COOMEVA MEDICINA PREPAGADAISSN 1692 - 5556 August- September 2017 - Issue 136 AUTÓNOMOS 1 Y CON LÍMITES INDEPENDENT CHILDREN WITH BOUNDARIESwww.revistasaludcoomeva.com
COOMEVA MEDICINA PREPAGADAISSN 1692 - 5556 August- September 2017 - Issue 136 YOUR HEALTH AND LOVING YOURSELF: AUTÓNOMOS SELF-CARE AND SELF LOVE Y CON LÍMITES INDEPENDENT CHILDREN WITH BOUNDARIES www.revistasaludcoomeva.comIssue 136August – September 2017Revista Salud Founder At the First International awareness activities and with a promo-Gilberto Lotero Muñoz (q.e.p.d.) Conference on Health Promotion tional and informational campaign, theChairman of the Board held in Ottawa, Canada, in 1986, objective of this concept is to inspireJosé Vicente Torres Osorio five strategies were introduced to esta- people with the conviction that the firstExecutive President Of the blish a new concept of public health in step to caring for their short and long-Cooperativo Coomeva Business Group the world. Soon after, self-care began to term health lies in the choices theyAlfredo Arana Velasco gain momentum as an important element make on a daily basis.CEO Coomeva Sector Salud in the quest for collective well-being. The following are simple actions youGilberto Quinche Toro A key element of this quest is taking per- can take that are fundamental to begin-Prepaid Medicine CEO sonal responsibility; this allows people ning to build a better state of wellbeing:Jorge Alberto Zapata Builes to establish practices that help reduce selecting the right foods at the super-National Director of Strategy risk factors such as physical inactivity, market, deciding whether to eat out orand New Business tobacco use, excess alcohol use and at home (in order to manage portionMauricio Castillo Pérez unhealthy eating habits. The control an control and ensure the quality of theNational Director of Marketing individual has over each of these areas ingredients), determining how often toSector Salud resides deep within each person. exercise throughout the week, mana-Camilo Ernesto Diusaba Perdomo As an agency, Coomeva Private ging how much stress you can tolerate,General Manager Healthcare acknowledges that self-care and even deciding how many hours ofDavid Montes Canal is the foundation of its members’ health replenishing sleep you need.Editorial Committee and is launching the campaign, Your These choices will help improve thePascual Estrada Garcés Health and Loving Yourself (CuidarteNational Director of Prepaid es Quererte). By creating health and •conditions of the physical and mentalHealthcareHernán Darío Rodríguez health of ourselves and of our familiesMEC National DirectorBlanca Inés Vélez Editorial and Graphic Direction, Magazine General Editor Journalists CommercializationNational Director of Oral Health prepress and printing Paula Andrea Montoya T. Isabel Vallejo Jiménez El ColombianoSandra Viviana Muñoz Rodríguez El Colombiano Magazine Editor Ana María López de Mesa Cali: Marisol MonsalveDirector of Epidemiology Tel.: (4) 331 5252 Natalia Estefania Botero C. Paola Cardona 310 544 2354Bertha Lucía Varela Rojas [email protected] Graphic Editor Natalia Ospina [email protected] Nacional Auditoría Médica Hugo A. Vásquez E. Ingrid Cruz Bogotá: Ana María EchandíaMartha Liliana Cifuentes Design Daniela Granada 3183764776Coordinadora Nal. de Carolina Alzate Photography Medellín: Mónica GómezRelacionamiento con Prestadores ShutterStock - Cortesy 312 202 7269Claudia Alexandra García [email protected] Nacional de PrestaciónSinergia SaludJulián VillegasNational Chief of RiskManagement in HealthEditorDavid Montes CanalEditorial CoordinatorMelissa Arce PérezCollaborators The contents of all Salud Coomeva Medicina Prepagada S.A. magazine articles are illustrative in nature and/or for general knowledge. In no case are theyGina Isabel Massi Ambard meant to replace the advice or guidance of a physician. Readers shall not use this information in order to self-diagnose and/or perform an analysis, diagnosis orClaudia Alexandra García treatment of a disease or health problem without consulting with a certified physician.Germán Jiménez Loaiza The product and service offers made in the ads published in the Salud Coomeva Medicina Prepagada S.A. magazine are the sole responsibility of the adverti-Xiomara Iveth Campo sers. Also, the company is not liable nor obligated to provide its affiliates the services, procedures or treatments described in the contents of articles that areViviana Trujillo Jiménez not included in the coverage offered by Coomeva Medicina Prepagada S.A., nor shall they be obligated to include them in their plans and services. All rightsMarco Emilio Ocampo reserved. May not be reproduced in any form or system. © 2017
CONTENTAugust - September 2017 7 25 49 65( ) ( ) ( ) ( )WITH YOUR WORLD WITH YOUR BODY WITH YOUR MIND CORPORATE8 Prevention 26 Go natural 50 Harmony in health 66 Special Foot placement, Is going gluten-free The importance The benefits of key for a good runner a healthy trend? of friendship breastfeeding12 Little giants 30 Grandparents 54 For your smile 68 Institutional Setting boundaries Difficulty The negative effects At the forefront of when raising children swallowing of teeth grinding clinical excellence17 Trends 32 Prevention 56 For him 72 Campaign Writing Self-examinations: Vasectomies: a Cuidarte es to heal inspecting your body permanent option quererte20 Focus on 36 Infographic 58 Your generation 74 Directory Sleep When you 5 keys to achieving New providers and studies are expecting emotional balance updated contact information22 Harmony in health 40 For her 62 Couples Kitchen hygiene Calcium, an ally Enjoying life to your health as a couple 42 Trends Understanding papillomavirus
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23% CON TU MUNDOOF COLOMBIA’S ( ))WITH YOUR WORLDADULT POPULATIONSUFFERS FROM HIGH TO SOME DEGREE,BLOOD PRESSURE, HIGH BLOODACCORDING TO THE PRESSURE CAN BEMINISTRY OF HEALTH. GENETIC. THE TWO MOST COMMON RISK FACTORS, HOWEVER, ARE OBESITY AND PHYSICAL INACTIVITY. WHATS ITS FUNCTION? Blood pressure helps circulate the blood through the blood vessels and brings oxygen and nutrients to the tissues so they may function properly. GETTING A TIMELY DIAGNOSIS While high blood pressure does not always present symptoms, getting diagnosed on time helps prevent heart disease and strokes. A BALANCED DIET Leading a healthy diet that is low in salt, getting regular exercise and taking medications can help lower and control blood pressure. 7
( )WITH YOUR WORLD FOOT PLACEMENT KEY FOR A GOOD RUNNER Running is instinctual, but do we do it correctly? The desire to run is not enough; proper training, shoes and technique are also essential. ADVISOR MAURICIO AGUIRRE Doctor and specialist in sports medicine, Practitioner at Coomeva Medicina Prepagada8
( )WITH YOUR WORLD preventionWith the popularity of 2K, 5K, (The way you step when 10K and even longer races, you walk, run and jump many people are determined directly influences your physicalto get out and run in the next competi- health, especially your ankles,tion, at all costs. Before they start trai- knees, hips and back.ning, they buy running shoes and one ortwo accessories that were recommended If you chose heel, you are making a mis-to them or that they saw being used by take. “When the weight of your body landsrunners at big marathons. When the on your heel, you lose all of the foot’s abi-time comes to start training, they go out lity to absorb your weight. The idea is toto run, and after five or ten blocks their land on the front of your foot, where thebodies cannot go anymore. The worst base of your toes is the first third of yourpain is not immediate, however. It beco- foot starting from your toes and workingmes unbearable the day after, yet in most towards your heel,” he explains.cases, can be avoided. One way to find out if you have the When people first begin a physical proper technique is to run in place: if youactivity, they tend to make mistakes that land on your heel, try to correct your stepthe body later pays for. These can range to land on the front part of your foot. Dr.from not running the right distance or Aguirre recommends doing this little byselecting the wrong route or shoes, to little until achieving the proper techni-having poor technique with how the foot que, and beginning your running routine.lands on the ground. Slow and steady. According to Dr. Mauricio Aguirre a THE PERFECT SHOEspecialist in sports medicine, an expert on Do not fall into the trap of buying run-chronic conditions and a competitive ning shoes with air bubbles. They cantriathlete many people begin running actually cause the most damage.without proper training just to loseweight, especially individuals with a his- This is because shoes with moretory of physical inactivity or who spend cushion in their soles damage the muscleslong periods of time being inactive. This in the sole of the foot. Mauricio Aguirreis how chronic bone and muscle condi- cites studies that demonstrate that thesetions can occur. Before going down the path of beco-ming a runner, Aguirre explains that wefirst must learn to walk and that it is bestto take it step by step. Dr. Aguirresuggests going on slow walks at first andlater increasing your pace gradually.Walking will not help you lose the calo-ries or weight that you want, however thiscomes with time.STEPPING CORRECTLYOnce you have regulated your pace, it isimportant to pay attention to how yousupport your feet when you run. Thisleads to the question: when you run, doesyour heel or toe hit the ground first? 9
WITH YOUR WORLD( )prevention CHOOSE THE RUNNING SHOES THAT FIT HOW YOU STEP SUPINATION NEUTRAL types of shoes have been tied to an increa- OVERPRONATION se in plantar fasciitis. To find out what type of step you have, notice The modern technology of big athletic what the wear is like on your shoes. If the grea- shoe companies helps to create shoe lines test wear is on the inner part of your shoes, with less cushion. This helps prevent then you are a supinator and you will need a vibrations from reaching the heel, which shoe that provides more cushion. When you can later affect ankle, knee and hip joints put your shoes on a flat surface and there is no and even the lumbar region. incline, you have a neutral step and should seek shoes that provide cushion and arch Injuries caused by the poor selection of support. If the inner side of both your heel and running shoes include conditions such as metatarsals (where your big toe is) show more plantar fasciitis (inflammation of the wear, this is evidence of overpronation and tissues in the soles of the feet); osteoarthri- you should find shoes with the most arch tis in the kneecap, joint degeneration in support possible, which is why shoes with the hips, degenerative disc disease (which cushioning and stability are recommended. can cause back pain), periostitis in the tibia (a muscle injury), and even fractures (due to the wear on the bones), cramps and inflammation in the tendons of the knees or ankles. It is also important to not go out run- ning just because you want to. Running requires strengthening your muscles and following a training plan that is not only specific to an individual’s needs, but also to their skills, helping runners to use their ins- •tincts more and experience less injuries10
( )WITH YOUR WORLD 11
WITH YYOOUURRWWOORRLLDD( )little giants¿CÓMO CRIAR NIÑOSCON LÍMITES?Saber decir “no”, tener autoridady reprender ayuda a educar hijosmás responsables y autónomos.SETTING BOUNDARIESWHEN RAISING CHILDRENKnowing how to say “no,” havingauthority, and disciplining childrenhelps them become moreresponsible and independent.12
( )WITH YOUR WORLD ASESORA ADVISOR GLORIA HURTADO GLORIA HURTADO CASTAÑEDA CASTAÑEDA Psicóloga PsycologistTodos hemos visto a esos niños We have all seen those children on pequeños que se tiran al suelo en the floor of the supermarket in los supermercados y arman un such a bad tantrum that evenberrinche que requiere hasta la ayuda de the store’s security staff must come help,los bomberos porque sus padres no les because their parents would not give in topueden cumplir el antojo, regalarles el what they wanted or give them the latestmás reciente avance de la mercadotec- product being sold in the market: a new toynia: un nuevo carro, la muñeca de car, the latest doll or the popular figurinemoda, el popular personaje de la última from the most recent big-screen cartoon.película animada. Whispers of those watching say: “What Y entre los que observan se esparce el a spoiled kid,” “That kid is such an emba-murmullo: “Qué niño tan malcriado”, rrassment to her parents,” “What that boy“ese niño está avergonzando a los needs, is a good punishment.” Meanwhile,padres”, “lo que necesita es un buen cas- the parents are trying to subdue the inten-tigo”. Los padres, mientras tanto, tratan se fury of their children and must dealde contener la marea de furia de sus hijos with the embarrassment.y pasan la vergüenza. This problem leads to one question: La pregunta de este problema es una: How can you set boundaries while raising¿cómo criar hijos con límites? Estamos en children? We live in a time where it isla época que tiene como eslogan el hacer- almost encouraged to be the child’sse amigo de los hijos. Para la psicóloga friend. For psychologist Gloria HurtadoGloria Hurtado Castañeda nada más des- Castañeda, this notion could not be fur-cabellado que esto: “Ellos pueden tener ther from the truth, “They can have thou-mil amigos, muchísimos, pero padre y sands of friends, tons of them, but theymadre solo son dos, nadie más, y ese rol only have one father and one mother, nono se puede trastocar nunca”. Quizá esta one else, you can’t ever change that.”sea la primera cuota para crecer con lími- Perhaps this is the first step to settingtes, entender que el hijo está ahí para ser boundaries; understanding that childrenguiado, para ser educado, para que se les are there to receive guidance and to bemuestre el camino. taught so they can be shown the way.CON DISTANCIA THINKING LONG TERM“A los hijos hay que ponerles límites, hay “You have to set boundaries with chil-que enseñarles que los padres son los que dren. You have to teach them that parentsponen orden en sus vidas y que eso no es are the ones that keep their lives in order,negociable. Uno de los problemas que se and that that is not negotiable. One of thetienen hoy en día, es que no se les cumple problems that occurs in today’s world isla palabra a los niños, entonces el padre le that parents don’t stick to their word; thepromete un castigo en caso de que pierda parent will set a punishment in case theel año, y le dice, por ejemplo, que lo cam- child fails the school year saying, for 13
WITH YOUR WORLD( )little giants (Es ideal que los niños aprendan el valor de las cosas materiales, del esfuerzo de los padres por conseguirlas y del buen uso del dinero. Este mensaje les ayudará a luchar por lo que desean en la vida.bia de colegio. El muchacho, luego, pierde example, that the child will have to chan-el año y continúa en el mismo colegio, ge schools. The child later doesn’t pass¡pues no!, hay que cumplirle porque sino and ends up going to the same school.en la próxima se lo van a pasar por la galle- No! You have to stick to your word becau-ta. También es esto un llamado a los se next time they won’t pay attention topadres, que no hablen con rabia, porque you. This is also a call to parents to notsi les prometen un castigo es mejor que se speak out of anger; if they set a punish-los cumplan”, dice la experta. ment, it is better for them to follow through with it,” our expert says. En Europa, por ejemplo, Francia serehusa a unirse a la lista de 51 países In Europe, for example, France refuses todel mundo que prohiben pegarles nal- join the list of 51 countries around thegadas a los hijos como una forma de world that prohibit spanking children as acrianza. De hecho, quedan como los form of childrearing. In fact, these are theúnicos que van en contravía de las only ones that go against the norms ofreglas de la modernidad en este sentido modern society in the sense that they advo-que abogan por suprimir el castigo físi- cate for eliminating physical punishment.co, y por ello el Consejo de Europa, en This is why the Council of Europe deman-2015, les hizo esa exigencia. Los galos ded this of them in 2015. The Frenchdefienden su tradición e indican que defend their tradition and argue that thanksgracias a las nalgadas, sus hijos no son to spanking, their children do not throwberrinchudos ni malcriados, que tienen tantrums and are well-behaved, and thatuna generación obediente, libre. they have an obedient and free generation.REPRENDER SIN EXCESO HOW TO DISCIPLINE“Una cosa es el maltrato infantil y otra WITHOUT GOING OVERBOARDcosa son las nalgadas con la mano, noestoy hablando de usar chanclas ni “One thing is child abuse, and anothercorreas, no, sino de unas nalgadas como is spanking with your hand. I am not tal-manera de represión, de castigo, creo que king about using a flip-flop or a belt, no.esto es importante para la crianza y para I’m talking about a few spankings as aque los niños puedan mantener una rela- way to repress or punish them. I thinkción de respeto con sus padres”, dice la that this is important for the child’sexperta, quien agrega que si desde que upbringing and for children to have a res-los hijos están pequeños se traza una rela- pectful relationship with their parents,”ción amorosa y de autoridad, no habrá our expert says who adds that if a lovingnecesidad de acudir recurrentemente a and authoritative relationship is esta-esta forma de sanción. blished with children when they are very young, this form of punishment will only Otro punto que hay que tener en need to be used sparingly.cuenta es la necesidad de la palabra Another point to consider is the need14
( )WITH YOUR WORLD“no”, pues es muy común que los niños to use the word “no,” as it is very commonno acepten una negativa cuando los for children to not pay attention to nega-mayores acceden fácilmente a sus capri- tion when parents give in easily to whate-chos, que van desde un juguete en el ver they want, whether that be a toy fromsupermercado, hasta un programa de the supermarket, a television program ortelevisión y el uso de celulares y tabletas the use of cell phones or tablets aten momentos en que no conviene. “Las inappropriate times. “Things seem to becosas parecen estar al revés, pues son los backwards, as children become the onesniños quienes imponen las reglas en la that enforce the rules of the house. Thiscasa, y esto también hay que conversarlo must also be discussed with those thatcon los que cuidan de los menores, en take care of the children, who are oftenmuchos casos los abuelos y decirles que the grandparents, and they must be told(las reglas se deben aplicar”. that the rules must be enforced.” Children must learn to understand the value of material objects, the effort parents make to obtain them, and how to manage money. This message will help them fight for what they want in life. 15
WITH YYOOUURRWWOORRLLDD( )little giants Aunque la disciplina es la base de un While good discipline is the founda-crecimiento con límites, Hurtado tion of setting boundaries, HurtadoCastañeda sugiere que hay cosas que se Castañeda suggests that there are thingspueden negociar, como que el pequeño that can be negotiated such as childrenquiera vestirse de una u otra forma, o que wanting to dress a certain way or whatno quiera comer: “Eso sí, cuando un they do not want to eat: “When childrenniño no quiere comer se puede aceptar, do not want to eat, then yes, tell thempero no para cambiarle la comida por la ‘okay.’ But don’t exchange the food forque él quiera, sino para decirle que whatever other food the child wants. Tellentonces no come hasta que sea la hora them that they can’t eat until it is time forde la siguiente ingesta”. De esa manera se the next meal.” This helps make children•pueden crear niños autónomos, apegados •become independent and stick to thea las normas: libres rules, this makes them freeEN EL PROCESODE EDUCARPara criar niños bien formados, los padres deben establecer reglasbásicas. Estas consisten en crear límites claros y sencillos, cumplircon los premios y castigos impuestos, pensar en el efecto de susacciones a largo plazo, nunca rendirse ante las súplicas de sus hijos,permitir que los niños expongan con argumentos por qué quierenalgo, exigir que cumplan con sus obligaciones antes de jugar, no faci-litarles demasiado las cosas y recompensarlos cuando cumplangrandes objetivos, ya sea escolares o las tareas de casa.THE ROAD TOCHILDREARINGIn order to raise children well, parents must set some basic rules.This involves establishing clear and simple boundaries, followingthrough with rewards and punishments, thinking of the long-termeffects of their actions, never giving in to children when they beg,requiring them to finsih their chores before they play, not making ittoo easy for them to get things and rewarding them when theyreach major goals, whether these be school or chore-related.16
( )WITH YOUR WORLD trendsHEALWRITING TOWriting therapy is an alternative way to letting your emotionsout, allowing you to understand your options and expresswhat you cannot say out loud. ADVISOR For Japanese writer Haruki adds that when we write, we are present OMAIRA Murakami, it does not help to just and focus our attention; it is a time to GIRALDO SOTO think of things in his head, he can reflect in order to achieve understanding.Clinical psychologist, business coach only organize his thoughts when he wri- and biocentric educator tes. “After using my hands to write … I am A THERAPY FOR ALL finally able to organize and understand Writing is a liberating experience, it is not what is in my head, which isn’t much else a practice that is exclusive to journalists, than what is in other people’s heads,” he professional writers, philosophers, huma- writes in his new book What I Talk About nists or language experts. It is a practice When I Talk About Writing. founded on words, which belong to all of us. More and more people are reaching Taking a pencil and beginning to write out to therapists, attending writing cour- sentences or typing as your ideas and ses or clubs, or are keeping a diary and reflections flow, is an act that connects take a few minutes during the day to write the mind, body and emotions. According out their feelings and the them flow. to Omaira Giraldo Soto, clinical psycholo- gist and coach, “Through my body, I’m This concept is not new to therapy. giving shape to an idea I have: my body According to Giraldo, it has been used for becomes engaged, I place it in a specific many years for different strategies such as position to write and I must connect my writing a letter to someone that you have entire body so that I can do that.” Giraldo not been able to express an uncomfortable 17
feeling to (even if it is not delivered to that (The advantage of writing therapyperson), or repeating statements and phra- is that people do not have to answer toses through neuro-linguistic programming. norms or rules. They can express themselvesIt has now become a trend, as people are freely in order to begin to develop their ownbeginning to give its benefits a try. internal processes. According to the concepts of Alexánder writing about it helps let it out and process, especially in more complex casesRodríguez Bustamante, academic coordi- understand where they’re coming from. that require interpreting the meaning ofnator of the Family Therapy program at When we see them in writing, we have a these feelings and memories in order toLuis Amigó Catholic University, better understanding of our ideas that do obtain positive benefits from the practice.something that appears as basic as writing not allow us to let our suffering go.the plans and goals you want to achieve “Developing a new understanding of this The article Writing to Heal, publishedcan be very powerful. It benefits, “…our idea, and writing it down, will help by the American Psychologicalinner selves because there is something we modify your interpretation of it. You will Association, quotes psychologist James W.want to accomplish…This depends on read it and realize certain things about Pennebaker. A professor at the Universityeach of us. There are no magical formulas, what you think or say. It gives you an of Texas and a leading researcher on thebut there are words that strengthen our opportunity to make an interesting reflec- uses of language on mental and physicaldesire to achieve things in life in a positive tion,” she explains. health, Pennebaker explains that writingway, without focusing on one’s own failu- goes hand in hand with therapy becauseres or errors, or those of others.” Either way writing is used, the recom- people that repeatedly talk about their mendation is to receive guidance from a situation in the same way, do not impro-FOR BETTER OR FOR WORSE therapist to understand and address the ve, “There has to be growth or a change inWriting as a form of therapy can be used emotions that will begin to arise during the the way that they see their experiences.”in two ways: to release harmful orsuppressed emotions and to turn yourdreams into reality. When there issomething painful that you can’t seem toidentify, as Omaira Giraldo Soto explains,
He has found, for example, that themore terms referring to cause and effectare used such as “because,” “realize,” and“understand,” the greater the benefit.PEACE AND BALANCEAs Alexánder Rodríguez Bustamanteaffirms, when we lose someone, forexample, “…The pain is undoubtedlythere and it will take time to be able tofind that peace and balance. By jottingdown a few words on a piece of paper,we let out what we feel, and how we aredealing and processing it. And of course,‘things will come up.’ There is no speci-fic formula, each individual mustaddress their own internal issues. This iswhy writing requires making it a habit,being creative, not using labels, keepingnew and old desires in perspective, crea-ting your own outlook on life and chan-ging from a defeatist paradigm to onethat is proactive.” When people who cannot expressthemselves easily write, they are able letout what they feel, Giraldo explains. Sheadds that writing helps those who cannotcarry on complex conversations easily and“end up pausing all the time,” because itallows them to plan what they are going tosay so that when they say it out loud, theyhave more confidence. She uses writing in her coaching ses-sions, “It has been a very useful tool, butI understand that it is not for everyone.” The first step is to give it a try. Just startwriting, do exercises to make it a habit,become dedicated to it and seek out thesupport of experts if you want to see grea-ter results. Take note of the words of thosepsychologists that use writing with theirpatients and who ascribe to the quote inthe American Psychological Association artic-le, “After all, writing’s power to heal lies•not in pen and paper, but in the mind ofthe writer.”
FOCUS ON SLEEP( )STUDIES These diagnostic studies are used on special cases. They help specialists find the right treatment for patients. ADVISOR MARÍA EUGENIA TORO Director of the Sleep Program at the Neurological Institute of Colombia (Indec, Spanish acronym). You can get more information about sleep studies at Revistasaludcoomeva.com Sources: Asociación Colombiana de Medicina del Sueño Colombiana (Acmes), Instituto Neurológico de Colombia, Indec.
A sleep study is generally conducted with patients who mentary to other treatment. It measures your heart rate, your may have sleep apnea, movement disorders that occur breathing, when you wake up, any abnormal movements, and during sleep, and parasomnias such as REM sleep beha- explores whether your condition is related to organ function,vior disorder. With insomnia, the most common disorder, among other issues,” explains María Eugenia Toro from Indec.sleep studies are usually not required. The two most common studies that are conducted are lab Referrals for this study are issued by specialists after the studies (a nocturnal polysomnography) and outpatient tes-patient is questioned about their situation and, depending on ting (respiratory polygraphy), both measure physical variablesthe case, after the person who sleeps with the patient gives an such as the air flow in and out of the lungs when the patientaccount of the patient’s sleep history. With this data, an over- breathes, oxygen levels in the blood, the position of theview of the most adequate treatment options is made, which can body, and the patient’s respiratory and cardiac distress andinclude medications, changing personal habits, alternative medi-cine and therapy. “This study is a diagnostic aid and is supple- •frequency. The following explain the differences between these two methodsNOCTURNAL 12POLYSOMNOGRAPHY HOURS IS HOW LONGOptimally, this study is conducted in a room similar THE LAB STUDY ORto that of a hotel. It registers sleep cycles and pha- “NOCTURNALses through cables that are placed on the patient’shead (electroencephalography) and helps determine POLYSOMNOGRAPHY”if patients wake up or have fragmented sleep. During CAN TAKE.the study, the patient’s sleep is observed and it canalso be recorded. 10RESPIRATORY YEARS IS THE AVERAGE NUM-POLYGRAPHY BER OF YEARS THAT THEThis outpatient study is less complex and can be con- OUTPATIENT OR “AT HOME”ducted at home. It does not determine what phase of STUDY HAS BEEN ON THE RISE,sleep the individual is in, but it does establish how many WHICH FOCUSES ON DIAGNO-breathing pauses occur each hour as well as thepatient’s oxygen saturation. Experts expect that once SING SEVERE SLEEP APNEA.other sensors that provide more information are added,this exam could become the sleep study of the future.SLEEP IS CHANGE OF PACEESSENTIAL ► The modern and fast-paced lifestyles of today that comeHuman beings experience two with greater levels of stress are making sleep disordersphases when they sleep. The more common.function of deep sleep (notREM) is to repair our tissues; it ► Eating habits, work routines, the time spent using techno-is also the phase in which our logy and voluntary sleep deprivation lead to changes in ourgrowth hormones are activated. sleeping patterns.During the second phase (REM),brain functions are improved ► If poor sleep is making you experience long workdays, feel cons-such as our memory. tantly irritable and have poor relationships, it is key to adopt proper sleep hygiene and get support before it is too late. ► Your physician will decide whether a sleep study is necessary.
WITH YOUR WORLD( )harmony in health KITCHEN HYGIENE Maintaining healthy practices when using raw or cooked foods helps prevent illness. ADVISOR LUIS NORBERTO CORREA SÁNCHEZ General practitionerAccording to the WHO, 70% of 1 Wash your hands with soap 2 Keep raw foods separate from cases of diarrhea are caused by the and water before touching cooked or prepared foods, as consumption of contaminated food by scrubbing the back microorganisms can be passed onfood or water. Luis Norberto Correa and front of your hands, in bet- to cooked or prepared foods. Also,Sánchez, general practitioner and specia-list in medical law, explains that this is ween your fingers and under- use different equipment, kniveswhy, “…the prevalence of food poisoningin Colombia is approximately 26,000 for neath your nails. According to and cutting boards for both rawevery 100,000 inhabitants, with an avera-ge of 55% of these cases being diarrhoeal the manual, “Five keys to safe and cooked foods. If you are goingdiseases.” Hepatitis A and salmonella arealso diseases caused by the consumption eating,” this prevents 35% of all to store the food in the fridge, doof contaminated foods or beverages. diarrhoeal diseases. 7 so with an airtight container. Some common symptoms that can lead Use a hat that can cover yourto the diagnosis of a foodborne illness 6 Before and after cooking, hair so it does not come intoinclude stomach aches, cramping, vomi- wash your utensils, cooking contact with food, wear a faceting, nausea, fever, chills, general dis- supplies and kitchen coun- mask to prevent fluids escapingcomfort and breathing problems. ters. When you taste your from your nose or mouth andAccording to a study published in the food for consistency and fla-Journal of Environmental Health, only5% of people that use the bathroom wash vor, make a habit of using a wear an apron to protect thetheir hands long enough to eliminate thegerms that can cause these infections. different recipient or diffe- food from coming into contact In order to avoid these symptoms and rent utensils each time. with any dirty clothes.potential illnesses due to poor habits, it isimportant to implement healthy foodhygiene practices when cooking.22
( )WITH YOUR WORLD CROSS- CONTAMINATION Cross contamination is the transmis- sion of a contaminating substance (bacteria, chemical or physical pro- duct) from a contaminated food pro- duct to an uncontaminated one through surfaces that first contact the contaminated product, then touch the uncontaminated one. This occurs, for example, when you use a knife to cut raw chicken or meat, then use it again on cooked or prepared food without washing it; or if a raw food is placed on a cutting board and then a cooked or prepared food contacts it without it being disinfected.3 Do not use the same cutting 4 Wash your fruits and 5 Wash your washcloths, sponges board you use for fish with vegetables with a little and kitchen towels with soap chicken, meat or vegetables. soap and rinse them well. and water, then let them soak Then, to disinfect them, in a water and baking soda or To prevent illness, use a let them soak for 10 to 15 vinegar solution to disinfect minutes in a solution of them. Allow them to dry as clean cutting board for each one liter of water to 2 microbes reproduce quickly in tablespoons of baking unsanitary and moist places. one (four cutting boards of 9 soda or vinegar. 10Change them often. a different color), as meat Do not use your cell phone Avoid wearing rings, while you are cooking becau- bracelets and wat- and vegetables involve se this can contain bacteria ches while cooking that can contaminate food or because they can be different bacteria. the area you are preparing it contaminants. They in. As a preventative measure, can also be dange-8 Cover your food with alu- try to not go to the bathroom •rous and get caught minum foil, plastic wrap if you are cooking. on something or a lid. Keep the lid of your garbage closed to prevent foods from coming into contact with insects. Properly dispose of your waste. 23
( )CON TU MUNDO24
30 CON TU CUERPOMINUTES, THREE ( ))WITH YOUR BODYTIMES A WEEK IS THERECOMMENDED BECAUSE OF ITSAMOUNT OF TIME TO EFFECTS ON CAR-SWIM FOR THOSE DIOVASCULARWHO WANT TO HEALTH, MUSCLESTART PRACTICING STRENGTH, FLEXI-THIS ACTIVITY. BILITY AND BODYWEIGHT, SWIMMING IS CON- SIDERED A COM- PLETE EXERCISE. IT IS ALSO A RECOMMENDED WAY TO RELAX. A COMPLETE EXERCISE Swimming works the musculoskeletal structure of the legs, core and arms; it is good for your motor coordination, is toning, and is a non-impact exercise. A TENSION-RELIEVER Swimming releases endorphins, which relieves stress, anxiety and improves your mood. It also benefits the cardiorespiratory system. STRENGTHENS THE MIND Being immersed in the water increa- ses the blood flow to the brain, which stimulates neurons and impro- ves cognitive function and memory. 25
( )WITH YOUR BODY IS GOING GLUTEN-FREE A test can be A HEALTHY TREND? used to determine if someone is gluten-intolerant. Eliminating gluten from your diet without any reason can lead to serious problems.26
( )WITH YOUR BODY go natural ADVISOR t is becoming more common to findSANDRA PATRICIA gluten-free products at the grocery ALFARO Istore. But who should actually be Nutritionist, practitioner at including these products in their diet?Coomeva Medicina Myths have been created, based on a lack Prepagada Eliminating this proteinof knowledge or on certain trends surrounding the consumption of gluten. To better understand gluten, it is important to know that it is a composite (of proteins found in wheat, barley, rye from your diet without replacing the nutrients that it provides with other foods such as corn or millet, can and oats. Its function is to give texture to lead to malnutrition. foods as it prevents them from falling apart or from losing their properties. It can also be found in products such as medications, vitamins and supplements. “Gluten is a combination of two pro- A study conducted by researchers from teins: gliadin and glutamine. It is a com- both Harvard and Columbia University ponent found in breads, desserts and even published in the British Medical Journal, chocolate. It is important to have a good found a connection between a lack of glu- understanding of what it is in order to not ten in the diet and the incidence of car- eliminate it from your eating regime for diovascular disease. According to the no reason,” nutritionist Sandra Patricia study, people who do not have celiac Alfaro explains. disease and do not consume this protein Can eliminating gluten help you lose have a greater risk of dying from a cardio- weight? In response to this question, our vascular or coronary event. nutritionist indicates that there is no evi- dence of this. She warns that a healthy KNOW THE SYMPTOMS person that eliminates it from their diet There are two conditions that determine can experience health problems due to whether people are gluten-intolerant: having the potential of becoming deficient in a gluten allergy or celiac disease. Gluten vitamin B complex, a group of vitamins allergies are common among Europeans that are essential to how enzymatic, and some Argentineans. This is a genetic physiological, energy and defense mecha- trait that creates a reaction in the immune nism processes function. system similar to that which occurs with a “Our diets should be balanced, and typical food allergy reaction such as swelling, should include the nutrients we need. nausea and difficulty breathing. Instead of avoiding gluten, the idea is to Celiac disease is an autoimmune avoid consuming industrialized products disease that is caused by an intolerance that affect our nutrition,” Alfaro affirms. to the protein in the gluten, affecting 27
WITH YOUR BODY( )go natural(A gluten-free diet involves com- Sources: Sociedad Americana de Diabetes ALTERNATIVES IF YOU pletely eliminating foods that contain, or and Federación de Asociaciones de Celíacos de España. HAVE A GLUTEN ALLERGY are derivatives of, wheat, rye, barley and oats. Such a diet should be followed only A gluten-free diet includes products that allow you to maintain a with the recommendation of a specialist. wide variety in your diet. It is mainly based on natural and fresh foods that do not contain this protein. Before purchasing these the digestive system. This condition products, you should check the ingredients on the nutrition label, leads to a series of complications and to avoid buying bulk foods and omit those products without labels. atrophy in the small intestine. Common Some ideas for the foods you may eat include: symptoms include diarrhea, weight loss and abdominal pain. Grains: Corn, rice, millet, buckwheat, quinoa, According to the U.S. National Library amaranth, carob powder, of Medicine, “Symptoms may occur in the tapioca, yucca and potato. digestive system, or in other parts of the body. One person might have diarrhea Dairy products: Milk and and abdominal pain, while another per- milk products (cheeses, son may be irritable or depressed.” cottage cheese, cream, natural yogurt and The reaction can be different in each cheese curds). individual. It can also be silent, with no symptoms to show. Some symptoms that Sweeteners: Honey, sugar, are related to having this condition inclu- syrups, aspartame, cyclama- de anemia, height problems, behavioral tes, saccharin and fructose. problems, hair loss, miscarriages or bone fractures from light bumps or hits. To find out if you have this disease, it is best to see a specialist and get blood tes- ting that can help diagnose it. This will help determine whether it is necessary to eliminate gluten from your daily diet. If this disease is not diagnosed on time or if patients do not lead a gluten-free diet, they may suffer from anemia, low bone density or autoimmune disorders. Gluten-free diets have become a trend, often followed by many people who do not have celiac disease. Self-medicating or coming to conclusions without receiving important analysis can be life-threatening •and lead to serious health problems28
( )WITH YOUR BODY Fruits: All fruits, as well as dehydrated and fresh fruits, vegetables and legumes. Fats: Vegetable oils, butter and margarine (not all), vinegar and natural herbs and spices.Proteins: Eggs, fish or freshseafood that is not breaded;meats and cured meats suchas cured Spanish ham andhigh quality baked ham.Beverages: Coffee, tea,natural fruit juices andnectars, beer and wine. 29
WITH YOUR BODY( )grandparentsSDIWFFICAULLTYLOWINGThis disorder consists of the inability to swallow liquid or solidfoods. It is common in elderly patients who have a medicalhistory of neurological problems. ADVISOR LEONOR MEDINA TEJADA Geriatrician and ear, nose and throat specialist, practitioner at Coomeva Medicina PrepagadaDysphagia, difficulty passing food According to a study published by feeling who suffer from issues with swa- down your throat, is a very Northwestern University, “Dysphagia is llowing are mostly psychological. They unknown condition and often common in adults that have experienced claim that it feels like the food is stuckgoes unnoticed. This condition is a neurological event, a stroke or structural in the walls of their throat, that swa-brought on by other conditions: tumors, damage such as treatments for head and llowing produces an uncontrollablecomplications with common diseases, or neck cancer.” cough or that it is necessary to massageit may be the result of a psychological their neck in order to get the bolus to godisorder, trauma or an eating disorder According to reports from the down correctly and not feel like theysuch as bulimia or anorexia. University of Chile Clinical Hospital, have an obstruction in their throat. both ischemic and hemorrhagic strokes Sometimes they fear that they will die According to geriatrician and ear, nose are the most common causes of swa- from choking.and throat specialist Leonor Medina llowing disorders. Humans swallow 2,500Tejada, this condition is very common in times a day, even when we are sleeping, Of the cases that she has treated, andthe elderly, when the body begins to reject which is why this issue is something that after conducting a detailed check-up,food and experience different diseases. goes beyond getting proper nourishment. Medina Tejada has treated youth that“Sometimes a persistent cough can lead to cannot eat after they have undergone exten-the patient not being able to eat. I have Other symptoms of this condition can sive diets and deprived themselves of foodalso treated cases, however, of newborns include weight loss, pain while swallowing, in hopes of achieving a model-like figure.that can’t swallow normally and can only chest discomfort, frequent heartburn,receive IV fluids liquids. While this can coughing or having a scratchy throat when “Cases of eating disorders such as buli-sometimes be caused by a genetic defect, eating, especially when drinking liquids. mia and anorexia must be analyzed by psy-rigorous testing is needed to diagnose it,” chiatrists and psychologists,” she states.our specialist explains. PSYCHOLOGICAL COMPLICATIONS Similarly, “Children and babies may expe- Many of the symptoms people report rience swallowing issues caused by birth30
defects or by disorders that can occur in ( )WITH YOUR BODYtheir neurological development.” Movimiento es vida According to the American CancerAssociation, cancer treatment can lead to ¡Nos movemosswallowing complications, especially with por ti!cancers of the throat, esophagus and sto-mach. This can be risky, as poor nutrition Acércate a nuestrais very dangerous when people’s immune nueva sede.systems are low. Also, chemotherapy andradiation treatments bring side effects (+57) (4) 444 15 16such as dizziness and nausea, which can Cra. 48 #7 - 312 - Sede Pobladomake it difficult for some patients to eat. Cra. 45 #53 - 38 - Sede Cent3r1o If you have ever had a throat condition www.cfmed.cosuch as a cyst or tumor, or if you havepoor eating habits that have been recu-rrent, Medina Tejada recommends seeingan expert to obtain a timely solution.Some methods for improving the abilityto swallow include considering the consis-tency of the food, the position of the body•when eating and receiving support fromfamily or caretakers
WITH YYOOUURRBBOODDYY( )prevention SELF-EXAMINATIONS: INSPECTING YOUR BODY Breast and testicular self-examinations are easy to do. It is easy to make them part of a health routine or practice in order to detect any abnormalities on time.32
( )WITH YOUR BODYADVISORSDIANA MARÍA MONTOYA VELÁSQUEZOb/GynIVÁN DARÍO LÓPEZ ARANGOUrologist, practitioner at CoomevaMedicina PrepagadaAccording to the WHO, the most 36% such as indentations, retractions, wrinkles, common type of cancer among ulcers, dimpling, puckering, sores, scaly skin women is breast cancer. Among CASES OF CANCER IN WOMEN or skin that looks like an orange peel; and ifmen between ages 15 and 35, testicular THROUGHOUT THE WORLD there is nipple retraction, nipple deviationcancer is the most common type. or changes to its color. Breasts and armpits ARE BREAST CANCER, are also probed to detect the presence of It is therefore important to observe and ACCORDING TO masses, and the nipple is pinched to detectfeel around the breasts are testicles once a THE WHO. the discharge of any blood or pus.month in order for people to becomemore familiar with their bodies and be 90% TESTICULAR SELF-EXAMable to more easily detect any abnormality, A testicular self-exam is best performedbe seen by a physician on time, and if an TO 95% OF MEN THAT HAVE while taking a hot shower or immediatelyearly diagnosis is made, increase the chan- TESTICULAR CANCER, RECO- after a hot shower, as the scrotum and theces of not being as affected by the disease. muscle that is attached to the testicles are VER FROM IT, ACCORDING more relaxed, making them easier to feel.BREAST SELF-EXAM TO THE AMERICANThis self-exam is not a 100% guarantee of CANCER SOCIETY. Urologist Iván López Arango explainsachieving a breast cancer diagnosis becau- that when performing a testicular self-se if the growth is very small, it may not be (soft, spherical masses that are sensitive and exam, it is important to determineable to be detected. This exam should the- can move upon touch) in the armpits, that whether one of the testicles is larger thanrefore not serve as a replacement, but as a should not be confused with a cancerous the other (generally the one on the right)complement to the clinical breast exam growth (which are generally hard, solid, are and that the epididymis (the structureand mammogram (which every woman not sensitive and do not move upon touch. that produces sperm) can be located at theshould do annually once they turn 50). top rear part of the testicle. The epidid- Breast self-exams are used to observe the ymis is a natural protrusion that can be Women should begin to conduct breasts and detect whether there are any painful when touched.breast self-exams upon the age of their changes in color, size or shape. They are alsofirst menstruation and should continue to used to determine if there is a burning sen- The main objective of the testiculardo so for the rest of their life. It is best to sation, or changes in the texture of the skin self-exam is to detect whether there aremake a habit of it and perform the exam areas that are harder or have a differentin the first days after the woman’s period density compared to the opposing testiclehas ended, which is when the breasts are and to verify that both testicles are in themost tender and swollen. If you no longer scrotal sac. Upon the detection of anymenstruate, choose a day to always per- lumps, it is important to get an urgentform the exam on each month. appointment with your urologist. Gynecologist and obstetrician, Diana Other warning signs include pain orMontoya Velásquez, explains how breast swelling in the testicles or in the areatissue is not always smooth as it is a gland around the groin; a change in the testicle’sand most women can feel areas that are size, color or consistency; and a heavy,denser or have lumps. It is also important swelling sensation or any pain or dis-to note that there are also lymph nodes comfort in the scrotum. 33
BREAST SELF-EXAM: MAKE IT A ROUTINE AUTOEXAMEN TWO-STEP TESTI-First exam and one breast and then the other. Take your time. CULAR SELF-EXAM 1 Inspect all the areas of the breast in First exam and one testicle and front of a mirror: first stand and with then the other. your arms hanging at your waist, then put them on your waist and last, raise 1 Hold the testicle with one hand as them above your head. the other presses down with the thumb, index and middle finger.2 First conduct the exam using light touch, then do so using a firm touch. Laying Examine the entire surface of the down with a pillow under your left shoulder, lift your left arm, and use the testicle, including its top and bottom. three middle fingers of your right hand to feel around your left breast. Divide the breast into four sections and examine each section. •2 Apply light pressure and roll it bet- ween your fingersAlso examine yourarmpits and nipples.
WITH YOUR BODY( )InfographicEWHXENPYEOUCARTE ING Week 1 to 4In just over 9 months, what The fertilized egg divides intobegan as a small, fertilized several cells and travels to theegg will grow into a baby. uterus where it attaches to theLearn about its development, uterine wall.month by month. ADVISOR BERNARDO VEGA HENAO, Ob/Gyn, practitioner at Coomeva Medicina Prepagada Growth chart Week 18-22The following arethe average Fine hair covers its body.measurements of The baby’s skin starts to show itsbabies, listed by color and its five senses have beenthe week developed.of pregnancythat the baby is at: Actual approx. size between weeks 5 and 9 14mm According to DANE 8 cm statistics from 2016, 18 cm the percentage of 33 cm births in Colombia 37 cm by gender were: 40 cm 50 cm * Graph to scaleWeek 9 13 17 22 27 31 40
Week 5 to 9 Week 10-13 Week 14-17The cells become an embryo. The The embryo is now a fetus. Vital Its hair begins to grow.heart, liver, kidneys, hands and feet organs are completely developed. The proportion of its limbsbegin to develop. Its skin and nails begin to grow becomes normal. It begins as well as its sex organs. to turn and move its hands. The fetus makes random The baby’s sex can now be movements. determined with greater accuracy. Week 23-27 Week 28-31 Week 32-40Its facial characteristics can be Its eyelids develop. The hair All of the organs are developed,identified. Its eyebrows and that covers the body begins to especially the eyes. Its skin becomeseyelashes develop. The fetus fall. The baby grows until it smooth. It begins to turn upside down.begins to gain weight and store fat. nearly fills the entire uterus. The baby is ready to enter the world.48g,ir6ls% 51, 4 % 19,7% 79,4%Births by length of pregnancy boys BETWEEN WEEKS 28 AND 37 BETWEEN WEEKS 38 AND 41
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WCOITNH TYUOUCRUEBROPDOY( )for her CALCIUM,AN ALLY TO YOUR HEALTH Including this mineral in your diet and taking it as a supplement is important for the skeletal, muscle and cardiovascular systems to function properly. ADVISOR ÉDGAR RAMÍREZ BOJACÁ Ob/Gyn and epidemiologist, practitioner at Coomeva Medicina Prepagada When people talk about taking cal- cium, what is the first thing that comes to your mind? Perhaps the idea of drinking milk to protect your bones comes to mind, of course! It is true that this is one way to protect your bones. However, this mineral is not just important for the skeletal system, it also plays a role in our muscle and cardiovascular systems. According to the U.S. National Library of Medicine, “The body stores more than 99 percent of its calcium in the bones and teeth to help make and keep them strong. CALCIUM- RICH FOODS Milk, yogurt and cheese are the most widely recognized sources of calcium.40
( )CON TU CUERPO REQUIREMENTS BY AGE GROUP THINGS TO CONSIDERIt is important to consume calcium throughout your entire life. Humans need it fromthe day they are born. Each age group has different needs, however: ► Truth: The body loses its ability to absorb this mineral when meno-Age and population group Recommended daily amount pause hits. Menopause in womenBabies up to 6 months old 200 mg is a sign of change; they experien-Babies between 7 and 12 months old 260 mg ce hot flashes, changes in moodChildren between ages 1 and 3 700 mg and changes in how their bodyChildren between ages 4 and 8 1,000 mg functions. The body’s ability toChildren between ages 9 and 13 1,300 mg absorb calcium is not an excep-Teens between ages 14 and 18 1,300 mg tion. Ramírez states that withAdults between ages 19 and 50 1,000 mg menopause, the concentration ofMen between ages 51 and 70 1,000 mg calcium reduces in the bones. AsWomen between ages 51 and 70 1,200 mg estrogen levels lower and as theAdults over age 71 1,200 mg absorption of calcium in the intes-Pregnant or breastfeeding teens 1,300 mg tine lowers, more of this mineral isPregnant or breastfeeding women 1,200 to 1,500 mg therefore excreted through the kidneys.The rest is stored throughout the body in necessary. “This is not true. Studies showthe blood, muscles and in the fluids bet- that about 50% of the population does ► The consumption of calcium leadsween cells. Your body needs calcium to not get their basic needs for calcium met to kidney stones. False. In orderhelp muscles and blood vessels contract through their diet, which makes taking for kidney stones to form, highand expand, to secrete hormones and calcium supplements necessary. The same doses of calcium (over 2,500 mg aenzymes and to send messages through thing happens with people who think that day) must be taken over longthe nervous system.” because they take these supplements, they periods time. don’t need to include this mineral in their So, are supplements necessary? The diet. This also isn’t true because supple- ► Calcium causes weight gain. False.answer is yes. According to Édgar Ramírez ments alone are not enough to meet the When calcium attaches to fatBojacá, Ob/Gyn and epidemiologist, needs of the skeletal system, cardiovascu- cells, it affects our bodyweight;some people think that the calcium you however, its consumption canreceive from the foods you eat every day is •lar system and central and peripheral ner- actually stabilize bodyweight inenough, and that supplements are not some cases. vous system,” our expert explains ► All calcium supplements are the same. False. The use of calcium citrate is preferred for its effects on the bones. ► Vitamin D is needed for calcium to be absorbed. True. Without vitamin D, there is a higher risk of developing osteoporosis. Some sources of this vitamin include direct and controlled sun exposu- re, and eating eggs and fish.Kale, broccoli and Nuts such as walnuts,green leafy vegetables. almonds and pistachios. 41
WITH YOUR BODY( )trends UNDERSTANDINGPAPILLOMAVIRUS There is still more to learn about the human papillomavirus (HPV) and its connection to cancer. This virus is considered the most common sexually transmitted disease. ADVISOR Confusion persists both among the lly active couples will develop some mani- ANA MARÍA general population and healthcare festation of this virus at some point GUEVARA ZAMBRANO professionals about this virus, throughout their lives. But how can you sometimes leading to false alarms and cau- identify it? This virus nearly always Ob/Gym sing more than just a few people to panic appears in the genital area, which is why before it is necessary to do so. The first initial symptoms appear there: genital mistake we make is thinking that the warts, abnormal pap smears, pruritus human papillomavirus (HPV) is an issue (itchiness) and a bad odor. that just affects females. This virus attacks both men and women equally through Another important tidbit. Ninety per- microtraumas that occur during sexual cent of infections heal on their own intercourse. Whether contact is oral, vagi- without medical intervention. Some peop- nal or anal, is all that is needed for this le will not even know they were ever infec- virus to be transmitted from one person ted because the virus is silent at first and to another is mucus and skin. does not show any symptoms. It can even take between five and ten years for the first Currently, HPV is considered the most symptoms to appear. The remaining 10% common sexually transmitted disease. of infections can lead to precancerous Ana María Guevara Zambrano, Ob/Gyn lesions and cancer, “This depends on the and colposcopist at the Pablo Tobón individual’s immune system and the type Uribe Hospital, states that 80% of sexua- of virus that was transmitted, depending42
( )WITH YOUR BODYon whether it is high or low risk,” Guevaraclarifies. This disproves yet another myth:being infected with the virus does notmean that you have cancer, as it can takeyears for HPV to develop into cancer.THERE ARE MANYSTRANDS OF THE VIRUSAccording to the U.S. National CancerInstitute, there are more than 200 types ofHPV, about 40 of which affect the geni-tals. Sexually transmitted HPV is dividedinto two categories: low-risk HPV (whichcauses genital warts), and high-risk HPV,which can cause different types of cancer(cervical cancer, anal cancer, oral andthroat cancer, vulvar cancer, vaginal can-cer and penile cancer). As the U.S. National Library ofMedicine explains, “Most HPV infections 43
( )WITH YOUR BODY(A pap smear is a tool MORE FACTS that can help detect the war- ON HPV ning signs of HPV on women. Performing this exam regularly 1 Another way this virus can be transmi- is a key method of prevention. tted is from mother to child during birth. If the mother is infected and has condyloma (genital warts), when the baby passes through the birth canal, it can become infected, but not neces- sarily develop the disease.go away within 2 to 3 years and do not red the vaccine, does not mean that it will 2 The virus can only be transmittedcause cancer. Some HPV infections, fight the virus or that you will never catch through sexual contact, not directhowever, can persist for many years. Those the virus. The vaccine can only provide a contact, unless there is direct frictioninfections can lead to cell changes that, if certain percentage of protection and the with a lesion.not treated, may become cancerous.” earlier it is administered, the more capa- ble the immune system will be of produ- 3 HPV cannot be transmitted from using How can it be prevented from turning cing antibodies that prevent an infection the clothes of someone that is infected,into cancer? For women, pap smears can from developing.” by sharing a bathroom with them ordetect changes in the cervix, which can later through other similar practices.turn into cancer if they are undetected. HPV The FDA indicates that this vaccinetests can also help diagnose the disease. was approved to be used on women bet- 4 Precancerous lesions are more ween ages 9 and 26 to prevent cervical, common among men. Anal sex canWHAT ABOUT THE VACCINE? vulvar, vaginal and anal cancers caused by increase the risk of transmission.Guevara states that despite the boom of HPV, as well as precancerous lesions. Itadverse effects that have been attributed was also approved to be used on men to 5 Other methods of preventing trans-to the vaccine, this type of immunization prevent anal cancer, precancerous anal mission include using condoms anddoes not represent a threat to those who lesions and genital warts caused by HPV. avoiding having several partners.receive it, “Before becoming sexually acti-ve, all girls should receive this vaccine as a Getting vaccinated is a method of pro-method of prevention. It is important to tection that of course has greater resultsclarify that just because you are administe- •when it is applied on populations that have yet to become sexually active44
( )WITH YOUR BODY 45
WCOITNH TYUOUCRUEBROPDOY( )keep in mindURIC ACID,A SILENTENEMYHigh levels of this substance cancause serious illness. Being able todetect its symptoms and treat iton time is crucial. ADVISOR JORGE ENRIQUE VIVAS Physician, specialist in internal medicine, practitioner at Coomeva Medicina PrepagadaWhile it does not get as much through urine. Some people’s bodies pro- metabolic birth defect that affects the attention as diabetes, its health duce too much of it, leading to what is purine enzyme, which prevents this acid impacts can be equally as devas- called hyperuricemia, which can cause from breaking down appropriately.tating if it is not treated properly. If someone to become ill.someone is suffering from joint pain, Warning signs of abnormal uric acidkidney damage (such as kidney stones and WHAT HAPPENS IF URIC ACID levels can be very different: joint paininflammation) or cardiovascular pro- LEVELS GET TOO HIGH? (ankles, knees, elbows), kidney stones, orblems, one of the causes could be high Dr. Jorge Enrique Vivas, a specialist in inter- pain and inflammation in this region ofuric acid levels in the body. nal medicine, suggests getting your blood the body. If there is not a high concentra- tested at a laboratory in order to determine tion of uric acid, then the patient may not According to the U.S. National if you have high uric acid levels in the even feel any pain.Library of Medicine, “Uric acid is a che- blood. High levels of this substance are con-mical created when the body breaks down sidered to occur when they pass 7.0 milli- According to the U.S. Nationalsubstances called purines,” which are grams per deciliter in the blood (normal Library of Medicine, hyperuricemia (highfound in proteins, especially red meats values range between 3.5 and 7.2 mg/dL). uric acid levels in the blood) may therefo-and beer. They are also found in liver, re be caused by metabolic acidosis (a con-anchovies and dried beans and peas. Patients who are diabetic, obese or that dition where there is too much acid in the have high blood pressure, should be aware body), alcoholism, chemotherapy-related According to the above source, most of this condition’s symptoms, Dr. Vivas side effects, diabetes, over exercising,uric acid dissolves in the blood and travels adds. Some people are also born with a hypoparathyroidism, lead poisoning,to the kidneys. It then exits the body leukemia, medullary cystic kidney disease46
( )CON TU CUERPO PREVENTION Dr. Jorge Enrique Vivas states that there is not much awareness in Colombia about how to prevent high levels of uric acid in the blood. He believes that there is a grea- ter focus on blood sugar and diabetes. He asserts that it is important to lead a balanced diet, and avoid the excess consumption of protein, especially red meats. He recommends leading a healthy lifestyle, staying physica- lly active and by doing so, preventing obesity, which is one of the main causes of high uric acid levels.and nephrolithiasis, among others. In its advanced stages, gout can occur.Symptoms of gout include hyperuricemia,periodic episodes of severe arthritis, and insome situations, tophi (deposits of uric acidin the form of physical lumps under the skin,•especially in the area around the joints) 47
( )Piensa en ti,CON TU CUERPOno en tus pagos Activa el Débito Automático para el pago de tu mensualidad de Coomeva Medicina Prepagada, CEM o Salud Oral siguiendo estos pasos:Si tienes Cuenta Corriente Bancolombia Acércate a la oficina 2. Diligencia el formato más cercana de Autorización de Pagos1.• Cuenta Ahorros Bancolombia Bancolombia. Pre-Autorizados con el código 46681.• Tarjeta de Crédito American ExpressSi tienes Tarjetas 1. Acércate a la oficina 2. Diligencia el formatode Crédito más cercana de Solicitud de Pagos Coomeva Medicina Pre-Autorizado Visa Prepagada.• Mastercard• Diners A partir del mes siguiente de haberte inscrito, se realizará el proceso de pago automático. Si el resultado no es satisfactorio se te notificará telefónicamente al día siguiente.Cooperando es posible Medicina Prepagada 48 Nos facilita la vidaPara poder acceder a este servicio, el titular de la cuenta bancaria o tarjeta de crédito debe ser el mismo titular del contrato en Coomeva MedicinaPrepagada. Se debe diligenciar correctamente el formato. Debe tener dinero disponible en su cuenta de ahorros, corriente o tarjeta de crédito.
60% CON TU MENTEIS THE PERCENTAGE OF HOW ( ))WITH YOUR MINDMUCH MORE CREATIVE PEOPLEWHEN THEY PRACTICE HEAL-THY SLEEP HABITS, ACCORDINGTO A UNIVERSITY OFCALIFORNIA STUDY (U.S.).CREATIVITY IS AN ABILITY THAT ALL HUMANS HAVE. SOMEACTIVITIES HELP STIMULATE AND ACTIVATE OUR CREATIVITYFROM CHILDHOOD.LET YOUR CREATIVITY FLOW BE ORIGINAL RESPECT DIFFERENCESPlay games where you have to give the Make up symbols other than conventional Engage in activities that are related togreatest number of responses in the symbols, that represent different activities being able to see issues, problems andleast time possible with words from a such as being quiet, “no smoking allowed,” situations from different perspectives.specific category. and playing soccer, among others. 49
WWIITTHHYYOOUURRMMININDD( ))harmony in health FRTHIEEIMNPORDTASNCHE OIFP Building communication networks and supportive and collaborative networks among friends is essential to having an adequate and balanced development.50
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