Our earthquakes

September 2017 earthquake served us to reveal the face of society and the role of the State. The earthquake divided Mexico in two: one where citizens demonstrated their solidarity; and the other, an ineffective government which fell behind, displaced by the power and commitment of the people. Social structure allows people to create networks and share information that helps to manage and confront disasters. Social capital benefits are immense. Ours and previous experiences in earthquakes exalt the role of community and the transcendence of solidarity, empathy and of the commitment of those who exercise it

Clinical considerations in physician-assisted death for probable Alzheimer's disease : decision-making capacity, anosognosia, and suffering

Background: Requests for physician-assisted death (PAD) in patients with cognitive impairment are complex and require careful consideration. Of particular difficulty is determination of whether the request is voluntary and well considered. Results: Euthanasia and physician-assisted suicide (PAS) are both legal in The Netherlands, Luxemburg, Colombia, and Canada. Euthanasia is legal in Belgium, while PAS is legal in Switzerland and Oregon, Washington, Montana, Vermont, and California (USA). Upon a PAD request, evaluation of the capacity to consent medical treatment is relevant for the decision-making process, while evaluation of testamentary capacity is appropriate before an advance euthanasia directive is written. Anosognosia assessment throughout the Alzheimer’s disease continuum provides essential and relevant information regarding the voluntary and well-considered nature of the PAD request; meanwhile, early assessment of hypernosognosia or subjective cognitive decline assists in formulation of a clinical prognosis. Furthermore, the assessment of physical and psychological suffering should incorporate verbal and nonverbal cues as well as consideration of the psychosocial factors that might affect due care criteria. Conclusion: The clinical approach to a PAD request should consider the legal framework and the decision-making capacity, assess memory deficit awareness and the perception of suffering, and evaluate mental competency when considered pertinent

La prevalencia de las alteraciones renales en pacientes con síndrome de Sjöngren es de 6.2 en 30%. La mayoría de los estudios se han realizado en población mixta de pacientes. En México se desconoce la prevalencia de estas alteraciones, razón por la cual

La prevalencia de las alteraciones renales en pacientes con síndrome de Sjöngren es de 6.2 en 30%. La mayoría de los estudios se han realizado en población mixta de pacientes. En México se desconoce la prevalencia de estas alteraciones, razón por la cual han realizado este estudio con énfasis en el metabolismo del calcio y del fósfor

La prevalencia de las alteraciones renales en pacientes con síndrome de Sjöngren es de 6.2 en 30%. La mayoría de los estudios se han realizado en población mixta de pacientes. En México se desconoce la prevalencia de estas alteraciones, razón por la cual

La prevalencia de las alteraciones renales en pacientes con síndrome de Sjöngren es de 6.2 en 30%. La mayoría de los estudios se han realizado en población mixta de pacientes. En México se desconoce la prevalencia de estas alteraciones, razón por la cual han realizado este estudio con énfasis en el metabolismo del calcio y del fósfor

Supplementary Material for: Clinical Considerations in Physician-Assisted Death for Probable Alzheimer’s Disease: Decision-Making Capacity, Anosognosia, and Suffering

Background: Requests for physician-assisted death (PAD) in patients with cognitive impairment are complex and require careful consideration. Of particular difficulty is determination of whether the request is voluntary and well considered. Results: Euthanasia and physician-assisted suicide (PAS) are both legal in The Netherlands, Luxemburg, Colombia, and Canada. Euthanasia is legal in Belgium, while PAS is legal in Switzerland and Oregon, Washington, Montana, Vermont, and California (USA). Upon a PAD request, evaluation of the capacity to consent medical treatment is relevant for the decision-making process, while evaluation of testamentary capacity is appropriate before an advance euthanasia directive is written. Anosognosia assessment throughout the Alzheimer’s disease continuum provides essential and relevant information regarding the voluntary and well-considered nature of the PAD request; meanwhile, early assessment of hypernosognosia or subjective cognitive decline assists in formulation of a clinical prognosis. Furthermore, the assessment of physical and psychological suffering should incorporate verbal and nonverbal cues as well as consideration of the psychosocial factors that might affect due care criteria. Conclusion: The clinical approach to a PAD request should consider the legal framework and the decision-making capacity, assess memory deficit awareness and the perception of suffering, and evaluate mental competency when considered pertinent