Views And Reviews Minerva


BMJ 1998; 316 doi: (Published 16 May 1998) Cite this as: BMJ 1998;316:1544

An analysis of 40 medicolegal claims based on admissions as medical emergencies showed that 20 of the 29 deaths were probably avoidable (Journal of the Royal College of Physicians of London 1998;32:125-9). Ten of the patients were not seen by a consultant or senior registrar, and in a further ten cases the consultant input was minimal. Changes are needed, says the article, to ensure a full assessment of emergencies by experienced physicians who ideally have no other duties on their “take” day apart from teaching trainees how to assess and manage patients who are acutely ill.

This year marks the 50th anniversary of the start of the Framingham heart study, in which 5209 people agreed to have detailed medical examinations every two years as their health was kept under observation (JAMA 1998;279:1241-5). The study has made substantial contributions in showing the links between heart disease and hypertension, dietary fat, raised serum concentrations of cholesterol, and smoking. The 50 years have seen important social changes too—in the words of one of its directors, when the study started there was no fast food and lawnmowers didn't have engines.

In a series of 2109 kidney transplants at the University of Minnesota 16 patients developed acute ischaemia of a leg (Surgery 1998;123:344-50). Fifteen had …

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