Annals of Internal Medicine is published by the American College of Physicians, an organization of more than 115,000 internal medicine physicians and medical students. These 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.
American ginseng, a widely used herbal supplement, reduced the anticoagulant effect of warfarin, a commonly prescribed blood thinner (Article, p. 23). At the end of the four-week study involving 20 young, healthy volunteers, those who took ginseng had lower blood levels of warfarin and less of an effect on blood clotting than those volunteers who were given a placebo pill. Authors say that patients and doctors should realize the ginseng can undermine the blood thinning effects of warfarin and that when doctors prescribe warfarin, they should ask patients about use of ginseng.
Researchers observing the handwashing practices of 163 physicians in a large university hospital in Switzerland found an average of 57 percent followed standard hand hygiene practices (Article, p. 1). Internists (doctors of internal medicine) and medical students washed hands most often, while surgeons, anesthesiologists and critical care physicians washed hands least often. An analysis of physicians' self-reported questionnaires found that those most likely to wash hands were aware they were being observed, felt they were a role model for other colleagues and also had a positive attitude toward hand hygiene after patient contact. Factors associated with poor handwashing compliance were high workload and activities associated with a high risk for cross-transmission.
It has been known since the 1840s that handwashing can prevent health-care associated infections; most recently, the introduction of alcohol-based hand-rub solutions have made proper hand washing easy without water. An editorial writer says that in the United States, "hand hygiene rates average 40 percent to 60 percent on a good day" (Editorial, p. 65). He says that "(h)and hygiene and use of alcohol-based hand-rub solutions must become a ritual, automatic behavior" and alcohol hand-rub solution dispensers must be put "on every doorpost in every health care facility."
(Clinical Guidelines, p. 57.)