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People’s Pharmacy: Nurse distressed that doctors don’t wash hands

Q. Yesterday, my next-door neighbor (a nurse in our local monster-size hospital) vented aggressively about doctors she witnesses moving from patient to patient without washing their hands or wearing gloves. According to her, MRSA and C. diff infections are rampant at this hospital.

When nurses have suggested hand-washing or gloves to these doctors, there have been disciplinary comments placed in their personnel records. I had to ask her to repeat what she said because I found it almost incomprehensible.

A. We find it as perplexing as you do. Public-health authorities are exhorting everyone (doctors, nurses and patients) to wash hands regularly and thoroughly, especially as we enter cold and flu season. MRSA (methicillin-resistant Staph aureus) and C. diff (Clostridium difficile) are potentially life-threatening infections and require extreme measures to eradicate from a hospital. Hand-washing is an essential first step.

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Q. Your recent column about using probiotics in yogurt to reduce blood pressure in an otherwise healthy young person was way below the standard of care.

I am a physician. Had I treated such a patient with yogurt and he developed a stroke, I would be sued for malpractice. You need to caution your readers to stick with their medicine if they have hypertension.

A. The gentleman in question wanted to try to get his variable blood pressure under control with natural remedies before taking medicines. He puts in 20 kilometers a week on his NordicTrack and reports low-to-normal cholesterol levels.

That said, your point is well-taken that hypertension is associated with an increased risk for stroke. Medication can control serious elevations in blood pressure while people use other strategies to bring hypertension under control.

Our Guide to Blood Pressure Treatment discusses the role of medicine as well as nondrug approaches. Anyone who would like a copy can send $3 in check or money order with a long (No. 10), stamped (70 cents), self-addressed envelope to: Graedons’ People’s Pharmacy, No. B-67, P.O. Box 52027, Durham, NC 27717-2027. It also can be downloaded for $2 from our website: www.peoplespharmacy.com.

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Q. I have Barrett’s esophagus, a precancerous condition that can sometimes turn into cancer of the esophagus. Several years ago, my gastroenterologist recommended that I take a low dose of aspirin to prevent the abnormal cells from morphing further into dangerous ones.

I don’t know whether he had anything besides intuition behind this idea, but I agreed and have followed his suggestion ever since. Do you know of any studies relating to aspirin and Barrett’s?

A. Your question is fascinating because it seems counterintuitive. Aspirin can be irritating to the digestive system, so how could it be helpful against cancer? In reality, though, there is substantial evidence that aspirin can help prevent a number of common cancers, especially within the digestive tract.

Your gastroenterologist was relying on science, not intuition. One study reported that regular use of aspirin or other NSAIDs (nonsteroidal anti- inflammatory drugs) reduces the risk of esophageal cancer (Gastroenterology, March 2012). A more recent analysis found that aspirin and NSAIDs decrease the risk of Barrett’s esophagus and may protect against cancer of the esophagus (Digestive Disease and Sciences online, Sept. 12, 2014).