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( )CON TU CUERPO UNDERSTANDING THE CAUSES AND TREATING ACNE Although it is a multifactorial condition, it affects men and women differently. Are hormones responsible? ADVISOR ÓSCAR ROSERO, endocrinologist 52
( )WCOITHN YTUOUCRUEBROPDOY for her Buying lots of facial creams, trying (Consultations for acne homemade remedies, and trying to are usually more frequent in hide it with makeup are some of the women, states the specialist. things you do when you are desperate to make it go away quickly. Without a doubt, tes the specialist. Likewise, added sugar acne is a skin disorder that can be quite should be avoided in all its presentations, uncomfortable and even affect self-esteem as well as hydrogenated vegetable fats and personal confidence, but some measu- used in the bakery and pastry industry. res can take make the condition worse. This is in addition to maintaining ade- Professional and all-inclusive treatment is quate hydration. “We’ve been told that necessary because each case is different. diet doesn’t make acne worse, but expe- rience has shown us that it does. Not so Endocrinologist Óscar Rosero much the hormonal part, but rather the explains that both the presentation and response of the glands at the skin level,” the approach to this condition is diffe- the endocrinologist points out. rent for men and women. “So far it has The specialist indicates that, from a hor- not been specifically determined if it is a monal point of view, women are more hormonal disease. However, hormones complex than men because they have do interfere, more frequently in women monthly cycles, which cause physical and from the point of view of age as well as mental changes. “This forces us not to menstrual cycles,” he states. fight with hormones, but rather identify them. The idea is that the woman knows This is how the classic acne of adoles- herself and deals with her cycles in the cence exists, acne related to ovulation or the menstrual period, and even that of •best, knowledgeable way,” states Rosero menopause. Another recurrent, hormo- nal type of acne is associated with poly- HORMONES AT WORK cystic ovary syndrome, which is related to insulin resistance and varies from mild These vary according to the woman’s stage of life, so all-inclusi- to severe. “This syndrome is accompa- ve and differentiated treatment is required, according to age. nied by other characteristics such as changes in the menstrual cycle, oily skin, ► Intrauterine stage: in the initial phase of growth, the girl greasy hair, hair loss, and increased body receives a hormonal load from her mother. hair,” clarifies the specialist. ► Pre-adolescence – adolescence: the hormones allow for LIFESTYLE MATTERS the arrival of the first menstruation and begin to In some cases, a healthy diet and lifesty- organize the cycle. le will impact the evolution of acne. “There is no point in using the most ► Maturity: ovarian function is regulated. expensive and advanced treatments if we ► Menopause: the ovarian function decreases do not solve our internal metabolic envi- ronment,” Rosero reiterates. and the follicles dry up. Therefore, the recommendation is to opt ► Senescence: all cycles have passed. for a joint treatment: dermatologist, endocrinologist, and include the nutritio- nal aspect. “There are foods that have been identified as generators or perpetra- tors of skin damage, including milk,” sta- 53
( )CON TU CUERPO FOHCUISVONDecember 1st is World AIDS Day, an opportunity to catch up on the advances in HIV treatment as well as the challenges which still face patients and ( )treating physicians. ADVISOR SEBASTIÁN JIMÉNEZ Medical specialist in Auditing and High Management in Health, with a master’s degree in HIV Find more information about HIV on our website revistasaludcoomeva.co. 54
( )WCOITHN YTUOUCRUEBROPDOY fozcouosmona Today, HIV is considered a chronic condition like hyperten- recovery. The awareness process is not only for the general public, sion or diabetes. It’s not like it was 30 years ago when there but also for health personnel who need to free themselves from was no antiretroviral therapy and the diagnosis was fatal. A prejudices about this condition in order to provide better care, lot of progress has been made, both in available treatments and in since treatment is determined according to each person’s particu- health programs. However, more education on the subject is nee- lar conditions. For specialist Sebastián Jiménez, the biggest cha- ded in order to reduce the stigma and also to promote prevention. llenge is in rural areas, where even getting an HIV test can result This would allow more tests to be done for early diagnosis and, in a safety risk, even though a patient, with proper treatment, can consequently, achieve a much more efficient immunovirological stop transmitting the virus and just be a carrier. ALL THE TOOLS 16.4 % According to specialist Sebastián Jiménez, WAS THE INCREASE IN HIV Colombia has one of the most robust HIV CASES IN COLOMBIA IN 2019, care programs, thanks to the Ministry of Health’s Clinical Practical Guidelines (2014). ACCORDING TO THE In addition, there is a wide availability of NATIONAL HEALTH INSTITUTE. antiretroviral drugs, prophylactics, and tests. THERE IS A GROWING TREND PERMANENT YEAR AFTER YEAR. TREATMENT 80 % When a patient starts antiretroviral treatment, he must continue it for the rest of his life, because (APPROXIMATELY) OF THE stopping it leads to the deterioration of health and ANTIVIRAL MOLECULES the creation of resistance. There is also a pre-expo- AVAILABLE FOR HIV TREAT- sure prophylactic treatment, which prevents people MENT WORLDWIDE ARE who are exposed to the virus from being infected. USUALLY INCLUDED IN 90-90-90 HEALTH PLANS. IS THE GOAL OF UNAIDS TO COVID-19 CONTRIBUTE TO THE END PRECAUTIONS OF THE EPIDEMIC. IT AIMS FOR 90% OF PEOPLE WITH ► Patients with HIV may have lower HIV TO KNOW THEIR STATUS, defenses, so they are more likely to RECEIVE CONTINUED THE- contract any virus. RAPY, AND HAVE VIRAL ► They are recommended to be strict with SUPPRESSION. all biosafety measures and avoid crowds. ► Maintaining a healthy lifestyle makes the body stronger and better able to respond to Covid-19. 55
TAKE CARE OF YOUR CHILDREN’S TEETH The journey to healthy teeth is also projected from childhood. Learn how to identify signs of cavities or oral diseases that should be treated early. 56
( )WITH YOUR BODY for your smile ADVISOR A SIMPLE TECHNIQUE JOHANNA CHAVARRIAGA ROSERO , specialist in Pediatric Dentistry WITHIN EVERYONE’S REACH Much of an adult’s oral health also corresponds to the Lift the lip helps care they have had since early childhood. The first two parents check the and a half years of a child’s life can be extremely impor- tant for their permanent teeth. That is why this period of time is evolution of the referred to by specialists as the “golden period.” teeth at home. Johanna Chavarriaga Rosero, specialist in pediatric dentis- Cavities and other try from the Universidad Javeriana and member of the diseases occur on Colombian Academy of Pediatric Dentistry (Academia the surfaces of the Colombiana de Odontología Pediátrica), indicates that this teeth, so you must period of time “is a phase of plasticity that extends from con- check them fre- ception to two years of age, where many changes can occur as quently to look for a result of stimuli, such as diet or lifestyle.” changes. Therefore, it is essential to teach parents and caregivers to Opaque white constantly evaluate the oral health of children from birth. One spots near the recommended technique is lift the lip, an oral evaluation strategy gum are an indica- to assess the condition of the first groups of teeth that break tor of deteriora- through. This way it is possible to identify signs of cavities or tion. If left unat- other problems such as abscesses, injuries, extra or missing teeth. tended, brown spots may appear. Chavarriaga explains that cavities usually begin as white spots, which usually appear close to the gum. That is the first Cavities, trauma, indication that the tooth is losing minerals and becoming fractures, and porous. A monthly evaluation by parents can help identify other conditions in changes and act on them early. the baby teeth can result in permanent “It has been proven that permanent teeth can be affected consequences. when infections occur in children’s teeth. Permanent teeth can also be affected when there are traumas to the baby teeth, also called milk teeth, since they serve as a guide for the per- manent ones,” states the specialist. ALWAYS USE TOOTHPASTE Although the amounts should clearly be much less, toothpaste should always be used when brushing a child’s teeth from the time the first tooth breaks through. Chavarriaga recommends using fluoride toothpaste of at least 1,000 ppm (parts per million), at least twice a day, as three times is ideal. “From the time the first tooth breaks through until the first eight front teeth have developed, an amount similar to half a grain of rice should be used. When the teeth are complete, the size of a lentil should be used,” states the pediatric dentist. According to the World Health Organization, a child under the age of two should not consume sugars, and breastfeeding is recommended until the child is at least two years old. The invitation is for parents, from the beginning, to become familiar with the natural state of the baby’s mouth to identify anomalies more easily. In addition, it is key to visit the pediatric dentist before the child’s first birthday. 57
)CORPORATE 10th OF DECEMBER IS INTERNATIONAL HUMAN RIGHTS DAY, DECLARED BY THE UN. NO CONDITION OR OPINION SHOULD COMPROMISE HUMAN RIGHTS. THESE ARE NATURAL AND INHERENT TO ALL. HOPE FOR THE YOUTH HIGHLIGHT THEIR IMPORTANCE HEALTH IS COMPREHENSIVE From the UN, it is sought that young The aim is to raise awareness at home Ultimately, the preservation of rights people act as agents of change and and in academia about values such as is about mental and physical health. construction, in the defense and pro- equality and justice, and to put an end to This is how conditions of peace and motion of rights. the discourse of discrimination. equality are promoted.
TU MISIÓN DE MAMÁ: AMARLO, SENTIRLO Guarda durante 18 años tus CÉLULAS MADRE del cordón umbilical y aprovecha un precio especial por ser madre usuaria de Coomeva Medicina Prepagada. Pensando en la vida saludable de tu bebé, nos aliamos a America Cell Bank para ofrecerles un gran descuento del $40% Además, Coomeva Bono de Medicina Prepagada te $276.000 entrega un regalo + 12 años adicionales adicional: de almacenamiento cubierto. También te brindamos: Financiación a 9 meses Prueba de tamizaje Pruebas genéticas. sin intereses. neonatal con 10% de dcto. Un seguro biológico para tu hijo: Las células madre que almacenes ahora podrán ser usadas en cualquier momento para tratar enfermedades como leucemia, anemia o para tratamientos de terapia celular. ¡Consulta tu especialista! Para más información comunícate con un Somos mucho más que planes de salud. representante de American Cell Bank 317 4388320 medicinaprepagada.coomeva.com.co *Descuento del 40% ya aplicado en la tarifa Coomeva Medicina Prepagada, precio público general: $9.600.000.
( ))CORNPTOIGROATE institutions COOMEVA EMERGENCY MEDICAL SERVICES, THE FIRST CHOICE FOR YOUR HEALTH This new company, which is part of the ADVISOR Coomeva Cooperative Group, is GUSTAVO OCAMPO structured to continue growing as a Coomeva Emergency gateway to health services in Colombia Medical Services Manager Since 2002, Coomeva Emergency completely renovated in 2019 and new years has been particularly useful during Medical Services, CEM, has posi- renovations are expected to begin in the current global health emergency. tioned itself as the best comple- 2021), as well as ongoing staff training. Those who have the service have been mentary option for the home health able to avoid face-to-face attention; during care needs of Colombians 24 hours a Although physicians have all the the strictest of the obligatory preventative day. CEM professionals, trained to per- skills needed to care for a patient in any confinement, 70% of the consultations form remote triage, can determine what circumstance, home care training is not were done virtually or by phone, without type of care is needed together with the common in medical schools, so CEM any detriment to the quality of care. user. Telephone, virtual, and home con- has dedicated itself to establishing agre- sultations are available with general ements with these institutions that Home visits also continued, but not practitioners, psychologists, nurses, or allow professionals to update their before making a strong investment in nutritionists, making more efficient knowledge, while sharing this type of adequate protective elements that allow medical care possible. “Before using care with students, which can be cha- CEM to have a 5.3% accumulated infec- your EPS, private healthcare, or insu- llenging for some. tion rate among its personnel during rance policies, the user should use our the pandemic, while, according to the service first. Only 4% of our cases are “The trick is knowing how to ask WHO, the average infection rate among transferred to an institution, and the questions so that the patient can give health personnel is up to 14%. other 96% we solve on site,” explains you the right answer. Questions cannot Gustavo Ocampo, CEM manager. be vague, they must be clear, and a rela- NETWORK OF BENEFITS tionship of trust must be established so The service has coverage in Cali, Bogotá, To reach these figures, constant that a video appointment will be just as Medellín, Barranquilla, Cartagena, and investment in technology and logistics is effective as if you were at the doctor’s Pereira. In these cities, care is not only provi- important (the home care units were office,” Ocampo affirms. ded at home, but the user can request it The experience gained in these 18 60
( )CONTIGO CONNECT WITH CEM Find out more on our website www.cem.coomeva.com.co and the national service line 018000 930 932. To access the home health service, just call #586 or use the App. QR CODE TO DOWNLOAD THE APP: Apple Store: Play Store: wherever they are, even if you are in your car and feel sick. FOR COOMEVA MEMBERS To make it even more widely accessible, CEM has esta- blished important partnerships with wide ranging By being a member of the Cooperative, you will be channels such as Gane, Rappi, and other outstanding able to access a preferential plan with national and international brands; it will even soon start differentiated rates and benefits with several providing access to home care services through telemedi- national partners. Relief is also available during the cine to Colombians abroad. national state of emergency. CEM also offers personalized services at the business In addition, during the last year we have worked level with integral solutions for the assurance and provi- hard to develop internal synergies with the sion of health care tailored to the different companies, different companies in the Group, seeking to including the outsourcing of processes. Today, it has more complement the services of the members, health, than 1,400 affiliated companies in collective plans, protec- financial, and insurance activities. ted areas, transfers, and telemedicine/telementoring. As a result of the changes in the social security system in The global trend is for telemedicine and telemento- Colombia and the worldwide transformation of health services ring to increase their numbers, after users became mas- sively familiar with the modality during the pandemic provision schemes in the midst of the pandemic, Grupo and used the different tools, which allowed them to per- Coomeva has committed to the creation of Coomeva Emergency ceive the advantages in terms of comfort, warmth, time- liness, solutions, and trust. Now, CEM has 115,000 Medical Services as an independent company, highlighting that clients; by 2024, it plans to provide care for more than more than 18 years ago, Coomeva Private Healthcare started this 200,000 Colombians, provide more than 1.5 million great initiative as a business unit. •services, and save more than 100,000 lives 61
( )CONTIGO THE ABCs ADVISOR ANDRÉS FELIPE TORRES OF STEM CELLS Specialist in Stem Cells and Cell Regeneration Regenerative medicine is emerging as an option for treating diseases. Coomeva Stem cells are the basis of regenerative Private Healthcare facilitates its users’ medicine. They represent a biologi- access to this service through a cal insurance that allows people to partnership with America Cell Bank. improve their quality of life or that of their families, implementing a more 62 friendly treatment for diseases such as lymphoma, Alzheimer’s, leukemia, or ane- mia. Anticipating the future to know if diseases like these are going to affect an individual or not is impossible. Genetics and lifestyle play a major role; however, prevention is still the best medicine and, in this case, translates into the preserva- tion of the body’s cells for later use as a therapeutic tool in the processes of tissue regeneration. How is this possible?
(( )COCROPNOTRIAGTOE tterendndesncias (Coomeva’s new partnership Private Healthcare with America Cell Bank allows its users to access this service at a lower cost. They will also receive a $276,000 bonus and 12 additional years of storage. Coomeva Private Healthcare, together the blood, a sample of umbilical cord mine whether it is feasible, compatibility with America Cell Bank, laboratory, and tissue is taken. “Blood and tissue cells and viability studies are carried out. If stem cell bank, made a partnership that have different characteristics because the family has saved a sample of the makes this option more accessible. some are precursors of blood cells. The umbilical cord, in this case the child These cells are present in various tissues cells present in Wharton jelly, as we would be one hundred percent compati- of the body, such as bone marrow, teeth, know this tissue, are those that can be ble, while the viability is determined by blood, skin, and the umbilical cord. In regenerated. They are called mesenchy- the patient’s weight. fact, thanks to them and their constant mal cells and have the greatest potential renewal, the body has the possibility of in regenerative medicine. Applications From America Cell Bank’s perspective, healing naturally. Dr. Andrés Felipe have demonstrated that they can be used transplants can also be done with bone Torres, a specialist in stem cells and cell in any person because they do not pre- marrow cells from a compatible donor, regeneration, states that, after years of sent incompatibility,” adds Dr. Torres. whether a family member or not, or in research, it was concluded that stem cells some cases from the patient himself. The in the umbilical cord have better plasticity PRESERVATION specialist emphasizes that Wharton’s jelly and greater effectiveness in the treatment The cells must be stored in a stem cell “is an extraordinary help for families. It of degenerative diseases when compared bank with specific conditions, where they would be the best therapy in the event to other adult stem cells. “They are at a guarantee not only the reserve, but also that one of these diseases knocked on our stage where they are looking to multiply the quantity and quality of the biological door. For example, a person can ensure rapidly, and this makes the therapeutic material. This process is known as cryo- their child’s treatment or the treatment of response in patients much higher.” preservation and its main objective is to grandparents or other family members It is possible to collect them at the time prevent cell aging and degradation that of birth, where in addition to collecting happens over the years. “The good thing •who have difficult to manage diseases.” about this technique is that it can be sto- red for many, many years. In addition, 70 they can be expanded and stored in grea- ter quantities,” adds the specialist. DISEASES CAN BE TREATED BY DIRECT APPLICATION OF One of the areas of greatest applica- STEM CELLS FROM THE tion of regenerative medicine is UMBILICAL CORD. childhood cancer. During chemo and radiotherapy sessions, the body’s malig- nant cells are destroyed, but healthy bone marrow cells are also destroyed, and one way to regenerate them is through a stem cell transplant. To deter- 63
( ))CORNPTOIGROATE directory OUR MEDICAL NETWORK IN THE CARIBBEAN Learn about news and updates regarding our network of specialists. INFORMATION UPDATES Pneumology Speech Therapy Carmelo Rafael Dueñas Castell María Helena Barbosa Marulanda CARIBBEAN REGION Address: calle 5 # 6 - 47, Centro de Address: calle 16 # 15 - 16 Diagnóstico Cardiológico, cons. 101 Phone: 3177411075 - 3157114972 BARRANQUILLA Phone: 6657078 - 3044985218 Plastic surgery Pediatric Dentistry Rafael Hernández Herazo FONSECA Lorena Oñate Oñate Address: cra. 58 # 70 - 129, cons. 401 Clinics, medical centers, Address: cra. 19 # 2 D - 12, cons. 11 y 12 Phone: 3533177 - 3603330 - and hospitals Phone: 5885223 - 3175689429 - 3006577944 Clínica La Esperanza S.A.S. 3157335543 Address: calle 15 # 21 -40 Clinics, medical Phone: 3173794949 NEW PRACTITIONERS centers, and hospitals Neuroavances S.A.S. SANTA MARTA BARRANQUILLA Address: cra. 59 B # 79 -251 Dental clinics Pediatric Orthopedics Phone: 3858125 ext. 118 Clinic Smile S.A. and Traumatology Address: av. de Los Estudiantes Jhonny Eliécer Carreño Sánchez Diagnostic imaging cra. 12 # 17 A - 71 Address: cra. 47 # 82 - 150, Centro Radiólogos Asociados Villa Phone: 4204810 - 3104491810 - Pediátrico Carreño Country Cure & Latorre 3016326752 Phone: 3450974 - 3232989497 Address: calle 78 # 57 - 215, piso 1 Phone: 3198611 - 3182115027 Home Consultation BECERRIL Innovación en Cuidado General Dentistry Pathology Ambulatorio S.A.S. - ICAD Miguel Enrique Anteliz Galán Jesús A. Pérez García Address: cra. 19 # 12 - 37, C.C. Address: cra. 5 # 10 - 64 Address: cra. 48 # 70 -61 La 19, local 12 Phone: 3116565909 Phone: 3459637 - 3564455 Phone: 3183281809 - 3145974940 CARTAGENA CARTAGENA Pediatrics Clinics, medical centers, Clinics, medical centers, Eliana Eugenia Cantillo Tinoco and hospitals and hospitals Address: calle 24 # 3 - 95, ed. Diagnóstico y Terapéutica en Centro Radio Oncológico Empresarial Banco de Bogotá, of. 1307 Gastroenterología y Hepatología IPS del Caribe Ltda. Phone: 4209109 - 3106422378 - S.A.S. - DITEG Address: cra. 48 # 30 - 60, 3123658329 Address: av. San Martín cra. 2 # 13 - 89 barrio Armenia Phone: 6510246 - 3137662660 Phone: 6499070 VALLEDUPAR Endocrinology Endocrinology 64 Centro Médico Sebastián Lucía Beatriz Taboada Barrios Villazón Ovalle S.A.S. Address: calle 6 A # 3 - 17, Address: transv. 18 B # 20 B - 7 ed. Jasban, cons. 609 A Phone: 5802733 - 5809287 Phone: 3155617998
(( )COCROPNOTRIAGTOE directory RIOHACHA IN THE CARIBBEAN REGION, WE HAVE A MEDI- General Dentistry CAL NETWORK IN THE FOLLOWING CITIES: Alba Ureche Moscote Address: calle 7 # 11 - 114 • Agustín • Fundación • Sabanalarga Phone: 7275757 - 3165266760 • Hatonuevo • San Juan Codazzi • La Jagua SANTA MARTA • Albania del César Clinics, medical centers, and hospitals • Barrancas de Ibirico • Santa Marta Sociedad de Cirugía Ocular del Caribe S.A. • Barranquilla • La Loma • Sincelejo Address: cra. 8 # 28 - 123 • Becerril • Magangué • Turbaco Phone: 4323920 - 3184963399 - 3044962808 • Bosconia • Maicao • Urumita • Cartagena • Puerto • Valledupar SINCELEJO • Ciénaga • Villanueva Home Consultation • Fonseca Colombia Gestión Integral del Cuidado • Riohacha Address: cra. 24 # 14 - 19, barrio La Palma Phone: 2807586 - 3002098801 (Remember that you have access to more than 780 profes- sionals and 330 health institutions in the Caribbean region. Download our Coomeva MP App For more information about Coomeva Private Healthcare’s Medical Directory, please visit: oficinavirtualmp.coome- va.com.co/DirectorioMovil-Web or scan the following QR code with your mobile device. 65
( ))CORNPTOIGROATE prevention IS IT TIME FOR AN APPOINTMENT? Don’t wait until you feel bad to visit the doctor. Regular check- ups can help you prevent illnesses. ADVISOR tions, follow-up may be more frequent. disease ideally every six months,” states DAVID ARISTIZÁBAL COLORADO A general physical examination, inclu- the doctor. He also recommends that women visit the gynecologist annually to General practitioner ding an assessment of your sense organs, have tests (such as a pap smear) done as lungs, and heart, is usually done during the directed by the treating physician. ¿ How often should you go to consultation as well as a neurological assess- the doctor? This is a question ment of motor skills and sensitivity. The According to the needs of each indivi- that depends on many diffe- doctor looks for any irregularities in the dual, “ophthalmology check-ups should be rent factors. According to Dr. abdomen, the joints, pulse in the extremi- done, especially for those who present David Aristizábal from Clínica ties, and characteristics of the skin. visual symptoms or a family history of glau- Somer, different prevention and health coma. Check-ups with other specialists are promotion programs seek early manage- Of course, we must not neglect other also important, such as gastroenterology or ment or detection of the most important check-ups. “We must not forget oral internal medicine, depending on the speci- conditions affecting different age health. Regardless of age, you should visit groups: babies, children, teenagers, your dentist to prevent cavities and gum •fic case,” concludes Aristizábal adults, and elderly adults. “Once a year, you should visit your gene- (In our Coomeva MP app ral practitioner to have a check-up and iden- you can find our network of specialists and tify possible risk factors, such as obesity, book your appointments. We can answer all your being overweight, having a sedentary lifesty- questions through our WhatsApp: 315 458 6354. le, smoking, having an unbalanced diet, etc., as these factors could increase the risk of cardiovascular disease, for example,” sta- tes Aristizábal. Depending on the progno- sis, predisposition, or underlying condi- 66
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