viernes, 3 de agosto de 2012

Dieting vs. Exercise for Weight Loss


Dieting vs. Exercise for Weight Loss

Chase Jarvis/Getty Images

Phys EdTwo groundbreaking new studies address the irksome question of why so many of us who work out remain so heavy, a concern that carries special resonance at the moment, as lean Olympians slip through the air and water, inspiring countless viewers to want to become similarly sleek.
PHYS ED
Gretchen Reynolds on the science of fitness.
And in a just world, frequent physical activity should make us slim. But repeated studies have shown that many people who begin an exercise program lose little or no weight. Some gain.
To better understand why, anthropologists leading one of the new studies began with a research trip to Tanzania. There, they recruited volunteers from the Hadza tribe, whose members still live by hunting and gathering.
Providing these tribespeople with a crash course in modern field-study technology, the researchers fitted them with GPS units, to scrupulously measure how many miles each walked daily while searching for food. They also asked them to swallow so-called doubly labeled water, a liquid in which the normal hydrogen and oxygen molecules have been replaced with versions containing tracers. By studying these elements later in a person’s urine, researchers can precisely determine someone’s energy expenditure and metabolic rate.
The researchers gathered data for 11 days, then calculated the participants’ typical daily physical activity, energy expenditure and resting metabolic rates. They then compared those numbers with the same measures for an average male and female Westerner.
It’s long been believed that a hunter-gatherer lifestyle involves considerable physical activity and therefore burns many calories, far more than are incinerated by your average American office worker each day. And it was true, the scientists determined, that the Hadza people in general moved more than many Americans do, with the men walking about seven miles a day and the women about three.
But it was not true that they were burning far more calories. In fact, the scientists calculated, the Hadza’s average metabolic rate, or the number of calories that they were burning over the course of a day, was about the same as the average metabolic rate for Westerners.
The implication, the scientists concluded, is that “active, ‘traditional’ lifestyles may not protect against obesity if diets change to promote increased caloric consumption.” That is, even active people will pack on pounds if they eat like most of us in the West.
The underlying and rather disheartening message of that finding, of course, is that physical activity by itself is not going to make and keep you thin. (It’s worth noting that the Hadza people were almost uniformly slight.)
The overarching conclusion of that study, which was published last week in the journal PLoS One, is not really new or surprising, says Dr. Timothy Church, who holds the John S. McIlhenny Endowed Chair in Health Wisdom at the Pennington Biomedical Research Center in Louisiana and who has long studied exercise and weight control. “It’s been known for some time that, calorie for calorie, it’s easier to lose weight by dieting than by exercise,” he says.
People stick with low-calorie diets more readily than they continue with exercise to drop pounds.
And another newly published and fascinating review, by Dr. Church and others, goes some way to explaining why. Its main point: As in the Hadza study, human metabolism appears to be less revved by activity than was once believed.
“There’s this expectation that if you exercise, your metabolism won’t drop as you lose weight or will even speed up,” says Diana Thomas, a professor of mathematics at Montclair State University in New Jersey, who led the study.
But she says close mathematical scrutiny of past studies of exercise and weight loss shows that that happy prospect is, sad to say, unfounded. One of the few studies ever to have scrupulously monitored exercise, food intake and metabolic rates found that volunteers’ basal metabolic rates dropped as they lost weight, even though they exercised every day. As a result, although they were burning up to 500 calories during an exercise session, their total daily caloric burn was lower than it would have been had their metabolism remained unchanged, and they lost less weight than had been expected.
The problem for those of us hoping to use exercise to slough off fat is that most current calculations about exercise and weight loss assume that metabolism remains unchanged or is revved by exercise.
So Dr. Thomas has helpfully begun to recalibrate weight loss formulas, taking into account the drop in metabolism. Using her new formulas, she’s working with a group of volunteers at Pennington, providing them with improved predictions about how much weight they can expect to lose from exercise.
The predictions are proving accurate, she says, and although her forecast is for less weight loss than that under the old formula, the volunteers are pleased. “It’s better to meet lower expectations,” she says, “than to be disappointed that you’re not losing what you supposedly should.” (You can find a basic version of the revised weight loss calculator here.
She is perhaps her own best advertisement. In the past few years, she’s shed 70 pounds and, using her formulas for how many calories she’s actually burning each day thanks to a daily walk, has regained none of it.



Stress


Obesidad. Infografia


jueves, 2 de agosto de 2012

EL RIO LOIRA EN FRANCIA

http://www.odisea2008.com/2012/07/el-rio-loira-en-francia.html


VIERNES, 13 DE JULIO DE 2012

EL RIO LOIRA EN FRANCIA

Continuamos de paseo por los ríos franceses, e indiscutiblemente después, sino a la par, que los hermosos paisajes del Sena están los del valle del Loira.

El río Loira es un largo río europeo, que discurre por Francia, nace en el monte Gerbier-de-Jonc, en el departamento de Ardèche, y desemboca en el océano Atlántico en un amplio estuario después de Nantes.

Es el río más largo de Francia y pasa por las ciudades de Orleans, Tours y Nantes. Es famoso porque en sus riberas se hallan numerosos castillos y palacios de los siglos XVI al XVII francés, conocidos en su conjunto como «Castillos del Loira».

Aquí tienen un mapa con el recorrido del río:

000-Mapa del rio Loira

Veremos algunos de sus paisajes, utilizando dos obras, la primera en dos tomos (aunque por lo que he podido ver tienen los mismos grabados ambos), Wanderings by the Loire (Paseos por el Loira) y el segundo tomo Wanderings by the Loire (Volume no. 2) ambas escritas por Ritchie, Leitch y con grabados de las pinturas y dibujos de J. M. W. Turner en una edición de 1833. La tercera del mismo autor e ilustrador es una recopilación de los escritos y grabados de la obra “Wanderings by the Sena” y de la indicada anteriormente, se titula Liber fluviorum, or, River scenery of France en una edición de 1857, quizás con los grabados en mejores condiciones.

Esta vez no he tenido tiempo de ponerles información al pie de las imágenes, sin embargo los interesados pueden fácilmente con el nombre indicado en la lamina (que obtienen pasando el cursor sobre ella), a través de Google encontrar referencias a cada lugar.

Para ampliar (recomendado), piquen sobre la lámina para acceder al servidor y una vez allí, busquen el tamaño original.

001- Beaugenoy-Wanderings by the Loire- 1833- J. M. W. Turner

002-Blois-Wanderings by the Loire- 1833- J. M. W. Turner

003-Palacio de Blois-Wanderings by the Loire- 1833- J. M. W. Turner

004-Amboise-Wanderings by the Loire- 1833- J. M. W. Turner

004a- Castillo de Amboise-Wanderings by the Loire- 1833- J. M. W. Turner

005-Canal entre el Loira y el Cher cerca de Tours-Wanderings by the Loire- 1833- J. M. W. Turner

006-Nantes-Wanderings by the Loire- 1833- J. M. W. Turner

007- Tours-Wanderings by the Loire- 1833- J. M. W. Turner

008- Otra vista de Tours-Wanderings by the Loire- 1833- J. M. W. Turner

009- Saumur-Wanderings by the Loire- 1833- J. M. W. Turner

010-Montjen-Wanderings by the Loire- 1833- J. M. W. Turner

011- Entre Clairmont y Mauves-Wanderings by the Loire- 1833- J. M. W. Turner

012- Costa de Mauves-Wanderings by the Loire- 1833- J. M. W. Turner

013- Clairmont-Wanderings by the Loire- 1833- J. M. W. Turner

014 Orleans-Wanderings by the Loire- 1833- J. M. W. Turner

015- San Julian en Tours-Wanderings by the Loire- 1833- J. M. W. Turner

016- Otra vista de Saumur -Liber fluviorum, or, River scenery of France-1857- J. M. W. Turner

017- San Florent -Liber fluviorum, or, River scenery of France-1857- J. M. W. Turner

018- Castillo de Hamelin entre Oudon y Ancenis -Liber fluviorum, or, River scenery of France-1857- J. M. W. Turner

019- Castillo de Nantes -Liber fluviorum, or, River scenery of France-1857- J. M. W. Turner

020- Escena en el Loira -Liber fluviorum, or, River scenery of France-1857- J. M. W. Turner

He corregido contraste de los originales y enmarcado en blanco.

Saludos.


Chocolates en el IMSS


CREDITO: 
Alberto Aguirre M.
Aunque quisiera, ningún funcionario del gobierno calderonista pudo evitar que los administradores de la empresa Promeca -la filial mexicana de Orthofix, una fabricante italiana de prótesis médicas- desmantelaran su cuartel general en el DF.
Desde hace medio año que están vacíos los libreros de madera, empotrados en los muros blancos en las dos plantas del local que se ubica en un tramo de la avenida Doctor Vértiz, de la colonia Letrán-Del Valle. Nada quedó dentro de los tres privados o en la Sala de Juntas de las oficinas, de 240 metros cuadrados, que serían “perfectas para escuela de idiomas” y cuya renta asciende a 30,000 pesos mensuales, de acuerdo con corredores inmobiliarios que la ofertan actualmente, sin saber que allí ocurrió uno de los fraudes más escandalosos de las épocas recientes.
Hace una semana se hizo público el lado foráneo de este escándalo, luego de que Orthofix International aceptara pagar 5.2 millones de dólares a la Securities and Exchange Commission (SEC) y adicionalmente fuera sancionada con una multa por 2.2 millones de dólares por el Departamento de Justicia de Estados Unidos, luego de que presentara en una Corte del Distrito Este de Texas una causa judicial para investigar el pago de mordidas a funcionarios del Instituto Mexicano del Seguro Social.
No sólo se trató de sobornos en efectivo para funcionarios de la división y la Coordinación Técnica de Bienes Terapéuticos, así como de la Coordinación de Adquisiciones de Bienes y Contratación de Servicios del IMSS, sino también de la entrega de electrodomésticos, laptops y otros artículos de lujo a los oficiales mexicanos, ya fuera de manera directa o a través de fachadas, que le permitieron multiplicar por 90 sus ingresos, en un lapso de apenas 10 años.
La sanción impuesta por la SEC a la farmacéutica trató de ser equivalente a los 56.1 millones de pesos obtenidos por Promeca en el periodo 2009-2010, por los contratos que obtuvieron en las licitaciones internacionales convocadas por el IMSS para la adquisición de bienes de consumo de uso terapéutico. De acuerdo con fuentes familiarizadas con esas asignaciones, la penalización para la compañía mexicana es exigua dado el favoritismo que gozaron durante las últimas tres administraciones del IMSS, incluida la actual. Tan sólo en el 2010 recibieron 8.1 millones de pesos por la asignación de al menos 25 partidas derivadas de la adjudicación de diversos contratos.
Fundada en 1994, Promeca obtuvo la representación de Orthofix y se integró al padrón de proveedores del IMSS en el 2002. Ese primer año obtuvo ingresos que apenas rebasaron los 650,000 pesos, según la información disponible en la base de datos de Compranet.
Con oficinas el DF, Monterrey, Guadalajara, Veracruz y Mérida, y una red de distribuidores que se extendía a Chihuahua, Hermosillo, Tijuana y San Luis Potosí, la empresa tuvo un auge bajo la dirección del abogado Arturo Alberto Soto Cabrera.
Este periodo coincidió con la segunda fase de un programa del IMSS para adquirir material de clavos, tornillos, alambres, agujas, pines y otros dispositivos que se implantan quirúrgicamente para tratar fracturas, así como las placas destinadas a remplazar huesos o articulaciones.
De una etapa previa, en la que establecieron convenios y se contrataron licitaciones con fabricantes mexicanos, se pasó a un periodo en el que las compras se realizaron de manera desconcentrada: primero a las direcciones regionales y posteriormente a cada unidad médica compradora, bajo un esquema denominado “inventario cero”. El IMSS no cuenta con piezas embodegadas y las existencias disponibles en los hospitales son propiedad del proveedor, quien las puso en consignación.
Para el 2008, el IMSS tenía en la Dirección General a Juan Molinar Horcasitas. Y para la adquisición de esos insumos se aplicaría otro esquema: compras “consolidadas” a cargo de una Unidad Médica de Alta Especialidad, de la que saldrían las piezas que cubrirían las necesidades de abasto de 35 delegaciones y 15 centros hospitalarios.
La primera compra consolidada estuvo a cargo del Hospital de Traumatología y Ortopedia de Magdalena de las Salinas y para mayo del 2012 la convocante fue el Hospital de Traumatología y Ortopedia de Puebla, con el apoyo de la Coordinación de Adquisición de Bienes y Contratación de Servicios del IMSS. Ese contrato, por 48 millones de pesos, fue asignado a Promeca.
Ese esquema operó nuevamente en julio del 2010, cuando se convocó a la licitación internacional 00641321-011-10, pero se canceló antes de realizarse la presentación de propuestas, ante quejas por favoritismos y denuncias veladas por corrupción.
Dos meses después, el IMSS lanzó una nueva convocatoria para una licitación internacional para la adquisición del material. Esta vez, la entidad convocante fue el Hospital de Traumatología y Ortopedia de Lomas Verdes, Estado de México.
Entonces, al menos cinco empresas denunciaron públicamente que se estaba “favoreciendo sólo a un proveedor”. Y es que dos aparatos -un cabezal para correcciones angulares y una rótula artificial- sólo eran fabricados por Orthofix y comercializados por Promeca, cuyo representante legal era entonces Héctor Manuel Dzib y Sosa.
Sus contrapartes en el IMSS eran María Elena Mondragón Galicia, Coordinadora de Adquisición de Bienes y Contratación de Servicios, así como Óscar Arellano, Coordinador Técnico, y Magdalena Leal González, titular de División, ambos del área de de Bienes Terapéuticos

Embarazo patológico

Mecanismos moleculares de la preeclampsia 
Molecular mechanisms of preeclampsia.
Vitoratos N, Hassiakos D, Iavazzo C.
2nd Department of Obstetrics and Gynecology, University of Athens, Aretaieion Hospital, 11528 Athens, Greece.
J Pregnancy. 2012;2012:298343. Epub 2012 Feb 23.
Abstract
Preeclampsia is one of the leading causes of maternal morbidity/mortality. The pathogenesis of preeclampsia is still under investigation. The aim of this paper is to present the molecular mechanisms implicating in the pathway leading to preeclampsia.

 
Journal of Pregnancy 2012 
Otros artículos con temas importantes sobre enfermedad hipertensiva del embarazo pueden ser consultados en el siguiente enlace
http://www.hindawi.com/journals/jp/preeclampsia/ 

 
Atentamente
Dr. Benito Cortes-Blanco
Anestesiología y Medicina del Dolor

Claves de los grandes ponenetes


SHOOTING | PISTOLS




SHOOTING | PISTOLS

Handgun Ban Tests a British Olympian

Rebecca Blackwell/Associated Press
British athletes are competing in the Olympic cartridge pistol competition for the first time since 1996, doing something that is illegal for nearly everyone in the country.
LONDON — Sixteen years ago, it was Britain that was trying to make sense of a mass shooting, with the nightly news filled with grieving relatives and old family photographs.
Rebecca Blackwell/Associated Press
Georgina Geikie practicing the 25-meter pistol, one of two events she will compete in at the London Games.

Readers’ Comments

A 43-year-old named Thomas Hamilton was the gunman, and his killing floor was not a midnight movie showing but a primary school in Dunblane, Scotland. He killed 17 people, all but one of them children, before committing suicide.
But the reaction here could scarcely have been more different from the one in the United States to the mass shooting in Colorado. With outrage still white hot, gun opponents in Britain organized a successful campaign for a gun ban, and by the end of 1997 Parliament had outlawed the private ownership of nearly all handguns.
It is against that backdrop that Georgina Geikie, a 27-year-old English barmaid, will approach the firing line at the Royal Artillery Barracks here Wednesday. She is the first British athlete to compete in an Olympic cartridge pistol competition since 1996, and she will be doing something that is illegal for nearly everyone in the country — and until recently was illegal for her as well.
There is Ping-Pong diplomacy and perhaps soccer can indeed explain the world, but no Olympic sport has the political dimension of shooting. It is as universal as any activity; more countries have a representative in the Olympic shooting events than all others except for judo, swimming and track and field.
But there is an almost complete divergence between the United States and Britain, whose laws and public attitudes toward guns lie at nearly opposite ends of the spectrum.
Members of the United States Olympic shooting team seem no more inclined than gymnasts or fencers to talk about politics, preferring to discuss the finer points of their sport.
At a media appearance here, the shooting team members answered the perhaps inevitable questions about Aurora, Colo., with practiced forbearance: target shooting and gun massacres have nothing to do with each other, they said; safety is a priority for sport shooters; they were as shocked and saddened as anyone by the killings, which took place about 90 minutes from their practice site.
Whatever happens as a result of the rampage in Aurora, there is almost no chance that it will affect their sport. Beyond that assurance, officials with the team acknowledge that the benefits of the strong and loyal gun culture in the United States go far, particularly in an activity that is expensive but not particularly prominent.
“We have one of the larger direct-mail campaigns of any of our sports,” said Buddy Duvall, executive director of the USA Shooting Team Foundation.
Contributions to the team come in from gun enthusiasts, and firearms bearing little resemblance to those at the Olympics are sold in Web auctions, with the proceeds going to the American team.
Then there is Britain.
“Olympics to Boost Shooting,” read a news release from the British shooting team. One of the team’s top shooters, Peter Wilson, said in the release that he hoped the main legacy of the Olympics “is that people start to have a positive outlook on shooting.”
Wilson uses a shotgun, which, like rifles, air guns and some significantly modified pistols, remains legal here. The guns used in three Olympic shooting events, the ones involving cartridge pistols, were banned altogether in 1997.
Since then, anyone wanting to practice had to do so on the Continent or at least in Northern Ireland, where the laws are looser. There were no exceptions: an up-and-comer like Geikie and a veteran like Mick Gault, who was awarded the Order of the British Empire as one of the most successful British competitors of any sport, both kept their guns in Switzerland and traveled there on weekends to practice.
“It was the end of our sport for a while,” said Margaret Thomas, an orthodontist and former Olympian. She quit shooting pistols after the ban, considering it too much trouble. Now she is Geikie’s coach.
Those who kept at it faced some unusual arrangements. At the 2002 Commonwealth Games in Manchester, pistol event competitors were handed their guns only after being locked in the firing range, and they had to return their pistols to officials before the door was unlocked.
Lars Baron/Getty Images
Georgina Geikie, an English barmaid, during qualifying earlier this week.

Readers’ Comments

With the 2012 Games approaching, Britain’s strict laws posed something of a problem, even after officials granted an exception to allow the pistol events to go on as scheduled. The problem was the British team itself.
“It would have looked absolutely ridiculous if we were not allowing our shooters to practice here,” said Kate Hoey, a member of Parliament for the Labour Party and a former sports minister who has supported lifting the ban.
In 2008, government officials granted a temporary exemption loosening, but not lifting, the ban. Competitors were allowed to practice in Britain in the three events that used banned guns. The number of licenses to allow certain sport shooters to own pistols was capped in the low double digits, and only four ranges in the country were authorized for target practice.
The exemption was not looked on favorably by gun control advocates like Chris Williamson, another Labour member of Parliament.
Citing a regular and steady tally of gun fatalities in Britain that have not drawn as much attention as massacres like the one in Dunblane and a more recent rampage in Cumbria, Williamson says additional restrictions are needed, if not an outright prohibition on all guns. Among the rules he is pushing is a ban on keeping guns at home, more aggressive regulation of air guns and yearly mental fitness tests for gun owners.
Williamson said he did not have anything against target shooting, adding that the competitors should still be able to practice their sport. But he acknowledged that additional regulation might make practicing more difficult.
“We’ve got to get control of this,” he said. “If that means we may be a little less competitive in this Olympic sport, then I think that’s a price worth paying.”
Sport shooters are hoping the exemption for those practicing for the Olympics will be extended, at least until Rio de Janeiro in 2016.
There is where Geikie may come in. She is not spoken of as a gold medal hope (though some newspapers have referred to her as the Lara Croft of Britain, after the buxom English pistol-brandisher of the “Tomb Raider” franchise), but gun advocates say a strong performance by Geikie would help their cause.
“What we really need is another successful shooter,” said Hoey, the Labour member of Parliament. “If only she could do really well and get some publicity, then it’s really much easier.”

Stone Links: Boyle’s Olympic Incoherence


Stone Links: Boyle’s Olympic Incoherence

The Stone
The Stone is a forum for contemporary philosophers on issues both timely and timeless.
At The Paris Review, Rafil Kroll-Zaidi parses the opening ceremony of the London Games and finds it to be a semiotic mess — a jumble of signifiers never exceeding haphazard pastiche. We should have expected no less, he argues, as its director, Danny Boyle, has always shown himself, as a filmmaker, to be more of an “executive technician” than an artist of coherent vision. The erraticism of the opening ceremony — indeed, its mild insanity — follows from the striking inconsistency (in many senses) of his oeuvre: Boyle’s films range from the high of “Trainspotting” to the (very) low of “Sunshine,” with the treacly, manipulative “Slumdog Millionaire” falling somewhere in between.
Guns Might Kill People After All: Evan Selinger examines the old gun lobby saw, “Guns don’t kill people; people kill people,” at The Atlantic. Philosophers call the sort of view of technology it embodies instrumentalism: technologies can be used as instruments to any end subjects choose to put them — in the case of guns: shooting tin cans, hammering nails, or killing people, among many other uses — but they are in themselves neutral. Selinger expounds on the trouble with this position: “By equating firearm responsibility exclusively with human choice, the N.R.A. claim abstracts away relevant considerations about how gun possession can affect one’s sense of self and agency.” In the words of French philosopher Bruno Latour, “You are different with a gun in your hand; the gun is different with you holding it. You are another subject because you hold the gun; the gun is another object because it has entered into a relationship with you.”
Automating Humor: At his blog, Zach Weinersmith considers the possibility of an algorithmic joke generator. He begins with some very entertaining evolutionary speculations — it’s not clear how literally we should take them — that show why the following principle should be true of us humans:
Confusion —> Understanding —> Pleasure (CUP)
From here he goes on to discuss and refine the principle, relating it to humor and the “one-liner” joke. Finally, he considers some formal rules that might be fit to generate these one-liners mechanically. It should be said, this post is highly speculative. But it is equally captivating.
Also:
At The New Statesman, a discussion of the relation between existence and the Internet.
A rumination on Barack Obama’s recent utterance, “You didn’t build that,” at The Washington Post.
At The Guardian, a review of Michael Foley’s “Embracing the Ordinary.”
Crooked Timber posts a revealing graph of the relation between how great a sport is and how much it belongs at the Olympics.
And finally, at Three Quarks Daily, a video clip of Gore Vidal sparring with William Buckley. The term “pro-crypto-Nazi” — presumably minted for the occasion — turns up.

Telemedicina. Alerta

Telemedicina entre el HUC y Atención Primaria
La Voz de Tenerife
La puesta en marcha de la Consulta Virtual en varias especialidades en el centro hospitalario con Atención Primaria permite dar una respuesta precoz al problema de salud que plantea el paciente. La puesta en marcha por parte del Complejo Hospitalario ...
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iRobot pone la telemedicina en piloto automático
Technology Review en español
Ni siquiera los médicos a los que les gusta la tecnología se pasarían media hora o más aprendiendo a manejar un robot con un joystick. Un nuevo robot de InTouch Health e iRobot está diseñado para hacer que la telemedicina sea tan fácil como tocar la ...
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Prevención de muerte súbita en atletas.

Prevención de muerte súbita cardíaca: consideraciones para volver al deporte en atletas con anomalías cardiovasculares conocidas. 
Prevention of sudden cardiac death: return to sport considerations in athletes with identified cardiovascular abnormalities.
Link MS.
Tufts Medical Center, NEMC Box #197, 750 Washington Street, Boston, MA 02111, USA. MLink@tuftsmedicalcenter.org
Br J Sports Med. 2009 Sep;43(9):685-9.
Abstract
Sudden cardiac death in the athlete is uncommon but extremely visible. In athletes under age 30, genetic heart disease, including hypertrophic cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy, and ion channel disorders account for the majority of the deaths. Commotio cordis, involving blunt trauma to the chest leading to ventricular fibrillation, is also a leading cause of sudden cardiac death in young athletes. As the athlete ages, coronary atherosclerosis contributes to an increasing incidence of sudden death during sporting activities. For athletes with aborted sudden death or arrhythmia-related syncope, an implantable cardioverter defibrillator is generally indicated, and they should be restricted from most competitive sports. Participation in competitive athletics for athletes with heart disease should generally follow the recently published 36th Bethesda Conference Eligibility Recommendations for Competitive Athletes with Cardiovascular Abnormalities.

 

Atentamente
Anestesiología y Medicina del Dolor

Análisis de 208 fibrobroncoscopias realizadas en una unidad de cuidados intensivos


 
Atte.
Dr.Máximo Cuadros Chávez

¿Cómo transmite malas noticias el médico especialista? Estudio realizado con médicos especialistas del Hospital General de México


 
Atte.
Dr.Máximo Cuadros Chávez