THE COUGH THAT NEVER CEASES. SEVEN IMPORTANT CAUSES.

We refer to a cough that lasts more than three weeks and that never ceases to end. The cough is a reflex that that our body uses as a defence mechanism to expel or clean foreign bodies from our airways. If the cough becomes a chronic cough, it would not be normal and it would be warning us that there is something wrong.

The cough can present itself as part of acute pathologies that would be generally infectious and of a short duration. We will be analysing the persistent and chronic cough within this article, as it is a symptom of many pathologies that need to be diagnosed as soon as possible.

CAUSES OF THE CHRONIC COUGH

1. ASTHMA

Asthma is a disease that produces an inflammation and reversible obstruction of the bronchial tubes. It is characterised by the presence of a certain type of cough that is predominantly dry, nightly and accompanied by respiratory difficulties. It is usually produced by an allergy to pollen, fungi, animal hairs, foods, vasomotor alterations, etc.

2. CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD)

Chronic obstructive pulmonary disease covers three types of pathologies and they are: chronic bronchitis, emphysema and long-term asthma in people that have been smokers. This disease is due to the permanent and irreversible inflammation of the bronchial tubes. It is usually caused by tobacco and produces a cough every morning and different amounts of sputum.

3. GASTROESOPHAGEAL REFLUX

Gastroesophageal reflux is the way in which gastric contents travel through the oesophagus and produce a feeling of heartburn or burning in the throat, mouth or retrosternal.

This acid usually produces laryngeal irritation that causes a commonly dry and persistent cough. Gastroesophageal reflux can only present this cough as an only symptom without being aware that the reflux is present.

4. POSTNASAL DRIP

Postnasal dripping is the constant presence of mucus within the throat. This dripping is caused by inflammatory processes in the nose (Rhinitis) and in the mucous membrane that surrounds the sinuses (Sinusitis).

5. CHRONIC LARYNGITIS

Inflammation of the larynx that lasts more than three weeks, results in a dry cough that is usually accompanied by hoarseness, that is commonly due to the misuse of the voice, the presence of nodules on the vocal chords or irritants such as tobacco, alcohol, gastroesophageal reflux.

6. TUBERCULOSIS

Tuberculosis is a pulmonary infection that is produced by Koch’s bacillus and which the main symptoms are: a chronic cough with sputum of blood, fever, tiredness, night sweats, etc.

7. LUNG CANCER

Lung cancer usually does not have any initial symptoms, but a recent cough that lasts more than three weeks, or an existing cough that changes intensity or tone, or that simply has the presence of blood in the sputum, would alert us of this pathology.

OTHERS

Cystic fibrosis, bronchiectasis, cardiac failure, parasites such as worms and pharmaceuticals to treat hypertension such as captopril, etc. are other pathologies that will produce a cough that is not as frequent.

Lastly, we want to remind people that when faced with the presence of a cough that lasts for more than three weeks, then medical assistance should be sought out in order to obtain a diagnosis as quickly as possible.

Dr. J. Hurtado Martínez

Medical Director of HealthSalus

LA TOS QUE NO CESA. SIETE CAUSAS IMPORTANTES.

Nos referiremos a la tos que no cesa, como una tos que dura más de tres semanas. La tos, es un reflejo que nuestro organismo utiliza como mecanismo de defensa, y que sirve para expulsar o limpiar de cuerpos extraños nuestras vías respiratorias. Si la tos se convierte en crónica, ya no seria normal, y nos estaría  avisando de que algo no anda bien. 

La tos puede presentarse en patologías agudas, generalmente de tipo infeccioso y  por corto tiempo. La tos crónica y persistente, es la que analizaremos ahora por ser uno de los síntoma de patologías que hay que diagnosticar lo antes posible. 

CAUSAS DE TOS CRÓNICA

1. ASMA
El asma es una enfermedad que produce inflamación y obstrucción reversible de los bronquios. Se caracteriza por presentar un tipo de tos, predominantemente seca y nocturna acompañada de dificultad respiratoria. Generalmente se produce por alergia a pólenes, hongos, pelos de animales, alimentos, alteraciones vasomotoras, etc.

2. ENFERMEDAD PULMONAR OBSTRUCTIVA CRÓNICA (EPOC)

Las enfermedad pulmonar obstructiva crónica abarca generalmente tres tipos de patologías que son: la bronquitis crónica, el enfisema y el asma de larga duración en personas que hayan sido fumadoras. Esta enfermedad es debida a la  inflamación permanente e irreversible de los bronquios. Generalmente debida al tabaco, produce una tos matutina, con producción de mayor o menor expectoración.

3. REFLUJO GASTROESOFÁGICO

El reflujo gastroesofágico consiste en el paso del contenido gástrico hacia el esófago, produciendo sensación de ardor o quemazón a nivel retroesternal, garganta y boca. Este ácido produce a menudo irritación de la laringe dando lugar a tos persistente, generalmente seca. El reflujo gastroesofágico puede presentar la tos como único síntoma sin tener conciencia de que se tiene reflujo.

4. GOTEO RETRONASAL

El goteo retronasal, es la presencia constante de mucosidad a nivel de la garganta. Este goteo es consecuencia de procesos inflamatorios localizados tanto a nivel de la nariz (Rinitis), como a nivel de las mucosas que envuelven los senos (Sinusitis).

5. LARINGITIS CRÓNICA

La inflamación de la laringe por más de tres semanas, da lugar a una tos seca, generalmente acompañada de ronquera, y debida principalmente al mal uso de la voz, irritantes como el tabaco, el alcohol, reflujo gastroesofágico, o a la presencia de nódulos en las cuerdas vocales.

6. TUBERCULOSIS

La tuberculosis es la infección pulmonar producida por el bacilo de koch y cuyos principales síntomas son: tos crónica con expectoración sanguinolenta, fiebre,  cansancio, sudoración nocturna, etc.

7. CÁNCER DE PULMÓN

El cáncer de pulmón, generalmente no da síntomas en sus comienzos, pero una  tos de reciente aparición que dura más de tres semanas, o una antigua que cambia de intensidad o tonalidad, o simplemente la presencia de sangre en la expectoración, nos tiene que poner en alerta.

OTROS

La fibrosis quística, las bronquiectasias, la insuficiencia cardíaca, algunos fármacos para tratar la hipertensión como el Captopril, o los parásitos como las lombrices, son otras de las patologías que producen tos, aunque generalmente con menos frecuencia.

Y para finalizar volver a recordar, que siempre, y ante la presencia de una tos que dura más de tres semanas, se debe de buscar asistencia médica, para lograr un diagnóstico lo más rápidamente posible.

Dra. J. Hurtado Martínez

Directora Médica de HealthSalus

PREVENTIVE MEASURES AGAINST CORONAVIRUS. COVID-19

The coronavirus is a microorganism that needs a living being to reproduce itself. Coronavirus or COVID-19, is a type of virus that is highly contagious and that causes important pathologies in the respiratory system. This virus is spread from person to person through droplets of saliva that we expel when we talk, sneeze or cough.

SYMPTOMS

The symptoms that can emerge after the contagion of COVID-19 take place between the second and fourteenth day after the contagion has occurred.

Approximately 80 percent of people affected by the virus only present mild or moderate symptoms. Another small group of people present severe symptoms and others do not present any symptoms whatsoever.

These symptoms are:

• Fever (A temperature higher than 38 degrees)
• Cough (Usually dry and without any sputum)
• Pain (Headaches, throat pain, sometimes leg pain or consistent pain throughout the body)
• Extreme tiredness
• Diarrhoea
• Loss of smell and appetite

SEVERE SIGNS OR SYMPTOMS

• Tightness in the chest and experiencing pain when taking any deep breaths (pleuritic pain)
• Dyspnoea or loss of breath
• Red blotches throughout the skin that could indicate sepsis or an extended infection
• Bruised lips
• Pale skin
• Cold sweat or loss of consciousness

The dyspnoea or loss of breath usually occurs on the seventh day after contagion and patients can suffer from respiratory insufficiency on the eighth day. It is important to keep an eye out on these days in case patients still have a fever or cough.

The dyspnoea or loss of breath can indicate that the infection has moved to the lung and that it is causing pneumonia.

DIAGNOSIS

The presence of the virus can be determined through a sample taken by a swab in the nose and pharynx or through a blood test. An X-ray would be used to diagnose this virus in cases when patients present severe symptoms such as pneumonia.

PREVENTIVE MEASURES

The virus spreads from person to person and through small particles of saliva that we expel when we talk, cough or sneeze. Various studies have verified that these particles have various sizes with big particles falling to the ground and small particles being suspended for a small period of time in the air and then dispersed throughout it.

1. SOCIAL DISTANCING

Always maintain a minimum of two metres or six feet of distance from person to person.

2. COUGHING OR SNEEZING

Always cough or sneeze in a tissue and then get rid of it.

If we don’t have a tissue to hand, then we will cough or sneeze where the bend of our elbow is located, never in our hand as we can use it to touch our nose, mouth or eyes without meaning to and these are usually the most common ways through which the virus enters our system.

3. FREQUENT HAND WASHING

Frequent hand washing and also forearm washing, is to be completed with water and soap for a period of 20 seconds. This is one of the most important measures that we need to take into account. If we are unable to use water and soap then we will use a water-alcohol extract that will need to contain at least seventy per cent of alcohol.

4. CLEANING OF SURFACES

The cleaning of door handles, railings, tables or places where we usually congregate, will be undertaken with common detergents or bleach solutions.

If there are any patients in the house that suffer from coronavirus, then they will maintain the same hygiene measures previously mentioned and should be isolated in a room if able. Them and everybody that came into contact with them will be isolated for a period of fourteen days.

5. FACE MASKS

The use of facemasks has to always be coupled by frequent hand washing with water and soap or with water-alcohol extract gels. The external part of facemasks should not be touched and these should be removed cautiously from the back so as to not touch the front, as it could have come into contact with the virus.

PRECAUTIONS

We should all take the preventive measures mentioned within this article and recommended by the World Health Organisation (WHO) however, the people mentioned below should take special precautions.

• People older than 65 years old with or without any previous pathologies
• Pregnant women
• People of any age that suffer from previous pathologies such as diabetes, hypertension, cardiovascular diseases, chronic lung diseases, (asthma, emphysema, chronic bronchitis), cancer patients, people that are severely overweight, immunosuppressed patients and patients that have received a transplant
• Patients that have autoimmune diseases such as rheumatoid arthritis, lupus or patients that are treated with immunosuppressive drugs or steroids. In this cases, we will need to look out for any other symptoms that are not a fever as they might not exhibit other symptoms due to the treatments that they are already taking

TREATMENT                                                                                   

There is currently no treatment for the virus and we hope that a vaccine would be available in roughly a year from now.

The World Health Organisation (WHO) recommends that we are always hydrated and that any medication taken is always done so under medical supervision.

To conclude, we want to highlight that we should maintain a healthy diet, do as much physical exercise as possible within our limitations and maintain the best state of mind possible during quarantine.

We need to care of older and vulnerable people and think about one another. This is the way that we will defeat this virus.

Dr J. Hurtado Martínez                                                                                                  
Medical Director of HealthSalus

MEDIDAS DE PREVENCIÓN DEL CORONAVIRUS. COVID-19

El coronavirus es un microorganismo que necesita de un ser vivo para reproducirse. El coronavirus o COVID-19 es uno de esos virus sumamente contagiosos que producen importantes patologías a nivel del aparato respiratorio y que se contagia de persona a persona a través de las gotitas de saliva que expulsamos al hablar, estornudar, o toser.

SÍNTOMAS

Los síntomas que pueden aparecer tras el contagio del COVID-19 se dan entre los días dos al catorce después del contagio.

Aproximadamente el 80 por ciento de los afectados solo presentan síntomas  leves o moderados. Otro pequeño grupo presentan síntomas graves, y algunos otros no presentan síntoma alguno.

Estos son:

• Fiebre (Temperatura alta de más de 38 grados)
• Tos (Generalmente seca y sin expectoración)
• Dolor (Dolor de cabeza y garganta, a veces de piernas y generalizado en todo el cuerpo)
• Cansancio extremo
• Diarrea
• Pérdida del gusto y del olfato

SIGNOS Y SÍNTOMAS DE GRAVEDAD

• Opresión en el pecho, y dolor al respirar profundamente (dolor pleurítico)
• Disnea o falta de aire
• Manchas rojas en la piel que pueden estar indicando una sepsis o infección generalizada
• Labios morados
• Piel pálida
• Sudoración fría y pérdida de conciencia

La disnea o falta de aire, suele darse alrededor del séptimo día, y es  en al octavo cuando se puede entrar en insuficiencia respiratoria. Hay que estar muy atentos si por esos días el paciente todavía presenta tos y fiebre.

La disnea o falta de aire puede estar indicando que la infección ha pasado al pulmón y que se está produciendo una neumonía.

DIAGNÓSTICO

La presencia del virus se puede determinar a través de una muestra tomada con un bastoncillo a nivel de la nariz y la faringe o con una analítica de sangre. Cuando aparecen los síntomas graves como neumonía el diagnostico se hará con una radiografía.

MEDIDAS DE PREVENCIÓN

El virus se contagia como hemos dicho de persona a persona y a través de las pequeñas partículas de saliva que expulsamos al hablar, toser, o al estornudar. Estas partículas son de diferentes tamaños, unas grandes que caen al suelo y otras pequeñas que se mantienen por corto tiempo en el aire y después se dispersan como se ha verificado en diversos estudios.

1. DISTANCIAMIENTO SOCIAL

Mantener siempre una distancia entre persona y persona, mínimo de dos metros o 6 pies.

2. TOSER O ESTORNUDAR

Siempre lo haremos sobre un pañuelo que posteriormente desecharemos.

Si no tenemos un pañuelo a mano, toseremos o estornudaremos a nivel de la flexura del codo, nunca sobre la mano, la cual sin que nos demos cuenta nos la podríamos llevar a la nariz, boca u ojos que son las vías habituales de entrada del virus.

3. LAVADO FRECUENTE DE LAS MANOS

El lavado frecuente de las manos se realizara con agua y jabón incluso hasta el nivel del antebrazo durante 20 segundos. Es una de las más importantes medidas que debemos tener en cuenta. Si no se puede acceder en ese momento a jabón y agua, utilizaremos una solución hidroalcohólica que contenga al menos un sesenta por ciento de alcohol.

4. LIMPIEZA DE SUPERFICIES

La limpieza de pomos de la puerta, barandillas, mesas o lugares en los que nos desenvolvemos habitualmente, se hará con los detergentes habituales o soluciones de lejía.

Si hay enfermos de coronavirus en casa se mantendrán las mismas medidas de higiene y al ser posible aislado en una habitación. El y sus contactos lo harán durante catorce días.

5. MASCARILLAS

El uso de las mascarillas tiene que ir siempre acompañado del lavado frecuente de las manos con agua y jabón o de geles hidroalcohólicos. Las mascarillas no se tocarán por la parte externa y se quitarán cuidadosamente desde atrás, para no tocar la parte de delante que ha podido tener contacto con el virus.

PRECAUCIONES

Todos debemos de seguir las medidas de precaución señaladas y recomendadas por la Organización Mundial de la Salud (OMS), pero las siguientes personas deber tener especial precaución.

• Mayores de 65 años con o sin patologías previas
• Embarazadas
• Personas de cualquier edad con patologías previas como son diabetes, hipertensión, enfermedades cardiovasculares, enfermedades pulmonares crónicas (asma, enfisema, bronquitis crónica), enfermos de cáncer,  inmunodeprimidos y trasplantados, sobrepeso importante, etc.
• Los pacientes con enfermedades autoinmunes como artritis reumatoide,  lupus o pacientes que estén en tratamiento con inmunosupresores o corticoides, prestarán mucha atención a cualquier síntomas que no sea fiebre ya que por los tratamientos que llevan pueden no presentarla 

TRATAMIENTO

Actualmente no hay un tratamiento para el virus y esperamos que la vacuna esté disponible aproximadamente en un año.

La OMS (Organización Mundial de la Salud) recomienda mantener siempre una buena hidratación, y cualquier tipo de fármaco que se utilice se hará siempre bajo supervisión médica.

Para terminar señalar que durante la cuarentena debemos de tener una alimentación lo más saludable que podamos, hacer ejercicio físico dentro de nuestras posibilidades y mantener el mejor estado de ánimo posible.

Cuidemos de las personas mayores y vulnerables, y pensemos cada uno en el otro. Esta será la forma en la que venceremos al virus.  

Dra J. Hurtado Martínez

Directora Médica de HealthSalus

PREVENTIVE MEASURES FOR THE FLU

The flu is a viral infectious disease that is commonly characterised for the brusque emergence of its symptoms within the winter season.

The flu virus is spread from person to person via saliva droplets that we expel when we talk, whether we see them or not.

The virus can also be spread when the sufferer coughs, sneezes, places their hand over their mouth or touches objects with their contaminated hands.

SYMPTOMS

The symptoms are:

• High fever. Higher than 38 degrees.
• Intense headache.
• Joint pain.
• Extreme tiredness.
• Sore throat.
• Blocked nose.
• Cough.

TREATMENT

• Have bed rest for the week that it approximately lasts.
• Ensure that you are well hydrated by drinking hot drinks, orange juices and lemon teas rich in Vitamin C.  
• Taking medication to reduce the fever and the pain.

COMPLICATIONS

The most serious complications that can arise from having suffered the flu are bronchitis and pneumonias.

PRECAUTIONS

Pregnant women, diabetics, people that have low immune systems or people that suffer from chronic pulmonary diseases have to take precautions to avoid contracting the flu.

PREVENTIVE MEASURES

• Use disposable tissues.
• Coughing or sneezing on your arm and not over your hands.
• Regularly wash your hands.
• Maintain a high level of hygiene, especially where pregnant women, children and people that suffer from chronic illnesses or are immunosuppressed are present.
• Vaccines to be administered to as many people as possible.
• Maintain a varied diet rich in vitamins and antioxidants, which are present in fruits and vegetables.

Humanity has always been contact with multiple virus and will continue to do so, we have survived them up to now and will keep doing so in the future.

Dr. J Hurtado Martínez

Medical Director of HealthSalus

MEDIDAS DE PREVENCIÓN DE LA GRIPE

La gripe es una enfermedad contagiosa, de origen vírico, que se da fundamentalmente en la época invernal y que se caracteriza por la aparición brusca de sus síntomas.

El virus de la gripe se contagia de una persona a otra a través de unas gotitas de saliva que todos expulsamos al hablar, las veamos o no.

El virus también se extiende cuando el infectado tosa, estornude, se ponga la mano en la boca o toque objetos con sus manos contaminadas.

SÍNTOMAS

Los síntomas son:

• Fiebre alta. Más de 38 grados de temperatura.
• Cefalea o dolor de cabeza intenso.
• Dolores en las articulaciones.
• Cansancio extremo.
• Dolor de garganta.
• Nariz bloqueada.
• Tos.

TRATAMIENTO

• Mantenerse en cama durante la semana que aproximadamente dura.
• Mantenerse bien hidratado, bebiendo bebidas calientes, zumos de naranja y tés de limón ricos en vitamina C.
• Medicación para la fiebre y el dolor.

COMPLICACIONES

Las bronquitis y las neumonías son las mayores complicaciones a las que puede llevar una gripe.

PRECAUCIONES

Las personas con defensas bajas, embarazadas, diabéticos, o con enfermedades pulmonares crónicas, entre otros, deberán de tomar las mayores precauciones posibles para evitar el contagio de este virus.

MEDIDAS DE PREVENCIÓN

• Usar pañuelos desechables.
• Toser o estornudar sobre el brazo, nunca sobre la mano.
• Lavarse frecuentemente las manos.
• Mantener una higiene máxima, especialmente donde haya niños, embarazadas, enfermos crónicos o inmunodeprimidos.
• Vacunaciones para el mayor número de personas posibles.
• Llevar una alimentación rica y variada en vitaminas y antioxidantes, presentes en frutas y verduras.

La humanidad ha estado siempre en contacto con múltiples virus y continuará estándolo, hemos sobrevivido a ellos, y lo seguiremos haciendo.

Dra. J. Hurtado Martínez

Directora Médica de HealthSalus

LEMON. THE GOLDEN CITRUS FRUIT.

This fruit originated in Asia and is currently cultivated worldwide. The lemon is the fruit of the lemon tree and should never be omitted from a healthy diet.

PROPERTIES

1. ACTIVATOR OF THE IMMUNE SYSTEM

Its high content of Vitamin C activates the immune system by increasing our defences and helping us to combat diseases, usually infectious.  

2. COLLAGEN

Lemons help to form collagen and thereby contribute to the maintenance of strong bones and joints. They also contribute to having healthy teeth, gums, skin and hair.

3. ELASTICITY

The elements of lemons contribute to the elasticity found within our larger arteries and in turn, help them to prevent the emergence of thrombi within them.

They also contribute to maintaining the basal membrane of small blood vessels stable thereby, avoiding capillary fragility and preventing them from rupturing.

4. PREVENTION OF CANCER

Certain studies suggest that certain types of acids present in lemons would intervene in the prevention of various types of cancer, by blocking a type of cancerous substances called nitrosamines. The limonoids or small phytonutrients present within lemon rinds would act in the same way.

5. ANTISEPTIC

Lemons act as a potent antiseptic by helping scarring.

6. PREVENTION OF DISEASES

A number of studies have been able to demonstrate how lemons aid in the prevention of degenerative, cardiovascular and eye diseases.

7. ANTIINFLAMATORY

The presence of antioxidants such as flavonoids, reduce pain and inflammation.

8. BLOOD PRESSURE

The elements present within lemons help to prevent high blood pressure by acting as diuretics.

9. PECTIN

Pectin is another element present within lemons. This soluble fibre decreases cholesterol and glucose levels, whilst also feeding the good bacteria present within our intestinal flora.

10. IRON ABSORPTION

The Vitamin C present in lemons help us to absorb the iron present within vegetables, especially green leafy vegetables such as spinach, watercress, swiss chard, etc. Pouring a small quantity of lemon juice on top of these vegetables, helps the body to absorb their nutrients much more effectively.

OTHER BENEFITS OF LEMON

IN TEA

Lemon is usually used to treat colds and coughs due to their anti-inflammatory properties. It is prepared using hot water and honey.

DIARRHOEAS

Lemons are used as a component of alkaline lemonade to combat the dehydration caused by diarrhoea. It is prepared by dissolving half a teaspoon of salt, half a teaspoon of baking soda, half a teaspoon of sugar and the juice of two lemons into a litre of boiled or bottled water. This lemonade is drunk in small sips until the diarrhoea improves.

In addition to all of the uses explored within this article, it is also important to add that lemons can also be used as salad dressings and in the elaboration of meals, desserts, juices, sorbets, sherbets, etc. Lemon sorbets and sherbets can be used to aid the digestion of large meals.

Lemons are a source of health. 

Dr. J. Hurtado Martinez

Medical Director of HealthSalus