Diplomate, Board Certification of Emergency Medicine
Chairman, Department of Emergency Medicine Ma'ayenei Hayeshua
Hospital
Continuing about letters:
Hand washing we said is critical in hospital situations, but
has undergone a change recently. Iodine -- the active
ingredient in polydine -- has been found to be less effective
than chlorhexidine. Most hospitals have already made the
switch. The newest rage is waterless alcohol solutions. This
avoids problems of skin dryness and breakdown, as well as
bacteria living on the moist surfaces of faucets.
However, what is clear is that rubbing is the most effective
factor. Indeed, bacteria will learn to deal with all sorts of
antiseptics, but if they are pushed off physically, they
cannot do damage. Therefore, before I suture, I use a syringe
with sterile water -- no antiseptic -- and fire a spray into
the wound. Studies have shown this to be an effective way to
reduce infection. At home, soap and running water are just
fine -- for the same reasons. Similarly, drinking cranberry
juice helps prevent urinary tract infections because it has a
substance in it that prevents bacteria from sticking.
Unclean bathrooms is a topic that has been discussed in this
column before, and I don't know what to add. Yeshivas and
schools are particularly bad in this regard. Absence of
toilet paper and soap as well as the towel on the pole are
all dangerous. And yes, many people do not bother washing
their hands after using the facilities.
CMV can be a bad virus, but it is ubiquitous, meaning it is
one of the most common viruses and is basically all over. I
doubt protecting your child from it serves any purpose, and I
think medical science has already discounted it as a cause of
chronic fatigue syndrome.
Herpes is another common infection that causes cold sores and
this same family causes chicken pox and shingles. This virus
cleverly hides in the body and finds ways of attacking again
when the conditions are ripe, fleeing back to its hiding
place when the body fights back. It is the cause of Bell's
palsy in all probability and also shingles, which can spread
to children if one is not careful. It could have been the
cause of this girl's problem, and may not be related to poor
hygiene.
Keeping up one's resistance is a tough one for me to talk
about as I do not always do what I should. The answer is:
exercise, lose weight, stop smoking, eat well, sleep well,
avoid stress and don't push yourself. This strategy will help
prevent cancer and heart disease.
Lastly, it seems that Dr. Zimmerman is the same physician
that was a year behind me at Einstein. If my correspondent
could pass on my regards, I'd be very grateful. Write me in
care of the Yated.
A message from Glaxo, sponsor of this column. Flolan
is Glaxo's drug for pulmonary hypertension, a difficult to
manage disease where the blood pressure in the lungs alone is
high. Flolan is the only drug approved for treatment of this
malady, and should be considered if you are suffering from
this disease.
