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sábado, 15 de octubre de 2011

Jorge Chirinos comenta sobre vacuna polio adulto

La enfermedad no es sólo de niños lo que pasa es que en ellos se dan los cuadros más severos y no tienen la memoria inmunológica contra los 3 tipos de polio. Y se prefiere la IPV a la OPV en adultos porque el riesgo de parálisis secundaria a la vacuna es más alto en adultos que en niños, y que sólo la OPV tiene ese riesgo obviamente. Se vacunan los adultos en poblaciones en que no hay inmunidad de la comunidad adulta contra el virus y no tienen defensas y en poblaciones adultas especiales como en zonas endémicas o en trabajadores de laboratorio con virus de polio. La gran mayoría de las comunidades adultas sí tienen anticuperos contra los tres subtipos de Polio. En poblaciones especiales y si no han recibido vacunacion completa de niños es que se vacuna a un adulto. Cuando residente me llamó mucho la atención ver a un adulto de Europa ir al INSN a pedir su dosis de polio intramuscular con su carnet de vacunación... hace ya 17 alos atrás.


Should adults get vaccinated against polio?
In the United States, routine vaccination of people 18 years of age and older against polio is not recommended because most adults are already immune and also have little risk of being exposed to wild polio virus. Vaccination is recommended, however, for certain adults who are at increased risk of infection, including travelers to areas were polio is common, laboratory workers who handle specimens that might contain polioviruses, and healthcare workers in close contact with patients who might be excreting wild polioviruses in their stool (e.g., those caring for recent immigrants from central Africa or parts of Asia).
If an adult is at increased risk of exposure and has never been vaccinated against polio, he or she should receive three doses of IPV, the first two doses given 1-2 months apart, and the third 6-12 months after the second. If time will not allow the completion of this schedule, a more accelerated schedule is possible (e.g., each dose separated four weeks from the previous dose).
If an adult at risk previously received only one or two doses of polio vaccine (either OPV or IPV), he or she should receive the remaining dose(s) of IPV, regardless of the interval since the last dose.
If an adult at increased risk previously completed a primary course of polio vaccine (three or more doses of either OPV or IPV), he or she may be given another dose of IPV to ensure protection. Only one "booster" dose of polio vaccine in a person's lifetime is recommended. It is not necessary to receive a booster dose each time a person travels to an area where polio may still occur.
http://www.vaccineinformation.org/polio/qandavax.asp


As an adult, do I need this vaccine?
Most adults do not need polio vaccine because they were already vaccinated as children. But three groups of adults are at higher risk and should consider polio vaccination in the following situations:
You are traveling to polio-endemic or high-risk areas of the world. Ask your healthcare provider for specific information on whether you need to be vaccinated.
You are working in a laboratory and handling specimens that might contain polioviruses.
You are a healthcare worker treating patients who could have polio or have close contact with a person who could be infected with poliovirus.
Adults in these three groups who have never been vaccinated against polio should get 3 doses of IPV:
The first dose at any time,
The second dose 1 to 2 months later,
The third dose 6 to 12 months after the second.
Adults in these three groups who have had 1 or 2 doses of polio vaccine in the past should get the remaining 1 or 2 doses. It doesn't matter how long it has been since the
earlier dose(s).
Adults who are at increased risk of exposure to poliovirus and who have previously completed a routine series of polio vaccine (IPV or OPV) can receive one lifetime booster dose of IPV.
For additional details, consult the Polio Vaccine Information Statement  [PDF-74.9KB]and the Adult Immunization Schedule.
http://www.cdc.gov/vaccines/vpd-vac/polio/in-short-both.htm#who


Adults: Most adults do not need polio vaccine because they were already vaccinated as children. But three groups of adults are at higher risk and should consider polio vaccination: (1) people traveling to areas of the world where polio is common, (2) laboratory workers who might handle polio virus, and (3) health care workers treating patients who could have polio.
Adults in these three groups who have never been vaccinated against polio should get 3 doses of IPV: the first dose at any time, the second dose 1 to 2 months later, the third dose 6 to 12 months after the second.
Adults in these three groups who have had 1 or 2 doses of polio vaccine in the past should get the remaining 1 or 2 doses. It doesn't matter how long it has been since the earlier dose(s).
Adults in these three groups who have had 3 or more doses of polio vaccine (either IPV or OPV) in the past may get a booster dose of IPV.
Ask your health care provider for more information.
http://www.nlm.nih.gov/medlineplus/druginfo/meds/a601177.html#app4


Polio immunisation timetable
All children are offered polio immunisation as part of the routine immunisation programme. A full course of polio immunisation consists of five doses of vaccine as follows:


 ChildrenAdults (who have not been immunised as a child)
Primary CourseThree doses of vaccine - as DTaP/IPV(polio)/Hib at two, three and four months of age.Three doses of vaccine - as Td/IPV(polio), each one month apart.
4th doseThree years after the primary course - as part of the DTaP/IPV(polio) pre-school booster at 3 years and four months to 5 years.5 years after the primary course - as Td/IPV(polio).
5th doseAged 13-18 years - the school leaver booster - as Td/IPV(polio).10 years after 4th dose - as Td/IPV(polio).

 

The primary course of three injections gives good protection for a number of years. The fourth and fifth doses ('boosters') are needed in later years to maintain protection. After the fifth dose, immunity remains for life and you do not need any further boosters (apart from some travel situations - see 'Travellers', below).
http://www.patient.co.uk/health/Polio-Immunisation.htm

 

3. Polio Vaccination of Adults

Routine vaccination of adults (>18 years of age) who reside in the United States is not necessary because most adults are already immune and have a very small risk of exposure to wild poliovirus in the United States. Some adults are at increased risk of infection with poliovirus. These include:
travelers to areas where poliomyelitis is endemic or epidemic
laboratory workers handling specimens that may contain polioviruses, and
healthcare workers in close contact with patients who may be excreting wild polioviruses
In addition, members of specific population groups with a current disease caused by wild polioviruses (e.g., during an outbreak), are also at increased risk.
Recommendations for poliovirus vaccination of adults in the above categories depend upon the previous vaccination history and the time available before protection is required.

For unvaccinated adults at increased risk of exposure to poliomyelitis, primary immunization with IPV is recommended. IPV is preferred because the risk of vaccine-associated paralysis following OPV is higher in adults than in children. The recommended schedule is two doses given at a 1- to 2-month interval, and a third dose given 6 to 12 months later.

In some circumstances time will not allow completion of this schedule. If 8 weeks or more are available before protection is needed, three doses of IPV should be given at least 4 weeks apart. If 4-8 weeks are available before protection is needed, two doses of IPV should be given at least 4 weeks apart. If less than 4 weeks are available before protection is needed, a single dose of either OPV or IPV is recommended. In all instances, the remaining doses of vaccine should be given later, at the recommended intervals, if the person remains at increased risk.

Adults who have previously completed a primary course of OPV and who are at increased risk of exposure to poliomyelitis may be given another dose of OPV (if available). These adults are not at increased risk of VAPP. The need for further supplementary doses has not been established. Those adults who previously completed a primary course of IPV and are at increased risk may be given a dose of either IPV or OPV.

Adults who have previously received less than a full primary course of OPV or IPV and who are at increased risk of exposure to poliomyelitis should be given the remaining doses of IPV, regardless of the interval since the last dose and type of vaccine previously received. It is not necessary to restart the series of either vaccine if the schedule has been interrupted.

http://sprojects.mmi.mcgill.ca/tropmed/disease/polio/vaccine.htm#adults

 

--- El vie, 14/10/11, Claudio Mori gonzales <clagui57@gmail.com> escribió:


De: Claudio Mori gonzales <clagui57@gmail.com>

Asunto: [SALUD_LORETO] esperemos los comentarios de Jorge
Para: clagui57.ensayyyossss@blogger.com, "SaludLoreto" <salud_loreto@yahoogroups.com>, "SANFERNANDOPERU" <sanfernandoperu@yahoogroups.com>, clagui57.saludloreto@blogger.com
Fecha: viernes, 14 de octubre, 2011 11:31


 
- Mostrar texto citado -
Hola Claudio
 
Hace un par de semanas más o menos pasaron un especial en la TV refiriendo que varios niños vacunados contra la polio (creo que tres) había tenía dicha enfermedad. El Ministerio de Salud decía que muy eventualmente hay riesgo, en especial cuando la persona está baja de defensas.
 
Aquí he visto vacunas para la polio en adultos. ¿no era una enfermedad de niños?
 
Atentamente, Mario


- Mostrar texto citado -
---------- Mensaje reenviado ----------
De: Accinelli, Mario <MAccinelli@southernperu.com.pe>
Fecha: 14 de octubre de 2011 10:38
Asunto: Sobre la polio en el Perú
Para: Claudio Mori Gonzales <clagui57@gmail.com>

 

- Mostrar texto citado -
Hola Claudio
 
Hace un par de semanas más o menos pasaron un especial en la TV refiriendo que varios niños vacunados contra la polio (creo que tres) había tenía dicha enfermedad. El Ministerio de Salud decía que muy eventualmente hay riesgo, en especial cuando la persona está baja de defensas.
 
Aquí he visto vacunas para la polio en adultos. ¿no era una enfermedad de niños?
 
Atentamente, Mario
 
From: LASALLELIMA1974@yahoogrupos.com.mx [mailto:LASALLELIMA1974@yahoogrupos.com.mx] On Behalf Of Claudio Mori Gonzales
Sent: Friday, October 14, 2011 7:10 AM
To: lasallelima1974@yahoogrupos.com.mx
Subject: [LASALLELIMA1974] [Medicina para Legos] para el comentario del Doctor Jorge Chirinos
 
 
- Mostrar texto citado -
 
Hola a tod@s
Reenvio estemail.¿ Alguien sabe de los niños con reaccion postvacunal a polio?
Saludos
Lupe
 

Date: Thu, 13 Oct 2011 17:23:35 -0500
Subject: El gobierno de Finlandia dice que va a pagar por "el cuidado médico de por vida" para los 79 niños que han sido irreparablemente dañados por la vacuna.
From: luisperulorber@gmail.com
To: luisperulorber@gmail.com
Finlandia admitió esta semana que la vacuna contra la gripe suína causa narcolepsia, un trastorno crónico del sistema nervioso que hace que la gente sienta un deseo incontrolable de dormir.
El Gobierno finlandés, en reconocimiento a este vínculo, dice que va a pagar por "el cuidado médico de por vida" para los 79 niños que han sido irreparablemente afectados por la vacuna. La narcolepsia no es el único efecto secundario. Médicos finlandeses y de otros países admiten las victimas de esta vacuna también sufren de alucinaciones y "colapsos físicos paralizantes", dicen los investigadores finlandeses.
Leer más

Traducción Luis Miranda  12 de Octubre de 2011

Fuente:
NaturalNews.com
http://real-agenda.com/2011/10/12/vacuna-contra-gripe-suina-sin-duda-causa-trastornos-cronicos-del-sistema-nervioso/
- Mostrar texto citado -
---------- Mensaje reenviado ----------
De: lupe vidal valenzuela <lupevidal@hotmail.com>
Fecha: 14 de octubre de 2011 06:15
Asunto: [SANFERNANDOPERU] Finlandia va a pagar por dañados de vacuna.
Para: sanfernandoperu@yahoogroups.com


 
- Mostrar texto citado -
Hola a tod@s
Reenvio estemail.¿ Alguien sabe de los niños con reaccion postvacunal a polio?
Saludos
Lupe
 

 

Date: Thu, 13 Oct 2011 17:23:35 -0500
Subject: El gobierno de Finlandia dice que va a pagar por "el cuidado médico de por vida" para los 79 niños que han sido irreparablemente dañados por la vacuna.
From: luisperulorber@gmail.com
To: luisperulorber@gmail.com

Finlandia admitió esta semana que la vacuna contra la gripe suína causa narcolepsia, un trastorno crónico del sistema nervioso que hace que la gente sienta un deseo incontrolable de dormir.

El Gobierno finlandés, en reconocimiento a este vínculo, dice que va a pagar por "el cuidado médico de por vida" para los 79 niños que han sido irreparablemente afectados por la vacuna. La narcolepsia no es el único efecto secundario. Médicos finlandeses y de otros países admiten las victimas de esta vacuna también sufren de alucinaciones y "colapsos físicos paralizantes", dicen los investigadores finlandeses.
Leer más


Traducción Luis Miranda  12 de Octubre de 2011


Fuente:
NaturalNews.com
http://real-agenda.com/2011/10/12/vacuna-contra-gripe-suina-sin-duda-causa-trastornos-cronicos-del-sistema-nervioso

---------- Forwarded message ----------
From: Jorge Chirinos <jchirinosmd@yahoo.es>
Date: 2011/10/14
Subject: Re: [SALUD_LORETO] esperemos los comentarios de Jorge
To: SALUD_LORETO@yahoogroups.com


 

La enfermedad no es sólo de niños lo que pasa es que en ellos se dan los cuadros más severos y no tienen la memoria inmunológica contra los 3 tipos de polio. Y se prefiere la IPV a la OPV en adultos porque el riesgo de parálisis secundaria a la vacuna es más alto en adultos que en niños, y que sólo la OPV tiene ese riesgo obviamente. Se vacunan los adultos en poblaciones en que no hay inmunidad de la comunidad adulta contra el virus y no tienen defensas y en poblaciones adultas especiales como en zonas endémicas o en trabajadores de laboratorio con virus de polio. La gran mayoría de las comunidades adultas sí tienen anticuperos contra los tres subtipos de Polio. En poblaciones especiales y si no han recibido vacunacion completa de niños es que se vacuna a un adulto. Cuando residente me llamó mucho la atención ver a un adulto de Europa ir al INSN a pedir su dosis de polio intramuscular con su carnet de vacunación... hace ya 17 alos atrás.

Should adults get vaccinated against polio?
In the United States, routine vaccination of people 18 years of age and older against polio is not recommended because most adults are already immune and also have little risk of being exposed to wild polio virus. Vaccination is recommended, however, for certain adults who are at increased risk of infection, including travelers to areas were polio is common, laboratory workers who handle specimens that might contain polioviruses, and healthcare workers in close contact with patients who might be excreting wild polioviruses in their stool (e.g., those caring for recent immigrants from central Africa or parts of Asia).

If an adult is at increased risk of exposure and has never been vaccinated against polio, he or she should receive three doses of IPV, the first two doses given 1-2 months apart, and the third 6-12 months after the second. If time will not allow the completion of this schedule, a more accelerated schedule is possible (e.g., each dose separated four weeks from the previous dose).
If an adult at risk previously received only one or two doses of polio vaccine (either OPV or IPV), he or she should receive the remaining dose(s) of IPV, regardless of the interval since the last dose.

If an adult at increased risk previously completed a primary course of polio vaccine (three or more doses of either OPV or IPV), he or she may be given another dose of IPV to ensure protection. Only one "booster" dose of polio vaccine in a person's lifetime is recommended. It is not necessary to receive a booster dose each time a person travels to an area where polio may still occur.

http://www.vaccineinformation.org/polio/qandavax.asp


As an adult, do I need this vaccine?

Most adults do not need polio vaccine because they were already vaccinated as children. But three groups of adults are at higher risk and should consider polio vaccination in the following situations:

  • You are traveling to polio-endemic or high-risk areas of the world. Ask your healthcare provider for specific information on whether you need to be vaccinated.
  • You are working in a laboratory and handling specimens that might contain polioviruses.
  • You are a healthcare worker treating patients who could have polio or have close contact with a person who could be infected with poliovirus.

Adults in these three groups who have never been vaccinated against polio should get 3 doses of IPV:

  • The first dose at any time,
  • The second dose 1 to 2 months later,
  • The third dose 6 to 12 months after the second.

Adults in these three groups who have had 1 or 2 doses of polio vaccine in the past should get the remaining 1 or 2 doses. It doesn't matter how long it has been since the
earlier dose(s).

Adults who are at increased risk of exposure to poliovirus and who have previously completed a routine series of polio vaccine (IPV or OPV) can receive one lifetime booster dose of IPV.

For additional details, consult the Polio Vaccine Information Statement Adobe Acrobat print-friendly PDF file. [PDF-74.9KB]and the Adult Immunization Schedule.

http://www.cdc.gov/vaccines/vpd-vac/polio/in-short-both.htm#who


Adults: Most adults do not need polio vaccine because they were already vaccinated as children. But three groups of adults are at higher risk and should consider polio vaccination: (1) people traveling to areas of the world where polio is common, (2) laboratory workers who might handle polio virus, and (3) health care workers treating patients who could have polio.

Adults in these three groups who have never been vaccinated against polio should get 3 doses of IPV: the first dose at any time, the second dose 1 to 2 months later, the third dose 6 to 12 months after the second.

Adults in these three groups who have had 1 or 2 doses of polio vaccine in the past should get the remaining 1 or 2 doses. It doesn't matter how long it has been since the earlier dose(s).

Adults in these three groups who have had 3 or more doses of polio vaccine (either IPV or OPV) in the past may get a booster dose of IPV.

Ask your health care provider for more information.

http://www.nlm.nih.gov/medlineplus/druginfo/meds/a601177.html#app4


Polio immunisation timetable

All children are offered polio immunisation as part of the routine immunisation programme. A full course of polio immunisation consists of five doses of vaccine as follows:

  Children Adults (who have not been immunised as a child)
Primary Course Three doses of vaccine - as DTaP/IPV(polio)/Hib at two, three and four months of age. Three doses of vaccine - as Td/IPV(polio), each one month apart.
4th dose Three years after the primary course - as part of the DTaP/IPV(polio) pre-school booster at 3 years and four months to 5 years. 5 years after the primary course - as Td/IPV(polio).
5th dose Aged 13-18 years - the school leaver booster - as Td/IPV(polio). 10 years after 4th dose - as Td/IPV(polio).


The primary course of three injections gives good protection for a number of years. The fourth and fifth doses ('boosters') are needed in later years to maintain protection. After the fifth dose, immunity remains for life and you do not need any further boosters (apart from some travel situations - see 'Travellers', below).
http://www.patient.co.uk/health/Polio-Immunisation.htm


3. Polio Vaccination of Adults

Routine vaccination of adults (>18 years of age) who reside in the United States is not necessary because most adults are already immune and have a very small risk of exposure to wild poliovirus in the United States. Some adults are at increased risk of infection with poliovirus. These include:

  • travelers to areas where poliomyelitis is endemic or epidemic
  • laboratory workers handling specimens that may contain polioviruses, and
  • healthcare workers in close contact with patients who may be excreting wild polioviruses
  • In addition, members of specific population groups with a current disease caused by wild polioviruses (e.g., during an outbreak), are also at increased risk.

Recommendations for poliovirus vaccination of adults in the above categories depend upon the previous vaccination history and the time available before protection is required.

For unvaccinated adults at increased risk of exposure to poliomyelitis, primary immunization with IPV is recommended. IPV is preferred because the risk of vaccine-associated paralysis following OPV is higher in adults than in children. The recommended schedule is two doses given at a 1- to 2-month interval, and a third dose given 6 to 12 months later.

In some circumstances time will not allow completion of this schedule. If 8 weeks or more are available before protection is needed, three doses of IPV should be given at least 4 weeks apart. If 4-8 weeks are available before protection is needed, two doses of IPV should be given at least 4 weeks apart. If less than 4 weeks are available before protection is needed, a single dose of either OPV or IPV is recommended. In all instances, the remaining doses of vaccine should be given later, at the recommended intervals, if the person remains at increased risk.

Adults who have previously completed a primary course of OPV and who are at increased risk of exposure to poliomyelitis may be given another dose of OPV (if available). These adults are not at increased risk of VAPP. The need for further supplementary doses has not been established. Those adults who previously completed a primary course of IPV and are at increased risk may be given a dose of either IPV or OPV.

Adults who have previously received less than a full primary course of OPV or IPV and who are at increased risk of exposure to poliomyelitis should be given the remaining doses of IPV, regardless of the interval since the last dose and type of vaccine previously received. It is not necessary to restart the series of either vaccine if the schedule has been interrupted.

http://sprojects.mmi.mcgill.ca/tropmed/disease/polio/vaccine.htm#adults



--- El vie, 14/10/11, Claudio Mori gonzales <clagui57@gmail.com> escribió:

De: Claudio Mori gonzales <clagui57@gmail.com>
Asunto: [SALUD_LORETO] esperemos los comentarios de Jorge
Para: clagui57.ensayyyossss@blogger.com, "SaludLoreto" <salud_loreto@yahoogroups.com>, "SANFERNANDOPERU" <sanfernandoperu@yahoogroups.com>, clagui57.saludloreto@blogger.com
Fecha: viernes, 14 de octubre, 2011 11:31

 

Hola Claudio
 
Hace un par de semanas más o menos pasaron un especial en la TV refiriendo que varios niños vacunados contra la polio (creo que tres) había tenía dicha enfermedad. El Ministerio de Salud decía que muy eventualmente hay riesgo, en especial cuando la persona está baja de defensas.
 
Aquí he visto vacunas para la polio en adultos. ¿no era una enfermedad de niños?
 
Atentamente, Mario

---------- Mensaje reenviado ----------
De: Accinelli, Mario <MAccinelli@southernperu.com.pe>
Fecha: 14 de octubre de 2011 10:38
Asunto: Sobre la polio en el Perú
Para: Claudio Mori Gonzales <clagui57@gmail.com>


Hola Claudio

 

Hace un par de semanas más o menos pasaron un especial en la TV refiriendo que varios niños vacunados contra la polio (creo que tres) había tenía dicha enfermedad. El Ministerio de Salud decía que muy eventualmente hay riesgo, en especial cuando la persona está baja de defensas.

 

Aquí he visto vacunas para la polio en adultos. ¿no era una enfermedad de niños?

 

Atentamente, Mario

 

From: LASALLELIMA1974@yahoogrupos.com.mx [mailto:LASALLELIMA1974@yahoogrupos.com.mx] On Behalf Of Claudio Mori Gonzales
Sent: Friday, October 14, 2011 7:10 AM
To: lasallelima1974@yahoogrupos.com.mx
Subject: [LASALLELIMA1974] [Medicina para Legos] para el comentario del Doctor Jorge Chirinos

 

 

 
Hola a tod@s
Reenvio estemail.¿ Alguien sabe de los niños con reaccion postvacunal a polio?

Saludos
Lupe
 


Date: Thu, 13 Oct 2011 17:23:35 -0500
Subject: El gobierno de Finlandia dice que va a pagar por "el cuidado médico de por vida" para los 79 niños que han sido irreparablemente dañados por la vacuna.
From: luisperulorber@gmail.com
To: luisperulorber@gmail.com

Finlandia admitió esta semana que la vacuna contra la gripe suína causa narcolepsia, un trastorno crónico del sistema nervioso que hace que la gente sienta un deseo incontrolable de dormir.

El Gobierno finlandés, en reconocimiento a este vínculo, dice que va a pagar por "el cuidado médico de por vida" para los 79 niños que han sido irreparablemente afectados por la vacuna. La narcolepsia no es el único efecto secundario. Médicos finlandeses y de otros países admiten las victimas de esta vacuna también sufren de alucinaciones y "colapsos físicos paralizantes", dicen los investigadores finlandeses.
Leer más


Traducción Luis Miranda  12 de Octubre de 2011


Fuente:
NaturalNews.com
http://real-agenda.com/2011/10/12/vacuna-contra-gripe-suina-sin-duda-causa-trastornos-cronicos-del-sistema-nervioso/

---------- Mensaje reenviado ----------
De: lupe vidal valenzuela <lupevidal@hotmail.com>
Fecha: 14 de octubre de 2011 06:15
Asunto: [SANFERNANDOPERU] Finlandia va a pagar por dañados de vacuna.
Para: sanfernandoperu@yahoogroups.com

 

Hola a tod@s
Reenvio estemail.¿ Alguien sabe de los niños con reaccion postvacunal a polio? 

Saludos

Lupe

 


Date: Thu, 13 Oct 2011 17:23:35 -0500
Subject: El gobierno de Finlandia dice que va a pagar por "el cuidado médico de por vida" para los 79 niños que han sido irreparablemente dañados por la vacuna.
From: luisperulorber@gmail.com
To: luisperulorber@gmail.com

Finlandia admitió esta semana que la vacuna contra la gripe suína causa narcolepsia, un trastorno crónico del sistema nervioso que hace que la gente sienta un deseo incontrolable de dormir.

El Gobierno finlandés, en reconocimiento a este vínculo, dice que va a pagar por "el cuidado médico de por vida" para los 79 niños que han sido irreparablemente afectados por la vacuna. La narcolepsia no es el único efecto secundario. Médicos finlandeses y de otros países admiten las victimas de esta vacuna también sufren de alucinaciones y "colapsos físicos paralizantes", dicen los investigadores finlandeses.
Leer más


Traducción Luis Miranda  12 de Octubre de 2011


Fuente:
NaturalNews.com
http://real-agenda.com/2011/10/12/vacuna-contra-gripe-suina-sin-duda-causa-trastornos-cronicos-del-sistema-nervioso/






--
Publicado por Claudio Mori Gonzales para Medicina para Legos el 10/14/2011 05:09:00 AM

 

__._,_.___

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