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Cough

Coughing is a reflex that keeps your throat and airways clear. Although it can be annoying, coughing helps your body heal or protect itself. Coughs can be either acute or chronic. Acute coughs begin suddenly and usually last no more than 2 to 3 weeks. Acute coughs are the kind you most often get with a cold, flu, or acute bronchitis. Chronic coughs last longer than 2 to 3 weeks. Causes of chronic cough include:

  • Chronic bronchitis
  • Asthma
  • Allergies
  • COPD (chronic obstructive pulmonary disease)
  • GERD (gastroesophageal reflux disease)
  • Smoking
  • Throat disorders, such as croup in young children
  • Some medicines

Water can help ease your cough - whether you drink it or add it to the air with a steamy shower or vaporizer. If you have a cold or the flu, antihistamines may work better than non-prescription cough medicines. Children under four should not have cough medicine. For children over four, use caution and read labels carefully.

Cytomegalovirus Infections

Cytomegalovirus (CMV) is a virus found around the world. It is related to the viruses that cause chickenpox and infectious mononucleosis (mono). Between 50% and 80% of adults in the United States have had a CMV infection by age 40. Once CMV is in a person's body, it stays there for life.

CMV is spread through close contact with body fluids. Most people with CMV don't get sick and don't know that they've been infected. But infection with the virus can be serious in babies and people with weak immune systems. If a woman gets CMV when she is pregnant, she can pass it on to her baby. Usually the babies do not have health problems. But some babies can develop lifelong disabilities.

A blood test can tell whether a person has ever been infected with CMV. Most people with CMV don't need treatment. If you have a weakened immune system, your doctor may prescribe antiviral medicine. Good hygiene, including proper hand washing, may help prevent infections.

Centers for Disease Control and Prevention

Delirium

What is delirium?

Delirium is a mental state in which you are confused, disoriented, and not able to think or remember clearly. It usually starts suddenly. It is often temporary and treatable.

There are three types of delirium:

  • Hypoactive, where you are not active and seem sleepy, tired, or depressed
  • Hyperactive, where you are restless or agitated
  • Mixed, where you change back and forth between being hypoactive and hyperactive
What causes delirium?

There are many different problems that can cause delirium. Some of the more common causes include:

  • Alcohol or drugs, either from intoxication or withdrawal. This includes a serious type of alcohol withdrawal syndrome called delirium tremens. It usually happens to people who stop drinking after years of alcohol abuse.
  • Dehydration and electrolyte imbalances
  • Dementia
  • Hospitalization, especially in intensive care
  • Infections, such as urinary tract infections, pneumonia, and the flu
  • Medicines. This could be a side effect of a medicine, such as sedatives or opioids. Or it could be withdrawal after stopping a medicine.
  • Metabolic disorders
  • Organ failure, such as kidney or liver failure
  • Poisoning
  • Serious illnesses
  • Severe pain
  • Sleep deprivation
  • Surgeries, including reactions to anesthesia
Who is at risk for delirium?

Certain factors put you at risk for delirium, including:

  • Being in a hospital or nursing home
  • Dementia
  • Having a serious illness or more than one illness
  • Having an infection
  • Older age
  • Surgery
  • Taking medicines that affect the mind or behavior
  • Taking high doses of pain medicines, such as opioids
What are the symptoms of delirium?

The symptoms of delirium usually start suddenly, over a few hours or a few days. They often come and go. The most common symptoms include:

  • Changes in alertness (usually more alert in the morning, less at night)
  • Changing levels of consciousness
  • Confusion
  • Disorganized thinking, talking in a way that doesn't make sense
  • Disrupted sleep patterns, sleepiness
  • Emotional changes: anger, agitation, depression, irritability, overexcitement
  • Hallucinations and delusions
  • Incontinence
  • Memory problems, especially with short-term memory
  • Trouble concentrating
How is delirium diagnosed?

Your health care provider may use many tools to make a diagnosis:

  • A medical history, which includes asking about your symptoms
  • Physical and neurological exams
  • Mental status testing
  • Lab and diagnostic imaging tests

Delirium and dementia have similar symptoms, so it can be hard to tell them apart. They can also occur together. Delirium starts suddenly and can cause hallucinations. The symptoms may get better or worse and can last for hours or weeks. On the other hand, dementia develops slowly and does not cause hallucinations. The symptoms are stable and may last for months or years.

What are the treatments for delirium?

Treatment of delirium focuses on the causes and symptoms of delirium. The first step is to identify the cause. Often, treating the cause will lead to a full recovery. The recovery may take some time - weeks or sometimes even months. In the meantime, there may be treatments to manage the symptoms, such as:

  • Controlling the environment, which includes making sure that the room is quiet and well-lit, having clocks or calendars in view, and having family members around
  • Medicines, including those that control aggression or agitation and pain relievers if there is pain
  • If needed, making sure that the person has a hearing aid, glasses, or other devices for communication
Can delirium be prevented?

Treating the conditions that can cause delirium may reduce the risk of getting it. Hospitals can help lower the risk of delirium by avoiding sedatives and making sure that the room is kept quiet, calm, and well-lit. It can also help to have family members around and to have the same staff members treat the person.

Emphysema

What is emphysema?

Emphysema is a type of COPD (chronic obstructive pulmonary disease). COPD is a group of lung diseases that make it hard to breathe and get worse over time. The other main type of COPD is chronic bronchitis. Most people with COPD have both emphysema and chronic bronchitis, but how severe each type is can be different from person to person.

Emphysema affects the air sacs in your lungs. Normally, these sacs are elastic or stretchy. When you breathe in, each air sac fills up with air, like a small balloon. When you breathe out, the air sacs deflate, and the air goes out.

In emphysema, the walls between many of the air sacs in the lungs are damaged. This causes the air sacs to lose their shape and become floppy. The damage also can destroy the walls of the air sacs, leading to fewer and larger air sacs instead of many tiny ones. This makes it harder for your lungs to move oxygen in and carbon dioxide out of your body.

What causes emphysema?

The cause of emphysema is usually long-term exposure to irritants that damage your lungs and the airways. In the United States, cigarette smoke is the main cause. Pipe, cigar, and other types of tobacco smoke can also cause emphysema, especially if you inhale them.

Exposure to other inhaled irritants can contribute to emphysema. These include secondhand smoke, air pollution, and chemical fumes or dusts from the environment or workplace.

Rarely, a genetic condition called alpha-1 antitrypsin deficiency can play a role in causing emphysema.

Who is at risk for emphysema?

The risk factors for emphysema include:

  • Smoking. This the main risk factor. Up to 75% of people who have emphysema smoke or used to smoke.
  • Long-term exposure to other lung irritants, such as secondhand smoke, air pollution, and chemical fumes and dusts from the environment or workplace.
  • Age. Most people who have emphysema are at least 40 years old when their symptoms begin.
  • Genetics. This includes alpha-1 antitrypsin deficiency, which is a genetic condition. Also, smokers who get emphysema are more likely to get it if they have a family history of COPD.
What are the symptoms of emphysema?

At first, you may have no symptoms or only mild symptoms. As the disease gets worse, your symptoms usually become more severe. They can include:

  • Frequent coughing or wheezing
  • A cough that produces a lot mucus
  • Shortness of breath, especially with physical activity
  • A whistling or squeaky sound when you breathe
  • Tightness in your chest

Some people with emphysema get frequent respiratory infections such as colds and the flu. In severe cases, emphysema can cause weight loss, weakness in your lower muscles, and swelling in your ankles, feet, or legs.

How is emphysema diagnosed?

Your health care provider may use many tools to make a diagnosis:

  • A medical history, which includes asking about your symptoms
  • A family history
  • Other tests tests, such as lung function tests, a chest x-ray or CT scan, and blood tests
What are the treatments for emphysema?

There is no cure for emphysema. However, treatments can help with symptoms, slow the progress of the disease, and improve your ability to stay active. There are also treatments to prevent or treat complications of the disease. Treatments include:

  • Lifestyle changes, such as
    • Quitting smoking if you are a smoker. This is the most important step you can take to treat emphysema.
    • Avoiding secondhand smoke and places where you might breathe in other lung irritants
    • Ask your health care provider for an eating plan that will meet your nutritional needs. Also ask about how much physical activity you can do. Physical activity can strengthen the muscles that help you breathe and improve your overall wellness.
  • Medicines, such as
    • Bronchodilators, which relax the muscles around your airways. This helps open your airways and makes breathing easier. Most bronchodilators are taken through an inhaler. In more severe cases, the inhaler may also contain steroids to reduce inflammation.
    • Vaccines for the flu and pneumococcal pneumonia, since people with emphysema are at higher risk for serious problems from these diseases
    • Antibiotics if you get a bacterial or viral lung infection
  • Oxygen therapy, if you have severe emphysema and low levels of oxygen in your blood. Oxygen therapy can help you breathe better. You may need extra oxygen all the time or only at certain times.
  • Pulmonary rehabilitation, which is a program that helps improve the well-being of people who have chronic breathing problems. It may include
    • An exercise program
    • Disease management training
    • Nutritional counseling
    • Psychological counseling
  • Surgery, usually as a last resort for people who have severe symptoms that have not gotten better with medicines. There are surgeries to
    • Remove damaged lung tissue
    • Remove large air spaces (bullae) that can form when air sacs are destroyed. The bullae can interfere with breathing.
    • Do a lung transplant. This is might be an option if you have very severe emphysema.

If you have emphysema, it's important to know when and where to get help for your symptoms. You should get emergency care if you have severe symptoms, such as trouble catching your breath or talking. Call your health care provider if your symptoms are getting worse or if you have signs of an infection, such as a fever.

Can emphysema be prevented?

Since smoking causes most cases of emphysema, the best way to prevent it is to not smoke. It's also important to try to avoid lung irritants such as secondhand smoke, air pollution, chemical fumes, and dusts.

NIH: National Heart, Lung, and Blood Institute

Flu

What is the flu?

The flu, also called influenza, is a respiratory infection caused by viruses. Each year, millions of Americans get sick with the flu. Sometimes it causes mild illness. But it can also be serious or even deadly, especially for people over 65, newborn babies, and people with certain chronic illnesses.

What causes the flu?

The flu is caused by flu viruses that spread from person to person. When someone with the flu coughs, sneezes, or talks, they spray tiny droplets. These droplets can land in the mouths or noses of people who are nearby. Less often, a person may get flu by touching a surface or object that has flu virus on it and then touching their own mouth, nose, or possibly their eyes.

What are the symptoms of the flu?

Symptoms of the flu come on suddenly and may include:

  • Fever or feeling feverish/chills
  • Cough
  • Sore throat
  • Runny or stuffy nose
  • Muscle or body aches
  • Headaches
  • Fatigue (tiredness)

Some people may also have vomiting and diarrhea. This is more common in children.

Sometimes people have trouble figuring out whether they have a cold or the flu. There are differences between them:

Signs and SymptomsColdFluStart of symptomsSlowlySuddenlyFeverRarelyUsuallyAchesSometimes (slight)UsuallyFatigue, weaknessSometimesUsuallyHeadacheRarelyCommonStuffy nose, sneezing, or sore throatCommonSometimes

Sometimes people say that they have a "flu" when they really have something else. For example, "stomach flu" isn't the flu; it's gastroenteritis.

What other problems can the flu cause?

Some people who get the flu will develop complications. Some of these complications can be serious or even life-threatening. They include:

  • Bronchitis
  • Ear infection
  • Sinus infection
  • Pneumonia
  • Inflammation of the heart (myocarditis), brain (encephalitis), or muscle tissues (myositis, rhabdomyolysis)

The flu also can make chronic health problems worse. For example, people with asthma may have asthma attacks while they have flu.

Certain people are more likely to have complications from the flu, including:

  • Adults 65 and older
  • Pregnant women
  • Children younger than 5
  • People with certain chronic health conditions, such as asthma, diabetes, and heart disease
How is the flu diagnosed?

To diagnose the flu, health care providers will first do a medical history and ask about your symptoms. There are several tests for the flu. For the tests, your provider will swipe the inside of your nose or the back of your throat with a swab. Then the swab will be tested for the flu virus.

Some tests are quick and give results in 15-20 minutes. But these tests are not as accurate as other flu tests. These other tests can give you the results in one hour or several hours.

What are the treatments for the flu?

Most people with the flu recover on their own without medical care. People with mild cases of the flu should stay home and avoid contact with others, except to get medical care.

But if you have symptoms of flu and are in a high risk group or are very sick or worried about your illness, contact your health care provider. You might need antiviral medicines to treat your flu. Antiviral medicines can make the illness milder and shorten the time you are sick. They also can prevent serious flu complications. They usually work best when you start taking them within 2 days of getting sick.

Can the flu be prevented?

The best way to prevent the flu is to get flu vaccine every year. But it's also important to have good health habits like covering your cough and washing your hands often. This can help stop the spread of germs and prevent the flu.

Centers for Disease Control and Prevention

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