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Articles 
Elaine L. Larson, Susan X. Lin, Cabilia Gomez-Pichardo, and Phyllis Della-Latta Antibacterial products for general cleaning, laundry, and handwashing did not reduce the frequency of symptoms of viral infectious disease in households of essentially healthy persons. This result does not preclude the possibility that these home products reduce bacterial disease symptoms.
Klaus Juul, Anne Tybjærg-Hansen, Peter Schnohr, and Børge G. Nordestgaard In the adult Danish population, heterozygotes for the factor V Leiden mutation had a hazard ratio of 3 for venous thromboembolism relative to noncarriers of the mutation. For homozygotes, the hazard ratio was 18. When smoking, obesity, and old age were all present, the absolute 10-year thromboembolic risk was 10% in heterozygotes and 51% in homozygotes.
James M. O'Brien, Jr., Carolyn H. Welsh, Ronald H. Fish, Marek Ancukiewicz, Andrew M. Kramer for the National Heart, Lung, and Blood Institute Acute Respiratory Distress Syndrome Network* Mechanically ventilated patients with acute lung injury have the same risk-adjusted outcomes whether they are obese or overweight or have normal body mass index. O'Brien and colleagues' findings suggest that normal weight, overweight, or obese patients benefit equally from lower tidal volume ventilation for acute lung injury.
Stephanos J. Hadziyannis, Hoel Sette, Jr., Timothy R. Morgan, Vijayan Balan, Moises Diago, Patrick Marcellin, Giuliano Ramadori, Henry Bodenheimer, Jr., David Bernstein, Mario Rizzetto, Stefan Zeuzem, Paul J. Pockros, Amy Lin, Andrew M. Ackrill for the PEGASYS International Study Group* The researchers assessed the efficacy and safety of 24 or 48 weeks of treatment for chronic hepatitis C virus (HCV) infection with peginterferon-
Improving Patient Care
Lisa I. Iezzoni, Bonnie L. O'Day, Mary Killeen, and Heather Harker Persons who are deaf or hard of hearing face considerable barriers to communicating with physicians. As the population ages, physicians will encounter many more persons with hearing limitations. Ensuring effective communication is essential to safe, timely, efficient, and patient-centered care. The authors offer practical advice that we all need to hear.
Reviews
Stefan Zeuzem This article reviews the data on interferon-based therapies among patients with hepatitis C whose clinical findings mean that they are relatively unlikely to have a sustained virologic response. It also discusses the potential of the new pegylated interferons.
Clinical Guidelines
U.S. Preventive Services Task Force* The U.S. Preventive Services Task Force found insufficient evidence to recommend for or against routine screening of parents or guardians for the physical abuse or neglect of children, of women for intimate partner violence, or of older adults or their caregivers for elder abuse.
Heidi D. Nelson, Peggy Nygren, Yasmin McInerney, and Jonathan Klein This review provides the evidence to support the U.S. Preventive Services Task Force's position on screening for family and intimate partner violence.
Editorials
J. Todd Weber and James M. Hughes In this issue, Larson and colleagues found no difference in rates of infectious disease symptoms among families who used handwashing and household-cleaning products with and without antibacterial ingredients. Their trial shows that we can hold nonmedical products that claim to have health benefits to the same standard of evidence as new drugs, as we strive to provide the evidence base for public health recommendations.
Mark S. Lachs In this issue, Nelson and colleagues found essentially no studies of reasonable quality supporting specific effective intervention for family violence. In light of the evidence, why should clinicians screen for a disease for which there are no proven effective interventions? Because for some conditions that clinicians regularly encounter, robotic devotion to evidence-based medicine places us at risk of dehumanizing certain aspects of doctoring.
Letters Metformin Hepatotoxicity
Management of the Clinically Inapparent Adrenal Mass
Glenn D. Braunstein for the National Institutes of Health State-of-the Science Adrenal Incidentaloma Panel—RESPONSE Postmenopausal Hormone Replacement Therapy and Cardiovascular Disease
Advance Directives, Due Process, and Medical Futility
Infliximab for Recurrent, Sight-Threatening Ocular Inflammation in Adamantiades–Behçet Disease
P. P. Sfikakis, P. H. Kaklamanis, A. Elezoglou, N. Katsilambros, P. G. Theodossiadis, S. Papaefthimiou, and N. Markomichelakis Acute Renal Failure Associated with Legionellosis
Correction: The Future of Primary Care
Gregory A. Crooke and Thierry H. Le Jemtel
David M. Stamilio
Andrew D. Auerbach and Jennifer Kleinbart The articles discussed in this Update cover topics important for general internists with active inpatient practices. These original research papers published in 2002 gave new insights into common inpatient diagnoses and frequent challenges for inpatient physicians. | |||||||||||||||||||||||||||||||||||||||||||||||||
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2a plus a low or standard dose of ribavirin. The results suggest individualized treatment according to genotype. Patients with HCV genotype 1 require treatment for 48 weeks and a standard dose of ribavirin; for those with genotypes 2 and 3, 24 weeks of treatment with peginterferon-