Guayaquil: Clinica Kennedy Alborada, Torre Sur, piso 10 cons. 1004
Samborondón: Clinica Kennedy Samborondón, Torre Alfa 5to piso consultorio 512
CERER
  • Inicio
  • Quienes Somos
  • Especialidades y Servicios Médicos
  • Seguros Médicos
  • Staff Médico
  • Para Pacientes
    • Eventos para Pacientes
    • Promociones
    • Revista
    • Artículos para Pacientes
  • Para Médicos
    • Eventos para Médicos
    • Publicaciones
    • Consejos
    • Artículos Actualizados
  • Contacto
  • Inicio
  • Quienes Somos
  • Especialidades y Servicios Médicos
  • Seguros Médicos
  • Staff Médico
  • Para Pacientes
    • Eventos para Pacientes
    • Promociones
    • Revista
    • Artículos para Pacientes
  • Para Médicos
    • Eventos para Médicos
    • Publicaciones
    • Consejos
    • Artículos Actualizados
  • Contacto

Uncategorized

CERER > Uncategorized
Oct7
00

You’ll understand how bonuses and payments on the platform

By alejandro - Uncategorized

Casino utan Svensk Licens guide 2023 Casinon utan Spelpaus

A 100 free spins no deposit bonus is something you should definitely take advantage of if you like to play slots. You should weigh the bonus’s benefits and drawbacks before deciding whether it is a good fit for you. To help you recognize them when you see them casino utan svensk licens, a brief description of each is provided here. CasinoTop.com is world’s trusted and independent resource to online casino.

This guarantees your overall safety when playing on these websites. You don’t have to cash in real money to play your favourite games on the site. If you’d like to experience exclusive gaming, Qbet offers a Qrewards VIP program. As a member ジョイカジノ, you’ll enjoy several benefits, including high withdrawal and deposit limits. Fortunately, casinos without a Swedish license come to the rescue. MetaSpace casino utan svensk licens casino utan svensk licens, the emerging P2E NFT blockchain game—built by Indian developers—is now officially licensed by RAK DAO as a Gaming Studio…

More importantly, only select bonuses with reasonable wagering requirements. All casinos without a Swedish license have well-outlined terms and conditions. You’ll understand how bonuses and payments on the platform work. Smartphones are quite popular in Sweden, considering there are more than 8 million smartphone users in the country.

They also use SSL encryption and have their live casino games regularly tested by independent authorities. In short, if you stick to a reputable casino website, you shouldn’t run into any safety concerns. There is a significant distinction between casinos that have a Swedish license and those that do not. Time limits are required in licensed Swedish casinos, thus these establishments must include self-control measures. These time constraints are applied more loosely by casinos who do not hold a Swedish licence.

At the end of our review process, we only recommend casinos that meet all our criteria and pass our rigorous tests. This allows Swedish players to confidently choose from a list of safe and reputable non-Swedish licensed casinos. We strive to be your trusted guide through the complex world of international casinos.

Also, there is an interesting topic to explore – pay and play casino utan svensk licens. Our team are always cautious when adding casinos licensed in Curacao to our list of recommended sites deneme bonusu veren siteler, as we prioritize player safety and security above all else. However casino utan svensk licens deneme bonusu veren siteler, there are plenty of reputable casinos licensed by Curacao that have earned our seal of approval. EMTA is the regulatory body responsible for licensing and regulating online gambling in Estonia. Casinos licensed by EMTA undergo regular audits to ensure fair gaming practices and player protection. The MGA is one of the top regulatory bodies in the online gambling industry, known for its strict regulations and player protection measures.

Oct4
00

That’s why we made a list of the highest websites instead

By alejandro - Uncategorized

Best Online Casinos 2025 7,000+ Real Money Sites Rated

If you need to make certain you select a mobile-friendly option, select from our listing of best mobile on-line casinos. With over 600,000 registered members within the Casino Guru community, players worldwide contribute their critiques and ratings of online casinos. These reviews are scored on a scale from 1 to five and are used to calculate an overall User Feedback Score ranging from Terrible to Excellent. By far the biggest and most commonly found sites that supply prepaid cards are PaysafeCard casinos. There are other options ジョイ カジノ, like Visa Vanilla and Neosurf, but PaysafeCard has the most important share of the market ベラジョン, making up around 12% of deposits.

Take your decide of three,000+ online on line casino games from the industry’s premium suppliers. The newest and best online slots like Play’n GO’s Book of Dead and Playtech’s Age of the Gods are solely a contact away. Take a seat at certainly one of our online blackjack tables or strive your luck with on-line roulette.

The easy approach to decide which are the highest 10 on-line casino sites is to go by revenues. This part picks out ten casinos, six of which soak up probably the most cash in their states. Popularity brings in the cash, but that doesn’t imply they’re mechanically one of the best.

Your pal may also want to fulfill a couple of fundamental standards, like verifying their account or inserting a guess. It is important that there’s a good choice of assist channels. These ought to embody stay chat, e-mail オンラインカジノ, and cellphone, however increasingly, players prefer messaging apps like WhatsApp and official social media channels. Many trusted land-based casinos, like Caesars Palace, Golden Nugget, and Borgata, now operate online.

However, some individuals do not enjoy taking half in slots without the potential of successful something. If that is your case, perhaps you would make use of no deposit on line casino bonuses オンライン カジノ, which may give you an opportunity to win some money without having to spend any of your individual. Casinos that accept cryptocurrencies often enable prompt deposit occasions, allowing gamers to begin out playing without delay. Withdrawals in cryptocurrencies from on-line casinos are usually processed in a short time ベラジョン, sometimes inside hours. Whether you favor casino video games or sports betting, you’ll earn each Loyalty Level Points and Bonus Store Points on every real cash wager you make.

Bovada Casino, on the other hand オンラインカジノ, is renowned for its complete sportsbook and wide number of casino games, together with desk games and reside supplier choices. This kind of bonus is usually geared toward newly registered clients who’ve simply created an account at an online on line casino. While generally winnings from such bonuses can’t be cashed out, they symbolize a superb resource of free enjoying credits. In most cases, they arrive within the form of further spins for slot video games, but some casinos give them in the type of bonus money for any sport, which means you can even use them for desk games. Canadian players also can select from a broad array of online casinos and on-line on line casino bonuses. To filter bonuses suitable for Canadian gamers, set the ‘Bonuses for Players from’ filter to ‘Canada.’ We also have a list of no deposit bonuses for Canadian gamers ready for you.

Mobile casino gaming in 2025 contains dedicated apps and optimized websites for seamless gaming experiences on Android and iOS devices. At SlotsandCasino, you’ll be able to play on line casino games, having fun with a combine of popular on line casino video games, together with a number of both slot machines and conventional table video games. The on line casino additionally prides itself on its reliable customer service, which plays a vital position in guaranteeing a optimistic consumer expertise. Navigating by way of the multitude of on-line casinos to search out the best one can typically look like a daunting task. It’s not solely about the games on provide but also the security, bonuses, and person expertise. We’ve completely reviewed and compiled a list of the most effective online casinos where real money play is an choice.

At sweepstakes casinos onsmartwatch オンラインカジノ, that’s the same as using 100 Sweepstakes Coins. Log in to any on-line or sweepstakes on line casino to search out the latest and hottest slots. These video games are available all types—from traditional 3-reel slots to exciting 8-reel, jackpot, and Megaways video games from high providers like Pragmatic Play. It’s unimaginable to choose one definitive best online on line casino for real cash that might suit each player’s needs. That’s why we made a list of the highest websites instead, so you can filter via the various great on-line casino sites in the marketplace and select the proper one for you. It’s not that common, however as soon as again it is dependent upon the websites you use and the kinds of bonus you are trying to cash in on.

Cryptocurrencies and Neteller have also been within the spotlight these days, however we warn you that no legal gambling platform is allowed to offer them. Luckily, you can select from one of the wonderful alternatives listed above. Seneca Buffalo Creek Casino places you at the middle of charming, walkable experiences.

All you may have to do is register for a web-based account and deposit funds via your chosen banking technique, then you can begin to play real cash versions of your favourite online slot machines. There are so many amazing casinos online offering nice free slot machines right now. If you’re new to online slots check out our beneficial slot casinos to get began. The Czech Gambling Act of 2017 has opened up the web casino market, which now has numerous legal and controlled online casinos for Czech gamers to select from.

Sep20
00

To ensure you are enjoying the finest option

By alejandro - Uncategorized

The Brook Sportsbetting And Casino

CoolCat Casino offers players over 220 of essentially the most thrilling free on line casino video games that the orldwide internet has to supply. With an infinite array of table games and an intimate high restrict lounge, there’s no better place to get in on the motion than our beautiful gaming flooring. Whether you like Pai Gow or blackjack, pull up a seat ジョイカジノ ジョイカジノ, place your bet, and luxuriate in personalised service as you play.

We have created the identical on line casino experience you need with casino video games and a on line casino restaurant with a lodge and occasions heart close to Idaho Falls and Pocatello. We even host live music occasions and have an RV park for those who favor to camp quite than stay in resort rooms. We’re always ready to get together and invite you to affix us and experience a full-service casino closer to house. To choose an excellent on line casino to play gambling games on our greatest tip is to easily choose one of our really helpful casinos. You need to play on a casino that has a wide recreation range, a quantity of protected and secure banking options ジョイカジノ0, good customer support, and fast withdrawals.

777 is a part of 888 Holdings plc’s famend Casino group, a worldwide chief in online casino video games and one of the largest online gaming venues on the planet. 888 has been listed on the London inventory Exchange since September 2005. Everything we do is designed to offer one of the best gaming expertise attainable. Part of the celebrated 888casino Club, 777 benefits from a protracted and award winning history in online gaming.

IGT – International Game TechnologyOne of the oldest on line casino game creators , IGT was founded in 1975. With the invention of the web オンライン カジノ おすすめ, its in depth catelog of games went online. Players Club members shall be allowed to trade factors free of charge play on Mondays & Tuesdays in quantities of $5 – $50. Players will choose the quantity to be purchased based on their point availability and personal desire.

Both brands are all-American favorites and now each do an excellent job at online on line casino. Below is a snapshot of how slots have developed over the last few decades. Exciting 150% bonus as much as $2,500 plus 25 free spins to kickstart your journey as a new player. If you choose a giant and well-known online on line casino with good critiques, a excessive Safety Index, and a massive quantity of glad clients , it is fair to say that you could trust it.

Before you play, remember to study the totally different hands and their rankings. The royal flush is by far the highest, closely followed by a straight flush. Once you’ve got this down check out some free games to place your skills to the take a look at earlier than you bet with real money. Our choice of free video poker games is among the best around. Select a trusted real cash on-line casino and create an account by filling within the required details ベラ ジョン カジノ, such as your name, e mail handle ベラ ジョン カジノ, and chosen password.

There are many authorities that license and regulate on-line casinos. Some of them focus on playing inside a particular nation, while different have a more global method. Also, we should always level out that there are circumstances in which game suppliers create a number of variations of the same video games, each with a different RTP and house edge. In these cases, you’ll have the ability to expect completely different results at completely different on line casino websites. To ensure you are enjoying the finest option, you can check the RTP inside the game itself. Choosing a top rated on-line on line casino should assist you to avoid unfair treatment.

This is possible as the games are streamed in real-time from a land-based on line casino or a studio recreated to mimic a land-based on line casino. Play video games in real time with real reside sellers – it’s the ultimate on-line Live Casino. Take a seat, choose your recreation, tackle our sellers and brace yourself for a on line casino experience like no other. With 1 オンライン カジノ,200 slots and digital desk games this lively vacation spot makes on your premier leisure vacation spot in the Hudson Valley region. Enjoy your favorite drink and cheer on your staff at Bar 360, situated at the heart of all the motion, supplying you with 360-degree views of our gaming floor. Fuel up on your subsequent massive win with Chef Scott Conant’s soulful spin on American comfort meals at THE KITCHEN, an SC spot.

Bitcoin casino is an internet gambling platform that accepts cryptocurrency. On such sites ビットカジノ ボーナス, gamblers might play various sorts of video games using BTC. The main advantage of Bitcoin casinos over ordinary platforms is 100 percent safe, anonymous, and hassle-free playing. We often enlarge our foyer with high-tech on-line games to offer a mind-blowing Bitcoin playing experience to all players.

Sep5
00

In 1971, artificial leather purses and other products were

By alejandro - Uncategorized

Luxury Fake Designer Bags Store

However, unlike the Hermès icon, the larger leather tote zips up, with a middle compartment big enough for a 13-inch laptop. A slightly more paired back take on the Hermès classic, this Birkin-inspired bag is a more accessible alternative. However, it’s not just a good Birkin alternative, the Prada Galleria is an icon in and of itself. Rooted in tradition, the Prada bag was first introduced in 2007 and is named after the affluent label’s flagship store in Milan. Characterized by its unique replica birkin bags, layered look with framed compartments, the sumptuous leather exterior is lined with a soft suede interior.

Unfortunately, the market is flooded with counterfeits that may look genuine at first glance but fail in quality and craftsmanship. This guide will walk you through the most reliable ways to authenticate a Gucci bag, covering everything from materials to hardware affordbag, packaging, and seller verification. Are you looking for the style and sophistication of a Goyard tote bag, but don’t want to break the bank?

One can definitely see the difference in the serial number font. To prevent the counterfeiters from copying serial numbers, Chanel introduced several technologies. First of all, the French fashion house elaborated a unique font for the digits. Next, they manufactured a sticker with the double cross X lines that would have prevented the sticker to be removed. There are also two lines to the left and right sides of the serial.

Early products for the Nantai market were mostly made of textiles, synthetic leather, and chemical fibers in small local family enterprises. There are both big and small wholesale leather products businesses in Guangzhou’s Sanyuanli, Tangxia, Huadu, Tangxi, and Shiling replica bags, among other localities. Since then, the leather goods business has exploded all over, fueling the rapid growth of hardware manufacturing.

If these are missing, there’s a possibility somebody ripped them out, but the more likely explanation is that the bag is fake. The shipping method of replica products is the same as normal, but you need to confirm how the customs of your country/region determines whether the products are replica products. We have met some customers who are looking for the original factories of brand cosmetics in China, and they hope to purchase cosmetics from the original factories of these brands. This not only guarantees the quality of cosmetics, but also obtains a lower price. Many brands have foundries in China, which provides a lot of convenience for making bags. The price of a branded bag is usually several thousand dollars, but in China you can buy a copy for several tens of dollars.

Baginc is made up of a team of fashion enthusiasts who have a passion for celebrity style and fashion handbags. Aliexpress carries a variety of products that include everything from clothing to home improvement tools. It’s a great designer dupes website, but it does require some hunting. There are also plenty of designer-inspired items that you can’t miss out on too.

When it comes to choosing a dupe over the original Louis Vuitton product, there are a few reasons to consider. Shopping at physical stores for dupes has its benefits, as you can see and feel the quality of the products in person. In terms of where to find physical stores with quality Louis Vuitton dupes replica birkin bags, popular retailers like Walmart offer a variety of options. When selecting dupe products in physical stores, it’s important to keep a few tips in mind.

Replica purses are not produced according to the quality standards of the original luxury designer items. The craftsmanship will not be as precise and flawless as a designer purse. There are many terms used for handbags that simulate designer styles. Inspired-by replicas have a slightly different graphic, pattern, or design than the original. Colors and accent details may also differ from the inspiring design.

The history of this manufacturing spot dates back to the early 70s. In 1971, artificial leather purses and other products were first produced in Baigou Town’s Gaoqiao Village. Gaoqiao Village is the reason for the explosion of factories in the townships around. This chapter will talk about the top 5 local Chinese markets where retailers can get high-quality products in bulk.

A global survey by Boston Consulting Group (BCG) and Vestiaire Collective suggested widespread consumer support for buying secondhand products directly from brands. Some 70 per cent of 12,000 respondents supported the idea – and 50 per cent of secondhand shoppers surveyed said they had purchased brand items at full price. Sarah Willersdorf, BCG’s global head of luxury, says that consumers who buy secondhand goods usually go on to buy full-priced goods from the same brand. One category of consumers has ample purchasing power, shops casually and accepts fast fashion and luxury goods. These consumers see a clear distinction between “worthy” classic items and “unworthy” fads or perfunctorily purchased items. They are willing to pay for classic pieces and the most brilliant new models.

Sep1
00

There are many international licenses that accept Swedish

By alejandro - Uncategorized

Topp 10 casino utan svensk licens Jämför casinon utan Spelpaus

Apart from Spelpaus casino utan svensk licens, Sweden provides a number of additional gambling responsibility resources and services that can help players successfully manage their gaming. The player is often in charge of declaring and paying taxes on earnings from gambling. You cannot do this (as effectively) at casinos operating under a Swedish license. Furthermore, there is no assurance that any potential winnings will be tax-free. You may be subject to 30% tax if you play at a casino that has a licence from a gambling regulator outside of the EU or EEA.

It can take up to three banking days before the money is returned to your card, for example. Despite this, many people prefer to play casino games using debit or credit cards rather than Spelpaus. This is true for all government games, including lotteries, scratch cards, Vegas slots deneme bonusu veren siteler, and Casino Cosmopol.

The material is as complete as possible and contains a lot of useful information that will answer most of your questions and help you make informed decisions. As a new player from Sweden casino utan svensk licens, you’re eligible for a welcome bonus. Reload bonuses and cashback offers are promotions available to regular Swedish patrons. In most online casinos without a Swedish license casino utan svensk licens deneme bonusu veren siteler, you can’t play live games for free.

Still, you stand a good chance of winning considering their number. Usually, to do this, you need to register, replenish your balance, and register a unique code. If this does not work, contact the support staff to have the issues fixed. It is necessary to enter this code into the field that has been set aside just for it. Consequently, your balance will be credited with additional rewards. No, you can absolutely rely on this information as it is trustworthy.

It’s important to stay safe when playing at online casinos and betting sites without Swedish license. There are many international licenses that accept Swedish players, and they all offer a varying degree of player protection. Our team of experts have carefully reviewed and tested each casino on this page to ensure that they meet our high standards for safety, security, and fairness. A casino without Swedish license does not have to adhere to the strict regulations and limitations set by Spelinspektionen.

There is no geo-blocking and it is permitted for Swedish players to play at casinos with this licence. However, because Anjouan is located outside of the EU/EEA casino utan svensk licens, winnings are subject to 30% tax. Because the licence is affordable and simple to obtain, operators of all skill levels are drawn to it. Despite being less well-known than other licenses, players who are open to testing out new options can find it appealing.

Men and women share their experiences, help one other solve difficulties, and encourage one another in their efforts to overcome gambling addiction. BetBlocker is a free tool that allows you to restrict access to thousands of sports betting websites. 99,496 Swedish citizens were prohibited from gambling on Spelpaus.se in September 2023.

Ago31
00

It’s a simple, no-frills intercourse toy for dudes, making it

By alejandro - Uncategorized

India’s #1 Sex Toys On-line Viva Awa Adult Toys Store

You might by chance hit the incorrect button throughout play, but switching again to the correct mode is simple sufficient. Unlike lots of the other toys we’ve examined, the Magic Wand Rechargeable just isn’t waterproof. This makes it a bit harder to scrub, as you can’t submerge it, although you possibly can simply wash the silicone cap. If you understand and love the sensations that a Magic Wand provides but want that you could use the toy within the bath or underneath operating water, this mannequin may be well well value the improve for you. But in distinction to our high decide, the Rechargeable mannequin, the Waterproof version can’t be used while charging. This suction vibrator has a mix of suction and vibration settings and an progressive “liquid air” characteristic.

In order to search out the best sex toys, we looked at reviews lesbian toys, recommendations, and … did tons and many private testing. I’ve written about salacious things prior to now, so I have no shame in my coworkers figuring out too much about my personal life. Additionally, we checked out versatility in each options, use, and the kinds of bodies they can be utilized on. In this case, we do believe a toy that may be a jack of all trades could be finest, however there’s also nothing incorrect with being a master of none. This elegant steel toy has a lot to offer for each cis and trans guys, says Richards. “For myself and my different vulva-having companions armbinder, curved metal wand toys are almost universally a guaranteed orgasm gode rabbit,” he says.

Once in place, switch it on and the vibrator starts delivering rumbly vibrators right to the glans (tip) of your penis. Other perks of the Arcwave Ion include the fact that it has an open top for easy clean-up, is completely waterproof, which keeps bathtub masturbation on the table, and is lighter-weight than many competitor strokers. The Tenga Flip Orb is a masturbation sleeve that engulfs your penis absolutely, for optimum pleasure. It consists of what Tenga calls a stable finish orb, cross rampart, geared edge, and dynamic flick orb. Put simply, it’s lined with 4 distinctive textures and completely different shapes, which make for distinct pressures and sensations. «LONG JOHN (one size) gave Me the most important orgasm squirt of My life! It hit My face viberators, My submissive’s face and sprayed all round the bed.»

Thanks to a swiveling mechanism at its middle, this versatile vibrator can rework from a dual external and inside stimulator into three other toys. Once twisted, one finish of the toy sports a nozzle that may provide tongue-like licks or clitoral suction, while the other has a curved, bulbous head for inner or exterior stimulation. The versatility of this progressive toy, as nicely as its cheap price level, make it perfect for pleasure-seekers still exploring their sexual tastes.

Rather than using vibration or pulsation to stimulate the penis armbinder bondage, sleeves often function textured nobs and nodules on their inside. Are you seeking to add somewhat (or a lot) of excitement to your life? Hankey’s Toys manufactures and sells the finest quality, excessive finish, adult novelties for the discriminating customer. We offer the best, customizable, handcrafted toys that may be discovered on-line or for sale anywhere. We concentrate on uber practical and fantasy designs and have something for everyone.

Most importantly, we respect the fantastic factor about diversity, and our team contains folks with totally different beliefs, expertise, and experiences. «The day hasn’t dawned but when some other toy outdates this basic. Its large head, versatile neck, and its sturdy vibrations have put orgasm in reach for countless seekers,» Dr. Queen says. Tyomi Morgan is an authorized sexologist, pleasure coach sex toys for lesbians, and the creator of The Cowgirl Workout lesbian toys0, a exercise that helps people feel extra assured within the cowgirl intercourse position. Jessica O’Reilly, PhD, is a sex and relationship professional at sex toy manufacturers Womanizer and We-Vibe.» Not all penis sleeves are designed to make the dick greater or longer, they’re also for erotic enhancement within the bedroom and a few are for adding girth solely.

Fleshlight is probably essentially the most well-known name in male intercourse toys and is now synonymous with masturbation sleeves (like Band-Aid to adhesive bandages). As the name implies, Fleshlights are masturbation sleeves disguised as flashlights, scoring points in phrases of discretion. The inside is far more exciting than a lightbulb, sporting a like-life entrance and a good lesbian sex toy, ribbed inside. It’s a simple, no-frills intercourse toy for dudes, making it nice for novices and occasional sex toy customers. Toys “can improve the possibility of reaching orgasm, whilst also lowering the time it takes to orgasm,” explains medical sexologist and sex therapist Ness Cooper. The alternative of this high-grade material offers safety in use and the choice to warmth or chill the toys.

With over 40 years in the adult industry, Simply Pleasure is always evolving. Our brand-new intercourse toys rejoice advances in fashionable expertise while our enthusiastic staff has grown to over one hundred members. We have additionally struck up exclusive deals with luxurious brands, giving our clients first entry to fantastic new intercourse toys at unimaginable prices. You’ll discover favorite manufacturers like Doc Johnson, Main Squeeze, b-Vibe, Bodywand inflatable didlo, Bathmate, Oxballs sex machine attachments, Satisfyer and more. You will find every little thing you need to boost your intercourse life in our online drug store.

Womanizer has a five-year warranty for all of its toys, for a lot longer than most different firms on this listing. For these in search of clitoral stimulation, this 4.7-inch vibrator has 12 depth levels and a battery life of four hours after a cost time of two hours. The Womanizer Pro W500 makes use of Pleasure Air Technology, which stimulates the clitoris with gently pulsing air strain. Like different panty vibrators, Moxie+ isn’t essentially the most powerful sex toy out there. Consider getting a wand vibrator if you’re seeking intense sensations. Both toys share so much, together with the silicone finish, highly effective vibrations, and a magnetic clip to keep them in place.

Ago22
00

Conoce más acerca del Síndrome de Down y el manejo fisiátrico que requieren (rehabilitación)

By alejandro - Uncategorized

Sabias que la Rehabilitación ayuda a mejorar el estilo de vida del paciente con Síndrome de Down?

 

SÍNDROME DE DOWN Y EL MANEJO FISIATRICO

DEFINICIÓN

 

El síndrome de Down es una anomalía en los cromosomas que ocurre en 1,3 de cada 1.000 nacimientos. Por motivos que aún se desconocen, un error en el desarrollo del óvulo fecundado lleva a que se formen 47 cromosomas en lugar de los 46 que se desarrollan habitualmente. El material genético en exceso cambia levemente el desarrollo regular del cuerpo y del cerebro del bebé.

El síndrome de Down es uno de los defectos genéticos de nacimiento más comunes. Afecta a todas las razas, aún no existe cura para el síndrome de Down y tampoco es posible prevenirlo.

Las personas afectadas presentan un conjunto de síntomas diversos: cognitivos (bajo nivel intelectual), fisonómicos (ojos almendrados, nariz pequeña con una gran depresión en el tabique nasal, forma anormal de las orejas, etc.) y médicos (cardiopatías, etc).

CAUSAS:-

Presentan un exceso de material genético que explica los tres tipos existentes: Síndrome de Down por trisomía del par 21; por mosaicismo o por translocación.

DIAGNÓSTICO:-

Se puede realizar entre la semana 9 y la catorce de gestación a partir de pruebas prenatales (engrosamiento del pliegue nucal, Triple Sreening y Amniocentesis) o en el momento de su nacimiento.

Los rasgos físicos más frecuentes son:

·         Cara plana.

·         Nariz pequeña y plana.

·     Ojos achinados, almendrados, con fisuras oblicuas palpebrales. Las aperturas de los ojos se inclinan hacia arriba.

·         Oreja displástica. Desarrollo anormal de las orejas.

·         Bajo desarrollo óseo del tercio medio del rostro.

·         Maxilares y boca reducidos, con mala oclusión dental, lo que les puede obligar a respirar por la boca. Los problemas en la respiración afectan al desarrollo de las mejillas y limita la capacidad pulmonar.

·         Pliegue profundo en el centro de la palma de la mano.

·         Falange central displástico. Un solo surco de flexión en el quinto dedo, en lugar de dos.

·         Pliegues epicentrales. Pliegues de piel extras en la parte exterior del ojo.

·         Pelvis displástica. Desarrollo anormal de la pelvis (visible a través de rayos X).

·         Problemas de desarrollo corporal. Menor estatura media que la población general, con cierta tendencia a la obesidad.

·         Hay que recordar que no hay ninguna relación entre el grado en que se manifiestan los rasgos faciales y el nivel cognitivo que pueden alcanzar.

·         Síntomas Psicomotrices.

·   Hipotonía de los músculos. Tienen reducido tono muscular debido a la perdida de ligamentos. Lo que se traduce en flacidez y torpeza de movimientos.

·         Síntomas Psicomotrices.

·        Ausencia del reflejo de Moro en recién nacido. Un bebé sin Síndrome de Down, si se le suelta, o se le expone a un ruido fuerte, extiende brazos, piernas y manos, arquea la espalda, echa la cabeza hacia atrás.

·         Hiperflexibilidad. Habilidad excesiva de flexionar las extremidades.

·         Pérdida de la capacidad auditiva.

·         Problemas de visión.

·         Problemas del Lenguaje y la Comunicación.

Síntomas Fisiológicos

Entre un 35% y un 50% de las personas con Síndrome de Down tienen alguna cardiopatía congénita. Dentro de los problemas del corazón, los más frecuentes son los defectos del canal aurículoventricular, las septaciones incompletas1 y las válvulas defectuosas.

También son frecuentes los desequilibrios hormonales e inmunológicos, como los que afectan al nivel de hormonas tiroideas o la mayor vulnerabilidad ante las infecciones. Cuando son lactantes, presentan un riesgo superior de mortalidad debido a la mayor incidencia de enfermedades infecciosas (infecciones respiratorias crónicas, del oído medio, tonsilitis recidivantes, etc.).

Otras patologías que pueden ir asociadas al Síndrome de Down son los problemas gastrointestinales. También existe un riesgo relativamente elevado a padecer Alzheimer cuando llegan a edades avanzadas.

 Retraso del Desarrollo.

El desarrollo de los niños/as con Síndrome de Down es más lento que el de los demás. Alcanzan más tardíamente la capacidad para darse la vuelta, sentarse o para responder a los estímulos externos. El retraso de desarrollo podría estar relacionado con la hipotonía.

Los niños/as con Síndrome de Down tienen que recibir un tratamiento

adecuado desde los primeros meses de vida que contemple el bienestar físico, psicológico y social . Habrá de contar con la participación de todos los

implicados/as: las personas con Síndrome de Down, sus familias, especialmente el padre y la madre, ,además del equipo

multi e interdisciplinario  donde  el Medico Fisiatra es el que coordina el tratamiento de Rehabilitación, deberà de realizar: Terapia física, terapia ocupacional, Terapia de lenguaje, desde los primeros momentos de vida, , se lograrán grandes mejoras en su bienestar, calidad de vida y en sus posibilidades de desenvolverse en la vida con autonomía.

REHABILITACIÓN. 

El paciente con Síndrome de Down requiere rehabilitación con: 

Terapia física, terapia ocupacional y terapia de lenguaje.

 Terapia Física.

Los niños/as con Síndrome de Down se caracterizan por tener un tono muscular bajo (flacidez), lo que hace que sus movimientos sean torpes.

El tratamiento consiste en la realización de una serie de ejercicios físicos encaminados a mejorar la capacidad de movimientos y hacer que camine de manera más estable. Debe comenzar en los primeros meses de vida, pues cuanto antes empiece, mejores resultados se obtendrán a la hora de acelerar el desarrollo motor.

1.- Técnica Bobath.

Se basa en el principio según el cual los niños con Síndrome de Down conservan los reflejos primitivos que interfieren en el control de los movimientos voluntarios. El terapeuta contrarresta estos reflejos adiestrando en el movimiento opuesto.

Los tratamientos de fisioterapia basados en las técnicas Bobath buscan también la normalización del tono muscular. Por ejemplo, se entrenan las posturas capaces de aumentar el tono muscular y aquellas que facilitan los movimientos deseados: mayor equilibrio de pie, movimientos activos e individuales de brazos y piernas, etc.

2.- Técnicas de tratamiento basadas en el Concepto Vojta.

El método Vojta constituye una técnica de diagnóstico y de tratamiento global que busca la estimulación de respuestas reflejas de los músculos, presionando los puntos del cuerpo en los que se encuentran las terminaciones nerviosas.

El tratamiento  consiste en ir reproduciendo estos patrones de conductas motrices globales en el orden cronológico que se originan normalmente. Se trata de ir realizando determinados movimientos contrarios a los que aparecen de forma espontánea en distintas regiones clave del cuerpo y lograr que estas contrarresistencias se propaguen al resto del organismo.

3.- Cinesiterapia.

La cinesiterapia es el conjunto de intervenciones que utilizan el movimiento con fines terapéuticos. Puede ser activa, o pasiva:

La cinesiterapia tiene efectos positivos sobre el sistema cardiovascular, respiratorio y muscular.

  1. a) Se vencen las resistencias externas que obstaculizan o impiden el movimiento.
  2. b) Se distiende las fibras acortadas o contraídas.
  3. c) Se eleva el tono, la fuerza, el volumen y la tensión muscular.
  4. d) Se favorece el funcionamiento y la transmisión de los impulsos

nerviosos, mejorando el equilibrio y la coordinación del movimiento.

  1. e) Se aplica peso cada vez mayor de forma progresiva.
  2. f) Las repeticiones del ejercicio no deben ser muchas y han de realizarse de forma espaciada para lograr una buena recuperación.
  3. g) Puede realizarse manualmente o por medio de instrumental (circuito de poleas, muelles, resortes, etc.).

Así mismo se  evitará deformidades por malos hábitos posturales (escoliosis y pie plano).

 Terapia Ocupacional.

Su finalidad es el desarrollo de las habilidades necesarias para desenvolverse con autonomía en la vida diaria (vestirse, comer, usar el baño, etc.). El terapeuta ocupacional también presta asesoramiento sobre las ayudas técnicas específicas para compensar las dificultades en la realización de las distintas actividades, enseñándole a utilizar de forma óptima estas herramientas.

 Terapia de Lenguaje.

Busca eliminar o compensar las alteraciones lingüísticas y de la comunicación que se dan en las personas con Síndrome de Down (alteraciones en la articulación de las palabras, falta de fluidez verbal, etc.). La logopedia estimula las capacidades conservadas y el desarrollo de destrezas nuevas para lograr un habla lo más inteligible posible. Los objetivos que se persiguen con los tratamientos de logopedia son:

 Reducir los factores que obstaculizan la comunicación. Postura inadecuada, mala dentición, alteraciones emocionales y conductuales, etc.

 Mejorar las funciones deterioradas. Para lograr este objetivo, se suelen utilizar técnicas que consisten en la repetición sistemática de tareas.

 Estimular las funciones residuales. Este objetivo se basa en el principio de neuroplasticidad, según el cual las funciones que están conservadas sirven para sustituir y apoyar aquellas que están deterioradas.

Debe  incluirse las siguientes técnicas:

 Relajación total o de distintas zonas corporales.

 Ejercicios de respiración.

 Ejercitación muscular del sistema bucofonatorio y órganos asociados.

 Impostación vocal, que entrena a la persona a fonar (producir voz, hablar) correctamente, coordinando la respiración y los movimientos del sistema bucofonatorio y evitando la utilización de músculos innecesarios y las pautas incorrectas.

Ago22
00

¿Cómo le pongo límites a mi hijo?

By alejandro - Uncategorized

Si tienes problemas de conducta con tu hijo, aprende a ponerle limites!

¿Cómo le pongo límites a mi hijo?

Psicología

Hoy por hoy es motivo de preocupación dentro de la vida familiar y esto por sobre todo en padres principiantes.

Déjame decirte que la base de todo es el AMOR; esta es una decisión y una responsabilidad.

La típica frase “que el amor mueve montañas” es una verdad, en este caso una montaña de preocupación, de dolor, tristeza, ira, enojo; pero que la puedes retirar de tu camino porque no hay obstáculo gigante que el amor no pueda vencer.  Entonces quien ama: enseña, orienta, corrige, desde las fortalezas con afecto y con respeto que es pilar fundamental de la educación; preferible es pecar por el exceso de respeto que la falta de ello.

¿Qué es un límite?

Es un organizador de vida y se trata de enseñarles a nuestros hijos a comportarse en familia como los deberá hacer luego en sociedad.

Lo que no le consentirás a otras personas, tampoco debe consentirles a ellos.

¿Cuándo y Cómo establecer los límites?

En todo momento que la situación lo amerite, y aún antes que algo se presente porque también es cierto que preferible es prevenir que lamentar.

Y los estableces con:

  • Normas claras de convivencia;
  • Marcando pautas de lo que debe y no hacer.

Empezando cuando antes mejor, de acuerdo a la edad y según la necesidad se irán haciendo adaptaciones.

¿Qué actitud debo tener en el momento de establecer los límites?

Primeramente la actitud correcta que debes tener es de estar seguro y convencido que aquellas normas son lo mejor para ellos y que lo deseas alcanzar.

Así también hablarles con firmeza y autoridad, que debe ir acompañado de una cara seria que es señal no verbal que también educa.

Sin gritos, ni peleas inútiles, solo asumir el rol de padres.

¿Si no se cumplen con las reglas que  hacer?

Debe haber una sanción, una disciplina manejable, bien impartida y entendida porque el fin es formar y educar, de tal forma que las normas las interiorice y su propio yo sea un autoregulador que lo oriente por sí mismo con sus mejores valores sin necesidad de otro controlador.

Recuerda:

  •  Educar desde el discurso

  • No maltrato verbal o psicológico
  • Firmeza y amor

  • No maltrato permisivo
  • No maltrato físico (el golpe no educa, educa solo el apoyo)
  • Reglas claras no negociables

DRA. TERECITA LOPEZ VELEZ

PSICÓLOGA CLÍNICA

 

Page 80 of 80«‹787980

Últimos Eventos

  • Przegld serwisw informacyjnych 2025.880
  • Прими вызов удачи Plinko casino от BGaming — ставки на случайность с выплатами до x1000 и гарантией
  • Find A Filipino Spouse: Your Information To To Finding A Filipino Bride
  • Tips On How To Meet International Singles On-line At Home And Overseas
  • Zažijte adrenalin a výhry Komplexní svět online kasina, živých her a sportovních sázek s red on bet,

Especialidades y Servicios Médicos

  • Reumatología
  • Fisiatría
  • Psicología
  • Terapia Física
  • Terapia Ocupacional
  • Terapia de Lenguaje
  • Terapia con Ondas de Choque
  • Estimulación Temprana
  • Morfometría y Densitometría Ósea
  • Ecografía Articular

GUAYAQUIL

Dirección: Clínica Kennedy Alborada, Torre sur, piso 10, consultorio 1004.
Teléfono: 2232 400 – 0967481000 -0969918632

SAMBORONDÓN

Dirección: Clinica Kennedy Samborondón, Torre Alfa 5to piso cons. 512
Teléfono: 6024 389- 0989948480

0969918632
Copyright © 2017 | CERER
Desarrollado por @cluiggi