21 IS - 2 AU - J P Wyatt AU - M Campbell Y1 - 2004/03/01 UR - http://emj.bmj.com/content/21/2/205.abstract N2 - Retrospective chart review of patients admitted to a general medical service in Chicago found that 26% had new physical findings, leading to a change in diagnosis and treatment, when examined by the attending physician on take. The author acknowledged the small sample size (100 patients over 28 days) and lack of control group. Even taking this into account, in a clinical era of reliance upon sophisticated and technologically advanced investigations, it is refreshing to be reminded of the role of traditional examination skills. ▴ Reilly BM. Physical examination in the care of medical inpatients: an observational study. Lancet2003;362:1100–5.OpenUrlCrossRefPubMedWeb of Science Prescribed drug related problems are well recognised. This observational study adds to an already large body of evidence. Some 6.5% of medical admissions to an acute teaching hospital screened by a pharmacist were judged to have resulted from drug related problems. Most of these were deemed to have been potentially preventable. The “problems” included prescribing problems, monitoring problems, and adherence/compliance problems. Of particular relevance to A&E, there was a comparatively large number of patients who presented with gastrointestinal problems having been prescribed non-steroidal anti-inflammatory agents in the presence of two or more “risk factors”. ▴ Howard RL, Avery AJ, Howard PD, et al. Investigation into the reasons for preventable drug related admissions to a medical admissions unit: observational study. Qual Saf Health Care2003;12:280–5.OpenUrlAbstract/FREE Full Text It has been suggested that Chlamydia pnemoniae infection plays a part in the pathogenesis of coronary artery disease. This randomised placebo controlled trial looked at the possible role of a three month course of azithromycin in over 7747 patients with a recent myocardial infarction and positive IgG titres for C pneumoniae. No difference in the rates of death, re-infarction or need for re-vascularisation was found at 14 months. ▴ O’Connor CM, Dunne MW, Pfeffer MA, et al. Azithromycin for the secondary prevention of coronary heart disease events. The WIZARD study: a randomized controlled trial. JAMA2003;290:1459–66.OpenUrlCrossRefPubMedWeb of Science This was the first of two companion papers on the potential role of automative external defibrillators (AEDs) in the prehospital setting. … ER -