Cinco cosas que quizás no sabe sobre la cera de los oídos y algo más
Paula McGrath BBC
- 17 marzo 2014
La cera o cerilla de los oídos es uno de esos productos corporales que pocos quieren discutir en público.
En el pasado, esta sustancia llegó incluso a ser usada como bálsamo para labios y cataplasma para heridas.
Pero la cera de los oídos tiene otras muchas cualidades. Algunos estudios recientes señalan que funciona como un indicador de la acumulación de sustancias tóxicas en el organismo e incluso podría ayudar a diagnosticar ciertas enfermedades.
BBC Mundo explora cinco secretos de la cerilla que tal vez muchos lectores desconozcan.
1. Cómo sale
Image caption Las células del canal auditivo son únicas porque pueden migrar.
Las células dentro del canal auditivo son únicas en el organismo, ya que pueden migrar. "Si colocáramos una gota de tinta junto al tímpano veríamos que poco a poco se desplaza hacia afuera en cuestión de semanas por el movimiento de estas células", explicó Shakeel Saeed, médico del Royal National Throat, Nose and Ear Hospital de Londres, un centro especializado en otorrinolaringología.
Si ese movimiento no tuviera lugar el canal auditivo se taparía con células muertas producto del proceso natural de renovación celular.
Este fenómeno impulsa hacia el exterior a la cera y se cree que el movimiento de la mandíbula al hablar o comer ayuda en ese proceso. La cera es producida por glándulas especiales en la piel del canal auditivo. El nombre técnico para esta materia cerosa es cerumen.
Saeed señala que la cerilla puede ponerse más oscura con la edad. Los hombres, por otra parte, pueden tener más pelos en la oreja cuando envejecen y esto puede dificultar la salida natural de la cera.
2. Tiene propiedades antimicrobianas
La cera de los oídos contiene aceites, pero está constituida en gran parte por queratinocitos, células epiteliales muertas además de otras sustancias.
Entre 1.000 y 2.000 glándulas producen péptidos antimicrobianos (un tipo de moléculas), mientras que las glándulas sebáceas cercanas a los pelos aportan a la mezcla alcoholes, una sustancia oleosa llamada escualeno, colesterol y triglicéridos.
La producción de cera no varía mucho entre hombres y mujeres. Tampoco entre jóvenes o viejos. Pero un nuevo estudio indicó que el contenido de triglicéridos sí que baja en el hemisferio norte de noviembre a julio.
La cera también contiene lisozima, una enzima con propiedades antibacterianas. Otros investigadores no están de acuerdo y aseguran que la cera es un medio perfecto para la proliferación de bacterias.
3. De dónde venimos importa
Image caption Utilizar un hisopo o bastoncillo de los oídos para obtener cerilla es más barato que un análisis de ADN.
Las personas de origen asiático producen un tipo diferente de cerumen, de acuerdo a científicos del Instituto Monell en Philadelphia. Un pequeño cambio en el gen ABCC11 es responsable de una cera más seca y de olores menos intensos en las axilas de individuos de China, Japón y Corea.
El estudio del Instituto Monell midió la concentración de 12 compuestos orgánicos volátiles en la cerillas de individuos caucásicos y asiáticos.
En 11 de los 12 compuestos la cera de las personas blancas tenía más sustancias productoras de olores.
Kate Prigge, investigadora de Monell, explicó que los científicos analizan el olor de la cera, como un primer paso para determinar si ese aroma podría servir para detectar enfermedades.
El instituto estudia una enfermedad de causas genéticas llamada enfermedad de la orina de jarabe de arce, que puede ser diagnosticada fácilmente a través del aroma de los compuestos de la cera. Utilizar un hisopo (copito de algodón, bastoncillo de los oídos) para obtener una muestra de cerilla es mucho más barato que realizar un análisis de ADN.
El doctor Prigge reconoce que su trabajo genera reacciones de sorpresa. "Si le cuento a alguien que me dedico a estudiar los olores corporales generalmente se ríe. Pero cuando explicamos cuánta información puede obtenerse a partir de esos aromas la gente entiende por qué me dedico a esto".
4. Mejor un vacío que una jeringa
Image caption La producción de cera no varía mucho entre hombres y mujeres.
Carrie Roberts tiene poco más de 40 años y desde hace tiempo tiene un problema de cera excesiva en sus oídos. Ya su médico retiró la cerilla en múltiples ocasiones con una jeringa. Cuando intentó usar un remedio casero de aceites tibios acabó con los oídos tapados.
Roberts decidió pagar por un tratamiento de micro-succión, en el que el canal auditivo es limpiado por una especie de mini-aspiradora.
Saeed prefiere utilizar en su hospital este método al de la jeringa. "Con la jeringa uno va a tientas y ciegas, sin visión directa. Si uno usa agua hay que hacer que el agua pase más allá de la cera para que pueda expulsarla al salir".
"Si el agua no tiene por donde pasar no hay que forzarla. No es común que se dañe el oído durante este procedimiento pero puede suceder".
En la micro-succión, en cambio, el especialista mira el canal auditivo a través de un microscopio.
Carrie dice que tratamiento no le causó ningún dolor y fue muy rápido.
"Se siente un poco como esos tubos de succión que le ponen a uno en la boca cuando va al dentista, solo que en esta ocasión se trata del oído. Para mí es mucho mejor que la jeringa ya que fue más rápido, no me sentí mareada y no tuve usar aceites durante una semana luego del tratamiento".
5. Puede ser un indicador de la contaminación
Image caption Existen algunas enfermedades del metabolismo que afectan a la cerilla.
La cera de los oídos, como otras secreciones, puede tener trazas de ciertas toxinas en el cuerpo, por ejemplo, de metales pesados.
Existen también algunas enfermedades del metabolismo que afectan a la cerilla.
Uno de los hallazgos científicos más notables relacionados con esta secreción fue un tapón de cera de 24 cm en una ballena azul.
A diferencia de los seres humanos, que expulsan su cera y sus células epiteliales muertas, estas ballenas la retienen. Así, se registra la historia del animal al igual que los anillos en el tronco de un árbol revelan la variación de épocas de lluvia o sequía a lo largo de su historia.
La cera de la ballena fue analizada por Sascha Usenko, un científico de la Universidad Baylor en Waco, Texas. Usenko y sus colegas determinaron en base a la cera del cetáceo que en sus 12 años de vida había entrado en contacto con 16 tipos diferentes de contaminantes como pesticidas.
La mayor exposición a sustancias tóxicas fue en el primer año de vida, lo que sugiere que esas sustancias fueron transferidas a la ballena durante el embarazo o a través de la leche de su madre.
Cuando el animal llegó a la madurez sexual, la cera muestra altos niveles de cortisona, la hormona del estrés, resultado probablemente de la competencia con otros machos por aparearse.
Una más.
Sabías que el padre de la medicina Hipócrates de Crotona, hace 2.500 años, probaba el sabor del cerumen?
Hardluckasthma.blogspot.com
Friday, November 29, 2013
760-370 B.C.: How did Hippocrates assess his patients
Hippocrates examining a child, a painting by Robert Thom, 1950's. |
Hippocrates became the most famous physicians of ancient Greece during the Age of Pericles by his skill and gentle approach as a physician. His approach to medicine was highly regarded not just by his patients, but by his peers. By his example, and through his writings, he would almost single handily improve the image of medicine.
In order to help future physicians develop the skills and technique needed to become a respected physician, and to create a good image of the profession, he compiled all the medical wisdom from the school of Cos into a series of 60 medical treaties called The Hippocratic Corpus.
Most historians now believe that he did not write all of the Corpus by himself, although most would agree that he was, for whatever reason, the most significant and respected physician of his era, and for this reason his name is attributed to the treaties. It would go on to become the cornerstone of Greek medicine, and all of medicine for the next 2,000 plus years.
In this way, Hippocrates became the most famous physicians of his era and all time. Not only was he referred to as "The Great Physicians" during his time by the philosopher Plato, but he is referred to by most historians as "The Father of Medicine."
By resorting to simple or natural remedies first, Hippocrates, like other physicians at the school of Cos, preferred the medical philosophy of looking out for the best interest of the patient, and to avoid risky treatment. Such may be evident by the motto "first do no harm."
When Hippocrates was called to help a patient, he would pack his bags and travel to the patient's home. As he was taught by his predecessors at the school of Cos, he would consider the patient as a whole. As noted by 18th century physicians Bernardino Ramazzini, Hippocrates encouraged the following:
'When you come to a patient's house, you should ask him what sort of pain he has, what caused them, how many days he has been ill, whether the bowels are working and what sort of food he eats.' (1, page 15)
Of the assessment of the patient, Garrison said:
Hippocrates instituted, for the first time, a careful, systemic, and thorough-going examination of the patient's condition, including the facial appearance, pulse, temperature, respiration, excreta, sputum, localized pains, and movements of the body. (2, page 89-90)
Medical historian Max Neuburger said the following were also assessed:
Odour of the sweat, of the sputum, of the vomit, the urine, the faeces, of the discharge from wounds; the taste of skin secretions, of wax from the ear, of nasal mucus, of the tears and sputum (sweet or the contrary) and of diverse other body fluids had to be investigated, partly by the physician, partly by the patient himself. (5, page 145)
The color, consistency, and smell of phlegm was also assessed. The assessment was useful in helping the physician come up with a diagnosis and prognosis, which would help determine if the patient was curable. If the patient was curable, the prognosis was used to determine the eventual remedy or cure.
For instance, as noted by Neuburger:
Yellow sputum, mixed with a little blood, occurring at the beginning of the illness in a patient suffering from inflammation of the lungs is a sign that he will recover, and is beneficial, occurring for the first time about the seventh day it is a somewhat surer sign. (5, page 145)
Hippocrates himself wrote the following of his assessment:
Thus, it considers the voice, as to its clearness or hoarseness. It examines the discharges from certain regular channels; and drawing consequences from their odour, colour, consistence or fluidity,—he judges of the character of the disorders, and the existing state of the patient; and by the same means, medicine is even enabled, not only to ascertain the past, but likewise his future state. After having thus become acquainted with diseases, by their symptoms, if nature is unable to effect a cure, art then teaches how to excite those salutary movements, by which, without danger, the system may discharge itself of what is injurious to it. (3)
Regarding the movements of the body, Hippocrates was known to listen to a patient's heart and lung sounds by placing his ear upon his patient's chest, although if he wanted a more thorough examination of the humours inside the patient's chest, he would shake the patient, gently perhaps. This allowed him to hear secretions, if they were present, in the patient's chest. (2, page 90)(5, page 146)
The procedure was called succussion, and was mainly used to recognize the presence of pus in the lungs to diagnose the presence of an empyema. In fact, if a physician performed the procedure and failed to diagnose empyema when it was present, this was considered a "sign of lack of surgical dexterity," said Neuburger. (5, page 157)
According to Neuburger:
This shaking was supposed to effect the outflow of pus from the parenchyma of the lung by way of the bronchi... Recognition during this process of teh splashing sound which occasionally occurred (in pyo- and hydropneumothorax, but also in bronchiectasis and cavities) resulted in the employment of succussion (known now as Hippocratic succussion) as a diagnostic method in order to determine whether and where pus were situated in the pleural cavity, also the most suitable spot for incision in thoracocentesis (a procedure involveing placing a needle into the chest and drawing up the excessive pus in the pleural space, or the cavity surrounding the lungs). (5, page 146)
Neuburger said that succussion was also used to diagnose empyema (pus in the pleural space). He said, "If it, and the pouring of fluid into the throat to excite coughing and expulsion of the pus, fail, then the operation of thoracocentesis is called for." (5, page 146)
Sounds other that the rare secretions heard upon succussion were also listened for by auscultation. Some conditions caused a rattling sound in the trachea. Diseases such as pneumothorax might cause crepitations, which is air bubbles under the surface of the skin, particularly on the upper chest area. Pleuritic frictions, or what is now called a pleural rub, was also listened for. This might indicate pleural a collapsed lung (pneumothorax) or other such malady.
Certain noises in the chest may indicate hydrops of the lungs, or what would now be considered pulmonary edema caused by heart failure, kidney failure, or sometimes pneumonia. Hydrops is an old term for water in the lungs. Of this, Neuburger wrote:
Of the diagnosis of "Hydrops of the lung" it is stated: "When the ear is held to the side and one listens for some time, it may be heard to deethe inside like vinegar." A pleuritic friction is well described... "A grinding may be heard which sounds as if it came from two leather straps."
The Hippocratic concept also took into consideration the desires of the patient. As noted by Withington:
The wishes, and even the whims of the patient are to be indulged as far as possible, and a physician should rather lose his fee than trouble a sick person about it, for the memory of a good deed is better than a temporary advantage. He should also neglect no opportunity of serving the poor and the stranger, for "where the love of the art is, there is the love of man ". This last quotation, indeed, is from a work of very doubtful authorship, but it expresses the spirit, if not the words of Hippocrates. (4, page 51)
He paid attention to the prognosis more so than the diagnosis. According to Neuburger, was "that the preservatoin of the organism be his goal." He was well aware of the "limitations and of the potentialities of his art." And he made sure he "occupied himself only with those diseases in which a cure might be anticipated and approached the sick-bed inspired by the principle: 'Do good, or at least do no harm.'" (5, page 147)
He spared no effort to ease the mind of the suffering, even when he knew there was no chance that his remedies would cure the patient's disease.
References:
- Ramazzini, Bernardino, writer, "Disease of Workers," Wilmer Cave Wright, translator, 1964, New York, Hafner, (8)
- Garrison, Fielding Hudson, "An introduction to the history of medicine, 1922, (9)
- Hippocrates, "The Art of Medicine," Section I, Treaties III, translated by John Redman Coxe, "The writings of Hippocrates and Galen," 1846, Philadelphia, Lindsay and Blakiston (10)
- Withington, Edward Theodore, "Medical History from the Earliest Times: A Popular History of the Art of Healing," 1894, London, The Scientific Press. (3)
- Neuburger, Max, writer, "History of Medicine," 1910, translated by Ernest Playfair, Volume 1, London, Oxford University Press
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