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Special Edition • March 2011 • Costa Rica, Central America •

Tels.: (506) 2208-8417 (506) 2208-8419

Tel: (506) 2220-0911 www.centrofecundar.com www.journalcr.com

Finding Your New Smile

At the state-of-the-art facilities of Dental Cosmetics Costa Rica, OUR patients are offered a wide variety of restorative and cosmetic dentistry treatments at very affordable prices. Our highly experienced cosmetic dentists, are dedicated to helping each of his patients achieve bright, radiant teeth that transform their smiles and help them regain their self-confidence.

Avenida Escazú, office 206 San José - Costa Rica info@dentalcosmeticscr.com Phone: +506 22287658 US phone #: (305)428-3820

www.dentalcosmeticscr.com


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OUR TEAM Marta Araya, Marketing & Sales Manager E-mail: marta.araya@journalcr.com / sales@journalcr.com • classified@journalcr.com Tel: 905-JOURNAL (5687625) Erick Murillo Valenciano • Editors Board Member E-mail: editors@journalcr.com Design & Production: Artestudio W E-mail: design@journalcr.com SALES: sales@journalcr.com / classified@journalcr.com

Special Edition

NEWS: news@journalcr.com INFO: info@journalcr.com The Journal® The Journal is a Monthly english-language newspaper with headquarters in Carrillo, Guanacaste. Suplex S.A. Infocom® Infocom is a media service and provides the most of the Costa Rica and Central America news content. (*) Representing Edition-Production Company. THE JOURNAL Tel: 905 JOURNAL 905 5687625 (No additional cost) E-mail: info@journalcr.com www.journalcr.com

March, 2011


THE ULTIMATE LIFESTYLE For sale in Villa Real

America including a stunning glass elevator with access to all the floors throughout the unique design. The requirements for this estate were set high right from the beginning including the engineering and its supervision. The exacting process of the engineering was under the watchful eyes of engineer Antonio Murillo. His fulltime supervision was tireless and demanding right through the completion of this perhaps one of a kind estate in Costa Rica. Not only is this estate exciting and marvelous to look at, but it is a property any buyer can feel confident with its ability to stand the test of time as well as the environmental conditions of Costa Rica. This outstanding estate includes a completely-equipped professional Viking kitchen, four master bedroom suites, formal dining room, pool and jacuzzi, BBQ Viking kitchen, gym or fifth bedroom and steam sauna, nine bathrooms,

Swimming - Entertainment Area

F

rom the moment you approach the exterior of this stunning estate you get a feeling of it regal and commanding presence. This luxury estate captures the imagination with its stunning design and features along with a lifestyle found only in the gated community of Villa Real, Santa Ana. This new estate was built with the highest standards using North American

guidelines, materials and supervision. This outstanding estate was designed and developed with a fresh and inviting open floor plan making use of the breathtaking views from every floor to ceiling window. No detail was left undone and this estate will surpass even the highest expectations. Every facet of the design and development of this property was supervised by

developer Gregory Shelby, who’s known for his creative and inspirational luxury homes built in Chicago, Beverly Hills, Palm Springs California and Costa Rica. In addition to this impressive estate he is about to finish another outstanding home also located in Villa Real. With an extraordinary view of the mountains, the valley, and even the Gulf of Nicoya in

Jacuzzi

the distance this home reflects the high quality lifestyle of one of the most prestigious gated community in Costa Rica, Villa Real. This estate is located just meters away from the president of the country, Laura Chinchilla, and other residents of importance all who demand a lifestyle of quality, the best security and infrastructure, and a balance of the marvelous flora and fauna found in this eco-residential community.

Master Bathroom

three social rooms, one per floor, high definition movie theater and designer furnishings and art. Every feature of this simply exquisite estate completes the Ultimate lifestyle in Villa Real.

The property is located close to the country’s most exclusive area of recreation, entertainment, and business, in Escazu and Santa Ana, it is only 20 minutes away from the airport and an hour from the gorgeous beaches on the Costa Rican Pacific coast.

Open and Inviting Layout With an impressive central spiral staircase accented by a panoramic window measuring twelve meters high this estate dazzles one’s senses. The open floor plan is outstanding for entertaining on a grand scale or simply making family life efficient and exciting. This estate may be one of only a few in all of Costa Rica which has been designed for people with reduced mobility using the handicap guidelines from North

Family Room

HD Ciinema

Viking Kitchen

DEVELOPERS Gregory Shelby / Antonio Murillo Tel.: (506) 8866-8734

LOCATION: Villa Real, Santa Ana, Costa Rica

Email: info@villareal4sale.com Visit our website: www.villareal4sale.com

AGENTS WELCOME

OFFERED AT: $4,000,000


Lumbalgia Aguda

Acute Low Back Pain

Dr. José Pérez Berríos

Dr. José Pérez Berríos Neurosurgeon Clínica Bíblica Hospital San José. Costa Rica Tel.: (506) 2522-1000

Médico Neurocirujano Hospital Clínica Bíblica San José. Costa Rica

L

a lumbalgia aguda (LA) es un problema médico muy serio. A escala mundial, se ha documentado que del 60 al 80% de las personas lo padecerá alguna vez en la vida; además, en cualquier momento, lo padecen del 2 al 5% de la población mundial.

Es una de las causas más comunes de visita al médico y es el motivo más frecuente de discapacidad en personas menores de 45 años (1). En los EEUU, el costo total anual derivado de los cuidados médicos y la pérdida de la productividad asociados está cerca de los $ 100 billones. Además, el 10% de los pacientes gastan el 90% del total.

¿Qué pasa si no se recibe tratamiento?

LA es aquella que ha estado presente por tres meses o menos. La lista de esquemas de tratamiento es muy larga, y en su mayoría, se reportan alrededor de un 90% de éxito. Sin embargo, la mayoría de las personas con LA no complicada mejorarán en el primer mes, y el 90% se recuperará en los tres primeros meses. Este es el motivo por el cual muchos tratamientos parecen actuar tan bien. Aunque muchos de estos esquemas tienen una apariencia científica, la mayoría no tienen ningún fundamento(2).

• • • • • • •

¿Cuándo se debe ir al especialista?

Dolor presente por más de tres meses sin mejoría, que ocurre en reposo o que empeora. Edad avanzada, pérdida de peso o historia reciente de cáncer. Uso prolongado de esteroides.

Infección reciente del tracto urinario o la presencia de fiebre persistente.

Traumatismo capaz de causar fracturas, como un accidente de tránsito o una caída seria. En ancianos, un trauma menor, especialmente en personas con diagnóstico de osteoporosis.

Debilidad severa o entumecimiento en una pierna, el área genital o perineal; o cambios en la capacidad urinaria o movimientos intestinales. Estos son signos de posible compromiso de nervios espinales.

Casos no complicados

Si no hay presencia de signos de fractura, infección, tumor, o este presente un déficit neurológico, no son necesarios estudios de rayos X, TAC, RMN o EMG. Tampoco hay tratamientos fantásticos por muy caros que sean; la recuperación será igual de rápido con ellos o sin ellos. Ya que la mayoría de las personas con una LA no complicada se recuperan espontáneamente, surge la pregunta: ¿hay algún tratamiento verdaderamente útil? La respuesta es sí. Estudios científicos han demostrado que los pacientes que son educados sobre el problema y asesorados en sus problemas, tienden a sentirse mejor más rápido y tienen menos molestias que en el

grupo control. La actividad física también es beneficiosa; se ha visto que los pacientes que hacen ejercicio regularmente mejoran más rápido si se mantienen haciéndolo; además, tienen menos posibilidad de padecer futuros episodios de dolor. La actividad que aumenta el dolor debe evitarse, pero un poco de dolor con los ejercicios es algo que se considera normal.

En caso de presentarse una sintomatología severa, los medicamentos para aliviar el dolor tipo antiinflamatorios no esteroideos, son de gran utilidad. El grado de alivio del dolor y la velocidad del retorno a las actividades habituales es similar tanto con el uso de los narcóticos como de los no narcóticos. Sin embargo, éstos tienen una incidencia significativamente mayor de efectos secundarios y de complicaciones. Por lo tanto, son poco de poca utilidad. Los esteroides tampoco han demostrado tener utilidad al valorar los riesgos de su uso. Los relajantes musculares tampoco se recomiendan. Debemos recordar que el 90% de todos los pacientes en esta categoría mejoran, aún sin tratamiento. Luego de unos pocos días de reposo relativo (evitar alzar, llevar o mover cargas), debe iniciarse un programa de ejercicios isométricos de fortalecimiento progresivo, de amplitud de movimiento y estiramiento, así como de condicionamiento aeróbico. Es mejor si se está bajo la instrucción de un terapista físico. El uso de calor, masaje relajante, estimulación eléctrica y tracción pueden dar un alivio temporal de horas, pero no ofrecen beneficios a largo plazo y no dejan de ser costosos. El dormir en una cama dura es también una buena idea.

Casos complicados

Hay muchas opciones disponibles para el 10% de los casos que no mejoran a pesar de un programa apropiado de ejercicios. La mayoría de los pacientes no desean cirugía, aunque a menudo es la mejor opción. Existen muchos tratamientos conservadores (no quirúrgicos), pero la mayoría no funcionan. Para los pacientes con predominancia de síntomas en los miembros inferiores, con imágenes de TAC o RMN que evidencian una pequeña herniación discal, puede ser útil el bloqueo epidural. Esto consiste en inyectar el espacio alrededor de la raíz espinal con anestésico local y esteroides para disminuir la inflamación. Estudios científicos han demostrado que el bloqueo facetario (inyección de anestésico local en las pequeñas articulaciones posteriores de la columna vertebral) y la rizotomía (inserción en el canal espinal de una sonda que corta o destruye el nervio que lleva el dolor) no son efectivos.

En caso de dolor localizado en una pierna, entumecimiento, debilidad o pérdida de control de esfínteres, se debe obtener un estudio de imágenes (radiculografía, TAC o RMN) para documentar la presencia de signos de compresión radicular. Si los estudios revelan una herniación discal, la cirugía para extraer la parte del disco que comprime la raíz nerviosa es el mejor tratamiento, y preferiblemente dentro de los primeros seis meses. Su remoción a través de una incisión en la piel (disectomía abierta) aún es la “regla de oro”. Técnicas más recientes como la cirugía con láser, la microcirugía y la disectomía percutánea (succión del material discal a través de un tubo que se coloca a través de la piel) no han probado ser superiores a la disectomía abierta, y sus efectos a largo plazo aún se desconocen. A veces, generalmente en pacientes mayores, los estudios

imaginológicos revelan una estenosis espinal, que consiste en un estrechamiento del espacio existente entre las raíces nerviosas. Esto es causado por el crecimiento de las articulaciones y ligamentos debido a cambios artrósicos, dando como síntoma principal la claudicación de la marcha tipo neurogénico. El bloqueo epidural usualmente funciona, pero solo por un corto tiempo. El único tratamiento efectivo es realizar una laminectomía, procedimiento quirúrgico que consiste en recortar hueso y ligamentos de las zonas de estrechez dejando mayor espacio a las estructuras nerviosas. En casos de inestabilidad espinal asociada o la presencia de espondilolistesis con o sin espondilolisis, lo más recomendable es complementar el proceso descompresivo o la disectomía con una fusión interna posterolateral (PLIF por sus siglas en inglés) con colocación de implantes espinales de titanio u otro material disponible. Referencias

1. Woodwell D. National Ambulatory Medical Care Survey: 1996 Summary. Advance Data #295, Dec 17, 1997. 2. Bigos SJ et al. Acute Low Back Pain Problems in Adults. Clinical Practice Guideline No. 14. AHCPR Publication No. 95-0642. Rockville, MD: Agency for Health Care Policy & Research, 1994.

A

Ext. 2038 / 2039 Celular: (506) 8321-6137 jperezb@clinicabiblica.com jpbneuro@medicos.cr www.clinicabiblica.com

cute low back pain (ALBP) is a serious medical problem. Worldwide, it has been documented that 60 to 80% of people will suffer it some time in life; in addition, anytime, suffer it from 2 to 5% of the world’s population.

It is one of the most common causes of visit to the doctor and is the most frequent reason of disability in people younger than 45 years (1). In the US, the annual total cost derived from medical care and loss of productivity associated is near the $ 100 billion. In addition, 10% of patients spend 90% of the total.

What if you do not receive treatment?

ALBP is one that has been present for three months or less. Treatment schemes list is very long and mostly reported around 90% of success. However, the majority of people with the uncomplicated will improve in the first month, and 90% will be recovered in the first three months. This is the reason why many treatments seem to act as well. Although many of these schemes are scientific appearance, most have no basis (2).

• • • • • • • •

When to go to the specialist?

Pain for more than three months without improvement, which occurs in sleep or worse. Advanced age, loss of weight or recent history of cancer. Long-term use of steroids.

Recent infection of the urinary tract or the presence of persistent fever. Trauma capable of causing fractures, such as a traffic accident or a serious fall.

In older people, with lesser trauma, especially in people with osteoporosis. Severe weakness or numbness in one leg, genital or perinea area, or changes in urinary capacity or bowel movements. These are signs of possible commitment of spinal nerves.

No complicated cases

If there is no presence of signs of fracture, infection, tumor, or present a neurological deficit, are not necessary rays X, CT, MRI, or EMG studies. There is also fantastic treatments by very expensive to make; the recovery will be just as fast with them or without them.

Since the majority of people with ALBP uncomplicated recover spontaneously, the question arises: is there some really useful treatment? The answer is yes. Scientific studies have shown that patients, who are educated on the issue and ad-

vised on their problems, tend to feel better faster and have less discomfort than in the control group. Physical activity is also beneficial; seen patients who exercise regularly to faster improve if you keep doing; in addition, have less chance of suffering from future episodes of pain. Activity that increases the pain should be avoided, but a bit of pain with exercise is something that is considered normal. In case of severe symptoms, medications to relieve pain type non steroidal anti-inflammatory are useful. The degree of pain relief and speed of return to usual activities is similar with the use of drugs as non narcotic. However, they have an incidence significantly increased side effects and complications. Therefore are of little use. Steroids nor have shown useful in assessing the risks of its use. Muscle relaxants are not recommended. We must remember that 90% of all patients in this category improve, even without treatment. After a few days of rest on (avoid lift, carry, or move loads), an isometric exercise gradual strengthening of amplitude of movement and stretching, as well as aerobic conditioning program must be started. It is better if you are under the instruction of a physical therapist. The use of traction, electrical stimulation, relaxing massage, heat can provide temporary relief for hours, but do not provide long-term benefits and continue to be expensive. Sleep on a hard bed is also a good idea.

Uncomplicated cases

There are many options available to 10% of the cases that do not improve in spite of an appropriate exercise program. The majority of patients do not want surgery, although it is often the best choice. There are many conservative treatments (non-surgical), but most do not work. For patients with predominance of symptoms in the lower members with CT or MRI images that show a small disc herniation, epidural block may be useful. This consists of injecting the space around the spinal root with local anesthetic and steroids to decrease inflammation. Scientific studies have shown that the facetary lock (injection of local anesthetic in subsequent small joints of the spine) and rhizotomy (insertion into the spinal canal probe, which cuts or destroys the nerve that carries pain) are not effective.

In case of pain in his leg, numbness, weakness or loss of sphincter control, get studies of images (CT scan or MRI) documenting the presence of signs of root compression. If studies reveal a disc herniation, surgery to remove part of the disk that compresses the nerve root is the best treatment, and preferably within the first six months. Their clearance through an incision in the skin (open diskectomy) is still the “golden rule”. Latest laser surgery, microsurgery and percutaneous diskectomy (suction of the disc material through a tube placed on the skin) techniques have not proved to be higher than the open diskectomy, and its long-term effects are still unknown. Sometimes, usually in older patients, imagine studies reveal spinal stenosis, which consists of a narrowing of the space between the nerve roots. This is caused by the growth of joints

and ligaments due to arthrosic or degenerative changes, giving primary symptom claudicating gear neurogenic type. Blocking epidurals usually works, but only for a short time. The only effective treatment is to perform a laminectomy, surgical procedure that involves cutting bone and ligaments in tight areas leaving more space to nerve structures. In cases associated with spinal instability or the presence of spondylolisthesis with or without spondylolysis, ideally complement the decommpresive process or the diskectomy with a posterolateral internal fusion (PLIF) with placement of spinal titanium implants or other available material.


Equipo de Anestesia Equipo de Anestesia Veterinario Piccolo Express – Química Humana VetScan iStat – Gases VetScan VS2 - Química Vet. Vetscan VSPro – Coagulación Vet. VetScan HM2/5 – Hematología Vet. Rayos X Vet. – Convencional/CR/DR Monitoreo Humano & Veterinario Ultrasonido Humano & Veterinario 2D, 3D, 4D, Doppler, Color, etc. Mesas Quirúrgicas (Tamb. Veterinarias) Lámparas Quirúrgicas LED/Halógena Camas, Camillas, etc.


The art of

Laser teeth whitening Smile Design Dental implants Porcelain veneers Porcelain crowns and bridges Comfortable dentures Full Mouth Rehabilitation Root Canals Invisalign (orthodontics without braces) TMJ disorder treatment

San José - Costa Rica info@dentalcosmeticscr.com Phone: +506 22287658

From left to right: Dr. Roberto Hernández (Endodontist), Dr. Alejandro Mora (Oral Rehabilitation and Aesthetics specialist), Dr. Félix Guido (Orthodontist), Dr. Gustavo Gutiérrez (Periodontist) and Dr. Andrés Fernández (Oral and Maxillofacial Surgeon).

Costa Rica is known for its beautiful beaches and for its peace and environmental friendly politics, but in the past few years another great quality has grown: top quality and affordable dentistry. Dental Cosmetics Costa Rica (DCCR) is one of this modern dentistry centers which provides almost every procedure by top specialists in all areas of dental treatments. “Our philosophy is to give our patients the best of the best. We take care of every detail in order to give them their smiles back and to make their visit the most pleasant moment”, comments Dr. Andrés Fernández, one of the most prestigious oral and maxillofacial Costa Rican surgeons and partner of DCCR. Dental implants, crowns, bridges, porcelain veneers, laser teeth whitening, root canals and Invisalign orthodontics are some of the procedures DCCR offers of Avenida Escazú, an exclusive lifestyle center in San Jose and right next to

Dental Cosmetics Costa Rica is an advanced center of modern dentistry in the most exclusive area of San Jose CIMA Hospital, the most modern medical facility in Costa Rica. “We keep ourselves updated with the latest techniques and technology available in dentistry by constant research and ongoing continuous education around the world”, adds Dr. Alejandro Mora, the oral rehabilitation specialist and also an associate of DCCR. So, if you are in need of a dental specialist or you are just thinking about improving your smile, here in Costa Rica you have a great staff of specialists and a state of the art clinic just around the corner. Just get rid of your fear to smile. Ignacia Mora Journalist

“I have been to at least 20 dentist in my life time and never have I found a doctor as good as Dr Mora”, said James Roach, one of Dental Cosmetis Costa Rica patients after getting a Full Mouth Rehabilitation with Dr. Alejandro Mora.

The truth about

A complete staff of specialists in dentistry, the ultimate technology and a modern and comfortable confortable environment allows us to offer a large variety of dental services for you, including:

immediate load

smiling

implants

Modern dentistry

Specialists agree that “one stage implants” are not a solution for every dental patient

Immediate load implants, known as “one stage implants” have become very popular as an option for those who want a rapid solution for missing dental pieces. These titatnium posts are placed with the respective permanent tooth in one stage, wich means that in one week (2 visits), you can leave the dentist’s office with an implant and your definitive porcelain crown. But this is not all the truth about this “one stage implants”, because they are not a solution for everyone. Immediate load implants, in fact, are the same implants specialists use in two stage procedures- when patients has to get the implants and one temporary tooth in one visit and 4 to 5 months later, return to the dental center to get the definitive crown-. The only difference between “two stage implants” and “one day implants” relies on the patient, because

depends on his or hers bone quality, the implant retention and the healing capacity of each person. “The only way to know if the patient fill the requirements is in the exact moment of the implant placement”, says Dr. Andrés Fernández, Oral and Maxillofacial specialist and partner of Dental Cosmetics Costa Rica (DCCR), which means that it is impossible to know previously to the surgery if the patient is a candidate for immediate load implants or not. “It would be wonderful if we could offer everyone an immediate load implant option, but this is not being honest with them, because you cannot know until you have seen the bone height and quality and also depends on the initial stability of the implant when

placed”, adds Dr. Alejandro Mora, Oral Rehabilitation specialist and partner of DCCR. “Also the more implants you are going to have connected to each other, the better predictability for immediate load”, explains Dr. Mora. “For example, if you get an individual implant it would have a lower success rate than two or three implants that will be connected together”, concludes. Ignacia Mora Journalist

The best place to smile in Costa Rica

CONTACT INFO

Dental Cosmetics Costa Rica is located in Avenida Escazú office 206, second floor, in San Jose. For more information call at 001 +506 2228 7658 (with Tammye) or email at info@dentalcosmeticscr.co You can also visit their website: www.dentalcosmeticscr.com

Oral Rehabilitation and Cosmetic Dentistry Center Contact us at +506 22287658 info@dentalcosmeticscr.com Avenida Escazú, office 206 San Jose, Costa Rica


A hardware store where you’ll find everything, at a price you can afford!

Hardware

Painting

• • • •

Helpful specialized staff Heavy-duty building equipment Ample customer parking Delivery to your site

Sand, Stone, Blocks and Cement Open Monday to Friday from 6:00 a.m. to 5:00 p.m. Open Saturdays from 6:00 a.m. to 3:00 p.m. New summer schedule from 6:00 a.m to 7:00 p.m Huacas, Guanacaste Phone (506) 2653-5020 Fax: (506) 2653-8291 www.comaco.co.cr


Es obligación del especialista presentar y discutir con el paciente las diferentes posibilidades restauradoras que son aplicables en cada caso. Al asumir una postura preventiva se puede, utilizando los implantes dentales, evitar la preparación de dientes naturales, garantizando menos daño, menor riesgo de sobrecarga de los dientes remanentes y mejor pronostico a largo plazo. Ademas de eso, el especialista en implatología oral debe siempre decidirse por el planeamiento de mayor durabilidad. Con frecuencia las soluciones con implantes dentales son muy superiores en lo que se refiere a la función, comodidad y estética cuando son comparados a los resultados obtenidos por los métodos convencionales, esto confirmado en innumerables estudios multicéntricos.

IMPLANTES DENTALES Una nueva manera de sonreir!

La Implantología oral es una técnica que se ha convertido en los últimos años, en predecible, simplificada y segura. Este tratamiento es cada vez más solicitado por los mismos pacientes y para nosotros los especialistas es muchas veces el tratamiento más idóneo. Los implantes dentales son un sustituto artificial que nos va a servir como raíz de un diente ausente. Tras un periodo para que se fije al hueso (oseointegración) servirá de anclaje para un diente nuevo, esto toma un tiempo entre los 2 a 6 meses. En los ultimos anos, los implantes dentales pasaron a hacer parte de la odontología clínica restauradora como una importante alternativa de tratamiento en la ausencia de los dientes naturales. Este hecho provoco un gran cambio en el planeamiento y en la secuencia de tratamiento de cualquier rehabilitación oral, ofreciendo innumerables oportunidades y posibilidades tanto en la ausencia de un solo diente como en la de todos o varios dientes. En la odontología actual me parece imposible desconsiderar la posibilidad de indicar los implantes dentales. Incluso en los casos de dientes con grandes lesiones, con compromiso del soporte periodontal, se debe analizar cuidadosamente la validez de su mantenimiento. Dependiendo del pronostico a corto plazo, osea 5 años, la solución a través de la sustitución de los dientes por implantes dentales es frecuentemente mas barata, mas rápida y mas duradera.

El especialista debe hacer una minuciosa evaluación clínica de aspectos muy importantes, para ver si el paciente es o no candidato para la terapia con implantes dentales, como por ejemplo las enfermedades sistémicas del paciente, si es hipertenso, diabético, el volumen del hueso, si es o no fumador, importante determinar si es alcohólico, si padece de enfermedad periodontal. Cada caso debe ser evaluado previo al tratamiento con los implantes.

VENTAJAS:

Las ventajas que ofrecen los implantes dentales son muchas, dentro de las que podemos citar es que mejoran el aspecto, ya que cuando se pierden los dientes, los huesos de la cara pierden volumen dando al rostro un aspecto envejecido. Los implantes dentales frenan este proceso,

y tienen el aspecto y función de los dientes naturales. Mayor comodidad, ya que los implantes dentales evitan en gran medida la incomodidad de las prótesis removibles parciales y totales, ya que ellas se apoyan sobre las encías y el hueso de los maxilares. Con el paso del tiempo se produce una reducción del hueso y altera el ajuste de la misma con perdida de estabilidad. Ademas de la incomodidad se produce irritación de la encía. Los implantes dentales evitan la irritación de las encías y las molestias habituales con las prótesis removibles o totales mal ajustadas. Mejora el habla ya que permite que el paciente pueda hablar con mas confianza y de una manera mas natural. Permiten comer mejor, ya que los pacientes con prótesis totales en el mejor de los casos comen con solo un 15-20% de eficacia mastiactoria respecto a las personas con dientes naturales. Con el paso del tiempo el hueso de los maxilares se reduce, la eficacia masticatoria se reduce aun mas, lo que hace difícil comer ciertos alimentos. Los implantes dentales pueden restaurar la eficacia masticatoria hasta un nivel similar a los dientes naturales y podrá disfrutar de la comida. Dan mayor seguridad ya que los pacientes no necesitaran taparse la boca para reír o sonreír, por miedo a que su dentadura pueda caer de la boca o enseñar el espacio de un diente ausente, mejorando en gran manera su seguridad y la confianza en su aspecto. Los implantes dentales eliminan la necesidad de modificar o desgastar dientes sanos, dando como resultado una restauración mas conservadora y estética. Cualquier persona que haya perdido uno o varios dientes se puede beneficiar con los implantes, ya sea por lesión, enfermedad o caries puede ser un candidato para la terapia con implantes dentales siempre y cuando conserve una cantidad de hueso

Consulta: (506) 2208-8604 / Fax: (506) 2208-8654 Hospital CIMA, San José, Torre Médica II, Piso 6, Consultorio 604. dr.ocampo@clínicaocampo.com

www.clinicaocampo.com

suficiente y encía sana. Tanto si falta uno como si faltan todos, existen soluciones con implantes que pueden ser satisfactorias, recuperando la función y evitando una mayor perdida de hueso. Algunas personas creen que su edad es un impedimento para disfrutar de las ventajas de los implantes dentales. Sin embargo, la salud es el factor mas importante, si la tiene para una extracción dental, probablemente la tendrá para que coloquen implantes dentales.

CONTRAINDICACIONES:

Algunas enfermedades crónicas pueden contraindicar el tratamiento con implantes dentales. Tras una cuidadosa evolución de su historial medico y dental, el especialista decidirá si usted es un candidato para implantes. Las investigaciones han demostrado que el éxito de los implantes dentales han alcanzado un porcentaje de éxito de mas del 95% en estudios múltiples.

CUIDADOS:

Es importante resaltar que al igual que con los dientes naturales, una buena higiene oral es uno de los factores mas importantes para su conservación. Importante realizar revisiones periódicas para valorar la salud de los implantes y de la encía.

Dr. Esteban Ocampo Corella

Especialista en Implantes Dentales Universidad de Chile


FULL BILINGUAL HEALTH CARE…

In case of any emergency …

1. Call (506) 2665-0704 or (506) 8388-2859 2. Physcian in charge: Dr. Monica Guardia director, radiologist and primary care physician 3. Have your information available

In case of trauma

CRSM Santa Monica EMERGENCY CARE CENTER We provide the best health care services in Guanacaste as Primary Care Physician, Radiology ( X rays, Ultrasound and Mammograms) and Trauma Center.

We will provide immediate assistance. If you need an ambulance service we will provide one. If you will require transportation service with air ambulance service please provide information of insurance company. WE WILL BRING OTHER SPECIALISTS TO OUR FACILITIES AS REQUESTED.

Casts

If you need one, we will have our orthopedic team evaluate each individual case. We also provide crutches and any other type of immobilizations.

Specialiasts (Referrals)

• CRSM EMERGENCY CARE • We provide the best service with specialists in all major areas. • Trauma center

• Ground and Air Ambulance service to San Jose or International transportation.

Internal Medicine, Gastroenterology, Surgery, Ob/Gyn, Pediatrics, Neurosurgery, Cardiology, ENT, Ophthalmology and Psychiatry. centroradiologicosantamonica@gmail.com

CRSM emergency care center

PRIMARY CARE PHYSICIANS, X RAYS, BREAST HEALTH CENTER AND ULTRASOUNDS

Primary care physician

Will cover all of your needs with full bilingual physician. Physical exams, annual checkups, PAP smears . We provide the best service and referrals to the best specialists in the Guanacaste area.

X rays

We provide all major areas in Radiology for plain films as well as contrast media. For requirements. Contrast media includes barium enema, IVP (intravenous pyelogram) , upper and lower gastrointestinal studies for adults and children.

Ultrasounds

Adults and children, male or female. Sonography is one of our best programs offered for the following areas: neck, soft tissues, shoulder, knee, breast, abdominal, OB/GYN, transvaginal.

Breast health care

Mammography and ultrasounds are provided. We cover follow ups.

WE WILL CONTACT YOUR PRIMARY CARE PHYSICIAN BACK HOME BY REQUEST

• WE ARE HERE FOR YOU 24/7

• (506) 2665-0704 or (506) 8388-2859

• centroradiologicosantamonica@gmail.com

If you have an emergency, call us …

CRSM

CENTRO RADIOLOGICO SANTA MONICA DE GUANACASTE DR. M. GUARDIA C. Director-Radiologist 20 years experience

Across from Hospital Dr. Enrique Baltodano Liberia, Guanacaste, Costa Rica (506)2665-0704


30%

de descuento

en vestidos de fiesta, bodas, graduaciones y quince aĂąos. Santa Ana 2582-1459

Moravia 2240-0154

Sabana 2232-2468

Oferta vĂĄlida del 15 de Marzo al 15 de Abril. *Aplican restricciones. www.wappafashion.com


Coastal Spanish Institute Enjoy the coast while you learn

T

he Coastal Spanish Institute(CSI) offers high quality Spanish instruction in Playa Tamarindo, Guanacaste, Costa Rica. Our school consists of 14 open-air “Ranchito” style classrooms located in a beautiful natural setting. Our highly trained Spanish Professors all have years of experience in teaching Spanish as a second language, and will customize every class to the needs of each particular group of students. Each day of classes is separated into separate lessons for grammar and conversation, with a different professor for each. This exposes students to different accents and teaching styles. While we provide a solid grammatical base of the Spanish language, the focus is on being able to SPEAK rather than slowly write. This makes our Spanish instruction particularly applicable to real-world use. CSI offers a variety of optional activities for students throughout the week, including beach trips, river tours, and sunset sails. We also facilitate weekend trips to many fantastic locations throughout Costa Rica such as Monte Verde, Volcan Arenal, Montezuma, and Manuel Antonio.

CSI also works with the Costa Rican Surf Institute (CRSI), which is located on our campus, to provide the best surf instruction in Tamarindo. CRSI does not offer simple one day lessons to get students to “just stand up” on a foam board, but instead provides surf programs by the week (2 weeks is recommended) so that students can progress their surfing ability and learn to properly longboard on the perfect beginner waves of Playa Tamarindo. CRSI programs include board rentals, surf lessons, guided daily surfing, lessons in oceanography, video analysis, and weekly surf trips out of Tamarindo. Combined Spanish/Surf programs are very popular; if students wish to surf, CSI will arrange classes opposite the tide so that students are free to surf during high tide (which changes weekly). CSI can arrange student housing at local host families, on-campus student residences, or local hotels/hostels. Students may also arrange their own housing. More detailed information on our different Spanish programs is on the following page.

If you have any questions, please do not hesitate to call or email Sonia at:

Classes

Intensive Spanish Program

Classes begin every Monday. Your program can be as short as a week or as long as you wish. We offer 12 levels of Spanish instruction, from beginner to advance. Your program will begin with a brief written and oral test to help place you in the appropriate level. Classes run from 8am-12pm and from 1pm-5pm. All group classes have a maximum size of 6 students.

30 Spanish lessons per week, 55 minutes per class. The perfect Spanish program for someone who prefers a more intensive Spanish language course. The format is the same as the Standard Program. The difference is that under this option you will receive an additional 2 hours of conversation per day. Student’s understanding of and ability to use correctly various parts of speech will be furthered develop while also building additional vocabulary, speaking and writing skills.

Methodology Our teaching technique is referred to as the Communicative Approach. This style encourages student interaction. You might say that you “learn more because you learn better”. The program consists of a variety of interesting and interactive exercises created to encourage you to practice the Spanish language in a real life setting. This approach helps to build your confidence, which in turn increases your motivation to learn more. The foundation of the Spanish language classes consists of a combination of exercises, role playing, reading, conversation, and grammar. Each Spanish teacher customizes a program tailored to the needs of the students. You can choose from any of the following Spanish course options:

Standard Spanish Program 20 Spanish lessons per week, 55 minutes per class. This Spanish language program consists of classes with a maximum of 6 students per teacher. Spanish courses are held from 8:00 a.m. to 12:00 p.m. or from 1:00 p.m. to 5:00 p.m.; and are composed of a combination of conversational grammar and practical conversation and/ or lectures.

Private Spanish Program You can choose from 2-6 hours per day of private instructions where you are the only student! If you have little time available or prefer something very intensive, then please consider taking private Spanish language courses. Private instruction can be utilized to cover general or specialized Spanish language topics. It is also possible to take a group class and add a few hours per day of private instruction to your Spanish program.

Spanish & Surf Program 20 Spanish lessons per week. 55 minutes per class. In addition to your Spanish classes, you will receive surf lessons along with surf board rental. Surf board rental is included in the cost of the program. You will receive (in addition to the board rental) 6 hours of surf instruction per week. Surf classes are provided by our staff of local surf professionals. Each week also includes video analysis of your surfing, as well as one surf trip to a location outside of Tamarindo.

(506) 2653-2673/ 2653- 2674/8878-6106 info@coastalspanish.com • www.coastalspanish.com

If you have any questions, please do not hesitate to call or email Sonia at:

(506) 2653-2673/ 2653- 2674/8878-6106 info@coastalspanish.com • www.coastalspanish.com



The Journal Edition # 211