INDEPENDENDT WORK

El gerundio se forma en inglés añadiendo la desinencia 'ing' (sin 'to') al infinitivo del verbo.
To play / jugar playing / jugando
CONSIDERACIONES
- Cuando el infinitivo termina en consonante precedida de una sola vocal pronunciada más fuerte, la consontante última se duplica:
To sit sitting (sentarse)
- Cuando el infinitivo termina en '-e' muda, ésta desaparece.
To write writing (escribir)
- Cuando el infinitivo termina en 'ie' cambia a 'y' + 'ing'
To lie lying (mentir)
USO DEL GERUNDIO
- Como sujeto en una expresión
Reading English is easier than speaking it / Leer inglés es más fácil que hablarlo
- En algunas expresiones de prohibición
No smoking / Prohibido fumar
- Se emplea para obtener la forma progresiva de los verbos
I am reading a book / Estoy leyendo un libro
- Cuando a un verbo precede de forma inmediata una preposición se utiliza la forma de gerundio.
After swimming I felt cold / Después de nadar me sentí resfriado
They had difficulty in finding a parking place / Tuvieron dificultad para encontrar una plaza de aparcamiento
- Como complemento de un verbo
His hobby is painting / Su hobby es la pintura
- Se utiliza frecuentemente después de los verbos 'to go' y 'to come'
Come sailing with us next Saturday / Ven a navegar con nosotros el próximo sábado
A)- Escribe las siguientes frases con el verbo en gerundio (utiliza los verbos de ejemplo):

say / have / become / get up / play


1. He doesn't like plaging with other people.
2. Before becoming a teacher, he worked in a farmer.
3. He left without saying goodbye.
4. I hate getting up early in the morning.
5. They love having parties.

Gerundio (verb+'ing') e Infinitivo ('to'+verb)


GENERALIDADES

Pon el gerundio:

1. Después de las preposiciones. She left without kissing me. We’re thinking of going to Italy. Los verbos más frecuentes que solemos encontrar con el gerundio son:

like, love, hate, enjoy, miss, feel like, mind, finish, risk, practise, put off, stop, suggest, can’t help, fancy, admit, deny, give up, imagine, keep (on), put off (postpone), spend time, can’t stand, delay, regret, avoid, consider, involve, go on (=continue)


2. Después de algunos verbos. I enjoy eating out. Do you mind giving me your address?

3. Como el sujeto de una frase. Smoking is bad for you. Skiing is expensive
Pon 'to' + Infinitivo:
1. Para dar una respuesta a la pregunta ‘Why’ (¿por que?) Why did you stop working? - To spend more time with my children. for spend
for to spend

Observa los ejemplos con el negativo ‘not to’:

We hope not to be in the same flat next year.
She decided not to get married.

Los verbos más frecuentes que solemos encontrar con 'to' + infinitivo son:

would like, want, need, decide, hope, arrange, expect, plan, forget, seem, appear, wish, promise, offer, refuse, learn, manage, afford, agree, fail, tend, happen, mean, prepare, pretend, threaten, attempt.
2. Después de los adjetivos It’s not easy to find a good man.
3. Después de algunos verbos I forgot to phone the bank. She needs to see you urgently.


GERUNDIO E INFINITIVO CUANDO LOS DOS SON POSIBLES

Existen verbos con los que se puede poner el gerundio (-‘ing’) o el infinitivo con ‘to’.
En algunos, el significado de la combinación de los dos verbos cambiará al poner infinitivo o gerundio.

Lee los siguientes ejemplos y su explicación en español.

STOP
- I stopped to have a beer.
Se interrumpe la actividad que se está haciendo para beber una cerveza.

- I have stopped drinking beer.
Se interrumpe la actividad (en este caso de beber cerveza).

TRY
- I tried to lift the box but it was too heavy.
Se intenta algo difícil que requiere esfuerzo.
- Why don’t you try closing the window if the traffic is too noisy?
Se intenta un experimento, test o prueba para ver si funciona.

LIKE
- I like to get up at 6am.
Me gusta el resultado de la actividad porque me da tiempo a desayunar y hacer otras cosas
tranquilmente.

- I like getting up at 6am.
Realmente me gusta realizar la actividad.

NEED
- I need to work harder.
Tengo la obligación de hacer algo.

- This room needs painting.
Hay necesidad hacerlo (en voz pasiva)

REMEMBER Y FORGET
1. Remember to buy milk on your way home.
2. I remember kissing my first girlfriend.

1. I forgot to phone Dad on his birthday.
2. I’ll never forget seeing my wife for the first time. She looked beautiful.

1. Se refiere a recordar u olvidar cosas que tienes o tenías que hacer.
2. Se refiere a recordar u olvidar cosas que ocurrieron en el pasado.

REGRET
- We regret to inform you that your application for a loan of 5000 Euros has not been accepted.
Normalmente se utiliza para comunicar malas noticias.
- Do you regret leaving school early and not going to university?
Lamentas cosas que ocurrieron en el pasado.

GO ON
- After winning the Kings Cup, Valencia went on to win the Champions League.
Expresa un cambio de actividad.
- They went on complaining about their holiday all evening.
Expresa que se continua realizando la misma actividad.



© Copyright La Mansión del Inglés C.B. - Todos los Derechos Reservados . -

INDICATION FOR THE YEART

- Acute Myocardial infarction (AMI), without complications
- Stable Angina.
- Leve-moderate valvular insufficiency.
Arrhythmia-controlled known cause.
Post - pacemaker.
Post-catheterization.
Post - angioplasty.
Post-stent.
Post-myocardial revascularisation. (RVM).
Post-Valve replacement Aórtica. (CVA).
Post-Changing mitral valve. (AVP).
- Hypertension control.
- Compensated heart failure.
- Syncope.

CONTRAINDICATIONS FOR THE YEAR.
- Myocardial infarction with complications (myocardial Killip Killip III or IV, with pericarditis, fever, chills, arrhythmias, or precordial pain that continues).
- Unstable angina.
- Diabetic patients not controlled.
- Decompensated heart failure.
- Severe arrhythmias.
Disease-valvulares severe.
- Untreated congenital diseases in children of type cianosante.
- Septicemia.
- States feverish.
- Pulmonary edema.
- Trombo pulmonary embolism.
- Musculoskeletal diseases that prevent the exercise.

SITUATIONS OF CAUTION.
- Patients anticuagulados.
- Patients with a decrease in BP during the exercise.
- Patients who take beta blockers.
- Patients who take diuretics.
- Fever or chest pain

THE RECOVERY AFTER A HEART ATTACK

The recovery after a heart attack requires a series of strategies for rehabilitation, always coordinated by a cardiologist, but including a rehabilitation doctor, nurses, dietitians, physical therapists and occupational therapists, and so on. Everything that has been done by one after a heart attack, including the handling of emergency, stay in the coronary unit, subsequent decisions of medical or surgical treatment is not definitive, in the sense of treating the disease that produced it. Of you. Depends, from that moment, a series of physical and mental adjustments in their lives, to determine that everything suffered by you., And that all the work of so many people, have served for something. STRESS The psychological component of coronary artery disease is a mystery, but there is no doubt that there are people who exert undue pressure on themselves throughout their lives. After a heart attack, it is not changing jobs or other radical changes, but to reduce stress in daily activities, avoiding excesses of work, deadlines, etc.. DIET It is very important to keep in the proper weight, avoiding all kinds of saturated fat (animal), and foods high in cholesterol. This will prevent a return to form atherosclerotic plaques in the arteries. SNUFF The nicotine in each cigarette affects blood pressure and heart rate, and accelerates atherosclerosis. Take advantage of the traumatic experience by just happen to stop smoking once and for all.

COLOMBIA¨N CRIME

ESSAY ABAUT COLOMBIA CRIME IN A PROBLEM THAT AFFECTS US ALL

In organized crime in Colombia refers to the crime on a large scale, mainly related to drug trafficking, but also with smuggling, kidnapping, extortion and trafficking in human beings for prostitution, for this reason rates homicide in Colombia are among the highest in the world. With the homicide rate in Colombia three times higher than that of Brazil or Mexico.

According to the OAS narco-paramilitares control at the present time 51% of Colombian territory and dominate the new and scattered minicarteles that abound in Colombia, which is a development of the traditional signs of drug trafficking. The narco-paramilitares possess million hectares of the best land in Colombia and eagerly await the NAFTA to invest their money encaletado new lucrative business besides, the crime is no longer the result of an abnormal and dangerous subject, but a highly trained people and specialized, they see a great opportunity to gain wealth and willing to use any means, aided by an ally of immense power as corruption, which is based on the lure of wealth of anyone who falls rendered by the temptation of easy money . The great danger of organized crime is that the victim is society as a whole.

It is also important to recognize the great difficulty level judicial investigation to unmask the criminals who are inmiscuidos in legal activities, allowing them to act covertly in illegal activities openly. Undoubtedly, the challenge posed by organized crime to society deserves current efforts in all orders from social, cultural, legal, governmental and state levels. In Colombia, it is necessary to adapt the system of judicial inquiry to the current challenges, tending to the professionalization and specialization of the adversarial system. The forensic investigation requires a thorough modernization and a structure that allows for interdisciplinary work of technical scientific connotations; strengthening the formation of specialized investigative teams that generate both operational and scientific knowledge of organized criminal activity. It is a priority to strengthen assistance to victims, so that their collaboration, which is undoubtedly essential, facilitate obtaining valuable information on criminal groups.

In conclusion I think that the work of the society at the present time, is to create conditions for people to see and understand that we act in accordance with the law earns individual and social, not as far as where the offense produces good profits and so few restrictions, but the possibility of forming a criminal enterprise is very appealing.

BY ERICA POVEDA

PATARROYO IS A SUCCES MAN

Manuel Elkin Patarroyo is an excellent scientist, that has dedicated his life to the investigation in medicine, is one of the few Colombians recognized world-wide level by research in medicine; he created the malaria vaccine, but the international people not recognize his labor whit an better scientistis.

Patarroyo began his research to very early age, always looking for the form to help people, for this reason, liege the several investigations, he create the vaccine against malaria which has had some problems but that every time is confirmed that she is effective. For this reason, each one of its investigations has made them with animals in this case rats, to avoid damages in the humans, is a really successful person in its work of investigation and like doctor, Furthermore, the great contribution of Patarroyo to the world of the science is its form of creating a new vaccine, La segunda gran aportación de Patarroyo al mundo fue la entrega de la patente de su vacuna sintética a la Organización Mundial de la Salud, para que su producción masiva no estuviese penalizada por la existencia de patentes que encariciesen el medicamento.the second major contribution to the world was Patarroyo delivery of the patent on he synthetic vaccine to the World Health Organization for its mass production were not penalized by the existence of patents that encariciesen medicine.


The Corporation for the Sustainable Development of the South of Amazonía, Corpoamazonía, has open a file for accusations about irregularities made by the team of investigators of the experimental center; however, in a visit that made to the experimental center the past October 19 that some animals were in terrible state of health, the page of Internet of the experimental center says: "the animals will be manipulated and maintained appropriately to generate reliable results that guarantee the best conditions for the animals in experimentation."


In conclusion the tests in Latin America show that the vaccine is effective for 40% of the patients, ascending until 70% of effectiveness if the patient is smaller than five years, in my opinion, I think that but people should help to continue working in with this scientist and power achieved the results waited with this vaccine.

ADJETIVES

A PARTIR DE UN SUSTANTIVO

hope, esperanzagrace, graciachild, niñorain, lluviagold, oroWest, oestefriend, amigopleasure, placeratom, átomo
hopeless, desesperanzadograceful, graciosochildish, aniñadorainy, lluviosogolden, dorado, de oroWestern, occidentalfriendly, amistosopleasurable, placenteroatomic, atómico


A PARTIR DE UN VERBO

to eat, comerto act, actuarto contribute, contribuirto work, trabajar
eatable, comestibleactive, activocontributive, contribuyenteworking, que trabaja


A PARTIR DE OTRO ADJETIVO

blind, ciegoyellow, amarillopractic, práctico
blindfold, a ciegasyellowish, amarillentopractical, práctico

TO HAVE

VERBO TO HAVE (tener, haber)

PRESENTE SIMPLE: I haveyou havehe haswe haveyou havethey have

PRESENTE PERFECTO: I have hadyou have hadhe has hadwe have hadyou have hadthey have had

FUTURO SIMPLE: I shall haveyou will havehe will havewe shall haveyou will havethey will have

FUTURO PERFECTO : I shall have hadyou will have hadhe will have hadwe shall have hadyou will have hadthey will have had

PASADO SIMPLE: I hadyou hadhe hadwe hadyou hadthey had

PASADO PERFECTO: I had hadyou had hadhe had hadwe had hadyou had hadthey had had

CONDICIONAL SIMPLE: I should haveyou would havehe would havewe should haveyou would havethey would have

CONDICIONAL PERFECTO: I should have hadyou would have hadhe would have hadwe should have hadyou would have hadthey would have had

A Presente SimplePasado SimplePresente PerfectoPasado PerfectoFuturo SimpleCondicional SimpleFuturo PerfectoCondicional Perfecto

FORMA INTERROGATIVA have I?had I?have I had?had I had?shall I have?should I have?shall I have had?should I have had?

FORMA NEGATIVA I have notI had notI have not hadI had not hadI shall not haveI should not haveI shall not have hadI should not have had

VERBO TO BE (ser, estar)

PRESENTE SIMPLE: I am /you arehe iswe areyou arethey are

PRESENTE PERFECTO: I have beenyou have beenhe has beenwe have beenyou have beenthey have been

FUTURO SIMPLE: I shall beyou will behe will bewe shall beyou will bethey will be

FUTURO PERFECTO: I shall have beenyou will have beenhe will have beenwe shall have beenyou will have beenthey will have been

PASADO SIMPLE: I wasyou werehe waswe wereyou werethey were

PASADO PERFECTO: I had beenyou had beenhe had beenwe had beenyou had beenthey had been

CONDICIONAL SIMPLE: I should beyou would behe would bewe should beyou would bethey would be

CONDICIONAL PERFECTO: I should have beenyou would have beenhe would have beenwe should have beenyou would have beenthey would have been

A Presente SimplePasado SimplePresente PerfectoPasado PerfectoFuturo SimpleCondicional SimpleFuturo PerfectoCondicional Perfecto

FORMA INTERROGATIVA am I?was I?have I been?had I been?shall I be?should I be?shall I have been?should I have been?

FORMA NEGATIVA I am notI was notI have not beenI had not beenI shall not beI should not beI shall not have beenI should not have been

QUOTES

LEADRE SHIP:

Accept the challenges so that you may feel the exhilaration of victory. - George S. Patton

If you do not look at things on a large scale, it will be difficult to master strategy. - Miyamoto Mursashi

Nothing limits achievement like small thinking. Nothing equals possibilities like unleashed thinking. - William Arthur Ward

What if you have failed in the past? So, at one time did every man we recognize as a towering success. They called it "temporary defeat." - Napoleon Hill

To be able to lead others, a man must be willing to go forward alone. - Harry Truman

SUCCESS:

The secret to productive goal setting is establishing clearly defined goals, writing them down and then focusing on them several times a day with words and emotions as if you've already achieved them. - Denis Waitley

One step at a time is enough for me. Impatience is simply a way of beating yourself up. - Susan Jeffers

The worst bankrupt in the world is the man who has lost his enthusiasm. Let a man lose everything else in the world but his enthusiasm and he will come through again to success. - H. W. Arnold

Constant effort and frequent mistakes are the stepping stones to genius. - Elbert Hubbard

Without goals and plans to reach them, you are like a ship that has set sail with no destination. - F. Dodson

THE ANGINA

THE ANGINA

The angina is characterized by a sensation of pain, malaise, constriction or uncomfortable pressure in the center of the chest.

These symptoms last few minutes generally.
The sensation associated with the angina can also extend to the arms, back, neck, jaw or stomach.

When it happens the angina?

The angina symptoms appear when the provision of blood and oxygen to the heart is insufficient. These symptoms are temporary, and can be attributed to several factors, including: the taking of steps that they require of a physical effort, like raising stairs or running? situations of the high emotional stress. exhibition to very warm temperatures or you cold. In these situations, the cardiac frequency and arterial pressure increase, and the heart requires of a greater provision of blood and oxygen. But in that it suffers of angina, the coronary arteries cannot completely satisfy the increase in the demand on the part of the heart.

What causes the angina?

The angina symptoms are caused by the effects of the aterosclerosis, that is the accumulation of plate in the arteries that go towards the heart. A deficiency in the flow of blood by an artery is called isquemia. Less frequent causes of angina include the disease of the valves of the heart, the hipertrofica cardiomiopatía, or the not controlled arterial pressure. The angina and the attacks to the heart the symptoms of the angina are very similar to those of an attack to the heart, but there are very important distinctions between the two conditions. The symptoms of the angina appear of temporary form, and they must to a partial diminution in the blood flow to the heart. During an attack to the heart, the flow of blood to the heart stops completely, and the symptoms more intense and are prolonged.

Stable angina and Unstable Angina There are two types of angina, stable angina and unstable angina: Stable angina In the people with stable angina, the symptoms appear generally of foreseeable way, because they appear when doing physical activity or during moments of stress or anxiety. In most of the cases, the symptoms are alleviated with nitroglycerin. Unstable angina the symptoms of unstable angina appear without warning, and can even happen at moments of rest. During an episode of unstable angina, the malaise sensation can acute and be prolonged than in somebody with stable angina. The unstable angina is an acute coronary syndrome, and must be treated like an emergency.
.

STRESS THE CAUSE OF MANY DISEASES

In the world , illensses are caused by increase of work personal, obligation which may be increasing mortality and morbility rates in child, young and old people that work more than 8 hours at day can suffer many disease.

In the firs place it is important to mention that excess of work in people that excess of work inpeople that work more than 48 hours at week invrease the risk of obtain illnesses by stress in to 70 % , Besides, researches realized during this year in different enterprises confirm that people that suffer stress could become to get to be very aggressive.


On the other hand it is important to clarify that no single stress is the instant case of many diseases that appear today in people in day, so that other factors of risk exist, but that united of stress takes control hard but and their consequences can arrive to be mortal.

In summary being stress the important cause but so that people can suffer illnesses it self to me can be dealt with a suitable medico, personal and psychological process obtaining like result one better quality of life.

cars accidents

WOMEN RESPONSIBLE FOR THE ACCIDENTS, AGGRESSIVENESS AND VIOLENCE IN THE STREETS

Nowadays, in Bogota we can see some road rage it can cause a lot of tragic accidents, but women are not the only guilty ones of this situation. There are many aspects that can increase this kind of problem.

Fist of all, “ secretaria de transito y transporte” argues that a high percentage of women haven’t done an exam or they didn’t approve it. Furthermore, the majority of teachers are men and they haven’t been interested in women learning this activity. Besides, the women are but careful and not very often they handle before of to have taken alcohol this makes that they are less aggressive and violent and they avoid accidents, very different from the men, who by nature are aggressive and often they handle under effects of the alcohol.

Although it is to mention and to have in account that some women are a little violent and entertaining at the time of handling and that this can cause an accident, but in relation with the men is minim. Also all the people are not tolerant at the moment for confronting a problem less and if one treats in a street.

In conclusion I believe that the best form to avoid great accidents, violence and aggressiveness in the streets is that people think that the cars are means that facilitate the life to us that must complicate it, on the other hand we do not have to learn to being but tolerant

SAD LIFE OF A KIDNAPPED

To speak of kidnapping is to make reference to exist worse situations that the death, situations that imply privation of the freedom, of the tranquility, of the privacy and of the physical integrity among others. Also their family and the negative consequences that imply this situation.

For these people begin a possible consequences of the kidnapping (somatic alterations, emotional alterations, changes in their style and quality of life, in their plans, etc.) and they consider that once they lose their freedom, begin a true nightmare, days, months or year in the wide jungle away friends, family, food, way of communication and expose theirself a realistic the powerful jungle, insects, reptiles as snake, crocodiles etc. A new life for who their true life is in the city.

On the other hand, for they there are a change in their feeding, food few nutritious and with few conditions of hygiene is maybe the main cause of many illness and until the death, because many kidnapped who suffer any illness with the kidnapping this spreads to worsen for lack of care, stress, climate or the same depression that finished with the death, moreover for these people their physical appearance have changed totality an extreme thinness and weakness for longer hours of walk intro the jungle.

Without doubt and all things considering, the kidnapped is an act of violence that carry away mental disorders, suffering, lose of family nucleus. The kidnapping never will have justification and a kidnapper hasn’t forgiveness.

by ERICA POVEDA

CARDIAC REHABILITATION

IN THIS MOMENT A BIG NUMBER PEOPLE HAVE MANY CARDIAC ILLNESS BUT THE ADVANCE MEDICINE FIND NEW POSSIBILITYS FOR TO RECOVER HEALT THE PATIENS , THIS IS KNOWN AS CARDIAC REHABILITATION.

CARDIAC REHABILITATION IS A GOOD PROGRAM THAT SEARCH THE PATIENTS CAN TO RETURN ACTIVITIES IN YOUR LIFE, FOR EXAMPLE , WALK, DANCE, ETC, ALWAYS SEARCH THE BEST RECOVER IN THE PATIENT WHIT THE SMLL TIME. BESIDES, OTHER OBJECTIVE THE THIS PROGRAM IS THE FAMILY CAN HELP WHIT THIS PROGRAM . FOR THIS REASON IT IS NECESSARY THE PATIENTS ARRIVE TO HOSPITAL WHIT A FAMILY FOR THE DOCTOR AND NURSING CAN TO TEACH AND EXPLANATION THE DIFERENT PHASES , EJERCICES, ACTIVITIES AND THE PROCESS.

THE PHASES TO SHAPE THIS PROGRAM ARE TREE: PHASE I, IT STARTS FROM THE VERY FIRST DAY IN PATIENTS WITH IMA NOT COMPLICATED OR WHEN CLINICAL AND HEMODYNAMIC CONDITIONS ARE STABILIZED. THIS PHASE IS INTENDED TO COUNTERACT THE EFFECTS OF PROLONGED SLEE, AND IS BOTH THE IDEAL TIME TO INITIATE THE ACTIVITIES OF SECONDARY PREVENTION, BECAUSE IT EDUCATES THE PATIENT ABOUT HIS DISEASE , DIET, RISK FACTORS AND MODIFICATION, AS HE GUIDED IN THEIR PRODUCTS CARE TO BE AT HOME, PHYSICAL ACTIVITY ALLOWED AND WARNING SIGNS FOR HELP., PHASE II (OR ACTIVE PHASE OF SUPERVISED EXERCISE)
• YOU CAN START WITH THE TEST ERGOMÉTRICA EARLY (5-15 DAYS AFTER IMA OR A WEEK AFTER SURGERY). AT THIS STAGE WHEN IT IS RAISING THE PATIENT'S FUNCTIONAL CAPACITY. AND PHASE III (MAINTENANCE PHASE) • AT THIS STAGE, THE PATIENT DEVELOPS PHYSICAL ACTIVITY INDEPENDENTLY, ACCORDING TO A TRAINING PLAN ESTABLISHED AT THE END OF PHASE II. AT THIS STAGE THERE IS NO NEED TO INCREASE THE FUNCTIONAL CAPACITY, BUT RETAIN IT.

SUMARY THIS PROGRAM IS THE BEST OPTION FOR THE CARDIAC PATIENS HAVE A GOOD AND EARLY RECORVER HEALT.

BY ERICA POVEDA

THE CARDIAC REHABILITATION PHASES

PHASE I:

It starts from the very first day in patients with IMA not complicated or when clinical and hemodynamic conditions are stabilized. This phase is intended to counteract the effects of prolonged sleep (lack of physical conditioning, orthostatic hypotension, pulmonary embolism and others) and is both the ideal time to initiate the activities of secondary prevention, because it educates the patient about his disease , diet, risk factors and modification, as he guided in their products care to be at home, physical activity allowed and warning signs for help. • From the physical point of view, the activity should be isotonic 1-2 METS, which is to correspond to an activity such as washing patient. It imposes control heart rate in the early mobilization for not exceeding 120 lat / min or exceed 20 beats in the frequency baseline patient, but if you are consuming beta blockers should not present manifestations of chest pain, shortness of breath, palpitations or fatigue , as well as alterations in the ST segment, or reduce blood pressure more than 10-15 mm Hg. It can be used with the Borg scale of intensity below 14. • Blood pressure and heart rate will be taken to the patient to 5 minutes of stretching or warming in a standing position. • Some researchers 6 recommend starting physical training to 48 hours after the IMA or immediately after surgery and saw no need to be very "protocolizado" because the purpose in the years 60 and 70 to prevent episodes thromboembolic, met today with thrombolysis and other therapeutic measures. • This phase, which includes a visit from a member of the rehabilitation team, is aimed at encouraging the sick and commit to a family member in the group. Some older patients may serve as volunteers and share their experiences about how to learn to live with heart disease. • The team comprehensive cardiac rehabilitation are: nurses, fisiatras, cardiologists, dietitians, social workers, psychologists and occupational therapists. • In the coronary care unit, patients with low risk are urged to sit beside the bed and make her self, but once transferred to the next hospital room, sit down and make it walk alone, walk attendants inside the room and corridors to 2 times daily, beginning with 5-10 minutes to half an hour. At this stage it is appropriate to stratify the risk, as this determines the protocol to be followed in Phase II. • Once the patient returns to his home (Phase 1.5 or after discharge), members of the medical team and their families continue checking their state of health and recovery, as well as providing resources for strengthening. This phase includes low-level exercises and small work home with a level of 2-3 METS. The exercises should consider the involvement of arms, legs and trunk; walk pausadamente distances growing for fitting muscle and achieve a gradual reintegration into society and the family. It is transmitted to the patient precise instructions for carrying a lifestyle satisfactory and he stresses the importance of controlling risk factors.


PHASE II (or active phase of supervised exercise)

• You can start with the test ergométrica early (5-15 days after IMA or a week after surgery). At this stage when it is raising the patient's functional capacity. 11-14 • Members of the group I (low risk) have a functional capacity normal (group 1), thus requiring no increase and the only thing needed is to moderate aerobic exercise or isometric exercises soft. Its purpose is to act as a secondary prevention against the sedentary and contribute to the control of other risk factors (dyslipidemia, hypertension, diabetes mellitus). Moreover, as your risk is very low and moderate exercise, it is imperative that they are controlled area hospital and may be exercised at home, in community spaces and even in his work, which includes surveillance and monitoring transtelefónico and Internet-based systems, but requires definitive studies on the effectiveness and safety of these approaches, 12 to increase the reference of patients and accessibility of services for cardiac rehabilitation and secondary prevention. • Patients in Groups II and III, have diminished their functional ability, it needed to increase and realize this phase of physical training in a supervised in an area hospital, follow the traditional protocols and receive outpatient care at the hospital once graduates this institution. In some countries of Eastern Europe there was a regime sanatorial, whose drawback was to isolate patients in their normal lives. 6 • During the training sessions physical monitor clinical manifestations, and the routes electrocardiográficos hemodynamic values before, during and after exercise. 8, 9 • The latter, like any other therapeutic measure is indicated and tailored along the lines of basic prescription: 1 ro. Frequency of training of not less than 3 times per week 2 do. Duration of training: 30-45 minutes. Basically is divided into 3 stages: heating, cooling and hardening resistance or, in each session may include a stage recreation of 10-15 minutes to improve psychosocial aspect, as well as integration and adherence to the plan. 3 ro. Intensity Training: Based on the pulse of training, 60-80% of V02 maximum anaerobic threshold and heart rate threshold, can be used Borg scale. 4 -7 4 to. Mode exercise. 5 to. Progression of training: It depends on the level of initial fitting, prior history of physical activity, health status, age, personal preference of the patient and other factors. The educational sessions are conducted in groups or individual.



PHASE III (maintenance phase)

• At this stage, the patient develops physical activity independently, according to a training plan established at the end of Phase II. At this stage there is no need to increase the functional capacity, but retain it. In patients with low-risk sports fan and contraindications can continue without increasing functional ability, but in those with high-risk stage II may last longer, in this case, considering the possible move to phase III when they have reached 6 METS in the stress test. 6 • Patients moderate exercise by controlling heart rate or using the Borg scale and further control risk factors, including psychosocial adjustments necessary.

HEART

CARDIAC REHABILITATION

What is the cardiac rehabilitation? Cardiac rehabilitation programs are multifactorial therapeutic systems for people suffering from heart disease. With physical exercise and scheduled action on the cardiovascular risk factors, provides a slowdown in the progression of atherosclerosis and a decrease of new coronary events, as well as the number of hospitalizations and deaths from ischemic heart disease, improving both the feeling of well as the social reintegration. What diseases can improve with cardiac rehabilitation programs? All diseases that affect the cardiovascular system, such as:

• Angina. • After myocardial infarction.

• Congestive heart failure.

• After a heart surgery.

• After a heart transplant

• After angioplasty with or without stenting.

• Patients carrying Pacemakers.

• Congenital Heart Disease.

• arrhythmias.

• rheumatic heart disease.

At what time should begin rehabilitation Heart? Cardiac rehabilitation consists of three phases. Phase I: Phase admission directed not to lose muscle mass and elasticity with the rest. The aim will be short, with demonstrations early psychological support to the patient and his family. Phase II: Period largest rehabilitation and starts after discharge from hospital comprising the first two months. We shall now proceed to program the level of performance of each patient according to their clinical features and testing effort, trying to avoid complications. It introduces the knowledge about the disease should take, methods for controlling the risk factors in its tracks food, psychological and physical. It also should include knowledge about emergency actions (SPC, DEA, treatment with nitrites, etc.). Phase III: You must last throughout the patient's life. Try reintegration patient to their environment and socio family. We must continue with the program learned, being checked regularly by a multidisciplinary support units (Doctors header, cardiologists, psychologists, physiotherapists, dietitians, etc..). Who are the team of cardiac rehabilitation? The cardiac rehabilitation programs - Phase III are performed on an outpatient basis, and should be integrated into sports centers both public and private. Many skilled professionals are part of the cardiac rehabilitation team, including some or all of the following: • Cardiólogo. • General Medical • Nursing / DUE rehabilitation. • psychologist or psychiatrist • Physiotherapist. • Dietician. • Occupational Therapist ..... In what is the cardiac rehabilitation program? It is designed especially for each patient, depending on their clinical characteristics and physical, and as a result of his stress test, and will be supervised by a cardiologist and a medical team of specialists in physical therapy. The cardiac rehabilitation should include the following activities: • progressive exercise program to improve fitness and functional ability. • Talks health education, to advise on changes in lifestyles: • Smoking cessation courses. • Lessons from food. • Learning relaxation techniques and training in coping skills for stress management. • Help to return to their jobs. • In all these facets takes an enormous importance and the role VOLUNTEERS IN CARDIOVASCULAR DISEASES.

PROFILE

I’m going to write about my profile. To start my name is Erica Johana Poveda Montaño, I was born in Zipaquira I’m 23 year old and I have lived all my life in this country. During twenty years I lived with my parents and my brothers, I’ve got three sisters and one brother and we always have been a very close family.Now I live with my daughter who is my life. She `s three year old and She is a very intelligent child.I’m student of nursing; actually I’m in ninth semester al the La Sabana University. I like so much help the people and contribute to improve their health. For this reason I would like to be specialist in education, I believe that many of our illness can be avoid if we have a good life styles or a suitable habits as food, exercise etc.I consider me a good person I `m happy, extrovert and I always try to help my friends when they can need it. I have got many friends in the University and in my job. I think that in the life all need many hands for to reach our future.I’m responsible with my tasks and I have dedication and patience with the people who I look after.I like to be updated in subjects of health, besides I like so much to read, the science has new things every day and new treatments can to save more lives.Some very important in my career is the English, generally the good books and articles of health is in English and thinking in this the University teach others languages like English and French. I have been studying for three year and I feel that can understand it, but I need practice much more.Moreover one of my plans is travel to United States or Australia, in these countries there are few nurses, and furthermore a nurse has best opportunities.I would like to get married with my boyfriend He is daughter’s father and I believe the marriage is the basis of the family and the best values by our sons are inside of the family.You must be independence, but not selfish, to be sincere but not offensive.